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Full text of "Diseases of cattle, sheep, goats and swine"

(Lift i- B. Hill ffiibrarg 

Nnrtli (Earoltna ^tnXt 
Inttipraitg 



111 




C 



This book was presented by 

MILTON M. LEONARD, D.V.M. 

TO THE 

VETERINARY MEDICAL LIBRARY 



This book is due on the date indicated 
below and is subject to an overdue 
fine as posted at the circulation desk. 



EXCEPTION: Date due will be 
earlier if this item is RECALLED. 



APR 2 9 2002 



.^ j? J* ** 



DISEASES OF CATTLE, SHEEP, GOATS, 
AND SWINE. 



BY THE SAME AUTHOR. 



lloiinl S/v,, 4:^S //./,/...., 4()(; Uliistrathni^. 

A Handbook of Horse-shoeing. 

With Introductoiy Chai)ters on the Anatomy and Physiology 
of the Horse's Foot. The section on the " Practice of Shoe- 
ing" contains 'A full-))age plates" and descriptive notes 
supplied by Albeht Wheatley, F.R.C.V.S. 



t;() Idifjo jUKjcx (14.1 X 10 'inchet!). 31,"> llli/xfnifi 
An Atlas of Veterinary Surgical Operations. 



A Surgical Operating Table for the Horse. 



ll,il/t/I Sn,. f)lS jwf/rx. [K, i/Ii/stn/fiottx. 
Studies in Clinical Veterinary Medicine and Surgery. 
By r. J. C'ADioT and ,ixo. A. W. Dollar. 



I?in//il Sn*. 2(i'.t yv///r.s-. 272 ill >(.■<( nttionx. 
The Practice of Veterinary Surgery. 

Vol. I.— Opehative Techxique. 



Ihyildl 8n(. ,S.")3 pagrx. 31,") IHiixfnif/d/i.t. 
The Practice of Veterinary Surgery. 

By H. MoLl;EK and Jno. A. W. DoLLAU. 

Vol. III. — liEGIONAL SUKGEKY. 



DISEASES OF 

CATTLE, SHEEP, GOATS 
AND SWINE 



By 



G. MOUSSU 

PROFESSOR AT THE VETERINARY COLLEGE OF ALPORT; DOCTOR 
OF MEDICINE; DOCTOR OF SCIENCE, ETC. 



JNO. A. W. DOLLAR, M. R. C V. S., F. R. S. E., M. R. L 

PRESIDENT OF THE ROYAL COLLEGE OF VETERINARY SURGEONS; VICE- 
PRESIDENT OF THE ROYAL INSTITUTE OF PUBLIC HEALTH; CORRE- 
SPONDING MEMBER OF THE CENTRAL SOCIETY OF VETERINARY 
MEDICINE OF PARIS; ASSOCIATE OF THE SOCIETY OF VETER- 
INARY MEDICINE OF BRABANT (BELGIUM); LIFE MEM- 
BER OF ROYAL ITALIAN SOCIETY OF HYGIENE, ETC. 



AMERICAN VETERINARY PUBLISHING COMPANY 
CHICAGO 
PUBLISHER 
1920 

(All Rights Reserved) 



PEEFACE 



No apology seems called for in presenting to English -speaking 
veterinary surgeons and students a treatise on the diseases of cattle. 
To those entrusted with the onerous task of preventing or curing disease 
in cattle, sheep, and swine the scantiness of permanent literature dealing 
with the subject must always have proved a matter of some embarrass- 
ment, while to teachers and students alike the want of a concise and 
modern text-book has long been a difficulty of the first order. It is 
hoped that the present volume may go some way towards remedying 
this state of affairs. 

As on previous occasions, the writer has freely availed himself of 
foreign sources of information. Two years ago he purchased the 
literary rights in Professor Moussu's " Maladies du Betail," which 
had even then attained an European reputation, and which forms the 
backbone of the present volume. To obtain further information, the 
more important German treatises have been laid under contribution, 
while all accessible English, American, and Colonial literature of recent 
date has been referred to. (The references practically extend up to 
the moment of writing — the latest being June, 1905.) In this way 
the work may in some degree claim to have assumed an international 
character. The extent of the additions is indicated by an increase in 
the number of illustrations of 140, and of the text of nearly 50 per cent. 

Professor McQueen has performed the greatly- valued service of 
reading j)roof-sheets and advising the writer as the book passed 
through the press. 

To Dr. Salmon, of the United States Department of Agriculture, 
special thanks are due for his generous permission to quote from the 
annual reports of that body. 

Other acknowledgments will be found in the text. 



PREFACE. 



Once again the writer, who on this occasion chances also to be the 
President of the Eoyal College of Veterinary Surgeons, appeals for 
lenient judgment on work performed under no common stress of duties, 
professional and political. 

JNO. A. W. DOLLAR. 

56, New Bond Street, 

London, England, 

June, 1905. 



CONTENTS 



SECTION I. 

DISEASES OF THE OEGANS OF LOCOMOTION. 

CHAP. PAGE 

Methods op Examination 1 

I. DISEASES OF BONES 3 

General Diseases . 4 

Eachitis 4 

Osseous Cachexia 7 

Local Affections 20 

Fractures 20 

Fractures of the horns 21 

Detachment of the horns ........ 23 

Fissuring of the horns 24 

Fractures of the horns .... .... 25 

Exostoses 27 

Spavin in the ox. 27 

Eing-bone 28 

Suppurating ostitis ......... 29 

Bone tumours 30 

II. DISEASES OF THE FOOT 31 

Congestion of the Chxws ........ 31 

Contusions of the sole 31 

Laminitis . . . . . . . . . . .32 

Sand crack 34 

Pricks and stabs in shoeing ........ 36 

Picked-up nails, etc. (" Gathered nail") 37 

Inflammation of the interdigital space (Condj'lomata) ... 38 

Canker 40 

Grease ........... 41 

Panaritium — Felon — Whitlow 41 

Foot rot ........... 43 

III. DISEASES OF THE SYNOVIAL MEMBEANES AND OF THE 

AETICULATIONS 45 

I. Synovial Membranes and Articulations .... 45 

Synovitis 45 

Inflammation of the patellar synovial capsule . , , , 45 



CONTENTS. 



CHAP. 
III. DISEASES OF THE SYNOVIAL MEMBRANES AND OF THE 
ARTICULATIONS— coj/<//< ueiL 
I. Synovial Membranes and KKncvLX-vios^a— continued. 
Distension of the synovial capsule of the hock joint 
Distension of tendon sheaths in the hock region 
Distension of the synovial capsule of the knee joint 
Distension of the synovial capsule of the fetlock joint 
Distension of tendon sheaths 

Distension of tendon sheaths in the region of the knee 
Distension of the bursal sheath of the flexor tendons 
Traumatic synovitis—" Open synovitis" 
Traumatic tendinous synovitis 
Traumatic articular synovitis — Traumatic arthritis —" Open 
arthritis" 



III. 



IV 



IV 



ir. Strains of Joints .... 
Strain of the shoulder .... 
Strain of the knee 

Strain of the fetlock .... 
Strain of the stifle joint 
Strain of the hock joint 
Luxation of Joints 
Luxation of the femur 
Luxation of the patella 
Luxation of the femoro-tibial articulation 
Luxation of the scapulo-hiimeral joint 

IIVGKOMAS 

Hygroma of the knee .... 

Hj'groma of the haunch 

Hygroma of the trochanter of the femur 

Hygroma of the stifle 

Hygroma of the point of the hock 

Hygroma of the point of the sternum . 

DISEASES OF MUSCLES AND TENDONS 

Rupture of (he external ischio-tibial muscle 
Rupture of the flexor metatarsi . 

Parasitic Diseases of Muscles . 
Cysticercus disease of the pig 



Beef measles 
Trichiniasis — Trichinosis 



RHEUMATISM 

Articular iheumatism 
Muscular rheumatism 

Infectious Forms of Rheumatism ok Pseudo-riieum 
Infectious rheumatism in young animals 
Infectious pseudo-rheumatism in adults 
Scurvv — Scorbutus ,,.... 



(Biceps femoi 



.CONTENTS. 



SECTION II. 

DISEASES OF THE DIGESTIVE APPAEATUS. 

CHAP. PAGE 

Semiology of xni-: Digestive Apparatus 106 

I. DISEASES OF THE MOUTH 121 

Stomatitis 121 

Simple stomatitis . . . . . . . . .121 

Catiirrhal stomatitis in sheep ...... 122 

Necrosing stomatitis in calves 123 

Mycotic stomatitis in calves ....... 12-1 

Ulcerative stomatitis in sheep . . . . . .125 

General catarrhal stomatitis in swine 126 

Ulcerative stomatitis in swine . . . . , .127 

Mercnrial stomatitis . . . . . . . .128 

Glossitis ........... 130 

Superficial glossitis . . . . . . . .130 

Acute deep-seated glossitis ... . . . . .131 

Chronic glossitis . . . . . . . . .132 

II. DISEASES OF THE SALIVAEY GLANDS, TONSILS AND 

PHAEYNX 134 

Parotiditis (Parotitis) 134 

Acute parotiditis . . . . . . . . . 1 34 

Chronic parotiditis— Parotid fistula . . . . .136 

Inflammation of the submaxillarj^ salivary gland . . .137 

Tonsilitis in pigs .......... 138 

Pharyngitis 138 

Pseudo-membranous pharyngitis in cattle . . . . 141 

Pseudo-membranous pharyngitis in sheep .... 142 

Pharyngeal polypi . . . . . . . . .143 

III. DISEASES OF THE (ESOPHAGUS 145 

CEsophagitis .......... 145 

Stricture of the oesophagus ........ 148 

Dilatation of the a'sophagus . . . . . . .149 

Oesophageal obstructions . . . . . . . .152 

Euptures and perforations of the oesojihagus . . . .157 

IV. DEPEAVED APPETITE— THE LICKING HABIT— INDIGESTION 158 

Depraved ajipetite in the ox 158 

Depraved appetite in calves and lambs ..... 160 

Colic in the ox 162 

Colic due to ingestion of cold water — Congestive colic . . 162 
Colic due to invagination . . . . . . .163 

Colic as a result of strangiUation . . . . . .167 

Diseases of the stomach 169 

Indigestion 170 

Gaseous indigestion . . . . . . j . : 17Q 



X CONTENTS, 

CHAP. PAGE 

IV. DErHAVED APPETITE— THE LICKIXG HABIT— INDIGESTIOX 
— continued. 

Indigestion — c(,i,tliiiiril. 

Impaction of the rumen — Indigestion as a result of over- 
eating 175 

Impaction of the omasum (third stomach) . . . .179 

Abomasal indigestion . . . . . . . .182 

Acute gastiic indigestion in swine . . . . .185 

Y. INFLAMMATION OF THE GASTEIC COMPARTMENTS . .186 

Eumenitis—Eeticulitis— Gastritis 180 

Acute gastritis ISS 

Catarrhal gastritis in swine . . . . . . .190 

Ulcerative gasti'itis ........ 191 

Chronic tymj^anites . . . . . . . .194 

Gastric disturbance due to foreign bodies . . . .198 

Tumours of the gastric compartments 202 

VI. ENTERITIS 203 

Acute enteritis 203 

Heemorrhagic enteritis ........ 206 

Chronic enteritis (Chronic diarrhrea) ...... 207 

Dysentery in calves . . . . . . . . .210 

Diarrhoeic enteritis in calves 212 

VII. POISONING 215 

Poisoning due to food 215 

Poisoning by caustic alkalies . . . . . . .216 

Poisoning by caustic acids . . . . . . . .217 

Poisoning by common salt . . . . . . . .217 

Poisoning by the nitrates of potash and soda . . . .217 

Poisoning by tartar emetic 218 

Poisoning by arsenic . . . . . . . . .218 

Phosphorus poisoning . . . . . . . . .219 

Mercurial poisoning ......... 219 

Lead poisoning : Saturnism ........ 220 

Coj^per poisoning 221 

Carbolic acid poisoning 221 

Poisoning by aloes . . . . . . . . .221 

Iodoform poisoning 222 

Iodine poisoning : iodism 222 

Strychnine poisoning ......... 222 

List of plants poisonous to stock 223 

Colchicum poisoning 256 

Poisoning bj' auniial mercury ....... 256 

Poisoning by bryony ......... 256 

Poisoning by castor oil cake 257 

Poisoning by cotton cake ........ 257 

Poisoning by molasses refuse 258 

Diseases produced by distillery and sugar factory i)ulp . . 259 

VIII. PARASITES OF THE DIGESTIVE APPARATUS .... 263 
Gastro-intestinal strongylosis in sheep ..... 263 

IjumbricGsis of calyes . , . , . , , , ,267 



CONTENTS. Xi 

CHAP. P^(.g 

VIII. PARASITES OF THE DIGESTIVE AVFAUAT\JS~conti»,re,l. 

Strongylosis of the abomasum in the ox .... . 268 

Parasitic gastro-enteritis, diarrhoea, and anremia in cattle, sheep 

and lambs .......... 268 

Intestinal coccidiosis of calves and lambs (Psorospermosis, hremor- 
rhagic enteritis, bloodj' flux, dysentery, etc.) . . . .271 

Intestinal helminthiasis in ruminants ...... 275 

IX. DISEASES OF THE LIVER 279 

Congestion of the liver 280 

Nodular necrosing hepatitis 280 

Cancer of the liver and bile ducts 282 

Echinococcosis of the liver 283 

Suppurative echinococcosis ........ 288 

Cysticercosis . . . 290 

Distomatosis — Liver fluke disease— Liver rot .... 293 

SECTION III. 

EESPIKATOEY APPAEATUS. 
I. EXAMINATION OF THE RESPIRATORY APPARATUS . .311 

II. NASAL CAVITIES 319 

Simple coryza . . . . . . . . . . 319 

Gangrenous coryza ......... 320 

Tumours of the nasal cavities ....... 325 

Purulent collections in the nasal sinuses. Nasal gleet . . 326 

Purulent collections in the frontal sinus ..... 327 

Purulent collections in the maxillary sinus ..... 329 

(Estrus larvse in the facial sinuses of sheep 330 

III. LARYNX, TBACHEA AND BRONCHI 333 

Laryngitis 333 

Acute laryngitis 333 

Pseudo-membranous laryngitis ...... 333 

Tumours of the larynx 335 

Bronchitis 336 

Simple acute bronchitis 337 

Chronic bronchitis ........ 337 

Pseudo-membranous bronchitis 339 

Verminous bronchitis in sheep and cattle (Husk, hoose, etc.) 340 

IV. LUNGS AND PLEURA 343 

Pulmonary congestion . . . . . . . . .343 

Simple pneumonia ......... 343 

Pneumonia due to foreign bodies — Mechanical pneumonia . . 347 
Pneumonia due to tlie migration of foreign bodies from the 

reticulum .......... 348 

Pneumomycosis due to Aspergilli 350 

Gangrenous broncho-pneumonia due to foreign bodies . . 351 

Infectious broncho-pneumonia 354 

Broncho-pneumonia of sucking calves ...,., 356 



CONTENTS. 



CHAP. 

IV. T.UNGS AND Tl.'EVRM—cojdinued. 



Sclero- caseous broncho -pneuinoi 
Pulmonaiy emiihysema 
Diseases of the pleura 

Acute pleurisy 

Chronic pleurisy . 
Pneumo-thorax . 
Hydro-pneumo-thorax and pyo-pneumo-thorax 



a of sheep .... 358 

359 



361 
361 
362 
362 
366 



V. DISEASES OF STRUCTUEES ENCLOSED WITHIN THE MEDI- 
ASTINUM 368 

Tumours of the Mediastinum 369 



SECTION IV. 

THE OEGANS OF CIRCULATION. 

Semiology of the Organs of Circulation 370 

I. CAEDIAC ANOMALIES 374 

Ectopia of the heart 374 

II. PERICARDITIS 375 

Exudative pericarditis due to foreign bodies .... 376 

Chronic pericarditis 389 

Pseudo- pericarditis 390 

III. ENDOCARDITIS 394 

IV. DISEASES OF BLOOD-VESSELS 396 

Phlebitis 396 

Accidental phlebitis 396 

Internal infectious phlebitis (Utero-ovarian phlebitis) . . . 398 

Umbilical phlebitis of new-born animals 399 

LTmbilical phlebitis or omphalo-phlebitis . . . . .402 

V. DISEASES OF THE BLOOD 406 

Septicaemia of new-born animals 406 

Takosis: a contagious disease of goats 412 

Blood-poisoning (Malignant oedema) in sheep and lambs in New 

Zealand 415 

Piroplasmosis . . . . . . . . . .416 

Bovine piroplasmosis 416 

Bovine piroplasmosis in France ...... 424 

Ovine piroplasmosis ........ 425 

Diseases produced by trypanosomata . . . . . .426 

Louping-ill 429 

Suggested measures for prevention ..... 435 

Braxy ........... 435 

Bilharziosis in cattle and sheep 439 

Jleat stroke— Over-exertion .,,.... 442 



CONTENTS. XIU 
CHAP. PAGE 

VI. DISEASES OF THE LYMPHATIC SYSTEM 444 

The lymphogenic diathesis 448 

Caseous lymphadenitis of the sheep ...... 453 

Goitre in calves and lambs 453 

SECTION V. 

NERVOUS SYSTEM. 

Cerebral congestion 456 

Meningitis ........... 456 

Encephalitis .......... 458 

Cerebral Tumours 459 

Insolation ........... 460 

Post-partum paralysis — Milk fever — Mammary toxremia — Par- 
turient apoplexy — Dropping after calving . . . .461 

Coonurosis (Gid, sturdy, turn-sick) 467 

" Trembling," or Lumbar prurigo, in sheep .... 475 

SECTION VI. 

DISEASES OF THE PERITONEUM AND ABDOMINAL 
CAVITY. 

L PERITONITIS 478 

Acute peritonitis .......... 478 

Chronic peritonitis . . . . • ■ . . .481 

Ascites ............ 483 

Peritoneal cysticercosis ........ 485 

II. HERNIA 487 

Congenital hernite ......... 487 

Perineal hernia of young pigs ...... 487 

Umbilical hernia 488 

Acqiiired hernite 489 

Hernia of the rumen ......... 490 

Hernia of the abomasum 493 

Hei^nia of the intestine . . . . . . . .494 

Treatment of hernise ......... 495 

Diaphragmatic hernia ......... 496 

Eventration 499 

Fistulse of the digestive apparatus 500 

SECTION VII. 

GENITO-URINARY REGIONS. 

Diseases of the Urinary Apparatus 502 

I. POLYPI OF THE GLANS PENIS AND SHEATH . . .506 

Inflammation of the sheath 506 

Persistence of the ui-achus ........ 508 



XIV CONTENTS. 

CHAP. PAGE 

II. DISEASES OP THE BLADDER 511 

Acute cystitis . . . . . . . . . .511 

Chronic cystitis 513 

Urinary lithiasis. Calculus formation . . . . .514 

Calculi in bovine animals . . . . . .515 

Urinary calculi in sheej) 518 

Paralysis of tlie bladder . . . . . . . .519 

Eversion of the bladder . . . . . . . .519 

Heematuria ........... 520 

III. DISEASES OF THE KIDNEYS 527 

Congestion of the kidneys ........ 527 

Acute nephritis . . . . . . . . . .528 

Chronic nephritis .......... 530 

Hydro-nephrosis 531 

Infectious pj'elo-nephritis 533 

Suppurative nephritis and perinephritis ..... 537 

The kidney worm {Sclernstoma pinguicola) of swine . . . p39 

IV. GENITAL APPARATUS * . 542 

Vaginitis ........... 543 

Acute vaginitis 544 

Contagious vaginitis ........ 545 

Croupal vaginitis ......... 545 

Chronic vaginitis . . . . . . . . .5-16 

Metritis 547 

Sejjtic metritis . . . . . . . . .547 

Acute metritis ......... 550 

Chronic metritis ......... 552 

Epizootic abortion in cows ........ 553 

Salpingitis — Salpingo-ovaritis ooo 

Torsion of the uterus ......... 556 

Tumours of the uterus 559 

Tumours of the ovary 559 

Genital malformations 560 

Imperforate vagina 560 

Nympho-mania .......... 562 

V. DISEASES OF THE MAMMARY GLANDS 565 

Physiological anomalies ........ 567 

Wounds or traumatic lesions ....... 568 

Chaps and cracks ......... 568 

Milkfistuloe 569 

Inflammatory diseases 570 

Congestion of the udder 570 

Mammitis . . . . . . . . . . .571 

Acute mammitis ......... 573 

Contagious mammitis in milch cows ..... 580 

Chronic mammitis . . . . . . . .581 

Gangrenous mammitis of milch ewes ..... 583 

Gangrenous mammitis in goats 584 



CONTENTS. XV 

Chap. pagr 

V. DISEASES OF THE MAMMARY GLANDS— c<)»////»«/. 

Cysts of the udder 585 

Tumours of the udder ......••• 585 

Verrucous papillomata of the udder ...... 586 

VI. DISTURBANCE IN THE MILK SECRETION AND CHANGES 

IN THE MILK 587 

Microbic changes in milk. Lactic ferments .... 588 

VII. MALE GENITAL ORGANS 594 

Tumours of the testicle .....••• 594 

Accessory gknds of the genital apparatus 597 



SECTION YIII. 

DISEASES OF THE SKIN AND SUBCUTANEOUS 
CONNECTIVE TISSUE. 

L ECZEMA , 599 

Acute eczema ........•• 599 

Chronic eczema 600 

Sebaceous or seborrhoeic eczema 601 

Eczema due to feeding with potato pulp ..... 603 

Impetigo in the pig ......... 605 

Acne in sheep .......... 606 

Fagopyrisni (Buckwheat poisoning) ...... 608 

II. PHTHIRIASIS 60S 

Scabies— Scab— Mange . • .611 

Scabies in sheep . . . . . . . • • .611 

Sarcoj^tic scabies ......... 612 

Psoroptic mange — Sheep scab 614 

The tobacco and sulphur dip 626 

Lime and sulphur dips 627 

Arsenical dips ........ 632 

Carbcdic dips ......... 633 

Chorioptic mange — Symbiotic mange — Foot scab . ' . . 636 

Mange in the ox ......... . 638 

Sarcoptic mange ......... 638 

Psoroptic mange ......... 639 

Chorioptic mange 640 

Mange in the goat 641 

Sarcoptic mange . . . . . . . . .641 

Chorioptic mange ......... 642 

Mange in the pig . . . . . . . . . . -642 

Demodecic mange . . . . . . . . .643 

Demodecic nnnge in the ox . . . . . . . 644 

Demodecic mange in the goat ...... 644 

Demodecic mange in the pig ....... 644 

Non-psoroptic forms of acariasis 645 

Hypodermosis in the ox (warbles) 64^^ 



CONTENTS. 



CHAP. 

III. EINGWORM 



Eingworin in the sheep, goat, and pij 
IV. WARTS IN OXEN .... 



Urticaria in the pig 
Scleroderma 

V. SUBCUTANEOUS EMPHYSEMA 



rxr.ti 
649 
()J3 
055 
G5() 
657 

659 



SECTION IX. 
DISEASES OF THE EYES. 

Foreign bodies . . . . . . . . . .6(51 

Conjunctivitis and keratitis 662 

Verminous conjunctivitis 662 

Verminous ophthalmia of the ox . . . . . . . (Hi.'i 



land; 



md 



SECTION X. 

INFECTIOUS DISEASES. 

Cow-pox — Vaccinia 

Cow-pox and human variola — Preparation of vacc 

Tetanus 

Actinomycosis . ... 
Actinomycosis of the maxilla 
Actinomycosis of the tongue . 
Actinomycosis of the pharynx, parotid 
Tuberculosis 

Tuberculosis of the respiratory apparatus 

Tuberculosis of the serous membranes 

Tuberculosis of lymphatic glands . 

Tuberculosis of the digestive tract 

Tuberculosis of the genital organs 

Tuberculosis of bones and articulations 

Tuberculosis of the brain 

Tuberculosis of the skin 

Acute tuberculosis — Tuberculous septicaemia 
Swine fever — Verrucous endocarditis and pneumonia of the 

Swine fever ...... 

Verrucous endocarditis of the pig . 

Pneumonia of the pig ... 
Htemorrhagic septictemia in cattle 



neck 



669 
67U 
672 
67;} 
674 
675 
6S2 
690 
694 
696 
699 
700 
701 
702 
703 
7C4 
710 
710 
7i;3 
714 
716 



SECTION XL 

OPERATIONS. 

I. CONTROL OF ANIMALS 720 

Control of oxen 720 

Partial control . . . . . . . . .720 

Control of the limbs . . . . . . . .720 



CONTENTS. 



I. CONTROL OF .XNIUAIuS— continued. 
Control of oxen — continued. 

General control 

Control by casting 
Control of sheep and goats . 
Control of pigs .... 
Anaesthesia ..... 

II. CIRCULATORY APPARATUS . 
Bleeding .... 
Bleeding in sheep . 
Bleeding in the pig 
Setons, rowels, plugs, or issues . 

III. APPARATUS OF LOCOMOTION 

Surgical dressing for a claw .... 

Amputation of the claw or of the two last phalanges 

IV. DIGESTIVE APPARATUS 

Ringing pigs .... 
oesophagus 

Passing the probang 

Crushing foreign bodies in the a3sophagi 

ffisophagotomy 

Sub-mucous dissection of the foreign body 
Rumen ...... 

Puncture of the rumen . 
Gastrotomy ...... 

Laparotomy 

Hernise 

Inguinal hernia in young pigs 

Imperforate anus .... 

Prolapsus and inversion of the rectum 

V. RESPIRATORY APPARATUS . 

Trephining the facial sinuses 
Trephining the horn core 
Frontal sinus .... 

Maxillary sinus .... 

Tracheotomy ..... 

VI. GENITO-URINARY ORGANS . 

Ur.ethrotomj' in the ox . . . 

Ischial urethrotomy 
Scrotal urethrotomj' 

of the catheter and urethrotomy in the 
of the catheter in the cow 
Castration ..... 
Castration of the bull and ram 
Bistournage .... 
Martelage .... 
Castration by clams 



CONTENTS. 



CHAP. 

VI. GENITO-URINAEY ORGANS— co/i^m»ed 

Castration — continued. 

Castration by torsion . 
Casti'ation with the actual cauterj' 
Castration by the elastic ligature . 
Castration of the ram . 
Castration of boars and young pigs 
Castration of cryptorchids 
Female genital organs . 
Castration of the cow . 
Castration of the sow . 

Suture of the vuha .... 

Trusses 

Section of the sphincter of the teat 

Dilatation of the orifice of tlie teat 

Ablation of the mammje 



tot 
loH 
758 
759 
759 
760 
760 
761 
765 
768 
769 
770 
770 
771 



DISEASES OF CATTLE, SHEEP, 
GOATS AND SWINE. 

SECTION I. 

DISEASES OF THE ORGANS OF LOCOMOTION. 

METHODS OF EXAMINATION. 

Accidental and local diseases of the apparatus of locomotion are 
matters of less urgency in the case of cattle than in that of the horse. 
On the other hand, general affections, such as rheumatism and osseous 
cachexia, demand a larger share of attention, and are of the utmost 
importance. 

As the accurate diagnosis of any disease demands careful and 
systematic examination, the practitioner usually observes a certain 
order in his investigations, as indicated below : — 

(1.) Inspection, from the side, from the front and from behind, re- 
veals the existence of deformities of bones, limbs, muscles and joints, 
articular displacements, and irregularities of conformation or of gait. 

By inspection of an animal as it walks various forms of lameness, and 
their particular characteristics, are rendered visible. 

(2.) Palpation and pressure will detect changes in local sensibility, 
the softness or hardness of tissues, the existence of superficial or deep 
fluctuation, (Edematous swelling, and abnormal growths like ring-bones 
and exostoses, as well as the exact character of articular eidargements. 

(3.) Percussion is of little value in examining the apparatus of loco- 
motion. Nevertheless, percussion of the claws, and of certain bones of 
the limbs, or of flat bones, may afford valuable information in cases of 
laminitis, ostitis, and periostitis. Percussion along the longitudinal 
axes of the limb bones is also useful in diagnosing intra-articular frac- 
tures, sul)-acute arthritis, osteomyelitis, etc. 

(4.) The gait. Lame animals should be made to move, in order to 
assist both in discovering the cause, and in estimating the gravity of the 
condition. Sometimes it is advisable to turn the animal loose, but most 
frequently it is moved in hand, either in straight lines or in circles. 

D.C. B 



2 DISEASES OF THE ORGANS OF LOCOMOTION*. 

Information so obtained should always be supplemented by local 
manipulation and by passive movement, such as flexion, extension, 
abduction, adduction and rotation of the joints. 

A knowledge of the characteristics of normal movement in any given 
joint, renders it comparatively easy to detect abnormality, such as 
increased sensibility, articular crepitation or friction, and to diagnose 
fractures with or without displacement, ruptures of tendons or 
ligaments, etc. 



CHAPTER I. 

DISEASES OF BONES. 

The diseases affecting bony tissues may broadly be divided into local 
and general. Local diseases like ostitis, periostitis, necrosis, fracture, 
etc., are somewhat rare, and are less important in cattle than such 
general diseases as rachitis and osseous cachexia. 

Eachitis is a disease of young animals, and occurs during the growing 
period. Osseous cachexia is a disease of adults. Nevertheless, there is 
a relationship between these two morbid conditions, for they frequently 
co-exist in one family. Moreover, brood mares and cows suffering from 
osseous cachexia give birth to foals and calves, which, if left with their 
mothers, almost inevitably become rachitic. 

The general characteristic common to both rachitis and osseous 
cachexia consisting in diminution in the normal proportion of mineral 
salts entering into the constitution of the bone, numerous theories have 
been advanced to explain this irregularity in nutrition. 

The theory of insuflBciency is one of the oldest. It presupposes that 
the young animals' food contains insufficient mineral salts necessary for 
building up the skeleton, hence rachitis ; or again, that the daily food 
of the adults does not afford sufficient mineral salts to compensate for 
the normal transformation which is continually going on within the 
organism, and for the direct losses which occur through the medium of 
the urine, milk, etc. 

This extremely simple theory appears perfectly logical, but unfortu- 
nately does not fit in with all the observed facts. In reality, rachitis 
attacks children whose supply of milk, from a chemical point of view, 
leaves nothing to be desired. The same is true of animals, particularly 
of young pigs. The so-called "acid theory" has therefore been ad- 
vanced to explain the points left obscure by its predecessor. 

The acid theory. According to this theory, the food may contain 
more than sufficient mineral material without, however, preventing the 
development of rachitis or of osseous cachexia. 

In animals suffering from digestive disturbance the alimentary tract 
may become the seat of excessive fermentation or of changes in secretion. 
There is thus produced an excess of lactic acid which passes into the 

13 2 



4 DISEASES OF BONES. 

circulation and accumulates in the tissues, checking the processes which 
end in ossification or, in the case of adults, even leading to decalcification. 

It seems fairly well estahlished that experimental administration of 
lactic acid to animals causes diminution in the quantity of calcium salts 
contained in the hones (Siedamgrotsky, Hofmeister). On the other hand 
however Arloing and Tripier failed to produce rachitis experimentally. 

Bouchard revived this theory in a somewhat modified form. He con- 
siders that calcium salts are ahsorhed as carbonates and chlorides and 
phosphoric acid as phospho-glyceric acid. The reaction which these 
compounds undergo within the organism ends in the formation of the 
phosphate of calcium necessary to ossification, but this " phosphate of 
ossification " cannot be deposited if the organism contains an excess of 
lactic acid. 

Theory of inflammation. A third theory which until now has received 
very little support is that called the theory of inflannnation. The general 
lesions which characterise rachitis are regarded as resulting from primary 
attacks of ostitis and osteo-periostitis. The cause of these forms of 
inflammation is not suggested. 

To the above views may be added that more recently emitted by 
Dr. Chaumier, according to which rachitis is of an infectious nature. 
Unfortunately no proof of this has yet been adduced. 



GENERAL DISEASES. 

RACHITIS. 

Eachitis is a disease of youth, and is common both to the human 
species and to all domestic animals. It is characterised by irregularities in 
development and by imperfect consolidation of the bones. The boundary 
between rachitis and osseous cachexia is difficult to define and in fact 
at the present moment the two diseases can scarcely be defined with 
exactitude. Eachitis again is often complicated with softening of the 
bones, disease of the limbs, arrested development, etc., but it must not be 
forgotten that although the irregularities in ossification and development 
of the skeleton are the symptoms most striking to the eye, they do not stand 
alone, and that from the point of view of development all the tissues, 
including the muscles, are more or less affected and that most of the 
physiological functions such as digestion and the secretion of urine are 
deranged. 

Etiology. One of the principal causes suggested is that of heredity, 
and so far as human beings are concerned, one seldom fails to discover 
the rachitic taint. Certainly the offspring of individuals marked by any 
debilitating disease like alcoholism, tuberculosis, syphilis, etc., are poorly 



RACHITIS. 5 

equipped for their future development. Their tissues lack the necessary 
qualities and, c ceteris pavihus, their physiological functions are performed 
less perfectly than are those of normal individuals. 

It is difficult to apply such information to domestic animals, because 
badly developed subjects are not used for reproduction and the import- 
ance assigned to heredity can therefore scarcely be sustained. The 
conditions of life, on the contrary, have an unquestionable influence, 
and if rachitis is so frequent in young animals living near towns, for 
example, it is undoubtedly due to that want of air, light and liberty, 
which first affects the mother's health and later that of her offspring. 

The same may be said of insufficient and improper food ; for in this 
connection quality is of even greater importance than quantity. Even 
free feeding is insufficient if the fodder does not contain the material 
necessary for sustaining and building up the developing frame, a point 
which readily explains the occurrence of rachitis when young animals 
receive a diet deficient in certain chemical constituents. 

This occurs in young lambs and pigs where the mothers are given too 
little variety or too small a quantity of food. 

In calves and foals rachitis is rare but occurs when the mothers are 
exhausted or cachectic or are debilitated by chronic wasting diseases like 
tuberculosis or osseous cachexia. The milk is then no longer of normal 
chemical constitution. 

One fact appears to dominate the whole subject of the causation of 
rachitis, viz., the failure to assimilate sufficient of the mineral salts 
required in building up the skeleton. This failure to assimilate may be 
caused by too meagre feeding, but even when the food is sufficiently rich, 
some digestive disturbance may reduce the amount absorbed below 
normal. This appears the only plausible explanation unless we admit Dr. 
Chaumier's theory that the disease is of an infectious character. 

Symptoms. The onset is absolutely insidious and the diagnosis of 
rachitis is never made- until nutrition has long been abnormal. 

This disturbance of nutrition is revealed by irregularity and abnor- 
mality in appetite, by difficulty in rising and moving about, and by the 
animals lying down for long periods. The subjects are feeble, sluggish 
and badly developed. 

Next supervenes the second phase characterised by deformity of bones. 
This is of two kinds — deformity in the neighbourhood of joints (deformity 
or enlargement of the epiphyses) and deformity of the diaphyses. The 
former results from irregularity in ossification of the articular cartilages. 
The latter is followed by loss of rigidity in the bones of the limbs which, 
under the influence of the body weight and of muscular contraction, bend 
in different directions. 

The bones appear of increased thickness principally towards the 



RACHITIS. 



articulations. The latter are deformed, and on palpation are found to 
be surrounded by uneven and irregular growths. 

The front limbs are distorted. In young pigs, lambs, and less 
frequently in foals, calves and dogs, the jaws become deformed, and 
mastication is rendered difficult. 

The vertebral column may also l)e affected, and lordosis (bending 
downwards of the l)ack) or skoliosis (lateral bending of the back) is some- 
what frequent. 

Cyphosis, or ui)ward l)ending of the back, seldom occurs, and when 
seen, sometimes results from disease other than rachitis. 

General development is always in- 
terfered with and the young creatures 
are generally' dwarfed. 

The digestive apparatus is dis- 
ordered, the appetite is irregular and 
sometimes depraved, w^hile indiges- 
tion, gastritis, and enteritis are not 
exceptional. Physiological and patho- 
logical research has shown that the 
quantity of phosphoric acid elimi- 
nated in twenty- four hours in a 
rachitic child is double the quan- 
tity passed b}^ a healthy infant. 
The amount of urea in the urine 
(whicli is a criterion of nutrition, and 
usually varies in proportion to the 
amount of food ingested) is, on 
the contrary, diminished even when 
highly nitrogenous food is given, 
thus suggesting diminution in nu- 
trition. 
Lesions. The lesions are represented by abnormal and irregular 
tliickening around the inter-articular cartilages. The cartilage is 
thickened, compressible, very spongy and without regular ossification. 
Diffused periostitis exists principally towards the extremities of the bone. 
Beneath the periosteum the surface of the bone appears rough and 
softened. On section the medullary canals are seen to be enlarged and 
filled with marrow of a gelatinous character. The Haversian canals are 
dilated, and the entire tissue appears very vascular. Chemical analysis 
proves that the mineral constituents of the bone, particularly the phos- 
phates, have diminished by one-half ; the organic constituents on the 
other hand are increased in a similar ratio, but the ossein is abnormal. 
Ossification has, in a word, been incomplete. 




Fig. 1.— liachitis ui a voiui" ''oat. 



RACHITIS. 7 

Diagnosis. Diagnosis presents no difficulty except in the early stages 
before deformity has occurred. 

Eachitis can scarcely be mistaken for any other condition except 
perhaps infectious rheumatism, but the rapid course of the disease in the 
latter case, the persistence of fever and the swelling of the joint cavities 
sufficiently differentiate the conditions provided care is exercised. 

Prognosis. From an economic point of view the prognosis is very 
grave for if the lesions are extensive there is nothing to be gained by 
keeping the animal. 

Treatment. Treatment differs very little, whether the animals are 
still being suckled or have been weaned. In the former case it is 
necessary to improve the quality and chemical constitution of the 
mother's milk by giving food, richer both in mineral salts and in 
nitrogenous material. 

Cooked grains, milk, and forage of good quality should be given freely. 
When the mothers are exhausted and anaemic it is better to feed the 
little animals artificially or to change them to a foster-mother. Those 
already weaned should be given good rich milk, eggs, boiled gruel, and 
drugs, such as the phospho-chlorate of lime, 1 to 1^ drachms per day (for 
a calf) ; lacto-phosphate of lime, 1 to 1^ drachms ; bi-phosphate of lime, 
1 drachm, or simply ordinary phosphate of lime. Oil containing 1 per 
cent, of dissolved phosphorus may be given in doses of 1 to 2^ drachms, 
according to the size of the calves, but its use calls for much care, and it 
should only be given for alternate periods of a fortnight. The glycero- 
phosphates are not very active. Beef meal in doses of 6 drachms to 
li ounces and chloride of ammonium in doses of 30 to 60 grains have 
also been used advantageously. The above drugs, but particularly the 
bi-phosphate of lime and chloride of ammonium, stimulate nutrition and 
diminish the quantity of phosphoric acid eliminated. 

OSSEOUS CACHEXIA. 

" Osseous cachexia " is a general disease which develops slowly and 
progressively, producing its most marked effects on the bony tissues. 
It has received a great many diflereht names, such as osteoporosis, 
osteoclastia, osteomalacia, fragilitas ossium, enzootic ostitis, bone 
softening, etc., but none of these appears so appropriate as the term 
osseous cachexia, suggested by Cantiget. 

All the above-mentioned names are applicable to some phase of the 
disease, but none to the disease in its complete development. Thus the 
name " osteoporosis," accepted by German authors, is quite applicable 
to the phase of rarefying ostitis seen at the commencement, but this 
condition occurs in other diseases. The expressions " osteoclastia " and 



8 OSSEOUS CACHEXIA. 

" fragilitas ossium " suggest the fragility of the bones and the common- 
ness of fracture. The term "osteomalacia" is warranted during the 
period of bone softening. The term "gout," though in practice confusing, 
has l)een held to be justified by the frequent appearance of synovitis and 
arthritis; while that of "enzootic ostitis" indicates the appearance of 
the disease in all the stables in one district, without however pointing 
to its nature. It is possible that under certain circumstances the train 
of symptoms might be incomplete, and then the terms above indicated 
would be quite inappropriate. "Osseous cachexia," on the other hand, 
is very comprehensive, and appears to cover the entire development of 
the disease, for which reason it here receives preference. 

Law defines the disease as "a softening and fragility of the bones of 
adult animals, in connection with solution and removal of the earthy 
salts." He descabes it as an enzootic disease of mature animals — mainly 
cows — in which the decalcifying process proceeds most actively in the 
walls of the Haversian canals and cancelli of the affected bones. In 
consequence of the removal of the earthy salts the bones become soft 
and more or less fragile. 

The disease has been observed in England, Scotland, United States, 
France, Belgium, and Jutland, and generally in districts with low- 
lying damp pastures. It attacks cows which are heavy milkers. 
Susceptibility appears to increase with advancing age. 

History. Having been described by Vegetius, the disease was again 
observed about 1650 in Norway where it was treated by the administra- 
tion of crushed bones. It is fairly frequent in some parts of Germany 
and Belgium. In France it was studied in 1825 by lioux, and in 1846 
by Dupont, but Zundel in 1870 was the first who gave a good description 
of it, founded partly on the authority of German authors and partly on 
observations made by himself in the Valley of the Lower Ehine. Since 
that time it has successively been reported in the Yonne by Thierry, in 
the Nievre by Vernant, in the Aube by Collard and Henriot (1893), in 
the Indre by Cantiget, as well as in La Vendee by Tapon in 1893. In 
that and the succeeding year Moussu also saw numerous cases in the 
districts of Indre-et-Loire, Loire-et-Cher, Berry, Sologne, and in some 
parts of Beauce. 

Symptoms. The first symptoms are difficult to detect and interpret, 
especially at the commencement of an outbreak and in parts where the 
disease is rare they may lead to confusion and errors in diagnosis. On 
the other hand, in regions where the disease is common the practitioner 
will be able to form his diagnosis from the appearance of the first signs. 

To render clear the mode in which the symptoms develop we may 
divide the progress of the disease into four phases, though this grouping 
is somewhat arbitrary. 



OSSEOUS CACHEXIA. . 9 

1. The initial phase is not ^Yell marked, and is announced by digestive 
disturbance and by wasting. The former of these symptoms may be 
referred to some other cause, but consists in irregularity, diminution 
and sometimes perversion of the appetite. These earlier signs are soon 
followed by loss of spirits, and some interference with movement, but 
the symptoms only become of importance or attain their full develop- 
ment when the animals remain lying for a long period in the stable. 

2. The second phase is characterised by more precise signs, which 
become almost pathognomonic. Difficulty in rising is added to the 



Fig. 2. — Horse suffering from osseous cachexia. 

alread}^ existing tendency to remain lying, and to the interference with 
movement. 

When _ lying down the patient no longer responds to the trifling 
stimulus, which a healthy animal needs to cause it to rise. It remains 
languid and apparently lazy, though in reality it experiences pain 
and difficulty on attempting to get up. The least muscular effort when 
lying down often causes it to moan, as do efforts to change its position 
or to walk. Even when standing still, it may appear to be in pain, 
and patients often assume a position similar to that of a horse suffering 
from laminitis. 

At the end of this second phase, swellings appear, due to synovitis or 
arthritis of the extremities, synovitis of the sesamoid or navicular 
sheaths or to inter-phalangeal arthritis or arthritis of the fetlock joint. 
Weakness becomes marked, and the appetite is very irregular. 



10 OSSEOUS CACHEXIA. 

Secretion of milk diminislies or ceases and abortion is not un- 
common . 

3. The third phase is characterised by fractures, and it is this 
pecuHarity of the disease which has procured for it the names of fragi- 
litas ossium, and osteoclastia. These fractures may affect any portion 
of the skeleton. Animals so suffering sometimes break a leg whilst 
trotting or the pelvis in simply jumping over a ditch; a collision with a 
fixed object like the jamb of the stable door, or a fall on the ground, 
may result in the fracture of one or several ribs. 

Such shocks would be of no importance to a healthy animal, but to 
one suffering from osseous cachexia, any violence, or even the slightest 




Fig. 3. — Pig suffering fioiii osseous cachexia (foiu'tli stage). 

muscular effort may be follow^ed by fracture of the gravest character, 
involving even the vertebral column. In cows the pelvis, femur, and 
tibia are most frequently injured. 

In horses, particularly in riding horses, fractures are commonest in 
the region of the forearm, cannon bone, and anterior phalanges. So 
extremely fragile are the bones at this stage that the horse represented 
herewith broke twelve ribs at one time by simply falling on its side. It 
is interesting to note that such fractures are never accompanied by any 
extensive bleeding. They Imve little tendenc}^ to repair, no real callus 
formation occurs, and on post-mortem examination one often finds the 
ends unconnected by temporary callus, worn, and rounded by reciprocal 
friction. 

At this stage but under other circumstances, the animals show great 
reluctance to rise, remaining down for twelve to twenty-four hours 
without shifting their position. If forced to get up, they stand as 
though fixed in one position, the respiration and circulation become rapid, 
and they soon grow tired and fall. 



OSSEOUS CACHEXIA. 



11 



i. The fourth phase, or period of osteomalacia, i.e. softening of the 
bones, is also the last. It is rarely seen in large animals like horses and 
oxen, because accidents so often accompany the preceding stages and 
necessitate slaughter ; but it is common in goats and pigs. 

In this phase the bones become elastic, soft and depressible, yielding 
to the pressure of the operator's fingers. 

The flat bones are particularly liable to this change, which is common 
to domesticated animals. The bones of the 
head are the first to suffer ; later those of the 
pelvis. The lower jaw becomes sw^ollen, par- 
ticularly about the centre of the branches 
which may attain three, four, or five times, 
their normal thickness. 

The depression in the submaxillary space 
disappears. The upper jaw undergoes similar 
changes, becoming deformed and thickened 
until the cavities of the sinuses and the 
hollow appearance of the palate are lost, while 
the face is so changed that it cannot be 
recognised as that of a horse, goat, etc. 

The molar teeth are almost buried, their 
tables alone being visible at the bottom of a 
depression, the edges of which rise above the 
neighbouring parts (pig). 

Mastication is clearly impossible, the jaws 
appear paralysed, the muscles powerless, and 
only swallowing is possible, a fact which 
explains why life is only prolonged to this stage 
in animals which can be fed with a spoon or 
bottle (pigs and goats). The bones of the 
cranium, although greatly changed in texture, are always less deformed 
than those of the face. 

The changes are such that it is often easy with a mere post-mortem 
knife to cut the head completely in two. Osseous tissue, properly 
so-called, has disappeared. 

All the constituent tissues, with the exception of the skin and muscles, 
i.e., the bone, periosteum and aponeuroses, have the appearance and 
consistence on section of the fibro-lardaceous tissue seen in chronic 
inflammation. 

The following is a condensed description of the disease as given by 
Law : — 

Symptoms. Poor condition or even emaciation, with very visible 
projection of the bones. The coat is rough, skin tense, inelastic s^nd 




Fio. 4 



Deformity of the 
face in the horse shown 
in Fig. 2. 



12 OSSEOUS CACHEXIA. 

hidebound, appetite variable, sometimes impaired, and nearly always 
perverted (or depraved) so that the i^atient will lick the manger con- 
tinually or pick up and chew all sorts of objects : bones, leather, 
clothing, wood or iron, stones, etc. The amount of food consumed 
may, however, be up to the normal. The most marked feature is the 
difficulty and stiffness of locomotion. . . . Temperature and yield 
of milk may remain normal. 

" Later, appetite and milk secretion fail, temperature rises a degree 
or two, the animal refuses to rise, remaining down twelve to twenty-four 
hours at a time, and . . . when rising . . . remaining on the 
knees for a time, moaning and indisposed to exert itself further. At 
this stage many cases begin to improve and may get well in live or six 
weeks. Some will remain down for several weeks and finally get up 








FiG. 5. — Head of a pig suffering from osseous cachexia. 

and recover. With constant decubitus, however, the animal falls off 
greatly, becoming emaciated and weak, the appetite may fail altogether, 
and the patient is worn out by the persistent fever, nervous exhaustion 
and poisoning from the numerous bed-sores . . . which are common 
over the bony prominences. It is in these last conditions, above all, 
that fractures and distortions of the pelvic bones, and less frequently of 
the bones of the legs occur." 

" The disease may advance for two or three months, and in case of 
pelvic fractures and distortions, there may be permanent lameness, and 
dangerous obstruction to parturition, even though the bones should 
acquire their normal hardness through the deposition of lime salts." 

In horses, the different phases of the disease develop precisely as in 
bovines. The apparent differences between affected horses and cattle 
result in reality from differences in their capacity for continuing work. 
In the first phase, horses are incapable of work, their movements being 



OSSEOUS CACHEXIA, 



18 



badly co-ordinated. They are inclined to stumble, and appear as though 
suffering from strain of the lumbar muscles. 

In the second phase pain referable to the bones sets in. Lameness 
develops without visible lesions and is rapidly followed by synovitis and 
arthritis in the lower portions of the limbs, and by wasting and anasmia. 

The animals seem unable to move rapidly, or if forced to do so may 
sustain fractures even at a trot : the limb bones sometimes break or 
ligamentous insertions in the neighbourhood of joints are torn away, 
resulting in sudden falls on the ground and fracture of ribs or even of 
the vertebral column. This corresponds to the 
third phase, osteoclastia, in oxen. 

From then onwards, horses become useless 
and, if not destroyed, may, after a few weeks 
or months, develop the condition known as 
osteomalacia, in which the flat bones become 
softened, the head, the branches of the lower 
jaw and the face become deformed, while 
mastication and other functions are impeded. 

Germain gives the above symptoms as 
characteristic of the mode of development of 
the disease in French and Algerian horses 
imported into Tonquin, and his description, 
written several years ago, is fully confirmed by 
more recent observations. Since Tonquin was 
taken over by the French, however, improved 
methods of culture have resulted in the produc- 
tion of better cereals and forage ; the fodder 
plants have been vastly improved, to the great 
benefit of imported animals. 

In the goat, the disease shows some slight 
peculiarities. Thus, in the second phase, during 
which goats and sheep. suffer so markedly from 
lameness and pain in the bones, goats often 
walk on the knees. The disease, however, is uncommon in these animals. 
The phase of osteoclastia is also less marked and fractures are rare, 
because the animals weigh less and also because they are less exposed 
to falls and violent shocks. The bones, nevertheless, are extremely 
fragile and fractures may be produced at will. 

Osteomalacia, on the other hand, is always well marked. 

Eegarding the development of the disease in pigs, we may repeat what 
has just been said respecting the goat. Walking on the knees is often 
one of the first signs, fractures are somewhat rare, and the period 
of softening and deformity is always very noticeable. 




Fig. 6.— Osseous cachexia. 
Tills condition (le\ eloped 
in two months, the last 
month of gestation and 
the first of lactation. 



14 OSSEOUS CACHKXIA. 

Course. The development of the disease is slow, lasting from one to 
three months as a rule, and is little influenced hy hygienic conditions. 
Good milking cows, however, seem to be most frequently attacked, 
probably because of the great losses of nutritive material which occur 
through the milk. The calves borne by such animals are often rachitic. 
Oxen are less commonly attacked. Horses rarely suffer from the disease 
in France, but frequently in Tonquin. Pigs reared on very poor soil 
seldom escape attack. 

If treated from the beginning, or even before the second phase has 
become well developed, the disease may be cured, but after this 

period little improvement need be 
expected. 

Causation. The prol^lem of why 
^^ osseous cachexia occurs has natu- 

rally given rise to numerous 
explanations, some plainly inad- 
missible, others, however, of greater 
or less plausibility. 

The fact which, from the earliest 
times, appears to have attracted 
most attention is the relation 
defective nourishment bears to 
development of the disease. In 
Norway, as early as the year 1650, 
the plant known as sterregraes 
(which renders animals dull and 
heavy) was thought to be the cause 
of the disease ; two centuries later, 
in 1846, the Anthericum ossifragnm 
Fig. 7.-0sseous cachexia: softening of ^^^^^^ similarly regarded. Zundel, 
the maxillae. . ^^ ^ , . -, ,. , ,, ^, 

ni 1870, clanned that the Grermans 

first referred the development of 
the disease to chemically incomplete forms of nourishment. This opinion 
seems fully confirmed by the remarkable observations of Germain on 
European horses imported into Cochin- China, and it is finally placed 
beyond question by the work of Cantiget. Basing his researches on 
analysis of the soib he proved that osseous cachexia only occurs in cattle 
depastured on land which is too poor in phosphoric acid and calcium 
phosphate, and that it can be banished by enriching the soil with suitable 
manures up to a point when the proportion of phosphoric acid becomes 
normal. In good land, suitable for raising cattle, the proportion of phos- 
phoric acid, according to the best exponents of agricultural chemistry, 
should not fall below 4,000 kilograms to the hectare. Cantiget and 




OSSEOUS CACHEXIA. 15 

Brissonet have shown that where the soil contams less than 1,500 kilo- 
grams to the hectare, osseous cachexia is almost permanently present. 
As soon, however, as this proportion is raised ahove 2,000 kilograms by 
suitable culture, the losses diminish, and the cachexia finally disappears. 

This view was greatly strengthened by fodder analyses, which showed 
that in all cases where the soil is poor in calcium phosphate, the forage 
is poor in phosphoric acid, and vice versa. The food is too poor in 
mineral salts, firstly for normal development ; and secondly for the 
proper nutrition of the skeleton. 

Germain is of a similar opinion with regard to the occurrence of 
osseous cachexia in horses in Cochin- China, where the soil is very poor 
in lime. The fodder and cereals are poor in mineral salts, and even 
when given in large quantities do not furnish proper (chemical) nutri- 
tion. Clear proof of the correctness of this view is afforded by the fact 
that feeding with forage and cereals obtained from France or Algeria 
prevents the disease appearing, or diminishes and finally removes the 
previously existing symptoms. Furthermore, Germain shows that 
Europeans, living solely on the products of the country, to some extent 
suffer like the horses. 

This theory though based on sufficiently solid foundations to carry 
conviction, has been questioned, and it may be desirable to record briefly 
the criticisms advanced against it. 

One of the most important is as follows : — 

As osseous cachexia of oxen occurs in certain well-defined districts in 
France, and seems due to the feeding, why does it not attack horses in 
the same regions in an enzootic form? The answer appears to be that 
horses receive a greater amount of rich food, particularly of cereals, 
which contain much larger amounts of mineral salts, including phos- 
phates, than does ordinary forage. 

The most serious objection was made by Tapon, who states that in • 
1893 he saw osseous cachexia in oxen on farms in La Vendee where 
superphosphate had been used for years, wdiilst the disease did not exist 
on other farms wdiere such chemical manures were not employed. 
Before attaching much weight to this objection, however, it would be 
necessary to know^ the richness in phosphoric acid of the soil on the 
respective farms, for it is possible that, in consequence of natural condi- 
tions and in spite of the use of certain mineral manures, the richness of 
the soil on the first-mentioned farms, though manured with superphos- 
phates, was still below that of the others which had received no artificial, 
manure. 

The system of culture is also of importance, for at the present day, 
even with the use of artificial manures, cropping would rapidly im- 
poverish soils which w-ere not suitably and snfiiciently enriched. 



16 OSSEOUS CACHEXIA. 

Abundance or apparent richness of food signifies nothing if quaUty is 
lacking. 

It may also be asked : if the question of nourishment is of such prime 
importance why are animals of European origin in Cochin-China 
aftected, whilst the indigenous races prove immune? The answer 
would ajDpear to be that, in addition to the defective quality of food, 
other factors, such as adaptation to environment and relative digestive 
power, play a considerable part in the production of the disease. 

Favouring causes. Whilst conceding that the disease is due to one 
determining cause, viz. the food, it is unquestionable that other causes 
may favour its appearance. Abundant milking is one, so that the 
disease most frequently appears six to eight weeks after calving. Gesta- 
tion may also determine an attack. The disease is rarer in oxen than in 
milch cows. Starvation and bad hygienic conditions also have a certain 
influence ; it is well known that during dry years, particularly when 
fodder is scarce, osseous cachexia makes the greatest ravages. Law 
states that the disease has been attributed to excess of organic matter in 
the soil, to succulent watery foods, as rank watery grasses, potatoes, 
turnips and other roots deficient in nutritious solids. Some agent — 
microbe or toxin — swallowed with the food has been suspected but not 
yet isolated. 

Other explanations have been advanced but up to the present time 
they scarcely deserve to be regarded even as hypotheses. Thus Anacker 
in 1865 declared that the disease commenced as muscular rheumatism, 
was succeeded by destructive or atrophic ostitis, and ended as osteo- 
porosis. So far as the order of the osseous lesions is concerned, this 
view is quite correct, but the ossific changes are consequences and not 
causes. 

The idea that the disease was due to nn infectious agent has been 
advocated by Leclainche, without, however, having been proved. 
Petrone is the only person who has hitherto suggested that osteo- 
malacia in man is due to infection with a nitric ferment {Micrococcus 
nitnficans). According to him, pure cultures of this organism injected 
into dogs, produce osteomalacia. These statements, however, require 
confirmation. 

Lesions. The chief lesions are to be found in the bones. They 
consist in rarefaction of the compact tissue, increase in size of the 
medullary cavity and Haversian canals, and enlargement of the areola 
of the spongy tissue. The bone marrow loses its fatty constituents, 
appears red and gelatinous, and contains a greatly exaggerated number 
of blood-vessels. When heated, the bones do not yield oil as in healthy 
subjects, and when dry, they seem abnormally porous. In the osteo- 
clastic phase, the bones become very friable and even the shafts assume 



OSSEOUS CACHEXIA. 



17 



a si^ongy appearance. They diminish in density. These changes 
correspond to the stages of eccentric rarefying ostitis and osteoporosis 
of German authors. 

The flat bones often show well-marked periostitis, but the great 
thickening sometimes seen in certain of the bones of the head appears 
to be the result of a special osteo-periostitis. It is quite certain that 
the disease is due to something more than a mere want of mineral 
constituents in the bone, and poverty in this respect certainly does 
not explain the hj^pertrophic changes. The nutrition of the bones as 
a whole is disturbed, resulting in alterations both in the ossein and 




Fig. 8. — Transverse section through the middle region of the face in a pig 
suffering from osseous cachexia. 



in the mineral salts, the whole process being accompanied by symptoms 
of osteo-periostitis. 

The fractures which occur so frequently during the osteoclastic phase 
have well-marked peculiarities. The extravasation of blood is trifling, 
and no callus forms, even when the ends of the bones are immobilised 
by external aid ; if the ends are left free, they soon become worn and 
polished by rubbing against one another. 

In the neighbourhood of the articulations and ligamentous insertions 
the periosteum soon undergoes change, and it is not uncommon to find 
sub-periosteal and intra-osseous extravasations of blood. 

Germain has also noted in horses the disappearance of the interver- 
tebral and articular cartilages, and the frequent occurrence of anchylosis, 
true or false. 

D.C. C 



18 OSSEOUS CACHEXIA. 

In the final stages, the bones may be cut with a knife, and a time 
arrives when bony tissue seems completely to have disappeared ; thus, as 
shown in Fig. 8 herewith, it was possible to cut the entire head of a pig 
into thin slices without the slightest difficulty. All parts of the head had 
been aftected by the softening change. 

From the chemical point of view, the diminution in mineral salts and 
in phosphate of calcium has long been recognised, but the degree of this 
change varies according to the phase. In human beings the proportions 
have been estimated as follows: Normal bone, 50 to 80 per cent, of 
phosphate of calcium ; bone in persons suffering from osteomalacia, 5 
to 20 per cent, of phosphate of calcium. The changes in the ossein 
have not been carefully studied. We only know that histologically the 
ossein becomes fibrillar, and that chemically it no longer retains its 
normal comi^osition. 

The diagnosis is difficult, particularly on the first occasion of seeing 
the disease, and especially if this is of an enzootic character. The 
practitioner may also have some hesitation in diagnosing isolated cases 
in regions where the disease seldom occurs. 

Otherwise, diagnosis is usually easy, as soon as lameness or synovitis, 
or arthritis of the lower regions of the limbs appears. Only in isolated 
cases are the lesions likely to be mistaken for accidental injuries, and it 
is also fairly easy to differentiate them from the localised lesions of 
rheumatism. The latter disease seems more frequently to attack the 
upper joints of the limbs, and is often accompanied by intense fever and 
cardiac disturbance. 

Prognosis. In a general sense the disease is very grave, because it 
appears as an enzootic, and, in dry years and those during which there 
is a scarcity of forage, inflicts enormous losses on the breeders of certain 
countries. When advice is sought towards the end of the second phase 
of the disease the prognosis is therefore very grave. Under such cir- 
cumstances it is often better to slaughter rather than to treat, provided 
that the affected animals, like cows, pigs, or goats are still of some value. 

The prognosis is much more hopeful if treatment is attempted at an 
early stage, when improved diet and the use of suitable drugs sometimes 
lead to recover}'. 

Treatment. We know that in the Middle Ages this disease was often 
treated 1)}^ the administration of crushed bones, and even at the present 
day ground bones are frequently recommended. Treatment must be 
subordinated to proper feeding, no system of medication being of any 
value whatever unless the food is suitable. 

Germain states that imported horses in Cochin-China recover if 
simply returned to their former diet, i.e. to cereals and forage obtained 
from France or Algeria. Cantiget shows that such improvements in 



OSSEOUS CACHEXIA. 19 

cultivation as the free distribution of superphosphate manures on 
impoverished soils modify the chemical composition of the forage, 
and render it capable of building up and sustaining the organism and 
bony tissues ; treatment should therefore be essentially prophylactic 
in character. 

Animals suffering from osseous cachexia should be fed on cereals and 
forage obtained from rich districts where the disease has never occurred ; 
but, as in times of scarcity questions of expense almost always receive 
first consideration, it may be necessary to substitute bran for such 
products, or give oats, maize, beans, rice, and oil or cotton cake, etc., 
all of which can be obtained commercially, and are of sufficient 
nutritive richness. It is often advantageous to give such food cooked 
and slightly salted. 

Commercial ground bones and calcium phosphate (bi- or tri- basic), in 
doses of 1 ounce per day for oxen and 1^ to 2 drachms for pigs or goats, 
have given excellent results in the hands of most practitioners. Some 
recommend the addition of iron salts or bitter tonics like gentian or 
nux vomica in doses of 2^ drachms per day for a full-grown ox. 

Law declares that the treatment should be varied " with the pre- 
dominance of the causes, essential or accessory. . . . Green clover, 
alfalfa, and other leguminous products, ground oats, beans, peas, 
linseed or rape cake . . . and vetches may be especially recom- 
mended. . . . The free access to common salt and a liberal supply 
of bone meal are helpful. . . . Apomorphia is especially valuable in 
correcting the perverted appetite and stimulating digestion. A change 
of pasture is always advisable. In all cases where possible the water 
should be changed as well as the food. Attention to the housing, 
grooming, and general care of the animals should not be neglected. 
Finally, every drain upon the system should be lessened or stopped. 
The milk may be dried up, and the animal should not be bred." 

Meat meal also renders good service, but the use of cod liver oil, 
suggested by Zundel, is too expensive, and phosphorised oil is too 
dangerous to be adopted in ordinary treatment. 

Local treatment for synovitis and arthritis has been recommended. 
It is ineffective unless accompanied by good feeding and internal 
medication. On the other hand, the lesions often diminish rapidly or 
totally disappear under the influence of general medication alone. 



c 2 



20 FRACTURES. 

LOCAL AFFECTIONS. 

FRACTURES. 

Although oxen, sheep, goats, and pigs are much less siihject to 
fractures than the horse and dog, nevertheless, they do suffer from 
such accidents. Eepair is perfectly possible, but the cases are often not 
worth treating, unless the subjects are young or of considerable value. 
On the other hand, in fat and heavy subjects, it is difficult to fix the 
parts in position. Slinging produces l)ad results, and generally should 
not be encouraged. 

Apart from fractures accompanying general chronic diseases, like 
rachitis and osseous cachexia, the vertebra, the pelvis, the ribs, or any 
of the limb bones, may be fractured in consequence of accident. 

Such fractures may be either complete or incomplete (fissures), 
simple or compound. 

The general signs which indicate fracture are always the same, viz., 
loss of function, local pain, abnormal mobility, crepitation, due to rubbing 
together of the ends of the bones, and deformity of the part. Diagnosis 
is generally easy ; i^rognosis on the other hand is very variable. 

The vertebral column may be accidentally fractured in the region of 
the neck in consequence of the animal falling on its head ; in the dorso- 
lumbar region, from falling into ditches or ravines, or, in the case of 
bulls fighting, from violent muscular efforts. Fractures of the first 
kind are immediately fatal ; those of the second result in paraplegia 
of the hind limbs, and necessitate immediate slaughter. 

Fractures of the pelvis comprise :— 

1. Fractures of the angle of the haunch, resulting from external 
violence and characterised by sinking of the external angle of the 
ilium, deformity of the hip, and lameness without specially marked 
characters. This fracture is rarely complicated. The symptoms of 
lameness diminish with rest, but deformity continues. 

2. Fractures of the floor of the pelvis, usually extending from the 
anterior margin of the pubis to the foramen ovale and from the 
posterior margin of the foramen ovale to the end of the symphysis. 
They result from obstetrical manipulation, as in forcibly removing a 
foetus which is too large, or a monstrosity. As a rule, the animals 
cannot rise, or if they succeed in doing so, are incapable of moving. 
Diagnosis is made by exploration through the rectum. Such fractures 
always necessitate slaughter. 

Fractures of the neck of the ilium and of the base of the cotyloid 
cavity, even in cases of dislocation, are rare despite what has been 
said to the contrary. 



FRACTURES. 21 

In the fore limb, fractures of the scapula and humerus are usually 
of traumatic origin, are seldom accompanied by marked displacement, 
and are capable of uniting if a long rest at grass is allowed. Pitch 
bandages should be applied to the surface, covering all the surrounding 
regions, viz. the withers, ujjper portion of the forearm, girth and chest, 
to assist in immobilising the region of fracture, and to promote union. 

Fractures of the forearm are more difficult to treat, because the 
bandage applied must extend as far as the hoof. In this case displace- 
ment often occurs. It is therefore necessary, firstly, to reduce the 
fracture, and bring the ends in perfect contact, for which purpose it 
may be requisite to cast the animal, and give an anEesthetic; and, 
secondly, to apply a pitch plaster in the form of a shallow gutter, leaving 
the inner surface of the limb uncovered along a line about two inches 
wide following the course of the veins of the forearm. 

Fractures of the metacarpus and metatarsus usually heal well in all 
animals of moderate weight, such as heifers, steers, goats or sheep, 
provided a simple plaster bandage, covering the entire limb or prefer- 
ably with an opening in the position above indicated, is applied and 
continued downwards as far as the claws. 

In sheep and goats it is sometimes even sufficient to use a splint 
formed of straw-boards, and in the case of oxen, of wood, applied over a 
cotton-wool padding and retained in position by straps, or in the case 
of the heavier animals by dextrine or pitch bandages. 

In the hind limb, fractures of the femur are more serious, because the 
apparatus that can be used to secure immobility is seldom or never 
effective ; excepting in young animals, it is therefore usually better to 
slaughter. 

Fractures of the tibia are treated like those of the forearm when it 
appears desirable to keep the animals alive. 

Plaster bandages can very easily be prepared by saturating tarlatan 
in a mixture of equal parts of thoroughly dry plaster and water. Six to 
ten thicknesses of tarlatan, arranged alternately longitudinally and 
transversely, are sufficient. When adjusted they can be kept in position 
until the plaster has hardened by means of dry bandages applied from 
below upwards, which can be removed after a lapse of half an hour to 
an hour. 

FRACTURES OF THE HORNS. 

Anatomy of the horns. The horns form organs of defence, and 
project on either side of the frontal bone at the poll. Each consists 
firstly of a bony basis generally known as the horn core ; secondly, of a 
horn-secreting membrane ; thirdly, of a horny sheath, the horn properly 
so called. 



22 



FRACTURES. 



(1.) The horn core projecting from the frontal bone does not 
develop until after birth. About the third month a little prominence 
appears under the skin, which, as it develops, assumes a conical' shape, 
and may be seen to be covered with a horny substance. In proportion 
as the horn core grows, there develops within it a cavity which may 
either be of a simple character or divided by a longitudinal partition. 
This communicates with the frontal sinus, a fact which explains the 
collection of pus in the sinuses as a result of injuries to the horns. 
The sin as of the horn core does not exist in young animals, and is not 
completely developed before the third or fourth year of life. 

(2.) The horn-secreting membrane is formed by the skin, which under- 
goes special development around the base of the horn and comes to 




Fig. 



-C, horn ; P, modified skin forming the keratogenous membrane ; 
0, liorn core, exhibiting a double sinus. 



resemble that of the coronary band, from which the hoof or claw is 
secreted. The band is about one-fifth of an inch in breadth. The 
papillae of the dermis are specially developed at this point, and the 
epithelium which they secrete eventually forms the horn. 

The internal surface of the growing horn is adherent to the horn core 
through the medium of another tissue formed by a specially differentiated 
periosteum which is continuous with the periosteum covering the frontal 
bone. It is not a true periosteum, but a vascular tissue formed of papillary 
layers analogous to those of the podophyllous tissue of the ox's claw or 
horse's hoof. 

This keratogenous membrane receives a rich vascular supply from 
the arterial circle formed at the base of the horn core by a division 
of the external carotid, the blood conveyed by which is freely distri- 
buted to the enlarged papillae. The great vascularity of these parts 



FRACTURES. 23 

explains why lesions of the horns are often follo\Yed by such profuse 
bleeding. 

(3.)- The horn secreted by the papillcB of the horn band (which is 
analogous to that of the coronary band of the horse) forms a cone 
varying in its curve in various breeds. Its base is hollow, and 
contains little depressions holding the papilla from which the horn is 
secreted. From its base up to the end of the horn core the walls pro- 
gressively increase in thickness. From this point it is solid ; in a 
fully-grown horn the bone does not extend more than one-half or 
two-thirds of the entire length. 

In the adult, the development of the horns varies with different 
breeds and is affected by sex. In the bull the horns are short, but in 
the cow and ox long. Short and fine in animals of improved breed like 
the Durham, they are long and thick in breeds of working oxen. 

Injuries affecting the horns are of three classes, determined by the 
part affected. 

1. Detachment of the horn or sheath. 

2. Laceration : — 

(a) Of the horny sheath alone. 

(/>) Of the horny sheath and of the horn core. 

(c) Of the horn core alone, the horny sheath remaining intact. 

3. Fractures : — 

(a) Of the terminal half of the horn. 
(h) Of the lower half. 
{c) Of the base. 

DETACHMENT OF THE HORNS. 

When the 3'oke is badly fitted or padded, it is liable to cause a 
continual strain or a succession of shocks producing chronic inflam- 
mation of the keratogenous membrane. Should the end of the horn 
then be struck heavily, it is quite possible that the horn will either 
partially or wholly be detached. In this case it falls away without there 
necessarily being any important lesion of the horn core. 

Such accidents are not infrequently caused by the driver striking the 
ox on the horn with the yoke in order to keep it quiet while it is being 
harnessed. 

The prognosis of this condition is not grave, except for the fact 
that working animals cannot be used until the horn is completely 
regrown. 

The treatment simply consists in thoroughly cleansing and disin- 
fecting the horn core and then applying a protective dressing. The 
bony basis is surrounded with a mass of tow saturated with an antiseptic 



24 FISSURINC OF THE HORNS. 

solution, like 2 per cent, creolin or carbolic acid solution, which is kept 
in position by a spiral bandage passed around the horn, and secured in 
a figure of 8 on the opposite horn. Instead of applying such a dressing, 
some practitioners content themselves with using an antiseptic ointment 
or even a simple dressing of tar. 



FISSURING OF THE HORNS. 

Causation. In a general sense fissures may result from any violence 
affecting the centre portion of the horns, such as blows with the yoke 
or accidental bruises inflicted by the animals themselves in fighting 
with their neighbours. 

Symptoms. Whether the fissure is confined to the horny covering 
itself or whether it extends to both the i)ortions constituting the horn, 
that is, the horny covering and the horn core, two very noticeable 
symptoms are always present : 1. A straight fissure resembling a sand 
crack, and appearing usually on the convexity of the horn, and, 2. A 
very trifling hsemorrhage, which does not appear until some hours or 
even a day after the accident. 

Diagnosis. If the lesion only affects the horn core, diagnosis is 
always difficult, for one can hardly perceive any sensitiveness of the horn 
near the fissure. 

Prognosis. Provided that the horn core is not injured, the prognosis 
is favourable ; but in the contrary case, it should be reserved ; for 
haemorrhage extending to the interior of the frontal sinus not infrequently 
causes suppuration in that cavity. 

Treatment. Attempts should first be made to check haemorrhage by 
applying masses of tow saturated with cold water and frequently wetted 
with slightly antiseptic solutions, such as 2 per cent, creolin or 
carbolic acid. If haemorrhage persists in spite of this simple treatment, 
astringents may be employed, which, by causing the formation of a clot, 
mechanically arrest further extravasation of blood. These astringents 
vary considerably in value, and we should particularly warn practi- 
tioners against perchloride of iron, which causes necrosis of the 
tissues, and later, formation of pus. A 5 per cent, solution of gelatine 
is haemostatic and excellent for the purpose named, as also is hydroxyl 
solution. When once haemorrhage is arrested, the keratogenous mem- 
brane rapidly heals in consequence of its vascularity, and soon secretes 
fresh horn. 



FRACTURES OF THE HORNS. 



25 



FRACTURES OF THE HORNS. 

Etiology. Fractures of the horns, Kke fissures, are produced by 
violence, but of a more marlced cliaracter. They are termed complete 
or incomplete, according as the entire thickness of the horn or' only a 
portion of that thickness is involved. 

The fracture may affect either the terminal half or the basilar half ; 
or, again, it may have its seat in the frontal bone below the origin of the 
horn core, in which case a flake of bone will be detached. Such fractures 
assume varying forms, and may either- be deeply excavated, oblique, 
smooth, regular or dentated. 

Symptoms. The symptoms are extremely simple. They consist 
mainly in the mobility of the frac- 
tured end, and such phenomena 
as sensitiveness, haemorrhage, etc. 
When the fracture extends to the 
frontal bone, crepitation may also 
be noted. 

Prognosis. The prognosis is not 
grave unless the fracture extends 
to the basilar half of the horn or 
affects the frontal bone. 

Treatment. (1.) If the fracture 
is confined to the horn core, it is 
only necessary to bring the frag- 
ments into regular apposition, after 
having removed the broken end of 
the horn itself. 

(2.) In treating a fracture affect- 
ing the middle portion of the horn or in treating animals destined for the 
butcher, the best method is to make a simple wound by dividing the 
parts with a saw below the fracture. This is a painful operation, neces- 
sitating anaesthesia, and requiring the animal to be cast or firmly fixed to 
a post or placed in a trevis. To diminish the painful stage of the opera- 
tion, it was formerly recommended to make a circular incision extending 
through the entire thickness of the horn proper, and then to remove 
with a fine, very sharp saw the portion of the horn core. This, however, 
is scarcely practicable, and it is much better to make a direct section. 
Haemorrhage is checked with compresses,- moistened with cold water, 
after which a dressing known as the " Maltese cross dressing " (Fig. 10) 
is applied according to general principles. 

The surface of the section, after washing with an antiseptic solution, 
is powdered with iodoform or a mixture of iodoform and boric acid, 




Fig. 10.- 



-Dressiiig for fracture of 
the horn. 



FRACTURES OF THE HORNS. 



covered with a mass of tow or cotton wool, saturated with liquid anti- 
septic, and then surrounded with a flat pad of wadding, which extends 
completely around the horn as far as its base. A second pad of larger 
size, intended to protect the wound against external violence, is arranged 
around the free extremit}^ of the horn. This is kept in position by two 
small cross bandages. Another bandage, the loop of which is fixed to 
the base of the opposite horn, is then applied in spiral turns, completely 
enveloping the former pads and extending from the base to the point. 
Arriving at the free end, the operator reverses the bandage, draws it 
tight, and continues down to the base of the horn, fixing it by figure of 8 
turns passed around the base of both horns. 

(3.) In dealing with fractures of the lower third of the horn in working 
oxen, it is necessary to seek consolidation of the horn by callus formation, 

so that the animals may again 
become useful in the yoke. 
Very great difficulty accom- 
panies attempts to immobilise 
the horn in such cases, since 
the least shock to the extremity 
of the horn destroys the union, 
on account of the length of the 
lever represented by the horn 
itself. 

The first method of treatment 
consists, after the wound has 
been carefully disinfected, in 
fixing the ends in place by 
tightly applied pads, surrounded 
These are supported by several 




Fig. 11. — S2>lint for fractured horn. 



by splints, curved to fit to the horn 
turns of a spiral bandage. 

Were one certain of the cleanliness of the wound and of its perfectly 
aseptic condition, it would be better at once to have recourse to a fixed 
bandage, strengthened by plaster or silicate of soda. 

These bandages are applied longitudinally and should extend a con- 
siderable distance on either side of the fractures. If the horn is long and 
thick, it is best to use a fixed dressing of this kind secured by bandages 
in the form of a Maltese cross. 

All these methods, however, are more or less inconvenient, and tbe 
most practical procedure often consists in removing the horn. Treatment 
should only be attempted when the owner specially requests it in order to 
render the animal useful for working or show purposes. 

Moreover, however strong the dressing, accidents are frequent, for 
accidental shocks to the fractured horn interfere with the co-aptation of 



FRACTURES OF THE HORNS. 



27 



parts, and diminish the chance of perfect union. To avoid these draw- 
backs, the apparatus shown in Fig. 11 has been invented. 

This apparatus consists of a splint, the middle of which fits the back of 
the animal's poll, the sides being gouged out to receive the lower half of 
the horn and notched, to enable the fractured horn to be well supported 
by bandages. 

(4.) Fractures of the base of the horn are more serious, because a 
fragment of the frontal bone is usually torn away with the horn core. 
As a rule, the fracture is 
subcutaneous or without ex- 
ternal wound. The horn is 
displaced, and swings loosely. 
On examination, a charac- 
teristic crepitation sound is 
easily detected. In such frac- 
tures haemorrhage is subcu- 
taneous and often extends to 
the frontal sinus, in conse- 
quence of which it is not 
uncommon for pus to form 
in the sinus as a complica- 
tion. 

Treatment includes reduc- 
tion of the fracture, and the 
application of a fixed plaster 
or silicate bandage cover- 
ing the fron to-occipital and 
superior auricular regions. 

When a skin wound exists, it is better to remove the horn and bony 
fragment, and to apply an antiseptic dressing in order to prevent infection 
of the frontal sinus. 




Fig. 12. 



-Dressing for fracture of the base 
of the horn. 



EXOSTOSES, 

SPAVIN IN THE ;OX. 

Exostoses are somewhat uncommon in the bovine species, and when 
they occur are rarely of great clinical interest. Nevertheless, in cows 
and old working ^' oxen one sometimes sees metatarsal spavin. Its 
gravit}^ however, appears to be very much less than in the horse, on 
account of its position. Very commonly there is only trifling lameness. 

Treatment by application of biniodide of mercury ointment or the 
actual cautery gives good results. The principal precaution required is 
to prevent the animals licking the parts. 



28 



RING-BONE. 



RING-BONE. 



Ring-bones only occur in working oxen, and particularly in aged 
animals used in hilly regions. They result almost exclusively from 
wounds, ligamentous and tendinous strains, and articular injuries. 

They are preceded (as can usually be proved by dissection of limbs) by 




Fig. 13. — Tibia. Lesions due to open fracture and displacement. Irregular 
callus formation and seenestrum. 



fibrous or fibro-cartilaginous induration in or about the coronet or one 
of the phalanges. These thickenings increase the diameter of the 
pastern in all directions. Ring-bones are seldom very large ; but as they 



SUPPURATING OSTITIS. 



29 



partially or entirely surround the insertions of the lateral ligaments, 
inter-phalangeal articulations or insertions of the digital extensors, they 
are painful, and produce lameness of varying intensity. 

Diagnosis is easy, partly because the tension of the skin and the 
fibrous thickening render palpation painful. 

Prognosis is grave, because the effect of ring-bone is sometimes to 
render working animals useless. 

Treatment. To relieve the diseased claw of pressure due to its bearing 
on the ground, the shoe should be removed and the claw freely pared. 





Fig. 14. — Sarcoma of the periosteum 
beneath the scapula. 



Fig. 15. — Sarcoma of the periosteum 
covering the upper end of the tibia. 



If necessary, the healthy claw of the same foot may be raised by placing 
a piece of thick leather between the sole and the shoe. It is advisable at 
once to apply an energetic plaster, or, better still, to resort to firing in 
points. 

SUPPURATING OSTITIS. 
In addition to the changes in bone resulting from rachitis, osseous 
cachexia, tuberculosis, and actinomycosis, one sometimes sees cases of 
periostitis or ostitis pure and simple. As a result of external injury or 



30 BONE TUMOURS. 

direct wounds, the bone may be contused and injured, becoming the seat 
of diffused periostitis, necrosis, suppurating ostitis or osteomyelitis. 
Open fractures may produce the same results. 

Treatment comprises disinfection of wounds, antiseptic injection of 
fistulfe, the application of antiseptic pencils, curettage, the removal of 
sequestra, and vesicant or resolvent complications. When such condi- 
tions extend to neighbouring joints and produce suppurative arthritis, 
the animals oudit to be killed. 



BONE TUMOURS. 

The only bone tumours of real importance from a practical point of 
view are malignant growths represented by rapidly spreading epithelio- 
mata or sarcomata, originating in the periosteum. Fortunately such 
tumours are rare. 

They are not difficult to diagnose, as they develop rapidly, are accom- 
panied by pain and lameness ending in diminution or loss of the power 
of movement, and frequently attack neighbouring lymphatic glands. 
Even when in good condition, animals lose flesh and appetite, and finally 
die of general wasting. The diagnosis is sufficiently guided by the 
deformity of the parts, the bosselated appearance of the tumours, the 
absence of fluctuation, the haemorrhage which follows exploratory punc- 
ture, the character of the little fragments of tissue removed through 
these punctures, and finally the leukocytosis, which accompanies the 
development of malignant tumours. 

The prognosis is grave, for it is usually difficult or out of the question 
to have recourse to removal, resection or amputation, when the tumours 
have acquired any considerable size. Success is impossible unless 
intervention is early, and the growth is in a readily accessible part. In 
other circumstances early slaughter is indicated. 



CHAPTER II. 
DISEASES OF THE FOOT. 

CONGESTION OF THE CLAWS. 

Congestion of the cla^vs is not infrequently confused with contusion of 
the sole. It is, however, essentially different, and presents closer 
analogies with laminitis. The condition is characterised by congestion of 
the entire vascular system of the claw and principally of the velvety 
tissue. Like laminitis, it affects all four limbs ; in rare cases the two 
front or two hind. 

Congestion of the claw results almost exclusively from enforced move- 
ment on hard, dry and hot ground. It is commoner in animals 
unaccustomed to walking, and in heavy beasts which have been travelled 
considerable distances to attend fairs or markets. It is commonest in 
the bovine and porcine species, and less common in sheep. 

The symptoms appear after animals return from a long journey by 
road. They are characterised by unwillingness to bear weight on the 
feet and ditiiculty in movement. Standing is painful, and the animals 
resist being moved; as soon as released they lie down. 

Diagnosis presents no difficulty, though the condition is sometimes 
mistaken for slight laminitis. 

Prognosis is favourable. 

Absolute and prolonged rest is always followed by recovery, no 
internal medication being necessar}', though this result is promoted by 
enveloping the claws in wet compresses or by using cold foot baths, etc. 

CONTUSIONS OF THE SOLE. 

Contusions of the sole are only seen in animals which work without 
shoes or in such as are badly shod. 

Work on rocky ground, movement over newly metalled roads, and 
wounds produced by sharp stones, are the principal causes of contusion 
of the sole. Badly applied shoes, flat or slightly convex on their ujjjDer 
surfaces, may also produce bruising in the region of the sole. The 
anterior angle of the claw is rarely affected. 



32 • CONTUSIONS OF THE SOLE. 

Lameness is the first symptom to attract attention. It is slightly 
marked, unless the bruising has been overlooked until suppuration has 
set in. It affects only one or two limbs, and is rarely accompanied by 
general disturbance, such as loss of appetite, fever, exhaustion during 
work, etc. 

Locally the claw or claws affected are abnormally sensitive to per- 
cussion of the wall, and particularly to compression of the sole. 

The parts are hot to the hand, and thinning the sole with a knife shows 
little perforations, irregular points and crevices in the horn. One 
may also find softening, infiltration and hfemorrhage within the horn 
similar to those of corn in the horse, undermining of the sole over 
limited areas, and sometimes suppuration, if the animals have been 
forced to work when lame. 

Complications like necrosis of the velvety tissue or of the bone, though 
comparatively common in the horse, are rare in oxen. 

Diagnosis is not difficult provided the history of the case is known. 
Confusion with laminitis is scarcely possible, for the gait of this lameness 
and the local symptoms are all different. Examination of the sole will 
usually dispel any remaining doulit. 

Prognosis. The prognosis is favourable. When the horn is simply 
softened and a blackish liquid transudes, the lesion is trifiing; if the 
discharge is reddish grey the lesion is graver, and implicates all the 
velvety tissue ; finally, separation of the horn from the secreting 
membrane and the discharge of true pus point to death of the 
keratogenous tissue or of the bone. 

Treatment should be commenced by carefully thinning the sole 
around the wound and applying moist antiseptic dressings or cold 
affusions. Eemoval of loose portions of horn hastens repair by allowing 
discharge, which has accumulated between the living tissues and the horn 
itself, to escape freely. The extirpation of necrotic tissue and the appli- 
cation of surgical dressings are only called for in specially grave cases. 

This treatment usually gives good results. The acute complications 
which are so common and so dangerous in the horse seldom occur in 
the ox. 

Most of these operations can be performed without casting, provided 
the animal is placed in a trevis or is sufficiently secured. 

LAMINITIS. 
Laminitis is characterised by congestion, followed by inflam- 
mation of the horn- secreting tissues of the foot. It is now rare in 
oxen and very seldom assumes an acute form. 'J'he slow pace at which 
animals of the bovine species move may sufficiently explain this rarity ; 



LAMINITIS. 33 

nevertheless, prolonged travel on stony roads with heavy vehicles, rapid 
and repeated marches to towns or imj)ortant fairs, are sufficient to pro- 
duce attacks. Before the days of railways, and for some time after 
their introduction, in Britain cattle were travelled by road, and laminitis 
was common. 

Long journej's in crowded railway trucks may also produce the disease, 
although the animal has not been forced to walk. Persons engaged in 
exhibiting cattle at shows are well aware of this. Prolonged main- 
tenance of the standing position will produce the trouble, to which 
the joltings of the railway journey may also contribute their share. 
Prolonged standing on board ship may induce laminitis, 

" Show condition " and the consumption of highly nitrogenous, and 
particularly of farinaceous, foods favour the occurrence of laminitis. 

Breed is also considered to have some influence, and laminitis is said 
to occur more frequently in animals raised in flat districts, because in their 
case the space between the digits is larger than in mountain-bred cattle. 
In this connection the body weight may perhaps play a certain part. 

The symptoms vary somewhat, depending on whether laminitis is 
general and aft'ects all four feet, or restricted to the two front or the two 
hind feet. 

The internal claws always seem more severely affected and more sensi- 
tive than the external. In very rare cases the animal remains standing, 
l)ut usually it lies down, and will only rise under strong compulsion. 

When standing, the symptoms are similar to those noted in the horse ; 
the animal ajDpears as though absolutely incapable of moving. If all 
four feet are afi'ected the animal assumes a position as though just about 
to rise ; if the front feet alone are affected the animal kneels in front 
whilst it stands on its hind legs, a very unusual position for the ox to 
assume ; Anally, if the hind feet alone are affected, the animal seems to 
prefer a position with the feet under the body both in front and behind. 
(See Veterinarian, 1894, case by Bayley, and note by Nunn.) 

It is always difficult to make the animal move. Walking seems pain- 
ful, and most weight is thrown on the heels. The body swings from 
side to side as the limbs are advanced, and each limb is moved with a 
kind of general bodily effort. 

The claws are hot, sensitive to the slightest touch, and painful on 
percussion. 

Throughout the development of laminitis the general symptoms are 
very marked. The appetite falls off" early, fever soon appears, and in 
grave cases the temperature rises to 105"^ or to 106° Fahr. Thirst is 
marked, and the animal seems to prefer cold drinks. The muzzle is dry, 
the face anxious and expressive of pain. Wasting is rapid. 

The ordinary termination is in resolution, which occurs between the 

D.C. D 



34 DISEASES OF THE FOOT. 

eighth and fifteenth day, provided the patient has been suitably treated. 
The disease rarely becomes chronic. On the other hand, the claw occa- 
sionally separates, as a consequence of haemorrhage or suppuration, 
between the horn proper and its secreting membrane. Should this 
comi)lication threaten, the pastern becomes greatly swollen, the ex- 
tremities become intensely congested, and separation commences at 
the coronet. Loss of the claws, however, like suppuration, is rare. 

Diagnosis. Congestion of the sole, the early stage of infectious 
rheumatism and osseous cachexia may, at certain periods of their 
development, be confused with laminitis ; but the history' and the 
method of development of the above-mentioned diseases always allow 
of easy differentiation. 

It should, however, be added that, in certain exceptional conditions 
(suppurating echinococosis, producing chronic intoxication, tumours 
of the liver, and tumours of the pericardium and mediastinum), 
symptoms may be shown that suggest the existence of laminitis, 
although it is not really present. In these cases pain ma}' possibl}^ be 
felt in the bones of the extremities. 

The prognosis is usually favourable, but necessarily depends on the 
intensity of the disease. Fat stock always suffer severely. 

The treatment varies in no important particular from that prescribed 
for the horse, and is usually followed by rapid improvement. The chief 
indications are free bleeding from the jugular, the application of a 
mustard plaster over the chest, and the administration of a smart purga- 
tive (1 to 2 lbs. of sulphate of soda, according to the size of the animal) 
at first, followed by laxatives. This treatment may be completed by 
giving salicylate of soda ^jcr os in doses of 5 to 8 drams, or arecoline in 
subcutaneous injection, 1 to 1^ grains. Local treatment consists in cold 
affusions or poultices to the feet. 

Failing cold baths, clay plasters applied to the feet are useful. To 
ensure success all these methods should be utilised simultaneously. In 
cases of separation of the claw, antiseptic dressings, with a thick pad of 
tow placed under the sole, become necessary. 

Chronic laminitis may perhaps occur in the ox as in the horse, but, as 
a rule, oxen are slaughtered before the disease can assume this form. 
In dealing with fat, or even with fairly well-nourished, oxen it would 
clearly be more economical to slaughter early, and so prevent wasting 
and the resulting loss from disease. 

SAND CRACK. 

Sand crack — that is to say, the occurrence of vertical fissures in the 
Wall of the claw — is not absolutely rare in bovines. It is commonest in 



SAND CRACK. 35 

working oxen drawing heavy loads, though in very exceptional cases it 
affects animals which have never worked. (Moussu describes one case 
in a young ox where four sand cracks existed simultaneously.) It may 
also result from injuries to the coronet. In contrast to the case of the 
horse, and owing to the different conditions under which the ox performs 
its work, the disease is commoner in front than in hind feet. In 
drawing, the ox's front limbs play the principal part, and the animal 
pivots, so to speak, on the claws of the front limbs. 

The position of the crack may vary. It is commonest on the inner 
surface of the claw, rare at the toe, and still rarer at the quarter. 
It is often superficial and complete, extending throughout the entire 
height of the claw, but not throughout its thickness ; sometimes it is 
complete and profound, the fissure then extending to the podophyllous 
tissue. 

The symptoms are purely local in the case of superficial lesions. 
When the injury is deep seated, or when it originates in a wound of the 
coronet, lameness is present. Intense lameness, swelling of the coronet, 
and blood-stained or purulent discharge point to grave injury and 
probable complications. 

Diagnosis is easy. The prognosis naturally varies with the symptoms. 
It is favourable when the fissure is merely superficial, but becomes grave 
when it is deep seated and the animal is exclusively used for heavy 
draught. 

Treatment. When the lesion is superficial and unaccompanied by 
lameness, no surgical interference is necessar3\ Rest or very light work 
is alone required. As soon as lameness appears, rest is obligatory. The 
application of antiseptic poultices, containing 2^ to 3 per cent, of carbolic 
acid, creolin, etc., usually alleviates pain in a short time, and facilitates 
healing in the depth of the fissure. 

In exceptional cases, where complications have occurred in conse- 
quence of suppuration beneath the fissure, suppuration in the coronary 
region, or necrosis of the podophyllous tissues, an operation becomes 
necessary, and is of exactly similar character to that performed under 
like circumstances in the horse. 

Over a space of 1 to IJ inches on either side of the fissure the horn 
is thinned "to the blood," and the subjacent dead tissue removed. The 
claw is then thoroughly cleansed with some antiseptic solution, the 
wound freely dusted with equal parts of iodoform, tannin and boric 
acid, and covered with pads of tow or cotton wool, fixed in position by 
appropriate bandages. After such operations a long rest is essential 
for complete recovery, during which, however, the animal may be 
fattened. 

The object of operation is to prevent complications, like chronic 

D 2 



36 DISEASES OF THE FOOT. 

suppuration and necrosis, which would endanger the animal's life, rather 
than to effect perfect restoration of usefulness for the work previously 
done. 

PRICKS AND STABS IN SHOEING. 

The wall of the ox's claw is so thin that shoeing is alwa_ys somewhat 
difficult, more especially as nails can only be inserted in the external 
wall. Moreover, as very fine nails must he used, they are apt to bend, 
penetrate the podophyllous tissue, and cause injuries of varying import- 
ance. The ox is often very restless when being shod, and, even though 
firmly fixed, usually contrives to move the foot every time the nail is 
struck. The farrier, therefore, may easily overlook the injury which he 
has just caused, and by proceeding and ignoring it may transform a 
simple stab into a much more dangerous wound. 

Symptoms. In most cases lameness appears immediately the animal 
leaves the trevis, but, although this is more difficult to explain, lameness 
is sometimes deferred until the day after, or even two days after, shoeing. 
Though little marked at first, lameness may become so severe that the 
animal cannot bear the pain caused by the foot touching the ground. 
When this stage is reached general disturbance becomes marked, fever 
sets in, rumination stops, and appetite is lost. 

These symptoms jjoint to the occurrence of suppuration. The pus, 
confined within the horny covering of the foot, causes very acute suffering 
and sometimes grave general disturbance ; later it burrows in various 
directions, separating the podophyllous tissue from the horn, and ends by 
breaking through " between hair and hoof " in the region of the coronet. 
In excejDtional cases, comj^lications such as necrosis of the podophyllous 
tissue extending to the bone, and suppuration of its spongy tissue, may 
be observed. 

Diagnosis. "When the farrier suspects he has pricked an animal 
the immediate withdrawal of the nail will remove any doubt, because 
bleeding usually follows. If the condition is only detected at a later 
stage, the early lameness having been misinterpreted, examination of 
the claw and taj^ping the clenches of the nails will cause the animal 
to show pain at a given point, thus indicating the penetration of the 
nail. Removal of the offending nail is painful, and is often followed by 
discharge of pus or blood-stained fluid, which clearly points to the 
character of the injury. In obscure cases the shoe should not be 
reapplied. 

When the horn wall is separated from the sensitive structures, there is 
marked general disturbance, and pus is discharging at the coronet, it is 
practically imiiossible to err in diagnosis. 

Prognosis. In cases of simple nail puncture the prognosis is hopeful, 
provided that the condition is at once diagnosed. The longer it remains 



PRICKS AND STABS IN SHOEING. 37 

unrecognised, particularly if complication like necrosis has occurred, the 
graver becomes the outlook. 

Treatment. In cases of simple puncture the nail should immediately 
be withdrawn and the animal placed on a perfectly clean bed to prevent 
the wound becoming soiled or infected. If lameness appear and become 
aggravated, the shoe should be removed and antiseptic poultices applied. 
In the majority of cases the lameness will then diminish, and in a few 
days comj^letely disappear. 

In cases of discovery within the first few days the same treatment is 
applicable, and is often sufficient. If, on the contrary, pus is discharging 
at the coronet, if lameness is intense and the general symptoms marked, 
it may be needful to operate. 

The stages of operation comprise : thorough thinning of the horn in the 
shape of an inverted V over the afiected portion of the wall, removal of 
the loose necrosed parts, disinfection of the wound, and the application 
of a surgical dressing covering the entire claw. 

PICKED-UP NAILS, Etc. r GATHERED NAIL.") 

Penetrating wounds of the plantar region are, as in the horse, usually 
included under the heading of " Picked-up Nails." They are only seen 
in oxen or cows which are not shod. Pointed objects, like nails, harrow 
teeth, sharp fragments of wood or glass, etc., may produce injuries of 
the character of that now in question. 

In considering the position of such wounds we may for convenience 
divide the plantar region into two zones, one extending from the toe of 
the claw to the point of insertion of the perforans tendon, the other 
comprising the region between this insertion and the bulb of the heel. 

Symptoms. Lameness occurs immediately, and varies with the in- 
tensity of the existing pain. If the offending body has not remained 
fixed in the wound, this lameness may in a few moments disappear, 
either for good or merely for a time. The recurrence of lameness on 
the following day or a couple of days later marks the commencement 
of inflammatory changes in the deeper seated tissues. This lameness 
in many instances is accompanied by a movement suggestive of string- 
halt, the foot being kept on the ground only for a very short time, or 
sometimes not being brought into contact with the ground at all. 

The depth to which the offending object has penetrated, and the 
direction it has taken, may sometimes be discovered by a mere casual 
examination of the sole. In other cases only the orifice by which it has 
penetrated can be found. If the injury has existed for several days, the 
discharge from the puncture will be thin aiid blackish, purulent, or 
blood-stained, according to the case. Fever and general systemic dis- 
turbance suggest an injury of a grave character. 



38 DISEASES OF THE FOOT, 

Diagnosis. The diagnosis is easy, inasmuch as the lameness ahiiost 
directs examination to the foot. 

Prognosis is rarel}^ grave. The direction, the situation and mode of 
insertion of the flexor tendon, which forms the plantar aponeurosis, 
ensure this aponeurosis being rarely injured by objects penetrating from 
without. The points of the offending bodies usually pass either forwards 
to tlie phalanx or backwards in the direction of the plantar cushion. 

Treatment. The first stage in treatment consists in removing the 
foreign body and thoroughly thinning the neighbouring horn. An 
antiseptic poultice consisting of linseed meal saturated with B per cent, 
carbolic acid or creolin solution is then applied. Considerable and pro- 
gressive improvement usually takes place in a few hours. If lameness 
persists, surgical interference becomes necessary ; in the anterior zone 
it is confined to removing any dead portions of the velvety tissue and to 
extirpating the fragment of bone which has undergone necrosis. In the 
posterior zone the sinus must be probed and laid open, so that all the 
diseased parts can be treated as an open wound. 

If, as happens in exceptional cases, the plantar aponeurosis is found 
to be severely injured, the complete operation for picked-up nail, as 
practised in the horse, may be performed, or the claw may be ampu- 
tated. In the former operation the horn covering the sole is first 
thinned " to the blood." 

The stages of operation are as follows : — 

(1.) Ablation of the anterior portion of the plantar cushion. Trans- 
verse vertical incision at a distance of 1^ inches in front of the heel ; 
excision of the anterior flap. 

(2.) Transverse incision and ablation of the plantar aponeurosis b}^ 
the same method. 

(3.) Curettage of the i^oint of implantation of the aponeurosis into 
the bone. 

(4.) Antiseptic dressing of the claw. 
Finally, if the primary lesion, wherever it may have started, has 
become complicated by arthritis of the interphalangeal joint, it will 
be necessary to remove the claw, or, l)etter still, to remove the two 
last phalanges, the latter operation being easier than the former, and 
providing flaps of more regular shape and better adapted for the 
production of a satisfactory stump. 

INFLAMMATION OF THE INTERDIGITAL SPACE. 
(CONDYLOMATA.) 

Condylomata result from chronic inflammation of the skin covering 
the interdigital ligament. Any injury to this region causing even 
superficial damage may result in chronic inflammation of the skin 



INFLAMMATION OF THE INTERDIGITAL SPACE. 



39 



and hypertrophy of the papinpe, the first stage in tlie production of 
condylomata. 

Injuries produced by cords sHpped into the interdigital space for 
the purpose of Hfting the feet when shoeing working oxen are also 
fruitful causes. 

Inflammation of the interdigital space is also a common complication 
of aphthous eruptions around the claws and in the space between them. 
Continual contact with litter, dung and urine favour infection of super- 
ficial or deep wounds, and by causing exuberant granulation lead to 
hypertrophy of the papillary layer of the skin. When the animal 
stands on the foot the claws separate under the pressure of the body 
weight and the condylomata are relieved of pressure. When, however, 
the limbs are rested, the claws mutually approach, compress the 




Fig. 10. — Cond^iloiiiata of lliu iutenligitul space and sidebones. 

abnormal vegetations, flatten, excoriate, and irritate them, thus favouring 
their further development. 

The symptoms are easy to detect. The animals appear in perfect 
health, but have difficulty in walking, and show pain. They walk as 
though on sharp, rough ground, and lameness is sometimes severe. 
Locally, the anterior surface of the claws and the interdigital space 
are markedly congested and sensitive, or painful on pressure. The 
growths are of varying size, isolated or confluent, bleeding, excoriated, 
or covered with horn, and are visible between the claws when the animal 
stands on the limb. In many cases they form a perfect cast of the 
vertical interspace. When the superficial layers have undergone 
conversion into a horn-like material, lameness diminishes or disappears. 

Diagnosis presents no difficulty. 

Prognosis is only grave in so far as the condition interferes with 
animals working, but it may render working oxen entirely useless. 

Treatment in the early stages is of a preventive character, and 
consists in placing animals which have been accidentally injured or 
attacked with foot-and-mouth disease on a perfectly clean bed. 



40 DISEASES OF THE FOOT. 

Surgical treatment is the only reliable method in cases where hyper- 
trophy of the papillary layer is well marked, and is extremely simple. 

The animal should be fixed in the trevis, the foot to be operated on 
separately secured, and the growths completely removed with sharp 
scissors or with a bistoury and forceps. When bleeding has subsided 
the wound is covered with a mixture of equal parts of iodoform, tannin, 
and powdered boric acid, and an interdigital dressing is applied. The 
dressing is removed after five to ten days, according to circumstances. 
If the cicatrix shows signs of exuberant growth it is dusted with 
powdered burnt alum, and the parts are treated as an open wound. 
When the growths are covered with horn and no longer painful it is 
not desirable to interfere with them. 

CANKER. 

Canker — i.e., chronic suppurative inflammation of the podophyllous or 
velvety tissue — is accompanied by hypertrophy of the papilla and pro- 
gressive separation of the horn of the sole. It is much rarer in the ox 
than in the horse, although it occasionally occurs. 

Prolonged retention in dirty stables, where the bedding is mixed with 
manure and continually moistened with urine, is the principal cause of 
the disease. Individual predisposition and the action of some specific 
organism may also have some influence. 

Canker in oxen, like the same disease in horses, is recognised by 
softening and separation of the horn of the sole, and by progressive 
extension of the process towards neighbouring parts. The usual course 
consists in invasion of the podoph^^llous tissue, separation of the wall and 
of the heels, and pathological hypertrophy of the horn-forming tissues, 
producing condylomata. 

The new growths do not attain the same dimensions as in the horse, 
but, on the other hand, the disease very frequently takes a progressive 
course, involving the whole of the claw. A trifling accidental injury may 
be followed by infection of the subungual tissues, and thus become the 
point of origin for canker. 

Canker may attack only one claw ; on the other hand, it may extend 
to both claws of one foot, or to the claws of more than one foot in the 
same animal. 

Diagnosis. Diagnosis is easy. The separation of the horn, the 
presence of a caseous, greyish-yellow and offensive discharge between 
the separated parts and the horn-secreting tissues, the appearance of 
the exposed living tissues, etc., leave no room for doubt. 

Prognosis. The prognosis is grave; for, as in the horse, the disease 
is obstinate. 



PANARITIUM — FELON — WHITLOW. 41 

Treatment consists in scrupulously removing all separated horn, so 
as fully to expose the tissues attacked by the disease. The parts should 
then be thoroughly disinfected with a liquid antiseptic, and a i^rotective 
pressure dressing applied. 

As a rule, cauterisation with nitric acid, followed by applications of 
tar or of mixtures of tannin and iodoform, iodoform and powdered burnt 
alum, etc., effect healing, without such free use of the knife as has been 
recommended in the horse during the last few years. 



GREASE. 

Grease in the ox seems only to have been described by Morot and 
Cadeac, and even in these cases the descriptions appear rather to apply 
to elephantiasis or fibrous thickening of the skin than to grease proper. 
Tbe descriptions are not sufficiently clear, and the symptoms described 
differ too much from the classical type seen in the horse to convince us 
without further confirmation of the occurrence of the disease. 



PANARITIUM-FELON-WHITLOW. 

Any injury in the interdigital space or flexure of the pastern may, 
under unfavourable circumstances, be complicated l)y death of the skin, 
necrosis of the interdigital ligament, of the fibro-fatty cushion in the 
flexure of the pastern, and of the terminal portions of the tendons. 

These lesions are sometimes regarded as panaritium. In reality, 
they correspond exactly to what, in the horse, are known as "cracked 
heels" and " quittor." The primary injury becomes infected with 
organisms which rapidly cause death of the skin or the formation of a 
deep-seated abscess and necrosis of the invaded tissues. 

Causation. Neglect of sanitary precautions and filthy stables con- 
stitute favouring conditions, the feet being continually soiled and irritated 
by the manure and urine. Animals reared on plains, and having broad, 
flat, widely-separated claws, are more predisposed than animals from 
mountainous regions, in which the interdigital ligament is stronger and 
the separation of the claws less marked. Any injury, abrasion, or cut 
may serve as a point of origin for such complications. 

Panaritium may even occur as an enzootic with all the characters 
noted in isolated cases. In Germany it has received the name of "con- 
tagious foot disease." These enzootic outbreaks of panaritium follow 
epizootics of foot-and-mouth disease, with lesions about the claws. 
Through the superficial aphthous lesions the parts become inoculated 
with bacteria, and the severity of the resulting injury is in some 
measure an indication of the virulence of the infecting organism. 



42 DISEASES OF THE FOOT. 

Symptoms. The Ih-sl important symptom consists in intense local 
pain, rapidly followed by marked lameness. The affected region soon 
becomes swollen ; the coronary band appears congested ; the skin of the 
interdigital space projects both in front and behind ; the claws are 
separated, and all the lower portion of the limb appears congested 
and o-dematous. The engorgement usually extends as high as the 
fetlock, and the parts are hard and extremely sensitive. The patient 
is feverish, loses appetite, and commences to waste. After five to ten 
days sloughing occurs at some point — if the ligament is affected, in the 
interdigital space ; if the tendons, or the fibro-fatty cushions, the slough 
appears in the flexure of the pastern. The dead tissue may separate and fall 
away, or remain in position macerated in pus. Separation is generally slow, 
requiring from twelve to fifteen days, and, unless precautions are taken, 
complications occur. If only the interdigital ligament or fibro-fatty 
cushion be necrotic, recovery may be hoped for ; but, on the other hand, 
if the tendons, tendon sheaths, ligaments, or bones are affected, complica- 
tions like suppurating synovitis, suppurating ostitis, arthritis, etc., super- 
vene, with fatal results. Death may occur from purulent infection, unless 
the animal is slaughtered early. 

The diagnosis is easy. The intensity of the lameness, separation of 
the claws, swelling of the pastern region, sensitiveness of the swollen 
parts, and al)sence of lesions in the ungual region sufficiently indicate 
the nature of the condition. 

The prognosis is grave, for complications may result, in spite of 
proper treatment. 

Treatment. Treatment consists, first of all, in thoroughly cleansing 
the affected limb and placing the animal on a very clean bed. The parts 
are next subjected to antiseptic baths containing carbolic acid, creolin, 
sulphate of zinc, or sulphate of copper. It is often more convenient, and 
quite as efficacious, to apply antiseptic poultices to the foot and pastern, 
and to allow them to remain for some days, being moistened several 
times daily with one of the solutions indicated. The effects are: rapid 
diminution of the pain, delimitation of the necrotic tissues is hastened, 
and the abscess is more readily opened. 

Many practitioners recommend early intervention in the form of 
deep scarification in the interdigital space or pastern region. The 
local bleeding, and the drainage which takes place through the wounds 
so made, is said to hasten recovery or to prevent complications. 

When the abscess has opened, and the dead tissue separated, the 
abscess cavity or wound should be regularly washed out with a disin- 
fecting solution, to prevent compHcations, in case fragments of necrotic 
tissue have been retained. If, however, complications have occurred, no 
hesitation should be felt in freely incising the parts, and, if necessary, in 



FOOT ROT. 43 

removing one or both phalanges. When both joints of one foot are 
affected, and arthritis threatens to or has set in, there is no object in 
treating the animal, and early slaughter is to be recommended. 

In cases where the disease follows foot-and-mouth disease, and 
threatens to become enzootic, it can generally be prevented spreading 
by keeping the foot-and-mouth subjects on very clean beds, and 
frequently washing the feet with antiseptic solutions. Disinfection of 
the sheds is also very desirable. 

FOOT ROT. 

Foot rot is a disease of sheep, and, like canker, is confined to the 
claws. 

Thanks to the progress of hygiene, it tends to become rarer, but is 
still seen in the enzootic form in some portions of England and Scotland, 
in the mountains of Vivarais, the Cevennes, and the Pyrenees. 

It affects large numbers of animals at once, animals belonging to one 
flock or to neighbouring flocks in one locality, and when it invades a 
sheep farm, all the animals may successively be attacked at intervals, 
according to the local conditions. 

Symptoms. The disease develops rather insidiously, and the patients 
always retain an excellent appetite. It begins with lameness, which is 
at first slight, later becomes accentuated, and in the last j^eriods is very 
intense. On examination, the coronet and lower part of the limb as 
high as the fetlock are found to be swollen. Palpation reveals exaggerated 
sensibility, and on direct examination, a foetid discharge is discovered in 
the interdigital space. This discharge, which is peculiar to the onset of 
the disease, only continues for a week or two, and is succeeded by a 
caseous exudate which is always offensive, which moistens and macerates 
the horn, the skin, the tissues in the interdigital space, and the region of 
the heels. From the 20th to the 30th day after onset the claw separates 
al)ove in the interdigital space. The separation extends towards the 
heel, then to the toe, exposing ulceration of the subjacent podophyllous 
tissue. 

From this time the patients experience very severe pain, and, as in 
other diseases of the feet, remain lying for long periods. Movement 
becomes extremely painful, and the animals frequently walk on tlie knees. 
The subungual lesions become aggravated, separation of the claw 
extends, necrosis of the podophyllous tissue and of subjacent tissue 
becomes more extensive, and the interphalangeal ligaments and the 
extensor or flexor tendons become involved. Finally, the claws are lost, 
and synovitis and arthritis are added to the complications already existing. 

In an infected locality the development is always the same. The 



44 DISEASES OF THK FOOT. 

animals lose flesh, become anaemic, and, miless vigorously treated, soon 
die. The ordinary duration of the disease is from five to eight months, 
sometimes more. If, however, patients are isolated and well treated 
they recover. 

Causation. The specific cause of foot rot still remains to he dis- 
covered, although everj'thing points to the conclusion that it consists 
in an organism capa])le of cultivation in manure, litter, etc., for foot rot 
is transmissible by cohabitation, by mediate contagion through infected 
pasture, by direct contact and by inoculation. 

The chief favouring influences are bad drainage, filthy condition of 
the folds, and herding in marshy localities. 

Diagnosis. The condition can scarcely be mistaken, for the sheep 
suffers from no other disease resembling it, excepting, perhaps, foot-and- 
mouth disease. 

Prognosis. The prognosis is grave, for the disease usually assumes 
a chronic course, affects entire flocks, and the patients require individual 
attention. 

Treatment. The primary essential to success in treatment consists 
in separating and isolating the diseased animals in a scrupulously clean 
place and providing a very dry bed. 

In the early stages the disease may be checked by astringent and 
antiseptic foot baths. It is then sufficient to construct a foot-bath at the 
entrance to the fold, containing either milk of lime, 4 per cent, sulphate 
of iron, copper sulphate, creolin, etc. Through this the sheep are passed 
two or three times a week. These precautions rarely suffice when the 
feet are already extensively diseased ; and when the horn is separated to 
any considerable extent, surgical treatment is indispensable. All loose 
portions of horn should be removed and antiseptic applications made to 
the parts. 

When a large number of sheep are affected the treatment is very 
prolonged, but it is absolutely indispensable, and the numerous dressings 
required necessarily complicate the treatment. It would be valuable to 
experiment with small leggings, which would retain the dressings in 
position, and, at the same time, shelter the claws from the action of the 
litter, while favouring the prolonged action of the antiseptic. 

When the lesions are not extensive, a daily dressing is sufficient. 

Among the materials most strongly recommended are antiseptic and 
astringent ointments containing carbolic acid, iodoform, or camphor. 
Vaseline with 5 per cent, of iodine is very serviceable, and much to be 
preferred to applications like copper sulphate, iron sulphate, etc. Its 
greatest drawback is its expense. 



CHAPTER III. 

DISEASES OF THE SYNOVIAL MEMBRANES AND 
OF THE ARTICULATIONS. 

I.— SYNOVIAL MEMBRANES AND ARTICULATIONS. 
SYNOVITIS. 

Inflammation of the sj'iiovial membranes, or synovitis, may affect the 
synovial sacs either of the joints or of the tendon sheaths. It may be 
acute or chronic and occur either idiopathically or follow the infliction of 
an injury. Its two chief forms are simple, or "closed," sj^novitis and 
suppurative, or " open," sj-novitis, the essential distinction between which 
is that in the latter micro-organisms are present, whilst in simple 
sj'novitis they are absent. In all cases the disease is characterised by 
distension of the sac affected. 

Synovitis produced by a wound communicating with the outer air 
may be complicated by suppuration, and if the synovial membrane of a 
joint be involved the primary synovitis is almost always followed by 
traumatic arthritis. 

