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NEGRI IJODIES (HIPPOCAMPUS.)
St'itinn stuin,\l, follo-SKiiig the method of O. I.entz, Berlin.

Carinine : Negri luuius. Light blue : Ganglion cells.

Red: Red blood corpustUiX. Blue: Nuclei of cells.

Deep blue : Nucleoli of cells.

DISEASES OF THE DOG

AND

THEIR TREATMENT

DR. GEORG MULLER

PROFESSOR DIRECTOR OF THE CLINIC FOR SMALL ANIMALS AT THE VETERINARY
HIGH SCHOOL AT DRESDEN

AND

ALEXANDER GLASS, A.M.. V.S. (McGill)

LECTURER ON CANINE PATHOLOGY IN THE VETERINARY DEPARTMENT
UNIVERSITY OF PENNSYLVANIA

THIRD ILLUSTRATED EDITION
REVISED AND ENLARGED

CHICAGO

ALEXANDER EGER, PUBLISHER

1911

Entered according to the Act of Congress, in the year 1896, by

ALEXANDER GLASS, A. M., V. S.,
In the Office of the Librarian of Congress, at Washington, D. C.

NOTE TO THIRD EDITION.

The present edition of this work has been entirely re- written, a
large amount of new material added, and every endeavor has been made
to bring the work up to the standard of the present day. While pre-
paring the manuscript of this edition the second edition of Dr. Mtiller's
work has appeared and has been closely scrutinized and all valuable
additions incorporated in this work. One portion of this work that
differs materially from the German is that of therapeutics. In the
practice of Canine medicine, where we must necessarily administer
medicine by force, concentration of the dose is very essential; the writer
cannot impress too strongly on the practitioner and student that the
constant aim must be to administer all drugs in doses as small and
compact as possible, for it frequently happens that the excitement caused
by the repeated administration of large amounts of decoctions and
infusions in nervous or highly bred animals does more harm than the
original disease.

The writer is under great obligation to Dr. Preston Hoskins for his

suggestions and his careful reading of the proof; to Drs. Spang, Sommer

and Jureasu for their assistance in translation, and to Dr. Meyer for his

aid in the chapter on rabies.
Philadelphia, Pa.,
September, 1, 1911,

ALEXANDER GLASS.

rill)

PREFACE.

In writing these pages tlie author has endeavored to give a short,
accurate, and clear definition of the modern knowledge of diseases of
the dog, and to adapt his treatise to the requirements of the profession.

Speculations and hypotheses have been studiously avoided, while,
on the other hand, plain facts have received careful consideration.

Diagnosis has been given the most prominent place, as it deserves
in a work of this kind, and the author has endeavored to establish the
symptoms with their relation to the disease and to confine their thera-
peutic treatment to a knowledge of normal and pathological anatomy
and physiology, for he believes that it is on a clear and accurate knowl-
edge of the normal and pathological structure of life the fundamental
base of clinical science lies.

The writer has also included some selected formulae which he
considers of practical value to the reader.

Due consideration has been given to modern literature whenever it
appeared consistent, and a glance at the contents will also show that the
author has added the results of his own researches and observations.
These have been derived from his experience as director of the clinic of
small animals in this locality.

His space has been somewhat restricted, and he has had to dispense
with the details of the bibliography of our literature, but this is not of
much consequence when we have such works as Friedberger and Froh-
ner's, Hoffmann's, Vogel's, and others at our disposal.

The illustrations in this work are nearly all original. Some, however,
have been obtained from other works, principally from Ellenberg and
Baum's Anatomy of the Dog, edited by Paul Parey, and the author
expresses his thanks for their use.

The author would feel gratified if his work be favorably received
by those who are interested in the diseases of the dog.

G. MULLER.

(iv)

NOTE.

While lecturing on the diseases of the clog the writer recognized the
fact that there was not in existence a work that could really be called a
text-book for the student and the practitioner; there were then, and
have been issued since, a number of "popular" works that endeavored
to fill the dual role of text-book for the veterinarian and a "Dog Book"
for the layman; these, as a rule, have been inadequate for the former and
confusing to the latter. With the purpose of supplying this want the
writer, several years ago, began to write a book on the subject, but two
3'ears ago read this work by Professor Mviller, and instantly recognized
its value as a text-book: every detail in the diseases of the dog being
carefully considered, and the whole so admirably arranged that the
student can readily find and study any subject in a clear and condensed
form.

He secured from the author the right of translation, and has made
it as exact as possible, perhaps in some parts too literal, but has done so
in the endeavor to closely follow the original. He has also added, in
the proper places, the results of his own observations, and also every-
thing of value that has been added to veterinary science since the appear-
ance of Dr. Muller's work, thus making a second and much enlarged
edition.

The metric system, as in the German work, has been followed,
with the hope that its use may be a slight aid to the general adoption
of what may be the future international system of measurement.

ALEXANDER GLASS.

(v;

NOTE TO SECOND EDITION.

Knowing that many active and enthusiastic observers are working
constantly in the line of diseases of direct contagion this edition has
been delayed in the hope that some new and important discovery of
original research would be made, and to a certain extent we have been
rewarded by the work of Babes and of Negri in respect to the quick
diagnosis of Rabies. It has been thought possible that some one might
be able to make a culture of Distemper in dogs that would by inoculation
of the young animal render it either immune or at least slightly suscept-
ible to this disease. This, however, has not yet been accomplished.

While the plan of the work, the admirable arrangement of which is
due to Dr. Muller, has not been changed a great number of alterations
have been made. The articles on Distemper, Rabies and Tuberculosis
have been remodeled, and the therapeutics throughout the work have
been brought up to the standard of the present day, the tendency of
which appears to be, and rightly, to use as little medicine as possible and
in small and convenient doses; and to pay particular attention to hygiene,
good nursing, and sanitation in kennels.

I am indebted to Dr. John Reichel for assistance in the pathology
of Rabies, and to Walter McDougall for drawings. Plates in color after
my own photographs have been added.

ALEXANDER GLASS.

(vi)

CONTENTS.

PAGE

General examination 1

the physical condition 1

the structure and constitution of the body 3

the nutritive condition 3

the mucous membranes of the head 4

skin and subcutaneous membrane 5

oedema 6

emphysema 6

the temperature 7

increased temperature 7

sul^normal temperature 9

local temperature 10

Diseases of the digestive apparatus 11

the examination of the digestive apparatus 11

the condition of the throat and niouth 12

examination of the oesophagus 16

examination of the stomach 17

digestion of a meat-diet in the stomach 22

the digestion of milk in the stomach 22

action of digestion on hydronaceous food 22

physical examination of the bowels 25

the faeces 28

physical examination of the liver 32

examination of the spleen 33

examination of the pancreas 33

diseases of the mouth, tongue, and salivary glands 34

inflammation of the mucous membrane of the mouth 34

ulcerous inflammation of the mouth 34

foreign bodies in the tongue 36

gangrene of the tongue 36

diseases of the teeth 37

dentition 40

malformations of the ca\'ity of the mouth 41

warts in the mouth 42

ranula 42

inflammation of the salivary glands ' 43

parotitis 43

idiopathic parotitis 43

abscess of the glands 44

inflammation of the mucous membrane of the throat 46

diseases of the oesophagus 48

(vii)

viii CONTENTS

Diseases of the digestive apparatus — Continued. page

foreign bodies in the oesophagus 48

CESophagitis 50

stenosis 50

dilatation of the oesophagus 51

paralysis of the oesophagus 51

diseases of the stomach 52

acute catarrh of the stomach 52

chronic catarrh of the stomach 53

other disorders of the stomach 54

diseases of the intestines 58

intestinal catarrh 58

mycotic inflammation of the stomach and intestines 63

constipation 64

obstipation 65

prolapsus of the rectum 74

imperforate anus 78

hemorrhoids 81

intestinal parasites 82

round worms 82

tapeworms 84

oxyuris vermicularis 93

dochmius 93

other parasites 94

diseases of the peritoneum 95

inflammation of the peritoneum 95

abdominal dropsy 99

diseases of the liver 104

catarrhal jaundice 104

hypersemia of the liver 107

inflammation of the liver 108

acute parenchymatous inflammation of the liver 108

interstitial hepatitis 108

abscess of the liver 109

fatty liver 109

neoformations of the liver and gallstones 110

amyloid liver 110

lardaceous liver 110

poisons Ill

Diseases of the respiratory organs 115

the physical examination of the respiratory apparatus 115

examination of the nose 115

physical diagnosis of the larynx and windpipe 117

physical diagnosis of the lungs 119

shape of the cavity of the chest 119

number and character of the respiratory movements 120

percussion of the thorax 123

auscultation of the thorax 125

diseases of the nasal ca\'ities 128

nasal catarrh 128

CONTENTS ix

Disease of the respiratory organs — Continued. page

pentastoma taenioides 128

epistaxis 129

tumors 130

diseases of the larynx 133

acute laryngeal catarrh 133

chronic catarrh of the larynx 135

diseases of the upper air-passages and bronchial tubes 137

catarrh of the windpipe and bronchia 137

acuts catarrh of the large bronchia 138

acute catarrh of the smaller bronchia 139

parasitic bronchitis 140

diseases of the lungs 141

catarrhal inflammation of the lungs 141

chronic interstitial pneumonia 143

cedema of the lungs 144

croupous inflammation of the lungs 146

anthracosis pulmonum 146

emphysema of the lungs 146

diseases of the pleura 147

pleuritis 147

hydrothorax 151

pneumothorax 152

hjematothorax , 153

Diseases of the circulatory apparatus 154

examination of the circulatory apparatus 154

examination of the heart 154

position and size of the heart 155

character of the heart-pulsations 156

character of the heart-sounds and bruits 156

character of the jjulse 157

diseases of the heart 158

valvular defects 160

idiopathic hypertrophy of the heart 163

diseases of the pericardium 165

pericarditis 165

dropsy of the pericardium 166

hemorrhage of the pericardium 166

filaria in the blood 167

Diseases of the urinary and sexual apparatus 169

examination of the urinary apparatus 169

examination of the prepuce and urethra 169

examination of the prostate 171

examination of the bladder 172

examination of the urine 173

amount of urine 173

color of the urine 174

transparency of the urine 175

the specific gravity of the urine 1"^

X CONTENTS

Disease of the urinary and sexual apparatus — Continued page

foreign substances in the urine 175

diseases of the kidneys 181

inflammation of the kidneys 181

acute inflammation of the kidneys 182

chronic inflammation of the kidneys . 184

amyloid kidney ' 186

abscess of the kidneys 187

inflammation of the pelvis of the kidney 188

hydronephrosis 189

cysts of the kidneys 189

nephritic stones 190

tumors of the kidneys 190

animal parasites of the kidneys 190

diseases of the bladder 191

catarrh of the bladder 191

debilitated conditions of the bladder 195

stone in the bladder 197

urethrotomy 199

Diseases of the male sexual organs 204

diseases of the prostate 204

inflammation of the prostate 204

hypertrophy of the prostate 205

tumor of the prostate 206

diseases of the penis and prepuce 206

phiniosis and paraphimosis 206

gonorrhoea 207

specific gonorrhoea 208

neoformations of the glands and prepuce 208

diseases of the testicle and its coverings 208

inflammation of the scrotum 208

injuries to the testicle and scrotum 209

cuterebro emasculator 211

Diseases of the female sexual organs 211

diseases of the vagina and uterus 211

inflammation of the vulva and vagina 211

prolapsus of the vagina and uterus 212

diseases of the uterus 215

inflammation of the uterus 215

catarrhal metritis 215

septic metritis 216

obstetrics 219

irregularities of the sexual instinct 222

castration of the bitch 223

diseases of the mammary gland 225

inflammation of the mammary gland 225

neoformations of the mammarv gland 226

COXTENTS xi

PAGE

Diseases of the nervous system 228

examination of the nervous system 228

disturbances of consciousness 228

disturbances of sensitiveness 228

disturbance of motility 229

diseases of the brain and its coverings 235

hyperaemia of the brain 235

anaemia of the brain 236

cerebral hemorrhage 237

traumatic lesion 238

inflammation of the brain 239

comparatively rare diseases of the brain 241

diseases of the spinal cord and its memlsranes 243

cerebro-spinal meningitis 243

inflammation of the spinal cord and its membranes 243

paralysis of the nerves 252

epilepsy 255

chorea 259

catalepsy 262

bronchocele 264

Diseases of true infection 267

distemper 267

infectious bronchial catarrh 267

infectious hemorrhagic gastroenteritis 282

Septic and pyaemic diseases 287

septicopyaemia 287

malignant oedema 288

anthrax 289

rabies 290

tuberculosis 302

hemoglobinuria and piroplasosis 307

tetanus 309

Constitutional diseases 312

anaemia 312

leukaemia 313

diabetes mellitus 316

diabetes insipidus 318

obesity 319

uraemia 320

scurvy 321

Priessnitz's bandage 322

Diseases of the organs of locomotion 323

diseases of the bones 323

rhachitis 323

fractures of the bones 325

xii CONTENTS

PAGE

Diseases of the articulations 337

inflammation of the joints 337

acute synovial inflamniation of the joints 338

chronic synovial inflammation of the joints 339

purulent inflammation of the joints 339

rheumatic inflammation of the joints 340

disease-producing malformation of the joints 341

Injuries of the joints 344

wounds of the joints 344

contusions of the joints 345

distortions of the joints 346

luxation of the joints 347

dislocation of the lower jaw 348

dislocation of the ell^ow 349

dislocation of the patella 350

Diseases of the muscles 353

muscular rheumatism 353

cysticercus and trichina 355

diseases of tendons and bursa mucosa 356

Wounds and their treatment 359

wounds 359

course and healing process in a wound 361

diseases resulting from septic infection of wounds 361

treatment of wounds 365

ulcers and ulcerations 369

contusions 370

Diseases of the claws and foot-pads 378

ingrowing claws 378

inflammed claw 379

contusions and wounds of pads 380

Hernial rupture 381

abdominal hernia 381

description of hernia 381

reducible hernia 382

irreducible hernia 383

inguinal hernia 387

method of castration 388

sarcocele 391

hydrocele 391

umbilical hernia 391

femoral hernia 393

perineal hernia 394

Diseases of the eyes 395

affections of the eyelids 395

closure of the eyelids 395

entropion 395

ectropion 397

CONTENTS xiil

Disease of the Eyes — Continued page

diseases of the conjunctiva 401

inflammation of the conjunctiva . 401

catarrhal conjunctivitis 402

purulent conjunctivitis 403

diseases of the cornea '. 406

inflammation of the cornea 406

keratitis superficialis 407

keratitis profunda or parenchymatosa 408

abscess of the cornea 409

ulceration of the cornea 410

dermoid of the cornea 413

pterygium 414

injuries to the cornea 414

diseases of the lens, cataract 416

diseases of the sclerotic membrane, of the nervous portion of the eye,

and of the vitreous humor 422

inflammation of the iris 422

purulent inflammation of the eye 423

dropsy of the anterior chamber (glaucoma) 423

diseases of the optic nerve and the retina 424

prolapsus of the eyeball 425

Diseases of the ear 429

serous cyst 429

external canker 432

internal canker (otitis) 434

deafness, partial or complete 438

prasitic canker of the ear 439

Diseases of the skin 441

inflammatory condition.s of the cutaneous membrane 441

erythema 442

urticaria 444

eczema 445

acne 455

alopecia 458

cutaneous affections caused by animal parasites 461

ceratopsyllus canis 462

haematopinus piliferus 463

trichodectes latus 464

Ixodes ricinus 465

leptus autumnalis 465

cutaneous diseases due to animal parasites 465

sarcoptic mange 465

follicular mange 469

demodex follicularum 469

filaria 474

cutaneous affections caused by vegetables parasites 475

favus 4/0

herpes tonsurans 4/6

trypanosomiasis 4/8

xiv CONTENTS

PAGE

Tumors 480

soft and hard fibroma 480

lipoma 481

sarcoma 482

papilloma 483

warts 483

flat condyloma 483

484
carcinoma ^°^

myxoma 4oo

adenoma 48o

anojioma 48o

487
myoma •

chondroma 487

infectious genital tumors 488

ILLUSTRATIONS.

FIG. PAGE

1. Dog ^^■ith a?dema of the skin 6

2. Laryngoscope 12

3. Pocket electric light 12

4. Holding the mouth open with tapes 13

5. Mouth speculum 14

6. Gag 14

7. Section through center of abdomen 18

8. Position of stomach when empty 19

9. Position of stomach when full 19

10. Stomaeh-pumi3 20

11. Contents of the stomach (four hours after eating) 21

12. Intestinal canal of the dog 26

13. Examnation of the lower bowel with speculum 28

14. Microscopical examination of the fajces 30

15. Eggs of intestinal parasites in fseces (round worm) 31

16. Right side of the abdomen 32

17. Gangrene of the tongue 37

18. Longitudinal section through an incisor tooth 37

19. Improvised gag 39

20. Tumors of the gums 40

21. "Wire 6craseur 41

22. Warts of the mouth 41

23. Glands of the head 43

24. Abscess of the neck 45

25. Mucous cyst 45

26. SpirojDtera Sanguinolenta 51

27. X-ray picture of coin in the stomach 56

28. Dog ^vith obstruction of the intestines 67

29. Mode of administering a clyster 69

30. Lamlsert suture '^0

31. Suture of the intestines "1

32. Hairpin method of anastomosis 72

33. Hairpin method of anastomosis, first stage 73

34. Hairpin method of anastomosis, second stage 73

35. Prolapsus of the rectum with invagination 75

36. Stitching rectum (tobacco-bag stitch) ■ 77

37. Method of suturing in amputation of the lower bowel 77

38. Inflammation of the anal glands '9

39. Pseudo-perineal hernia 80

40. Ascaris mystax S2

41. L^terus of the Taenia coenurus (enlarged) 85

42. Taenia serrata ^^

43. Taenia marginata, posterior end of worm 86

44. Taenia cucumerina, DipyUdium caninum 87

45. Taenia ccenurus 88

(XV)

xvi ILLUSTRATIONS

FIG. PAGE

46. Tsenia echinococcus 89

47. Taenia echinococcus 90

48. Oxyuris vermicularis 93

49. Anchylostomum uncinaria 94

50. Wall of cajciim with trichocephalus depressiusculus 95

51. Section through the abdomen 96

52. Dog with ascites 99

53. Diagramatic section of the pharynx 116

54. Position of the frontal sinuses 117

55. Right side of the thorax and abdomen 120

56. Left side of the thorax and abdomen 121

57. Pleximeter 123

58. Field of percussion 124

59. Stethoscope 125

60. Dog Avith chronic catarrh 130

61. Pentastoma taenoides 131

62. Cross-section of the head of a dog 131

63. Pentastomum denticulatum 132

64. Egg of the Pentastomum tenoides 132

65. Trocars for puncture of the thorax 151

66. The heart in position 154

67. Diagram of the blood circulation 160

68. Heart, with filaria immitis in the ventricle 167

69. Male catheter 169

70. Passing the catheter 170

71. Female catheter 171

72. Median section through the pelvic cavity 171

73. Speculums 172

74. Section through the pelvis of the male 172

75. Areapikometer 175

76. Spectrum of urine in hajmoglobinuria 176

77. Haematin crystals 176

78. Epithelium found in the urine 178

79. Uric cylinders 178

80. Urine of a dog with cystitis 179

81. Urine of a dog with cystitis 193

82. Apparatus and method of irrigating the bladder 194

83. Urethrotomy 200

84. Enlargement of scrotum 210

85. Vaginal speculum 212

86. Prolapse of the vagina 213

87. The genito-urinary organs of the bitch 214

88. Double catheter for washing out the uterus 216

89. Retractors, single and double 220

90. Apparatus for the extraction of foetus 221

91. Tumor of the mammary gland 226

92. Diagram of the brain, showing the various motor centers 231

93. Motor centre points of the dog 232

94. Paralysis of the posterior extremities 244

95. Paralysis of the cord 247

96. Dog with })achymeningitis ossificans 248

ILLUSTRATIONS xvii

Fig. page

97. Facial paralysis of the left side 253

98. Malignant struma 265

99. Blood of a dog affected with piroplasma canis 307

100. Dog with tetanus 310

101. The blood in leukocytha^mia 314

102. Rixdius and ulna of dog affected with rickets 324

103. Skiagraph of fracture of the humerus 327

104. Diagram of union of fracture in the tibia of the dog 328

105. Plaster splint on fracture with support around body 330

106. Pitch plaster put on in layers 332

107. Effects of tight bandaging of a sphnt 332

108. Different methods of amputation - 333

109. Skiograph of osteosarcoma of the radius with opening in upper part of the

bone 335

110. Skiagrajih of the ulna \vith middle and lower third of the bone nearly gone. 335

111. A large hv]wdermatic syringe for puncturing enlarged joints 343

112. Muzzle 349

113. Dog with dislocation of the hip 351

114. Skiograph of luxation of the hip 352

115. Laceration of the tendo achilles 356

116. Dog with elbow boil (hygroma) 357

117. Apparatus for the antiseptic irrigation of wounds 366

118. Different forms of stitches 367

119. Muzzle 368

120. Bandage for injuries or amputation of the tail 375

121. Amputation of the tail 376

122. Longitudinal section of the nail 378

123. Diagram of the first and second phalanx 378

124. Pads of foot 379

125. Dog's shoes 380

126. Scrotal hernia of right side 387

127. Genital organs of the dog 389

128. Inguinal hernia of bitch 390

129. Umbilical hernia 392

130. Plaster on umbilical hernia 392

131. Middle section through the pelvis sho-\ving the organs 393

132. Double perineal hernia 394

133. Entropion operation of lower eyelid 396

134. Diagrammatic position of sections and mode of stitching in operation for

entropion 397

135. Diagrammatic position of section in operation of entropion 397

136. Entropion operation 398

137. Entropion operation and mode of stitching 398

138. Protrusion of the membrana nictitans 400

139. Removal of the membrana nictitans 400

140. Dermoid of cornea 413

141. Leucoma 415

142. Gray cataract of both eyes 417

143. Instruments used in the cataract operation 418

144. Discission of the lens 419

145. Lobular extraction of lens 420

xviii ILLUSTRATIONS

TIG. PAGE

146. Lobular extraction of lens 421

147. Dislocation of the lens 421

148. Iris coloboma 423

149. Dislocation of the eyeball 426

150. Muscles of the left eye 428

151. Hematoma of the ear 430

152. Ear-cap 430

153. Earhood or net 431

154. Mode of bandaging the ear 432

155. Mode of bandaging the ear 433

156. Kramer's ear speculum 435

157. Ear swab and mode of using it 436

158. Moist eczema of the shoulder 447

159. Chronic eczema of the back 448

160. Acne of the nose 455

161. Acne muzzle 456

162. Head of the dog flea 462

163. Female pulex pentranse 463

l64a. Haematopinus filiferus 464

1646. Trichodectes latus 464

165. Ixodes ricinus 465

166. Female sarcoptes of the dog 466

167. Female sarcoptes burrowing in the skin 466

168. Development of the acarus folliculorum 469

169. Acarus folliculorum greatly magnified 469

170. Hair follicle invaded by demodectes folliculorum 469

171. Head of dog affected with demodectes folliculorum 472

172. Favus spores 475

173. Trichophyton tonsurans after treatment 476

174. Dependent fibroma 481

175. Multiple formation of warts 483

176. Chronic ulcer 490

177. AVire ^craseur 491

178. Manner of tying the mouth 492

FULL PAGE PLATES.

Negri bodies (hippocamous) section stained, following the method of O. Lenz,

Berlin Frontispiece

Stomacace (necrotic gangrene of the jaw) 34

Ranula (salivary cyst of the tongue) 42

Spiroptera sanguinolenta (encysted in the oesophagus) 50

Method of administering medicinal vapors 136

Section of the hippocampus major, showing Negri bodies 298

A smear of mucous from the bronchial membrane of a dog 306

Cultivation of a tubercular bacilli 310

Tetanus (lockjaw) 310

Rachitis (rickets) 324

Dermodectes folliculorum. (dermodictic mange.) a 470

Infective tumor of dogs (natural size) 488

Infective genital tumor of dogs (the initial stage) 488

Infective genital tumor of dogs (the fully developed stage) 490

DISEASES OF THE DOG.

GENERAL EXAMINATION.

In making an examination of the dog for the purpose of diagnosis it is
best to class it under two heads: a general and a special examination.

The general examination, used when the organism is considered as a
whole, is the method generally followed in surgical diseases, as in the case
of an injury where we first carefully examine the injured region and then
direct our attention to the other parts of the body.

The special examination is made when we consider single special
organs of the body, particularly those of secretions and excretions. If
our attention is called to some specially striking symptom, we at once
examine a certain organ or group of organs. Frequently, for more cer-
tain diagnosis, it is necessary to make a microscopical examination of
the blood, urine, or faeces; or by means of a trocar obtain some of the con-
tents of certain cavities or tissues of the body to ascertain their true char-
acter and composition. The Rontgen rays are also used to obtain a
photograph of some foreign body or pathological alteration of the inner
structures; or the skin examined to detect the presence of parasites or
their embryos; and it may be necessary in some instances to inoculate
another animal or series of animals with the virulent material of some
disease to confirm a diagnosis.

In making a general examination the following points have to be
observed: 1. The physicial condition; 2. the structure and constitution;
3. the nutritive condition; 4. the mucous membranes of the head; 5.
the skin and subcutaneous membranes; and 6, the temperature of the
body.

THE PHYSICAL CONDITION.

The physical condition of the dog suffering from any bodily ailment

presents more rapid and marked changes than any other animal. Even

in slight indispositions, such as disturbances of the stomach and digestive

apparatus, the animal will be downcast, irritable and nervous, and often

1 1

2 GENERAL EXAMINATION

show a disinclination to move, or may change constantly from one place
to another. Nervousness, a staring look in the eyes, great restlessness,
constant barking or howling point to beginning of congestion of the brain.
But these symptoms may also be found in a number of other diseases;
for instance, in cases of pentastomes in the nose or cavity of the forehead,
in cases of parasites of the intestines, in rabies and distemper.

Howling is observed in a great many of the various painful diseases,
particularly in disorders of the stomach and intestines. Colic of the intes-
tines may present great nervous excitement; a nervous animal sometimes
will swallow indigestible substances, foreign bodies, show a tendency to
bite, but that does not necessarily mean that the animal has rabies; but
if this is accompanied by a hoarse, howling bark and a staggering gait,
it will change the existing suspicion to a certainty.

Symptoms resembling rabies may appear from the presence of pen-
tastomes in the nasal cavities, from taenia ecchinococcus in the intestines,
foreign bodies between the teeth, in the pharynx, stomach and intestines,
or as the result of continuous sexual excitement. Further, we may
may have uncontrollable movements which are caused by changes in the
physical condition; they appear in certain circumscribed diseases of the
cerebrum and cerebellum or from cysts, tumors, abscesses, hemorrhages
of the brain and in certain forms of poisoning or from distemper,
slight convulsions, etc., but this subject will be taken up in detail
later on.

Dulness or total indifference to external influences, staring expres-
sion of the eye, a slow staggering gait, sleepiness or coma (entire
unconsciousness), are seen in the various diseases of the brain and its
coverings, from injury to the skull, or to shock, in serious infectious dis-
eases, such as distemper, septicaemia and infectious hemorrhage, gastro-
enteritis, in poisoning by some narcotics, or uraemia, acute jaundice,
acute anaemia and in all diseases that are terminating fatally.

In some cases we see short attacks of unconsciousness brought on
by great excitement and pain, as in surgical operations, cysts in the
brain, anaemia, continued hemorrhage, abscess or tumors in the brain,
effects of certain poisons, etc.; for further information on this subject see
article on the examination of the nervous system. In making an exami-
nation of the physical condition of an animal, we must always take into
consideration the fact that the symptoms may be very much modified
by the presence of strangers or the veterinarian; on the other hand, pet
dogs may often hide certain symptoms, or from fear may present symp-
toms that are very much exaggerated.

Very sick animals will not rise when called by a stranger or even by
the owner when a stranger is present, while a healthy animal will rise
or bark, and show its presence in various ways. The position of the

GENERAL EXAMINATION 3

animal when lying down is to a certain extent a diagnostic symptom.
Dogs which are affected by lateral or one-sided diseases of the chest, for
instance, lateral pneumonia, pleurisy, or pneumothorax, ;vvill take a sitting
position or lie on the sternum with the legs under the body.

THE STRUCTURE AND CONSTITUTION OF THE BODY.

The development of the skeleton may be used as a basis for deter-
mining what sort of constitution an animal has, at the same time taking
into consideration the great difference there is in form between the differ-
ent breeds of dogs in the strength and shape of the bones; we can fre-
quently obtain some diagnostic information concerning a defective con-
stitution from the following indications: of softness of bones, there are
flat non-arched ribs, a narrow chest, a marked change in the shape of the
skeleton, the swelling of the ends of the ribs at the union of the bone to
the sternum, by the contortions of long bones, and a swelling of the joints
as seen in all rachitic animals. For further information on this subject see
the article on the examination of the respiratory apparatus. In rare
instances there is a marked deformity of the spinal column, an upward
curvature (kyphosis) , a lateral curvature (skoliosis) , an upward and lateral
curvature (kyphoskoliosis) , and a downward curvature (lordosis) .

THE NUTRITIVE CONDITION.

The general condition may depend, to a large extent, on the age of
the animal, how he has been fed, and the amount of exercise he has had,
but, as a general rule, if the animal's condition is poor, it is due to the
presence of some disease. The skin, to a certain extent, is a diagnostic
guide; if the animal is healthy the skin will be loose and pulled easily from
the different parts of the body, whereas in disease it is tight and loses its
softness and smooth feeling to the fingers. The body loses its symmetry,
the eyes are sunken in their sockets. In slight cases of emaciation we
must depend, to a certain extent, on the history of the cases from the
owner. Weighing the animal is also useful to determine whether an
animal is gaining or losing during the course of treatment; this is especi-
ally valuable where the animal is being reduced in cases of plethora, or in
convalescence from acute disease; the gain shows that the animal is im-
proving; but at the same time we must not lose sight of the fact that we
may have an increase of weight from csdema, or any dropsical condition.
A rapid emaciation is seen in diseases of the digestive apparatus, in all
acute and chronic feverish affections, in certain cases of poisoning, and in
rabies. A gradual loss of flesh may be seen in cachexia, as a result of
chronic infectious and constitutional diseases, such as tuberculosis, leu-

4 GENERAL EXAMINATION

kirmia, diabetes, carcinoma, and in chronic nephritis. A slight loss of
flesh is also seen following surgical operations. As an opposite to ema-
ciation, we may see a rapid accumulation of adipose tissue; this may
occur from laziness, a disinclination to take exercise or resist it when
forced to do so, or to close confinement where the animal is the pet of a
sick person. Disturbances of the respiratory and circulatory apparatus
have a tendency to produce accumulations of fat in the abdominal and
thoracic walls, in the pericardium, and in the heart.

THE MUCOUS MEMBRANES OF THE HEAD.

In making a general examination, the first thing to do is to examine
the visible mucous membranes, to see the color of them, the conjunctiva,
and also of the mouth and throat. It is best to examine more than one
mucous membrane, as the examination of one only may lead to an error
in diagnosis. Rapid exercise, particularly in hot weather or in high wind,
may produce a temporary congestion of the mucous membranes. Red-
dening of the eyes is often a perfectly normal condition in some breeds of
dogs. Abnormal paleness of the mucous membranes may be due to
decrease in the amount of blood in the system from severe internal or
external hemorrhage, or from slight but frequent hemorrhage internally.
It may be due to decrease in the amount of haemoglobin in the blood
corpuscles, in diseases peculiar to the blood, as in ansemia, leukaemia,
pseudo-leukeemia, and in all diseases producing great loss of fluids, such
as disease of the kidneys, disease of the stomach and the bowels, in tuber-
culosis, carcinoma and also in slow pus formations that are accompanied
with or without fever, in defective heart action, as in collapse, where the
heart's action is, to a certain extent, paralyzed for the time, as in many
acute diseases or violent poisons, or from depressing drugs; also in dis-
eases of the heart and its covering, the pericardium. A blue or cyanotic
coloring is sometimes seen where there is defective oxygenation of the
blood and it is loaded with carbon dioxide. This is also seen where the
blood in the lungs does not come in contact with oxygen, as in contract-
ion of the trachea or larynx, or by the inflammation or swelling of these
parts, foreign bodies, internal or external tumors, pressing on the air-
passages; also in acute bronchitis, in the various forms of pneumonia, in
large pleuritic exudates, in hydrothorax, in severe ascites where the dia-
phragm is pressed on, in rigidity of the muscles, as in eclampsia in bitches,
in strychnine poisoning, and in some heart affections; in cases of defective
blood circulations in the capillaries, from disease of the heart, especially
if there is fatty degeneration; from defective valvular action, from depos-
its on them; from pericardiac exudates; from the action of poison acting
directly on the heart; or from some injury or pressure on the jugular; in

GENERAL EXAMINATION " 5

diseases where there is a great accumulation of blood in the head, as in
acute hypcrsemia of the brain and inflammation of the brain. In the
latter case the redness of the mucous membrane is lighter in color or
more of the arterial tint. A yellow color (icteric) generally denotes some
disorder of the liver, such as gastro-duodenal catarrh, causing a swelling
and obstruction of the ductus choledochus; occasionally, from calcareous
deposits or foreign bodies in the bile-ducts or the presence of tumors that
press on the bile-ducts. In rare instances these yellowish discolorations
may be due to disturbances of the liver cells, or from such poisons as
phosphorus and, in extremely rare cases, from mycotic meat poisoning
and infectious diseases. The icterus which appears in phosphorus poison-
ing is due to biliary engorgements, and decomposition of the blood.
Various spots or red patches known as petechial spots are seen on the
mucous membranes of the head. These are a valuable aid to diagnose
certain internal diseases, such as phosphorus poisoning, scurvy, meat
poisoning, and in septicaemia.