The commonest forms of chronic simple synovitis are : — 

INFLAMMATION OF THE PATELLAR SYNOVIAL CAPSULE. 

Inflammation of the synovial membrane of the femoro-patellar joint 
is most commonly seen in working oxen as a consequence of strains 
during draught. It is also found in young animals which have 
injured the synovial capsule through falls, slips, or over-extension of 
the limb. 

Symptoms. Development is slow and progressive, and injury may 
not l)e discovered until the. lameness which follows has become fairly 
marked. This lesion is characterised by swelling in the region of the 
stifle. On palpation, fluctuation may readily be noted both on the outer 
and inner surfaces of the joint. The exudate is sometimes so abundant 
and distension so great that the straight ligaments, the neighbouring 
Ijony prominences, and the ends of the tendons are buried in the liquid 
swelling. 

Lameness, which is at first marked, often diminishes with exercise. 
The length of the step is lessened. 



46 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Diagnosis. The diagnosis presents no difficulty, but the lesions 
must be distinguished from those due to tuberculosis in this region, 
rheumatic arthritis, and the specific arthritis seen in milch cows. 

The prognosis is grave, for the disease renders animals useless 
for work. 

Treatment. Rest, cold moist applications, and massage constitute 
the best treatment in the early stages. Should swelling persist, one 
may afterwards apply a smart blister or even tap the joint aseptically, 
drawing off the fluid and then applying the actual cautery. Irritant 
injections must be avoided. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE HOCK JOINT. 

Bog Sjxirin in the Or. 

Bog spavin is frequent in working oxen and in oxen from three to 
five years old. It is due lo strain in draught or to strain produced in 
rearing up at the moment of covering. Old bulls, heavy of body, and 
stiff in their limbs are predisposed to it. 

Symptoms. The symptoms usually develop gradually and without 
lameness, but sometimes declare themselves more rapidly with lameness, 
accompanied by marked sensitiveness on palpation. At first the hock 
show^s a generalised doughy swelling, soon followed by dilatation of the 
articular synovial sac. Somewhat later four different swellings appear— 
two in front, separated by the tendons of the common extensor and 
flexor metatarsi, and two at the back, extending inside and outside to the 
flexure of the hock. 

Diagnosis. The only precaution required in diagnosis is to avoid 
confusion with articular rheumatism. "** 

Prognosis. The prognosis is rather grave in the case of working 
oxen, and even of bulls ; often slaughter is preferable to treatment. 

Treatment dift'ers in no respect from that of distension of the stifle- 
joint. In young bulls aseptic puncture and drainage of the joint, 
followed l)y the application of the actual cautery, probably give the 
best results. 

DISTENSION OF TENDON SHEATHS IN THE HOCK REGION. 

Like the preceding, this condition is rarely seen except in bulls and 
working oxen. It is characterised by dilatation of the ui)per portion of 
the tarsal sheath, one swelling appearing on the outer side, the other on 
the inner. 

The differential diagnosis is based on the position of these synovial 
sacs, which are quite close to the insertion of the tendo-Achillis, and on 
the absence of any swelling in front of the joint. 



DISTENSION OF THE SYNOVIAL CAPSULE OF THE KNEE JOINT. 



47 



Treatment is identical with that indicated in the last condition. 

Massage and cold water applications should be employed at first, to 
be fohowed by aseptic puncture and withdrawal of fluid, supplemented if 
necessary by firing in points. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE KNEE JOINT. 

This is one of the rarest conditions now under consideration, because 
the synovial membranes of the knee joint are everywhere strongly 





Fig. 17. — Front view of the ox's 
hock, showing the relations of 
the tendons and synovial sacs. 



Fig. 18. — Side view of the ox's hock. The syno- 
vial sac of the true hock joint has been injected 
to show the relations of the sacs. 



supported by very powerful ligaments. The synovial capsules of the 
carpo-metacarpal and inter-carpal joints are incapable of forming sacs 
of any size. On the other hand, the radio-carpal may become moderately 
prominent in front, especially towards the outside above the superior 
carpal ligament. When weight is placed on the limb, the excess of 
synovia is expelled from the joint cavity towards this little sac, which 



48 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICQLATlONS, 

then becomes greatly distended. If, on the other hand, the knee is bent, 
the sac shrinks or disappears. 

Treatment. Treatment is restricted to the appUcation of a Ijhster or 
to firing in points. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE 
FETLOCK JOINT. 

The synovial capsule of the fetlock joint in the ox is strongly sup- 
ported in front and at the sides, but may protrude under the anterior 
ligament, producing a swelling behind the metacarpus under, the five 
branches of division of the suspensory ligament and slightly below the 
sesamoid bones. These distensions, like bursal swellings, are commoner 
in hind limbs and in old working oxen. Their development is always 
followed in time by a certain degree of knuckling over. At first the 
metacarpus and phalanges come to form a straight line, but later the 
fetlock joint itself is thrust forward. 

The diagnosis necessitates careful manual examination of the region 
of the fetlock joint. 

The prognosis is somewhat grave, for the disease sooner or later 
necessitates the destruction of certain animals. 

Treatment is practically identical with that used in all such con- 
ditions : friction with camphorated alcohol, cold affusions and massage 
in the earlier stages, followed if needful by blisters or firing in points. 

DISTENSION OF TENDON SHEATHS. 

Distension of the synovial capsule which surrounds the superior 
suspensory ligament, like distension of the articular capsule of the 
fetlock, occurs in working animals, and most commonly affects the front 
limbs. It is indicated by two swellings, one situated on either side of 
and behind the branches of division of the suspensory ligament and in 
front of the flexor tendons. These two swellings extend higher than the 
articular swellings, which, however, they sometimes accompany. The 
surface of the fetlock is then swollen, doughy on pressure, and some- 
what painful. 

These enlargements may produce more or less marked lameness and 
cause knuckling. 

The diagnosis is clear from local examination. 

The prognosis is unfavourable, as the animals after a time become 
useless for work. 

Treatment. The beginning of the disease may often be cured by 
balhs of running water, combined with massage. At a later stage, local 
stimulants, blisters, or firing are necessary. The best treatment 



TEAUMATIC SYNOVITIS — "OPEN SYNOVITIS." 49 

probably consists in puncturing the parts with antiseptic precautions, 
washing out the synovial cavity with an antiseptic, and immediately 
afterwards lightly firing the surface of the region in points. 

DISTENSION OF TENDON SHEATHS IN THE REGION 
OF THE KNEE. 

Any of the numerous tendon sheaths which facilitate the gliding of 
tendons in the neighbourhood of the knee may become ■ inflamed 
and give rise to a chronic synovial swelling. The commonest of 
such swellings is due to distension of the sheath of the extensor 
metacarpi' magnus, which appears as a vertical line in front of the 
knee, extending from the lower third of the forearm and slightly to 
the outer side of the central line. This synovial enlargement arises in 
oxen working on broken roads, in clay or marshy soils, where the 
animals are liable to stick fast, and are often obliged to struggle 
vigorously in order to extricate themselves. 

The diagnosis is based on the position and direction of the dilated 
synovial sheath. 

Treatment is identical with that of other cases of chronic synovitis. 

DISTENSION OF THE BURSAL SHEATH OF THE FLEXOR 
TENDONS. 

This condition is rare. It is announced, as in the horse, by a 
dilatation of semi-conical form, the apex of which is situated opposite the 
lower margin of the carpal sheath, the base extending as high as the 
infero-posterior third of the radius. 

The dilatation is more marked on the inner than on the outer side 
of the limb. 

Distension of the synovial sheath of the common extensor of the 
digits in the fore limb and of the extensor of the external digit is still 
rarer than the preceding conditions. 

TRAUMATIC SYNOVITIS-" OPEN SYNOVITIS." 

^Yhen an injury in the neighbourhood of a joint penetrates deeply, it 
may implicate either the synovial sheath of a tendon or the synovial 
membrane of a joint. If the body inflicting the wound is aseptic, a 
condition which in accidental wounds is rare, the wound may have no 
grave consequences. Usually, however, the body producing the injury 
is infected, and the infection rapidly extends throughout the tendon 
sheath or synovial sac. In the first case, traumatic suppurating synovitis 
of a tendon sheath is the result ; in the second, a suppurating articular 
synovitis arises, which soon becomes complicated with injury of the 
articular cartilages, ligaments, etc. (traumatic arthritis). 

D.C. E 



50 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

The primary lesion maj' oiil}^ affect the periarticular region, not 
directly extending to the synovial membranes, and only after an interval 
of some days may symptoms of suppurating synovitis or suppurating 
arthritis appear, in consequence of progressive invasion of the parts by 
specially virulent microl)es. 

TRAUMATIC TENDINOUS SYNOVITIS. 

Suppurative inflammation of the synovial bursffi of tendons in conse- 
quence of wounds most commonly affects the sesamoid sheaths of the 
front or hind limbs ; more rarely, the tendon sheaths of the hock or 
knee ; and, exceptionally, the small synovial sheaths of the extensors of 
the metacarpus and phalanges, etc. 

Such inflammation follows injuries with forks, harrow teeth, or any 
sharp foreign body. It is characterised by the existence of a fistula or 
wound, indicating the course taken by the body inflicting the injury, 
from which at first normal synovia escapes. Later, however, the 
discharge becomes turbid, and after the second day gives place to a 
clotted, serous, or purulent fluid. 

A diffuse, oedematous, warm, painful swelling very rapidly develops 
around the injury. The animal is more or less feverish and lame. The 
swelling soon extends throughout the entire length of the infected 
synovial sheath. The patient loses appetite, and unless treatment is 
promptly undertaken, complications supervene which often necessitate 
slaughter. The prognosis is always grave. 

Treatment. Continuous irrigation has long been recommended. It 
is worthy of trial, but in the majority of cases occurring in current 
practice it cannot be carried out. 

Moussu prefers a form of treatment which he claims has always 
succeeded in horses and oxen — viz., irrigation of the parts, followed by 
injection of sublimate glycerine solution. 

He first washes out the infected synovial cavity with boiled water 
cooled to 100° Fahr. A counter-opening may become necessary, and 
the washing should be continued until the escaping water appears 
perfectly clear. Immediately after each such irrigation he injects from 
7 to 14 drams of glycerine containing 1 part in 1,000 of corrosive 
sublimate. He repeats this treatment daily. 

By reason of its affinity for water and for the liquids in the tissues or 
suppurating cavities into which it is injected, the glycerine penetrates 
in all directions, reaching the finest ramifications of the synovial sacs, a 
fact which explains its superiority over aqueous antiseptic solutions. 

Suppuration is rapidly checked and repair becomes regular. The 
pain and lameness progressively diminish, and recovery may be complete. 



TRxVUMATIC ARTICULAR SYNOVITIS — TRAUMATIC ARTHRITIS. 



It is advisable to assist this internal antiseptic treatment by external 
stimulants and by the use of a blister. Solutions of greater strength 
than 1 part of sublimate to 500 of glycerine are only required during the 
first few days of treatment and until suppuration diminishes. Later, 
they prove irritant, and interfere with healing. 

TRAUMATIC ARTICULAR SYNOVITIS-TRAUMATIC ARTHRITIS— 
"OPEN ARTHRITIS." 

It has been described above how primary inflammation of the 
articular synovial membrane 
produced by a wound may 
rapidly develop into sup- 
purating arthritis. 

Symptoms. The pain is 
very marked at the moment 
when the accident occurs, 
but this pain, due to the 
mechanical injury inflicted, 
diminishes or completely dis- 
appears after some hours. 
Soon, however, synovial dis- 
charge sets in, announcing 
the onset of traumatic syno- 
vitis. At first limpid, it 
soon becomes turbid, then 
curdled, and finally grumous, 
purulent and greyish in 
colour. 

Pain then returns, rapidly 
becomes intense, continuous 
and lancinating. It produces 
lameness, sometimes so severe 
that no weight whatever can 
be borne on the limb. A 
difl'use, oedematous, warm and 
extremely sensitive swelling 
then rapidly develops around 
the whole of the injured joint. 

General disturbance, with fever and loss of appetite, appears, indicating 
a ver}^ alarming condition. 

It is sometimes a little difficult to differentiate between this condition 
and that due to injury of a tendon sheath, Init as a rule diagnosis is easy. 

Prognosis is very grave. Life is threatened, and wasting occurs very 

E 2 




/ 



V 



^i 



Fig. 19. — Suppurative arthritis of the fetlock. 



)2 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



rapidly. Infection of the synovial membrane is soon followed by 
necrosis and erosion of the articular cartilages, as well as by softening 
and inflammatory change in the ligaments, etc. 

Treatment. Should the patient be in reasonably good condition, but 
otherwise of no particular value, it should at once be slaughtered. If, on 
the other hand, it possess a special value, and the owner wish to preserve 

its life, the same antiseptic 

' ' ^'-*^ treatment should be adopted 

£] ;; \, , as was indicated in dealing 

' "y""'^' ' with suppurating synovitis of 

tendon sheaths. The loss of 
the articular cartilage of the 
joint is followed by free granu- 
lation and union of the apposed 
surfaces of bone resulting in 
anchylosis of the joint and 
qualified recovery. Such re- 
sults, however, are only likely 
to follow in relatively light 
animals which are capable of 
standing for considerable 
periods. 

II.— STEAINS OF JOINTS. 

When, in consequence of 
muscular contraction or ex- 
ternal violence, the bony sur- 
faces constituting a joint are 
displaced so as to stretch, 
lacerate, or partially tear the 
ligaments, synovial capsule or 
tendons supporting the joint, 
so-called sprain, or strain, or 
wrench results. The articular surfaces are not sufficiently displaced to 
cause luxation, but a series of periarticular injuries result, and are 
followed by the symi^toms which we recognise as those of strain. Joints 
in Avhich movement is restricted within narrow limits, such as the hock 
or fetlock, are most liable to such injuries, which also occur in very freely 
movable articulations like the shoulder and stifle. 




Fig. 20. — Suppurative art! iritis following 
traumatic osteo-periostitis. 



STRAIN OF THE SHOULDER. 

This accident is produced by the animal falling on its side, by slipping 
at the moment of landing, the limb being extended and in contact with 



STRAIN OF THE KNEE, o3 

the ground, by the foot shpping at the moment when it is leaving the 
ground and the Hmb is at its extreme Kmit of backward extension, by 
side shps, etc. The periarticular lesions will then be found on the 
front, back, or internal surface of the articulation, depending on the 
manner in which the accident has occurred. According to some authors, 
violent muscular efforts, as well as work in soft clay soil, bogs and rice 
swamps, are also capable of causing strain of the shoulder. 

Symptoms. At first moving appears difficult, the patient lies down 
a great deal, then lameness becomes characteristic. Movement of the 
scapulo-humeral joint being painful, the patient endeavours as far as 
l^ossible to avoid it ; the limb is advanced stiffly in an abducted position 
and with a mowing movement. This semi-circular movement avoids 
the necessity of flexing the scapulo-humeral angle, but diminishes the 
length of the stride. 

Locall}^ the region of the scapulo-humeral angle is swollen, doughy, 
and extremely sensitive on manual examination. If the practitioner 
endeavours to flex it by lifting the limb the animal flinches. 

Diagnosis. The diagnosis is not very difficult, although the peculiar 
mowing movement is also seen in other cases, such as cracked heels and 
mallenders. 

Prognosis. The prognosis is favourable, for, provided there has been 
only a moderate strain of the tendons or isolated injury to the muscles, 
recovery is almost certain. 

Treatment. Treatment consists in resting the animal and in 
assisting repair. 

The parts can be immobilised by the application of a vesicant or 
mild blister. A week or ten days later dry friction, muscular and peri- 
articular massage are indicated, and gentle exercise should be commenced. 
The same treatment may be employed in strain of the ell)ow joint and 
in strains of muscles or tendons in the neighbourhood of joints. Such 
lesions are, however, very rare in the ox. 

STRAIN OF THE KNEE. 

Strain of the knee is commoner in the ox than in the horse, because of 
the special conformation of the knee in the ox and the mode of working 
under a yoke. This mode of working gives less individual liberty to the 
fore quarters, and sometimes interferes with the animal's efforts when 
moving a load. Strains of ligaments and periarticular injuries occur as 
a general rule on the inner side of the limb. 

The symptoms consist in lameness, exaggerated sensibility on pressure, 
pain on forced flexion of the knee, and swelling of the entire periarticular 
region. 

The prognosis is somewhat serious in working oxen. 



54 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Treatment, when applicable, should consist of stimulant dressings, 
massage, and douches. 

STRAIN OF THE FETLOCK. 

This is one of the commonest accidents of draught oxen. 

Causation, Working on rough, irregular, rocky ground, or on roads 
with deep ruts, is the commonest cause of this condition. When the 
animal moves on irregular surfaces the two claws do not hear an equal 
share of weight ; sometimes the whole weight is for a moment thrown 
on one claw. 

The phalanges, therefore, are displaced inwards or outwards, or are 
twisted around their vertical axis, causing the fetlock joint and its sup- 
porting ligaments to he more or less severely strained. The internal or 
external ligaments of the joint or the suspensory ligament or flexor 
tendons may even he lacerated. 

The fetlock may also he strained by the animal making violent efforts 
to free the claws or pastern which have become fixed in a hole in the 
ground, in bogging, in hobbling, or in leaping a fence. 

Symptoms. Lameness is noticeable from the beginning, but is 
unaccompanied by any visible lesion. On examination of the limb, the 
entire region from the fetlock downwards is found to be sensitive to 
pressure, and painful when forcibly extended or flexed from side to 
side. This sensitiveness is particularly marked when the phalanges are 
rotated on the shank. A few days later the entire fetlock becomes the 
seat of diffused swelling. 

Diagnosis is facilitated by the fact that the fetlock has an entirely 
different appearance from that seen when tendon sheaths or the synovial 
capsules of joints are distended. 

Prognosis. The prognosis varies considerably, according to the extent 
to which deep-seated structures are involved, and the gravity of the 
lesions is usually proportioned to the intensity of the symptoms. 

Treatment. Frequent cold applications, cold foot baths for an hour 
or two night and morning, and even cold poultices are useful. When 
the pain has somewhat diminished, which usually occurs in from three 
to four days, vesicants may be employed, and, at a later stage, massage. 
Failing improvement by these methods, the injured region may l)e fired 
in points. 

Strain of the hind fetlock occurs under precisely similar conditions to 
those al)ove descrilied in the case of front limbs. 

STRAIN OF THE STIFLE JOINT. 

Strain of the stifle joint results from over-extension of ligaments 
without displacement of the patella, and also (and probably more 



STRAIN OF THE HOCK JOINT. 55 

frequently) from injuries to the aponeurosis and tendons of insertion of 
the abductor muscles of the femur and tibia. 

Causation. Strain of the stifle may follow violent collisions, such as 
occur in entering or leaving the stable, from falls on rough ground, from 
direct blows, from slips, etc., or even from the sudden and violent 
contraction of the muscles of the antero-external surface of the quarter. 

Symptoms. Lameness follows immediately or soon after the accident, 
and is of a peculiar character ; to avoid using the injured joint, the 
animal advances the hind limb with a mowing movement. 

The injured region exhibits diffuse inflammatory swelling, which 
impedes palpation, and makes it difiicult to determine the exact nature 
of the local lesion. The thigh at the stifle is painful. 

Diagnosis and prognosis. Diagnosis presents no considerable diffi- 
culty. The prognosis must be based on the intensity of the symptoms, 
and becomes grave if the tendons or aponeurotic insertions be injured, 
or extensive damage have been done to ligaments. 

Treatment. At first, continued cold applications, douches, and 
massage are most useful ; blisters are more effective in the grave cases, 
and comprise not only the ordinary blisters, but the powerful mixed 
blister containing tartar emetic, powdered hellebore, bichromate of 
potash, etc. If for any special reason it is of importance to preserve 
the animal's life, the parts may be fired ; but for economic reasons it 
is usually better to fatten it for the butcher. 



STRAIN OF THE HOCK JOINT. 

Causation. Strain of the hock joint is commonest in j'oung oxen 
which are being trained to work. Their hind quarters are necessarily 
more or less free, and the animals are apt to make side movements to 
avoid the goad, thus exposing the hock to irregular strain. 

The internal ligaments are more frequently strained than the external, 
a fact due to the conformation of the hocks. 

Symptoms. Strain is accompanied by lameness, most marked when 
the animals endeavour to turn, by exaggerated sensibility of the entire 
hock region, and, in grave cases, by subcutaneous oedema. 

Diagnosis and prognosis. Diagnosis is simple. The prognosis is 
sometimes grave, because a spavin or a permanent chronic enlargement 
of the capsule of the true hock joint may form. 

Treatment. It is often desirable at once to apply an extensive 
blister over the whole hock and to supplement this at a later stage by 
cold applications, or by continuous cold irrigation for half an hour or 
more both night and morning. 

In exceptional cases the use of the actual cautery becomes necessary. 



5G DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

III.— LUXATION OF JOINTS. 

Luxation consists of permanent displacement of the bony surfaces 
forming a joint, and may follo^Y violent mechanical injury or any 
other cause. 

Luxations have been divided into congenital, i.e., such as exist from 
the time of birth ; spontaneous, i.e., those which result from some defect 
of conformation or constitution ; and acquired or accidental, which occur 
as results of falls, wounds, accidents, etc. 

From the point of view of their duration, luxations are termed 
temporary when they do not necessitate reduction, progressive when 
the tendency is towards greater and greater displacement of the surfaces, 
or permanent when reduction is impossible. 

Those commonest in bovines are luxations of the femur, luxation of 

the patella, femoro-tibial luxation, and luxation of the scapulo-humeral 

joint. 

LUXATION OF THE FEMUR. 

Luxation of the head of the femur with displacement beyond the 
cotyloid cavity is very frequently congenital. The condition also occurs 
with some frequency in adults or aged animals in consequence of 
relaxation of the articular ligaments and the absence of the subpubic 
ligament (pubio-femoral ligament). 

Causation. Luxation may be congenital, the head of the femur 
being displaced backwards and carried above the cotyloid cavity. This 
form is of no jjractical interest, because the animals are not usually 
reared. More frequently in young or adult animals it assumes the 
spontaneous progressive form, in consequence of degenerative changes in 
and relaxation of the coxo-femoral interosseous ligament. The head of 
the femur presses on the upper margin of the cotyloid cavity, which it 
injures, and eventually becomes lodged in the neighbourhood of the neck 
of the ilium, in the great sciatic notch. 

This luxation is also found as a purely accidental occurrence in 
animals which have suffered from falls and from slipping of the hind 
limbs backwards or sidewards, as occasionally follows awkward leaping 
movements. The slipping outwards of the limbs, which causes this form 
of luxation, is comparatively easy, because of the absence of the pubio- 
femoral ligament. The accident may also be followed merely by 
subluxation, that is to say, tearing of the inner portion of the capsular 
ligament and rupture of some portion of the adductor muscles of the 
thigh without rupture of the interosseous fibres, the head of the femur 
not quitting the cotyloid cavity. This accident occurs in stables with 
smooth, slippery floors, and in railway trucks. It may affect one side 
or both. The latter condition is exceptional. 



LUXATION OF THE FEMUR. 57 

Finally, luxation may be either complete (in which case the capsular 
and interosseous ligaments are both ruptured) or incomplete. In the 
former case, the head of the femur becomes displaced upwards and 
forwards towards the great sciatic notch, more rarely backwards in the 
direction of the ischium, and in exceptional cases downwards and 
inwards below the pubis into the foramen ovale. 

Symptoms. The symptoms vary, depending on whether the luxation 
is of the spontaneous, progressive order or, on the contrary, is accidental. 
In progressive luxation, the animals are able to rise and walk with 
difficulty. The affected limb swings when the animal is advancing, not 
as though it were paralysed, but simply as though displaced at its upper 




Fig. 21. — Accidental luxation of the hip joint. 

part. Pain is exhibited when weight is placed on the limb, and there is 
difficulty in movement. The limb appears shorter than its neighbour 
when the animal stands on it, and the prominence representing the 
trochanter is more marked. When a false joint has formed, the limb is 
rigid, is moved stiffly and abducted, and the stride is shortened. 

In accidental luxations, either of one or both limbs, the attitude 
assumed by the animal is often characteristic. One of the limbs is ex- 
tended at right angles to the longitudinal axis of the body, and some- 
times both limbs assume this position, an attitude which would be 
absolutely impossible under normal conditions. The animal cannot 
rise. It lifts the front part of the body by rising on its knees, but the 
hind quarters do not follow. The ruptured adductor muscles are unable 
to bring and hold the limb parallel to the longitudinal axis of the body ; 
the abductors act unopposed, and at the moment when the animal makes 



58 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

its greatest ell'ort to rise the limb (or liml)s) is carried outwards and the 
body comes to the gromid on the udder or groin. 

Inspection discovers a depression where the great trochanter should 
be. On appl^'ing the open hand over the hip joint, whilst an assistant 
who grasps the pastern moves the limb in different directions, one can 
feel and hear, in spite of the mass of muscle covering the part, a modified 
crepitation due to sero-sanguinolent effusion in and around the joint. 
This crepitation can also be detected by pushing the hand as high up as 
possible on the internal surface of the thigh, and thus exploring the 
neighbourhood of the luxation. 

Diagnosis. The position which the animal assumes when one 
endeavours to make it rise is characteristic. Diagnosis of progressive 
luxation, however, is more difficult. 

Prognosis. The prognosis is extremely grave ; for, even though 
reduction can be effected, one is practically unable to ensure that the 
parts shall remain in position. 

Treatment. Treatment comprises reduction of the luxation and 
fixation of the parts. Eeduction can be effected without very much 
difficulty by casting the animal on the affected side, placing a block 
of wood, or a pail, between the thighs, and manoeuvring the limb 
in the desired direction. Ah, however, subluxation is the condition 
most commonly seen, there is frequently no reduction to effect. More- 
over, fixation of the joint after reduction is almost impossible in such 
heavy subjects, and luxation is very liable to recur. From an economic 
standpoint, slaughter is advisable or imperative. 

LUXATION OF THE PATELLA. 

Luxation of the patella is not uncommon in working oxen, and is 
occasionally seen in cows as the result of a slip when entering or leaving 
the byre, the reason being the peculiar anatomical arrangement of the 
femoro-patellar articulation. 

The internal lij) of the trochlea of the femur is very high, the external, 
on the other hand, being only slightly developed. The patella itself is 
smaller than that of the horse, and possesses a small cartilaginous 
prolongation, principally on its inner face, in marked contrast with the 
large cartilage found in the horse. As in the latter animal, the out- 
ward displacement of the patella is only prevented by the internal patellar 
ligament and the femoro-patellar aponeurosis. Under the influence of 
varying causes to which the joint is exposed, these supporting structures 
often prove insufficient to prevent the patella being displaced outwardly. 

Causation. From an anatomical standpoint, luxation inwards seems 
impossible. It certainly must be very rare and be preceded by rupture 
of the external ligament. On the other hand, as in the horse, it seems 



LUXATION OF THE PATELLA. 59 

l^ossible that the patelhi may be caught on the summit of the internal hp 
of the trochlea, especially if the trochlea happens to present a flattening 
at that point. 

Outward luxation may be spontaneous or accidental. It is termed 
spontaneous, when produced by relaxation of the ligaments of attachment 
or by irregular muscular action ; accidental, when resulting directly from 
any external mechanical cause. Violent contraction of the triceps cruralis, 
by lifting the patella beyond its normal limit of travel, helps, or at least 
permits, the patella to be displaced outwardly at the moment when the 
muscle relaxes. 

Pathological relaxation of the ligaments and muscles, b}^ allowing the 
patella to descend too far on the trochlea, also renders displacement 
possible, hence spontaneous luxation sometimes occurs even while the 
animal is at rest in the stable. This luxation is certainly only of a 
temporary character, or perhaps only of the nature of subluxation, and 
is often reduced by mere muscular contraction when the animals are 
forced to move. 

Should the hind limb slip in a backward direction the angle of the 
joint becomes more obtuse and the lips of the trochlea are turned down- 
wards, thus greatly favouring lateral displacement of the patella, which 
under these circumstances is no longer immobilised on the trochlear 
pulley ; displacement outAvards then occurs, constituting the condition 
termed luxation. 

Various forms of mechanical violence, like blows, collisions of the stifle 
with the jambs of doors, falls, etc., may also bring about this luxation. 

The symptoms of fully-developed accidental luxation are charac- 
teristic. Immediately the accident occurs, the limb is immobilised in a 
state of complete extension ; neither the stifle nor the hock joint can be 
flexed, and only the fetlock joint retains any degree of mobility. 

Movement is very difticult. The hind limb appears rigid, as though 
formed of one bone. The pastern is directed backwards and dragged 
along the ground, and when weight is placed on the limb the anterior 
surface of the pastern may almost be in touch with the ground. The 
limb is advanced, but the foot cannot be placed properly on the ground. 

Locally the patella is found to be outside the external lip of the 
trochlea, and its internal ligaments are extremely tense. 

If the luxation is spontaneous and of muscular origin, or a consequence 
of relaxation of the tendons, it is usually noticeable immediately the 
animal leaves the stall. The animal cannot move without great difiiculty. 
It grows steadily worse with the lapse of time, because the synovial mem- 
brane becomes irritated and chronic arthritis is set up. 

The symptoms are identical with those of traumatic luxation, but are 
only temporary. 



60 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Diagnosis. The position of the hmb and the displacement of the 
patella are sufficiently distinctive to render diagnosis fairly easy, and to 
allow of this accident being differentiated from luxation of the femoro- 
tibial joint or hooking of the patella in the ischio-tibial muscle. 

Prognosis. The prognosis varies greatly. If the luxation is of 
traumatic origin and the accompanying symptoms are not grave, reduc- 
tion may be followed by permanent recovery. On the other hand, in 
spontaneous luxation recurrence is almost inevitable. 

Treatment. The indications for treatment may be comprised in a 
single phrase : reduction, with immobilisation of the parts for a suffi- 
cient time. To effect reduction, a strip of webbing is fixed around the 
pastern of the affected limb, passed over the withers, in front of the 
shoulder of the opposite side, and brought round in front of the neck or 
between the front limbs. By means of this an assistant exercises strong 
traction on the limb until the fetlock is raised as high as the elbow of the 
same side. The operator then applies strong inward pressure to the 



Fig. 22. — Bandage for luxation of the patella. 

patella, which usually slips back on to the gliding surface of the trochlea 
at the first or second effort. 

After-treatment comprises the application of a smart blister, produc- 
ing oedematous infiltration of all the tissues around the joint, and thus 
impeding movement and recurrence of luxation. For this purpose various 
preparations are used — e.g., cantharides, biniodide of mercury, croton 
oil, etc. It is also advisable to fix the animal so that for a time it cannot 
lie down, and to secure the pastern to the neck by means of a side-line. 

As an experiment, cases of simple fixation of the patella on the summit 
of the internal lip of the trochlea might be treated by Bassi's method — 
i.e., subcutaneous division of the internal lateral ligament of the patella 
which holds the bone in its abnormal position. 

Finally, in spontaneous luxation, occurring in young animals in which 
blisters have been inefi'ectually tried after reduction, Benard's bandage 
may be used, though it is not generally regarded as very practical. It 
consists of a piece of cloth of elongated lozenge form about four feet 
in length, six inches in breadth at its centre and two inches at its ends. 
Its centre is pierced by a transverse opening intended to surround 
the patella, and carries a loop for the purpose of supporting the turns of 
bandage. A second longitudinal opening is situated about eight inches 
from the centre. 



LUXATION OF THE FEMORO-TIBIAL ARTICULATION. 



61 



Eeduction being effected, the whole region of the stifle joint is covered 
with Burgundy or ordinary pitch and the bandage then appHed. The 
patella projects through the central opening. The end A is passed 
backwards around the thigh, and through the aperture B ; the two cross 
ends are then brought forward, crossed again at the end, the loop over 
the patella carried a second time backwards, again crossed, and finally 
fixed in front under the patella. The bandage should be firmly applied, 
without, however, being so tight as to interfere with circulation, and must 
be left in place from eight to ten days. 

Van Denmoegdenberg recommends placing the patient on an inclined 
plane, with the hind quarters a foot higher than the front, so as to cause 
permanent contraction of the anterior muscles of the quarter, and thus 




Fig. 23. — Backward luxation of the feiiioro -tibial joint, 
by Professor Besnoit.) 



(From a photograph 



immobilise the patella. Simple cold baths, frequently repeated, friction 
with camphorated alcohol or essence of turpentine, complete this original 
but somewhat questionable treatment, and are said to result in recovery 
in a fortnight. 



LUXATION OF THE FEMORO-TIBIAL ARTICULATION. 

This form of luxation is rare, a fact explained by the strength of the 
lateral ligaments of the joint, and of the cruciform interosseus ligaments. 
It may assume different forms, according as the head of the tibia is dis- 
placed in front of, behind, to the inside, or to the outside of the lower 
extremity of the femur. In all, therefore, it may appear in four different 
forms. The commonest is backward luxation. 



62 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



Causation. AVitli the sole exception of luxations or subluxations 
due to tuberculosis (lateral luxations, either inwardly or outwardly, 
occurring during tubercular arthritis, Avith more or less marked destruction 
of the condyles), these luxations are always accidental or the result of 
mechanical violence. 

They result from leaping into hollows, falling into deep ditches or 
ravines, or galloping through broken or steep places. Any violent shock 
affecting the femur, either in front or from the outside, is capable of 
causing luxation l)ackwards or inwards. 

Symptoms. The most frequent condition is backward luxation of the 
upper extremity of the tibia. Movement becomes difficult, the limb 
is held rigidly, and all the lower part of the 
leg is extended. None of the joints can be 
flexed. The leg is dragged forward, without 
the animal being able to place the foot flat on 
the ground, and the claws are trailed over the 
litter or the toe grazes the soil. 

On local examination the stifle is seen to be 
deformed. The lower extremity of the femur 
and the patella appear prominent. The upper 
part of the tibia is thrust backwards, and seems 
to have disappeared, leaving a depression below 
the femoro-patellar region. The muscles form- 
ing the back of the thigh at this level are 
thrust out of position, and appear to project 
abnormally. 

Yiewed from behind, the inner line of the 
thigh appears more or less convex when the 
upper extremity of the tibia is luxated inwardly. 
On local examination the displacement of the 
bones can be readily detected. In luxation 
forwards the prominence of the stifle is caused by the summit of the 
tibial crest and by the patella, whilst the lower extremity of the femur 
cannot be felt. In outward luxation the upper extremity of the tibia 
forms an abnormal prominence, above which a horizontal digital 
depression appears. 

Diagnosis. Provided that the examination is made soon after the 
occurrence of the accident, little difficulty will be found in coming to a 
conclusion, but the diagnosis necessitates more care when examination is 
deferred for two or three days, because extensive efi'usion then exists. 
Luxations or subluxations of tuberculous origin are generally consecutive 
to old-standing destructive tuberculous arthritis. 

The prognosis is grave — firstly, because reduction is difficult; and. 




Fig. 24.— Luxation back- 
wards and inwards of the 
femoro-tibial joint. (From 
a photograph by Professor 
Besnoit.) 



LUXATION OF THE SCAPULO-HUMERAL JOINT. 63 

secondly, because it is often impossible to maintain the reduction and to 
preserve complete immobilisation of the injured joint. 

Treatment should not l)e undertaken except in young animals which 
have not yet attained full development. 

In attempting to reduce outward or inward luxation of the tibia the 
animal should be cast on the side opposite to the lesion. Counter- 
extension is practised by passing a length of webbing around the limb in 
the region of the groin ; extension in the direction of the length of the 
femur by means of a loop of webbing fixed to the cannon bone : the 
operator uses both hands in endeavouring to replace the head of 
the tibia. 

In forward luxation of the tibia counter- extension is effected by 
means of a loop of webbing passed above the hock and drawn forward. 
Extension is made backwards in an oblique direction, the operator again 
being left free to effect reduction with both hands. 

Eeduction of backward luxation of the tibia is still more difficult, in 
consequence of the contraction of the mass of muscle at the back of 
the thigh. 

Plaster bandages are the most convenient means of immobilising the 
parts after reduction. 

LUXATION OF THE SCAPULO-HUMERAL JOINT. 

This luxation, like that of the femoro-tibial articulation, is exceptional. 
It may assume one of two forms, depending on whether the head of the 
humerus is displaced inwardly, or towards the back of the glenoid cavity ; 
but as a rule luxation occurs inwardly. Forward luxation of the head 
of the humerus is almost impossible, in consequence of the resistance 
offered by the tendons of the flexor brachii and antea spinatus muscles. 
Similarly, luxation outwards is very difficult, the tendon of the postea 
spinatus being very powerful and offering enormous resistance. 

Inwardly, on the other hand, the insertion of the subscapularis is 
much less powerful, and there is no real opposition to movement of the 
head of the humerus. 

Causation. Violent meclianical shocks transverse to the upper third 
of the arm may, by sheer force, displace the head of the humerus in an 
inward direction, causing rupture of the internal wall of the capsular 
ligament and of the subscapularis muscle. Jumping from high to low 
ground and falling on the front limbs tend to displace the glenoid cavity 
in front of the head of the humerus, and often result in luxation of the 
bone in a backward direction, a luxation, however, which almost always 
assumes a postero-internal direction. The commonest causes of these 
luxations are the sideward falls of animals which have attempted to 



61 DISEASES OF THE SY.VOVIAL MEMBRANES AND ARTICULATIONS. 

cover others. Whether the subject be a bull or a cow, if the stationary 
animal suddenly moves to one side, or if the moving animal is frightened 
by the appearance of a dog, one of the front limbs may be violently 
dragged away from the body ; the resistance of the capsular ligament 
and internal muscles of the shoulder may be overcome and luxation 
produced. 

Symptoms. Symptoms are immediately apparent : no weight can be 
placed on the injured limb, and the animal moves on three legs. All 
muscular action is avoided, the limb is slightly shortened as a conse- 
quence of the head of the humerus slipping behind the shoulder, which 
is held rigidly during movement ; the points of the claws are dragged 
along the ground. 

On local examination the point of the shoulder appears to be deformed 
and outwardly displaced, in consequence of the pressure exercised by the 
displaced head of the humerus. Below the glenoid cavity and coracoid 
process lies a depression, at the base of which the displaced humerus 
can be felt. This depression, however, is soon filled up by the sero- 
sanguinolent effusion consequent on luxation. 

Diagnosis. Bearing in mind the conditions to which the accident is 
due, the diagnosis presents no great difficulty. 

Prognosis. The prognosis is grave, for although it is relatively easy 
to reduce the displacement, it is very difficult to keep the joint fixed 
in position. 

Treatment. To effect reduction, the animal should be cast on the 
sound side, and a loop of webbing passed under the arm, in order to 
provide for counter-extension. The limb is extended by direct traction 
on the cannon bone or fetlock, whilst the operator endeavours to effect 
reduction with one hand placed in front and one behind the joint. 

In young animals of trifling weight immobilisation may be attempted, 
the best method being the application of pitch plasters. If, on the other 
hand, the subject is heavy, there is so great a chance of displacement 
when lying down and rising, that such cases are usually sent to the 
butcher, or abandoned to chance. Eelative recovery, sufficient to permit 
of growth or fattening, may take place without professional assistance. 

IV.— HYGEOMAS. 

Hygromas result from chronic inflammation of serous bursfe, naturally 
existing, or of serous burspe which form at prominent points where the 
skin is exposed to repeated friction, blows, shocks, or over-extension. 

They usually develop slowly, without producing marked pain or 
alarming symptoms, and therefore the practitioner is seldom consulted 
until the swelling has attained a considerable size. 



HYGROMA OF THE KNEE. 



65 



The hygroma is usually characterised by its non-painful character 
and by regular fluctuation throughout. The walls of the serous bursas 
are merely thickened, so that palpation is easy. 

Should the hygroma become infected and inflamed, it assumes the 
same characters as an abscess : it becomes highly sensitive, is surrounded 
by oedematous infiltration, shows more marked fluctuation at some 
specialised point, and eventually breaks, discharging pus. 

Long-standing hygromas often have thickened fibro-cartilaginous 
and extremely hard walls, which render 
examination more difficult. 

Where the hygroma is much exposed 
to friction the skin covering it undergoes 
complete transformation, the layers of 
epidermis becoming converted into a 
substance resembling horn. The entire 
substance of the wall of the hygroma then 
undergoes change, and is often infiltrated 
with lime salts or encrusted with plates of 
bone of varying thickness. 

HYGROMA OF THE KNEE. 

This condition is very common in 
bovines, a fact explained by the manner 
in which these animals rise. Whilst the 
hind limbs are being lifted, the entire 
burden of the body weight is transmitted 
to the knees and the tissues covering them ; 
so that, if the ground is rough, the skin may 
be sufficiently displaced to produce lacera- 
tion of the subcutaneous connective tissue, 
serous efl'usion in the layers of connective 
tissue, and the immediate production of 

an hygroma beneath the skin and in front of the synovial sheaths of 
the extensor tendons. 

Hygroma is principally caused by falls on the knees, roughness of the 
stable floor, prolonged decubitus during the course of a serious disease, 
or after an attack of foot-and-mouth disease. 

Hygromas may be no larger than a turkey's egg or a man's clenched 
fist, but sometimes assume the dimensions of a child's head. Calcifica- 
tion and ossification of the walls and cornification of the skin are 
commonest in old hygromas of the knee. 

The sensibility and uniform fluctuation make mistakes in diagnosis 

D.C. F 




Fig. 25. — Old-standing hygroma 
of the knee. PE, external coat; 
CC, cornified coat ; CO, osseous 
coat ; CP, pus cavity ; PI, internal 
coat. 



()(j DISEASES OF THE SYNOVIaL MfeMBRAiNES AM) ARTlCULATtONS. 



difficult. The condition can only- be confused with distension of the 
synovial sheath of the extensor metacarpi magnus ; but this (synovial) 
swelling extends in the same direction as the tendon, i.e., vertically, 
attains the lower third of the radius, and is broadest above. Hygromas 
must also be distinguished from tumours. Moussu only mentions a 
single case of this kind, the tumour l)eing very slightly l)Osselated and, 
naturally, revealing no fluctuation. 

The prognosis is not grave, though the condition may prove trouble- 
some, because the original injuries may be continued even during treat- 
ment and prevent recovery. 

Treatment. Success rarely follows 
cold applications or l)listering, which 
are only of value at the commence- 
ment. It is better to puncture the 
cavity aseptically, remove the fluid 
contents, and fire the grow^th in points. 
Free opening of the lowest portion of 
the swelling is followed by discharge 
of liquid, but almost inevitably by iur 
fection at a later stage, and by suppu- 
ration. Eecovery certainly may occur, 
a slight thickening of the anterior 
surface of the knee remaining ; but 
the process is often very prolonged. 
Home authors prefer to pass a seton or 
drain vertically through the swelling. 
The results are identical with those 
following free opening and drainage, 
suppuration being unavoidable. 

If the animal be sufficiently valu- 
able to warrant surgical intervention, 
the entire hygroma, together with its 
indurated wall, may be excised. An 
elliptical fragment of skin is removed from the front of the swelling, and 
the whole mass .separated by dissecting away or tearing through the connec- 
tive tissue. Considerable care is necessary to avoid injuring the synovial 
sheaths of the extensor tendons. This treatment, which is only applicable 
in valuable animals, is completed by firmly suturing the lips of the w^ound, 
and applying an antiseptic surgical dressing or a plaster bandage similar 
to that used in operating on broken knees in horses.* The animal must 
be prevented from lying down until the wound has firmly united. 

* See Dollar's "A Surgical Operating Table for the Horse." (London: Gay 
and IHrd.) 




Fig. 26. — Hygroma of the knee. The 
skin has undergone conversion into 
a substance resembling horn. 



Hygroma of the stifle. 67 

HYGROMA OF THE HAUNCH. 

With the exception of hygroma of the knee, hygromas are commoner 
on hind than on front Hmbs. That of the haunch is Hmited to the 
external angle of the ilium. It follows violent falls or collisions with 
door posts, and results from laceration of the layers of subcutaneous 
connective tissue and separation of the skin from subjacent parts. 

The effusion is often of a sero-sanguinolent character. It is more 
frequent in animals occupying narrow or irregularly shajDed stalls, the 
hygroma being developed through repeated collision of the angle of the 
haunch with the wall. Finally, it may follow prolonged decubitus. 

Diagnosis is easy, but the prognosis has a certain element of gravity, 
because, should suppuration occur, it may be succeeded by necrosis of 
the aponeurosis inserted into the external angle of the ilium. 

Treatment should first be directed to removing the cause. Of the 
various modes of intervention, the best probably consists in disinfecting 
the parts, puncturing the swelling, and injecting some irritant of an 
antiseptic character, or simply washing out the cavity. Iodine and 
carbolic solutions are most commonly employed. Firing is contra- 
indicated. 

HYGROMA OF THE TROCHANTER OF THE FEMUR. 

This condition is rare, except in thin milch cows kept under bad 
hygienic conditions and insufficiently supplied with bedding. Continual 
bruising of the prominences of the quarters whilst the animal is lying 
is the usual cause. 

This hygroma forms a hemispherical swelling covering the trochanteric 
prominence. Movement is interfered with, and the stride is shortened. 

The condition can only be confused with the diffuse swellings due to 
periarthritis in the coxo-femoral region, which frequently occur in cows 
suffering from infectious pseudo-rheumatism. 

The prognosis is somewhat grave, for in case of suppuration the 
insertions of tendons and fascia into the summit of the trochanter may 
become necrotic. 

Treatment. The first point is to supply the animal with ample clean 
bedding. The swelling may be repeatedly blistered. If considered neces- 
sary, a puncture may be made under antiseptic precautions, the fluid drawn 
oft', and the cavity washed out ; but it is better to avoid opening the parts 
with a bistoury, on account of the danger of suppuration and of necrosis 
of the tendons and aponeurotic tissues in the neighbourhood. 

HYGROMA OF THE STIFLE. 

Hygroma of the stifle or of the patella appears under the skin, outside 
the external ligament of the femoro-tibial articulation. It usually follows 

F 2 



OS DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



repeated abrasion when l^'ing do\Yn, especially if the paving of the stalls 
is rough or irregular. 

The swelling varies in size from a hen's egg up to that of a child's 
head, and exhibits fluctuation throughout. 
' The prognosis is somewhat serious, for 

liere again complications may result from 
necrosis of neighbouring aponeuroses. 

Some authors recommend passing a seton 
dressed with some irritant material through the 
swelling. Aseptic puncture, however, seems 
preferable, followed by washing out of the 
cavity and the application of a blister. 

HYGROMA OF THE POINT OF THE 
HOCK. 




This hygroma usually results from blows 
with the ox-goad, which cause inflammation 
of the subcutaneous connective tissue and 
oedematous infiltration extending down the leg. Afterwards the slightest 



Fiu. 27. — Capped hock. 




Fig. 28. — Hygroma of the point of the sternum. 



injury, or even the friction due to the animal lying down, causes liquid 
to collect and an hygroma to form. 

This hygroma is readily infected and often suppurates ; it then 
becomes very sensitive, producing intense lameness. More frequently, 
however, under the influence of prompt treatment, the liquid is 



HYGROMA OF THE POINT OF THE STERNUM. 69 

absorbed, the layers of subcutaneous connective tissue become hardened, 
and undergo more or less extensive induration. 



HYGROMA OF THE POINT OF THE STERNUM. 

Hygroma of the point of the sternum is a rarity. It only occurs 
in thin animals in which the jjoint of the sternum is prominent, and 
which are confined to stables with rough floors and provided with 
insufficient bedding. 

The swelling should not be opened, for the tissues in front of the 
sternum readily become the seat of suppuration. 

If treatment is desirable, the fluid may be drained off by means of an 
aseptic puncture. 



CHAPTER IV. 
DISEASES OF MUSCLES AND TENDONS. 

RUPTURE OF THE EXTERNAL ISCHIO-TIBIAL MUSCLE 
(BICEPS FEMORIS). 

The l)iceps femoris muscle extends from the superior spinous process 
of the sacrum to the region of the patella and the external surface of 
the thigh, Ahove, it is inserted into the sacrum and the posterior 
margin of the ischium, helow into the supero-external surface of the tibia. 
It completely covers the coxo-femoral articulation, and its passage over 
the summit of the trochanter is lubricated by a serous bursa. The whole 
of its anterior margin is connected with the fascia lata by an aponeurotic 
expansion. From varying causes this aponeurotic layer may become 
fissured ; during the backward and forward movements of the limb the 
summit of the trochanter may enter the fissure and become fixed there 
l)y the tension and resistance of neighbouring tissues. This accident 
has been descrilied as " displacement or rupture of the biceps femoris 
muscle." 

According to Cruzel, fixation of the biceps femoris may occur, in very 
thin animals, without rupture of the musculo-aponeurotic layer, the 
process being then simply confined to stretching of the aponeurotic layer 
over the summit of the trochanter. Under such circumstances the 
musculo-aponeurotic layer presents a cup-like depression, into which the 
summit of the trochanter fits, and thus effectually prevents movement of 
the muscle. 

Whether the accident is due to an actual fissure, or only to stretching 
of the aponeurosis, the symptoms are the same. 

Causes. The principal predisposing causes are thin condition and 
malformation of the limbs (turning outward of the hind toes). 

The accident may occasionally be caused by a slip backwards, or by 
extreme efforts in draught when ascending hills. 

Symptoms, hnmediately the accident occurs the liml) becomes fixed 
in a position of maximal extension. The trochanter being caught, the 
femur can no longer be flexed, and the lower joints are also fixed in 
such a way that the limb can only be moved as a whole. The claws 



RUPTURE OF THE EXTERNAL ISCHIO-TIRIAL MUSCLE (BISCEPS FEMORIS). 71 

are dragged along the ground, and the affected limh, which can never be 
completely advanced, is brought forward with a mowing movement. 

On local examination, the trochanter appears to be very prominent, 
and situated directly above a rigid cord which extends parallel with 
the anterior margin of the affected muscle. 

If the accident consists merely in the formation of a depression in 
the muscle, in which the summit of the trochanter is fixed, and if there 
is no Assuring, the muscle and the femur are certainly immobilised, but 




Fig. 29. — Arrangement of the external ischio-tibialis muscle. 1, Anterior 
margin of the muscle ; 2, fascia lata. 



the limlj can be moved to a certain extent, the " mowing " movement is 
less marked, and there is no well-defined rigid cord along the anterior 
margin of the muscle. 

Diagnosis. The condition can only be confused with luxation of the 
patella ; l)ut manual examination of the affected parts revealing the 
presence of a rigid cord l)elow the trochanter at once removes any 
doul)t. 

Prognosis. The prognosis is only grave in working animals. More- 
over, the accident is . now much rarer than formerly, if only because 
animals are better looked after and better fed. 

Treatment. If the accident results simply from the formation of a 
depression in the musculo-aponeurotic layer which replaces the muscle 



72 DISEASES OF MUSCLES AND TENDONS. 

at the point where it passes over the trochanter, there is nothing to be 
done. Eeduction will occur spontaneously, and entire liberty of action 
will be regained. Cruzel states that it is sometimes sufficient to force 
the animal to move down a slope, in order to withdraw the trochanter 
from the depression in which it has been lodged, and to restore its 
normal mobilit}-. 

Eest and good feeding favour the deposition of fat, and soon alter 
the conditions responsible for the accident ; the muscles of the quarter 
become surrounded with fat, the external ischio-tibial muscle (biceps 
femoris) is thrust outwards on account of its superficial position, and 
then cannot be ruptured by the summit of the trochanter. If, on the 
other hand, the musculo-aponeurotic layer is fissured and the summit of 
the trochanter firmly fixed in the opening, oj^eration becomes necessary. 
This consists in incising the anterior margin of the muscle over the 
afore-mentioned rigid cord. The margins of the wound retract, the 
tension of the cord is diminished, the trochanter released, and the 
normal play of the limb restored. 

Numerous methods of operation have been described and a numl)er 
of special instruments invented. The earlier methods consisted in simple 
sul)cutaneous section of the rigid cord formed by the musculo-aponeurotic 
layer and the muscle. Subcutaneous section is carried out exactly like 
tenotomy, using straight and curved tenotomes. The seat of operation 
is about three inches below the summit of the trochanter. In the 
absence of tenotomes, section may be performed with a bistoury intro- 
duced from below the muscle by means of a grooved director, which has 
been inserted through a cutaneous puncture made at the point indicated 
over the anterior margin of the prominent cord. 

In better nourished subjects, in which this cord is less prominent, 
the operator may, to ensure greater accuracy, make a vertical incision 
an inch or two in length at the point selected over the anterior margin 
of the muscle, isolate this muscle by means of the director; and after- 
wards perform the section. Considerable hfemorrhage occasionally 
follows division of some small muscular vessel, but is of no consequence 
unless the wound has been infected. 



RUPTURE OF THE FLEXOR METATARSI. 

The rupture of this tendon-muscle is exceptional, and, according to the 
description given by Furlanetto, is attended by the same symptoms as in 
the horse — i.e., flexion of the stifle joint is not accompanied by flexion of 
the hock or of the metatarsus on the til)ia. The cannon-bone hangs 
vertically when the liml) is moved. 

Eecovery follows prolonged rest. 



CYSTICERCITS DISEASE OF THE PIG. 



73 



Wounds and sections of tendons in the region of the cannon bone, 
sections of the tendo-AchiUis, etc., have been seen and described. All 
such injuries may heal under antiseptic treatment and after aseptic 
suture of the divided ends, provided the sutures and dressings are applied 
immediately. If, on the other hand, suppuration, infection, necrosis 
of tendons, synovitis or arthritis occur as complications, such injuries 
become extremely serious, and from an economic standpoint render it 
better to sacrifice the animal rather than attempt treatment. 

Strains of tendons and tendinitis occur in the front limbs of oxen, 
particularly of those used in carts. The chief indications are swelling in 
the region of the cannon bone and fetlock, uneven contour of the flexor 
tendons, sensibility on pressure, and lameness of varying intensity. 

Treatment consists in continuous cold irrigation, massage, the 
application of a blister or even of the actual cautery. As a rule, how- 
ever, it is better to rest and fatten the animal. 

A frequent complication of such injuries of tendons consists in 
knuckling over at the fetlock. 

PARASITIC DISEASES OF MUSCLES. 



INFECTION WITH CYSTICERCI. 

Infection of the connective and muscular tissues with cysticerci 
results from the entry into the body of embryos of Tcenia soliiun and 
Tcenia saginata of man. It occurs in man and almost all animals, but 
is only of grave clinical importance in the pig and ox. 

The following table shows the chief cystic (cestode) parasites of animals, 
though the cysts are not always confined to muscular structures : — 



Adult. 


Larva. 


Xame. 


Host. 


Nam p. 


Ho.st. 


Tcmiia saginata 
Tcenia solium . . 
Tcenia marginata . 
Tcenia ccenurus 
Tcenia ecliinococcus 


Man 
I\Ian 
Dogs 
Dogs 
Dogs 


Cijsticercus hovis . . . 
Cysticercus cellulosce . 
Cijsticercus tenuicollis . 
Ccxnurus cerebralis . . 
Ecliinococcus polymor- 
l)hus 


Cattle. 

Swine and man. 
Cattle, sheep, and swine. 
Cattle and sheep. 
Cattle, sheep, swine, man, 
etc. 



CYSTICERCUS DISEASE OF THE PIG. 

This disease of the pig is due to Cysticercus ceUidosce, the cystic form 
of the Tcenia solium or Tcenia armata of man. As a disease of the pig 
it has been recognised from the most ancient times, and is stated to be 



74 DISEASES OF MUSCLES AND TENDONS. 

the cause of Moses and Mohammed having prohibited the consumption 
of pork by their disciples. In the Middle Ages it formed the subject of 
legislation. It was, however, only when the investigations of Van Beneden 
and Kuchenmeister had completed those of the zoologists of the seven- 
teenth and eighteenth centuries that the evolution of taeniae became well 
known and the importance of the cystic phase clearly established. 




ric )0— \ piece ot poik 
heiMh infected with, poik 
me isles {Cysticncus idUi 
losa) wxiwixX ^i/e. (Stiles 
Kepoit L S \ Buiciu of 
Voucnltuic 1901 ) 




Fig. 31. — An isolated pork-measle bladder woiiu (Ci/sticcrcus 
ceUulos(c), with extended head, greatly enlarged. (Stiles, 
Report U.S.A. Bureau of Agriculture, 1901.) 



Causation. The cause of cysticercus disease in the pig ma}' be 
summed up in one phrase — viz., ingestion of eggs or eml)ryos of T<enia 
soUnm. 

Young animals alone seem to contract the disease. . After the age of 
eight to ten months they appear almost entirely proof against it. 

It is very rare in animals reared in confinement, but is relatively 



CYSTICERCUS DISEASE OF THE PIG, 



75 



common in those roaming at liber t}' 
to discover human excrement and 
the embryos of taenia. The eggs 
having been swallowed, the six- 
hooked embryos are set at liberty 
in the intestine, perforate the 
tissues, enter the vessels, and are 
carried by the blood into all parts 
of the body. Those alone develop 
well which reach the interstitial and 
intermuscular connective tissue. 
The others in the viscera usually 
disappear. Their presence in the 
.depths of the muscles produces 
slight general disturbance and 
signs of local irritation, due to 
the development of the cyst itself. 
At the end of a month the little 
vesicle is large enough to be visible 
to the naked eye ; in forty to forty- 
five days it is as large as a mustard 
seed, and in two months as a grain 
of barley. Its commonest seats are 
the abdominal muscles, muscular 
portions of the diaphragm, the 
psoas, tongue, heart, the muscles 
of mastication, intercostal and cer- 
vical muscles, the adductors of the 
hind legs, and the pectorals. 

Symptoms. The symptoms of 
invasion are so little marked as 
usually to pass undetected. Occa- 
sionally, when large quantities 
have been ingested, signs of en- 
teritis may occur, but these are 
generally ascribed to some entirely 
different cause. In some cases there 
is difficulty in moving, and the grunt 
may be altered. 

Certain authors declare that 
the thorax is depressed between 
the front limbs, but this symj^tom 
is of no particular vaUie, and is 



because tliey are mucli more likely 

M 




Fig .5'2. -Se\ei.il poitioiis ot .m adult 
porlv-iiieasie tapeworm (Tccnia soltinn), 
natural size. (Stiles, Report U.S.A. 
BureaiT of Agriculture, 1901.) 



70 



DISEASES OF MUSCLES AND TENDONS. 




Fig. 33. — Large (a) and small (b) hooks of 
pork-measle tapeworm {Tcvnia solium). 
X 280. (After Leuckart.) 



also common to osseous cachexia and rachitis. Paralysis of the tongue 
and of the lower jnw is of greater importance. In exceptional cases, where 
the cj'sticerci are very numerous and penetrate the hrain, signs of 
encephalitis, vertigo, and turning sickness (gid, sturdy) may he produced. 
These signs, however, disappear, and the cysticerci undergo atrophy. 
Interference with movement may give rise to suspicion when the toes of 

the fore and hind liml)S are 
dragged along the ground, and 
thus hecome worn. This pecu- 
liarity is due to the presence 
of cysts in the muscles of the 
limhs, hut it occurs in an al- 
most identical form in osseous 
cachexia. 

One symptom alone is 
pathognomonic, and it appears 
only at a very late stage — viz., the presence of cysts under the thin 
mucous membranes which are accessil)le to examination, such as those 
of the tongue and eye. 

Visual examination then reveals 
beneath these mucous membranes 
the presence of little greyish-white, 
semi-transparent grains the size of 
a grain of barley, or even larger. 
Unfortunately, in an animal so diffi- 
cult to handle as the pig, this visual 
examination is decidedly troublesome, 
and is usually replaced by palpa- 
tion. In many instances the disease 
does not attract attention during the 
patient's life, and is only discovered 
on slaughter in consequence of the 
lesions by which it is characterised. 
Diagnosis. As the characteristic 
lesions of cj'sticercus disease are 
to be found in the depths of the 
muscular and connective tissues, and 
as the external symptoms may be regarded as of doul)tful significance, 
the diagnosis can only be confirmed during life by manual examination 
of the tongue. This examination of the tongue has been practised since the 
earliest times. Aristophanes even speaks of it, and in the Middle Ages 
it was performed under sworn guarantees. The regulations concerning 
the inspection of meat have finally led to the suppression of this calling. 




Fig. 34. — Mature sexual segments of 
pork-measle tapeworm ( Trt'mrt soUtnii), 
sliowing the divided ovary on the pore 
side. cp, Cirrus pouch ; gp, genital 
pore ; n, nerve ; ov, ovary; t, testicles ; 
tc, transverse canal ; iif, uterus ; v. 
vagina ; vc, ventral canal ; vd, vas 
deferens ; vf/, vitellogene gland, x 10. 
(After Leuckart.) 



CYSTICERCUS DISEASE OF THE PIG. 



77 



In this method of exammmg the tongue, the operator commences by 
throwmg the animal on its side, usually on the right side, and holding 
it in this position by placing his left knee on its neck. He then passes 
a thick stick between the Jaws, and behind the tusks, opens the mouth 
obliquely, raising the upper jaw by manipulating the stick. Finally he 
fixes one end of this last by placing his foot upon it, and holds the 
other extremity by slipping it under his left arm. In this position he 
is able to grasp the free end of the tongue and by digital palpation to 
examine the tongue itself, the gums, the free portions of the fraenum 
lingufe, etc. 

If he discovers cysts, the diagnosis is confirmed, but failure to do so 




Fig. 35. — Gravid segment of pork-measle tapeworm [Tienia 
soZt«;«), showing the lateral branches of the uterus enlarged. 
(Stiles, Report U.S.A. Bureau of Agriculture, 1901.) 



by no means disposes of the possibility of infection. Eailliet declares 
that about one animal in four or five shows no cysts beneath the tongue, 
and, moreover, fraud is possible in this connection, it being quite possible 
to prick the little cysts with a needle so that the liquid contents escape, 
and examination gives no positive result. For these reasons intra-vitam 
examination alone is now discounted, and the chief reliance is placed on 
post-mortem search. 

Prognosis. The prognosis is very grave, not on account of danger to 
the lives of the infected, but because infected meat may be offered for 
human consumption. Should such meat, in an insufficiently cooked 
condition, be eaten by man, its ingestion is followed by the development 
of Td'nia soUiuJi. If cooking were always perfect it would destroy the 



^8 



DISEASES OF MUSCLES AND TENDON'S. 



cysticerci 




but the luicertaiiity in this respect should prevent such meat 
being consumed. The cysticerci are killed at 
a, temperature of 125° to 130° Fahr. 

Lesions. The lesions are represented by 
cysts alone — i.e., by semi-transparent l)ladders, 
each of which contains a scolex or head armed 
with four suckers and a double crown of hooks. 
The little bladders are most commonly found 
in the muscles, lodged in the interfascicular 
tissue, which they slightly irritate. 

The number present varies extremely, 

depending on the intensity of infestation and 

the number of eggs swallowed. Whilst in 

to discover, in others 



Fig. 36. — Eggs of pork- 
ineasle tapeworm {Tcenia 
solmvi) : a, with primi- 
tive vitelline membrane ; 
6, without primitive vitel- 
line membrane, but with 
striated embrj-ophore . 
X 450. (After Leuckart.) 

some cases difficult 
they are so numerous that the tissues 
ap2)ear strewn with them. 

They are commonest in the muscles 
of the tongue, neck, and shoulders, in 
the intercostal and psoas muscles, and in 
those of the quarter. 

The viscera — viz., the liver, kidneys, 
heart, lungs, etc. — are less commonly in- 
fested, and in these organs the cysts 
degenerate very rapidly. In animals 
which have been infested for a long time, 
the cysts may even have undergone caseo- 
calcareous degeneration, the liquid being 
absorbed and the lesions presenting the 
ajDpearance of little oblong firm nodules. 

On cutting through masses of muscle 
the vesicles protrude from between the 
bundles. 

In young animals, infestation with 
cysticerci causes wasting and ill-health; 
subsequently the patients improve in 
ajipearance, later on fatten, and gain 
marketable condition. 

Of the carcases examined in Prussian 
slaughter-houses between 1876 — 8t2, one 
in every 305 was found infested ; between 
1885 — 1)3, one in every 537. 

Treatment. There is no curative treat- 
ment. Only preventive measures are of 




Fi(i. o7. — Half of hog, showing the 
portions most likely to become 
infested with pork measles. 
(After Ostertag.) 



BEEF MEASLES. 



Id 



value. These are confined to rendering it ini})0SHil)le for animals to ingest 
eggs of the Tcenia solium. 

Cysticercus disease is rare in the north, centre, and east of France, 
and in districts where animals are reared in confinement. It is commoner 
where pigs are at liberty, such as Limousin, Auvergne, and Perigord. It 
is frequent in North Germany, where the custom of eating half-cooked 
meat contributes to the propagation of Tcenia solium. It is also frequent 
it Italy. 

BEEF MEASLES. 

Causation. The disease of beef measles is due to the penetration 



m 




M^M-' 







j\i:^ 



Fig. 38. — Cysticercus ccUnloscc in pork, c. Cysts; v, fibrous 
tissue capsule wbicli forms around the cyst. 



into the connective and muscular tissues of embryos of the Tcenia scuji- 
nata, or unarmed teenia of man. 

This disease, unlike that of the pig, has only been recognised 
within comparatively recent times, and only after Weisse's experiments 
(St. Petersburg, 1841) on feeding with raw^ flesh was attention drawn to 
it, although as early as 1782 the Tcenia saginata had been described by 
Goeze. 

Measles in the ox is rarely seen in France, but is common in North 
and East Africa. Alix has found it in Tunis, Dupuys and Monod in 
Senegal, and it is common in the south of Algeria. The disease is due 



80 



DISEASES OF MUSCLES AND TENDONS, 



simply to oxen swallowing eggs or embryos of the unarmed tsenia, a 
fact which explains the frequency of the disease in places where the 




Fig. 39. — Anatomy of the Cysticercus celluloscB (after Robin). A, Cyst; 
B, scolex with hooks ; C, hooks ; D, magnified fragment of cyst. 

inhabitants are of nomad habits, and consequently disregard the most 
elementary rules of public and general hygiene. 

Furthermore, cattle in the Sahara, in Senegal and in the Indies, 

have a very marked habit of eat- 
ing ordure, and as no attempts are 
made to prevent it, the risk to these 
animals is greatly increased. 

As in the pig, the embryos 
which reach the stomach and intes- 
tine penetrate into the circulatory 
system, and are thereby distributed 
throughout the entire organism. 

The development of the cysti- 
cercus is complete in forty days, 
and if swallowed by man in infected 
meat after this period it again gives 
rise to the Tcenia saginata. 

The age of the animals seems of 

less importance than in the case 
Fia. 40 -Section of a beef tongue heavily ^^ ^^^^ ■ ^^^, ^^^ ^^^^^ ^^^^.^^ 

mfestecl with beet measles, natural size -^ '=' ■ ■, n i • 

(Stiles, Annual Report U.S.A. Bureau l^'^ve seen cases ot beef measles ni 
of Agriculture, 1901). animals of ten years old. 




BEEF MEASLES. 



81 



Symptoms. The 

symptoms are still less 
marked than in the pig, 
and in ordinary cases of 
infection always escape 
observation. Stiles, how- 
ever, gives the following 
account of a case experi- 
mentally infected : — 

"Symptoms. Four 
days after feeding seg- 
ments of T. saginata to 
a healthy three-months- 
old calf, the patient 
showed a higher tem- 
perature (the normal 
temperature was 39'2" 
C). The calf ate but 
little on that day, showed 
an accelerated pulse, 
swollen belly, staring- 
coat, and upon pressure 
on the sides showed signs 
of pain. The next day 
the animal was more 
lively, ate a little, and 
for nine days later did 
not show any special 
symptoms except pain 
on pressure of the abdo- 
minal walls, and a slight 
fever. Nine days after 
the infection the tem- 
perature was 40"7° C, 
pulse 86, respiration 22 ; 
the calf laid down most 
of the time, lost its ap- 
petite almost entirely, 
and groaned consider- 
ably. When driven it 
showed a stiff gait and 
evident pain in the side. 
The fever increased 

D.C. 




82 



DISEASES OF MUSCLES AND TENDONS. 



gradually, and with it the feebleness and low-spiritedness of the calf, 
which now retained a recumbent position most of the time, being 
scarcely able to rise without aid, and eating only mash with ground 
corn. Diarrhoea commenced, the temperature fell gradually, and on the 
twenty-third day the animal died. The temperature had fallen to 
38-2° C. During the last few days the calf was unable to rise ; in fact, 
it could scarcely raise its head to lick the mash placed before it. Pulse 
was reduced by ten beats. On the last day the heart-beats were very 
much slower, yet firm, and could be plainly felt. Several days before 

death the breathing was laboured, and 
on the last day there was extreme 
dyspnrea." 

Diagnosis. In forming a diagnosis 
we meet with the same difficulty as in 
the case of the pig. It is always easy 
to examine the tongue ; but when 
visible lesions are absent diagnosis in 
the case of the ox remains doubtful 
and problematical even more than in 
the pig. 

In the carcase, diagnosis is much 
easier. The cysts are sought for, 
as in the pig, by making sections of 
muscle, those usually selected being 
the pterygoid, cervical, cardiac, and 
psoas muscles, and those of the 
quarters. 

Prognosis. The prognosis is grave, 
not indeed for the infected animals, 
which seem little injured by the para- 
site, but for human beings, who run 
the risk of contracting Tcenia iiwrmis 
V)y eating insufficiently-cooked meat. 
A temperature of 115° to 120° Fahr. destroys the cysticerci, but in 
roast meats the central temperature of the mass always remains below 
this figure. 

Salting for fifteen to twenty days destroys the vitality of the parasite. 
Lesions. The lesions are confined to the presence of the cyst and 
of two little zones of chronic inflammation immediately surrounding it. 
Unless heavily infested the subjects fatten just as well as others. 

The vesicles are semi-ti-ansparent, y\ inch to ^ inch in length, slightly 
ovoid in form, and contain a taenia head with four suckers, but without 
hooks. 




Fig. 42.— Apex, dorsal, and lateral 
views of the head of beef-measle 
tapeworm {Tcenia saginata), show- 
ing a depression in the centre of the 
apex. X 17. (Stiles, Report U.S.A. 
Bureau of Agriculture, 1901.) 



BEEF MEASLES. 



83 



In seven to eight months the cysts undergo degeneration, the Hquid 
is absorbed, and calcium salts are deposited throughout the mass. The 
lesions which remain have, in the ox, the appearance of interstitial 
disseminated tuberculosis. 

There is no curative treatment. The infested animal recovers spon- 
taneously with the lapse of time, for the cysticerci undergo degenerative 
processes, but the flesh of such animals is of little commercial value. 

From a preventive standpoint we can only hope to improve matters by 
a gradual and progressive change in social and public hygienic conditions. 

When the life of the nomad shall have been entirely replaced by 
that of the highly-civilised European and private hygienic precautions 




Fig. 43. — Sexually mature segment of beef-measle tapeworm {Tcenia 
saginata). c.x>., Cirrhus pouch with cutIius ; d.c, dorsal canal; 
fjT.jj., genital poi-e ; 7i., lateral longitudinal nerves; ov., ovary; 
s^/., shell-gland; ^., testicles ; ?t^., median uterine stem, enlarged (in 
part after Leuckart) ; v., vagina ; v.c, ventral canal, connected by 
transverse canal ; tc, vd., vas deferens; vg., vitellogene gland. 



have rendered it impossible for animals to obtain access to segments or 
eggs of the Ttenia saginata, beef measles will disappear. 

At present, in the countries where the disease is common, one 
experiences a feeling of astonishment that it is not far more frequent; 
for experiment has shown that a person infected with one unarmed 
tapeworm expels with the fpeces an average of four hundred proglot- 
tides per month, each proglottis or segment of the worm containing 
about 30,000 eggs, each of which is capable of developing into a 
tapeworm. 

G 2 



84 



DISEASES OF MUSCLES AND TENDONS. 



Beef measles is rather common in Germany, but rare in France, 
Switzerland, and Italy. 

TRICHINIASIS-TRICHINOSIS. 

Trichinosis is a disease caused hy the entrance into the body of the 
Trichina spiralis. This parasite is swallowed in the larval form, and 
undergoes sexual changes in the intestine, at first producing intestinal 
trichinosis, which represents the first phase in the development of the 
disease. 

The trichinte breed rapidly. The embryos penetrate into or are 
directly deposited in the blood-vessels, which convey them to all parts of 




Fig. 44. — Gravid segmeut of beef- 
measle tapeworm [Tcenia sagi- 
nata), showing lateral branches 
of the uterus, enlarged. (Stiles, 
Annual Report U.S.A. Bureau 
of Agriculture, 1901.) 




Fig. 45. — Egg of beef-measle tapeworm 
{Tcenia saginata), ^\•ith thick egg-shell 
(embrvophore"), containing the six- 
hooked embryo (oncosphere), enlarged. 
(After Leuckart.) 



the body, thus setting up the second phase of the disease, known as 
muscular trichinosis. 

Trichinosis as a disease has long been recognised. Peacock in 1828 
and J. Hilton in 1832 mentioned the existence of the cysts of trichinae ; 
Owen in 1H35 gave the name of Tridiina spiralis to the parasites con- 
tained in the cysts. Trichinosis being common in Germany at that time, 
A'irchow and Leuckart undertook its investigation, but mistook other 
nematodes of the intestine for the Trichina spiralis. In 1847 Leydy 
recognised that trichinosis occurred in American pigs. 

In 1860 Zenker found muscular and intestinal trichinosis on post- 
mortem examination of a girl who had been suspected of suffering from 
tyi)hoid fever, and a carefully conducted inquiry revealed the fact that 



TKICHINIASIS — TRICHINOSIS. 



85 



this girl had some time previously eaten a quantity of raw ham. Virchow 
and Leuclcart returned to their investigations, and the life liistory of the 
parasite soon hecaine definitely known. 

Causation. Trichinosis is capable of attacking all mammifers with- 
out exception, from a man to a mouse ; and most animals which can be 
made the subjects of experiment contract the disease in varying degrees. 

The intestinal form is seen in l)irds, but the muscles do not become 
infested by the embryos. 

Cold-blooded animals are proof against the disease. 

After the ingestion of meat containing cysts of the parasite, the 
processes of gastric and intestinal digestion set the larvse at liberty. 
These larvae become sexual at the end of four 
to five days, and the females, which are usually 
twice as numerous as the males, begin laying 
eggs from the sixth day, continuing for a 
month to six weeks. Each female lays 
approximately from 10,000 to 15,000 eggs. 
The embryos perforate the intestinal walls, 
pass into the circulation, and are hurried into 
all parts of the system. This period of infes- 
tation constitutes the first phase of the disease. 

Askanazy, in 1896, suggested that it was 
not the embryos which perforated the intes- 
tinal walls and thus reached the blood-vessels, 
but the fertilised female trichinae themselves, 
which entered the terminal chyle vessels and 
laid their eggs directly within them. 

This observation is of great interest, for 
it contradicts the view held by Leuckart and 
proves that treatment is useless even in the 
first phase. 

The males are about J^ inch in length, the females J inch to .jV inch, 
and are ovo viviparous. 

Symptoms. The symptoms lack precise character, even when the 
disease is known to be developing, and moreover they have only been 
carefully observed in experimental cases. As soon as the laying period 
begins, signs of intestinal disturbance may be observed, possibly due to 
embryos perforating the intestinal walls (if we accept Leuckart's view), or^ 
according to Askanazy, to adult females penetrating the chyle vessels and 
disturbing intestinal absorption. 

These symptoms are only appreciable in cases of " massive " infesta- 
tion. If shght, the disturliance passes unperceived. In severe cases 
the symptoms consist of diarrhcea, loss of appetite, grinding of the teeth, 




Fig. 46. — Male trichina from 
the intestine. (Colin.) 



86 



DISEASES OF MUSCLES AND TENDONS. 



abdominal pain in the t'orni of dull colic, and sometimes irritation of the 
peritoneum. The embryos carried by the circulation then escape into 
the tissues and, like the cysticerci, become encysted, preferably in the 
muscles, in the interfascicular connective tissue towards the ends of the 
bundles. Each (asexual) parasite plays the part of a foreign body, 
causing infiltration of serum and exudation of leucocytes in its neighbour- 
hood, and soon l)ec()ming encysted in the interior of a little ovoid space 
surrounded by a libro-fatty Avail. Fat granules accumulate at each end 
of the cyst. 

The' parasite, which at iirst appeared straight, soon assumes a bent 
form, then that of a figure " C),"" then of a figure " B," and preserves a 





48. — Tnchiiiie encys- 
ted in the nuisciilar 
tissue. (Colin.) 



ri({. 49.— Old (degene- 
rated) trichina cyst. 

(Colin.) 



latent vitality throughout the entire period of encystment. These cysts 
are of very small dimensions, invisible to the naked eye, and their 
disct)very necessitates the use of the microscope. They are about (j^^tli 
inch in length and j^„th inch in width. Very frequently two or three 
cysts may be found arranged in line, presenting the appearance of 
beads on a string : more rarely two parasites may be found in one cyst ; 
exceptionally, as many as six or seven. The appearance of " beads on a 
string " is due to the fact that the parasites follow the interfascicular 
capillaries. 

In anim^vls which are kept for a long time and fattened the cyst walls 



TRICHINIASIS — TllICHINOSTS. 87 

undergo fatty infiltration. The change is commonest in pigs. In the 
same way calcareoui-' infiltration sometimes occurs, but only when the 
parasites have lost their vitality. This calcareous degeneration consists 
in the deposit of carbonate and phosphate of lime in the walls of the cyst ; 
it never begins before the seventh or eighth month after infestation, 
and is sometimes much longer delayed. 

No man or animal ever becomes infested except l)y the ingestion of 
meat or drink containing larval trichinfe. The pig and small rodents 
are most frequently attacked. Man contracts trichinosis by eating in- 
sufficiently cooked infected pork. The fact that small rodents, par- 
ticularly rats, eat the bodies of their kind explains the persistence of 
tricliinosis in certain regions. Pigs roaming at large, and thus liable 
to find and eat the dead bodies of such rodents, may contract trichinosis 
in this way or from eating ordure. 

For some weeks after the larva; have penetrated the muscular tissues 
the animals show stiffness of the limbs, difficulty in moving, and in 
mastication, etc., but these troubles disappear in a short time. 

The above facts explain why trichinosis in the pig is almost unknown 
in France, Italy, and Spain. It is commoner in Germany and in certain 
States of Europe, such as Holland and Kussia, although investigations 
had previously shown that in Paris about 7 per cent, of the sewer rats 
were sufferers from trichinosis and that in Germany the percentage rose 
as high as 15 to 20. In Chicago and Cincinnati, U.S.A., the proportion 
of rats suffering from trichinosis has been as high as 50 to 70 per cent., 
and as in some of the Northern States pigs were bred in complete 
freedom, it follows that at one time very large numljers of American pigs 
nuist have suffered from trichinosis. 

In consecpience of sanitary precautions this proportion has since 
greatly diminished. 

Diagnosis. ])uring the animal's life diagnosis is a difficult matter, 
though, on the other hand, simple microscopic examination of suspected 
meat is sufficient at once to settle the question. In dealing with the 
living animal, however, it is necessary, as in examining suspected meat, 
to obtain a fragment of muscle in order to submit it to microscopic 
examination. This fragment can be obtained l)y the method known as 
" harpoonage." — a trocar provided with a cutting hook, or a trocar the 
canula of which has a sharp-edged opening near its end, being thrust 
into the muscle. On removing the trocar the elasticity of the tissues 
causes a fragment to project into the opening in the canula, and on with- 
drawing the latter a fragment sufficient for examination is obtained. 
One may proceed in the same way by harpoonage when examining large 
masses of suspected meat the surface of which reveals no lesion. 

The specimen having l)een obtained, a few fragments of the 



88 DISEASES OF MUSCLES AND TENDONS. 

muscular fasciculi are crushed between t^YO glasses and examined 
with a low power. 

The trichinae will be found towards the ends of the muscle near 
the region of the tendons ; few or none exist in the fat. These 
parasites are most readily discovered in the diaphragm, in the 
muscles of the shoulders and quarters, and in the psoas muscles. 

Prognosis. The prognosis is relatively favourable so long as infesta- 
tion is only moderate. But it is very grave from the point of view 
of public hygiene, on account of the possibility of persons becoming 
infected by eating the diseased meat. 

Treatment. There is no 'curative treatment. Formerly it was 
believed that, provided the condition were early diagnosed, the intes- 
tinal form might possibly be cured by administering purgatives and 
vermifuges so as to prevent the embryos penetrating the system. 

After Askanazy's discoveries this view had to be abandoned, and 
the practitioner is necessarily powerless in dealing with the muscular 
form. Time alone effects improvement and a relative cure by causing 
caseo-calcareous degeneration of the cysts. ^Vith a prophylactic object, 
every precaution should be taken to prevent the possibility of pigs being 
contaminated. This question particularly interests America, because of 
the extreme prevalency of pig trichinosis there. 

From the point of view of public hygiene all infected meat should 
be seized and destroyed, despite the fact that perfect cooking destroys 
the vitality of the parasites, which perish at 120° Fahr. 

Ordinary salting but slightly affects their vitality, which explains 
why from time to time the importation of meat has to l)e prohibited 
and why meat should always be scrupulously inspected. 



CHAPTER V. 
RHEUMATISM, 

In bovine pathology the term " Eheumatism " is appHed to a number 
of different morbid conditions, the sole connection between which is that 
they seriously affect the organs of locomotion. This reason may perhaps 
l)e accepted as sufficient for including the study of rheumatism amongst 
diseases affecting locomotion. 

The disease is of considerable importance, and for this reason the 
study of rheumatism itself necessarily precedes the description of 
pseudo-rheumatism, secondary rheumatism, or infectious rheumatism 
in young and adult animals. 

ARTICULAR RHEUMATISM. 
Acute rheumatism has a clearly marked predilection for the arti- 
culations. Sometimes the great serous meml)ranes are simultaneously 
affected (pleura, pericardium, endocardium), but only in very exceptional 
circumstances are they primarily attacked. That form of rheumatism 
known as visceral is as a general rule secondary in comparison with 
articular rheumatism. Several joints and tendon sheaths may be 
attacked at the same time. Under such circumstances rheumatism 
may be defined as a febrile disease, probably of an infectious nature, 
revealing itself by simple or multiple inflammation of joints and the 
tissues surrounding them, and capable of becoming complicated with 
inflammation of the pleura, pericardium, endocardium, meninges of 
the l)rain, etc. 

Causation. All authors agree in recognising the influence of 
heredity, of wet and cold, of sudden changes in temperature, draughts 
in the stable, prolonged exposure to low temperatures, or the chilling 
of animals saturated with perspiration. These are and cannot be other- 
wise than occasional causes ; l)ut the determining cause remains at 
present unknown. 

[ In human pathology it has been proved beyond dispute that a certain 

relationship exists between arthritism, or the " ui'ic acid diathesis," and 
rheumatism. This fact is so well recognised that doctors have said that 

^ rheumatism was to arthritism what scrofula is to tuberculosis. That, 

L 



90 RHEUMATISM. 

however, does not advance our knowledge of the question in the smallest 
degree, and it may simply be that arthritism represents one of the 
principal favouring conditions in the development of rheumatism. 

In domestic animals the uric acid diathesis is little known, renal 
lithiasis is no more a rarity than gravel ; but at the present time no 
one appears clearly to have estal)lished the relationship between these 
diseases and the development of rheumatism. What, however, we must 
all admit is that rheumatism exhibits all the phases of development of 
a rapidly progressive infectious disease. 

Numerous attempts have been made by doctors during the last few 
years to discover the presence of a microscopic agent and to demonstrate 
its pathological characteristics. Several microbes have been described, 
but one is forced to confess that the results have until now been very 
contradictory and uncertain ; and yet there is little room to doubt that 
the disease is of an infectious character. 

Symptoms. The symptoms are generally well defined and well 
developed. The onset is sudden ; an animal which one day before 
appeared perfectly well is attacked in one or several joints. Usually 
the upper joints of the limb are involved — the shoulder, elbow, knee, 
haunch, stifle, hock. 

Nevertheless, invasion is probably not as sudden as it appears to 
be, and, as in the human species, the subject begins by feeling erratic 
pains, which, however, pass unnoticed. The animal moves with diffi- 
culty, as though it were suffering from laminitis, and has pain when 
placing weight on the limb, while the joint attacked soon shows a 
swelling which extends to the tendon sheaths and the neighbouring 
serous bursae. The local temperature is higher than that of sur- 
rounding parts, sensibility becomes very marked, and pain attends 
the slightest pressure on, or even movement of, the affected joint. 
Intense lameness follows, which may even at first give rise to the 
suspicion of fracture. The animals remain lying for long periods, 
groan from time to time, and suffer great pain when rising. 

In some cases the local manifestations appear to be transferred 
from one joint to another. 

These local symptoms are accompanied by high fever. The 
temperature rises to 105° or 106° Fahr., the pulse to 80 or 90, and 
the breathing is enormously accelerated if the patients are forced 
to move. 

Loss of appetite is very marked. Eumination may be suspended, 
and these grave symptoms are accompanied by constipation, rapid 
wasting, cessation or marked diminution of the milk supply, decrease 
in the quantity of urine passed, etc. 

A few days after the onset, visceral complications may occur, though 



ARTICULAR RHEUMATISM. 91 

fortimafcely such complications are far from being constant. Auscultation 
and percussion sometimes reveal the lesions of pleuris}^ endocarditis, 
pericarditis, etc. 

The development of articular rheumatism varies greatly, and may 
occasionally continue for ^Yeeks or months, the condition of one joint 
improving only to be followed by inflammation of another. 

The visceral lesions rarely disappear completely', and it is not un- 
common to note sj'mptoms of chronic valvular endocarditis. Eelapses 
are somewhat frequent, and the disease may continue in a chronic form 
after the acute symptoms have disappeared. 

Lesions. The joint itself is not alone affected. All the tissues sur- 
rounding it are congested, swollen and painful, particularly the sheaths 
and insertions of the tendons. Within the inflamed synovial capsules 
of the joints an increased quantity of turbid synovia accumulates, dis- 
tending the joint and producing a condition of hydrarthrosis. 

In animals slaughtered during the course of the disease one finds 
congestive infiltration of the limbs. 

The temperature of the parts near the affected joints is higher than 
that of neighbouring regions. Sensibility is much more acute, and the 
slightest external pressure gives rise to pain. 

In favourable cases the joint may appear scarcely injured. The 
principal symptoms are those of pain. In old-standing cases certain 
l^ermanent changes may occur, such as thickening and hardening of the 
wall of the synovial capsule, fibrous infiltration of the tissues around the 
joint, or even diffuse and irregular calcareous infiltration. 

Cases of false or true anchylosis are rare, the animals usually being 
slaughtered before such conditions can develop. 

Complications. The commonest complications are endocarditis and 
pericarditis. Valvular endocarditis localised in the auriculo-ventricular 
valves is revealed by a systolic sound, and by tumultuous or irregular 
beating of the heart when the animals are forced to move. Pericarditis, 
which seems rare in bovine animals, is much commoner in sheep. This 
pericarditis, however, produces none of the external signs of pericarditis 
due to a foreign body. Like tuberculous pericarditis, it is only accom- 
panied by a trifling amount of exudate, and is recognised by increased 
cardiac dulness and diminution in the cardiac sounds on auscultation. 

Simple pleurisy associated with pericarditis is frequent in sheep, but 
unknown or little known in the ox. 

If in animals other visceral complications occur, affecting the peri- 
toneum, meninges of the ])rain or intestines, they are at present little 
recognised. 

Diagnosis. Articular rheumatism can only be confused with osseous 
cachexia or laminitis. Osseous cachexia, however, possesses symptoms 



92 RHEUiMATISM. 

peculiar to itself, and generally extends to an entire district, whilst 
rheumatism appears in an isolated form. Again, the arthritis peculiar 
to osseous cachexia most commonly affects the joints of the extremities 
(fetlock and phalanges). The disease may be differentiated from laminitis 
by simply manipulating the joints, which are painful in rheumatism 
but not in laminitis, and by percussing the claws, which are painful in 
laminitis but not in rheumatism, and by noting the character of the gait. 

Prognosis. The prognosis is grave, as in all acute diseases which 
are capable of assuming a protracted chronic form. It is also necessary 
to take into account the loss of condition, the possibility of relapse, and 
the complications due to prolonged decubitus. 

Treatment. The first indication is to place the patients in a nearly 
constant temperature, to supply bedding generously, and to arrange for 
the animal being undisturbed. Among drugs salicylate of soda gives the 
best results if administered in sufficient doses — 6 to 7 drams per day for 
oxen or cows of medium size, 45 to 75 grains for sheep. 

Diuretics, like bicarbonate of soda, nitrate of potash and hay tea or 
infusion of couch grass, pellitory, etc., also give good results. 

The joints attacked may be blistered, but it is often preferable to use 
mild ointments, containing camphor or belladonna, because, as soon as 
pain diminishes, moderate massage of the affected parts, which favours 
rapid absorption of the effiisions, can then at once be resorted to. The 
diet should consist of easily digested food and of lukewarm hay tea, etc. 
When the animals are suffering from kidney disease in any form 
salicylate of soda is contra-indicated. 

Antipyrin may also be of service in doses of 45 to 75 grains for bo vines 
and 15 grains for sheep. Preparations of methyl salicylate can only be 
used for animals of value. 



MUSCULAR RHEUMATISM. 

Muscular rheumatism is due to causes similar to those of articular 
rheumatism. The symptoms, moreover, often occur simultaneously, or 
may alternate with the articular manifestations, with which they are 
seldom entirely unconnected. 

Moist cold seems to be the predetermining cause, whether it acts 
indirectly on the nerve trunks or affects the capillar}^ circulation in the 
muscles, through the medium of the vaso-motor supply. The results are 
revealed by the development of neuralgia, neuritis or interstitial myositis; 
and these diseases, by producing more or less intense pain, cause 
difficulty in movement or distinct lameness. Attempts have been made 
to explain the development of these lesions by ascribing a certain action 
to the uric acid (which is said to be in excess in the body), and to the 



MUSCULAR RHEUMATISM. 93 

lactic acid, which accumulates in the muscular tissue after fatigue or 
over-exertion, and may occasionally produce temporary myositis. Up to 
the present time, no satisfactory proof has heen furnished enabling us 
to identify the myositis of rheumatism with the myositis of over-exertion, 
which, moreover, appears to differ from it in essential particulars. 

Symptoms. Muscular rheumatism is often ill-recognised in veterinary 
medicine, and closer observation would appear to suggest that it is 
much less frequent than has been stated. Generalised muscular rheu- 
matism is rare; patients stand stiffly as though incapable of moving; 
the limbs and the back appear rigid, and the animal seems only capable 
of changing its position by a single movement of its whole body. One 
might readily believe at first sight that the case was one of generalised 
laminitis or slight generalised tetanus. The animal has difficulty in 
rising ; when moving the limbs are dragged, and the patient is cautious 
in lying down. 

Most frequently the disease is localised in one region, such as the 
shoulder, the loins, or the quarters. The affected part is stiff, tense, 
painful, hard, and as though in a state of cramp. Palpation and pressure 
reveal the presence of very exaggerated sensibility, which varies within 
wide limits, according to circumstances, changes in atmospheric con- 
ditions, etc. These local signs are accompanied by a general reaction of 
varying severity, somewhat resembling that seen in articular rheumatism. 
Appetite is diminished or suppressed, as is rumination ; the muzzle is dry 
and hot ; the temperature may rise as high as 103° or 104° Fahr. 

Lesions. The lesions are imperfectly recognised, because those who 
might most easily observe and study them have often neither the means 
nor the leisure for the purpose. Possibly one would at times discover 
lesions of neuritis ; but in any case it is not so very rare to discover 
lesions of interstitial sclerosing myositis in the depths of the muscles of 
the quarter, loins, shoulders, etc., a condition rarely found in any other 
disease. Naturally these are only the ultimate lesions of muscular 
rheumatism ; for slight attacks leave no traces visible to external 
examination. 

Diagnosis. The commonest error is that of mistaking the condition 
for laminitis of all four limbs. The history often suffices to eliminate 
this disease from consideration, while palpation and percussion of the 
claws remove any remaining doubt. 

The prognosis is not usually grave, and recovery sometimes follows 
the adoption of good hygienic conditions. On the other hand, certain 
patients lose flesh rapidly. 

Treatment. Salicylate of soda and antipyrin still form the two most 
efficacious drugs, particularly the first, which may almost be regarded as 
a veritable specific in rheumatism. The doses vary with the size of the 



94 RHEUMATISM. 

patients, from 2^ to 7 drams per da3^ These doses are continued for six 
to eight days consecutively. Some authors prefer saUcylic acid, which, 
however, is more irritant, in doses of 15 to 75 grains. Tartar emetic, in 
doses of 2 J to 4 drams per day until purgation is established, is also said 
to have proved of great value in the hands of the older practitioners. 
Local treatment comprises stimulating frictions with camphorated alcohol, 
ammonia, and oil of turpentine. Such applications are usually of great 
service, particularly when associated with methodical massage of the 
affected parts. These modes of treatment should be supplemented with 
a proper dietary and the administration of tepid, diuretic fluids as 
required. 

Infectious Forms of Eheumatism or Pseudo-Eheumatism. 

Under the head of infectious rheumatism or pseudo-rheumatism may 
be grouped joint diseases of a rheumatic type accompanjnng various 
general or local diseases in young animals and adults : diseases of the 
umbilicus, rachitis, peri-pneumonia, retention of the foetus, dysentery, 
etc. These diseases are characterised by articular symptoms, which 
sometimes appear early, sometimes only when the disease itself is 
declining, and develop suddenly or gradually, the joint cavities them- 
selves either being directly invaded by the agents of the primary disease 
or remaining exempt. These pseudo-rheumatic attacks are due to the 
localised action of microbic toxins on the articular synovial membranes. 
Sometimes the serous membranes of the large body cavities are also 
implicated. 

This theory explains the development of acute arthritis without the 
presence of gonococci during the course of an attack of blenorrhagia in 
man, and may be applied in respect of certain forms of arthritis or 
synovitis without the presence of microbes in domestic animals. 

INFECTIOUS RHEUMATISM IN YOUNG ANIMALS. 

Causation. To explain the occurrence of infectious rheumatism in 
young animals a variety of causes has been invoked, such as bad feeding, 
the absence of that purgation which usually follows the action of the 
mother's first milk {i.e., colostrum), and clears the bowel of meconium, 
the effect of heredity, of chills,, of insuftieient food, and of unduly abun- 
dant or very rich food, which has been said to produce indigestion and 
its various complications. 

All these causes may play a certain part in favouring the develop- 
ment of infectious rheumatism, but none constitutes the direct cause. 

Lecoq and Loiset in their investigations regarding this disease in 



INFECTIOUS RHEUMATISM IN YOUNG ANIMALS. 95 

colfcs mentioned the almost invariable existence of lesions in the umbilical 
region. Bolinger in 1869 recognised the possil)ility of infection by way 
of the mnbilical vein. Eoll and Guillebeau are of the same opinion, and 
Morot's excellent study shows that here must be sought the most fre- 
quent point of origin of the articular symptoms. In animals born in dirty 
stables the umbilical cord becomes infected at the time of birth, or its 
cicatrix a few days later. The result is the development of rapidly fatal 
septicaemia, suppuration in the wound, omphalitis, omphalo-phlebitis, or 
umbilical arteritis ; and to this infection are due the various complications, 
which may. appear almost immediately, as in the case of septic^nemia of 
calves, or may be deferred for a shorter or longer interval, for so long indeed 
that the umbilicus may appear to have healed externally (infectious pneu- 
monia and endocarditis, infectious arthritis, etc.). The umbilical cord 
and the tissues surrounding the cicatrix form excellent culture grounds 
for those micro-organisms which always exist in such abundance in litter 
and manure ; and there is, therefore, no difficulty in understanding why in 
dirty stables infection so readily occurs. The infective agents may be of 
very varying kinds, a fact which explains the difference in the symptoms 
which follow umbilical infection ; although ovoid bacteria, streptococcus 
pyogenes, and the bacilli of necrosis seem most common. 

Omphalitis and omphalo-phlebitis are not the only diseases capable 
of producing infectious rheumatism in young animals. Certain infections 
resembling dysentery and diarrhoeic enteritis are also its frequent 
forerunners. In 3'oung animals even rachitis, which is accompanied 
by various digestive disorders, may serve as the point of origin for 
infectious rheumatism and all its complications. 

In older animals — i.e., in animals from five to six months, or even twelve 
to fifteen months — infectious rheumatism may occur without a clearly 
defined cause. It then develops with the symptoms and lesions of that 
condition known as " osteomyelitis of adolescence" in human pathology. 
These forms of osteomj-elitis are due to infection with streptococci 
and staphylococci. In veterinary medicine the pathogeny has not yet 
been accurately ascertained. 

Symptoms. Infectious rheumatism in young animals assumes one 
of two clinical appearances, possibly due to different causes, viz. — plastic 
or suppurative arthritis following umbilical infection, and simple 
exudative arthritis. In the former variety symptoms appear soon after 
birth, rarely after the age of two months, and as an exception in animals 
of six to eight months affected with rachitis. The onset is sometimes 
sudden; the patient, though healthy on the previous evening, is un- 
able next morning to rise or move. Hence in France this disease has 
received the titles, amongst others, of laminitis and paralysis of the 
Bewly born. 



96 



RHEUMATLSM. 



Certain joints, often a pair, appear swollen, hot and painful. The 
synovial sacs are distended, and in the upper joints of the limb appear 
much more prominent than in the lower. When the patients are still 




Fig. 50. — Young bull suffering from infectious rheumatism. 

able to move they walk on three legs, but usually they remain lying 
permanently, and if aroused show great difficulty in rising and very 
acute pain in moving. 

General disturl)ance is also very marked; the temperature varies 
between 103° and 105° Fahr. The animals are dull, have no appetite, and 

exhibit intense thirst. The 
pulse rate and respirations 
are increased, and not un- 
commonly symptoms of grave 
visceral complications, such 
as endocarditis, pleurisy, 
pneumonia, etc., can be de- 
tected. Diarrhoeic enteritis 
sometimes appears as a 
secondary development. 

The animals remain per- 
manently lying down. They 
can only be induced to rise 
with difficulty, and, when 
moved, exhibit very acute 
pain. 

In many cases the disease then takes a rapid course and ends 
fatally. Death is the usual termination whenever any of the above- 
mentioned visceral complications exist. Recovery is exceptional. In 




Fig. 51. — Attitude when walking of a 
suffering from infectious rlieumatism. 



calf 



INFECTIOUS RHEUMATISM IN YOUNG ANIMALS. 97 

certain Incky cases, sometimes without any treatment whatever, the 
symptoms become less acute, the appetite persists or improves, fever 
diminishes, the condition of the joints remains stationary, and after the 
hipse of several weeks there is ground for anticipating recovery. In all 
cases, however, the convalescents remain thin and sickly, exhibit pain 
and capricious appetite, and in very few cases indeed is there any economic 
reason for keeping them alive. 

More frequently infectious rheumatism terminates by abscess forma- 
tion in the joints. The articular cavity becomes filled with pus, the 
tissues covering one of the synovial sacs soften, and the abscess opens, 
discharging fibrinous clots, thin watery pus mixed with synovia, 
and debris of articular cartilages or ligaments. Pytemia is the final 
complication when the patients are not slaughtered. 

In the cases comprised under the second heading the symptoms 
appear more slowly and develop insidiously, the chief, viz., a tendency 
to remain lying and difficulty in movement, long preceding the appear- 
ance of exudative arthritis. The course depends chiefly on the nature 
of the infective agent. In calves suffering from peripneumonia, calves 
from stables in which epizootic abortion rages, rachitic calves or calves 
suffering from severe diarrhoeic enteritis, the joints do not become 
the seat of suppuration. 

In such cases the arthritis is of a simple exudative character, but 
without microbic infection of the joint cavity. This form is less 
dangerous, and is often curable provided the original cause be kept 
in mind. 

Lesions. The lesions are always very marked, and are quite 
different from those of simple rheumatism. The synovial membranes 
and the periarticular tissues are always thickened, injected, inflamed, 
and infiltrated. 

In more benign cases the synovial exudate from the joint cavities 
is simply cloudy, contains no infectious germs, and proves sterile on 
attempts at cultivation. In such cases there is no abscess formation. 
But most frequently this stage of serous exudation is only temporary, 
and the articular fluid, which at first seems sterile, may, when tested 
some days later by means of cultures, reveal the presence of organisms. 
The synovia accumulated within the joint sometimes contains fibrinous 
flocculi, which are at first small, but later form veritable coagula, filling 
up and thickly coating all the prominences of the joint and moulding 
themselves on the extremities of the bones constituting the articulation. 
Sometimes the cartilages undergo very rapid ulceration, the subjacent 
layers of bone become inflamed, and the osteoarthritis which develops 
is so severe and painful that the patients are forced to remain abso- 
lutely still, and are quite incapable of rising. The lesions may 
D.C. H 



98 RHEUMATISM. 

remain stationary at this point. In other cases suppuration occurs in 
the articulation itself, the wall of the synovial cavity, the periarticular 
tissues, and the skin soften ; then the ahscess breaks, giving rise to open 
suppurating arthritis. Animals are rarely kept long enough to become 
so gravely affected ; many die before this stage, and the others are 
usually slaughtered. Moreover, they rapidly perish from exhaustion 
and from visceral complications of a pyfemic character. 

In many cases post-mortem examination reveals nothing whatever in 
the region of the umbilical cord (through which infection has occurred), 
but the germs of infection may be found in the blood or general 
circulation ; or again, careful investigation may show ulceration of the 
umbilicus, lesions of omphalitis, of ascending umbilical arteritis in 




Fig. 52. — Ulcer;ition ot the articnlav cartilage in infections rlienniatism. 

consequence of infection of the thrombus, of umbilical phlebitis, or of 
infective peritonitis, etc. The infectious agent reaches the liver through 
the l)lood-vessels, then attains the posterior vena cava, after which the 
infection assumes the gravest possible character, producing complications 
like arthritis and purulent infection, with the formation of multiple 
abscesses in the depths of the viscera. 

The Staphylococcus aureus and various streptococci are the most 
frequent but not the only causes of these infections. 

The diagnosis is not difficult, provided the disease be not mistaken 
for true rheumatism. As true rheumatism is very rare in young animals, 
and as, on the other hand, attention is aroused by the presence of 
lesions of the umbilicus and by the ex-istence of diarrhceic enteritis, 
rachitis, etc., there is seldom room for doubt. 

Prognosis. The prognosis is extremely grave whenever the case 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 99 

results fi-om infection of the umbilicus. French statistics place the 
mortality at 90 per cent, and German at 75 per cent. 

Curative treatment can only be attempted with any chance of success 
in the simple exudative form. Even then it is necessary to simultaneously 
treat the primary disease, such as rachitis or diarrhoeic enteritis. 

The recommendations of former practitioners as to the use of saline 
purgatives, cream of tartar, etc., were probably due to their having recog- 
nised that diarrhoea is sometimes the primary cause. 

Moussu has seen simple exudative arthritis in rachitic subjects 
disappear, together with the rachitis, under proper treatment. 

The indications therefore are, firstly, to take measures against the 
primary disease, treating the local lesions separately with blisters, douches, 
or simply cold applications and massage. Provided the general condition 
can be improved, recovery may follow. 

Unfortunately, this treatment is useless against infectious rheumatism 
with suppurative arthritis resulting from infection of the umbihcus. In 
such cases treatment, if undertaken, should be directed towards perfectly 
disinfecting the umbihcal wound or any existing sinuses. 

Injections of strong carbolic solution, the application of antiseptic 
ointments or of antiseptic pencils containing iodoform, salol, etc., into the 
sinuses, followed by a surgical dressing covering the umbilicus, form the 
basis of this primary treatment, which, it need scarcely be said, has little 
chance of checking the course of already existing arthritis. The use of 
internal antiseptics and of antipyretics like camphor, salicylate of soda, 
etc., is worthy of trial. On the other hand, prophylactic treatment in an 
infected area has every chance of succeeding. The use of dry, clean 
litter under the mother and the new-born calf, thorough cleansing of 
the umbilical cord or umbilical cicatrix, and the application to the 
umbilicus of a small surgical dressing or even a smear of tar, almost 
always suffice to prevent the occurrence of these forms of arthritis. 

INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 

The infectious pseudo-rheumatism of adults differs from infectious 
rheumatism in young animals in that it never becomes complicated 
with suppurative arthritis, and rarely affects more than one joint at 
a time. The hind limbs are the parts usually attacked, and the joints 
seem predisposed to disease in the following order of frequency : the 
femoro-tibial, coxo-femoral, and hock joints. 

On account of its greater frequency in cows, it has been termed 
"arthritis of milch cows" and "infectious arthritis of milch cows," etc. 
In reality it may also attack bulls and oxen, but such cases are 
exceptional. 

H 2 



100 



EHEUMATISM. 



Causation. First mentioned l)y Coulbeaux in 1824, and by Pauleau 
in 1832, this disease has been well-studied by Ph. Hen. Old works 
mention it as attacking good milkers in the best dairies around Paris, 
and Heu declares it to be the most deadly disease after peripneumonia 
and tuberculosis. 

This form of arthritis usually appears in an insidious form after 
abortion, retention of the foetus, or post-partum metritis. In cases of 
epizootic abortion infectious rheumatism sometimes assumes an epizootic 
form, and completes the devastation begun by abortion. Under other and 
much rarer circumstances it may follow enteritis of adults or attacks 
of mammitis, etc. The pathogeny of these forms of arthritis is not 




Fig. 53. — Infectious rheumatism. Arthritis of the left stifle joint. 



difficult to understand, for in the greater number of instances they form 
delayed consequences of local uterine infection. 

The soluble products secreted by infectious organisms multiplying 
within the uterus are absorbed by the uterine mucous membrane, causing 
slow intoxication ; and in consequence of the special elective aflfinity 
which the toxins show for the articular serous membranes, and in many 
cases also for the visceral serous membranes, the special characteristics 
are developed. Under certain circumstances the joint cavity may even 
become the seat of true microbic infection. 

Symptoms. The appearance of the first symptoms is difficult to 
identify, for many cows abort, fail to " cleanse," or become affected with 
metritis without infectious rheumatism supervening. It is a long-delayed 
condition, which may be postponed for weeks or even for several months 
after an abnormal parturition, and to a time when the symptoms of 
metritis have almost entirely disappeared. The onset is characterised 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 



101 



by difficulty in rising, and soon afterwards by lameness, or by the animal 
failing to place weight on one of the hind limbs. The affected joint, 
usually one of the articulations of the stifle, appears markedly enlarged, 
is not appreciably hot to the touch, but reveals a certain amount of 




Fig. 54. — The femoro-tibial joint in a case of 
infectious rheumatism. All the articular sur- 
faces of one side have undergone change (the 
condyle of the femur, interarticular cartilage, 
and the upper extremity of the femur). 




FiCx. 55. ~ 
joint. 



Normal femoro-tibial 



painful sensibility on pressure. The periarticular tissues are infiltrated 
and the synovial sacs slightly distended. 

After a few days, a week or two at most, the periarticular swelling 
diminishes, and the condition appears to remain stationary. 

Appetite is normal or only diminished. The pain continues, and 
causes progressive wasting and diminution in the yield of milk. 

If at this time the practitioner makes a careful digital examination of 
the diseased region, he may find one of two conditions. In the first, the 



102 



RHEUMATISM. 



synovial sacs appear distended, fluctuating and in exactly the same 
condition as in ordinary bog-spavin. This is what has been termed the 
exudative form of infectious arthritis. In the second, the enlarged joint 
remains very sensitive, the walls of the synovial sac are thickened, 
fluctuation is either absent or only slightly marked, but induration is 
very manifest. This constitutes the plastic form. 

Exudative arthritis is the form usually seen at first. It may preserve 




Fig. 56. — Plastic form of infectious iheuiiiatism (pseiido-anchylosis). 



its primary characteristics, but only too often proves to be the fore- 
runner of the plastic form, which develops with the lapse of time. If 
nothing is done wasting becomes more marked, and is accompanied by 
cachexia. jThe animals are unable to rise, the complications insepar- 
able from decubitus occur, and wasting or secondary purulent infection 
sets in. 

Lesions. In the exudative form the changes are confined to inflam- 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 103 

mation and thickening of the synovial memhranes, intra-articular 
exudation, and sometimes grooving of the cartilages without ulceration 
of the articular surfaces a^nd without disorganisation of the joint. 

The plastic form, on the other hand, leads to destruction of the 
cartilages, ligaments, and sub-cartilaginous bony layers, induration and 
calcification of the walls of the synovial cavity, and even periostitis of the 
ends of the bones, with the formation of false joints. The internal 
surface of the inflamed synovial membranes begins to granulate, the 
fibrous clots distending the articular dilatations are perforated by 
these extending granulations, and fibrous tracts soon develop even 
in the articulation itself, undergo calcification, and produce complete 
anchylosis. 

Diagnosis. The diagnosis is easy. The animal's history and 
symptoms, and the stationary character of the pain in the earlier 
stages are sufficient to prevent any error. 

Prognosis. " The prognosis is grave, but not fatal. In the exudative 
form recovery may follow early treatment. In the plastic form, however, 
the chances of success are extremely- meagre. 

Treatment. It is easier to prevent than cure, particularly in these 
forms of arthritis. The means are simple, and consist in always 
treating the post-partum infection as soon as it is recognised. The 
animals can be effectively safeguarded against later articular complica- 
tions by the free use of intra-uterine antiseptic injections, until the 
uterine injuries have wholly healed, and by the administration of saline 
purgatives and diuretics. 

When infectious arthritis is diagnosed, it is still necessary to resort 
to the same methods if the uterine symptoms persist, and to complete 
the treatment by local applications. 

The best method of local treatment seems to consist in puncturing 
the articulation aseptically, removing almost all of the liquid exudate, 
and immediately thereafter firing the skin covering the joint in points 
or lines. 

If treatment has been invoked too late, if plastic arthritis with 
the formation of fibrous bands within the joint and destruction of the 
cartilages and calcification of ligaments, etc., already exists, there is no 
economic object in undertaking treatment. Fattening may be attempted, 
or the animals may be handed over to the butcher, if wasting is not too 
far advanced. 

The use of cold douches, plaster bandages, blisters containing nitrate 
of mercury, painting with sulphuric acid, etc., are too inconvenient and 
too inefticient to be recommended in actual practice. Similarly, the 
salicylate of soda, which is so useful in simple rheumatism, has no real 
superiority over diuretics in this condition. 



104 RHEUMATISM. 

SCURVY-SCORBUTUS. 

Definition. " Scurvy is a subacute or. chronic trophic disorder 
characterised ])y debiHty, inanition, anaemia, swelhng and bleeding of 
the gums, gingival ulceration, dropping of the teeth,- and petechial or 
more extensive hfemorrhages and exudations in the skin, serosa, and 
solid tissues." 

Causes. " Among the lower animals, pigs especially suffer, when 
kept in close, foul quarters and fed on a monotonous and insufficient 
ration. Formerly scurvy . . . was attributed to an exclusive diet of 
salt food ; to excess of sodium and deficiency of potassium salts ; to the 
absence of fresh vegetables ; to tainted food, etc. In pigs the food and en- 
vironment are usually chiefly at fault, the subjects have been kept . . . 
in foul buildings, in a hot, moist atmosphere, and with an uniform diet 
of maize or other unvarying and insufficient ration. Eoll attaches 
great importance to putrid food. Benion has found the affection 
mainly in obese swine, the forced feeding and intestinal fermentations 
manifestly operating as factors. Hess and others attribute the disease 
in pigs to the germ of erysipelas. Stengel has produced purpuric disease 
in animals by inoculation of the extravasated blood from human scurvy 
patients. Miiller and Babes found a slender bacillus and streptococci in 
the tissues of scorbutic gums. . . . There is considerable presumption 
of the existence of a microbian cause, the efficiency of which is dependent 
on the unhygienic conditions above stated, while these unwholesome 
conditions are equally non-pathogenic in the absence of the microbe." 
Lesions. " The blood is black and incoagulable or clots loosely, rigor 
mortis is slight, changes may be found in the number and character of 
the white and red blood globules, but are not constant ; there is usually 
an excess of sodium salts and deficiency of potassium ones, and there is 
marked petechiation of the skin, mucosae and serosa. The bone marrow 
may be abnormally red and the bones fractured at the epiphyses, or 
carious. . . . The gums are softened, swollen, red and uneven, with 
hasmorrhagic discoloration, erosions, necrotic areas and ulcers." 

Symptoms. " Anorexia or fastidious appetite, prostration, debility 
and sluggish, indifferent movements, are followed by the local lesions on 
the skin and gums. On the skin appear petechiae and extravasations, 
which often implicate the bristles, so that they may be shed or pulled 
out with ease, the bulbs appearing dark and bloodstained (bristle rot). 
These may be followed by necrotic sloughs, and deep ulcers that are slow 
to heal. The gums are red and swollen, with hsemorrhagic spots, and 
bleed on the slightest touch. Erosions, sores, and ulcers are not 
uncommon ; the tongue is dry and furred, and the mouth exhales a foetid 
odour. The teeth may become loose in their sockets. Swelling of the 



SCURVY — SCORBUTUS. 105 

joints . . . may be noticed, and lameness or stiffness from muscular 
or inter-muscular extravasation. Blood effusions into . . . the eye 
have been noticed, and paralytic or comatose symptoms from similar 
effusions on the brain. In the absence of improvement the patient 
becomes more and more debilitated and exhausted, and death may be 
preceded by profuse exhausting diarrhoea." 

"Prognosis is unfavourable in advanced cases, and when the faulty 
regimen cannot be corrected." 

Treatment. " The first consideration is to correct the unwholesome 
conditions of life, purify the building and its surroundings, and allow a 
free range on pasture. Subject each patient to a thorough soapy wash, 
and if possible allow clean running water in which a bath may be taken 
at will. Access to green food and invertebrates (slugs, larvse, etc.) is 
important, or a varied diet of grain, middlings, bran, roots, fruits, tubers, 
cabbage, silage, etc., must be furnished. Iron and bitters (gentian, nux 
vomica) are useful, and sometimes small doses of arsenite of soda solu- 
tion or cream of tartar are useful. Acorns or horse-chestnuts are 
recommended. For the mouth a wash of potassium chlorate, soda 
biborate, or potassium permanganate may be resorted to. . . . In 
the case of fat pigs it is more profitable to butcher at once, as soon 
as early symptoms appear." From Law's " Veterinary Medicine," 
p. 558, Vol. III. 



SECTION II. 

DISEASES OF THE DIGESTIVE APPARATUS. 

SEMIOLOGY OF THE DIGESTIVE APPARATUS. 

The group of diseases which affect the digestive aparatus is one of 
the most important in bovine pathology, because ahnost all animals of 
the bovine species are bred with the object of utilising to the full their 
powers of digestion and assimilation. 

Whether we consider adult fat animals, calves intended for slaughter 
or milch cows, the object sought is always the same — i.e., to secure the 
greatest possible economic return through the medium of the digestive 
functions. 

Even although in working oxen there is no tendency to overfeeding, 
the animals remain none the less predisposed to diseases of the digestive 
apparatus; the meal-times are often too short, and rumination has to be 
performed under the yoke or during work — in a word, under unfavourable 
physiological conditions. 

Semiology. To ensure correct diagnosis it is necessary here, perhaps 
more than in any other department -of pathology, to be capable of grasp- 
ing the symptoms or syndromes and signs afforded by the different parts 
of the digestive apparatus ; to know how to co-ordinate and group them 
so as logically to deduce the final synthesis, the diagnosis. The diagnosis 
]3roving correct, the prognosis becomes easy, and this is the chief object 
from the economic standpoint. The practitioner who undertakes treatment 
knows how to deal with the case, and the owner likewise knows what he 
undertakes to do. 

Although this classification may appear arl)itrary, we shall consider 
successively diseases of the mouth, of the pharynx, u>sophagus, stomach, 
intestines, etc., firstly describing the symptoms characterising these 
diseases. At the same time we should state that many symptoms are 
common to a large number of diseases and in themselves have absolutely 
nothing characteristic. They are simply sign-posts capable of showing 
the way. 

Mouth. External examination reveals the condition of the muzzle, 
the lips and their commissures, and the surroundings of the buccal 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



107 



opening, and detects the existence of any desquamation, rents, eruptions, 
ulcerations, etc., which may be present. 

In quiet aijimals the practitioner can examine the cavity of the mouth 
single-handed, hut in troublesome animals it becomes necessary to have 
an assistant, who seizes the muzzle with one hand and the tongue with 
the other, or who simply fixes the animal's head. In exceptional cases 
it will be necessary to secure the patient to a post, tree, or wall. The 
mere attempt at examination will show whether there is trismus or 
absolute freedom of movement in the jaws. 

By introducing the fingers between the commissures and applying 
them to the bars or to the free 
portion of the tongue, the prac- 
titioner will be able approxi- 
mately to estimate the local and 
general temperature. The sen- 
sations experienced will also 
inform him of the degree of 
moisture or dryness of the 
mouth and of its sensibility. 

On separating the jaws, he 
will note the odour exhaled and 
its possible abnormalities — its 
acid, sourish, foetid, or putrid 
character. He will directly ob- 
serve any anaemia or hyper- 
remia of the mucous membrane, 
from the inner surface of the 
lips and cheeks up to the soft 
palate, although owing to the 
thickness of the buccal epithe- 
lium it is not always easy to 

estimate anaemia or hyperemia in the ox. The surface of the tongue 
should also be examined, and a note made whether it appear dry, pasty, 
dusty, sooty, etc., though these appearances are occasionally apt to lead 
one astray. The observer should also inquire regarding want of appetite, 
depraved or exaggerated appetite, etc. 

Even the manner in which the animal picks up its food will serve 
to direct his attention to the development, or possible existence, of some 
disease of the mouth, although want of appetite is not always charac- 
teristic of a lesion in the pharynx or oesophagus, but sometimes of a 
lesion in its neighbourhood, like hypertrophy of the retropharyngeal or 
bronchial lymphatic glands. 

This examination will also detect the existence on the lips of wounds, 




Fig. 57. — Examination of the mouth. 



108 



DISEASES OF THE DIGESTIVE APPARATUS. 



cuts, injuries or specific eruptions (aphtha, tuberculous ulcerations, the 
ulcerations of gangrenous coryza, etc.) on the gums indications of 
gingivitis, periostitis, mercurial poisoning, actinomycosis of the maxilla, 
and ulcerations of all kinds ; on the tongue, of wounds, of simple or 
specific inflammatory eruptions (aphtha, the ulcerations of actinomycosis, 
tuberculosis, gangrenous coryza, etc.), as well as the swellings due to 
superficial or deep-seated glossitis. By the same method of examination, • 
though with somewhat more difficulty, one can detect abnormal mobility, 
irregularity of development, caries, etc., of the teeth, the condition of 
the excretory ducts of the salivary glands, the state of the hard and 

soft palate, and the existence of 
fissures, vegetations, polypi and 
tumours. 

Salivary glands. The salivary 
glands, particularly the parotid and 
submaxillary, should be examined 
by direct inspection and palpation. 
Direct inspection reveals the 
existence of swellings, deformity 
of parts, increase in salivation, or 
ptyalism, which sometimes occur 
in conjunction with foot-and- 
mouth disease, actinomycosis, 
acute stomatitis and mercurial 
poisoning, as well as increase in 
size of the salivary ducts. 

Palpation reveals the degree 
of sensibility of the parts, the 
existence of crdema, induration, 
cysts, and, more frequently, distension of the salivary ducts as well as 
the presence of calculi, tumours, the direction of fistulae, etc. 

Difficulties may occur, particularly when the submaxillary and parotid 
glands are affected ; but methodical and complete examination will usually 
enable one to differentiate the conditions. 

Pharynx. The pharnyx may be examined externally by inspection 
and palpation, and internally by direct digital palpation. Inspection 
reveals possible deformities of the region of the gullet, palpation the 
condition of the tissues as well as abnormal sensibility and infiltration. 
Internally, digital examination must be cautiously conducted, and after 
a strong gag has been securely inserted in the mouth. Under such con- 
ditions it is without danger. The hand being inserted exactly in the 
median line will detect obstructions which may already have been partly 
identified by external palpation, as well as the existence of inflammation 




Fig. 58. — Examination of the mouth 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



109 



with or without the formation of false membranes, and of ulcerations, 
polypi, etc. 

(Esophagus. In consequence of its anatomical formation, situation 
and course, the oesophagus may be divided into two distinct parts — viz., 
the cervical, which can be examined from the outside, and the thoracic, 
which cannot so be examined. 

The cervical part may be examined by inspection, by palpation from 
one side, or by palpation with both hands and from both sides. 

Inspection leads to the detection of changes in the shape of the 
oesophagus and of the jugular furrow. In fat subjects, however, it is of 




Fig. 59. — Examination of the phaiynx. 



little value. As the position and the course of the oesophagus are known, 
unilateral palpation, or, better still, bilateral palpation, employing both 
hands, is of very nnich greater service. These methods reveal the 
presence of swellings, infiltrations, changes in shape and sensibility, the 
presence of foreign bodies, the existence of dilatations or contractions 
of the tube, etc. 

Auscultation and percussion, though recommended by some prac- 
titioners, are not of much service. 

Inability to swallow, due to change in the oesophagus, is also detected 
by inspection. Its existence suggests a number of jjossible conditions, 
such as fissure or ulceration of the oesophagus, compression in the 
mediastinal region as a result of tuberculous or other disease, contraction 
or dilatation of the oesoiduigus, etc. Furthermore, inspection will betray 



110 DISEASES OF THE DIGESTIVE APPARATUS. 

the existence of dilatation of the tul)e, to which vomiting and regurgitation 
of food are sometimes due. 

Internal exploration is the only method of detecting changes in the 
thoracic portion, and may also be utilised to locate lesions in the cervical 
region. It is practised by passing a sound of small calibre or any 
flexible cylindrical object, such as a cart rope, etc. The patient must be 
fixed with the head extended on the neck and a proper gag or speculum 
introduced into the mouth. Exploration assists us in recognising the 
existence of inflammation of the oesophagus, true or false contraction, 
dilatation and the presence of obstructions. 

In animals of the bovine species all these lesions — viz., inflammation 
of the oesophagus, fissuring and ulceration, obstructions, compressions, 
dilatations and contractions of the tube — although not very frequent, 
are nevertheless from time to time encountered. 

Stomach. Exploration of the stomach or of the different gastric 
compartments presupposes an exact knowledge of the respective positions 
of the different reservoirs. Topographical anatomy shows that the rumen 
is situated in the left flank, and that it occupies the whole of the left 
abdominal region from the diaphragm to the pelvic cavity. As a con- 
sequence, it may be explored from the region of the twelfth rib ; it is 
inclined slightly from above downwards, and from left to right, its ex- 
treme right border extending as far as, or a little beyond, the white line. 

The reticulum, the smallest of the four reservoirs, is situated in the 
sub-ensiform region at right angles to the median plane of the body. On 
the left it touches the rumen and the diaphragm ; on the right side it 
is in contact in front with the diaphragm, above with the omasum, and 
to the right and towards the rear with the abomasum. The omasum is 
situated above the reticulum and conical right portion of the rumen ; 
in front it touches the liver, and towards the back and left the rumen. 
The abomasum is situated obliquely in the right hypochondriac region, 
its anterior surface resting on the lower wall of the abdomen towards the 
middle and right side of the body, its pyloric portion extending upwards, 
behind the right hypochondriac region. 

Rumen. The rumen can be examined by inspection, palpation, per- 
cussion, and auscultation. The use of the oesophageal sound and of the 
trocar and canula is also of value in diagnosis. 

Inspection affords information of a varying character, according to 
the moment when it is practised, even in a condition of health. It only 
extends to the condition of the flank before or after a meal, etc., empti- 
ness of the rumen being accompanied by hollowness of the flank, and 
distension, following an abundant meal, by fulness in this region. 

When digestion is not proceeding normally, the flank may be distended 
unduly by gaseous accumulations or by the presence of solid food. In 



SEMIOLOGY OF THE DIGESTIVE APPAKATUS. 



Ill 



abdominal and mediastinal tuberculosis and in gastro-enteritis there may 
be simple tension or slight dilatation. "When indigestion or enteritis is 




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entering on a favourable stage, the flank may appear hollow, and in cases 
of chronic diarrhoea it may a^^pear retracted. 



112 DISEASES OF THE DIGESTIVE APPAKATUS. 

Digital examination or palpation may be practised over the entire 
region of the flank. It shows whether the rmuen is full or empty, 
reveals the consistence of the contained food in cases of chronic indiges- 
tion, the sensibihty of the walls, and the rate and order of the muscular 
contractions. Direct or indirect percussion maybe carried out on a hori- 
zontal line from the twelfth rib as far back as the flank, and vertically 
from the lumbar vertebrae to the white line. In health one discovers in 
young animals an upper zone of normal resonance due to gas, a zone of 
semi-dulness and an inferior zone of absolute dulness, due to the liquids 
in the rumen. The spleen, wdiich is attached to the supero -anterior sur- 
face of the left side of the rumen, does not seriously restrict the area 
open to percussion. 

In pathological conditions percussion from above downwards may pro- 
duce a tympanitic sound, due to gaseous indigestion or a clear sound 
throughout the greater portion of the vertical diameter suggestive of 
acute gastro-enteritis with the formation of gas in the rumen, or of 
adhesive peritonitis preventing the rumen from collapsing. Indigestion 
due to excess of solid food, on the contrary, is characterised by a dull 
sound throughout the entire region from above downwards. Percussion 
along a horizontal line permits of the delimitation of certain zones which 
vary a great deal in area, according to the case. 

Auscultation is more instructive than percussion. Like percussion, it 
may be practised throughout the entire depth of the abdomen, from the 
transverse processes of the lumbar vertebrae as far as the white line, and 
in a horizontal direction from the eleventh rib to the region of the flank. 

Auscultation of the upper zone enables one to detect sounds of 
deglutition, gurgling sounds (glou-giou), and a sound resembling falling 
w'ater, due to the movement of solids or liquids in the rumen and 
reticulum. The sounds heard vary in different cases, and depend on 
the state of repletion or of emptiness of the rumen. 

Auscultation of the middle zone reveals : 

Firstly, a very special crepitation sound, which may be compared to 
the deflagration of a handful of salt thrown on burning coal. It is 
believed to result from the bursting of bubbles in the contents of the 
rumen under the action of normal digestion. 

Secondly, a churning sound produced by the rhythmic peristaltic 
contractions of the rumen, by which the substances ingested are very 
intimately mixed. By applying the ear over the flank region or by 
palpation the rhythmic contractions of the rumen, two per minute in 
most cases, can readily be perceived. 

In practice examination of the rumen is confined to these four methods. 

Puncture. From an exclusively scientific point of view, exploration of 
the rumen also comprises analysis of the gas collected through puncture 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 113 

and analysis of the liquids removed by aspiration (first stages of gastric 
digestion). Normally, these gases, in the order of their abundance in the 
mixture, consist of the follo^Ying : Carbonic acid, carburetted hydrogen 
and nitrogen. 

In disease, and in most cases of abnormal fermentation, the carbu- 
retted hydrogen is greatly in excess of the carbonic acid. In chronic 
gastro-enteritis, ammonium sulphide and other offensive gases are found 
in addition. 

Chemical analysis. In the rumen the ingested food is macerated in 
an alkaline liquid at a temperature of 100° to 101° Fahr. (the alkalinity 
is due to the saliva) , This process markedly modifies the composition of 
the ingested matter. Nevertheless, the upper portion in contact with the 
gas sometimes presents a slightly acid reaction, probably due to carbonic 
acid. The sugary and fatty materials contained in the food respectively 
undergo lactic and butyric fermentation. Only a small quantity of the 
starch, however, is transferred into sugar. In the calf, and in very young 
animals, the reaction of the rumen is acid throughout the entire period 
of sucking. In disease, when rumination has long been suspended and 
chronic loss of appetite or gastro-enteritis exists, the reaction is generally 
acid. The sugars, gums, and soluble salts of forage, roots, etc, are dis- 
solved in the rumen, but fatty materials undergo no modification. 

The reticulum, which is the smallest of the gastric compartments, is 
situated in the sub-ensiform and retro-diaphragmatic regions, extending 
right and left of the middle line to a nearly equal distance. Above and 
to the left it communicates freely with the rumen, to the right with the 
omasum. 

In practice it can only be examined in two ways : inspection and 
palpation. 

By inspection changes in the configuration of the ensiform region 
may sometimes be detected. Such changes are rare, and must be dis- 
tinguished from congenital deformity. They sometimes accompany 
inflammation of the reticulum produced by a foreign body, when the 
lower abdominal wall is directly perforated by such body. 

In cases of inflammation of the reticulum due to foreign bodies, 
abscess formation, perforation, etc., it is possible to detect cedematous 
infiltration, abnormal sensibility, fluctuation and increased heat, etc., by 
manipulating the parts with the fingers or the clenched fist. 

If the evidence pointing to the presence of a foreign body in the 
reticulum is considered sufficient, gastrotomy may be performed and the 
interior of the viscus examined with the hand, but although the operation 
is i^ossible it is very rarely practised. 

Omasum. The omasum occupies, so to speak, a position inverse to that 

D,C. . I 



114 DISEASES OF THE DIGESTIVE APPARATUS. 

of the reticulum, lying deep down on the right side, behind the diaphragm, 
under the hypochondrium, and above the abomasum and reticulum. 

It is the only gastric compartment which cannot be examined, although 
when impacted it may be felt on the right side. 

Abomasum. The abomasum is lodged in the lower part of the right 
flank under the circle of the hypochondrium. It extends obliquely from 
below, upwards from the sub-ensiform to the sub-lumbar region. The 
smaller curvature is turned towards the rumen on the left side ; the larger 
curvature is in contact with the abdominal wall. In spite of what has so 
often been stated by those who have never seen it, the abomasum can be 
examined and is accessible along the circle of the hypochondrium. 

In adults useful information can rarely be obtained by inspection ; 
but in sucking calves the abomasum, if distended by indigestion, gastro- 
enteritis, etc., sometimes appears prominently in the right abdominal 
region. Palpation with the fingers or with the fist will detect exag- 
gerated sensibilty, irritation, inflammation, or distension. 

Percussion and auscultation furnish no very precise information. The 
information obtained by the above-described examination of the stomach 
is in practice amplified by a search for certain symptoms which are usually 
easy to detect. They comprise : 

(a) Suppression or irregularity of rumination. This very important 
symptom suggests the degree of gravity of the digestive disturbance, and 
to some extent the gravity of the general condition. Suppressed rumina- 
tion is a common symptom in many diseases, some of which are purely 
digestive, though all are not. It is, however, a grave sign in most cases, 
{h) Eructation, which is usually frequent, may be regarded as normal 
provided the exhaled gas preserves the fresh odour of grass or of the food 
swallowed, like brewers' grains, turnips, etc. Sometimes the gas is sour, 
acid, foetid, or putrid, all of which conditions indicate disease. 

(c) Yawning is not common. It becomes frequent and attracts 
attention in certain abnormal conditions ; in others, again, it may be 
completely suppressed. 

(d) Nausea and vomiting are rare. Vomiting is commoner in calves, 
and results from inabihty to digest the milk, or simply to over-distension 
of the abomasum. The matter vomited by adults usually consists of 
partly masticated food, and is derived from the rumen ; while the con- 
tents of the abomasum are occasionally rejected, in which case the 
material is of pulpy consistence and has an acid smell. 

(e) Digestive disturbance is sometimes accompanied by various modi- 
fications in the breathing, such as immobilisation of the hypochondriac 
region and of the diaphragm ; abnormal sensibility and reflex coughing 
on palpation, and, in inflammation of the reticulum due to foreign 
bodies, costal respiration. 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



115 




Vc.o 



Gi 



Fig. 61. — Position of the iUxloniinal \iscera, scon from below. Gi, large intestine; 
Y.c.f/., left pouch of the rumen ; E, E, epiploon (line of insertion) ; P, paunch or 
rumen; A j;, xyphoid appendix of the sternum ; E, reticulum ; C, abomasum; Y.c.iL, 
right pouch of the rumen ; Ig, small intestine. 

I 2 



116 DISEASES OF THE DIGESTIVE APPARATUS. 

It is by metliodiGiilly observing, grouping, and classifying the 
symptoms presented that one is enal)led to detect the Hnks connecting 
them. 

Intestine. The intestinal mass is contained in the right half of the 
abdomen above the compartment of the stomach. The large intestine 
occupies the upper zone, corresponding externally with the hollow of 
the flank from the thirteenth rib to the haunch. The small intestine 
occupies the middle zone from the thirteenth rib to the entrance to the 
pelvis and the stifle region ; the inferior zone is occupied by the rumen 
and abomasum, and in pregnant females by the gravid uterus. 

Notwithstanding these indications it is somewhat difficult to examine 
the mass of the large intestine, separated as it is from the abdominal wall 
by the U-shaped inflection of the duodenal loop, of which the deep retro- 
grade branch is in contact with the terminal portion of the floating colon. 

Inspection of the right flank furnishes no information of value 
in diseases of the intestine, nor is auscultation of much service beyond 
enabling one to detect the frequency, diminution, or absence of bor- 
borygmus. Palpation alone is really of service. Practised gently and 
superficially with the tips of the fingers it detects abnormal sensibility 
in acute cases of enteritis ; when with more energy, palpation reveals 
whether the bowel be full or empty, provided that the muscular resis- 
tance be not too marked. 

Colic. In colic the clinical signs, their varieties, and the lesions which 
give rise to them are of much more importance. When it results from 
intestinal congestion a frujore (due, for example, to the ingestion of cold 
water), colic is usually violent, sudden, and of relatively short duration. 
In other cases it is violent and prolonged for several hours, a whole day, 
or even two days, and may be followed by coma and suppressed peristalsis ; 
it then indicates invagination, volvulus, or strangulation. Sometimes, on 
the contrary, it remains dull and is' slow and continued (acute gastro- 
enteritis, hfemorrhagic gastro-enteritis, etc.). 

Finally, colic of the latter character may, in addition, be accompanied 
by icterus, in cases of retention of bile, biliary calculi, hepatitis, etc. 

Anus. Examination of the anus is easy. Simple inspection reveals 
its presence or absence, and consequently the existence of congenital 
rectal atresia, which is somewhat common in calves and colts. Digital 
exploration is, however, sometimes useful, for in occasional cases an anus 
may exist, which externally appears normal, but terminates in a sac, the 
rectum being closed by a membranous partition. 

Nothing is easier to recognise than tenesmus ; it occurs in cases of 
profuse diarrhoea, diarrhoea of calves, and dysentery in newly-born 
animals. 

Rectal exploration. Exploration of the rectum is a last and most 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



117 



valuable means of coiifirming the diagnosis in all. visceral diseases of the 




"id 



pelvis and abdomen. To utilise this method to the full, the rectal pouch 



118 DISEASES OF THE DIGESTIVE APPARATUS. 

should first be thoroughly emptied by the free use of enemata, the 
subsequent examination being made with great care. The animal's hind 
legs being secured, the operator smears his hand and forearm with some 
fatty substance, and, forming the fingers into a cone, introduces them 
with gentle pressure through the anus, the palm of the hand being turned 
downwards. Passing the hand gently along the rectum, the operator 
will be able to distinguish the conical posterior pouches of the rumen, 
the loop of the duodenum, the mass of convolutions of the small intes- 
tines and of the colon, etc. Next, he will examine the vagina, uterus, 
bladder, ureters, kidneys, aorta, and the pelvic and sub-lumbar lymphatic 
glands. He may be able to recognise distension of the rumen with food, 
twists of the intestine, hernia, mesenteric or diaphragmatic invagination 
or volvulus of the bowel, etc. 

In other cases he may be able to discover lesions of the kidney, of the 
uterus, of the broad uterine ligaments, of the ovaries, or of vessels. 

In all cases it is desirable to make a methodical and complete 
examination, whatever the primary object may have been. Such 
an examination may be carried out as follows : The operator having 
introduced his hand into the rectum, begins by examining the state 
of the pelvic organs, the rectum, base of the vagina, the body and 
horns of the uterus, the bladder and the lymphatic glands and ligaments 
of the pelvis. 

By laying the hand flat in the rectum and pressing gently downwards 
the anterior border of the j)ubis may be felt, somewhat more deeply 
placed. The rectum is then thrust slightly to the right, and the 
ascending branch of the right ilium, as high as the sacro-iliac articula- 
tion, and the lower surface of the sacrum, are directly examined ; lastly, 
the hand is directed towards the left, gliding down the left ilium, and 
returning to the point of departure. In this way the state of the pelvic 
floor, of the arteries, veins, and lymphatic glands, etc., the degree of 
mobility, tension, or fulness of the uterus, as well as the condition of the 
broad ligaments, are all ascertained. 

Still more deeply placed, and at the extreme limit to which the arm 
can be introduced, will be found some or all of the above-mentioned 
organs — viz., the small intestine, large intestine, kidney, etc. 

Defaecation: Examination of the faecal material. The character of 
the faices is very important in certain diseases ; e.g., diarrhoea assumes a 
varying importance, according as the discharges are of an alimentary, 
serous, mucous, or sanguinolent type, and are slight, temporary, intense, 
profuse, or continued. In other cases defiecation is slow, becomes diffi- 
cult, and various degrees of constipation exist. Defecation may be 
completely sujjpressed, as in invagination or strangulation of the intes- 
tines ; on the otber hand, one may observe diarrhoea, dysentery (microbic 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 119 

or sporozoic diarrhoea), and intestinal hgemorrhage. The last-named may 
be of varying degrees of acuteness, from the passage of simple drops or 
streaks of blood, distributed over almost normal excreta, to the passage 
of unchanged blood in liquid jets or in clots. 

Macroscopic examination. Macroscopic examination takes cognis- 
ance, firstly, of the quantity (40 to 80 lbs.), consistence (firmness or soft- 
ness), colour (olive green, blackish green, greyish black, sooty, or tarry) 
and odour (normal, foetid, putrid, etc.) of the faeces. 

Sometimes the excreta are moulded and covered with glairy mucus, 
or contain such abnormal products as undigested food (a sign of 
chronic diarrhtea), false membranes, false membranes due to pseudo- 
membranous enteritis, fibrinous clots, or parasites like liver flukes, tfenite 
and strongyles. 

Microscopic examination. Microscopic and bacteriological examina- 
tion is sometimes useful ; and even when macroscopic examination has 
revealed nothing, it is possible to detect the presence of the eggs of 
parasites like flukes, strongyles, hooked worms, etc., the presence of 
sporozoa (as in intestinal coccidiosis) and of specific microbes, as in the 
diarrhcea of calves, etc. 

It is only by the synthesis of methodically collected signs that 
one finally succeeds in exactly diagnosing the numerous diseases which 
may aft'ect the intestine : intestinal congestion, invagination, volvulus, 
intestinal strangulation (mesenteric or diaphragmatic hernia, etc.), 
atresia of the anus, acute or htemorrhagic enteritis, or intestinal 
helminthiasis. 

Liver. The liver is situated in the right sub-lumbar region. It is 
fixed behind the diaphragm and under the hypochondriac region, and 
extends from the ninth to the thirteenth rib. It can be examined by 
palpation through the last intercostal spaces and behind the thirteenth 
rib. In health it is difiicult to pass the fingers sufiiciently under the 
hypochondriac circle to reach the liver; but in case of morbid hyper- 
trophy it extends more or less beyond the last rib, and palpation be- 
tween the last ribs sometimes reveals abnormal sensibility. 

Percussion better than palpation enables one to delimit the space 
occupied by the liver, particularly towards the back, where there is no 
interposed layer of lung. Percussion is especially useful in detecting 
hypertrophy due to cancer, tuberculosis, echinococcosis of the liver, etc., 
or hepatic atrophy. In isolated cases icterus may exist, confirming the 
conclusions otherwise arrived at. 

Pancreas. The pancreas is situated rather deeply in the right sub- 
lumbar region, below the kidney, behind the liver, above the floating 
colon, and within the duodenal loop. It is therefore very difficult to 
examine ; moreover, the diseases which affect it are still little understood. 



120 DISEASES OF THE DIGESTIVE APPARATUS. 

The point most prominently brought forward by this demonstration 
of the topographical anatomy and semiology of the digestive apparatus 
is the difficulty of accm-ately diagnosing digestive diseases in the ox when 
one confines oneself to a superficial examination. To have any chance 
of arriving at an exact diagnosis, methodical and thorough examination 
is indispensable. Given this condition, accurate diagnosis becomes 
possible, despite all difficulties. 



CHAPTER I. 
DISEASES OF THE MOUTH. 

STOMATITIS. 

Definition. By stomatitis we mean inflammation of the buccal 
mucous membrane. Stomatitis may be simple — i.e., due to accidental 
causes, to varying local forms of irritation, or to wounds ; or, on the 
contrary, it may be specific, of infectious origin, like the stomatitis 
of foot-and-mouth disease, gangrenous coryza, cattle plague, etc.; 
or, finally, it may be of toxic origin, like the stomatitis of mercurial 
poisoning. 

Here we shall only study the simple forms of stomatitis, the 
gangrenous stomatitis of calves, and mercural stomatitis. The others 
will be noticed in speaking of the diseases of which they form one of 
the symptoms. 

SIMPLE STOMATITIS. 

Causation. Simple stomatitis of bovine animals is often due to 
feeding with rough forage, or forage containing prickly or spiny plants, 
like thistles, sea holly, eryngo, etc. Sometimes it follows prolonged 
irritation by rough teeth, premolars or stumps, or accompanies the shed- 
ding of the temporary molars. Ingestion of irritant plants like nettles, 
certain specimens of the orders Lahiatre and Umhelliferce, leaves 
covered wdth vesicant insects, cabbage and turnip leaves infested with 
aphides, oil beetles, etc., or the swallowing of hot liquids, may also, 
though more rarely, produce it. Finally, in grave diseases of the diges- 
tive apparatus, the buccal mucous membrane may secondarily become 
affected. 

Symptoms. The primary symptoms are usually represented by 
ptyalism and a certain difficulty in grasping food. In other cases the 
mucous membrane appears slightly dry for some time before salivation 
sets in. On introducing the fingers into the animal's mouth some 
elevation of temperature may be noted, and on direct inspection the 
non-pigmented regions are seen to be abnormally vascular, a fact which 



122 DISEASES OF THE MOUTH. 

has earned for this form of stomatitis the names of " erythematous " 
and " erysipehitous stomatitis." 

If the stomatitis is due to local multiple irritation, such as results 
from spines and prickles in the food, the ahnormal vascular appearance 
is confined to the neighbourhood of the abrasions or punctures, and the 
affected regions are of very varying size. In some cases, principally as a 
consequence of trilling local irritation and of burns of the first and 
second degree, blisters of varying size may develop and break, leaving 
behind ulcerations, which, however, always heal rapidly. The aphthous 
non-contagious stomatitis mentioned by certain authors seems most 
probably to pertain to this class. 

Diagnosis. The diagnosis is usually easy, and a little attention to 
the accompanying symptoms is sufficient to avoid confusion with the 
various forms of symptomatic stomatitis. 

The prognosis is favourable. 

Treatment is based on removal of the determining cause, if this can 
be recognised, withdrawal of rough forage, removal of sharp points on 
the teeth, extraction of stumps, etc. As a rule, recovery follows rapidly. 
It can be hastened by washing out the mouth directly, or by means of a 
syringe, with water containing honey, vinegar, decoctions of brier twigs, 
oak bark, barley or rice. This treatment is completed by supplying 
nourishing gruel and food demanding little mastication. 

CATARRHAL STOMATITIS IN SHEEP. 

" The more delicate buccal mucosa in these animals would render 
them more subject to inflammations, but this is more than counter- 
balanced by the mode of prehension of aliments, not by the tongue, but 
by the delicately-sensitive lips, and further by the daintiness and care 
with which these animals select their food. The treatment would not 
differ materially from that prescribed for the ox." (Law's "Veterinary 
Medicine," Vol. II. p. 15.) 

[The treatment referred to consists of simple astringent and anti- 
septic washes, borax given in the drinking water, or mixed with honey 
or treacle and smeared occasionally on the tongue. Washes of sodii 
hyposulphis or sulphis, or even weak solution of carbolic acid, may be 
used after the irritant cause has been removed. Vinegar or diluted 
mineral acids may be used alternately with decoctions of blackberry bark 
or other vegetable astringents. When there are symptoms of gastric 
disorder a laxative, followed by vegetable bitters and other tonics, may 
be prescribed. Foreign bodies — thorns, wire, etc. — fixed in the tongue, 
cheek, or palate should be searched for and removed at the first 
examination of the patient.] 



NECROSING STOMATITIS IN CALVES. 123 



NECROSING STOMATITIS IN CALVeS. 



Definition. This name is applied to a special stomatitis, which in very 
young animals produces superficial necrosis of more or less extensive 
areas of the buccal mucous membrane, and sometimes of subjacent parts. 

The disease, although somewhat rare in France, has been mentioned 
by Lafosse and well studied by Damman and Lenglen. 

Causation. Its cause is still imperfectly understood. Some regard it as 
a consequence of insufficient nourishment, of disturbance resulting from 
dentition, of general exhaustion, and of bad hygienic conditions. These 
explanations* are scarcely sufficient, however, and at the present time 
there is a tendency to regard it as a complication of primary grave, 
debilitating diseases, like the diarrhoea of calves, omphalitis, omphalo- 
phlebitis, etc. Moussu has never seen it apart from omphalitis, and 
he considers the lesions due to the action of the bacillus of necrosis. 
Infection occurs through the mnbilicus becoming soiled by contact with 
the litter. 

The early symptoms consist in loss of aj)petite, congestion of the 
mucous membranes, and salivation. Early examination of the buccal 
cavity reveals the presence everywhere, except on the palate, of whitish- 
grey or yellowish patches, whose aspect is markedly in contrast with that 
of neighbouring parts. These are fragments of the mucous membrane 
undergoing necrosis. They are numerous, are surrounded by a narrow 
inflamed zone, and may be from | inch to 1 inch in diameter. 

Necrosis advances rapidly, and extends throughout the thickness of 
the mucous membrane ; the slough soon becomes delimited and separates. 
The odour of the mouth is then absolutely fcetid, and the saliva appears 
streaked with pus and blood. 

The ulcerations exhibit a livid base, and show no tendency to heal. 
Necrosis extends in depth, and affects the muscles, tendons, and even the 
periosteum and the bones. The teeth are frequently loosened. 

Grave complications, such as pharyngitis, broncho-pneumonia, infec- 
tious enteritis, and septicaemia soon appear, and the animals are carried 
off by septic infection and intoxication in a few days — at the longest 
in a week. 

Diagnosis. The diagnosis is only difficult at first ; and, at a later 
stage, the only mistake possible is that of confounding the condition with 
a very grave attack of aphthous stomatitis. Local sanitary conditions 
are sufficient to secure the avoidance of this error. 

Prognosis. The prognosis is extremely grave ; the disease usually 
results in death ; recovery is exceptional. Very luckily the disease seems 
to become rare in direct proportion as the hygienic conditions of cattle 
breeding and keeping are improved. 



124 DISEASES OF THE MOUTH. 

Treatment. Curative treatment always appears to be ineffectual 
when a grave primary disease has already enfeebled the animal before 
necrosing stomatitis appears. In those cases where the stomatitis con- 
stitutes the primary condition, attempts should l)e made as far as possible 
to cleanse the wounds. The buccal cavity should be thoroughly washed 
out, and the wounds then cauterised with solution of carbolic acid of 
G per cent, strength, nitric acid of 10 per cent, strength, hydrochloric 
acid of 7 to 8 per cent, strength, or chromic acid of 20 per cent, 
strength. 

This local cauterisation is performed with a tampon of cotton wool 
fixed to a handle ; for necessarily it is impossible to apply uny dressing 
whatever of a permanent nature. The cauterisations may be repeated 
twice a day. The stump of the umbilical cord should never be forgotten, 
for it sometimes contains a mass of necrotic tissue the size of a man's 
thumb. It should be thoroughly cleansed and the wound plugged with 
a mixture of iodoform and boric acid. 

This treatment will not avail unless the functions are stimulated by 
rich food that can be easily masticated and digested, and by giving milk 
of good quality, or boiled milk, eggs, meat-powder, cooked beans, etc. 
Aromatic infusions and hay tea containing coffee and small quantities 
of alchohol or tincture of quinine are also of service. 



MYCOTIC STOMATITIS IN CALVES. 

Tltrnsh. Muijuet. 

"This is a form of stomatitis manifested by a raised white patch on the 
mucous membrane and determined by the presence of the Oidiiim albicans 
{Sacchavomyces albicans), a cryptogam discovered by Berg in 18-12 in 
thrush in children. It is closely allied to the vnicor, and attacks only the 
young and feeble. The white crust consists of epithelial cells intermingled 
with an abundance, of the white mycelium and oval spores of the fungus. 
Andry in his artificial cultures found that it was pearly white when grown 
on gelatine, dirty white on potato, and snow white on carrot." 

Symptoms. " Buccal mucosa, red, congested and tender, shows here 
and there white curdy looking elevations, or red erosions caused by the 
detachment of such masses. These bear a strong resemblance to the 
crusts seen on this mucosa in rinderpest, but are easily distinguished 
by the absence of the attendant fever, and by the discovery, under the 
microscope, of the specific microphyte. The eruption may extend to the 
pharynx and oesophagus and interfere fatally with deglutition, but usually 
it merely renders sucking painful and is not serious." 

Treatment. Cleanse and disinfect the sheds, " and invigorate the young 
animals by sunshine, free air and exercise. Locally . . . borax, which 



ULCERATIVE STOMATITIS IN SHEEP. 125 

arrests the growth of the parasite, whether in artificial cultures or in the 
mouth. The powder may be rubbed into the sores, or it may be mixed 
with . . . molasses and used as an electuary. As substitutes boric 
acid, salol, thymol, potash chlorate, or Condy's fluid may be used." 
(Law's "Veterinary Medicine," Vol. II. p. 3().) 

ULCERATIVE STOMATITIS IN SHEEP. 

The name of ulcerative stomatitis of sheep has been given to a disease 
which is characterised by the appearance of a pultaceous deposit on the 
surface of the buccal mucous membrane and later by the development of 
ulcerations and of vegetative growths. 

Causation. The cause is imperfectly understood. In certain years 
the disease appears to attack lambs at the time of weaning, but it may 
also affect flocks of animals as old as fifteen or eighteen months, two 
years, or even more. It is contagious, and may extend to one-half or two- 
thirds of the entire number in the flock. Full-grown and old animals 
appear to be immune. 

It was formerly thought, a j^rion, and in consequence of the character 
of the buccal deposit, that the disease was identical with thrush, and that 
the lesions were produced by O'ldium albicans. Neumann in 1885 declared, 
however, that he could not And the fungus in question in scrapings from 
the mucous membrane. 

Moussu had similar negative results in the experiments he made 
during 1894, when he examined both young and old animals belong- 
ing to flocks in the departments of Berry and of La Brie. 

In addition it has been suggested that the disease affects badly cared- 
for and badly fed lambs, and subjects suffering from "watery cachexia." 
This seems correct in many cases, and Moussu has seen ulcerative 
stomatitis decimate flocks which had previously been attacked with 
intestinal helminthiasis and verminous broncho-pneumonia ; but, on the 
other hand, in the environs of Melun he saw it in animals which had 
previously been quite free of disease and were kept under perfect hygienic 
conditions. 

The conditions in which animals are reared, the use of common drink- 
ing ponds, and the method of supplying flocks with food, are the chief 
causes of the distriljution of the disease. 

Symptoms. The symptoms consist in loss of appetite, or rather in 
difficulty in grasping and masticating food, wasting, a certain degree of 
dulness, and salivation. Somewhat later one often sees appear on the 
free margin of the upper and lower lips an eruption of small vesico- 
pustules, wdiich quickly become covered with yellowish-brown crusts and 
bleed on the slightest touch. The lips swell, become sensitive and pain- 
ful, so that examination of the cavity of the mouth should be made with 



126 DISEASES OF THE MOUTH. 

care. The mucous membrane is then seen to present a very varymg 
number of greyish-white or greyish-brown points, each of which is due to 
the destruction of the epithehum and to the production of a pultaceous 
deposit, which can very readily be removed, leaving uncovered superficial 
ulcerations, which bleed if very lightly touched. These ulcerations are 
of irregular shape, and are distril)uted most freely over the gums, the 
internal surface of the lips and cheeks. The palate and tongue are only 
invaded in the last stages. Still later one notes, instead of these ulcera- 
tions and as a consequence of abnormalities in the process of repair, 
reddish violet turgid vegetations varying in size from that of a millet 
seed to that of a pepper-corn or even of a small mulberry. 

The total duration of the disease varies with its degree of intensity. 
In favourable cases it may not exceed eight to ten days ; in grave cases 
it continues for fifteen to twenty days. Recovery is usual when the 
subjects are vigorous and well-nourished lambs, or well-kept sheep, 
previously free of disease. On the other hand, Moussu has noted a mor- 
tality of 15 to 20 per cent, in thin animals of bad bodily condition and 
already depressed by verminous broncho-pneumonia and intestinal hel- 
minthiasis. When the attack is about to prove fatal, complications such 
as gastro-enteritis, resulting from septic infection or intoxication, and 
accompanied by foetid diarrhcea, often make their appearance. 

Diagnosis. The diagnosis presents no difficulty, the characteristics of 
this stomatitis being entirely different from those of the aphthous form. 
The claws are never affected, and there is no lameness. 

Prognosis. In this connection the practitioner will do wisely to avoid 
committing himself, and to closely study the conditions under which the 
disease has developed. ^In all cases the appearance of foetid diarrhoea 
must be regarded as of very unfavourable augury. 

Treatment. The first precaution to take consists in separating all 
the healthy animals in the flock, and placing them in a non-contaminated 
spot. 

The diseased are then treated one by one ; each day the buccal cavity 
is washed out with boiled water or with a solution of borax or boric acid. 
After each washing the ulcerations should be touched with tincture of 
iodine or with some other rather active antiseptic solution. Finally it 
might be useful, and would be of value, to add to the gruel or water a 
small quantity of common salt and of salicylate of soda at the rate of 
15 grains to the pint. 

GENERAL CATARRHAL STOMATITIS IN SWINE. 

Causes. " Swine suffer from simple stomatitis when exposed to 
thermal, mechanical, or chemical irritants. Such irritants comprise food 
that is too hot, or is hard and fibrous, or which contains spikes and awns, 



GENERAL CATARRHAL STOMATITLS IN SWINE. 127 

capable of entering and irritating gland ducts or sores, or food which is 
fermented or putrid, food or medicine of an irritant character. The habit 
of catching and holding swine with a running noose over the upper jaw, 
and the forcing of the jaws apart with a piece of wood in search of the 
CijsticercHs ccllulosa are further causes. In several specific infectious 
diseases inflammation of the mucous membrane, with eruption or erosion, 
is not uncommon. This aphthous fever is marked by vesicular eruption, 
muguet b}^ epithelial proliferation and desquamation, hog cholera and 
swine plague by circumscribed spots of 'necrosis and erosion. Patches of 
false membrane are not unknown, and local anthrax, tubercle, and acti- 
nomycosis are to be met with. Inflammation may start from decaying 
teeth." 

" Symptoms resemble those in other animals, refusal of food, or a dis- 
position to eat sparingly, to select soft or liquid aliments, to swallow hard 
materials half chewed, or to drop them, to champ the jaws, and to seek 
cold water. Accumulation of froth around the lips is often seen, and 
the mouth is red, angry, dry, and hot, and exhales a bad odour." 

" Treatment does not differ materially from that adopted in other 
animals : Cooling, astringent, antiseptic lotions, honey and vinegar, and 
in ease of spongy or eroded mucosa, tincture of myrrh daily or oftener. 
Soft feeding, gruels, pulped roots, . . . and clean water should be 
constantly within reach. In case of . . . indigestion a laxative, 
followed by vegetable tonics, will be in order." (Law's "Veterinary 
Medicine," Vol. II. p. 17.) 

ULCERATIVE STOMATITIS IN SWINE. 

" This is the scorbutus of Friedberger and Frohner, the glossanthrax 
of Benion." 

Causes. " It has been attributed to insufficient or irritant food, to 
damp, close pens, and to chronic debilitating diseases, and all these 
act as predisposing causes. In gastritis and in infectious fevers like 
hog cholera, swine plague, and rouget (hog erysipelas) the spots of con- 
gestion and petechias on the buccal mucous membrane may become the 
starting points for ulcerative inflammations. These conditions appear, 
however, to be supplemented by infection from bacteria present in the 
mouth or introduced in food and water, and, as in the case of other 
domestic animals, the most successful treatment partakes largely of dis- 
infectant applications." 

Symptoms. " Loss of appetite, grinding of the teeth, champing of 
the jaws, the formation of froth round the lips, foetor of the breath, red- 
ness of the gums and tongue, and the formation of vesicles, or white 
patches, which fall off, leaving red, angry sores. These may extend, 
forming deep unhealthy ulcers, with increasing salivation and foetor. 



128 DISEASES OF THE MOUTH. 

As the disease advances the mitial duhiess and prostration become more 
profomid, and debiHty and emaciation advance rapidl.y. Unless there is 
early improvement an infective pharyngitis or enteritis sets in, mani- 
festly determined by the swallowing of virulent matters from the 
mouth, and swelling, redness, and tenderness of the throat, or colics 
and offensive black diarrhoea, hasten a fatal issue. Eachitis may be 
a prominent complication, as it seems in some instances to be a pre- 
disposing cause." 

Treatment. " Isolate the healthy from the diseased, and apply dis- 
infection to all exposed articles and places. Employ local antiseptics as 
in other animals. Sulphuric or hydrochloric acids, in fifty times their 
volume of water, or tincture of iron, chlorate of potash, or chloride of 
ammonia, or borax have been used successfully. Bitters and aromatics 
have also been strongly recommended," (Law's " Veterinary Medicine," 
Vol. II. p. 29.) 

MEKCURIAL STOMATITIS. 

This form of stomatitis possesses certain distinguishing characters, 
and develops after severe or trilling mercurial poisoning. 

Causation. Sheep sometimes suffer from mercurial poisoning as a 
result of the use of baths containing corrosive sublimate or mercurial 
ointment for acariasis or other cutaneous parasitism. Animals of the 
bovine species seem predisposed to the disease as a consequence of their 
special sensitiveness to the action of mercury, which is not shared by 
other species. 

Mercurial jjoisoning may occur accidentally, l)ut is usually the result 
of some attempt at treatment. Any preparation containing mercury or 
mercurial salts may produce it. In domesticated animals it most fre- 
quently results from the action of the ordinary mercurial blister or 
mercurial ointment of the j)harmacopoeia, or again of calomel. Sometimes 
it follows the use of mercurial salts in uterine douches, or in lotions used 
to wash out large abscess cavities or wounds. 

The application of blisters or of antiparasitic dressings, or infriction 
with grey ointment over extensive surfaces, favours this intoxication. It 
may result from direct local intra-cutaneous absorption, from vapour given 
oft' by mercurial applications obtaining entrance into the body through 
the broncho-pulmonary and digestive tracts, from vapour given oft" by 
metallic mercury (as in ships' holds), or from ingestion of mercurial 
compounds licked off the skin, as certainly occurs. Hitherto in all dis- 
cussions, even the most recent, on the mechanism of poisoning, partisans 
of different views do not appear to have given sufficient attention to these 
now clearly proved facts. The conclusion to be drawn is that in animals of 
the bovine species mercurial preparations ought to be used with caution. 



MERCURIAL STOMATITIS. 129 

and that even under sacli conditions stomatitis may appear. Finally, it 
should be remembered that all lesions of the kidney indicated by albumi- 
nuria and other signs, and all lesions of the liver, favour poisoning by 
checking or preventing the elimination of mercury by the kidney, or by 
interfering with its transformation in the hepatic cells. 

Nature. Eegarding the essential nature of stomatitis, it would appear 
(according to the work carried out in 1890 by Gallipe on mercurial stoma- 
titis in mail), that we should regard it as a septic stomatitis, and not as a 
primary toxic stomatitis. The mercury absorbed by the body not only 
produces salivation, but a very important change in the chemical compo- 
sition of the saliva. The vitality and toxicity of the saprophytic microbes 
normally present in the buccal cavity appear gfeatly to increase, and 
although only the most trilling erosions may exist in the mucous mem- 
brane, true intra-mucous inoculation takes place, and forms the point of 
origin for septic stomatitis. 

It has been found that it is not even necessary to have lesions in the 
buccal mucous membrane ; in fact, this is the weak point in the theory 
emitted. Nor is a modification in the chemical composition of the saliva 
sufficient ; for when a mixture of iodine and the iodides, for example, is 
being given, the saliva is chemically modified, and yet stomatitis, properly 
so-called, does not occur. 

What seems most probable is that mercurial stomatitis is a toxi- 
infectious stomatitis, in the development of which mercury acts primarily 
by its toxic effect on the salivary glands, whose secretion it modifies, and 
on the l)uccal epithelium, the renewal of which it checks. Infection of 
the mucous membrane is thereby favoured, even in the absence of any 
previous lesion, and stomatitis develops. 

Symptoms. The symptoms consist in abundant salivation with 
discharge from the mouth, suggesting the existence of foot-and-mouth 
disease. In grave cases the saliva appears streaked with blood, even 
from the beginning. The buccal cavity exhales an intense foetid odour 
which, during the following days, becomes more marked ; the mucous 
membrane is pale in colour, and coated with a greyish exudate. The 
mouth is hot and sensitive, the gums are swollen, reddish-violet in 
colour, and painful. Alveolar periostitis soon sets in, the teeth become 
loose, and mastication is rendered impossible, especially as the inflam- 
mation causes the tongue to swell and lose its mobility. These 
symptoms are unaccompanied by fever. 

In the last stage ulcerations and local necroses appear on the gums, 
on the inner surface of the lips and cheeks, and around the commissures 
of the lips. The patients are almost unable to feed, rapidly lose flesh, 
become anaemic, and die from septic infection. The temperature is often 
below normal. 

D.C. K 



130 DISEASES OF THE MOUTH. 

A toxi-infectious gastro-enteritis, with foetid, blood-stained diarrhoea, 
is grafted on the primary stomatitis. CompHcations in connection 
^yith the respiratory, circulatory, and urinary apparatus appear, and 
the patients die in a condition of absolute exhaustion. 

Naturally this termination is not inevitable ; trifling cases of poisoning, 
and even grave forms, when properly treated, may, and should, recover. 

Diagnosis. The diagnosis is mainly based on the history, except in 
cases of accidental and unsuspected poisoning. 

Prognosis. The prognosis is grave, for even when the disease does 
not prove fatal the animals remain anai-mic and exhausted for long 
periods. 

Treatment should principally be directed towards combatting the 
local comjilications. When poisoning is due to external applications 
of mercury or its salts the skin should be washed with soap and water, 
and afterwards dressed with a soluble sulphide, which renders the mer- 
cury insoluble. The mouth should frequently be rinsed with boiled water, 
with decoctions of barley or marsh-mallow, with a 30 per cent, solution of 
boric acid or alum, or with a 1 to 2 per cent, solution of salicylic acid. 

Fully grown cattle receive daily doses of 1:|- to 2 drams of chlorate 
of potash internally. This drug appears to owe its favourable action 
to the fact that it is partly eliminated by the salivary glands. Lastly, 
with the idea (which may, perhaps, be illusory) of minimising and 
checking the liad effects of the mercury introduced into the body, certain 
jDractitioners have recommended the administration of eggs, flowers of 
sulphur (2 J to 5 drams), sulphate of iron (1^ to 2 J drams), and of iodide 
of potassium (1^ to 2^ drams), drugs which are alleged to form insoluble 
compounds with mercury. 

GLOSSITIS. 

The term " glossitis " is applied to all inflammations of the tongue, 
whether superficial or deep seated. These inflammations may result 
from trifling causes, in which case they are termed " simple, acute, 
or chronic golossites " ; or, on the other hand, from well-recognised 
causes, like tuberculosis or actinomycosis, in which case they receive 
the name of " specific glossites." Here only ordinary glossites are 
investigated, the others being more particularly described in chapters 
specially reserved for the description of the primary diseases of which 
these form symptoms. 

SUPERFICIAL GLOSSITIS. 

This condition is characterised by lesions in the mucous membrane 
or in the immediately subjacent tissues, deeper seated structures not 
being involved. 



ACUTE DEEP-SEATED GLOSSITIS. 131 

The causes are similar to those of simple stomatitis, and as in animals 
of the bovine species the tongue is the principal and almost the only 
organ of prehension, it is particularly exposed to the chance of injury. 

As mechanical injury done by rough fodder first makes its effects 
felt on the tongue, superficial glossitis is often due to the action of sharp 
or prickly plants like fnrze, wrest-harrow, thistles, sea-holly, etc. The 
glumes, awns, and spikelets on certain plants play a similar part. 

Caustic medicinal draughts, hot drinks, and sharp points on the 
molar teeth may also produce the disease without the rest of the buccal 
mucous membrane being involved. 

Symptoms. These are extremely simple. There is, first of all, some 
difficulty in grasping the food and some diminution of appetite, which, 
however, is more apparent than real, the digestive organs acting well. 
The second symptom consists in moderate salivation without special 
characters. 

The local symptoms alone are characteristic. The mucous membrane 
covering the tongue appears red, swollen, locally inflamed, and painful. 
The inflamed areas are usually located on the free part near the frsenum 
or opposite the molar teeth. 

Thorns, foreign bodies, awns or spikelets of rough grasses can often 
be seen implanted in the tongue, and if the disease has existed for a 
short time, little ulcerations may not improbably be discovered. 

Diagnosis. The characteristics of this superficial glossitis are suffi- 
ciently marked to allow of easy diagnosis, and to prevent it being 
confused with the lesions of actinomycosis or tuberculosis or with the 
extensive desquamation which accompanies foot-and-mouth disease. 

Prognosis. The prognosis is never grave. Recovery occurs in six 
to eight days, provided the primary cause be removed. 

Treatment consists in avoiding the use of rough food, in removing 
foreign bodies implanted in the mucous membrane or in rasping rough 
and irregular teeth. For the rest, as in stomatitis, mere attention to 
cleanliness suffices. The mouth is washed out with boiled water, boric 
acid solution, mixtures of vinegar and water, or with water containing a 
small percentage of alcohol. 



ACUTE DEEP-SEATED GLOSSITIS. 

This disease has also been termed parenchymatous and interstitial 
glossitis, because all the deep-seated tissues, including the muscles and 
connective tissue layers are involved in the inflammation. 

Causes. The disease may be due to a neglected attack of super- 
ficial glossitis, to some grave microbic infection, or to excoriation and 
ulceration of the mucous membrane. Very often it is of traumatic 

K 2 



132 DISEASES OF THE MOUTH. 

origin, aiul is due to violent traction on the tongue by herdsmen or 
othei's when administering draughts of their own composition. This 
traction causes rupture of the muscle and slight interstitial hemorrhage. 

The symptoms develop somewhat rapidly. Whilst at first the animal 
shows difficulty in grasping food, it is soon totally incapable of doing so. 
The tongue loses its mobility, is no longer protruded from the mouth, and 
swallowing becomes so painful that salivation sets in. On direct exami- 
nation the tongue is found swollen, thickened, immobile, painful, and 
occupying the whole of the oral cavity, sometimes projecting beyond the 
region of the incisors, and preventing the mouth being closed. Inflam- 
mation may become so intense that the point of the tongue hangs out of 
the mouth. It becomes blackish, bleeding, swollen, and excoriated by 
contact with foreign bodies or simj)ly with the row of incisor teeth. 
The saliva becomes foetid, blood-stained and purulent, and contains large 
quantities of broken down epithelial cells. It is not uncommon to note 
more or less extensive necrosis. 

Diagnosis. The diagnosis of this form of glossitis presents no 
difficulty, for if under certain conditions it may resemble, for example, 
the glossitis of actinomycosis, it differs essentially from that disease by 
its rapidity of development, by its complications, and also by the absence 
of the specific ray fungus. 

Prognosis. The prognosis is grave, not only on account of the 
possible complications, but also because the animals are unable to feed 
and therefore lose flesh with very great rapidity. 

Treatment. The first steps in treatment are in the nature of local 
disinfection, in order to prevent general infection. The mouth therefore 
should be washed out five or six times per day with boiled water, followed 
by antiseptic injections until improvement commences. Solutions of 
boric acid or l)orax (8 per cent.), chlorate of potassium (2 to 3 per cent.), 
or salicylic acid (3 to 4 per cent.), are useful, but the free employment of 
1, 2, or 3 per cent, solutions of chloral is even preferable. 

With the idea of protecting the organ from external injury, Lafosse 
formerly suggested the use of a suspensory bandage for the tongue, fixed 
to the base of the horns by small bandages. Guittard recommends 
scarification of the free part, and the application of a support perforated 
at the bottom to allows the blood, saliva, pus, etc., to escape. In spite of 
careful attention the disease may last from two to three weeks. 



CHRONIC GLOSSITIS. 

This form of disease has also ))een termed " sclerosing glossitis " and 
" non-actinomycotic wooden tongue," because it is anatomically charac- 
terised by induration of the tissues, and because apparently it resembles 



CHRONIC GLOSSITIS, 133 

true "wooden tongue," with which it was confused until within the last 
few years. Imminger in 1888 and Pflug in 1891 descrihed two forms. 
The first, termed " superficial sclerosing glossitis," is said to be the 
more frequent, and most commonly affects young animals suffering from 
irregularities in dentition. It seems due to a superficial acute glossitis 
assuming a chronic form. The submucous connective tissue in time 
undergoes hyperplastic changes, so that the tongue at first becomes 
swollen and afterwards absolutely rigid. One never finds ulcerations or 
actinomyces. 

Diagnosis. A close examination will always enable the case to be 
diagnosed at the first visit, or under any circumstances after a short 
time. 

The prognosis is very grave, because the animal has the greatest 
difficulty in grasping and masticating food, or may even be unable to do 
so. Patients lose flesh very rapidly, and end by dying of hunger. 

Treatment is of little service. The administration of iodine, the 
only drug which appears indicated, has proved of very questionable 
value. Economically, it is better to slaughter the animal. 



The second variety is rare, and has been termed " deep-seated 
sclerosing glossitis." It is simply a chronic form of ordinary deep- 
seated glossitis. The layers of connective tissue sei)arating the muscles 
are reju'esented by very hard, inelastic vertical partitions. As a con- 
sequence, the whole tongue becomes indurated and more or less com- 
pletely immobile. In this condition, again, there is neither ulceration 
nor actinomyces. 

Diagnosis. The diagnosis necessitates a careful examination. In 
the living animal it is very difficult to establish a distinction between 
this and the preceding form, though after death the task becomes much 
easier. • 

The prognosis is grave, complete restoration of the parts being 
impossible. 

The treatment differs in no respect from that given in the preceding 
instance. It is of little value. 



Imminger and Pflug have also described a deep-seated nodular scleros- 
ing glossitis, characterised anatomically by the existence in the depth of 
the tongue of fibrous nodules, varying in size between a small nut and 
a fowl's egg. The tongue is only slightly increased in size. 

This disease may perhaps be due to actinomycosis. 



CHAPTER II. 

DISEASES OF THE SALIVARY GLANDS, TONSILS 
AND PHARYNX. 

PAROTIDITIS (PAROTITIS). 

The term " parotiditis '" indicates an intlammatory condition of the 
parotid gland. Of this disease several forms exist. The disease is termed 
simple when due to accidental causes or infections, specific when result- 
ing from some special disease germ like the ray fungus. Anatomically, 
these diseases consist in inflammation of the glandular parenchyma and 
connective tissue stroma which surrounds the acini. 

ACUTE PAROTIDITIS. 

Causation. The causes of acute parotiditis are varied. Mechanical 
violence or contusions (due to collisions with fixed bodies, horn thrusts, 
or hlows from the ox-goad) may produce it, the glandular parenchyma 
and connective tissue separating the acini or the peri-glandular tissue 
being torn, crushed, lacerated, and often also directly infected in conse- 
quence of the injury. Ascending infection through the medium of the 
salivary ducts represents a second possible cause of the disease. 

Finally, parotiditis may, in some cases, constitute only a localisation 
of a general disease. It seems a fact that in rare circumstances paro- 
tiditis may assume an epizootic character, and attack a large number of 
animals in a particular stable or in neighbouring stables ; and if, under 
these circumstances, we are unable to blame the food (which has not been 
done), we are forced to admit the influence of infection and contagion. 

Symptoms. Whatever the cause, the symptoms are generally well 
marked. In many cases the first indication of the disease is apparent 
or real want of appetite, always complicated with difficulty in swallowing, 
and often accompanied by trifling fever. 

Salivation, resulting from irritation of the gland and inability to 
swallow, becomes abundant, and at once draws attention to the buccal 
cavity and adjacent parts. Inspection of the patient then reveals the 
existence in the parotid region of a diffuse swelling, which on palpa- 
tion is found to be hot and painful, and to occupy the whole of 



ACUTE PAROTIDITIS. 



135 



tii 



the parotid region between the lower jaw and the upper extremity of 
the neck. The lesion is usually unilateral, but occasionally bilateral. 

Parotiditis may terminate in resolution, suppuration, or necrosis. 
The suppuration may either be simply subcutaneous and extra-glan- 
dular, or may involve a portion of the salivary gland and of the parotid 
lymphatic gland in addition. 

Necrosis is exceptional, though Moussu saw double and total gangrene 
of both parotids, complicated with septicaemia, in the animal, of which a 
sketch is given herewith. 

If the disease is due to violent injury by a foreign body, traces of a 
wound may be found, but it 
is often useless to search for 
these, even when the parts 
have been pricked with a 
sharp goad. When the in- 
flammation has resulted from 
ascending infection of the 
salivary ducts, exaggerated 
sensibility may sometimes 
be detected throughout the 
whole length of Stenon's 
duct, particularly at the point 
where the duct crosses the 
jaw. There is always marked 
difficulty in moving the head, 
particularly towards the side, 
and sometimes in a vertical 
plane. The head is extended 
on the neck, and is held stiffly 
in such a way as to suggest 

the possibility of tetanus. Some observers have described as an impor- 
tant symptom marked swelling of the orifice of Stenon's duct. It is cer- 
tainly difficult to detect, and furthermore is of no great significance. 

Diagnosis. Although diagnosis is easy, it is a difficult matter to 
detect the point of origin of the disease. The salivation and difficulty 
in swallowing might seem to suggest pharyngitis, a condition which 
sometimes exists simultaneously. The distinction between this disease 
and the forms of chronic parotiditis, or tumour formation in the parotid 
(due to actinomycosis, lymphadenoma, melanoma), is also easy, on ac- 
count of the slow development of the last-named conditions. The only 
condition liable to be confused with that under consideration is abscess 
of the sub-parotid gland. 

Prognosis. The gravity of the disease varies greatly. When 




Fig. 63. — Acute parotiditis. 



13G DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

inflammation is slight, resolution usually occurs in eight to fifteen days. 
The onset of suppuration is announced hy renewal of the fever, by more 
marked swelling, which becomes localised at a given point, and by the 
existence of deep or superficial fluctuation. Care, however, is required 
to detect the last named. 

Necrosis may occur suddenly when the infecting organism is specially 
virulent, and may afi"ect one-third, one-half, or the whole of the gland. 
The prognosis then becomes extremely grave, and if diagnosis has not 
been prompt and treatment energetic, death may follow in a short time 
from septic infection. 

Treatment. Unless some well-marked sign foreshadows a compli- 
cation, treatment should be directed to ensuring resolution. Bleeding 
has been recommended ; its good effects, however, are open to doubt, 
though one cannot entirely forbid it. All practitioners agree in recog- 
nising the value of vesicant applications. The afi'ected parts may be 
freely dressed with an ointment containing 2 per cent, each of pulverised 
tartar emetic and bichromate of potash, with the ordinary cantharides 
blister, or even with a weak mercurial blister, provided that the animals 
can be prevented from licking the wound. 

Some practitioners prefer vesicants prepared with cantharides and 
croton oil. Whatever be the vesicant chosen, it is best after three or 
four days to apply emollients of slightly antiseptic character, such as 
ointments containing camphor, boric acid, salol, etc. When abscess 
formation is recognised the abscess should be opened as early as possible. 
Some precautions are necessary to avoid injuring important nerves and 
vessels ; in dealing with a deep-seated abscess it is necessary to use the 
knife for dividing the skin alone, to seek the abscess by blunt dissection 
wdth the finger or with round-pointed scissors, and to open it with a 
similar instrument. The cavity should then be freely washed out with a 
warm antiseptic solution — 3 per cent, carbolic solution, or 1 per cent, 
iodine solution, etc. If necessary a drain composed of iodoform gauze 
can be inserted, or a counter-opening made. 

In the case of partial necrosis, all the necrotic tissue must be carefully 
removed, injury to vessels, which would favour septicfemic infection, being 
avoided. Afterwards free antiseptic irrigation should be employed several 
times per day. 

In necrosis of the entire parotid extirpation may seem indicated ; but 
the greatest prudence is demanded, for the operation is extremely serious 
and delicate. 

CHRONIC PAROTIDITIS — PAROTID FISTULA. 

When a case of acute parotiditis is not treated, and does not end 
in suppuration, it is usually succeeded l)y chronic inflammation and fibrous 



INFLAMMATION OF THE SUBMAXILLARY GLAND. 187 

induration of the gland. Any obstruction of Stenon's duct, whatever the 
originating cause (foreign bodies Hke wheat awns, oat grains, calculi, etc.) 
stops the flow of saliva throughout the excretory apparatus, and produces 
over the entire parotid region a doughy swelling, which might seem to 
indicate the existence of indolent parotiditis. The collections of liquid 
thus produced have improperly been termed " salivary abscesses." If 
ascending infection fails to occur, or if infection is unimportant and does 
not lead to suppuration, a relatively painless chronic parotiditis develops, 
and in this case movements of the head and mastication and deglutition 
alone are impeded. 

The salivary ducts, however, may l)ecome so distended that the main 
superficial collecting duct undergoes softening, and the sldn covering it 
becomes ulcerated, just as would occur had a true abscess formed. 
Under such circumstances the sldn soon jdelds and a salivary fistula is 
estal)lished. 

The symptoms consist in swelling or induration of the gland, inter- 
ference with movement of the head and with mastication ; the whole 
developing slowly without pain or fever. 

The distinction of this condition from actinomycosis of the parotid 
may sometimes present some difficulty until a fistula develops. 

The prognosis is grave, because there is no hope of normal condi- 
tions being restored. 

Treatment. Treatment often proves unsuccessful. Should the 
condition have resulted from an obstruction, it is first necessary to 
attempt the removal of such obstruction, whether it be a foreign body 
or calculus, and so to re-establish the normal channel for the saliva. 
Local stimulation may be tried, though in cases of fistula without much 
hope of success. Smart blistering of the parts surrounding the opening 
and firing in points have been recommended ; but rather than persist in 
prolonged treatment of doubtful value, it is often better to prepare the 
animals for slaughter. 



INFLAMMATION OF THE SUBMAXILLARY SALIVARY GLAND. 

Inflammation of the submaxillary gland is rare in the ox. As in the 
horse, it is usually caused by the penetration of foreign bodies, such as 
glumes or awns of grain, fragments of straw, thorns, etc., into Wharton's 
duct. 

The difficulty in grasping food and the restricted movement of the 
tongue are the first symptoms to attract attention. On examination, 
the- region of the " barbs," usually on one side, appears injected, swollen, 
inflamed, and sensitive. 

The submaxillary space is effaced by the swelling of Wharton's duct; 



188 DISEASES OF THK SALIVARY GLANDS, TONSILS AND PHARYNX. 

the corresponding sul)niaxillary gland is doughy and painful on pres- 
sure. The symptoms rarely heeome more threatening than this. 

The diagnosis presents no difficulty. 

The prognosis is favourahle. 

Treatment consists primarily in removing the obstruction from the 
duct. Steady pressure from behind, forwards along the course of the 
duct, may sometimes cause the foreign body to be ejected into the mouth, 
along with a jet of offensive saliva. The distended and inflamed duct 
soon becomes emptied, and all the symptoms rapidly diminish. In other 
cases, when the obstructing body is firmly fixed in position, it is necessary 
to open the duct within the mouth by a stroke of the bistoury. 

TONSILITIS IN PIGS. 

" Acute and chronic forms are seen. The former has the general 
causes and symptoms of pharyngitis — fever, duhiess, a disposition to lie 
with head extended and buried in litter, drooping ears, watery eyes, 
indifferent appetite, painful deglutition, and sometimes vomiting. Mouth 
red and hot, breath foetid, tonsils swollen, their alveoli filled with muco- 
purulent matter or with foetid cheese-like masses. Cough at first dry 
and hard, later loose and gurgling. 

In chronic form there is general swelling of the tonsils with 
distension of follicles by above-mentioned putty-like masses, which are 
often calcareous. These are due to the proliferation of microbes, which 
find in these alveoli a most favourable field for their propagation. The 
affection usually ends in recovery, but may go on to grave local ulceration 
and general infection. 

Treatment. Astringent antiseptics to buccal mucous membrane. 
Electuaries of honey or treacle and borax, sal ammoniac, chlorate or 
permanganate of potash and externally stimulating embrocations to the 
skin of the throat. In some cases solutions of iron chloride or tinc- 
ture of iodine may be used with advantage and as a wash for the mouth 
and fauces. Attend to general health. If constipated give Glauber's 
salt or jalap, . . . and elimination through the kidneys must be 
sought through the use of nitrate of potash or other diuretic." (Law's 
" Veterinary Medicine," Vol. II. p. 46.) 

PHARYNGITIS. 

Inflammation of the mucous membrane of the pharynx is less frequent 
in the ox than in the horse, a fact probably due to its less sensitive 
character in the ox and to differences in the methods of working oxen. 

Causation. The causes are numerous and varied ; and although 
local microbic infection undoubtedly plays the most effective part in the 
development of the disease, it is none the less certain that external 



PHARYNGITIS. 139 

influences are of considerable importance. For this reason chills, 
sudden variations in temperature, sudden arrest of perspiration, and 
currents of cold air have always been invoked as causes. Cruzel thinks 
that the ingestion of ice-cold water in winter is sufficient to produce 
acute pharyngitis. The action of rough forage may of itself explain the 
development of pharyngitis in animals constantly kept indoors under 
excellent hygienic conditions. In such cases the disease may be regarded 
as of traumatic origin. Furthermore, it is necessary to mention direct 
injuries of the mucous membrane caused by clumsy- examination, 
awkwardness in passing the probang, and attempts on the animal's part 
to swallow sharp foreign bodies, which scratch, tear, lacerate, or 
l^enetrate the mucous membrane and become fixed in it. 

Finally, another series of causes, and not the least important, 
remains to be considered — viz., the forced administration of irritant 
substances like ammonia, tincture of iodine, oil of turpentine, very hot 
liquids, etc. 

To sum up, the four great series of causes consist in direct irritation, 
intra-pharyngeal wounds, variations in temperature, or primary or 
secondary microbic infections. 

The symptoms are characteristic. They consist in loss of ajipetite, 
difficulty in swallowing, consequent on the condition of the pharynx, and 
fever, which is often marked from the first. Pharyngeal dysphagia can 
easily be distinguished from that due to injury of the oesophagus, 
inasmuch as it occurs on the first attempt to swallow. 

Urged on by hunger, the animal grasps food, which it chews and 
attempts to swallow, but immediately allows it to fall back into the 
manger, or ejects it by a painful coughing effort. In the case of liquids, 
even of lukewarm drinks, the same accident occurs, the food or liquid being 
returned by the nostrils. Slight salivation results from this difficulty in 
swallowing. The animal's attitude is similar to that in parotiditis. The 
head is held stiffly, extended on the neck, in order to avoid compressing 
the region of the pharynx, and can only be moved slowly and with much 
pain. There is no apparent swelling of the parotid region, but on 
manipulating or pressing on the gullet the animal sometimes manifests 
the very acute tenderness of the parts by coughing and endeavouring to 
thrust away or to kick the examiner. Finally, examination of the mouth 
sometimes shows reddening and excessive sensibility of the soft palate 
and of the pillars of the fauces. 

These symptoms often assume a more alarming character, or are com- 
plicated by others ; in fact, the condition very rarely stops at pharyngitis, 
but is usually accompanied by inflammation of the larynx, of the soft 
palate, and of the naso-pharynx. The whole throat is then inflamed ; 
the nose and sometimes the eyes discharge, and there is difficulty in 



140 DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

swallowiii<:;", interference with respiration or noisy respiration, and intense 
fever. 

Diagnosis. The diagnosis presents no difficult^', the s_ymptoms men- 
tioned l)eing easy to identify, whether the condition be simply inflam- 
mation of the pharynx or be of a more extensive character. Never- 
theless, cases occur where the symptoms are alarming, but in which 
one might hesitate between the diagnosis of ordinary acute sore tliroat 
and the sore throat wdiich ushers in gangrenous coryza. A definite 
expression of 'opinion must then be deferred to a later date ; for one 
cannot be absolutely certain whether or not the other signs of gan- 
grenous coryza will appear. 

When there is only difficulty in swallowing one might a priori sus- 
pect traumatic injury of the mucous membrane, with or without the 
presence of a foreign body. It is also necessary to bear in mind the 
possibility of difficulty in swallowing being occasioned by reflex irritation 
without local lesions, originating in enlargement of the retropharyngeal 
lymphatic glands as a consequence of tuberculosis or other disease. 

The prognosis is favourable ; even without treatment acute pharyn- 
gitis usually tends to recovery in eight to twelve days, and rarely becomes 
complicated. Nevertheless, some reserve ought to be exhibited in cases of 
pharyngitis due to the action of rough forage, the removal of the cause being 
here indispensable to any improvement. Similarly in cases of pharyngitis 
due to foreign bodies having penetrated the mucous membrane, which 
are chiefly characterised by inability to swallow, the disease may continue 
for a very much longer time than above indicated, unless the foreign 
body is discovered and removed. Inflammation is limited to a zone sur- 
rounding the point of implantation. It extends more deeply with move- 
ments of the foreign body, and may end in the formation of an abscess. 
Of this variety is Hopsomer's remarkable case, in which a darning- 
needle finally obtained exit through the submaxillary space, in which it 
had caused the formation of an abscess. 

Treatment. The treatment is the same whether we are dealing with 
a simple acute pharyngitis or with a more widely distributed inflannna- 
tion. It consists in smartly stimulating the region of the throat with 
mustard, cantharides oil, or ointment, or with an ointment containing 
2 per cent, of tartar emetic and of bichromate of potash, and then cover- 
ing the parts with a flannel hood. This mode of treatment seems 
preferable to that recommended by German authors — viz., the applica- 
tion of cold compresses to the throat, the administration of cold gargles, 
etc. Moderate bleeding, to the extent of two or three quarts, has the 
great advantage, as in all similar cases, of lowering the temperature. 

This treatment may, if necessary, be completed by the internal 
administration of 3 to 5 drams of Kerme's mineral (oxysulphuret of 



PSEUDO-MEMBRANOUS PHARYNGltIS iN CATTLE. 141 

antimony) in electuary, according to the animal's size. Medicated 
inhalations diminish local irritation, render swelling less painful^ and 
facilitate the separation of false memhranes and the discharge of 
adherent mucous secretions. 

The ordinary food should be rej^laced by cooked roots, lukewarm 
drinks and gruels, all rough fodder being prohibited. 

If difficulty in swallowing alone continues, the operator should 
examine the mucous membrane of the pharyngeal cavity with the hand, 
in order to discover and remove any foreign body which may have 
become implanted there. 

PSEUDO-MEMBRANOUS PHARYNGITIS IN CATTLE. 

In addition to the above acute forms of pharyngitis, a pseudo-mem- 
branous, croupal, or pseudo-diphtheritic pharyngitis has been described in 
the ox. It is due to polymicrobic infection, and is characterised by the 
formation of false membranes on the pharyngeal mucous membrane. 
The condition seems to be a pharyngitis of exceptional intensity, vary- 
ing markedly from the classic type and being most nearly related to 
severe sore throat, laryngitis, gangrenous coryza, etc. 

It rarely attacks aged cattle, but is readily transmissible to calves and 
young stock. Cadeac failed to inoculate it on guinea-pigs and rabbits. 
Damman succeeded with sheep and with rabbits, the latter dying in 
twenty-four hours after inoculation with hfemorrhage at the seat of 
puncture. Loffler hypodermically infected mice and produced extensive 
infiltration of the abdominal walls, and often of the peritoneum, surface 
of the liver, kidneys and intestine, on which formed a thick yellowish 
exudate containing the organism. 

Causes. Ldffier found filaments of a long delicate bacillus about half 
the thickness of the bacillus of malignant oedema. The bacillus did not 
grow in nutrient gelatine or in sheep's blood serum, but readily grew in 
blood serum of the calf. Cadeac gives as predisposing causes : sudden 
chills, rapid alterations of temperature, inhalation of irritant vapours, sup- 
pression of cutaneous secretion, swallowing irritant liquids, and injuries. 

Symptoms. The nasal membrane is reddened, thickened and covered 
in patches with false membrane, causing snuffling and wheezing breathing. 
The throat is tender and swollen, cough is frequent, gurgling, and followed 
by expulsion of false membrane, muco-pus and some blood. Shreds of 
false membrane adhere to the nose and lips. Other symptoms are : fever, 
accelerated pulse, dark mucous membranes, haggard countenance, mouth 
open, hanging tongue, stringy salivation, and constipation or diarrhoea. 

The disease runs a rapid course, and death may occur in twenty-four 
hours. Eecovery may be equally rapid, but often convalescence is 
protracted. 



142 DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

Lesions. Intense congestion of mucosae of nose, mouth, pharynx, 
larynx, and bronchi, with here and there patches of false membrane, 
which may be soft or tough, according to the duration of the attack. 
The deep surface of the false memhranes is blood-stained ; and, according 
to Preitsch, false membranes sometimes occur in the oesophagus, rumen, 
and omasum, which in consequence may show patches of ulceration. 

Treatment (as for the horse). This includes poultices, counter-irri- 
tants, laxatives, febrifuges, alkalies and antiseptics. Inhalations of medi- 
cated vapour, warm water to which has been added some antiseptic — 
carbolic, lysol, creolin, camphor, sulphurous acid ; or for calves, iodoform, 
oil of turpentine, calcium sulphide, silver nitrate, coal tar. To detach 
the false memhi'anes ipecacuanha and potash chlorate, or soda sulphate, 
or magnesia sulphate may be tried. Papayin and pepsin have been 
suggested as appropriate remedies. Anyodnes — digitalis, belladonna, 
morphia and aconite — may be useful. Tracheotomy is indicated as a 
last resort. 

PSEUDO-MEMBRANOUS PHARYNGITIS IN SHEEP. 

Pioche-Lubin states that this is common in flocks as a result of moving 
the sheep in dusty enclosures. The dust is supposed to excite the intense 
croupous inflammation of the mucous membrane. The disease has been 
noticed in spring in young lambs shortly after weaning. Damman 
states that he transmitted the disease to the sheep from the exudate of 
the calf. 

Symptoms. Frotliy salivation with constant movements of the jaws, 
viscid nasal discharge, difficult deglutition, panting, snufliing breathing, 
throat swollen and very tender, frequent cough, discharge of exudate. The 
head and neck are extended, the eyes dull, appetite is lost, the mucous 
membranes are red or cyanotic, and the animal appears weak and listless. 
As respiration becomes more difficult the mouth is held open, the tongue 
is protruded, and with each cough shreds of false membrane are expelled. 
Death from sufl'ocation is not uncommon. 

The lesions are not different from those seen in the calf. 

The treatment is similar to that for the calf. Tepid drinks con- 
taining hydrochloric acid, or sulphate of soda (1 lb. to 50 sheep) in the 
drinking water, has been recommended. Fumigation with sulphurous 
acid or chlorine may be tried. Small numl)ers may be treated by swab- 
bing the throat with solution of sodii hyposulphis or weak caustics and 
antiseptics. 



In young and in adult pigs pseudo-membranous pharyngitis is often 
only a manifestation of pneumo-enteritis. It therefore calls for no special 



PHARYNGEAL POLYPI. 143 

description at this point. No exact investigation of the organisms which 
produce these forms of pharyngitis with false membrane formation has 
been made in veterinary surgery. We only know that these diseases are 
not true diphtheria due to " Klebs' bacillus." Treatment should be very 
energetic from the commencement, but otherwise it differs in no respect 
from that ordinarily adopted. 

Tonics and stimulants, like alcohol, wine, coffee, etc., are indicated. 

[The following account of the disease is summarised from Law's 
" Veterinary Medicine," Vol. II.] 

" Pseudo-membranous pharyngitis has long been recognised as a 
contagious disease of swine, attacking especially swine kept in herds 
or in close, insanitary pens. Young pigs are more liable to attack than 
older animals, perhaps, owing to the older animals having suffered the 
disease in early life. 

Modern observation shows that pharyngitis with false membranes 
is common in swine plague, and the present tendency is to refer all 
such cases to that category. It is, however, altogether probable that 
the occurrence of local irritation, with the addition of an irritant or septic 
microbe altogether distinct from that of swine plague or hog cholera, 
gives rise at times to this exudative angina. Certain it is that septic 
poisoning with the food is not at all uncommon in the hog, in the absence 
of these infectious diseases. 

Symptoms are those of sore throat, with much prostration, a croaking 
cough, yellow discharge from nose and mouth, and marked muscular 
weakness. The tongue, tonsils and soft palate are red, swollen, and 
studded with patches of false membrane. The identification of swine 
plague may be made by the history of the outbreak, the number of 
animals affected, the tendency to pulmonary inflammation, the enlarged 
lymph glands, the presence of the non-motile bacillus, which does not 
generate gas in saccharine media, and which readily kills rabbits and 
pigs with pure cultures of the germ. 

Treatment. Isolation, cleansing and disinfection. Locally antiseptics 
and generally a febrifuge regimen will be advisable." 

PHARYNGEAL POLYPI. 

The term "pharyngeal polypi" includes tumours of varying 
character, which affect the polypus form, and occur with considerable 
frecpiency in the bovine species. Many of these polypi are simply actino- 
mycotic growths springing from the pillars of the fauces, from the 
upper parts of the palate or from its posterior surface. Less frequently 
they arise from the lateral walls or the free surface of the hard palate. 

Symptoms. The symptoms are so characteristic that the diagnosis 
rarely presents much difficulty. They may shortly be described as 



144 DJSEASES OF THE SALIVARY GLANDS, TONSILS AND PHARVNX. 

indicative of repeated obstruction in the pharyngeal, cesophageal or 
laryngeal region. At the moment of deglutition, the polypus is thrust 
towards and obstructs the oesophageal orifice. 

Eeflex stimuli are thus excited, which prevent deglutition; an attack of 
coughing occurs, and food mixed with saliva is ejected from the mouth 
and nostrils. The attack of coughing displaces the polypus either 
in a forward or lateral direction, and swallowing then again becomes 
possible, until by changing its position the growth produces fresh signs 
of obstruction. 

In other cases the polypus may only be of such small size as to 
impede the food passing through the pharynx on its way into the 
oesophagus or to cause difficulty in respiration by partially blocking 
the pharyngeal portion of the nasal cavities. In such cases deglutition 
is only checked and rendered slowei". 

Or again, the pedicle of the polypus may be sufficiently long to allow 
the growth at certain moments to fall in front of the laryngeal opening. 
Respiration is then painful, difficult and noisy. Unless the growth is 
displaced during the subsequent attack of coughing, asphyxia may appear 
imminent, or may even occur unless assistance is afforded. 

Guided by these symptoms, the operator will explore the pharynx 
manually, and thus discover the position and size of the tumour. 
Tumours of the naso-pharynx produce very similar symptoms. 

The prognosis is based on the information obtained by manually 
exploring the pharynx. It is relatively favourable if the polypus has a 
well-marked neck, but is very grave if the tumour is largely sessile and 
cannot be removed. 

Treatment. Medical treatment ajipears useless except in cases of 
polypi due to the presence of actinomyces. The administration of iodine 
and iodide of potassium, in large doses, may then lead to resorption ; but 
extirpation is often preferable. 

In other cases extirpation is the only rational treatment. The 
operation necessitates the performance of provisional tracheotomy in 
order to avoid risk of asphyxia. The growth may be directly removed 
through the buccal cavity without incision, provided that it prove pos- 
sible to pass the chain of an ecraseur around the pedicle ; or through the 
buccal cavity, with incision, after vertically or obliquely dividing the soft 
palate ; or, lastly, through the larynx, after performing median laryn- 
gotomy, thus obtaining access to the pharynx. 

Only the first method of intervention is to be recommended ; the last 
two are more delicate. They necessitate after-treatment, and when the 
patients are in a condition for slaughter it is frequently preferable to 
send them to the butcher. The essential point is not to act without a 
full knowledge of the causes. 




CHAPTER III. 
DISEASES OF THE OESOPHAGUS* 

The CL'sophageal tube is of very simple anatomical construction, and 
performs an equally simple physiological function ; nevertheless, in the 
ox it is liable to a large number of diseased conditions. These con- 
ditions may affect only a circumscribed area of the 
mucous membrane or the entire extent of the tube. 
Agahi, both the muscular and mucous tissues may 
be affected, as in inflammation of the oesophagus 
accompanied or followed by contraction, and in the 
formation of (esophageal abscesses and tumours ; 
or the muscular tissue alone may be affected, as Fm. 64.— Schema il- 
in cases of dilatation. Even where no lesion is . l^s^'i'ating anatomy 
apimrent the normal rhythm of deglutition may ° ,^^ oesopiagus. 

.^ . , f -, -.1 • •- •. 1 ^-u n ^ strong external 

1)6 niterfered with, either by the presence of a | j, ^^ muscle, in- 

foreign body (obstruction) or by spasm of the mus- temiediate cellulo- 

cular layers (oesophagismus) or by compression due elastic layer, inner' 

to tissues surrounding the oesophagus (false con- ^^y^^ °^ mucous 

tractions) . "o^s ^XV able of 

We shall successively study the different forms ^^,^,^^ dilatation 

of oesophagitis, contraction, and dilatation, together 

with their complications ; then obstructions, ruptures of the oesophagus, 
oesophagismus, and false contractions. 



(ESOPHAGITIS. 

Inflammation of the oesophagus may be due to many different causes, 
and may occur in one of three different degrees of severity. It may 
be either superffcial, i.e., limited to the epithelial layer of the mucous 
membrane ; or deep, affecting the entire thickness of the mucous mem- 
brane (epithelium, corium, and oesophageal glands) ; or, finally, it may 
attack both the mucous and muscular layers. German authors recog- 
nise various divisions, such as erythematous, catarrhal, follicular, and 
phlegmonous oesophagitis. In reality these are not always different forms, 
but simply successive stages in the evolution of a single morbid condition. 

D.C. L 



146 DISEASES OF THE (ESOPHAGUS. 

Here we shall only study the ordinary forms of oesophagitis, leaving 
on one side those which occur symptomaticall}' during foot-and-mouth 
disease, cattle plague^ gangrenous coryza, actinomycosis, etc. 

Causation. The causes of oesophagitis may be divided into three 
groups of different character: — (a) Eough fodder (clover containing wrest- 
harrow, thistles, thorns, furze, or splinters of wood, etc.) must he placed 
in the first rank, for its repeated action abrades and irritates the mucous 
membrane to such an extent as finally to produce inflammation. This 
inflammation usually remains superficial and of moderate intensity ; its 
occurrence can be anticipated during years of scarcity, when the animals 
feed on rough and irritating material like fern, broom, heather, furze,- etc. 

(h) Hot drinks, whether in the nature of beverages or medicinal 
draughts, are a frequent cause of cesophagitis if administered by careless 
or inexperienced persons. The mucous membrane is scalded over a 
varying area and with different degrees of severity, or is destroyed 
by the chemical action of such drugs as ammonia, dilute acids, iodine 
solution, etc. 

(c) Eough or clumsy manipulation in withdrawing or displacing 
foreign bodies, or merely passing the probang, produces that variety of 
cesophagitis termed traumatic. In clumsy hands oesophageal sounds or 
catheters may abrade or even tear the mucous meml)rane and sul)jacent 
tissues. 

Symptoms. These vary to some extent, according to the intensity 
of the inflammatory phenomena. If the lesions are superficial and only 
implicate the epithelium, as in catarrhal oesophagitis, the symptoms often 
pass unnoticed, and only produce difficulty in swallowing. When inflam- 
mation has involved the entire thickness of the mucous membrane the 
immediate consequence is loss of appetite due to pain during swallowing. 
After the bolus of food has been masticated, and has passed into the 
pharynx, the animal stretches out its head and neck and seems to be 
making efforts to force it down the oesophageal canal. The progress of 
the bolus is slow and clearly difficult. 

In oesophagitis due to scalding the blisters are soon broken by the 
passage of food, the corium is exposed, and the animal has equal difficulty 
in swallowing either solids or liquids. The reflex action provoked by the 
passage of the food over these lesions may be so violent that the ingesta 
never arrive at the stomach, but are violently rejected by a sudden and 
unexpected antiperistaltic contraction. Even saliva is returned. More- 
over, in these cases the history is generally clear, and the animal is 
feverish or greatly depressed. These objective symptoms are very 
significant, and when, in addition, an abnormal and exceptional degree 
of sensibility is detected at some point by palpation, they unmistakably 
indicate the existence of cesophagitis. 



(ESOPHAGITIS. 147 

The irregularity in deglutition, and therefore also in rumination, 
sometimes excites moderate tympanites without any very apparent cause. 
Should the condition still appear doubtful the oesophageal sound may be 
passed, but with great care. It generally aggravates the pain and pro- 
duces intense antiperistaltic movements, which the practitioner should 
not attempt to overcome. 

Complications. If cesophagitis is moderate, recovery is the rule. 
The symptoms of pain gradually diminish. 

When, on the contrary, inflammation is very intense, as in certain 
cases of traumatic cesophagitis, the injured spot may become infected 
and suppuration follow. The existing fever then persists or becomes 
more marked ; the animal is extremely depressed ; respiration may be 
difficult and accelerated, and aj^jDetite is entirely lost. 

If the (esophageal abscess remains submucous the diagnosis is 
difficult, but it is often problematical, even when the abscess develops 
ill the cervical region. The jugular furrow (usually on the left side) 
becomes the seat of a severe diffuse inflammatory swelling, the course of 
^\hich clearly indicates the development of the symptoms. In exceptional 
cases fluctuation may be detected. 

If from the first the abscess develops around the cesophagus or in the 
course of suppuration comes to occupy this position, swelHng in the 
jugular furrows is more apparent and easier to detect, and in this case 
fluctuation may be localised. When the lesions are within the thorax 
no tangible symptoms can be detected. Death may occur in a few days, 
when an abscess in the lower cervical region breaks into the anterior 
mediastinum, or when an abscess in the thoracic region opens into the 
pleural cavity. In cesophagitis produced by scalding and from swallowing 
hot or caustic liquids the mucous membrane, and sometimes the muscular 
tissue, is destroyed, and ulcerations and cicatrices result, or the oesophagus 
may even be perforated, with rapidly fatal results ; even when recovery 
occurs, cicatrices form and cause very grave contraction. 

Diagnosis. The diagnosis is generally easy, provided that the 
symptoms noted are methodically analysed and the history of the 
case is taken into consideration. 

Prognosis is favourable in ordinary cases. On the other hand, it 
may be very grave when general symptoms become marked, when the 
vital functions are disturbed and a deep-seated abscess appears to be 
forming. 

Lesions. In the first degree the lesions are confined to inflammation 
and desquamation of the epithelium ; in the second, to inflammation of 
the corium and of the mucous membrane ; in the third, to infiltration of 
the submucous layers and of the muscular and pericesophageal tissues. 
Sloughing and perforation follow the administration of caustic liquids. 

L 2 



148 DISEASES OF THE (ESOPHAGUS. 

Treatment. As the direct application of medicines to the inflamed 
mucous menibiane can only be of a momentary character, treatment is 
confined to administering emollient, anodyne, and slightly astringent 
drinks, the action of which is assisted by feeding with milk, farinaceous or 
mucilaginous foods. Under these circumstances recovery occurs in ten 
to fifteen days. The application of stimulant or blistering ointments 
along the jugular furrow may have a good effect. 

When the general condition of the patient becomes aggravated, and 
the formation of an abscess appears certain, it is best to recommend 
slaughter. In the case of a submucous abscess the passage of the pro- 
bang may, however, predispose or cause the abscess to open into the 
oesophagus, and thus lead rapidly to recovery, but tliis is exceptional. 
The "pointing" of the abscess and its opening towards the jugular 
furrow may be followed by temporary improvement, but at a later stage 
is followed by fistala formation, or by contraction of the cesophagus 
itself. From an economic standpoint it is better to slaughter. 

STRICTURE OF THE CESOPHAGUS. 

Under normal conditions the cavity or lumen of the oesophageal tube 
is, so to speak, imaginary : the walls of the tube lie flatly together, and 
the mucous membrane is in folds. During the act of swallowing the 
tube becomes dilated to a degree varying with the size of the bolus of 
food, and again retracts as soon as deglutition is effected. Whenever the 
dilatability of the tube is markedly diminished by changes in its walls, 
and, in a much higher degree, when this dilatability has disappeared, 
true stricture exists. In the former case small boluses of food and 
liquids alone succeed in passing the stricture ; in the latter, liquids alone 
can pass. 

Causation. Strictures are never primary. They result from intense 
■attacks of cesophagitis, ending in sclerosis of the mucous coat, extensive 
ulceration consequent on scalding, or interstitial inflammation affecting 
the muscular coats, which then become thickened or sclerosed. 

Internal injuries due to attempts to withdraw^ or propel foreign 
bodies along the oesophagus may also cause strictures. 

Lesions. In simple strictures the lesions are confined to the develop- 
ment in the depths of the mucous membrane and in the muscular layers 
of inflammatory tissue, which becomes denser with lapse of time. This 
alters the character of the walls and the structure of the tissues, and 
causes them to lose their elasticity. After extensive ulceration the tissue 
of the cicatrix contracts and hardens to a very varying degree. 

Symptoms. The apparent symptoms are very clearly marked ; the 
appetite is good, and the animal masticates as usual, but in the act 
of deglutition is seen to extend the head on the neck, and to make 



STRICTURE OF THE (ESOPHAGUS. 



149 



m 




efforts to swallow, which prove unavaiHiig when the contraction is 
too marked. A reflex antiperistaltic movement often causes the sub- 
stances ingested to be at once rejected. These violent efforts, however, 
in time provoke dilatation above the stricture. A quantity of food 
accumulates in this dilatation, and the symptom so characteristic of 
cesophageal stricture then appears — viz., regular regurgitation. The 
second constant symptom associated with compression or obstruction 
of the oesophagus is tympanites after feeding, however trifling may 
be the amount swallowed. Eumination is 
suspended, and even eructation of gas is 
difficult. Finally, the characteristic sign of 
stricture is noted on passing the probang, 
which reveals the existence of the condition, 
indicates its position, and suggests its degree 
of development. 

Diagnosis. Strictures only develop pro- 
gressively and slowly, a fact which enables 
them to be differentiated from oesophagitis. 
It is more difficult to differentiate them 
from dilatations, because the stricture always 
ends by becoming complicated with dilata- 
tion ; but this distinction is of little prac- 
tical importance, the consequences being 
identical. 

Prognosis. The prognosis is very grave, 
and there is no economic reason for attempt- 
ing treatment except in special cases ; the 
indications are in the direction of slaughter. 

From the economic standpoint there is 
no treatment. Basing their actions on 
human practice, the Germans have recom- 
mended progressive dilatation of the lumen of the oesophagus by passing 
a series of catheters of gradually increasing size. What, however, is 
justifiable in human medicine, where the only object is to keep the 
patient alive at any cost, may be highly objectionable in veterinary 
practice ; and in the present instance this is the case. Except in very 
rare instances, which the practitioner alone can apj)reciate, dilatation is 
contra-indicated, and the owner's interest lies in slaughtering the animal 
before it has lost much condition. 



Fig. 65. — Scliema of recent 
and old-standing contraction 
of the oesophagus. R, simple 
contraction ; D, secondary 

dilatation. 



DILATATION OF THE CESOPHAGUS. 

Dilatations are more frequent than strictures. Their mode of origin 
is easily understood. When the muscular tissue has lost its tonicit}' and 



150 



DISEASES OF THE (ESOPHAGUS. 



contractile power at a given point, or when, as a consequence of any form 
of inflammation, it has begun to undergo atrophy, the mucous membrane 
becomes herniated, because its circumference is not supported regularly 
during deglutition. The ectasia, which at first is of small size, becomes 
more marked in consequence of the tendency that exists for the food to 
accumulate in the dilated region. Dilatation is thus set up. 

Localised attacks of oesophagitis, accidental injuries and fissuring of 
the oesophageal muscular tissue, produced by clumsy efforts to displace 
foreign bodies with the probang, are the principal 
causes of dilatation. When the probang is impru- 
dently or clumsily manipulated, it may press exces- 
sively at any point where the oesophagus makes a 
slight bend, and thus split the contracted muscular 
coat without injuring the lax mucous membrane. 

Oesophageal contractions, as we have seen, may 
form the point of origin of dilatations, but in this 
case the dilatations are more regular in form, and 
affect the entire circumference of the tube. The 
muscular tissue is still everywhere normal, and 
becomes dilated in consequence of equally-applied 
excentric pressure. 

Symptoms. When the dilatation develops 
slowly and progressively, as a consequence of mus- 
cular atrophy, the symptoms remain unnoticed for 
a long time, and the owner only begins to be 
anxious when the animal loses condition, or when 
the driver or cowman detects masses of half-chewed 
food mixed with the saliva in the manger. 

Certain signs are pathognomonic ; others may 
be regarded as of secondary importance. By care- 
fully watching an animal which is feeding the 
following symptoms may be noted : As a general 
rule hunger is very marked, and the animal chews 
its food and swallows the first few mouthfuls in a perfectly normal way. 
Three, five, eight, or even ten mouthfuls may be swallowed ; then the 
animal suddenly stops, appears a little anxious, extends its head and 
neck, an antiperistaltic contraction occurs, and one or two masses of 
food are rejected and fall into the manger. The discomfort being thus 
momentarily relieved, the animal, which is dying of hunger, although 
faced with food which it is unable to swallow, returns to its meal, swallows 
one, two, or three boluses of food, regurgitation again occurs, and the 
whole process is repeated. 

What is going on under these circumstances is easy to explain. 




J 



Fig. 66. — Schema of 
oesophageal stricture 
(the muscular layer 
above the stricture 
has undergone atro- 
phy ; the mucous 
membrane is di- 
lated). 



DILATATION OF THE (ESOPHAGUS. 151 

At the commencement of the meal the dilatation is usually empty, or 
nearly empty. A mouthful of food is swallowed. It descends the oeso- 
phagus until it arrives at the diverticulum, into which it partially or 
wholly passes, the peristaltic wave of contraction ceasing at this point. 
The second mouthful follows with the same result, then a third, a fourth, 
etc. The diverticulum soon hecomes filled to repletion, and no more food 
can enter it. The food therefore accumulates in the upper portion of the 
oesophageal tube until the latter becomes nearly filled ; but as this tube, 
provided its innervation is intact, is intolerant of the presence of any 
foreign body, and as efforts to swallow prove fruitless, a sudden anti- 
peristaltic wave of contraction occurs, with the result that all the material 
contained in the tube above the dilatation is ejected into the mouth, 
whence it falls into the manger. The same result follows any further 
attempts to swallow during a particular feeding time. From this it will 
be seen that the animal can ingest at a given time only as much as the 
dilatation will contain. 

In the intervals between meal times and under the action of the saliva 
and warmth, the food collected in the dilatation becomes softened, breaks 
down, and slowly moves onward towards the rumen. When the next 
feeding time arrives the dilatation is almost empty, and the same set of 
symptoms recurs. 

If, instead of forage, the animal begins by taking gruel or very fluid 
material, deglutition appears normal, or at least fairly easy ; but if drinking 
is deferred until after taking hard food, it becomes almost impossible, 
because the passage is obstructed. These symptoms are, so to speak, 
pathognomonic. Under any circumstances they are so significant that 
error in diagnosis is unlikely. 

By careful examination oesophageal regurgitation can very easily be 
distinguished from true vomiting ; the character of the rejected material 
shows that it has not come from the stomach, while the boluses of food 
preserve their cylindrical form, and are still saturated with saliva. 

Some secondary signs also deserve to be mentioned, such as the 
animal's anxiety and restlessness whilst its neighbours are feeding, the 
existence of trifling and intermittent tympanites due to suppressed 
eructation, suppression or irregularity of rumination, constipation, etc. 
At a later stage there is rapid wasting and disordered appetite, and 
finally the patients die slowly of hunger, whatever efforts are made to 
feed them. 

When the seat of dilatation is in the cervical portion of the oesophagus, 
there are other symptoms which leave no doubt as to the condition. 
When empty the pouch cannot be detected ; but during a meal the accu- 
mulation of food causes it to assume the appearance of a doughy, diffuse, 
indolent swelling, which alters the outline of the jugular furrow, yields 



lo2 Diseases of the (f.sopHAGts. 

to in-essiire, and sometimes produces respiratory disturbance by pressing 
on the trachea, the pneumo-gastric and inferior laryngeal nerves, etc. 

When the dilatation is intra-thoracic and the above-described symptoms 
have been observed, the dilated spot can only be detected and localised by 
using the probang. The greatest possible prudence, however, is required 
in manipulating the instrument, in order to avoid rupturing the thin walls 
of the dilated portion. 

The diagnosis is not always easy ; when food is regurgitated, and 
one finds by auscultation that the sound usually produced by the passage 
of solids or liquids into the rumen is absent, there need be no hesitation 
in diagnosing either a dilatation or a stricture. The clinical consequences 
being the same, the possible error would be of little importance. 

Prognosis. The animal's life is rarely in immediate danger, but from 
the economic point of view the j^rognosis is extremely grave, and it is in 
the owner's interest to slaughter the animal as soon as possible in order 
to avoid loss. Even in cases of dilatation in the cervical region, surgical 
interference is not advisable. 

Treatment. As foreshadow^ed by what has been said, there is no 
rational economic treatment. When the dilatation is in the cervical region, 
one might in exceptional cases attempt to restore the regular calibre of 
the oesophagus by removing an elliptical portion of mucous membrane, 
and bringing the muscular tissue together w'ith sutures ; that is to say, 
when the rupture or fissuring of the muscular coat has been accidental. 
But as one is usually unable to remove the primary cause, to which the 
change in the muscular tissue is essentially due, the dilatation would 
recur without the operation having conferred any benefit. 

When an exact diagnosis has been made, the only useful indication 
is to confine the animal to very fluid food, which will not obstruct the 
oesophagus. Ordinary forage should be withheld. 

CESOPHAGEAL OBSTRUCTIONS. 

In this chapter we shall only consider such obstructions as occur in 
consequence of the animal having attemi)ted to swallow without sufficiently 
chewing objects which become arrested in the oesophagus. 

Obstruction is termed "total" or " partial," according as the obstructing 
l)ody fills the entire calibre of the oesophagus at the point of obstruction, 
or only occupies a part of the space. Partial obstructions produced by 
Ijeet and turnip tops, etc., are usually but momentary ; liquids and saliva 
are still able to pass between the obstruction and the walls of the tube, 
and as soon as the arrested food becomes a little softened it is displaced 
and the oesophagus again becomes patent. 

Causation. The circumstances under which this accident occurs are 
extremely easy to understand. Obstructions are produced by apples, 



(Esophageal obstructions. 153 

potatoes, .turnips, carrots, cabbage-stalks, beetroots, etc., which, whether 
shced or not, are swallowed gluttonously. Not having been sufficiently 
comminuted, and being of larger size than the cesophagus can readily 
accommodate, they become arrested at some point between the com- 
mencement of the oesophagus or a few inches behind the pharynx, or 
just in front of the point of entry of the gullet into the stomach. The 
latter is the commonest position, though not infrequently the ol)struction 
occurs in the intra-thoracic portion. 

It may occur in the stable, but is commoner in animals which, having 
broken loose, have entered orchards, gardens or potato or turnip fields 
and attempted to swallow apples, cabbages, potatoes, etc., found there. 

In sheep, obstruction of the oesophagus is due to similar causes, but 
in their case the above-mentioned objects are replaced by small wild 
apples, turnip shells, Jerusalem artichokes, horse-chestnuts, carrots, etc. 

The symptoms may be divided into general and local. 

General symptoms. As soon as the foreign body becomes fixed in 
position, the animal begins to make exceptional efforts to swallow. The 
head is extended on the neck, and the oesophagus and the muscles sur- 
rounding the trachea are violently contracted. These efforts proving 
fruitless, feeding is necessarily stopped, and the animal at once appears 
slightly anxious. 

Very soon afterwards salivation sets in, saliva l)eing continuously 
secreted. If the obstruction is total, the saliva cannot be swallowed, 
and is either returned in quantities l)y antiperistaltic movements or 
escapes in frothy filaments from the mouth. 

Tympanites is not long in appearing. It is progressive, and results 
both from arrest of eructation and from continued fermentation in the 
rumen. It may eventually come to a standstill, or may continue and 
threaten to produce asphyxia. 

Local symptoms. The local symptoms are ditiicult to appreciate, 
except in cases of cervical obstruction. Sometimes the foreign body 
produces a local swelling, which changes the outline of the jugular 
furrow, most frequently on the left side. In many cases it can only 
be detected by manipulating the i^arts between the trachea and the 
lower surface of the cervical vertebrae. "When the obstruction is within 
the thorax, the probang alone can detect its position. 

Diagnosis. The diagnosis is usually easy. The history and the 
observed symptoms are often very clear, and the suddenness with which 
the obstruction has made its appearance prevent the condition from 
being confused with dilatation or stricture. 

The prognosis is very variable. It is often easy to remove the 
obstacle ; in other cases intervention is difficult, and death ma}' occur 
rapidly. 



154 DISEASES OF THE (ESOPHAGUS. 

Treatment is confined to one essential point — removal of the 
obstruction. The chief difficult}^ lies in choosing the mode of inter- 
vention. Moreover, success depends on several factors, which, in the 
order of their imi)ortance, are as follows : the size of the ol)structing 
body ; the time which has elapsed since the accident occurred ; the 
bodily condition of the animal — i.e., whether it be fat or thin — and the 
extent to which tympanites has developed. 

The first thing to do (and in favourable cases all that is required) is 
to puncture the rumen and leave the canula for some time in position. 
The onward progress of the foreign body, especially when the obstruc- 
tion is in the intra-thoracic portion of the tube, is often impeded by the 
tympanites, which tends to thrust the object towards the pharynx, or at 
least to fix it in position. In consequence of a sudden change in the 
conditions of pressure the foreign body may move and pass into the 
rumen ; all danger is then at an end. 

Even though the obstruction does not immediately cease, puncture of 
the rumen, by removing the danger of asphyxia, allows one at least to 
wait for several hours, sometimes until next day, during which time the 
object may pass into the rumen without further extraneous assistance. 
The other methods may be grouped into four series : 

I. External taxis. This is directed towards loosening the foreign 
body and thrusting it towards the pharynx and buccal cavity. It can 
only be used against obstructions in the cervical region. Two methods, 
although very ancient, are still practised. 

{a) The first is carried out in the following way : the animal is fixed 
to a post or tree so that it cannot struggle, its head being drawn up as 
high as possible. The operator stands on the left side, with his back 
turned towards the patient's head, his left hand is pressed into the right 
jugular furrow, his right hand is placed on the left jugular furrow imme- 
diately below the foreign body. By using the fingers the foreign body 
is moved, and is progressively thrust towards the pharynx, in spite of the 
animal's efltbrts to swallow. In carrying out this manipulation it is 
absolutely indispensable not to let slip the obstructing body for a single 
instant, otherwise the peristaltic action will immediately return it to its 
former place. When it has been raised as far as the pharynx, an 
assistant passes his hand into the back of the mouth, as indicated in a 
former chapter, seizes the object and withdraws it ; or, instead, the 
assistant takes over the operator's duties, while the latter himself 
extracts the foreign body. 

{h) In the second method the animal is tixed in a different position, 
the head being held about 10 to 12 inches from the ground, with the 
neck lowered and inclined towards the earth. As in this position the 
oesophagus is longitudinally relaxed, and can be dilated to its fullest 



OESOPHAGEAL OBSTRUCTIONS. 



155 




extent transversely, the difficulty of displacing the obstacle should be 
very much less. In this case the operator always stands on the left side 
of the neck, but with his back towards the animaVs body. The right 
arm is passed around the neck and the right hand pressed into the 
right jugular furrow, the left hand being similarly engaged in the left 
jugular furrow. The method of employing the fingers 
is identical, or instead of the fingers the thumbs may 
be used. 

When the obstructing object has been lifted as far 
as the pharynx it has a tendency to fall out of the 
mouth, and if it fail to do so it can be fixed in position 
and removed as in the preceding case. 

II. Extraction. These methods are applicable to 
cases where the foreign body has become fixed in the 
cervical region, but more especially to obstructions in 
the intra-thoracic part of the oesophagus. In the 
majority of cases they are dangerous, and may lead 
to pinching, rupture, or perforation of the cesophageal 
mucous membrane. They should therefore be re- 
garded as exceptional measures. Theoretically, the 
instruments described are perfect, but practically they 
do not secure the results anticipated, because one can 
never prevent displacement, wrinkling, and involution 
of the cesophageal mucous membrane. 

The forceps probang has the drawback of seldom 
grasping smooth foreign bodies with sufficient firm- 
ness to permit of their extraction. 

The corkscrew sound exposes one to the great 
danger of completely piercing the oesophagus, because 
it has to be managed blindly, and because one never 
knows at what depth the corkscrew portion should be 
protruded in order to obtain a proper bold of a foreign 
body. 

III. Passage of the probang. When taxis fails or 

is inapplicable, we are forced to attempt thrusting the foreign body 
onwards. The method is much safer than the preceding, but, never- 
theless, demands great tact, prudence, and gentleness. Suitable oeso- 
phageal sounds are made with cupped extremities, though in cases of 
emergency an instrument can often be successfully improvised from a 
cane, whip handle, or flexible stick, about 4| to 5 feet in length, securely 
wrapped at one end with cloth or tow and freely coated with some greasy 
material such as lard, vaseline, or oil. 

The end of the sound having arrived in contact with the obstacle, 



I 

Fig. 67. — (Eso- 
phageal sounds. 
Probands. 



156 DISEASES OF THE (ESOPHAGUS. 

the operator exercises moderate but permanent pressure. The obstacle 
may not move immediately, because of spasm of the oisophagus, which 
grasps it. It is therefore necessary to wait and to take advantage of a 
moment when the resistance is less, and even then the obstacle may 
not move. 

Eough manipulation with improvised sounds may tear, fissure, or 
perforate the muscular and mucous coats, producing the gravest 
consequences. 

IV. Crushing. The crushing of an obstruction in the cervical 
region was long ago suggested, and is still greatly commended by 
empirics and farriers. It is performed by means of a little mallet and a 
piece of board. The method is barbarous, and exposes the animal to 
such grave complications as crushing of the oesophageal walls, followed by 
necrosis, laceration of the connective tissue, and interstitial hfemorrhage, 
injuries of the superficial or deep-seated jugulars, of the carotid artery, 
pneumo-gastric nerve, etc. It should never be practised, even although 
attempts have been made to improve it by replacing the mallet and board 
by sj)ecially formed forceps intended for crushing potatoes or roots. 
Only in the rare cases where one is certain that the foreign body consists 
of a very ripe fruit could crushing be justified, and in this case there is no 
need to have recourse to special instruments, for the hands alone suffice. 

Injection of alkaloids. The practitioner occasionally finds him- 
self in the embarrassing position of having vainly tried all the above 
methods. Before adopting the last resource, viz., oesophagotomy, it is 
then worth while to test the action of certain alkaloids, injected sub- 
cutaneously, after having punctured the rumen. 

We know that pilocarpine and eserine stimulate secretion and the 
action of the bowels. Injected under the skin they cause frequent 
swallowing efforts, and intense peristalsis extending throughout the 
length of the digestive tract. Doses of 1| to 2 grains of pilocarpine and 
1 to 1^ grains of eserine, according to the size of the animal, scmietimes 
produce excellent results, and rapidly remove obstructions. 

Apomorphine, the effects of which are, so to speak, inverse, because 
they tend to produce anti-peristalsis and vomiting, may l)e tried in doses 
of 2 or 3 grains. 

(Esophagotomy. The last resource is cesophagotomy, which, how- 
ever, is only applicable in cases of obstruction of the cervical portion of 
the CEsophagus. It should be performed as described in the section here- 
after on operative manipulation. (See also Mdller and Dollar's "Eegional 
Surgery," p. 16G.) 

The point selected is necessarily governed by the position of the 
obstacle. There is no need to enter into full details. We may remark 
that it is not always necessary to perform the complete operation, and 



RUPTURES AND PERFORATIONS OF THE (ESOPHAGUS. 157 

the third and fourth stages can sometmies he avoided hy suhstituting for 
them attempts to hreak down the foreign body by submucous manipula- 
tion. The oesophagus, having been exposed and isolated, is punctured 
with a straight tenotome immediately below the obstacle. A curved 
tenotome is then introduced, and the root, potato, or fruit divided. As a 
rule, a little pressure from the outside then causes one or other of the 
fragments to move onwards and deglutition becomes normal. 

Attempts have also been made to divide the obstructing body directly 
without previous incision and without isolating the cesophagus. It is 
much more difficult, for the least movement of the patient changes the 
relationships of the super-posed layers and introduces obstacles to the 
manipulation of the blunt-pointed tenotome which is employed. More 
success often attends attempts to puncture the ol)ject with a fine trocar. 

RUPTURES AND PERFORATIONS OF THE CESOPHAGUS. 

Causation. Wounds of the oesophagus caused l)y external violence 
are rare, or at least secondary ; lacerations produced from within, on 
the contrary, as a result of clumsy manipulation are relatively frequent. 
They may extend throughout the length of the tube, but in a far greater 
number of cases are found near the entrance to the stomach at the point 
where the oesophagus turns towards the left. 

The passage of the oesophageal sound or probang is apt to exaggerate 
this curvature, and if pushed violently the instrument may produce first 
a flexure, then a partial rupture or even a perforation of the tube. 

In other cases a rough, irregular, infected foreign body may when 
swallowed penetrate the wall and cause inflammation, necrosis and 
perforation of the oesophagus. 

The symptoms are always very grave, and of rapid development. 
They consist in local oedematous swelling, sero-sanguineous infiltration 
at the entrance to the chest, in the pretracheal region and along the 
jugular furrows. 

The pneumo-gastric and inferior laryngeal nerves being compressed, 
dyspnoea results. If the (esophagus is perforated in the thoracic cavity 
septic pleurisy at once sets in. 

Diagnosis. The diagnosis is easy, provided the history point to 
perforation of the oesophagus. 

The prognosis is fatal whenever the perforation is within the thorax. 
It is sometimes possible to intervene in cases of perforation in the 
cervical region, but from the economic standpoint such intervention is 
of Httle value. 



CHAPTER IV. 
DEPRAVED APPETITE-PICA-THE LICKING HABIT. 

Depraved appetite, causing animals to swallow l)odies which cannot 
pi-opeiiy be descrihed as food, is frequent. The condition is commonest 
in adult animals of the bovine species, in calves and in lambs. The 
consequences are sometimes very serious, so that although depraved 
appetite does not represent a well-defined morbid entity, it is important 
to be in a position to remedy it. 

Depraved appetite does not appear under the same conditions in 
young and in old animals. In adults it often results from faulty 
feeding, or from some wasting disease which develops insidiously, or 
remains unrecognised ; in young animals it is the result of insufficient 
nourishment. 

Pioloff & Pioll hold that pica is the first symptom of osteomalacia 
(which see). 

DEPRAVED APPETITE IN THE OX. 

Causation. In the bovine species depraved appetite occurs in adult, 
debilitated animals, which are often, though not always, suffering from 
some well-marked digestive disturbance. 

The frequency of this symptom, and the peculiarities in its occur- 
rence, have caused it to be referred to a large number of different causes, 
among which may be mentioned bad hygiene, chronic gastro-enteritis, 
tuberculosis, osseous cachexia, pasteurellosis, gestation, etc. 