The nasal and buccal discharges are treated fully under the head of
Examinations of the Digestive and Respiratory Apparatus. We will
only consider here such discharges from the eye as seen in very sick
animals and are due to acute febrile disturbances. In some cases the pad
of fat that fills the posterior part of the orbital cavity is very rapidly
absorbed and the eye has a sunken look; the fever may produce an irrita-
tion of the mucous glands surrounding the eye and cause the accumula-
tion of a profuse mucous discharge, varying in color from gray to grayish-
yellow, seldom pure yellow. This accumulates about the corners of the
eyelids, or may even close and glue up the eyelids entirely; this is not a
symptom of true conjunctivitis, but some acute disorder involving the en-
tire system. For further information see chapter on Diseases of the Eye.

SKIN AND SUBCUTANEOUS MEMBRANE.

The skin presents a number of conditions which are diagnostic.
Of course, there are a number of local diseases of the skin which are
treated in detail in section on Skin Diseases. The skin-changes in color are
seen mainly on the belly and inner fascia of the thigh; a reddened or
slightly yellow color is to be classed under the same head as if it had been
present on the mucous membrane; that is, if the skin is very red it indi-
cates a high temperature or the commencement of some sympathetic
skin eruption; or if it is yellow it indicates some disturbance of the liver or
portal system. In cases of distemper we often see a pustular eruption on
the abdomen and inner fascia of the thigh (the exanthema of distemper —
dog-pox) ; this is a very prominent diagnostic symptom of the disease. The
skin of a sick dog is very dry and hard, it is very hot in cases of intense

6 GENERAL EXAMINATION

fever, and cold in animals that are very much debilitated, or after severe
external or internal hemorrhage, or collapse from shock. In fat dogs the
skin has a very unpleasant greasy feel to the touch. An unfavoraljle
symptom of disease is when a fold of the skin is lifted by the hand and
remains in the same position when released. Profuse perspiration is
rarely seen in dogs except where they may have been badly frightened.
Dogs do perspire constantly, but it is insensible perspiration.

The hair is also a useful guide in diagnosis. In sick, badly fed, or
neglected animals, or if they are infested with parasites, it loses its gloss,
becomes dry and brittle, breaking easily, and in some cases falls out par-
tially or entirely. As a rule, in all dogs that have undergone a severe
illness, the hair falls out to a large extent; in bitches that have nursed a
large litter of puppies, the hair falls out in large Ciuantities after weaning.

Fig. 1. — Dog with a?deina of the skin. + marks indentation made bj' the pressure of the finger.

The odor of the skin is sometimes very offensive, especially in dogs
suffering with distemper and septicaemia, meat poisoning, infectious
hemorrhagic gastro-enteritis, and certain skin affections, and in animals
that are neglected and filthy.

CEdema and emphysema of the skin are very important diagnostic
points. By oedema or dropsy of the skin (anasarca) we understand it to
be an abnormal accumulation of fluids in the skin and the subcutaneous
cellular tissues. This condition is caused by the fluids not being reabsorbed
by the lymph vessels in the same proportion that they come out of the
blood vessels. We recognize oedema by a swollen or bloated, painless,
cool condition of the skin, with the obliteration of all wrinkles; if the
swelling is pressed with the finger, the indentation remains visible for
sometime (Fig. 1) ; this may come from a number of diseased conditions,
and it is seen sometimes over the entire body, but chiefly in the lower

GENERAL EXAMIXATIOX 7

portions of the body and extremities, testicles, prepuce, scrotum, abdomen,
and chest. It occurs as a complication in diseases of the heart, especially
where there is imperfect valvular action, in acute and chronic disorders
of the kidneys and cirrhosis of the liver and in the majority of prolonged
acute affections. In rare instances it is caused by true diseases of the
blood — anaemia, leukaemia, and pseudo-leukaemia, abdominal dropsy,
hydro-thorax, and dropsy of the pericardium.

The oedema which appears in the locality of an inflammation (collat-
eral cedema) is of special interest to the surgeon, as it is the only visible
symptom of the inflammatory process that is going on under the skin.
CEdema may be also seen as a result of the pressure caused by tight or
improper bandaging.

Emphysema of the skin is where the skin looks as if there was air in
the subcutaneous tissue. As a rule it is confined to small circumscribed
parts of the body, but it has been observed by the author where the whole
body has been involved. There is an intense swelling of the parts, and
on pressure with the finger the indentation, unlike oedema, immediately
disappears. On rubbing over the parts with the hand a slight crackling
sound can be heard and felt; on pressure, the air can be driven from the
affected portion into the subcutaneous or other tissues beyond the border-
line. This condition may be caused by the admission of atmospheric air
from the outside into the subcutaneous tissues, by means of small wounds
in the skin, especially in the neck, wall of the chest, and the head, and gas
or air from some of the internal organs by a perforation of their walls,
such as the larynx, trachea, oesophagus, the bowels, or stomach. In
cases where there are perforating wounds of the chest, wounds of the
larynx or windpipe, or from fractures of the ribs, with complicated in-
juries of the lungs. Emphysema may also occur from gas formed by
breaking down the contents of abscesses or hemorrhagic infiltrations.
In malignant abscesses, we find the swelling is doughy and painful, the
enlargement becomes crackly and septicaemia develops.

Increased Temperature of the Body.

The normal temperature of the dog taken at the rectum differs from
37.5 C. to 39; as a rule, younger animals have a higher temperature than
adults. The normal temperature in young animals is generally about
39.2 and 39 in older animals. The vaginal and rectal temperatures are
practically the same. The prepuce temperature is about 1.5, and the
skin temperature at the warmest places on the body about 1° lower than
the rectal temperature.

The author, after a series of observations covering over a large num-
. bcr of animals, finds the above to be correct and particularly as far as the
prepuce, vagina and skin temperature is concerned.

8 GENERAL EXAMINATION

The following averages were obtained from a series of temperatures
taken from both normal and feverish animals: 1, in the bitch the average
difference between the rectum and vaginal temperatures was about 0.06
and 2, in the male the difference between the rectum and prepuce was 1.43;
some cases when the animal became nervous or excited, when the pre-
puce temperature was taken and the penis became erected, this increased
the temperature up to 40, so that it will be seen that it is not advisable
to take the temperature from the prepuce, as the difference may range
from 2 to 3 degrees.

The average difference between the axilla and the rectal temper-
ature is 0.93 and between the inguinal temperature and the rectal is
0.81. The method for taking these temperatures is as follows: Place
the thermometer in the so-called axillary groove (arm-pit) and inguinal
groove (the hollow between the thigh and scrotum in males and between
the thigh and mammary glands in the bitch), firmly hold the ther-
mometer for five minutes so that the mercury end of the thermometer will
be covered by the folds of the skin. Where you have to take the tem-
perature in these two localities one degree should be added to the therm-
ometer reading. As a rule the temperature of the normal animal is higher
in the evening, and slightly higher after a hearty meal, violent exercise,
lying in the sun or near the fire. The rectal temperature, so-called body
temperature, is taken by means of a maximum or clinical thermometer,
the thermometer is slightly oiled, or the anus may be oiled and the
thermometer placed as far as possible into the rectum (allowing a small
portion of the instrument to protrude to facilitate removal) ; allow it to
remain for at least five minutes. Hard dry pieces of excrement or a
highly inflammatory condition of the bowels may prevent the ther-
mometer from giving the exact temperature of the body. In severe cases
it is always advisable to take the temperature at least three times daily,
morning, noon and in the evening, and care must be taken to carefully
note any change in the reading of the thermometer. The temperature
must be kept on a temperature chart, and can be watched with a great
deal more certainty than trusting to the memory. Any change in the
temperature as indicated on the chart, either rise or fall, indicates some
change in the animal's condition, and should be considered a symptom.
As soon as we detect an increase of the temperature of the body above
the normal that we know is not due to overheating or too great exertion,
we define it under the name of fever.

The course and severity of a fever are regulated according to the
amount and character of the fever-producing substances (pyrogenes),
which have penetrated into the blood-circulation. In some cases we may
have a rapid increase in the temperature (fever-paroxysm) ; this is often
observed in the early stages of distemper or where some tissue has com-

GENERAL EXAMINATION 9

menced to suppurate. In cases where the temperature remains the same
it is called a continuous fever, and if it does not change more than 1°
(celsius) it is known as a remittent fever; but when it is found that it
varies greatly, oscillating between a very low, subnormal and a very
high abnormal temperature, it is called irregular or atypical fever.

A constant and prolonged high temperature is very rarely seen in
the dog. The temperature, as a rule, in early stages of all acute diseases
rises ver}^ quickly, but it generally falls slowly as the disease advances,
notwithstanding the complications, and may reach a normal or frequently
a subnormal condition. In cases of septicaemia, which is rather a common
disease in the dog, we may see an abrupt lowering of the temperature
below the normal and continue so, the animal falling into a state of coma
and death follows in a short time.

A fever, as a rule, begins with a chill or a number of them; this is a
shivering or quivering of the muscles and skin and finally of the whole
body. These chills come on at intervals. The rise in the temperature is
not always an accompaniment of the fever, as has been shown in cases of
septicaemia; we must, therefore, always take into consideration the other
symptoms of fever. These are: shivering, cold, increase in the number
of the pulse and respirations; the digestion is immediately impaired and the
urine is changed in quantity and composition. All the secretions and
excretions are altered from the normal and the nerve-centres show
increased irritability. The changes in the pulse and respiration are
fully described under the head of Examination of the Circulatory Appara-
tus. The changes in digestion are seen in the entire loss of appetite, con-
stipation, and increased thirst. The kidneys show the effects of the
disturbance by the decrease in the amount of the urine secreted, a much
higher specific gravity, and a decreased amount of the chlorides in the
urine, an increase in the amount of urates, and a high acid reaction. In
nursing bitches the milk is much lessened in quantity, the skin becomes
dry and firm, and the sebaceous glands almost cease secreting. The
nerve-centres show the effect by the dulness of the animal and the indiffer-
ence to surrounding objects or persons, and great restlessness and twitch-
ing of the muscles. If the temperature is high, the animal becomes
weak and falls away in weight very rapidly.

A Temperature Below Normal (Subnormal) of the Body.

A subnormal temperature is often observed in cases where the
crisis or highest temperature has passed and the animal is going on
toward recovery or convalescence. In the majority of cases, as the
temperature goes down the pulse lessens, the respirations become even
and regular, the appetite begins to return, and the animal shows more

10 GENERAL EXAMINATION

interest in its surroundings. In collapse there is a rapid fall of tempera-
ture, and the heart's action, as shown by the pulse, becomes weak and
fluttering and soon imperceptible; the mucous membranes are pale, and
the animal weak and even paralyzed. There is also a subnormal tempera-
ture in great hemorrhage, in acute and chronic diseases, in icterus gravis
(acute congestion of the liver, with yellowness of the mucous membranes),
in all acute diseases of the brain, in various cases of poisoning, in latter
stages of distemper, and in septicaemia, in infectious hemorrhagic gastro-
enteritis.

In increase or decrease of the local temperature; increased heat of the
part is generally due to some injury or some surgical disease, and, as a rule,
has with it tenderness to the touch and swelling. A local heat can also be
felt in all inflammations that are not located too far from the surface of the
body. Coldness of any part indicates an impaired circulation in the part.
In all cases of collapse the extremities are the first to become cold, because
of the impaired action of the heart. In cases of compression of an artery
by ligatures, or tumors, pressing on the blood vessels, an embolus, or
thrombus, the part of the body that has thus lost its circulation becomes
cold from impaired circulation. Paralyzed extremities are always slightly
colder to the touch than active parts.

DISEASES OF THE DIGESTIVE APPARATUS.
EXAMINATION OF THE DIGESTIVE APPARATUS.

In making an examination of the digestive apparatus we have to
consider the following points:

The appetite; the method of giving the food in different animals
varies very much, also is influenced to a large extent by the quality of
the food, the way in which it is presented to the animal. The age, the
use to which an animal is put, such as a hunting dog or the laboring dog
of Belgium and other European countries, the breed; size also has an
influence on the amount of food eaten by the animal and the quantity of
water it drinks. Some animals have a strong appetite, eat large quan-
tities, digest it well, whereas others are dainty eaters, eat small quanti-
ties, and are easily satisfied.

A loss of appetite may result from a number of causes; mainly, from
the presence of a fever in the system, by disorder of the stomach and
digestive apparatus, lack of food, cold, chilliness, poisons, and in conse-
quence of such diseases as distemper, infectious hemorrhagic gastro-
enteritis and septicaemia. An abnormal increase of the appetite may be
seen in diabetes mellitus and by the presence of tape-worm. A depraved
appetite is seen in rabies, when the animal will eat straw, wood, stone,
I'ags, and faeces, but we must also take into consideration the fact that
young animals, particularly in puppies, when they are teething, between
the ages of four and ten months, will pick up small indigestible objects,
such as buttons, pieces of tape, muslin, coal, wood, etc. All dogs, par-
ticularly if the stomach is upset, will eat grass, and also in some cases they
show a depraved appetite by eating horse droppings or decayed objects,
and the well-known habit dogs have of chewing bones. When the animal
has great thirst, drinking large quantities of water, it may indicate
diabetes insipidus, and mellitus, chronic nephritis, dropsy (ascites), or
exudative pleuritis. As a result of acute and prolonged diarrhoea,
decayed meat poisoning, catarrh of the stomach and in cases of irritation
of the stomach, the animal drinks large quantities of water and immedi-
ately vomits it again.

In certain diseases, particularly of the mouth and throat, such as
irritations of the mucous membrane of the mouth, stomatitis, decayed

DISEASES OF THE DIGESTIVE APPARATUS

teeth, tumors or foreign bodies in the cavity of the mouth, raniila, in
di.seases of the masseter muscle, buccal membrane, maxillo-temporal
articulation, the animal is unable to eat large pieces of food, taking only
small finely cut-up food or liquids.

Difficulty in swallowing may be present in all the conditions already
mentioned and in some cases the animal will drop the food out of the
mouth after it has taken it up. Inability to swallow may be seen in

Fig. 2. — Larj'ngoscope.

inflammation of the pharynx and larynx, in the paralytic stage of rabies,
as the result of certain poisons, such as meat poisons, in periods of brain
disease, injury to the mouth and throat, tumors or foreign bodies in the
throat or larynx, contraction or ossification of the larynx, in tetanus,
large swelling in the region of the neck and goitre.

Fig. 3. — Pocket electric light.

Condition of the Mouth and Throat.

The examination of these parts requires a good light such as day-
light, or a clear lamp when the posterior part of the throat has to be
examined. This can be accomplished by means of a perforated laryn-
geal mirror or any reflecting mirror (Fig. 2), or a portable electric
lamp (Fig. 3). The best method of opening the mouth with the hands is
to grasp the upper jaw with one hand, pressing the cheeks between the
teeth, which forces the mouth partially open and prevents the animal
closing the mouth, and with the other hand pull down the lower jaw.
Another method to obtain a good view of the interior of the mouth is to
put two strings or tapes around the lower and upper jaws (Fig. 4) ; lay the

EXAMINATION OF THE DIGESTIVE APPARATUS 13

dog on his side or, what is better, directly on his back and throw the light
into the cavity of the mouth. The mouth and a large part of the throat
can then be easily examined. In nervous or uneasy animals we can
use a speculum (Fig. 5) or a gag if the mouth has to be kept open for
some time; it is best to use a gag which can be placed between the teeth
on one side, or by means of a wedge-shaped piece of wood. In certain

Fig. 4. — Holding the mouth open with tapes.

operations of the interior of the mouth and teeth a wooden bar held in
place by means of a chain is used (Fig. 6). When the deeper portions
of the mouth and throat are to be examined the mouth is opened, and by
means of the finger, a spatula, or the handle of a spoon, the tongue is
depressed. A good view of the posterior of the throat can be obtained by
grasping the tongue with forceps and pulling it forward.

In cases where the mouth remains partially open, the animal being
unable to close it, we must examine it very carefully, as it may be a
symptom of rabies; of some brain disease; secondai'y stages of distemper;
in some bacterial poisons, severe injury of the mouth or in fracture of the

DISEASES OF THE DIGESTIVE APPARATUS

inferior maxillary. It may also be due to some foreign bodies located
between the teeth or some strain of the articulation of the inferior maxil-
lary. In paralysis of the jaw, the mouth can be closed by putting a stick

Fig. 5. — Mouth speculum.

under the jaw and lifting it; this cannot be done in cases of luxation of
the articulation or where there is some foreign body between the teeth,
such as bones or pieces of wood. The mouth cannot be opened com-
pletely in trismus (tetanus) or in partial anchylosis of the articulation; the

Mjig^

Fig. 6.— Gag.

introduction of the speculum being very painful in some cases of tooth-
ache. In injuries of the various masticating muscles, disease of the ar-
ticulation of the jaw and infectious hemorrhagic gastro-enteritis. If the
speculum iy introduced frequently, the mouth may remain partially open.

EXAMINATION OF THE DIGESTIVE APPARATUS 15

On opening the mouth, if there is a very offensive odor coming from it, it
indicates either an ulceration of the mouth, due to ulcerative stomatitis,
which has erroneously been called scurvy, disease of the teeth and in cer-
tain diseases of the stomach, in dyspepsia, foetid bronchitis, or in gan-
grene of the lungs; it is frequently noticed in animals which are very sick,
where the mouth is filled with unhealthy mucus or where particles of
food lie in the mouth or throat. In infectious hemorrhagic gastro-
enteritis, a very offensive odor is noticed. In cases of poisoning, by
phosphorus, or prussic acid, the odor of the drug is frequently detected in
the breath. On examining the teeth and gums we may see large ossific
deposits of the alveolar process (dental alveolar periostitis) causing sepa-
ration of the gums and loosening of the teeth. An intensely inflamed
state of the gums, where they are bleeding and ulcerated, indicates
ulcerative stomatitis, mercurial poisoning, or scurvy; very often tumors
(epulides) are found on the inner border of the incisors and interfere
more or less with eating. Very frequently foreign bodies lie between the
teeth, causing increased flow of saliva. The cutting of the milk (tempo-
rary) teeth and a change of dentition (cutting of the permanent teeth)
may cause intense inflammation of the entire mouth. The tongue is
examined; it may appear dry, paralyzed, and in some cases shrunken and
lie on the floor of the cavity of the mouth; from paralysis of the tongue as
a result of distemper, disease of the brain, or infectious hemorrhagic gas-
tro-enteritis. The author has noticed paralysis of the tongue in acute
convulsions. The tongue may be greatly swollen and enlarged in acute
inflammation of the mouth, or from parenchymatous inflammation of
the tongue. Foreign bodies, such as needles or sharp objects may pene-
trate the tongue. Sometimes wounds and scars may be noticed on the
edges of the tongue in dogs suffering from paralysis of the masseter muscle
and by biting the tongue when the animal is in a convulsion. The color
of the tongue is a deeper red from fevers, inflamed conditions of the mouth ,
and certain heart affections. A cyanotic (reddish-blue color) is seen
when the animal is partially suffocated. The tongue is coated as a result
of most fevers, but it is also observed in animals which are perfectly
healthy. A heavy coating of the tongue is noticed in stomatitis, gastric
catarrh, and in acute internal diseases; also in acute cases of distemper.
In infectious hemorrhagic gastro-enteritis, the tongue is frequently
covered with a dirty-brown coating. As a rule, a paralyzed tongue lies on
the floor of the cavity of the mouth. In gangrene of the tongue that
organ is swollen bluish-gray. The tip of the tongue may sometimes be
bluish-black, caused by being bitten or being maliciously tied with a
string. A bluish-red discoloration around the edge of the tongue may
be due to distemper, stomatitis, infectious hemorrhagic gastro-enteritis
and various other causes.

16 DISEASES OF THE DIGESTIVE APPARATUS

After administration of violent poisons the mucous membranes of
the cheeks and inferior surface of the tongue are found to be gray in
color, hanging in shreds, and intensely inflamed, and later abscesses form
on the sloughed parts. This is observed in infectious hemorrhagic gastro-
enteritis, stomatitis, and distemper, as a result of decayed teeth and
formation of abscesses on the mucous membrane of the cheeks. Ranula
appears on the floor of the mouth-cavity on one side of the tongue; it is
long and oval, sometimes the shape of a goose egg; the sac is a fluctuating
swelling with a thin wall. Small whitish enlargements resembling warts
frequently appear on the mucous membrane of young dogs. They are,
however, of little or no importance. The salivary glands are frequently
swollen and abscesses form in their structure. As a result of these irrita-
tions we may have colloid infiltration of the glands, and after
inflammation, they become indurated, the secretion of saliva is some-
times greatly increased and runs out of the mouth in long, thready
strings; this is also seen in all inflammatory conditions of the mouth or
where there is an abscess located in the mouth or throat during teething;
in cases of mercurial poisoning, and from some caustic poisons, and
after the hypodermic injection of pilocarpine. From inflammation of the
pharynx, rabies, and by certain parasites burrowing through the tissues
of the body.

The secretion of saliva is lessened during all fevers, and from the
effects of some poisons, fevers, diarrhoea, and after the injections of
atropia.

The saliva is bloody after injuries of the mouth. It may be slightly
stained with blood from stomatitis, scurvy, infectious hemorrhagic gastro-
enteritis, and gangrene of the tongue. The soft palate and pharynx are
sometimes the seat of acute or chronic inflammations, and sometimes we
find abscesses of these parts from the presence of foreign bodies (needles,
splinters of bone or wood) . It is well to feel these parts when making an
examination. The tonsils are affected, as a rule, in all cases of pharyn-
gitis. It generally protrudes from the side of the base of the tongue in a
dark-red, sausage-like formation. The subparotid lymphatics are invari-
ably found to be swollen, in all cases of inflammation of the pharynx.

Examination of the (Esophagus.

The oesophagus protrudes from the pharynx on a level with the
first cervical vertebra. The anterior part of it lies between the wind-
pipe and the longus colli in the median line of the neck. It extends from
there to the left side of the windpipe and passes to the right side of the
aortic arch between both membranes of the mediastinum, in the shape
of a flat arch, and perforates the diaphragm at the twelfth dorsal vertebra

EXAMINATION OF THE DIGESTIVE APPARATUS 17

and reaches the stomach at the left side. The width of the oesophagus is
not regular in its entire length, being narrower at the region of the pharynx
and at the cardiac and just before it unites with the stomach.

The oesophagus is examined externally by the hand (palpation),
or internally by the pharyngeal sound or probang, and we may find trau-
matisms, tumors, foreign bodies (pieces of bone, wood, large pieces of food)
which become lodged in the oesophagus generally just beyond the
pharynx in the region of the neck, where they can be easily felt by the
hand. The thyroid gland is sometimes enlarged from local inflamma-
tion, struma, or carcinoma and care must be taken not to mistake this
for a foreign body. Very frequently we find the lymphatics of this region
are enlarged. Carcinomas or sarcomas are sometimes found along the
course of the oesophagus.

The introduction of the laryngeal probang is comparatively easy
in the dog. The best probang is one less than the size of the little finger
and it must not be too flexible, the length should be from 20 to 30 cm.;
this size, of course, is for the ordinary sized dog; in very small animals
the ordinary sized urethral catheter can be used. Care must be taken
to have the probang perfectly smooth and uniform in diameter. If the
probang is very stiff it may be made more flexible by rubbing it briskly
with a towel or putting it in warm water for a few seconds. The
method of introducing the probang is as follows: The mouth is held open
as described on page 12; the head is extended and it is introduced along
the upper wall of the throat, keeping it high up so as to avoid the larynx.
If the probang should slide into the trachea instead of the oesophagus and
cause dsypnoea, the instrument must be instantly withdrawn. The
animal will attempt to swallow it, but that will assist the sounds. It will
glide along easily until the obstruction is reached, or glide directly into
the stomach. In cases where there is a foreign body in the oesophagus the
probang will come against it, preventing the instrument going any
farther. Great care must be taken at this juncture not to push the pro-
bang too hard as it may lacerate the walls of the oesophagus, particularly
if there is a stricture or a tumor; or if it is a foreign body, it may cause it
to be more firmly imbedded or the probang may rupture (perforate) the
w^alls of the oesophagus.

Examination of the Stomach.

Baum, who has made a careful study of the position of the dog's
stomach, finds when the stomach is filled with food, its outlines can be
easily recognized by palpation (Fig. 7). It lies in the left side of the
abdominal cavity, the inferior portion resting on the liver and the ante-
rior portion against the diaphragm, the left surface going toward the
2

DISEASES OF THE DIGESTIVE APPARATUS

abdominal wall, but between that and the wall lies the left lobe of the
liver. This left lobe extends as far as the pelvis, coming close to the left
kidney; the left or cardiac end of the stomach extends as far as the ninth
rib and posteriorly as far as the thirteenth rib and the anterior border of
the left kidney. The right or pyloric end of the stomach is directed on
the median line to the right. The larger part of the stomach is enclosed
by the liver and the diaphragm coming in contact with the anterior side.
The cardiac end of the stomach is directed toward the median line and
the pyloric toward the right. The empty stomach (Fig. 8) extends
anteriorly as far as the left pillar of the diaphragm and toward the chest
as far forward as the tenth rib and posteriorly as far as the twelfth rib,

Fig. 7. — Section through centre of abdomen.

and is completely covered by the liver on the left side. Only a very small
part of it comes in contact with the diaphragm and the inferior face of the
ninth and tenth dorsal vertebra. The pyloric opening is directed toward
the right and very slightly forward (Fig 9). When the stomach is
very much distended with gas or food, it comes almost directly in contact
with the abdominal walls, and when greatly distended it extends as far as
the umbilical region and lies against the ribs and the left abdominal wall
and the left and ventral lobes of the liver being pushed almost entirely
away from the surface of the stomach, depending on the amount of the
distention.

From the above anatomical details it can be readily seen that it is
nearly impossible to make a reliable examination of the stomach when it
is empty or even when it is fairly well distended. The cardiac and pyloric

EXAMINATION OF THE DIGESTIVE APPARATUS

openings are so deeply seated they are extremely hard to examine. To
make a manual examination of the stomach, the animal nmst be placed

Fig. 8. — Position of stomach when empty.

in a standing position or sitting in the favorite position of the dog, that is,
resting on the hind legs. The finger is pressed into the abdomen back of
the xiphoid cartilage or on the right side beneath the cartilaginous ends of

Dorsal vertebrae.

Lumbar vertebrae.

Fig. 9. — Position of stomach when full.

the ribs; the digital pressure at first may be gentle, but this can be in-
creased until the stomach is outlined.

When a very careful examination has to be made to detect the

DISEASES OF THE DIGESTIVE APPARATUS

presence of foreign bodies or tumors in the stomach, the author proceeds
in the following manner: Place the dog on his back and if difficult to
handle, or vicious, narcotize it, and press the fingers on the abdominal
walls; at the same time an assistant can bring the front and hind legs
together, bending the spine as much as possible. This position relaxes
the abdominal muscles and the stomach can be easily outlined and its size
felt. A distended or engorged stomach can be recog-
nized by palpation or when the abdominal walls are
relaxed the stomach can be easily detected lying in
the umbilical region and extending under the false
ribs. If the distention is due to gas it can easily be
recognized by the tympanitic sound on percussion; if
the distention is due to the presence of some fluid it
will be indicated by fluctuation. Great distention
of the stomach by gas is found as a result of certain
poisons, stenosis of the bowels and in alteration of
the normal position of the stomach. Great ac-
cumulation of gas is seen in the stomach in gastric
catarrh, but it may also be present in an entirely
healthy stomach. The contents of the stomach may
feel soft or doughy according to the quality of the
food, and how it was prepared, w^hen eaten. The
normal condition of the stomach after eating is that
of slight distention. Pyloric stenosis may also cause
distention of the stomach. Tumors on the wall of
the stomach are extremely difficult to diagnose, ex-
cept perhaps in small animals where the tissues are
more elastic and less dense. Foreign bodies of mod-
erate size and of some dense structure can be felt in
the stomach, by manipidation. Certain foreign
bodies, such as needles, stones, etc., can be detected
in the stomach by means of Rontgen or X-rays (see description of foreign
bodies in the stomach) . Pain on pressure of the stomach may be produced
by manipulation, but it is not always present; it may be noticed in acute
gastric catarrh, toxic gastritis, infectious hemorrhagic gastro-enteritis.
It must be remembered, however, that it is only the filled or distended
stomach that can be felt, due to the lobe of the liver lying between the
stomach and the abdominal wall and pain on pressure may indicate some
disorder of the liver and not of the stomach. Consequently, in making a
diagnosis we must include other observations, particularly an examination
of the contents of the stomach.

We can obtain the contents of the stomach either by the substance
which the animal may vomit itself or by means of the stomach-

FiG. 10. — Stomach-pump.

EXAMINATION OF THE DIGESTIVE APPARATUS

pump. This has been recommended by Frick, and only for therapeutic
purposes.

The stomach-pump is operated in the following manner: In large
dogs an ordinary horse catheter is used and in small dogs a large male
human catheter or a small rubber hose. We pass the catheter, as de-
scribed in the examination of the cesophagus, into the stomach and to the
free end of the catheter or rubber hose, which' should be about 30 cm.
long, we put a small funnel at the other end of the tube (Fig. 10). Pour
a certain amount of water into the stomach through the tube, at the
same time holding the tube high, and then manipulate the region of the
stomach and next depress the tube, and the siphon which has been formed
will soon empty the stomach of its contents. This method is to be used

Fig. 11.

-Contents of the stomach (four hours after eating) : Muscular fibre, starch cells, fat cr>-stals
and cells, round cells, epithelium, vegetable cells, fungus.

in very urgent cases where poison is suspected, but as a rule is very hard
to do except in very quiet animals and where there is a trained assistant,
such as in a hospital; but in private practice the easier wa}- is the better,
that is, to administer an emetic. The best means is to give a dose of
apomorphia hypodermatically.

I^ .\pomorphia hydrochlorate, 0.04

Aqua distil., 4.00

Sig. — Ten to twenty drops hypodermatically.

In a few minutes free vomiting occurs and the contents of the stomach
can then be examined. Of course, you must take into consideration
the time which has elapsed since the animal has taken the food and the
character of the alimentary matter. It would be well, therefore, that
you know the following facts concerning (Fig. 11) digestion in the dog's
stomach:

22 DISEASES OF THE DIGESTIVE APPARATUS

Digestion of a Meat Diet in the Stomach.

After taking a full meal of meat cut in small pieces the digestion
in the stomach is veiy active and free; it increases until the third hour
antl slowly decreases until the ninth, and is nearly over at the twelfth
hour. After eating a very large meal the digestion is somewhat slower
and lasts considerably longer, the different kinds of meat also vary in the
t ime of their digestion. Pork is the easiest to digest and others are classified
in the following order: mutton, veal, beef, and lastly the flesh of other
animals (Astley Cooper) ; skin, tendon, sinew, cartilage, and bones are
very hard to digest; the latter are digested from their surface and are
reduced as the gelatinous parts are acted upon and dissolved and the
lime salts remain unchanged. Fat meat is harder to digest than lean;
fat undergoes no change in the stomach, but passes on and is digested
in the intestines. The gastric juice acts on and reduces roasted meats
and if raw meat is chopped up in small pieces the gastric juice acts on it
much more quickly. It has never been satisfactorily settled whether raw
or cooked meat is easier to digest.

The Digestion of Milk in the Stomach.

Milk is comparatively slow in digestion. After an animal had taken
249 grammes of milk he was destroj^ed four hours later and 13 grammes
of cheese and 1 gramme of fluid was found in his stomach.

Action of Digestion on Hydrocarbonaceous Food.

Five hours after a meal consisting of rice and potatoes the mass was
liquefied and softened; the mashed portion of the potatoes had disappeared
but the lumps remained. After a meal of rice, the following observations
were made: After one hour 10 per cent, was digested, after two hours
25 per cent., after three hours 50 per cent., after four hours 82 per cent.,
after six hours 90 per cent., after eight hours 99 per cent., and at the end
of ten hours it had entirely disappeared (V. Hofmeister).

Both Ellcnberger and Hofmeister have come to the conclusion that
rice is chiefly digested in the intestines, as there is so much muriatic
(hydrochloric) acid in the stomach immediately after eating that sac-
charation cannot take place; and also that the dog swallows his food with
so little mastication that the saliva has no time to make any change in
the starch.