It is very certain that the peculiarity in the appetite is, above all, the 
result of incomplete and irrational alimentation. The animal has certain 
special requirements, to meet which the food must be of suitable compo- 
sition. If these alimentary and digestive conditions are not fulfilled, 
depraved appetite may occur, even in animals which appear well 
nourished. Certain authors refer the appearance of this condition to 
want of certain soda salts in the daily ration, and, in support of this 
opinion, they point to the frequency of the disease in mountainous 
regions where the geological formation is chiefly granite, as in the Black 
Forest. Alluvial soils are supposed not to produce it. It certainly seems 
more common on soils lacking in certain constituents or exhausted by 



DEPRAVED APPETITE IN THE OX. 159 

repeatedly growing certain crops. Nevertheless, in France it might be 
urged that pica occurs equally on all kinds of soil, and a German author, 
Lemke, ascribes this perversion of nutrition to the want of phosphorus. 
Haubner and Siedamgrotsky attribute it to a nervous disorder. All causes 
which exhaust the organism, esj)ecially all chronic diseases of digestive 
origin, may induce aberration of appetite. 

Permanent stabling, confinement, absence of sunlight, want of exer- 
cise and pure air contribute to the general debility which predisposes to 
attack. Dry seasons, by reducing the supply of food, have a similar effect. 

In tuberculosis and in pasteurellosis, it is the general organic de- 
cline which produces these puzzling changes in appetite. Similarly 
the influence of gestation depends on the superadded demands on 
the organism caused by the development of the fcetus. 

Symptoms. The symptoms may be divided into two phases. 

In the first phase, the animals still preserve their appetite, but 
whenever they have an opportunity they eat earth, sand, manure, litter 
saturated with urine, plaster, etc. They lick the walls, the boarding, the 
mangers and the trees, and they chew and swallow linen spread out to 
dry. 

This phase may continue for a very long time, three to four months 
or more, provided no acute complication results from the eating of such 
foreign material. There is no fever, but the aj^petite, although well 
preserved, is often capricious, and the ordinary food is eaten slowly. 

In the second phase, which frequently marks the development of 
complications produced by the passage, contact, or prolonged sojourn of 
various materials in the digestive tract, fever appears, little marked as a 
rule, but continuous in character. 

The appetite is dimhiished. The animal wastes ; the secretion of 
milk diminishes, and signs of chronic gastro-enteritis may be noted. The 
perversion of appetite still continues ; rags, decomposing or filthy 
materials, pieces of old shoes, etc., are eaten, and it is not surprising 
that such substances should have an unfavourable effect on the mucous 
membrane of the digestive tract. 

The Agisting process slowly leads to marked emaciation, and after an 
interval of from six months to a year, or even two years, the patients 
die in a state of complete exhaustion. The lesions found on post-mortem 
examination are those of various diseases capable of producing depraved 
appetite or simply lesions of chronic gastro-enteritis. 

Diagnosis. The diagnosis presents no difficulty. The important 
point is to discover whether or not there exists some previously un- 
recognised primary disease. 

Prognosis. The prognosis of this condition is grave, because de- 
praved appetite is frequently only a symptom of some incurable disorder, 



160 DEPRAVJ'^D APPETITE — PICA — THE LICKING HARIT. 

or because the changes in the digestive mucous nieml)rane are ah-eady 
too far advanced to permit of much improvement. 

The lesions comprise : general emaciation, presence of a yellow 
serum in the fatty tissue, muscles pale and flabby, catarrh of the 
mucous membrane of the stomach and bowel. The blood seems less in 
quantity and coagulates feebly or not at all. 

Treatment. The treatment should be directed against the primary 
cause, if such exists (osseous cachexia, pasteurellosis, gestation, etc.). 

In other cases a change in management and in feeding, and the 
administration of food rich in mineral salts like chlorides, carbonates, and 
phosphates of lime, soda or potash, produces the best possible results. 
The leguminous foods, sainfoin, clover and lucern, are to be recommended. 
The animal, if formerly stabled, should be turned out and its living con- 
ditions entirely altered. 

It is often useful to place a block of rock salt in the manger ; when 
hyperacidity of the stomach is suspected lime water, chalk, or magnesia 
should be given. Where digestion is weak or slow HCl, pepsin and 
vegetable bitters are indicated. Nevertheless, one sees cases which refuse 
to yield to any of the ordinary methods. In treating these, Lemke has 
recommended the subcutaneous injection of chloride of apomorphine, a 
drug which may be regarded as a true specific. The doses vary between 
1^, and 3 grains, and an injection is given once a week for three weeks in 
succession. After this the tendency to pica is said to disappear and the 
general condition to improve. The treatment must be repeated every 
three months in countries where depraved appetite appears general and 
permanent. 

It is difficult to understand by what mechanism this drug produces 
the effects attributed to it, but those who have employed it speak very 
highly of its action. 

We may add that in addition to the different modes of treatment, it is 
not infrequently necessary to hastily perform gastrotomy in order to 
avoid fatal consequences, which would otherwise follow indulgence in 
this habit. When an animal has swallowed a considerable quantity of 
linen, for example (and Moussu has seen cases in which many pounds 
weight had been devoured), immediate intervention is required to avoid 
intestinal obstruction. Furthermore, when the history is quite clear 
gastrotomy allows the entire mass of foreign bodies, ingested at different 
times, to be removed. 

DEPRAVED APPETITE IN CALVES AND LAMBS. 

Causation. Depraved appetite is commonest in calves and lambs 
when the animals are insufficiently nourishexl, or when the mothers are 
suffering from chronic debilitating diseases and are therefore yielding 



DEPRAVED APPETITE IN CALVES AND LAMBS. 161 

milk poor in fat and in mineral constituents. In a few rare cases it is 
impossible to discover what causes the young animals to devour these 
foreign materials. Even fally-grown sheep, when shut up together in 
winter, acquire the habit of chewing each other's wool, sometimes to 
the extent of virtually depilating their fellows and accumulating wool 
balls in their stomachs. 

Symptoms. Calves have a tendency to lick themselves or their 
neighbours, and thus little by little collect a varying quantity of hair 
which they swallow. When this habit of licking is little marked the 
quantity of hair ingested may not be dangerous ; but in the contrary 
case the hair (which cannot be digested) accumulates and is permanently 
retained in the abomasum. It soon becomes converted into masses, 
cemented together with mucus, and forms round balls, to which the name 
of oegagrophiles has been given. If these cegagrophiles, or hair balls, are 
of small size, they prove of trifling importance ; but too frequently they 
attain considerable dimensions and obstruct the pylorus or the intestine. 
The young calves then refuse all nourishment, and die in twenty-four to 
forty-eight hours in a state of complete exhaustion or after a series of 
epileptiform attacks. 

In lambs the complications due to depraved appetite develop in a 
similar way, but the wool swallowed is obtained from the mothers. The 
lauibs first suck the locks of wool, then tear them off and swallow them. 
So long as these peculiarities of appetite are little marked no bad results 
follow ; but if the shepherd is careless, and fails to note the condition of 
his young flock sufficiently early, accidents occur. 

The wool is not so easily converted into balls as is hair, but it soon 
accumulates in the pyloric region or in the intestine, and forms obstruct- 
ing masses. The little patients lose appetite and lie down in corners, 
where they are found dead after twenty-four to forty-eight hours. The 
masses of wool or of hair are rarely passed with the excrement ; more 
frequently they are vomited, but this again is exceptional; usually they" 
become arrested at the entrance to the pylorus. The lambs show colic, 
tympanites of the abomasum, and attempts at vomiting, though unfor- 
tunately these are often overlooked. The quantity of wool found in the 
abomasum and intestine on post-mortem examination may be consider- 
able, in relation to the size of the digestive compartments. Death results 
from intestinal obstruction, exactly as in the case of calves. 

These aberrations of appetite in lambs have been considered as due 
to the want of sufficient mineral salts in the mother's milk ; and it has 
been stated that the lambs practise this habit because of the laxative 
result of the fat contained in the wool swallowed. The explanation seems 
very logical, though it is by no means perfectly proved. It is certain that 
this habit becomes particularly common after years in which forage has 

D.C. M 



162 COLIC. 

been scarce and among flocks in bad bodily condition. The force of 
example also plays a certain part, and animals probably imitate one 
another, and so acquire the disease. This explains the importance of 
early segregation. 

Diagnosis. The diagnosis of depraved appetite, pica, or the licking 
habit presents no difficulty ; but it can only be arrived at by the cow- 
man or shepherd, for the symptoms can only be detected by continued 
watching. 

The diagnosis of pyloric or intestinal obstruction is very difficult in 
the absence of information. It becomes easy after the first post-mortem 
examination has been made. 

Prognosis. The prognosis is grave. In calves, obstruction of the 
bowel by hair-balls inevitably causes death, and in sucking lambs the 
mortality may be high : as much as 15 per cent, to 20 per cent, according 
to the observations of several observers. The mortality occurs about 
the age of six weeks to two months, whilst the licking habit may begin 
towards the end of the second week. 

Treatment. Prophylaxis demands that the mothers (whether cows 
or ewes) be well fed. An excellent precaution consists in adding to the 
food a sufficient quantity of salt and of phosphate of lime (2 drams 
to 2^ drams of each). This treatment of the mothers is necessary 
as soon as the tendency to licking becomes manifest. 

In calves the best method of avoiding fatal results is to prevent the 
young animals licking one another ; and the method now usually prac- 
tised on well-managed farms consists in applying a simple muzzle of 
wicker work immediately after each meal. 

In lambs treatment is more difficult. As soon as the shepherd 
sees any tendency to depraved appetite the lambs should only be left 
with their mothers whilst being suckled. The flock should be exercised 
in the open, and ordinary salt should be placed at a number of points on 
'the ground occupied by the animals. 

COLIC IN THE OX. 

COLIC DUE TO INGESTION OF COLD WATER. CONGESTIVE COLIC. 

Causation. Congestive colic occurs in the stable, in animals which 
have been doing heavy work, and, returning in a heated condition, drink 
large quantities of cold water. It is commoner when animals have not 
eaten for a considerable time, and when, therefore, the stomach is nearly 
empty. Under these circumstances chill of the digestive viscera is direct 
and immediate. 

Symptoms. This form of colic occurs suddenly, soon after the water 
has been swallowed, and is characterised by violent pain. At first the 



COLIC DUE TO INGESTION OF COLD WATER — CONGESTIVE COLIC. 163 

animals show uneasiness, stamp, and continually move about striking 
themselves in the flank with the feet or horns, swishing the tail, etc. 
They refuse food, lie down and rise frequently, and paw the ground. 

As a general rule this form of colic lasts from half an hour to one 
hour, and terminates in recovery. In some rare cases where death 
occurred Cruzel found on post-mortem examination congestion of the 
abomasum, and, in a few, congestion of the small intestine, with or 
without rupture. 

The diagnosis is easy, on account of the suddenness of onset, rapid 
development and history of the disease, discovered on questioning the 
owner or herdsman. 

The prognosis is not grave. This form of colic generally cures itself. 
Nevertheless precautions are required against possible complications, 
such as intestinal hfemorrhage and invagination. 

The necessary preventive measures are self-evident. Animals return- 
ing from work should not be allowed to drink freely of cold water, but 
should first receive a little food and afterwards water at the temperature 
of the atmosphere. 

When colic has set in, the patient can be walked about. If pain 
persists, the region of the abdomen may be dressed with oil of turpen- 
tine, mustard, or similar counter-irritants. The application of warm 
clothing is also useful. Finally, in grave cases, a moderate quantity 
(three, four, or five quarts) of blood maybe withdrawn from the jugular. 
The administration of stimulants like wine, alcohol, etc., is also 
indicated. 

COLIC DUE TO INVAGINATION. 

Invagination consists in the passage of one portion of the intestine 
into the next-following portion. "When once the condition has been set 
up it tends to become aggravated, the invaginated part being drawn 
further and further forwards. Invaginations therefore may vary in 
length between a few inches and sixteen to twenty inches. 

Law states (Vol. II. p. 347) that in cattle and swine invagination of 
the large colon is almost impossible owing to the relation of the bowel 
with the layers of the mesentery. The anatomical arrangement is 
opposed to the formation of invagination, yet this accident is not 
uncommon in cattle and swine. The small intestine can be invaginated 
into the caecum or into itself. The caecum may become invaginated, or 
it may pass into the colon or rectum. 

Cartwright, Veterinarian (1829), reports a case of invagination in 
a bull calf, and Youatt gives particulars of a similar case which was 
followed by sloughing and discharge per anum of the intussuscepted 
portion of bowel. (See also Moller and Dollar's " Eegional Surgery," 
p. 328.) 

M 2 



164 COLIC. 

Causation. This variety of colic is due to a number of somewhat 
obscure causes. In a general sense we may say that anything which 
increases intestinal peristalsis increases the risk of invagination. The 
accident may follow intestinal congestion, but is most frequent in 
animals suffering from intestinal worms, or in animals used for heavy 
work. Under the influence of violent tractive efforts the peristaltic 
movements are stimulated, and the intestine being in an oblique 



--%1^ 




Fig 



68. — Invagination of tlie intestine in an ox (the constricting portion has 
been incised longitudinally). 



position on a plane inclined backwards, the contracted portion may slip 
into the dilated section behind it. 

Invagination may also occur without any apparent cause, even in 
animals standing in the stable. 

Symptoms. The attack always occurs suddenly, develops rapidly, 
and is of an extremely grave character. 

Colic conies on while the animal is working, moving about, or resting, 
according to circumstances, and at first resembles that due to congestion. 
It afterwards becomes very violent ; the animals paw, stamp, show great 
uneasiness, throw themselves violently down, and rise suddenly, only to 
again lie down as before. The face expresses anxiety, suffering and 
depression ; the tail is often kept lifted, and efforts are continually made 
to deffecate, mucus being passed. By passing the hand into the rectum 
the invagination may occasionally be discovered. 



COLIC DUE TO INVAGINATION. 165 

Colic persists with great intensity for ten to twelve hours,. interrupted 
only by rare periods of calm. At the end of this time, however, it may 
suddenly disappear, and the animal may fall into a semi-comatose state. 
This indicates the onset of necrosis in the invaginated section, the painful 
reflexes no longer being transmitted to the sympathetic system. The 
disappearance of colic is sometimes regarded as a sign of improvement, 
but this improvement is illusory. From this time onwards the animals 
stand stolidly, obstinately refusing both food and drink. If they lie down, 
it is with great care. Palpation of the right side of the abdomen is 
painful, and the animal actively resents it. One of the most important 
and constant signs at this stage is the absence of defaecation, due to ob- 
struction of the intestine, which is occluded. The animals may survive 
for ten, twelve, or even fifteen days (see also Moller and Dollar's 
"Regional Surgery," loc. cit.). The invaginated, necrosed portion may 
even be passed with the fieces, and recovery may occur, the continuity of 
the intestinal tube being secured by the adhesion of the serous surfaces ; 
l)ut such spontaneous recoveries are exceptional. Usually after a few 
days death results from peritonitis. 

Occasionally, trifling invaginations may become reduced spontaneously. 
Diarrhoea, with the passage of blood-stained material is then seen for a 
time, a sign which alone at this stage would justify the diagnosis of 
invagination. 

Diagnosis. The intensity of the colic and the absence of defeca- 
tion for several days afterwards, justifies the diagnosis of invagination. 
Purgatives then remain without effect. In addition, rectal exploration 
offers a valuable means of diagnosis. The last portions of the intestine 
are found absolutely empty, and the arm when withdrawn is found to 
be covered with viscous blood-stained mucus, resulting from the sero- 
sanguinolent exudate, due to compression of the blood-vessels. 

In cases of this kind accompanied by the above-mentioned symptoms 
abdominal exploration by the rectum should always be practised, but it 
rarely gives exact information. The hand, when passed towards the 
right flank, may sometimes reach the invaginated part, which conveys the 
impression of a cylindrical swelling. The invagination, however, can 
rarely be reached. If the operator is successful, he will find that as he 
displaces this cylindrical mass or attempts to grasp it, the animal shows 
signs of exaggerated sensitiveness. 

The prognosis is of exceptional gravity. Apart from the rare cases 
where the invaginated portion becomes necrotic and is eliminated, death 
is inevitable. Unless an operation is performed, septic peritonitis may 
develop about the fifth or sixth day. 

Treatment. The only treatment consists in surgical intervention. 
Some practitioners have recommended giving large doses of purgatives 



166 COLIC. 

with the idea of causing changes in the neighhourhood of the invaginated 
part ; hut such treatment presents Httle chance of success. The same is 
true of the administration of hirge doses of ohve oil, either in the form of 
draught or of enema. 

Siehert attemi^ted reduction hy generating CO2 from soda hicarho- 
nate dissolved in water and diluted HCl, injected .successively per 
rectum. In time ffeces and CO2 escaped, and the patient recovered. 
Siehert claims to have cured hy this method a cow with invagination of 
five days' duration ; hut the effect of his treatment may he douhted, as 
afterwards a portion of howel was found in the cow's dung. 

When diagnosis is certain, the only treatment that can he recom- 
mended consists in performing laparotomy followed hy enterotomy. 
One cannot, however, operate in all cases, nor do all cases offer the same 
chances of success. If the invagination is situated in the first portion 
of the small intestine, and is hidden beneath the circle of the hypo- 
chondrium, intervention is out of the question, but if it has been 
detected by rectal exploration in the last portion of the intestine, 
operation may prove successful. Only in cases of the latter description 
should it be attempted. 

Laparotomy is performed in the right flank according to the usual 
method (see MoUer and Dollar's "Regional Surgery," p. 313). After 
opening the peritoneal cavity, the invaginated loop of intestine must be 
sought. It is not always easy to discover amongst the mass of intestines 
present, but can be recognised by its hardness and by the congestion 
of neighbouring parts. After withdrawing it through the abdominal 
opening, the operator may then proceed by one of several methods. 

(1.) Some authors recommend grasping the two ends, drawing them 
apart, and thus reducing the invagination. The actual manoeuvre is 
not difficult, but even when unattended by accident or tearing of the in- 
testine it is by no means always followed by recovery. Although the 
intestine may not appear gangrenous externally, necrosis often occurs 
eventually. 

This method should only be practised during the first twenty-four 
hours after the appearance of colic, and even then one must always bear 
in mind the possible consequences just mentioned, and the chances of 
rapidly fatal septic peritonitis. 

. (2.) The second method consists in removing the invaginated portion 
of intestine. It is best to apply bichromatised catgut or silk ligatures 
to all the arteries which pass from the mesentery into the loop to be re- 
moved ; after which the loop itself may be simply divided an inch or two 
above and below the invagination, in order to be quite certain that one is 
operating on healthy tissue, the divided ends being held meanwhile by 
an assistant. The intestine is afterwards sutured with a fine needle and 



COLIC AS A RESULT OF STRANGULATION. 167 

bichromatised catgut or boiled silk. The form of suture will be found 
described in Dollar's " Operative Technique." It may be valuable to test 
the efficacy of decalcified bone tubes for uniting the ends of the intestine. 

The operation is long, delicate and difficult, and it is imperative not 
to infect the abdominal cavity during its performance. To prevent this 
the liquid and solid materials present in the bowel may be thrust upwards 
and downwards away from the diseased part before the section is made ; 
and in this way the wound and the operator's hands are preserved from 
infection. The intestine should be kept closed during the application of 
sutures by means of flat clamps cautiously applied. In their absence the 
ends may be held by an assistant, whose hands should previously have 
been carefully disinfected. 

(3.) In cases where the serous coats of the two portions of bowel con- 
stituting the invagination are to some extent adherent, another opera- 
tion of a less perilous character may be performed. This consists in 
liberating the invaginated part by means of longitudinal incision, without 
previously disengaging the parts, and without resection. The invagi- 
nated (external) portion of intestine is divided longitudinally ; the gan- 
grenous part immediately becomes visible, and may be removed. The 
operator has then only to suture the longitudinal wound, an operation 
which is much easier and demands much less time than any circular 
intestinal suture whatever. These operations must not be attempted 
except in response to the express wish of the owner, who should be fully 
informed of the dangers to which they expose the animal ; for after 
the second day of invagination local peritonitis has often developed 
and one is then operating on injured or infected tissues, in itself a 
very unfavourable modifying condition. The current formula that " the 
operation was very successful " is not accepted in veterinary practice 
when the patient dies three or four days afterwards. From the eco- 
nomic standpoint it is better to slaughter animals of any value, for 
unless secondary peritonitis has occurred, and the animal is not feverish, 
the meat is fit for consumption. " Volvulus," or twist of the intestine, 
is said to be almost unknown in cattle, though Eeichert records a case of 
volvulus of the ileum. 

COLIC AS A RESULT OF STRANGULATION. 

The symptoms of this colic dift'er very little from those of the preceding 
with which they are often confused. But in regard to its causation the 
condition is essentially different. 

Causation. Strangulation of the intestine in the ox may be produced 
in several different ways : by the passage of a loop of intestine through 
a tear in the epiploon, through the diaphragm, mesenteiy, broad liga- 
ment of the uterus, the serous layer surrounding the spermatic cord, etc., 



168 



or by strangulation of an intestinal loop by fibrous bands resulting 
from chronic jjeritonitis, etc. Of these various causes, the three prin- 
cipal may here be described : — 

(1.) Tearing of the mesentery. As a result of mechanical violence 
the ej)iploon or mesentery becomes fissured, and the peristaltic move- 
ments cause a loop of intestine to pass through and become fixed in 
the fissure. If the opening is narrow, as is usually the case, the base 
of the intestinal loop, riding on the lower lip of the slit, becomes con- 
stricted by the margins of the ojjening through which it has passed. 

(2.) In pelvic hernia a loop of intestine passes between the spermatic 
cord and the walls of the pelvis. The fissure in this case is in the 
serous fold which supports the large testicular arteries and the vas 
deferens. The fold is often ruptured during castration, especially during 

the practice of " bistournage," in conse- 
quence of traction exercised on the cord. 

(3.) Pseudo - ligaments and fibrous 
bands due to chronic i^eritonitis. — In 
local, sul.)acute or chronic peritonitis false 
membranes may become organised, form- 
ing fibrous cords or folds connecting the 
parieto-visceral.or inter-visceral surfaces. 
If by accident a loop of intestine insinu- 
ates itself beneath one of these fibrous 
bands, the passage of digestive material 
is first impeded and then stopped. The 
intestine becomes engorged, and symp- 
toms of strangulation soon folloM'. 
The symptoms appear suddenly, and are similar to those of inva- 
gination. They consist of very acute colic, which disappears after ten 
to twelve hours. 

The peristaltic movements drive the semi-digested food, whether liquid 
or gaseous, towards the lower (strangulated) end, from which it cannot 
escape. It therefore distends the herniated loop and sets up intestinal 
engorgement. This constitutes the first stage of strangulation, and is 
accompanied by severe disturbance in the local circulation. The nuicous 
membrane of the intestine becomes swollen and infiltrated, so that it 
alone soon fills the entire neck of the hernia. Necrosis of the loop of 
intestine is then only a matter of time. 

The diagnosis of colic l)y strangulation is difficult. The condition 
cannot often l)e recognised at an early stage, and may easily and 
excusably be confused with invagination. Only in rare cases will rectal 
and abdominal examination enable one to detect a pelvic or mesenteric 
hernia. 




Fig. 69. — Schema of hernial 
strangulation. 



DISEASES OF THE STOMACH. 169 

The prognosis is even graver than in cases of invagination. Intes- 
tinal hernia progresses very rapidly, necrosis soon sets in, and is 
followed by fatal consequences if the condition be not relieved. 

The treatment is exclusively surgical. As a general rule, whenever 
colic is recognised as resulting from strangulated hernia, it is imme- 
diately necessary to perform laparotomy in the right flank, and after 
having discovered the cause of strangulation, to divide the mesentery, 
epiploon, serous fold supporting the testicular cord, or accidental fibrous 
bands, so as to free the herniated loop and avoid necrosis. If necrosis 
already exist, the intestine may be resected, exactly as in invagination. 

DISEASES OF THE STOMACH. 

In ruminants diseases of the gastric compartments are numerous, 
and, although they have been recognised since the earliest times, much 
remains to be discovered concerning at least some of them. This fact 
results from the imperfect state of our knowledge concerning the essential 
phenomena of gastric digestion in ruminants. Digestion really consists 
of a number of different acts — some mechanical or neuro-motor, some 
chemical ; in addition to which must be reckoned the phenomena of 
sensation, concerning which patients cannot give any information. 

The mechanical phenomena, consisting in the constant movement 
of ingested material through the different compartments, rumination, 
eructation, evacuation towards the intestine, etc., are well known to us; 
and a careful examination of diseased animals enables us to estimate the 
importance of changes in them. 

On the other hand, the chemical phenomena are little understood. 
It has hitherto been considered that the rumen, reticulum, and omasum 
are only simple diverticula, with mechanical functions, and that the 
abomasum is the reservoir in which the chemical changes take place. 
Another view, which is perhaps not altogether justified, presupposes 
that the chemical transformation of the food in the abomasum takes 
place as in other animals, and in particular as in man, in whom the 
chemistry of gastric digestion has been the object of extremely careful 
research by certain French and other pathologists. We do not believe 
(for reasons too long to be explained here) that the gastric digestion of 
ruminants, or even of herbivora in general, can be identified with that 
of omnivora. 

The nature of the food being totally different, the chemical reactions 
in the stomach and intestines are also different ; in proof of which we 
need only cite the single fact that ptyalin is absent from the saliva. 
Straw and oats are not digested in the same way as a mutton cutlet. 

But even supposing that the broad outlines of physiological action 



170 INDIGESTION. 

are the same, nothing has hitherto heen discovered in veterinary surgery 
respecting possible variations in the chemical processes taking place in 
the stomach during different gastric diseases ; and it appears not impro- 
bable that in this direction causes might be discovered which veterinary 
practitioners have hitherto sought elsewhere. Excess or insufficiency of 
hydrochloric acid, and variations in the quantity of the organic acids, play 
so important a part in the theory of gastric pathology in man, that it is 
scarcely surprising to find similar ideas recurring in the pathology of 
domestic animals. The correctness of these views remains to be proved ; 
and without wishing actually to classify dyspeptic conditions as in man, 
we may assert that diseases described under other names stand in direct 
relation to variations in the gastric secretion or to disturbance of gastric 
movements — e.g., simple chronic tympanites, which, without a doubt, is 
often a neuro-motor dyspepsia. 

The classification we shall adopt in studying the diseases of the 
gastric compartments is, therefore, extremely simple. In the first 
series we shall consider sudden, accidental, and temporary forms of 
indigestion, and in the second series, acute or chronic forms of gastric 
inflammation. 

INDIGESTION. 

GASEOUS INDIGESTION. 

Gaseous indigestion, also described as indigestion of the rumen, is 
characterised by the rapid accumulation of gases (chiefly carbon dioxide, 
carbon monoxide, and marsh gas), due to fermentation in the upper 
part of the rumen. It is common in oxen and sheep, and has received 
the names of mephitic indigestion, acute tympanites, meteorism, etc. 
It occurs during or immediately after feeding. 

Causation. Numerous causes have been invoked to explain the 
sudden occurrence of gaseous indigestion. 

The most important is the particular condition of the animal at the 
moment when it has been attacked. For if external influences alone 
were responsible, there is no reason why all the animals of a given herd 
or flock, or of a particular stable, which are under similar conditions 
as regards feeding, etc., should not be affected in the same way. 

That the external causes cited (cold, excessive heat, stormy weather, 
etc.) may afi"ect different animals differently and unfavourably is beyond 
doubt. But the temporary morbid condition of the animal itself is the 
essential condition to the development of indigestion. 

In all probability the animal has in every case been more or less 
unwell, except in those attacks of indigestion resulting from progressive 
poisoning during the course of a meal, such as occur when toxic plants 



GASEOUS INDIGESTION. 171 

like belladonna, veratrine, colchiciim, poppies, tobacco, hemlock, etc., 
have been eaten. In such temporary abnormal states movement of the 
rmnen is partly abolished, or at least is markedly retarded, and, as a 
consequence of vaso-motor disturbance, the mucous membrane is pro- 
bably not so abundantly covered with mucus nor so freely irrigated with 
secretion, as usual. Under these conditions, if the animal, which may 
appear perfectly well, is allowed to partake of soft, wet, fermentescible 
food, gaseous indigestion is very likely to develop. 

Cultivated grasses, like lucern, sainfoin, clover, and especially grasses 
grown on artificially manured fields, are regarded as particularly liable 
to cause gaseous indigestion. This conclusion seems justified by expe- 
rience, particularly by the fact that young shoots or young, tender 
after-growths are very liable to fermentation. 

This exaggerated tendency to fermentation of tender grasses has even 
been held exclusively responsible for indigestion, and the cessation of 
peristalsis in the rumen has been considered a secondary phenomenon, 
due to distension. 

Whether atony of the rumen be the primary condition and abnormal 
fermentation secondary or inversely, whether fermentation be primary 
and atony secondary, is not of importance ; for either view may be 
adopted without altering the results, and without the theory being 
invalidated by the objection that other animals subjected to similar 
influences had not contracted the condition 

We have already drawn attention to the importance of the condition 
of the animal's health for the time being. Digestive peristalsis being 
diminished, eructation, admixture of food in the rumen, and its onward 
movement being impeded, fermentation proceeds rapidly. As a conse- 
quence the rumen becomes distended, and, cause and effect changing 
places, the distension in its turn arrests peristalsis, which had previously 
only been checked. 

Local chills, produced by ingestion of food covered with rime, hoar- 
frost, or simply with dew, may favour gaseous indigestion ; such condi- 
tions retard or suspend the peristaltic movements by direct local action, 
and probably by producing vaso-motor disturbance of the mucous mem- 
brane. In very rare cases chill has an undeniable influence, either by 
provoking general vaso-motor disturbance, which reacts on the secretions, 
or neuro-motor trouble. Gaseous indigestion is not uncommon in animals 
living on dry winter food, which have been moved from their ordinary 
quarters and sent on railway journeys or to fairs, etc. As a general 
rule this form of indigestion is commonest in spring, when the transi- 
tion from dry winter food to grass, etc., has not been carefully 
effected. It is also frequent during stormy weather in full summer. 
Marked barometric changes seem to have an influence on the general 



172 INDIGESTION. 

health, and particularly on the nervous system, thus favouring organic 
fermentations. 

Symptoms. The earlier symptoms of indigestion escape observation, 
but they soon begin to develop rapidly, and are then very easy to follow. 
They always exhibit the same characters, developing, however, with 
more or less rapidity in diftei-ent cases. Soon after they commence 
feeding animals appear to experience special discomfort, which causes 
those at grass to stop grazing ; even when stabled they stop feeding. 
From this time they show eructation, repeated yawning, restlessness, 
and some anxiety. 

In a quarter of an hour, or less, the left liank begins to project, both 
laterally and vertically, so that eventually the walls of that part of the 
abdomen may project above the transverse processes of the lumbar 
vertebrae. The right flank also becomes swollen, as a consequence of 
the intestine being thrust out of position. The animal very rapidly 
shows general disturbance ; the nostrils are dilated, the mucous mem- 
branes congested, respiration becomes rapid, and asphyxia threatens. 
The respiration soon becomes panting, for the distended rumen para- 
lyses the diaphragm and compresses the lungs. To ease respiration 
the animals open the mouth, extend the neck, and stand with the 
front limbs spread apart; but this fails to prevent dyspncea l)ecoming 
more intense and asphyxia imminent. 

The heart beats more rapidly, the superficial veins appear swollen, 
and the mucous membranes cyanotic. The rhythmic contractions of the 
rumen can no longer be detected by manual examination of the left 
flank ; and on auscultation one neither hears the liquid nor the rolling 
sound, but only exaggerated crepitation. Finally, there is marked 
tympanitic resonance on percussion. 

In cases of very grave tympanites the gaseous pressure in the 
interior of the rumen appears to stop the crepitation sound. The 
animals soon become unable to walk or even to move, suddenly fall 
to the ground, and die rapidly from asphyxia. 

The rapidity with which gaseous indigestion develops varies greatly. 
Sheep and oxen may die from tympanites, within an hour or even half 
an hour of their arrival in the field ; but more frequently the symptoms 
develop slowly, only becoming alarming after some hours and continuing 
for twelve or even twenty-four hours without causing death. 

As a rule, the gas is voided by a series of eructations which empty the 
rumen, and recovery follows ; but when distension is extreme eructation 
cannot occur, and gaseous indigestion then ends in asphyxia and death. 

Lesions. It might be imagined that this form of indigestion would 
only appear when the rumen contains a large quantity of food ; but, 
in point of fact, the rumen often contains very little. 



GASEOUS INDIGESTION. 173 

On post-mortem examination the rumen is fomid to contain an 
enormous quantity of gas, which, when collected and submitted to 
analysis, reveals approximately the following composition : — Carbonic 
acid, 74 per cent. ; carburetted hydrogen, 24 per cent. ; sulphuretted 
hydrogen, 2 per cent. ; nitrogen, traces. The composition of this 
mixture varies within certain limits, according to its origin ; but 
carbonic acid always predominates. 

Lungwitz, after elaborate experiments with different foods kept in 
closed vessels at the body temperature and with similar agents fed for 
days as an exclusive aliment to oxen provided with a fistula of the rumen 
for purposes of collection, found carbonic dioxide the predominating gas 
in all cases, though the proportion varied with the nature of the food. 

Marsh gas varied from 16 to 39 per cent., being especially abundant 
in cases of abstinence. Hydrogen sulphide was found only in traces. 
Oxygen and nitrogen were present in small amount, and were attributed 
to air swallowed with the food. In fermentation the oxygen may be 
completely consumed. 

The abdominal organs, particularly the intestine, are congested, as a 
result of impediment to the venous circulation. The thoracic organs 
exhibit the lesions of asphj^xia. 

Pathogeny. Death is due to carbonic acid poisoning, brought about 
in two different ways — viz., progressive asphyxia, caused by inability to 
inflate the lungs, and absorption of carbonic acid gas from the rumen ; 
by virtue of the laws of diffusion, part of the gas contained in the rumen 
passes into the blood. 

The diagnosis is always very easy, and even farm servants may 
recognise the condition. 

The prognosis varies, according to the rapidity with which the 
disease develops. In rapid cases, where the condition is fully estab- 
lished in thirty minutes to one hour, asphyxia may be threatened 
from the beginning ; but in others, ('jj., when the attack follows con- 
sumption of dry food, tympanites may develop slowly, only attaining 
its maximum intensity after a considerable lapse of time. In general 
one may say that tympanites is grave in proportion to the rapidity 
with which the gas is generated. 

Treatment. From the prophylactic point of view, it is necessary to 
avoid suddenly changing animals from dry to green food ; the transition 
should be effected by giving mixtures of dry and green food. 
Curative treatment comprises a large number of methods. 
The latest, and one of the most practical, consists in massage of 
the left flank. The open hand is applied to the left flank and sharply 
pressed directly downwards, care being taken not to injure the parts. 
This manipulation excites reflex action, awakens the dormant contractility 



174 IXDIGESTIOX, 

of the rumen, and leads to restoration of peristaltic movement. The 
gases pass into the omasum and abomasum, or in many cases make their 
way into the cesophagus. The sudden impulses somethnes cause food to 
he returned into the mouth, eructation recommences, and the gas accu- 
mulated in the rumen is partially and progressively evacuated. This 
manipulation is often practised in breeding districts, particularly in the 
case of sheep, in which the disease occurs with the same characters. 
The shepherd fixes the animal between his legs, and, thrusting the 
extended fingers of either hand into the flanks, makes sudden, sharp 
movements, which again set up eructation and get rid of the excess of gas. 

In Germany cold douches are often applied to the flanks. These 
excite vaso-motor action and reflex peristaltic movements, which result 
in eructations and in the evacuation of the rumen. But this is not a 
very practical method, and necessitates arrangements which seldom 
exist on sheep farms. 

The action of massage may be completed by administering stimulants 
like wine, alcohol, or infusions of such aromatic plants as cummin, fennel, 
peppermint, camomile, etc. These act first of all mechanically, by clear- 
ing the terminal portion of the oesophagus. Furthermore, they stimulate 
the mucous membrane of the rumen, causing reflex peristaltic contrac- 
tions, and, as a consequence, circulation of the partly digested food ; 
finally, the majority of them arrest fermentation. 

With the latter object, ether and assafoetida are also given. The use 
of these drugs, however, entails disadvantages, and if the animal has 
finally to be slaughtered renders the flesh unfit for consumption. 

The giving of absorbents is probably most widely practised. The 
ammonia which many of them contain absorbs carbonic acid, thereby 
diminishing the pressure of gas contained in the rumen, and therefore 
the distension of the first gastric reservoirs. Unfortunately this action is 
only temporary, and if the drug is given in too concentrated a form, the 
mucous membrane of the mouth, of the oesophagus, and sometimes even 
of the rumen and reticulum, may be irritated and inflamed, producing 
lesions of stomatitis, pharjaigitis, oesophagitis, contraction of the ceso- 
phagus, etc., which after recovery from the acute condition may gravely 
aftect the animal's general health. A further drawback is that the flesh 
rapidly acquires an ammoniacal odour. 

Perhaps the best internal treatment consists in administering purga- 
tives such as hyposulphite or sulphate of soda or sulphate of magnesia, 
in doses of 10 to 20 ounces, according to the animal's size, or, in the 
case of pregnant animals, in small frequently repeated doses. These 
check fermentation, and so arrest the evolution of gas, whilst by their 
purgative properties they excite contraction of the gastric reservoirs and 
cause eructation. 



IMPACTION OF THE RUMEN. 175 

None of these methods of treatment, therefore, should be used 
exclusively, but all may be utilised as auxiliaries to mechanical or 
surgical measures, and all should be preceded by the use of the pro- 
bang and puncture of the rumen. 

The first of these operations, the technique of which scarcely requires 
description, is often of little value ; for the solids and liquid contents of 
the rumen being permeated with gases, rise as a fermenting mass into 
the upper portions of the rumen, and continually obstruct the open end 
of the catheter, so that very little gas escapes. 

Puncture of the rumen is much more effective and easier to perform. 
The owner himself often operates with an ordinary pocket knife, some- 
times introducing a couple of fingers or a short length of elder-wood 
tube into the wound thus produced. 

The incision should be made at one stroke, for any hesitation may 
cause the wall of the abdomen to recede from the rumen, which lies 
immediately below. Should gas escape under the skin, emphysema, 
which often extends to the loins and along the quarters, may be pro- 
duced, and may be followed by diffuse subcutaneous suppuration, re- 
sulting from pyogenic germs entering the subcutaneous tissue. 

Large quantities of gas escape from the puncture, sometimes with 
such force as to drive out the canula. The flow of gas then ceases. In 
other cases the tube becomes blocked ; because, as the pressure within 
the rumen diminishes, the gases dissolved or mixed with the partially 
digested food are freed, and the whole contents of the rumen become 
converted into an aerated, bubbling mass. Liquid or semi-liquid materials 
may be ejected to some distance, or may pass between the skin and the 
muscles, or between the walls of the rumen and the abdomen, producing 
various complications, like necrosis, abscess formation, etc. Such acci- 
dents can be avoided by exercising firm pressure with the fingers on the 
tissues surrounding the canula. 

Even when the rumen has resumed its normal size recovery is not 
certain, and may not occur for several hours, or even several days, after- 
wards. The patients should therefore be kept under observation for 
some time, and it is usually best to leave the canula in place for one or 
two days, and to put the animal on low diet. 

Necrosis of aponeurotic tissues, fistula formation, and local peri- 
tonitis only occur if the instrument is dirty or is introduced in a 
wrong direction. 

IMPACTION OF THE RUMEN. INDIGESTION AS A RESULT OF OVER-EATING. 

In this condition the rumen is over-distended with food. The 
symptoms are principally due to abnormal fermentation, the peristaltic 



176 INDIGESTION. 

action of the rumen being in abeyance, and the food faihng to pass to- 
wards the omasum and abomasum. Eumination is generally' suppressed. 

The disease usually follows change of diet. When the diet has long 
been restricted, as occurs during years of bad harvests, and animals are 
afterwards set at liberty in rich pastures, they eat greedily, distend 
the rumen with large quantities of green fodder, and set up all the 
necessary conditions for this form of indigestion. Similar results follow 
when gluttonous animals are freely supplied with rich food. Working 
oxen also suffer if withdrawn from work and fed with roots, beetroot 
refuse, brewers' grains, or other manufacturing residue for the purpose 
of fattening. These materials can only be absorbed in moderate 
quantity, and the large amount of water, etc., they contain is apt to 
disturb the animal's digestive powers, while owing to its fine state of 
division such food cannot be returned to the mouth for secondary masti- 
cation, and rumination therefore remains incomplete: the food accumu- 
lates in the rumen, distending and eventually paralysing it. This is a 
common result of feeding on semi-liquid pulp, which in order to be 
ruminated should be mixed with rough forage. 

Insufficiency of drinking water is another and more frequent cause, 
especially during the winter, because the ox-herd or cowman is often too 
lazy to give a regular and sufficient supply unless water is laid on in the 
stable itself. The dry food l)ecomes compacted into a mass, which cannot 
be returned to the mouth for rumination. Moreover, less saliva is then 
secreted, and Colin has shown that rumination is impossible when the 
parotid ducts are ligatured. 

Symptoms. As may readily be imagined, the symptoms vary, 
according to the quantity and digestibility of the food swallowed. In 
the first place the appetite falls off: animals suffering from commencing 
indigestion only take part of their food ; later on appetite ceases, and 
with it rumination. Trifling colic sets in, resembling that due to con- 
gestion, and is indicated by unrest, switching of the tail, lifting of the 
hind legs, slight groaning, moving from side to side, and lying down 
and rising at short intervals. The animals seem oblivious of their sur- 
roundings, anxious, and at times semi-comatose. 

When the case has been neglected for several days the animal may 
masticate without having any food in the mouth, and may attempt to 
eructate and to regurgitate food ; but such attempts always fail. It then 
absolutely refuses food, and animals which have eaten large quantities of 
green forage may show tympanites. If called in at this period of the 
disease the veterinary surgeon finds nothing positive except signs refer- 
able to the digestive apparatus. By methodically examining the digestive 
tract, and in particular the stomachs, one discovers during palpation of 
the left Hank that the rumen is distended. This is characteristic. By 



IMPACTION OF THE RUMEN. 177 

palpation it is even possible to detect marked resistance and a 
certain characteristic tirmness resulting from accumulation of food. The 
percussion sounds over this region are dull, and pressure causes pain, as 
though the rumen and peritoneum were inflamed. When the open hand 
is laid flat on the rumen and thrust downwards, no peristaltic move- 
ment can be discovered. Finally, on auscultation the normal sounds, 
including crepitation, fermentation, and rolling sounds are all absent. 

There are no well-marked general symptoms. Kespiration and 
circulation are hardly accelerated, nor is the artery particularly tense- 
Course and Termination. The course of the disease varies, and the 
condition may be divided into two forms, acute and chronic. The first 
develops in a single day, and may cause death by the same mechanism 
as acute tympanites — i.e., asphyxia or carbonic acid poisoning ; the 
other continues for five, ten, or even twenty or thirty days, according to 
the promptitude with which treatment is undertaken. 

In protracted cases, however, the indigestion itself ceases to be as im- 
portant as the complications. Sometimes spontaneous recovery occurs, 
the food passing away towards the intestine, or even being vomited, 
though the latter conclusion is rare. Eecovery may also follow from 
treatment. If the disease is neglected it may become complicated with 
gastro-enteritis. 

The diagnosis is not very difficult. Indigestion resulting from im- 
paction is distinguished from acute tympanites by its less rapid course 
and by the less marked distension of the rumen (in this case due to solid 
food), and from acute gastro-enteritis by the varying degree of fever 
which accompanies the latter condition. 

Prognosis. The prognosis is always grave, even in cases of acute 
indigestion resulting from eating green food. 

In this case gaseous indigestion occurs as a complication, and neces- 
sitates immediate intervention. The other forms may rapidly yield to 
proper treatment, or, in spite of every care, may give rise to prolonged 
complications. 

Lesions. On post-mortem examination of animals which have died 
of complicated forms of the disease, we find certain lesions peculiar to 
gaseous indigestion associated with impaction of the rumen. 

If death has followed the consumption of root pulps, we see signs of 
poisoning. As a consequence of prolonged stagnation of food in the 
rumen, there follows an exaggerated organic fermentation, whose pro- 
ducts are absorbed through the stomach or intestine and pass into the 
circulation. 

These various fermentations, which may be of the lactic, butyric, 
and even putrid order, produce changes in the mucous membrane of the 
rumen ; wide tracts of the epithelium may be shed, exposing the corium, 
u.c. N 



178 INDIGESTION. 

and producing enormous ulcerations, which in certain cases implicate the 
entire inner surface of the rumen. 

The treatment must be varied, according to the cause, symptoms, 
and immediate complications. When the disease is of an acute type, 
such as that produced by over-gorging with lucern and green food, it is 
best to proceed as in gaseous indigestion, i.e., to puncture the rumen and 
give frequent large doses of purgatives until the stomach and bowels have 
been freely unloaded. The animals should then be kept for some days 
on small quantities of easily digested food, and should be allowed luke- 
warm, mucilaginous drinks. 

When tympanites and impaction occur simultaneously, immediate 
surgical intervention becomes necessary, and gastrotomy may then he 
performed by a very simple method. 

Two loops of cord are passed around the abdomen, one behind the 
hypochondriac circle, the other in front of the angle of the haunch. 
Assistants placed on the right side draw these loops tight, so as to im- 
mobilise the left flank. A bistoury is then thrust directly through the 
walls of the abdomen and rumen. As a consequence of the pressure 
exercised by the ropes, if not of the pressure of gas itself, the food material 
contained in the rumen is often expelled in a powerful stream. As the 
superposed tissues cannot very readily change their mutual relations, the 
author of this suggestion claims that there is little danger either of in- 
fectious materials passing into the subcutaneous connective tissue, or of 
peritonitis ; but this rude treatment can only be resorted to in cases of 
extreme urgency, and it appears by no means without danger. 

Injections of 10 to 15 centigrammes of pilocarpine and 5 to 10 centi- 
grammes of eserine are also useful. 

When impaction of the rumen assumes a less acute form, moderate 
doses of purgatives may be given and repeated daily, or twice a day, until 
the peristaltic action of the rumen is restored and resumes its normal 
rhythm. In certain cases, however, recovery is only apparent. The 
food in contact with the walls of the rumen breaks down, and passes 
away into the abomasum and intestine, while appetite returns. The 
animals then resume feeding, and some days afterwards show all their 
former symptoms. Low diet should therefore always be continued for 
some time. 

In spite of treatment, or in consequence of treatment being too long 
delayed, no improvement may follow. The ingested food is not expelled. 
Putrid fermentation results, auto-intoxication sets in, and the tempera- 
ture rises to 40° or 41" C. Unless gastrotomy is performed death is then 
certain. 

This operation should be undertaken whenever the fever rises to 40° C, 
and two-thirds of the contents of the rumen removed. The rumen should 



IMPACTION OF THE OMASUM (THIRD STOMACH). 179 

not be completely emptied, as there is danger of collapse of its walls. 
Complications in the region of the wound can be avoided by drainage. 

If the operation succeeds, the patients must be placed on very low 
diet or on milk for some days, and should be given lukewarm farinaceous 
drinks, and a little hay of good quality to excite rumination. In old 
milch cows this operation is seldom followed by a satisfactory recovery. 
Apart from the loss of milk, the animal loses condition, refuses to feed, 
and gradually succumbs to exhaustion. 

IMPACTION OF THE OMASUM (xHIRD STOMACH), 

Definition. "A form of indigestion, of which the prominent feature 
is the drying and impaction of the ingesta between the folds of the third 
stomach. It may seem to be a primary disease, but in very many cases 
it occurs as a result of some acute febrile or inflammatory affection." 
(Law's " Veterinary Medicine," Vol. II. p. 123.) 

Synonyms. Dry murrain, clew-bound, fardel-bound, stomach stag- 
gers, grass staggers, vertigo, chronic dyspepsia, chronic indigestion. 

Causes. Torpidity of the omasum, suppression of salivary secretion, 
with absence of " waves of liquid floating the flnely divided food from the 
mouth or rumen to third stomach, are prime conditions of desiccation of 
the contents." The third stomach, like the first and second, has no pro- 
vision for liquid secretion, and depends for its supply on constant flush-*^ 
ing by swallowed fluids. Therefore, if feeding and rumination are 
arrested and salivary secretion is suppressed, and if movements of the 
rumen and resulting overflow into the third stomach are checked, the 
ingesta of the third stomach, compressed between its folds, becomes 
drained of liquid and converted into a powder or dry mass. All febrile 
and inflammatory affections tend to this end, and more or less dryino- 
with impaction of the contents of the omasum, is a constant feature in 
such cases. But in the majority of cases this condition is to be looked 
on as a secondary or subsidiary aft'ection, and the real disease must be 
sought elsewhere. 

The explanation of the susceptibility of the third stomach in consti- 
tutional troubles has been sought in the source of its innervation. Electric 
stimulation of the vagus rouses the movements of the first and second 
stomachs, but not those of the third. Action of the third stomach is 
excited by stimulation of the spinal cord, and of the sympathetic nervous 
branches going to the ganglionic cells in the \Yalls of the omasum (Colin 
and Ellenberger). Its nerve supply _coming from a difierent source, de- 
rangement of its function may occur independently of antecedent disorder 
of the first or second, and its motor supply coming from a source so closely 
related to the vaso-motor centres, perhaps aftbrds some explanation of the 

N 2 



180 INDIGESTION. 

connection of disorders of the omasum ^Yitll febrile and inflammatory 
diseases. 

Food is an important cause. Impaction of the omasum is a winter 
disease — the time of dry feeding. Dry, fibrous, innutritions fodder, and 
scarcity of water contribute to its production. It attacks cattle in spring 
or autumn on pastures in which fresh grass grows among the dead, 
dried, or withered stems of a previous growth. It occurs when stock 
are fed on corn or corn stalks (maize stalks) affected with smut or ergot, 
or on cereals or grasses similarly damaged, and in both cases especially 
when the water supply is deficient or restricted. 

Sheep and goats, which habitually drink little, suffer less than do 
cattle, which drink freely. 

Other causes. Fermented foods, microbian ferments and their pro- 
ducts, which tend to induce torpidity of the omasum, fever, and lessened 
secretion of saliva, with diminished supply of liquid from mouth or rumen. 

Pericarditis, by causing vascular stasis m the omasum, may induce 
torpor and imj^action. 

Lead poisoning paralyses action and favours impaction. Finely 
divided food stuffs — meal and bran — eaten greedily, may pass in quantity 
directly into the omasum and induce impaction. " The most acute and 
fatal forms occur in connection with a sudden change from dry to rich, 
luscious, green food in spring, the unwonted stimulus giving rise to 
■ general irritation of the whole gastric mucosa, with disordered and im- 
paired function of all four stomachs, but especially of the third. Such 
cases are usually congestive and inflammatory, and the suspension of the 
gastric movements is a grand cause of impaction. In such cases, too, 
the brain or spinal cord, or both, are seriously involved, and the early 
death is preceded by torpor, paralysis, violent delirium or convulsions, 
following largely the type of acute lead poisoning." (Law, loc. cit.) 

The symptoms depend on the degree of impaction, and vary from 
simple, irregular, or suspended rumination to severe gastric and nervous 
disorder. The less acute cases are marked by failure to re-establish 
regular rumination or partial convalescence from fever or inflammation. 
The fever subsides, but the appetite remains capricious, the muzzle dry, 
eyes dull, spirits low, and breathing accelerated ; the condition is some- 
times accompanied by moaning. Slight tympanites may appear, and 
the contents of the rumen may feel solid, the mouth hot, clammy, and 
foetid. The bowels are constipated, the fftces small in quantity, hard, 
covered with mucus or blood- streaked, and containing particles of undi- 
gested food ; in other cases diarrhoea may set in, to be followed later by 
constipation. Alternations of constipation and diarrhoea may be repeated 
again and again. Exploration by pressure of the closed hand over the 
omasum will give an impression of solid resistance. There may be slight 



IMPACTION OF THE OMASUM (THIRD STOMACH). 181 

shivering, the ears and limbs are cold, the hair is erect in patches, dry 
and lustreless. 

In cases occurring independently of previous disease, diarrhoea may 
be the first symptom observed, the malady being preceded by local irrita- 
tion and congestion ; but this soon gives place to constipation or diarrhcea 
and the symptoms above mentioned. The animal is found lying apart 
on its left side, with its nose in its right flank, the pulse and breathing 
quickened, the eyes congested ; expiration is accompanied by a grunt. 
The patient walks with its back arched and dragging its limbs. The 
appetite may continue, but only in an impaired and irregular form, and 
as rumination ceases grinding of the teeth becomes common. The 
secretion of milk is diminished or arrested, emaciation advances day by 
day. Fcetid eructation may be a marked symptom. This form may 
last from ten to fourteen days, and merge finally into paralysis of the 
hind limbs, drowsiness and stupor, or delirium and convulsions. 

"In more acute cases (from sudden access of green food, change of 
water, or ingestion of irritant plants), the affection partakes more or 
less of the nature of congestion or inflammation of the viscus (omasitis), 
and may run a rapidly fatal course" (Law, loc. cit.). The animal is seen 
apart from the herd in a characteristic recumbent position, the eyes are 
red and glassy, the eyelids semi-closed, the patient shows much drowsi- 
ness and stupor, but when raised may still feed in a sleepy, listless 
manner. The bowels are loose or confined, the pulse and breathing 
accelerated, the right hypo-chondrium is firm and tender, and the sound 
of fermentation absent or subdued over the omasum. Soon nervous dis- 
order appears, the eyes glare wildly, the animal seeks relief in motion — ■ 
sometimes in a straight line, sometimes to one side — and being blind and 
unconscious of obstacles, may fall into pits or ditches, knock against 
trees, fences, gates, or buildings, and continue pushing against resisting 
objects, breaking its horns or teeth; and otherwise sustaining injury 
through violent muscular contractions. 

Course. Chronic cases may continue indefinitely, with symptoms of 
poor health, impaired digestion, and gradual loss of condition. After 
death the omasum may contain dried food which the animal consumed 
several months before the attack. 

In cases ending in early recovery there occurs abundant diarrhcea, 
"the ffeces are mixed with flattened, dark, solid, and polished masses, the 
impacted ingesta from the omasum. Tympany subsides ; movement 
in rumen and omasum and rumbling in bowels can be heard. Appetite 
returns." (Law.) 

Diagnosis. The condition of the pulse and respiration, and the 
grunting with expiration may lead to confusion with pneumonia. 

At first there is no fever, tenderness is confined to the right flaxrk ; 



182 INDIGESTION. 

there is an absence of pulmonary crepitation, of pleural effusion, 
and of movement in the rumen and omasum. Signs of gastric and 
intestinal disorder can be detected. 

Lesions. The omasum is gorged — it may be twice its normal size — 
solid, resistant, almost stony. The spaces between the leaves are 
packed with dried food, which, when removed, carries a layer of epi- 
thelium from the mucous meml)rane. (This (layer on contents) is not 
inconsistent with health.) 

The rumen contains ingesta packed in masses, more or less offensive 
from putrefaction. 

The abomasum is empty of food, but contains much mucus. Its 
mucous membrane is congested. 

The small intestine is red in places, empty and collapsed. 

The larger intestine contains a quantity of dry, glistening pellets, and 
much mucus. 

Treatment follows the lines of impaction of rumen, though the 
response is usually less certain, and always slower. Flax-seed tea, 
several bucketfuls per day, will often succeed. 

Epsom and common salts, with sol. ammoniae, excite thirst ; licpiids 
should be supplied freely. 

In obstinate cases, and in absence of gastric or cerebral congestion, 
20 croton beans, or 20 drops of croton oil, may be added to the purgative. 
Nux vomica stimulates the nervous supply. Enemata may be given 
freely. 

Other remedies, stimulating contractility and secretion, are : Eserine, 
1^ grains ; veratrine, 1 grain ; barium chloride, 10 to 15 grains ; or pilo- 
carpin, 3 grains, hypodermically. 

The patient may be days or even a week without alvine discharge and 
recover. 

If fever and symptoms of gastric congestion appear, a blister may be 
applied to the right side over the omasum. 

Nervous symptoms, such as dilated pupils, blindness, congested 
mucous membrane, hot horns and ears, drowsiness or excitement, are 
combated by applying cold water or ice to poll, etc. 

When free action of the bowels is restored, laxative diet, roots 
(pulped), green food, plenty of common salt, and free access to drinking 
water should be prescribed. 

During convalescence a course of tonics, including nux vomica, is 
advisable to help in restoring normal gastric functions. 

ABOMASAL INDIGESTION. 

Primary indigestion in the abomasum appears to be rare in adults, 
for until the present time no one has given a sufficiently characteristic 



ABOMASAL INDIGESTION. 183 

description of this disease to enable it readily to be recognised. On the 
other hand, it is to be presumed, although final proof has certainly not 
been furnished, that in cases of gaseous indigestion, or of impaction of 
the rumen, the abomasum, whose physiological action is predominant, 
must simultaneously suffer. 

Primary abomasal indigestion, on the contrary, is common in young 
animals before weaning, so that the condition has been given the name 
of "milk indigestion." It could not very well be otherwise, for the 
abomasum is the only one of the gastric divisions which in ruminants 
is active during the first few weeks of life. At this period it is larger 
than the other gastric reservoirs ; and the rumen, the reticulum, and the 
omasum do not undergo great development till weaning begins. 

Causation. Milk indigestion attacks young animals, under varying 
conditions. 

In animals suckled by the mother the disease rarely occurs, but yet 
when the mothers are good milkers, like the Flemish, Norman, Jersey, 
and Holland breeds, and when there is too long an interval between the 
feeds, calves, which are naturally greedy, and in addition are hungry, are 
apt to take too large a quantity of milk — in fact, they often gorge to the 
fullest possible extent. Owing to its over-distended state the abomasum 
either fails to secrete sufficient of the rennet ferment necessary for 
coagulating the milk or secretes an insufficiently active ferment. The 
first stage of digestion remains incomplete, giving rise to so-called 
"milk indigestion." 

When the cows are employed in ploughing, etc., or in drawing carts, 
not only are the calves fed at long intervals, but the milk is not always 
of proper chemical composition even in the udder. As a result of 
work, fatigue, over-exertion and irregular feeding, the cow's yield of milk 
for the time is less digestible than the normal supply, or may even prove 
irritant to the calf's stomach. Milk indigestion is thus set up. 

When the cows are fed on factory waste, like beetroot-pulp or brewers' 
grains, toxic or irritant products may even find their way into the milk, 
which then irritates the little creature's abomasum and produces gastric 
indigestion. Just as in the production of congenital alcoholism in man, 
the young animal is then ingesting, unknown to those responsible for 
its well-being, chemical substances which produce various pathological 
changes. 

But milk indigestion is commonest of all in calves fed by hand. The 
food usually given is a mixture of milk from the previous night, and 
skim milk or even butter milk. It contains lactic ferments and various 
microbes, some capable of producing toxic principles. 

When swallowed and brought directly in contact with the mucous 
membrane these cause abomasal indigestion. 



184 INDIGESTION. 

Symptoms. Soon after feeding, the little animal appears dull and 
somnolent, and shows moderate abdominal pain, suggesting trifling 
colic. 

This stage is soon followed by nausea ; the breathing and the heart's 
action become rapid, vomiting efforts are made, and finally milk, in 
the form of firm or partially softened curds, depending on the time which 
has elapsed since the last feed was taken, are vomited. The quantity 
ejected varies. Pressure over the right side of the abdomen produces 
pain, and tympanites of the abomasum may sometimes be detected on 
percussion. 

The sensitiveness and gaseous inflation are confined to the middle 
and lower zone of the hypochondrium. Soon after vomiting the animal 
begins to improve. The patient seems brighter, relief is very marked, 
and in some cases proves permanent ; but more frequently a certain 
degree of depression persists, the mouth emits a sourish odour, and for 
a time the appetite remains poor. This temporary irritation of the 
abomasum has a tendency to become permanent ; or even to extend to 
the intestine, in which the conditions appear more favourable to the 
development of micro-organisms than do those in the stomach. In- 
digestion then becomes complicated with diarrhceic enteritis. 

The diagnosis presents no difficulty. 

The prognosis is not serious, provided that the young animals are 
carefully attended to ; but such complications as diarrhoeic enteritis may 
become very grave if neglected. 

The treatment. To prevent recurrences : 

(1) The periods of feeding should be regulated ; 

(2) The cows should not be worked, or should be worked as little as 
possible ; 

(3) Mixed milk, or milk which has already undergone lactic or other 
fermentation, should be avoided. 

If the calves must be reared by hand, the mixed milk should at least 
be boiled or relatively pasteurised by heating to 70° or 80° C, and the 
buckets used for feeding should be kept scrupulously clean. These 
precautions become absolutely necessary when diarrhcea exists amongst 
the calves. Curative treatment consists in placing the animals on low 
diet for two or three days after the attack of indigestion, or in giving 
them boiled milk diluted with from one-half to two-thirds of boiled 
water. 

The addition of a mild saline purgative like sulphate of soda, in doses 
of one-half to three-quarters of an ounce, usually ensures a cure. 
Infusions of lime-tree flowers, peppermint, camomile, etc., may ad- 
vantageously be used to replace boiled water in diluting the first 
foods. 



ACUTE GASTRIC INDIGESTION IN SWINE. 185 

ACUTE GASTRIC INDIGESTION IN SWINE. 

The causes comprise putrid food, swill, spoilt turnips, potatoes, 
apples, succulent vegetables, frozen food, and the admixture of caustic 
alkaline powders (used in washing table dishes) with the swill. Indi- 
gestible matters — hoof, horn, hair, bristles, tree bark, etc. — when not re- 
jected by vomiting, cause gastritis and indigestion. Lastly, medicinal 
substances and poisons, paint and lead, sometimes produce the disease. 

Among the symptoms may be mentioned dulness, arching of the 
back, standing with the feet brought together, erection of the bristles, 
hiding under the litter, grunting, uneasiness, shifting from place to 
place, tenseness of the abdominal wall, borborygmus ; these may be 
followed by diarrhoea and recovery. Speedier relief is aftbrded by 
copious vomiting of irritant matters. 

The treatment should commence with the free administration of 
emetics. To combat alkaline poisoning vinegar may be given, followed 
by a laxative. Prophylaxis calls for greater care in feeding. 



CHAPTER V. 

ACUTE INFLAMMATION OF THE GASTRIC COM- 
PARTMENTS. 

RUMENITIS-RETICULITIS GASTRITIS. 

Causation. Acute primary inflammation of the first gastric reser- 
voirs, viz., the rumen and reticulum, is not common. It sometimes 
accompanies such infectious disorders as foot-and-mouth disease, gan- 
grenous coryza, etc., hut then constitutes an added phenomenon which 
should be studied along with the original disease itself. Piumenitis or 
reticulitis may however follow the ingestion of irritant foods or plants, 
of very hot liquids, and more frequently still of unskilfully compounded 
medicines. In such cases the mucous membrane is directly attacked, 
and pathological congestion, infiltration, and desquamation may follow, 
or even' vesicles and ulcerations may rapidly be formed. 

Symptoms. Inflammation of the rumen or reticulum is announced 
by loss of appetite, suspension of rumination or of regular peristalsis, 
sUght tympanites, and particularly by excessive sensitiveness to palpa- 
tion. This sensitiveness is general, but is more specially marked in 
the left lower third of the abdominal cavity, and in the retro-ensiform 
region which corresponds to the position of the reticulum. Moderate 
fever is present. 

These symptoms, which indicate the gravity and intensity of the 
inflammation, may persist, become aggravated, provoke vomiting from 
the rumen, and leave as a legacy motor dyspepsia, or even more serious 
consequences. On the other hand, they may progressively diminish 
and disappear for good. 

Lesions. The lesions comprise hj-pertemia of the walls of the rumen 
and of the mucous membrane, extensive local exfoliation of epithelium, 
and sometimes true ulceration of the mucous membrane. 

Diagnosis. The diagnosis is based on the exceptional sensitiveness of 
the gastric compartments on palpation, and also on the history, provided 
relial)le information can be obtained. 

Prognosis. The j)rognosis should be reserved, because it is never 
possible to foretell whether acute lesions may not give place to chronic 



RUMENITIS — RETICULITIS — GASTRITIS. 187 

disease, which, though apparently luiimportant, may terminate in grave 
consequences. 

Treatment. Owing to their local action demulcent drinks and teas 
are indicated. Cooked food is useful, hecause it makes little demand on 
the digestive powers ; steamed hay and farinaceous suhstances are 
given, hoth on account of their nutritious qualities and of the slight 
local irritation they cause when swallowed. 

Lukewarm drinks and saline laxatives, such as the sulphate of soda, and 
carbonate of soda or Carlsbad salt in small doses of 1^ to 2 ounces, seem 
most useful in combatting the reflex atony of the digestive compartments. 

Inflammation of the omasum, like that of the rumen and reticulum, 
occurs as a secondary phenomenon in conditions like rinderpest, Texas 
fever, foot-and-mouth disease, anthrax, and gangrenous coryza (malig- 
nant catarrh) ; but primary inflammation is much rarer even than that 
of the rumen and of the reticulum. 

This is accounted for by the deep position of the omasum, which is 
thus sheltered from external violence, early contact with irritant foods and 
from the effect of chills, etc. It can only become inflamed by the prolonged 
action of irritant food and drink, which have already produced lesions in 
the rumen and reticulum ; or as a consequence of the prolonged stagnation 
of dry food in cases where animals have been deprived of water. 

Under these conditions inflammation of the omasum develops slowly, 
and from the clinical point of view is identical with what was formerly 
known as obstruction of the omasum. Obstruction or impaction is 
probably much rarer than has been stated, in so far at least as it con- 
stitutes a primary condition, for in the great majority of cases it is 
consecutive to impaction, inflammation of the rumen, or inflammation 
of the abomasum. Obstruction of the omasum, which was formerly 
invoked in all doubtful and ill-defined cases of digestive disturbance, 
seldom occurs as an isolated disease. 

It has been suggested that the omasum, being supplied with nerves 
solely by the sympathetic system, and provided with a relatively weak 
muscular coat, was more susceptible than the other reservoirs to the 
reaction of abdominal reflexes, and therefore more subject to inflam- 
mation, indigestion and obstruction. We do not hold that view, because, 
as a result of its general situation and the position of its orifices of 
communication, this compartment is easily able to expel its contents 
so long as they are liquid. Its function appears chiefly to be to complete 
the trituration of food after rumination. 

We do not consider that inflammation of the omasum never occurs, 
for we are well aware of the contrary, and that the inflammation assumes 
a subacute course and is accompanied by stasis of the semi-digested food 
between the mucous leaves which partly fill the cavity. We simply wish 



188 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

to emi^hasise the view that the condition is not a primary and isolated 
inliammation. 

Symptoms. The symptoms are always vague and very difficult 
clearly to define. 

Inflammation of the omasum is indicated hy relative loss of appetite, 
marked thirst, general atony, and diffuse and vague sensitiveness in the 
inferior half of the right hypochondrium (zone of the asternal ril)s). 
There are no pathognomonic symptoms. 

Obstruction has also been described as accompanied by loss of 
appetite, constipation, the passage of black, coated, foetid and sometimes 
blood-streaked fteces, symptoms of chronic tympanites with foetid eructa- 
tions and sometimes vomiting. These sometimes accompany hydrochloric 
acid dyspepsia, a form of chronic gastritis, and, from our standpoint, the 
stagnation of food in the omasum is only secondary. We therefore 
interpret the facts in quite a different manner, and believe that only by 
a rational and physiological interpretation of the symptoms ol)served can 
one diagnose the condition. 

Diagnosis. The diagnosis of inflammation of the omasum can only 
be made l\y a process of exclusion ; and although we are admittedly 
dealing with a condition secondary to disturbance of the rumen and 
reticulum, or on the other hand consecutive to inflammatory states or 
to modifications in the secretion of the abomasum (dyspepsia), the 
diagnosis does not present insuperable difficulties. 

The prognosis is only grave when the primary acute or chronic 
conditions of the other gastric compartments are serio.us. 

The lesions comprise abnormal vascularity of the mucous membrane 
and desquamation, and even gangrene, of the leaves. The partially 
digested food is not passed on, becomes dry and hard, and in time 
aggravates the local condition. 

The treatment does not essentially differ from that of other gastric 
inflammations. The object to be attained is to evacuate as completely as 
possible, not only the omasum, but all the gastric reservoirs, for which 
purpose one may freely administer demulcent drinks — linseed gruel, 
bran mashes and lukewarm liquids containing laxatives. At first such 
alkaloids as arecolin and pilocarpine may be subcutaneously injected 
to ensure energetic and speedy evacuation. 

Later on slightly stimulant aromatic infusions, like infusions of sage, 
peppermint, hyssop, thyme, etc., stimulate the functions of the stomach 
and hasten the return of normal conditions. 

ACUTE GASTRITIS. 

The term " acute gastritis," sometimes " gastro-enteritis," is used 
in bovine pathology to indicate inflammation of the abomasum. If this 



ACUTE GASTRITIS. 189 

inflammation is confined to the superficial epithelial layers it is defined 
as superficial catarrh of the abomasum ; if, on the contrary, it extends to 
the deep epithelium of the gastric glands and to the mucous corium, it 
is termed deep-seated gastritis. 

Clinically it is impossible to make these distinctions. We simply 
recognise degrees of gravity, and only in this way can one diagnose 
acute gastritis, phlegmonous gastritis, ulcerative gastritis, etc. 

Causation. The abomasum frequently becomes inflamed as a conse- 
quence of irritant foods, apart altogether from lesions of the rumen or 
reticulum, the mucous membrane lining the abomasum being so much 
more delicate than that of either of the two first comi^artments. 

Irritant plants, parasites, acid drinks, very cold water, certain acid 
or toxic industrial residues like mouldy brewers' grains, fermented 
vegetable pulp, decomposed beet, etc., and mouldy or spoilt forage of 
any kind may all produce acute gastritis. 

Intense feeding — i.e., feeding with farinaceous materials, with large 
quantities of beans, roots, peas, given regularly — may also cause gastritis 
by overtaxing the functions of the organ. Frozen or fermented roots 
and sudden changes in feeding produce similar results. Chills have also 
been blamed, but it is probable that they only act as favouring causes. 

Symptoms. It is necessary to consider these very carefully in order 
to arrive at a correct diagnosis. 

Inflammation of the abomasum is attended with moderate fever, 
diminution in appetite, irregularity in rumination and some tension of 
the rumen, without, however, true tympanites. 

At first the bowels are constipated, but in time foetid diarrhoea sets 
in. Examination of the digestive apparatus on the left side and in the 
right posterior abdominal region reveals nothing abnormal, but pressure 
over the lower portion of the abdomen and along the cartilages of the 
right hypochondriac region produces, on the contrary, well-marked pain. 
This region corresponds to the position of the abomasum. 

The conjunctiva appears reddish yellow, as in most visceral inflam- 
mations. 

Some authors have described attacks of extreme excitement, but 
these are no more pathognomonic than is grinding of the teeth, which 
is a constant symptom, or the metallic sound noted on auscultation 
of the rumen. This sound occurs in all cases of inertia of the rumen, 
and indicates distension and emptiness of the viscus (acute peritonitis, 
chronic adhesive peritonitis, inflammation of the reticulum as a conse- 
quence of the presence of foreign bodies). 

Dull colic and groaning are not uncommon. Finally, Thierry and 
others have all mentioned an alliaceous smell of the eructations as 
pathognomonic. 



190 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

Acute gastritis develops regularly in ten to fifteen days, after which 
the symptoms diminish and disappear, giving place to normal health. In 
grave cases, despite proper treatment, acute gastritis more frequently 
ends in a chronic condition, finally leading to gastric atrophy, and the 
insufficient secretion of hydrochloric acid, with all the consequences of 
these conditions. The glands of the stomach degenerate ; the secretion 
hecomes abnormal and dyspepsia is set up. 

Diagnosis. The diagnosis is rather difficult, for the condition is very 
apt to be confused with primary dyspepsia, or with inflammation of the 
gastric compartments. It might also be mistaken for acute enteritis of 
the first part of the small intestine ; but as gastritis is very often compli- 
cated with duodenitis, such a mistake is without serious consequences. 

Prognosis. The prognosis is grave, not because death is a frequent 
termination, but because the disease very often leads to chronic incurable 
lesions. 

The lesions consist of congestion of the vascular network of the 
mucous and subepithelial coats, serous infiltration of the corium and 
submucous connective layers, desquamation, and later in excessive 
proliferation of the epithelium. 

When the inflammation is deep seated the epithelium of the gastric 
glands becomes swollen and cloudy, and undergoes a kind of atrophic de- 
generation. In very grave cases, petechia, superficial capillary haemor- 
rhages, and slight ulceration may be noted. The mucous folds are 
always thickened and infiltrated. 

Treatment. In cases of gastritis or acute gastro-duodenitis mode- 
rate bleeding (three to four quarts) and local stimulation were formerly 
recommended. This practice certainly has its advantages, provided it is 
not pushed to excess. Sinapisms give good results, but as they must be 
left in position for a considerable time, it is often better to apply vesicants 
over the lower right hypochondriac region. At first purgatives are useful, 
because they unload the digestive tract, arrest the organic fermentation 
which results from stagnation in the movement of food along the alimen- 
tary tract, and diminish the tendency to intoxications or infections. 

At a later stage small doses of laxatives and bicarbonate of soda should 
be given daily, the diet being of an emollient character, and consisting of 
milk, starchy or farinaceous foods, and small quantities of good hay. 

Linseed, bran, cooked grain, decoctions of pellitory, barley and 
various cereals may also be administered with advantage. 

CATARRHAL GASTRITIS IN SWINE. 

Definition. Inflammation of the gastric mucosa, with muco-purulent 
discharge. 



ULCERATIVE GASTRITIS. 191 

The causes comprise irritants, fermented or putrid swill, decomposed 
food, excess of brine, alkalies (washings from table dishes, hotels, etc.), 
gastric parasites. 

The condition occurs also in hog cholera, swine plague, rouget, etc. 

The chief symptoms are : Inappetence, vomiting, uneasiness, colic, 
constipation or diarrhoea, fever, stiffness, tense and tender abdomen, 
arched back, frequent grunting, limpness of the tail. Sudden vomiting 
may bring about a rapid recovery. 

Treatment calls for a complete change of food, which may include 
freshly cooked roots, linseed or meal, butter milk, boiled milk, etc. 

As an emetic 30 grains of ipecacuanha may be given. Constipation 
can be relieved by a dose of calomel or jalap. If diarrhoea is persistent 
small doses of grey powder should be given, and to combat the irritation of 
the gastric mucous membrane bismuth subnitrate is also useful. 

The piggery should be cleansed and disinfected, and the litter frequently 
changed. 

ULCERATIVE GASTRITIS. 

Ulcerative gastritis (ulcer of the abomasum) is recognised after death, 
but hitherto it has been impossible to so clearly identify the symptoms as 
to permit of diagnosis during the animal's life. In has been found 
after death in adults and in calves (Ostertag). 

Causation and Pathogeny. The cause of gastric ulceration is 
decidedly obscure, though we know that certain forms occur during 
infectious diseases like cattle plague, foot-and-mouth disease, gangrenous 
coryza, and as a consequence of certain direct local infections ; other 
forms result from. the administration of drugs; and finally some are of 
secretory origin. 

In human medicine at the present day there is a tendency to refer 
the development of round ulcer and ulcerative gastritis to the secretion of 
an excess of hydrochloric acid. Probably the same cause may be at work 
in domestic animals, but the proof has not yet been given. 

With regard to the pathogeny, the theories of embolism or of throm- 
bosis of capillary vessels find favour with few authorities at the present 
day. Yet these explanations are logical enough, for if we prevent 
physiological irrigation of any given part, it is possible to conceive that 
ulcer formation may follow from auto-digestion, i.e., from the simple 
action of the gastric juice on a surface which is no longer protected. 

The theory of microbic origin has been advanced ; but although it may 
be accepted in relation to the intestine, where the most varied organisms 
abound, it is scarcely so applicable to the stomach, in which acidity is 
always very marked and must exercise a very energetic antiseptic action. 
In sucking calves, however, this theory appears the most plausible. 



192 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

It is quite certain that ulceration may result from the unwise use 
of drugs, like tartar emetic or arsenious acid, especially if these be 
administered for long periods ; but such ulceration always occurs at the 
same points, viz., at the deepest portion of the rumen, reticulum, or 
abomasum. 

On the other hand, ulceration due to secretory disturbance occurs at 
different points, and the figure opposite shows that the mucous folds 
themselves may be injured and perforated. 

Lesions. Ulceration of the abomasum varies in severity. The case 
referred to showed excavated ulcers from the site of which a portion 
or the whole of the epithelium and glandular layer had been shed ; true 
round ulcers, which had destroyed the entire depth of the mucous mem- 
brane and had produced chronic inflammation and sclerosis of the muscular 
layer ; and finally perforations resembling cleanly punched-out holes. 

The Symptoms are those of a mild form of ordinary acute gastritis, 
without marked fever, and without special injection of the conjunctiva. 
The appetite is diminished and irregular, but more as a consequence of 
excessive reHex sensibility of the injured organ than from absence of 
hunger. This excessive reflex sensibility of the abomasum causes relative 
or absolute gastric intolerance, so that only a small amount of the food 
ingested passes towards the intestine. 

Absolute intolerance on the part of the abomasum may even occur, 
as in a case described by Moussu in 1895, which produced a very special 
form of impaction of the rumen, absolutely different from primary 
impaction. 

Intolerance of the abomasum for food already ingested and rumi- 
nated may extend to the omasum. Peristalsis of the rumen then ceases, 
and slight tympanites occurs. The most ciiaracteristic condition is the 
existence of obstinate constipation. If ulceration takes place without 
producing any important vascular lesion, which, however, is rare, the 
faeces are hard and coated, but without other peculiarity ; if, however 
(and this appears to be the rule), local haemorrhage occurs, the extra va- 
sated blood is modified by the gastric and intestinal juices, and the faeces 
appear of a black, tarry colour. This coloration is very significant, 
and differs from that produced by the bile. It occurs only in gastric 
haemorrhage, and at intervals. 

Diagnosis. The diagnosis of gastric ulcer is difficult, and can only be 
arrived at with confidence when the above-mentioned coloration of the 
faeces can be detected. 

Prognosis. From an economic standpoint the prognosis is grave. The 
patient may recover ; the ulcers may heal, but cicatrisation is always pro- 
longed, and as, on the other hand, the glandular apparatus of the abomasum 
is generally more or less injured, complete recovery is impossible. 



ULCERATIVE GASTRITIS. 



193 




Fig. 70. — Ulcerative gastritis. 1, Typical round ulcer; 2 and 3, ulcers perforating 
folds of the abomasum ; 4, 5, and 6, old-standing ulcers with sclerosis of the walls 
of the abomasum and adhesive perigastritis. 



D.C. 



194 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

Treatment should be directed towards checking haemorrhage, dimin- 
ishing intolerance to food, and assisting the healing of the lesions. 
These objects are facilitated by prolonged complete rest in the stable, by 
injecting ergotine, or, '7 per cent, saline solution, at the time when the 
haemorrhage occurs, and, if possible, by placing the animals on milk diet 
or on emollient food, like gruels, emollient infusions, barley, milk, cooked 
roots, etc. 

Stimulation over the region of the abomasum is also of value. At a 
later stage, when the acute symptoms have diminished, Carlsbad salts, 
in doses of 1 to 2 ounces per day, can be given. Bicarbonate of soda is 
also of considerable value. 

CHRONIC TYMPANITES. 

Chronic Indigestion— Obstruction of the Abomasum— Chronic Gastritis — 

Dyspepsia. 

Among iiathological conditions of the stomach in ruminants a 
certain number are clinically marked by one constant symptom, viz., 
chronic tympanites, a fact which was formerly recognised as indicative 
of chronic indigestion. 

It is evident that such titles have only the signilican.ee accorded 
them, and the term chronic indigestion used only to mean that gastric 
digestion was badly performed, and that the condition was more or less 
permanent. It being granted, on the other hand, that the term in- 
digestion is used to characterise temporary conditions during which 
digestion is suspended, and produces immediate disturbance, it would 
appear that the term gastric dyspepsia is more exact and more in 
conformity with the present state of our knowledge of general physio- 
logy. In studying this question it is clear a number of facts still 
require explanation, for, as has been previously indicated, we know 
almost nothing concerning the variations in the chemical phenomena 
of gastric digestion under different morbid conditions ; nevertheless, the 
dominant fact, the imperfect or irregular digestion, is easily a^jpreciable. 
Future discoveries will no doubt enable us more exactly to differentiate 
several dyspeptic conditions due to chemical or mechanical causes and 
with or without anatomical lesions. At present it is sufficient to indicate 
the limits of inquiry. 

Causation. The symptom of chronic tympanites accompanies a 
great number of very different conditions — some due to disease of the 
digestive tract itself, others to general diseases or lesions of neigh- 
bouring parts. In the latter cases the tympanites is only indicative 
of secondary dyspepsia ; in the former, on the other hand, the dyspepsia 
is primary. 

Secondary dyspepsia occurs very commonly during tuberculosis. 



CHRONIC TYMPANITES. 195 

diseases of the liver, subacute or chronic peritonitis, gestation, lesions 
of the mediastinum, etc., etc. 

(a) Secretory or Chemical Dyspepsia. In primary dyspepsia it is 
impossible to discover any lesion sufficient to explain the disturbance. 
Chronic tympanites, for instance, follows prolonged consumption of 
rough or bad food (in years when forage has been scarce or winter 
food has been lacking), and too short a supply of water for weeks in 
succession. It also occurs as a consequence of acute inflammation of 
one or other of the gastric compartments — rumenitis, reticulitis, gas- 
tritis. Sometimes it assumes an insidious, slow, progressive form, 
without any apparent cause whatever. 

In these various conditions, the mucous membrane of the gastric 
compartments suffers from the deferred results of the bad feeding 
or want of water. Its secretory powers and anatomical structure be- 
coming modified, it is no longer able regularly to elaborate the juices 
necessary for digestion, and chronic indigestion, imperfect digestion, or 
dyspepsia result. Similar results follow acute inflammation of the 
omasum, reticulum, or rumen. Integral rejjair becomes impossible. 
Anatomical injury is done, disturbance of secretion follows, and dys- 
pepsia is a necessary consequence. 

(b) Motor Dyspepsia. Finally, it would appear that general bad 
health, al)stinence and exhausting work, may produce a form of dys- 
pepsia, unconnected with secretory disturbance, but resulting from 
mechanical disturbance due to general enfeeblement and to atony of 
the muscular walls of the gastric compartments. The rumen ceases 
to perform its work of mixing the food, the reticulum also acts badly, 
and the abomasum receives imperfectly prepared material. The result 
is what might be described as motor dyspepsia, in o^^position to those 
forms which are of chemical origin. 

The condition may vary in degree, peristalsis being diminished (one 
contraction every two or three minutes instead of two per minute), or 
being simply intermittent and occurring only for a few hours during 
the day, or finally being altogether suppressed. Suppression is never 
absolute, but atony may be so marked that the mixing of the food is 
very imperfectly performed. 

Symptoms. The most constant symptom present in all dyspeptic 
conditions is chronic tympanites, indicated by a certain degree of 
tension or by permanent dilatation of the rumen. 

Eumination is impeded and irregular, the distended rumen loses its 
power of contraction, and no longer causes eructation nor passes gas 
into the intestine. It becomes progressively inert, whether the inertia 
be primary and occur suddenly, as a result of some particular condition 
of the sympathetic system (motor dyspepsia), or secondary and of slow 



196 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

development in consequence of disturbance in the gastric secretions and 
of abnormal organic fermentation (secretory dyspepsia). 

This symptom of tympanites is always accompanied Vjy irregularity, 
diminution, and frequently also by depravity of appetite. 

Wasting occurs, but to a very varying degree, according to the 
nature of the primary condition and the method of feeding. 

These general symptoms are accompanied either by constipation or 
by diarrhoea ; and as stagnation of food leads to fermentation, which 
always forms products differing from those of normal digestion — toxic 
materials in fact — a chronic auto-intoxication results, which in its 
turn, if not remedied, becomes a cause of irritation, and aggravates the 
bad general condition. 

In many cases fever is absent, except during the final complica- 
tions, in animals in the last stages of wasting; but some signs always 
exist on which the diagnosis may be founded. 

The most frequent clinical type of these dyspeptic conditions is 
motor dyspepsia, consisting in relative atony of the rumen without 
disturbance in the secretion of the gastric mucous membranes. 
Luckily, this is the most easily curable form, and is only marked by 
distension, dulness and constipation. 

Dyspeptic diseases of secretory origin are little understood. Their 
essential causes have been badly described, and their clinical symptoms 
are ill-recognised. 

We cannot prove whether the forms said to be due in man to excess 
of hydrochloric acid and insufficiency of hydrochloric acid really occur 
or are well defined in domestic animals : nor are we better informed as 
to the exact part played by the organic acid of fermentation (lactic, 
butja-ic, acetic acid, etc.) ; but the most complete investigations which 
have yet been made justify our supposing there is some parallel. 

Moussu described primary ulcerative gastritis in 1895 ; and as this 
form is almost certainly associated with excess of pepsine, the occur- 
rence of an excess of hydrochloric acid also seems possible, the 
more so as the symptoms noted resemble the general symjDtoms of 
that condition — preservation of appetite and of the motor power of 
the rumen, accumulation of food in the rumen as a consequence of 
reflex intolerance of the abomasum, constipation, and vomiting. 

In addition to these two morbid conditions, a third occurs with 
some frequency. It is characterised by chronic tympanites, alimen- 
tary diarrhcea (the food being badly digested), and progressive wasting. 
This condition seems due to an insufficiency of hydrochloric acid, 
brought about by chronic gastritis, the epithelial cells of the mucous 
membrane appearing incapable of producing sufficient hydrochloric 
acid for digestion. 



CHRONIC TYMPANITES. 197 

Diagnosis. In the present state of our knowledge regarding diges- 
tion in ruminants the precise diagnosis of these pathological conditions 
must always remain difficult ; but it is indisputable that with the above 
grouping of symptoms we are more likely to succeed than by confining 
ourselves to the diagnosis formerly common, viz., that of chronic tym- 
panites or chronic indigestion. 

The difference between primary and secondary dyspepsia should always 
be borne in mind, and careful examination will often reveal the special 
condition which has served as the point of departure for gastric disturb- 
ance. Thus generalised tuberculosis, or tuberculosis of the liver or 
mediastinum, should always be sought for, and the possible existence 
of such conditions of the liver as echinococcosis, cancer of the bile 
ducts, tumours, etc., and diseases of the kidneys should be borne in 
mind. The influence of gestation, which so frequently causes gastric 
disturbance complicated with albuminuria, should never be over- 
looked, and in these secondary forms of dyspepsia the determining 
cause, and not the objective symptoms should receive chief attention. 

Prognosis. The prognosis of secondary forms of dyspepsia varies 
with the gravity of the primary disease. The prognosis of primary 
dyspeptic conditions varies greatly, and that state in which hydro- 
chloric acid is too sparingly secreted is certainly the gravest. 

Lesions. The lesions have not been carefully studied, but it is 
probable that in many cases they might afford a key to the symptoms 
noted. Like all mucous lesions, they are difficult to demonstrate 
histologically. Infiltration and thickening of the mucous corium and sub- 
mucous layers have been described. Such lesions indicate nothing ; but 
in some cases new growths have been found in the gastric compartments 
or contractions about the pyloric orifice, the essential importance of 
which cannot be doubted. 

Treatment. If our knowledge is still insufficient to enable us pre- 
cisely to diagnose what we have termed " gastric dyspepsia," or what is 
still currently described as " chronic dyspepsia," the difficulty is even 
greater when attempting to lay down lines of treatment, because of the 
lack of known facts and the want of a base for reasoning. Thus we find, 
without being able to explain why, that some prescribe tartar emetic, 
others rapid and energetic purgatives, others, again, laxatives ; whilst 
German authors, apparently without any justification, recommend oil 
of turpentine. It seems to us, however, that one might do better than 
this and attempt to lay down some rational indications for treatment. 

(a) In cases characterised only by chronic tympanites, without diar- 
rhoea, without manifest constipation (motor dyspepsia), and without any 
other apparent organic disturbance, drugs calculated to stimulate peri- 
stalsis of the rumen seem indicated. The most promising comprise 



198 CHRONIC INFLAMMATIOX OF THE GASTRIC COMPARTMENTS. 

ipecacuanha in doses of 1 to 2 drams per day, tincture of nux vomica in 
similar doses, powdered nux vomica in doses of 45 to 75 grains, and 
laxatives like Carlsbad salts in doses of 8 to 10 drams. 

Little by little peristalsis returns, becomes regular, and the chronic 
tympanites disappears for good. This is frequently the case during 
gestation, when the condition simply consists in motor dyspepsia without 
anfemia. 

(/>) If, on the contrary, chronic tympanites is accompanied by 
constipation, and the faeces are hard or, as is usually the case, covered 
with mucus, suggesting the probability of excess of hydrochloric acid, 
salines are indicated — not to the point of producing purgation, which 
would not lead to any lasting improvement, but still as laxatives, con- 
tinued daily for ten, fifteen, or twenty days, or, if necessary, even longer. 

Carlsbad salts in doses of 8 to 10 drams, or one-ounce doses of sulphate 
of sodium associated with 2^ drams of bicarbonate of potash after each 
meal, are to be recommended in preference to bicarbonate of soda alone, 
because they act on the secretions, on the muscular system, and also on 
the liver. 

(f) Finally, when chronic tympanites is accompanied by diarrhoea, 
a condition which usually indicates insufficient secretion of hydrochloric 
acid, the administration of that acid tends to arrest or check organic 
fermentation and to facilitate digestion in the abomasum by supple- 
menting the diminished physiological secretion. The dosage is an 
important point. At first small quantities should be given, 2J drams 
per day, divided into two doses and freely diluted in the drinking water ; 
but this amount may, if necessary, afterwards be doubled or trebled. The 
drinking water is not rendered irritant by these doses, for it is admitted, 
and Moussu has confirmed the fact by analysis, that the quantity of 
HCl in the gastric juice may rise as high as "2 to '3 per cent. Chloride 
of sodium, the excito-secretory action of which on the gastric mucous 
membrane is well known, may be given for long periods in doses of 
1 to 1^ ounces per day. 

In these various chemico-pathological states the food should receive 
the closest attention. The forage, which should be good, ma}' be supple- 
mented by the addition of cooked roots, demulcent drinks, and, if 
possible, milk. 

GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 

These morbid conditions are extremely complex, but the facts that 
they are due only to one cause, and that they possess certain symptoms 
in common, permit of a certain grouping. It would obviously be 
illogical to speak of traumatic indigestion of the rumen, reticulum, and 
abomasum, as has been done in more than one book on this subject ; for 



GASTRIC DISTURBANCE DUE TO FOREIGN BODIES, 199 

the gastric disturbances described below should be considered as 
complications, and not as diseases. 

Causation. In young animals foreign bodies may be composed of 
hairs, wool, bristles, cotton, and clover hairs. 

Hair balls are common in the rumen, and are sometimes met with in 
the fourth stomach. They cause irritation, indigestion, sometimes pyloric 
obstruction, dilatation, and eventually death. 

Wool balls in lambs, bristle balls in young pigs, cause much gastric 
irritation. Cotton balls occur in lambs fed on cotton-seed cake ; the fibre 
constitutes a foreign body. The hairs of clover leaves may form a ball 
in the abomasum of lambs. 

Under the influence of depraved appetite animals of the bovine 
species consume, apart from their regular food, the most varying sub- 
stances, such as linen, fragments of wood, nails, stones, gravel, sand, etc. 
Moreover, forage, even when of good quality, often contains foreign 
bodies like nails and pins (when the fields are near factories), sewing or 
knitting needles (when the animals are looked after by women), frag- 
ments of iron wire derived from bales of compressed forage, etc., etc. 
The ingestion of such objects is followed by various consequences, which 
may be studied in three divisions, in the first of which the foreign object 
is soft in character, in the second is blunt at one extremity and pointed 
at the other, and in the third is pointed at both ends. 

(1.) Soft objects. The movements of the rumen, the warmth and 
the action of the digestive fluids, may cause soft objects to be broken 
up ; the disturbance they produce is then insignificant. 

Of such substances, however, some are quite incapable of digestion 
(clothing, sacks, linen, etc.), and may produce obstructions ; others are 
both indigestible and heavy (gravel and sand), and may fall into the 
depressions of the compartments, where they remain, or, if passed into the 
reticulum, may become arrested in the deepest lying jjart. They then 
produce atony of the muscular coats, slowing of peristaltic movements, 
diminution in the frequency of eructation, and, as an additional conse- 
quence, chronic tympanites, sometimes visible at the flank. 

The symptoms are vague and common to a number of the digestive 
diseases already described. The animals masticate without having any- 
thing in the mouth ; rumination becomes irregular or is altogether sup- 
pressed, but this is not characteristic, being a symptom common to 
many visceral diseases. 

Later, as a result of auto-infection, diarrhoea sets in ; under the 
influence of abnormal fermentation in the gastric compartments the 
eructations become foetid ; the animals fall into a condition of marasmus. 
Death usually results after a varying time — when large quantities of 
foreign substances have been ingested, in twenty to thirty days. 



200 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

The diagnosis chiefly rests on the history, and can only he of a 
confident character when one knows what quantity and what kind of 
foreign hody has heen swallowed. 

The prognosis is grave, hecause the animal usually dies of pro- 
gressive exhaustion. 

Treatment. There is only one rational form of treatment — viz., 
gastrotomy, followed hy examination of the rumen and reticulum and 
removal of the foreign hody. Before undertaking operation the sui^eon 
should he fully informed as to the cause and the prohahle results to be 
expected. 

(2.) Foreign bodies with one pointed extremity. These usually con- 
sist of large-headed nails, or fragments of iron wire rolled up at one end, 
which have been swallowed during primary mastication along with 
forage. 

When ingested, they may become implanted at any point in the 
gastric apparatus without necessarily penetrating deeply. When fixed 
across the division of the reticulum, they cause slowing of its physio- 
logical action. Should they penetrate the wall either of the reticulum 
or of the rumen, they may attack on the right the liver, or on the left 
the diaphragm or spleen, producing suppurating hepatitis, splenitis, or 
respiratory disturbance. The hypochondriac region then appears sensi- 
tive. The muscular portion of the diaphragm is partly paralysed, and 
costal respiration set up, while frequent coughing of reflex origin is pro- 
voked by irritation of the pneumo-gastric and diaphragmatic nerves, and 
may give rise to suspicion of some thoracic disease, from which, however, 
it is distinguished by the absence of discharge, expectoration, and pul- 
monary symptoms. 

Finally, if implanted in the lower wall or sides of the rumen or 
reticulum, foreign bodies may carry with them infectious agents and 
set up localised or generalised peritonitis. 

Early diagnosis is a matter of great difficulty, as it can only rest on 
the diaphragmatic disturbance or on the symptoms of peritonitis. 

Lesions. Small-sized sharp bodies cause lesions of trifling extent, 
which in most cases are only indicated by retardation of movement of 
the gastric compartments, between which and the diaphragm, and be- 
tween the diaphragm and the posterior portions of the lung, various 
adhesions are set up. In such cases the peripheral inflammation ends 
by producing a fibrous sleeve, which prevents the pleural cavity becoming 
infected. Other cases show patches of adhesive peritonitis or signs of 
generalised peritonitis, the real cause of which often evades discovery 
during life. 

Treatment. Gastrotomy is the sole means of eftecting a cure, but we 
are forced to admit that it only gives good results when the operator 



GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 201 

knows what he is trying to find. Without this information he acts in the 
dark, is obhged to abandon himself to chance, and although luck some- 
times favours him, it more often leaves him in the lurch. 

(3.) Foreign bodies pointed at both ends. Bodies like needles, pins, 
straight fragments of iron wire, knitting-needles and broken hairpins, 
become implanted in the gastric walls and travel in the most diverse 
directions, in obedience to the varied movements of the organ injured. 
They produce results similar to those just described. Most frequently 
they fall into the lower part of the gastric compartments, pass near the 
ensiform cartilage, between the pleura and the triangularis sterni into 
the thickness of this muscle, or into the mediastinum, and there produce 
either an abscess in the region of the ensiform cartilage, an abscess of 
the thoracic wall, or a collection of pus in the sub-pericardial or sub- 
pleural region (pseudo-pericarditis). They may even reach the peri- 
cardium, causing pericarditis, and sometimes, when adhesions are set up 
between the heart and pericardial sac, carditis. 

By deviating to the right or left, the foreign body may produce 
pleurisy or even pneumonia. If it moves towards the right, it involves 
the liver and produces suppurative hepatitis ; if to the left, suppurative 
splenitis. Travelling in a downward direction, it encounters the abdo- 
minal wall, and after producing an abscess may be eliminated ; passing 
backwards, it falls into the peritoneum, and may lead to peritonitis. In 
those exceptional cases in which foreign bodies reach the abomasum 
they generally become implanted towards the greater curvature, pro- 
ducing in the abdominal wall an abscess which breaks externally, and 
through which the foreign body is discharged ; gastric fistula is then 
a common sequel. 

The symptoms vary, according to the complications. The earliest 
comprise digestive disturbance, which coincides with the passage of the 
sharp object through the rumen or reticulum, and depends on whether 
such passage produces local peritonitis and pain, rendering movement of 
these compartments impossible. Later, when the diaphragm has been 
penetrated, respiratory disturbance occurs, and is" succeeded by apparent 
improvement, which in its turn may be followed by the occurrence of 
pericarditis, pleurisy, or abscess formation. 

In other cases where suppurative hepatitis or splenitis, or even 
peritonitis may be present, the symptoms are extremely vague and very 
difficult to refer to their real cause. 

Diagnosis is difficult, unless the owner is able to supply exact infor- 
mation that at some previous time the animal had swallowed such and 
such an object. 

The prognosis is grave, though cases occur where a foreign body is 
tolerated, and may for a long time be retained without producing accidents. 



202 TUMOURS OF THE GASTRIC COMPARTMENTS. 

Treatment. Gastrotomy should not be performed unless the operator 
is possessed of very precise information. In such case the rumen and 
reticulum should be emptied and the foreign body sought for and removed. 

When the symptoms strongly point to the presence of a foreign body 
exploratory gastrotomy may be performed, but the operator will do well 
to employ the operation only as a last resort. 

]\Iany complications, like septic peritonitis, hepatitis, and splenitis, 
are practically hopeless ; but others show a tendency to recovery. This 
is the case when abscesses form in the thoracic or abdominal wall, or 
beneath the pleura or pericardium. The entire difficulty consists in 
diagnosis, for when once this is clearly defined intervention is fully 
justified. As, however, the surgical measures vary in every case, the 
exact course to be adopted must be left to the initiative of the surgeon. 

Tu:\rouRs of the gastric compartmknts. 

Papillomata result from hypertrophy of normal papilla? ; they 
resemble those of the pharynx and oesophagus. The growth may attain 
the size of a fist. It often resembles a cauliflower in appearance. When 
very large, such growths may cause obstruction. A very striking illus- 
tration of a papilloma of the mucous membrane is given on p. 180 of 
Moller and Dollar's " Eegional Surgery." 

Sarcoma has been noted by Paule, Kitt, and Schiitz as forming in 
the subserous tissue of the omasum, and later bulging out as a wounded 
swelling of irregular size. 

Actinomycosis of the abomasum has been reported by Professor 
Axe. 



CHAPTER VI. 
ENTERITIS. 

Enteritis consists in inflammation of the intestine, or, more pre- 
cisely, in inflammation of the intestinal mucous memhrane. All the 
constituent portions of the intestinal tube may be affected (duodenum, 
jejeunum, ileum, colon, caecum) ; but clinical distinctions and localisation 
of inflammation in the various parts are very difficult in the domesticated 
animals, and at present it is impossible to describe with any accuracy 
the differences between duodenitis, enteritis of the jejeunum and ileum, 
colitis or typhlitis. Without doubt certain symptoms suggest that some 
regions are more affected than others ; but clinically we are only able 
to distinguish between acute and chronic enteritis. Acute enteritis may 
assume different forms, according to its intensity, rapidity of development, 
and lesions, so that it is possible to distinguish between such conditions 
as simple acute enteritis and haemorrhagic enteritis. 

Chronic enteritis, an abstraction founded on our knowledge of such 
specific forms of enteritis as are due to tuberculosis, distomatosis, 
helminthiasis, etc., usually assumes the diarrhceic form. 



ACUTE ENTERITIS. 

As acute enteritis, whether localised in one portion of the intestine or 
involving the whole intestinal tube, is produced by varying causes, and 
assumes very vaiying degrees of intensity, its clinical symptoms are 
equally diverse. 

Causation. The various forms of enteritis result from two great 
series of causes : infections and intoxications. Normally the intestine 
contains an extremely large number of different microbes, which may 
prove of service so long as circulation, secretion, and peristalsis continue 
normal ; but as soon as any perturbation occurs, either in the blood 
supply or in the movement of the bowel, normal secretion is impeded ; 
abnormal organic fermentation commences, producing irritant principles 
or toxins which at once set up local irritation, or, being absorbed, produce 
that complex of symptoms which we recognise as enteritis, intoxication 
of intestinal origin, or even infection. 



204 feNTERlTlS. 

Bearing in mind these facts, we are better able to understand the 
]iart phi3^ed by cold, by damaged fodder, by intense, stimulating feed- 
ing, or sudden changes in the food, as well as by the action of drastic 
purgatives, which modify beyond physiological limits the condition of 
the glands, or even cause local desquamation of epithelium. 

Toxic substances or plants act similarly by modifying either the 
circulatory, secretory, or motor systems. 

Symptoms. The first appreciable external symptoms appear to result 
from fever — loss of appetite, suspension of rumination, dryness of the 
muzzle and of the mouth, earthy-red colour of the conjunctival mucous 
membrane, etc. 

On manipulating the left flank one notes neither tympanites nor 
sensitiveness — in a word, there is no indication of functional disturb- 
ance of the rumen. 

On the right side, on the contrary, palpation causes the animal to 
resist and to show signs of pain. According as this sensitiveness is more 
marked in the middle or upper region or towards the hypochondriac 
circle, we infer that the inflammation is most acute in the large or 
small intestine, either in the middle portions or, again, in the most 
anterior portion. The temperature always rises at the commence- 
ment, attaining 103° to 104° Fahr. (39-5° or 40° C), but rarely a higher 
point, a fact which negatives the idea of a rapidly progressive infectious 
disease. Slight colic appears, and is accompanied by constipation ; the 
faeces are covered with mucus, or false membranes, or are completely 
enclosed in fibrinous tubes. After four or five days the faeces change 
in character. Constipation gives place to a liquid, blackish, very foetid 
diarrhcea. Finally the mouth exhales a stercoraceous odour, resulting 
from foetid eructation. 

The passage of flat or tubular false membranes continues for a certain 
time. 

When false membranes constitute the chief symptom, the condi- 
tion is termed " pseudo-membranous, croupal, or diphtheritic enteritis." 
This form is only a variety of acute enteritis, but is grave, because 
complications due to haemorrhage or infection are very liable to occur. 

In certain cases movement causes groaning. In the slighter forms 
the patient may recover spontaneously. If fed with easily digested 
materials, the symptoms diminish in intensity. Towards the eighth 
day the faeces become normal, appetite and rumination reappear, and 
the secretion of milk which had fallen off rises to its normal amount. 
Eesolution has occurred. 

More frequently, either because the animals have less power of 
resistance or because decomposition is taking place more actively in 
the intestine, or, again, because intoxication is setting in, the disease 



ACUTE ENTERtTIS. 205 

becomes aggravated. Constipation is more marked, and the feces passed 
are in small masses, covered with layers of epithelium, or sometimes 
streaked with blood. In other cases the diarrhoea becomes exaggerated 
and assmiies a mucous or sero-mucous character ; the temperature rises, 
and death results from exhaustion and infection, micro-organisms passing 
from the lumen of the intestine through its walls and invading the 
general circulation. 

Lesions. To study the lesions to advantage the autopsy must be 
performed as soon as possible after death. 

In slight cases they consist of trifling generalised congestion of the 
intestinal mucous membrane. The points most affected show infiltra- 
tion of the submucous coat, and sometimes of the muscular coat ; the 
wall of the intestine is double its normal thickness, but the thickening 
never equals that seen in cases of rapidly fatal intestinal congestion. 

At a more advanced stage the mucous membrane clearly is inflamed, 
its surface is covered with a fibrous exudate, and the glandular and 
epithelial cells proliferate, assume the embryonic form, and produce the 
new tissue which one recognises under the form of false membranes. 

The false membranes are generally but slightly adherent, and are 
readily expelled. 

In other cases, however, they adhere firmly, and when detached by 
the friction caused by movement of semi-digested food through the bowel, 
produce rupture of capillary vessels ; this explains the presence of blood 
streaks in the fffices. 

The diagnosis is relatively easy, especially at the onset, on account 
of the special character of the fsces and the sensitiveness of the right 
flank. 

The prognosis is seldom grave. If the enteritis is taken at the 
beginning, recovery is usual ; but if the animal has been ill for eight 
or ten days and is exhausted, and if fever and diarrhcea are intense, the 
prognosis should be guarded. 

The treatment is that of all acute inflammatory diseases. Mustard 
plasters may he applied to the chest and abdomen and left in position 
for some hours, or may be repeated. Some practitioners prefer hot 
blankets or dry friction, or, again, rubbing with essence of turpentine, 
but this substance should be spread over large surfaces, in order to 
prevent injury to the skin. Bleeding is only justifiable in plethoric 
animals, and should never be exhaustive. 

To relieve the digestive symptoms purgatives are at first given, even 
though diarrhoea is marked from the onset ; for purgatives still consti- 
tute the best intestinal antiseptics, because they get rid of the intestinal 
contents and microbes. The diet should be carefully selected, and may 
consist of gruel, mucilaginous materials, linseed tea, cooked roots, etc. 



206 ENTERITIS. 

Of drugs, sulphate of sodium in doses of 10 to 15 ounces is pro- 
bably the best. It can gradually be replaced by 2 to 3 drachm doses of 
bicarbonate of soda or of ordinary salt per day. Laudanum, camphor, 
and bismuth relieve persistent colic and diarrhcea. Pilocarpine, veratrine 
and eserine, though recommended by some authors, present no advantage 
in our opinion. The first two of these substances certainly cause purga- 
tion, but the action is quite temporary. The last induces violent con- 
traction of the striped muscular tissue, and may produce grave lesions or 
invagination when the bowel is diseased, thickened or infiltrated. 

H.EMORRHAGIC ENTERITIS. 

This form of enteritis derives its name from the dominant symptom, 
which consists in the passage of unaltered or clotted blood in the faeces. 
Ill the former case the blood is bright in colour, as if it came directly 
from an open vessel. In the second it is coagulated, and assumes the 
form of fibrinous clots, which seem to result from the superposition, 
in the intestinal tract of their constituent elements, viz., serum, blood 
corpuscles, and fibrin. 

Causation. Htemorrhagic enteritis is rarely seen except during the 
hottest days of summer, and in young animals which have previously 
shown nothing abnormal. The high temperature seems to favour its 
appearance, but is always supplemented by another cause, viz., the 
ingestion of irritant food, particularly of weeds and toxic plants or 
herbage of bad quality ; amongst such may be mentioned dog's mercury, 
and plants of the order Papaveracese, EuphorbiacefB, etc. Otherwise 
the often rapid manner in which the disease develops indicates toxic 
enteritis. 

In other cases, more benign in appearance, but quite as grave in 
reality, blood is passed continually, and the disease assumes a chronic 
form. It is then of parasitic origin, and is due to intestinal psoro- 
spermosis. 

Symptoms. The primary symptoms are similar to those of acute 
enteritis, and consist of fever, dryness of the muzzle and of the mouth, 
colic and constipation. This is soon followed by loose motions con- 
taining blood or blood clots, according as the hfemorrhage occurs at a 
greater or less distance from the rectum. The faeces are then ejected 
violently to a considerable distance, on account of the exaggerated 
intestinal peristalsis. 

The disease may produce death in twenty-four hours, though usually 
the end is deferred for several days, or, in cases due to sporozoa, for a 
considerably longer time. In these cases there is some chance of 
recovery, provided that treatment be prompt. 

The diagnosis is very easy. 



HEMORRHAGIC ENTERITIS. 207 

The prognosis is in all cases grave. 

The lesions are ill-recognised. The animals die rapidly, and if not 
immediately examined show no characteristic lesions. The changes to be 
looked for consist in intense congestion or ulceration of the intestine, or 
even in ulceration of arterioles and of arteries of considerable size. 

In parasitic enteritis one finds localised inflammation and, in the 
epithelial interstices, sporozoa, which cause the rupture of blood-vessels. 

Treatment. It is necessary to act energetically from the outset, 
and to arrest haemorrhage by acting on the intestine, on the vascular 
system, and on the skin. Mustard plasters or other external stimulant 
applications are therefore indicated. Internally, small doses of 
astringents like tannin, preparations of opium, 25 per cent, solution 
of sulphuric acid in alcohol, etc., are given to produce constriction of 
the vessels, though they seldom arrest the discharge of blood for long. 
In most cases it is necessary to have recourse to subcutaneous injections 
of ergotine, in doses of 5 to 10 grains in young animals, and 15 to 45 
grains in adults. The dose may be given in two parts to prevent an 
unduly severe action. The smooth fibres of the small vessels are thus 
directly excited, and haemorrhage ceases in consequence of clotting in 
the contracted vessels. 

One may give for the same purpose injections of arseniate of 
strychnine, which has the advantage of sustaining the tone of the 
heart and preventing syncope. The dose should not exceed 1*5 grains 
in large animals. 

Finally, a stimulating diet containing milk, alcohol, soup, cooked 
vegetables, and small quantities of vegetable pulp is useful. 

With early treatment animals sometimes recover in a few hours. 

Intra-venous or subcutaneous injections of physiological salt solution 
(2 drachms of sodium chloride in one quart of water) may prove of value 
when haimorrhage has been abundant and vascular pressure is low. 

CHRONIC ENTERITIS (CHRONIC DIARRHCEA). 

Chronic diarrhcea is common in byres. It appears suddenly, often 
fails to attract attention, and assumes the form of simple diarrhoea, a 
fact which accounts for it frequently being described as chronic diarrhcea, 
dysentery, etc. 

Causation and pathogeny. This form of diarrhoea occurs sporadi- 
cally throughout France, and under exceptional circumstances may 
permanently attack a number of animals in a given place. 

The immediate cause is not known, but without doubt the disease 
is of microbic origin. Like Lignieres, Moussu at one time believed 
that this disease was very probably identical with that known in 



208 



ENTERITIS. 



Argentina under the names of diarrhcea, cnteque, or bovine pasteurellosis. 
The hypothesis has not been verified, and Lignieres' treatment, said by 
him to have succeeded in Argentina, always failed in Moussu's hand. 

The only point which seems admissible is that this disease, which 
Moussu considered to have analogies with chronic sporadic dysentery 
in man, is due to one or several organisms, which develop in the 

intestine and produce toxins, causing 
diarrhoea, without, however, marked in- 
fiammation of the intestinal mucous 
membrane. 

Symptoms. The onset is often over- 
looked. The diarrhcea gradually in- 
creases without appearing to be very 
serious ; but it persists in varying de- 
grees of intensity. The patients do not 
appear to suffer, and do not lose their 
appetite or spirits, but in time the 
diarrhcea becomes exhausting ; they 
waste, and after some months become 
excessively thin and poor. 

Intestinal peristalsis becomes exag- 
gerated without the existence of colic or 
tympanites. The evacuations are fre- 
quent, and little by little the abdomen 
retracts, until, in horseman's parlance, 
"the belly is up to the back," even in 
cows of four, seven, and eight years' 
bearing. 

The diarrhcea is serous, always foetid, 
and without tenesmus. 

The ffeces may either be very soft 
or be passed in veritable jets. They 
are always a little discoloured, and 
frequently contain grain or undigested 
forage. They always contain numerous bubbles of gas. 

The wasting during later periods of the disease is absolutely 
characteristic, and different from that of other wasting diseases, such 
as chronic broncho-pneumonia, tuberculosis, etc. The patients finally 
become walking skeletons. The red corpuscles of the blood progressively 
decrease, until the number may fall as low as 800,000 or even 500,000 
red corpuscles instead of six millions, the normal figure. The tedenia 
common to wasting conditions appears, and the animals die without 
suffering, in a condition of absolute exhaustion. 




Fig. 71. — Appearance of a patient 
suffering from advanced chronic 
diarrhoea. 



CHRONIC ENTERITIS (CHRONIC DIARRHCEA). 



209 




Fig. 72. — Appearance of a portion of the small 
intestine in chronic diarrhoea. 



ComiDlications are rare, though occasionally intestinal haemorrhage or 
broncho-pneumonia occurs. The temperature, which remains normal or 
shows very slight changes throughout the course of the disease, may then 
oscillate between lOl"" 
and 103° Fahr. (38° and 
39-5° C). 

Lesions. At the first 
glance no lesions can be 
detected on post-mortem 
examination except those 
of generalised wasting, 
but when the autopsy is 
carried out immediately 
after death all the in- 
terior of the intestine appears affected. The mucous membrane of the 
abomasum and the mucous folds appear infiltrated, thickened, and with 
moderate sub-epithelial congestion. The intestine seems friable, and 
tears with the slightest traction. The sul>epithelial portions of the 

mucous folds are 
infiltrated and con- 
gested, while the 
more prominent 
parts of the folds, 
which are exposed 
to the friction of 
semi-digested food, 
become eroded. 

Throughout the 
length of the jejeu- 
num and ileum the 
mucous membrane 
exhibits multitudes 
of small ulcera- 
tions. 

Histologically, 
the epithelium and 
the glands seem atrophied, without any inflammatory change having 
occurred in the mucous or submucous coats. 

The colon and the caecum show similar lesions, and in addition 
brown deposits of pigment under the mucous membrane and along the 
course of the small blood-vessels. This lesion resembles that found 
in chronic dysentery in man, and suggested to Moussu a possible 
connection between the two diseases. 

D.C. P 




Fig. 73. — Atheromatous lesions of the aorta in chronic 
diarrhoea. 



210 ENTERITIS. 

The liver is less than the normal size. In the heart Monssu has 
seen one case of sclerosis of the auricles and calcareous infiltration of 
the sub-endothelial lining of the aorta. 

In several instances he has noted calcareous infiltration of the 
mesenteric lymphatic gland. 

Diagnosis. It is easy to diagnose this condition, and quite possible 
to distinguish it from the diarrhcea of tuberculous enteritis, infectious 
hepatitis, and other conditions. 

Prognosis. The prognosis is very grave, and the disease almost 
always proves fatal. 

Treatment. At the present moment no curative treatment is kno^Yn. 
Lignieres' treatment — viz., the injection of physiological salt solution 
and serum from healthy oxen, and saline solution or defibrinated blood 
— has never given permanently successful results. 

All the drugs usually employed against diarrhoea, the antiseptics, 
astringents, etc., fail, or confer merely momentary benefit. Econo- 
mically, nothing is to be gained by keeping the patients alive. With 
great care existence may be prolonged for months, or even for several 
years, but the animals never regain condition, and are never of any use. 

The most rapid and lasting good effects follow the administration of 
2| to 8 fluid drachms of hydrochloric acid per day, given in two portions 
and very freely diluted. 

DYSENTERY IN CALVES. 

This disease sometimes appears on the first day after birth, frequently 
on the second or third. It may be mistaken for septicaemia of umbilical 
origin. 

Symptoms. The young animal may be born vigorous and in good 
condition, though this is exceptional. More frequently it is puny and 
below normal weight. The first evacuation (of meconium) may exhibit 
the diarrhceic character ; in other cases this peculiarity only appears on 
the second or third day, when half- digested milk is passed. The fluid 
is greyish, extremely fcetid, and rapidly becomes brownish and blood- 
stained. Evacuation is frequent and accompanied by tenesmus. 

The patients at once become very dull, refuse to suck, and resist 
efforts to feed them by hand. The temperature rises, and the diarrhoea, 
which at first was of an alimentary character, becomes mucous, serous 
and blood-stained. The little patients appear "tucked up," the flanks 
sink in, the strength diminishes, and in twenty-four hours, or two or 
three days at most, they die of exhaustion. 

Recovery is exceptional, and when the disease assumes this character 
it usually attacks a considerable proportion of the other animals in 
the byre. 



DYSENTERY IN CALVES. 211 

Causation. The exact cause of this form of dysentery in new-horn 
calves has not yet heen identified, but the disease is undoubtedly a microbic 
enteritis, and may even be a primary septicaemia of puerperal origin. 

For a very long time this dysentery was mistaken for simple 
diarrhoea, though it exhibits neither the characteristics, course, nor 
termination of the latter disease. 

The co-existence of epizootic abortion and dysentery in certain byres 
has led some authors to believe that a connection exists between the 
two diseases, and that the young are infected with dysentery at birth. 
Evidently, intra-uterine infection is not exceptional, and it seems quite 
natural that the new-born calf may equally suffer when the foetal 
envelopes and fluids are infected before parturition. Epizootic abortion 
is probably not the only disease which may produce this condition. 

The diagnosis is very simple. The course of the disease and its 
rapid development prevent it from being mistaken for ordinary diarrhoea. 
It is more difficult to distinguish from septicaemia of umbilical origin, 
although this disease also has well-marked characteristics. 

The prognosis is not hopeful. Statistics show that almost all the 
affected animals die, and that those exceptional cases which survive 
remain puny and sickly. There is no economic advantage in attempting 
to save them. 

The mothers of affected calves seldom show any sign of illness, 
though the after-birth is often retained. 

Lesions. The macroscopic lesions are of very trifling importance 
compared with the gravity of the disease. The digestive tract appears 
congested throughout. The intestinal mucous membrane is moderately 
swollen, but without gross lesions. The intestinal contents exhale a 
sickly, foetid odour. The smaller vessels and capillaries forming the 
peripheral vascular network appear distended, as in septicasmia. The 
carcases putrefy with extreme rapidity. 

Curative treatment is very uncertain. Varying results have been 
obtained with doses of 4 to 5 drams of slight purgatives like boro- 
tartrate of potassium, sodium sulphate, and magnesium sulphate ; 
small doses of intestinal antiseptics like salicylic acid, 15-grain doses of 
salicylate of soda, 45 to 75 grains of carbolic acid, 2 jjer cent, carbolic 
solution in doses of 7 to 12 drams ; 1 per cent. Lysol solution in doses 
of 2 to 4 ounces; benzo-naphthol, lactic acid 45 to 75 grains, tar water, 
lime water, etc. Although all these preparations, when carefully used, 
generally give good results in the early stages of simple diarrhoea, 
they appear to fail in dysentery of new-born calves. 

Prophylactic measures are more reliable. They consist : 

(1.) In scrupulous disinfection of the byres when the first case of 
abortion occurs ; 

P 2 



212 ENTERITIS. 

(2.) In successively isolating cows which are ahout to calve in a 
small specially detached stable ; 

(3.) In carefully disinfecting the genital organs of cows which have 
aborted, firstly with boiled water at a temperature of 100° Fahr., and 
then with 1 per cent, iodine solution. 

Calves which are infected when born cannot be saved, but abortion 
can be prevented and dysentery so stamped out. 

DIARRHCEIC ENTERITIS IN CALVES. 

This disease is usually called " simple sporadic diarrhoea." It may 
appear at any time before weaning, and can usually be cured if treated 
early before the patients show bodily wasting. 

Causation. Indigestion from failure of the abomasum to deal with 
the milk usually precedes diarrhoeic enteritis ; it may terminate without 
complications, but very often is followed by diarrhoea. Anything which 
produces milk indigestion, therefore, favours the occurrence of enteritis. 
Such predisposing influences include over-distension of the abomasum, 
milk of bad chemical composition, milk tainted by keeping or by storage 
in dirty and infected pails, etc. The addition to the milk of nutritive 
substances which the abomasum and intestine are not yet capable of 
digesting, such as wheat, rye, barley, or maize meals, very often produces 
diarrhoea even when the meal is well cooked. 

Chills, privations, irregular feeding, and badly-managed weaning 
may facilitate its development, but none of these causes, however impor- 
tant they may be, seem to play any other part than that of favouring tlie 
multiplication of the numerous varieties of microbes to be found in the 
intestinal tract. Vascular disturbance occurs, either as a result of direct 
irritation of the intestinal mucous membrane or of the action of toxic 
products contained in milk which has served as a culture medium for 
these microbes ; this is followed by secretory disturbance, and the 
intestinal contents being modified in character, the microbes normally 
present undergo changes in number and quality. Inoffensive organisms 
assume pathogenic qualities and secrete toxic principles, normal digestion 
is disturbed, the intestinal defence becomes less perfect, toxic principles 
which the liver is incapable of destroying are absorbed, and diarrhceic 
enteritis is set up. 

Symptoms. Diarrhceic enteritis appears during the second week of 
life, towards the end of the first month, or even later. It is characterised 
by the passage of faeces consisting of mucus and containing little clots 
of milk. 

This is the first stage of alimentary diarrhoea, also termed " white 
diarrhoea" or "white scour." It may prove unimportant; it may last a 



DIARRHCEIC ENTERITIS IN CALVES. 213 

day or two and then cease. Most commonly diarrhoea increases and 
assumes a mucous and then a serous character, whilst the dejecta exhale 
a very characteristic repulsive smell. The excrement becomes greenish 
brown, and after several days or a week or more may appear blood- 
stained. The number of evacuations varies enormously, depending on 
the gravity of the condition. The ejected material is irritant, and the 
parts soiled by it, like the perineum, hocks, and back of the cannon 
bones, become slightly inflamed as though blistered; later, the hair 
falls away. 

The general health then begins to suffer. Fever remains moderate, 
but the mouth is pasty, the tongue coated, and the breath foetid. 

The patients become thin, and lose their appetite and spirits. Palpa- 
tion of the abdomen, especially of the right flank, is slightly painful, and 
the pulse is accelerated. 

The diarrhoea may spontaneously diminish if the animal's constitution 
prove sufficiently strong; but if it follows its course, the little patient 
becomes weaker, eats less, the evacuations increase and are accompanied 
by tenesmus. In seven to eight days, in rare cases in foui- to five, the 
animal dies from toxi-intoxication of intestinal origin, or from infection 
resulting from intestinal germs, particularly the bacterium Coll communis, 
obtaining entrance into the circulation. On the other hand, the diarrhoea 
may continue for weeks. 

The diagnosis is easy, and there should be no difficulty in distin- 
guishing this disease from dysentery and from umbilical phlebitis, 
which are also accompanied by diarrhoea. 

The prognosis is grave, unless treatment is early undertaken. In 
the latter case there is a good chance of recovery. 

Lesions. The macroscopic lesions are not of much interest, being 
confined to congestion of the intestinal mucous membrane, superficial 
desquamation of the epithelium, small vascular erosions, and general 
wasting. 

The mesenteric lymphatic glands are swollen and oedematous. 

After death from general infection, it is not uncommon to find pleural, 
peritoneal, and pericardial exudation or even endocarditis. 

Even in cases where no post-mortem change has had time to occur 
cultures from the blood yield varieties of the bacterium Coll communis. 

Treatment. The meals should be given at fixed hours, and regulated 
both as regards quantity and quality. These precautions alone suffice to 
prevent the appearance of diarrhoeic enteritis. 

Curative treatment has every chance of succeeding when under- 
taken at the outset. Delafond and Trasbot recommend mild purgatives, 
which act more rapidly than intestinal antiseptics. These comprise boro- 
tartrate of potash in doses of 4 to 5 drachms, sodium sulphate in 



214 ENTERITIS. 

of 2^ to 4 drachms, sulphate of magnesia, etc. By evacuating the howel 
and removing a large number of the germs which have multiplied there, 
they arrest intoxication and prevent infection. Nevertheless, they should 
not be administered for long, and after one or two doses should be fol- 
lowed by antiseptics like benzo-naphthol, in doses of 15 to 30 grains, sali- 
cylic acid in doses of 5 to 10 grains, or salicylate of soda 45 to 60 grains. 
Mucilaginous and sweetened drinks containing lactic acid in doses of 45 
to 75 grains per day may be given between the meals, or at intervals if 
the calf is sucking. 

Laudanum in doses of 6 to 10 drops per day administered in rice 
water, extract of opium, weak solutions of tannin, etc., are also of value. 
Filliatre has successfully used tar water in the first stages. The solution 
consists of vegetable tar 6 drachms, boiling water 1 quart. This solution 
is used tepid in the proportion of 1 part to 3 parts of warm milk. 

Decoctions of spiked purple loosestrife, willow bark, etc., are also of 
great value in certain districts. 

The drug which appears least dangerous, however, is that so often 
successfully used in young children — viz., subnitrate of bismuth. It 
can be given in doses of 30 to 45 grains per day, with lactic acid in doses 
of 75 to 150 grains, according to the size of the patients. If the animals 
are greatly exhausted and have been ill for some time there is less chance 
of recovery, and under these circumstances Dr. Lesage's anti-colic serum 
might be used. 

It gives excellent results in infants, and it has proved successful in 
simple diarrhcea of calves. 



CHAPTER VII. 
POISONING. 

Accidental poisoning is frequent in domesticated animals. It may 
present no visible lesions, and it is therefore very important to recognise 
the symptoms ^Yhich indicate the secret lesion. 

POISONING DUE TO FOOD. 

Under this title are included all forms of poisoning resulting from the 
iiigestion of bad fodder. Such expressions as "intestinal typhus" and 
" typhic gastro-enteritis " only indicate a special stage in the condition, 
which is never twice the same. 

Causation. The most important changes in the food ingested do not 
consist in a mere modification in its chemical composition, but in the 
presence of various parasites which develop in grain and forage, after 
moistening, or after abnormal fermentation in the interior of the grains. 
These parasites are chiefly represented by fungi belonging to the genus 
Mucor : AspevfiUlm or PeniciUmm ; blight — Puccinia graminis, Uredo 
linearis; smut — Tillctia caries, Ustilago segetum, Ustilago mayclis ; 
yeasts of different kinds resulting from the fermentation of brewers' 
grains ; and, finally, unrecognised microbes which act by means of the 
poisons they secrete. 

The symptoms are always very vague. At first the only marked 
symptom is loss of appetite, accompanied by dryness of the mouth and 
muzzle, depression and constipation. The animals never clearly show 
signs of gastro-enteritis ; nevertheless, the changes in general health 
point very clearly to a digestive origin. 

In cases of acute poisoning the symptoms develop rapidly. Torpor 
becomes more marked, the movements of the heart tumultuous, and the 
temperature rises to 105° Fahr. (40'5° C), diminishing later until death 
occurs. 

In chronic forms of poisoning constipation is present at first, but is 
soon followed by profuse, foetid, blackish diarrhoea, sometimes containing 
streaks of blood and accompanied by abdominal pain. 

In exceptional cases these digestive symptoms are amplified by the 
presence of broncho-pneumonia, pleuro-pneumonia, nephritis, and cystitis, 



216 POISONING. 

as in poisoning by tannin and essential oils. These complications are 
of infections origin. 

In young animals, like lambs and young pigs, still with their mothers 
alimentary intoxication may also occur though the mothers show no 
signs of illness. The passage of poisonous principles into the milk 
cannot be disputed. Moussu has seen numerous cases of alimentary 
intoxication in lambs whose dams were fed with decomposed beet pulp, 
and in sucking pigs whose mothers had received bad maize, turnips, etc. 

Diagnosis. Careful examination of the substances with which the 
animals are fed, and consideration of the history, prevent confusion with 
ordinary poisoning. Anthrax as a cause can easily be eliminated. 

The prognosis is grave, unless the practitioner is summoned early. 

The lesions are those of acute gastro-enteritis— congestion of the 
mucous membrane, abomasum, and intestine, submucous infiltration, 
shedding of the epithelium, which sometimes attains the stage of ulcera- 
tion, suffusion and intestinal or superficial haemorrhage, dilatation of the 
capillaries, etc. 

The symptoms of poisoning are produced by the absorption of toxic 
products, which pass from the intestine into the blood current. 

Poisoning is frequently complicated by infection produced in a similar 
manner. 

Treatment. The first point is to change the food. This alone is 
often sufficient to disjDose of the digestive disturbance in a week or tAvo. 
In addition, mustard plasters may be applied, and purgatives, stimulants 
and mucilaginous drinks may l)e given. Finally, diuretics are useful in 
eliminating the toxic products accumulated in the blood. They comprise 
general stimulants like wine, alcohol, tea, coffee, etc. Subcutaneous or 
intravenous injection of physiological salt solution is indicated. 

POISONING BY CAUSTIC ALKALIES. 

The cause consists in the administration of insufficiently diluted 
solutions of ammonia in cases of tympanites, or the ingestion of quick- 
lime, used for disinfecting stables, by animals suffering from depraved 
appetite. 

The symptoms indicate injury to the anterior part of the digestive 
tract. They consist in salivation, loss of appetite, colic, indigestion, 
diarrhoea, and progressive loss of strength. 

Diagnosis is only jiossible when the history is clear. 

The prognosis is grave if the doses swallowed have been so large 
as to cause severe burning of the mouth, cesophagus, rumen, etc. The 
local lesions are grey and soft. 

Treatment consists in immediately giving acidulated draughts con- 
taining vinegar or 1, 2 or 3 per cent, of hydrochloric acid, and emollient. 



POISONING BY THE NITRATES OF POTASH AND SODA. 217 

mucilaginous drinks containing opium for the purpose of calming the 
irritation. 

POISONING BY CAUSTIC ACIDS. 

Cases of this kind are rare. Gerlach described a case of poisoning by 
straw which had been removed from sulphuric acid carboys. Abadie 
saw a number of cases which were traced to the unskilful treatment of 
two empirics. 

The symptoms point to the existence of stomatitis, oesophagitis, and 
gastro-enteritis. Death occurs rapidly, with a running-down pulse. On 
post-mortem examination one discovers more or less deep burning of the 
mucous membrane of the digestive tract. 

The diagnosis is difficult in the absence of information. 

The prognosis is grave. 

Treatment comprises administration of alkaline draughts, solutions 
of bicarbonate of soda, calcined magnesia, etc., and of mucilaginous drinks 
containing opium, chalk, etc. This may produce temporary relief. 

Water mixed with whipped whites of eggs is also extremely valuable, 
but it is often better to slaughter the animal as soon as the condition is 
diagnosed. 

POISONING BY COMMON SALT. 

This form of poisoning is rare in oxen on account of the large 
quantity of salt which can be ingested without producing bad effects. 
It is commonest in animals to which old brine has been given or which 
have received rough salt containing toxic substances (sheep and pigs). 
Beef, pork, or fish brine, four or five months old, is especially dangerous 
because of the toxins it contains. Half a pint is a fatal dose for a pig 
(Reynal). The symptoms include marked thirst, vomiting and diarrhoea ; 
at a later stage motor and nervous disturbance appears, resulting from 
poisoning of the cerebro-spinal system. Paralysis, epileptiform convul- 
sions, trismus, coma and death characterise extremely acute cases. 

To the naked eye, the lesions are those of acute gastro-enteritis ; 
and, in many cases, of marked congestion of the brain and medulla and 
of the mucous membrane of the bladder. 

The treatment is prophylactic and hygienic. Old brine and salt of 
doubtful purity should be avoided. The symptoms should be treated by 
administering diuretics, preferably soda bicarbonate, which does not 
irritate the kidney, and by giving mucilaginous drinks with anodynes. 

POISONING BY THE NITRATES OF POTASH AND SODA. 

This form of poisoning has frequently been described as following the 
ingestion of water used for washing sacks which have contained chemical 



218 POISONING. 

manures. Occasionall,y it results from the administration of medicines 
containing excessive doses of nitrate of potash. The symptoms vary in 
severity with the purity of the salt, with its nature, and with the degree 
of concentration of the solution : nitrate of potash is more dangerous 
than nitrate of soda. 

The chief symptoms may he grouped as follows : — 

Salivation, indigestion and tympanites, nausea, vomiting, diarrhoea, 
and (especially) intense polyuria : the kidney may he irritated to such a 
degree as to produce albuminuria and haematuria. Intense dulness 
and general weakness precede death, which sometimes occurs in four to 
twelve hours after the poison has been taken. 

The lesions are to he found in the digestive and urinary apparatus. 
The kidneys are congested and hypertrophied, or present changes indi- 
cating epithelial nephritis. The ureters and the bladder may show 
similar lesions. 

Treatment comprises removal of the cause, and the administration 
of emollients, narcotics, and diffusible stimulants. 

POISONING BY TARTAR EMETIC. 

Tartar emetic is sometimes given for the purpose of favouring secretion 
and restoring rumination ; occasionally the proper dose is exceeded and 
poisoning occurs. Given repeatedly, tartar emetic is apt to accumulate 
in the deeper portions of the gastric compartments and to produce 
general symptoms of super-purgation, and such local symptoms as 
ulceration and even perforation of the walls of the stomach, which in 
turn is followed by abscess formation in the abdominal wall. 

Diagnosis is easy. The prognosis is grave. 

Treatment is confined to the administration of mucilaginous and 
diuretic fluids. Tannin has been recommended. 

POISONING BY ARSENIC. 

Overdoses of Fowler's solution produce rapidly fatal results, in 
twenty-four to forty-eight hours. Lesions are little marked. 

Arsenious acid acts like tartar emetic by accumulating and producing 
local gastritis ; it may also cause acute poisoning, being in that case 
characterised by severe colic with tympanites, salivation, and foetid, some- 
times blood-stained, diarrhoea. The urine becomes albuminous, and re- 
mains scanty. Incomplete paralysis is sometimes produced, and various 
forms of hgemorrhage result from changes in the constituents of the blood. 

If the gastric compartments are perforated, an abscess may develop 
in the abdominal wall. The lesions are those of acute gastro-enteritis. 
The contents of the stomach exhales an odour resembling garlic. The 



MERCURIAL POISONING. 219 

parenchymatous organs — the Hver, kidney, and heart — show fatty de- 
generation in chronic cases. 

In prescribing arsenic, one should begin with small doses, which can 
gradually be increased as the animal becomes accustomed to the drug. 
Curative treatment consists in administering antidotes, such as hydrated 
oxide of iron, sulphate of iron, and calcined magnesia. 

Haubner described a form of chronic arsenical poisoning produced 
in the neighbourhood of blast furnaces near Freiberg. Similar forms 
of poisoning may perhaps occur in the neighbourhood of chemical and 
smelting works in England. 

PHOSPHORUS POISONING. 

Though the chronic form is common in men, phosphorus poisoning 
only occurs accidentally in animals through eating phosphorus paste, 
used as a poison for rats, or as a consequence of excessive doses given 
medicinally. Some cases have been described by Maury. 

The symptoms comprise salivation, loss of appetite, alliaceous 
odour of the buccal cavity, arrest of intestinal peristalsis, indigestion, 
colic, diarrhea, exhaustion and death in a state of coma. Albumi- 
nuria and icterus also occur. 

The lesions are the same as those of arsenical poisoning — viz., 
stomatitis, pharyngitis, and gastro-enteritis. The specific changes con- 
sist in fatty degeneration of the liver and kidneys, and the peculiar 
odour resembling garlic exhaled by the flesh. 

Death is a consequence of deoxygenation of the blood, which appears 
black, and when spectroscopically examined reveals only the lines of 
reduced hcTemoglobin. 

Treatment. Oil and milk dissolve phosphorus and render it more 
easily assimilable ; they should never be administered. Large doses (up 
to six fluid ounces) of essence of turpentine have been recommended. 
This prevents the phosphorus absorbing oxygen at the expense of the 
blood. Saline purgatives assist in eliminating the poison. 

MERCURIAL POISONING. 

Mercurial poisoning may result either from the administration of 
medicines or from accident. Cases of the former kind follow the internal 
use of sublimate or calomel. Doses of 2 to 2^ drams of calomel, if 
repeated for a certain time, may prove toxic in the ox. Accidental 
poisoning results from the use of mercurial ointment as a parasiticide 
over large surfaces. Poisoning, however, rarely occurs unless the animal 
is able to lick the parts. Some authors have tested this point by freely 
applying mercurial ointment over parts likely to absorb it readily, with- 
out having seen any bad effect. 



220 POISONING. 

Symptoms. Free salivation, the saliva gradually becoming foetid 
and blood-stained. The slight irritation of the buccal membrane first 
seen is soon replaced by congestion of the gums, then by gingivitis and 
periostitis, with local ulceration and haemorrhage. The portion of the 
gums surrounding the teeth becomes violet, and suppurative alveolitis 
may follow. 

As a consequence of disturbance in the digestive secretions digestion 
ceases, defaecation becomes irregular, the faeces are often hard and coated, 
and can only be passed with difficulty, though sometimes there is profuse 
foetid diarrhoea. 

Eespiration is difficult, jerky, or even dyspnceic, and is accompanied 
by discharge from the nose and by expectoration. The gait is irregular, 
and paral3'sis may follow. Finally the skin shows an eruption resembling 
that of impetiginous eczema ; vesico -pustules, covered with yellowish 
crusts, appear over the entire surface of the body. 

Lesions. The lesions of haemorrhagic gastro-enteritis are sometimes 
accompanied by catarrhal tracheo-bronchitis, and even intra-pulmonary 
haemorrhage. The muscles are discoloured, appear as though boiled, and 
are covered with ecchymoses. Blood effusions occur beneath the ecze- 
matous crusts, but the rest of the skin is anaemic. 

Treatment includes administration of raw eggs, or, better still, of 
white of egg beaten up in water ; the albumen in coagulating imprisons 
the mercury. Failing these, other bodies, like flowers of sulphur and 
iodide of potassium, which with mercurial salts form soluble and 
harmless compounds, may be given. Chlorate of potash has also been 
recommended. 

Complications like stomatitis and gastro-enteritis are treated b}^ the 
usual methods. 

LEAD POISONING : SATURNISM. 

Lead poisoning is very rare, and seldom occurs except near camps or 
factories. It then results from swallowing lead " spray" mixed with the 
grass or from inhalation of lead vapour. 

The symptoms comprise salivation, nausea, colic, obstinate consti- 
pation, tympanites, and arrest of milk secretion. A peculiar form of 
trembling affects the head ; epileptiform convulsions, amaurosis, and 
paralysis may also occur. General sensibility diminishes, and death 
follows. 

The disease may assume a chronic form, characterised by a blue line 
around the gums, changes in the joints, albuminuria, and bodily wasting. 

The lesions are those of ulcerative stomatitis, anaemia of the mucous 
membranes, and fatty degeneration of the epithelium. In the chronic 
form the kidneys are atrophied. 



POISONING BY ALOES. 221 

Treatment consists in giving substances which form insokible com- 
pounds Avith lead. It comprises the administration of dikite sulphuric 
acid, solutions of sodium sulphate or magnesia, milk, eggs, and iodide of 
potassium. 

COPPER POISONING. 

This is a rare form of poisoning. It may follow ingestion of food 
stored in copper vessels, licking of ointments containing copper salts, or 
ingestion of vine leaves, or leaves of other plants which have been sprayed 
with sulphate or acetate of copper to prevent " mildew." 

The symptoms comprise vomiting of green-coloured material, colic, 
diarrhoea, muscular weakness, and convulsions. The urine contains dis- 
solved albumen and haemoglobin. 

The lesions are those of acute enteritis and dilatation of the 
stomach. The essential lesion consists in decomposition of the blood 
with the formation of methaemoglobin. Nephritis and granular degene- 
ration of the muscles form secondary symptoms. 

Treatment consists in administering raw eggs, albumen, milk, muci- 
lage, flowers of sulphur, or calcined magnesia. 

CARBOLIC ACID POISONING. 

Carbolic acid poisoning sometimes follows the use of carbolic acid 
solutions in the form of injections, enemas, or baths. 

Symptoms. Administered in over-doses or for too long a time, car- 
bolic acid produces stomatitis, oesophagitis and vomiting. 

True poisoning is characterised by changes in the kidneys and bladder ; 
the urine becomes Ijrown and turbid, and possesses a well-marked carbolic 
odour, the animals suffer from severe trembling and appear stupid, and 
coma and paralysis precede death. 

The specific lesions consist in parenchymatous nephritis, sometimes 
accompanied by renal haemorrhage, cystitis and hyperemia of the lung 
and brain. The flesh has an odour of carbolic acid, which renders it unfit 
for human consumption. 

Treatment consists in giving stimulants and slight diuretics, such 
as ether, alcohol, wine, coffee, saline sulphates, or Glauber's salt. The 
last named forms phenyl-sulphuric acid, which is not toxic. Olive, 
rape, or linseed oil has been recommended. All these drugs are useless 
if the kidney lesions have become too pronounced. 

POISONING BY ALOES. 

This form of poisoning is caused by administering over-doses of aloes. 

Apart from the accidents possible in pregnant female animals, large 
doses of aloes produce symptoms of super-purgation — profuse diarrhoea, 
running down pulse, and nervous prostration. 



222 POISONING. 

The lesions are those of gastro-eiiteritis, the intestine l)eing empty, 
and its mucous membrane of red colour. 

Treatment is confined to administering drugs Hke camphor, rice, 
bismuth, opium, chloral, and emollients, which diminish peristalsis and 
lessen secretion. 

IODOFORM POISONING. 

The causes are limited to the licking of wounds which have been 
dressed with iodoform. 

The symptoms include gastric disturbance, somnolence, coma, and 
the signs of iodism. 

The only lesions are those of fatty degeneration of the kidneys and 
liver. 

Treatment comprises the exhibition of vomitants, stimulants, and 
diuretics. 

IODINE POISONING : IODISM. 

Death by iodine poisoning is absolutely exceptional : the complications 
described under the name of iodism are rather to be referred to satura- 
tion of the organism than to true poisoning. 

The cause of iodism is unduly prolonged administration of iodide of 
potassium, or of iodine in solution. 

The symptoms include discharge from the eyes, coryza, hypersecre- 
tion from all the mucous membranes, and gastric disturbance. The 
cutaneous eruption exhibits special peculiarities, including desquamation 
of the epidermis in the form of bran-like scales, and pruritus. 

The first indications in treatment are to discontinue the drug and to 
administer stimulants and nutrients like milk, cod-liver oil, etc. 

STRYCHNINE POISONING. 

Strychnine poisoning is most commonly due to over-doses of the drug 
accidentally given during treatment. 

The symptoms comprise tetanic convulsions, hyperaesthesia and 
dyspnoea. As a result of muscular rigidity, the ribs cannot be moved, 
and death by asphyxia follows. 

Treatment comprises the use of anaesthetics, and the administration 
of chloral hydrate, as long as the contractions continue. Bromide of 
potassium, tobacco, tannin, etc., are also useful. 



The chief part of the botanical descriptions in the following list have 
been extracted, by permission, from the Annual Eeport for 1898 of the 
United States Bureau of Animal Industry, p. 392. To Dr. D. E. Salmon, 



PLANTS POISONOUS TO STOCK. 223 

who gave this permission, and who also kindly supplied the blocks, the 
writer (Mr. Dollar) desires to express his very sincere thanks. Consider- 
able modifications have been made, and in the case of the more important 
poisonous plants, details of symptoms and treatment have been added. 

LIST OF PLANTS POISONOUS TO STOCK.* 

perisporace.t; (rot-moitld family). 

Aspergillus glaucus. — This is the common flocculent woolly mould 
which sometimes develops to a dangerous extent on corn, oats, and other 
food grains which have either been harvested before full maturity or been 
stored in a damp place. The mouldy growth is pure white at first, but 
changes with the ripening of the spores to gray and then green. The 
spores are apparently the cause of the so-called enzootic cerebritis, or 
" staggers," of horses, which, during the winter of 1898-99, was rej^orted 
as having caused very heavy losses in the southern portion of the United 
States. European investigators have shown that the spores of this mould 
will grow within the living body if they are introduced into the blood. 
Death is probably caused by some poison which is simultaneously produced 
with the mould in the body of the animal. 

HYPOCREACE.E (eRGOT FAMILY). 

*ClaYiceps purpurea. — This, the most common species of ergot, 
infests various species of native and cultivated grasses. It sometimes 
causes great losses of stock. 

POISONING BY ERGOT OF RYE : ERGOTISM. 

Causation. This form of poisoning is due to the presence of ergot in 
grain or forage. 

Symptoms. The symptoms are seldom very marked. In mild cases 
pregnant females may abort ; grave cases are indicated by local gangrene 
of the mucous membrane and gangrene of the extremities, particularly 
in poultry, in consequence of the constrictive action of the drug on the 
peripheral blood-vessels, on the vaso-motor centres, and on unstriated 
muscular fibres. 

Treatment. The use of chloral and morphine has been suggested in 
this condition ; but as the lesions when discovered are established and 
permanent, this treatment seems illusoiy. More is to be expected from 
preventive measures and the avoidance of ergotised food. 

* The names of plants proved beyond doubt to be poisonous to stock are marked 
with an asterisk. The evidence in regard to the toxic properties of others is not in 
every case entirely convmcmg, though there is good ground for strong suspicion. 



224 



POISONING. 



USTILAGINACE.E (SMUT FAMILY). 

Ustilago maydis. — The black powdery fungus known as corn smut is 
common throughout the corn-producing districts of the central United 
States, and is occasionally reported as being fatal to stock. Experiments 
made in Wisconsin and elsewhere show that it is not a very active poison 
when eaten in moderate quantity. When given in gradually increasing 
amounts up to 2 lbs., no effect was noted, but 4 lbs. on each of two 
successive days caused the sudden death of one cow. Since corn smut 




Fig. 74. — Fly anianita {Annuiita Duiscaria). a, Mature plant; h, top view of cap 
showing corky, patches — both one-lialf natural size. 

has l)een shown to be less fatal when wet, it seems probable that its 
physical and not its chemical character may be responsible for the death 
of cattle which have eaten it in considerable quantity. 



POISONING BY SMUT OF BARLEY. 

Causes. The presence of smut in straw, in millers' grains, or in 
damaged kiln-dried grains which have fraudulently been added to grain 



PLANTS POISONOUS TO STOCK. • 225 

sold for feeding, represents the principal source of this form of 
poisoning. 

The symptoms are very vague. There is indigestion, with a ten- 
dency to nausea, and vomiting. Diarrhoea may be present : At a later 
stage the heart and nervous system are affected. The gait becomes hesi- 
tating, the animals show general dulness and spasm of the pharynx ; 
death, when occurring, is by cardiac or respiratory syncope. 

Treatment consists in giving an entire change of food, and adminis- 
tering stimulants and purgatives. 

AGARICACEiE (MUSHROOM FAMILY). 

Amanita muscaria. — The well-known fly amanita (fly fungus ; deadly 
amanita) may be found from spring to early winter in pine forests 
throughout the United States. Cows are supposed to be killed by eating 
it, and almost every year the daily papers chronicle the death of several 
human beings who were led to eat the fungus through mistake for some 
edible species. The fresh cap is frequently rubbed up with milk and 
used to poison flies. 

PHALLACE^ (STINK-HORN FAMILY). 

*Clathrus columnatus. — In an article published in the Botanical 
Gazette (Vol. XV. p. 45), Dr. Farlow, of Harvard University, gives an 
account of an investigation of a case of poisoning in hogs which was 
caused by eating this peculiar fungus. It grows in patches in oak woods 
and openings, and is quite common throughout the Southern States. 

POLYPODIACE^ (fern FAMILY). 

Pteris aquilina. — In July, 1895, nineteen cattle died in Maryland, 
which were supposed to have been poisoned by eating the common 
bracken fern. Very few similar cases are on record, but one European 
authority cites one in which five horses were killed by eating hay con- 
taminated with this fern, and another states that cases are quite frequent 
among cattle in England. 

EQUISETACE^ (hORSETAIL FAMILY). 

Equisetum arvense. — The field horsetail was reported from Con- 
necticut in 1871 as being poisonous to horses. Cases are very rare, and 
it is probable that this plant is deleterious only when eaten in consider- 
able quantity, and then perhajjs only on account of its physical character. 
Experiments made in Europe show that a similar species {E. j^alustrc) is 
fatal to horses when fed in considerable quantity with hay. 

D.C. Q 



226 • POISONING. 

TAXACE.E (yEAV FAMILY). 

Taxus minor. — The common yew, or ground hemlock, is called poison 
hemlock in some places. The leaves of this shrub are probably poisonous 
to stock, as are those of the European yew. This species is more acces- 
sible to stock than the western yew {Taxus hrevifolia) , which grows only 
in deep caiions. 



YEW POISONING (TAXUS BACCATA). 

The leaves of yew, when eaten in any considerable quantity, are very 
poisonous. Two ounces to eight ounces, according to the size of the 
animal, slow the heart's action, produce weakness, staggering, and 
apoplectic congestion, which may have a fatal result in less than an 
hour. The bark is less injurious, and the fruit is scarcely poisonous 
at all. 

The early symptoms, which are only seen in chronic cases, consist 
in excitement, followed by somnolence and muscular weakness, with 
slowing of the respiration and circulation. 

POACE^ (grass family). 

Lolium temulentum. — The seed of the darnel, or poison rye grass, an 
introduced annual especially abundant on the Pacific Slope, is considered 
poisonous to both man and animals. 

Stipa robusta. — This is a perennial plant which is known in x\rizona 
and New Mexico as sleepy grass. It produces a narcotic effect on horses 
and cattle that feed upon it, but stock bred in that region rarely touch it. 

Zea mays. — -The numerous deaths that are frequently attributed to 
Indian corn are mostly due, not to any poison inherent in the plant, but 
rather to parasitic or saprophytic fungus growths, as noted under Asper- 
gillus and Ustilago. The green fodder is very apt to cause severe and even 
fatal tympanites if the animal's diet is not properly regulated. Death 
has also been attributed to the presence of nitre (potassium nitrate) in 
the growing stalks. It is supposed that in very rich soil this substance 
will sometimes accumulate in the stalks in considerable quantity during 
prolonged drought. 

poisoning by the biale tufts of maize. 

The green tufts alone are toxic ; the toxicity disappears after drying. 
Prolonged administration produces nephritic colic and renal lithiasis. 

poisoning by sweet sorghum grass. 

This form of poisoning is characterised by attacks of trembling, 
tympanites, and frequent attempts to urinate. The heart beats feehly. 



PLANTS POISONOUS TO STOCK. 



227 



and the jiulse grows progressively weaker, until at last it becomes 
imperceptible. 

MELANTHACE.E (bUNCH-FLOWER FAMILY)- 

*Chrosperma muscsetoxicum. — The bulbous portion of the fly poison, 
or crow poison, an eastern plant, is sometimes eaten by cattle with fatal 





Fig. 75. — False hellebore [Veratrum 
viride), one-third natural size. 



Fig. 76.— Lily of the valley {Con- 
vallaria majdlis), one-third 
natural size. 



results. The bulbs, when crushed with molasses, are used to stupefy 
flies. 

*Yeratrum viride. — The leaves of the common swamp hellebore 
(American white hellebore ; false hellebore ; Indian poke) of the eastern 
and northern portions of the United States have proved fatal to man and 
to horses. Sheep eat the young leaves and shoots with apparent relish. 
The seed is poisonous to chickens. 

Zygadenus venenosus. — The name death camas has been applied 
to this plant in the North-West of America to distinguish it from the 
true camas {Quamasia qnamash), which is highlv esteemed for food by 

Q 2 



228 POISONING. 

the Indians. In Oref:>on it is erroneously called "lobelia" by most 
stockmen and farmers. Horses, cattle, and sheep, as well as man, 
are poisoned by eating the bulb. 

Zygadenus elegans. — The bulbs, and perhaps the leaves, of the 
GlaiuoK.s zi/iiddciiiiii, or alkali grass, are poisonous to cattle. 

COXVALLARIACE.E (lILY OF THE VALLEY FAMILY). 

Convallaria majalis. — All parts of the lily of the valley are power- 
fully poisonous, and are liable to injure cattle and horses. 

H.KMODOIIACE.E (BLOODWORT FAMILY). 

Gyrotheca capitata. — This is the red root, or paint root, of the 
Atlantic coast and Cuba, so called on account of the red colour of its 
sap. White hogs are supposed, throughout the Southern United States, 
to be particularly sul)ject to the poison contained in the plant. 

faCtACe.e (beech family). " 

Quercus sp. — In Europe the acorns of various species of oak cause 
sickness and death in hogs and cattle. This efi'ect may possibly be due 
to tympanites, but may also be due in some w'ay to the tannin or the 
bitter principle which they contain. 

poisoning by acorns. 

The acorn, or fruit of the oak {Qaercus rohiir and Quercus sessili- 
Jiora), is much valued as a food for swine. "A peck of acorns a day 
with a little bran will make a hog, 'tis said, increase a pound w'eight 
jwr diem for two months together." Though largely consumed by swine 
with no apparent ill eftects, acorns constitute a dangerous food for young 
cattle, especially when eaten before they are ripe and when herbage or 
other feeding is scanty or restricted. 

The symptoms comprise dulness, loss of appetite, constipation, 
followed by diarrhtea, with straining and colick}' pains, head carried 
low, eyes retracted, with mucus about the eyelids and blood-stained 
discharge from the nose. Frequently the abdomen is distended. 
Temperature normal. 

The lesions are, abrasions of the buccal membrane on the palate, 
cheeks, etc. ; impaction and intense congestion of the omasum. 

Treatment. Change of pasture. Alkalies — potash or soda bicar 
bonate, magnesia ; tonics and stinudants. 



PLANTS POISONOUS TO STOCK. 



229 



URTICACE.E (nettle FAMILY), 

* Urtica gracilis. — The slender nettle covers thousands of acres of 
reclaimed swamp land in ]\Iicliigaii and Wisconsin, which is made nearly 
worthless by its dense growth, horses refusing to pass through it to culti- 
vate the soil. 

CHEXOPODIACE.E (gOOSEFOOT FAMILY). 



Sarcobatus vermiculatus. — Black 
shrub which grows iii strongly 
alkaline soil in the south-western 
and western portions of the United 
States. A correspondent in New 
Mexico states that on one occasion 
he counted as many as 1,000 sheep 
that had been killed by eating, the 
leaves of this plant. It is claimed 
that cows are not affected by eating 
it at any time, and that sheep can 
Qat it quite freely in winter. Death 
is perhaps due more to tympanites 
rather than to any poisonous sub- 
stance which the plant contains. 

PHYTOLACCACE.E (POKEWEED FAMILY). 

* Phytolacca decandra. — The 

leaves of the common pokeweed 
(poke ; garget ; American night- 
shade) of the eastern half of the 
United States is occasionally eaten 
by cattle with fatal results. 



greasewood, or cliico, is a scraggy 




Fig. 



-Sleiuler nettle {Urtica gi-aciJis). 



ALSINACE.E (pink FAMILY). 

* Agrostemma githago. — The 
common corn cockle (cockle; mul- 
lein pink) is a weed common to both the United States and Europe. 
Poultry and household animals are occasionally poisoned by eating the 
seeds or the bread made from wheat contaminated with the seeds. 



MAGNOLIACE.F. (MAGNOLIA FAMILY). 

lUicium floridanum. — The leaves of this species of anisetree are 
supposed to be poisonous to stock. 



230 



POISONING. 



EANUNCULACE.E (CROWFOOT FAMILY). 

* Aconitum napellus. — Aconite (monkshood ; wolfsbane) is very com- 
monly cultivated in gai'dens, and is therefore capable of doing great 
damage to stock. Horses and cattle have frequently been poisoned by 
eating the leaves and flowering tops. 

* Aconitum columbianum. — The Western aconite, or monkshood, is 
native in the north-western portion of America, where it sometimes 
poisons sheep. 

Anemone quinquefolia. — The common wind flower, which grows 
throughout most of the United States, is extremely acrid and poisonous. 
Cattle seldom touch it. The plant loses most of its poison in drying. 




Fig. 78. — Pokeweed {Phytolacca clecandra), one-half natural size. 



* Delphinium tricorne. — The dwarf larkspur, or stagger weed, of the 
north-eastern quarter of the United States has been especially reported 
from Oliio as fatal to cattle in April, when the fresh leaves appear. 

* Delphinium consolida. — The seeds of the commonly introduced 
field larkspur are well known to be poisonous; the leaves are known 
in Europe to be fatal to cattle. 

* Delphinium menziesii.--The purple larkspur of the north-western 
quarter of the United States is very common throughout Montana. In 
one case of poisoning reported by Dr. E. V. Wilcox, of the Montana 
Experiment Station, over GOO sheep were affected, 250 of which were 
claimed to have been killed by the weed. An experiment made by 



PLANTS POISONOUS TO STOCK. 



231 



Dr. S. B. Nelson, Professor of Veterinary Sciences in the Washington 
State Agricultural College, shows that it is possible to feed as much as 
24f lbs. of the fresh leaves to a sheep within a period of five days 
without any apparent ill effect taking place. An experiment made by 
Dr. Wilcox shows that the extract from less than an ounce of the dried 




Ftg. 79. — Corn cockle {Agrostemma git- 
liago). a, Sprays showing flowers and 
seed capsule, one-third natural size ; 
6, seed, natural size ; h, seed, four 
times natural size. 




Fig. 80. — Aconite {Aconitum columhia- 
man), a, Flowering plant ; b, seed cap- 
sule — both one-third natural size. 



leaves killed a yearling lamlj in two hours, the dose having Ijeen given by 
way of the mouth. 

LARKSPUR POISONING IN SHEEP.* 

Severe losses have from time to time been recorded, especially in 
America, from larkspur poisoning, the number of animals lost amounting 

* The following account is summarised from a bulletin of the Montana Experiment 
Station by Dr. WUcox. 



232 POISONING. 

to tliousands. The first signs of poisoning are slight general stiffness 
and straddling gait, esi)ecially of the hind legs. The stiffness hecomes 
more and more pronomiced, until walking is difficult and evidently painful. 
Soon there are manifested various involuntary twitchings of the muscles 
of the legs and sides of the body, and loss of control or co-ordination of 
the muscles. Ordinarily there is no increase in the quantity of the saliva, 
no dribbling of saliva from the mouth, no champing of the jaws or at- 
tempts at swallowing. The sheep manifest none of the mental disturb- 
ances frequently seen in cases of poisoning from other sources, as for 
example loco-weed and lupine. There is no impairment of the special 
senses. The sheep seem to hear and see as well and as correctly as under 
normal conditions of health. 

Xo indications of any disturbances of the digestive functions are to be 
seen. The appetite remains good, and the sheep eat up to the ver}^ last. 
They were observed eating industriously during the intervals between the 
attacks of spasms which they have during the last stages. 

At first the frequency of the pulse and of the respiratory movements 
is lessened and the temperature is lowered. The pulse remains very 
weak, but in the later stages becomes very rapid, in some cases 180 per 
minute. Toward the last also the respiration is very shallow and rapid. 
During the final convulsions the respiration is sometimes 120 per minute, 
but so shallow that the air is simply pumped up and down the windpipe. 
The air in the lungs is therefore not renewed, and the animal dies by 
asphyxia or suffocation. 

So long as the sheej) can stand on its feet, or walk, it keeps up with 
the flock as nearly as possible. The exercise, however, excites it, makes 
its respiration more rapid, and it has frequently to lie down for a moment 
and then get up and hobble along after the flock. The worst cases can 
thus easily be detected, since they straggle behind'the rest of the flock. 

The later stages follow rather rapidly. The involuntary movements 
become more frequent and more severe. All four legs tremble and shake 
violently. In fact, all the muscles of the body contract si)asmodically until 
the animal totters over on its side and dies in the most violent spasms. 

LarksjDur has the effect of arresting the heart's action and respiration 
and of paralysing the spinal cord. 

Treatment. Place the animal by itself in a cool, quiet, shaded place 
and avoid all excitement. Of the drugs tested, atropine sulphate dis- 
solved in camphor water has given the best results. Wilcox (Bull. 15, 
Montana Ex. Station) recommends for sheep from ^\^ to ^^ grain in the 
earlier, and ^ to -| grain in the later convulsive stages. Cattle require 
from four to five times these doses. Inhalations of ammonia vapour, 
and small doses of alcohol and ether, are also useful. 

In other cases very good results have been obtained from giving 




Fi(i. 81. — DeJphininni )nenziesii. 

(To illustrate " Larkspur Poisoning." From the Annual Report, U.S.A. 

Department of Agriculture, 1898.) 




Fig. 82. — Delnhinium menzicsii. 

(To illustrate " Larkspur Poisoning." From the Annual Report, U.S.A. 

Department of Agriculture, 1898.) 




Fig. 83. — Ddplnnium scopulonim. 
(To illustrate " Larkspur Poisoning." From the Annual Report, U.S.A. 
Department of Agriculture, 1898.) 



PLANTS POISONOUS TO STOCK. 



233 



permanganate of potash in the form of a drench : 5 to 10 grains for an 
adult sheep or pig, 15 to 20 grains for a horse, and 30 to 50 grains for an 
ox, dissolved in a pint or two pints of water. 

* Delphinium geyeri. — TheAVyoming larlispur is well known through- 
out Wyoming, Colorado, and Nebraska under the name of poison weed. 




Fig. 84. — Dwarf larkspur {Del])liiniuvi 
tricorne), one-third natural size. 



Fig. 8.5. — Cursed crowfoot (Bannnciihis 
sccleratus.) 



It is reported to be the most troublesome plant to stock in Wyoming, the 
dark-green tufts of foliage being especially tempting in spring when the 
prairies are otherwise dry and barren. 

Delphinium recurvatum. — This species of larkspur grows in wet sub- 
saline soil in the southern half of California. It has been reported from 
San Luis Obispo county as fatal to animals. 

Delphinium scopulorum. — The tall mountain larkspur of the Rocky 
Mountains has been reported to the Canadian Department of iVgriculture 
as poisonous to cattle in the high western prairies of Canada. 

Delphinium trolliifolium. — This plant is common throughout the 
coast region of northern Cahfornia, Oregon, and Washington. In 



234 



POISONING. 



Humboldt Count}', Cal., it is known as cow poison, on account of its 
fatal effect on cattle. Its toxic character has been questioned. Per- 
haps it is not e(|ually poisonous throughout all stages of its growth. 

*Helleborus viridis. — -The green hellebore is a European plant, some- 
times self-sown from gardens. All parts of the plant are poisonous. 
Cattle have been killed by eating the leaves. 



POISONING BY HELLEBORE. 

This form of poisoning is of slow progress, the plant producing 

irritation of the digestive mucous 
membrane. The symptoms con- 
sist in loss of appetite, blackish, 
glairy diarrhoea, and intermittence 
of the pulse. 

* Ranunculus sceleratus . — 

The cursed crowfoot, or celery- 
leafed crowfoot, is found through- 
out the eastern half of the United 
States and also in Europe. Cattle 
generally avoid all of the butter- 
cups, but fatal cases of poisoning 
from this plant are recorded in 
European literature. When dried 
in hay, the plant appears to be 
non-poisonous. The bulbous crow- 
foot (R. hidbosas) and the tall crow- 
foot {R. acris) are well-known to 
be very acrid in taste, and it is 
probable that all of the species 
which grow in water or in very 
marshy land are poisonous. 

POISONING BY RANUNCULACE.E. 
l^iG. bb. — Mandrake {rodo'jikijUum 

pelt a turn). Poisoning only occurs when 

the green plants are eaten. Dry- 
ing causes certain essences contained in them to disappear, and thus 
destroys their toxicity. 

This form of poisoning is indicated by yawning, colic, blackish, fcetid 
diarrhoea, and rapid loss of strength. 

The animals suffer from stertorous breathing, weakness of the pulse, 
and aberration of vision. They die in convulsions. 




PLANTS POISONOUS TO STOCK. 235 

BERBERIDACE.^ (BARBERRY FAMILY). 

Podophyllum peltatum. — The leaves of the common mandrake, or 
May apple, of the eastern half of the United States, are sparmgly eaten 
by some cattle. Cases of poisonmg are very rare, but the experience 
of one correspondent shows that the milk from a cow that had been 
feeding on the plant off and on for about three weeks was so extremely 
laxative as to be positively poisonous. The accident occurred to a baby, 
fed exclusively on cow's milk. The physiological effect of the milk was 
precisely like that of mandrake. It was shown that the cow ate the plant, 
which was abundant in one pasture, and when the animal was removed 
to a pasture free from the plant the child's illness stopped at once. 

BUTNERIACE^ (STRAWBERRY- SHRUB FAMILY). 

Butneria fertilis. — The large oily seeds of the calycanthus, or sweet- 
scented shrub, contain a poisonous alkaloid, and are strongly reputed to 
be poisonous to cattle in Tennessee. 

PAPAVERACEiE (POPPY FAMILY). 

Argemone mexicana. — The Mexican poppy is reputed to be poisonous 
to stock both in the United States and in New South Wales. The seeds 
are narcotic, like opium. 

* Chelidonium majus. — The yellow milky sap of the celandine, an 
introduced weed common in the eastern United States, contains both an 
acrid and a narcotic poison. Both are powerfully active, but cases of 
poisoning are rare, as stock refuse to touch the plant. Eeeks, of Spalding, 
however, describes (J. Comp. Path, and Tlicrap., Dec. 1903, p. 367) an 
outbreak of poisoning by common celandine in which twenty-one valu- 
able cows were affected and three died. The symptoms comprised exces- 
sive salivation and thirst, convulsions, unconsciousness and epileptiform 
movements. 

* Papaver somniferum, opium poppy, or garden poppy : P. rhoeas, 
field poppy, red poppy, or corn poppy. — These plants are sometimes 
self-sown from gardens. Both contain acrid and narcotic poisons, and 
European literature records the death of various animals from eating 
their leaves and seed pods. 

POISONING BY POPPIES. 

The consumption of poppies causes arrest of peristalsis, secretion of 
foamy saliva, colic, depression, coma, and in severe cases death by 
stoppage of respiration. 



236 



POISONING. 



PRUNACE.E (plum FAMILY). 

* Prunus caroliniana. — The laurel cherry, or mock orange, is native 
in the south-eastern quarter of the United States, and is there often 
cultivated for hedges. The half-withered leaves and the seeds yield 
prussic acid, and .are poisonous when eaten hy animals. 

* Prunus serotina. — The wild black cherry is a valuable forest tree 
which ranges througliout the eastern half of the United States. Cattle 

are killed by eating the partially 
withered leaves from branches 
thrown carelessly within their 
reach or ignorantly offered as 
food. The leaves of various other 
wild and cultivated cherries are 
probaljly poisonous to cattle in 
the same way. 

VICIACE.E (pea family). 

Aragallus lambertii. — The 

Lambert, or stemless loco weed, 
is, next to the following species, 
the best-known representative of 
a large group of closely related 
plants which are native to the 
western half of the United States, 
and are known as loco weeds on 
account of the peculiar excited 
condition wdiicli they induce 
in animals that eat of their 
leaves. Horses and cattle are both 
affected, but the chief damage is 
done to horses. After being per- 
mitted to graze on any of these 
plants the animal acquires an un- 
natural appetite for them, and soon refuses all other kinds of food. It 
rapidly becomes unmanageable, shows brain symptoms, and finally dies 
from lack of proper nourishment. 

Astragalus mollissimus. — This, the woolly loco weed, is perhaps the 
best known of all the loco weeds. It is the species most abundant in 
Colorado, where from 1881 to 1885 nearly $200,000 was paid out in 
l)ounties in an attempt, to exterminate it. The plant is still abundant 
in that State, and reports of the damage done by it continue frequent. 




Fig. 87. — Black cherry {I'rKniis serotina), 
one-third natural size. 




Fig. 88. — White loco weed [Argallus spicatus) in tiower. 
(From the Annual Report, U.S.A. Department of Agriculture, 1900.) 




Fig. 89. — "White loco weed (Aryallas *7)/(•((//^s), showing seed pods, 
(From the Annual Report, U.S.A. Department of Agriculture, 1900. 




Fici. 90. — IjOCO weed [Astragalus splendcns). 
(From the Annual Report, U.S.A. Department of Agriculture, 19U0.) 



PLANTS' POISONOUS TO STOCK. 



237 



Specimens of the three following species of Astragalus have been for- 
warded to the Division of Botany with the information that they were 
causing great financial loss in the districts noted. It is quite probable 
that other species are dangerous also. 

POISONING BY WHITE LOCO WEED (aEAGALLUS SPICATUS). 

This is an erect tufted perennial, 4 to 18 inches high, with pinnately 




Fig. 91. — Steinless loco weed 
{Aragallus lamhertii). a, 
Flowering plant; h, seed 
pods ; c, cross-section of 
seed pod — all one - third 
natural size. 




\ 



Mm\W 



\j ^ 






Fig. 92. — Woolly loco weed (Asfragalws 
v2ollissimus). a, Whole plant ; b, sec- 
tion of pod — both one-third natural 
size. 




divided leaves and spikes of white or cream-coloured flowers, shaped like 
those of the pea. The pod is one-celled, and when shaken produces a 
rattling sound, which gives the plant the name of " rattle weed " in some 
localities. The white loco weed is exceedingly common throughout Mon- 
tana. It occurs most abundantly on the northern slopes of foothills up 
to an altitude of about 8,000 feet. Its preferred habitat is for the most 



238 POISONING. 

part in rather drj- situations. The habit of the plant varies in different 
parts of Montana. In some localities the flowers are pure white, while 
in others they are decidedly yellow. 

In Colorado the plant which is most ordinarily known as loco weed 
is Astragalus mollissimus, while in Montana the species already named is 
perhaps most important ; but there are others which have a rather wide 
distribution and are known to produce the same efifects. Among these 
may be mentioned A. splendens, A. lagopus, and .4. hesseyi. 

The losses caused from the loco disease are very heavy in nearly all the 
Eocky Mountain States. The locoed condition is so commonly observed 
among sheep and horses that cases are not reported, and it is practically 
impossible to learn the exact extent of the disease. In the Judith Basin 
one prominent stockman was nearly ruined financially by the prevalence 
for a number of years of the loco habit among his sheep. In another 
instance the raising of horses was abandoned over a large tract of 
country on account of the loco weeds. 

The loco disease occurs under two forms — an acute and a chronic. 
An acute case of loco disease was observed by Dr. Wilcox in a two-year- 
old ewe with a lamb at its side. The ewe was observed eating large 
quantities of white loco weed on May 22nd, 1900. During the afternoon 
of the same day it became unmanageable, and the lamb was badly 
afifected. An examination of the ewe at this time showed that it was 
completely blind and was affected with dizziness. It walked around in 
long circles to the right, and after a short period remained standing for 
a few moments in a sort of stupor. At the beginning of each attack 
the head was elevated and drawn to the right ; eyelids, lips, and jaws 
were moved rapidly. Each attack lasted from one to two minutes* 
and the intervals between the attacks lasted about five minutes. The 
second day the attacks became more severe and of longer duration, the 
head being turned more decidedly to the right and the animal sometimes 
falling upon the ground. Similar symptoms, accompanied by digestive 
disturbances, were manifested by the lamb during the second day, and it 
died during the afternoon. On the morning of the third day it was 
found that the ewe was pushing against the fold, and had apparently 
been in that position during the greater portion of the night. The 
animal then began to whirl round to the right. Later it became unable 
to stand, and the spasmodic movements were largely confined to the legs. 
On the morning of the fourth day it died. The pupil of the eye was at 
no time dilated, and the expression was nearly normal. The pulse was at 
first very irregular, but on the second day became again regular and of 
normal frequency. The only remedy which was tried was frequent 
injections of one-quarter grain doses of morphine, but this was without 
effect. Two other ewes ate smaller quantities of loco weed at the same 



PLANTS POISONOUS TO STOCK. 239 

time and were similarly affected, but less severely. In these cases 
morphine was tried with better success. The lambs, however, died from 
the poisonous properties contained in the milk of the mother. 

The general symptoms of loco disease are quite familiar to all stock 
raisers. Perhaps the most characteristic are those of cerebral origin, and 
are shown in peculiarities of gait and action, w^hich may be compared to 
a drunken condition. The brain disturbances may consist in impairment 
of the special senses or in irregular motor impulses, which produce inco- 
herent muscular action. In some cases the animal becomes blind. More 
frequently the animal makes errors in judgment of the size and distance 
of objects. These visual disturbances are often quite ludicrous. The 
animal often takes fright, apparently at imaginary objects, or at objects 
which under ordinary circumstances would cause no alarm. Locoed 
horses are somewhat dangerous for driving purposes on account of their 
tendency to run away. Such horses are frequently attacked with kicking 
fits without any apparent cause. The sense of hearing is often affected, 
and the response to sounds is irregular and out of proportion to the 
volume and character of the sound. Irregularities in muscular move- 
ments of sheep may assume a variety of forms. The animal may simj)ly 
carry its head in an extended or otherwise unnatural condition. In some 
cases the back is arched. Trembling is a characteristic symptom. In 
locoed horses a great difficulty is sometimes experienced in persuading 
them to go backward. Locoed sheep are exceedingly difficult to manage. 
The different members of the flock may suddenly take a notion to run 
away in different directions, with the result that it is almost impossible 
for the shepherd to prevent their becoming separated. In cattle the 
disease appears to be rare, although symptoms, so far as observed, 
are essentially the same as those in sheep and horses. Occasionally 
locoed cattle manifest dangerous symptoms, and attack men and other 
animals. 

In chronic cases of loco the animal gradually becomes more emaciated 
and crazy. In sheep the fleece may be shed in patches or as a whole. 
The animal becomes unable to care for itself, and is apt to fall into the 
water while attempting to drink. Fits of trembling are of frequent 
occurrence, and the animal finally dies of inadequate nutrition and total 
exhaustion. In chronic cases of loco disease in horses the animal is 
usually left to its own resources on the range. During the later stages 
it may remain for weeks at a time upon a small area of ground without 
taking water. Dr. Wilcox saw a number of such cases in horses that 
were almost unable to walk. Under such circumstances the animals 
seldom or never lie down. One horse which was seen remained for a 
period of two weeks, in 1897, upon a piece of ground about 150 feet 
square. During this time the horse had no water. 



240 POISONING. 

Numerous autopsies on locoed sheep and horses revealed slight con- 
gestion of the brain membranes in all cases. The lungs and heart were 
in normal condition. Fatty tissue was considerably reduced in quantity, 
and the muscles were paler in colour than under normal conditions. 

The most serious mistake in connection with loco disease is made in 
allowing locoed sheep to remain with the rest of the flock. The loco 
habit is apparently learned by imitation of locoed animals, and so long 
as locoed sheep are allowed to remain with other sheep the loco habit 
rapidly spreads. An experienced sheep raiser, after being nearly ruined 
financially through the loco disease, adopted the method of immediate 
isolation and the feeding of locoed sheep for mutton. His stock was 
replaced with sheep that were free from the loco habit, and the trouble 
has been entirely eradicated from his range. 

No specific remedy for the loco disease has been discovered, and in 
the nature of the case no such remedy is likely to be found. In the 
present state of knowledge concerning the subject the only rational 
treatment to be recommended is that of confinement and feeding with a 
nutritious diet. By separating the locoed sheep at once from other sheep 
the spreading of the habit will be prevented, and the locoed animals may 
be fattened and thus prevented from becoming a total loss. Although 
locoed animals may readily be fattened and sold for mutton, their 
recovery from the loco habit is apparent only, and is due to their 
inability to obtain the loco weed. Such animals when allowed to run 
upon the range again almost invariably return to their old habit of 
eating loco weed. Animals which have once been locoed are, therefore, 
unsuitable for stocking the range. 

In combatting the loco disease the most rational methods include 
providing salt for the sheep, the immediate removal of locoed sheep 
from the band, confining them in a fold, and feeding them upon a 
nutritious diet. They may thus be fed for market, and their pernicious 
habit will not spread to other sheep. In the case of locoed horses, an 
apparent recovery takes place if they are confined in a stable and fed on 
ordinary cultivated forage or allowed to run in pastures where no loco 
weeds are found. Such horses are always somewhat dangerous, and 
more apt to run away or become unmanageable than horses which have 
not become affected with this disease. 

* Crotalaria sagittalis. — The rattlebox (rattle weed ; wild pea) is an 
annual weed which grows on sandy soil throughout most of the eastern 
half of the United States. In some jeavH it is especially abundant in the 
bottom lands of the Missouri Valley. Horses and sometimes cattle are 
killed in this region by eating grass or meadow hay which is contami- 
nated with the plant. 



PLANTS POISONOUS TO STOCK. 



241 



Lupinus leucophyllus. — This herbaceous shrub is a representative of 
a very large genus of plants, many of which are widely and abundantly 
distributed throughout the western United States, and are generally 
known as lupines. The above species is very abundant in Montana, 
where it is said to have caused the death of a very large number of 
sheep. There is some question whether the animals are killed by a 
poisonous constituent of the plant 
or merely by tympanites. The seeds 
of all the lupines are probably dele- 
terious in the raw state. In Europe, 
however, the seeds of Lupinus alius, 
after the bitter taste has been re- 
moved by steeping and boiling, are 
eaten by human beings as well as 
by cattle. 

POISONING BY LUPINES (lUPINUS 
LEUCOPHYLLUS ; L. SEPvICEUS ; L. 

CYANEUS). 

These plants are commonly 
known by the names blue pea, 
blue bean, and wild bean. They 
are coarse, silky-haired perennial 
herbs, with blue flowers arranged 
in conspicuous terminal racemes, 
which blossom in June and July, 
with long- stemmed leaves, which 
are divided into from seven to 
eleven leaflets radiating from a 
common point. The fruit is a hairy, 
several-seeded pod, and the seeds 
are small and somewhat flattened. 

As a rule these plants do not 
occur in the flat river bottoms. 

They occur most abundantly on the foothills and mountain ranges at 
moderate elevations. 

During the season of 1900 the lupines in Montana began to bloom 
about May 20th, and the first full pods were collected on June 5th. 
Lupines are not very extensively eaten by sheep during the spring and 
summer, except when they are unusually hungry or are being driven 
from one range to another. Lupines are more often eaten by sheep in 
summer on the mountain sides, and in the fall and early winter after 

D.C. R 




Fig. 93. — Rattle box {Crotalaria saglt- 
talis). rt, Whole plant; &, cross-section 
of seed pod— both one-third natural 

size. 



242 tOlSONlNG. 

early frosts have opened the pods and the seeds have fallen out. Lupine 
hay is greedily eaten by all kinds of stock during the winter, and large 
quantities of this hay have been fed for the past fifteen or twenty years. 
Lupine, hay is cut in different jeavs at dates ranging from the 1st of 
July to the middle of September. "When cut during the first half of July 
the newl}' ripe pods, full of seeds, are secured in the hay. When, how- 
ever, the harvesting of luj)ine hay is postponed until September, the 
pods become ripe and split open, and the majority of seeds fall out. A 
striking variation in the quantity of pods containing seeds is noted 
during different years. Daring seasons in which May and June are wet. 
the quantity of pods is usually large. When, however, these months are 
dry only a few pods are found on each phmt, and a vast majority of the 
flowers fail to be fertilised. 

Dr. Wilcox has observed that sheep are especially fond of the pods of 
various leguminous jjlants before they become mature and while they are 
still in a succulent condition. 

Dr. Wilcox saw a flock of sheep which while being driven from one 
range to another, in a hungry condition, was allowed to feed upon an 
area of lupines in a nearly ripe condition. Within two hours the sheep 
manifested violent symptoms of poisoning, and ultimately 100 out of the 
lot of 200 died. He afterwards saw many hundreds of fatal cases in 
sheep and a number in horses, both from eating green lupines and 
lupine hay. 

As an experiment two sheep were given each 150 medium-sized 
lupine pods (L. leucophijllus) which were entirely full of ripe seeds. The 
sheep ate the pods readily. Both sheep became frenzied within about 
forty-five minutes after feeding upon the lupine pods, and died al)0ut one 
hour later. The symptoms in these cases were the same as those 
observed in poisoning under natural conditions. 

The symptoms of lupine poisoning are so well known in Europe 
that chronic lupine poisoning has been given the name liipinosis. It is 
characterised hj loss of appetite, fever, dyspnoea, constipation, and yellow- 
ness of the visible mucous membranes. Diarrhoea, sometimes of a san- 
guinolent type, appears later. The urine becomes albuminous, tinted with 
bile products or stained red by hii:;moglobin, and the head shows oedema. 
Death occurs in a few days. In America the chronic form has not been 
observed. In cases of lupine poisoning in Montana there was noted 
acute cerebral congestion, accompanied with mental excitement. The 
sheep rushed about in different directions, butting one another and other 
objects. The first stage of frenzy was soon followed by a second stage, 
characterised by pronounced irregularity of movement, spasms, and 
falling fits. In the majority of cases death occurred in from one-half to 
one and one-half hours. In extensive cases of lupine poisoning it was 




Fig. 94. — Lupine (Lupinus leucophijUus). 
(From the Annual Report, U.S.A. Department of Agriculture, 1900.) 













Fig. 95. — Lupine {Lupiuus lfiir,,/ilii/lh(.s) in hav. 
(From the Annual Report, U.S.A. Department of Agriculture, 1900. 



PLANTS POISONOUS TO STOCK. 243 

uniformly observed that a number of the sheep lingered on from two to 
four days before they died. The muscular convulsions resembled those 
caused by strychnme. The excretion of the kidneys was much increased 
and frequently was bloody. Post-mortem examinations of sheep poisoned 
by lupines revealed conditions similar to those in acute forms of loco 
disease, with the addition of a congested condition of the kidneys. 

No remedies have been tried in cases of jDoisoning from American 
species of lupine, but it seems reasonable to suppose that potassium 
permanganate would probably destroy the lupine alkaloids in the stomach 
if administered promptly after the first signs of poisoning. Experience 
and observation indicate that lupine hay is always dangerous for sheep if 
cut at a time when the seeds are retained in the hay. The evidence thus 
far collected regarding this matter indicates that the seeds are the most 
poisonous part of the plant. 

POISONING BY VETCHES (lATHYRUS SATIVUs) : LATHYRISM. 

In the horse this disease is due to feeding on grain containing 
the seeds of vetches, but in the ox to eating the green portions of the 
plants. Feeding has to be continued for at least a month to produce 
accidents. 

The earliest symptoms consist in suppression of milk secretion, and 
somnolence. Nervous symptoms — -from which alone the horse suffers — • 
soon make their appearance. The neuro-muscular system is attacked. 
Interference with the nervous system is followed by inco-ordination of 
movement, and later by paraplegia of the hind quarters. Eoaring is not 
noticeable, probably because the patients rarely move rapidly. 

The lesions have been little studied, but appear to consist in con- 
gestion and infiltration of the meninges, cord, and roots of the lumbo- 
sacral plexus. 

Treatment. If the animals are paralysed, treatment is rarely of 
value ; otherwise it is sufficient to remove the cause and to administer 
purgatives and diuretics, with the object of eliminating toxic products. 
Eecovery follows in three to four weeks. 

Robinia pseudacacia. — The common locust tree is native in the 
central and eastern parts of the United States, and is extensively 
cultivated for ornamental purposes throughout the Union. The bark 
and leaves contain a powerful poison, and persons have been killed by 
eating these parts. 

* Sophora secundiflora. — The beautiful bright-red beans of the frijo- 
lillo, or coral bean, of southern and western Texas contain a powerfully 
poisonous alkaloid. The plant is said to have poisoned stock in Texas 
and in northern Mexico. 

R 2 



244 



POISONING. 



L1NACE.E (FLAX FAMILY). 

Linum rigidum. — The large-flowered yellow flax is reported from 
Pecos Valley, Texas, as poisonous to sheep. An investigation made by the 
Bm-eau of Animal Industry, U.S.A., showed that the plant is poisonous. 




Hi,^ 




Fig. 96. — Caper spurge {Evphorbia 
lathijris). a, Upper half of plant, 
one-third natural size ; b, seed 
capsule, natural size. 



Fig. 97. — Snow on the mountain {Eu- 
pliorhia marginata). a, ^Yhole plant^ 
one-third natural size; b, seed capsule, 
natural size. 



MELIACE.E (UMBRELLA-TEEE FAMILY). 

* Melia azedarach. — ^The Chinese umbrella tree is much cultivated 
for ornament, and sometimes grows wild in the South. A correspondent 
from Arizona stated that three of his hogs were poisoned by eating the 
seeds, which were ignorantly offered to them for food. 



EUPHORBIACE.E (SPURGE FAMILY"). 

Euphorbia. — There are many species of spurge native to the United 
States, nearly all of which contain an acrid milky juice. Stock generally 



PLANTS POISONOUS TO STOCK. 



245 



avoid them, but cattle have been poisoned by drinking water into which 
the plants have been throwai. The juice of E. mavcjinata and E. hkolour 
is used to some extent in Texas to brand cattle, it being held to be 
superior to a red-hot iron for that purpose, because screw worms will not 
infect the fresh scar and the spot heals more readily. 

* Jatropha stimulosa. — The seeds of the spurge nettle of the Southern 
States are extremely poisonous. Stock avoid the plant on account of its 
stinging hairs. 

* Ricinus communis. — The castor oil plant is quite commonly 




Fig. 98. — Castor oil plant {Ricinm 
comtntmis). 



Fig. 99. — Eed chestnut {^■Escnliis pavia). 
a, Flowering branch ; h, seed— both 
two-ninths natural size. 



cultivated in the warmer portions of the United States, and grows 
wild in the South. The seeds have been accidentally eaten by 
horses with fatal effect, and they have been strewn on pasture lands 
in the North-West for the purpose of killing sheep that w^ere tres- 
passing thereon. A Frenchman has discovered a method of making 
cattle immune to the effects of the toxalbumin contained in the 
seeds, so that they may be fed to stock without causing any ap- 
parent ill effect. A note on poisoning by castor oil cake will be 
found hereafter. 



246 



POISONING. 



* Buxus sempervirens 

for hedges, are poisonous to all kinds of stock 



A.CEiE (box family). 

The leaves of the common hox, cultivated 



^.scuLAcr. (horse-chestnut family). 



iEsculus californica, California 




Fig. 100. — "Water hemlock {Cicu fa niacu- 
lata), showing section of spindle-shaped 
roots and lower stem, the leaves, flowers, 
and fruit, one-half natural size ; also fruit 
and cross-section of seed, enlarged five 
times. 

which contained nearly 50 per cent. 
from the effects of the poison, and 
further suffering. 



huckeye : M. glabra, Oiiio buck- 
eye ; fcetid buckeye : M. hippo- 
castanum, horse - chestnut : M. 
paYia, red buckeye. — The leaves 
and fruit of these species are 
generally regarded as poisonous 
to stock. The fruit may be easily 
converted into food by \Yashing 
and boiling. It is believed that 
a small quantity of the unpre- 
pared fruit of the California buck-* 
eye will cause cows to slip their 
young. 

hypericace^ (st. John's wort 
family). 

* Hypericum perforatum. — 

The common St. John's-wort is 
commonly believed to cause dis- 
agreeable eruptions on cows' 
udders and on the feet of white 
haired animals. This species 
and the spotted St. John's wort 
(H. inaculatu))i) were brought into 
the United States Bureau of Agri- 
culture by Dr. G. W. Bready, from 
Norwood, Maryland, who stated 
that five horses were poisoned in 
May, 1808, by eating meadow hay 
of these plants. One horse died 
two were killed to prevent their 



POISONING ]{Y ST. JOHN S WORT. 

The ingestion of St. John's wort produces excitement followed ))y dul- 
lness, interference with vision and hearing, and by visual hallucinations 



PLANTS POISONOUS TO STOCK. 



247 



with a tendency to lean backwards, the front Kmbs remaining fixed in 
position. The patient often sits down on the hind quarters Hke a dog. 

APIACE^ (carrot family). 

* Cicuta maculata. This is the water hemlock (spotted hemlock ; 
beaver poison ; cowbane), which grows most abundantly throughout the 




Fig. 101. — Orepfon water hemlock {Cicuta 
vagans). a, Plant with leaves, one-sixth 
natural size ; b and 6\ rootstock and 
horizontal roots, showing section, half- 
size ; c, terminal leaflets, one-sixth na- 
tural size ; d, flowering spray, full size. 




Fia. 102. — Poison hemlock [Coniioii mac- 
jdatnni), showing upper portion of 
plant with flowers and seed, one-third 
natural size. 



United States. It is one of the best known poisonous plants. Stock are 
not infrequently killed by eating the fleshy roots or hay with which the 
plants are mixed. 

* Cicuta vagans. — Cattle are frequently killed in Oregon and 
Washington by eating the large fleshy rootstocks which have been 



248 



POISONING. 



washed, frozen, or dug out of the soil, or b}- drinking water in marshes 
where the roots have been trampled upon. The roots of the other 
species of Cicuta are undoubtedly poisonous, but cases have been 
reported against one other species only, namely, C. hohmdcri. It grows 
in marshy land in California. 

* Conium maculatum. — The well-known poison hemlock, or spotted 
hemlock of Europe, is an introduced weed not uncommon in the north- 
eastern section of the United States and in California. The plant is 




Fig. 103. — Narrow-leaf 
laurel (Kalviia an- 
gustifolia), showing 
flowering branch, one- 
third natural size. 




Fig. 104. — Broad-leaf laurel (Kalmia latifoUa). 
a, Flowering spraj', one-third natural size ; 
h, vertical section of flower showing pecu- 
liar attachment of stamens, natural size ; c, 
fruiting capsules, natural size. 



generally avoided by stock on account of its bad odour, but animals 
have been killed by eating it in the fresh state. Since the poisonous 
constituent is volatile, the dry plants are not so dangerous. 



POISONING BY HEMLOCK AND WILD CHERVIL (aNTHRISCUS SYLVESTRIS). 

Poisoning only results from ingestion of the green plants. It is 
characterised by salivation, nausea, dyspnoea, generalised trembling and 
vertigo, paraplegia, and symptoms of gastro-enteritis, 



PLANTS POISONOUS TO STOCK. 



249 



POISONING BY FENNEL. 

This disease, seen in Algeria, and recently studied by Bremond and 
Bojoly, need only be mentioned. The information at present available 
is indefinite, and the symptoms so closely resemble those of Texas fever 
that there seems a possibility of 
confusion having arisen. 

The lesions are those of hemor- 
rhagic gastro-enteritis. 

Treatment consists in giving 
tannin, opium, and emollients, 

Oxypolis rigidus. — The cowbane 
is natural in swamps throughout 
the eastern half of the United 
States. The leaves and roots are 
reputed to be poisonous to cattle. 

Slum cicutsefolium. — The leaves 
of the hemlock water parsnip, which 
is more or less common throughout 
the United States, are said to be 
poisonous to stock. 



ERICAE^ (heath FAMILY). 

Andromeda poli folia. — The 

wild rosemary, or moorwort, is a 
plant native to the northern regions 
of Europe, Asia, and America, en- 
tering the United States only in 
the extreme north-east. The leaves, 
which have been eaten by sheep 
with fatal effect, contain a narcotic poison known as andromedotoxin. 
The plant is not very dangerous in its native habitat, because it grows 
in bogs which are inaccessible to stock. 

* Azalea occidentalis. — The California azalea is very much dreaded by 
sheep men who drive their flocks into the southern Sierras for pasture. 
Investigation has shown that the leaves contain a poisonous substance. 

* Kalmia angustifolia. — The narrow-leaf laurel is abundant in the 
north-eastern section of the United States, where it is also well laiown 
as sheep laurel and lamb-kill. The leaves contain andromedotoxin, 
and sheep and calves are frequently poisoned by eating them. 

* Kalmia latifolia. — The broad-leaf laurel is native throughout the 
greater part of the eastern half of the United States, and is known by 




Fig. 105. — Branch ivy (Leiicothoc cates- 
hcei). a, Flowering branch ; &, fruiting 
capsules. 



250 



POISONING. 



a great variet}' of common names, the most important of which are 
laurel and iv^. The latter name is most commonly used south of Mary- 
land. Scores of cattle and sheep are poisoned annually by eating the 
plant. It is pro])a1)ly the most dangerous of all the shrubs belonging 
to the heath family. 

* Leucothoe catesbaei. — This is the branch ivy, hemlock, or calf-kill, 





Fig. 106. — Staggerbush (Pieris mari- 
ana), showing flowering branch, 
one-third natural size. 



Fig. 107. — Great laurel {Ithododcndron maxi- 
mum). (7, Flowering branch ; b, fruiting 
capsules — both one-third natural size. 



of the Allegheny Mountains. It is well known in that region to be fatal 
to all kinds of stock. 

* Leucothoe racemosa. — The swamp Leiicothoi' of the Atlantic and 
Gulf States has l)een reported from New' Jersey as especially fatal to 
calves. 

* Pieris mariana. — The stagger bush of the Atlantic Coast region, 
Tennessee, and Arkansas is commonly know'ii to be poisonous to 
calves and to sheep. The name stagger bush was applied to the 
shrub on account of the peculiar intoxicating effect of the leaves. 

* Rhododendron californicum. — The California rhododendron is 



PLANTS POISONOUS TO STOCK. 



251 



native on the Pacific Slope from San Francisco to British CoUimbia. 
The phmt is reported from Oregon as poisonous to sheep. It is quite 
probable that the leaves contain andromedotoxin, but they have not 
been tested. 

* Rhododendron maximum. — The great hiurel (i-osebay ; moun- 
tain laurel ; rhododendron) is a large evergreen bush or small tree which 
is quite commonly cultivated for ornament, and 
is found native in the Allegheny Mountains. The 
leaves contain andromedotoxin, and they are occa- 
sionally eaten by stock with fatal effect. 

PRIMULACE,^ (primrose FAMILY). 

Anagallis arYensis. — The pimpernel is a 
European plant which has obtained a specially 
strong foothold in California, where it grows 
luxuriantly and is sometimes known as poison 
weed. It is suspected of having caused the death 
of a horse at Santa Ana. Chemists have isolated 
a powerfully poisonous oil and a strongly active 
ferment from the plant. 

OLBACE.'E (olive FAMILY). 

Ligustrum vulgare. — The privet, or prim, is 
a garden shrub, introduced from Europe and 
Asia, which is much used for hedges, and has 
escaped from cultivation in western New York 
and southward to North Carolina. Accidents have 
been occasioned in children both by the fruit and 
the leaves. The plant is to be suspected in cases 
of poisoning in animals. 

APOCYNACE.F. (DOGBANE FAMILY). 

Apocynum androsaBmifolium, spreading dog- 
bane : A. cannabinum, Indian hemp. — These 
plants are generally distributed throughout the 

United States. Stock generally avoid them in pasture fields on account 
of their acrid milky juice. When dry they are not so poisonous as when 
in the fresh state. 

Nerium oleander. — The oleander is a common house plant throughout 
a large portion of the United States. It grows freely out of doors in 
the Southern and Western States, and has probably escaped from culti- 
vation in some places. It grows wild in northern Mexico. The leaves 




Fig 108. — IMilkweed 
{Asdepias eriocarpa), 
one-sixth natural size. 



252 



POISONING. 



are well known to be most powerfully poisonous, and stock are occa- 
sionally killed by eating them. 



ASCLEPIADACE.E (MILKWEED FAMILY). 



* Asclepias eriocarpa. — This is the 
leaves which is known as milkweed in 



plant with broad mullein-like 
California. Several authentic 
accounts of the poisoning of 
sheep have been secured 
against the plant in Men- 
docino County. It is espe- 
cially feared on very warm 
days by sheep men when 
they are compelled to drive 
their flocks through dry, 
barren valleys. It sometimes 
grows on cultivated land, and 
is cut with hay. 

* Asclepias syriaca. — This 
is the common milkweed, or 
silkweed, of the north-eastern 
quarter of the United States. 
Experiments show that the 
milky juice so abundant in 
all parts of the plant is very 
acrid and poisonous. It is 
listed among the poisonous 
plants of Europe. 

SOLANACE^ (potato FAMILY). 

* Datura stramonium: 
D. tatula. — These two species 
very closely resemble each 
other, and are most com- 
monly known in the United 
States by the name of jimson 

weed. They are European plants which have become weeds in waste 
grounds and about dwellings throughout the greater portion of the 
country. One or two instances are recorded in which cattle have been 
poisoned by eating hay containing the young leaves. 

* Hyoscyamus niger. — The black henbane is an ill-smelling plant, a 
native of Europe, now naturalised in Michigan, and from New York north- 
ward. One or two cases are recorded in European literature in which stock 




Fig. 109. — Jinisou weed {Datura stramonium). 
a, Flowering spra3' ; b, fruiting capsule — both 
one-third natural size. 



PLANTS POISONOUS TO STOCK. 



253 



have been poisoned by eating the phxnt of their own accord, but there 
is very httle danger from it, on account of its ill odour and harsh 
texture. 

* Nicotiana tabacum. — This is the tobacco most commonly cultivated 
in the United States. It is native to South America and has escaped 
from cultivation to some extent in the Southern States. According to 
some authorities stock are not always disposed to shun this plant on 
account of its characteristic ill odour and taste, but, on the contrary, 





Fig. 110. — Bittersweet {Solaniim dulca- 
mara), a, Flowering spray ; h, fruit — 
both one-third natural size. 



Fig. 111.— Black nightshade {Sola- 
niim nigrum), one - third natural 
size. 



will eat a small amount of the leaves with apparent relish, especially 
when they are somewhat fresh. Stock have, however, been poisoned by 
eating leaves which were placed within their reach to dry, and also by 
eating food contaminated with the juice of the leaves. Considerable 
precaution should be used in applying tobacco juice to fresh cuts or 
bruises in stock, as the poison is easily absorbed into the system and 
may prove fatal. There are several native species of tobacco in the 



254 



POISONING. 



western half of the United States, all of which are undouhtedly poisonous 
if eaten even in moderate quantity. 



-^% .. 



TOBACCO POISONING. 

Tohacco poisoning may l)e produced hy haths or lotions containing 
tohacco juice, which is often used as a parasiticide. The ingestion of 

tobacco leaves in forage may also 
produce j)oisoning. Doses of 1 ounce 
in the goat and 10 ounces in the ox 
are toxic. 

The symptoms consist in sali- 
vation, vomiting, nausea, diarrhoea, 
cardiac palpitation and dyspnoea. 

The lesions are those of gastro- 
enteritis with cerebral congestion. 

Treatment consists in giving 
tannin, black coffee, etc. 

Solanum dulcamara. — The 

bittersweet, or climbing night- 
shade, is a European weed, now 
introduced in the north - eastern 
quarter of the United States. The 
leaves are suspected of being poi- 
sonous to stock. 

* Solanum nigrum. — The black 
nightshade (common nightshade ; 
garden nightshade) is a common 
weed in cultivated fields throughout 
the greater portion of the United 
States. Cattle seldom eat the plant, 
but a few cases of poisoning are 
recorded for calves, sheep, goats, 
and swine. 
* Solanum triflorum.— The spreading nightshade is a native of the 
Great Plains (United States), and also a common garden weed from 
Arizona and Texas to Ih-itish America. Complaints of the poisoning 
of cattle by this plant have been sent to the Department of Agriculture 
from Nebraska. Experiments show that the berries are poisonous. 

Solanum tuberosum. — The small, immature tubers of the common 
cultivated potato and tliose that have turned green from exposure to 
the sun are slightly poisonous. The green fruit and tlie white sprouts 




Fig. 112. — Spreading niglitshade (Sola- 
num trifloriiJii), one-third natural size. 



PLANTS POISONOUS TO STOCK. 



255 



from mature potatoes are likewise poisonous. In all of these cases the 
deleterious suhstance may be removed or destroyed by thorough boiling. 



SCROPHULARIACEiE (fIGWORT FAMILY). 

Digitalis purpurea. — The purple foxglove is a common garden plant 
which has sparingly escaped from 
cultivation and is. naturalised to 
some extent on Cape Breton Island. 
Horses are occasionally poisoned 
in Europe by nipping the plants 
from gardens or by eating hay 
contaminated with it. 

Gerardia tenui folia. — The 
slender gerardia is native to the 
eastern half of the United States, 
and has been specially reported as 
poisonous to sheep and to calves 
in the Southern States. 

Gratiola officinalis. — The hedge 
hyssop of the Southern States 
contains an acrid poison. The 
same plant grows in Europe, and 
is there regarded as poisonous to 
stock. 

Pedicularis. — The plants of this 
genus are commonly called louse- 
wort. In Europe several species 
are suspected of being slightly 
poisonous to stock. One of these, 
P. palustris, occurs in Labrador, 
and there are over thirty species 
native to the United States, largely 
Western. They should all be suspected of being poisonous 




Fig. 113. — Siieezeweed [Helinuiim au- 
tainnalc), one-third natural size. 



CAMPANULACE.E (bELL-FLOWER FAMILY). 

Lobelia inflata, Indian tobacco : L. kalmii, brook lobelia : L. spicata, 

pale-spiked lobelia : L. syphilitica, great lobelia.- — All of the species in 
this genus contain an acrid and usually milky juice, and are poisonous. 
None has been specially reported as poisonous to stock, but the above- 
named species are to be suspected, because they fre(j[uently occur in 
grass and are sometimes found in meadow hay. 



256 POISONING. 

AMBROSIACE.E (ragweed FAMILY). 

Xanthium canadense. — The young seedlings of the American cock- 
lebur are reported from Texas as being rapidly fatal to hogs. 

Xanthium spinosum. — The spiny clotbur is suspected of being poi- 
sonous, but few cases have been definitely recorded against it. The 
seeds apparently contain a toxic compound. 

Xanthium strumarium. — The young seedlings of the broad cock- 
lebur are reported from Georgia as being fatal to hogs. Experiments 
seem to show that the seed is poisonous. 

CARDUACE.E (THISTLE FAMILY). 

*Helenium autumnale.— Sneezeweed (sneezewort ; autumn sneeze- 
weed; stagger weed; false sunflower) is found throughout the greater 
portion of the United States, being most abundant in the Southern and 
Eastern States. Sheep, cattle and horses that are unfamiliar with the 
plant are often poisoned by it when driven to localities where it is abun- 
dant. Stock avoid it, as a rule, but it is claimed that they sometimes 
develop a taste for the plant, and are killed quickly by eating it in large 
quantity. 

Senecio jacobaea. — The tansy ragwort, or stagger wort, is a European 
plant which grows as a weed in ballast about New York and Philadelphia. 
Farther north, in Nova Scotia, it has become extensively naturalised, and 
it is there regarded by stock men as poisonous. It is interesting to 
note that S. guadalcnsis of Mexico is also considered fatal to stock. 



COLCHICUM POISONING. 



Fodder of bad quality often contains leaves, flowers, and particularly 
seeds of colchicum, which produce nausea, vomiting, colic and diarrhcea. 
The colchicine acts particularly on the kidney and heart, producing 
specific disturbance, indicated by hsematuria, polyuria, and cardiac pal- 
pitation, with lowering of the body temperature. 

Even when poisoning is not fatal, it is very apt to produce abortion. 

POISONING BY ANNUAL MERCURY. 

Annual mercury given in green fodder is stated to produce indiges- 
tion, diarrhcea, vesical and intestinal haemorrhage, and early death. 
Some authors, however, deny that it has such toxic properties. 

POISONING BY BRYONY. 

In large doses all parts of the bryony plant are toxic — the root, stalk, 
and leaves. 



POISONING BY COTTON CAKE. 257 

Bryony is sometimes used as a purgative. Poisoning is characterised 
by nausea, sweating, diuresis, frequent action of the bowels, and, in grave 
cases, by tetaniform convulsions followed by death. 

POISONING BY CASTOR OIL CAKE. 

Causation. Excessive use of this form of cake is the usual cause 
of such poisoning, though bad quality is also an important factor. The 
castor oil beans are often insufficiently crushed and compressed, so that 
a considerable amount of oil is contained in the cakes as sold ; but the 
most dangerous constituent is undoubtedly the material known as ricin, 
which, in some specimens of cake, may exist in highly dangerous 
quantity. 

The oil contained in the cake, like every other fatty substance, 
favours intestinal peristalsis and the onward movement of the digested 
food. The laxative principle excites secretion, and if the cake be given 
for considerable periods, the most serious consequences may ensue. 

Cakes prepared from mixed rape seed and castor beans act in a 
similar way, though in a longer or shorter time, according to their rich- 
ness in ricin. 

The earhest symptom consists in purgation, which gradually de- 
velops into superpurgation, and is followed by direct irritation of the 
muscous membrane, indicated by serous, foetid, and sometimes san- 
guinolent, diarrhcea. The symptoms may appear in twenty-four hours. 
They are usually accompanied by a rise in temperature of 2° to 3° Fahr. 
Secretion of milk ceases, and animals heavy with young sometimes abort. 
In exceptional cases death follows. 

The lesions are those of hafimorrhagic enteritis. 

Treatment is principally of a preventive character. The cakes should 
be examined, and if they contain insufficiently crushed seeds or beans 
should be discontinued or given in smaller quantities. The proportion 
of ricin in mixed rape and castor cakes should be determined. 

Curative treatment consists in removing the cause and treating the 
enteritis. The latter is best controlled by giving emollients, diuretics, 
and mucilaginous drinks prepared from linseed, marsh-mallow, barley, etc. 

POISONING BY COTTON CAKE. 

Cotton cake forms a rich food, which fattens animals very rapidly, 
but given in excess may produce true poisoning, and if prepared from 
undecorticated seed may produce mechanical irritation ending in ob- 
struction of the bowel. 

The latter accident occurs only in the sheep. It consists in ob- 
struction of the omasum (uesophageal gutter), and particularly of the 

B.C. S 



258 toisoNiNG. 

abomasum, by the woody seed covering, the fibres of which become 
aggkitinated and close the pyloric opening, just as do the fragments of 
wool or the hairs in animals affected with the licking habit (pica, de- 
praved api)etite). The mass thus formed passes into the intestine, and 
is apt to become fixed at some point and to cause death. 

In the ox, as in the sheep, true poisoning may result from the action 
of an injurious principle which Cornevin discovered in the seed and 
particularly in the meal. The relative rarity of such accidents is 
exjDlained by the composition of the cakes, wliich are rich in husks but 
poor in meal. 

In the first series of accidents the symptoms resemble those pro- 
duced by the intestinal obstructions pecuUar to the licking disease; in 
the second they appear about the eighth to the fifteenth day, and are 
indicated l)y sensitiveness of the abdomen and by efforts to pass urine. 
The urine is albuminous ; at a later stage it becomes darker in colour, 
reddish, and stained with ha;moglobin. The mucous membranes exhibit 
a sub-icteric tint. 

Lesions. The liver shows interstitial hepatitis, consequent on changes 
in the hepatic cells due to the poisonous principle. The kidney first 
shows lesions of interstitial, but afterwards of epithelial, nephritis ; the 
endothelium of the tubes appears to be undergoing proliferation. 

Treatment should only be undertaken when the organic lesions 
seem trifling, and suggest the possibility of cure without excessive 
outlay. Under such circumstances it is sufficient to remove the cause 
and to supply proper diet. 

• 

POISONING BY MOLASSES REFUSE. 

Molasses refuse is much used about Paris and in the department of 
Le Nord for fattening or simply for feeding animals. Added to rough 
fodder, even of poor quality, the refuse renders it palatable, and thus 
forms an economic food ; it also improves the condition of animals with 
broken wind. Its poverty in nitrogenous materials (the refuse consists 
of GO per cent, of hydrocarbons ; 10 to 12 per cent, of potash and soda 
salts) renders it necessary to enrich it in this respect. Moreover, only 
a limited quantity should be given. If given in larger amounts than 
2 to 2^ parts per 500 parts of body weight it may produce bad effects. 
In this case the earlier symptoms point to interference with the urinary 
apparatus, the digestive apparatus being affected later ; both accidents 
are due to the potash and soda salts present in the refuse, and may 
become so well marked as to constitute true poisoning. 

The symptoms consist in abundant diuresis, resulting from the 
excess of potash and soda salts, and are followed by albuminuria. Super- 
purgation is usually present. 



DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 

Lesions. On post-mortem examination one finds lesions of irritant 
gastro-enteritis, and of chronic nephritis. 

Treatment consists in withdrawing the molasses refuse, and giving 
milk, mucilaginous fluids, barley water, and cereals, which soothe the 
kidney. 

DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 

This disease, which is very common in France and Germany, results 
from feeding on distillery and sugar factory residues, consisting for the 
most part of beet pulp. 

In 1860 Guionnet described it under the name of disease of the 
abomasum, and more recent work by Butel, Rossignol, and Arloing has 
thrown a great deal of light on its exact nature. 

Causation. Guionnet attributed the injurious action of beet pulp, 
etc., to excess of acidity, due to the addition of sulphuric iicid during 
manipulation in the factory ; but it has since been shown that this acidity, 
if existing, is specially due to various fermentation products, the results 
of lactic, butyric, ai)d acetic fermentation, etc. 

Rossignol regarded the symptoms as wholly due .to the excessive 
proportion of water, viz., 90 per cent. ; but this does not explain the 
general symptoms of poisoning. 

The real cause is to be sought in the manner of preserving the pulp 
in simple earth silos or in cemented silos, where it undergoes fermenta- 
tion and putrefaction. The contained liquid is then extremely toxic. 
Filtered through porcelain and injected under the skin, it produces 
vaso-motor and vaso-paralytic disorder, identical with that seen in acute 
forms of the disease ; in other cases it excites abnormal secretion, and 
leads to permanent diarrhoea and chronic gastro-enteritis. 

This liquid, if injected intravenously, may prove toxic in doses 
of 2 to 3 cubic centimetres per kilogram of bodily weight. Its in- 
jurious effect is due to toxins secreted by special bacilli, which were 
isolated and studied by Arloing. The toxicity diminishes as the pulp 
becomes older, and can be avoided by adding antiseptics like common 
salt, which prevent fermentation. These experiments of the Lyons 
professor are certainly very interesting, and, although perhaps not 
identical with what occurs in practice, sufficiently indicate the way in 
which poisoning occurs. 

Pathological disturbance only follows the use of decomposed pulp. 

Animals reared on farms where distillery and sugar factory pulp is 
regularly given become accustomed to it, and are rarely affected. The 
chief sufferers are those recently imported, or recently placed on such 
food ; in them the disease may assume either the acute, nervous, sub- 
acute, or chronic form. 

s 2 



260 POISONING. 

Acute form : Symptoms. This form is exceptional in the ox, but 

is more frequent in the sheep. In oxen the earlier sjanptoms point to 
digestive disturbance, and consist of dulness, loss of appetite, colic, 
sensibility of the abdomen, cessation of rumination (without tympanites), 
and constipation. The excreta are hard, coated, and blackish in colour, 
but not blood-stained. 

Diarrhoea follows, is accompanied by aggravation of the general symp- 
toms, the temperature rises to 104"* or 106° Fahr. (40° or 41° C), and 
exhaustion is pronounced. Other, less characteristic, symptoms, such as 
grinding of the teetli and mastication without food being present in 
the mouth may accompany the above and arouse fears of peritonitis. 
In sheep the dulness and prostration shown at first suggest the existence 
of anthrax — a view strengthened by the fact that the respiration becomes 
very frequent and the fever intense, whilst death may be rapid, and may 
sometimes occur with startling suddenness. 

Lesions. Bacteriological examination, or even a naked-eye examina- 
tion, made immediately after death enables one easily to differentiate 
between the two conditions. When the animals have died very rapidly — 
in one night — lesions of enteritis alone are present. More marked cases 
exhibit thickening and intense congestion of the mucous membrane of 
the abomasum, which may be of a deep mahogany colour. 

The intestine itself is affected, and even though the glandular 
epithelium is little changed, the intercellular spaces show ecchymoses 
and multiple luemorrhages, which give the contents of the digestive 
tract the appearance of wine lees. 

The abdominal viscera scarcely present any characteristic lesions. 
The liver has the appearance of having been boiled, as in many forms 
of poisoning. The kidney is congested and blackish ; the spleen only 
appears hypertrophied when post-mortem examination has been delayed 
and micro-organisms from the intestine have invaded the circulatory sys- 
tem. After death the kidneys and spleen very rapidly undergo softening. 

Nervous form : Symptoms. Whilst in the first form the symptoms 
appear especially due to diastatic ferments present in the pulp liquid, 
in the nervous form they appear rather to result from the convulsing 
and paralysing action of ptomaines. 

The ox seems more particularly susceptible to the action of the latter. 
It shows symptoms resembling those of horses sufferiiig from a severe 
abdominal form of influenza : profound depression, mahogany- coloured 
conjunctiva, lachrymation, infiltration of the cornea, high temperature 
(104° to 106° Fahr.— 41° to 41-5° C), strong action of the heart, but 
small pulse. The cerebral symptoms are especially marked. The animal 
suffers from vertigo, and when excited, or when attempts are made to 
administer medicine, it thrusts its head against the wall, as though 



DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 261 

suffering from a cerebral tumour. It also shows hyperaesthesia, slight 
colic, and sensitiveness of the abdomen. 

In sheep the symptoms consist in alternate extreme depression and 
extreme excitability. 

In both species the termination is always rapid : death occurs in a 
few^ days. 

The abdominal lesions are identical with those of the acute form. 
They consist in gastro-enteritis, or, rather, intense congestion of the 
abomasum and intestine, with extravasation of blood around the acini 
of the glands and beneath the mucous membrane, etc., and in more or 
less marked desquamation of epithelium. 

The annexed organs sometimes present secondary changes : in the 
nervous centres the lesions are more marked ; the meninges are con- 
gested, in some cases inflamed, and cerebro-spinal fluid is present in 
increased quantity. 

Subacute or Chronic form : Symptoms. This form is equally 
frequent in the ox and sheep ; it develops insidiously, and for a time 
may escape detection. 

The symptoms are those of slight gastro-enteritis without tympa- 
nites; but this condition is succeeded by serous, foetid, uncontrollable 
diarrhoea, which weakens the animal and causes death from excessive 
wasting and hydr?emia. 

The sensitiveness of the entire right side of the abdomen, the special 
diarrhoea, the cardiac disturbance, and the widely-distributed oedema, 
usually suffice to prevent confusion with the ordinary forms of gastro- 
enteritis. In sheep the diarrhoea is blackish, sometimes blood-stained, 
and is accompanied by a sub-icteric or icteric tint of the mucous mem- 
branes, of the skin, and of all the tissues. The intensity of coloration 
affords a guide to the rapidity of development of the disease. The urine 
is also bile-stained, and there appears to be an exchange of functions 
between the two great depurative organs, the liver and kidney. The 
urine may become sanguinolent, because it contains either unchanged 
blood or simply dissolved haemoglobin. 

The lesions are similar to those previously described, but with 
modifications of intensity. When diarrhoea has been marked and per- 
sistent, the digestive mucous membrane is hardened, indurated, and 
appears as though tanned. This is due to chronic inflammation, 
probably to the gastro-enteritis with which the condition begins. The 
liver appears as if cooked ; the fat, the majority of the tissues, and 
especially the conjunctiva, exhibit a light yellow tint, pointing to hepatic 
disturbance. 

The diagnosis is generally easy in all three forms, provided that 
the food be examined. 



262 POISONING. 

The prognosis varies ; the acute and nervous forms are usually 
fatal. But Avlien the disease develops slowly, recovery may occur. 

Pathogeny. Practical observation and laboratory researches show- 
that the above conditions result from poisoning. Histological examina- 
tion of livers from sheep which have died rapidly shows complete 
degeneration of the hepatic cells, which become incapable of per- 
forming their function. The biliary acids, no longer being withdrawn 
from the circulating blood, produce general intoxication, destruction of 
the blood corpuscles, and the appearance of hfemapha-ic icterus and 
luemoglobinuria. 

Treatment. Being convinced that acidity alone caused this disease, 
the older practitioners suggested the administration of salines. In 
reality it is necessary to check fermentation. Drainage of the silos in 
which beet pulp is stored is often sufficient for this purjDose ; but if badly 
arranged, drainage rather assists the growth of moulds and various 
organisms in the mass, which affords a medium favourable to their 
multiplication. Complete desiccation would undoubtedly give much 
better results, but cannot economically be effected. The best practical 
measure consists in storing the pulp in special silos, divided into 
compartments by lattice work partitions. The escape of liquid is 
facilitated by forming the floors of the silo with a sufficient slope. 
Preservation, however, is not perfect, and some compartments are 
always found damaged. Excessive fermentation can be checked by 
adding ordinary salt to the pulp in the proportion of "2 per cent. 

Curative treatment com})rises restricted diet for several days, and the 
administration of milk, carbonate of soda, and stimulants, which favour 
excretion of the toxins. Some patients may be saved by subcutaneous 
injections of large quantities of normal salt solution. When poisoning 
is pronounced, and the viscera are clearly injured, it is more economical 
to slaughter the animals, provided that the icterus does not render the 
flesh useless for sale. 



CHAPTER VIII. 

PARASITES OF THE DIGESTIVE APPARATUS. 

Parasites of the digestive apparatus are extremely common in 
ruminants, some, like the infusoria of the rumen, being of no importance, 
others, on the contrary, appearing to play a predominating part in the 
development of certain forms of anaemia and serious wasting diseases, 
such as the various forms of gastro-intestinal strongylosis, coccidial 
enteritis, etc. 

GASTROJNTESTINAL STRONGYLOSIS IN SHEEP. 

PARASITIC CiASTRO-ENTERITIS. OVINE PASTEURELLOSIS. 

Verminous diseases of the abomasum are common in the sheep and 
goat, but (in France at least) appear rare in the ox. 

Causation. Gastro-intestinal strongylosis is produced by various 
parasites of the genus Strongylus, such as Strongylus contortus, 
Stronfjijlus conroluttis, Sfroiuii/his instahilis, Strongylus circumcinctus, 
Strongijlus ^fiUcoUs, which occur not only in the abomasum, but also 
in the small portions of the first intestine, sometimes in very large 
numbers. 

The first is a threadlilce worm, pointed at both extremities, and from 
^ to 1 inch in length. It exhibits a red tint, which zoologists refer to the 
presence of blood in its digestive apparatus, derived from the host's in- 
testinal mucous membrane. Some doubt has been thrown on the nature 
of this coloration, however ; and certain Italian authors, in common 
with Lignieres, have declared it due to a certain red pigment developed 
in the tissues of the parasite, the spectroscopic reaction of which differs 
from that of haemoglobin. 

The strongyles are said not to penetrate the mucous membrane, but 
simply live on the intestinal contents. This may be true of certain 
varieties, but it is none the less certain that others penetrate the mucous 
membrane deeply, even to the extent of becoming half-embedded in it. 
Particularly is this the case with Strongylus circuujcinctus, found in the 
epizooty which occurred at Grignon, and also found by Moussu in grave 
epizootics which he has from time to time investigated. 

According to Lignieres this gastro-intestinal strongylosis only plays a 



26-i PARASITES OF THE DIGESTIVE APPARATUS. 

trifling part in the development of the ahove-raentioned disease, which 
he dechires to be due to infection with a cocco-hacillus of the Pas- 
teurella group, the development of which alone, he states, explains 
all the symptoms. 

In France the disease now under consideration has never extended 
be3'ond limited regions, hut in A^rgentina, where Lignieres carried out his 
investigations, it is said to be very fatal. Lignieres bases his opinion on 
the following facts : — 

Firstly, that experimental verminous infection of young animals does 
not produce either anaemia or cachexia. 

Secondly, that animals in excellent condition may prove to be infested 
with large numbers of parasites. 

Thirdly, that animals which have succumbed to this disease, hitherto 
regarded as verminous, sometimes prove to harbour few or no parasites. 

Fourthly, that this grave and fatal disease, and the symptoms by 
which it is clinically recognised, can be produced with cultures of the 
cocco-bacillus, which he has isolated. 

These statements are very precise, but Mossu declares that he has 
never yet been convinced of the reliability of the last statement referring 
to experimental transmission, any more than of the data regarding 
alleged protective vaccination. 

The symptoms of gastro-intestinal strongylosis or ovine pasteurel- 
losis point to a progressive pernicious annemia of chronic or sul)acute 
form. Rapidly progressive cases are exceptional. 

In France the form seen is almost invariably chronic. The animals 
appear dull, sluggish, and feeble ; they lose appetite, waste, become 
anaemic, then cachectic, and, after several months, die of exhaustion 
and wasting, after having shown diarrhoea during the later stages. 

The ffeces are pasty, and exhale a very marked putrefactive odour. 
There is little room to doubt that auto-intoxication from resorption of 
intestinal products is continually going on. 

The animal's general appearance is bad, the ears are pendant, the 
wool is dry and dull, and can be removed in handfuls Ijy the slightest 
pull. There are no other external symptoms, and the diagnosis can only 
be arrived at by discovering the eggs of the parasite in the faeces. ■ 

Lesions. Post-mortem examination reveals all the general lesions 
of advanced cachexia and of gastro-enteritis of varying intensity. The 
abomasum and first portions of the small intestine usually contain a 
consideral)le number of strongyles ; tfieniae are often present in the 
intestine, and Moussu declares that he has always found a certain 
number of hooked worms and oesophagostomes. 

The peritoneal, pleuritic, and pericardial exudates common in most 
wasting conditions are always present, but the quantity of exudate in 



GASTRO-INTESTINAL STRONGYLOSIS IN SHEEP. 



265 



each cavity varies within wide Hmits. The Kquid may even resemble 
that due to inflammation or infection ; sometimes it is light pink or 
red in colour. 

Pulmonary lesions usually exist. Moussu has almost always found 
gastric strongylosis associated with pulmonary or tracheo-bronchic 
strongylosis, but Lignieres asserts that the Argentine cases showed 
nodules of hepatisation which had nothing to do with the pulmonary 
strongylosis, and which appeared to result from areas of pneumonia 
produced by the si)ecific cocco-bacillus and other organisms. He has 
even found abscesses and cavernous spaces in the lung. 

Pathogeny. According to Lignieres the specific agent of pernicious 
anpemia is a cocco-bacillus which stains well with fuchsin, violet, blue, 
safranin, etc., but does not 
take Gram, and which in 
cultures assumes either 
the strepto-bacillary form 
or occurs in barrel- shaped 
masses. It grows in simple 
bouillon at dS^ C, but 
better still in peptonised 
bouillon, which turns tur- 
bid for live or six days, 
afterwards becoming lim- 
pid in consequence of the 
organisms falling to the 
bottom of the vessel. It 
does not coagulate milk. 
On agar the culture is 
thin, bluish, shows an 
iridescent reflection, and 
when old appears whitish. 
Grown on gelatine, the appearances are similar — the gelatine is not 
liquefied ; on serum the pellicle is scarcely visible. 

The organism is said to be pathogenic for guinea-pigs, ral)bits, dogs, 
and, of course, for sheep. Moussu, however, does not consider that the 
reported cases of transmission through the blood stream or by subcu- 
taneous injection are really convincing or characteristic. He does not 
question the fact that Lignieres discovered a special pathogenic agent in 
all cases and in all his patients; but what appears to him debatable 
is the exclusive part which Lignieres attributes to that agent. 

The fact that in Argentina, just as in France, strongyles have always 
been discovered in epizootics of this nature of itself constitutes some- 
thing ; and causes the second fact, that it has never yet been proved 




Vui. 114. 



A\-astin- .In., t.) ■ 
strongylosis. 



2C6 PARASITES OF THE DIGESTIVE APPARATUS, 

that any heavy moi'tahty occurred in the ahsence of parasitic infestation, 
to assume considerable importance. Moussu regards these two facts as 
the greatest obstacles to Lignieres' theory. He states that in his view 
the verminous affection is the essential, primordial and primitive 
affection, and that microbic infection is only secondar}^ and an almost 
inevitable result of grave verminous infestation. 

It is quite certainly wrong to think that verminous affections may 
continue with scarcely any injury to the animal, especially when such a 
belief is based on observation of a few parasites which are not of a pre- 
datory character. In most cases of the kind now under consideration, 
the various parasites found {Stronf/ijlus circuiiicinctus and fiUcoUs, Anchy- 
lostomes, etc.) cause more or less grave lesions. 

These intestinal wounds facilitate the infection to which the fatal 
course of the disease is due. The disease, then, is not a special unvarying 
infection, but consists of multiple superposed infections. 

It is wrong to l)elieve and to teach that the parasitic disease is of 
no importance, and Moussu declares his belief that the proposed vacci- 
nations will prove unavailing. He is of opinion, on the other hand, 
that when the parasitic invasion can be overcome the mortality will 
be checked, and only those animals which are already suffering from 
severe infections will succumb. Is not this precisely what has been 
observed in human pathology regarding miners' anfemia or miners' 
worm disease (anchylostomiasis) ? 

The diagnosis presents no difficulty for 'those who liave had a little 
practice with the microscope, since the presence of eggs of the parasite 
can always be detected in the fteces in cases where external signs have 
given rise to suspicion of gastro-entestinal strongylosis. 

The macroscopic diagnosis on post-mortem examination is not so easy 
as might be supposed, and when very small varieties are in question it is 
sometimes necessary to examine the mucous membrane of the abomasum 
or intestine very carefully in order to discover the parasite. 

The prognosis is grave, because before attention has been drawn to 
many patients, the entire herd may be more or less infested. It is also 
grave because the pastures are infested with eggs or embryos, and the 
power of increase of these parasites is enormous. 

Treatment. The earliest and most energetic means should be 
adopted in all cases. Treatment comprises : — 

Drainage of swampy pastures. 

Dressing of the pastures with chemical manures, preferably with 
iron sulphate, at the rate of 40 to 80 lbs. per acre. 

Disinfection of manure to destroy the contained eggs or embryos. 

The use of chalk, iron sulphate, various acids, etc. 

As regards curative treatment, the diseased animals should be grouped 



LUMBKICOSIS OF CALVES. 267 

and isolated as far as possible, and should receive doses of the following 
vermifuge :— 

Powdered areca nnt . . . . . , . . . . . . 2 ounces. 

Arsenic . . . . . . . . . . . . . 30 grains. 

The above is sufficient for ten animals, and a dose should be given 
daily for a period of six days in a small quantity of bran. Treatment 
is completed by abundant nourishment, and by distributing about the 
pastures pieces of rock-salt suitably protected.. 

Many other vermicides or vermifuges have been suggested, but are 
less easy to use. They comprise essence of turpentine, mixtures of 
oil with essence of turpentine and benzine, picrate of potash in doses 
of 7 to 20 grains per day, ethereal extract of male fern, etc. 

LUMBRICOSIS OF CALVES. 

Following the example of human medicine, we apply the term 
" lumbricosis " to a disease caused by ascarides in calves, although 
Neumann separates the ascarides of calves from the lumbricoid ascarides 
with which they are usually confused in current practice. 

Causation. The disease is exclusively due to infestation with embryos 
of the parasite, which in young calves afterwards develop in the first 
portions of the intestine and in the abomasum, interfering with secretion, 
and producing mechanical disturbance, colic, and digestive irregularity, 
eventually followed by marked loss of condition. Death may even follow, 
either from rupture of the pylorus or duodenum, or from secondary 
septicaemia of intestinal origin, due to the parasites burrowing into the 
mucous membrane and facilitating infection. In adults of all species 
lumbricosis is rare. It occurs principally in young animals from the 
time of weaning up to the age of eighteen months or two years. 

The diagnosis cannot usually be formed until the parasites are 
found in the ffeces, but microscopic examination sometimes reveals the 
presence of the eggs, and thus excites suspicion. 

Provided the condition is diagnosed early, the prognosis is not 
grave ; but when patients have become exhausted and anfemic they re- 
quire a long time to recover, even when freed from parasites. 

Treatment. Guittard recommends empyreumatic oil as very effica- 
cious, and gives it in doses of 2^ to 3 drachms diluted with ordinary oil, 
or emulsified with any kind of mucilage. 

Calomel gives good results, and may be administered in doses of 15 to 
60 grains, according to the animal's age and size. 

Powdered areca nut would probably be easier to administer with the 
food. Oil of turpentine is given mixed with ordinary oil, but its action 
is less certain. 



268 PARASITES OF THE DIGESTIVE APPARATUS. 



STRONGYLOSIS OF THE ABOMASUM IN THE OX. 

Altboufi;h well studied by Stadelmann and Ostertag in Germany, and 
by Stiles in x\merica, this disease has not 3'et been regarded in France as 
giving rise to accidents. 

It is produced by the Strongyhis convolutus rel Ostertarii, which 
becomes embedded under the epithelium of the mucous membrane and 
causes the formation of small nodules, the size of a pin's head or lentil, 
which can be detected on palpation. The cavity thus formed beneath 
the epithelium communicates with the gastric cavity by a little orifice, 
through which the cephalic end of the parasite passes. 

PARASITIC G ASTRO-ENTERITIS, DIARRHOEA, AND ANAEMIA 
IN CATTLE, SHEEP AND LAMBS. 