The effect of the disturbance of gastric secretion on digestion is
as follows: When, from any cause, the secretion of gastric juice is les-
sened or altered the following changes are observed: The digestion
of albumin, and the antiseptic and antizymotic action of the gastric

EXAMINATION OF THE DIGESTIVE APPARATUS 23

juice is much lessened, for there is no doubt that gastric juice can destroy
the infectious bacteria that are carried into the stomach by the food;
consequently, the secretion thus being much less acid, with the lessened
digestion of albvimen, fermentation is easily started. When the gastric
secretion is subacid it irritates the mucous membranes of the intestines
and lessens the peristaltic action. Subacidity is frequently seen in all
anaemic diseases, in fevers, in erosion of the mucous membranes, from
the effects of corrosive poisons, in cancer of the stomach, and in chronic
catarrh of that organ.

The digestion of starch is impaired by an oversecretion of hydro-
chloric acid; this condition, according to the researches of Ellenberger
and Hofmeister, is not of great importance, although in man it is fre-
quently seen in ulceration and in acute and chronic catarrh of the
stomach. "Nervous dyspepsia," so common in man, does not seem
to occur in the dog.

In testing the contents of the stomach for free hydrochloric acid the
best reagent is red paper and phloroglucin-vanillin solution. Moisten
a small piece of this paper with a few drops of the filtered fluid-contents of
the stomach. If free acid is present the red color of the paper will turn
blue. This reaction may also occur if lactic acid is present. This,
however, is rarely present in the contents of the stomach. In testing
with phloroglucin (vanillin) place a few drops of the following solution:
PhloroglucinS parts; vanillin 1 part; alcohol 30 parts; with equal quantity
of the filtered fluid of the stomach. Put in a porcelain dish and heat but
do not luring to a boil. If there is free hydrochloric acid present, it will
produce a dark red precipitate; if it is present in a small amount, the pre-
cipitate will be l^right red; if the acid is not present, the precipitate will
be brown or reddish-brown. If methyl-violet solution is used, if a trace of
free acid is present, it will color the solution sky-blue. The test is made
in the following manner: Make a certain quantity of the solution, di-
luting the water until it is light violet. Divide this into equal parts put-
ting into two test-tubes. To one of the tubes add a few drops of the
filtered gastric fluid and if any free acid is present, the solution changes
to sky blue and by comparison with the other tube the amount of free
acid can be approximated, being guided by the change in the color.

Testing with lactic acid is much easier and more certain. The best
method is that of Uffelman: 100 grammes of a 2 per cent, solution of
carbolic acid are to be mixed with one drop of chloride of iron solution,
which makes the mixture deep blue; if a few drops of the filtered contents
of the stomach are added and muriatic acid only is present, it becomes
clear as water; if lactic acid is also present, it becomes greenish-yellow
in color.

In summing up the preceding investigations it is readily seen that

24 DISEASES OF THE DIGESTIVE APPARATUS

the stomach may not be digesting all that the animal eats, but still the
animal be in fairly good health; while, of course, it must also be under-
stood that in fevers or any general disturbance, the digestive powers are
greatly impaired.

Albumin is almost entirely digested in the intestines, the stomach
merely preparing it; fat and starch are digested only in the small intes-
tines; muscular tissue must have a previous preparation in the stomach,
or, if it reaches the small intestines without becoming saturated with
gastric juice, it is not digested in the intestines. No digestion whatever
takes place in the large intestines.

No animal vomits more easily than the dog, and it may be produced
from a number of causes, as a reflex irritation of the stomach, viz.,

1. By irritation of the mucous membranes of that organ by emet-
ics, posions, splinters of bone, or even by overloading. Vomiting
frequently is caused by the animal eating grass.

2. By sympathetic irritation from other organs, intestinal parasites,
uraemia, peritonitis, irritation of the intestines, or uterine inflammations.

3. Vomiting may result from serious coughing spells, as a result of
laryngitis, l^ronchitis, or liquids getting into the larynx.

4. In obstruction of the bowels, foreign bodies blocking up the bowel,
hernia or twisting of the intestines. In some cases of the latter con-
dition excrement is vomited.

5. In the early stages of distemper and infectious hemorrhagic gas-
tro-enteritis, persistent vomiting is almost invariably present.

6. From various brain-affections (meningitis, commotio cerebri).
Very often in certain diseases of the pharynx and where foreign bodies
have become imljedded or fixed about the root of the tongue, pharynx
or oesophagus and in pharyngitis, movements of the throat resembling-
vomiting are frequently noticed.

The amount of vomited matter depends to a certain extent on the
density of the material in the stomach, what it is composed of, and the
cfuantity present in the stomach at the time of the vomiting. In cases
where the animal vomits, when the stomach is full, the vomited material
will either be the food in a uniform pulpy mass, or the mass may be
largely fluid, with the food lying in it, with little alteration from when
it was swallowed. It depends largely on how long it has been in the
stomach and whether the stomach has digested it. When an animal
vomits when the stomach is empty, there generally is a small quantity
of water mixed with the mucus; the color varies greatly according to
the circumstances, white, yellowish-gray, yellow or yellowish-green;
this latter condition depends on staining from bile pigment. Other
colors may also appear. It may be gi'cen from eating grass; violet as
a result of licking a wound or eruption that has been treated with pyok-

EXAMINATION OF THE DIGESTIVE APPARATUS 25

tannin. The vomited material may be streaked with traces of blood,
due to rupture of some capillary vessels of the stomach. For further
particulars see the article on Ha?mostases.

The vomited material varies according to the pathological condit-
ions, from a thin watery fluid to thick mucus. In acute or chronic
catarrh of the stomach it is stringy and glassy. The presence of blood in
the vomited material may be due to the animal swallowing some sharp
foreign body, the action of some corrosive poison, from infectious hemor-
rhagic gastro-enteritis, ulceration of the stomach, gastric ulcer, or we may
see it in hemorrhage of the mouth, trachea or pharynx, where the animal
swallows the blood and vomiting it again may lead to a mistaken diag-
nosis of infectious hemorrhagic gastro-enteritis. This may also occur
when an animal licks a wound and thus swallows a large amount of blood
and then vomits it. In hemoptysis (bloody cough from the respiratory
organs) it is frothy and a bright color. In hematemesis (vomited blood) ,
the blood is dark, varying from a dark red-brown to a dark brown. In
rare instances where abscesses form in the pharynx, oesophagus, stomach,
or the region adjacent to that organ, when they break they may cause
vomiting and the material vomited is stained with blood. Fa?cal ma-
terial is sometimes vomited up in the latter stages of obstruction of the
bowels and in acute diffuse peritonitis.

Vomited material is generally acid in reaction but it is alkaline in
poisoning by alkalies, and in severe hematemesis. Vomited material is
generally pungent and unpleasant, particularly when there is a collection
of fatty acids in the stomach, and very offensive when fsecal material
or putrid meat is vomited. This also occurs in rare instances, from
violent poisons, and in carcinoma of the stomach, etc. A foul odor may
be given to vomited material in cases of injury of the pharynx and oesoph-
agus. In cases of certain poisons, the characteristic odors of the drug
can be detected, as in the case of phosphorous, carbolic acid, iodoform,
or hydrocyanic acid. Internal parasites are frequently found in vomited
material.

Eructation of gas (belching) is frecjuently seen in perfectly healthy
animals, particularly when they rise and stretch themselves. It is also
seen in catarrh of the stomach.

Physical Examination of the Bowels (Intestines).

The examination of the intestines can either be made through
the abdominal wall or the rectum. The situation and size of the various
abdominal organs can be seen approximately in Fig. 12.

The manual examination of the intestines is made in the following
way: The animal is put in a standing position and placing one hand

DISEASES OF THE DIGESTIVE APPARATUS

on the abdominal wall and the other hand on the other side of the body-
directly opposite, a steady pressure is brought to bring the hands to-
gether and the ends of the fingers are moved from one position to another
and thus outline and palpate the different portions of the intestines.
While doing this, attention must be paid to see if the animal winces or
evinces pain, and whether it is slight or intense. By this means we dis-
cover abnormal accumulations of fa?cal matter in the large intestines,
also whether there are any foreign bodies or tumors in the intestines.
Intense pain is shown in the early stages of diffuse peritonitis, and in a
milder degree, but still very acute, in toxic enteritis, complete obstruction
or stenosis of the bowel, and in infectious hemorrhagic gastro-enteritis.

Fig. 12. — Intestinal canal of the clog. BZ, Caecum; Bs, pancreas; G, colon; H, ileum L, jejunum,
M, stomach; md, large intestine; Z, duodenum; 1, curve of the duodenum; 1' flexures of the large in-
testine; 2, convolutions of the small intestine; 3, anus; 4,4, anal glands; 4', opening of glands.

If the bowels are pressed very hard, pain is evinced when there is acute or
chronic catarrh of the intestines. A circumscribed or localized pain is
seen in intestinal stenosis, tortion or volvulus of the intestine and from
the presence of foreign bodies. One must remember in making such an
examination that certain painful conditions of the abdominal muscles
or even the pain that severe pressure may produce, when the muscles
are stretched or compressed, must not be mistaken for intestinal pain.
In certain long standing cases of chronic intestinal catarrh, the writer
has found a certain amount of pain on pressing the finger tips between the
loops of the intestines.

An increase in the periphery of the abdomen may indicate collec-
tions of adipose tissue in the abdomen, pregnancy in bitches, overload-
ing of the stomach with food, or great accumulation of faeces in the large
intestines. The same condition is observed from accumulations of gas
in the stomach and intestines as a result of catarrh of the stomach and

EXAMINATION OF THE DIGESTIVE APPARATUS 27

intestines, certain poisons, stenosis of the intestines, peritonitis, paralysis
of the intestines, escape of gas from the stomach and intestines into the
abdominal cavity (meteorismus peritonis), and also when these organs
are punctured by foreign bodies, from accumulations of fluid in the ab-
dominal cavity, in peritonitis exudata, rupture of the bladder, or ascites.
Particularly relaxv>d and flabby abdominal muscles may often make an
animal look as if it had dropsy of the abdomen. In great accumulations
of urine in the bladder, large tumors or cysts in the abdominal cavity,
dropsy of the uterus and in hydronephrosis. Lateral (one-sided) disten-
tion of the abdomen may be caused by hypertrophy of the liver, disten-
tion of the stomach, various tumors, abscesses of the abdominal walls,
hernise and other surgical diseases. A decrease in the periphery of the
abdomen may result from continued diarrhoea, lack of proper or sufficient
food, or consumption.

Large accumulations of faecal matter in the colon and rectum is indi-
cated by a large sausage-like mass the consistency of putty and is pitted
by pressure. These obstructions cause painful irritation and swelling
of the mucous membrane. These swellings are found under the spinal
column. Foreign bodies that have been mixed with the food or if an
animal in play catches certain objects in his mouth, such as glass, stones,
hard or soft rubber balls, cork, etc., and accidentally swallows them and
they become lodged in the intestines they are easily outlined by palpa-
tion by the same means we outline tumors on the abdominal wall. Soft
foreign bodies, such as hair balls, overloading of the intestines, or slight
invagination are rather hard to diagnose.

The rectum is examined in the following manner: The animal is
placed either in a standing position or on his side, and the index fin-
ger (or in small animals, the little finger), having been dipped in oil, is
inserted into the rectum, the other hand being used to hold the tail to
one side, or to keep the animal quiet. It is frequently necessary to
muzzle the animal and in almost all cases an assistant holding the ani-
mal greatly facilitates the examination. Very frequently after an ex-
amination, the finger is stained with blood, or even blood in large quan-
tities is observed. This is generally due to the venous engorgement
of the rectal mucous membrane and the capillary vessels are easily
ruptured. We examine the rectum when certain symptoms are shown
in defecation or the faeces indicate some abnormal condition of the
rectum, such as inflammation, abscesses, tumors, or dilation or con-
traction of that organ. Or we may examine the rectum to remove
foreign bodies or particularly hard pieces of faeces or to diagnose ab-
normal conditions of the neighboring organs, or structures, such as the
prostate gland, vagina, uterus, neck of bladder, or if tumors or abscesses
are suspected in the pelvis. In very small animals the examination of

DISEASES OF THE DIGESTIVE APPARATUS
organs can be made easier by palpation of the abdominal

these
wall.

In certain cases where light has to be thrown on the rectal mucous
membrane the necessary examination can be made by means of a specu-
lum and then a mirror or an electric torch can be used to throw the light
into the cavity. Inflammation of the rectum from any cause, such as
hemorrhoids, fistulae, foreign bodies, or abscesses, can be readily exam-
ined by this means.

lio. i:j. — Examinatiou of the lower bowel with speculum.

The Faeces.

The number of times that an animal has an evacuation of the
bowels depends on the two circumstances: The quantity and character
of the food and the rapidity with which it passes through the bowels.
Normally, an animal has two or three passages daily; sometimes even
less. Diarrhcea, as a result of catarrh of the intestines, may be due to
a variety of causes, such as irregular diet, cold, or to some infectious
disease (distemper), latter stages of infectious hemorrhagic gastro-enteritis,

EXAMINATION OF THE DIGESTIVE APPARATUS 29

septicaemia, or some irritant in the food; but it may also be caused by
a laxative independent of the catarrh.

Constipation is common in all old dogs and in starved animals, in
animals weakened from exhausting diseases, in animals that have not
had sufficient exercise, or fed with constipating food, icterus, peritonitis,
in the onset of all diseases with rise of temperature, in the majority of
chronic affections of other organs, in all cases of obstruction of the bowels,
such as collections of dry faeces in the large intestines, atresia ani, from
large collections of internal parasites, tumors in the intestines or adjacent
structures, hypertrophy of the prostate gland, too much hair around
the anus, swelling of the anal glands, or from tumor of the anus. Animals
suffering from lumbago frequently do not attempt to defecate on ac-
count of the pain evacuation of the bowels causes them.

Constipation alternated with diarrhoea is frequently a symptom
of chronic intestinal catarrh — due to twisting of those organs — or in-
vagination, hernia, foreign bodies, loss of the vermicular motion and
in all copious exudations from the peritoneum. Pain during evacua-
tion of the bowels (tenesmus) is seen in inflammation or obstruction of
the lower bowels and in inflammation or ulceration of the rectum, or
rheumatism of the abdominal muscles. Involuntary evacuation of the
bowels is seen in prolonged attacks of diarrhoea, paresis of the cord,
and when an animal is dying, from the presence of an abscess, from
enlargement of the prostate, from splinters of wood in the lower bowel,
or from enlargement of the rectal glands.

The amount of excrement passed by an animal in a given time de-
pends on the quantity and quality of the food that the animal has taken.
A vegetable diet produces much more faeces than a meat diet. In an
ordinary sized dog fed on bread, the amount of faeces passed amounts to
20 per cent, of the amount eaten; but if the same animal is put on a meat
diet the amount of faeces is only about 12 per cent. (Ellenberger), In
diarrhoea the relative amount is changed, for in this condition the intes-
tinal juices secreted to aid digestion are not reabsorbed, but remain with
the faeces and are thrown out.

After an obstinate constipation the amount of fluids is also greatly
increased, and with it there is also a very offensive odor, due to decom-
position of the faeces and to the various excrementary matters that have
remained in the bowels.

The shape, size and color of the stools are a rather important matter
to consider. In normal health they are cylindrical in form, hard or soft,
according to the diet; in meat diet they are black or brownish- black and
of pitchy consistency. The faeces of sucking puppies resemble thick
green pea soup; these are rarely seen as the mother invariably licks them
up. Medicine changes the color of the faeces. Calomel and bismuth

DISEASES OF THE DIGESTIVE APPARATUS

stain them greenish-black and iron preparations turn them black; on
meat and fat mixed they are dark gray-brown, and on bread and milk
diet they are yellow-brown or almost clay color. If the animal has eaten
much bones, they are whitish. The alimentary matter cannot be dis-
tinguished with the naked eye, except in the case of bread, which is passed
almost as it is taken into the stomach. Bodies, such as wood, bones,
hair, straw, earth, etc., can also be seen in the faeces. Under the mi-
croscope (Fig. 14) we can see numerous particles of food that have
passed without digesting in animals that have good health. In impaired
digestion we see pieces of muscle, connective tissue, etc., with the naked
eye.

The following deviations in the appearance of the faeces may be
observed :

If the faeces contain large quantities of food that is ordinarily very
easily digested, or of food that shows little or no evidence of having been

■iW

Fig. 14. — Microscopical examination of the fsece?. Vegetable matter, starch cells, muscular fibres,
epithelial cells, and fungoid growths.

digested, disorder of the stomach or intestines is indicated. This con-
dition may also result from fevers, gastro-intestinal catarrh, from increased
peristalsis, forcing the food through the intestinal canal before it has
had time to digest, from fright, the presence of irritants in the food,
from the administration of laxatives or in old, exhausted or weakened ani-
mals. Biliousness will produce a stool that is yellow colored. Continuous
diarrhoea produces a mucous or watery appearance of the faeces. In
catarrh of the intestines the faeces contain a large quantity of mucus
and have a peculiarly foamy appearance. Clrayish-white, or clayey,
with a dull gloss indicates a plugging of the bile duct or some stoppage
of the flow of bile (retentions icterus). The presence of pus indicates the
bursting of some suppurative foci into the intestinal track, such as ab-
scesses or ulceration of the large intestine, or the rectum. Bloody stools
are frequently passed after a digital examination of the rectum, insert-
ing the thermometer, from certain poisons, so-called hemorrhagic en-

EXAMINATION OF THE DIGESTIVE APPARATUS

teritis, from proctitis (inflammation of the rectum), in rare instances,
from distemper, infectious hemorrhagic gastro-enteritis, septicaemia,
and in cases of mycotic meat poisoning. Blood may be found on the
surface of the stool or mixed with the pus. Which portion of the intesti-
nal track the blood comes from can be arrived at in the following way:
If the blood is found to be mixed all through the material in the faeces it
comes from the stomach or small intestines. But if the blood is in clots
or streaks and lying on the surface of the stool, it has come from the
lower part of the large intestine or the rectum. The color of the blood is
diagnostic; when the blood has escaped into the intestine in the anterior
portion, it is dark brown, a greenish-brown, or even black; but from the
lower intestines the blood is hardly changed in color and in proctitis the

Fig. 15.— Eggs of intestinal parasites in faeces (round worm). Magnified 70 times.

blood is normal in color, and is easily detected in the faeces, either in the
form of pure blood or bloody mucus.

The odor of the faeces is unpleasant, nauseating or offensive, especi-
ally when the animal has had a meat diet, and particularly so in cases of
long-standing constipation from mycotic meat poisoning; or in the latter
stages of septicaemia, in distemper, diarrhoea, toxic enteritis, or infec-
tious hemorrhagic gastro-enteritis. Free bile in the faeces gives them a
particularly offensive odor.

The presence of the following objects in the faeces may aid in diag-
nosis by giving an important clue to certain disorders; stones, sand,
pieces of bone, straw, grass, splinters of wood, hair, portions of sloughed
tissue, whole or portions of parasites (ascarides, oxyuris, taenia) (Fig. 15),
and more minute examination by means of the microscope may determine
the nature and some of the above-named objects if they should be in a
state of fine division.

DISEASES OF THE DIGESTIVE APPARATUS

Physical Examination of the Liver.

The liver covers the posterior surface of the diaphragm and extends
as far back on the abdominal wall as the umlnlical region. On the right
side it extends posteriorly and laterally along the ribs. The gall bladder
lies at about the height of the cartilage of the ninth rib, but does not
extend as far as the abdominal wall.

The physical examination of the liver is very difficult to make.
Fortunately, the diseases of the liver in the dog are very rare and can be
detected by symptoms other than the direct examination of the gland.
The liver is examined by percussion and palpation (Fig. 16). The percus-
sion area of the liver is where the liver lies against the abdominal wall and

Fig. 16. — Right side of the abdomen, showing the position of the organs.

the ribs; this takes in on the right side the lower third of the eighth,
ninth and tenth ribs and upward and backward over the twelfth and
thirteenth ribs, and on the left side the twelfth rib. Under normal
conditions a dull hollow sound is heard on the percussion over the region
of the liver. The liver, however, may vary a great deal in the different
breeds of dogs and also in individual animals.

The liver very frequently is in an abnormal position from various
diseases, as a result of exudative pleuritis, emphysema of the lungs,
pneumothorax, etc., also when the stomach and intestines are filled with
gas from accumulations of fluid in the abdominal cavity. Increase in the
size of the liver may indicate hyperaemia, fatty liver, amyloid degenera-
tion, abscesses, carcinoma, parenchymatous hepatitis, or biliary engorge-
ment. A decrease in the size of the organ is found in cirrhosis of the liver.

The palpation of the liver is made in the following manner: the hand

EXAMINATION OF THE DIGESTIVE APPARATUS 33

is placed on the chest wall and the thumb extends back of the curvature
of the ribs and is pressed in the region of the liver or the thumb can be
placed on the last rib and with the tips of the fingers the region of the
liver palpated. The usual position of the animal is to place it on its
side. The palpation of the liver is particularly easy in an animal having
very flabby abdominal w^alls, or where a collection of fluid, such as ascites,
has just been removed. Pain on pressure of the liver is seen in cases of
parenchymatous hepatitis, in hypersemia of the liver, and in early
stages of cirrhosis of the liver. In cases of carcinoma of the liver, large
uneven nodules are felt on palpation and in the latter stages of cirrhosis,
small uneven nodules are detected on the surface of the liver. The liver
is particularly firm and inelastic in cirrhosis, hyperaemia, and biliary
engorgement. Abscesses may be detected by fluctuation, but only when
they have attained a great size.

The Spleen.

The spleen is situated in the left hypochondriac region, is very diffi-
cult to examine through the abdominal wall. Certain definite swellings
or engorgements of the spleen may result from various affections of the
liver, lungs, and heart, from tumors in the region of the porta hepatica,
in various infectious diseases, such as distemper. When large splenitic
tumors are present, in fat animals they are almost impossible to detect;
in thin animals they are easily detected by palpation. Percussion in
such cases can also be made about the last two intercostal spaces at the
curvature of the ribs.

The Pancreas.

The pancreas, on account of its twisted right-angle position, makes
a direct examination almost impossible (Fig. 16); enlarged pancreas may
occur as a result of tumors, carcinoma or adenoma; they may be detected
by palpation in the region of the twelfth dorsal to the third lumbar
vertebra. But it is generally unsatisfactory, and a diagnosis is better
made of diseases of the pancreas by finding undigested food in the faeces
and the presence of sugar in the urine.

34 DISEASES OF THE DIGESTIVE APPARATUS

DISEASES OF MOUTH, TONGUE AND SALIVARY GLANDS.
Inflammation of the Mucous Membrane of the Mouth. Stomatitis.

Clinical Symptoms. — The first symptom the animal will show will
be the slow, careful way in which it eats; it will leave any large, or hard
pieces of food untouched, and swallow small pieces without mastication.
The saliva is greatly increased in amount and frequently runs out
of the corners of the mouth in thin, glass-like threads or strings. On
making an examination of the mouth, all of the mucous membranes
Avill be found swollen, red, and inflamed; the gums are especially so during
dentition (gingivitis) ; the inner surface of the cheeks, the tongue, and
soft palate are also inflamed; as a rule, the tongue is coated and covered
with thick mucus and saliva. Ulcers sometimes appear in the different
parts of the mouth and particularly on the tip and edge of the tongue.

The duration of the disease depends largely on the causes producing
it; as a rule, it is not of much importance and disappears without any
medical interference. In some cases, where it is caused by diseased
teeth, it is more obstinate, and if it becomes chronic it is apt to become
a case of stomacace.

Therapeutics. — The animal should be fed lightly, the principal diet
being soup or liquid foods, beef extracts or juice of fresh meats, and the
animal given plenty of fresh water to drink. This washes out the thick
saliva and mucus off the tongue and between the teeth. Common salt,
carbonate of soda, or Carlsbad salts or some such saline waters as Hunyadi,
Apenta or Veronica, can be used with good results, and the mouth should
be washed out with any of the following disinfectant and astringent solu-
tions: 1 to 2 per cent, solution of boric acid, potassium chlorate, 5 per
cent, solution of alum, 5 per cent, solution of permanganate of po-
tassium, sol. of peroxide of hydrogen or red wine. Inflamed gums can be
rubbed with tincture of myrrh, tincture of catechu, or with a solution of
15 per cent, tannin in glycerine.

Ulcerous Inflammation of the Mucous Membranes of the Mouth. Ulcera-
tive Stomatitis (Stomacace). Necrotic Stomatitis.

Etiology. — This is an inflammation and necrotic ulceration of the
mouth, and is generally seen in delicate, weak and ansemic house dogs
and is associated with the presence of decayed teeth (tartar, caries).
It is seen, however, in a small proportion of cases where the teeth are
perfecti}' sound, and where the animal seems to be in fairly good health,

STOMACACE {necrotic gangrene of the Jaw.)

DISEASES OF MOUTH, TONGUE AND SALIVARY GLANDS 35

especially, when they are recovering from acute or exhausting diseases.
This condition in some cases seems to be due to some bacterial infec-
tion of the mucous membrane and the tissue directly surrounding the
teeth; the true nature of this hypothesis has not as yet been settled. It
is also a question if it is infectious, but if not, it certainly affects a
certain number of animals at a time. Ulcerative stomatitis is also
seen as a symptom in scurvy, infectious hemorrhagic gastro-enteritis,
and in certain cases of poisoning, particularly mercurial. A simple case
of stomatitis either from improper treatment or a weak nutritive con-
dition, may become an acute case of stomacace.

Clinical Symptoms. — At first the gums are swollen and red in the
neighborhood of certain teeth, generally the incisors and more rarely the
molars. The gums are very red and painful to the touch and bleed readily.
After a few days the inflamed portion becomes green and dark purple
on the dividing line (line of demarcation) with the other tissues. The
hemorrhage from the affected parts is constant and deep abscesses form,
involving the alveolar processes. This gangrenous inflammation ex-
tends and the teeth become very loose and fall out. In extreme cases,
the jaw becomes affected and necrosis sets in and large portions of the
jaw exfoliate. This condition may also involve the neighboring tissues;
but as a rule the tongue is rarely affected to any great extent. The
odor of the stomach is very offensive; there is a bad-smelling, sticky mu-
cus running from the corners of the mouth. Generally the appetite is
fairly good, although it is very difficult for the animal to masticate or
swallow, and bolting the food whole, while affected with this disease,
has a tendency to upset the stomach.

A favorable termination of this disease is only to be expected in
young, strong, healthy dogs, provided it has not become too far ad-
vanced. With proper treatment and favorable conditions the ulcers
clean up gradually, and after two weeks they are usually all healed up;
but sometimes the fever keeps on increasing and the disease becomes
septic in character from absorption of the dead tissues, causing blood-
poisoning and collapse, followed by death. The author has noticed
a gangrenous lobular pneumonia from the aspiration of the purulent
matter.

Therapeutics. — The animal must be fed lilierally, but with easily
digested food and soft as possible. Remove all the diseased tissues as
soon as possible and prevent the spread of the ulcerated portions of
the mucous membrane; wash the mouth freciuently Avith deodorizing or
antiseptic mouth washes such as have been mentioned in the previous
disease, being careful not to let the animal swallow any of the prepara-
tions. This is done by holding out the animal's head in such a position
during the application of the medicine that the fluid will run out of the

36 DISEASES OF THE DIGESTIVE APPARATUS

mouth. The purulent uk-crations are to be painted with tincture of iodine
or touch the ulcers with any of the albuminous preparations of silver,
which are better than the stick of nitrate of silver. As soon as the
ulcerated surface begins to granulate, milder astringent mouth washes
may be used, such as tincture of myrrh, or permanganate of potassium.
Syringe the mouth with a solution of tannin and glycerine, 1 to 20.
The general symptoms of septicaemia will be found under the head of
that disease.

Foreign Bodies in the Tongue.

Foreign bodies, such as pins, needles, fish hooks, etc., frequently find
their way into the tongue. It is always well to examine the mouth care-
fully, when an animal appears to have ptyalism, where it is con-
stantly moving the jaw as if it were chewing, swallowing or making
efforts like vomiting or does actually vomit, or where the animal rubs the
mouth with the paws, as if to drag something out of the mouth. We may
find foreign bodies, sticks, needles, splinters of wood in or under the
tongue. It is sometimes very difficult to find a foreign body, particu-
larly when the tongue is greatly swollen and the animal keeps it con-
stantly moving, and at the same time the mouth filled with thick saliva;
too great care cannot be used to detect a foreign body. Go all over
the body of the tongue with the finger. The writer has found needles,
some of them threaded, at the base and on the ventral side of the tongue.
In some cases the needles were completely reversed, the point being
toward the tip of the tongue. To remove the foreign body, imbedded
in the tongue, the free portion of the tongue should be pulled out as far
as possible by means of a pair of forceps. In some cases such as fish
hooks, the foreign body should be pulled out in the direction it enters
the tongue, so that the barb will not further lacerate the tissues; in cases
Avhere the fish hook is ringed in the shank, it must be cut by means of a
wire cutter. No treatment is required after the foreign body is success-
fully removed.

Gangrene of the Tongue.

This may occur from Ixnndaging the tongue or rubber bands put on
the tongue, maliciously or otherwise, or if some of the larger blood
vessels of the tongue are cut transversely. The tongue is greatly swollen
and the gangrenous portion is separated from the healthy part by a
sharply defined line of demarcation. The gangrenous portion is dark
bluish-red or bluish-black and covered with more or less pieces of necrosed
tissue mixed with thick mucus and saliva. This is cold and non-

DISEASES OF THE TEETH

sensitive (see Fig. 1 7) . In some cases if we forcibly pull out the tongue
the gangrenous portion becomes detached. Experience shows that
the loss of a portion of the tongue does not interfere very much with
the prehension of the food. The only evidence is seen in the animal
eating and drinking more slowly. Generally these cases heal very
rapidly, as soon as the gangrenous portions of the tongue either slough
ofT or are amputated. It is remarkable that in cases where the tongue
is liluish-black and cold, the animal will make a good recovery with
little or no treatment other than the removal of the diseased portion.

Fig. i;

— Gangrene of the
tongue.

Fig. is. — Longitudinal section
through an incisor tooth; a,
cement; b, enamel; c, ivory or
dentine; d, pulp cavity and alve-
olar dental membrane; e, maxill-
ary bone.

For further treatment see page 34, under Treatment for Inflammation
of the Mucous Membrane of the Mouth.

DISEASES OF THE TEETH.

Dogs are frequently subject to various dental disorders, such as ac-
cumulations of tartar on the teeth, alveolar periostitis; rarely caries of the
teeth, and still more rarely fistulae of the gums.

We understand by tartar of the teeth, a calcareous deposit on the
neck of the teeth at the border of the gums. This is gray, yellowish-
gray, or greenish-gray and sandy or chalk-like in structure. This tar-
tarous substance is deposited chiefly around the canine or molar teeth
and gradually pushes the gums back and often loosens the tooth, which,
acting as a foreign body, causes great irritation. Furstenberg found

38 DISEASES OF THE DIGESTIVE APPARATUS

tartar of the teeth of a dog contains calcium carbonate 50.79 per cent.,
calcium phosphate 41.4.3 per cent., sodium chlorate 1.02 per cent., po-
tassium sulphate 1.02 per cent., mucus and food debris 4.05 per cent.,
water with traces of magnesium carbonate 2.71 per cent. The tartar
can be removed by scraping it off with a small cup-shaped instrument
or a sound with a leaf-like tongue. Some remove it with a hook-shaped
pair of pincers. If there is a large quantity of tartar on the teeth, it is
best to put the dog under ether and avoid struggling on the part of the
animal, and also facilitate the removal of the tartar without injuring
the soft structures of the mouth. The teeth can then be cleaned with
such tooth powders as chalk, charcoal, using a tooth brush or a
coarse cloth, Albrecht advises in cases of tatar formation to take a
blunt stick, cover the end with a cloth, and dip it in pumice stone and
alcohol and rub on the teeth.

Alveolar Periostitis. — Inflammation of the alveolar periosteum or
the so-called alveolar dental membrane in combination with suppura-
tive periostitis alveolaris purulenta (periodentitis purulenta) is a very
important disease, as it has a very important bearing on the value of
certain breeds, particularly the terrier class. If it affects very young
animals, it is apt to destroy portions of the enamel and leave the teeth
unsightly and discolored. This condition is very apt to follow diseases
of the blood in very young animals, particularly those that are anaemic,
have persistent diarrhoea or have distemper at that period when the
permanent teeth are just about or are coming through the gums.

Caries of the Teeth. — This condition has been observed by a num-
ber of authors (Moller, Hoffman), but is of very rare occurrence.

Caries of the teeth may result from the teeth being broken by
animals in play catching hard objects, stones, coal, etc., sharp bodies
running into the gums or becoming imbedded between the teeth.

By caries clentum, we define an active process of molecular de-
struction of the enamel and bone of the teeth. This process always
begins on the surface and mainly in the cavity of the crown of the tooth
forming a grayish or blackish spot. This spot, which is the decayed
part of the tooth, advances deeper into the tooth, going on toward the
pulp. This penetrates into the tooth until it reaches the nerve, and
thus exposes it to the atmosphere, inflames it and makes it very
sensitive.

There are certain microbes found in carious teeth, but whether they
are directly connected with the decay of the teeth is not definitely
known. True dental caries is very rare in the dog. Necrosis of the
teeth is frequently mistaken for caries. In old dogs we often see an
acute inflammation of the periosteum and the alveolar process becoming
inflamed, the tooth is lifted out of its socket, and finally forced out entirely.