A disease characterised by anaemia with wasting and diarrhoea is 
sometimes produced in cattle by the presence in the fourth stomach 
of small strongyles varying in size between 3 and 9 millimetres in length, 
according to the variety encountered. One variety of the smaller size 
has been named by McFadyean Strongi/hts graciUs. Penberthy, who 
described the disease in the Jour, of Comp. Path, and Therap. for 1894, 
p. 249, states that in certain cases he also found the Strongj/lus ventri- 
cosKS, the Tricocephaliis qffiinis, and minute straight worms about -^^ of 
an inch long, which he regarded as anguillulfe. Neumann declares 
that pernicious anaemia with catarrh of the abomasum in young animals 
is due to Strongylus conrolatiis. 

The symptoms comprise anaemia, wasting, and diarrhoea of varying 
severity. In acute cases, which are common between the ages of six 
months and two years, husk is sometimes (accidentally) present. The 
disease is rarest in summer. Certain animals lose flesh rapidly, though 
appetite is retained. Acute foetid watery diarrhoea follows. The animal 
shows tenesmus, appears dejected, and has a temperature of 103° to 
105° Fahr. The mucous membranes become pale, the pulse small and 
weak, the appetite capricious, the eyes sunken, belly tucked up, coat harsh 
and dry and hide tight. Wasting is rapid. The animals are listless, and 
often lie down for long periods. Death occurs from exhaustion. 

The parasite. Scrapings from the abomasum and intestine when 
diluted with water and viewed under a lens show minute bodies re- 
sembling short, fine hairs. When isolated these are easily visible with 
the naked eye. In situ they appear to be lying on the mucous mem- 
brane, sometimes with the head fixed in the latter. They vary in length • 
from 7^^3 to 2*^- of an inch, and are brownish in colour. For a detailed 
description see Penberthy loc. cit. McFadj'ean (Jour, of Comp. Path, and 



PARASITIC GASTRO-ENTERITIS, ETC., IN CATTLE, SHEEP AND LAMBS. 269 



Therap. for 1896, p. 314) also gives a very full description, illustrated by 
plates, of the two species of strongyles which he regards as the cause 
of gastritis in cattle in England. 

The lesions are those of wasting diseases. The first three gastric 
compartments may be thin, but usually show no abnormality. The 
mucous membrane of the abomasum shows evidences of catarrh, is 
sometimes covered with a loose croupous material, or is denuded of its 
epithelium and even extensively destroyed. In acute cases it is more 
or less deeply reddened over spots or extensive patches. Occasionally 
it appears jelly-like, owing to effusion into its substance. Except for 
the catarrhal condition 
the small intestines may 
be healthy, but the large, 
especially the colon and 
ciecum, show lesions simi- 
lar to, l)ut more pro- 
nounced than, those of 
the abomasum. 

The treatment com- 
prises administration of 
the usual vermifuges, of 
which Penberthy prefers 
turpentine. The diet 
should be nutritious and 
easily digestible. Among 
drugs, non - irritant iron 
salts, cod liver oil, bitter 
vegetable tonics and com- 
mon salt are recom- 
mended. The animals should be housed and kept warm ; the litter, 
containing parasites, should be destroyed. The pastures may be dressed 
with salt and lime ; those worst infected should be ploughed. An un- 
infected water supply is essential- 
Parasitic Gastro-enteritis in Sheep and Lambs. A disease in seven 
to eight months old lambs, closely resembling the above, was described 
by McEadyean in the Jour, of Comp. Path, and Therap. for 1897, p. 48. 
Sheep over one year old w-ere not affected. 

The symptoms comprised diarrhoea, rapid wasting, impaired appetite, 
thirst, a tendency to lick and swallow sand or earth, dulness, and con- 
tinued fever (105° to 108° Eahr.). There was no evidence of acute pain 
or of marked cough. 

Duration. The disease sometimes proved fatal in one or two days, 
but sometimes extended over several days or weeks. The mortality 




Fig. 115. — Caudal extreiuitj- of luale Strojif/ijln.H cer- 
vicoritis. (Block kindly lent by Prof. McFadyean. 



270 



PARASITES OF THE DIGESTIVE APPARATUS. 



varied from 10 to 20 per cent., but in many cases almost all the 
members of a flock exhibited diarrhoea and loss of condition. 

The cause appeared to be the presence of small nematode worms in 
the fourth stomach, which generally exhibited gastritis with inflammatory 
congestion of the mucous membrane, though in a considerable number 
of cases the lining membrane of the stomach was markedly ansemic. In 
a large number of cases the irritation of the mucous membrane was 
continued into the duodenum, but as a rule the remainder of the small 
intestine was not inflamed. 

The worms named by McFadyean Stronf/ijlus ccrvicornis are from 10 

to 12 mm. in length, so that although not of mTcroscopic dimensions 

they cannot be seen when suspended in the stomach contents. They 

are readily detected in microscopical preparations under a low power. 

The treatment is similar to that of gastro-enteritis in cattle, but chief 

attention should be directed to 
prophylaxis. 

* * * * 

A verminous disease, closely 
simulating the above, and 
affecting cattle, sheep, and 
goats in Texas, is described 
by Ch. Wardell Stiles in the 
Annual Eeport of the United 
States Department of Agricul- 
ture for 1900, p. 356. The 
disease was of mixed character, 
and consisted in various de- 
grees of verminous gastritis, 
verminous enteritis, and ver- 
minous bronchitis. In the 
stomach were found the common twisted wireworm {Stroiigi/hts contortus) 
and Ostertag's encysted wireworm {Stronr/yJiis Ostertagi). It appeared to 
be present in every calf, steer and cow examined (post-mortem), and was 
undoubtedly the chief agent in causing death. The sheep and goats 
were very similarly aflected. In the bowel of cattle were found the 
hookworm {Uiicinana radiata), nodular disease worm {(Esophagostoma 
(■ohiiiihidiium) : in that of sheep the hookworm {Uncinaria cernua) and 
nodular disease worm {(Eso})h ago stoma cohimhiaiim)i), and the fringed 
tapeworm {TJiysanosovia actiiiioidcs). In the lungs of the cattle Stron- 
gylits micrnrus (the small-tailed lungworm), and of sheep the thread- 
worm strongyle {Stwiigijliis filaria) were detected. 

Treatment. Sulphate of copper, gasoline and coal-tar creosote 
were tried, but the best results were obtained from doses of 30 grains 




Fig. 116. — Caudal extremity of male Stroii 
gylus confoiiiis. (Block kindly lent by Prof 
McFadyean.) 



Intestinal coccidiosis of calves and lambs. 271 

(for a lamb) up to 100 grains (for a two-year-old sheep) of thymol in 
1 per cent, coal-tar creosote solution. 

INTESTINAL COCCIDIOSIS OF CALVES AND LAMBS (PSORO- 
SPERMOSIS, H/EMORRHAGIC ENTERITIS, BLOODY FLUX, 
DYSENTERY, ETC.). 

History. This disease is very common in the Avalon and surrounding 
districts, sometimes assumes the characteristics of a true epizootic, and 
affects young bovine animals between the ages of six months and two 
years, but is commonest and most contagious in animals of from ten to 
eighteen months old. 

It attacks animals in good or bad condition, without distinction of 
breed or species. It begins towards the end of July, attains its maximum 
development towards the end of August and September, and dis- 
appears in October, though occasionally it continues until November. 
In exceptional cases Degoix has seen it during January and February in 
animals which had returned from the fields to the byres about the end 
of November. It develops earlier than verminous bronchitis, in con- 
junction with which, however, it often occurs. It is commonest in warm, 
moist, rainy years, and amongst animals pastured on swampy ground 
containing numerous springs and streams. Year after year it attacks 
animals occupying particular pastures in summer. The soil of these 
pastures is undoubtedly infested with the germs of the disease, just as 
in places the soil is infested with anthrax bacilli. The appearance of 
symptoms is preceded by an incubation period of one or two months. 
The length of this incubation period is fixed by the observations which 
Degoix has made during the past twenty years, and depends on the time 
which elapses between the animals being turned into infected pastures 
and the appearance of the preliminary symptoms. 

Symptoms. The disease commences with liquid, serous, fcetid, 
greenish-black diarrhcea, the material being voided without special strain- 
ing and the animals losing neither their spirits nor appetite. Fever can 
scarcely be detected, the temperature ranging between 38° and 39° C. 
On the second or third day the diarrhoea changes in character. Though 
it always remains fcetid, it now becomes mucous, reddish-black, or 
sanguinolent, and contains more or less frequent blood clots of varying 
size. 

The passage of this material causes violent straining, which becomes 
more and more common, and is accompanied by very pronounced rectal 
tenesmus. The animals stand with their backs arched for one or two 
minutes, sometimes longer, and the liquid escapes in large quantities, 
soiling the quarters and hocks. The animals are dull, show a certain 



272 PARASITES OF THE DlGPISTIVE APPARATUS. 

degree of colic, and frequently grind the teeth. Appetite is lost, thirst is 
severe, and rumination ceases. Wasting makes rapid strides, the coat 
stares, the animals have difiticulty in standing on account of their weak- 
ness, fever sets in, and the temperature rises to 40° C. This condition 
may last from five to ten days and terminate either in recovery or death. 
Kecovery is frequently rapid in animals which have continued to eat, and 
in which the acute period has heen of short duration — five to seven days 
at most. On the other hand, it is slow if the appetite has disappeared 
and the acute period has heen prolonged beyond ten days. 

The diarrhoea, which has lost its sanguinolent character towards the 
sixth or eighth day, may continue for somewhat longer. The attacks of 
straining become rare, and cease between the tenth and fifteenth days. 
The appetite remains capricious for a long time. 

Convalescence is marked by alternate improvement and retrogression. 
The animals are weak, and only recover quickly under energetic treatment 
and forced feeding with concentrated digestible foods like milk, soup, 
cooked grain, etc., administered for three weeks or more. 

Death may occur towards the tenth or fifteenth day from exhaustion. 
The patients become very anaemic and thin, the eyes are withdrawn into 
the orbits, and the animals aj^pear indifferent to what goes on about 
them. They still groan feebly, occasionally grind the teeth, and lie con- 
tinually on the chest with the head extended. The body temperature 
falls and death follows. 

In well-bred animals in good condition the disease sometimes assumes 
a much graver and more rapidly progressive form, with peracute symp- 
toms, and makes as many, if not more, victims than that previously 
described. 

The process is as follows : After suffering for a day from serous 
diarrhoea, to which the owners pay little attention, the animals show 
sanguinolent diarrhoea and pass blood clots. This is almost immediately 
followed by very violent convulsive attacks — true eclampsia. The 
animals are then unable to stand, lie on the side with the head 
outstretched and resting on the ground, the eyes withdrawn into the 
sockets and often showing pirouetting movements (nystagnuis), the neck 
drawn upwards and backwards (opisthotonos), and the limbs rigidly 
extended. From time to time the wdiole body is shaken by extremely 
violent convulsive movements. 

This condition, which is sometimes preceded by weakness of the hind 
quarters and symptoms of locomotor ataxia and inco-ordination, may con- 
tinue from six Lo thirty-six hours ; in nine cases out of ten it terminates 
in death. 

Causation. On microscopic examination of the serous dejections 
one finds distributed throughout the liquid mass very small numbers of 



INTESTINAL COCCIDIOSIS OF CALVES AND LAMBS. 273 

ovoid corpuscles having a double outline, and contents of varied 
appearance ; these are the coccidia. 

When the diarrhoea has become sanguinolent and muco-fibrinous, the 
fluid contains these coccidia in considerable quantities, and large numbers 
of them may be found in the mucus, where they are mixed with epithelial 
dehris, blood corpuscles, and lymphatic cells, etc. They are rarer in the 
clots. Coccidia cannot be found in the f^ces of healthy animals, even in 
those occupying the same pastures with the diseased. Should the clinical 
symptoms be thought insufficient of themselves clearly to identify the 
disease, a simple microscopic examination of the faeces will remove any 
doubt. 

Lesions. Post-mortem examination immediately after death enables 
one exactly to identify the habitat of the parasite and the lesions it pro- 
duces. These lesions are to be found throughout the large intestine, 
from the caecum to the anus. 

The large intestine is almost or entirely empty, the mucous membrane 
is reddish-brown in colour, lies in folds, is cedematous, and everywhere 
covered with a coating of mucus. This coating varies in character at 
different points ; in places it forms more or less thickened patches of 
greyish or yellowish colour, and of a resistant character, as though mixed 
with coagulated fibrin. These patches are fairly well defined, they are 
irregular in form, and vary in width from some millimetres up to several 
centimetres. They are more or less adherent to the mucous membrane, 
from which they can easily he stripped away. The mucous membrane 
thus exposed is slightly depressed, and of a whitish colour, thus markedly 
contrasting with the surrounding red coloration. This depression repre- 
sents a slight ulceration, which, though superficial, is clearly visible to 
the naked eye. 

Microscopic examination of the mucus patches reveals the existence, 
both superficially and in the depths, of epithelial cells derived from the 
mucous membrane, of vesicular cells derived from the Lieberkuhnian 
follicles, of numerous blood and lymphatic corpuscles, and, distributed 
irregularly throughout this mass of cells, of coccidia, resembling those 
found in the dejections. 

In thin sections of the intestine, made through the ulcerated mucus- 
covered patches, and in a direction perpendicular to the mucous 
membrane, one finds that the epithelial covering of the intestine has 
disappeared. 

The Lieberkuhn's follicles are shortened, their orifices are irregular 
and partly blocked with epithelial debris. In a large number of these 
follicles the blind extremity is dilated, and more or less filled with coccidia, 
varying in appearance according to their stage of development. The 
epithelial cells normally lining these blind ends seem to have disappeared, 

D.c. T 



274 PARASITES OF THE DIGESTIVE APPARATUS. 

and to have been replaced by the parasites. This, however, is not really 
the case. It is easy to prove by suitable dissection (after maceration of 
the sections in 30 per cent, alcohol) that the coccidia are lodged in epithe- 
lial cells which have become modified in shape and undergone hypertrophy 
as the parasite has grown, whilst the nucleus has been pushed to one end 
and undergone atrophy. 

Alongside the deceased glands may be found others which are quite 
healthy. In the parts which are most markedly affected the interglan- 
dular connective tissue is infiltrated and slightly thickened. Degoix has 
never discovered coccidia in the cells of the intestinal mucous membrane 
itself. The lesions may be met with throughout the large intestine, but 
are more numerous and grave as the rectum is approached. 

This disease is characterised by extensive inflammation, affecting the 
entire mucous membrane of the large intestine, by more or less extensive 
ulceration of this bowel, the ulcers being covered with muco-fibrinous 
patches rich in coccidia, by localisation of the parasites in the epithelial 
cells of the glandular cul-de-sac, by the appearance of the disease at a 
special time of year and in special districts, where it assumes the form 
of an enzooty, and by the fact that it always appears in the same pastures. 
The mortality varies between 12 and 25 per cent, from year to year. 

Microscopic appearances. The protozoa which produce this disease 
assume the form of ovoid cysts, varying in length from 18 to 25 ^, and 
measuring at the widest part about 13 /x. They possess a hyaline envelope 
whose existence is proved by its double contour line, and yellowish, 
granular, highly refractile contents. This granular material does not 
always occupy the whole of the cavity. At a certain stage of develop- 
ment it collects towards the centre, forming a nucleus and leaving clear 
spaces at the poles of the cell. At a later stage this nucleus divides into 
four portions which afterwards separate. 

Treatment. The protozoa, in their cystic condition, are very resistant 
to destructive influences. The most common natural cause of their de- 
struction is drying in the open air. Unfortunately, in the localities where 
the patients usually live, that is, filthy byres, wet pasturages, etc., this 
destruction only takes place to a very limited extent. 

The disease can be attacked by prophylactic and therapeutic measures. 

Prophylaxis consists — firstly, in destroying the parasites contained in 
the dejections by the free use of 3 per cent, sulphuric acid solution ; and, 
secondly, in removing the 3^oong animals from infected fields during the 
months between June and September. 

Therapeutic treatment comprises — firstly, stimulant applications 
to the abdomen ; secondly, disinfection of the intestine by the adminis- 
tration of salol, benzo-naphthol, very diluted solutions of creolin, etc ; 
thirdly, intestinal irrigation by the administration of mucilaginous drinks 



INTESTINAL HELMINTHIASIS IN RUMINANTS. 275 

containing bicarbonate of soda, supplemented by general tonic treatment 

and the supply of concentrated, very nourishing, and easily digested food 

(Degoix, Revue genemle de Mcdecine VHerinaire, No. 28, February 15th, 

1904, p. 177). 

***** 

McFadyean describes a similar disease to the above in two to three 
months old lambs {Jour, of Comp. Path, and Therap., March, 1896, p. 31). 
The mortality reached 10 per cent. The lambs at the time the disease 
broke out in the flock were closely folded together with the ewes on 
growing roots, which, needless to say, were much soiled with earth and 
fseces before they were completely consumed. 

INTESTINAL HELMINTHIASIS IN RUMINANTS 
(Ox, Sheep, Goat). 

Verminous disease of the intestine is often accompanied by similar 
disease of the stomach (gastro-intestinal strongylosis of the sheep, lum- 
bricosis of the calf), but it also occurs apart from the 
presence of gastric parasites. Parasites are more 
frequent in the intestine than in the abomasum, 
because the alkaline intestinal juices prove a much 
more favourable medium for their development than 
do the acid juices of the stomach. 

The actual parasites may include ascarides, stron- 
gyles, hooked worms, oesophagostomes, tricocephales, 
sclerostomes, and various taeniae (Tcenia expansa et 
alba). Many of these have already been, or will here- 
after be, referred to. ^^«- Ii7--Head of 

TT- ,.,,.. , , , ,., . Tcenia alba of the 

Helmmthiasis due to round worms like stron- -, , ,.., 

ox and sheep. (After 

and the various forms of hooked worm, is Neumann.) 




graver than that due to flat worms, but most extra- 
ordinarily varied collections are sometimes met with. Speaking gene- 
rally, however, helminthiasis more particularly affects young animals 
like calves, lambs, and yearling sheep, is rarer in adults, and in all cases 
the complications it produces are of trifling importance in adults as com- 
pared with those caused in the young. 

The persistence of verminous diseases in certain infested countries, 
districts, farms, or pastures is explained by the enormous number of eggs 
or embryos passed with the faeces and disseminated with manure, as well 
as by the high degree of resistance of the eggs and embryos to destructive 
influences. 

Causation. The various forms of intestinal helminthiasis are all due 
to embryos or eggs of worms obtaining entrance to the stomach or bowels 

T 2 



276 



PARASITES OF THE DIGESTIVE APPARATUS. 



of suscepti])le animals. Nevertheless, external conditions largel}^ favour 
infestation. The existence of marshes, ponds, and stag- 
nant water on certain pastures, heavy annual rainfall, 
the occurrence of wet seasons, etc., favour the existence 
and growth of embryos, and, as a consequence, the in- 
festation of animals. 

The symptoms of intestinal helminthiasis are always 
very vague, whether the victims be oxen, sheep, or goats. 
They point to the slow and progressive development of 
a pernicious anremia, characterised primarily by inter- 
ference with appetite and digestion, then by anaemia, 
and finally by cachexia. The patients are dull, lose 
condition, suffer from depraved appetite, and, during 
the cachectic period, from diarrhoea, and die in a con- 
dition of exhaustion. These forms of helminthiasis are 
much more frequent in sheep than in oxen. 

The diagnosis is only arrived at by discovering 
parasites in the fteces, or, in those doubtful cases where 
one has been led to make a microscopic examination 
of the excrement, by the detection of large numl)ers 
of eggs. 

From an economic standpohit the prognosis is grave, 
l)ecause severely infected animals recover their condi- 
tion very slowly, whatever treatment be adopted. 

Treatment includes the measures previously indi- 
cated regarding the destruction of germs, eggs, or em- 
Ijryos distributed over the pastures, and the drainage of 
wet grounds and stagnant pools. Where such diseases 
are common, the pastures should be dressed with iron 
sulphate, and the stable manure disinfected or burned. 

Curative treatment comprises the administration of 
such anthelmintics as can be given with the food. They 
should not require to be administered by force, as this 
proceeding would not only necessitate a great loss of 
time, but might result in accidents. 

Arsenious acid, in doses of 15 grains per day, and 
tartar emetic, in doses of 75 to 150 grains, according to 
the animal's size, are among the best drugs for oxen, and 
may be given for four or five days running. Benzine, 
oil of turpentine, and empyreumatic oil are more diffi- 
cult to administer. 
In the case of sheep, preference should be given to areca nut, 
in doses of 75 to 120 grains, according to the animal's size, and to 



\ 


1 


Fig. 118 


.—Adult 


specimen of the 
fringed tape- 
worm {Thi/m- 


nosoma actini- 
oides). (After 
Stiles, 1893.) 



INTESTINAL HELMINTHIASIS IN RUMINANTS. 



277 



tansy, which are convenient to give, and can be added to bran, oats, or 
beetroot. 

Adult tapeworms of oxen are of relatively minor importance, but one 
tapeworm of sheep, viz., the fringed tapeworm {Thysanosoma actinioides), 
also known as Tuniia JiiKhviata ; Moniezia funhnaia deserves notice. 




Fig. 119. — Ventral and apex views of the head of the fringed tapeworm 
{Thijsanosoma actinioides). X 17. (After Stiles, 1893.) 

as at times it forms a veritable scourge to the sheep industry of 
North America and South America. 

Disease. The disease in sheep caused by the fringed tapeworm has 
l)een studied in detail by Curtice, who considers that next to scab it is 
the most important sheep disease of the western plains of North America. 
The financial loss it causes is extensive, and results from the failure of 
the lambs to fatten, the small crop of wool, and the weakening of the 
animals, so that they cannot withstand cold winter weather. The para- 
sites develop slowly, and are present in considerable numbers before their 




Fig. 120. — Segments of the fringed tapeworm {Thysanosoma actinioides), 
showing canals and nerves, and (/) frmged border, {t) testicles, and {ut) 
uterus. Enlarged. (After Stiles, 1893.) 



presence is suspected. Toward September the lambs fail to grow as they 
should ; in November the symptoms are marked. First, the w^orms pro- 
duce local irritation of the intestine, which finally develops into a chronic 
catarrhal inflammation ; their presence in the gall-ducts produces similar 
results, and obstructs the flow of bile ; infected lambs are large-headed, 
under-sized, and hide-bound ; their gait is rheumatic, and they appear 
more erratic than the other sheep, standing oftener to stamp at the 
sheep-dogs or herds, and lagging behind the flock when driven ; the 



278 PARASITES OF THE DIGESTIVE APPARATUS. 

general symptoms are those of malnutrition, and Curtice considers them 
nearly identical with the symptoms of the " loco " disease ; in fact, he 
states that it is extremely difficult to distinguish between the two diseases, 
and believes that the fact that the worms " may tend to produce depraved 
appetites and a morbid craze for a particular food is also reason for sus- 
pecting that the loco disease may depend on the tapeworm disease." 
General systemic disturbances result from malnutrition ; the usual fat 
is absent ; serous effusions are noticed in the body-cavities, serous infil- 
tration in the connective tissue. 

Treatment is similar to that of parasitic gastro-enteritis of sheep and 
lambs (wliich see). 



CHAPTER IX. 
DISEASES OF THE LIVER. 

From the physiological standpoint the liver is an organ of such im- 
portance that its pathology should be studied as completely as possible. 
Furthermore, it is often the seat of a number of varying lesions, either of 
parasitic, toxic, infectious, or cancerous origin. 

In animals of the bovine species the liver is placed in the right retro- 
diaphragmatic region, so that it is somewhat difficult to examine by any 
of the ordinary methods, like palpation and percussion. Under normal 
conditions it is entirely concealed beneath the hypochondrium, except 
towards the upper margin of the thirteenth rib, where it can be examined 
by palpation. When, as in various morbid conditions, it is considerably 
increased in size, it extends as far as the margin of the hypochondriac 
circle, thus becoming directly accessible to palpation and percussion. 
Sometimes it even enters the hypochondriac region, passing outside the 
omasum and abomasum, which it then thrusts towards the middle of the 
abdominal cavity. 

The margin of the liver exhibits a depression lodging the gall bladder 
nearly opposite the centre of its vertical depth. 

As the liver is so deeply situated, percussion is found to be the method 
of examination which gives the best results. Beyond the limits of the 
zone of auscultation, percussion gives above a semi-dull sound, then, 
proceeding downwards, a dull sound due to the liver, the omasum, and 
the collection of liquid in the bowel. When this dulness is well defined, 
clear, broad from above downwards, and extends to or beyond the hypo- 
chondrium, it indicates hypertrophy of the liver. By deep palpation of 
the posterior margin of the hypochondrium the liver can then be sounded, 
and its excessive size detected. 

The symptomatology of the liver is still very imperfectly understood, 
for in practice the urine is rarely tested for bile pigments, nor attempts 
made to ascertain whether the glycogenic function is normal by the test 
for alimentary glycosuria. 

In this connection nothing has yet been done to assist in diagnosing 
certain hepatic conditions. Fortunately, those diseases of the liver 
which we have to study are more often of a parasitic nature than true 
diseases of the hepatic tissue. 



280 DISEASES OF THE LIVER. 

The reported cases of venous or biliary cirrhosis, moreover, are too ill- 
defined and too incomplete to be taken as a type for description. We 
leave them on one side. In a similar way, apart from parasitic cholan- 
geitis and cholecystitis, inflammations of the biliary ducts are little 
known, and are rare. 

CONGESTION OF THE LIVER. 

In bovine pathology only passive congestion of the liver, often a result 
of various primary affections with cardiac lesions, is well recognised. 

Active congestions probably occur during infections or intoxica- 
tions of various kinds, but have not been made the object of special 
research. 

Among diseases likely to produce passive congestion must be included 
all those which interfere with the return circulation through the posterior 
vena cava. All cardiac affections with lesions of the valves or orifices of 
the right heart, all forms of pericarditis, tumours or lesions of the 
mediastinum compressing the posterior vena cava, produce stasis, 
passive congestion, and progressive development of what is called 
" cardiac liver." 

Symptoms. The liver is considerably hypertrophied, as a consequence 
of the stasis of blood and progressive dilatation of the portal system. Its 
zone of dulness increases in size, whilst on palpation its borders may 
sometimes be detected. This condition is always accompanied by 
digestive disturbance. 

The function of the liver is more or less interfered with ; the urine is 
scanty in amount and charged with deposit. Ascites of varying intensity 
frequently occurs ; cardiac disturbance accompanies or usually precedes 
the above symptoms. 

The lesions of passive congestion are represented by progressive 
dilatation of the entire portal venous system (nutmeg liver). In time 
this dilatation may produce biliary cirrhosis, as a result of chronic 
irritation of the blood-vessels and perivenous inflammation. This 
condition is known as " cardiac cirrhosis of the liver." 

The diagnosis of this pathological condition is generally easy, provided 
that the primary disease which causes it be recognised. 

The prognosis is always grave, and the practitioner is limited to 
treating the primary affection, such as endocarditis, pericarditis, etc. 

NODULAR NECROSING HEPATITIS. 

This form of inflammation of the liver is somewhat rare in animals of 
the bovine species. The disease is difficult to diagnose, and is often only 
recognised on post-mortem examination. 



NODULAR NECROSING HEPATITIS. 



281 



Isolated tracts of the liver become inflamed, between which the rest of 
the tissue preserves its normal character ; the parts affected appear to 
undergo complete degeneration, the cause of which is difficult to 
explain. On examining affected animals after death, the liver is found 
to be greatly enlarged, and apparently invaded by multiple tumours. On 
section, the parenchyma generally is of normal colour, but' the diseased 
parts are represented by dirty greyish-yellow tissue of a lardaceous 
character, somewhat resistant to the knife. 

The affected spots vary in size, between that of a lentil or hazel nut 
and an egg, and are formed of necrotic tissue. 

The periphery is the seat of true chronic fibro-plastic inflammation. 

Causation. According to Stabbe, these lesions are produced by 
microbes, originating -in the intestines, and carried to the liver by the 




Fig. 121. — Appearance of the liver in necrosing hepatitis 



mesenteric veins. The lesions and blood of the liver yield cultures of a 
microbe resembling that of necrosis ; nevertheless, such lesions have not 
been experimentally reproduced. 

According to Berndt, infection from the uterus is possible, and indeed 
probable. Moussu has only seen three cases of this particular condition 
of the liver in living animals. Two of these were in a working ox and a 
bull respectively, so that Berndt's view would not seem to be exclusively 
applicable. Moussu is convinced that infection is of intestinal origin, 
and that it takes place through the mesenteric veins ; he claims to 
have found the proof of this in the existence of multiple pylephlebitis 
and complete obliteration of the subhepatic veins in some cases. 

Symptoms. The symptoms are so vague as to render diagnosis diffi- 
cult. Berndt, on the other hand, regards it as fairly easy. He states 



282 DISEASES OF THE LIYER. 

that the disease occurs in old cows, which after parturition show loss of 
appetite, polydipsia, fever, dyspnoea, and short, feeble cough, suggesting 
pneumonia. After a few days the animals appear extremely weak, 
remain lying for long periods, and exhibit icterus. Percussion of the 
liver detects abnormal sensibility and hypertrophy. 

The three cases seen by Moussu showed only slight yellowness of the 
membranes, general weakness and difficulty in walking, which at first 
glance appeared to suggest laminitis, marked hypertrophy of the liver, 
sensitiveness over the hepatic region, and, as complications, uncontrollable 
diarrhcea and peritonitis. But these symptoms are also noted in suppu- 
rating echinococcosis, and even in cancer of the biliary ducts, so that 
diagnosis does not appear easy. Nevertheless, there is alwaj's marked 
fever, and on post-mortem examination it is not* unusual to find, in 
addition to the hepatic lesions, a certain amount of perihepatitis, partial 
peritonitis, and even pleurisy in the region of the diaphragm. The 
question is of little practical importance, for the gravity of the disease 
just described is such that economically no treatment is possible. The 
great point lies in correctly diagnosing disease of the liver, and that is 
relatively easy. 

CANCER OF THE LIVER AND BILE DUCTS. 

Cancer of the liver, that is, broadly speaking, the development in the 
liver of malignant tumours, capable of becoming generalised throughout 
the organism, is comparatively rare when compared, with parasitic 
diseases of the same organ. It may be primary or secondary in 
character, but is much more frequently secondary. In bovines primary 
cancer assumes the forms of adenomata, trabecular epitheliomata, or 
adeno-carcinomata. Moussu describes a case in which the growths 
assumed the form of papillomata or adeno-papillomata extending 
throughout the biliary ducts, and partly obstructing the common bile 
duct, which was greatly dilated. 

The real cause of these, as of all other primary tumours, remains 
shrouded in mystery. 

Secondary cancer is more frequent ; it occurs usually in the form 
of little isolated tumours (nodular cancer) of varying size and greyish 
colour. 

Symptoms. Clinically the description, or rather the identification, 
of cancers of the liver is difficult, and the diagnosis particularly trouble- 
some in cases of primary cancer. 

In secondary cancer (following tumour of the testicle in oxen castrated 
by the method of bistournage, for example) the general condition, on the 
other hand, is usually so afiected that attention is pointedly drawn to the 



ECHINOCOCCOSIS OF THE LIVER. 



283 



seat of the secondary growths. The patients lose appetite, the fteces 
become foetid, and diarrhoea sets in without clear signs of enteritis. 

Examination of the liver always reveals hypertrophy, and sometimes 
sensitiveness. The patients rapidly lose flesh, become cachectic, and the 
proportionate number of red blood corpuscles diminishes. From the 
normal of six or seven millions the number may fall to one million or 
less, while that of the white corpuscles considerably increases. This 
leucocytosis, which accompanies all forms of visceral cancer, enables 
one to distinguish between cancer and chronic forms of diarrhoeic enteritis ; 
it must not be confused with leucaemia. Moderately developed ascites is 
common, in consequence of obstruction in the porto-hepatic circulation. 




Fig. 122. — Poition of pig's liver infested with echinoccocus hydatid, natural 
size. (Stiles, Annual Report, U.S.A. Department of Agriculture, 1900.) 

The diagnosis of cancer of the liver or biliary ducts is surrounded 
with difficulty, and the prognosis is extremely grave, because no treatment 
is possible. 

ECHINOCOCCOSIS OF THE LIVER. 

This term is applied to the development in the depths of the hepatic 
parenchyma of hydatids of Tcenia ecldnococcus. 

The echinococcus 113 datid is found in man, cattle, sheep, swine, etc. 
It represents an intermediate stage of development of the echinococcus 
tapeworm of dogs. Since this parasite develops its larval stage in 
man also, and further, since it is the most dangerous animal parasite 
found in man, it is important to thoroughly understand its life history 
in order to guard against infection. 

Adult stage {Tccnia echinococcus). 



284 



DISEASES OF THE LIVER. 



Hosts. Dog, dingo, jackal, wolf. 

Life history. Starting with the adult tapeworm (Fig. 124) in the 
small intestine of the dog or wolf, the eggs are scattered over the ground 
and are swallowed hy the intermediate host with the fodder or water. 
Upon arriving in the stomach the egg-shell is destroyed, and the six- 




Fia. 123. — Portion of the intestine of a 
clog infested with the adult hydatid 
tapeworm (^Tivnia echinococcus, 
natural size. (After Ostertag, 1895.) 




Fig. 125. — Hooks of adult hydatid tape- 
worm, a, From a hydatid ; h, three 
weeks after feeding to a dog ; c, from 
an adult; d, combined figures of a — c, 
showing the gradual changes in form. 
X 600. (After Leuckart, 1880.) 



Fig. 124.— Adult hydatid tapeworm 
{Tcrnia ccliinococctis) enlai-ged. 
(After Leuckart, 1880.) . 



hooked emhryo, which is thus freed, hores its way through the intestinal 
wall, and wanders, actively or passively (that is, carried along hy the 
blood), to various' organs of the body — liver, lungs, ovaries, bones, skull, 
etc. — where it develops first into an accjiludoci/st, which may develop 
further, as shown by the accompanying illustrations. The heads which 
are formed, upon being devoured by a dog or wolf, then develop into 
adult tapeworms. 



ECHINOCOCCOSIS OF THE LIVER. 



285 



Young animals are most exposed to this disease ; in adults or aged 
animals the migration and development of the embryo are more difficult. 




Fig. 126. — Diagram of an echinococcus hydatid, oi, Thick external cuticle ; 
'pa, parenchyni (germinal) layer ; c, d, e, development of the heads, 
according to Leuckart ; /, g, h, i, 7c, development of the heads accord- 
ing to Moniez ; I, fully-developed brood capsule with heads; j)i, the 
brood capsule has ruptured, and the heads hang into the lumen of 
hydatid ; n, liberated head floating in the hydatid ; o, j), q, r, s, mode of 
formation of secondary exogenous daughter cyst ; t, daughter cyst with 
one endogenous and one exogenous grand-daughter cyst ; «, v, x, foi-ma- 
tion of endogenous cyst, after Kuhn and Davaine ; y, z, formation of 
endogenous daugliter cysts, after Naunyn and Leuckart ; y, at the 
expense of a head, .?, from a brood capsule; evag, constricted portion 
of the mother cyst. (After K. Blanchard, 1886.) 

These embryos perforate the tissue of the liver, become fixed in it, 
and derive from it the nourishment necessary for their conversion into 
cystic bladders of varying size, either sterile or fertile. 

The number of vesicles is rarely large, and when only one or two are 



286 



DISEASES OF THE LIVER. 




Fig. 127. —A racemose echino- 
coccus, natural size. (After 
Leuckart, 1880.) 



present the}' seldom produce sufficient disturbance to attract attention. 

On the other hand, ^Yhen numerous they deform the liver, produce 
glandular atrophy, increase the total size of 
the organ, and lead to the appearance of 
clearly-marked symptoms. 

The cystic vesicles contain a clear, limpid, 
transparent fluid, in which float secondary, 
daughter, or granddaughter vesicles. 

Symptoms. Echinococcosis of the liver 
has no well-marked sj'mptoms, and is there- 
fore difficult to diagnose in animals whose 
liver is deeply seated, and therefore 
beyond palpation. The signs which may 
characterise the period of penetration of the 
embryos through the intestine and into the 
depths of the liver, and which are probably 
represented by slight colic, vague pain and 
diarrhoea, usually pass unnoticed. But later, 
when the liver is extensively invaded ap- 
petite becomes irregular without apparent 
cause, animals show intractable diarrhoea, 

general feebleness, dulness, and wasting. 

These symptoms do not point with sufficient clearness to a special 




Fig. 128. — Section through a 
multilocular eehiiiococcus. 
X 30. (After Leuckart, 
1880.) 




Fig. 129.— a nuiltilociilar echino- 
coccus from the hver of a steer, 
natural size. - (After Ostertag, 
1895.) 




Fig. 130. — A multilocular echino- 
coccus from the pleura of a hog, 
natural size. (After Ostertag, 
1895.) 



ECHINOCOCCOSIS OF THE LIVER. 



287 



ifiili 




Fio. 131. — Echinococcus 
bladder worm or hydatid. 



visceral lesion, but as they call for a complete examination, the prac- 
titioner is almost forced to a certain conclusion by the fact that the 
examination remains negative except in re- 
gard to the liver. The liver seems large and 
sensitive, and may sometimes be considerably^ 
hypertrophied, for cases have been seen in 
the ox where the normal weight of 10 to 12 
lbs. has been increased to 60 or even 100 lbs., 
while in the pig, whose liver normally weighs 
4 lbs., the weight has been as high as 20 or 
40 lbs. In such cases percussion and pal- 
pation show that the liver extends beyond the 
right hypochondriac region and invades a 
large portion of the corresponding flank. But 
such great enlargement is exceptional, and 
when only a dozen vesicles are present, al- 
though the functions of the liver may be 

seriously disturbed, the information obtained by physical examination 
is seldom sufficient to justify an exact diagnosis. The 
liver is found to be enlarged and thickened ; otherwise 
the examination gives negative results. 

The diarrhoea may result from failure of the liver to 
secrete sufficient bile to destroy intestinal toxins, or to 
carry on its glycogenic function ; but it may possibly be 
the direct result of chronic intoxication by the contents 
of the vesicles. 

Experience has shown, in fact, that in man, when a 
superficial vesicle becomes ruptured, the peritoneal cavity 
is flooded with the contents of the cyst ; the daughter 
cysts adhere to the peritoneum, and that almost invari- 
ably vascular disturbance occurs, accompanied by itching 
of the skin and an eruption resembling that of urticaria. 
The liquid of the vesicles contains an active tox- 
albumin. 

Diagnosis. In certain cases, diagnosis is possible, and 
even easy, l)ut in others it is extremely difficult and ahnost 
impossible. 

Prognosis. The prognosis is always grave, for if the 

lesions in the liver do not produce death, as usually 

happens, they so profoundly aflect the animals' general 

state, that it is no longer worth while to keep them alive. 

No practical treatment exists. In exceptional cases it certainly might 

be possible, although in the large herbivora always difficult, to expose 



Fig. 132. — 

Tceninecliino- 



288 



DISEASES OF THE LIVER. 



the liver and to puncture and evacuate the contents of some of the 
cysts ; but the result would he illusory, because some vesicles would 
always be inaccessible, and economically intervention would be incomplete 
and useless. 

Although there is no useful method of treatment, prophylaxis is 
possible and valuable. It consists in preventing the development of 
tfeniffi in farm and sporting dogs. For this purpose it is sufficient to 
prevent their obtaining raw offal containing vesicles of echinococci from 
sheep, oxen, or pigs, and also to free them from any helminths which 
they may harbour. In this way they no longer spread eggs of ta^nise 




^^t'Col&c axl n/3^ <^' 



Fig. 133. — Pig's liver with echinococcus cysts. (After Eailliet.) 

with their hieces in the neighl)ourliood of ponds or drinking places, and 
the cattle do not ingest the embr3^os. 



SUPPURATIVE ECHINOCOCCOSIS. 

Causation. Simple echinococcosis may remain undetected for a long 
time, and young animals affected with it may grow up without exhibiting 
marked general disturbance. The old echinococci end by degenerating, 
the wall of the cyst becomes modified, the liquid it contains, turbid, 
lactescent, then caseous ; the vesicle becomes wrinkled, and finally 
nothing resembling the primary vesicle remains. The liquid is soon 
absorbed, and the primary cyst is only represented by a caseous magma, 
which undergoes calcareous infiltration and progressive atrophy. 

Under other circumstances the development of the- echinococcus 



SUPPURATIVE ECHINOCOCCOSIS. 289 

vesicles is less regular ; they may become accidentally infected and 
transformed into encysted abscesses, constituting suppurative echino- 
coccosis of the liver. The membrane of the vesicles usually resists the 
passage of microbes, but the fibrous tissue surrounding the cyst is very 
vascular ; and if, in consequence of vascular disturbance in the liver 
(which may result simply from feeding, trifling infection or other visceral 
disease), the blood should for a short time be infected, microbes pene- 
trate through solutions of continuity in the wall of the vesicle, which 
becomes a centre of suppuration. The liquid becomes turbid, the primary 
cyst is transformed into an abscess, and suppurative echinococcosis is 
set up. 

Symptoms. The general condition resulting from the development 
of suppuration in echinococcus cysts is very different from that of true 
echinococcosis. If the abscess develops rapidly, acute generalised peri- 
tonitis or localised peritonitis of the right anterior abdominal region 
may almost immediately occur, producing all the characteristic symptoms 
of ordinary peritonitis. In all cases, even in the absence of well-marked 
peritonitis, perihepatitis occurs, and the liver becomes adherent to the 
posterior surface of the diaphragm, to the hypochondriac region, to the 
abdominal wall, or to one of the gastric compartments. 

This perihepatitis is indicated by exceptional sensitiveness in the right 
hypochondriac region, and by respiratory disturbance due to fixation of 
the diaphragm. 

In certain cases these abscesses seem to develop like " cold " abscesses 
— i.e., without fever, and this without producing very marked digestive 
disturbance ; but the patients waste rapidly, become weak, show slight 
subicteric coloration of the membranes, and appear to lose their 
strength. Movement is slow and hesitating, as though the animals 
were suffering from laminitis, the anaemia becomes more marked from 
day to day, and examination of the blood reveals abundant leucocytosis, 
the existence of which often assists in the diagnosis of internal suppura- 
tion. In a few months, at least in the cases we have seen, the animals 
become cachectic. 

In other and still more obscure cases suppuration of the liver is 
accompanied by total hypertrophy, excessive sensitiveness in the right 
hypochondriac region, progressive loss of appetite, excessive thirst, and 
uncontrollable diarrhoea and fever, although in the case mentioned above 
there was little fever and no diarrhoea. The course of these cases, which 
probably result from intestinal infection, is much more rapid. In a 
fortnight or three weeks, sometimes less, the patients are carried off by 
intoxication, generalised purulent infection, or septicemia. 

Diagnosis. The diagnosis of suppurative echinococcosis and of 
primary abscess of the liver is difticult to establish. It is attained 

D.C. U 



290 



DISEASES OF THE LIVER. 




Fig. 134.— Thin - necked 
bladder - worm {Cysti- 
cercus tenuicollis), with 
head extruded from 
body, from cavity of 
a steer, natm-al size. 
(Stiles, Annual Report, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



chiefly by a process of exclusion, though the signs 
furnished by percussion of the right flank, and by 
examination of the blood, 
are of some assistance. 

Prognosis. The prog- 
nosis is extremely grave. 
Treatment is of little 
value. Even supposing 
that the diagnosis has been 
exact, surgical intervention 
is out of the question, and 
only this would appear 
theoretically to ofi"er a 
chance of success. The 
abscesses are multiple, 
deeply placed, separated 
from one another, and 
sometimes surrounded by 
enormous tracts of in- 
flamed tissue. In fact, the condition is of such a 
character as entirely to prohibit active measures. 

CYSTICERCOSIS. 

This disease is produced hy the thin- or long- 
necked bladder-worm {Ct/sticercus tcuuicoUis) found 
_ in cattle, sheep, and swine. 

The cj^sticercus rej)resents 
an intermediate stage of de- 
velopment of the marginate 
tapeworm {Ttema margi- 
nata) of dogs and wolves. 
It is by no means un- 
common in Europe and 
America, and occurs in the 
body cavity of cattle, sheep, 
swine, and other animals, 
attached to the diaphragm, 
omentum, liver, or other 
organ. 

When eaten by dogs or 
wolves, it develops into the 
marginate tapeworm, which was formerly confused 
with T. solium of man, and gave rise to the 




Fig. 136.— Head of the 
marginate tapeworm 
{Tcniia marginata). 
X 17. (Stiles, Annual 
Eeport, U.S.A. Bureau 
of Agriculture, 1901.) 



fcrj 



En 



s^ 



Fig. 135.— The marginate 
tapeworm {Tteiiia mar- 
;/ ill at a), natural size. 
(Stiles, Annual Report, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



CYSTICERCOSIS. 



291 



erroneous idea that the pork-measle tapeworm occurs in dogs as well 
as in man. 

Life history. In tracing the life history it is best to begin with the 




Fig. 137. — Small and large hooks of (A) Tcenia marginata, (B) T. serratn, and (C) 
T. ca'Hurus. a, Small hooks ; h, large hooks, x 480. (After Deffke.) 

egg, produced by the adult tapeworm in the intestine of dogs. These 
eggs, containing a six-hooked embryo, escape from the dog with the 




Fig. 138. — Sexually mature segment of the marginate tapeworm {Tirnia marginata). 
cp, Cirrus pouch ; gp, genitpJ pore ; n, nerve ; ov, ovary ; sg, shell gland ; t, testicles 
tc, transverse canal; id, uterus; v, vagina; vc, ventral canal; vd, vas deferens: 
vg, vitellogene gland. Enlarged. (After Deffke.) 

u 2 



292 



DISEASES OF THE LIVER. 




excrements, and are scattered on the ground, either smgly or confined 
in the escaping segments of the tapeworm. Once upon the ground, 
they are easily washed along hy rain into the 
drinking water, ponds, or hrooks, or scattered on 
the grass. Upon heing swallowed with fodder or 
water, they arrive in the stomach of the inter- 
mediate host (cattle, sheep, etc.), where the egg- 
shells are destroyed and the embryos set free. 
The embryos then traverse the intestinal wall, 
and, according to most authors, arrive either ac- 
tively, by crawling, or passively, by being carried 
along by the blood, in the liver or lungs, where 
they undergo certain transformations in structure. 
While still in the finer branches of the blood- 
vessels of the liver, which they transform into 
small, irregularly-shaped tubes about 12 to 15 mm. 
long and 1 to 1*5 mm. broad, the embryos lose their six hooks, and 
develop into small, round kernels, which are generally situated at one 



Fig. 139.— Egg of the 
marginate tapewonii 
( Tcenia m argin nta), 
with six-hooked em- 
bryo, greatly magai- 
fied. (Stiles, Annual 
Eeport U.S. A. Bureau 
of Agriculture, 1901.) 




Fig. 140.— Portion of the liver of a lamb which died nine days after feeding with eggs 
of the marginate tapeworm {Tcenia marginata), with numerous "scars," due to 
young parasites. (After Curtice.) 

end of the tubes. The embryo can first be seen about four days after 
infection. The " scars " (Figs. 140 and 141) described in the liver of 



DISTOMATOSIS— LIVER FLUKR DISEASE— LIVER ROT. 293 

animals infested with Cysticercns tenuicollis are nothing more nor less 
than these tubes, or altered blood-vessels, caused by the growth and 
wandering of the parasites. 

Curtice takes a somewhat different view — that is, he considers the 
liver as a place of destruction for the young parasites, rather than a 
normal place for their development; he also claims that the embryos, 
which may even travel the entire length of the intestine of the inter- 
mediate host, traverse the intestine and arrive directly in the position 
where they complete their larval development without first passing 
through the liver. 

After developing into the full-grown bladder worm, the parasites 
remain unchanged until they are devoured by a dog or wolf, or until. 




Fig. 141. — Cross-section of the liver of a lamb which died nine days after feeding with 
eggs of the niarginate tapeworm [Tcenia marguiatu). (After Curtis.) 

after an undetermined length of time, they become disintegrated and 
more or less calcified. 

If the hydatid is devoured by a dog or wolf, either when the latter 
prey upon the secondary host or when the dog obtains the cyst at a 
slaughter-house, the bladder portion is destroyed, the scolex alone 
remaining intact in the digestive fluids. The head holds fast to the 
intestinal wall with its suckers and hooks ; by strobilation (transverse 
division) it gives rise to the segments, wdiich as we have already seen, 
together with the head, go to make up the adult tapeworm. Kepro- 
ductive organs of both sexes develop in the separate segments, and 
eggs are produced, within which are developed the six-hooked embryos, 
the point from which we started. 

DISTOMATOSIS -LIVER FLUKE DISEASE -LIVER ROT. 

In France the name of distomatosis has been given to a disease caused 
by the presence of distomata in the bile ducts. It is the " liver rot " of 
England, the Eberfiiule of Germany, and is produced by the growth in 



294 



DISEASES OF THE LIVER. 



the biliary ducts of oxen, sheep, and goats of two species of distomata, 
viz., the Distoma Iwpaticum or Fasciola Iwpatica, and the Distoma lanceo- 
latam. 

In 1875 Zundel established the causative relation between the pre- 
sence of distomata in the liver and the development of progressive fatal 
cachexia in most of the animals affected. This 
B opinion was emphasised by the works of Leuckart 

and Thomas on the development of distomata, 
and at the present day the parasitic theory is 
accepted as beyond question. 

Fasciola hepatica {Distoma hcpaticnin). — The 
connnon liver fluke of cattle, sheep, swine, etc. 

Life history. The adult parasite, instead of 
producing young similar to itself and capable 
of developing directly into adults in cattle, pro- 
duces eggs which develop into organisms totally 
different from the adult form, living a parasitic 
life in other animals. In scientific language, the 
parasite is subject to an alternation of genera- 
tions, together with a change of hosts. The fol- 
lowing summary of the life history will make this point clear : — 

(«) The adult Itennaphroditic worm (Figs. 144 and 145) fertilises itself 
(although a cross fertilisation of two individuals is not impossible) in the 
biliary passages of the liver, and produces a large number of eggs. 

{b} Eggs (Figs. 143, 146 and 147). — Each egg is composed of the 



Fig. 142.— Fr^s•r(•o/r 
iica. A, yoiin: 
adult parasite. 
Railliet.) 






Fig. 148.— Eggs of Fasciola Itc^'afica. A, 
from the bile duct ; B, embryonic ; C, after 
opening. (After Eailliet.) 



Fig. 144. — Common liver 
fluke {Fasciola hejxi- 
tica), natural size. 
(Stiles, Annual Report, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



following parts : (1) A true germ cell, which originates in the ovary and is 
destined to give rise to the future embryo ; (2) a numl)er of vitelline or 
yolk cells, which are formed in a specialised and independent portion 
(vitellogene gland) of the female glands — instead of developing into embryos 
the yolk cells form a follicle-like covering for the true germ cell, and play 
an im})ortant role in the nutrition of the latter as it undergoes further 



DlSTOMAl'OSlS — LIVER FLUKE JDISEASE — LIVER 



295 







3 == ; 






S 5« -^ 



i. 



o s 



g p 



^1 

O 01 



2 ■'^ 



29G 



DISEASES OF THE LIVER. 



development ; (3) a shell surrounding the germ cell and vitellme cells, 
and provided at one end with a cap or operculum. The eggs escape from 
the uterus of the adult through the vulva, are carried to the intestine of 
the host with the bile, then pass through the intestines with the contents 




Fig. 146. — Egg of the common liver 
fluke (Fasciola heimtica), exa- 
mined shortly after it was taken 
from the liver of a sheep. At one 
end is seen the lid or operculum, o ; 
near it is the segmenting ovum, e ; 
the rest of the space is occupied 
by yoke cells which serve as food ; 
all are granular, but only three 
are thus drawn. X 680. (After 
Thomas, 1883, p. 281, Fig. 1.) 



^.- 




-^ 



Fig. 147. — Egg of the common liver 
fluke containing a ciliated embryo 
(miracidium) ready to hatch out : 
d, remains of food ; e, cushion of 
jelly-like substance ; /, boring pa- 
pilla ; h, eye-spots ; A-, germinal 
cells. X 680. (After Thomas, 
188:-5, p. 283, Fig. 2.) 



of the latter, and are expelled from the host with the ffecal matter. Many 
of them become dried, and then undergo no further development; but 
others are naturally dropped in the water in marshes, or, being drojjped 
on dry ground, they are washed into water by the rain, or are carried to 
a more favourable position by the feet of animals pasturing or passing 
through the fields. After a longer or shorter period of incubation, which 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 



297 



varies with the temperature, a ciUated emhryo (mii-acidium) is developed. 
At a temperature of 20° to 26° C. the miracidium may be formed in ten 
days to three weeks ; at a temperature of 16° C. the development takes 
two to three months; at 38° C. it ceases entirely. Experiments have 
shown that as long as these eggs remain in the dark the miracidium will 
not escape from the egg-shell; accordingly it will not escape during the 
night. When exposed to the light, however, or when suddenly brought 




Fig. 148.— Embryo of the 
common liver fluke {Fas- 
ciola hej^atica), horing into 
a snail. X 370. (After 
Thomas, 1883, p. 285, 
Fig. 4.) 




Fig. 149. — Sporocyst 
of the common liver 
fluke which has de- 
veloped from the 
embryo, and con- 
tains germinal cells. 
X 200. (After 
Leuckart, 1889, p. 
109, Fig. 67 B.) 




Fig. 150. — Sporocyst 
of the common liver 
fluke, somewhat 
older than that of 
Fig. 149, in which 
the germinal cells 
are giving rise to 
redite. X 200. (After 
Leuckart, 1889, p. 
109, Fig. 67 C.) 



into contact with cold water, the organism bursts the cap from the 
egg-shell, crawls through the opening, and becomes a — 

(c) Free-swimming ciliated miracidium (Fig. 148). — As already stated, 
this organism is entirely different from its mother. It measures about 
0*15 mm. long; is somewhat broader in its anterior portion than in its 
posterior portion ; on its anterior extremity we find a small eminence, 
known as a boring papilla ; the exterior surface of the young worm is 
covered with numerous cilia, which by their motion propel the animal 
through the water; inside the body we find in the anterior portion a 
simple vestigial intestine and a double ganglionic mass provided with a 
peculiar pigmented double cup-shaped eye-spot ; in the posterior portion 



298 



DISEASES OP THE LIVER. 



of the body cavity are found a number of germ cells, which develop into 
individuals of the next generation. 

Swimming about in the water, the miracidium seeks out certain snails 
{Limud'a trtiiicatnia, L. odliuensiH, L. rnhcUa), which it immediately attacks 
(Fig. 148). The miracidium elongates its papilla and fastens itself to the 
feelers, head, foot, or other exterior soft portion of the body of the snail ; 




Fig. 151.— Iledia of tlie 
CO 111 111 on liver fluke 
{Fascio la h]ep atica), 
containing germinal 
cells which are develop- 
ing into cercariae. xl50. 
(After Leuckart, 1889, 
p. 269, Fig. 129 A.) 




Fig. 152.— Eedia of the 
common liver fluke, 
with developed cerca- 
riae. X 150. (After 
Leuckart, 1889, p. 270, 
Fig. 180.) 




Fig. 153. — Free cercaria 
of the coiiimon liver 
fluke, showing two 
suckers, intestine, large 
glands, and tail. (After 
Leuckart, 18H9, p. 279, 
Fig. 187.) 



some of the parasites enter the pallial (lung) cavity and attach themselves 
there. After becoming securely fastened to the snail the miracidium 
discards its ciliated covering, and shortens to about half its former length 
(0'07 mm. to 0'08 mm.). The parasites now bore their way into the body 
of the snail, and come to rest in the liver or near the roof of the pallial 
cavity, etc. ; the movements gradually cease, and we have before us the 
stage known as the — 

{(1) Sporocyst (Figs. 149 and 150). — The eye-spots, ganglionic swellings, 
and vestigial intestine become more and more indistinct, and are finally 



biStOMATOSIS — LIVER FLUKE DLSEASfe^LIVER ROT. 



^95 



lost. The sporocyst grows slowly at first, then more rapidly, and at the 
end of fourteen days or so measures 0*5 mm. The germ cells mentioned 
as existing in the posterior portion of the miracidium now develop into 
individuals of a third generation, known as — 

(e) lic'due (Figs. 151 and 152). — The redi?e escape from the sporocyst 
when the latter are from two weeks (in summer) to four weeks (in late 
fall) old. Upon leaving the body of the sporocyst they wander to the 
liver of the snail, where they grow to about 2 mm. long by 0'25 mm. 
broad. Each redia consists of a cephalic portion, which is extremely 
motile, and which is separated from the rest of the young worm by a 
ridge ; under the latter is situated an opening, through which the next 




Fig. 154. — Portion of a grass stalk with three encapsuled 
cercariae of the common liver fluke {Fasciola kei^atica). 
X 10. (After Thomas, 1883, p. 291, Fig. 13.) 



■Xiffii^'... 




Fig. 155. — Isolated en- 
cysted cercariaof the 
common liver fluke. 
X 150. (After Leuc- 
kart, 1889, p. 286, 
Fig. 142.) 



generation (cercarise) escape. The posterior portion of the worm is pro- 
vided, at about the border of the third and the last fourths of the body, 
with two projections. There is a mouth with pharynx situated at the 
anterior extremity, the pharynx leading to a simple blind intestinal sac. 
The redia, as well as the sporocyst, may be looked upon as a female 
organism, and in its body cavity are found a number of germ cells, which 
develop into individuals of the next generation, known as^ 

(/) Cercance (Figs. 153 — 155). — These organisms are similar to the 
adult parasites into which they later develop. The body is flat, more or 
less oval, and provided with a tail inserted at the posterior extremity. 
The oral sucker and acetabulum are present as in the adult, but the 
intestinal tract is very simple; on the sides of the body are seen two 
large glands, but the complicated genital organs of the adult are not 
visible, The cercaria leaves the redia through the birth opening, remains 



300 



DISEASES OF THE LIVER. 



in the snail for a longer or shorter time, or passes out of the body of the 
snail and swims about in the water. After a time it attaches itself to a 
blade of grass (Fig. 154) or some other object, and forms a cyst around 
itself with material from the large glands, at the same time losing its 
tail. It now remains quiet until swallowed by some animal. Then, upon 
arriving in the stomach — of a steer, for instance — the cj^st is destroyed, 
and the young parasite wanders through the gall-ducts or, as some believe, 



i^^-odi 




Fig. 156. — Drawing fiora a microscopic preparation, showing a haemorrhage in the 
parenchyma of the hver caused by the common liver fluke {Fasciola hepatica). 
a, Atrophic hver tissue ; h, round-cell infiltration ; c, a portion of the parasite ; 
d, haemorrhage. (After Schaper, 1890, PL I., Fig. 1.) 



through the portal veins to the liver, where it develops into the adult 
hermaphrodite. 

From the above we see that this parasite runs through three genera- 
tions, namely : 

(1.) Ovum, miracidium, and sporocyst . . . first generation. 

(2.) Redia . . . second generation. 

(3.) Cercaria and adult . . . third generation. 

During this curious development, which lasts about ten to twelve 
weeks, there is a constant potential increase in the number of individuals, 
for each sporocyst may give rise to several (five to eight) redijE, each 
redia to a larger number (twelve to twenty) cercarise, and each adult to an 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 



301 



enormous number (37,000 to 45,000) of eggs. This unusual fertility of the 
parasite is necessary because of the complicated life history and the com- 
paratively small chance any one egg has of completing the entire cycle. 

Hosts. An interesting and, from an agricultural standpoint, an 
important matter connected with this fluke is that it is found in a large 
number (about twenty-five) of domesticated and wild animals, and this 




Fig. 157. — Drawing from a microscopic preparation, showing the glandular hyper- 
plasia of the mucosa of a gall-duct caused by the common liver fluke {Fasciola 
hepatica). a, Hypertrophied submucosa ; b, interstitial connective tissue; c, com- 
pressed lobule ; d, lumen of the gall-duct — thickened fibrous wall of the gall-duct. 
(After Schaper, 1890, PI. I., Fig. 2.) 

fact probably explains to some degree the wide geographical distribution 
of the parasite. 

Symptoms. The symptomatology of this disease may clinically be 
divided into three well-marked periods : 

I. Primary period. The primary phase commences with the pene- 
tration of the embryos of the parasite into the body, firstly into the 
intestine, and then into the liver by ascending the bile ducts. This phase 
occurs during the last months of the year, October, November, and 
December, and is rarely accompanied by alarming symptoms. At this 
time the sheep appear in good health, the summer being over, and the 



302 



DISEASES OF THE LIVER. 



animals, being well nourished and fat, are able to resist the first attacks 
of the parasite, so that even an observant shepherd only notices a little 
dulness, want of condition, and muscular weakness. It requires a care- 
fully trained eye to note these very general symptoms, for the bodily 
condition only changes very slowly and progressively, the appetite remain- 
ing good. Experienced butchers, however, in the districts where disto- 
matosis is common, readily detect this condition. The animals make 
little resistance when handled. 

Nevertheless, even in this primary phase, the conditions are not always 



C. 




Fig. 158. — Drawing from a microscopic preparation showing a fluke in the tissue of 
the liver, a, Necrotic liver tissue ; 6, atrophic liver cells ; c, spines on the fluke, 
showing the outline of the body. (After Schaper, 1890, PI. III., Fig. 5.) 

as above sketched, and a certain number of deaths may occur. Gerlach 
has mentioned the possibility of death by cerebral apoplexy, in conse- 
quence of the young distomata penetrating to the brain. Moussu has 
certainly never seen such a complication, but has seen death from 
hepatitis, perihepatitis, and secondary pericarditis in animals gravely 
infested. The young embryos, whether they penetrate only by the bile 
ducts, as has been stated, or are carried to the liver by the blood stream, 
often excavate canals in the substance of the gland before establishing 
themselves in the bile ducts. They make their way as far as Glisson's 
capsule, and may even penetrate it ; and as they carry with them innumer- 
able intestinal germs, when they arrive rid the bile ducts, they set up 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 



303 



hepatitis, perihepatitis, with the formation of numerous false mem- 
branes, or even infectious fibrinous peritonitis. Should the patients die 
during this phase one finds young distomata at the surface of the liver, 
or even in the thickness of the false membranes. 





Jan. 


•Feb. 


Mar 


Apr. 


May 


Jun. 


July. 


Aug. 


Seft. 


Oct. 


Nov. 


Dec. 




















/'\ 














13 

A 










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/\ 








/ 


/ 




,aS 


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y 


/ 


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'^^ 


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lian. 


Feb, 


Maf 


Apr. 


iviay. 


dun. 


duly 


Au^. 


Sepr 


Ort. 


Nov. 


Dec. 


f* 














































93 
— A — 


























/\ 


























/ \ 






fD 


















/ 




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/53 








4-1 












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/ 


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32 




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Steers 


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30 


SOX. 


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1=^ 


^5- 


^m 


L±±^ 


t-^f ' 



Jan. 


TeU 


Mar 


Apr. 


May 


Jun. 


ilulj, Aug Sepl. 


<3et. 


Nov. 


Dec. 




















A 






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Fig. 159. — Tabular diagrain of the occurrence of the common liver fluke [Fasciola 
hepatica) durmg different months of the year, a, Cattle; 6, sheep; c, swme. 
(After Leuckart, 1889, p. 301, Fig. 147.) 



\Yhen infestation is discrete the appearances are quite different. 
Careful breeders have even stated that at this period the young sheep 
appear to show a greater tendency to fatten. 

II. Second period. In the primary phase deaths are exceptional ; they 



804 



DISEASES OF THE LIVER. 



only become common towards the end of the winter. During the second 
or middle period (December and January) the patients lose flesh, appear 
less active, show less regular appetite and greater thirst. The conjunctiva 
becomes pale and swollen, the sclerotic has a bluish tint, and the eyelids 
are somewhat infiltrated. The wool appears drier and less curly ; locks 
of wool part readily from the skin, and the individual fibres become dry 
and fragile. 

This phase is accompanied by very marked antemia, rapid exhaustion 
during movement, and inability to run for any length 
of time. 

The different methods of examination reveal 
nothing specially striking, except that the valvular 
sounds of the heart are sharper, and that trifling 
cedenia occurs under the thorax and abdomen. 

Microscopic examination of the faeces reveals the 
presence of eggs of distomata. The sheep rapidly 
become thin from about the end of January, even 
although the appetite persists and nourishing food 
is given. 

III. Third, or wasting, period. The decline, 
which sets in about February, appears extremely ob- 
stinate, and resists all treatment. 

The patients become feeble, eat less, and digest 
badly. Submaxillary oedema, common to advanced 
wasting diseases, then appears. If the sheep are re- 
moved from the fold to pasture, the swelling of the 
submaxillary space is very noticeable. It consists in 
an indolent cedematous tumefaction, which disappears 
when the animals are travelled, but reappears when 
grazing on account of the low position in which the 
head is then held. 

The condition then becomes complicated with 
diarrhoea, and soon grows alarming. On examination, extensive dropsy 
may often be found in the thorax, pericardium, and abdomen. 

Death results from exhaustion ; the animals do not appear to suft'er, 
but become extraordinarily antemic, and perish without a struggle. The 
blood is simply rosy in colour, like gooseberry syrup : the clot is soft 
and gelatinous : the number of red blood corpuscles has fallen from 
about seven millions to a few hundred thousand. 

Icterus is rare, though certain cases have been described where it has 
appeared during the last and even during the middle stage. 

When animals begin to die in a district which has long been infested, 
the losses are enormous, the condition sometimes constitutes a perfect 




Fig. 160.— The large 
American fluke 
{Fasciola magna), 
natural size. 
(Stiles, Annual 
Eeport, U.S.A. 
Bureau of Agricul- 
ture, 1901.) 



DISTOMATOSIS — LTVER FLUKE DISEASE — LIVER ROT. 



305 



scourge. It should be remarked, however, that all those affected do not 
die ; anmials kept under good conditions may even survive for several 
months, although greatly wasted. 

Towards March and April the parasites leave their position, and are 
conveyed by the current of bile towards the intestine, to be rejected 
with the faeces. This is the period of convalescence and recovery; but 
recovery is only relative, for the parasites are never entirely evacuated. 
The distomata then recommence their 
life cycle outside the animal body. 

Unfortunately the mortality caused by 
distomata is accidentally aggravated by 
other diseases, and the scourge then be- 
comes an absolute disaster for the dis- 
tricts where such complications occur. 
Thus Besnoit and Cuille, of Toulouse 
have shown that distomatosis may be- 
come complicated with a form of very 
rapidly fatal haemorrhagic septicaemia, 
produced by an ovoid bacterium. 

Distomatosis, already sufficiently 
grave, then becomes infinitely more 
serious, if only from the fact that it 
may prove the point of origin of an 
absolutely fatal complication. 

In bovine animals the symptoms de- 
velop exactly as in sheep, though the 
cachectic period is uncommon and the 
injury done is often less important than 
in sheep. The patients exhibit irregular 
appetite, wasting without appreciable 
cause, anaemia, and even diarrhoea. In 
spite of excellent winter feeding they 
do not regain condition, and relative re- 
covery only sets in with the approach of spring. Death from simple 
distomatosis is exceptional, but in animals so predisposed enteritis de- 
velops more easily, as do all forms of infection of intestinal origin. 

The disease is, however, also grave for bovines because successive 
reinfection occurs, and the disease may be prolonged for years. 

Causation. Distomatosis is due to one cause, viz., the entrance of 
embryo flukes into the digestive apparatus of herbivora. 

The adult distomata in the biliary ducts continually discharge large 

quantities of eggs, though the process is most active between February 

and June or July. The eggs are carried away with the bile and 

D.c. X 




Fig. 161. — Macerated specimen 
of large American, fluke, show- 
ing the digestive system and 
acetabulum. X 2. (After Stiles, 
1894, p. 226, Fig. 2.) 



306 



DISEASES OF THE LtVElt. 



and pass on to the pastures, where they continue then- Hfe cycle, thanks 
to moisture and the presence of stagnant water. The embryos, having 
escaped from the egg, enter the bodies of the snails found in or near 
stagnant water {Limnaa truncatida), become converted into sporocysts, 
and afterwards into rediaj and cercariae. The cercarise become encysted 
on the lower surface of blades of grass in damp pastures, whence they 
are transferred to the animals' stomachs along with the grass itself. 

As the LivDuea truncatida lives not only in marshy regions, but also 
in all damp situations, the embryos of distomata are distributed over 
enormous areas, and the disease itself is 
equally widespread. The embryo, after in- 
gestion, is set at libert}^, and passes from the 
intestine into the innermost recesses of the 
liver, being guided up the bile ducts by 
the current of bile. At this point it attaches 
itself to the wall of the bile duct, passes 
through its various stages of evolution, and 
attains the adult form. It then begins lay- 
ing eggs, and thus starts a new evolutionary 
cycle. 

The life cycle of Distoma lanceolatnm is 
not yet known, and this variet}^ moreover, 
is less widely distributed than the Distoma 
liepaticum. 

The bile ducts are more easily pene- 
trated by the distoma in young animals, a 
fact which explains why calves and lambs 
are particularly affected. Adults present a 
less favourable nidus, a fact which renders 
them less easily infected, but does not en- 
tirely prevent the parasites from attacking 
them. Old animals, although unable to resist entirely, seldom harbour 
many of the parasites. 

Wet years appear to favour the extension and propagation of dis- 
tomatosis in an extraordinary fashion, a fact which is easily understood, 
if we regard the phases of evolution of the parasite. The autumn appears 
particularly favourable to the infection of herds. This is explained by 
the fact that, during the summer, the dryness of the fields entirely pre- 
vents the development of such eggs as may be distributed over them ; 
whilst wet periods during the autumn favour this development. 

On the other hand, the grass becomes eaten down in autunni, so that 
the animals gather it almost level with the ground. As the cercariae 
attach themselves to the lowest leaves they are then ingested in much 




Fig. 162. — Limncca trunca- 
tula. Natural size and mag- 
nified. (After Railliet.) 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVEU ROT. 307 

larger quantities. The bad effects of wet seasons are not immediately 
apparent, but appear during the following spring. 

Distomatosis is common throughout almost the whole of Europe, 
Africa, and America. In France it is most serious in the moister 
regions of Sologne, in Berry, the mountainous and wet districts of the 
great central plateau, and particularly in the Pyrenees. It particularly 
attacks oxen in the valley of the Meuse, the marshes of Picardy, the 
lower regions of Normandy, and in aril the mountainous pastures of the 
central plateau. 

Lesions. The lesions of distomatosis vary with the stage of develop- 
ment of the parasites. During the primary phase of invasion of the 
bile ducts by young distomata one finds interstitial diffuse hepatitis, due 
to perforation of the gland by young parasites, adhesive perihepatitis, 
with the formation of false membranes, and not uncommonly slight 
peritonitis. 

Zoologists state that the young distomata penetrate the liver by 
passing upwards against the current of bile. It does not appear impos- 
sible, however, that they may penetrate by another path, particularly as 
so-called "erratic" forms of distomatosis like distomatosis of the lung, 
heart, lymphatic glands, and various other tissues are not uncommon. 
It has been suggested that the young distomata, arriving in the bile 
ducts, perforate the gland, giving rise to these lesions of perihepatitis, 
peritonitis or erratic distomatosis ; but this view is scarcely in harmony 
with the fact that the parasites are usually found in the bile ducts. 

During the second phase, corresponding to the development of almost 
adult distomata, the perihepatitis and peritonitis set up either produce 
fatal results by secondary infection or diminish and disapi^ear. The 
parasites develop in the bile ducts, in which they attain the adult con- 
dition. They steadily ascend towards the origins of the ducts, dilating 
them in their passage in an extraordinary way. The number of para- 
sites varies greatly : sometimes there are but few, and they are only 
discovered on post-mortem examination ; in other cases the bile ducts are 
crammed with them, as many as six or seven hundred or even a thousand 
being present. The distended bile ducts always show chronic peripheral 
inflammation, which steadily becomes aggravated, producing pericanali- 
cular atrophying sclerosis. This condition is followed by change in and 
disappearance of a certain quantity of hepatic tissue, and by various 
forms of vascular and secretory disease. 

This is the period of greatest disturbance, not only in consequence of 
the actual presence, but also of the mode of living, of the parasites. 

Moussu declares that the parasites live principally on blood, at least 
during the first and second stage of their sojourn in the liver, adducing 
as proof that if one completely injects the vascular system of the liver 

X 2 



308 DISEASES OF THE LIVER. 

(arteries and veins), some of the injected matter ^Yill be found a day 
afterwards in the digestive apparatus of the parasites. 

The disturbances which they produce are therefore due to their 
actual presence and its consequences, to their mode of life, and to the 
intercurrent infections of which they are sometimes the initial cause. 

It is idle to object that the part played by these parasites is less 
important than has been suggested, and that the mortality results from 
intercurrent infection, and not from the parasites themselves. It is 
equally idle to point out that carcases of animals suffering from severe 
infection with distomata, particularly the carcases of sheep, are frequently 
found in slaughter-houses, in perfectly fat condition, and with the appear- 
ance of not having suffered in any way. These observations are perfectly 
correct and well founded. But it matters little that death results from 
an infection superadded to the distomatosis, if the presence of distomata is 
the determining factor in causing the superadded infections, and if such 
infection is, as Moussu believes, almost inevital)le in animals already 
exhausted by the action of the parasites. 

The fact that animals suffering from distomatosis and slaughtered for 
food are well nourished is not a valid objection ; for it has long been 
known that wasting and anaemia are not immediate consequences, and 
that before they are clearly apparent the distomata must have been 
present in the liver for several months. Bakewell and the Marquis 
of Behague have shown that in moderately infected animals there is 
a tendency to lay on flesh during the first and a portion of the second 
of development of the disease. 

If the animals are slaughtered before the period of progressive 
decline sets in, it is quite possible to form entirely wrong views regard- 
ing the importance of these parasites. 

The wasting process commences towards the end of the second phase 
of the disease, and then makes rapid progress. The parasites, which 
have then been continuously drawing on the blood for their nourishment 
for a long time, produce anemia, and some infection of the bile ducts, 
and usually a certain degree of icterus. 

The third phase is accompanied by general signs of cachexia, which 
need not again be described. They are similar to those of all pro- 
crressive cachexias. In animals which survive this phase and are 
ultimately slaughtered the liver always shows very marked sclerosis, 
commencing around the biliary ducts. Even after the parasites have 
been evacuated, these ducts appear indurated, thickened, fibrous, and 
sometimes encrusted with biliary deposits or obstructed with true calculi. 
These calculi may or may not contain parasites ; sometimes they simply 
contain e^o's : they are open, tubular, and perforated, but always irregular 
on the surface. 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT, 309 

When in addition complications have appeared, one usually finds 
general lesions of septicaemia and blood infection. 

In erratic distomatosis, which is of no importance clinically, disto- 
mata may become encysted in the lung or other viscus, and in time 
die. The cysts, which only contain one and rarely two parasites, 
present a fibrous shell, enclosing a blackish, pultaceous, grumous 
magma, which sometimes has undergone a certain amount of calcareous 
infiltration. The parasite may be entirely destroyed. 

Diagnosis. Early diagnosis is difficult, and can only be established 
by microscopic examination of the excreta and the discovery of eggs. 
On an average one may find one egg in each preparation when the 
liver contains 80 to 100 flukes. When wasting is very marked, and 
particularly when there has already been a number of deaths, diagnosis 
becomes extremely easy. It is sufficient to find flukes in any form 
{Distoma hepaticum vcl lanceolafnm) to be assured as to the cause of 
disease. 

Prognosis. In severely infested cases the prognosis is extremely 
grave, because no efficient method of treatment exists. Embedded 
in the liver, the parasites resist the action of all drugs, and we know 
of no anthelmintic eliminated hy the bile which in any way affects 
their vitality. When the disease is recognised early, the most econo- 
mical method is to fatten the animals as rapidly as possible and 
prepare them for slaughter. 

Treatment. There is no reliable curative treatment. The drugs 
which one might employ would kill the animal before poisoning the 
parasites embedded in the liver. Various mixtures containing sulphate 
of iron, juniper leaves, etc., have been recommended ; but rich food 
constitutes the best of all treatment, both from a curative and a pro- 
phylactic standpoint. 

With the view of preventing the disease, however, and protecting 
flocks from attack in places where the disease is common, certain 
precautions should be adopted. They comprise — {a) providing a free 
supply of rock-salt, either in masses placed in the mangers or dis- 
tributed with the food ; the salt increases gastric secretion, and has 
a slight action on the parasites : {h) adding to the food during the 
first months of winter branches of birch, juniper, willow, and broom ; 
the leaves of these plants contain aromatic or resinous' principles 
which act on the liver, are eliminated by the bile, and may have 
valuable results. 

But of all preventive measures the most efTective consist in draining, 
cleansing, and drying low, moist, or marshy lands, because the molluscs 
which are essential to the life cycle of the parasites are unable to 
develop where the soil is dry. The manure containing the eggs of 



310 DISEASES OF THE LIVER. 

the parasites may be disinfected by adding to it lime, sulphate of iron, 
or common salt. Common salt and lime spread over the pastm-es 
has a double beneficial influence, acting both as a manure and as a 
parasiticide. From May to August is the l)est time for spreading 
this dressing. 

The fluke embryos are destroyed by 1 to 2 per cent, solutions of 
common salt, and by f per cent, solutions of lime. 

In over-stocked fields the animals are obhged to graze very close 
to the ground, and are thus more exposed to infection. Over-stocking 
should therefore be avoided. Animals should not be left too long on 
the same ground. If infected they should at once be driven to higher 
pastures. Eaised water tanks can be placed in the pastures — they are 
less likely to become infected. Animals from known infected flocks 
or herds should not be purchased. Livers from infected animals 
should be cooked or destroyed. If eaten raw by dogs the eggs pass 
uninjured through the dog's intestine and infect fresh pastures. 

Sulphate of iron distributed in quantities of 250 to 400 lbs. per 
acre is valuable as a manure, and would probably have a greater 
eft'ect in destroying the embryos. 



SECTION III. 

RESPIRATORY APPARATUS, 

CHAPTER I. 

EXAMINATION OF THE RESPIRATORY APPARATUS. 

From the clinical standpoint a study of the respiratory apparatus 
implies the examination of the nostrils, nasal cavities, frontal and 
maxillary sinuses, larynx, trachea, and, for the purpose of ascertain- 
ing the condition of the lungs and pleura, of the chest. 

Nasal cavities. Examination of the external portion of the nasal 
cavities is extremely simple. The observer notes the degree to which 
the orifices are dilated, the frequency of the respiratory movements 
and the condition of the muzzle. He may find various eruptions, 
crusts due to discharge, etc., and will remark any peculiarities pre- 
sented by these. The depths of the nasal cavities can only be examined 
through the nostrils to a very limited extent ; but the condition of the 
pituitary mucous membrane, its degree of vascularity, and the exist- 
ence of ulcerations or of vegetations can be observed. 

Digital examination is sometimes useful in discovering the condition 
of the lower portions of the turbinated bones. The electric light does 
not greatly assist the observer, on account of the narrowness of the 
air passages. On the other hand, examination of the face, and pal- 
pation and percussion over the region of the frontal sinuses is of 
considerable value. By inspection, one discovers deformity caused by 
tumours, by ossific inflammation, or other lesions ; and detection is 
rendered easier by the fact that deformities are usually asymmetrical, 
only occurring on one side. 

Palpation reveals the degree of resistance and flexibility of the 
external bony wall as well as the condition of the subcutaneous 
tissues. 

Percussion sometimes discloses absolute dulness, due to tumours of 
the mucous membrane, of the turbinated bones, or of the bones of 
the face. 

The pharyngeal portion of the nasal cavities is difficult to reach, 



312 



RESPIRATORY APPARATUS. 



but can be examined by jiassing the hand, pahn upwards, into the 
pharyngeal cavity, when the fingers may be slipped behind the soft 
palate and thus introduced into the posterior nasal chamber. The 
animals should first be very carefully secured and a strong gag intro- 
duced into the mouth. 

Sinuses. Frontal sinus. — The frontal sinus occupies the greater 
part of the anterior cranial region and the summit of the head, ex- 
tending from the highest point of the poll as far forward as a line 
drawn between the two orbits. Above, it directly communicates with 
the sinus of the horn core. In this upper region, where it abuts on 
the sinus of the opposite side along the median line, it is of greatest 




Fig. 163. — Median section through an ox's head. Sf, Frontal sinus; N.Ph. naso- 
pharnyx; Vp., hard palate ; C, turbinated bones ; V., vomer; L., tongue; V. pa., 
soft paUite ; E., epiglottis ; La., larynx ; ffi., oesophagus. 



size. Below, on the other hand, it is very narrow, much broken up 
and incompletely divided into a series of cells, by thin, bony plates 
running in all directions. 

It is in direct communication with the nasal cavity. 
The frontal sinus, then, occupies all the supero-lateral portion of 
the cranial box, which is thus provided with a double wall. At one 
point, however, over a lozenge-shaped area, the cranial cavity is only 
protected by a single wall. It is in this region that the slaughter- 
man strikes the animal when killing it. 

The frontal sinus may be examined ])y inspection and palpation, 



EXAMINATION OF THE RESPIRATORY APPARATUS. 



313 



Inspection sometimes reveals deformity of the external wall of the 
sinus. Such deformity, however, is rare, and Moussu has only 
observed it in two cases of tuberculosis of the bones forming the 
cranial wall. 

By percussion one detects abnormal sensibility, and partial or com- 
plete dulness over certain areas. 

MaxiUarif sinus.— The maxillary sinus occupies the whole lateral 




Fig. 164. — General arrangement of the sinuses. The circular openings indicate 
points at which trepanation is performed. 



region of the face, from the inferior extremity of the maxillary spine 
as far as the sub-orbito-palatine region. In front its external wall 
is very solid, but behind, below the orbit, is extremely thin. Ex- 
ternally the sinus is largely protected by the anterior insertion of the 
external masseter muscle, a fact which explains how rarely it is 
injured. 

Larynx, In consequence of its deep situation, the larynx can 



314 



RESPIRATORY APPARATUS. 



Bcarcely be examined except by inspection, external palpation, internal 
digital palpation, and auscultation. 

External examination presents no difficulty, and enables one to detect 
lesions around or near tbe larynx. 

Palpation reveals the existence of cedematous swellings, enlarge- 
ments of the retro-pharyngeal lymphatic glands, inflammatory en- 
gorgements, etc. 

Internal digital examination, like examination of the pharynx, can 
only be performed after very firmly fixing the animal in position, and 
inserting a gag in the mouth. 

The hand is introduced, palm downwards, and passed as far as the 




Fig. 165. — Manual examination of the larynx in the ox. 



pharyngeal cavity. The index finger can then easily be slipped into 
the glottis. Exploration must be effected rapidly and without violence. 
It reveals the condition of the glottis, the presence, position and form 
of growths like myxomata and of new tissues, due to the presence of 
actinomyces, as well as tuberculous vegetations or ulcerations. 

By auscultation we discover the presence of normal or abnormal 
laryngeal sounds — roaring, whistling, or bubbling sounds, etc. 

Trachea. The trachea may be examined by palpation and 
auscultation. 

Palpation reveals the degree of sensitiveness, abnormalities in position 
or form, the presence of peripheral inflammations, fractures of rings, etc. 

Auscultation indicates whether the tracheal sound be normal or 
otherwise, or accompanied by abnormal sounds, like mucous rdh's, or 
by pathological sounds conveyed from the chest. 



EXAMINATION OF THE RESPIRATORY APPARATUS. 315 

Thorax. The thorax can he examined hy inspection, palpation, 
percussion, and auscultation. 

By inspection we discover whether the formation of the thorax 
as a whole is normal, or whether there exist congenital or acquired 
deformities, asymmetry like that produced by pneumo-thorax or devia- 
tions of ribs from the normal line, etc. One also notes the breathing 
movements, the manner in which the sides expand and contract, the 
respiratory rhythm, and any special peculiarities of inspiration or 
expiration. 

Palpation reveals the degree of sensitiveness of the thoracic wall and 
of the intercostal spaces, the existence of more or less extensive local 
cedematous infiltration, and the presence or disappearance of thoracic 
conditions like hydro-thorax. 

Percussion indicates the degree of sonority of the chest in different 
parts. It can either be practised directly with the hand or through the 
medium of a pleximeter. The latter method is preferable when 
dealing with fat animals. Percussion, however, gives slightly different 
results, according to the degree of fatness of the subjects. It should be 
practised both in a vertical as well as in a horizontal direction. 

At all points where the muscles are thick or well developed the results 
produced are negative, in the sense that only a dull sound is obtained. 
This is the result obtained in auscultating the areas marked 1, where 
one meets with the ileo-spinal and common intercostal muscle, and in 
that marked i, where the olecranian muscles are encountered (Fig. 166). 
Over the middle and inferior zones, however, the results are much more 
instructive. 

On the right side percussion of the middle zone gives, under normal 
conditions, a clear sound and perfect resonance from above doM-nwards, 
and from in front backwards, between the fourth intercostal space and 
the ninth rib. Beyond this point lies the liver, which gives a partial 
dull sound, and absolute dulness from the ninth to the twelfth rib, in 
consequence of its position, and of the projection of the diaphragm 
towards the thoracic cavity. 

Percussion of the inferior zone produces less marked resonance, which 
diminishes more and more towards the base, in consequence of the thin- 
ness of the pulmonary lobes at this point. This resonance does not 
extend as far as the hypochondriac region, because the lower part of the 
abomasum insinuates itself beneath the costal cartilages and causes a 
region of dulness. 

On the left side percussion gives precisely similar results, except 
in the upper portion of the middle zone. Beyond the ninth inter- 
costal space the sound changes, and has a tympanic character; because 
here the anterior and upper portions of the rumen are encountered, 



316 RESPIRATORY APPARATUS. 

as they are lodged beneath the hypochondrium. Below, the sound is 
dull, on account of the gastric compartments generally being full of 
food. 

Certain trifling modifications of this normal condition may be noted, 
depending on the degree of fatness or thinness of the subjects. The 
pathological changes which may occur are as follows : — 

A tympanic sound, with or without metallic character, may be found 
at a point where normally one would expect a clear sound (pneumo- 
thorax, diaphragmatic hernia). A dull sound may be met with in the 
same regions, all resonance being lost (pneumonia, broncho-pneumonia, 
pleural exudate, etc.). Partial dulness and partial loss of resonance may 
occur in regions which ought to give a resonant sound (deep pneumonia, 
tuberculous lesions, the presence of echinococcus cysts, etc.). 

Auscultation — i.e., examination by means of the ear — is the most 
valuable method of discovering and localising pulmonary, pleural, or 
cardiac lesions. 

Various sensations are conveyed to the ear, depending on the method 
in which the normal or pathological sounds are produced. 

The deductions to be drawn as regards the nature of existing disease 
are based on the intensity, character, duration, and special attributes of 
the sounds noted. 

Direct auscultation is the most certain method, but the ear cannot be 
applied with equal facility at all points. Under such circumstances 
a simple or binaural stethoscope, or the phonendoscope, may be used 
with advantage. 

To properly appreciate the sounds heard it is essential to be exactly 
acquainted with the relation between the lung and thorax. On the left 
side (Fig. 60) the anterior pulmonary lobe occupies the space between 
the first and fourth ribs, in front and above the base of the heart. The 
middle, or cardiac, lobe covers the left upper and postero-lateral part 
of the heart from the fourth to the sixth rib. The posterior lobe 
occupies all the region beyond the sixth rib as far as the twelfth. 

On the right side the arrangement is similar, but the anterior lobe 
and the cardiac lobe are more developed (Fig. 62), 

Under ordinary circumstances the extensive movement of the lung 
which occurs during inspiration produces a special sound known as the 
respiratory or vesicular murmur. Contrary to what has been written, 
and said, this sound in animals possessing absolutely sound lungs ends 
with inspiration. Expiration is silent, though it is easy to estimate 
its duration. 

In auscultating the lung, we may distinguish four zones, a superior 
zone, a middle zone, an inferior zone, and a scapular zone. 

The superior zone is bounded by the vertebro-costal gutter, descends 



EXAMINATION OF THE RESPIRATORY APPARATUS. 317 

approximately as far as the inferior line of insertion of the common 
intercostal muscle, and extends from the summit of the scapula in front 
to the hypochondrium behind. 

Auscultation of this region through the ileo-spinal and common 
intercostal muscle will always reveal, except in very fat animals, the 
vesicular murmur to a point as far back as the eleventh intercostal 
space. Nevertheless, this vesicular murmur is relatively feeble, and 
becomes imperceptible beyond the eleventh rib. 

The middle zone comprises the most convex portion of the ribs, and 
at this point the wall of the thorax is thinnest, while the lung below 
is thickest. 

For these reasons the vesicular murmur is heard at its maximum 




Fig. 166. — The areas over which auscultation of the chest may be performed, 
showing their extent, position and relations to the thoracic wall. 1, Upper 
zone ; 2, middle zone ; 3, inferior zone ; 4, subscapular zone. 

intensity at this point. Towards the upper and lower limits of this zone 
are found the great bronchial divisions, so that auscultation should 
always be practised with the greatest care at this point. The middle 
zone occupies approximately one-third of the total depth of the thorax. 
The vesicular murmur becomes weaker as one passes backwards, and 
finally disappears at a considerable distance from the angle of the 
hypochondrium, following a curved line the convexity of which is 
directed forwards, and which is continuous with that limiting the 
upper zone. 

These peculiarities are due to the anatomical arrangement and 
mode of insertion of the diaphragm on the internal surface of the 
hypochondrium . 



318 RESPIRATORY APPARATUS. 

The inferior zone is very limited, and corresponds externally to the 
inferior third of the thorax, and topographically to the cardiac lohe or 
middle lohe of the lung and to the inferior portion of the posterior lobe. 

As these pulmonary lobes are of comparatively slight thickness, the 
vesicular murmur is feeble. It can be heard over a trapezoidal space, 
forming a jirolongation of the middle zone, but not below in the region 
of the sternum or pectoral muscles. 

The fourth zone extends over the mass of the olecranian muscles. 
It is of triangular form, in consequence of the inclination of the scapula 
and humerus. Except in very fat animals the vesicular murmur is 
readily audible through the muscular mass on the right side l)etter than 
on the left, on account of the development of the right anterior pul- 
monary lobe. 

On the left side the beating of the heart is heard al)ove the 
pulmonary sounds. 

Clinically one may hear an exaggeration of the ordinary respiratory 
murmur whenever the lung is actively exercised, as, e.t/., immediately 
after trotting. This exaggeration, however, is often pathological. It is 
known as " juvenile or supplementary respiration," when due to the 
fact that some other portion of the lung is not acting. 

The respiratory murmur may be lessened in certain morbid con- 
ditions, such as emphysema and congestion of the lung, and may com- 
pletely disappear in pneumonia or broncho-pneumonia, a fact which 
is even of greater significance. 

In various jDathological conditions the respiratory murmur may also 
be modified. On the other hand, the movement of air in the bronchi 
also produces various sounds of importance. 

A number of different bronchial sounds may be distinguished; these 
include both inspiratory and expiratory sounds, for sometimes an ex- 
piratory sound may become audible and clearly appreciable, or may 
acquire characters of the greatest importance. 

The inspiratory sound may be strong, rough, rasping, painful, moist 
or rattling. The pathological expiratory sounds may vary between 
audible, strong, rough, prolonged, or rattling. The varieties of souffle, 
or rattle, are the tubal souffle of inspiration or expiration (met with 
in pneumonia or broncho-j)neumonia) ; the soft, deep-seated pleuritic 
souffle (peripneumonia) ; the continuous cavernous souffle (met with in 
tuberculosis) ; the broad amphoric souffle, in which the vibrations are 
extensive and of metallic character (met with in pneumo-thorax). 

As to the varieties of rales which usually accomj^any these souffles, 
they may all be met with in tuberculous animals, and comprise 
crepitant and sub-crepitant, mucous, cavernous, snoring and sibilant 
rales. 



CHAPTER II. 
NASAL CAVITIES. 

SIMPLE CORYZA. 

Simple acute coryza, or inflammation of tlie mucous membrane 
of the nasal cavities, is of comparatively trifling importance in bovine 
animals, and, were it not for the possibility of gangrenous coryza being 
confused with it, there would scarcely be any necessity for a special 
description. 

The onset of coryza is indicated by repeated sneezing and coughing, 
by congestion of the pituitary mucous membrane, which soon begins to 
secrete abnormally, and by difficulty in respiration, which becomes 
snoring or whistling. 

The discharge, transparent at first, then mucous and muco-purulent, 
is abundant in quantity ; the inflammation is arrested at this point or 
extends towards the facial sinuses, the pharynx and larynx ; the eyes are 
swollen and watering, and almost all the characteristic symptoms appear 
which mark the onset of gangrenous coryza. Two signs, however, are 
wanting. The appetite is fairly well maintained, and the temperature 
little above normal. Simple coryza occurs at all times of the year in 
consequence of sudden chills, but is commonest in spring and autumn. 

At first the distinction between this condition and gangrenous coryza 
can only be ascertained after taking the temperature. 

The prognosis is absolutely favourable, and often in forty-eight 
hours every symptom disappears. 

Treatment is confined to keeping the animals in stables at a suit- 
able temperature, sheltered from draughts. Emollient fumigations and 
inhalations of turpentine, creosote, or eucalyj^tus oil rapidly check the 
more alarming symptoms. Warm drinks and foods and cooked roots 
are recommended. 

In sheep, acute coryza as a consequence of chills, etc., occurs in 
autumn, but is moi'e commonly due to a parasitic cause, viz., invasion 
of the nasal cavities by larvae of certain oestridte. During the succeeding 
winter it continues under the form of chronic coryza, as a result of the 
larvte retaining their position in the sinuses. 



320 NASAL CAVITIES. 

Treatment of this ijarasitic coryza consists in trephining the sinuses 
and destroying the kirvae. 

GANGRENOUS CORYZA. 
Gangrenous coryza is a grave disease of diphtheritic character, which 
at first seems to be localised in the mucous membrane of the upper 
respiratory passages, but which exhibits a tendency to afiect all the 
mucous membranes of the system. 

The term "gangrenous coryza," adopted in France, has been re- 
placed in other countries, especially in Germany, by such descriptions as 
" contagious disease of the head," and "malignant catarrhal fever of the 
ox." Old writers describe gangrenous coryza as a disease common in the 
Jura, the eastern parts of France generally, and in the valley of the 
Saone. In reality this disease occurs everywhere, both in the centre, 
west and north of France, as well as in the eastern regions. Serious 
outbreaks frequently occur in Germany and Italy. 

Symptoms. Gangrenous coryza assumes three different forms, which, 
however, only represent successive degrees of intensity of the attack. 
In the peracute form death occurs in three to five days, even when the 
characteristic signs are not all as yet apparent. In the acute, and by 
far the most frequent form, the disease lasts from fifteen to twenty d'Ajs, 
and also ends in death in by far the greater number of cases. Finally, 
in the form usually termed chronic, the disease lasts from four to eight 
weeks, and most frequently ends in recovery. 

Acute and jj^rac^ic forms. — The onset is marked by very striking 
symptoms, which precede the local symptoms by some hours, or by a 
day or more. 

The temperature rises rapidly from the normal to 103° or 105° 
Fahr. (39'5° to 41° C), or even higher. Appetite and rumination are 
entirely suspended; the respiration becomes rapid and difficult, while 
the heart beats strongly and tumultuously ; the muzzle is dry, the 
mouth hot, and salivation so abundant as to suggest an attack of foot- 
and-mouth disease. Fteces and urine are only passed at long intervals, 
and dysuria is present. 

At first everything seems to indicate the development of an acute 
infectious disease ; but soon afterwards appear local indications affect- 
ing the respiratory, ocular, digestive, urinary, nervous and cutaneous 
systems. 

The respiratory symptoms are most important, and almost charac- 
teristic. Respiration becomes difficult, rough as in acute coryza, but 
soon assumes a snoring character, and is accompanied by a discharge, 
containing false membranes, from both nostrils. 

The serous and muco-purulent discharge becomes rusty or reddish- 



GANGRENOUS CORYZA. 321 

brown, soon acquires a very foetid smell, and is found to contain epithe- 
lial debris and yellowish-green false membranes. After the least effort 
to cough or the slightest touch on the membranes themselves — some- 
times without any visible cause at all — epistaxis sets in, the blood being 
mixed with the discharge or simply escaping in the form of reddish 
strings, like that occasionally seen in glanders. 

The mucous membrane of the nasal cavities is red, turgid, apt to 
bleed, and painful to the touch. 

Percussion of the nasal cavities, sinuses, and even of the horns reveals 
everywhere exceptional sensibility. 

Sometimes, but only in certain subjects, the lower portions of the head, 
including the muzzle, nostrils, lips and forehead, become infiltrated, as 
though the case were one of purpura. Thoracic complications are rarely 
absent, unless the disease is treated. Towards the end of the first week 
the respiration, still painful and snoring, becomes more rapid ; and 
auscultation reveals at various points in the lungs areas of bronchitis 
and of l)roncho-pneumonia, indicated by bronchial rales, rattling breathing, 
and tubal souffles, etc. These complications are accompanied by attacks 
of coughing, which increase the discharge, and may threaten to end in 
suffocation. This hajDpens when large masses of false membranes from 
the bronchi are thrown into the larynx and cannot readily be ejected 
through the glottis, which has been reduced in size by oedematous 
infiltration and inflammation. 

Percussion is generally useless. The appearance of the eyes is also very 
significant. These symptoms develop simultaneously with the respiratory 
disturbance, and are marked by infiltration of the eyelids, oedematous 
conjunctivitis, and ophthalmia. The cornea becomes whitish, infiltrated, 
opaque, and sometimes shows ulcerative keratitis ; or, on the other hand, 
it remains simply semi-transparent, and through it the media of the 
eye may be seen to have become opalescent. Ulcerative keratitis may 
develop rapidly and end in perforation of the cornea. 

In certain rare instances examination with the ophthalmoscope has 
revealed the existence of exudative iritis ; this condition may be com- 
plicated with synechia, intra-ocular haemorrhage, and result in perma- 
nent loss of vision. 

These ocular symptoms are accompanied by continuous, abundant 
and prolonged discharge of tears, intense photophobia, and exceptional 
sensitiveness to manual examination, etc. 

Digestive disturbance appears less important, and may be regarded as 
consequent on the febrile reaction, the general disturbance, or the condi- 
tion of the respiratory apparatus. But complete examination will show 
that from the onset of the disease a special form of stomatitis occurs. 
From the first the mouth is hot and dry : soon afterwards abundant 

J).C. Y 



322 NASAL CAVITIES. 

reflex salivation occurs, and the discharge, Uke that from the nose, becomes 
excessively foetid. This stomatitis differs entirely from ordinary forms 
of stomatitis and from the stomatitis peculiar to foot-and-mouth disease, 
and is characterised by the necrosis of fragments of epithelium forming 
false membranes. These on being shed leave exposed numerous ulcers 
distributed over the tongue, cheeks, and lips. Neither vesicles nor pus- 
tules are produced, but merely false membranes of small dimensions. 

The false membranes and ulcerations occur on the soft palate and in 
the pharynx. 

When the patients survive for a certain time, croupal enteritis and 
ulcerative enteritis, sometimes accompanied by haemorrhage, develop. 
The administration of enemata is followed by the passage of faeces con- 
taining considerable fragments of epithelium or of streaks of blood. 
From the outset these digestive complications are indicated by failure to 
ruminate, by cessation of peristalsis and by constipation, which is usually 
succeeded by abundant foetid diarrhoea. 

Functional disturbance of the genito-urinary api^aratus is rarer, or 
at least more difficult to detect. The animals refuse drink ; micturition 
seems to be suspended or very difficult. The urine may be albuminous 
or rose-coloured, in consequence of the presence of haematin ; more rarely 
it is purulent or sanguinolent. There may also be urethritis, cystitis, 
j)yelitis, and nephritis, with the passage of hyalin cylinders in the urine, 
although this is not always the case. 

In females the mucous membrane of the vagina and lips of the vulva 
usually seem congested and oedematous ; but it is rare to find diph- 
theritic false membranes, as on the buccal and nasal mucous membranes, 
etc. On the other hand, vaginitis and exudative metritis are common. 

Cutaneous outbreaks also constitute important symptoms by which 
this disease is recognised. At points where the skin is fine, on the 
inner surface of the thighs, around the girth, on the inner surface of 
the forearm, and on the mammae, etc., an exanthematous eruption 
occurs, followed later by the development of pustules, which at first 
sight might suggest cow-pox. 

These pustules are prominently apparent, and can readily be detected 
on palpation. They are more or less confluent, hard, and without a 
peripheral oedematous zone. 

In the case of the mammae these pustules occur most commonly on 
the teats, are round or slightly oval in form, bright red in colour, and 
sometimes violet-red. They never become converted into vesico-pustules, 
as in cow-pox, or into vesicles ; and in no way resemble the skin eruption 
peculiar to foot-and-mouth disease. 

Certain nervous 'symptoms have also been described, comprising 
trembling, epileptiform convulsions, and paraplegia of the hind quarters. 



GANGRENOUS CORYZA. 323 

Moussu has never seen nervous disturbance assume the form of 
epileptiform convulsions, and it is possible that the paraplegia referred 
to simply marks the last stage of the disease. 

Causation. The essential cause of gangrenous coryza has not yet 
been definitely ascertained. Within recent years teachers of the highest 
authority have represented the disease as a general affection belonging to 
the hpemorrhagic forms of septicaemia (Nocard and Leclainche). Nocard 
has found ovoid bacteria in the false membranes of the larynx, and 
Leclainche a paracoli-bacillus in the mesenteric ganglia and the intes- 
tines, but the disease has never been reproduced in a characteristic and 
comjjlete form similar to the clinical type. 

Other microbes have also been described as occurring in the blood or 
discharges ; but attempts to transmit the disease by using cultures or the 
different morbid products which observers have collected have invariably 
failed, and it has therefore been concluded that the disease is not 
contagious, but merely infectious. 

Moussu does not regard this disease as a haemorrhagic septicaemia, 
because the blood proves sterile unless grave pulmonary, intestinal or 
renal complications occur, and because the disease appears capable of 
being cured in a short time by simple methods. In the present state of 
knowledge he prefers to regard it as an infectious disease of diphtheritic 
form, at first localised in the upper respiratory and digestive tracts, 
always tending towards a grave toxaemia, and towards complications due 
to various other infections. 

Even though direct contagion has not been proved, it is impossible 
to doubt that stables may become infected. This is sufficiently proved 
by the continued appearance of the disease when disinfection is neglected 
after the occurrence of the first case. 

It is possible that the causes formerly assigned — viz., chills, .the 
influence of draughts, and a morbid predisposition — may increase sus- 
ceptibility in animals otherwise well cared for, l)ut it is quite certain 
that infection of the stable is an important factor. 

Lesions. The lesions vary with the complications, but those shown 
in the beginning are always identical. The mucous membrane of the 
nasal cavities is congested, inflamed, sphacelated, and ulcerated at dif- 
ferent points. The turbinated bones and the ethmoid cells may become 
necrotic ; in the larynx the region of the glottis is always most markedly 
affected ; the mucous membrane becomes ulcerated in the neighbourhood 
of the vocal cords, and the tissues may become more deeply attacked. 

In the trachea and bronchi the mucous membrane undergoes desqua- 
mation, and may become ulcerated at the points where false membranes 
have formed. The mucous membrane of the sinuses is always affected, 
but is rarely ulcerated. 

Y 2 



324 NASAL CAVITIES. 

Such complications as capillary bronchitis, broncho-pneumonia, and 
gangrene of the lung may be noted. 

The mucous membrane of the mouth presents a violet-red or 
blackish-red colour ; the tongue and gums are swollen, and ulcers 
as large as a lentil or a halfpenny' may occur either singly or in a 
confluent form. 

The genito-urinary apparatus reveals signs of croupal cystitis, 
submucous effusions of blood, vaginitis with the formation of false 
membranes, acute pyelitis, etc. 

Diagnosis. When the symptoms are fully developed the diagnosis of 
gangrenous coryza is extremely simple, but the absence of some of these 
may justify hesitation in forming an opinion. If the examination is 
carefully carried out, it is always possible to distinguish this disease 
from simple coryza, which is only accompanied by trifling fever, and in 
which appetite is preserved ; from foot-and-mouth disease, with its very 
characteristic buccal eruption and absence of lesions from the upper 
portions of the respiratory tract ; and from contagious ophthalmia. 

Prognosis. Up to the present time the prognosis has always been 
regarded as extremely grave, the mortality being sometimes as high as 
from 90 to 100 per cent., and moreover the cases which recover are 
invariably those of what is considered the chronic form. Sudden 
sinking of temperature during the disease is an unfavourable sign. 
From 1894 to 1900 Moussu never cured a single case, whatever his 
method of treatment ; nevertheless, it now seems possible to regard the 
condition a little more hopefully, provided that no incurable compli- 
cation occurs before the beginning of treatment. 

Treatment. Of all the modes of treatment suggested — viz., anti- 
febrile agents, general stimulants, purgatives, diuretics, external 
stimulant applications, etc. — none have succeeded. Antiseptics in- 
jected into the nasal cavities, antiseptics given internally, milk diet, 
and all the methods hitherto suggested are equally useless. 

The only treatment which appears to have achieved any degree of 
success is that of injecting physiological salt solution in large doses (up 
to six quarts per da}^ divided into three parts). All the animals treated 
by this method recovered, provided they presented no broncho-pulmonary 
complications. 

The sole inconvenience of this treatment is the difficulty in carrying 
it out when the animals are at a distance from the practitioner. It is 
indispensable that they should be close at hand, in order that he himself 
may make the injections at the proper time. There is some reason for 
hoping, however, that serum from animals which have recovered will 
prove to be more active than saline injections. 

This method of treatment should be followed up by the most rigid 



TUMOURS OF THK NASAL CAVITIES. 



325 



hygienic precautions. The mouth, nasal cavities and eyes should fre- 
quently be washed with antiseptic solutions. The stables should be freely 
ventilated, and the floors and bed kept in the cleanest possible condi- 
tion, etc. 

Whenever a case of gangrenous coryza is observed it should be 
isolated, and the stables should most carefully be disinfected. 

TUMOURS OF THE NASAL CAVITIES. 

Apart from actinomycosis of the upper jaw, tumours of the nasal 
cavities or of the sinuses are not frequent in bovine animals. They are, 
however, occasionally met with, and present symptoms which must be 




Fig. 167. — Transverse section through the nasal cavities near 
their centre (normal). 

carefully studied in order to avoid errors of diagnosis. Usually they 
are of the nature of myxomata, more rarely of fibro-myxomata. 

Symptoms. The dominant symptom is difficulty in breathing, both 
when moving and eating, a difficulty which is sometimes so considerable 
as to cause snoring respiration or roaring. Nevertheless, examination of 
the trachea and of the lung, visual examination of the lower portions of 
the nasal cavities, and manual examination of the pharynx, larynx and 
glottis give only negative results. It may even happen, as occurred in 
the case from which the illustration herewith was taken, that percussion 
of the maxillary sinus reveals normal resonance. 

In the case of tumours of small size the forehead is not deformed. 
When, on the other hand, the tumour partly obstructs the nasal cavities it 



326 



NASAL CAVITIES. 



may thrust on one side the septum nasi and externally cause well-marked 
asymmetry of the face. Sero-mucous or muco-purulent discharge then 
occurs. 

The diagnosis is somewhat difficult, for continuous or temporary 
roaring (or at any rate difficulty of respiration), heing the dominant 
symptom, must he distinguished from roaring due to a laryngeal lesion 
like paralysis or tumour formation, from perilarj^ngeal compression due 
to enlarged retropharyngeal glands, and from tracheal or pulmonary 
lesions ; and its origin must he located in the nasal cavities. 




Fig. 168. — Transverse section through the nasal cavities : myxoma of the right 
side and of the maxillary sinus. Deformity of the forehead and face. 

The prognosis is grave, in consequence of the difficulty of exploring 
the depth of these cavities and of the possible nature of the tumour. 
Nevertheless, in the case of simple myxomata permanent recovery 
usually follows extirpation. 

Treatment is confined to extirpation, which is quite j^ossible in the 
case of pedunculated tumours ; in the case of sessile tumours free 
trepanation of the roof of the nasal cavities becomes necessary. The 
operation is quite safe. 

PURULENT COLLECTIONS IN THE NASAL SINUSES. NASAL GLEET. 

From the clinical point of view two varieties of this condition may be 

distinguished— inflammation of the mucous membrane of the maxillary 



PURULENT COLLECTIONS IN THE FRONTAL SINUS. 327 

sinus and inflammation of the mucous membrane of the frontal sinus 
and of the horn core. These forms of inflammation frequently lead to 
suppuration. The pus collects in the depressions and divisions of the 
frontal or maxillarj^ sinus. 

PURULENT COLLECTIONS IN THE FRONTAL SINUS. 

Causation. In the majority of cases inflammation of the mucous 
membrane of the frontal sinus is produced by external causes : fractures 
of the horns and horn core accompanied by haemorrhage into the horn 
core ; fractures of the horn with exposure of the sinus of the horn core ; 
wounds and violent blows on the occipital region or the frontal bone ; 
cracks or depressions of the external wall of the sinus, etc. 

In all these cases, whether blood is eft'used or the mucous membrane 
of the sinus is merely infiltrated with serum, infection may be produced 
by germs being deposited from the air passing through the nasal cavities 
and causing sui^puration. 

Purulent collections in the frontal sinus may result from continued 
irritation, like that due to a badly fitting yoke. They also occur as an 
accidental comj)lication of general diseases like gangrenous coryza. 

Symptoms. The catarrh or purulent collection in the sinus may be 
unilateral or bilateral, and the symptoms vary, according to the form 
which it assumes. 

Unilateral collections. — Nasal haemorrhage is often the first symptom, 
but this is often regarded as of little importance, because the formation of 
pus does not occur until very much later. The animal shows ill-defined 
pain, loses appetite, remains dull and somnolent, and carries its head on 
one side. The horn on the injured side is hot and sensitive, and at a 
later stage the eye becomes affected by contiguity of tissue. It is then 
swollen, closed, and watery ; the conjunctiva is infiltrated, and somewhat 
inflamed. Sensibility and partial or comj)lete dulness of the affected 
side may be detected by palpation and percussion. On the animal 
being made to cough, a yellowish or greyish-white discharge of very 
fcetid and sometimes putrid character escapes. 

Bilateral collections. — Catarrh is rarely bilateral at first ; but if the 
unilateral lesion is not treated, it affects the median septum dividing the 
two cavities, and the inflammation extends to the second sinus. The 
animal then shows dull pain, and exhibits marked depression ; sometimes 
it appears quite prostrate. The head is carried low and inclined towards 
the ground, while the above-mentioned ocular symptoms and the indi- 
cations furnished by palpation and percussion extend to both sides. 
Coughing produces momentarily a double discharge, which the animal 
disposes of after the fashion of horned cattle. 



328 NASAL CAVITIES. 

Diagnosis. The diagnosis only presents difficult}^ in the early stages. 
Later the warmth and sensitiveness of the horns, the partial dulness, 
offensive character of the discharge, etc., render diagnosis easy. 

The disease is not likely to be mistaken for gangrenous coryza, 
despite the condition of the eyes, because it develops slowly, progres- 
sively, and without marked fever. 

Prognosis. If treated early, unilateral or bilateral collections of pus 
in the sinuses are capable of cure, but later when bodily health is im- 
paired and the local lesions of the mucous membrane very pronounced, 
there is less chance of success. 

Lesions. The initial lesions consist in cracks, fissures, or fractures 
of the bones of the face or exostoses of traumatic origin. In other cases 
the mucous membrane alone is aflected. Asa result of chronic irrita- 
tion it becomes thickened, inflamed, and ulcerated, and granulates 
freely. The depressions in the sinuses contain grumous, fcetid pus, 
which irritates the surrounding tissues and produces pain and general 
symptoms of cerebral irritation, which are sometimes very disquieting. 

Treatment. Numerous methods of treatment were formerly recom- 
mended, such as absolute rest, bleeding, cold aft'usions, perforation of a 
horn, section of a horn, etc. None of these is of any value. 

At first, provided only a certain degree of sensitiveness and simple 
catarrh without suppuration exist, antiseptic fumigations with tar, car- 
bolic acid, thymol, etc., are useful ; but later, when pus has formed, 
they are useless. At this period the only rational and efficacious treat- 
ment consists in trepanation. In unilateral collections three openings 
are necessary. 

The first is an opening into the sinus of the horn core. It is made 
f to f of an inch above the horn-secreting band of the horn. It must 
not be forgotten, however, in planning such an opening that the sinus of 
the horn core only exists in a rudimentary condition in young animals, 
and that it is scarcely possible to trephine the horns before the patient 
is three years of age. 

The second opening is made towards the upper part of the frontal 
sinus about f inch below the horn-secreting ring at the base of the 
horn and in a line with the axis of the horn core itself. Whatever the 
animal's age and however little the sinuses may be developed, this 
opening is certain to expose the cavity of the frontal sinus. 

In old animals where the frontal sinus is enormously developed, and 
where very large depressions exist in the orbital region, a third opening 
should be made just above a transverse line uniting the upper margins 
of the two orbits and inside the suborbital suture. 

These openings having been made, treatment consists — firstly, in 
completely washing out the cavity with boiled water, cooled to 95° or 



PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 329 

100° Fahr. ; and, secondly, in injecting antiseptic and astringent solutions 
so as to check the formation of pus. Among such may be mentioned 
3 per cent, carbolic solution, 5 per cent, carbolic glycerine, 2 per cent, 
solution of iodine in iodide of potassium, etc. 

Whatever the drugs employed, the cavities should be washed out 
every day, first with plain sterilised water, and then with antiseptic 
solutions at the body temperature, since cold solutions often cause 
inflammation of the mucous membrane of the opposite sinus. 

PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 

This disease is much rarer than that of the frontal sinus, and only 
within the last few years (Eies, 1899) has a really good description been 
given of it. 

The causation is imperfectly understood. Injuries to the suborbital 
region and maxillary ridge, caries of the molar teeth, and inflammation 
occurring during the development of general diseases represent the 
princii^al causes. 