DISEASES OF THE TEETH 39

In these cases the alveolar periosteum is destroyed, and a necrotic condi-
tion of the tooth causes it to become yellow; this is generally termed false
caries of the teeth. Alveolar periostitis commences with the formation
of an abscess at the root of the tooth, and the pus formed finds its way to
the outside of the gums through the alveolar process. It forms a fluc-
tuating swelling on the gums (abscess of the gums) ; the opening gener-
ally remains so, and if it is in the superior maxillary open fistulous
tracts may form under the eye just below the lower eyelid, and unless
carefully examined may be mistaken for a lachrymal fistula. By means
of a flexible probe the diagnosis can be made with certainty.

In all these cases the animals seem to have a more or less severe
toothache; they are irritable, eat very slowly and irregularly, drop more
or less saliva, refuse to have the mouth examined, and, if the affected
tooth is struck with something (a key is the best) , howl and evince great
pain, keeping the mouth open for some time afterward. When the mouth

Fig. 19. — Improvised gag (French).

is examined, the gums are swollen and painful, and there is a very foetid
unpleasant odor from the mouth.

When there is more or less pus present, the radical treatment is
to remove the offending tooth. For this purpose open the mouth by
means of the method described on page 12, using the mouth speculum
(Figs. 4, 5 and 6), or Fig. 19, which show's a mouth ga^" that is partic-
ularly useful where the incisor or canine teeth are to be examined as it
can be easily improvised and allows the mouth to be examined and at
the same time the animal does not open the mouth and move around the
tongue and interfere with the examination and an assistant can hold the
head steady and with an ordinary molar-forceps extract the tooth, being
careful to avoid breaking the crown. The tooth is seized with the for-
ceps as far down on the root as possible; it is first loosened by twisting
it several times from side to side and then drawn out with a strong pull.
The mouth must be thoroughly cleansed with warm water and the gums
pressed firmly together, so as to keep the cavity, if possible, from filling
up with a blood clot. This should be done immediately after extraction.
In cases of caries of the teeth, the tooth can be filled by first scraping

DISEASES OF THE DIGESTIVE APPARATUS

out the cavity with the dental cutter then disinfect the cavity by means
of a plug of cotton soaked in creosote, and washed out with alcohol or
ether and plugging it with amalgam, cement or gutta-percha. Hobday
has described a case where an artificial tooth has been bridged between
two teeth. In the United States this bridge-work and filling is done
frequently.

Dentition. — Newly born puppies do not have any teeth through the
gums. The first or temporary incisors appear a])out the third or fourth
week and the first permanent teeth appear about the fifth month. The
temporary canines appear about the fourth or fifth week after the tempo-
rary incisors are all in. The permanent teeth begin to come through
about the third or fourth month; the lateral and middle incisors
appear about the end of five months, and at the same time the second,

Fig. 20. — Tumors of the gums.

third, and fouth molars, the fifth molar about five months, the sixth
about six months, and finally the seventh about the end of the seventh
month, so that the dog has his full masticatory apparatus at the end of
seven months.

Change from the normal rotation of temporary to permanent teeth
varies; sometimes the permanent teeth will come through the gums and
push the temporary teeth to one side, but the latter remain in the jaw.
This is particularly noticeable in the very small breeds. This is gen-
erally avoided by pulling out the temporary incisors as soon as possible.
Very frec;[uently this allows the permanent teeth to come through the
gums at once and assume their normal position. This irregularity is
particularly noticeable when the animals are affected with some acute
infectious disease, such as distemper.

During the process of teething, the gums become very red and in-
flamed, and there is an increased amount of saliva; in some cases the in-
flammation is intense, with complete loss of appetite. Convulsions may

DISEASES OF THE TEETH 41

occur from reflex nervous irritation. This nervous irritation may pro-
duce a cramp of the lower jaw that is very similar to the paralysis of the
jaw in rabies.

These cases are best treated by simple sedatives, and if the gums
seem to be tough, they should be lanced with an ordinary gum lancet,
and thus assist the tooth to come through to the surface.

Malformations of the Cavity of the Mouth. — Malformations or growths
on the buccal membrane are frequently seen in the dog, located about the

Fig. 21. — Wire ecraseur.

edge of the gums and on the inner cheek. They are generally classed as
epulides. They vary in size from a pin-head to a walnut. They are
invariably pedunculated; very rarely they are seen with an extended base,
irregular on the surface; they are, as a rule, hard and elastic and deep
red in color; they may occur in various characters — fibroma, carcinoma
or sarcoma. The author observed a melanotic sarcoma in one case.
These epulides grow sometimes to be very large, pushing the teeth to one
side, making mastication very difl&cult, and preventing closure of the
mouth (see Fig. 20) .

Fig. 22. — Warts of the mouth.

These tumors can be removed by ecraseur of wire (Fig. 21) or by
cutting them out with a probe-pointed bistoury. The hemorrhage can
be checked by the thermo-cautery or by a solution of chloride of iron, but
the hemorrhage is generally so slight as not to require any styptic.
Loose teeth, or teeth that are firm but interfere with the removal and
eradication of the tumor should be extracted. If the tumor is firmly
attached to the bone or directly in the bone substance itself, the affected
bone should be removed with the knife or bone forceps and scraped with

42 DISEASES OF THE DIGESTIVE APPARATUS

a curette so as to prevent, if possible, the recurrence of the growth;
but frequently they return in spite of every precaution.

Warts in the Mouth. — In young dogs, generally under twelve
months, we frequently find on the lips, buccal membrane, and under
the tongue numbers of papilloma; these sometimes occur in enormous
numbers. These are small whitish-gray, pink or pinkish-black, wart-
like proliferations (see Fig. 22). These growths are generally of little
importance. They may appear in a few days and cover the surface of the
mouth and disappear as rapidly as they appear. No. treatment is re-
garded unless they are in such masses as to interfere with mastication.
If so, remove the largest with a curved pair of scissors and dress the
mouth with some astringent wash, and administer, liq. potassii arse-
natis (Fowler's solution) internally in the food.

Ranula. — Besides these tumors of the membranes of the mouth we
find a growth called ranula. It generally occurs under or on the side
of the ventral surface of the tongue and rarely painful to the touch, thin
walled, and more or less cylindrical. Often an animal will become very
slow in eating, and if the mouth is examined, we find on one side of the
tongue and under it a large-sized body, varying from the size of the little
finger to a chicken's egg, a fluctuating swelling, reddish-blue in color
and when opened with a knife it is found to be filled with a thick creamy
glue-like liquid (see Plate, page 42) . Many theories have been advanced
as to the cause of this disease; some consider it to be the formation of an
ordinary cyst and others contend it is due to the plugging of the ducts
of one or more of the salivary glands at the base of the tongue. In some
cases the cause of the trouble is due to the obstruction of the duct of
Wharton, which has its entrance into the mouth at the base of the lin-
gual ligament, and in other cases it is a cystoid degeneration of a few
glands at the base of the tongue, probably due to a plugging of the open-
ing of their ducts and a consequent inflammation of the glands themselves.
It therefore seems best to call all the cystoid formations under the tongue
ranula.

It is always advisable to operate on these cysts; cut down on the
cysts with a lancet and make a good-sized opening, and by mean-s of a pair
of curved scissors remove a portion of the upper part of the wall and
cauterize the inner w\alls of the cysts with the thermo-cautery or stick of
caustic silver. If Wharton's duct is involved, be guarded in the cauteriza-
tion, confining it only to the anterior part of the cyst toward the point
of the tongue. The injection of pilocarpine, which has been used with
success in man according to Soffintini's method, has been tried in ani-
mals by Hoffmann. It consists in creating a great amount of the salivary
secretion, and the force of the collected fluid from the inside breaks the
obstruction of the duct.

RANULA (salivary cyst of the tongue.^

DISEASES OF THE TEETH

Inflammation of the Salivary Glands.

{Parotitis; Mumps.)

Inflammation of the glands of the ear (parotiditis) appears either
as a consequence of some mechanical cause, or by infection from the cav-
ity of the mouth, from some existing inflammation of that part, as a
disease, due to the presence of a micrococcus which develops in the saliva
in the form of a diplostreptococcus or by direct infection from the blood
itself in the form of a diplococcus or from metastasis (septicaemia, pyaemia,
or^ in rare instances, distemper) . The latter requires special mention as

Fig. 23. — Glands of the head: 1, parotid gland; 2, submaxillary gland; 3, subzygomatic gland; 4,
Wharton's duct; 5, Bartholin's duct; 6, palatine gland; 7, orbital gland; 8, Nuckian duct; 9, lachrymal
gland.

a primary idiopathic parotitis (mumps). The writer has frequently
seen the gland in the region of the ear affected, more rarely the glands
of the lower jaw, and, least of all, the glands of the eye.

Etiology. — This disease is rather rare in the dog, but sometimes it
may take the form of an epizootic (Hertwig, Schussele). In these cases it
is probably due to some infecting virus that gets into the gland through
Steno's duct. The exact nature and time of incubation of this disease
are not known.

44 DISEASES OF THE DIGESTIVE APPARATUS

Symptoms. — The disease begins with a swelling of the gland and
the adjacent structures on one side or both sides of the ear. The loca-
tion of these glands is seen in Fig. 23. They swell rapidly and are very
tender to the touch, changing the whole appearance of the head and
neck. The animal is very droopy, carries the head and neck in a fixed
position, eats with great difficulty, and will swallow only very small
pieces. The saliva is very thick and forms tenacious bubbles at the
corners of the movith. The fever is seldom high, and in the majority of
cases in from five to eight days the swelling decreases and disappears
entirely in fourteen days (Hertwig).

In rare cases an abscess is formed in the gland, (abscess of the parotid,)
and invariably in one only. The gland swells as in mumps, only is much
quicker and surrounding tissues are much swollen and oedematous,
8oon a fluctuating portion is felt, which later opens in one or more
places and a thick, creamy pus escapes; the oedema of the surrounding
tissues disappears quickly, and the fever, which is rarely of much conse-
quence, goes down entirely and the wound closes in a short time.

The inflammation of the glands of the tongue and lower jaw gen-
erally forms abscesses which open in the month, the pus escapes, and the
sore heals up in a short time. The submaxillary generally breaks
through the skin and the sul^lingual into the cavity of the mouth. There
is never any consequence in any of these cases.

Therapeutics. — In the primary form of parotitis, where we do
not have the formation of an abscess, we obtain good results with warm
applications. Keep the animals as quiet as possible, and then rub on
ointments, such as vaseline and lanoline, or paint with tincture of iodine.

As soon as we see that the swelling is not going down within a cer-
tain time, but increasing gradually, we must try and open the abscess
as soon as possible and allow the pus to escape. If fluctuation can be felt,
cut down on that point, but if not, a portion of the skin and fascia have
to be carefully cut in the dependent portion, making a good-sized
opening. The gland is now exposed, the pus can be detected and opened,
a drainage-tube inserted and sewed to the tissues — if not sewed, the
animal will shake it out — and cleanse daily with an antiseptic solution.
It is better not to bandage the neck, as it interferes with the tube; in
some cases it is not necessary to insert the tube, but to clear the
opening daily and dilate it, if necessary. These abscesses heal rapidly if
there is exit for the pus.

Inflammations of the other salivary glands should be treated in
the same way. The abscess of the sul)maxillary should be opened from
the outside through the skin, and sublingual from the inside of the mouth
cavity. In the submaxillary, it is not necessary to put in a drainage-
tube, but simply to keep the wound clean. Frequently we have develop-

DISEASES OF THE TEETH 45

ing in this region intense localized inflammations and great oedema from
traumatisms, such as fights, blows or contusions. The swelling may
extend to the head and neck (Fig. 24). The treatment in such cases
consists in making a free opening to allow the pus to escape and heal it

Fig. 24. — Abscess of the neck. CEdema of the right side of the head.

as an open wound or dress it with an antiseptic held in place by means
of a Priessnitz compress.

Occasionally we find cysts form in the glands of the tongue. These
were first described by Siedamgrotsky as honey cysts. They are seen
on the lower side of the mouth in the region of the larynx, and are covered by
the muscles of the neck; or they may be on both sides of the larynx and

Fig. 25. — Mucous cyst.

appear as a conglomeration of small, crowded vesicles with thin, coarse
walls filled with a thick, honey-like fluid (see Fig. 25). In some instances
it is very thick, like cheese, and yellow or reddish. They originate in
the glands of the tongue, and as the cyst walls extend into the tissue of
that organ they must be classed under the head of ranula.

40 DISEASES OF THE DIGESTIVE APPARATUS

In treating these cysts the only practical method to pursue is to
remove them entirely, for if they are simply cut into they return in a
short time; but to cut out entirely a cyst located in this region is a rather
dangerous operation, as the base of the tongue and the region of the
larynx contain a large number of important blood vessels and nerves
and even if the entire cyst is removed, we may injure the submaxillary
gland, causing a salivary fistula that is impossible to heal. Consequently
it is only advisable to attempt to remove the smaller cysts; the larger ones
can be treated in the following manner: Make an incision into the cyst,
then inject into it some mild corrosive such as diluted tincture of iodine,
a weak solution of corrosive sublimate, or Lugol's solution of iodine. These
sohitions act as irritants to the walls of the cysts, break them down, and
destroy the secreting membrane and they soon heal up; the cicatricial con-
traction draws the tissues together and only a trace is left. Another method
is to use an aspirator or ordinary syringe, draw off the contents of the cyst,
and inject into the cyst a 3 to 5 percent, dilution of Lugol's solution, in-
jecting an amount equal to the original contents of the cyst. The object
of this injection is to stimulate the formation of pus in the sac. If it does
not produce the desired effect, inject it again. After the pus has formed,
make a long incision through the cysts and treat it as a simple surgical
wound. Frick advises after opening the cyst to cauterize it with the thermo-
cautery and sew up the opening. This causes that portion to slough off,
and the wound to heal by granulation. The method suggested by Siedam-
grotsky has been very satisfactory to the author. It consists of making
a good, big opening in a dependent part and injecting the parts freely
with mild caustic solutions, such as caustic potash or tincture of iodine.

Inflammation of the Mucous Membrane of the Throat.

{Pharyngitis; Angina Catarrhalis; Sore Throat.)

This disease in the dog is not by any means as important as it is in
man, and as yet there have not been recognized any cases in the dog that
could be compared with diphtheria, angina tonsillaris, and retropharyn-
geal abscess of man; at least such is the experience of the writers. The
general affections observed have been common catarrhal inflammations
which involve the whole or part of the throat.

Etiology. — The same causes that would produce stomatitis would
bring on inflammation of the throat. The most common cause of angina
catarrh is a continuation of the inflammatory processes from the neigh-
boring organs; for instance, in catarrh of the nose, or in laryngitis, and it
may appear as a complication of distemper and stomatitis. The chief
cause is cold, particularly in hunting dogs, such as setters or pointei-s
getting wet, when very warm, plunging into very cold water, or in house
pets that run from very warm rooms into the cold and lie on cold bricks

DISEASES OF THE TEETH 47

or flag stones. This disease is very much more common in winter than
summer and is more frequently seen in small or particularly fine bred
delicate animals. Friedberger and Frohner describe an epidemical
infectious pharyngitis that affects young animals when they are from
one to two wrecks old, and sometimes goes through an entire kennel,
attacking all ages.

Pathological Anatomy, Clinical Symptoms and Cause. — The changes
of the mucous membranes of the pharynx and soft palate are the same
as are recognized in all catarrhal inflammations. The mucous mem-
brane is a diffused red, sometimes spotted, and coated with a dirty
yellow mucus, giving it a dull glairy appearance. The membrane puru-
lent on its surface, except in very grave affections, when especially on
its tlorsal surface there may be seen a number of small, irregular gran-
ulations. As a rule, if the inflammation is at all severe, the tonsils
are also swollen and protrude out of their membranous pouches in the
shape of brownish-red enlargements, and occasionally the subparotid
glands may be involved by the formation of an abscess. We very rarely
see any fibrinous (croupal) membranes in any of the severe inflamma-
tions of the throat.

Clinical Symptoms. — The clinical symptoms of catarrh of the throat
are similar to acute stomatitis, and it is only by making a careful exami-
nation of the throat that we can make a correct diagnosis. In more
severe cases, beside increase and alteration in the saliva, which is thick
and tenacious, on manipulation in the region of the pharynx, it is pain-
ful. The subparotid lymph glands also are swollen and painful, and
there is a certain stiffness of the neck. The mucous membrane of the
pharynx should be examined and its changes from the normal considered.
The author has found, as a rule, that catarrh of the stomach accompanies
all these cases. Catarrh of the nasal passages and pharynx, and slight
fever is also seen in these cases, and in rare instances vomiting. The
course of the disease, as a rule, is favorable, but Frohner says if the in-
flammation of the pharynx extends into the Eustachian tube it may cause
deafness. Chronic pharyngeal catarrh is rarely or ever seen, but some-
times an ordinary case of catarrh of the pharynx may last three or four
weeks and cases have been known to recur from time to time*

Therapeutics. — First examine the larynx and see if there are any
foreign bodies present. This can be done by forcing open the mouth and
by means of a spoon handle or a spatula the tongue is depressed and the
fauces examined. Always be sure, however, to determine that the animal
is not suffering from dumb rabies. In these cases the owners are very apt
to imagine the animal has something stuck in the throat or eaten some-
thing that is poisonous. In a mild case give the animal milk, thin soup
bouillon; in more severe cases, an external liniment, such as camphorated

48 DISEASES OF THE DIGESTIVE APPARATUS

oil or soap-linimcnt, .should be rubbed on the throat or the mouth held
open and by means of a brush or an atomizer sprayed directly on the
throat; apply such astringent and antiseptic throat washes as lime water,
tannic acid 1 to 3 per cent., potassium chlorate of borax 2 to 3 per cent,
solution. In more acute or chronic cases, wash the mouth out with a
solution of permanganate of potassium, boric or salicylic acid, or paint
the throat with nitrate of silver, 1 to 2 per cent., or tannite of glycerine,
5 to 10 per cent.

DISEASES OF THE (ESOPHAGUS.
Foreign Bodies in the (Esophagus.

The foreign bodies that become fixed in the pharynx or oesophagus
of the dog in play or by gulping down their food as fast as possible, if an-
other animal is near, are numerous and varied; they consist of portions of
food, such as hard, irregular-sized pieces of meat that have been taken in
one gulp; long, sharp pieces of bone, such as mutton or fish, pieces of wood,
needles, or small stones; sometimes objects are swallowed by accident,
such as stones, buttons, glass, or india-rubber balls, corks, etc., and lodged
in the pharynx at the entrance of the oesophagus; or if the object is small,
it may go a certain distance into the tube and lodge there.

The symptoms may come on very suddenly and vary according to the
general character and position of the foreign body. As a rule, the animal
is restless and keeps the head and neck extended; it scratches itself on the
throat with the paws over the spot where the obstruction is located. If it
is in the pharnyx, the animal shows signs of choking or may vomit, from
time to time, small quantities of mucus and saliva, which is dirty and
frothy and may be stained with blood, and later pieces of undigested food
which in the later stages becomes foetid. It coughs frequently, and if the
obstruction is large, it refuses to eat or drink. If water is forced on the
animal, it passes down the throat very slowly and evidently with diffi-
culty, or may be vomited immediately after it is swallowed. If the
foreign body is in the oesophagus, it may be felt externally with the finger
or, opening the mouth and depressing the tongue, it may be seen lodged in
the pharnyx; if it is in the cervical portion of the oesoiDhagus, it can be de-
tected by making a careful examination along the course of the tube or by
the probang introduced into it, as has been described on page 17. The
latter method is the only way to positively determine the presence of a
foreign body when it has lodged in the thoracic portion of the oesophagus.
In introducing the probang it must be carefully inserted, and if it should
come in contact with the foreign body too great pressure must not be made
on it, as it is apt to pack the object more firmly or even cause perforation

FOREIGN BODIES IN THE (ESOPHAGUS 49

of the tube, "When making an examination of the tube externally, should
we find a part that is painful, we must not consider it the obstruction un-
less we find a hard swelling with it, as foreign bodies such as sharp splin-
ters of bone or wood often go down the tube, lacerate the mucous mem-
brane in its passage, and do not become imbedded. Needles, pins and
small pieces of wood may not be detected, even with the probang; in such
cases the Rontgcn or X-ray can be used to detect objects of certain den-
sity, such as metals, coins, etc., with the greatest certainty.

The object, if it goes into the stomach, passes through the intestines
and is passed through the rectum and causes no further trouble. Some
authors have observed needles passed per rectum in the faeces. It may,
however, lodge in the stomach and cause irritation and finally convul-
sions and death. If it is a sharp body, it may perforate the stomach, even
find its way out again by perforating the abdominal wall. If it is in the
thoracic portion of the tube, it may penetrate the wall, cause an abscess
and escape, or it may penetrate the wall of the thoracic portion and set up
septic pleuritis and result fatally. It is also probable that death may
occur from the foreign bodies if they are sharp, by penetrating either the
heart or one of the large blood vessels in the vicinity, and causing a hemor-
rhage, or it may also occur from septic inflammation of the oesophagus.

Therapeutics. — The treatment differs according to the character and
situation of the foreign bodies. If the foreign body is in the pharynx or at
the entrance of the oesophagus, it must be removed immediately either
with the finger or a pair of curved forceps. If the obstruction is located
in the lower portion of the tube, and it cannot be pushed down into the
stomach with the probang, it is advisable to attempt to get it up by an
emetic — a subcutaneous injection of apomorphia muriate, as per page 21.
If that is not successful, then perform oesophagotomy as soon as possible,
before the intense swelling interferes with the operation. If this opera-
tion cannot be performed on account of the foreign body being situated
too deeply in the thorax, it is best to give the animal small quantities of
lubricating substances, such as olive oil or any fatty oil. It is better to do
this than to use any great force to push the object into the stomach. If
the foreign body goes so far into the oesophagus that it lodges in the cardiac
portion of the stomach and by manipulation it can be detected, gastrec-
tomy can be performed and the foreign body removed in that way.
Porcher and Morey performed this operation successfully.

In very rare instances we also find an inflammation of the oesophagus
(oesophagitis) , with or without any ulceration. In the latter case it is due
to the irritation of caustic poisons or lacerations of the foreign bodies
going down the tube. This is best treated with lubricating oils, such as
almond or sweet oil. We may see, occasionally, a constriction of the
oesophagus (stenosis oesophagi) or a dilation (ecktasia and diverticulum),
4

50 DISEASES OF THE DIGESTIVE APPARATUS

but these conditions are impossible to improve by any surgical means that
we know of at present.

OEsophagotomy. — This is not a very difficult operation to perform in a
dog. The animal is laid on his right side, and if not too weak, is narco-
tized or the locality sprayed with chloride of ethyl. The oesophagus is
now exposed and examined to see if any portion is gangrenous from the in-
j ury . After having shaved off the hair, and washed the surrounding tissues
with antiseptics, the foreign body is located, and an incision is made in the
skin parallel with the jugular vein and over the foreign body. The incision
is now carried through the subcutaneous tissues and muscles, and the
oesophagus is exposed. Where the foreign body is located in the lower por-
tion of the cervical region, the incisions can be made on the median line
and by separating the muscles the oesophagus which lies on the left side
of the trachea can easily be distinguished. The incision made in the
oesophagus should only be large enough to allow the removal of the foreign
body. After the extraction of the foreign body, the wall of the oesopha-
gus should be sewed up with cat-gut, and the muscles sewed with silk
and the skin either left open or a drainage-tube placed in it. The ojxjning
is then treated as an ordinary wound. No food must be given for 48
hours, then only water or milk. The animal should be kept on liquid food
for at least two weeks. When a large portion of the oesophageal wall is
lost, that which is sloughed from necrosis, and the edges of the wound in
the oesophagus cannot be brought together, the case is hopeless.

Other Diseases of the (Esophagus.

In very rare instances we find inflammation of the oesophagus (oesoph-
agitis) . In this case it is due to the action of caustic poisons or a lacer-
ation cavised by foreign bodies going down the tube or from foreign bodies
becoming imbedded in the tube for a time and then dislodged, l:)y injuries
to the wall from the probang, and in still more rare instances from swallow-
ing hot or scalding food, by spread of inflammatory process from the
pharynx, or the presence of parasites (spiroptera). Oesophagitis is recog-
nized l)y great salivation, difficulty in swallowing, attempts at or true
vomiting and great pain shown by the animal on manipulation of the
oesophagus. The treatment consists in giving liquids, gruel or rice water
and in severe cases, small pieces of ice at frequent intervals.

Obstructions of the (Esophagus.

(Ste nos is Q^suphagus . )

This may result from the subsequent irritation and cicatricial contrac-
tion of the wall as a result of laceration by a foreign body. Occasionally
we may find malformation of the wall by an inflammatory process of the
same, from cyst formations, due to presence of spiroptera sanguinolenta,

SPIROPTERA SANGUINOLENTA {encysted in the oesophagus.)

PARALYSIS OF THE (ESOPHAGUS 51

which grow between the muscles and muscuhir coat of the oesophagus
(see Fig. 26 and Phite), or by a compression stenosis, from malignant
goitre, and still less frequently by cicatricial contraction as a result of
injuries, inflammations, etc., in the cervical region. The symptoms of
such injuries have been already described on page 49. In cases where
the stenosis gradually develops, the animal has more or less difficulty
in swallowing. This becomes more and more difficult until finally food
collects in a sausage-like mass, against the constriction. Examination
by means of a probang makes a diagnosis more certain. The successful
treatment of such a condition can only be expected if the cause is due to

Spiroptera Sanguinolenta.

the obstruction of the oesophagus by foreign bodies or the removal of
tumors if they should be the cause of compression in the region of the
oesophagus.

Dilatation of the (Esophagus ; Ectasia and Diverticulum.

This has been described liy a number of authors and is indicated by
great difficulty in swallowing, vomiting, etc. If the dilatation is in the
cervical region, along the line of the oesophagus, we find round elongated
lumps, varying in size, and by manipulation this collection of food can be
worked down into the stomach. The probang may be used to start it.
Great care, however, should be taken not to use too great force, as it will
only pack the food and fix it. The prognosis, as a rule, is unfavorable,
but if the animal is kept on liquid food exclusively, it will li-^e for a long
time.

Paralysis of the CEsophagus.

{Dysphagia Paralytica.)

This is due to the paralysis of the nerves that supply the region of the
neck, seen particularly in conjunction with paralysis of the larynx.
It may occur as a result of certain brain diseases, from certain poisons,
from intestinal mycosis, and also as a symptom of rabies. It is recognized
by constant dribbling of saliva from the mouth. The animal may make
efforts to drink water, but while the movements of the muscles of the neck
would lead you to think the animal was doing so, on close observation of

52 DISEASES OF THE DIGESTIVE APPARATUS

the vessel from which the animal was drinking, it shows little or no
diminution in the contents.

DISEASES OF THE STOMACH.

Acute Catarrh of the Stomach.
Gastritis Catarrhalis; Gastricismus; Acute Dyspepsia.

Etiology. — The following are generally the causes of this very common
disease: hot, frozen, fermenting or decaying alimentary matters, over-
feeding or gorging after a long fast, foreign bodies, such as sand, stones,
buttons, splinters of w^ood, and undigestible food that is not adapted or
intended to be eaten by dogs, and also from the presence of parasites.
As regards toxic gastritis, that will be taken up later on. We find also
that some diseases, such as distemper, some affections of the liver, and
intestinal catarrh have acute gastritis accompanying them. Very often
acute catarrh of the stomach is developed from simple colds, or clipping
the animal, too frequent bathing, and not drying it properly.

Pathological Anatomy. — The mucous membranes of the stomach are
hyperaemic and swollen; the folds of the membranes are distended and
covered with a thick tenacious mucus. At times there are seen small,
hemorrhagic erosions on the membrane.

Clinical Symptoms. — The first symptom of acute catarrh is loss of
appetite. The animal will be very dainty and pick out certain pieces,
generally meat, and eat them slowly, or, as is generally seen, refuse food
altogether. The animal is always very thirsty, drinking large quantities
of water. The animal vomits frequently, especially after eating or drink-
ing, but may vomit without anything on the stomach. If after eating, it
consists of masses of undigested food mixed with a tenacious mucus and
saliva; if after drinking water, the water is tenacious and forms bubbles of
thick mucus — this may be streaked with blood or more or less tainted
with bile, according to the condition of the liver. The tongue is coated
with a thick, white mucus and on pressure in the region of the stomach
the animal evinces pain, and the stomach may be distended with gas (see
page 20). The animal is irritable and wants to keep in the dark or
in cool places and not be disturbed, or may give sharp short cries,
change from place to place, and give every indication of stomachache.
The nose is dry and the body temperature uneven, that is, body hot, ex-
tremities cold, and there may be some rise of temperature. If the symp-
toms are of an alarming character, they are generally caused by some
toxic condition, due to the formation of poisons, generated in the
stomach (ptomains). With this we have a putrid smell from the mouth,
great depression, or even complete coma, and evidences of acute narcotic

CHRONIC CATARRH OF THE STOMACH 53

poisoning. See chapter on Mycotic Stomatitis, Catarrh of the Intestines,
and Inflammatory Hemorrhagic Gastro-cnteritis.

There are always some intestinal complications. There is increased
excretion of faeces, generally diarrhoea, and occasionally icterus of a
catarrhal nature. The animal, as a rule, makes a good recovery. In
very rare cases the condition becomes chronic, but death never occurs
except where some complication other than true catarrh of the stomach,
is present.

Therapeutics. — The treatment differs according to the exciting cause,
and also the severity of the symptoms. If the cause has been the eating
of some putrid matters and if you suspect some to be present in the stom-
ach, it is best to give the animal an emetic, such as the hypodermatic in-
jection of apomorphia, as described on page 21; such emetics as tartar
emetic, ipecacuanha or antimonial wine are not advised, they are all
very depressing. After the animal vomits and the vomited matter is
putrid and offensive matter, it is well to give the animal 8 to 10 ounces
of warm water with a small cjuantity of bicarbonate of soda in it. It is
good practice to add a little creolin to the warm water. If it is not ad-
visable to administer emetics in such cases where the animal is greatly
depressed, calomel or Glauber salts can be given to sweep the intestinal
tract. Keep the animal on a low diet in the beginning; let the animal
do without food for a day, and then give small cpiantities of milk or
finely cut-up meat, soup, or beef tea, a stomachic, such as tincture of
rhubarb or nux vomica in small doses; if there is vomiting, carbonate
of sodium or magnesium is to be given in small doses several times
daily. Essence of pepsin is also useful to settle the stomach; it must
be given in teaspoonful doses three times daily.

Chronic Catarrh of the Stomach.
Gastritis Catarrhalis Chronica; Chronic Dyspepsia.

Etiology. — Chronic dyspepsia is rather common in the dog, especially
if the aninuil has had several attacks of acute dyspepsia. It may also ap-
pear as a secondary complication of various diseases, such as chronic dis-
ease of the liver, lung or heart, cancer of the stomach, gastric tumors, and
parasites.

Pathological Anatomy. — The mucous membrane is covered with a
tough, glassy mucus, dirty-white in color. In the early stages the
mucous membrane is red, and as the disease continues the membrane
becomes dark gray in color, due to pigment stains and more or less swol-
len, especially if the gastric glands become atrophied and indurated
from the constant irritation.

CUnical Symptoms. — They are similar to those of the acute catarrh

54 DISEASES OF THE DIGESTIVE APPARATUS

of the stomach; Init the appetite, while it may be very irregular, is not en-
tirely absent — one day very good and the next absent. Vomiting oc-
curs generally a short time after eating, and consists of undigested food
covered with quantities of tough, glassy mucus, sometimes streaked with
blood, and the tongue is more or less coated. There is pain on pressure in
the region of the stomach, especially after eating, although this is not a con-
stant symptom by any means. The animal becomes thin and shows every
S3^mptom of poor nutrition.

We must always take into consideration that the mere loss of ap-
petite does not always mean acute or chronic catarrh of the stomach, but
is a symptom present in a number of pathological conditions, and every
symptom must be carefully examined before coming to a definite
conclusion.

Therapeutics. — The washmg out of the stomach, so often resorted to in
man, is fully explained on page 21. This treatment is not to be employed
in all cases of this disorder; for in some cases it produces great irritation,
and if persisted in does more harm than good. Try to get the animal to
drink small portions of water, Avith some lime water in it, at frec|uent in-
tervals; if it will not drink, pour fresh water down its throat; in
anaemic animals, use tepid water, with a small ciuantity of a solution of
bicarbonate of sodium, a pinch or a teaspoonfid of Carlsbad salt, in warm
water, on an empty stomach. Hydrochloric acid well diluted can be
given after meals and the treatment described on page 53. In very
acute cases give naphthaline, salic3'lic acid, I'csorcin, menthol, or thymol.
As a rule, however, it is advisable not to do this unless you suspect some
irritant or poisonous material to be present. If the chronic catarrh
occurs as a result of other diseases, we must treat the original cause,
as very frequently when the other disease is treated successfully, the
gastric mucous membrane returns to its natural condition without any
other treatment.

I> Extract! rhei; 2.0

Sodii bicarhouatis, 100.0

M.
Sig. — A small pinch twice daily.

I^ Mentholis, 2.0

Sacchari lactis,

Guinmi arahic, aa 1.0

M. Et fiat pulv., No. x.
Sig. — Give one twice daily.

Other Disorders of the Stomach.