The dominating and characteristic symptom of the presence of pus 
in the maxillary sinus consists in incessant snorting, accompanied by 
violent movements of the head and the discharge of purulent or muco- 
purulent material. 

At the beginning of these attacks of snorting, which are produced 
by the reflux of pus from the sinus towards the nasal cavities, the 
respiration becomes snoring and rapid, and the animal makes sniffing 
movements as though the nasal cavities were partially obstructed. After 
these crises, the respiration again becomes silent. 

Contrary to what has been observed in purulent collections in the 
frontal sinus, the discharge is unilateral, reddish yellow in colour, 
viscous in consistence, and is accompanied by clots of a gelatinous 
material or even of blood. 

During the attacks of snorting, the discharge resembles that of 
croupal or pseudo-membranons bronchitis, but the material discharged 
is not moulded on the internal shape of the bronchi. The masses of 
discharge are irregular in form, and appear as though made up of fibrous 
tissue matted together. Attention having been attracted by the dis- 
charge, exploration of the trachea and chest reveals nothing ; on an 
examination of the sinuses, however, palpation and percussion betray 
a certain amount of sensitiveness, together with partial or comj^lete 
dulness, and the lesion is discovered. 

Diagnosis. Confusion between pus formation in the maxillary and 
frontal sinuses can be avoided by careful examination. 

Prognosis. The prognosis is not very grave ; the animals maintain 



330 NASAL CAVITIES. 

their appetite, but become thinner, and the condition shows no tendency 
to spontaneous cure. 

Treatment. The only rational treatment consists in trephining, an 
operation practised immediately aljove the maxillary tuberosity and over 
the lowest part of the sinus (Fig. 164). This opening allows the cavity 
to be washed out and the sinus drained. 

Antiseptic treatment exactly resembles that of purulent collections 
in the frontal sinus. Injections of astringents, dilute carbolic acid and 
iodine solutions, etc., are recommended. 

CESTRUS LARViE IN THE FACIAL SINUSES OF SHEEP. 
(false sturdy.) 

Causation. This disease of sheep, which sometimes produces vertigo 
reseml)ling that shown in gid or sturdy, is produced by the growth of 
larvte of (Eslnis oris in the frontal sinuses. The oestrus of the sheep 
assumes perfect insect form during the fine days of summer from July to 
September. The females swarm around the flocks and attempt to alight 
on the animal's head close to the nostrils, where they deposit their eggs 
or larvae. The larvfe crawl into the nostrils, thence into the nasal cavities, 
the meatus, and finally the sinuses, where they become fixed. In these 
sinuses they undergo complete development, increasing from a length of 
about Jo inch to from f to 1 inch before their transformation into the 
nymph and perfect insect. They remain in the sinus for eight to ten 
months. When numerous and well developed they may fill the whole 
of the cavity. 

Symptoms. It is easy for a careful observer to note the time at 
which the larvae penetrate the sinus. D.uring the hottest hours of the 
day the adult insects are continually hovering over the flocks, and on 
watching carefully one sees sheep suddenly become excited, tap with their 
feet, rul) their faces against any hard, resisting object in the neighbour- 
hood, plunge their nostrils into the dust, and snort violently. 

When the larvae have penetrated the nasal cavities they produce 
frequent attacks of sneezing by irritating the mucous membrane, and 
cause an intense sero-mucous and afterwards a moderate muco-purulent 
coryza. As long as the larvae remain of small size, the apparent results 
they produce are insignificant, as during the first months of winter ; but 
when they are numerous, and have become of considerable size, they 
cause symptoms which might suggest an attack of gid or sturdy. 

Thus the bodily movements become spasmodic, the gait irregular, 
and the animals show attacks of vertigo. They stagger and fall, making 
convulsing movements, grinding their teeth and rolling their eyes, while 
frothy saliva escapes from the mouth, etc. 



CESTRUS LARV.*: IN THE FACIAL SINUSES OF SHEEP. 



331 



Death may occur during such attacks, which, however, are happily 
very rare. Most commonly the animals are simply dull and somnolent. 
They feed badly, carry their heads low, and sometimes hide themselves 
under the mangers or in corners. 

In exceptional circumstances they bury their heads in the wool or 
carry them high in the air in walking, while they lift their front legs 
high, with a stepping movement. 

Diagnosis. The diagnosis of parasitic invasion of the sinus in the 




Fig. 169. — Parasitic invasion of the sinuses and coenurosis (showing the 
seat of operation in either condition). 



sheep is rather difficult, because certain of the symptoms suggest gid. 
One never finds the signs of true gid, however, and, on the other hand, a 
certain amount of discharge and attacks of snorting always exist. Finally, 
gid (coenurosis) only attacks young animals, whilst the larvae of oestridae 
are commonest in adults. 

To confound the disease with verminous bronchitis is still less likely, 
for although a discharge exists in both cases, this is accompanied by 
cough in bronchitis, and only by sneezing attacks in infection of the 
sinuses. 



332 NASAL CAVITIES. 

Finally, in bronchitis, histological examination leads to the discovery of 
eggs or embryos of the strongjdes. The diagnosis becomes very easy on 
post-mortem examination, the identification of the larva; of cestridte l)eing 
extremely simple. 

Prognosis. The prognosis is only grave when infestation is very 
pronounced. Most commonly the parasites complete their development 
without producing disquieting symptoms ; as summer approaches they 
are expelled and recovery occurs. 

Lesions. The only lesions consist in very active inflammation of the 
mucous membrane of the sinus, which appears excessively hypertrophied, 
and in the existence of larv». These develop in the midst of a magma of 
purulent, foetid discharge. The number of parasites usually ranges from 
two to twenty, although Zlirn declares that he has found as many as 
eighty in one subject. 

Treatment. Many precautions have been suggested for preventing 
infestation. Many are impossible or difficult to carry out in current 
practice, even the soaking of the nostrils in empyreumatic oil, and the 
majority are useless. The only suggestion to which we attribute any 
importance consists in trying to prevent the perfect insects from obtain- 
ing a lodgment in cavities in the walls or roofs of sheep-sheds. 

The really efficacious modes of treatment are also few in number, for 
the larvae are so firmly lodged in the mucous membrane of the sinuses that 
they can only be detached after these have been trephined. The use of 
nasal injections, embrocations and powders, with the object of making 
the animal sneeze, are ineffectual. 

Trepanation should not be performed until it is quite clear that the 
flock is badly infested, and when serious symptoms appear to threaten 
the lives of some of the animals. 

The operation, although very simple, requires care on account of the 
thinness of the bones. 

The anatomical directions are the middle line of the head, and a 
transverse line uniting the upper margin of the two orbits. The orifices 
are made in the two lower angles produced by the intersection of these 
lines (Fig. 169). 

It is then easy to remove with the fingers or forceps the larvae situated 
immediately below the point of trepanation, and afterwards to wash out 
thoroughly the cavities of the sinuses. If some lie at points which cannot 
be directly reached, they can be killed by injecting a little benzine and 
water. This proceeding is quite safe. 



CHAPTER III. 
LARYNX, TRACHEA AND BRONCHI. 

LARYNGITIS. 

Laryngeal diseases are common, but are usually only the local expres- 
sion of some grave general infection, such as foot-and-mouth disease, 
gangrenous coryza, or tuberculosis. Pathological conditions such as these 
can be disregarded for the moment, as they will receive attention under 
special heads. 

The two current forms of laryngeal disease are acute laryngitis and 
stridulous laryngitis. 

ACUTE LARYNGITIS. 

Acute laryngitis, like simple coryza, of which it is often only an 
accompaniment, is caused by chill, by irritant vapours, by smoke, etc., 
or by external traumatic causes. 

The cough is dry and painful at first ; afterwards it is accompanied 
by a discharge or by the swallowing of mucus or muco-purulent products. 
The respiration sometimes appears accelerated and difficult, but roaring 
or whistling and marked fever are rare. The slightest pressure over the 
laryngeal region causes pain and attacks of coughing. The respiration 
is normal while the animal is at rest, provided that the laryngitis remains 
localised ; frequently, how^ever, it is complicated with bronchitis. 

The appetite is somewhat diminished, but all these symptoms very 
rapidly improve. 

The diagnosis is leased on the frequency of the cough and the sensi- 
tiveness of the throat region. 

The prognosis is favourable in cases of simple laryngitis. 

Treatment consists in the administration of steam inhalations, 
warm drinks, the application of mustard plasters or blisters around 
the laryngeal region, and the administration of expectorants to facili- 
tate mucous discharge. 

PSEUDO-MEMBRANOUS LARYNGITIS. 

Pseudo-membranous laryngitis, also termed by German authors 
croupal or diphtheritic laryngitis, because it bears a certain resemblance 



334 LARYNX, TRACHEA AND BRONCHI. 

to human croup, is characterised l)y the formation of false membranes 
on the vocal cords, arytenoid cartilages, and subglottal region, etc. 

In France it has been described under the name of stridulous 
laryngitis, because its dominant symptom consists in attacks of intense 
dyspnoea, during which the respiration is accompanied by whistling. 
Without making any attempt to prejudge the nature of the disease, which 
resembles the pseudo- diphtheritic forms of larj'ngitis in man, we prefer 
the term pseudo-membranous laryngitis. Moreover, this pseudo-mem- 
branous laryngitis very frequently accompanies pseudo-membranous sore 
throat, tracheitis and bronchitis, with formation of false membranes. 

Causation. The causes suggested are similar to those of simple sore 
throat : they include chills, the ingestion of ice-cold water, or the inhala- 
tion of irritant gases, during outbreaks of fire, etc., etc. ; but it is quite 
certain that here, as in many similar cases, a primarily simple laryngitis 
is complicated by a well-marked infection. 

Symptoms. The general symptoms seen during the early stages 
consist in loss of appetite, general depression, rigors, and a rise in 
temperature of 1° to 2° Fahr. 

Then, after twenty-four or forty-eight hours, the respiration becomes 
more rapid, difficult, whistling and dyspnoeic, with intermittent attacks 
of suffocation. 

Examination of the chest gives negative results, but, on the throat 
being manipulated, the slightest pressure exercised over the larynx pro- 
duces attacks of coughing. During the first few days these attacks are 
loud, spasmodic, and difficult, but on succeeding days they lead to the 
discharge, from the nostrils or mouth, of masses of false membrane 
accompanied by whitish and sometimes blood-stained fluid. Secondarily 
the mucous membrane of the nasal fossre appears inflamed to a varying 
degree. The conjunctiva is also affected, the eyes are watering. An 
important symptom consists in the fact that this watering is accom- 
panied by internal ophthalmia, as in gangrenous coryza. 

In consequence of the respiratory difficulty, the animal takes up a 
characteristic attitude, holding its neck stiffly in a horizontal position 
and its head completely extended ; the nostrils are widely dilated. 
When the disease is fully developed rumination is suppressed, the 
bowels are constipated and the faeces are coated as in grave cases of 
enteritis, the yield of milk diminishes, the heart beats feebly, the pulse 
remains small ; death may occur from asphyxia, and proljably also from 
intoxication. 

The disease usually lasts from eight to ten days, but death may occur 
earlier. In the majority of cases, however, the animal can be saved. 
All the symptoms diminish, the temperature falls, rumination again 
ajipears and with it appetite, and the whole condition becomes normal. 



TUMOURS OF THE LARYNX. 335 

Many animals, however, remain thin and recover slowly ; these 
are principally cases which have suffered from pseudo-membranous 
bronchitis. 

Lesions. The lesions may be confined to the larynx, but may also 
invade neighbouring cavities. They consist in the formation of muco- 
albuminous and fibrinous exudates, covering the mucous membrane in 
superposed layers, penetrating the epithelial stratum, and adhering so 
strongly to the corium that attempts to loosen them cause the deeper 
seated structures to bleed. 

Diagnosis. The symptoms are sufficiently well marked to prevent 
any confusion arising except with gangrenous coryza, but in this case 
there is no ophthalmia lesion of the nasal cavities, cutaneous eruption, 
or eruption over the claws. 

The prognosis is grave when the disease attacks debilitated or 
exhausted animals. 

The treatment is confined entirely to treating symptoms. As in all 
acute inflammatory affections, moderate bleeding, sinapisms over the 
region of the larynx, repeated as often as necessary, or applications of 
antimonial ointment have been recommended. Applications of moxas 
or setons in the neighbourhood of the dewlap might possibly prove of 
value. 

Internally tartar emetic, in doses proportioned to the size of the 
animal (2i to 3 drachms in adults), has been recommended; also iodide 
of potassium. 

General stimulants, like alcohol, coffee, tea, acetate of ammonia, and 
suitable hygienic conditions suggest themselves. Tepid drinks can be 
given freely. Nourishing and easily digested food, and a ration of milk 
complete the treatment. 

Emollient and antiseptic fumigations are also of value, as in ordinary 
sore throat or laryngitis, for they favour the separation and discharge 
of the false membranes. 

TUMOURS OF THE LARYNX. 

Acute forms of pseudo-membranous laryngitis, or even tuberculous 
laryngitis, are not the only diseases which affect the larynx. It is by no 
means exceptional to discover intra-laryngeal tumours, mucous polypi, 
tuberculomes, and growths due to actinomyces, etc. 

The presence of these tumours is indicated by difficulty in respira- 
tion, fits of coughing, and threatened suffocation, accompanied by dis- 
charges of varying character. 

When the tumour is largely sessile, the respiration may simply be 

snoring or whistling, without any suggestion of suffocation ; but if, on 

• the other hand, it is pedunculated, displacement of the polypus produced 



330 



LARYNX, TRACHEA AND BRONCHI. 



by the currents of air during inspiration and expiration causes spasm of 
the glottis, fits of coughing and threatened suffocation. 

The diagnosis is not always easy, though examination of the nasal 
cavities, the sinuses, trachea and chest gives negative results. Ausculta- 
tion of the larynx may suggest the existence of the lesion, but an exact 
diagnosis can only be attained by digital examination of the larynx 
through the pharynx. 

The prognosis of these tumours is grave, because death from 

asphyxia may occur during an 
attack of coughing or as a con- 
sequence of the fits of suffoca- 
tion. 

Treatment. As it is usually 
extremely difficult, if not impos- 
sible, to discover the exact nature 
of the tumour, medical treat- 
ment, except for instance in the 
case of actinomycosis, is of very 
uncertain value. 

Surgical treatment alone sug- 
gests itself. Before attempting 
an operation tracheotomy should 
be performed and a metal canula 
inserted. The animal having 
been cast, and the upper laryn- 
geal vegion anaesthetised by 
means of cocaine, a vertical in- 
cision is made in the median 
line below the larynx, passing 
through the skin, the vertical 
junction between the neck mus- 
cles and the three first circles 
of the trachea, and access is 
thus obtained to the larynx and subglottal region. The operation 
should only be performed in exceptional cases, such as that of a valu- 
able stud animal. 

Provided that the new growth has a well-developed pedicle it can be 
removed through the mouth by the use of an ecraseur or simply by 
tearing out. 

BRONCHITIS. 

Diseases of the bronchi in bovine animals reveal very different 
characters, according to the nature of the primary cause, for which 




Fig. 170. 



Sessile form of intra-laryngeal 
polypus. 



SIMPLE ACUTE BRONCHITIS. 337 

reason cases occur of simple acute bronchitis, verminous bronchitis, 
simple chronic bronchitis, pseudo-membranous bronchitis, tuberculous 
bronchitis, etc. 

SIMPLE ACUTE BRONCHITIS. 

Simple acute bronchitis coexists with, or is often only the logical 
and inevitable complication of, coryza and acute laryngitis. It is com- 
monly associated with inflammation of the mucous membrane of the 
trachea. 

It accompanies cold and wet seasons, and usually appears with the 
autumn frosts, in animals still at grass. In animals under shelter it 
occurs after undue exertion followed by chills, and after sudden rain 
storms. It also attacks working oxen, which are much exposed to the 
weather. 

The symptoms follow very rapidly on the determining cause. They 
are ushered in by rigors, trembling attacks, diminution or loss of appe- 
tite, arrest of rumination, acceleration of breathing, and the appearance 
of a rough and spasmodic cough. 

In ordinary cases these symptoms rapidly diminish, even without 
treatment. The appetite again becomes moderate, rumination returns, 
but the cough remains more or less rough and spasmodic, ending in the 
discharge, or more often in the swallowing, of abundant bronchial 
mucus. 

This is the condition at the period of crisis. Percussion of the 
thorax reveals normal resonance. On auscultation of the sides during 
the period of onset, rough rales are heard, which at the period of crisis 
are replaced by mucous rales. The cough diminishes in frequency, and 
after a fortnight everything again becomes normal. 

The diagnosis is very easy, the important point being not to con- 
fuse common bronchitis with tuberculous bronchitis, which very often 
assumes a chronic form. 

Prognosis. The prognosis is not grave, even though the disease may 
assume a chronic condition. 

Treatment does not differ from that of acute bronchitis in the horse. 
It consists in antiseptic and steam fumigations, tepid drinks, the 
administration of doses of 2 to 3 drachms Kerme's mineral in 
adult animals, and of 1 to IJ drachms of iodide of potassium, given 
in a mash or in honey electuary. During convalescence tar water 
should be administered. 

CHRONIC BRONCHITIS. 

Chronic inflammation of the mucous membrane of the large 
bronchi and trachea may follow acute bronchitis, but it is also a frequent 

D.C. Z 



838 LARYNX, TRACHEA AND BRONCHI. 

termination of verminous bronchitis. It is fomid in fully developed 
animals, adult or old, and particularly in those inhabiting wet, cold 
vallej's. 

It is characterised by frequent paroxysms of coughing, which appear 
on the slightest provocation, such as the action of cold air on leaving the 
stable or of the air of a confined space on animals returning from the 
open ; concussion of the chest by the pleximeter, squeezing of the loins, 
rapid 'movement, etc. 

This coughing is accompanied by the discharge of mucus, which 
rarely arrives at the nostrils, but is swallowed in passing through the 
pharynx. Such mucus is always thick, greenish yellow in colour, and 
w^ithout smell. 

The respiration, although regular whilst the animal is at rest, becomes 
accelerated on moving, and after attacks o£ coughing. It is sometimes 
rapid and whistling. 

Percussion discloses neither partial nor complete dulness, but every- 
where irregularly distributed mucous rattling and sibilant rales are 
revealed by auscultation. 

There is no fever, the appetite is maintained, and, what is an even 
more important point, animals in good condition preserve their flesh. 
Interlobular pulmonary emphysema and emphysema resulting from 
dilatation are inseparable accompaniments of chronic bronchitis, for 
which reason the flank respiratory movement is frequently very 
^uarked. 

The diagnosis is of only moderate difficulty, because although in 
certain conditions the disease may be mistaken for tuberculosis or 
emphysema, it can be distinguished by bacteriological examination of 
the discharge, by an injection of tuberculin, by careful auscultation, 
and by consideration of the general condition. 

Lesions. The walls of the bronchi are thickened, the submucous 
connective tissue is sclerosed, the muscular fibres are modified in 
structure, and have become fibrous, while the epithelial layer is des- 
quamated and suppurating. The peribronchial tissue also undergoes 
sclerosis, and in certain cases the smaller bronchi present marked 
dilatations resembling small caverns (bronchi-ecstasis). 

Treatment can never be more than palliative ; the aim should be to 
prevent the lesions becoming aggravated, and to check the pathological 
secretion from the bronchi, but the lesions already existent can never 
be removed. Tar water should be perseveringly administered. Essence 
of turpentine in doses of 2 to 2| drachms per day in electuary 
(adults), creosote in doses of l^- to 1^ drachms, and terpine in 
doses of f to 1 drachm give the best results, and produce a marked 
improvement. 



PSEUDO-MEMBRANOUS BRONCHITIS. 339 



PSEUDO-MEMBRANOUS BRONCHITIS. 

The pseudo-membranous forms of bronchitis, formerly termed 
" croupal or di^jhtheritic bronchitis/' are rare. They develop suddenly 
or follow pseudo-membranous laryngitis. Like the latter, they are due 
to a specific infection, possibly aided by accidental causes. 

Their causation is imperfectly understood, and the}^ cannot be com- 
pared, still less homologated, with diphtheritic disorders in man. They 
are characterised by the formation of false membranes, which develop on 
the mucous surface, mould themselves over the internal surface of the 
large bronchi, and ramify throughout the bronchial channels like 
branches of trees. They are of greyish-yellow colour, and appear to be 
formed of fibrin, coagulated albumen, and epithelial debris cemented 
together with mucus. 

Symptoms. At the outset these pseudo-membranous forms of 
bronchitis have the same characters as acute bronchitis, which at the 
crisis would be marked by the expulsion of fragments of false membrane 
by coughing. Most frequently it seems that the bronchitis follows its 
regular course, and in such case it is only during convalescence or a 
considerable time afterwards that the membranes begin to be discharged 
during paroxysms of coughing. 

The patients are subject to intense dyspnoea, appear about to suffo- 
cate, and during the efforts then made the false membranes are dis- 
charged in the form of half-organised layers, or, on the other hand, in 
branched masses, resembling twigs. 

The dyspnoea at once ceases. Despite the development of these 
false membranes in the bronchi, no alarming symptoms are produced, 
wdiich is explained by the fact of the false membranes being adherent 
only to the inner surface of the principal conduits, without closing or 
even markedly obstructing them or the smaller passages leading to 
the pulmonary alveoli. When, however, they are displaced, violent 
reflex spasms are produced as soon as the fragments approach the 
larynx. 

Diagnosis. The diagnosis rests entirely on examination of the 
expectorated material. 

So far as the prognosis is concerned, it is less grave than might be 
supposed from the symptoms. The gravity arises from the fact that this 
disease has a certain tendency to become chronic. 

Treatment scarcely differs from that of ordinary bronchitis. Tar, 
creosote in doses of 2^ to 5 drachms given in oil ; terpine in doses of 
^ to f drachms per day can be recommended. Iodide of potassium also 
has certain advantages. 

z 2 



840 LARYNX, TRACHEA AND BRONCHI. 



VERMINOUS BRONCHITIS IN SHEEP AND CATTLE (hUSK, HOOSE, ETC.). 

Lambs, 3'Oung sheep, and calves sometimes suffer severely from infes- 
tation with lung worms, which set up great irritation in the bronchial 
passages, leading to chronic bronchitis. The animals show frequent 
attacks of paroxysmal coughing, during which some of the parasites may 
be expelled. The irritation produced causes serious loss of condition, 
and if not alleviated may lead to death. The parasite of the sheep is 
known as Strongylus filaria (sheep lungworm), that of the calf StromiyJm 
micrurus. The worms are from 2 to 4 inches long, whitish in colour, 
and of the diameter of a hat-pin. 

Treatment. According to generally accepted views among veteri- 
narians and zoologists, it is a comparatively simple matter to kill 
worms in the bronchial tubes, and a number of cases of the disease 
are reported in literature which are alleged to have been cured. These 
views, however, are open to very serious doubt. 

Neumann (1892b, pp. 590, 591, 593, 594) summarises the subject of 
treatment as follows : — 

Two different procedures in treatment are pursued. In one, sub- 
stances are passed into the digestive canal, which, being diffused in the 
blood, are believed to be capable of attacking the worms in the bronchial 
tubes. With this view, the picrate of potash (0*20 to 0*40 gram per head) 
is given, dissolved in thin gruel or mucilage ; creosote ; oil of turpentine ; 
a mixture of equal parts of oil of turpentine and tincture of camphor — a 
teaspoonful every day to each lamb in a mucilaginous fluid ; a mixture of 
creosote 120 grams, spirits of wine 500 grams, and water 700 grams — 
an ordinary spoonful every day to each animal ; or creosote 60 grams, 
benzine 300 grams, water 2 litres — an ordinary spoonful given every day 
for eight days to each sheep. Hall states he has successfully employed 
prussic acid in ten-drop doses, morning and evening. 

But experience has shown that, while such treatment is troublesome 
to carry out, its efficacy cannot be relied upon. 

Success is more certain with fumigations, as they penetrate directly 
to the worms, stupefy them, and induce fits of coughing that cause expul- 
sion. They are practised in buildings from which all forage is previously 
removed, and which are well closed. Into these the diseased [animals] 
are introduced, and on a red-hot shovel are placed rags, horns, feathers, 
hair, old pieces of leather, empyreumatic oil, tar, juniper berries, 
asafetida, etc. The intensity, duration, and number of these fumiga- 
tions are graduated as the sheep become accustomed to them. At first 
once a day may suffice, and then the intensity should be moderate and 
the duration about ten minutes; afterwards two, and finally three, may 
be given during the day, each lasting for twenty minutes. Kowalewsky 



VERMINOUS BRONCHITIS IN SHEEP AND CATTLE (HUSK, HOOSE, ETC.). 341 

says he has obtamed very good results from shnilar fumigations. Fumi- 
gations with chlorine, sulphur, and sulphuret of mercury or cinnabar 
have been recommended, but they are dangerous. 

(Stephen recommends as follows : Put about forty lambs at a time 
into an air-tight house, and place tar, sulphur, and turpentine in a pot of 
burning coals, suspended by a chain from the ceiling and brought as 
near to the heads of the animals as possible ; the fumes are to be allowed 
to fill the house, and more ingredients are added as required, the lambs 
being kept in the place for twenty-five minutes each time, and the process 
to be repeated on three occasions.) 

Tracheal injections in the verminous bron diitis of calves are of great 
utility ; but for a flock of sheep they would be troublesome and difficult 
to administer. However, Nieman, has successfully employed them on 
384 sheep belonging to several small owners. He used a solution of 2 
parts iodine and 10 parts iodide of potassium in 100 parts of distilled 
water. This fluid was mixed, in equal parts, with oil of turpentine, and 
made into an emulsion with olive oil ; each sheep received 5 to 8 
grams of the mixture, and the number of the injections varied according 
to the gravity of the disease — from two to three at two days' interval. 
The worms were killed and expelled during the paroxysms of coughing, 
and the bronchitis was modified. 

The medical treatment should be assisted by very nourishing food, 
and by bitter, stimulating, and ferruginous tonics, which arouse the 
digestive functions and allow those animals which are least exhausted to 
reach the period of elimination of the parasites. 

At the commencement of any kind of treatment it is well to have an 
examination of the flock, with the object of sending the worst cases to 
the butcher. 

The same medicaments have been employed in treating this malady 
in calves as in that of sheep, and no better results have been obtained. 
Numann and Janne have, however, been successful with asafetida (30 
grams), Chabert's empyreumatic oil (60 grams), and a mucilaginous 
decoction (500 grams) — a spoonful of this mixture being given in a half 
litre of milk, and the treatment continued for about a month. 

The results are less uncertain if the worms lodged in the bronchial 
tubes are directly acted upon, either by means of injections of the same 
kind as those employed for sheep, or fluid medicaments introduced 
directly into the bronchi. 

Eead says he has cured calves worn down almost to skeletons by 
verminous bronchitis by the following procedure : The head of the calf 
is slightly elevated, and about 2 drachms of ether, chloroform, oil of 
turpentine, or rectified oil of amber — single or combined — are poured 
into each nostril and allowed to vaporize there ; it will then, by the 



342 LARYNX, TRACHEA AND BRONCHI. 

respiration, be carried into the air passages, and thus destro.y the filarire. 
In some cases it must be repeated two or three times, but once has 
frequently the desired effect. 

The method of treatment by intra-traeheal injection, introduced by 
Levi, of Pisa, has yielded very satisfactory results. Levi has been com- 
pletely successful with a sheep. Eloire has employed it in sixteen calves 
affected with the disease, and all were cured. He used the following 
mixture : Black poppy oil, 100 parts ; oil of turpentine, 100 parts ; car- 
bolic acid, 2 parts ; purified cade oil, 2 parts. Each calf received 10 
grams of this mixture daily for three days. 

The injection, which should be given slowly, is followed by a fit of 
coughing, and the expired air has the odour of turpentine. This treat- 
ment has also been successful at Milan. Similar favourable results have 
followed Button's treatment of eight calves, some of which were in the 
last stage of verminous bronchitis. He employed a mixture of oil of 
turpentine, tincture of opium, pure carbolic acid, and water — the oil 
of turj^entine forming one-half of the mixture. The dose was ^ an 
ounce, and in the serious cases this was given every day for three days, 
and in other cases every second or third day. Kriwonogow has likewise 
cured twenty- two calves by giving each of them two tracheal injections of 
8 grams of the following mixture : Essence of cloves and oil of turpen- 
tine, 3()0 parts of each ; carbolic acid and olive oil, 30 parts of each. 

(Williams speaks highly of the administration of prussic acid. 
Penhale gives — by intra-tracheal injection, and slowly — oil of turpentine 
2 drams, carbolic acid 20 minims, and chloroform ^ a dram.) 



CHAPTER IV. 
LUNGS AND PLEURA. 

PULMONARY CONGESTION. 

Besides passive congestions of the lung, which it is unnecessary to 
descrihe here, and which result from cardiac or pericardiac affections or 
the compression of important vessels, there sometimes occur, particularly 
among young animals, cases of active congestion of the lung. Such cases 
are produced by over-exertion on the part of animals which have escaped 
from control or have been chased by dogs. 

They are most common in animals usually kept in stables, but which 
have accidentally escaped, or in very fat animals. 

Dyspnea and cough are the chief symptoms. The animals stop as 
tliough exhausted, extend their neck and head, dilate their nostrils and 
thrust their limbs out on either side of the body, while at the same time 
they appear in a condition of terrible distress. 

The respiration is rapid and short, the patient can scarcely breathe, 
and asphyxia seems imminent. On auscultation it seems that the 
respiratory murmur has disappeared over almost the entire extent of 
the lung. 

Death may occur very quickly. 

The diagnosis is extremely easy, provided that the history is known. 

The prognosis is grave. 

One of the most successful methods of treatment consists in free 
bleeding. In a great majority of cases this causes the symptoms to 
abate as though by enchantment. Cutaneous stimulation by mustard 
and similar irritants, as well as ablutions of cold water, are useful. The 
animal should be placed in a very airy spot. 

SIMPLE PNEUMONIA. 

History. Veterinary surgeons have long been divided in opinion on 
the question whether simple pneumonia occurs in animals of the bovine 
species. Whilst some affirm it, others think that all lesions of the lung 
in the ox, apart from pneumonia due to foreign bodies, should be 
regarded as of the nature of peripneumonia. 



344 LUNGS AND PLEVRM. 

Some ten years ago two veterinary surgeons of the department of the 
Aisne, Coulon and Ollivier, practising in a district where peripneumonia 
rages, made some extremely interesting ohservations on pneumonia in 
the ox. Their ohject was to distinguish between contagious peri- 
pneumonia and simple pneumonia during life, simple pneumonia having 
formerly been regarded as a non-contagious peripneumonia. Despite 
the rather unfavourable conditions in which ordinary practitioners are 
frequently placed, these gentlemen performed a work of great value. 
The facts which point to the occurrence of simple pneumonia are as 
follows : — 

The disease is not contagious. One may allow affected animals to 
mix with normal subjects without the disease being communicated. 
Pulmonary exudate from cases of simple pneumonia can be injected 
into the dewlap and hind quarters of young and adult animals, with- 
out pathological results. 

The lesions and course of simple pneumonia entirely differ from 
those of peripneumonia. 

Causation. Simple pneumonia is not common, and only occurs 
quite exceptionally in fat stock, or in milch cows kept in stables at a 
regular temperature, as in the north of France and near Paris. 

It occurs most commonly in working animals, which are exposed to 
variations in temperature and to chills. By causing vascular disturb- 
ance, chill favours microbic infection and visceral inflammation. Trasbot 
has described the case of an ox which, after having worked hard, and 
whilst freely sweating, was left exposed to the wind under a shed for 
about three hours. This animal contracted unilateral pneumonia the 
following day. 

Coulon and Ollivier have seen the disease in animals living in damp, 
low-lying valleys, or valleys exposed to the north wind, which are ex- 
posed in consequence to great variations in temperature. 

The symptoms follow almost the same course as in the horse, and 
one may distinguish three periods : — 

I. Period of onset. The symptoms which mark the onset of the 
disease are moderate fever, which progressively increases, and accelera- 
tion of respiration and of circulation. The number of the respiratory 
movements rises to twenty or twenty-five per minute, those of the 
pulse to fifty, sixty, or eighty. The conjunctiva becomes injected, and 
then of a yellow tint. At this period the appetite never disappears 
completely, rumination is regular, and there is neither tympanites nor 
colic. 

These general symptoms, which are not of special significance, are 
supplemented by more precise local symptoms — an abortive, difficult and 
painful, cough which is easily induced, and a whitish discharge. The 



SIMPLE PNEUMONIA. 345 

rusty expectoration which is characteristic of simple pneumonia in the 
horse and in man has never heen observed. 

Percussion discloses partial dulness, usually on one side, in the lower 
region of the chest : the respiratory murmur in this region is ascertained 
by auscultation to have diminished, whilst in the upper part and also on 
the opposite side the respiratory murmur is increased. 

II. Period of exacerbation. This period is characterised by accen- 
tuation of all the symptoms: the temperature rises, and may attain 
104° Fahr. ; the submaxillary artery is tense; the dulness becomes 
more marked, whilst crepitant and mucous rales are heard. In the 
portions still unattacked the function of the lung is exaggerated in 
order to make up for the defect of the diseased parts, and the respira- 
tion becomes juvenile. 

The appetite, which previously had been maintained, diminishes con- 
siderably, without, however, entirely disappearing, and intense thirst sets 
in, as a consequence of the fever. 

III. Period of crisis. The general symptoms remain stationary for 
four or five days ; the respiration, which is always affected, sometimes 
becomes as rapid as thirty to forty per minute; the tubal souffle which 
invariably occurs in pneumonia of the horse is not always clearly 
audible. 

Terminations. (1.) Eesolution. — This is indicated by the attenuation 
of all the symptoms and the disappearance of fever, which gradually 
sinks from 105° to 101° Fahr. The respiratory movements become fuller 
and fewer in number, the pulse slower, and the artery softer and more 
compressible. The cough changes its character, is stronger, more 
sonorous and prolonged, and is accompanied by the free discharge of 
muco-pus. The dulness descends, and the tubal souffle, if previously 
existing, is replaced by the returning crepitant rale. In general the 
disease runs its course in eight to ten days in young and in fourteen 
to fifteen days in aged subjects. 

(2.) Death by asphyxia is almost the only fatal termination of 
pneumonia in the ox. It occurs in one-third to one-fourth of the 
subjects attacked. Its approach is announced by a deep mahogany- 
red coloration of the conjunctiva. The pulse becomes very rapid, 100 
to 110 per minute, thready, small, and almost imperceptible, whilst the 
beating of the heart is strong and tumultuous. Eespiration is rapid and 
very laboured (50 to 70 per minute). The animal's attitude is typical; 
it stands with its limbs thrust out, its head extended, its nostrils 
dilated, and its mouth half open, discharging foamy and viscous saliva. 
Througiiout the greater portion of the lung gurgling sounds and 
crepitant mucous rales can then be detected. 

(3.) Cases ending in gangrene and suppuration are excessively 



346 LUNGS AND PLEURA. 

rare, and others resulting in chronic pneumonia have not been 
authoritatively described. 

Pneumonia is distinguished from broncho-pneumonia by the exist- 
ence of dulness at the period of crisis, whilst in the case of broncho- 
pneumonia this period is only marked by partial dulness, which is even 
then sometimes slight. Moreover, broncho-pneumonia usually develops 
much more slowly. 

The disease, then, is distinguished from peripneumonia by the 
following points : — 

(«) By the character of the temperature curve, which is regular in 
pneumonia, only attaining its highest point at the period of crisis, whilst 
in peripneumonia it ascends suddenl}^ and presents sudden oscillations. 

(h) The a]>petite remains, although diminished. 

(f) Sensitiveness in the region of the ribs is but feebly marked, or is 
entirely absent, simple pneumonia not being accompanied by pleuris3\ 

(d) The dewlap never shows ci'dema, a symptom which usually 
accomj)anies the period of crisis in peripneumonia, when the jugular 
veins and the anterior vena cava are compressed. 

{(') These signs alone are almost sufficient on which to base the 
diagnosis, but tliey are often supplemented by two others, of some 
what less importance (for in exceptional cases they may also be 
observed in simple pneumonia), viz. — the absence in most instances 
of a membranous sound, and of a well-marked souffle. 

Prognosis. Two-thirds of the cases recover. This proportion nn'ght 
be increased if the veterinary surgeon were called in at the beginning. 

Lesions. Post-mortem examination reveals neither pleural exudate 
nor pleural lesions. The lung is large and of increased weight, hepatised 
along its lower borders, and congested in its upper part. 

The sero-haemorrhagic infiltration of the interlobular spaces varies, 
according to the region examined : the upper regions are engorged and 
black, owing to capillary hemorrhages and blood clots, which completely 
surround the pulmonary lobule, the latter being violet or brownish-red 
in colour. In the hepatised portions the lobules are of a washed-out 
reddish tint, and the interspaces of a whitish colour. 

The bronchi are filled with frothy, whitish mucus; the small bronchi 
sometimes contain fibrous concretions and the mucous membrane is 
injected, and may be destroyed in places. The bronchial lymphatic 
glands are enlarged, congested, and contain small haemorrhages. 

It is important in making a post-mortem examination to be able to 
distinguish pneumonia from peripneumonia. This is comparatively 
easy if one bears in mind that in the latter pleurisy always exists, 
that the interlobular connective tissue spaces are always greatly dis- 
tended with a citrine-coloured serosity, that on section the peripneu- 



PNEUMONIA DUE TO FOREIGN BODIES— MECHANICAL PNEUMONIA. 



347 



monic lung resembles a mosaic ; and that, finally, the course of 
hepatisation is centripetal, the inflammation commencing at the peri- 
phery of the lobule, and progressively extending to\Yards the centre. In 
pneumonia, on the contrary, pleurisy is always absent; the interlobular 
connective spaces are only distended slightly, if at all, and always con- 
tain a brownish-red serosity : the course of hepatisation is centrifugal ; 
it commences in the pulmonary alveoli, and extends towards the peri- 
phery and the interlobular divisions. The following table gives a 
resume of the other differences between the two diseases: — - 



Peripnenuionia. 

ffidema of the dewlap. 

Pleural exudate. 

Centripetal lobular hepatisation. 

Extreme infiltration of the interlobular 
connective tissue spaces (priniar}' yellow 
infiltration). 



Pneumonia. 

No oedema of the dewlap. 

No i^leural exudate. 

Ascending centrifugal lobar hepatisa- 

tion. 
Moderate infiltration of the interlobular 

connective tissue spaces (secondary 

reddish-brown infiltration). 



Treatment. Good hygiene, regular ventilation, moderate warmth, 
and the administration of tepid drinks facilitate recovery. 

Certain German authors recommend cold compresses to the thorax, 
douches, and cold enemata in pneumonia. We do not think that such 
treatment has proved very successful, although it has been well tried. 

The classic treatment commences with moderate bleeding, the free 
application of mustard to the sides, the application of moxas, frictions 
with antimonial or blister ointment, and the administration of draughts 
containing 2 to 2J drachms of tartar emetic per day, or considerable 
doses of alcohol ; and this treatment seems to have given the best re- 
sults. Antithermic agents, like acetanilide, phenacetin and quinine sul- 
phate, are too costly to be greatly used in bovine medicine. Salicylate of 
soda is preferable. 

In order to assist circulation, support the tone of the heart and avoid 
engorgement of the lung and asphyxia ; digitalis should be given in doses 
of f to 1 drachm per day, or digitalin in subcutaneous injections of 5 to 6 
milligrammes, continued for five or six days. Finally, iodide of potassium 
may be given in doses of 1 to 1^ drachms, to reduce inflammation and as 
an expectorant. 



PNEUMONIA DUE TO FOREIGN BODIES MECHANICAL 
PNEUMONIA. 

It may happen that in examining a patient pneumonia is diagnosed 
under circumstances which seem to forbid its being regarded as simple 
or primary. This may be explained by the fact that ruminants are very 



348 LUNGS AND PLEUR^:. 

apt to suffer from pneumonia produced by foreign bodies. The lung may 
be penetrated either by some sharp object making its way forwards from 
the rumen or recticukim or by Hquid or soHd material passing into the 
trachea. These are two common methods by which this form of pneu- 
monia is produced. 



PNEUMONIA DUE TO THE MIGRATION OF FOREIGN BODIES FROM 
THE RETICULUM. 

Causation. The conditions under which food is swallowed by rumi- 
nants after preliminary mastication permit indigestible objects, such as 
stones, fragments of wood, nails, needles, bits of iron wire, etc., to enter 
the rumen, whence they reach the reticulum in consequence of peristaltic 
movements. Sharp, perforating objects, like needles or fragments of iron 
wire, penetrate the walls of the gastric compartments, and, impelled by 
the movements of these organs, pass through the intervening tissues, 
usually in the direction of the heart. Under conditions which cannot 
precisely be defined, these foreign bodies make their way towards the 
pleural cavity (usually the right, in consequence of the situation of the 
reticulum), traverse the diaphragm, and directly penetrate tbe base of 
the lung. 

As the migrating object is usually infected, its passage through the 
diaphragm always produces a localised patch of diaphragmatic pleurisy. 
Although possible, it is only rarely that the pleural sac becomes generally 
infected, or that rapidly fatal septic pleurisy is set up. Usually the 
localised pleurisy causes the base of the lung to become adherent to 
the anterior surface of the diaphragm. The foreign body continuing 
its movements, passes into the lung, and there sets up pneumonia. 

Symptoms. When the practitioner is first consulted he often finds 
only indications of the crisis period of a localised pneumonia at the base 
of the affected lung. The symptoms include fever, accelerated breathing, 
moaning, loss of appetite, cough without discharge, dulness over the base 
of the lung on percussion, disappearance of the respiratory murmur in 
the dull area, soufile opposite the inferior bronchi, and normal or juvenile 
respiration towards the front, i.e., in the anterior lobe, and sometimes 
in the cardiac lobe. 

The temptation under such circumstances is to deliver a diagnosis 
of simple pneumonia with prognosis of probable recovery. It should be 
remembered, however, that in all cases of basilar pneumonia without 
affection of the anterior lobes there is a considerable chance of the con- 
dition being due to the presence of a foreign body. On more careful 
examination it is found that the intercostal spaces opposite the affected 
region are very sensitive, and that the circle of the hypochondrium 'is 



MIGRATION OF FOREIGN BODIES FROM THE RETICULUM. 349 

con-espondiiigly sensitive. The owner, moreover, almost always informs 
the iDractitioner that for several weeks his animal has coughed, shown 
tympanites, diminished appetite, etc. 

Compression of the roots of the corresponding diaphragmatic nerve 
at the base of the neck always produces coughing. 

These symptoms rarely accompany the development of simple pneu- 
monia. Furthermore, the course of this accidental pneumonia is en- 
tirely different. Instead of developing regularly according to the above- 
described cycle, pneumonia due to foreign bodies develops slowly, and 
only becomes well defined after several weeks, whilst its tendency is to 
grow more and more aggravated. The zone of dulness extends both in 
a forward and upward direction. The souffle extends forwards. Auscul- 
tation and palpation sometimes reveal the formation of an abscess or 
local gangrene ; while there is slight oedema of the wall of the chest, as 
well as a gargling sound at the moment when the lung is displaced, 
high fever, intensely coloured urine, and very marked leucocytosis, etc. 
Death is inevitable, and when gangrene exists it sometimes occurs 
suddenly. 

Diagnosis. The diagnosis is based on the information furnished with 
regard to the course of the disease, the localisation of the hepatised zone, 
and the progressive character of the affection. 

The diagnosis, nevertheless, is always a little doubtful, but may be 
so far assured as to attain the position of a quasi-certainty. 

Prognosis. The prognosis is unequivocal. 

Treatment. No practical treatment, either to extract the foreign 
body or to combat the special pneumonia which it has produced, can 
be attempted. All the interlobular connective layers and the lobules 
themselves are invaded by various micro-organisms carried by the foreign 
body. Numerous fragments of tissue serve as centres of suppuration and 
gangrene, and the only chance would lie in attempting resection of the 
lung. Such intervention has no practical interest in veterinary surgery. 
It is true that when the existence of an abscess is suspected, an aseptic 
exploratory puncture may be made, and, in the event of the diagnosis 
being so far confirmed, the abscess might be opened through an inter- 
costal space. Under such circumstances, however deep the point of 
penetration of the foreign body, the development of the resulting abscess 
causes local pleurisy and adherence between the pleura and lung, so 
that there is no immediate danger of producing purulent pleurisy and 
pneumo-thorax. If small the foreign body might possibly be discharged 
through the passage thus afforded. 

In practice the best plan is to recommend slaughter as soon as 
the diagnosis becomes certain, provided that the meat can still be 
utilised. 



350 LUNGS AND PLEURA 

PNEUMO'MYCOSIS DUE TO ASPERGILLL 

The term pneumo-mycosis, or pulmonary aspergillosis, is used to denote 
a condition due to the growth in the respiratory apparatus of a fungus 
of the order aspergillus (family, Pci-'niporiw ,• sub-order, Pe}-isp())-iace(e ; 
order, Ascomycetes). 

In ruminants, as in all other animals, pulmonary aspergillosis 
occurs accidentally, and may often pass unperceived, in spite of the 
indications given by Lucet and Bournay regarding its development and 
symptoms. 

It seems most frequently to be caused by A.yx'njiUiis nif/er and Asper- 
(jillus fumigatns, particularly by the latter, ^Yhich, according to Eenon's 
work, also appears to be the most pathogenic. It only develops in animals 
whose respiratory apparatus is injured and is the seat of such lesions as 
those of chronic bronchitis, bronehi-ectasis, and of parasitic lesions 
or those containing cavernous spaces resulting from abscess formation, 
etc., etc. 

The fungi, or more properly the spores, which have accidentally 
jjenetrated into the respiratory channels germinate and develop in the 
pathological dilatations, causing disseminated areas of pneumonia and 
some mechanical disturbance, but not producing intoxication by liberating 
toxins. 

Causation. Infection occurs through the air passages, in conse- 
quence of the inspiratory current carrying spores of the fungi into 
the ramifications of the bronchi, where they develop if the soil is 
favourable. Development is favoured if the animals exposed to con- 
tamination are in bad condition, or if, as sometimes happens, the walls 
of the stables are not kept clean, and are covered with various forms 
of fungi. 

Prolonged feeding on musty fodder may also favour respiratory in- 
fection ; but it seems highly improbable that under ordinary conditions 
infection can occur through the digestive tract. Infection of the lung 
must also be regarded as exceptional, if one bears in mind the frequency 
with which oxen are fed on musty or mildewed fodder and the small 
numl^er of accidents recorded. 

Symptoms. The symptoms are obscure, and pulmonary aspergillosis 
is often only discovered on post-mortem examination. A cough is the 
chief symptom. It is dry at first. Afterwards it becomes spasmodic 
and frequent. 

Respiration is difficult, dyspnceic, efiected only with effort, and some- 
times even discordant. Expiration is sighing. 

Percussion reveals zones of partial or complete dulness when the 
lesions are near the surface of the lung, which, however, is rare. 



GANGRENOUS BRONCHO-PNEUMONIA DUE TO FOREIGN BODIES. 851 

Bournay has noted the occurrence of a musical sound resembhng that 
obtained by tappmg a small crystal or glass bell. 

Auscultation is said to reveal rough or sibilant rales, but as the 
lesions occur only in animals whose respiratory apparatus has already 
been impaired, it is difficult to offer an opinion on the subject. 

These signs are invariably accompanied by a certain amount of general 
ilhhealth, wasting, and irregularity of appetite and of rumination. 

On post-mortem examination the lung of the affected animal appears 
strewn with nodules, varying in size between a hazel-nut and a walnut. 
On section, Bournay claims to have found a wall or fibrous shell 
covering a greenish cryptogamic growth, in the centre of which was a 
yellowish, sharply defined kernel formed of masses of fungi {MfjceUnin, 
sterigmata and spores). In cases of rapid development, the pulmonary 
tissue around the parasitic lesion is completely hepatised. 

Diagnosis. Diagnosis is impossible without recourse to microscopic 
examination of the discharge. This examination, which, however, is 
somewhat difficult, may, after staining, result in the detection of debris 
of the mycelial filaments and of spores, with or without bacilli of tuber- 
culosis. The diagnosis as regards fungi can only be assured by prei)aring 
cultures. 

Prognosis. The prognosis is grave, because the disease is always 
superadded to lesions, which of themselves would justify a sombre view. 

Treatment. In consequence of the small number of observations pub- 
lished and the difficulty in diagnosis, no rational treatment has hitherto 
been laid down. From a purely theoretical standpoint, fumigations with 
tar and essence of turpentine and the inhalation of carbolic sj^ray have 
been recommended. Life in the open air would, without doubt, be 
equally or more efficacious. Preventive treatment consists in with- 
holding musty fodder and keeping the stables clean. 

GANGRENOUS BRONCHO-PNEUMONIA DUE TO FOREIGN 
BODIES. 

Foreign bodies which find their way into the trachea instead of 
the oesophagus provoke in most cases broncho-pneumonia, which very 
rapidly terminates in gangrene and death. 

Causation. Forced feeding of sick animals which have lost their 
appetite is one of the principal causes of this grave condition. In 
order to administer food such as mashes, gruel, hay tea, etc., the ox- 
herds have a bad habit of lifting the entire head and drawing forward 
the tongue whilst they pour the concoctions into the animal's mouth. 
The liquid cannot then be divided into portions, deglutition in the 
pharynx is badly effected, and the substances administered find their 



352 LUNGS AND PLEUR.E. 

way partly into the larynx and partly into the oesophagus. In the case 
of astringent, hitter, or highly stimulating drugs, a similar accident may 
he caused h}^ spasm of the pharynx or cesophagus, where the tongue has 
not heen left free and excessive quantities have heen given. 

Again, during the course of diseases complicated with paralysis of the 
phar^aix (coAV-pox, parturient apoplexy), obstruction of the pharynx and 
oesophagus (tympanitic indigestion), intense pharyngeal dysphagia (foot- 
and-mouth disease), etc., the risk of broncho-pneumonia due to foreign 
bodies is much greater still. It may even occur spontaneously in animals 
in the enjoyment of complete freedom (foot-and-mouth disease). 

Lastly, cases of broncho-pneumonia have been described as a conse- 
quence of inhaling foreign bodies, when the animals are fed, for example, 
with meal made from undecorticated cotton-seed. Under such circum- 
stances the lesions produced are similar to those of pneumoconiosis in man 
(the chronic forms of pneumonia of miners, charcoal-burners, quarrymen, 
stonemasons, etc.). 

Symptoms. The symptoms of gangrenous broncho-pneumonia 
become apparent immediately after the foreign body has entered the 
trachea. They commence with a violent, spasmodic cough, produced 
by reflex action, which in its turn is due to the laryngeal mucous mem- 
brane having l)een touched. But this cough is now too late to be of use, 
for the food, drug or liquid has passed into the depths of the trachea, 
and cannot be ejected. The cough soon ceases, and the animals may 
even return to their food. These appearances, however, are deceptive, for 
twelve, twenty-four or forty-eight hours later the cough reappears, whilst 
appetite diminishes. The attacks of coughing are succeeded by the dis- 
charge of a greyish or reddish-grey offensively smelling material ; respira- 
tion becomes more rapid, the heart's action violent, and the temperature 
rises to 103^ or even 105° Fahr. (89-5 to 40-5° C). 

The patients soon refuse all solid food, and if the chest is then 
examined by percussion one finds partial dulness, rarely simple dulness, 
over the cardiac lobes opposite the point where the girth passes. The 
partial dulness may rise to a varying height on both sides ; sometimes 
it is confined to one side. 

On auscultation the respiratory murmur in the upper two thirds of 
the lung appears exaggerated on both sides, and is found to have 
greatly diminished, or disappeared altogether in the inferior zone. 

Auscultation through the scapula almost always shows that the 
anterior lobes are affected ; but, at all events, in the examinations we 
have made, checked by post-mortem examination, the cardiac lobes have 
always proved to l)e most affected, a fact attributable to the direction of 
the principal bronchi. The lower portion of the posterior lobes may 
also 1)6 affected, but this is rarer. All the lower zone is irregularly 



GANGRENOUS BRONCHO-PNEUMONIA DUE TO FOREIGN BODIES. 353 

hepatised, and on auscultation one hears large moist rales, whilst 
respiration sometimes appears of a blowing character, and divided by 
a pause, but there is no tubal souffle. If the patient survive for a 
certain time, the sounds heard on auscultation undergo change; gurgling 
noises and sometimes true cavernous souffles are heard, as a result of 
suppuration in the bronchi and gangrene of one or more areas in the 
lung. Diffuse gangrene is rare, and the inferior zone is usually the only 
portion affected. 

During this phase the expired air has an aljsolutely characteristic 
gangrenous odour. 

Death occurs by asphyxia and intoxication, but some animals hold 
out for a fortnight and more. 

Lesions. Post-mortem examination reveals a suppurative but 
secondary inflammation of the mucous membrane of the nasal 
cavities, pharynx, larynx, and trachea. 

In the bronchi, sometimes very deeply placed, remains of foreign 
bodies are found in cases where some solid material has been inhaled. 
The mucous membrane of the bronchi is violet in colour, in places 
appears to l)e sloughing, and is covered by gangrenous patches immersed 
in a reddish-grey putrid fluid of offensive odour. In places the pul- 
monary tissue has undergone gangrene ; and incision of the diseased 
centres discovers irregular cavities, filled with a pultaceous, greyish 
material, which often makes its way into the l)ronchi. These are the 
irregular cavities which give rise to the gurgling sounds. The walls of 
these cavities are formed of disintegrating pulmonary tissue, which 
again is surrounded by a zone of grey hepatisation. The gangrenous 
areas may unite, forming vast caverns. If near the surface they 
cause adhesive or septic pleurisy. 

Diagnosis. The diagnosis is not very difficult, provided that an exact 
account can be obtained of the circumstances which preceded the appear- 
ance of the disease. The signs furnished by the discharge, the expired 
air, percussion and auscultation are sufficiently significant to remove any 
doubt. 

Prognosis. The prognosis is extremely grave, and in the great 
majority of cases fatal. 

Treatment. There is very little chance of recovery, no matter what 
treatment may be employed. The most favourable termination consists 
in the gangrene remaining limited to the bronchi and to a small frag- 
ment of the lung, so that the damaged tissues, being gradually delimited 
and sloughed oft", may finally be discharged by coughing. 

This is an exceptional termination, but attempts may be made to 
assist its evolution by giving alcohol in doses of 8 to 10 ounces per day, 
and salicylate of soda in doses of 4 to 5 drachms. When the condition 

D.C. A A 



354 LUNGS AND PLEURA. 

can be early diagnosed before intense and continued fever has set in, 
and ^Yhen the animal's condition is good, it is often preferable to 
slaughter the patient. 

INFECTIOUS BRONCHO -PNEUMONIA. 

The ox's lung is lial)le to so many and such extremely varied 
diseases that it seems desirable to add to the above descriptions 
some remarks on infectious broncho-pneumonia of external or in- 
ternal origin. 

Anatomically these forms of broncho-pneumonia are characterised 
by the occurrence of " islands " of pulmonary hepatisation, more rarely 
by extensive (massive) hepatisation ; in all cases the hepatisation is 
irregular, and in no way resembles that of simple pneumonia. 

Causation. The internal causes are numerous and varied. They 
are due to primary infection of an organ whence arises a general infec- 
tion, sometimes even true septicaemia. Some form of broncho- pneu- 
monia, such as simple broncho-pneumonia, purulent broncho-pneu- 
monia, gangrenous broncho-pneumonia, etc., then follows as a compli- 
cation. These l^roncho-pneumonias are therefore only manifestations 
of purulent infection or septicaemia. They frequently follow post- 
partum infections, vaginitis, metritis, and suppurative mammitis. 

Symptoms. The general symptoms first attract attention, and are 
extremely acute. They comprise high fever, loss of appetite, cessation 
of rumination and of milk secretion, breathlessness, blowing, etc. — all 
signs of grave and rapidly progressive infection. 

Sometimes at this period nothing more than the primary lesion, such 
as metritis or mammitis, can be detected. It may even happen that the 
uterus seems little affected, and, despite the accelerated respiration, 
neither partial nor complete dulness of the lung is discovered. 

Hepatisation only occurs some days afterwards, and with it irregular 
partial dulness localised in the lower zones, disappearance of the respira- 
tory murmur in the corresponding regions, exaggeration in the infected 
regions, an expiratory sound which is barely perceptible or may be of a 
blowing character, or, again, after several days may be transformed into 
a tubal souffle. 

The cough then becomes frequent, generally difficult, paroxysmal, 
feeble, and easily provoked. The appetite suffers, the patients seem 
to prefer fluid nourishment and lose flesh very rapidly. 

[f the broncho-pneumonia is about to terminate in suppuration 
or gangrene, "the respiration becomes sighing, the breath foetid, and 
the cough is accompanied by a greyish muco-purulent or gangrenous 
discharge. 



INFECTIOUS BRONCHO-PNEUMONIA. 355 

When the abscesses are deep-seated, the alarmmg symptoms retam 
their primary degree of intensity for weeks, until the animals are 
completely exhausted. Abscesses, originating in deep-seated parts, 
may even extend towards the surface of the lung, and produce either 
adhesive pleurisy that can be detected by palpation, or exudative 
pleurisy, easily recognised on percussion. 

When the infective microbes are not pyogenic the general con- 
dition appears less grave, the animals exhibit only moderate fever, 
appetite is diminished but not lost, wasting is slower, and may con- 
tinue for months, but the affected portions of lung become converted 
into fibrous masses or a material resembling spleen pulp. 

The duration of infectious broncho - pneumonia, therefore, varies 
with the nature of the infecting organism. In cases which terminate 
in gangrene, the animals may survive for three or four weeks ; in 
those where suppuration occurs, for several months. In short, recovery 
is the rule in simple broncho-pneumonia ; but from an economic stand- 
point there is little reason for keeping the animals alive. 

Diagnosis. The diagnosis is not generally very difficult ; for if at first 
the case may be mistaken for one of simple pneumonia, the persistence 
or prolonged aggravation of the symptoms and the irregularity in posi- 
tion of the lesions revealed by percussion and auscultation enable the 
condition to be distinguished at an early period from simple pneumonia. 

Confusion with acute or chronic pleuro-pneumonia may easily be 
avoided by noting the absence of pleural effusion, and of the soft 
pleuritic souffle of peripneumonia, etc. 

Where auscultation is chiefly relied upon it is more difficult to 
differentiate between this disease and acute tuberculosis, and between 
it and broncho-pneumonia produced by foreign bodies, although the 
latter disease develops differently. 

Prognosis. The prognosis is always extremely grave and, in cases 
where there is gangrene or abscess formation, fatal. From the economic 
standpoint the chronic form is also very grave. 

Treatment. As broncho-pneumonia is frequently of a secondary 
character, treatment should at first be particularly directly against the 
primary condition, whether in the mammary gland, uterus or else- 
where. Early treatment of suppurative mammitis, metritis, etc., is 
therefore necessary. 

Broncho-pneumonia is treated by free vesication of the walls of 
the chest, the administration of tonics and antiseptics, alcohol in small 
doses, acetate of ammonia in doses of 1 to 2 drachms, salicylate of 
soda in doses of 5 to 8 drachms per day, salicylic acid in doses of 1 
drachm, and creosote in doses of 1^ to 5 drachms, given in electuary, etc. 

Diuretics, farinaceous gruels, etc., may be used freely, and are of value. 

A A '2 



356 LUNGS AND PLEURA.. 

If the symptoms persist or ))ecome aggravated, and suggest the 
development of an abscess or gangrene, it is l)etter to slaughter the 
animal. 

BRONCHO-PNEUMONIA OF SUCKING CALVES. 

Young animals still with the mother, particularly calves during the 
first few weeks of life, are liable to broncho-pneumonia of a specialised 
character, as regards not only its causes, but its development and duration. 

Causation. The causes may be grouped under two principal heads : — 

(a) In slow or difficult cases of parturition, the foetus may be injured 
whilst being delivered, as a consequence of direct compression of the 
great blood-vessels, etc. (particularly of compression of the umbilical 
cord, compression of the thorax in the cardiac region, or partial pre- 
mature separation of the enveloiies), and may thus by reflex action 
make automatic inspiratory movements. 

Eespiration being impossible, inasmuch as the thorax has not yet 
passed the posterior passages, such inspiratory efforts made during 
the passage through the pelvis may cause amniotic liquid to pass into 
the bronchi. This accident is particularly liable to occur during 
deliveries with breech presentation. If, as happens frequently, the 
amniotic liquid has become infected either prior to or as a conse- 
quence of obstetrical manipulation, the result is fatal ; for the pas- 
sage of infected amniotic fluid into the bronchi develops a broncho- 
pneumonia of a degree of gravity depending on the character of 
infection. 

(h) By an entirely different mechanism broncho-pneumonia may 
occur in sucking calves during the first few weeks of life, even in the 
case of animals born in a vigorous condition, and kept in warm and 
well-arranged stables. This form follows diarrhoea, and constitutes a 
final complication whiclr is always of very marked gravity, and in 
most cases fatal. 

Such secondary l)roncho-pneumonia only occurs when the diarrhoea 
has resisted treatment, and it is important to note that the pectoral 
lesions appear at a time when the intestinal mischief seems to have 
diminished, the diarrhoea having lessened or disappeared. This variety 
of broncho -pneumonia of young animals is by far the most frequent. 
It has been termed broncho-pneumonia of intestinal origin, and exactly 
resembles, so far as its development and gravity are concerned, the 
broncho-pneumonia in young infants described by Sevestre and Lesage. 

The term broncho-pneumonia, moreover, is not strictly correct, or 
at least is not exclusive ; for the rapid forms often exhibit lesions 
other than those of broncho-pneumonia. Post-mortem examination 
reveals pleurisy and pericarditis. 



BRONCHO-PNEUMONIA OF SUCKING CALVES. 357 

Pathogeny. At the outset of these attacks of broncho- puhnonary 
disease, a careful bacteriological examination of the organisms to be 
found in the discharge of bronchial mucus leads to the discovery of 
bacilli which do not stain with Gram, and which resemble varieties 
of the colon bacillus ; in other cases of streptococci. At a later stage, 
when the animal has become weak, micro-organisms are present in 
much greater variety. Nocard found in lung abscesses the bacillus 
of epizootic lymphangitis. It seems that the development of various 
lesions in the thoracic cavity may be due to auto-infection, i.e., to 
the penetration from the intestine of germs which, after passing 
through the circulation, establish themselves at some point in the 
lung. The pleura is attacked at a later period as a consequence of 
continuity and contiguity of tissue. 

In a similar way pericarditis and even valvular endocarditis may be 
l^roduced. 

Symptoms. The symptoms are similar to those of all forms of 
broncho-pneumonia. Where diarrhoea has been neglected, the condi- 
tions may apparently improve without evident cause, whilst the respi- 
ration becomes more frequent. The patient soon suffers from cough, 
and in a few hours the existence of broncho-pneumonia is clearly 
apparent. Acceleration of breathing is the dominant symptom. The 
respirations may rise to fifty to sixty per minute, at which they con- 
tinue, while fever sets in. On percussion the thorax may appear of 
normal resonance throughout; but when pleural lesions and exudates 
exist, resonance gives place to partial or complete dulness. Should 
pericarditis or small cardio-pericardial adhesions exist, they may escape 
observation, but if the exudate is abundant or the adhesions multiple or 
of large size the usual symptoms of pericarditis develop progressively. 

On auscultation the respiratory murmur is always found to be greatly 
exaggerated in the healthy parts, usually the upper portions of the lung. 
On the contrary, it is attenuated or suppressed in the afiected regions. 
The other signs vary greatly, according to the extent, intensity, and more 
or less advanced condition of the lesions. Crepitant and bronchial rales, 
blowing respiration and tubal souffles, etc., are among the symptoms. 

The duration of the disease varies ; some patients may be carried oft' 
in five or six days, while others survive for one or two months, or even 
longer. A few recover, but they remain thin, puny, and atrophied, and 
are not worth keeping alive. 

Lesions. The lesions extend to the bronchi, the pulmonary tissue, 
and sometimes the pleura and pericardium. They consist in lesions of 
difi'use broncho-pneumonia, pleurisy with false membranes and parieto- 
pulmonary adherences, and pericarditis with partial cardio-pericardial 
adhesions. 



368 LUNGS AND PLEURA.. 

In rare cases abscesses caused by p_yogenic streptococci may be 
found. 

The anterior lobes, cardiac lobes, and lower part of the posterior lobes 
are those singled out for attack. 

Diagnosis. The diagnosis is not difficult, provided that the circum- 
stances preceding the appearance of the pulmonary lesions are known. 

Prognosis. The prognosis is very grave. 

Treatment. Treatment very often proves useless, because the patients 
have little resisting power and are exhausted, and also because they are 
suffering from a slowly progressive septiesemia. It may, however, be 
worth while in the early stages to apply blisters to the chest and ad- 
minister general stimulants : alcohol in doses of 8 to 12 drachms per day, 
divided into two parts and mixed with milk ; acetate of ammonia in doses 
of ^ to 1 ounce ; and tinctura digitalis 5 to 6 drops. 

The primary disease of the intestine is masked by the pulmonary 
symptoms, but should not be overlooked. Eice water, sub-nitrate or 
salicylate of bismuth may be added to the milk or albuminous solu- 
tions constituting the diet. When an epizootic of broncho-pneumonia 
complicates the diarrhoea it is necessary to take all the preventive 
measures w'hich have been suggested in connection with white scour 
and umbilical diseases in calves. These comprise disinfection of the 
premises and local disinfection of the animals affected. 

SCLERO'CASEOUS BRONCHO-PNEUMONIA OF SHEEP. 

The sheep suffers from a special form of broncho-pneumonia, which 
is seldom seen except in isolated cases, but which, under exceptional cir- 
cumstances, may nevertheless attack a certain number of animals in a 
particular flock. It was first noticed and described by Lienaux in 1896, 
and has more recently been studied by Sivori (1899). Moussu has only 
seen it in flocks in the north of France. 

Causation. The causes of this disease are still imperfectly under- 
stood. 

Sivori's researches show that the, disease may be referred to a micro- 
organism, but we do not yet know exactly by what path infection occurs. 

The agent of sclero-caseous broncho-pneumonia in the sheep appears 
similar to that described by Preisz and Guinard in 1891, and identical 
with the microbe of ulcerative lymphangitis of the horse (Nocard, 1897). 
It is probable that infection occurs through the respiratory apparatus. 

Symptoms. The clinical development of the disease is difficult to 
describe, because its course is slow and unaccompanied by well-marked 
external signs. 

The animals lose flesh, pant for breath when moved, drop to the 
rear of the flock cough frequently, feed badl and end li§' becoming 



PULMONARY EMPHYSEMA. 359 

cachectic. Many suffer from the disease and yet remain in fair bodily 
condition. 

On i)ost-mortem examination the hmgs are found not to collapse, 
having lost their elasticity, and are of a yellowish-white colour, which is 
only seen in this disease. On section the pulmonary tissue appears 
dense, hard, and of a fibrous and lardaceous character. At various 
points nodules with fibrous envelopes and caseous, yellowish or greenish 
contents are found. 

When the caseous nodules are near the surface the pleura may be 
chronically inflamed and thickened. The liver and kidney frequently 
contain caseous lesions. 

Diagnosis. The diagnosis becomes easy after the first post-mortem 
examination, for the lesions discovered cannot be mistaken for those 
of parasitic broncho-pneumonia, degenerated pulmonary echinococcosis 
or tuberculosis. In the living animal, on the contrary, the diagnosis 
is extremely difficult. 

Prognosis. The prognosis is grave. No special method of treat- 
ment is known. 

PULMONARY EMPHYSEMA. 

Pulmonary emphysema, i.e., exaggerated dilatation of the pulmonary 
tissue by air, is not uncommon in the bovine species, and occurs under 
the two classical forms — (1) alveolar or intra-lobular emphysema limited 
to dilatation of the alveoli ; and (2) interlobular emphysema, produced 
by the entrance and diffusion of air in the interlobular spaces in con- 
sequence of rupture of the lobules. 

These two forms are very frequently associated : — 

(1.) Emphysema by dilatation usually begins in the right pretracheal 
lobe ; also in the cardiac and even in the posterior lobes. 

(2.) Interlobular emphysema begins in the same regions, but it 
spreads readily in a backward direction, remaining interstitial ; or, on 
the other hand, becoming sub-pleural at the periphery of the lung. 

In both cases the pulmonary tissue is pale, the blood-vessels are 
partially obliterated by compression ; circulation and aeration of the 
blood are impeded— hence the appearance of the disturbance noted. 

Causation. Emphysema is seen in adult working oxen ; also, and to 
an even greater degree, in aged cows. It is produced by excessive strains 
in draught, or more often by the paroxysms of coughing so common 
during simple or parasitic bronchitis, broncho-pneumonia, pneumonia, 
chronic broncho-pneumonia, etc. Successive gestations also produce it. 

All these pathological conditions also interfere with the nutrition of 
the bronchial mucous membrane, particularly of its deep-seated muscular 
layer, which is then incapable of regulating the distribution of air ni the 



360 LUNGS AND PLEURAE. 

bronchial channels. The distribution being no longer regulated by reflex 
action, air accumulates at certain points as a result of the expiratory 
efforts made during coughing, and dilatation of the vesicles or lobules 
occurs. 

Diseases of the digestive apparatus, acute or chronic tympanites in 
particular, may plaj^ a certain part by compressing the diai^hragm, 
causing expiratory efforts and fits of coughing. 

Furthermore, swelling of the lymphatic glands at the entrance to 
the chest, by compressing the pneumo-gastrics, provokes reflex cough 
and finally emphysema. 

Symptoms. Pulmonary emphysema is marked by accelerated re- 
spiration due to diminution in the respiratory cajiacity, which is often 
very seriously afi:'ected ; to insufficient absorption of oxj^gen in con- 
sequence of diminution in the space available for exchange of gases in 
the lung, and to insufficiency of expiration. This acceleration in breath- 
ing, though little marked during repose, becomes very pronounced after 
exercise, or during hot weather ; and under these circumstances is 
accompanied by a paroxysmal, feeble but shrill cough, without discharge. 
This cough without discharge is frequently followed by swallowing. 

Percussion reveals an important point, viz., increase in the normal 
resonance of the thorax. 

On auscultation the vesicular murmur is found to be diminished, the 
respiration assumes a rough and rasping character, inspiration is diffi- 
cult, expiration painful, and often divided into two periods, as indicated 
by a slight double movement of the flank. Expiration is clearly audible. 
Its duration is generally less than that of insjDiration, although in some 
cases it is equal or even longer. It is accompanied by sibilant and 
snoring rdlcs, sometimes even mucous rales, of an intermittent character. 
In rare cases there may be difficulty of respiration, as in broken-winded 
horses. 

Diagnosis. The diagnosis may suggest a doubt as to whether 
emphysema or tuberculosis is present, but in the latter there is fever, 
the general condition is poor ; on percussion the thorax reveals areas 
of partial dulness ; and expiration is rough and prolonged, sometimes of 
a blowing character, a peculiarity which is exceptional in emphj^sema. 

Prognosis. The prognosis is not very grave, except where emphy- 
sema is only an accompanying symptom of another disease, such as 
chronic bronchitis, tuberculosis, etc. 

Treatment. Little can be done to check the development of the 
above descriljed pulmonary lesions ; but the cough may be relieved, and 
the pulmonary circulation improved by assisting the heart. 

The most prompt and efficacious assistance is given by digitalis in 
doses of ^ to 1 drachm per day for adults, iodide of potassium in doses of 



DISEASES OF THE PLEURA. 301 

1 to 1^ drachms, and bromide of potassium in doses of 1 drachm to 
guard against reflex excitabiUty of the pneumo-gastric. This treatment, 
however, should not be followed for more than five or six days, and 
should then be replaced by the administration of arsenious acid in doses 
of 15 grains per day, ground horse-chestnuts in doses of 3 ounces per 
day, etc., etc. 

DISEASES OF THE PLEURA. 

Primary inflammation of the pleura is very rare in animals of the 
bovine species, but secondary diseases of this membrane, on the other 
hand, are frequent. 

ACUTE PLEURISY. 

Cruzel, Fabry, and a number of practitioners have described the 
occurrence in working animals of acute pleurisy a frigore or sero- 
fibrinous pleurisy in consequence of severe, sudden variations in tem- 
perature, or prolonged chills. At the present day it seems fairly well 
established that pneumonia, and not pleurisy, is commonest under such 
conditions, and Moussu disclaims ever having seen primary pleurisy. 
On the other hand, pleuritic eff"usions are very common in contagious 
pleuro-pneumonia, secondary pleurisy due to pericarditis produced by 
foreign bodies, septic broncho-pneumonia or broncho-pneumonia due to 
foreign bodies, and the pleurisy which accompanies septicaemia con- 
sequent on parturition, etc. These forms of disease, however,' are not 
simple sero-fibrinous pleurisy, but septic or suppurative pleurisy, still 
little understood in veterinary surgery. 

Tuberculosis of the pleura, although very frequent, is rarely accom- 
panied by marked exudation. Like secondary disseminated pleural 
carcinoma, it usually assumes the vegetative and adhesive form, with 
adhesions of greater or less extent between the lung and wall of the chest. 

Symptoms. In all these morbid conditions the symptoms vary 
greatly, and it would be difiicult to give an accurate general descrip- 
tion of them. 

In acute pleurisy a frigore shivering attacks, moderate fever, dulness, 
loss of appetite, interference with rumination, dryness of the skin, rapid 
wasting and intercostal pain, first indicated by dull colic, constitute the 
usual symptoms. 

The respiration is short and irregular, interrupted when the exuda- 
tion is abundant. Pressure over the intercostal spaces produces pain, as 
does strong percussion. Percussion reveals an area of dulness bounded 
above by a horizontal line. 

Auscultation shows the respiratory murmur to have disajjpeared 
throughout the zone of dulness, and reveals the presence of a soft 



362 LUNGS AND PLEURA. 

pleuritic souffle (a soft tubal souffle quite different from that of con- 
tagious i)leuro-pneumonia) when pleural exudation is abundant. In 
septic or su^jpurative pleurisy fever is higher, loss of appetite more 
marked, wasting more rapid, and depression extreme, with, however, 
identical local S3'mptoms. 

Diagnosis. The diagnosis of pleural exudation presents little diffi- 
culty, because of the peculiar characters of the dulness and the pathogno- 
monic indications obtained by auscultation. The exudation is usually 
unilateral, the mediastinum being very resistant and not perforated 
in the ox. 

By passing the needle of a Pravaz's syringe with antiseptic pre- 
cautions through the intercostal space a little fluid may be drawn off 
and the diagnosis formed, the form and nature of the pleurisy being 
simultaneously established. The liquid extracted can be examined bac- 
teriologically, and can be grown on nutritive media, or inoculated into 
exi^erimental animals. 

The prognosis is grave, because in the ox pleurisy is very often of 
a secondary character. The outlook varies, however, with the form of 
the pleurisy and the nature and virulence of the infecting organism. 

Treatment. Treatment consists firstly in applying an energetic 
vesicant like antimonial ointment or liquid cantharides blister ; in- 
ternally diuretics such as soda bicarbonate, nitrate of potash, resin, 
and decoctions of pellitory, dogs' grass, etc., may be given. If thought 
desirable the chest may be tapped and the pleural cavity washed out 
with an antiseptic solution. 

CHRONIC PLEURISY. 

Chronic pleurisy is frequent in aged animals, but usually assumes the 
form of local adhesive pleurisy. The adhesions between the lung and 
pleura are more or less extensive ; they result from verminous broncho- 
pneumonia, echinococcosis, external injuries, etc. Clinically this form 
is of no importance, and is almost impossible to diagnose. During 
the development of pleural tuberculosis, on the contrary, adhesive dry 
pleurisy is frequent, and sometimes becomes so well marked that almost 
the whole of the opposing pleural surfaces may become united. 

PNEUMO'THORAX. 

The name pneumo-thorax is given to the condition produced by the 
entrance of air or gas into one of the pleural cavities. 

The accident is usually produced by rupture of the parenchyma of 
the lung and of the pleura, a rupture which produces a communication 
between the alveoli or a bronchus and the corresponding pleural cavity. 



PNEUMO-THORAX. 



363 



As soon as the rupture occurs air passes from the lung into the pleural 
cavity, and the lung collapses in consequence of the resilience of its 
elastic constituents. 

Under other, much rarer, circumstances pneumo-thorax occurs in con- 
sequence of gas generated in the digestive tract passing into the pleural 
spaces. The condition then makes rapid progress, and death occurs in a 
few days. 

Symptoms. The symptoms are well defined. As soon as the acci- 
dent occurs the animal exhibits extremely marked and sudden dyspnoea, 
accompanied by heaving at the flank or 
general agitation of all the muscles of 
the body. One of the lungs, in fact, has 
suddenly been called on to perform the 
functions of both, and at first it natu- 
rally has great difficulty in meeting this 
demand. 

The heaving at the flank and the 
general agitation of the body muscles is 
due to the fact that the regularity and 
rhythm of contraction of the diaphragm 
are disturbed, and the mechanical condi- 
tions have become difterent on the two 
sides. From the first, respiration is 
moaning and expiration becomes rapid, 
stertorous and deep, while the face is 
anxious-looking, and the nostrils are di- 
lated as though the animal was on the 
point of suffocation. On examining the 
animal from in front or behind, the thorax 
is easily seen to be wanting in symmetry, 
the side on which the pneumo-thorax 

has occurred being immobile as compared with the sound side. The 
latter, moreover, is dilated in order to compensate for the loss of function 
of the collapsed lung. 

Percussion reveals greatly increased resonance on the side of the 
pneumo-thorax. On the other hand, the opposite side yields a normal 
sound. 

Auscultation reveals an increase of the respiratory murmur on the 
side which is still acting and, on the contrary, complete and total sup- 
pression of the respiratory murmur on the afiected side. On applying 
the ear to the chest wall, a large soft, amphoric souffle of well-marked 
metallic character is heard. This is particularly clear on respiration, 
giving the impression of the existence of a large cavity beneath the ear. 




Fig. 171. — Schema illustrating open 
pneumo-thorax. Eight lung col- 
lapsed; pericardium and heart 
displaced towards the right. 



364 LUNGS AND PLEURJ-l 

The sighing sound heard on auscultation of the chest wall is louder than 
that heard externally or over the region of the nostrils or larynx ; and it 
seems to he reinforced, as though hy the resonance of a large cavity with 
thin metallic walls. Once or twice per minute, moreover, a sound may 
be heard like that of dropping water. It is of a very special character, 
resembling that produced by drops falling to the bottom of a hollow 
metallic vase, and setting up prolonged vibration. 

As secondary symptoms the heart's action is accelerated, the number 
of beats rising to 80 or even 120 or 130 beats per minute ; appetite is 
lost ; slight tympanites develops as a result of rumination and eructa- 
tion being suspended ; the peristaltic movements of the rumen are inter- 
rupted, and constipation develops. 

Diagnosis. The diagnosis of pneumo-thorax is easy, and the con- 
dition can scarcely be mistaken for any other except diaphragmatic 
hernia ; but the indications derived from percussion and auscultation 
are so different in the two cases that they need not be further 
emj^hasised. 

The task becomes more difficult, however, when an attempt is made 
to identify the exact form of pneumo-thorax, for three principal varieties 
are recognised. 

In open pneumo-thorax, the first and most frequent form, air passes 
from the lung into the pleura at each inspiration, and flows back from 
the pleural cavity towards the bronchus at each expiration. The intra- 
pleural pressure is then approximately equal to the intra-bronchial 
pressure, and undergoes similar oscillations. (It should be noted that 
the aperture in the lung is seldom sufficiently large to establish an 
absolute equality of pressure between the bronchus and the pleural 
cavity. Eespiration, therefore, though very seriously impeded, generally 
continues in a modified form.) 

In a second variety, termed " valvular pneumo-thorax," air passes 
freely from the lung into the pleural cavity, but is unable to return 
from that cavity towards the lung, because a flap of tissue acts as a 
valve and closes the orifice at the commencement of expiration. As 
soon as intra-pleural pressure rises above that of the inspiratory effort, 
the valve remains permanently closed. 

In the third variety, called " closed pneumo-thorax," the oriffce of 
communication is obstructed by some mechanism, and the pleural sac 
only contains a film of air. 

In practice, valvular pneumo-thorax is recognised by the movement 
of the thoracic wall (which in open and closed pneumo-thorax remains 
depressed), as well as by extreme intensity of the dyspnoea and attacks of 
threatened suffocation. Closed pneumo-thorax, which is only a termiiui- 
tion and a stage in the cure of open pneumo-thorax and of valvular 



PNEUMO-THORAX. 365 

pneumo-thorax, is suggested by progressive improvement in the symp- 
toms. Scientifically it is very easy to make this diagnosis by putting a 
manometric apparatus in communication with the pleural cavity by means 
of a simple hollow needle provided with a thick-walled rubber tube. 

In open pneumo-thorax the liquid column in the manometer under- 
goes rhythmic oscillations corresponding to the respiratory movements ; 
in valvular pneumo-thorax the intra-pleural pressure increases progres- 
sively until it becomes higher than the external pressure ; and finally, 
in closed pneumo-thorax, the column of the manometer assumes a cer- 
tain level at which it rests. 

Prognosis. The prognosis is very variable, according to the primary 
cause of the accident. Animals might recover, but economically there 
is little advantage in preserving them when the diagnosis is assured, 
except in cases of animals of great value, and when the primary disease 
admits of it. 

Causation. Pneumo-thorax may be produced by various causes. 
The most frequent cause in large animals is pulmonary echinococcosis, 
during the course of which a peripulmonary vesicle, after having injured 
several lobules, one of the air passages or even a bronchiole, may break 
through the pleura, thereby setting up direct communication between 
the bronchi and the pleural cavity. 

To pulmonary tuberculosis, with peripheral softened tubercles, 
perforating simultaneously into an alveolus or a small bronchus and 
iiito the pleura, must be assigned the second place. 

Vesicular and interstitial sub-pleural pulmonary emphysema is also 
a frequent cause of pneumo-thorax, the pleura being ruptured over the 
emphysematous points. 

Finally, and exceptionally, an abscess of the lung may open into the 
pleura and form sinuses, which may establish a communication between 
the digestive reservoirs and pleural-sacs ; but such accidents produce 
pyo-pneumo-thorax and septic pleurisy of a rapidly fatal character. 

The diagnosis of pneumo-thorax, and even of its varieties, does not, 
however, enable one to form a prognosis ; the important point is to 
ascertain the original cause. 

Treatment. It may be said of pneumo-thorax that no treatment 
exists, and that the position is one of expectancy. In fact, we possess 
no means of directly dealing with such diseases as echinococcosis, tuber- 
culosis, or emphysema. For this reason it is best as a rule to advise 
slaughter. Nevertheless, when the condition is due simply to pulmonary 
echinococcosis of a discrete character, there is some chance that after 
several months the animal may recover spontaneously. The communi- 
cating orifice becomes closed by reparative processes (cicatricial contrac- 
tion, the formation of a false membrane, limited adhesion between the 



366 



LUNGS AND PLEUR/E. 



two walls of pleura, etc.) ; the layer of air imprisoned within the pleural 
cavity is progressively absorbed, provided that it has not been acci- 
dentally infected ; the collapsed and partially splenised lung progres- 
sively regains its function under the inspiratory efforts, and after some 
months complete recovery may occur. This termination cannot always 
be confidently predicted, because complications may arise at any moment ; 
under no circumstances can complete recovery be anticipated when the 
primary disease is tuberculous. 

In cases of valvular pneumo-thorax with extreme oppression, attacks 
of suffocation threatening death as a consequence of excessive intra- 
pleural pressure, displacement of 
the mediastinum towards the oppo- 
site side, compression of the heart, 
and functional disturbance of the 
sound lung, it may be worth con- 
sidering whether the attacks of 
suffocation and threatened asphyxia 
can be modified or removed by pre- 
venting the excess of intra-pleural 
pressure. By simply passing a stout 
hollow needle through one of the 
intercostal spaces, the intra-pleural 
pressure may be reduced to that of 
the external atmosphere, and the 
effects of compression removed. 
This, however, is a last resort, and 
has no permanent effect. 




Fig. 172. — Hydro-pneumo-thorax. I, Point 
of adhesion of the i^leura ; P, healthy 
lung ; Ps, splenised lung ; E, liquid 
or purulent exudate ; Ca, air cavity 
constituting pneumo-thorax ; C, heart. 



HYDRO-PNEUMO-THORAX AND 
PYO-PNEUMO-THORAX. 



When pneumo-thorax is set up, 
it rarely remains simple. In the 
great majority of cases the pleura 
becomes infected, either directly, by the lesion which has determined 
the pneumo-thorax (tubercle, superficial abscess, actinomycotic lesion, 
etc.), or secondarily, by the penetration of germs from the air or from 
the bronchus (echinococcosis, emphysema). Simple pneumo-thorax then 
becomes converted into hydro-pneumo-thorax or pyo-pneumo-thorax, 
according to circumstances — that is to say, whether the exudation into 
the pleural cavity is of a simple character or is of the nature of pus. 
Symptoms. Hydro-pneumo-thorax is characterised by the signs 
common to true pneumo-thorax, which constitutes the primar}' lesion, 
viz., sudden difticulty in breathing, exaggerated unilateral resonance. 



HYDRO-PNEUMO-THORAX AND PYO-PNEUMO-THORAX. 867 

amphoric souffle accompanied by a sound like that of drops of water 
faUing into a metallic vessel, and by the signs of secondary exudative 
pleurisy, viz., moderate fever, dulness over the lower zones of the chest, 
limited above by a horizontal line, slight splashing sound, and a soft 
distant pleuritic souffle. 

All the secondary symptoms — loss of appetite, suppressed rumination, 
sighing, accelerated pulse, etc. — are found in a more or less accentuated 
form. 

In pyo-pneumo-thorax fever is more marked, while the signs noted 
on auscultation and percussion are identical, and are accompanied by 
digestive disturbance and marked oedema of the wall of the chest, 
which can be seen or detected by palpation. 

Diagnosis. The diagnosis is relatively easy when the lesion is 
secondary ; but the difficulty (as in simple pneumo-thorax) is to identify 
the exact character of the primary affection. 

On the other hand, pyo-pneumo-thorax and hydro-pneumo-thorax 
are not always complete ; adhesions of very varying character may exist 
between the lung and the chest wall ; hence it is impossible to group 
together all the possible symptoms. 

Diagnosis is facilitated by aseptically puncturing the chest with a 
Pravaz's syringe. 

Prognosis. The prognosis is extremely grave even in cases of hydro- 
pneumo-thorax. Treatment is useless, for even allowing that the primary 
disease might be cured, this process of cure, after reabsorption of the 
transudate, would be extremely tedious, and the animals would long 
remain in poor condition. 

Treatment. In hydro-pneumo-thorax no treatment is advisable. 
Nothing is gained by thoracentesis, at least at an early stage, or before the 
lesion causing the pneumo-thorax has closed. 

In pyo-pneumo-thorax, on the contrary, the theoretical course is to 
evacuate the pus and completely wash out the pleural sac with lukewarm 
non-irritant solutions of antiseptics. 



CHAPTER V. 

DISEASES OF STRUCTURES ENCLOSED WITHIN THE 
MEDIASTINUM. 

The mediastinum is a space enclosed in the median plane of the 
thorax by the ajDproach of the two opposite layers of plem'a. Needless 
to say, at those points where the layers are in apposition, the space is 
theoretical only. It extends from the suprasternal region to the dorsal 
subvertebral region, and encloses all the vessels which pass from or to 
the base of the heart, the trachea, the oesophagus, the pneumo-gastrie, 
diaphragmatic and cardiac nerves, etc., as well as the pericardial sac and 
the heart. The organs most frequently affected are the lymphatic glands 
lodged in the thickness of the mediastinum, the glands placed at the 
entrance to the chest, the bronchial glands, and the glands situated in the 
posterior mediastinum. 

Inflammation of the mediastinum may coincide with inflammation of 
the mediastinal layers of the pleura ; but this can only be detected on 
post-mortem examination. The lesions which can be recognised during 
life are simple inflammation of glands, resulting from pulmonary or 
pleural diseases, tuberculous inflammation of glands, and the presence of 
cancerous tumours of the mediastinum and hypertrophy of glands due 
to lymphadenitis. 

Simple inflammation of the lymphatic glands is secondary and 
consecutive to broncho-pneumonia, verminous bronchitis, infectious 
bronchitis, etc. 

It produces reflex irritation by compressing the pneumo-gastrie and 
laryngeal nerves, and is indicated by loud, spasmodic coughing. 

Treatment consists in administering iodide and bromide of potassium, 
terpine, in doses of 1 drachm per day for adults, essence of turpentine 
and tar water. 

Tuberculous inflammation of glands, inseparable from pulmonary 
tuberculosis, has very special characteristics peculiar to tuberculosis. 

Inflammation due to lymphadenitis is also very easy to diagnose 
as a rule, in consequence of the symmetrical enlargement of lymphatic 
glands elsewhere. 



TUMOURS OF THE MEDIASTINUM. 369 

TUMOURS OF THE MEDIASTINUM. 

Sarcomata, carcinomata, lymphomata, and lympho-sarcomata all 
occur in the mediastinum. They attack young healthy animals, and 
sometimes develop with such rapidity that in a few weeks they become 
generalised and invade the heart, lungs, and principal viscera. Their 
cause is at yet unknown. 

Symptoms. At first sight the symptoms are much like those of 
pericarditis caused by foreign bodies. They consist in deformity of 
the presternal region, swelling of the jugulars, submaxillary oedema, 
irregular pretracheal tumefaction, etc. 

The tumour, whatever its nature, commences in the mediastinmn, 
develops towards the entrance to the chest, where it projects, and before 
long produces in the pretracheal region clearly marked oedematous 
swelling. 

Between the two first ribs the tumour compresses the carotids, the 
jugulars, the nerve trunks, and also the trachea and oesophagus, pro- 
ducing difficulty in the return circulation, especially in the jugulars, 
swelling in the submaxillary space, loss of appetite and dyspnoea. 

Palpation aft'ords indication of a tumour of soft consistence, bosse- 
lated, more or less adherent to the skin, usually painless on pressure, 
and of irregular development. Compression of the oesophagus inter- 
feres with the deglutition of rough forage, impedes rumination, prevents 
eructation, and thus produces trifling but permanent tympanites. 

The heart is aflected reflexly or directly as a result of generalisation 
of the tumour, and the pulse may rise to 70 or even 120 per minute. 

During the first stages neither auscultation nor percussion points to 
any pulmonary lesion. At a later stage the lung itself may be affected. 
The other important functions are normal. 

Animals suffering from sarcoma, carcinoma, or lympho-sarcoma of 
the mediastinum waste very rapidly, lose appetite, become feverish, and 
soon develop cachexia. 

Diagnosis. The diagnosis of tumour of the mediastinum is easy, 
because of the well-marked character of the apparent symptoms. 

Prognosis. The prognosis must be regarded as extremely grave, 
and in most cases fatal, for there is no active method of intervention, 
extirpation being impossible. 

There is no treatment. The animal should at once be slaughtered. 



D.C. 



SECTION IV. 

THE ORGANS OF CIRCULATION. 

SEMIOLOGY OF THE ORGANS OF CIRCULATION. 

The semiology of the circulatory a^jparatus comprises the clinical 
examination of the heart, arteries and veins, and the examination of the 
pulse and blood. 

Heart. In animals of the bovine species, the heart is situated in the 
thoracic cavity opposite the third, fourth, fifth and sixth ribs, nearly in 
the median plane of the thorax, and inclined from front to back at an 
angle of 70 degrees. 

The pericardial sac touches the extremity of the sternum where it is 
in immediate contact with the lower insertion of the diaphragm. This 
peculiar arrangement favours the development of pericarditis due to 
foreign bodies. 

On the left side the pericardial sac may come in direct contact with 
the internal surface of the thoracic cavity opposite the lower extremity of 
the third, fourth, and sometimes fifth ribs. At all other points the 
pulmonary lobes, as expanded during inspiration, separate it from the 
thoracic wall. 

Although the pericardium and heart are situated in the median plane, 
percussion and auscultation should be performed on the left side, since 
the anterior and cardiac lobes of the left lung are less developed than 
those of the right ; but the heart can be auscultated on the right side, as 
is advisable at times. 

In the healthy ox there exists an area of the left thoracic wall which 
may be called the cardiac zone, on a level with which are heard the 
normal heart sounds. In diseased conditions this zone or area may 
vary in size, and the sounds may be modified. 

The heart can be examined by inspection, palpation, percussion, 
and auscultation. 

Under ordinary conditions inspection reveals nothing in well-nourished 
animals ; but in very thin subjects and in those suffering from recent 
cardiac lesions or pseudo-pericarditis, a rhythmic movement of the chest 
wall is sometimes detected. 



SEMIOLOGY OF THE ORGANS OF CIRCULATION. 



371 



Palpation is performed by placing the open hand on the cardiac zone. 
In this way the cardiac shock can be felt, its degree of intensity judged, 
and, in an imperfect manner, its rhythm. 

Percussion by means of the fingers or a pleximeter discloses the 
extent of the physiological area of partial dulness, due to the presence of 
the heart, as well as its variations in pathological conditions, particularly 
in pericarditis with marked exudation. 

In such cases there may even be complete dulness when the distended 
pericardium thrusts upwards the corresponding pulmonary lobe, and comes 
in contact with the internal 
surface of the thoracic wall, or, 
in cases of pericardial pneu- 
matosis, exaggerated resonance, 
and a tympanitic sound. 

Auscultation is carried out 
either directly or by the stetho- 
scope or the phonendoscope. 
The normal or pathological 
sounds of the heart are thus 
ascertained, as well as the in- 
tensity of the cardiac beats and 
sounds, the frequency of the 
rhythm, etc. 

When injuries have oc- 
curred which cause murmurs, 
it is best to use the stethoscope 
and to apply it at the points 
where murmurs are heard at 
their maximum intensity, i.e., 
exactly at the spot where the car- 
diac shock is noted, and towards 
the base, in the region where 
the great arterial trunks begin. 

In the latter case it is often useful to draw the left fore leg forward. 

Arteries. The arteries are rarely the seat of lesions that can be 
detected by examination, and therefore such examination is usually 
limited to noting the state of the pulse. 

Arteritis and thrombosis of arteries are rare, and although lesions 
of atheroma have been discovered in certain chronic diseases, such as 
tuberculosis, chronic diarrhoea, etc., they are difficult to detect, even 
on examination per rectum of the bifurcation of the aorta. 

Pulse. The examination of the pulse, on the contrary, is of great 
importance. In animals of the bovine species the pulse may be taken at 

B B 2 




Fig. 173. — Schema of a section through the 
chest opposite the heart. P^, Left lung ; 
Vd, right lung; cp, right and left pleural 
cavities ; P, pericardium ; I, V-, cardiac lobes 
of the lung interposed between the peri- 
cardium and thoracic wall. 



372 THE ORGANS OF CIRCULATION. 

a number of different points, such as the submaxillary artery, on the 
side of the lower jaw : in the case of very thin animals at the radial 
within and in front of the elbow joint ; at the internal saphenous 
artery, at the height of the mamma or scrotum ; or at the coccygeal 
artery, at the base of the tail. 

This examination reveals the frequency (50 to 60 per minute), the 
quality, whether strong, feeble, imperceptible, etc., the regularity, 
etc., etc. 

Yeins. The veins are more easily examined than the arteries, on 
account of their superficial position in most cases. 

Inspection and palpation are the only means of examination. 

Inspection shows the degree of fulness or collapse, and also the 
existence or absence of what has been termed venous pulse. 

Venous pulse occurs only at the lower extremity of the jugulars. 
It is very frequent in animals of the bovine species, and in thin animals 
is not necessarily a pathological symptom. It is due to reflux of blood 
in the anterior vena cava, under the influence of the expiratory effort ; 
sometimes to emphysema, tuberculosis, etc. ; in other cases to the 
return of blood towards the vena cava and jugulars at the moment of 
auricular systole, as a result of lesions of the tricuspid or auriculo- 
ventricular orifices. 

By palpation of the veins their permeabilit}' can be estimated, also 
the degree of distension or obstruction, and the condition of their 
contents. 

Capillary system. Among methods of arriving at the state of the 
circulatory system must be included an examination of the vascular con- 
dition of the accessible mucous membranes, such as those of the eye, 
mouth, nostril, vulva, etc. This examination is easy to carry out, 
and is of value in diagnosing congestive states, pneumonia, and local 
inflammation. 

Blood. Examination of the blood is sometimes necessary for the 
exact diagnosis of certain diseases, and therefore should be carried out 
whenever occasion requires. The physical state, coloration, and rapidity 
of coagulation afford valuable data in certain diseased conditions, and 
indicate the approximate richness in hsemoglobin, the normal or ab- 
normal composition of the plasma, and the richness of the blood in 
white corpuscles. 

Microscopic examination is still more valuable, whether carried out 
by the moist method, in which a drop of blood is compressed under a 
cover glass, or the dry method with or without staining. In the latter 
case the specimen is fixed with a mixture of equal parts of alcohol and 
ether or by immersing it in a 1 per cent, solution of osmic acid. 

By this means it is possible to detect the condition of the red and 



SEMIOLOGY OF THE ORGANS OF CIRCULATION. 373 

white blood corpuscles and haematoblasts ; the existence or non-existence 
of leucocytosis and its degree, as well as the existence, for instance, of 
leiicocythfemia. 

The blood corpuscles may also be counted. 

Histological examination, supplemented by suitable staining, reveals 
the presence of normal or abnormal blood corpuscles, parasites such as 
piroplasma, or microbes such as bacteria. 

Such examination necessarily presupposes a knowledge of what 
should be looked for in the normal state. 

In normal blood the red blood corpuscles predominate. They are all 
similar in form and, with few exceptions, of the same size. They stain 
strongly with acid solutions such as eosine. In pathological conditions, 
large or giant corpuscles may be found (macrocytes), as well as those of 
medium size (normal) and small size (microcytes). Some are vigorous 
and stain deeply; others, on the contrary, are degenerating or dead, and 
have no greater affinity for one constituent than for another of the 
double or triple stains commonly employed. 

In pathological conditions the hsematoblasts occur in very varying 
numbers. 

The white blood corpuscles found in health may be classified as 
follows : — 

Large and small lymphocytes, each of which has a round volu- 
minous nucleus and a narrow border, and contains a non-granular 
protoplasm ; their proportion varies between 22 per cent, and 25 per 
cent. : 

Polynuclear leucocytes or polymorphous leucocytes with a single 
nucleus, which originate in bone marrow, stain best with neutral colours, 
and are present in the proportion of 70 per cent, to 72 per cent. : 

Mononuclear leucocytes with an ovoid eccentric nucleus stain best 
with basic colours, and form about 1 per cent. : 

Polynuclear leucocytes stain best with eosine or acid colours, and 
form about 1 per cent, to 2 per cent. 

When these white blood corpuscles are in larger number the con- 
dition is known as leucocytosis, and when one or other variety is in 
very great excess the condition is known as leucfemia. 



CHAPTER I. 
CARDIAC ANOMALIES. 

ECTOPIA OF THE HEART. 

Ectopia of the heart, i.e., congenital malformation in which the heart 
is displaced from its normal position and thrust sometimes completely 
beyond the thoracic cavity, is not very rare. The heart may be well 
developed, but it is not enclosed by the thoracic walls when the thoracic 
cavity closes during the first stages of embryonic life. The sternum, 
which is cartilaginous and becomes ossified only at a later period, 
remains fissured along the median line, and the fissure, usually of 
oval form and with rounded margins, surrounds the auricles and the 
vessels at the base of the heart. The ventricles form a hernia pro- 
jecting beyond the thorax, which then only contains the two pleural 
sacs and a complete mediastinal partition. The pericardium remains 
undeveloped. 

Despite this malformation, the embryo develops. The foetus may 
in due season be brought forth living, but as a rule death occurs in 
a few hours. 

The diagnosis is easy, but this malformation cannot be treated. 
All that can be done is to protect the ectopiated organ against ex- 
ternal violence in cases where the young creature is born alive. 



CHAPTER II. 
PERICARDITIS. 

Pericarditis consists in inflammation of the pericardial sac. It is 
attributable to different causes, varying in importance and in causation. 

Specific pericarditis may be produced by the tubercle bacillus, or it 
may develop during an attack of contagious peripneumonia. Tuber- 
culous or peripneumonic forms of pericarditis as a rule form only com- 
plications of chronic pulmonary tuberculosis or peripneumonia. They 
are very rarely primary in character, and, like the allied forms of 
pleurisy, assume a vegetative and adhesive form in tuberculous cases. 

Moussu has never seen the true exudative form either in acute or 
chronic tuberculosis, but only vegetative and caseous forms. 

Simple acute pericarditis. Cases of simple acute exudative peri- 
carditis have been described, and have been referred to chills, wounds, 
or injuries in the region of the heart, and in a few cases to the 
rheumatic diathesis. 

Such forms of pericarditis may occur, but probably are very rare, 
for Moussu has seen but two cases. As the symptoms correspond 
exactly to those of exudative pericarditis produced by a foreign body, 
it is unnecessary to describe them specially. 

The only important detail to bear in mind w'ith this disease is the 
possibility of cure by suitable treatment, such as the application of 
stimulants or vesicants to the cardiac zone, the administration of sali- 
cylate of soda or diuretics, and complete rest. 

The diagnosis, moreover, should be confirmed by making an aseptic 
exploratory puncture with the capillary trocar. The nature of the 
liquid withdrawn will indicate whether the case is one of simple acute 
pericarditis or pericarditis due to a foreign body. 

Cancerous pericarditis is generally secondary, and is caused by 
development of tumours on the pericardial serou§ membrane, and in 
the myocardium. Moussu, however, has seen one case of primary 
cancerous pericarditis, the tumours being found only on the periphery 
■ of the myocardium. The growth assumes a vegetative form with 
moderate exudation. The symj)toms, however, so closely approach to 
those of exudative pericarditis due to foreign bodies that only the 



376 



PERICARDITIS. 



latter variety, which is by far the most frequent in animals of the 
bovine species, need be described. 

EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 
This condition has been erroneously described as traumatic peri- 
carditis, but the latter term "svould suggest that the disease was due 
to an injury acting from without. It may be defined as a disease pro- 
duced by the discharge into the peri- 
cardial cavity of some foreign body 
from the gastric compartments. 

Boizy in 1858 described several 
cases of this kind of pericarditis. 
Hamon in 1866 gave an excellent 
table of symptoms. Roy in 1875 
supplemented this with numerous ob- 
servations showing clearly the pos- 
sibility of recognising the disease by 
clinical examination. Pericarditis due 
to foreign bodies is to-day one of the 
best characterised diseases of the ox, 
and it is easy to diagnose. 

Before approaching the etiological 
side of the question, it is necessary to 
recall in a few words the anatomical 
arrangement of the pericardium and 
its relations to neighbouring organs. 

In the ox the diaphragm pre- 
sents a marked concavity directed to- 
wards the abdomen. The pericardium, 
situated exactly in the median plane, is fixed by its point to the sternum. 
A fold of adipose tissue directly connects it with the anterior surface of 
the diaphragm. On the abdominal side the conical right compartment 
of the rumen is in free communication with the reticulum, which is 
closely applied to the posterior surface of the diaphragm on the median 
hne opposite the spot occupied by the pericardium on the anterior sur- 
face (Fig. 176). As a result of this arrangement any object passing 
through the reticulum and diaphragm in the median plane would enter 
the pericardial cavity. These particulars indicate clearly how this form 
of pericarditis is produced. 

Causation. One of the chief causes of pericarditis by a foreign body 
is connected with the way in which oxen feed. They rapidly swallow their 
food and any foreign bodies that may be concealed in it, submitting 
it later on to a second mastication in the course of rumination. This 




Fig. 174. — Tumours of the surface of 
the heart. Primary cancerous peri- 
carditis and myocarditis. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 877 

method of feeding results in bolting the food almost without mastication, 
hence the possibility of swallowing foreign bodies. 

The proximity of the reticulum to the pericardium is also an impor- 
tant factor, because the foreign bodies fall into the reticulum as soon 
as the bolus of food begins to break up. It is important to notice, 
moreover, that pericarditis is commonest on farms where the oxen are 
attended by women, or in regions where sharp objects are to be found on 
roads or pastures frequented by the animals, such as the vicinity of 
needle, nail, and rivet factories. 

The sole cause is the penetration of a foreign body into the peri- 
cardial sac. 

Pathogeny. All kinds of foreign bodies are swallowed by oxen, as 
is abundantly shown by post-mortem examinations. These indigestible 
bodies pass with the food into the rumen, and accumulate in the deepest 
portions of that receptacle. Owing to physiological contractions the 
loAver wall of the rumen rises to the level of the orifice of communication 
with the reticulum, and so passes much of the material accumulated 
within it into this organ. 

Soft foreign bodies fall towards the lower parts of the reticulum, but 
sharp objects may lodge in its walls. Very often the bodies penetrate in 
this way without causing reticulitis or grave inflammation. The func- 
tions of the reticulum are not impeded. The commonest of such objects 
are needles, pins, nails, or fragments of iron wire. On account of their 
form, needles are the most dangerous. The sharpness of one extremity 
ensures its passing readily through the tissues, and as the point is 
the part that offers least resistance, the needle continues gradually to 
penetrate. 

If the foreign body becomes imi^lanted vertically in the lower wall of 
the rumen or reticulum it may be expelled directly through the medium 
of an abscess. This is a favourable termination, though it usually 
results in permanent gastric fistula. 

More often the objects penetrate the anterior wall of the reticulum 
and gradually work their way towards the diaphragm, impelled by the 
movements of the reticulum and the other digestive compartments. 
They perforate the muscle and pass into the thoracic cavity, either in 
the direction of the pericardium or of the pleural sacs. 

First as to the penetration of the pericardium. The foreign body, 
whatever it may be, produces by its presence alone very marked irrita- 
tion, and as in addition it is always infected in consequence of its having 
passed through the digestive compartments, inflammation is set up to a 
degree proportionate to the pathogenic qualities of the infective agent. 

Symptoms. The early symptoms are those of indigestion, and not of 
pericardial disease, a fact which is easy to understand, because at first the 



378 PERICARDITIS. 

whole mischief is in the abdominal cavity. The patients are dull, rest- 
less, and seem to be suffering from an obscure ailment. They remain 
standing more than usual, show more than ordinary deliberation in 
lying down, lose appetite, cease to ruminate regularly, and exhibit 
intermittent tympanites. 

The cause of these symptoms is as follows : At first the reticulum is 
partly immobilised by the local inflammation, and at a later stage move- 
ment of the diaphragm is checked by reflex action when the sharp body 
has progressed far enough to touch it. The rhythmic movements of the 
reticulum and the diaphragm are interfered with, rumination is dis- 
turbed, eructation ceases, and tympanites appears. 

The patient often utters slight groans, particularly when forced to 
move ; l)ut as this is a sign common to all grave diseases it can only 
give rise to a suspicion as to what has occurred. In ten to fifteen days 
this primary phase may have terminated ; but it is impossil)le to say 
how long it lasts, for it varies with each animal as with each variety 
of foreign body, and it may be prolonged for months. 

From the moment it reaches the thoracic cavity the foreign object 
makes its way towards the channel formed on either side by the ribs and 
below by the sternum, and therefore towards the point of the heart. 
This is the second phase of development. 

The passage of the foreign body through the diaphragm occupies a 
more or less considerable time, depending on its length ; the beginning 
of this second phase is characterised by relative immobility of the circle 
of the hypochondrium during respiration. The abnormal sensibility and 
pain impede contraction of the diaphragm. 

Palpation of the region of the xiphoid cartilage then reveals abnormal 
sensibility, and sometimes causes the animal to resent being handled. 

From this time the pericardial symptoms proper commence, the 
foreign body having come in contact with the pericardium. This phase, 
unlike those which precede it, presents well-defined symptoms. The 
irritation of the heart and its ganglionic system by a foreign body in the 
pericardium is shown by considerable acceleration of the heart beats 
even before there is any exudation into the pericardial sac. Instead of 
60 to 70 beats, the normal number, the pulse may rise to 80, 90, 100, or 
even 110 beats per minute. The heart sounds are tumultuous, dull and 
ill-defined, while the pulse appears bounding and strong. 

But this period of cardiac excitement while persisting is soon com- 
plicated by other symptoms. As soon as the foreign body penetrates the 
pericardial sac, there is infection, which produces an active form of 
inflammation and abundant exudation. From this time the pulse be- 
comes weaker and weaker, until, under the steadily increasing pressure 
on the heart, it is almost imperceptible. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 379 

There is only moderate fever. As soon as the exudation becomes 
considerable, the symptoms of pericarditis grow very marked : they may 
be grouped in the following order, according to their importance. 

A. Cardiac symptoms. On palpation of the cardiac zone on the left 
the impulse of the heart is no longer felt. Percussion, which under 
normal circumstances reveals only partial dulness, now seems to give 
pain, and indicates abnormal dulness distributed in a vertical plane. 
The pulmonary lobes between the pericardium and thoracic walls are 
thrust upwards. The distended pericardial sac approaches the parietal 
layer of the pleura and may adhere to it, hence the dulness. This dul- 
ness extends as far back as the xiphoid appendix of the sternum, and can 
be detected on both sides, marginated above by a convex line. 

In rare cases the dulness is absent, being partially rej^laced by tym- 
panitic resonance, due to the presence of gases in the distended peri- 
cardial cavity, which gases originate in the digestive reservoirs or result 
from putrid fermentation of the pericardial exudate. 

Simple or double pleurisy, or even pneumonia of the cardiac lobes 
resulting from infection by contiguity, may complicate cases of rapid 
pericarditis. The dulness then api^ears modified, as do the signs ob- 
served on auscultation. 

Auscultation furnishes valuable indications. From the outset it re- 
veals acceleration of the heart. At a later stage, but only for a short 
time, it permits of the detection of the pericardial rubbing sound which 
precedes serous exudation, and which may persist for several days when 
large quantities of false membrane are produced. 

If exudate is present in considerable quantities a liquid sound is 
heard at each heart beat. The heart appears to be beating in water, but 
the liquid note varies considerably. It has been termed the " claclaque " 
sound (Lecouturier, 1846), in allusion to the sound produced by the 
meeting of water ripples ; '• clapotement " sound (Boizy, 1858), with 
reference to the sound produced under the influence of a light breeze 
on the borders of a stream; " glouglou " sound (Roy, 1875), suggested 
l\y the noise of liquid escaping from an inverted bottle into a resonant 
vessel, etc. It is important, however, to remember that cases occur 
(principally when the pericardium is greatly distended and entirely filled 
with liquid) where, with the animal at rest, these sounds are difficult to 
detect. To render them noticeable the patient must be walked for a few 
yards. 

A^ernant, again, has described a sound as of dripping water, of quite 
special character ; he compared it to that resulting from the fall of drops 
of liquid on to a marble table or into a half-filled vessel. So far as can 
be ascertained this sound of dripping water greatly resembles that heard 
in pneumo-thorax, but it is less resonant and less prolonged. 



380 



PERICARDITIS. 



It appears to be characteristic of the presence of air in the peri- 
cardial cavity, and its special quality varies with the quantity accumu- 
lated in the pericardium. Masked by these pericardial sounds the 
beating of the heart seems dull, badly defined, distant and stifled. 

B. Jugular symptoms. The "jugular" symptoms are secondary, 
and result from the accumulation of liquid in the pericardial cavity. 
No intra-pericardial exudate can exist without exerting pressure on the 
heart, and as the auricles have very thin walls and are more compres- 
sible than the ventricles, this pressure immediately causes difficult}^ in 
the return circulation, whence venous stasis, varying in intensity, but 

clearly visible and appre- 
ciable on account of the 
distension of the jugulars. 
The venous stasis is 
general, for the pulmonary 
veins are as much com- 
pressed as the posterior 
and anterior venae cavse, 
but it is only apparent in 
the large superficial veins. 
This stasis is accompanied 
by venous pulse, and par- 
ticularly by peripheral or 
internal oedema, oedema of 
the lung, intestine, mesen- 
tery, etc., of the submaxil- 
lary space and of the dewlap 
and entrance to the chest, 
ffidema of the submaxillary 
space is specially charac- 
teristic, for it appears almost 
first amongst external signs. That of the dewlap follows at a later stage, 
and extends backwards as far as the umbilicus, rising above this point as 
high even as the entrance to the chest and the axillary region. 

C. Pulmonary symptoms. The pulmonary symptoms result from 
difficulty in the return circulation and from the venous stasis. They are 
due to passive congestion and oedema of the lung or to hydro-thorax. At 
rest the respiration may appear fairly regular, but at the least movement 
it is accelerated, and may rise to 40 or even 60 per minute. 

Percussion reveals lessened resonance of the parts, and in the case of 
hydro-thorax dulness marginated by a horizontal line, as in pleurisy. 

On auscultation the vesicular murmur may sometimes have dimi- 
nished or even disappeared, while the respiration may be blowing, as in 




Fig. 175. — Appearance of a patient suffering from 
fully-developed pericarditis. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 381 

active congestion, and in exceptional cases a tubal souffle may be 
observed. In most cases the animal has a paroxysmal, somewhat fre- 
quent cough, due to reflex irritability of the pneumo-gastric. 

Cruzel in addition mentions a double respiratory movement like that 
produced in the horse by broken wind. This is really the result of 
hydro-thorax, and is not a constant symptom. 

D. General symptoms. When the disease has lasted a certain 
time the patients show certain well-marked general symptoms : they 
remain standing in one position for long periods, with the head and 
neck extended, the front legs thrust outwards from the trunk and the 
body rigid, as though the least movement caused them pain. The 
general attitude expresses anxiety, the animals lie down with great care 
and seldom remain long in this position, which interferes with the 
functions of the heart and lung. In the last stages the animals 
remain constantly standing, appetite is almost entirely lost, and they 
waste rapidly. 

The course of pericarditis due to foreign bodies is very variable. 
Sometimes death occurs in eight or ten days. In other cases the animal 
may survive for weeks, provided it is well tended. Everything depends 
on the rapidity with which the foreign body moves and on the character 
of the infectious organisms which it introduces into the pericardium. 
Death is the inevitable termination, and occurs as a consequence of 
cardiac and respiratory syncope. It may follow suddenly as the result 
of a simple forced movement, even when the animal still seems to retain 
some amount of strength. When the organisms introduced into the peri- 
cardium are of marked virulence, complications such as septic pleurisy 
and pneumonia may be observed, and death soon takes place. 