Expansion or Dilatation of the Stomach (Gastrectasis , Dilatatio Ven-
tricuU) . — This condition may occur in the acute or chronic form. In acute
it is due to overloading the stomach with dry food and particularly when

OTHER DISORDERS OF THE STOMACH 55

the food is of a poor indigestible character. If the stomach is not
emptied by an emetic, the abdomen becomes greatly distended, particu-
larly in the epigastric region. The animal is restless, moving from one
place to another, the expression is haggard and indicates pain, there is
quick catchy respiration, and the pulse greatly increased in number.
In severe cases the animals die with dyspnoea. In less acute cases the
animals slowly recover or it is followed by an attack of acute gastric
catarrh.

The treatment consists in administration of an emetic, such as a
hypodermic of apomorphia.

A chronic dilatation of the stomach is frequently seen in dogs that
are fed on poor food and in animals that gulp down their food, partic-
ularly when they are only fed once daily. It may also occur from contrac-
tion of the pyloric end of the stomach or duodenum, from cicatricial con-
traction, the presence of carcinoma, or from weakness of the walls of the
stomach; this latter condition is rarely seen. In chronic dilatation of
the stomach there are all the indications of chronic catarrh with more or
less distention of the abdomen, particularly in the epigastric region.
On percussion of the region of the stomach a dull tympanic sound is
heard, which disappears when the animal eats any food; then palpation
of the stomach produces a splashing sound.

The treatment consists in giving the animal smaller quantities at
shorter intervals and the same medical treatment as is advised under
chronic dyspepsia. If it is suspected or diagnosed that there is pyloric
stenosis, you should try to remove it by surgical means.

Reversion or Inverted Stomach, Torsio Ventriculi, Volvulus Ventric-
uli. — This is observed where the stomach is turned on its axis and, as a
rule, occurs in the larger breeds of dogs. The stomach is completely re-
versed, so that the pyloric end is found in the left epigastric region instead
of the right, and the large curvature, instead of being on the left, is found
on the right and the oesophagus has a twist in it. On making an ab-
dominal incision the stomach is found to be greatly distended and the
spleen is greatly enlarged. The causes that may produce this condition
are violent exercise, particularly running up and down steps with an
empty stomach (Cadiac) , or the same exercise with a greatly distended
stomach (Jensen) . The symptoms come on very quickly, great distention
of the abdomen, dyspnoea, cyanosis, pain on pressure of the region of the
stomach, colicky pains and vomiting. Death generally occvirs in from 30
to 40 hours, either by suffocation or paralysis of the heart. The treat-
ment recommended by Cadiac is to gradually remove the gas from the
stomach by means of a trocar and opening the abdomen and returning
the stomach to its original position.

Foreign Bodies in the Stomach. — By this we mean stones, glass,

DISEASES OF THE DIGESTIVE APPARATUS

balls, pieces of money, rubber balls, needles, hair balls. These produce
the following symptoms: vomiting, loss of appetite, restlessness, animal
screaming with pain or howling, animal attempts to bite all who touch
him, colic and in the later stages great depression; where foreign bodies
become lodged in the pyloric portion of the stomach (see Fig. 27) there
may be no other symptom than acute catarrh of the stomach. We may
detect the foreign bodies by palpation or by means of the Rontgen or
X-rays.

Fig. 27. — X-ray picture of coin in the stomach.

Therapeutics. — If the foreign body is diagnosed, give an emetic.
Moller advises giving a good meal before the emetic is administered so
as to assist in holding the foreign body when the emesis occurs and this
prevents it doing any harm to the tissues. If the emetic does not succeed
in removing the foreign body, laparogastrotomy must be performed.
This is described in detail under that head later. In performing that
operation for this particular case, the incision should be made on the linea
alba close up to the xyphoid cartilage and thus bring the incision close
and parallel to the great curvature of the stomach; or, as Frick advises, on
the diaphragmatic position of the stomach directly on the great curva-
ture. In this operation, great care must be taken not to cut any of the
large arteries of the stomach, which are located on the great curvature.

OTHER DISORDERS OF THE STOMACH 57

The animal must be fed on the lightest of liquid food for at least a week
after the operation

Ulceration of the Stomach (Ulcus Ventriculi). — When bleeding occurs
from the stomach as the result of some acute inflammatory condition of
that organ, it always leaves an erosion of the mucous membrane. As a
rule, this heals up very rapidly in the dog, rarely leaving any cicatrix on
the membrane; abrasions of the mucous membrane from sharp pieces of
bone, splinters, or caustic agents also heal up very rapidly.

Ocasionall}^, however, we see true ulceration of the stomach. The
real cause of this condition has not yet been satisfactorily explained,
although many investigations have been made on the subject.

The ulcer in the beginning is an inflamed circular spot, from which
the mucous membrane peels, and gradually disappears, extending to the
deeper tissues where it forms a yellowish-red, unhealthy surface, with an
irregular, hard, indurated border. Very often they heal up, leaving an
irregular cicatrix, usually circular in shape.

In the dog, as in man, we find that in rare instances the ulceration is
so extensive as to perforate the stomach to the serous membrane and
form adhesions to the adjacent organs.

This condition may be present without presenting any symptoms
that can be recognized, and it is only on post-mortem that it is rec-
ognized, either by the presence of the ulcer, or a cicatrix is seen on the
mucous membrane of the stomach. The symptoms recognized are
generally those of gastric catarrh, with vomiting of blood at irregular
intervals. The treatment consists in administering bicarbonate of
sodium, argenti nitras or, better, some of the organic compounds of
silver, or subnitrate of bismuth is useful, but the use of hydrochloric
acid or a stomach-pump is contraindicated.

Cancer of the Stomach : Carcinoma Ventriculi. — Cancer of the stom-
ach is very rare. Symptoms consist of irregular attacks of gastric catarrh
with possibly vomiting and gradual loss of flesh, and if the carcinoma is
located in the pyloric end of the stomach, we would be apt to find pyloric
stenosis and dilatation of the stomach. Eberlin describes a case in which
a carcinoma was present in the pylorus and duodenum and accompanied
with acute icterus. It is almost impossible to detect with any degree of
certainty such a cancer by palpation. Parascandolo performed gas-
trectomy and removed a cancer from the stomach with complete success.

Parasites of the Stomach. — The spiroptera sanguinolenta is fre-
quently the cause of stenosis of the cesophagus (see Fig. 20 and Plate).
In the adult form this parasite is from 3 to 7 cm., the male 3 to 4 and the
female 6 to 7 cm., and are blood red in color. They may be solitary, or
several may occur in one ulcer. This nodule is frequently the size of a
pigeon's egg. The parasite is found in the submucous tissue with a

58 DISEASES OF THE DIGESTIVE APPARATUS

small opening into the stomach. In rare instances, this parasite is found
in the bronchial glands, the aortic wall, in the lungs, and in the neighbor-
hood of the kidneys (Railliet). The general symptom of these parasites
in the stomach is a catarrh of the stomach, gradual emaciation and
sometimes great restlessness. Hunter describes a dog who was greatly
emaciated and was destroyed as suspected of having rabies. On post-
mortem, the mucous membrane of the stomach was very much congested,
and he found six nodules the size of a walnut, in which there were
numerous spiroptera sanguinolenta.

Very rare instances are found where the larvae of the Gastrophilus
equi are found in the mucous membrane of the dog. The egg may have
been deposited in the hair of the dog, and by being licked off by the
animal, reached the stomach or, from depraved appetite, the animal ate
horse droppings. This mode of transfer was done experimentally by
Railliet.

DISEASES OF THE INTESTINES.

Intestinal Catarrh.

(Catarrh of the Bowels; Enteritis Catarrhalis.)

Catarrh of the intestines originates freciuently from the same causes
as catarrh of the stomach, when the animal has eaten some irritating sub-
stance, and it frequently happens that the two diseases occur together.

Intestinal catarrh is generally caused by the animal eating decayed,
tainted, fermenting, or indigestible food, or from intestinal parasites or
poisons. It also appears in an infectious form, attacking entire kennels
and animals of all ages. It is freciuently caused by cold or certain in-
fectious diseases and sympathetically in other disturbances of the in-
testinal tract, such as distemper, septicaemia from disturbances of the
circulation and from disorders of the liver, lungs, heart. Coccidia are
supposed to cause this disease, but the waiter never found but one case
in all his observations; in this one case the animal was greatly emaciated.

According to the duration and severity of the disease, we determine
whether we have acute or chronic catarrh of the intestines. The acute
form of the disease lasts from one to two weeks; the chronic often for
months.

Etiology. — The causes of acute and chronic catarrh in the intestines
are similar; the latter is frequently developed from the acute form and
from frequent return of the disease, the system becomes weakened and
the disease remains in a milder, but chronic form.

The disease may be located cither in the small or large intestines, or
in both. The small intestine is the common seat of the disease, but it is

INTESTINAL CATARRH 59

frequently found also in the large intestines. The various classifications,
such as duodenitis, jejunitis, ileitis, typhlitis, colitis and proctitis, are
useful only to the anatomist, but not to the observer. Proctitis is fre-
quently seen in the dog in an isolated form. This is given with more
detail on page 25.

Pathological Anatomy. — The effects of catarrh of the intestines are
practically the same as in all irritations of the mucous membranes. In
the acute form, the membranes may be swollen and reddened through the
entire intestine, or it may be confined to certain localities, where it is
reddened and congested, and the membrane raised and covered over its
surface with flaky, slimy epithelium. In very bad cases there is a large
number of these epithelial masses, with desquamation of the mucous
membrane. These masses of inflamed follicles become grayish-white
in color and project from the membrane or finally become ulcerated. In
some diseases, where there is severe catarrhal inflammation of the mucous
membranes, we find a sympathetic inflammation of the intestine, in
some cases even a necrosis from which follows ulceration of the bowel.
The writer had one case under his observation, where a young dog died
from a necrotic vdceration of the bowels.

In the chronic form, the redness is less intense; the mucous mem-
brane may even be pale or livid, grayish-red or dark red in color. In rare
cases it is slate color. The swelling is more regular and covers a larger
area, forming a true hyperplasia of the membrane; the inner surface
of the bowel becomes irregular and uneven w'ith projections over the
entire surface. In some cases the membrane shows true polypous forma-
tions, due to circumscribed hyperplasia of the connective tissues. AVhere
there has been cystoid degeneration of the follicles, the intestinal secre-
tions are stopped entirely and the mucous membrane is thin and smooth.

Clinical Symptoms. — The most prominent symptom of intestinal
catarrh is diarrhoea, especially if it is confined to the large intestine,
although there may l)e no diarrhoea whatever if the inflammation is con-
fined to the small intestine, as it is well known that the absorption of the
fluids and the formation of the faeces are confined to the large intestine,
and we often find intense inflammation of the small intestine with pro-
fuse diarrhoea without having the large intestine affected whatever.
On the other hand, we often find inflammation of the rectum and no
diarrhoea at all.

In making a diagnosis it is well not to identify too closely diarrhoea
and catarrh of the intestines — that is, consider each case of diarrhoea as
being due to catarrh of the bowels — as there are many conditions that
increase the peristaltic action and cause diarrhoea that are not directly
due to inflammation, such as cold or a sudden chill, to an animal that has
been kept warm, to poisonous substances, from the administration of

GO DISEASES OF THE DIGESTIVE APPARATUS

laxatives or cathartics, or great exertion in an animal, not accustomed to
it. It is, however, impossible to draw a distinct line between intestinal
catarrh and diarrhoea, but a conclusion can be arrived at by the number,
amount, and character of the diarrhoeic discharges.

The number of stools varies, to a certain extent, and their consist-
ency, from pulpy to thin, water evacuations. At first the passages are
clearer than natural, and yellower, and as the condition goes on they
become gray; this color is due to the fact that the passages are so frequent
that the liver is not able to furnish sufficient bile to color them, and in a
number of cases, there is a certain amount of thick gelatinous mucus
mixed in the excremental matter. In some cases the mucus becomes
very copious, and sometimes the passages are nothing but mucus, fre-
quently frothy, the stool being filled with small bubbles of gas and an
intensely offensive odor, and in rare cases blood and pus are present; for
further details see page 27.

In intestinal catarrh the animal is restless, changing its position
frequently, groans or cries, arches the back, or may rest the forepart of
the body on the ground and have the hind quarters elevated. This is an
indication of colicky pains. The examination of the abdomen externally
does not furnish much information. Sometimes the abdomen is drawn
up; in other cases it is distended. On applying the ear to the region of
the abdomen, a great amount of gurgling or rolling is heard in the cavity;
this may often be heard quite distinctly some distance from the animal.
This is due to the increased peristaltic action. On pressing the posterior
part of the abdomen, the animal often evinces pain.

Tenesmus and relaxation of the rectum are generally present in the
later stages of this disease. The animal makes prolonged and repeated
efforts to pass the excremental matter, and finally passes only small
amounts of mucus and blood, after great exertion. In some cases these
prolonged exertions cause the lower bowel to be protruded. This,
however, is generally seen in young puppies and only in very rare in-
stances in older dogs. If the tenesmus is very great, it indicates that
there is great irritation of the lower bowel (as regards the examination of
the lower bowel, see page 28).

The other symptoms of catarrh of the intestines are as follows: The
color of the urine becomes dark from the tinting of the bile pigment and
is lessened in quantity from the drain of fluids from the bowels. Fever
is present, but it is generally slight. There is loss of appetite, vomiting,
and yellow or icteric coloring of the mucous membranes, great thirst, and
the animal becomes weak very quickly and shows great depression. This
is specially noticeable when the inflammation is due to eating decayed
meat.

Chronic catarrh of the bowels resonil)los the acute form in many

INTESTINAL CATARRH 61

ways, but it is less severe in its symptoms. The faeces change from soft
to firm, like the stools of cliarrhcEa, and vice versa, the animal becoming
weak and thin, showing signs of anaemia; but in the chronic cases the ap-
petite is generally very good. In some cases where the disease has been
present a long time, when we examine the intestines by palpation, through
the abdominal wall, the intestines are found to be firmer and less elastic.

Prognosis. — In strong animals, this disease is generally not very se-
rious, but in young dogs or puppies, it causes great exhaustion and they
die from collapse before the diarrhoea can be checked; the chronic form
in old animals is generally very hard to control and must be looked upon
as a grave condition. Often attacks follow one after the other, com-
pletely prostrating the animal and carrying it off finally.

Therapeutics. — In slight cases the only thing to do is to keep the
animal in an even warm temperature, regulate the food and, as a rule,
lessen it in quantity and make it easier digested. Soup or broth, mixed
with bread or biscuit, rice, etc., friction to the stomach and a small quan-
tity of alcohol, in the form of whiskey or sherry, for weak, delicate dogs.
It must be borne in mind that in all cases of this disease the treatment
will depend entirely on the causes and symptoms that are observed. If
the cause has been the ingestion of decayed or putrid substances, or
internal parasites, the first thing to do is to clean the intestinal canal
out by means of a purgative, such as calomel, Glauber salt, or in weak
subjects or puppies, olive oil. If there is any indication that the liver is
disturbed, it is best to first administer a dose of calomel and follow up
with a saline purgative. Where there are copious and thin discharges
and an indication of excessive peristaltic action, laxatives are contra-
indicated; it is advisable to use narcotics, and in this instance opium is
always indicated, powdered opium, laudanum, morphia or Dover's pow-
ders. The attempt to substitute extract of belladonna or hyoscyamus
and bromide of sodium in this disease has not proved to be very success-
ful. Beside opium, we should also use the true astringents, such as tannic
acid, calumbo root, and cascarilla bark. Certain preparations of bis-
muth have a tendency to disinfect the intestinal canal and also to soothe
the irritated mucous membranes. Xeroform (bismuth tribomphen-
yticum) or bismuth subgallate or subnitrate. If ulceration of the bowels
is indicated by symptoms, the albuminoid or organic preparations of
silver or nitrate of silver are to be given, followed up by small doses of
naphthalin, salicylic acid or creosote. If we suspect that there is a certain
amount of putrid matter in the intestines beside, use saline laxatives to
sweep out the decayed material; after doing this administer xeroform or
resorcin (see treatment of mycotic gastro-enteritis) . It is well to make
one or two irrigations of the bowels daily by means of a rubber funnel
and a piece of rubber hose with a pipe of hard rubber at the end, which

62 DISEASES OF THE DIGESTIVE APPARATUS

is inserted in the rectum, as far as possible, and the fluid poured into the
funnel and allowed to gravitate slowly into the bowel. The best solu-
tions to use are a 1 to 2 per cent, solution of tannin, alum, or 1/2 to 1
per cent, solution of silver nitrate or one of the various synthetical silver
salts (argenol, argyrol, argentamine, picratol), the solution to be about
30 per cent. The amount to use is about 1 to 2 litres. If this amount
causes much irritation and straining, it must be discontinued; but it is
well to give the animal at least one injection by this method, as it helps
to clean out the lower bowel and facilitate the action of the medicinal
agent.

The treatment of chronic catarrh of the bowel is practically the same
as the acute. Catarrh of the rectum may be caused by an extension of the
irritant from the intestines, but this condition is more apt to result from
mechanical irritants, very hard faeces, sharp splinters of bone or wood,
rectal parasites; in male puppies that are housed with other older animals,
particularly stud dogs, the rectum of the younger dog is frequently
greatly irritated by attempted copulation on the part of the older male.
Proctitis is recognized by difficult and painful defecation and the passage
of small quantities of fseces covered with mucus and frequently bloody.
When making a diagnosis, the rectum can be examined by means of the
fingers previously oiled and introduced into the rectum or by means of a
rectal speculum. After removing the cause, hard fseces or a foreign body,
inject into the rectum, by means of a clyster apparatus already described,
a thin mixture of starch with a small amount of opium in it or alum or
organic silver solution. Tincture of nux vomica is very useful as a tonic
in one or two-drop doses, before meals, twice daily. The quantity of
food requires special attention. Give easily digested food and of a
character that will not produce a large amount of fseces; bones, fat, tendi-
nous, fibrous meat must be avoided. In order to counteract the loss of
strength, give small quantities of rare or raw meat, finely chopped, milk,
egg, rice and also the various peptone preparations. In young puppies
the various infant foods so largely used in children practice are used as a
substitute for milk. In persistent diarrhoea, give bismuth subgallate
subnitrate or salicylate or the organic compounds of silver. In rare cases,
where we find constipation present use a saturated solution of Glauber
salt, in teaspoonful doses; Hunyadi, Apenta or other laxative waters may
also be given. Any complication of the stomach will have to be treated by
the method advised under Catarrh of the Stomach.

The toxic and mycotic inflammations of the stomach will be
described separately.

Gastro-intestinal Inflammation. — Gastro-enteritis is caused by the
absorption of various acids or irritating substances and also by the exces-
sive use of drastic purgatives, such as aloes, calomel, croton oil. If the

INTESTINAL CATARRH 63

drug should be slowly soluble, or in the powder form, or contained
intimately mixed with some other substance, it may reach the small
intestines or even the large intestines and the rectum.

The intensity of the disease depends on the amount of the drug taken
and on the effect it has on the mucous membranes. The only result may
be an attack of acute'catarrh, with some loss of the epithelium of the mu-
cous membrane, or there may be also a gangrenous destruction of the
w^alls of the stomach. It is seldom that irritating agents get any further
than that organ, wasting their strength there and changing the wall of
the stomach into a blackened or tinder-like mass, and all the surrounding
tissues are swollen and reddened by hyperaemia or hemorrhages.

We may safely conclude that we have a toxic gastro-enteritis to
contend with when the symptoms of a serious gastric catarrh appear sud-
denly, especially after eating, and if the grave symptoms increase rapidly
and are accompanied by loss of appetite, salivation, vomiting, great
restlessness, severe pains taking the nature of colic, and on pressure on
the abdomen, it is painful and greatly distended, the vomited matter and
the passages from the intestines being mixed with mucus and blood,
tenesmus, great weakness and small frequent pulse.

The treatment consists, first, in giving an emetic, or use a stomach-
pump or wash the stomach, see page 21, and after that has had its effect,
give a laxative, an oleaginous one (olive oil or linseed oil) is the best,
rectal injections of warm w^ater, if there is much j^ain and irritation, small
quantities of opium can be given in the oil, and if the poison can be dis-
covered, use the proper antidotes, which are given in the chapter on
Poisoning.

Mycotic Inflammation of the Stomach and Intestines (Gastro-
enteritis, Mycotic Decayed Meat Poisoning). — This is a variety of toxic
inflammation, of the stomach and intestines. It is due to decayed meat
poisoning. This is seen after the animal has eaten decomposed meat,
offal or from drinking brine (Leisering), or eating cadavers of dogs or other
animals that have died infected with bacteria, i.e., pus, septic metritis,
mastitis, enteritis, nephritis; from drinking or licking the juices of de-
cayed meat, putrified cheese, sausage; fish and all such matters that are
filled with toxincs and tox-albumens, developed from the micro-organ-
isms such materials contain, also from drinking from stagnant ponds
and bodies of water containing decayed substances, or cadavers. This
condition is seen in all sorts and conditions of animals, in the best fed and
semi-starved, in the first from depraved appetite, due to indigestion.
Even when they are well fed, they get into the habit, if they are allowed to
roam in closely populated towns and villages, to go a regular route from
one garbage pail to another and eat all sorts of decayed vegetable or
animal matter. The active agent has a toxic principle present in it. The

64 DISEASES OF THE DIGESTIVE APPARATUS

symptoms of that form of poisoning are as follows: vomiting of an amount
of very offensive matter, rotten masses of meat and with it quantities
of bad-smelling mucus and sometimes accompanied by violent bloody
diarrhoea, intense thirst and high fever, 40 to 42°. The writer has seen,
however, instances where the temperature was subnormal, a small rapid
pulse, great weakness, often complete paralysis, great depression and
indifference to surroundings. Death generally follows with every symp-
tom of collapse in 15 to 24 hours. If the symptoms are less acute, there
is muscular or intestinal cramp, great difficulty in swallowing, disturbance
of sight, dilatation of the pupils, bloody urine. When an animal makes
a recovery, it is very weak for a long time, and it is almost impossible to
get the animal to eat.

After death, the process of decomposition begins almost imme-
diately, and if a post-mortem is to be held, it must be made as soon as
possible. If this is done, the stomach and intestines will present, an
intense hemorrhagic inflammation of their walls, swelling of the follicles
and mesenteric glands, as well as severe inflammatory changes in the
adjacent organs, liver, spleen, heart, etc.

The treatment has to be symptomatic. In the beginning give an
emetic (apomorphia) subcutaneously, washing out the stomach, with
warm water, or very weak solution of creolin, and the administration of
purgatives, emulsions of castor, olive, or linseed oil, and tepid rectal injec-
tions of creolin, and massage the abdomen with alcohol or a jDriessnitz
compress, with tepid water or flaxseed poultice. The bodily strength
of the animal should be kept up, with black cofTee, wine, whiskey, or
brandy, spirits of camphor. When there is great depression, spirits of
camphor may be injected subcutaneously. In mild cases we may treat
them in certain lines as catarrh of the stomach and intestines. The
animal should be fed on light foods, easily digested, and in small quantities,
no solid meat the first forty-eight hours.

Constipation, Costiveness.

This condition may result, from the animal eating food that is diffi-
cult to digest, i.e., potatoes, bread, beans, peas, dog biscuit, corn flour,
bones, particularly calf bones, or where the animal has little or no exercise,
animal kept on the chain or penned in a small yard, hunting dogs that
have worked hard during the open season and during spring and summer
do nothing, old dogs that have weakened digestions, particularly if they
have suffered from chronic intestinal catarrh (see under that heading).
Costiveness is also seen as a result of fever, rheumatism, peritonitis,
catarrhal icterus, and diseases of the spine.

OBSTIPATION G5

Obstipation.

(Occlusio Intestini; Ohturatio Intestini.

Constrictions of the intestinal tract may be formed in any region and
may vary in degree. They always produce more or less obstructions to
the passage of the alimentary matter, and when the constriction becomes
complete, the intestinal contents, being unable to pass, usually return
toward the stomach again, and are expelled by vomiting. In such cases
the animals die quickly. This is noticed in very rare instances, where a
hernia has strangulated and completely blocked up the canal. (For
further details see chapter on Hernia.)

Constriction may be caused by abnormal conditions of the intestinal
contents, from the alteration of the intestinal walls, by changes in the
position of the intestines, and, lastly, from external pressure.

The bowel is often blocked up by masses of excrement, as a result
of improper food or feeding which is not digested in the stomach or
intestine; these collections reach the lower bowel and from the constant
accumulations of excrement coming down from the small intestines
gradually blocks up the entire tract. We also see obstructions, caused
by pieces of wood or splinters of bone, that collect masses of fseces around
them and fill up the bowel, forming intestinal stones or calculi (copro-
liths). These invariably have a nidus or centre consisting of a marble,
pieces of cork, sponge, or other foreign bodies, or it may be caused by
large pieces of bone, stones, glass or metal balls, nuts, pieces of leather,
etc., some of which may be swallowed accidentally in the case of trick
dogs, or in play.

The constriction of the intestine, from being enclosed in a hernia
and the impaction of the intestinal contents pressing into the part is fre-
quently seen in the dog. The intestine frequently becomes twisted or
knotted, or even invaginated. These complications, as a rule, occur in
the small intestines. External compression of the intestines is frequently
caused from enlarged prostate or sarcomas in the pelvic cavity, helminths
or parasites that lie in cyst formations in the mucous membrane of the
intestines. Sometimes enormous abscesses form in the abdominal cavity,
and in rare instances they are caused by accumulations of fluids in the
abdominal cavity, as in the case of ascites. In newly born puppies we
sometimes see a congenital obstruction of the rectum (atresia ani).
-Great masses of fsecal matter may accumulate in the anal pouch; this may
be due in some cases to the swelling of the anal glands, or by the accu-
mulation of masses of hair gluing around the rectum and preventing
defecation; the same condition is seen in tumors of the anus or rectum.
For further details see page 29.
5

66 DISEASES OF THE DIGESTIVE APPARATUS

When a portion of the intestine becomes obstructed, the following
changes take place: In front of the obstruction, an enlargement forms,
due to the accumulation of gas and excrement matter, while the portion
of the intestine beyond the obstruction is empty and constricted. The
accumulation of gas and matter causes an intense inflammation of the
mucous membranes, which extends to the muscular coat of the intestines
and soon to the serous coat, and quickly the entire intestinal tract is
involved in the inflammation, the constricted portion becomes mortified,
and perforation follows, allowing the contents of the intestines to escape
in the abdominal cavity, causing purulent peritonitis.

Clinical Symptoms of Constipation. — The symptoms and course of
constipation are due to so many different causes that they will be de-
scribed separately.

In mild cases of constipation the symptoms are not especially charac-
teristic and resemble chronic catarrh of the stomach. At fii'st the animal
is noticed to defecate irregularly, the stools are smaller and passed appar-
ently with more or less difficulty, which is especially noticeable, consider-
ing the stools are very much smaller than natural.

When from having little exercise and living on highly spiced foods,
(veal or game,) or eating quantities of bone that they are unable to digest,
great accumulation of faecal matter gathers in the colon and rectum. The
most marked symptom is the repeated attempts of the animal to defecate
without any results or after great efforts only succeeding in passing a
small cjuantity of faeces. These are coated with mucus or blood and are
passed with more or less pain. The stools are small and are generally
yellowish-brown in color, and in powder-like masses that break up easily,
showing no moisture in them. The position of the tail is characteristic.
It is carried so as to form a curve at the rectum, the curve being from
the base to one-half of the tail. On pressing the fingers into the sides of
the abdomen, at the entrance of the pelvis up toward the spinal cord,
we find an elongated sausage-like body which is extremely sensitive to
the touch. This hard mass is found to extend downward and forward
toward the umbilicus. The intestines are greatly swollen on account of
the accumulation of gas and vomiting is sometimes present (Fig. 28).
On making an examination of the intestines by the hand, we may be
able to detect the distention. The colon is found to be dilated, through
its entire length, forming an enormous sac, filled with a putty-like mass;
and during palpation the animal as a rule evinces pain and resists it. This
examination should be carefully made, as it may lead to the discovery of
the original cause of the constipation. Slight diarrhoea may sometimes
be present in severe constipation; this is due to the mass lying in a sac
or pouch in the intestine, the firmer material gradually accumulating and
the fluid faeces passing over the collected mass. Long continued consti-

OBSTIPATION 67

pation (coprostasis) may cause infection of the blood from absorption,
of the fsecal matter, enteritis, mortification, peritonitis and death.

Symptoms of Obstruction of the Intestines. — In complete occlusion
of the intestines, due to foreign bodies, invagination or tortion, the
animal is irritable and cross and Trasbot has seen cases where the animal
showed symptoms very similar to rabies or where it may present the
other extreme, being dull and indifferent to the surroundings, refusing
all food, but showing great thirst, with no passage of faeces whatever.
The rectal temperature is slightly increased, the lower portion of the
abdomen is inflated with gas and very painful, even on the slightest
pressure; in some cases we may find decided icterus.

Fig. 28. — Dog with obstruction of the intestines.

The vomiting is constant and very severe, particularly in the later
stages of the disease, the animal vomiting whenever it drinks any water.
At first the vomited matter is normal, but later on it assumes a greenish
color (bile) and finally putrid, containing pieces of faecal matter.

By examining the abdominal region with the hand we can generally
locate the obstruction, which is hard and exceedingly painful on pressure.
The swelling can be moved about showing it to be part of the intestine.

In ordinary cases of constriction of the intestines, no definite prog-
nosis can be made with any degree of certainty as to its course and
duration. The constriction of the intestine may go on gradually and not
cause any serious symptoms for a long time, or it may progress very
rapidly and cause a complete constriction in two or three weeks. Where

C8 DISEASES OF THE DIGESTIVE APPARATUS

the condition continues for some time, the animal becomes gradually
weaker from day to day, loses flesh rapidly, pulse is smaller and finally
imperceptible, the temperature may rise but frequently it remains normal,
in a few days the animal may die in a condition of collapse. A favorable
termination may result, and foreign bodies, such as pieces of cork, bone or
wood may be macerated and passed out finally without any great trouble.
It is not difficult, as a rule, to detect the existence of a foreign body in the
intestines, but it is very difficult to tell its exact nature. By means of
palpation of the abdomen, see page 25, we may be able to detect hard,
foreign bodies, or objects, such as hair balls, but invagination or twisting
of the intestines is, however, rather difficult to diagnose. Metallic ob-
jects, stones, etc., can be diagnosed by means of the Rontgen or X-ray, or
by performing laparotomy. Where the intestine is completel}^ obstructed,
in front of the obstructed portion of the intestine, is greatly distended,
due to the collection of faeces and gas, and the intestine immediately
after the obstruction is contracted and empty. At the obstructed point
there will be found great inflammation of the mucous membrane, which
finally affects the muscular and serous coat and peritonitis, or the portion
becomes necrosed and a purulent peritonitis follows and the animal at any
of these stages may die of septicaemia.

Therapeutics. — In an ordinary case of constipation give plenty
of exercise and a carefully regulated diet. If it is advisable to give the
animal very little food for a few days, give plenty of water and small
quantities of soup, either beef or vegetable. In old animals, where diges-
tion is more or less weakened, give easily digested food and no bones
whatever. Clysters or mechanical laxatives, such as glycerine or soap
suppositories, and massage of the abdomen is advised. As a laxative,
oleum ricini 15.0 to 30.0 in a capsule or emulsion, Glauber or Epsom salts,
10.0 to 20.0, Hunyadi Janos, or Apenta water, teaspoonful doses.

When a case is very ol^stinate and does not respond to the previously
advised treatment, especially where we find the large colon filled with
fseces, and laxatives have no effect, the rectum must be emptied. The
finger after being well oiled is introduced into the anus where there will
be found hard fsecal masses in front of the sphincter. It is generally
impossible to remove them, except by breaking them up, cither with the
finger or having first injected a small quantity of oil or glycerine into the
rectum, or the handle of a spoon can be used to break up the masses,
taking care not to injure the mucous membrane. This is to be followed
by the injection of the clysters by means of the hose and funnel (see Fig.
29). The lower part of the bowel is filled with a coml^ination of luke-
warm water and a small quantity of oil. These clysters should be re-
peated frequently, at least several times a day, or even several days, until
the whole canal is emptied. Or what is better, glycerine suppositories,

OBSTIPATION

and later on administer a sharp purgative, followed by the administra-
tion of drop-doses of tincture of nux vomica.

The subcutaneous injection of such drugs as physostigmin, pilo-
carpine and arecoline are not, as a rule, satisfactory and barium chloride,

Fig. 29. — Mode of administering a clj'ster.

ichthlargan, tallianine are not to be advised, as their results are not at all
satifactory and at times actually dangerous to the animal. These latter
drugs are administered by intravenous injection into the saphena vein.
The vein is dilated by means of pressure and when filled, the hypodermic
needle is thrust into it, taking care the needle punctures the vein, which
will be indicated by a few drops of blood coming from the needle and con-
tinuing to drop as long as the pressure is kept on the vein. If it is the

DISEASES OF THE DIGESTIVE APPARATUS

cellular tissue no venous blood escapes. The injection is made and the
opening closed with collodion. As in the case in strangulated hernia,
or in the case of accumulation of the faeces in the rectum, due to faecal
stagnation^ or from the ulceration of abscesses of the rectum, we will
have to treat them as described above; but we may add to that the in-
jection of large quantities of soapy water several times daily, which can
be given with the apparatus illustrated in Fig. 29, and a dose of calomel
followed by castor or olive oil or glycerine injections into the rectum, or
suppositories in the form of glycerine, or a solution of glycerine and
water 1 to 10.

The stenosis of the bowel that is caused by the impaction of foreign
bodies is best treated with laxatives and not with purgatives. A'ogel
and others advise in the case of sharp or pointed objects, to feed the

Fig. 30. — Lambert. suture.

animal on thin liquid foods, soups of peas and vegetables, but if we do
not succeed in getting rid of the foreign body and, if a positive diagnosis
has been made, it is best to perform laparo-enterotomy as soon as pos-
sible, and not wait until gangrene and peritonitis have set in.

Laparo-enterotomy is performed in the following manner: the ani-
mal is anaesthetized and placed on its back, the lower part of the abdom-
inal wall shaved and washed with antiseptics. Make an incision, through
the linea alba, posterior to the umbilicus, back to the margin of the pubis
about 5 to 8 cm. long. First cut through the skin, then the muscles.
Before going into the abdominal cavity, all the hemorrhage must be
checked and the blood cleaned off, and then with the thumb and index
jfinger go into the abdominal cavity and, having located the portion of
the intestine wanted, pull it through the opening and hold the lips of the
wound together; an assistant can hold the edges of the wound together
and prevent the rest of the intestines from escaping, and also to prevent
possible infection from the escaping fluids, when the incision is made in

OBSTIPATION 71

the intestine. Make the cut longitudinally, on the intestinal line, on the
opposite side from the mesentery, remove the foreign body, taking care all
through the operation to prevent the fluids escaping into the al)dominal
cavity. "Wash the inside of the intestines with an antiseptic and unite it
by means of Lambert's suture (see Fig. 30) or Czerny's double suture
(see Fig. 31). For more exact detail on this subject, the reader is referred
to the works on canine surgery by French or Hobday. The operator now
takes a fine curved needle, and fine cat-gut suture and puts a number
of stitches through the mucous membrane and serous tissues, taking care
not to go through the mucous memljrane, so that when the thread is
tightened the two edges of the cut will he brought so as to face into the
intestine; these are tied, and another line of stitches is made over the
first, as is illustrated in the accompanying Fig. 31. The intestine is
returned to the cavit}', and the external wound sewed up with silk and

Fig. 31. — Suture of the intestines {Czerny).

dressed with an antiseptic dressing. In the male dog see that the dress-
ing is not soiled with urine.

The opening of the abdominal cavity is also to be performed in eases
"where we can recognize a total constriction of the bowels. In these cases
where the anatomical cause of the disease cannot be clearly established,
we have no other way to proceed than to treat the symptoms as they
present themselves, that is to give purgatives, or, in any case, do not
neglect to give plenty of watery clysters. The general treatment must
be directed toward keeping up the animal's strength. The first forty-
eight hours only water must be given and in small quantities. Subcu-
taneous injections of the spirits of camphor or ether are better than
administering them by the mouth, as they are vomited immediately.
Do not give the animal any food until the intestinal obstruction has been
removed or at least until there have been free defecation and the pas-
sage of the intestinal gas and the general condition is improved. And on
the third day the animal may be given food; it must be of the lightest
and easiest digested, such as soups, milk, bouillon with egg, meat, peptone,
and on the fourth day finely scraped rare or raw beef, or some of the

72 DISEASES OF THE DIGESTIVE APPARATUS

various foods used as substitutes for milk. "Where the animal is subject
to fffcal obstructions, it is well never to let him have bones if it can pos-
sibly be avoided.

Intestinal invagination occurs as a result of irregular or extraordinary
poristalsis, particularly when the intestinal wall is in a relaxed, debilitated
condition, as a result of intestinal catarrh from prolonged administration
of laxatives. Death as a rule occurs from the fifth to tenth day. The
symptoms of invagination are those of occlusion of the intestines, see
the above, and more or less blood on the fa?ces. We may be able by pal-
pation to detect the invaginated portion by feeling a circumscribed
elastic, elongated, sausage-like portion along the intestinal tract. This
is extremely painful on pressure. If it is detected, perform laparotomy,
reduce the invagination by lifting out the loop of intestine and reducing
the invagination, but if the irritation is too great, or necrosis has devel-
oped, perform enterectomy. See further on under Enterectomy.

Chronic Constipation. — This is seen occasionally in the dog. It is
due to a weakened or lessened peristaltic action of the bowels. It is seen
in all chronic diseases that are accompanied by emaciation and debility,
as in chronic catarrh, fevers, icterus, chronic peritonitis and in many dis-
eases of the nervous system; but it may be observed in many old but
healthy dogs, caused by an atrophy of the mucous and muscular mem-
branes of the intestines. This disease is frequently called chronic obsti-
pation, for it causes a form of constipation which would, as can be readily
understood, cause just such a train of symptoms as has been described
above.

These animals should be fed on non-stimulating, easily digested food
with or without the admixture of vegetable soup, and also plenty of
exercise and small doses of tincture of nux vomica. This treatment is far
better than the frecjuent administration of purgatives, especially
Glauber salt, jalap or aloes and cathartic pills.

Enterectomy, Entero anastomosis. — This operation becomes necessary
when a portion of the intestine becomes necrosed or where stenosis of a

Fig. 32. — Hairpin method of anastomosis, showing the manner in which the pin is bent.

certain portion causes accumulation of fa?cal matter anterior to the
contraction. The operation is only possible where there is a small sec-
tion of the intestine to be removed, as a section of any amount is apt, if
the animal makes a recovery, to be followed very quickly by marasmus
and terminate fatally in a very short time.

French has devised a very simple mode of operation, the technique
of which has proved very efficacious in the writer's hands. It is as follows :

OBSTIPATION

The animal is put under ether after the familiar antiseptic precautions
are used, cut down on the abdominal wall and having exposed the
necrosed or the stenosed portion, as the case may be, and very carefully
inspect the mesenteric blood supply, as great care has to be taken not to

Fig. 33. — Hairpin method of anastomosis, first stage {French).

ligate any vessel that would supply any but the portion removed. The
vessels are ligated by means of a curved needle being passed around them
through the mesentery, the anastomosing loop of the blood vessel being
taken up as close to the point of incision as possible. Then an ordinary

Fig. 34. — Hairpin method of anastomosis, second stage {French).

lady's hairpin, bent as in the accompanying cut (Fig. 32), is taken and
one prong is passed transversely across the intestine and the free ends of
the pin are seized by a pair of hemostatic forceps or tied with sutures and
another pin is inserted in a similar manner at the other point of resection;

74 DISEASES OF THE DIGESTIVE APPARATUS

this point of the operation is illustrated in Fig. 33. The intestine is
now cut close to the pins, and the mesentery cut as shown in the dotted
line, the severed ends with the pins brought together and the pins tied
or held by forceps both top and bottom (Fig. 34), and the suture is com-
menced at the mesentery, putting in the Lambert stitch on one side, then
turn over the intestine and stitch the other side. The stitching is to be
done very carefully and evenly, as on this depends the adhesion of the
anastomosis. French recommends the ordinary milliner's instead of the
surgical needle, as it makes a cylindrical hole that has no ragged edge
and the opening adapts itself to the suture, preventing hemorrhage or
leakage; the tops of the pins are now cut off by means of a pair of wire-
cutters and withdrawn, one at a time, and the two openings left by the
pins are sutured; great care is to be taken to keep the margins of the
mesentery in apposition; the cut in the mesentery is now closed by means
of a continuous suture. The after-treatment consists in keeping the
animal on a strict liquid diet, juice of meat, clear soup, or bouillon for
at least a week or ten days.

Prolapsus of the Rectum.

{Prolapsus Recti et Ani.)

Etiology and Pathological Anatomy. — The lower bowel is kept in
place by the peri-proctal connective tissue, the rectal ring, the levator
ani and the sphincter ani. By relaxing or distending these supports, we
find a prolapsus of the mucous membrane, or even the entire rectum
may be protruded (prolapsus recti), or a certain portion of the intestine
may become invaginated and only the invaginated portion protrude
(prolapsus recti cum invaginatione) or the prolapsed intestine may cause
a rectal hernia (hernia recti rectocele). If this prolapsus is not relieved
soon, it inflames very quickly and becomes torn and ulcerated, forming a
great swelling. It may become strangulated, and in rare cases gangre-
nous. It generally results from a relaxed condition of the rectal mucous
membrane or from excessive straining, from constipation, diarrhoea, or
labor pains, from the continued use of hot or irritating clysters, from
constitutional weakness of the sphincters and the peri-proctal connective
tissues. It frequently occurs in young dogs that have catarrh of the
lower bowel or as an accompaniment to distemper.

Symptoms. — If the mucous membrane is slightly protruded, it is only
noticed during defecation or urination. It is seen in the form of dark
red wrinkles that protrude from the rectum as soon as the abdominal
pressure has ceased. If the whole bowel is prolapsed, we find under the
tail a cylindrical projection, which protrudes from where the anus was, and
hangs downward. The mucous membrane that is exposed is wrinkled

PROLAPSUS OF THE RECTUM

and congested, and at the centre of the dependent portion an indenta-
tion is seen; this is the opening of the intestine. Through this we can
introduce the finger into the intestine. At the anterior end, the mucous
membrane passes directly into the skin and the anal opening. If there
is any invagination, the membrane does not terminate at the anus, but
seems to go into the rectum, and the protrusion can be lifted up and
passed into the rectum between the swelling and the rectum (see Fig. 35).
Therapeutics. — The first thing to do is to remove the cause, whether
it be due to diarrhoea or constipation, by putting the animal under

Fig. 35. — Prolapsus of the rectum with invagination.

treatment suitable for such conditions. The most important thing to do
is to reduce the prolapsus as soon as possible; place the dog on his front
legs and elevate the hind ones, and having cleaned and oiled the inflamed
portion, return it to its normal position and fill it with astringent solu-
tion, and if it is a long-standing case, opium in suppository or 5 per
cent, solution cocaine. If the mucous membrane is very much swollen
and inflamed, it is best to scarify it slightly. If the folds of the mucous
membrane are blackened and necrosed from prolonged exposure, they
must be trimmed off with the scissors. The writer has generally suc-
ceeded, even in very bad cases, in reducing the protrusions by bathing

7G DISEASES OF THE DIGESTIVE APPARATUS

them with cokl water or l)y compressing the protruded intestine on a
rubber band, or muslin, commencing at the external end and winding
toward the base of the swelling and while it is reduced by the pressure
return it to its normal position. It is much more difficult to reduce an
invaginated intestine, as the more you press on the protruded portion
the more it packs into the end of the rectum. A large bougie or candle
is inserted in the end of the protruded portion, and then it is pressed into
its natural position; or if this does not succeed, perform laparotomy and
draw the invaginated intestine back into position from the abdominal
cavity. There is little danger from this operation, if it is performed
with ordinary caution. The administration of a hypodermic injection
of morphia will insure relaxation and less straining on the part of the
animal.

After replacing the intestine, it is generally necessary to place a stitch
around the perineum, so as to prevent the recurrence of the protrusion.
What is called a tobacco pouch stitch is carried around the anus, and when
the strings are drawn it will be seen (as in the cut, Fig. 36) that it prevents
a recurrence of the protrusion by drawing the anus together. The sewing
of the rectum by this stitch closes up the opening sufficiently to prevent
the bowel coming out, but n,ot enough to prevent the escape of liquid
faecal matter. It is not advisable to apply cold irrigations or inject
astringents, as the dog is very apt to strain more violently after applica-
tion of either of these remedies.

At the same time, if the trouble is caused by diarrhoea, give opium,
and if caused by constipation, administer saline purgatives. Stockfelt
advised that a series of pins should be placed around the rectum
and united with threads, and thus produce a greater constriction
from the cicatrix when the irritation heals, so as to hold the parts in
position.

Grey made an opening on the median line of the abdomen and drew
back the intestine and stitched it to the opening with cat-gut sutures,
taking care not to put the stitch through into the mucous membrane of
the intestine.

When the prolapsus has been of long duration and reduction seems
impossible, it is best to take means to remove the protruded portion of
the intestines.

Amputation and Sewing by Means of the Double Suture. — Cut off
the hair from the region of the anus, then wash the affected parts and
region, with an antiseptic, put the animal under ether, the animal is laid
on a table, the posterior part of the body is elevated, the prolapsed por-
tion pulled out by means of forceps until normal mucous membrane is
seen. Then wash off and apply a rubber band tourniquet as close up to
the anus as possible, then a curved needle is passed through both layers,

PROLAPSUS OF THE RECTUM

and brought up to the surface. This is facilitated by inserting an ordi-
nary thermometer into the lumen of the intestine (Hobday) or, better still,
a cylinder of carrot (^"iborg). Tie this stitch and put another stitch be-
side this, and continue around the intestine until
it is stitched up. Cut off the portion posterior to
the stitches, remove portion of carrot and push the
stump back through the anus.

Amputation by Means of a Cross Suture. — •
The method advocated by Miller is performed in
the following manner: the animal is etherized and
the hair removed, the skin cleaned and two needles
with linen or silk suture put crosswise, as in Fig.
37, through the prolapsed portion, the portion pos-
terior to the stitch, is cut off; the stitches are then
pulled out from the lumen of the intestine and cut in
the centre, thus making two threads. These should
be tied, as in the second figure of the cut.

Another method is to place the animal under
ether, and having laid it on a table with the poste-
rior extremities elevated, the prolapsed portion is
pulled as far as possible out of the rectum. It
must then be rubbed in the hands, to remove as

much blood from it as possible, or a rubber band wound around it, from
its extremity to its base, and finally ligated at its base, and then, by
means of a bistoury, the protrusion is cut off about one-half of an inch
from the ligation.

Fig. 36. — Stitching rec-
tum (tobacco-bag stitch);
o, method of stitching; b,
stitch tied.

Fig. 37. — Method of suturing in amputation of the lower bowel.

After the blood vessels have been taken up by means of an in-
terrupted stitch (the interrupted stitch is much better, as it makes the
union of the lips of the wound much closer), sew up the serous mem-
brane, and afterward sew the muscular and mucous membranes; the
rubber band is removed, and the stump is pushed back into the opening.

78 DISEASES OF THE DIGESTIVE APPARATUS

Malformations of the Rectum and Anus.

Numerous malformations occur in the rectum; projecting polypus
formations of the mucous membrane of the lower bowel may project from
the rectum constantly, or may only be seen during defecation. We may
also find fibroma, adenoma, and other forms of tumors. The writer had a
particularly interesting case in a small dog that was cjuite old. The owner
had observed a slight bleeding from the rectum for at least a year; the
rectum was examined by means of a speculum and a carcinoma was found.
It was located about 5 cm. from anus on the superior portion of the rectum.
This tumor had hard raised irregular edges and depressed in the middle.
In the peri-proctal connective tissue, we occasionally find adenoma,
sarcoma and carcinoma. These growths are apt to cause considerable
trouble, as they cause constriction of the mucous membrane and inter-
fere with defecation.

In the anus, we find several types of tumors which we class, m a
general way, as anal cancers. They may either be adenomas or car-
cinomas and, as a rule, present mushroom or fungus-like bodies growing
firmly in the skin tissue itself, but having no attachment to the connective
tissue. Generally they are firm, or slightly elastic, and when they reach
a certain size, they are very slightly attached at their outer edge, and
the majority of them can be lifted from their base.

When they reach any size, they are apt to interfere with defecation.
These tumors are easily removed, particidarly when they have reached
a certain size. The only precaution to be observed is to remove the
tumor in its entirety and to avoid injuring the sphincter, which would
be apt to result either in paralysis of the sphincter or a rectal fistula.
Frick advises early removal of tumors from the interior of the rectum.
For information of the diseases of the rectum see page 74.

Imperforate Anus, Inflammation of the Anal Pouches, Diverticulum of the
Rectum and Hemorrhoids are classed under this Heading.

Imperforate Anus (Atresia Ani and Atresia Ani et Reeti). — This is a
congenital deformity and consists of a defective formation of the rectum
and in some cases of the lower bowel. It is seen in newly born puppies,
and it is usually confined to the cutaneous covering growing over the
anus (atresia ani), or it may be the rectum is only partially developed
and it ends in a blind sac some distance from the rectum (atresia ani et
recti). In these cases, the faeces are not passed and an artificial opening
must be made. The treatment is to cut the skin with a small knife, and
the edge of the wound sewed back, so as to prevent it from uniting again;

IMPERFORATE ANUS

but if it is found that the lower bowel is entirely occluded, it is better
to destroy the puppy. But if treatment is to l)e tried as in a particularly
valuable puppy, we can make a cross incision and by means of the index
finger we locate the l^lind end of the floating colon then, l)y means of the
forceps, draw it to the surface, open it and stitch the edges around the
anal opening, as in an ordinary wound.

Infiammation of the Anal Pouches. — These glands are located on both
sides of the anus, lying between the anus and the mucous membrane.

Fig. 38. — Inflammation of the anal glands.

The interior of the pouch is filled with tubular shaped glandular tissue,
ending in a short thin canal, see Fig. 38. The secretion of the gland is a
yellowish brown fluid, with a very unpleasant odor and an acid reaction.
From a variety of causes, such as local irritation, the accumulation of
hard faeces, splinters of bone, etc., and from various irritations of the
rectum, these glands become inflamed and the anus becomes swollen, on
one or both sides, generally the latter. The region is warm, painful to the
touch, and there is more or less fluctuation in the swellings. The animal
makes repeated attempts at defecation and there is every evidence of ten-
esmus. The animal is continually licking the anus and pulling and slid-
ing the hind ciuarters on the ground. On pressing the swellings between
the fingers, the contents of the anal pouches are emptied and are expelled

DISEASES OF THE DIGESTIVE APPARATUS

from the anus; this is a thick yellowish-brown liquid, often stained with
blood, and it has a very fcetid odor. In some instances the swelling
breaks through the skin at the anus, forming an anal fistula.

The treatment consists in pressing the engorged glandular tissue be-
tween the fingers, either the two fingers externally, or putting the index
finger into the rectum, and pressing on the pouches. If they cannot be
emptied in this manner, they must l)e opened by means of a curved bis-
toury, and Gutman injects tincture of iodine into the gland. In rare

Fig. 39. — Pseudo-perineal hernia.

instances it is necessary to curette the pouches. The general condition
may be assisted by laxatives, to assist in easier defecation.

Abscess of the Anal Glands. — The anal glands (acinos gland) which are
situated in the sphincter, forming the anus, become inflamed and cause
a swelling of the entire neighborhood of the anus, causing great inter-
ference with defecation. These generally form pus, fluctuate and break.
The treatment consists in opening the abscesses and treating them
antiseptically.

Diverticulum of the Rectum, Pseudo-perineal Hernia. — From the fre-
quent accumulation of fa^'/cs in the rectum, particularly in old animals,
the terminal portion of the floating colon and rectum becomes dilated and
forms a sac, and when this diverticulum becomes filled, the neighboring
structures are pushed out, and the condition may be mistaken for perineal
hernia (Fig. 39.) It can be differentiated from hernia by the fact that

HEMORRHOIDS 81

in this case the tumor is hard and puttj^-like and introducing the finger
into the rectum it is found to be filled with hard faecal matter. The
treatment consists in breaking up the faecal matter and removing it either
with the finger, instruments, or by means of clysters, gluten or glycerine
suppositories, giving the animal food suitable for this condition. Lienaux
operated by cutting the rectum, pulling out all the dilated portion,
excising it, and sewing the intestine to the anus as in prolapsus of the
rectum, (see Fig, 37).

Hemorrhoids.

These are diffuse or knot-shaped (varicose) distentions of the pos-
terior veins of the lower bowel at the anus. According to their position,
we may call them external or internal hemorrhoids.

The former are located outside the sphincter ani and in the sub-
cutaneous connective tissue. The latter are located inside the sphincter
and under the mucous membrane. Sometimes these enlarged veins burst
and cause considerable hemorrhage. This, however, rarely amounts to
anything, as the mucous membrane is generally more or less inflamed all
the time, and often the faeces are covered with mucous when they are
passed. It is not a rare affection in older dogs.

Clinical Symptoms. — The act of defecation is painful, the faeces covered
with mucus and sometimes blood — either pure blood or blood and
mucus mixed. On making a digital examination, which is very painful,
the mucous membrane is found to be roughened and uneven, or we may
see one knotty lump in the orifice of the anus. In rare instances they
appear as bluish-red ulcers which encircle the reddened rectum. The
animal is nervous, irritable, sliding the posterior part of the body on the
floor, especially on the carpet, so as to rub the rectum, and licking the
anus frequently.

The causes can generally be ascribed to a stagnation of the veins, from
irritation of the membranes, from bile or irritants dvie to poor or faulty
digestion, too much food, and in the majority of instances it will be found
that the liver is congested or inactive, from chronic constipation or lack of
exercise (Vogel states it follows pregnancy), and carcinoma or stenosis
in the posterior portion of the intestinal canal. In some cases it is due to
a disturbance of the circulation, from disease of the heart or lungs, and
from the irritation of habitual constipation.

Therapeutics. — The best treatment to pursue is first to use saline laxa-
tives, but not in large enough doses to purge, such as sulphate of mag-
nesia or sulphate of sodium, and cold enema and the application of an
ointment of lead plaster. Any knots may be removed by ligature, scarifi-
cation, or by the scissors, and afterward touched by the thermocautery.
6

DISEASES OF THE DIGESTIVE APPARATUS

INTESTINAL PARASITES.

(Hehninthiasis.)

Round Worms, Maw Worms (Ascaris Mystax).

Natural History. — The round worm of the dog, ascaris mystax,
ascaris marginata, is Avhite or yellowish-white, slightly reddish in color
and twisted in spirals; there is a difference in the two sexes (see Fig.
40), the males are about 6 cm. and the female about 12 cm. Their
thickness varies from 1 to 1.5 mm. The head is slightly flattened and
fitted with two wing-shaped borders, which start from the mouth and
enlarge slightly as they pass posteriorly. The mouth is a round small
opening, and fitted with three to six small lips, which cover a number of
proportionately large teeth. The caudal end of the male parasite is

n o

Fig. 40. — Ascaris mystax.

curved and pointed and has numerous small papillae on each side. The
caudal end of the female is pointed and straight. The vulva is about the
end of the first fourth of the body from the head. In the genital organs
there can generally be seen quantities of round eggs that on examination
are found to have a thick, hard shell, which is marked by numerous
small grooves. These eggs are found in enormous quantities in the
fa*ces of all dogs affected with the round worm (see Fig. 15). The de-
velopment of the embryo is not yet thoroughly understood, but from the
experiments of Grassi, Penberthy, Albrecht, Frohncr, it has been dem-
onstrated that the intestines of puppies that have never taken any-
thing but the mother's milk, contain numerous ascarides, and they have
demonstrated that an intermediate host is not necessary, but the worms can
be developed directly from the eggs in another animal of the same species.
As a rule, the round worms cause little trouble in the dog. Pem-
bcrthy found 250 in a six weeks old puppy that had constant vomiting,

T.£NIA 83

intestinal catarrh, emaciation, anaemia and decreased temperature.
But in some instances, large masses of these worms collect and cause
considerable catarrhal disturbance of the intestines, or they may even
cause symptoms of intestinal stenosis. In rare instances, the parasites
produce numerous hemorrhagic furrows or indentations in the mucous
membrane. There is no doubt that in some cases round worms cause
considerable nervous disturbance, such as cramps or epilepsy, and may
even perforate the intestinal wall, causing a secondary peritonitis. The
penetration of the parasite into the bile duct has been observed in young
animals — puppies under six months. From the observations of Kitt,
Gasteiger, Mingazzini, there is no doubt that these parasites cause harm,
not only by absorbing nourishment that should go to the host, but by
producing and excreting certain toxic substances that cause both inflam-
matory changes and nervous disturbances. These nervous symptoms
generally disappear with the expulsion of the parasite.

Therapeutics. — The principal agent used to remove the round worm
is floris cinae and santonin, the alkaloid of the plant Artemisia santon-
ica. Both can be administered and followed up by a dose of castor
oil, or the oil may be given with them. The floris cinse is given in doses
of 2.0 to 10.0 and the santonin in doses of 0.05 to 0.2 for the adult dog
and from 0.01 to 0.05 for young or smaller dogs. For the young
puppy give 0.025 rubbed up in a little sugar, or in triturate. Decoctions
of garlic, thymol, areca nut, are all administered by their various ad-
vocates. As a prophylactic measure, pregnant bitches that are about
to whelp and are suspected of having ascarides should be put in another
place, situated some distance from where they are to whelp and subse-
quently nurse their puppies and are then given medicine to expel the
parasites. This should be followed by a laxative, to wash out the para-
sites and what eggs may be in the rectum; and after that the region of
the anus should be washed to further remove the eggs that may be in that
region. Then the bitch is returned to the place where she is to whelp.

I^. Flor. cinje pulv,
01. ricini,
Sig. — To be given on an empty stomach.
I^. Santonin,

Chloroformum,
01. ricini,
Sacchanim,
Sig. — One-half in the morning and other in the after-
noon.

I^. Santonin, 0.2 to 0.3

Oh ricini, 45.0 to 60.0

Shake the bottle before using.

Sig — Divide into three portions and give one every
four hours.

50.

.01

84 DISEASES OF THE DIGESTIVE APPARATUS

Tape-worm.

Natural History. — The cestodes are flat tape-like worms without
mouth or intestines. They grow from one parent or head scolex and
adhere together, in a long ribbon-like colony. The head is furnished with
sucking cups and hooks, by which means it adheres to the mucous mem-
branes of the intestines. The parasite is narrow at the neck, gradually
widening and at its termination it consists of a number of matured seg-
ments that separate from the parent parasite, when they are fully de-
veloped, and are carried out among the faeces. Each segment is complete
in itself, having both male and female genital organs. This order are
hermaphrodites and are peculiar from the fact that they produce the
germs of the new nursing mothers, of the shape of eggs, while the nurse
remains sexless. The ripe segments (proglottides) are soon detached and
pass either into manure, or in water, plants or grass. The proglottides
break up and the eggs scatter in all directions. The eggs are covered
with a hard, tough shell, inside of which is a six-hooked embryo. If the
egg is taken into the stomach, the acid gastric juice dissolves the shell;
the embryo is liberated, and immediately fastens the hooks into the mucous
membrane of the intestine and from there penetrates into the connective
tissue of some of the adjacent organs, where it forms a sac-like cyst.
These cysts contain fluid, and are termed bladder worms, when empty
and cysticercus or cysticercoids when they contain fluid. In each of these
bladders we find the individual taenia head furnished with hooks and the
sucking caps. In some forms of the taenia these bladders divide and sul)-
divide into numerous daughter-cysts or breeding buds, all of which pro-
duce the little heads of the taenia. This is frequently seen in the echino-
coccus, where enormous masses are found. If any animal, or proper
secondary host, gets one of these ripe bladder worms into the stomach the
gastric juice dissolves its covering and it finds its way to the duodenum,
where it fastens itself by means of its hooks and sucking apparatus and
instantly becomes a breeding parasite.

The anatomical structure of the cestodes is very simple. The body
parenchyma is divided into two layers, an external and an inner covering.
In the latter, we find the sexual organs. The external layer is chiefly
muscular, and contains also a mass of calcareous nodules that replace
the defective bony structure of the cestodes. The surface of the head
is covered with a skin or cuticle, from which the hooks originate. A
digestive system and blood vessels are absent, but in the inner layer we
find a system of very much branched water vascular sj^stem, which is
connected with two elongated canals, united at each joint by a cross
system of similar canals, which is said to serve as an excretory apparatus.

T^NIA

The branches running into these canals end in a common orifice. Each
link or segment has an independent male and female sexual appa-
ratus. The male apparatus consists of numerous pear-
shaped testicular bladders with a canal of exit. The
end can be turned up into the female opening. In the
female portion we find ovaries, uterus and vagina. The
uterus is remarkably well defined in each segment (see
Fig. 41).

The following varieties are seen in the dog:
Taenia Serrata (Fig. 42). — This variety is from 0.5
to 6 m. in length and about 0.6 cm. in width when fully
developed. The head is large, proportionately, bullet-
shaped, often four-sided, and is fitted with about 40
hooks in two rows and also sucking disks, wdiich are oval of the Tania coen-
in shape. The first sections after the head are very nar- ^^^^ Cenarge
row, and the middle sections are almost four-sided. The anterior bor-

Fig

Uterus

Fig. 42. — Tienia Serrata.

der of the segments is much narrower than the posterior. The edges
are serrated or saw-like, hence the name. The genital orifice is situated

DISEASES OF THE DIGESTIVE APPARATUS

on the border, alternatino; one on the right and next on the left. The
full-grown segments are nearly square or may be broader than long.
The uterus has a long central body, with eight branches on the side.
These send out numerous subdivisions from each individual branch.

Fig. 43. — Tiunia marginata, posterior end of worm.

The eggs are indented on the sides and have a hard tough shell, 30 to
40 mm. long 31 to 30 mm. wide. The bladder worm is found in the
liver of the wild and domestic hare, called the cysticerus pisiformis.
This grape-shaped cyst has been found to grow as large as a hazel nut, has

T.€NIA

been found by Lesbre in the brain of a dog affected by taenia serrata.
This was probably caused by self-infection. This animal exhibited
symptoms resembling rabies, and was incessantly grinding the teeth and
snapping the jaws.

Taenia Marginata (Fig. 43). — This is the longest and widest tsnia
of the dog, being from 1.5 to 3 m. in length. In rare instances it
has been found to be 5 m. and the width of the developed segments is
about 0.5 cm. Its head is nearly rounded with four small sucking disks
and a double crown of 36 hooks. The segments are nearly square. In
the middle of the colony they may even be broader than long, with ir-
regular edges and partially overlap the following section. The sexual
orifice which is situated on the margin may be alternately on the right

Fig. 44. — Taenia cucumerina, Dipylidium caninum.

or left side, the right sections are longer than their width, which are 14 to
1(3 mm. and 5 to 7 mm. wide. The uterus has a short central body and
has five branches on either side, which are intertwined. The eggs are
irregularly round and enveloped in a tough thick shell. The bladder
worm of the taenia marginata is the cysticercus tenuicoUis, and is found
in the serous tissues of the sheep, cow, goat, pig, squirrel, and monkey
in captivity, and occasionally in man (Dewitz). Frequently we find
the cysticercus on the peritoneum and liver of the sheep and pig, vary-
ing in size from a pea to the size of a man's fist.

Taenia Cucumerina (Dipylidium Caninum) (Fig. 44). — This is a
small taenia 10 to 40 cm. long and 3 mm. wide. It has a small elongated
head, with sixty hooks with a retracted mouth or proboscis; the seg-

88 DISEASES OF THE DIGESTIVE APPARATUS

merits are rounded at the corners and are the shape of a cucumber, hence
the name, and have a small sexual orifice at each end. The individual
sections are about 8 to 10 mm. long and 3 mm. wide. These segments are
easily detachable, and are reddish-pink in color. This coloration is due

Fig. 45. — Tirnia coenurus.

to the color of the shell of the egg. The uterus is irregular, with double-
shelled, rounded eggs, six to fifteen massed together in elongated cocoons.
The primary stage of this taenia which is very common in the dog, is in
the abdominal cavity of the dog-louse (trichodectes canis) (Metchnikoff)

TAENIA

and also in the common dog-flea (ccrtopsyllus canis) and in the flea of
man (pulcx iiTitans).

Taenia Coenurus (Fig, 45). — This taenia is generally about 40 cm.
long, although in rare instances it may be 1 m. It has a small pear-
shaped head, with twenty-four to thirty hooks and four sucking disks.
The anterior links of the colony are always very short, and those at
the extreme end are elongated and narrow, 7 to 13 mm. long and 3 to
3.5 wide, white and shaped like a cucumber seed. The uterus has a long
central body, wath eighteen to twenty-six side branches. The eggs
have a hard shell, elliptical and 30 to 30 mm. diameter with an indurated
border. The larval state of this taenia, which is the coenurus cerebralis
(bladder worm) , varies in size from a small seed to a
large egg, and has a numl^er of nursing or daughter-
cysts or bladders on its inner wall. It is generally
located in the brain, and in rare instances in the spinal
cord. It is seen in all ruminants, especially sheep.

Taenia Echinococcus (Fig. 46) . — This is the smallest
taenia of the dog, most dangerous to man. Its greatest
length is 4.4 mm., and it has three and in rare instances
four segments. The last segment is the largest and the
only one to possess sexual organs. The uterus is large
and irregular, without any central border. The head is
round and has four sucking bodies and twenty-four to
forty-eight small imperfectly developed hooks, arranged
in two rows. The eggs are round and slightly elongated,
the shell being formed in several layers. The bladder
worm is the echinococcus polymorphus: the bladder is echmococcus: a, tape-

. worm, enlarged twelve

filled With a nonalbuminous fluid and generally has times; h, cyst con tain-
daughter-cysts on the sides. These cysts may assume '^^ ^^°-'^'' '^' ^mature

. ... head.

enormous proportions, ranging m size from a pea to a
man's head or even larger and on the walls we find numerous ammen
heads. There are two varieties of the echinococcus, the distinguish-
ing characters being the length of the hooks and the arrangement of
the eggs. It is found in the pig, cattle and sheep and very rarely
in solipeds and carnivora. In man it is generally found in or attached
to the liver or peritoneum, but it has also been found in the lungs,
kidneys, spleen, muscular system, pleura, bones and the brain.
The following parasites are occasionally found in the dog:
Taenia Serialis. — This parasite, about 35 to 75 mm. long, resembles
the Tsnia coenurus. The intermediate host of this parasite is found in
the ral)l)it.