It has been suggested that recovery might follow a return of the 
foreign body towards the reticulum. This view can only have been 
advanced as a consequence of errors in diagnosis, either as to the exist- 
ence of pericarditis or as to its nature. Pericarditis due to cold or rheu- 
matism sometimes becomes cured spontaneously. 

Death, again, may suddenly occur by syncope when the foreign body 
penetrates the myocardium, passes through it, and enters the ventricular 
cavities. 

The return of the foreign body is not conceivable, at all events after 
it arrives in the pericardial cavity. Up to that time the only dis- 
turbance is of a digestive character ; no pericarditis exists. But when 
for example the disturbance is due to long fragments of iron wire which 
may extend from the reticulum as far as the pericardium, it is clear that 
the pericarditis is of a kind which cannot be cured without leaving 
traces. In our opinion, natural recovery is impossible. 

Diagnosis. The diagnosis of pericarditis cannot be made until such 



382 PERICARDITIS. 

pericarditis actually exists, i.e., until the disease has arrived at the third 
stage of development mentioned above. 

As long as the symptoms point only to the first or second stage, the 
logical diagnosis is reticulitis produced by a foreign body. At this time 
the development of pericarditis, although possible, is not inevitable. 

When, on the other hand, one knows how the digestive disturbance 
has originated and developed and thereafter notes signs of cardiac irrita- 
tion, disappearance of the cardiac impulse, dulness of the heart sounds, 
venous stasis, etc., the diagnosis is easy even thus early. 

Mistakes are not very likely. Only in some cases are they liable to 
occur, as in acute peripneumonia of the anterior pulmonary lobes, 
causing compression of the pericardium of the anterior vena cava and 
producing secondarily venous stasis and oedema of the dewlap. Cases 
of specific pericarditis due to peripneumonia also occur, and under such 
circumstances a mistake would be even more excusable. Nevertheless, 
the temperature curve in itself is a sure indication, for whilst in peri- 
pneumonia the fever is always very marked, it is scarcely noticeal)le in 
pericarditis due to a foreign body. 

When the diagnosis of pericarditis has been arrived at it is desirable 
to determine the exact nature of the disease, for whilst cases of peri- 
carditis due to foreign bodies are incurable and in the interest of the 
owner the animals should be slaughtered, pericarditis due to cold or 
rheumatism may be successfully treated. Kheumatism generally affects 
the synovial membranes even before it produces pericarditis, and this 
indication, supplemented by the history of the case usually ensures one 
against mistakes regarding the initial cause. 

It is much more difficult to distinguish pericarditis due to a 
foreign body from pericarditis due to carcinoma and from the forms 
of pseudo-pericarditis produced by lesions in the neiglibourhood of the 
heart. When considering the latter we shall deal with this particular 
point. 

Prognosis. The prognosis is always fatal. 

Lesions. When the foreign body is very thin and sharp, the reti- 
culum may not become attached to the diaphragm. In such cases its 
passage has been rapid and the tissues have healed. 

Usually the reticulum, diaphragm and pericardium are united by a 
mass of fibrous tissue as thick as a man's arm. It resembles a fibrous 
sleeve surrounded by an oedematus zone, usually of slight extent. This 
mass of new fibrous tissue is traversed l)y a sinuous tract resulting from 
the irritant action of the foreign body on the surrounding tissues. All 
writers describe this fibrous sleeve, which, however, only occurs in cases 
where a very long foreign body has occupied a considerable time in pass- 
ing from the reticulum to the cavity of the chest. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 



383 



In very exceptional cases the sinuous tract is ramified, possibly as a 
result of displacements of the foreign body. 

The orifices of the tract are to be found, one in the reticulum, the 
other in the pericardium. On the side of the reticulum there is never |^ 
more than one opening, and in many instances the tract is already closed 
on that side, either by exuberant granulations or by a cicatrix. 

On the contrary, the fistula is more frequently open in the pericardial 
cavity. Its walls are of very varying appearance, depending on their age : 




Fig. 176.— Appearance of the lesions in a case of fatal pericarditis. P, inflamed peri- 
cardium, distended with exudate and adherent to the neighbouring pulmonary lobes ; 
], posterior lobe ; 2, cardiac lobe ; 3, anterior lobe ; Fp, pleural false membranes. 



they may be red, greyish, soft or hard, and when the lesion is of old 
standing they may have been converted into a sclerotic tissue. 

The pericardium appears distended with a considerable quantity of 
liquid of a special character — sometimes sero-sanguinolent, sometimes 
almost or entirely purulent ; sometimes yellowish, or greenish-grey ; 
sometimes frothy, inodorous, or very foetid. 

These characters depend on the nature and number of the germs 
which have invaded the pericardial cavity. They also vary with the 
gravity and number of the hemorrhages produced by the action of the 
foreign body on the myocardium. 



384 PERICARDITIS. 

The quantity of liquid also varies within very wide limits. There 
may be scarcely any exudation. In that case the pericarditis is of a 
partially adhesive character, with abundant false membranes. As a 
rule the quantity of fluid exudation varies between seven and eight 
quarts, but sometimes the quantity is much greater. Trasbot de- 
scribed an instance in which the united weights of the heart and peri- 
cardium exceeded 36 lbs. Hamon mentioned a case of pericarditis in 
which the liquid exudate exceeded twenty quarts. 

When inflammation is first set up the liquid is serous, yellowish, 
or reddish-yellow. It contains fibrinous Hocculi in suspension. Little 
by little this exudate becomes purulent, whilst the internal layers of the 
pericardial serous membrane undergo desquamation. These are next 
covered with false membranes of varying appearance ; the iibro-albu- 
minous exudation is wrinkled, villous and tufted. The two layers of 
serous membrane are connected at certain points by this exudation, the 
adhesions being sometimes very extensive. The pericardial sac pro- 
perly so called becomes the seat of marked lardaceous thickening, due 
to inflammation. The heart appears entirely covered with a layer of 
greyish or earthy-coloured granulation tissue, which appears as though 
baked, and was compared by Hamon to the back of a toad. It is atro- 
phied as a consequence of prolonged compression. 

Under the influence of the excentric pressure of the liquid the peri- 
cardial sac is distended and comes in contact with the walls of the chest, 
to which it may adhere. The foreign body, especially if small, is not 
always easy to find. 

The myocardium often displays interesting lesions. At first there is 
thickening, or more commonly sclerous degeneration, of the superflcial 
layers covering the ventricles, and then appears a crop of little miliary 
abscesses. Abscesses of considerable size have several times been 
detected in the walls of the ventricles and in the interventricular 
septum. 

The foreign body, moreover, may not only injure the myocardium, 
but may even perforate it completely and produce ulcerative endocarditis 
(Cadeac). In this case infectious germs very rapidly invade the circu- 
lation and all the tissues, and the animal dies of pyaemia. 

These essential lesions are accompanied by others of varying im- 
portance. Thus the lung is congested throughout, and by contiguity 
of tissue inflammation may extend from the pericardium to the lower 
part of the pulmonary lobes and to the pleura. 

Interference with the return circulation induces lesions due to venous 
stasis : dropsy of the chief serous membranes, oedema of the connective 
tissue, pleural and peritoneal exudations, etc. If the hind limbs never 
become swollen it is because the skin covering them is very resistant 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 385 

and does not readily yield. The liver becomes hypertrophied, congested 
and engorged with blood, and when the animals live for some weeks, 
shows the appearances known as cardiac or nutmeg liver. 

Treatment. The treatment of pericarditis due to the presence of 
foreign bodies is at present merely palliative. Often the only thing 
to be done is to slaughter the animal. 

We need not go back to the methods formerly recommended. All 
are illusory or mischievous, such as the use of purgatives to arrest or 
reverse the progress of the foreign body, removal of the foreign body 
after opening the rumen, puncture of the pericardium, etc. 

In 1878 Bastin successfully opened the pericardium and extracted 
the foreign body through a window produced in the thoracic wall. 

This operator recommends that after drawing the left limb forward 
and incising the skin and muscles, the operator, with his hand bound 
round with a cloth, should perforate the pleura, and then having found 
the foreign body, proceed to extract it. By this method it seems difficult 
to cause perforation of the pericardium, which would certainly lead to 
the production of pneumo-thorax complicated with fatal septic pleurisy. 

It must be borne in mind that the two pleural sacs, right and left, 
descend as far as the sternum (Fig. 173), and that it is not possible to 
touch the pericardium directly without perforating the pleura. 

Moussu has drained the pericardium through the pleura in the hope 
of relieving the pressure on the heart and facilitating the reabsorption of 
the oedema, in order to permit of the subsequent slaughter of the animal, 
but has had unsatisfactory results. Lastly, he has practised median 
trepanation of the sternum in the infra-pericardiac region. Here again 
the operation is difficult, because of the (Edematous infiltration of all the 
substernal region, while it is so dangerous to the patient, which must be 
cast and may suddenly succumb, that it is of no use in ordinary practice. 

There is probably only one condition in which it would be possible to 
attempt intervention with a fair chance of success, that is, when there 
exists a fibrous connection between the pericardium, lung, and wall of 
the chest on the right or left side. 

In such cases aspiratory puncture or incision of the pericardium in 
an intercostal space might prove of service, because it would not expose 
the animal to the danger of pneumo-thorax. 

The only difficulty lies in ascertaining beyond all question the existence 
of such an adhesion before attempting operation, and this is really very 
great, even having regard to the form of the dulness and the absence of 
all respiratory sound in the lower third of the thoracic cavity and cardiac 
zone. The pulmonary lobe between the heart and chest wall may be 
thrust upwards and l)e partially adherent to the pericardium and to the 
parietal pleura, and at the same time it may be impossible to avoid 
D.c. • c c 



386 



PERICARDITIS. 



producing operative pneumo-thorax when the cartihiges are resected to 
admit of incising the pericardium. 

The only logical method seems to be puncture of the pericardium 
through the xiphoid cartilage, as described below. 

The topographical anatomy of the thoracic viscera shows that the 
point of the pericardium extends along the sternum to a point close to 
the lower insertion of the diaphragm, and that the pericardial sac is 



^iH^L. 




r. Ax. F. 



Fig. 177.— Lesions of exudative iDeriearditis produced by a foreign body. Relation 
of tbe j)ericardium to the sternum and ensiform cartilage. Pericardium opened. 
D, diaphragm ; ffi, oedema of the dewlap, Ax, ensiform cartilage ; F, liver ; \b, gall 
bladder ; 1, posterior lobe of the lung, drawn backwards ; 2, cardiac lobe ; 3, anterior 
lobe ; E, spot where the foreign body penetrated, towards the point of the peri- 
cardium, between the neck of the ensiform cartilage and the circle of the hypo- 
chondrium. 



only separated from the xiphoid region, or rather from the region of the 
neck of the xiphoid appendix of the sternum, by the fatty cushion at the 
point of the heart. 

A glance at the annexed diagram (Fig. 177) will show this. 

The diagram, carefully reproduced from an anatomical preparation of 
an animal which succumbed to pericarditis, shows that the distended 
pericardium extends close to the neck of the xiphoid cartilage. 

First stage. Identify the three following anatomical guiding points : — 

(1.) Xiphoid appendix and white line. (2.) Point at which the circle of 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 



387 



the hypochondrium becomes attached to the sternum. (3.) Point at which 
the external mammary vein penetrates the abdominal wall (Fig. 178). 

Lines uniting these three points enclose a right-angled triangle, which 
the operator must imagine to be bisected by a third line. 

The incision, which should be about 8 inches in length, follows this 
bisecting line at an equal distance between the white line and the circle 
of the hypochondrium, to a point within about 8 inches of the anterior 
margin of the mamma. All these points are readily observable before 
the animal is cast. 

The cutaneous incision affords exit to large quantities of fluid, and the 



VM.a. 




Fig. 178. — Seat of operation for puncturing the pericardium by way of the ensiforni 
cartilage. L B, White line; H, hne of the hypochondrium; V. M.a., anterior 
mammary vein ; P, point where the pericardium is punctured through the incision. 



pectoral muscles attached to the neck of the ensiforni cartilage can then 
be divided with the bistoury. The area of operation is thus uncovered. 

Second stage. The second phase comprises incision of the tissues 
opposite the neck of the ensiform cartilage, about 8 inches in front of 
the base of the triangle and at equal distances from the points Nos. 1 
and 2; incision through the skin for a distance of 8 inches, and dis- 
section of the muscles of the ensiform region exposed at the neck of the 
cartilage. 

By means of the index finger or the index and middle lingers of the 
right hand the mediastinal space is explored, and the fatty masses round 
the base of the heart broken through. If the pericardium is greatly 
distended, the point of the sac can be felt with the tip of the finger, or 
its position can be recognised, even from a little distance, on account of 
the fluid contents transmitting the impulse of the heart. The sensation 
conveyed to the finger is very clear. 

cc 2 



388 



PERICARDITIS. 



The right index finger is then rephiced hy the left, and, a trocar about 
10 inches long and ^ inch in diameter being introduced along the index 
finger used as a director, the ^pericardial sac is reached. The exudative 
fluid transmits the impulse due to the beating of the heart, and the 
pulsations can be clearl}- distinguished when grasping the handle of 
the trocar. 

Third stage. Digital exploration of the course of the puncture and 
fatty cushion at the base of the heart, with the object of discovering the 
position of the pericardium. 

Fourth stage. Puncture with a trocar about 10 to 12 inches in 
length, puncture of the pericardium, -irrigation and dressing. 

The trocar is inclined in a slightly oblique direction from without 




Fig. 179. — Photograph of a patient immediately after operation. Extensive 
tedema of tlie dewlap and neck. 



inwards and forwards towards the median plane, in order that the point 
may not deviate towards the left pleural sac ; the left index finger is then 
withdrawn, and by a sharp thrust of the right hand the trocar is pushed 
forward about 1 to 1^ inches and the pericardial sac is entered. 

The position of the canula should not be altered whilst liquid is 
escaping, for if it is thrust in too far a considerable quantity of fluid 
may remain in the deepest portion of the sac. 

The cavity having been drained, a long strip of iodoform gauze is intro- 
duced into the track and a protective surgical dressing applied over the 
incision in order to prevent infection by the litter. 

In consequence of the introduction of the fingers into the track caused 
by puncture and the escape of ^pericardial liquid along the canula or after 
removal of the canula, the operative wound is necessarily infected ; but this 



CttROKlC PERICARDITIS. 



389 



is of little importance, because the opening is inclined downwards, 
and also because it is impossible to hope for aseptic healing. 

The dressing is renewed after forty-eight hours, and every three or 
four days afterwards. 

The cedematous infiltration about the front portion of the body 
disappears rapidly in two to three days, and should the animal be 
slaughtered the meat is quite sound in appearance. 

This operation does not aim at effecting a cure, but is simply for the 
purpose of allowing animals which would otherwise be valueless to be 
slaughtered and sold. 

CHRONIC PERICARDITIS. 

Pericarditis when due to tuberculosis may assume the chronic form. 
Tuberculous pericarditis, at least in a large number of cases, is only accom- 




FiG. ISO. — Photograph of the same subject as Fig. 179, taken six claj's later. 

panied by slight exudation, which might remain unnoticed unless the 
animals were carefully examined; but it causes the internal surface of the 
pericardial sac and the surface of the myocardium to become covered 
with exuberant vascular growths, which by setting up adhesions lead to 
partial or generalised union of the heart and pericardial sac. Between 
these adhesions, which form partitions, are found little cavities filled 
with sero-sanguinolent, grumous, or caseous liquid. In time the ad- 
hesions increase in number, pericarditis obliterates the free space, and 
the heart becomes wholly adherent to the pericardium. 

As in acute pericarditis, the fibrous layer undergoes thickening and 
hardening processes. The superficial layers of the myocardium undergo 
sclerous transformation, and the tissues forming the adhesions them- 
selves may assume the characters of fibrous tissue. 



390 



fERICARDlTlR. 



In one solitary case Moussu saw another form of chronic pericarditis 
with complete adhesion of the heart and pericardial sac, without any 
exudation and almost without any false membranes. He was unable to 
determine the exact cause, but was strongly inclined to regard the disease 
as having followed pericarditis a frigore or pericarditis of a rheumatic 
character. 

Adhesions l)etween the heart and pericardial sac are also said to be 
the inevitable though delayed result of all punctures of tlie peri- 
cardium through the ensiform carti- 
lage in cases of pericarditis due to 
a foreign body. 

Symptoms. If the chronic peri- 
carditis is limited to a few partial 
adhesions, it remains unnoticed 5 
but when it is more marked it offers 
certain signs of acute pericarditis, 
such as partial dulness of the car- 
diac area, which is more extensive 
than usual, disappearance of the 
cardiac shock, weakening of the 
sounds, feebleness of the pulse, 
very marked venous pulse, moderate 
stasis, extremely rapid and aggra- 
vated dyspnoea when the animal is 
forced to walk, threatened asphyxia 
if exercise is prolonged, and com- 
plete asystole. 

All these symptoms are due to 
the existence of adhesions between 
the heart and pericardium, which, 
by destroying the interpericardial 
space, interfere with diastole while 
preventing regular systole. 
Sudden death is a frequent consequence. 

The diagnosis of chronic pericarditis is very difficult. The prognosis 
is extremely grave, and we do not possess any means of dealing with the 
condition. 

PSEUDO-PERICARDITIS. 

Under this title we purpose grouping a certain number of pathological 
accidents due to different causes, but manifesting themselves by identical 
symptoms, which symptoms offer so marked a resemblance to those of 
pericarditis produced by foreign bodies as to suggest the presence of that 




Fig. 181. — Schema of a subpleural 
abscess on the right side which pro- 
duced symptoms of pericarditis (pseudo- 
pericarditis) . Po, Right lung, partly 
splenised and thrust upwards ; VI, 
parietal pleura separated from the wall 
of the lower half of the chest ; A, cavity 
of the subpleural abscess. 



PSEUDO-PERICARDITIS. 391 

disease. This refers to accidents by which the foreign body closely 
approaches, without actually touching, the pericardium, the lung or the 
pleural sacs, but in which it causes purulent collections which displace 
the pericardium, indirectly compress the heart, and finally cause symp- 
toms of an apparently pericardial character. 

Causation. During the development of pericarditis the foreign body 
perforates the reticulum and diaphragm, passing along the middle line 
of the body, without which it would not come in contact with the peri- 
cardium. If the perforation, however, occurs to the right or left of the 
median plane, the foreign body moves forward just as easily, but it 
misses the pericardium and passes either into the lung, where it causes 
fatal pneumonia ; or the pleura, where either it sets up septic pleurisy 
in the subpleural connective tissue or produces an abscess. 

The abscess is generally lateral, situated in the right subpleural 
region, or it may develop below the pericardium. These are the two 
varieties of pseudo-pericarditis seen by Moussu. 

There is, however, a third variety, which might be called " parasitic 
pseudo-pericarditis." It is extremely rare, and Moussu has only seen 
one case. It was due to the presence of an enormous hydatid cyst of the 
right lung as large as a man's head, which was situated towards the 
mediastinal plane of the lung and pressed on the supero-posterior sur- 
face of the heart and pericardium. In consequence of the permanent 
downward pressure which it exercised it interfered seriously with the 
heart's action and caused symptoms of pseudo-pericarditis. 

Symptoms. The general and external symptoms are those of peri- 
carditis — viz., dulness, diminution in appetite, irregular rumination, 
wasting, oedema of the dewlap, distension of the jugulars, marked 
venous pulse, great anxiety and dyspnoea when the patients are forced 
to move, etc. 

But the cardiac symptoms differ notably, and moreover vary, accord- 
ing to the nature of the lesions. Speaking generally percussion reveals 
complete dulness on one or both sides, and auscultation always indicates 
the absence of sounds due to extravasated fluid in the pericardial sac. 

When the abscess is situated below the pericardium, a condition 
difficult to diagnose, the dulness seldom extends very high on either 
side of the chest, and the sounds heard over the cardiac area, while 
much weaker than usual, are audible above the normal points. 

An abscess developing beneath the pleura on one side displaces the 
heart in the opposite direction. The cardiac beat is weakened by the 
compression, but, nevertheless, transmits an impulse to the purulent 
fluid, which in its turn conveys it outwards through the intercostal 
spaces in the form of movements corresponding in rhythm with the 
beating of the heart, so that at first glance one might imagine an 



3D2 



t>ERlCARDITlS. 



aneurism existed at the l)ase of the large arterial trunks. The lower pul- 
monary lobe is thrust upwards, and over the area of dulness pulmonary 
sounds completely disappear. 

When the heart is compressed by a large hydatid cyst or other lesion, 
the general and external symptoms are similar to those above described. 

Finally, one last symptom, which api)ears of some importance, may be 
mentioned. When animals suffering from pericarditis due to a foreign 
body are forced to move, the beating of the heart becomes so tumultuous 
that it can no longer l)e counted, and even in a state of rest it may rise to 




Fig. 182. — Appearance of an animal suffering from pseudo-pericarditis (infra- 
pericardial abscess). The dotted outline indicates the space occupied by 
the heart, which is thrust upwards. 



140 or 150 beats per minute. In cases of pseudo-pericarditis it rarely 
rises above 90 or 110. 

Diagnosis. The attempt to diagnose this condition accurately must 
not be regarded merely as a result of scientific curiosity. Under certain 
circumstances the diagnosis may be of very great importance. While 
the patient affected with pericarditis due to a foreign body is beyond 
all hope of recovery, certain cases of pseudo-pericarditis apj)ear amenable 
to treatment. 

The diagnosis, therefore, is of great importance, and the practitioner 
should spare no effort to confirm it, bearing in mind the symptoms 
enumerated, and remembering that the normal sounds of the heart 
never completely disappear. 

An aseptic exploratory puncture with a long, fine needle will some- 
times prove of great assistance. 



tSEUDO-PERICARDlTlS. S93 

Prognosis. Although grave, the prognosis is less so than in true 
pericarditis. 

Treatment. If clearly recognised, both suhpleural and subperi- 
cardial abscesses seem cm-able. By freely puncturing the pus-filled 
cavity through an intercostal space, the liquid may be evacuated and 
recovery may occur. Healing is favoured by carefully washing out the 
cavity with a non-irritant disinfectant. 

The only precaution required in making such punctures is to avoid 
the internal thoracic artery and vein, the intercostal artery, and the 
lower cul-de-sac of the pleura. 



CHAPTER III. 
ENDOCARDITIS. 

If the symptoms of pericardial diseases are well defined, we cannot 
say the same of diseases of the heart, properly so-called. Such affections 
often pass unnoticed, being detected only on post-mortem examination. 
Moreover, cardiac diseases are rare. Very frequently they are only of a 
secondary nature, accompanying or following better recognised condi- 
tions, such as infectious diseases, post-partum infections, etc. 

Causation. Endocarditis, i.e., inflammation of the endocardium and 
valves, is rarely primary, simple and benign. It was formerly thought to 
be the result of chills or of the rheumatic diathesis. These simple forms 
of endocarditis usually escape observation, though careful examination in 
the first instance reveals them. 

Much more frequently, however, endocarditis is secondary, malignant, 
infectious and infecting. This variety occurs as a comiDlication of post- 
partum infection or of very serious general conditions, such as peri- 
pneumonia, gangrenous coryza, aphthous fever, tuberculosis, etc. To 
detect it, not only must the original disease be accurately diagnosed, but 
all the changes the disease is producing in important organs must be 
followed. 

While it is generally admitted that all forms of endocarditis, even of 
the most benign character, are originally due to infection, it is certain that 
in those of the second group the organisms which have entered the blood- 
stream through a lesion of the uterus, lung or other tissue, are endowed 
with very great virulence. They attack some point on the endocardium, 
and produce either ulcerations which become covered with fibrous clots, 
or exul)eraiit new growths of a pathological nature, which generally are 
papilliform, fragile, and prone to become detached by rupture of their 
pedicle and thus to be launched into the general circulation and to form 
emboli. The surface of these infected vegetations, like that of the ulcera- 
tions, becomes covered with fibrinous clots, which are readily loosened, 
form emboli in their turn, and infect distant organs. 

Symptoms. The general symptoms of infectious endocarditis are by 
far the must important. They consist of prostration, loss of appetite, 
severe thirst, and high temperature. The local symptoms consist 



ENDOCARDITIS. 395 

principally of murmurs : soft murmurs due to insufficiency of the 
auriculo-ventricular valves, heard during systole, particularly opposite 
the point of the heart where the cardiac shock is most clearly felt. This 
fact differentiates them from the murmurs of chronic endocarditis, 
which are usually due to aortic contraction, and are accompanied by a 
systolic sound heard at the base of the heart, more in advance and at 
a higher point than those now under consideration. 

These murmurs or soutiles furthermore vary in intensity and in 
character, according to whether the endocarditis results from post- 
partum infection, pytemic disease, or some other cause. 

Diagnosis. The diagnosis of endocarditis has not yet been the 
object of really careful study in bovine pathology, but there is no doubt 
that it can often be detected by patient examination. 

Prognosis. The prognosis is very grave, and patients may die in 
a few days. 

Treatment comprises vigorous local stimulation over the cardiac 
area, the administration of antithermic and antiseptic drugs, such as 
salicylate of soda, or of digitalis, sparteine or other cardiac tonics. 

Pathologists have also described, chiefly as post-mortem curiosities 
of interest to pathological anatomists, various diseases and lesions due 
to insufficiency or contraction of the auriculo-ventricular, aortic, and 
j)ulmonary openings, lesions due to infectious myocarditis, to the pre- 
sence of parasites and to other causes. 

The symptoms of these various diseases or lesions in bovine 
animals are still too imperfectly understood to permit of more than 
a very limited description. 

In the present state of our knowledge, diagnosis would always be 
of an uncertain character, and for this reason we do not propose to 
deal with them at present. 



CHAPTER IV. 

DISEASES OF BLOOD-VESSELS. 

■ Diseases of vessels, arteries or veins, in animals of the bovine and 
ovine species are frequently nothing more than localisations of grave 
general disorders, and rarely admit of treatment. This is specially the 
case in regard to arteries, hut a study of the diseases of veins has some 
practical importance. 

PHLEBITIS. 

Phlebitis, i.e., inflammation of a vein, is of interest only in the case 
of bovine animals. In them certain conditions may occur which the 
practitioner should understand, with a view either to prevention or treat- 
ment. Inflammation of the veins may be due to external causes, such as 
surgical or accidental wounds (phlebotomy wounds, accidental wounds, 
local inflammations, etc.), or to infernal causes of infectious origin 
(general infection, puerperal infection, etc.). 

ACCIDENTAL PHLEBITIS. 

The jugular vein may become inflamed as a result of accidental 
wounds or of phlebotomy, but the mammary vein in cows is much more 
frequently affected. In both cases the disease is due to infection of the 
clot which seals the vessel ; it may assume the form of either adhesive 
phlebitis or suppurative phlebitis. Whether produced directly by the use 
of infected instruments or whether it is of a secondary character, trace- 
able to the clot being infected by germs entering from without being 
conveyed to the wounds by the head-stall chains, by litter, manure, etc., 
the result is the same. The inflammation, at first confined to the 
endothelium, extends to the wall of the vein and causes fibrin to be 
precipitated over the inner wall of the inflamed vein for a distance 
varying with each case. 

If the micro-organisms do not produce suppuration, the vein appears 
simply thrombosed and inflamed, the phlebitis remains of an adhesive 
character, and may disappear sj)ontaneously, provided the animal be kept 
quiet. If, on the other hand, suppuration is set up, the clot gradually 
breaks down, the internal surface of the vein develops granulations and 



ACCIDENTAL PHLEBITIS. 397 

undergoes suppuration, and the phlebitis is then said to become suppura- 
tive. The clot may even become entirely detached, transforming the 
suppurative phlebitis into a very grave form of hsemorrhagic phlebitis. 

The jugular is the commonest seat of adhesive phlebitis, the mam- 
mary vein of suppurative phlebitis. 

Symptoms. The symptoms are easy to recognise. The accidental or 
instrumental wound is the seat of a painful oedematous swelling. It dis- 
charges a reddish offensive serosity, or exhibits blackish-violet bleeding 
granulations surrounding a little central sinus. 

The affected vein, whether the jugular or mammary, soon becomes 
swollen, is sensitive to the touch and very rapidly becomes indurated 
in the direction of its origin for a greater or less distance. 

Phlebitis has then set in, and according as one or other complication 
predominates, it is described as suppurative or hfemorrhagic. 

Diagnosis and prognosis. The diagnosis presents no difficulty. In 
phlebitis of the jugular the neck is held stiffly, and the jugular furrow is 
partly obliterated. 

The prognosis is somewhat serious, particularly in phlebitis of the 
mammary vein, for obliteration of the vein interferes with the function 
of the venous plexus from which it springs, and, although there may 
be a limited vicarious circulation, the secretion of milk is indirectly and 
secondarily checked owing to difficulty of irrigation. 

The extension of phlebitis of the jugular towards the head and the 
venous sinuses of the cranial cavity, is quite exceptional. 

When the mammary vein is inflamed it appears collapsed in the 
direction of the heart and swollen, indurated, and painful in that of 
its origin in the mammary gland. 

Treatment. The first point requiring attention is so to fix the 
animal as to prevent the clot from being pressed upon or crushed, 
though, unfortunately, this cannot always be properly done. The diffi- 
culty is obviated by applying vesicants, which cause swelling and pain, 
and so reduce natural movement of. the parts to a minimum. 

At first, when the parts surrounding the operative wound are simply 
swollen and phlebitis is threatened, repeated application of tincture 
of iodine or a liquid vesicant is useful, and may prevent the disease 
developing. 

In existing cases a blister applied over and around the whole of 
the hardened tract may prevent the mischief from proceeding beyond 
the adhesive stage. In such case the clot becomes organised, the vein 
remains obliterated, and recovery follows. 

Similar treatment may also be employed in suppurative phlebitis, 
but as the clot gradually breaks down in consequence of the action of 
bacteria it is useful and almost indispensable to disinfect the vessel. For 



398 DISEASES OF BLOOD-VESSELS. • 

this purpose the openmg of the sinus must be enlarged, and, by means of 
a sterilised or very clean syringe with a curved nozzle, the parts washed 
out daily with warm boiled water, followed by an antiseptic injection 
containing 2 per thousand of iodine, 3 per cent, of carbolic acid, or, 
better still, glycerine containing 1 per thousand of sublimate. 

If in spite of this treatment the phlebitis extends towards the origin 
of the jugular or mammary vein, a counter-opening may be made at the 
point where the clot still remains adherent, and a strip of iodoform gauze 
saturated with tincture of iodine or with blistering ointment diluted to 
one-eighth with oil may be passed. Needle firing is also of value. 
Finally, as a last resource, a ligature may be applied to the vein above 
or beyond the clot. 

This operation, which in the horse is confined to hpemorrhagic 
phlebitis, is especially applicable to phlebitis of the mammary vein in 
the cow. As the vein is subcutaneous, the operation may easily be 
performed in the standing position ; the successive stages are as 
follows : — 

The patient is firmly secured and its hind limbs hobbled by passing 
a rope around the hocks in a figure of eight. It is steadied on one 
side by an assistant who presses on the quarter. 

One cubic centimetre of a 10 per cent, solution of cocaine is sub- 
cutaneously injected on each side of the vein at the point chosen. Ten 
minutes later a button-hole incision is made through the skin and a loop 
of thick catgut passed around the vein by means of a curved needle. 
The ligature is tied firmly with a surgical knot and the little wound 
afterwards covered with a mass of cotton wool secured by collodion. 

INTERNAL INFECTIOUS PHLEBITIS (UTERO-OVARIAN PHLEBITIS). 

The internal forms of phlebitis of parasitic or infectious origin are as 
yet little understood, but mention may be made of phlebitis of the utero- 
ovarian veins which frequently follows parturition and post-partum in- 
fection. This is probably in many instances the real cause of the post- 
partum paraplegia without gross or apparent material lesions. 

This form of infectious phlebitis may extend to the large internal and 
external iliac veins and produce embolism and septicaemia, as is shown 
by recorded cases. 

The mechanism of the disease is easily understood. The infective 
agents penetrate the veins of the uterine mucous membrane and pass 
from the lumen into the wall of the vein. Here they cause inflammation 
of the vascular endothelium, followed by the deposit of a fibrous clot of 
cylindrical form, which sets up partial thrombosis of the vein. This 
thrombosis becomes complete by the formation of a central clot due 
to venous stasis. 



UMBILICAL PHLEBITIS OF NEW-BORN ANIMALS. 399 

It is not necessary for the germs to penetrate at a number of points. 
The thrombosis progresses until it gains a large trunk beyond the 
original point of infection. 

Symptoms. Phlebitis of the veins of the pelvis is frequently mis- 
understood or overlooked, because the practitioner is apt to confine his 
attention to external signs, the paresis and paraplegia of the hind 
quarters. 

The symptoms usually appear from five to eight days after normal 
parturition or parturition in which there is retention of the after-birth 
followed by metritis. The animals show fever and lose appetite, signs 
which may be due to metritis, but soon after they experience difficulty 
in rising, and some days later remain permanently recumbent. 

The circulation is weak, and the entire intra-pelvic region painful ; 
the large nervous trunks are affected, exertion becomes difficult, and the 
animals refuse to rise. At this stage they should not be forced to do so. 

In two to three weeks improvement may occur and lead to recovery 
but in many instances various complications in the nature of purulent 
infection or septicemia set in, or the animals are previously slaughtered. 

Diagnosis. The diagnosis can only be determined after the symp- 
toms develop. Confirmation might in some cases be obtained by 
rectal exploration made methodically and gently. 

Prognosis. The prognosis is grave. 

Treatment. Treatment should be based on disinfection of the uterus 
by injections of boiled water or warm iodised solutions and drainage by 
means of strips of iodoform gauze. The animals should be placed on a 
thick and scrupulously clean bed, and as far as possible be spared any 
considerable exertion for a fortnight. By changing their position once 
or twice a day complications may be avoided. 

UIMBILICAL PHLEBITIS OF NEW-BORN ANIMALS. 

One of the most serious conditions met with in practice is that 
known as umbilical phlebitis of new-born animals. Whilst in fact it is 
easy to deal with phlebitis of the jugular or mammary vein, surgical or 
medical assistance becomes extremely difficult in this case, because the 
inflamed vein is deeply situated in the abdomen and passes through one 
of the most important internal organs, viz., the liver. When it is added 
that umbilical phlebitis is in 95 per cent, of cases of a suppurative 
character, the reader may form some idea of its gravity. 

Unless the condition is early diagnosed and measures are at once 
taken, such complications as infectious hepatitis, purulent infection, 
and septicaemia cannot be avoided. Death is then inevitable. 

In order clearly to understand this phlebitis, however, it is necessary 



400 



DISEASES OF BLOOD-VESSELS. 



to recall the aiiatoiiiical formation of the umhihcal region in the new- 
born animah 

At birth the umbiHeal cord is represented by a cyHndrical mass, 
surrounded by the terminal portion of the amnion. It enters the 
abdomen through a circular perforation in the abdominal wall known 
as the umbilical ring. This ring may be divided into two parts, one 
deeply seated, the fibro-aponeurotic ring, consisting of an aperture in 



Ro. ^ g 




Fig. 188. — I'osition of the abdominal viscera in a new-l)orn annual: E», vunien ; 
E, epiploon; lig, left kidney; Ig, small intestine; C, abomasum ; U, ureter; 
0, urachus ; R, rectum. Umbilical cord : Vo, Umbilical vein ; Aa, allantoid 
arteries; Ya, allantoid veins ; O, the urachus. 



the white line ; the other the superficial or cutaneous ring, formed 
by the skin, which is wrinkled all round it, and constitutes a kind of 
sleeve about an inch in length. This cutaneous sleeve is continuous 
with the amniotic tissues. The entire umbilical cord is therefore 
enveloped in an amniotic-cutaneous sheath. 

It is composed of four principal structures — the umbilical arteries, 
the umbilical vein, the urachus, and the interstitial mucous tissue. 

The umbilical arteries and vein consist of two parts — the extra-foetal 
part, which co-operates in forming the cord, and the intra-fatal part. 



UMBELICAL PPILEBITIS OF NEW-BORN ANIMALS. 401 

The first is formed of two arteries and two veins, in contra-dis- 
tinction to the condition in soHpeds, where the cord only contains one 
vein. In the second, the arrangement is as follows : The two mnbilical 
allantoid arteries on entering the abdomen curve backwards towards the 
entry of the pelvis, passing over the sides of the bladder enveloped in 
the lateral ligaments, and extend upwards towards the bifurcation of the 
aorta, finally pouring their contents into the internal iliac arteries. In 
the adult they may still he traced as annexes of these latter vessels. 
The two umbilical veins on passing through the ring unite to form one 
within the abdomen. This vessel passes forwards, rising along the 
lower al)d()minal wall, then becomes lodged in the thickness of the 
inferior middle ligament of the liver, and finally penetrates that organ 
where it unites with the portal vein. It is also connected with a vessel 
known as " the vein of Arantius," which places it in connnunication with 
the posterior vena cava, a vein not found in sohpeds. 

The fcBtal blood is purified by exchanges between it and that circu- 
lating in the maternal placenta, and when I'e-arterialised it returns by 
the umbilical vein. 

The urachus, found in the embryo and foetus, eventually gives rise 
to the bladder. In new-born animals this viscus is therefore open at 
its base, and communicates with the allantoid cavity through the 
urachus. The urachus starts from the base of the bladder, and, extend- 
ing along the median plane of the lower abdominal wall between the two 
umbilical arteries as far as the umbilical opening, takes its place in the 
cord alongside the vessels. Through it the secretions of the fcetal 
kidneys drain into the allantoid cavity. The interstitial mucous tissue, 
also called " Wharton's jelly," is a gelatinous material which unites 
these different vessels and helps to support and protect them in the 
umbilical cord. It is particularly abundant opposite the umbilicus. 

Innnediately after birth the umbilical cord ruptures of itself as a 
result of the fall which the young animal experiences or of movements 
made by the mother, as for instance when she attempts to rise. In 
certain other cases it is divided by the mother biting it, or it may be 
ligatured by some person present. However the rupture may be 
brought about, it always occurs at a distance of 2 to 4 inches from the 
umbilicus. The immediate result is to produce thrombosis of the 
umbilical vessels and obstruction of the urachus. The two umbilical 
arteries rarely bleed, for htemostasis is brought about by stretching, 
and these arteries, being very elastic, almost immediately retract and 
close. The umbilical veins simultaneously become blocked, and the 
single intra-abdominal vein having no further raison (Vetrc, gradually 
becomes obliterated. The urachus should normally be obHterated at 
the moment of delivery (Colin and Saint-Cyr), or at any rate soon 



D.C. 



D D 



402 DISEASES OF BLOOD-VESSELS. 

afterwards, as a consequence of rupture of the cord (Chauveau and 
Zundel). 

Immediately after delivery another change sets in. The extra-foetal 
portion of the cord, which remains attached to the umbilicus, dries on 
contact with the air, the Wharton's jelly retracts, the whole undergoes 
a kind of necrosis, assumes the appearance of a dry scab, and in eight or 
ten days falls awaj', leaving in its place the umbilicus, which should be 
half cicatrised on the fall of the cord. Thus the umbilical cord presents 
an extra-fcetal degenerated portion and a persistent portion about h to 
1 inch only in length, buried in the cutaneous ring of the umbilical 
region. 

If all the changes indicated occur normally and physiologically, the 
little wound in the region of the umbilicus cicatrises in a perfectly 
regular way. But unfortunately this is not always the case. At times 
the cicatrix becomes contaminated by manure, urine or dust, suppurates, 
and may then become the seat of various complications, such as um- 
bilical i^hlebitis, omphalitis or persistence of the canal of the urachus. 

UMBILICAL PHLEBITIS OR OMPHALO-PHLEBITIS. 

History. Umbilical phlebitis, and in a more general sense all patho- 
logical conditions of the umbilicus, in new-born animals have been the 
object of numerous investigations by Lecoq, Benard, Loiset (1843), 
Bollinger (1874); and more recently by Morot (1884), Uffredizzi (1884), 
Chassaing (1886), etc. 

Omphalo-phlebitis may occur as a primary condition or may appear 
as a complication of omphalitis and of persistence of the urachus. It 
consists essentially in suppurating inflammation of the umbilical vein, 
but is not infrequently accompanied by omphalitis, arteritis, peritonitis, 
and cystitis. 

Causation. The disease results from infection of the (normal) clot 
and of the wound resulting from severance of the cord. The infection 
may only cause simple phlebitis of the umbilical vein, but if the 
organisms are virulent the phlebitis almost inevitably degenerates into 
suppurative phlebitis. 

Formerly omphalo-phlebitis was thought to be caused by the 
mother licking the foal, by irregular tearing of the cord, by crushing 
and separation of the obliterating clot, etc. The truth is that all these 
causes favour infection of the umbilical wound, which is the primary 
cause, suppurative phlebitis being secondary only. 

When the cord is ruptured both the veins and arteries become 
plugged, and bleeding ceases. This plugging should end in organisation 
of the clot and obliteration of the vessels. If, however, the wound is 



UMBILICAL PHLEBITIS OR OMtHALO-I'HLEBITIS. 403 

infected, micro-organisms make their way between the clot and walls, 
and extend along the inner surface of the vein, infecting first the clot 
and then the vein, and thus setting up suppurative phlebitis. 

If suppuration does not continue, recovery may occur spontaneously. 
Infection may be confined to the clot, producing simple phlebitis, but it 
often extends along the umbilical vein to the liver, causes infectious 
hepatitis and purulent infection or septicaemia. Similar results may be 
produced by infection of the arteries, the organisms making their way 
as far as the bifurcation of the aorta, and thus gaining the general 
circulation. Moussu believes that this is the commonest method by 
which sei^tica'mia is produced in calves. 

Symptoms. In these cases it is usually the general symptoms which 
first attract attention, the local lesion passing unnoticed for a greater 
or less time. 

The animal shows intense fever, due to either suppurative phlebitis, 
infectious hepatitis, or, as often happens, to generalised infection. 
Appetite is lost, diarrhcBa is abundant, the respiration and circulation 
are accelerated, and the temperature rises to 104^ Fahr., or even 
105° Fahr. 

The local symptoms are those usually associated with omphalitis or 
phlebitis. An examination of the umbilical ring reveals an cedematous, 
hot, sensitive swelling, the lower part of which exhibits a chronic, sup- 
purating, fungoid, blackish wound o£ unhealthy appearance. 

This wound is the seat of one or more sinuses which penetrate the 
vein, arteries, or urachus. If only one sinus exists, it always passes 
upward and forward into the umbilical vein. The utmost precaution 
should be employed in examining the parts. Should it be thought 
desirable to probe the sinus in order to discover its direction, the probe 
must be very cautiously introduced, and only for a short distance, 
because rough handling would tear the tissues and carry infective 
material to deeper seated points. 

Complications. These are numerous and very grave. Long ago 
Lecoq described a disease suggestive of laminitis, which beyond doubt 
was only a form of purulent infection. At a later date Loiset studied 
a disease following omphalitis, in which interstitial abscesses deve- 
loped in the cord. This also was simply purulent infection. 

More recently complications such as pleurisy, pneumonia, infectious 
endocarditis, diarrhoeic enteritis, and especially suppurative polyarthritis 
of young animals have been referred to omphalo-phlebitis. All these 
complications result from infection. The micro-organisms themselves 
or the toxins they secrete appear to have a particularly injurious action 
on the serous membranes, a fact which throws light on the frequency of 
such complications as pleurisy, peritonitis, endocarditis and arthritis. 

D D 2 



404 DISEASES OF BLOOD-VESSELS. 

Intoxication also plays a certain part, and microhic toxins are 
responsible, at least at first, for the uncontrollable diarrlicea, arthritis 
with sterile exudations, etc. 

Diagnosis. This presents no difficulty. The alarming general symp- 
toms seen at the outset immediately suggest in the case of 3'oung animals 
the possibility of disease in the umbilical region. 

Prognosis. The prognosis is grave, it may be said very grave, 
because treatment is difficult to apply, and dangerous complications, 
which almost always prove fatal, may already have been set up. 

One must always distinguish, however, and take into account in 
forming the prognosis, the special characteristics of the phlebitis, and 
weigh carefully the signs of complication. The fistula should be 
cautiousl}^ explored, and its depth, etc., noted, while the temperature, 
circulation, respiration, etc., should be carefully studied. 

Treatment. A very important item of treatment consists in regu- 
larly and scrupulously cleansing the region of the umbilicus after the 
cord has separated and until the wound has completely cicatrised. 
The parts are washed with boiled water and dusted with boric acid, 
iodoform, etc. 

A still better plan, and one that almost certainl}' guards against this 
disease, is to apply an antiseptic dry dressing as soon as the new-born 
animal has become dry. This need only consist of a small sheet of 
antiseptic cotton wool fixed to the umbilicus by four pitch bandages 
or by two pieces of webbing passed over the back. In this way con- 
tamination of the cord and the risk of infection are avoided. 

In cases of fully-developed phlebitis the old generation of practitioners 
used to recommend local dressings with adhesive plasters, astringent 
and vesicant applications, etc. All such methods are useless, because 
they only act on a part of the diseased structures and cannot reach the 
blind ends of the sinuses. The classic treatment of suppurative phlebitis 
also is out of the question. 

All that can be done, therefore, is slightly to open up the sinuses 
and wash them out frequently with antiseptic solutions, such as boiled 
water, sublimate-glycerine, carbolic glycerine, etc., afterwards apply- 
ing antiseptic dressings. These methods, however, are scarcely likely 
to put an end to infectious complications such as suppurative poly- 
arthritis. 

There is no danger in using strong carbolic solution, 3 per cent, 
creolin, 4 per cent, chloride of zinc, sulphate of copper, etc. Should there 
be several sinuses and should one of them extend in a backward direction, 
it is necessary to make certain that no communication exists between 
the urachus and the bladder. For this purpose some boiled water may 
be injected into the sinus. If a communication exist, this water will 



UMBILICAL PHLEBITIS OR OMPHALO-PHLEBITIS. 405 

fill the bladder and distend the urachus. The treatment necessary in 
this case is similar to that of persistence of the urachus. 

It is well in all cases to be guided by the following principle : 
never to resort to treatment unless suppuration has occurred and the 
sinus is blind. To check suppuration a blister may be applied around 
the umbilical region while means are taken to prevent the animal 
licking the parts. 

Chassaing in 1886 suggested a rather original method of operation 
which deserves description. It is founded on the permanent treatment 
of sinuses, and consists in introducing a flexible osier stick, a kind of 
bougie, enveloped in tow and moistened with the following mixture : 

Collodion . . . . . . . . . . . . . . 3 parts. 

Sublimate . . . . . . . . . . . . 1 part. 

This is introduced for a distance of 3 to 4 inches into the fistula, and 
is fixed to the skin with gutta-percha or pitch. The dressing is renewed 
every five or six days, and healing takes place, it is said, in one, two, 
or at most three weeks. 

It is very likely that if the sinuses were previously cleared and 
simply plugged with antiseptics or treated by introducing pencils of 
salol, nitrate of silver, sulphate of copper, iodoform, etc., at least as 
good results might be obtained. 



CHAPTER V. 
DISEASES OF THE BLOOD. 

SEPTICi«:MIA OF NEW'BORN ANIMALS. 

The above title is given to that exceedingly fatal disease commonly 
known as " white scour," etc., the mortality in which often rises to 
95 per cent. 

The disease was studied by Poels in Holland in 1889, Dele in 
Belgium in 1891, Perroncito in Italy, Galtier in the centre of France 
in 1891 — 92, and quite recently by Nocard in Ireland in 1901. 

It occurs throughout all the breeding districts of France, and in some 
parts causes enormous losses, the mortality comprising two-thirds or 
even three-fourths of all new-born calves. In certain breeding estab- 
lishments in Normandy all the new-born animals without exception 
die unless special precautions are adopted. 

In foals, septicaemia of the new-born is very rare, because horse- 
breeding establishments are much better cared for, and breeding mares 
are segregated. In byres, on the other hand, the greatest promiscuity 
exists. The disease is equally uncommon in lambs, although it makes 
numerous victims in folds which have once been attacked. It is, how- 
ever, quite common in young pigs. 

Symptoms. The development and course of the disease are in 
certain respects characteristic. 

The disease usually appears within two or three days after birth, and 
only in rare cases after the second week. Calves which at birth appeared 
vigorous and in good health are found dull on the second day ; after the 
second or third meal they suffer from diarrhcea, and from that time 
refuse all nourishment, lie down as though exhausted, and sometimes 
die very rapidly. 

Some even perish in ten to twelve hours without showing diarrhoea ; 
altliough apparently well at night, they are found dead or dying the next 
morning. This is the peracute form. 

Most frequently the young creatures suffer for two or three days, 
sometimes a week. Appetite is partly preserved; at first the diar- 
rhoea resembles that due to inability to digest milk, but the feeces soon 



SEPTICEMIA OF NEW-BORN ANIMALS. 407 

become greyish or blackish and very foetid. The hair of the tail, 
quarters and hocks is soiled and matted, the skin irritable and reddish ; 
the patients lose strength, appear unsteady on their limbs, and develop 
rapid respiration and tumultuous action of the heart. . 

They take little food, become weaker by degrees, and die in a con- 
dition of exhaustion. 

Fever, well marked at first, frequently diminishes, and the tempera- 
ture may remain normal for several days, falling to 97° Fahr., or even 
95° Fahr., twenty-four hours before death. 

This is the commonest form of the disease. It lasts three to five 
days, and is always grave. 

Cattle-men recognise the disease chiefly by the diarrhoea and loss of 
appetite. 

I^astly, a third and rarer form occurs during which appetite is main- 
tained in spite of the diarrhoea. The animals remain thin, develop 
poorly, but survive for a month, six weeks or two months. The diarrhoea 
diminishes or disappears, but its disappearance is followed by complica- 
tions such as broncho-})neumonia, pleuro-pneumonia, endocarditis, acute 
arthritis, etc., a fact which led Prof. Galtier to give the disease the name 
of " septic pleuro-pneumonia in calves." These complications, again, are 
extremely grave, and generally prove fatal after a period of varying 
length. They are due to local development of micro-organisms of the 
kind which produce septicaemia, and similar to those described under the 
name of broncho-pneumonia of intestinal origin in sucking calves. 

They differ, however, as regards their cause, from the primary affec- 
tion, and may be due to very varied organisms, the commonest being 
those of suppuration. These organisms, in fact, are alien to the primary 
disease, and obtain entrance from without, very probably by the tracheo- 
bronchial tract. 

In young pigs septicpemia assumes the same forms as in the calf. 
In lambs the chronic form seems more frequent than the peracute 
and the ordinary forms. 

Causation. The septicaemia of calves, and possibly of all new-born 
animals, of whatever species, is produced by a microbe which flourishes 
in the manure and litter of stables, and which Nocard included in the 
group of Pasteurella. It can be found in the blood from the moment the 
flrst external symptoms appear until the time of death. During the last 
hours, however, the bacterium Coli communis also invades the circulation 
in many instances, and if cultures are not made until some hours after 
death, the colon bacillus and bacteria of putrefaction aie more particu- 
larly discovered. 

The microbe of calf septicaemia can be readily cultivated in jelly or in 
ordinary liquid media. Injected into the veins of experimental animals, 



408 DISEASES OF THE BLOOD. 

it reproduces the clinical symptoms, and causes death more or less 
rapidly, according to the dose injected. 

The virulence of cultures grown in defibrinated calf's hlood seems 
more intense, and Moussu has been able to reproduce the clinical form 
of the disease by applying to the umbilical cord of a new-born animal a 
pledget of cotton wool saturated with su^h a culture, and covering it with 
a dressing. The germs of the disease are spread throughout the byres 
through the medium of faeces. When the umbilical cord has become dry, 
that is, after the third day, the application of virulent cultures to the 
stump no longer causes infection. 

Pathogeny. The pathogeny of this septicaemia of calves and of new- 
born animals is easy to explain. 

At birth the young animals fall on the litter, and the uml)ilical cord 
becomes contaminated. The infective agent, finding an excellent culture 
medium in the tissues of the cord, at once begins to develop, increases in 
enormous numbers, steadily ascends along the cord, and sets up septi- 
caemia. It grows in the gelatinous Wharton's jelly and in the fibrinous 
plug closing the arteries and umbilical vein, and soon enters the true 
circulation. Septicaemia is then fully established, general disturbance 
sets in, and with it the diarrhoea by which it is externally indicated. 

It is important to remember, however, that infection occurs most 
readily through the medium of the cord, and during the first few days 
after birth : it may occasionally be brought about towards the eighth 
or tenth day, when the shrivelled portion of the cord falls ; in this case 
its entrance is effected through the little umbilical wound. 

Lesions. The lesions are sometimes so obscure that the practitioner 
may hesitate to deliver an opinion. 

In acute cases, where death occurs in two or three days, or even in 
ten to twelve hours, post-mortem examination reveals only increased 
vascularity of the serous membranes — the peritoneum, pleura, jjeri- 
cardium, etc. ; and it may be almost impossible to discover anything 
abnormal in the cord, for although the clots closing the arteries and 
veins are infected, they are neither separated from the walls of the 
vessels nor broken up. 

On the surface of the urachus, at the base of the bladder, and in 
the depths of the peritoneal folds supporting the allantoid arteries 
(sometimes also the hepatic vein), unequivocal signs of local ascending 
infection may, however, almost always be found, together with intense 
injection of the capillaries, little haemorrhagic spots, and commencing 
formation of false membranes, etc. 

The infection extends also by the lymphatic vessels contained in 
these peritoneal folds, and finally attains the sublumbar region. 

When the disease develops less rapidly the peritoneal cavity 



SEPTICEMIA OF NEW-BORN ANIMALS. 409 

contains a certain quantity of blood-stained serosity, as do the pleurse 
and pericardium, whilst vascular engorgement of the serous mem- 
branes is extremely marked. The intestine shows traces of congestion 
and inflammation throughout its length, and its contents contain the 
specific organism in very large numbers. 

Finally, in the chronic forms, the serous membranes and the intestine 
seem only slightly attacked, possibly because the lesions have undergone 
retrogressive changes. The striking features are the secondary lesions, 
such as those of pneumonia, broncho-pneumonia, pericarditis, and abscess 
formation in the lung. 

Nocard gives the following description of the lesions found during his 
investigation of "white scour" of calves in Ireland {J^cterinariau, April, 
190'2, p. 171 ; see also Prof. Mettam's paper, Vdcvinanan, June, 1902, 
p. 307) :— " The lesions found on autopsy vary according to whether the 
evolution of the disease has been rapid or slow. One lesion, however, is 
never absent — that of the navel and the navel vessels. In all the calves 
attacked we found a large umbilicus with hardened coats enclosing a clot 
easily broken down, sometimes soft and purulent. In every case, also, 
we observed blood suffusions, often very extensive, along the course of 
the umbilical vessels and of the urachus, invading often the posterior 
third of the bladder. In cases where the evolution had been rapid we 
found the lesions of true haemorrhagic septicaemia. All the viscera were 
congested to excess ; their surface was studded with petechia, ecchy- 
moses, or subserous blood suffusions. The capillary network of the 
peritoneum, pleura, and pericardium appeared strongly injected. This 
lesion was especially marked on the epiploon. The intestine was the 
seat of intense congestion, especially at the level of the ' floating 
colon.' 

" The mucous meml)rane was thickened, gorged with blood, and 
friable ; the solitary glands, thick and protruding, were sometimes 
transformed into a kind of bloody magma, or they were ulcerated, as in 
anthrax ; the contents of the bowel were mixed with a large quantity of 
blood. The mucous membrane of the fourth stomach was altered nearly 
to the same degree ; it was studded with interstitial haemorrhages, espe- 
cially above the level of the open edge of its folds. The mesenteric 
glands — especially those of the colon — were enormous, gorged with blood, 
reddish, and often hfemorrhagic. The mucous membrane of the bladder 
was often covered with petechiae, the urine which it contained was clear 
and limpid, but always rich in albumen. [In one sample which was 
analysed, the urine contained more than 4 grammes of albumen to the 
litre.] The lungs were gorged with blood, like the intestines ; sometimes 
they were manifestly cedematous, but generally their tissue was still 
supple, elastic, permeable, and without apparent lesion. 



410 DISEASES OF THE BLOOD. 

" In the su])acute forms the lesions are much less marked. The mucous 
membrane of the intestine is less congested ; sometimes oedema of the 
submucous tissue exists. The mucous membrane of the fourth stomach 
is often punctuated with brownish-red patches, traces of the capillary 
hfemorrhages w'hich were produced at the onset of the disease. The 
mesenteric glands are swollen, gorged with serum, but not hfemor- 
rhagic ; the liver is large and of a yellowish tint ; the spleen is little 
altered; the urine always contains albumen; the lungs are seldom 
quite sound ; they usually contain here and there small diffuse centres 
of catarrhal pneumonia, of nodular bronchial pneumonia, or simply of 
atelectasis. 

"These lesions are more constant and more dense if the animals 
have resisted the disease for some time ; they then constitute the 
transition stage between the simple collapse at the beginning of the 
disease and the suppurating lesion of lung disease. The joint lesions 
when they exist are very interesting. At the beginning all the peri- 
articular tissues are infiltrated with a yellowish gelatinous serosity. 
The synovial membrane is covered with vascular aborisations of an 
extreme richness, which extend on to the articular cartilages. The 
synovial capsules are distended by a considerable quantity of thick 
synovia of a deep yellow or brownish tint, holding in suspension flakes 
of fibrous exudate more or less dense and abundant. When the lesion 
is older the synovia is replaced by a thick fibrous exudate, which fills 
sacculations, and extends between the articular surfaces. In this case 
the lesion appears identical with that of the arthritis seen in pleuro- 
pneumonia of sucking calves." 

Diagnosis. The diagnosis presents no difficulty, for the development 
and acute course of the disease (the majority of patients die within a 
week of birth) leave little room for doubt. 

This disease is easily distinguished from dysentery in new-born 
animals, which appears at birth, as also from simple diarrhoeic ente- 
ritis; in the latter disease the symptoms are delayed, sometimes occur- 
ring only when the animals are weaned ; moreover, the disease is never 
so grave as that now under consideration. 

Should, however, the post-mortem appearances seem indecisive, the 
diagnosis can be based simply on the high mortality. 

Prognosis. The prognosis is extremely grave. About 95 per cent, 
of the animals attacked die, and among those which survive many show 
thoracic complications, that render them useless. 

Treatment. Treatment of animals already affected is useless, and, 
moreover, too costly. Drugs administered through the digestive ap- 
paratus to a large extent miss their mark, because the digestive symp- 
toms are secondary, primary infection having occurred through the 



SEPTIC^-MIA OF NEW-BORN ANIMALS. 



411 



circulation. The administration of purgatives and internal antiseptics 
can, therefore, only prove illusory. 

On the other hand, prophylactic treatment is of the greatest value ; 
all that is necessary is to prevent the umbilical cord from becoming 
infected. 

The great mortality, which causes such severe loss to breeders, is 
simply due to want of proper care of new-born animals. Even in 
carefully kept byres the mortality may be high, for the specific agent 
develops in litter contaminated with faecal matter, by lying on which 
young animals become fatally infected. 

To check or prevent this septicaemia in breeding establishments, it is 
merely necessary to take the same precaution as is taken in dealing with 
young children, i.e., to apply an aseptic or antiseptic dressing to the stump 
of the cord after ligation. As soon as the young animal has been dried 
by the mother or by artificial 
means, a carefully boiled 
ligature is applied to the 
cord at a distance of about 
1 inch from the umbilical 
ring. The portion of the 
cord below the ligature is 
snipped off, the remaining 
part is carefully washed with 
boiled water or boric solu- 
tion, and is surrounded with 
a mass of iodoform wool, kept 
in place by a bandage passed 
over the back. 

The cord will shrivel a 
little less rapidly than it 
would if exposed to the air, but will be protected from all infection. 
The young animal should be separated from the mother to prevent 
her from displacing the dressing by licking the parts. 

In a few days all danger is at an end. This method is very 
simple, and can be carried out even by the breeder and in an in- 
fected byre. Nocard recommends the use of umbilical dressings con- 
taining collodion, and the practitioner can choose whichever method 
he pleases. 

In grave outbreaks involving large establishments, the byres should 
be rigorously disinfected, and it is sometimes well to segregate cows 
about to calve in a special byre, from which the calves are not allowed 
to pass until the umbilicus is cicatrised. 




Fig. 184. — Dressing for umbilicus of new- 
born calf. 



412 DISEASES OF THE BLOOD. 



TAKOSIS: A CONTAGIOUS DISEASE OF GOATS.* 

This disease has heen seen in Angora goats hronght from Texas into 
Pennsylvania, U.S.A. 

Symptoms. The disease presents many of the symptoms usually 
accompanying a parasitic invasion, and is characterised by great emacia- 
tion and weakness, with symptoms of diarrhcea and pneumonia. In the 
early stages of the affection there is usually little to indicate that any- 
thing is seriously amiss with the animal. The first observable symptom 
manifested is the listless and languid appearance of the animal, evidenced 
by its lagging behind the flock, and is usually accompanied by a drooping 
of the ears and a drowsy appearance of the eyes. The pulse is slow and 
feeble, and the temperature is elevated slightly at first, but becomes sub- 
normal a few days before death. The highest temperature observed in 
the natural disease was 104"1°, and the lowest, in a prostrated animal a 
few hours before death, registered 99*7° Fahr. Snuffling of the nose, as 
in a case of coryza, with occasional coughing is sometimes in evidence. 

As the disease advances the animal moves about in a desultory 
manner, with back arched, neck drawn down toward the sternum, and 
with a staggering gait. Kumination is seldom impaired. The appetite, 
while not so vigorous, is still present, though capricious, and the affected 
animal shows plainly that the ravages of the disease are rapidly over- 
coming the restorative elements derived from the food. The fleece is 
usually of good growth, and presents a surprisingly thrifty appearance 
when the condition of the animal is taken into consideration. All the 
exposed mucous membranes appear pale, and the respirations are accele- 
rated and laboured. The goats finally become so weak that they are 
readily knocked down and trampled upon by their fellows. If picked up 
they may move off slowly and eat a little, but within a few hours are 
down again, and in this way linger for several days, shrinking to about 
half their natural weight, and occasionally bleating or groaning, with 
head bent around on the side or drawn down to the sternum. A fluid 
discharge from the bowels of a very offensive odour is usually observed 
in the last few days of life, but this symptom is not constant. 

Course and Susceptibility. This disease may assume a subacute or 
chronic type, usually the latter. The animal dies of inanition in from 
eight days to six or eight weeks. Several owners have reported deaths 
after only two or three days of illness, but the goats doubtless had been 
affected for a longer period, although not noticed on account of their 
mingling in the flock. Many of the animals live for weeks, but gradually 

* Annual Report, U.S.A. Bureau of Animal Industry, 1902, p. 854 (Mohler and 
Washburn). 



TAKOSIS : A CONTAGIOUS DISEASE OF GOATS. 413 

become weaker and more debilitated, finally dying in a comatose condi- 
tion. In no instance has the natural recovery of an animal after once 
the symptoms of takosis were noticed been observed or heard of. 

The younger goats seem to be the most susceptible to the disease, 
although the old animals are by no means immune. 

Pathological Anatomy. As already indicated, the general appearance 
of the carcase simulates that produced by a wasting disease. The visible 
mucous membranes are pale and anaemic, while the fleece, which appears 
somewhat dry and lustreless, furnishes a shroud for the extremely 
emaciated condition, that becomes plainly perceptible on skinning. The 
same anaemic condition of the subcutaneous and muscular tissues is 
observed on eviscerating the carcases. The lungs in most cases are the 
seat of a peculiar diversified inflammation, never of a remarkable extent. 
The external appearance of these organs is at times mottled, caused by 
a few congested areas, several patches of an iron-grey colour similar to 
areas of pneumonia during the process of absorption, and normal tissue. 
On section through the reddened patches, a frothy mucus may exude 
from the bronchioles, and in one case numerous punctiform haemorrhages 
were observed on the sides of the incision. This tissue, while not so 
buoyant as a normal portion would be, nevertheless floats when placed 
in water. 

The heart in all cases is pale and dull, its tissue soft and flabby, 
while inflamed areas, more or less penetrating, are present at times on 
the epicardium about the auricular appendages, and at other times on 
the endocardium, especially that lining the ventricles. These haemor- 
rhagic patches consist of either pure extravasated blood or blood mixed 
with serum, which gives them a more diffuse appearance and a gela- 
tinous consistence. The pericardium is slightly thickened, and usually 
contains a small increase of fluid tinged with blood. The liver usually 
appears normal, although the gall bladder is frequently distended with 
pale-yellow watery bile. The kidneys are anaemic and softened. The 
cortex appears slightly thicker and paler than normal, and contrasts 
strongly with the darker pyramids. The capsule strips oft" easily from 
the parenchyma of the organ. In one instance several pale areas simu- 
lating anaemic infarcts were observed under the capsule extending into 
the cortex, which probably resulted from the compression of the capillaries 
by the swollen parenchymatous cells. The presence of albumin in the 
urine was detected by the nitric-acid test. The spleen appears atrophied 
and indurated, and on section the fibrous tissue far exceeds the splenic 
pulp. Attachments by fibrous adhesions may fix the spleen to the 
diaphragm or the neighbouring organs. The intestines may contain 
normal faecal matter or semi-fluid faeces of a disagreeable odour. The 
surface of the mucous membrane is at times covered with a slimy 



414 DISEASES Ol' THE BLOOD. 

mucus or plastic exudate, and the appearance is that of a chronic catarrh 
associated with necrosis of the mucosa. 

Bacteriology. Examination of cultures and slides showed the presence 
of a micrococcus, usually arranged in the form of a diplococcus, which 
was found in pure cultures from the heart's blood, spleen, kidneys, and 
pericardial fluid, and essentially so in the tubes inoculated from the 
other organs. 

The specific organism of takosis appears in fresh bouillon cultures as 
a spherical or oval micrococcus with a diameter of 0"8 to 1 /a. In these 
cultures it is single or in chains of two, three, or four elements, but most 
frequently in pairs, as diplococci, with a diameter transverse to the axis 
of the chain greater than the longitudinal diameter. 

Treatment : Prophylaxis. Sudden climatic changes should be 
avoided as far as possible, and when shipments of goats for breeding 
purposes are to be made which necessitate their transportation over 
considerable distances the changes should be made during the months 
of summer or late spring, and not in the fall or winter, when the con- 
trast of temperature will be so much greater. 

Angora goats should be provided with stables that are thoroughly 
dry, erected upon ground that has perfect natural drainage. 

As a third measure of prevention may be mentioned careful feeding. 

The segregation or isolation of all affected animals as soon as they 
evince any symptoms of the disease will be found a most valuable means 
of protection for those that remain unaffected, and a strict quarantine 
over all of the diseased members of the flock should be maintained so 
long as the disease remains upon the premises. 

Medicinal treatment has proved unsatisfactory in many of the cases 
of takosis to which it has been applied. The best results have been 
derived from the administration of calomel in 0.1 -gram doses twice daily 
for two days, followed by arsenic, iron, and quinine, as follows : 

Arsenious acid . . . . . . . . . . . . 1-40 grams. 

Iron, reduced . . .. .. .. .. .. .. 12-00 ,, 

Quinine sulphate . . . . . . . . . . 6.00 ,, 

Mix and make into twenty powders, giving one to each adult goat 
morning and evening at the conclusion of the administration of calomel. 
After an interval of two days this treatment is repeated. In case the 
diarrhoea persists, the sulphate of iron has been substituted for the 
reduced iron, with beneficial effects. 

Conclusions. After i)reliminary investigation, the following con- 
clusions have been reached : — 

(1.) The disease described as takosis has appeared in many parts of 
America, but particularly in the Northern States, where it has caused 
great loss to many breeders of Angora goats. 



BLOOD POISONING IX SHEEP AND LAMBS. 4l5 

(2.) It is a progressive, debilitative, contagious disease, characterised 
by great emaciation and weakness, with symptoms ' of diarrhcea and 
pneumonia, and causes a mortaUty of 100 per cent, of those afi'ected 
and from 30 to 85 per cent, of the whole flock. 

(3.) From the carcases of numerous animals that have succumbed a 
new organism. Micrococcus c(ipri)ius, has been recovered in purity, and 
is presumably the etiological factor. 

(4.) This micrococcus possesses pathogenic proj^erties for goats, 
chickens, rabbits, guinea pigs, and white mice, but not for sheep, dogs, 
or rats. 

(5.) Medicinal treatment was attempted with varying success, while 
the immunising experiments thus far conducted (although too few to 
permit of any conclusive statement or accurate estimate as to their 
protective value) have shown highly encouraging results. When accom- 
panied with measures of isolation and disinfection, the treatment may 
prove of great assistance in the suppression and eradication of the 
disease in an infected flock. 

BLOOD POISONING (MALIGNANT CEDEMA) IN SHEEP AND 
LAMBS IN NEW ZEALAND. 

This disease, which occurs during the operations of shearing sheep 
and of castrating and docking lambs, is the cause of considerable loss 
annually to sheep breeders in several districts of New Zealand. In 1893 
J. A. Gilruth, Chief Veterinarian for New Zealand, issued a leaflet 
dealing with the disease and the preventive measures to be adopted. 
Generally the first thing that draws the owner's attention seriously to 
the condition of his flock is the discovery, in from thirty-six to forty- 
eight hours after docking or shearing, of a few dead sheep lying in 
various parts of the paddocks. Next morning he finds a few more dead, 
and so on for three or four days, when, as a rule, the mortality ceases. 

Symptoms. In the early stages of this disease the animal seems 
listless, disinclined to move about, and, if the sun is shining strongly, 
prefers to lie in the shade. If forced to move, the hind legs are drawn 
forward with a peculiar stiff, dragging motion, as if there were no joints. 
There are slight muscular tremors all over the body, which become 
spasmodic as the disease progresses. If the flock be driven about much, 
the diseased animal soon shows signs of great fatigue, ultimately dropping 
to the ground thoroughly exhausted. The breathing is fast and j)ainful, 
being maintained more by a series of spasmodic jerks than by any 
regular act. The pulse is quick and weak ; the temperature is very high, 
registering 106° to 108° Fahr., showing acute fever; the eyes close, and 
the whole face is expressive of pain. Gradually the spasms cease and 
coma sets in, resulting in death. The scrotum and surrounding skin 



416 DISEASES OF THK BLOOD. 

right along the floor of the ahdomeii and het\Yeen the hind legs hecome 
swollen and hlack. This gangrenous tissue, when present hefore death, 
can be peeled oft' without pain to the animal. On post-mortem examina- 
tion various conditions are met with. The animals are generally found 
to he among the best of the flock and in fairly good condition. The 
scrotal and perineal regions in lambs (between hind legs and below 
tail) are always, or almost always, gangrenous, this condition extending 
along to the floor of the chest, and sometimes implicating the tail. 
Man}' of the muscles, generally those of the shoulders, haunches, and 
loins, are dark in colour and infiltrated with a black, watery fluid. The 
intestines are generally healthy, though sometimes the peritoneum is 
inflamed. The spleen and liver are in the usual condition after death, 
due to febrile disturbance. In the chest, either the pleurae (coverings 
of the lungs) or pericardium covering of the heart) are often inflamed, 
with occasionally a fibrinous exudation, causing surfaces to adhere. 

Cause. In (jilruth's report for 1900 he demonstrated the cause of 
blood-poisoning to be a microbe known as the malignant oedema bacillus 
{Vihriuu Heptique of Pasteur). This organism, which is found in many 
dirty yards, swampy soils, etc., on gaining entrance to the system of 
almost any animal by means of a wound, rapidly increases in numbers, 
producing gangrene, or death, of the part affected first, and ultimately 
the death of the animal. 

Curative treatment is practically useless. 

Preventive measures. Destruction of the carcases of animals which 
have succumbed to this disease by efficient burial or by fire. Disinfection 
of surface soil of yards, etc., by quick-lime. Cleansing of floors and walls 
of sheds with strong hot lime wash containing crude carbolic acid in the 
proportion of 1 to 50. Disinfection of flesh cuts made by the shears or 
the docking or castrating knife. Boiling of docking and tailing knives 
before use. Observance of antiseptic applications even w^hen temporary 
yards are employed. Sheep and lambs after operation to be kept in. a 
paddock free from swampy patches. 

PIROPLASMOSIS. 
Under the title piroplasmosis is included a group of diseases caused 
by lipemosporidia, and found in animals of the bovine and ovine species. 
These affections are far from having the same importance in temperate 
as they have in tropical countries ; nevertheless, it is very important to 
be able to recognise them. 

BOVINE PIROPLASMOSIS. 

Bovine piroplasmosis has been described under different names, such 
as haemoglobinsemia, ha^moglobinuria, Texas fever (U.S.A.), tick fever 




Fig. 187. — Angora goat (photographed three days before death). 
(Ann. Eep. U.S.A. Bur. An. Ind. 1902.) 




Fig. 188. — The same goat as shown in Fig. 187. Position assumed after exhaustive 
efforts to regam its feet. (Ann. Rep. U.S.A. Bui'. An. Ind. 1902). 




Fig. 189.— Portion of a steer's hide, showing the Texas fever tick {Booj^JuIks 
annulatus) of the United States. Natural size. (Styles, Ann. Hep. Bur. 
An. Ind. 1900.) 




Fig. 190. — Two female ticks [Hyalomma aTjijptiitm) ovipositing. 
Natural size. (Photograph by J. E. Emery. Annual Report, 
U.S.A. Bureau of Animal Industry, 1900.) 



BOVINE PIROPLASMOSIS. 



417 



(Australia), tristeza (Argentine Republic), African coast fever, East 
Coast fever, redwater, Rhodesian fever (Cape), and bovine malaria. 

It was first described by Babes in 1888, in animals inhabiting the 
Danube Valley, and was termed by him bacterial hiemoglobinuria of the 
ox. Afterwards it was well described by Smith and Kilborne (in 1889) 
under the title of Texas fever. It was re-discovered in Finland by 
Krogius and Van Hellens in 1894 ; in Sardinia by San Felice and 
Loi ; in Australia in 1895 by Pound ; and it has been the object of re- 
markable investigations by Koch in South Africa (1898-1904). 

Nicolle and Adil-Bey (1899) state that it exists in a latent form in 
European Turkey and Asiatic Turkey ; and Lignieres (1900), after a 




Fig. 191. — Dorsal view of larva of BoojjJiilus annulatus of North America. Greatl^^ 
enlarged. (Stiles, Ann. Eep., U.S.A. Bur. An. Ind., 1900, p. 388.) 

series of researches in Argentina, suggests the final solution of the 
questions which it raises. 

Symptoms. Babes describes it as an acute febrile disease, clinically 
distinguished by the passage of blood-stained urine. The urine is 
coloured by dissolved haemoglobin ; red blood corpuscles are not found. 
Smith and Kilborne, and afterwards Stiles, described two forms : an 
acute, rapidly fatal form, in which the Piroplasma higeminum is found 
in the blood of the general circulation, in the spleen and kidneys ; and 
a chronic form, in which, notwithstanding the absence of clinical signs, 
the parasites may be discovered in the blood under the form of 
diplococci. 

Lignieres describes a grave and a benignant form. The grave form 

D.C. E E 



418 



DISEASES OF THE BLOOD. 



is indicated by dulness, loss of appetite, and considerable fever. In 
twenty-four hours the temperature rises to 104° or 105° Fahr., and 
the pulse to 100 or 120 per minute, while the respiration is greatly 
accelerated. 

The urine is of a light-red or brownish-red colour, resembling 
coffee-grounds, but it contains no blood corpuscles. The animals die 
in frora three to eight days with symptoms of asphyxia ; but this 
termination is not inevitable, and recovery may occur spontaneously. 
Improvement is indicated by a fall in temperature, disappearance of 




Fig. 192. — Ventral view of larva of Boojjhilus annularis of North America. Greatlj' 
enlarged. (Stiles, Ann. Rep., U.S.A. Bur. An. Ind., 1900, p. 388.) 

the blood-stained urine, and a return of appetite, together with marked 
thirst. 

Drs. Smith and Kilborne describe the symptoms as follows : — " The 
beast when first observed to be amiss appears to be dull and sluggish, 
with a disinclination to move, and hence it is generally found apart 
from the rest of the herd. The hair stands erect like that of an animal 
on a cold day (a staring coat), the ears hang, and the eyes have a dull 
and lustreless appearance. In some cases the animals cease to feed, 
or ruminate, in others they continue to nibble at the herbage until 
nearly the last, but in a languid, indifferent manner, indicating that 
they have little relish for their food, and they fall. off very rapidly in 
condition. There is generally a dribbling of saliva from the mouth, 
the muzzle may appear quite moist during the early stages of the 
disease, but it invariably becomes dry and crusty as the disease 



BOVINE PIROPLASMOSIS. 



419 



advances. Later on the animal manifests a strong reluctance to move, 
and Avhen compelled to do so, it walks with a dragging, straddling 
gait, as if weak across the loins. In severe cases, when the sick 
heast is left undisturbed, it will remain almost constantly in one 
place, standing with its head depressed and ears hanging in a drowsy 
semi-comatose condition, looking the very picture of complete nervous 
prostration. Other animals will lie down the greater part of the time 
and scarcely move, and when 
dead the limbs will be found 
in their natural position, and 
the head doubled round on 
the shoulder as .if asleep. On 
making a post - mortem ex- 
amination of some of these 
cases the carcase was found 
to be pale and bloodless, as 
if the animal had been bled 
to death. 

• "In other acute cases a 
twitching and quivering of 
the muscles will be observed, 
especially of those situated 
in the flank and behind 
the shoulder. The pulse 
and breathing are much 
quickened, and the animal 
will stand and grind its teeth 
and curl up its upper lip, 
indicating great uneasiness 
and pain. The ffeces during 
the early stages of the disease 
are very often soft, with a 
tendency to diarrhoea, more 
especially in transport oxen 

on the road, but they invariably become hard as the disease advances ; 
but whether hard or soft, they have generally a brownish tinge, and 
often mixed more or less with blood and mucus. In some severe cases 
which recover, the favourable crisis is often ushered in by a salutary 
diarrhoea." 

In the benign form the animal for the space of about a week 
shows indifference to its surroundings, loses its appetite, wastes, and, 
less frequently, has slight feverish symptoms, without discoloration 
of the urine. The only reason for the belief that this trifling 

E E 2 




Fig. 193.— Scutum and scutellum of female 
Boophiliis annulatus, showing mouth parts, 
porose areas i}}- (t.), and eyes (e). Greatly 
jiiagnitied. (Stiles, Ann. Eep., U.S.A. Bur. 
An. Ind., 1900, p. 392.) 



420 



DISEASES OF THE BLOOD. 



disturbance is due to piroplasmosis is furnished by examination of the 
blood, in which the parasites may be found in very small numbers in 
certain blood corpuscles. 

Calves seldom take the disease except in the benign form. 




Fig, 194. — A, red blood corpuscles containing pear-shaped Piroplasma higeminum 
(the typical form) ; B, red blood corpuscles containing round Pii-oplasma bige- 
viinum. (After Lignieres.) 

Lesions. At first glance the lesions appear to resemble those of 
anthrax, but may be differentiated from them in many details. 

The skin is covered with ticks or shows traces of their punctures. 




Fig. 19;-). 



The myocardium appears as if boiled, the spleen is invariably 
hypertrophied and two or three times as large as in the normal state. 

The kidneys are violet in colour and congested, and the adipose 
layer surrounding the kidney is infiltrated with a yellowish serosity. 



BOVINE PIROPLASMOSIS, 421 

The urine may present a variety of tints, derived from hajmogiobin. 
The Kver is often engorged with blood and the gall bladder always 
distended. 

When convalescence sets in, icteius appears ; but it is a special 
kind of icterus, depending on changes in the haemoglobin — in fact, a 
haemaphseic icterus. Histological examination of the blood furnishes 
the explanation of the disease by revealing the presence of the parasite. 



■.J 



^ 



Fig. 196. — Slow formation of free germs. 1, Pear-shaped organisms \\ith large chro- 
matic element and a flagellum; 2, newly-developed round cell without chromatic 
element ; 3, 4 and 5, formation of the chromatic elements ; 6, the germs about to 
escape ; 7, the germs freed. (After Lignieres.) 

Pathogeny. The parasite is the Piroplasnta hitioninum, which is 
easily demonstrated by drying the blood, fixing it and staining with 
very weak methylene blue. The blood is light in colour and pale, 
and the serum is tinted by the dissolved haemoglobin. The blood 




Fig. 197. — Kapid formation of free germs. 1, Newly-developed round parasite without 
distinct germs ; 2, round parasite with two germs ; 3, the germs approaching the 
surface and undergoing development ; 4, the germs beginning to grow outwards 
preparatory to forming new round parasites ; 5, the process previously noted is 
becoming more marked ; the protoplasm of the cell is undergoing degeneration, 
and scarcely stains at all ; 6, round parasites. This completes the cycle. These 
parasites (6) are similar to (1). (After Lignieres.) 

corpuscles diminish in number with extreme rapidity while the para- 
sites are developing, and in twenty-four or forty-eight hours may fall 
from some six millions and a half, the normal number, to one million 
or even to two or three hundred thousand red blood corpuscles per 
cubic millimetre. 

This destruction is due to the action of the piroplasmata, as may 
be sliown by staining with a "5 per cent, methylene blue or carholised 
thionine. These parasites usually assume a simple pyriform shape, 
and two or three may be found in one blood corpuscle. The number 



422 DISEASES OF THE BLOOD. 

of parasites and infected blood corpuscles is generally in direct ratio 
to the intensity of the infection. These parasites are found through- 
out the blood, but principally in that of the spleen, kidneys, and 
mesenteric veins. They are only abundant whilst the temperature is 
rising or at the moment when it reaches its highest point, and they 
often disappear before death or convalescence. 

The pyriform shape is only temporary, and corresponds to the acute 
phase of the disease, but the parasite assumes the round form as soon 
as convalescence sets in. This round form gives birth to one, two or 
three spherical spores, which are set free in the plasma after the 
destruction of the maternal protoplasm, and are able after trans- 
ference to a fresh red blood corpuscle to again assume the pyriform 
shape peculiar to the grave forms of disease. 

The parasite can only be cultivated in defibrinated blood from a 
haemoglobinuric subject, and the cultures do not always yield more 
than reproductions of the round form, the pear-shaped form only 
being produced with red blood corpuscles in the living animal body. 

Regarding the method of growth of the piroplasma in the body and 
in cultures, Lignieres believes that the parasite may produce two forms 
of spores differing in their nature. One, the active spore, has little 
resisting power. It soon degenerates outside the animal body, forms 
rapidly at the expense of one of the pear-shaped parasites, and may 
immediately reinfect another red blood corpuscle. The other, called 
the passive spore, is very resistant, and retains its vitality for a long 
time outside the body, being produced at the expense of spherical 
parasites already withdrawn and incapable of producing the disease. 

The form of piroplasmosis at present under consideration is peculiar 
to the ox, and none of the other domestic animals or experimental 
subjects can be inoculated with it. 

Subcutaneous or intravenous inoculation of the ox with 5 to 10 
cubic centimetres always gives positive results when made with blood 
or active products, such as the pear-shaped parasites or active spores, 
but is ineffectual when the parasites have already begun to retract 
in order to form passive spores. 

Calves i-eldom contract more than the benign form of the disease, 
and do not die. 

In the grave form following experimental infection the temperature 
begins to rise between the third and sixth day, and corresponds with 
a marked increase in the number of parasites to be found within the 
red blood corpuscles. The urine at first becomes albuminous, then 
htemoglobinuric, whilst the red blood corpuscles diminish in number 
to a very marked extent, falling from about six or seven millions to 
one million, or even a tew hundred thousands, in the course of a few 



BOVINE PIROPLASMOSIS. 423 

days. The temperature, which may previously have risen to above 
105° Fahr., suddenly falls, indicating the approach of death. 

If an immediate autopsy is made, the spleen is always found to 
be enlarged, the intestinal mucous membrane reddish in tint or blood- 
stained, and the serous membranes, particularly the endocardium, 
covered with petechi^e. 

Few or no parasites can be discovered except in the blood from 
the cardiac muscle and the kidneys. 

The grave form may end in recovery. This end is indicated by 
the temperature remaining normal after defervescence, the ai^pearance 
of hsemapliffiic icterus of an. obstinate character, and the progressive 
return of appetite. 

The disease is usually transmitted by adult and larval ticks carrying 
the parasite from infected animals. Lignieres has proved that this 
transmission occurs through the medium of passive spores, which, 
though themselves incapable of producing the disease, become active 
and infective in consequence of the local irritation produced by the 
poisonous saliva of the ticks. 

The pathogeny of Texas fever may be shortly summed up as 
follows : — Animals suffering from the disease carry in their blood a 
protozoan organism called the Piroplasnia bigoniniun, analogous to the 
parasite of human malaria ; once introduced into the blood, this 
organism remains there in an active condition throughout the animal's 
life ; it is transferred to susceptible cattle either within or without the 
infected district by the Southern (U.S.) cattle tick Boophilus annidatus ; 
Southern cattle, although carrying the protozoa, are harmless unless 
infested by this particular tick : the mature ticks and their eggs con- 
tain the protozoa, and the mystery of certain grounds over which 
infected animals have passed being first dangerous, then harmless, 
and again dangerous depends on — (a) the infestation of the ground 
with mature infected ticks ; {h) the destruction or. death of the mature 
ticks ; and (c) the hatching out of new (infected) ticks from the eggs 
laid on the ground l)y the mature female ticks. 

Dr. Salmon states that in Texas a successful method of protection 
is in practice based on the observations that young cattle do not 
suffer so severely as adults, and that the disease always assumes a 
milder form in winter. Young animals introduced during the winter 
are inoculated with virulent blood. They contract a mild form of 
disease, and afterwards resist. In this way the losses, which previously 
amounted to 90 per cent, of all freshly introduced stock, have been 
reduced to about 10 per cent. 

A remarkable and very interesting observation (if absolutely reliable) 
deserves to be mentioned, viz., that the ticks develop regularly in the 



424 DISEASES OF THE BLOOD. 

natural prairie, but do not develop in parts artificially sown with grass 
such as lucerne, and that when contaminated or diseased animals are 
transferred to artificial meadows they do not convey the disease to 
other animals already there ; the latter are proof against it. 

Diagnosis. The disease is so typical that it cannot be mistaken for 
anthrax. In anthrax the urine is never haemoglobinuric and very rarely 
hsematuric, and the faeces are sometimes blood-stained, a symptom never 
present in piroplasmosis. Anthrax can be transmitted to experimental 
animals, but piroplasmosis cannot. 

Prognosis. The prognosis is generally grave. 

Treatment. Van Hellens recommends the use of quinine in large 
doses. He give 5 drachms in one dose, and repeats it for the next two, 
three, or four days. 

Lignieres says that he has never obtained the slightest success 
with quinine, though it is true he has never given higher doses than 
2^ drachms. 

Attempts have been made to confer immunity by injecting animals 
with serum from others which have recovered. Vaccination with the 
blood of patients arrived at the period of convalescence has also been 
tried. The results, however, have not been very satisfactory. 

Lignieres has formulated an efiicient method of vaccination, of which 
he has not yet published the full details, but which appeared by reason 
of its simplicity likely to render great service. Nevertheless, his most 
recent reports seem to show that vaccination is not always eflicacious, 
and that in the Argentine Republic alone several varieties of the disease 
exist, two being caused by allied but different parasites. The vaccine 
used against one variety is powerless against the other. The problem of 
vaccination would therefore appear to be much more complex than in 
the case where one form only occurs in any particular country. 

The immunity arising from attacks of piroplasmosis is in direct ratio 
to the gravity of the disease, and according to Lignieres' views this 
acquired immunity is due to the secretion by the piroplasma of a sub- 
stance which is toxic for the red blood corpuscles. This toxic substance 
provokes, as in other diseases, an organic antitoxic reaction. 

BOVINE PIROPLASMOSIS IN FRANCE. 

Until recent years it did not seem that piroplasmosis occurred in 
France. It had been detected in Algeria, although its existence had not 
been conclusively proved. Mathis claims to have met with it in the 
department of the Loire in 1896 and in the Ain in consequence of 
the importation of Algerian cattle, but its ravages were comparatively 
triflinn-. 



BOVINE PIROPLASMOSIS. 425 

Having good reason to suspect that certain morbid conditions, known 
as mal de Brou, might be due to piroplasmosis, Lignieres endeavoured 
to verify his theory, and discovered that sometimes, but not often, this 
disease was mistaken in France for anthrax and mal de Brou. Piro- 
plasmosis in France appears less grave than in America, and is rarely 
fatal 

As regards its symptoms, it usually develops suddenly with fever, 
loss of appetite, acceleration of the pulse and respiratory movements, 
suppression of the milk secretion, and the passage of red haemoglobin- 
uric urine. In exceptional cases death may occur in from three to 
five days. 

On post-mortem examination a varying number of ticks {Ixodes 
Jiexagonus) are found on the skin, the spleen is always increased in 
size, and the kidneys are black and hgemorrhagic. 

The disease transmitted by ticks, as in Texas fever, seems due to 
the presence of a round parasite, different from the well-known Piro- 
plasma higeminum. 

The elucidation of this disease, which occurs towards the northern 
frontier of France in the neighbourhood of Maubeuge, calls for further 
investigation. It never appears to be very fatal, and it attacks more 
especially animals imported into the infected region. A method of 
vaccination identical with that used by Lignieres against one of the 
forms of the American disease may perhaps in the future prove avail- 
able against the disease in France. Until then the best treatment 
would appear to consist in free subcutaneous injection of saline solu- 
tion and the administration of evacuants, sulphate of quinine, and 
laxatives. 

OVINE PIROPLASMOSIS. 

Causation. The existence in France of this disease has not yet been 
clearly established, for in the only communication on the subject (by 
Leblanc in 1899) the writer seems to have confused the toxic hsemo- 
globinuria produced by feeding on decomposed beet pulp with the 
parasitic hemoglobinuria due to piroplasmosis. 

In Italy ovine piroplasmosis was described by Bonomo in 1896 under 
the title of parasitic icteric hfematuria of sheep. It is said to be due to 
a parasite of the red blood corpuscles {Amo'ha sporidium polyphagum), 
the said parasite being of oval form, very refractile, always occupying 
an outer position near the free margin of the corpuscle, and sometimes 
floating freely in the plasma. 

According to Babes, who described it under the name of garceac du 
mouton, the same disease appears to occur in the islands and low parts 
of the Danube valley. 



426 DISEASES OF THE BLOOD. 

Symptoms. The development of this parasite produces in the 
patient loss of appetite and high fever, accompanied by the passage 
of dark coloured lifemoglobinuric urine. Icterus is frequently present. 
The animals rapidly become exhausted, collapse and die. 

On post-mortem examination carried out immediately after death 
the spleen is found . to be large, the pulp being like wine lees. The 
liver is soft and yellowish ; the kidneys are soft and black. 

The disease is said not to be transmissible by direct trans- 
fusion ('?). 

It would appear that this disease has also been seen in Turkey by 
Nicolle and Laveran, near Constantinople, in 1899. The parasites {Piro- 
plasma oris) are round or slightly elongated and occur near the peri- 
phery of the red blood corpuscles. It is to be hoped in the interest of 
breeders in localities where this disease rages that Lignieres' method of 
vaccination aj^ainst bovine piroplasmosis may prove reliable and equally 
applicable in the case of sheep. 

DISEASES PRODUCED BY TRYPANOSOMATA.* 

In 1904 Professor Koch delivered an address, from which the following 
is a summary, to the Berlin Medical Society regarding his experiences 
and observations on diseases produced by trypanosomata in Africa : — 

A wide field of study has recently been opened by the discovery of 
various pathological protozoa. Three discoveries especially have directed 
attention to these special disease organisms— 

(1.) Laveran's discoveries regarding malaria. Eoss has shown that 
the malaria parasites are carried by mosquitoes {Anopheles daviger). 

(2.) The discovery of the protozoa of Texas fever by Smith. In this 
case ticks {lilujjicepJialas {hoophilus) anmdatus) convey the disease. 

(3.) The discovery of the trypanosoma of the tsetse disease, which is 
conveyed by a stinging fly {Glosshia morsitans). 

These discoveries were followed by numerous others indicating pro- 
tozoa as causes of disease. 

The trypanosomata are morphologically distinguished by the existence 
of a flagellum. When fresh blood is examined it is scarcely possible to 
overlook the protozoa in the preparation, for attention is at once attracted 
by the energetic way in which the red blood corpuscles are continually 
being displaced. The peculiar form of the protozoa, however, can only 
be detected in stained preparations. Eomanowsky's staining method is 

* An interesting article and a series of figures on the " Evolution of the 
Trypanosoma Evansi " were published in the Jour, of Comp. Path, and Therap. 
for September, 1904, p. 210. The same number also contained articles on several 
piroplasmic diseases. 



DISEASES PRODUCED BY TRYPANOSOMATA. 427 

probabl}' the best. Trypanosomata stained by this method show a fish- 
shaped body, the front end of which carries a flagellum. The body of 
the trypanosoma is coloured blue. At the anterior end may be seen a 
red- stained nucleus ; at the opposite end a much smaller red spot, which 
has been termed the nucleolus, but is more properly described as the 
centrosome. From the centrosome a red thread extends along the outer 
margin of the body as far as the front extremity, where it becomes 
continuous with the flagellum. 

The trypanosomata increase by longitudinal fission. The centrosome 
and then the nucleus divide, and finally a second flagellum is formed. 
Sometimes the young trypanosomata remain connected, producing the 
so-called " rosettes." 

The disturbance produced by trypanosomata seldom becomes acute, 
but often continues for years. The only sign of disease consists in ill- 
defined fever with long intermissions. The destruction of the red blood 
corpuscles causes anemia, the animals or men become weak and waste 
away, oedema and sometimes erythema occur at varying points in the 
body, and occasionally the lymphatic glands become swollen. 

The classical land of the tsetse disease is in the neighbourhood of the 
Zambesi. There it was seen and very well described by Livingstone ; 
but, unfortunately, further investigations have shown that tsetse disease 
extends over the whole of Africa. 

Whilst the trypanosomata of rats can only be conveyed to the one 
species, those of tsetse disease thrive in all mammals, particularly in the 
horse, mule, ox, dog, rat, and mouse. 

The tsetse organism has been shown to kill both horses and mules, 
but to be less dangerous for oxen. A certain relative immunity exists in 
some races. As regards the ass, observers are not agreed ; Koch failed 
to infect it. Sheep and goats are also but slightly susceptible. The 
conveyance of trypanosomata from the blood to uninfected animals 
occurs through the medium of a stinging fly (the Glossina morsitans) . 

Surra is endemic in the Philippines, Java, and the island of Mauritius. 
Koch regards the trypanosomata of surra as strictly analogous with the 
parasites of tsetse disease. Horses (and, in India, elephants) especially 
sufi'er from surra. Although the Glossina morsitans does not occur in 
India, other stinging flies replace it and convey the disease. 

Another variety of trypanosomiasis is mal de caderas, seen in 
South America, particularly in Argentina and Brazil. It aft'ects horses. 
According to Koch, the parasites of mal de caderas exactly resemble 
the tsetse and surra parasites. Other observers, however, declare that 
the mal de caderas parasites are distinguished from those before men- 
tioned by their particularly small centrosome. Mal de caderas affects 
not only horses, but all the other animals which suffer from tsetse. 



428 DISEASES OF THE BLOOD. 

Another variety of trypanosoma, the trypanosoma Theileri, is espe- 
cially striking on account of its size. It is only found in oxen, and 
exhibits a very slight degree of virulence. 

Koch divides trypanosomata into two great groups. 

The grouping is based on three important peculiarities : firstly, the 
morphology of the parasite ; secondly, its virulence ; and, thirdly, its 
relation to the host. 

The first group only exists in one species of animal. They have 
become so completely accustomed to this method of life that they can- 
not exist under other circumstances. Their virulence is slight but con- 
stant. This group comprises the trypanosoma of rats and the try- 
panosoma Theileri. 

The second group (to which all other trypanosomata belong) shows 
great variation in virulence and in form. These trypanosomata are not 
peculiar to any one species, but may affect dogs, rats, horses, etc. Their 
morphological peculiarities also vary according to the animals in which 
they are found. Thus, the tsetse parasites when cultivated in the bodies 
of dogs and rats become much smaller than usual, and the centrosome 
appears near the end ; when cultivated in horses the end appears 
pointed, and the centrosome lies near the centre ; in the pig the para- 
sites lose their peculiar short flagellum. Their virulence also varies 
within wide limits. 

It has been found possible, as in the case of bacteria, to modify the 
virulence of trypanosomata by successive passages through difierent 
animals. By inoculating dogs with comparatively innocuous trypano- 
somata and conveying the disease from dog to dog the virulence is 
markedly increased. On the other hand, parasites which prove ver}^ 
virulent for oxen become much less active for these animals after pas- 
sages through rats and dogs. This apparently trifling discovery laid the 
foundation for protective inoculation experiments. Parasites of the 
second group can also exist in the bodies of almost all mammals. 

Koch is of opinion that the parasites of surra in India and of tsetse 
disease in Africa are absolutely identical. Laveran, on the other hand, 
states that he has protected animals against tsetse, and that they have 
nevertheless suffered from surra. 

That this in no way disproves the identity of the two parasites is 
shown by other experiments. 

Koch, whilst in Dar-es-Salaam, made some interesting experiments 
for the purpose of discovering a method of protective inoculation. He 
had found that the virulence of the ox parasites could be modified. He 
therefore inoculated oxen first with these weakened parasites and after- 
wards with others of high virulence. All the control animals died while 
those treated as above remained alive. 



LOUPING-ILL. 429 

Veterinary Surgeon Schmidt kept these animals under observation, 
and reinoculated them from time to time with highly virulent material, 
notwithstanding which they were still perfectly well six years after the 
first inoculation. 

In practising this method, hoAvever, the trypanosomata used for the 
first inoculation must not be unduly weakened. The method would have 
appeared fully successful were it not for the fact that the protected and 
apparently quite vigorous animals still suffered from the presence of 
parasites in the blood. To extend its use, therefore, meant that one 
would not suppress, but would spread the disease. The effect would 
be to produce herds harbouring the parasite, which herds, though 
exhibiting no signs of illness, would nevertheless in a sense be propa- 
gating the active cause. Further observation has also shown that the 
protection so conferred is only relative. Dogs can always be infected 
with the blood of such animals. It has long been known in Africa that 
antelopes and buffaloes harbour trypanosomata in their blood without 
showing external signs of disease. 

Another method of protection must therefore be sought, such as 
destroying the various stinging flies ; but this offers little hope of 
success. Koch admits that he sees no method of dealing with them. 
The other method is directed against the parasite, and here he seems 
more hopeful. The disease can be rooted out by killing all diseased 
animals suspected of disease. The line of procedure is indicated by the 
experience gained in Mauritius and Java. When surra broke out in 
Mauritius almost all the oxen died in two years. In Java the nature of 
the disease was early recognised, and all suspected animals were at once 
slaughtered or isolated until slaughtered ; in this way the disease was 
soon stamjied out. 

LOUPING'ILL. 

The close analogy between the convulsive form of the disease 
described as " trembling " (which disease is well known in France) and 
the condition known in Britain as louping-ill lead us to give here a short 
account of the latter condition. For a great part of what follows we are 
indebted to articles by Meek and Greig Smith, published in the Veteri- 
narian, Vol. T.XIX, Nos. 820 and 840. 

Nature and Symptoms of the disease. The disease known usually 
as louping-ill or trembling has long been of annual and sometimes of 
biennial recurrence in certain parts of Great Britain. In these places 
sheep farmers look for the appearance about the middle of April, to its 
continuation during May, and to its gradual disappearance early in June. 
Lambs are most liable, but sheep are also quite susceptible to the disease, 
and in both the symptoms are the same. The disease under consideration 



430 DISEASES OF THE BLOOD. 

is rendered quite distinct by certain well-known symptoms. Though 
these have been described in various ways, the disease can be recognised 
by the more or less complete paralysis of the body and limbs. Symptoms 
may succeed one another very rapidly, or may be spread over some length 
of time. The animal at first loses control over the muscles, which are 
seen to twitch convulsively. It may fall down and struggle on the 
ground, sometimes jumping up again, often to some height. Between 
the fits it is often seen to stand trembling. These symptoms are fre- 
quently accompanied by frothing at the mouth. Some such appearances 
are the usual onset to the disease, and are followed by a paralysis which 
usually affects the hind limbs, but may also include more or less of 
the body and the head and neck. The fore-limbs are often similarly 
paralysed. The affected limb or limbs become cold to the touch. The 
paralysis necessarily brings the animal to the ground, though it may be 
able to crawl about by the aid of the unaffected legs. When the head 
and neck are affected the former is usually drawn to one side, and the 
eyes often become oblique. Excitement is greatly increased when the 
animal is disturbed. The symptoms, then, in a few words are more or 
less complete paralysis, preceded as a rule by fits and trembling. 

The small number which recover present " a wry neck, stiff" joint, 
high back, or other deformity." During recovery swellings occur at the 
joints ; these may be pierced with good results, giving a large discharge 
of pus. According to Fair, in the Veterinarian, Vol. VIIL, "these abscesses 
usually appear in the neighbourhood of the joints, but sometimes above 
the arms, the brisket, or any neighbouring part of the body." 

While the disease is characteristically a sheep ailment, other animals 
are also liable. Swine fed with the carcases or blood of sheep which 
have succumbed to louping-ill die with every characteristic of the disease 
in a short time. If the carcase has been boiled this does not occur. 
Swine will also frequently take the malady if allowed access to the grass 
of aff'ected fields. Cattle are said to take the disease, and in the North 
Tyne district it is said that if a cow takes louping-ill, the milk will give 
the illness to a calf or lamb. One or two cases of horses being attacked 
are also reported. 

Kegarding the infectious character of louping-ill, the following is very 
well known. Sheep bred on diseased places are not nearly so liable to 
the disease as sheep which have been introduced from unaffected places. 
Louping-ill may be introduced into a new place, but in such cases, 
unless the importation from affected farms be continued, the malady 
may disappear. 

Distribution of the disease. In Great Britain it is confined to the 
North Tyne district of Northumberland and to the contiguous border 
counties of Scotland, extendin*;; into Kirkcudbri^j-htshire and certain 



LOUPING-ILL. 



431 



valleys of Dumfriesshire. It is rare in Berwickshire, common in 
the north and west of Roxburghshire and the similar hilly districts 
of Selkirkshire and Peeblesshire. It occurs in Ayrshire, to a slight 
extent in Lanarkshire, and is found in the western parts and islands of 
Argyleshire and Inverness-shire. 

Not only is the disease very circumscribed in its distribution as a 
whole, but locally in the places mentioned infected and non-infected 
spots are pointed out. These may be quite contiguous. The flocks in 
the North Tyne district feed up and down the hills in limited " cuts," 
and it is one of the features of the illness that certain " cuts " are very 
liable to it, while others, even on the same farm, are just as free. In 
many cases the nature of the pasture is such as to suggest to an ex- 
perienced man the probability of its being subject to the disease. A dry 
and foggy pasture seems best suited for harbouring the cause of the 
malady. These infected places have remained wonderfully constant, but 




Fig. 198.— Larva of the 

grass tick. 
Length, j^th of 1 mch. 




Fig. 199. — Pupa of the grass tick. 
Length, TR^h of 1 inch. 



a peculiar feature about them is that some may be very bad for louj^ing- 
ill one year, and others bad another year. Of two adjoining farms, one 
may be badly attacked and the other mildly, while in the following year 
the conditions may be reversed. Districts may present the same pecu- 
liarities. Thus, though the disease is essentially endemic, it is not abso- 
lutely constant in its recurrence. There seem to be certain circumstances 
capable of favouring or retarding it. 

Lesions. The chief lesions are localised in the membranes of the 
brain and spinal cord, which are congested or inflamed, and contain an 
increased amount of cerebro-spinal fluid or a jelly-like, sometimes blood- 
stained exudation. Softening and hardening of the spinal cord have both 
been observed. Inflammation of the pleura and pericardium, with fluid 
or jelly-like exudation, are common ; lobar congestion of the lungs, endo- 
carditis, gastritis, and enteritis have all been described ; some observers 
have mentioned congestion of the kidneys and liver and swelling of 
the spleen. Lesions of the nerve-centres are the most constant and 
reliable. 



432 



DISEASES OF THE BLOOD. 



Etiology. Depressing and weakening influences of all kinds have 
been blamed for producing the disease, but the general consensus of 
opinion points in the direction of infection with micro-organisms carried 
and introduced into the sheep's system by the common sheep tick or 
" grass tick " {Ixodes reduvius). The following remarks on, and illus- 
trations of, this parasite are from an article by Mr. Wheeler, of Alnwick 
{Vetcrinanan, Vol. LXXIII., No. 867, p. 141). 

Life History of the Grass Tick. Sheep ticks (which must not be 
confused with the sheep-ked, or keb, a wingless six-legged fly, universal 
on sheep everywhere) are allied to the spiders. They pass through four 
stages of existence: the egg — the six-legged larva — the eight-legged 
pupa — and, finally, the eight-legged adult male or female. 

In each of the three stages of larva, pupa, and adult female, all 




Fig. 200. — Adult male of the grass 
tick. Length, ^th of 1 inch. 




Fig. 201.— Adult female. Length, |th of 1 inch. 



species of ticks attack some " host " or animal, either beast, bird, or 
reptile, to which they attach themselves by the " rostrum " or beak, and 
become greatly distended by suction of the host's blood. When replete 
they fall to the ground — if a larva or pupa, in order to undergo its 
metamorphosis to the next stage of its existence, and afterwards seek a 
fresh host ; if an adult female, to lay its eggs amongst herbage. The 
adult male is not capable of distension by suction, though it equally 
attaches itself to a host. 

After undergoing metamorphoses, grass ticks, with the exception of 
males, are light in colour, soft and lethargic, and remain concealed for 
some time while recovering strength before seeking a fresh host. 

Professor Neumann alludes to the fact that a fresh host is sought by 
ticks three several times during their existence. 



LOUPING-ILL. 



433 



The Larva. When first hatched out from the eggs, which are sup- 
posed to be laid at the roots of coarse herbage, the young ticks are 
white and soft, but soon gain strength. Provided the weather is favour- 
able, they climb up the stems, and, holding by their two posterior pairs 
of legs, await the passing of a host, employing their two front legs as 
insects use their antennae. 

In this, as in other " free living " stages of their existence, the young 
larvae show great activity, attaching themselves and clinging tenaciously 
to any moving object. They appear to be more numerous on the rank 
rushes growing in damp, undrained places. 

On finding a host, larvae attach themselves by the rostrum, and remain 
there for about two days, by which time they are distended, black and 
globular. At this time they are easily detached 
from the host, and have lost their activity and 
clinging habits. 

The Pupa. The possession of eight legs dis- 
tinguishes the pupa easily from the larva. The 
extra pair are placed behind the others. After 
the metamorphosis, the pupa takes up its posi- 
tion on the stalks of herbage, just as the larva 
had done, for another chance of attachment to 
a host. But whereas adult grass ticks seem to 
confine themselves mostly to sheep, cattle, and 
deer, the larvae and pupae attach themselves 
very readily to various hosts, such as horses, 
dogs, and even human beings. After about 
four days the pupa is again replete with blood, 
black and opaque, and again drops to the 
ground to undergo its second and final change. 

Adults. On reaching the adult age, both males and females again 
wait on herbage for a passing host. At this time, as well as after dis- 
tension of the female on the host, an action which appears, to be sexual 
intercourse freely takes place, even in confinement. On the host the 
females gradually distend (Fig. 202), and in the course of so doing vary 
much in colour and appearance. When fully replete, the female Ixodes 
reduvins becomes globular and black. One taken in this condition on 
April 15th commenced to lay on May 12th, and a few others taken at 
the same time commenced shortly afterwards. 

Grass ticks never remain on the host to undergo metamorphosis or to 
lay eggs. They must therefore during their cycle of existence contrive 
to find a fresh host no fewer than three times. 

In an article published in the Transactions of the Highland and 
Ag. Soc. for 1902 Mr. Wheeler draws attention to the close points of 

D.C. F F 




Fi(i. 202.— Partially dis- 
tended female. The 
dotted white line repre- 
sents the size of the 
tick before distension. 



434 



DISEASES OF THE BLOOD. 



resemblance between louping-ill, Texas fever, tsetse fly disease, surra, 
heart-water, yellow fever, and malaria. 

In the article previously referred to he summarises his conclusions 
as follows : — 

One species only of tick, Ixodes rediiriiis, commonly known as the 
grass tick, has been found to carry the louping-ill bacillus to the sheep. 
It is easily recognised by the red body of the young females, the legs, 
shield, etc., being dark brown. 

It lays its eggs, and undergoes its metamorphoses, in coarse 
herbage, and after each change seeks a fresh " host " on which to 
distend itself to a large size by suction of blood. 

In all stages grass ticks abstain from all food except when on a host. 





Fig. 203. — Female, tinder size. 



Fig. 204. — Headless female. 



and they are endowed with extraordinary powers of fasting until a host 
is found. 

Ticks soon die of drought where there is no good harbourage among 
rank vegetation. 

Judging from analogy, it is probable — 

That the bacillus can only be obtained from a diseased sheep, and 
inserted by the tick into another sheep. 

That ticks convey the bacillus through their eggs to their offspring, 
as well as retain it through their metamorphoses. 

That there is no danger in removing sheep from foul ground to 
cultivated lowlands, but that the disease is easily imported from one 
hill farm to another. 

Strong and fat animals are nearly as susceptible to attack as weakly 
ones. 

If the land is once free of disease, it can only be re-imported by 
diseased sheep, or ticks taken from them. 



BRAXY. 435 



SUGGESTED MEASURES FOR PREVENTION. 

Burning and cutting of long grasses, l)racken, rushes, etc. 

Salt and sulphur given to the sheep. 

Inoculation. 

Eemoval of all diseased sheep to a separate inclosure, where hand- 
picking and dipping are carefully attended to, the pasture is kept short, 
and damp places are drained. The sheep to be confined to this in- 
closure so long as the tick season lasts. 

Immediate slaughter and burial of all affected sheep. 

BRAXY. 

[The following is a very condensed account of a paper published by 
C. 0. Jensen on the above disease. It first appeared in English in the 
Veterinarian, Vol. LXIX., No. 825, p. 621, along with the original 
illustrations.] 

The name Braxy is applied to a disease in some respects resem- 
bling anthrax, which appears as an epizootic, and is best known in 
Iceland, the Faroe Islands, and parts of Norway, though it also occurs in 
Scotland and Cornwall. Krabbe describes the disease as infectious, very 
acute in its course, and as proving fatal within a few hours of the 
appearance of certain characteristic swellings about the posterior parts 
of the body. Post-mortem reveals extensive dark purplish staining of 
the abomasum and distension of the digestive canal with gas, while de- 
composition of the cadaver occurs with excessive rapidity, the liver and 
kidneys undergoing softening, the skin assuming a bluish tint, the wool 
becoming loose, and the entire carcase giving off a most offensive stench. 
Krabbe states that the disease was regarded as a form of anthrax — a 
view, however, in which he does not coincide. Somewhat later Messrs. 
J. Sigurosson, S, Jonsson, and Einarsson, all natives of Iceland, and 
the Norwegian State Veterinary Surgeon, Ivar Nielsen, carefully de- 
scribed the disease, throwing considerable Hght both on the conditions 
in which it appears and on its etiology. 

According to them, braxy is an acute, or even exceedingly acute, 
infectious disorder, which begins as a hsemorrhagic inflammation of the 
mucous membrane of the abomasum, is accompanied by excessive de- 
velopment of gas in the digestive canal, especially in the stomachs, and 
proves fatal in some cases by a kind of general infection, in others by a 
specific intoxication, or by dyspnoea due to tympanites. 

Braxy commits its chief ravages during the winter months : appearing 
first in autumn, the cases increase as winter api)roaches, to diminish again 
in spring ; in summer they are exceedingly rare. This fact explains why 

F F 2 



436 DISEASES OF THE BLOOD. 

the disease was so long regarded as due to climatic influences. Even at 
the present day, when it is known to be due to a specific organism, the 
action of temperature, etc., must still be regarded as i^robably playing an 
important part in infection. The disease is said not to occur in mild 
weather ; but whether or not this be true, every one is agreed that it is 
principally seen during frost, especially when frost is unaccompanied by 
snow. 

From experience gained both in Iceland and Norway, the disease 
appears to be often localised in certain districts and fields — a fact largely 
accounted for when we learn that up to the present little or no attempt 
has been made to prevent the spread of infection from the dead 
bodies. 

Braxy chiefly attacks young animals, and is rare in those over three 
years of age. Hjaltelin estimates the number of deaths in a single 
district during the years 1849 — 1854 at approximately 6,000, made up 
as follows : — 

Yearling lambs . . . . . . . . . . . . . . 2,440 

Two-year sheep . . . . . . . . . . . . . . 2,460 

Three-year sheep . . . . . . . . . . . . . . 1,020 

Annuals older than three years . . . . . . . . . . 80 

The younger animals suffer most, and in Norway Nielsen directs 
attention to the heavy fatalities amongst lambs. 

Symptoms. The sheep suddenly appears ill, is dull, lies about, and 
cannot be induced to rise ; all movement seems to give pain, and from 
time to time the animal groans ; the posterior parts of the body become 
swollen, and a little froth often escaj^es from the mouth. The pulse 
varies between thirty and thirty-five per minute, and is often imperceptible 
in the extremities ; the temperature may rise to 105° or even 108° Fahr. 
This condition may last some hours, and always ends with the animal's 
death; sheep, which overnight had shown no signs of illness, are often 
found dead in the morning. The incubation period is from forty-eight to 
sixty hours, but ordinary cases seldom live longer than from five to eight 
hours after the symptoms declare themselves. 

The striking post-mortem appearances, especially the haemorrhagic 
inflammation of the abomasum, were early the subject of remark. This 
appearance is very characteristic. 

If the animals are slaughtered, the most important change is found to 
be a purplish, dark, somewhat swollen patch in the