Taenia Litterata, pscudo-cucumerina , Taenia lineata. This parasite re-
sembles the Taenia cucumerina, is found in the fox, but rarely in the dog.

Taenia

90 DISEASES OF THE DIGESTIVE APPARATUS

When animals live on the sea-shore we frequently find them affected
with bothriocephalus latus. This parasite is found in its immature
state in certain fish.

Tape-worms are very common in dogs; some observers claim as high
as 54 per cent, of all animals. In Europe all varieties of the parasites
seem to occur according to different speaking countries. The record
given by Schones is as follows: Hunting dogs 52.94 per cent, were affected
mostly with Taenia serrata; butchers' dogs GG.6G per cent., mostly Taenia
marginata; watch dogs confined to the yards and grounds around build-
ings 40.44, mostly Taenia cucumerina; work dogs used to pull, 72.22,
mostly Taenia marginata; sheep dogs, 57.14 were affected not only with
Taenia coenurus to the extent of 7.14, but were also infected with Taenia
marginata. Taenia serrata. Taenia cucumerina; pet dogs 70.37, of which
36 had Taenia marginata. Taenia cucumerina and 15.74 Taenia serrata.

Fig. 47. — Taenia echinococcus ; mucous membrane of a portion of the intestine covered with the

parasites.

The writer finds in the United States by far the most prevalent is the
Taenia cucumerina, occurring in eighty-two of these cases. Taenia serrata
ten, and marginata only in two instances, and Taenia echinococcus never
observed.

There is no question that one individual is attacked to a greater
extent than others, and the parasite finds more favorable conditions in
the mucous membrane of the intestine of certain animals. The parasites
may be found in enormous numbers, particularly the Echinococcus
when they cover the mucous membrane and give it a velvety appearance
(Fig. 47).

Clinical Symptoms. — "When tape-worms are present they generally
cause more or less disturbance in the host, ^^cry decided symptoms,
such as chronic intestinal catarrh, can sometimes be attributed di-
rectly to the presence of the parasites. Infected animals, as a rule, are
restless, great eaters, and in spite of the amount of food they cat -they
remain thin. Often they produce the same symptoms as ascarides,

T.EXIA 91

but, as a rule, the tape-worm causes much more troul)le than the round
worms. Schieferdecker found that in the duodenum, where the Taenia
cucumerina are generally found, the mucous membrane had numerous
small tunnels through which the taenia passed in and out, and caused a
peculiar hypertrophy of the papilla?; in some cases they were four or
five times their own length. In some cases Lieberkuhn's glands were
sunken and collapsed and in several cases had completely disappeared.
The Taenia echinococcus, when they are present in large numbers,
cause great irritation of the intestines, with hemorrhagic infarction of
the tissues. In nervous animals they cause epileptic spasms or even
symptoms of rabies, such as a change of voice, paralysis of the lower
jaw, dulness and indifference to surroundings; Friedberger and Froh-
ner have also observed similar symptoms in dogs that have been af-
fected with a Taenia cucumerina. In rare instances the taenia have been
known to perforate the intestines. According to the observations of
Cadeac, the perforation was made by two of the Taenia serrata. In a
great number of instances it is impossible to say positively that the
animal has tape-worm unless the segments are observed in the faeces,
and the most dangerous to man (Taenia echinococcus) is extremely hard
to find, on account of the small size of the segments. The other tape-
worms are comparatively easy to find, as the segments are readily
seen on the outside of the stools or catch in the anus and hang on the
hair, the dog frequently drawing attention to them by licking the anus
or drawing the hind extremity along the floor by means of the front
legs. In doubtful cases it is well to give a small dose of some taeniafuge,
and the animal will generally pass a few segments.

Therapeutics. — The most important of the numerous taeniafuges
recommended are as follows:

1. Extract of Male Fern (extractum filix mas). — According to the
experience of the author, it is the best agent to use. It is to be given
on an empty stomach (in the morning being the best time). In smaU
dogs in doses from 0.5 to 1.0 and in large animals 2.0 to 5.0, in pill form
or in capsule. As this drug has no purgative properties, it must be followed
up in one or two hours by a dose of castor oil (30 to 50 grammes). Male
fern is very liable to deteriorate if kept any length of time. Therefore
it is wise to procure it from a drug house that can guarantee it is fresh.
It must be borne in mind that male fern in large doses is a poison, and
the maximum (4.0) must not be exceeded in a large dog. Gesimer ad-
vises filmaron in 0.2 to 1.0 capsules or a 10 per cent, solution of filmaron.
This should be given in the morning on an empty stomach and followed
by a dose of castor oil.

2. Kamala.— This is to be given in doses of 2 to 8 gm., and in large
animals up to 15.0. The powder may be rubbed in with a little ether

92 DISEASES OF THE DIGESTIVE APPARATUS

and given in capsule but when the powder is bulky, as in large doses, it
may be mixed with honey or syrup. It must be repeated in one hour
after the first dose. As it is a purgative, it is not necessaiy to follow it
up with any other drug, which is an advantage, but to completely empty
the intestines of the parasite, it is sometimes wise to follow it with a
laxative.

3. Kusso (Flores koso). — This is to be given in doses from 2.0 to G.O
grammes, diluted with milk, repeated three or four times at intervals of
three-quarters to an hour. OnJy a good result can be expected when
the drug is fresh. This should be mixed with, or followed by, a small
quantity of castor oil.

4. Areca Nut. — The pulverized areca nut is administered in from
1.0 to 4.0 in capsule mixed with honey or butter, followed by a laxative.
Schiel advises a combination of areca nut and kamala. Areca nut is
frecjuently vomited and must be given with raspberry syrup or some
other sweet syrup, which generally prevents it Ijeing vomited.

5. Chloroform. — 1.0 to 4.0 should be shaken up with castor oil and
given at once; the chief objection is, it is very apt to be vomited.

Pomegranate (Cortex granate). — In the shape of the macerated de-
coctions, 25 to 00 seeds (pumpkin seeds crushed and macerated in hot
water). Oxide of copper in doses of 0.01 to 0.05 daily for several days.
Turpentine 2.0 to 4.0 beaten up in the yolk of an egg, daily for three days.
Benzine pelletierum tannicum, strontium lacuticum, creolin, naphthol
are taeniafuges, but are only used to a slight extent, as they are much
less efficient than the first preparations mentioned.

After the animal has passed the parasites they ought to be picked
up on a shovel or other object and put in the fire to destroy the segments,
especially if you have reason to suspect that the Taenia echinococcus is
present, on account of the danger to man.

I^. 01. resin, felix mas, 0.75 to 1.0

Areca semina pulv., 1.0 to 2.0

F. M. Capsule No. 1.

Sig. — Give on an empty stomach followed l)y castor oil.

I^. 01. re.sin. feli.x mas, 1.0 to 4,0

F. M. Capsule No. 1.

Sig — Give on an empty stomach.

I^. Kamala, 1.0 to 2.0

Anipsthesin, 0.15 to 0.2

F. M. Capsule No. 1.

Sig. — Give on an empty stomach

T,t:xiA

[tc

I}. 01. res. fclix mas,
Kamala,

Ol. olivjp, 1 drop.
F. M. Capsule No 1.

I^. Chloroform, 2.0

01. ricini, 30.0

Sig. — Give in two doses one week apart.
I^. Areca semina piilv., 1.0 [to 3.0

Sig. — In capsule, honey or milk.

I^. Kousso, 4.0 to 6.0

Mel.

G. S. teaspoonful.
F. M. Electuray.
Sig.— To be given in two doses, one week apart.

Oxyuris Vermicularis. — By this name (Fig. 48)
we mean a small, white, thread-like round worm.
The female is from 9 to 13 mm. in length and the
male from 3 to 4 mm. in length. This parasite is
rarely found in the dog. They are generally located
in the rectum and the lower large intestines. They
cause great itching of the anus, and the animal is
observed to lick that part constantly and also to
frequently pull the hind-quarters on the floor.

These harmless parasites are removed by cly-
sters composed of solutions of salt water, quassia
bark, vinegar or a weak solution (1-2000) of corro-
sive sublimate.

Dochmius. — Dochmius (Anchylostomum uncin-
aria) (Fig. 49) is a small, thread-like parasite which
belongs to the family of strongylides (palisade worm) .
The end of its head is like a bell-shaped capsule,
having two small, curved teeth on its dorsal border
and four teeth on its ventral border. By means of
the bell-shaped disk and the teeth on the inner part
of its mouth it sucks and buries its head into the
mucous membrane of the intestine and sucks blood.
Three forms of this parasite are found in the small
intestine of the dog and are described as follows:
the Dochmius duodenalis, the male 10 mm. long,
the female 12 to 18 mm. long; the Dochmius trigo-
nocephalus, the male is 9 to 12 mm. wide, the
female 15 to 20 mm. wide, and the Dochmius steno-
cephalus, the male is G to 8 mm. long and the

Fi<;. 48. — OxyurLs ver-
micularis : a, magnified
diagram of the female; b,
the male, magnified; c,
natural size of the female;
d, natural size of the male
{Vierordt).

94 DISEASES OF THE DIGESTIVE APPARATUS

female is 8 to 10 mm. long. The Dochmius duodenalis is the parasite
that observers have named as causing the disease known as Egyptian
chlorosis. This disease is indicated in man by general anaemia. The
eggs, which are oval, are jsassed in enormous numbers in the faeces of
affected persons, and lie on the leaves of acjuatic plants or the moist
ground, and are taken up in the drinking water, food or eating of
grass by dogs, reach the intestines of the animal and the parasite soon
matures. One liranch of the Dochmius, seen in Austria, Italy and Japan,
Dochmius uncincoriasis, causes great disturbance, particularly in hunt-
ing dogs.

Animals affected with this parasite become anaemic, weak and
thin, develop hemorrhagic enteritis and catarrhal pneumonia and have
a peculiar discharge from the nose, of a thin, bloody mucus (Megnin,
Ilaillet). Peregand found these cases generally had piroplasma with

'a-

Fig. 49. — a, Male; b, female (natural size); c, magnified head (Jaksch).

the other symptoms. There are also oedematous swellings, ulcerations
or gangrenous swellings of the skin, with intense cachexia.

Therapeutics. — The treatment consists in the administration of
tseniafuges, felix mas, kamala, cadeot combined with calomel. Megnin
uses calomel and arsenic, the latter in 0.005 to 0.01 doses. Besides this,
give easily digested and nutritious food, milk, and eggs. The faeces of
all affected animals should be burned and the stools and benches where
the dogs sleep should be cleaned. Drinking water to be from a spring,
or else filtered or boiled.

The presence of this parasite is recognized in the same way as one
would locate the taenia, that is, by the presence of the parasite or eggs
in the faeces. They are easily recognized, the eggs being similar to the
ascarides.

Besides the already mentioned parasites, we also find the Distoma
echinatum (Generali and Ratz) and the Distoma heterophytes, found by
Jaiiyen in Japan and by Loots in Egypt, in the intestines. The Tri-

PERITONITIS

chocephalus depressiusculus is found in the caecum (Fig. 50) . This parasite,
according to a number of authors, may produce a catarrh or hemorrhagic
condition of the intestines and invagination of the caecum. Animals af-

FiG. 50. — Wall of the csecum with numerous Trichocephalus depressiusculus.

fected with these parasites suffer from dochmiasis or anaemia. This
distomum heterophytes was found in an animal presenting symptoms of
rabies.

DISEASES OF THE PERITONEUM.

Inflammation of the Peritoneiun — Peritonitis.

Etiology. — Peritonitis is comparatively rare in dogs and is generally
seen as a secondary disease; due originally to some irritation or in-
jury of some of the other organs of the abdomen, the stomach, intes-
tines, spleen, liver, kidneys, bladder, prostate, or the uterus. From
toxic gastro-enteritis, ulceration of the stomach or intestines, accumula-
tions of faecal matter in the intestines; from metritis or parametritis
after labor; from inflammation or abscess of the liver; from purulent inflam-
mation of the kidneys, or from purulent pleuritis; from rupture of the ab-
dominal viscera and the escape of food, faeces, gas, bile, pus, parasites
perforating the intestinal mucous membrane, and in rare instances from
the presence of parasites (Plerocerooides barletti) in the abdominal
cavity. It may also occur from a general inflammation of all the ser-
ous membranes of the body, as is sometimes observed in infectious dis-
eases; to pyaemia or metastatic peritonitis; from the breaking down of
tubercular masses that have collected on the peritoneum, or from can-
cer. Primary peritonitis is always caused by some injury to the ab-

DISEASES OF THE DIGESTIVE APPARATUS

dominal wall, shocks, blows, or by penetration of the abdominal walls,
or after some opei'ations and from cold (rheumatic peritonitis).

Pathological Anatomy. — According to the extent of the disease we
call it either partial (circumscribed) or general peritonitis (diffused);
according to its course, acute or chronic; and according to its character,
we call the exudate serous, fibrinous, purulent, putrid, or hemor-
rhagic. The purulent form of the disease is the most common and on
account of the extensive irritation that any inflammation causes in the
peritoneum, it is apt to take the diffuse form of the disease; and while
it may start originally as circumscribed, the disease generally becomes

Fig. 51. — Section through the abdomen of the dog showing the distribution of the peritoneum:
a, kidney; b, aorta; c, vena cava; d, intestine; d' , duodenum; e, pancreatic gland;/, spleen; g, liver; h,
subperitoneal fat.

diffuse in a short time. The peritoneum is first injected and ecchymosed,
becoming dull red and velvety, due to the removal of the endothelium
and partially to the exudate, which contains more or less fibrinous sub-
stances. This collects as a thick layer over the peritoneum and the
exudate unites the intestines to each other or to the different organs
in the abdominal cavity, or even to the sides of the abdominal wall. In
recent cases these adhesions are easily pulled apart, but later on they
become firmly united and are very hard to separate (adhesive i^erito-
nitis). There is also a quantity of fibrinous exudate thrown out, which is
accompanied by more or less liquid. This varies from a small quantity
to several litres. There is always some oedema of the serous wall of
the intestines, which becomes soft and friable (Fig. 51).

The chronic form may start out as such at the onset, biit generally
it follows an acute attack, the peritoneum becomes very much thickened

PERITONITIS 97

and adhesions form, with the intestines and the adjacent organs, at times
contracting the intestinal walls and causing a lessening of the diameter of
the intestinal canal. In the chronic form the exudate is not purulent, as
a rule, but is composed of a thick, hemorrhagic serum. In the dog, we
sometimes observe a form of ascites (see under that head) in which we
have a chronic thickening of the peritoneum and a collection of a turbid,
fibrinous exudate (inflammator}' ascites).

Circumscribed Peritonitis may be caused by any irritation of the
viscera, such as inflammatory and suppurative processes of the stomach,
intestines or uterus, classed as perigastritis, perienteritis and perime-
tritis and the irritation extend to the serous coat. We often find small
circumscribed deposits on the liver, occasionally on the spleen and other
alDdominal organs, that have originated from slight peritonitis. In
cases where there is a small amount of purulent peritonitis, the inflam-
mation remains in one locality and becomes encysted. As a rule, with
the exception of circumscribed peritonitis, death generally occurs in the
first stages of the disease, and it is only in the mild cases, where the
exudation is very slight, that there is any chance of recovery. The exu-
date breaks down and is re-absorbed but, as a rule, there is such an ex-
tensive alteration and adhesion formed that it is only in rare cases that
the animal ever is restored to perfect health.

Clinical Symptoms and Course of the Disease. — (1) Acute diffuse
peritonitis. When the disease is caused by some traumatism, by perfora-
tion, either from the intestines or externally, the symptoms appear very
rapidly. At first there is colic, great restlessness, and a stiff, unnatural
gait. The posterior extremities are carried out from the body and are
not flexed. The animal groans and cries. The pain is continual, the
abdomen is very sensitive on manipulation, the slightest touch produces
intense pain. There are some cases in this disease, however, where the
animal shows very little pain, but this is only seen where there is
great debility. The abdomen becomes distended in the early stages of
the disease, due to inflation of the intestinal tract from gas and later on
by the collection of the exudate. When the abdomen is distended, if
gas is present, on percussion, the sound is hollow^, and when exudate is
present, the sound is dull. The exudate, of course, lies on the floor of the
abdominal cavity; but where the exudate forms very rapidly, the whole
abdomen is filled up, pressing on the diaphragm, compressing the lungs
and causing great dyspncea.

In the early stages the abdomen is tucked up, the walls tense, firm
and painful to the touch, and it is generally some time before the abdomen
begins to enlarge from the collection of the exudate. As a rule, the bowels
are constipated except where there has been some diarrhoea, or diar-
rha'a alternated with constipation, present before the disease started,
7

93 DISEASES OF THE DIGESTIVE APPARATUS

which is seen in those cases where there is ulceration and perforation of
the mucous membranes. Vomiting is always present, the vomited
matter being greenish-yellow mucus, and in the latter stages we fre-
quently find faecal matter in the vomited material; the urine is lessened
in amount and contains a large amount of indican. There is total loss
of appetite. The temperature rises to 40° C. or above. If the disease is
not so severe as to cause death in a day or two the temperature fluctu-
ates, being high at one part of the day and then it becomes subnormal,
its character being remittent. The pulse is fast, thin and wiry, and
finally imperceptible.

The majority of cases are fatal, the animals dying in from one day
to a week, according to the intensity of the disease. They usually die in
a condition of collapse; in rare cases from heart-failure or suffocation
from the rapid collection of the exudate. The most rapidly fatal cases
are those due to the perforation with septic infection.

Circumscribed or Chronic Peritonitis produces less marked symp-
toms and is harder to recognize, the symptoms of diffuse chronic peri-
tonitis being those of ascites, and, as a rule, not diagnosed except on
post-mortem. The best way to confirm a diagnosis is to puncture the
abdomen with a small trocar and see the character of the fluid.

Therapeutics. — Remove the cause if possible; if this cannot be ac-
complished by surgical interference, acute diffuse peritonitis should be
treated with constant applications of cold water compresses to the ab-
domen, and, if the irritation is very intense, the application of a covmter-
irritant such as frictions of camphor oil, mustard poultices or mustard oil;
the latter is the best. Take 30 to 50 grammes, of a mixture composed of
mustard oil, 10 parts and olive oil 100, rubbing it well into the abdomen;
applications of hot water to the abdomen by means of the priessnitz
compress are also useful. Opium is to be given internally in doses of
0.1 to 0.5 grammes; laudanum 1.0 to 5.0, and where there is collapse
give whiskey and spirits of camphor. If there is any obstruction of the
bowels, give injections of warm water or subcutaneous injections of phy-
siological salt solution. The exudate should be removed by puncture
of the abdomen, but this is not to be done until the acute symptoms
have subsided. It must always be borne in mind (and this holds good
in inflammation of other serous membranes) that the production of a serous
exudate is a process that tends to lessen the acuteness of the existing
conditions, because the liquid helps to keep the intensely inflamed parts
separate and prevents frictions and its complicating inflammation, hence
it should not be removed too early but when the exudate is suspected to
be purulent and by means of an explorative puncture has been proven to
1)0 so, a laparotomy must be performed, and the whole abdominal cavity
washed out with a weak solution of salicvlic or boric acid. When the

ABDOMINAL DROPSY

animal shows signs of recovery, the diet must be carefully regulated, at
first milk, or thin soup, as the animal is very apt to vomit. Then the
lightest diet, soup, milk, juice of beef, a small quantity of lemon juice can
be administered, a teaspoonful at a time, or a teaspoonful of essence of
pepsin.

Abdominal Dropsy.

(Hydrops Ascites; Ascites; Hydrops Abdominis; Hydrops Peritonei.)

By this is meant a collection of serous liquid in the abdominal cavity
that originates without inflammatory symptoms, being due to transuda-
tion. The amount of liquid collected varies very much. In some cases
there are only a few spoonfuls, in others 15 to 20 litres of liquid.

The color of the liquid is sometimes as clear as water, but generally
it is reddish-yellow. It may also be filled w-ith flakes of fibrin,

Fig. 52. — Dog with ascites.

which indicate chronic peritonitis, or turbid as milk (chylous ascites).
When exposed to the atmosphere it usually remains fluid and only in
rare instances it becomes firm and jelly-like. It is thin and watery and
slightly sticky when pressed between the fingers and about the specific
gravity of blood serum. At first the peritoneum is normal, but, if this
condition lasts some time, the peritoneum becomes macerated, is pale or
dull white, and finally a general degeneration sets in. When the animal

100 DISEASES OF THE DIGESTIVE APPARATUS

has been repeatedly punctured, inflammatoi-y processes may take place,
and are followed by adhesions. The abdominal organs become anaemic
and freciucntly dropsical (Fig. 52).

Etiology. — Ascites never appears as an independent disease, but
must be regarded as a symptom of another disease. As the peritoneal
veins belong to the mesenteric system, any obstruction of the portal
veins cause these serous collections, for instance, in cirrhosis of the liver, or
tumors of that organ, or from compression of the mesenteric veins by tu-
mors, abscesses, etc. Ascites is also seen as a symptom of general dropsy of
the kidneys or lungs, and from defective action of the heart. It may also
be caused by local diseases of the peritoneum, such as tuberculosis, car-
cinoma, or from chronic inflammation between transudate and inflam-
matory exudates. In young animals ascites may develop without
any other complications or cause and may make a complete recovery
(Hutyra and Marek)-

Clinical Symptoms. — The chief clinical symptom of this disease
is the accumulation of fluid in the abdominal cavity. Small amounts
very frequently are not noticed and in fact, cannot be determined by
any means except by tapping. When there is a considerable collection
of serous fluid, the abdominal wall is distended, and, from being in the
lower portion of the abdomen, the cross-section outlines of the trunk
resemble those of a pear. There is a peculiar sunken appearance of
the flanks (see Fig. 52). When the tips of the fingers are struck against
the distended abdomen, there is a fluctuating movement; and when there
is a large quantity of fluid present, the splashing sound of the fluid can
sometimes be heard when the side of the abdomen is struck sharply
with the flat of the hand. By percussion, we can tell, to a certain
extent, the amount of the fluid present. The animal should be made
to stand, so that all the fluid lies in the base of the abdomen. By
percussing, beginning at the lower part of the abdomen and moving-
upward on the wall where there is fluid present, we will get a dull sound ;
and when the line of fluid is passed, we get the intestinal or tympanic
sound. It is very important that the animal should be in a standing
position, as it can be readily understood that when the animal is lying on
its side, the fluid gravitating to the lower side, we would get a clear tym-
panic sound all over the abdominal wall on the upper side and still
have a large quantity of fluid in the cavity.

The higher the fluid collects, the greater is the pressure on the ab-
dominal organs, and the consequent pressure on the diaphragm, causing
interference with normal respiration. The urine is generally nor-
mal, but reduced in quantity, and the quantity of the accumulated
fluid pressing on the bladder may sometimes cause involuntary emp-
tying of the bladder. In the later stages osdematous swellings appear

ABDOMIXAL DROPSY 101

in the extremities, or we may find a general dropsy, the digestion
is impaired, and the bowels disturbed. In the majority of cases diar-
rhoea is present, with occasionally vomiting. AVhile it seems very
easy to make a diagnosis when the above symptoms are present, still
the following diseases may present several or all of the symptoms above
described.

1. Acute or Chronic Peritonitis. — "\Mien one reads the sj'mptoms
of acute peritonitis the diseases can be readily separated, but in the
latter part of the disease, when the effusion has collected, or where the
chronic stage of peritonitis is present, it is a little difficult to separate
them, the only positive means being to puncture the walls with a small
trocar (hypodermatic) and obtain a small quantity of the fluid, and it is
rather common to see ascites associated with chronic peritonitis.

2. Fatty Deposits in the Abdomen. — This disease is quite frequently
present in old dogs; but a differential diagnosis can be made from
the fact, that, where there are enormous collections of fat present, the
abdomen is round in appearance, but does not become pendulous, whether
the clog is standing or recumbent. It is well not to puncture in these
cases, as it gives no information, and may cause internal hemorrhage.

3. Abnormal Collections of Urine in the Bladder. — In these cases we
feel a ball-shaped body in the posterior portion of the abdomen; this
swelling does not follow the changes in the position of the body, and is
not indicated by percussion. A good way to make a differential diag-
nosis is to lift up the animal by the posterior extremities, and if it is as-
cites the liquid will settle on the diaphragm and interfere with respira-
tion; if the bladder is filled, we do not have the dull percussion sound.

To further confirm the diagnosis pass the catheter.

4. Distention of the Bowels with Gas (Meteorismus) . — In this in-
stance, there is an absence of the fluctuation and the clear tympanic
sound all over the abdomen.

5. Collections of Urine in the Abdomen after Rupture of the Blad-
der.— On the passage of the trocar, the clear urine is passed which can
easily be recognized by the color and odor, with absence of urine on cathe-
terization, and ursemic fever, or convulsions.

6. In Advanced Gestation. — By careful manipulation the foetuses
can be easily distinguished in the abdomen.

Besides the above conditions, we may also have to distinguish be-
tween ascites and tumors of the abdominal cavity (hydrometra, pyome-
tra). All these affections can be recognized by carefully considering
the history of the case and the accompanying symptoms.

It is always well to carefully study the exciting cause of the disease,
as the course of treatment depends on it. This, however, is rather
hard to do, for, as a rule, the collection of fluid is caused by the dam-

102 DISEASES OF THE DIGESTIVE APPARATUS

ming or interference in the mesenteric system, by cirrhosis of the
liver, or some interference in the portal system. These are likely to
improve with tapping and symptomatic treatment. But in anasarca,
hydrothorax, general dropsy due to a weak heart, or valvular affections
of that organ, disorders of the lungs or kidneys, hydrsemia or marasmus;
it depends to a large extent on whether we can either restore the af-
fected organ to a normal condition, for if they are permanently affected,
the condition is generally chronic. Quite often we find affections of
the liver and spleen that are never recognized during life. To make
an examination of these organs it is well to do it just after the animal
has been tapped and the fluid has been removed; the walls of the
abdomen are collapsed, and the organs can be manipulated with greater
ease at that time. If tumors are present, they are readily recognized.

Notwithstanding all the etiological conditions described, there are
often cases where the cause can only be guessed at.

Prognosis and Therapeutics. — As a rule, the prognosis is unfavor-
able as we are unable to remove the exciting cause. The cases that re-
cover are generally in young dogs and the dropsy is the only existing con-
dition. In the majority of cases, the ascites disappears spontaneously.
Our first effort is to remove the exciting cause, if it is recognized; and
then to remove the dropsical effusion, either medicinally or surgically.
At the same time the animal should be well fed on highly nitrogen-
ous, easily digested food and tonics (see anaemia). This can be done in
the following ways:

1. By Laxatives. — This method is t;o be followed where there is con-
stipation associated with the disease. Saline purgatives are the best,
glauber salts, epsom or rochelle salts, such laxatives as jalap, podophyl-
lum, castor oil, are contraindicated, as they irritate the stomach and
destroy the appetite and weaken the animal. The salines are indicated,
only in sufficient doses, to cause a slight laxative action, so as not to
interfere with the appetite.

2. Diuretics. — This form of treatment has always been popular to
be given and is still much used. These are only used where there is posi-
tive evidence that there is no previous irritation of the kidneys. The
best are the vegetable diuretics, such as digitalis, strophanthus, caffeine,
salicylate of soda, oil of juniper, liq. potassii acetas; among the more
recent diuretics are theocin, theobromin, soda salicylate 4.0 to 6.0 in
sol., diuretin 4.0 to CO; the best saline drugs are acetate of potassium
and sodium.

I^. Tine, digitalis fol., 1.0

Liq. potas.sium acetate, 30.0

Sig. — One tea.spoonful throe times daily.

ABDOMINAL DROPSY 103

. Agurin,

0.1

to .0-1

Caffoine-sodium-salicylas,

2.0

to 5.0

Sacharrum alba.

5.0

M. F. et divid charter No X.

Sig. — One powder three times daily.

I^. Agurin, 2 to 6.0

Aqua menth. pip, 150.0

Sig. — Tablespoonful three times daily.

3. Hydrochlorate of Pilocarpine. — We may sometimes obtain very
good results with this drug. The injection of the solution subcutane-
ously is made once daily (0.005 to 0.01 of water). Zahn gave three drops
of the 1 per cent, solution on the tongue, three times daily. The admin-
istration of this drug causes the amount of saliva to be greatly increased,
and the amount of fluid exudates to be very much decreased. Frohner
recommends Arecolin.

4. Tapping or Puncture of the Abdomen. — This is indicated where
there is a large collection of fluid, that is pressing on the diaphragm,
and also used as a diagnostic procedure. Whether it is best to re-
move the fluid in all cases is a question that has not yet been decided;
yet the writer is of the opinion that the fluid should be removed, pro-
vided the animal is roljust and not too old, especially as the operation is
comparatively harmless, and has the advantage over purgatives and
diuretics in that the accumulation is removed ciuickl3\ In a great
number of cases the fluid has not accumulated after one or more punc-
tures. Friedberger and Frohner have seen old dogs that have died dur-
ing, or shortly after, the operation. The method of puncturing or tap-
ping is to take the ordinary trocar, a narrow caliber one is best, even if
it takes a long time to drain out. We also avoid unconsciousness, which
sometimes occurs where a large quantity is drained out too suddenly.
During the operation the pulse, respiration, and general appearance
of the animal must be watched carefully, in case the animal might col-
lapse from the shock. In such an event, the trocar must be removed
instantly and a subcutaneous injection of spirits of camphor must be
given. The trocar should always be boiled, immediately before using.

The method of operating is very simple. The place to insert the
catheter is generally about the umbilical region, on or to one side of the
linea alba. The animal should be placed in a standing position. Should
the canula become plugged either by the omentum or intestines coming
against the opening of the canula, it should be pulled downward, or moved
to one side or introduce an elastic catheter and push them to one side.
After the fluid has ceased to flow, remove the catheter and paint the
opening with collodion.

104 DISEASES OF THE DIGESTIVE APPARATUS

The other changes in the peritoneum have no special value. Tu-
bercular masses, sarcomas, and carcinomas have been already men-
tioned; also parasites. Plerocercoides barleti are found free or partially
encysted, also the pentastomum denticulatum was found by Rochcfon-
taine in great numbers in the subperitoneal cyst of the liver and mesen-
tery, and here also have been found the bladder cysts of the taenia
echinococcus.

DISEASES OF THE LIVER.

Catarrhal Jaundice.

(Icterus Catarrhalis; Icterus Gastro-duodenalis .)

Etiology. — In catarrh of the stomach we often find symptoms of
jaundice with that disease, especially where the inflammation of the
mucous membrane extends to the duodenum, and the ductus cholcdochus
l)ccomes closed by the swelling of its mucous membranes and prevents
the exit of the bile. As soon as such an ol)st ruction occurs, the bile can
no longer flow into the intestines; it becomes stagnant and dams back,
causing a pressure on the bile-ducts, and being unable to escape, it finally
enters the lymphatic vessels of the liver, from them into the blood through
the thoracic duct. After this there follows a series of symptoms that
have been named jaundice (icterus). In the early stages of the disease
we have to deal with an icterus that is produced by stagnation of the
bile. It has been found by observers that the pathological or artificial
stoppage of the flow of the bile, and, consequently, damming back of
the bile, will produce jaundice in forty-eight hours. This has a number of
names — stagnating icterus, icterus of reabsorption, or hepatogenous
icterus. While the swelling of the mucous membrane is generally the
cause of this disease, still there are a number of other causes that may also
produce it, such as foreign bodies in the ducts (parasites, gallstones, etc.),
from ulceration of the mucous membrane, by the cicatricial contraction of
tumors, or abscesses in or near the liver, from intestinal parasites invad-
ing the bile-duct, from the bile being very dense and flowing slowly, by
disturbance of the liver cells and the bile driven in an opposite direction
(Minkowski), and diffuse icterus (icterus per paranedesen) , in disturbance
of the blood circulation due to throml;)us in the portal artei'ies, the pres-
ence of bacteria, from the eating of decayed meat and from certain in-
fectious diseases, in cases of poisoning from phosphorus. The stop-
ping of the flow of bile sets up an inflammation of the tissues and some-
times forms abscess of the liver, but as the great majority of cases are
caused by the catarrhal form, we will desci'ibc that. Any cause that
will produce catarrh of the stomach will finally produce icterus, such as

CA TA RRHA L J A UN DICE 1 05

improper food, especially when it is frozen; cold drinks after over-heat-
ing; salt meat, or salt fish. That form of icterus that is so often seen
during distemper is very likely to be catarrhal.

Pathological Anatomy. — The symptoms of catarrh of the duodenum
are always present; the vessels are more or less injected, and the mucous
membrane swollen. As a rule, the mouth of the duct is closed, and it is
only by very strong pressure on the gall bladder that we are able to
open it and force the bile out of the duct. In some cases a white clot of
mucus is forced out and when the duct has been plugged up some time
the bile is converted into a syrupy or semi-solid mass, but in the majority
of cases it is due to swelling of the intestines and not to catarrh of the
mucous membrane of the duct.

In some post mortems, we may not find any swelling in the region of
the duct, but very frequently the post-mortem changes are so cjuick as
to be hardly recognizable at the autopsy. Another fact to be taken into
consideration, is that the canal is so very narrow in the dog that it takes
a very small amount of swelling to obstruct it.

The body of the liver may be changed; it is generally enlarged and
anaemic, and varies in color from a j^ellow to a yellowish-brown. The
color is irregular and it is mottled like a nutmeg. The cells of the liver are
infiltrated and filled with globules of fat, colored with brownish pigment,
in the shape of granulated clots. The cadaver is generally anaemic; the
Ijlood is clotted in the heart and large blood vessels or we find large
lumps of hard reddish-yellow coagulate, or the blood may be stained
yellow and contain white blood corpuscles in increased quantities. The
red blood corpuscles are not much changed, but vary in size. All the
tissues of the body, except the white substance of the brain, the spinal
cord, the peripheral nerves and the corneal tissue, are stained more or less
by the bile-pigment. The heart muscle undergoes a certain amount of
fatty degeneration. The kidneys are anaemic; in the pale portion of the
kidney we see extensive whitish stripes running in the direction of the
urinary canals; this is caused by an irregular fatty degeneration and
pigmentary infiltration of the canals (Siedamgrotsky).

Clinical Symptoms and Course of the Disease. — As this disease is
generally associated with catarrh of the stomach, the first symptoms in
jaundice will be of that disease — loss of appetite, increased thirst, vomit-
ing, coated tongue; in some rare instances, however, these may be absent,
the first symptom being that of jaundice (yellowishness of the mucous
membranes) .

When the bile and liile acids enter the blood the following symptoms
are observed:

1 . By the entrance of the coloring matter of the bile into the tissues,
they become more or less yellow, first yellowishness of the conjunctiva

106 DISEASES OF THE DIGESTIVE APPARATUS

and sclerotic coat; later the whole cutaneous covering becomes tinted.
The yellowishncss may be very plainly seen on the abdomen, on the inner
fascia of the thighs, and the mucous membrane of the mouth and throat;
the color may range from a light yellow to a dirty orange-yellow; the
latter color generally spreads over the entire body in the later stages of
the disease.

2. On account of the coloring matter being present in the urine, it is
changed from the normal to a yellowish-green or to a dark greenish color;
wdien put in a vessel and agitated it foams very quickly and if a piece of
paper or linen is placed in it, it becomes tinted the color of the bile. It
is also easy to detect the presence of bile color of the urine by chemical
examination. (For further details, see the chapter on the Examination
of the Urinary Apparatus.) Besides the bile acids, the urine almost
always contains albumen, short hyaline casts, pigment granulations, and
epithelium of the kidney.

3. On account of the stoppage of the flow of bile into the intestines,
the faeces become gray or clay-colored and contain much undigested fat,
and hydrobilirubin is present. The fat substances not being digested,
the fseces become very foetid; this change is due to the loss of the antiseptic
effect of the bile, and as the food is passed along the intestine the tonic
effect of the bile is absent.

4. The bile acids present in the blood produce a certain amount of
depression of the nerve-centres, and for this reason we find that the pulse
and respiration are subnormal in action, and the temperature is reduced.
Other symptoms of the narcotic effect of the bile are seen in some cases
■where there is depression, great muscular debility, indifference to sur-
roundings, somnolence and finally deep coma; we also find hemorrhagic
conditions of the skin or mucous membrane.

The local examination of the liver gives very, little satisfaction.
The writer has never been able, except in one case, to find any percep-
tible enlargement of the liver. Manipulation of the liver does not seem
to give the animals pain in the later stages of the disease. The prog-
nosis in the dog is generally unfavoral^le. The yellow coloration gradu-
ally becomes deeper, the temperature falls to subnormal in the majority
of cases, the pulse becomes weak and irregular, and finally death occurs with
general paralysis. If the cases progress favorably, the first sign is a
lessening of the coloration of the urine and a darker hue to the fseces;
the pulse becomes fuller and more regular, the temperature increases,
the animal shows more animation, and the color in the mucous membrane
and the skin becomes lighter, until it finally disappears. If there is a
relapse, it is generally by improper feeding.

Therapeutics. — ^^'e must first aim to reduce the irritation of the
duodenum also the bile-ducts. This is first effected by regulating the

OTHER AFFECTIONS OF THE LIVER 107

diet; small quantities of lean meat, milk, purees, gruel, and besides this
giving saline laxatives and alkaline in the form of carbonates and car-
bonic acid, if the constipation is persistent. Strong purgatives have
been recommended, such as calomel, castor oil, and infusions of rhubarb;
but they are of no particular value; in fact, in the majority of cases, they
do more harm than good, as they have a tendenc}' to swell the mucous
membrane. Enemas of warm water, two or three times daily are very
useful. "We can also try to empty the gall bladder mechanically, by
pressing the al^domen between the fingers in the region of the kidneys;
also by faradization — a strong current is to be applied in the region of the
liver on both sides of the abdomen; this must be kept up for ten minutes
at a time, twice daily. Or we may use emetics, it being claimed that the
compression of the liver during emesis, the violent contraction of the
abdomen, will often empty the gall bladder. We can also try to carry
the bile out of the system by the kidneys. The best drugs to use are
diuretics, such as acetate of sodium or potassium. Where there is great
debility or depression we can use spirits of camphor or ether. Boldine,
the alkaloid of the Pennus boldos, hasrecently been spoken of as producing
good results in jaundice; it is given in doses of 0.08 gramme daily with
calomel. Great weakness or persistent sleepiness can be treated with
camphor, ether, and caffeine.

I^. Sal. CaroHn fact. 10.0

Aqua, 150.0

M. F, Sig. — One tablespoouful three times daily.

I^'. Sodii salicylatis, 4 to 10.0

Syrupi Rhei, 200.0

M. F. Sig. — One tablespoonful morning and night.

I^. Ac. Tartaric, 15.0

Aqua distilata, 200.0

M. F. Sig. — One teaspoonful three times daily.

Other Affections of the Liver.

The other affections of the liver are of slight importance and are
rarely met with during life, consequently they will be only mentioned
briefly.

Hyperaemia of the Liver. — This may be caused either by an increased
or obstructed flow of the bile, and therefore it is important to be able
to distinguish between the two.

Congestive hyperemia of the liver is a normal condition during
digestion; it may be abnormally increased by eating large quantities
of food, especially if it is rich and irritating, and from want of exer-
cise; decayed or tainted food may also cause this condition.

108 DISEASES OF THE DIGESTIVE APPARATUS

Stagnating hypcripmia of the liver may be caused by defective
valvular action of the heart or a weakened condition of that organ;
in the later stages of acute diseases, such as the lungs; in cases where
large numbers of the lung capillaries become atrophied and useless; in
great pleuritic exudations; in extensive induration of the lungs, with
emphysema; and also in dropsy of the pericardium.

Pathological Anatomy. — The liver is greatly enlarged and very hard;
when a section is cut in it, the blood seems to run out of it in large quanti-
ties. This blood generally is dark colored, especially if the stagnation
has been prolonged. The liver tissue may be spotted, the spots cor-
responding with the central veins which are located in the centre of the
lobules; or we may notice peripheric zones (nutmeg liver) alternating
with lighter colored spaces. The liver gradually becomes smaller and its
surface dull, and later on the parenchyma finely granular.

Clinical Symptoms. — It is not possible to make a positive diagnosis
of this disease, we can only suspect it by great tenderness on pres-
sure in the region of the liver, and perhaps slight icterus, ascites may
accompany hyperaemia of the liver; but as these symptoms may all be
caused by catarrh of the bowels, it is well to be very cautious before
making a positive diagnosis.

Therapeutics. — Remove the cause if possible, regulate the diet and
administer saline laxatives.

Inflammation of the Liver (Hepatitis). — This disease appears in
three forms — parenchymatous, interstitial and purulent.

1. Parenchymatous hepatitis accompanies various infectious dis-
eases, probably in the same way that we see congestion of the liver.
It is seen as a symptom of acute phosphorus-poisoning, also as an ac-
companiment of certain infectious diseases.

The pathological-anatomical alterations are as follows: Enlarge-
ment, softening, and a friable condition of the tissue, which breaks
easily to the touch. At first it is dark red, but later on it becomes a
yellowish clay color, due to the enlarged acini; the capsule is dull and
thickened, due to a certain amount of perihepatitis. If the disease
lasts any time, the volume of the liver is greatly lessened.

The clinical symptoms are, evidences of catarrh of the stomach,
pain on pressure in the region of the liver, icterus, and the liver is found
on palpation to be enlarged.

2. Interstitial Hepatitis (Cirrhosis of the Liver) (Hardening of
the Liver). — This disease originates from causes that are at present un-
known. There is no doubt that certain chemical or bacterial poisons
which originate in the intestines have some part in causing this disease.
Friedberger and Frohner surmise that it is caused by valvular disease
of the heart.

OTHER AFFECTIONS OF THE LIVER 109

Pathological Anatomy. — There are two stages in this disease. In
the first stage the liver is very much enlarged and hard, the edges of
the lobes are blunt on the surface, there are a number of uneven de-
pressions. On making a transverse section, we find a net-work of red-
dish-gray tissues that surround the lobules; later on this involves the
lobules themselves. In the second stage we find a cicatricial contraction,
of newly formed tissue, and at the same time the disappearance of the true
tissue of the liver. The liver then becomes gradvuilly smaller and has
a very irregular surface; the capsule is thickened and in some places de-
pressed; the tissue is hard and tough when cut with a knife.

Clinical Symptoms. — The disease generally starts withovit any
visible symptoms, although it is a common disease in old dogs that have
lived well. When the disease has become pretty well advanced we find
evidences of an interference in the portal circulation by the appearance
of ascites and chronic catarrh of the stomach. "With these symptoms
we also find a tendency to constipation with occasional changes to diar-
rhoea. In rare instances a certain amount of icterus is present. This
is due either to the interference with the passage of the bile from the
gall bladder by catarrh of the duodenum or to a contracted condi-
tion of the small bile-ducts. There is no pain on pressure in the region
of the liver, even in the advanced stages of the disease. After removing
the fluid, the outline of the liver can be felt by palpation.

The disease is generally very slow, but ends fatally; when there is
ascites and some oedema of the extremities present, the end is not far
off.

Therapeutics. — This consists in treating the case as if it were one of
catarrh of the stomach, by means of saline purgatives and, if ascites is
present, by puncture. The disease should be regarded as incurable.

3. Purulent Inflammation of the Liver (Abscess of the Liver). —
This may be caused by injuries, such as blows or kicks, externally, or
from foreign bodies or perforating abscesses coming from the stomach,
from metastasis from phlebitis and thrombus undergoing purulent de-
struction, and from pyemia in abscess of the stomach, and in the bile-
ducts from the presence of gall-stones or parasites.

Pathological Anatomy. — Abscesses of the liver appear singly but
may be present in large numbers; the traumatic abscess is generally
solitary and the metastatic, multiple. The pus is cream-like and in
some instances foetid and reddish-green in color. Small abscesses may
heal by absorption, but the large ones open into the abdominal cavity
and cause fatal peritonitis.

Icterus symptoms, with frequent chills, point to abscess of the
liver. Treatment is useless.

Fatty Liver (Hepar Adiposum). — This is an abnormal diffuse fatty

110 DISEASES OF THE DIGESTIVE APPARATUS

infiltration of the cells of the liver. It is hard and seems anaemic when the
section is made through the organ. The cells are found to be infiltrated
with fatty globules and the nuclei pushed to one side.

This condition is seen in old dogs that have been well fed and had
little exercise, and is naturally a fatty infiltration. It must, however,
be distinguished from the fatty degeneration that is found to follow sev-
eral poisons, and in the later stages of consumption. In fatty infiltration
the blood of the portal vein carries abnormal quantities of fat into the
liver, which is deposited in the cells. In fatty degeneration the fat
originates in the cells themselves; this is due to the albumin separating
into two substances. One contains nitrogen, while in the other it is
absent. This latter part undergoes fatty degeneration.

The treatment of fatty liver is the same as for any adipose condition.

Neoformations of the Liver and Gall-stones. — The neoformations
found in the liver of the dog are sarcomas, carcinoma, adenoma, and lip-
oma. These cause irregular enlargements on the body of the liver, and
produce symptoms similar to those of cirrhosis of the liver. Some-
times large tumors can be felt through the abdominal wall.

Gall-stones are very rare in the dog. Frohner describes one case
where the animal died with an icterus gravel. Immediately after death
he found in the ductus choledochus a large bluish-black friable gall
stone, the size of a pea. On section, this was brownish-yellow in the
centre. Parascendolo described one case where the ductus choledochus
was impacted with a mass of stones. The only way that they might
be recognized would be the appearance of icterus, from retention, pre-
ceded by intense colic.

Treatment is the same as retention icterus; small gall stones may
be present in the gall bladder without causing any peculiar symptoms,
other than slight disturbance of the digestion.

Parasites. — The following parasites have been found in the liver:
distoma truncatum, distoma campanulatum, and distoma conjunc-
tum (Ercolani). In the bile-ducts, ascarides have been found, Ercolani
and Lissizin found a fully developed male eustrongylus gigas and coccidia
(Rivolta), also the l)ladder cyst of the echinococcus.

Amyloid and Lardaceous Liver. — Amyloid liver, as a rule, is a
symptom of a general amyloid condition, developed from a cachectic
state, from prolonged suppurating wounds or from chronic inflammation
of the pectoral membranes.

The liver is very much enlarged and blunt on the edges of the lolies.
On section, the cut surface is speckled and grayish-brown in color. On
microscopical examination the walls of the capillaries will be found to have
undergone amyloid degeneration; when stained with Lugol's iodine solu-
tion, the degenerated portions become mahogany-brown in color.

POISONS 111

Lardaceous liver is developed when we have a disease that has a
tendency to produce amyloid degeneration. The liver becomes very
large. With it we generally find amyloid kidney with albumin in the
urine and we also are apt to find an amyloid spleen.

POISONS.

A short abstract on poisons with their symptoms and treatment
is here given; it is not at all complete, and the student is referred to works
on toxicology.

Poisoning by Caustic Alkalies. — Caustic lime, soda or potassium,
lye, sal. ammoniac, etc. These in their concentrated form may be ad-
ministered accidentally, or may have been used in some external prep-
aration and licked off by the animal. Caustic soda or potassium may
be sw^allowed by animals that are very thirsty. The writer observed a
dog that was poisoned eating meat that had caustic lime sprinkled on it.

The lips, mouth, tongue, throat, and oesophagus are more or less
cauterized, with salivation and vomiting of strongly alkaline materials,
which is sometimes bloody. There is bloody diarrhoea. The potas-
sium preparations cause paralysis of the heart.

The treatment consists in the administration of vinegar or acetic
acid, gruels of flour, oat meal, starch, emulsions of oil (olive, linseed, or
cotton-seed). The giving of emetics or the use of the stomach pump
is contra-indicated, as they are apt to cause perforation of the stomach.

Poisoning by Caustic Acids. — This is of rare occurrence and is gen-
erally caused by the insufficient dilution of medicinal preparations, or
the vicious administration of acids.

The mucous membrane of the mouth, throat, and cesophagus, is
eroded or burnt brown. There is salivation and vomiting of a brownish-
black material, with a strong acid reaction, which contains more or less
blood, violent pain, small thready pulse, and finally collapse.

Therapeutics. — Emetics and the stomach pump are contra-indicated,
as there is danger of perforation, Limewater, dilute ammonia or
soda solutions, emulsions of olive, linseed, or cotton-seed oils, small c{uan-
tities of opium, and in case of collapse the subcutaneous injection of
ether or camphor.

Poisoning by Arsenic. — This is sometimes given intentionally on
pieces of meat, or caused by eating some of the various rat poisons, the
overdosing of Fowler's solution, or licking external preparations that
contain arsenic.

There is violent inflammation of the stomach and intestines, great
restlessness, bloody diarrhoea, vomiting and dyspnoea, great weakness,
and finally collapse and death in a few hours.

112 DISEASES OF THE DIGESTIVE APPARATUS

Therapeutics. — Emetics and iron preparations, the hydrated ses-
quioxide of iron every quarter of an hour, carbonate of magnesia, a
teaspoonful every twenty minutes, followed by alcoholic stimulants.
The stomach pump can be used, if there is not prompt emesis.

Poisoning by Hydrocyanic Acid; Prussic Acid. — This is generally
given intentional}}', in the foi'm of cyanide of potassium, rarely the pure
acid. There is an odor of bitter almonds on the breath. The symp-
toms are vomiting, yelping cries, dyspnoea, convulsions of the legs, and
death in a short time. If the dose should be small, there is restlessness,
fear, dyspnoea, dilated pupils, convulsions of the extremities, fall in tem-
perature until it is subnormal, marked slowness of the respirations and
pulse, cyanosis and unconsciousness.

Therapeutics. — Emetics, artificial respiration (rhythmic pressure
of the lower abdominal walls, bathing in cold water, stimulants, chlo-
rine water, and subcutaneous injections of atropia.

Poisoning by Carbolic Acid. — This is quite frequently observed
and is caused by the animal licking external preparations which con-
tain the drug; this is frequently seen as a result of the use of some of the
various preparations sold under the name of creolin, which are nothing
more than crude carbolic acid, or some coal tar by-product, and
the animal is bathed frequently in a strong solution of it. It may
also be caused by the animal licking a wound or the wound absorbing
carbolic acid, tar or creosote which has been applied as a dressing. It
may also he absorbed following the injection of strong solutions of carbolic
acid into the uterus. The urine is dark in color, frequently a dark olive
green, there is slight colic, pain on pressure of the abdomen, vomiting,
diarrhoea, great inflammation and redness of the mouth, marked weakness,
decrease in the temperature, twitching of the muscles, paralysis, con-
vulsions and collapse.

Treatment. — White of egg, glaubcr salts, and stimulants.

Poisoning by Iodoform. — This may be caused by licking wounds
dressed with the drug and also from the injections into cysts of too
strong solutions. In very large doses we find great gastric disturbance,
small, frequent pulse, decrease in the internal temperature, suppression
of urine, albuminuria, dulncss, and convulsions, alternated with great
excitement and finally collapse. In smaller doses we find catarrh of
the mucous membranes, emaciation, and skin eruptions.

Therapeutics. — In the acute form give emetics followed by carbonate
of potash, large quantities of starch, subcutaneous injections of atropia.
In the milder forms saline laxatives, tonics and, of course, immediately
remove the cause.

Poisoning by Phosphorus. — This may be caused by the animal eating
some of the various roach or bug poisons that have been spread on bread

POISOXS 113

and placed in a cellar or liuilding. There is constant vomiting, the odor of
the ejected matter is that of phosphorus, and if taken into a dark room
it is luminous.

There is great restlessness, howling, whining, fever, and indications of
intense irritation of the mouth and throat; and the saliva is thick and
copious. After these symptoms have been present for some time, the
animal becomes quiet, the mucous membranes become dirty yellow,
great pain on pressure on the liver, stomach, and intestines. The faces
are tinged with blood and there is albuminuria; and according to some
authors, if there is any icterus in a suspected case, it is a clear indication of
phosphorus poisoning; finally, there is paralysis and collapse.

Therapeutics. — Use sulphate of copper as an emetic, and turpentine
in emulsion as an antidote, and treat other symptoms as they appear.
Permanganate of potash, nitrate of cobalt, heavy magnesia, are antidotes.

I^. Cupri Sulphatis, 1.0

Aquae distillatse, .50 . 0

Sig. — Give a teaspoonful every ten minutes until eme-
sis occurs.

I^ 01. Terebinthinse, 20.0

Sol. Acacia, 50.0

Aqua. Distil., 200.0
Sig. — A tablespoonful every fifteen minutes.

Poisoning by Mercury. — 1. Acute poisoning by corrosive sublimate is
very rare. The symptoms are intense inflammation of the entire intesti-
nal tract, vomiting of blood and bloody diarrhoea, with intense local irri-
tation followed by symptoms of paralysis and death.

2. Mercurial Poisoning takes a slower course when caused by calomel
or mercurial dressings, particularly w'hen mercurial (blue) ointment is
applied for skin eruptions. We find salivation, catarrh of the stomach,
profuse diarrhoea, emaciation, with marked muscular debility.

Therapeutics. — In the acute form give gruels, milk, magnesia, water,
sulphur, iodide of potassium, stimulants. In the slower form of poisoning
give iodide of potassium, or sulphur.

Poisoning by Strychnia. — This is frequently administered intention-
ally, although it is often caused by the administration of too large doses of
nux vomica, dogs being particularly susceptible to the action of strychnia.
There are violent tetanic spasms, trismus, and opisthotonus. The convul-
sions are clonic, having intermissions between them, and the longer the
intermission the milder the attack and the more chance of a recovery.

Therapeutics. — Give narcotics, chloral hydrate in clysters, 2.5
grammes to 40.0 of water; morphia, tannin, and tincture of iodine.

Poisoning by Chloroform. — This is caused either by the careless ad-
8

114 DISEASES OF THE DIGESTIVE APPARATUS

ministration of chloroform during anaesthesia, or when animals are old or
have weak hearts or lungs. It destroys sensibility, reflex action, ir-
regular, weak pulse, dilated pupil, the blood becomes very dark and there
is congestion and cyanosis of the visible mucous membranes, arrest of
respiration and pulsation.

Therapeutics. — Cease the inhalation immediately, put the animal in
the fresh air, open the mouth, draw out the tongue by means of a pair
of forceps, and perform artificial respiration. Dash cold water on the
head, active friction of the skin, and the subcutaneous injection of
atropia, skopolamin, or strychnia.

ly. Atropia sulph, 0.05

Aqua distil., 5.0

Sig. — Inject a gramme of the solution subcutaneously.

Poisoning with Gas (Coal, Carbondioxide, or Illuminating). — Great
lassitude, insensibility, labored respiration, mydriasis, paralysis, and
convulsions.

Therapeutics. — Fresh air, artificial respiration, dash cold water on
the head, active friction of the skin, smelling salts, bleeding, and the in-
travenous injection of the physiological solution of chloride of sodium.

Poisoning by Iodine. — This may residt from the licking or the absorp-
tion of iodine, particularly when it is used in the injection of cysts in the
form of iodine or Lugol's solution.

The symptoms and course are very similar to iodoform. After a
toxic dose there is stomatitis and pharyngitis, brown patches on the tongue
and the vomiting of l)rown material, and if starch should be present in the
stomach in any (quantity, the material is turned bluish in color. The free
administration of starch solution, and sulphate of soda and sulphurette of
soda in solution 1 to 20 of water, must be given freely in teaspoonful doses.

DISEASES OF THE RESPIRATORY ORGANS.

PHYSICAL EXAMINATION OF THE RESPIRATORY APPARATUS.

In making an examination of the respiratory apparatus the following
points are to be considered:

Examination of the Nose.

It is a rather hard thing to make an examination of the nose, on ac-
count of the anatomical conformation of that part, and we are practically
restricted to the aid a nasal mirror can give us and the character of the
nasal secretions. The external portion of the nose is moist and cold in
health, colder than any other part of the body, and dry and w^arm when
a dog has any fever or elevation of temperature, in the first stages of nasal
catarrh, and in fevers or acute disease. This should not be taken as a
positive evidence, as frecjuently cases are seen where this is no guide, the
nose being cold when there is great fever or the animal in a state of
collapse.

Swelling, redness, and excoriation at the entrance of the nasal cham-
bers indicate an inflammatory and purulent condition of the nasal mucous
membrane.

Any discharge from the nose, beyond a natural moistness, indicates
some diseased condition. In cases of acute nasal catarrh it is clear and
thin, nearly pure serum in the beginning, but later on it becomes mucous
and finally muco-purulent. In chronic catarrh it is firmer, sticky, and
finally very tenacious, and sticks to the external opening of the nose,
often entirely closing it up and eroding the skin, where it comes in contact
with it. In distemper it is yellowish to yellowish-green in color; some-
times it is streaked with blood or pus, and in rare cases it has a foetid odor.

When the discharge is copious, especially when the head is jerked
downward with a sneezing cough, it is generally a sign of some irritation of
the frontal sinuses. A nasal discharge following coughing generally comes
from some trouble in the deep sections of the air-passages, larynx, wind-
pipe, bronchi, or the lungs; a rusty yellow discharge indicates croupous
pneumonia; this is, however, very rare. Frequent sneezing, with a
copious, purulent, bad-smelling discharge mixed with blood points to the
presence of pentastoma taenioides in the frontal or nasal cavities. In cases
of acute catarrh of the throat, foreign bodies, paralysis of the larynx, or

115

116

DISEASES OF THE RESPIRATORY ORGANS

large tumors in the throat, the discharge from the nose may be mixed with
some of the contents of the stomach. These affections are extremely rare
in the dog compared with other animals. True cases of bleeding of the
nose are seen in hemorrhagic catarrh of that organ, in suppurating con-
ditions of the nasal cavities from the pentastome, and also in distemper.
Hemorrhage of the lungs is indicated when there are large masses of
frothy blood discharged from the nose and mouth. Wheezy respiration is
generally due to some contraction of the nasal cavities, for instance, as a
consequence of violent nasal catarrh, tumors, fractures of the nasal bones,
narrowing of the nasal passages, pressure from some of the neighboring
organs, or solid collections of matter. In some breeds of dogs, such as
pugs and bulldogs, the passage is so narrow that a slight contraction may
cause them to breathe through the mouth. A simple method of detecting
whether the nostril is entirely obstructed is to hold a lighted candle in

Fig. 53. — Diagrammatic section of the pharynx: a, pharynx; b, palate; c, soft palate; d, epiglottic
wall; e, fnpnum; /, entrance to wsophagus; /;, entrance to the mouth i, entrance to the Eustachian tube;
k, entrance to the nasal passages; 1, epiglottis; 2, larynx; 3, cavity of the mouth; 4, epiglottis; 5, aryte-
noid cartilage; 6, palate; 7, vomer; 8, base of skull.

front of the nostril suspected and see if the flame is blown. If the nostril
is clear the flame moves violently or may be blown out, but if the obstruc-
tion is complete or partial the flame moves slightly or not at all. The
nasal sound is like a snore when copious accumulations of mucus have
collected on the mucous membrane, as in distemper, or the later stages of
simple catarrh of the nose. In all the affections named, many animals
seem to have an intense itching, which they indicate by rubbing the nose
against solid objects, or wiping it with the paws. We must recollect,
however, that the same symptoms may be observed in an animal infected
W'ith intestinal worms.

The naso-pharyngeal region can be examined by means of the laryn-
geal mirror; when the presence of foreign bodies or pathological process,
tumors, etc., is suspected, the mouth is held open by means of a speculum
and the mirror introduced into the mouth; this method of examination
should be made as quickly as possible as the instrument chokes the ani-

PHYSICAL DIAGNOSIS OF THE LARYNX 117

mal; the observer must act quickly and have a thorough understanding of
the region and any pathological symptoms noted.

Percussion of the nose and frontal sinuse is made with some light
metal hammer such as the handle end of a key, percussing first one nasal
bone and over the frontal sinuses, then the other, to note the difference in
sound. A dull sound may indicate a catarrhal condition of the nostril, or

Fig. 54. — Position of the frontal sinuses a, inferior; b, superior.

frontal sinuses, the presence of a tumor, or some pathological alterations;
on the other hand, the presence of a clear percussing sound should not be
taken as indicating that these changes are not present. Large tumors by
pressure cause changes or elevations on the nasal bones of the frontal
sinuses; such alterations may also be seen in the hard palate see (Fig. 54).

Physical Diagnosis of the Larynx and Windpipe.

The symptoms include the bark, cough, and respiration, as well as the
local symptoms. The bark is always rough, hoarse, or shrill in all affec-
tions of the internal larynx, and is always of great importance in rabies
(barking howl), or total loss of voice; this is particularly seen during or
after dog shows. The cough is an accompaniment of all affections of the

118 DISEASES OF THE RESPIRATORY ORGANS

larynx; and in the later stages of catarrh, where there is much mucus,
it is loose, moist, and rattling, and may be produced by slight pressure on
either side of the larynx, by cold, pressure, or after drinking; in any chronic
irritation of the larynx, any excitement, such as the pleasure of meeting a
person they know, will start a severe coughing spell. The respiration is
always dyspnoeic and accompanied by a stenotic bruit when from the results
of some diseased condition there is a contraction of the larynx. Ausculta-
tion of the larynx is performed by placing the ear directly on the larynx.
Normally the sound is a slightly wheezy respiration. Rubbing, creak-
ing, or rattling sounds indicate more or less liquid accumulations (mucus,
pus, or blood) ; wheezy, gasping, snoring sounds indicate severe swelling
of the mucous membrane or tough mucus (chronic catarrh) ; it may also
indicate the presence of tumors, membranous accumulations, and par-
alysis of the muscles of the larynx.

A local external and internal examination of the larynx can be
made. Externally the larynx can be examined to see whether it is
swollen, as in acute laryngitis; for fracture or dislocation of the cartilages,
for cedematous, phlegmonous, or emphysematous swellings of the part
or its surroundings, and sensitiveness to pressure, always indicates some
irritation of the larynx.

The internal examination of the larynx is very easy and simple except
in cases where the animal is very vicious; the method of keeping the mouth
open is fully described on page 12, and then by means of a spatula, or the
handle of a spoon, the tongue can be depressed or pulled out of the mouth
with a pair of blunt forceps; the examination should be made near a win-
dow or by means of a lamp or electric torch; the light can then be thrown
into the posterior portion of the throat. Vicious animals may be put
under ether or stupefied by morphine. When the mouth is opened and
the tongue depressed, we can easily see the entire pharynx and the upper
wall of the larynx and epiglottis, and in some cases a part of the windpipe,
and swellings, discolorations, hemorrhages, ulcerations, new formations,
foreign bodies, paralysis of the vocal chords can be readily diagnosed; a
good knowledge of anatomy and a quick eye is necessary, however. In
acute catarrh the mucous membrane of the larnyx is injected and red and
covered with slimy white or yellowish mucus. In chronic catarrh it is
not so red, but the mucous membrane has a number of bluish-red vessels
running through it and covered with tough, glassy, or purulent mucus;
the membranes are sometimes granular; we may also find at the entrance
of the oesophagus foreign bodies, tumors, or abscesses. The trachea is
examined externally by palpation to sec if there is any change or disloca-
tion of the rings, cedematous or phlegmonous swellings of the surrounding
structures and enlargement of the thvroid gland.

PHYSICAL DIAGNOSIS OF THE LUNGS 119

Physical Diagnosis of the Lungs.

The lungs of the dog consist of a number of layer-like portions which
are united by the bronchi and connective tissue; the anatomical posi-
tions of the lungs are shown in Figs, 55 and 50. The left lung is divided
into two portions or lobes, an anterior and a posterior; the former is
again subdivided in two; this division is not very distinct in some eases.
The section that divides the large loljes begins opposite the fourth and
fifth vertebne and runs downward and backward as far as the sixth rib;
the anterior lobe extends as far as the first rib, and anteriorly and pos-
teriorly to the sixth rib; the large posterior lobe extends back as far as the
eleventh or twelfth vertebra, where it extends upward and lies between
the vertebra? and the diaphragm. The left lung has a small incision near
the heart, called the heart incision. The right lung is somewhat larger
than the left, and extends as far back as the twelfth or thirteenth verte-
bra; it is divided into four lobes, the posterior lobe being considerably
larger than the corresponding lobe of the left lung. The cardiac lobe lies
upon the heart, almost surrounding that organ; the other lobes hold the
same relation as they do in the left lung. The middle lobe of the lungs is
a club-shaped portion that lies in a special groove in the mediastinum, ex-
tending anteriorly as far as the heart and posteriorly to the diaphragm.

In making an examination of the lungs we must take into considera-
tion the shape of the cavity of the chest, sensitiveness to pressure, the
number and character of the respiratory movements, the character of the
cough, and the information dcM'ived from auscultation and percussion.

Shape of the Cavity of the Chest. — In healthy animals the two sides of
the chest should be symmetrical. A depression on one side means pain
in that portion of the chest, dry pleuritis, recent fractures of the ribs, one-
sided contraction of the lung after a rapid absorption of the exudate of
pleurisy. In a case where there is a fractured rib there may be a protru-
sion in one place, an inflammatory condition of the ribs, and tumors of the
wall of the chest; when the whole chest seems swollen, it indicates doul)le
pleuritis, with a great amount of exudate present; when only the posterior
half of the thorax seems distended and we find the abdomen enlarged, it
indicates ascites, tumors, or collections in the abdominal cavity.

Sensitiveness to Pressure. — This is produced by a number of inflamma-
tory conditions of the skin and subcutis, the ribs, or the intercostal mus-
cles as in cases of muscular rheumatism, or in fracture of the ribs, and
quite frequently in pleuritis; in this case there is pain on pressure between
the intercostal spaces, and there may be great pain shown when there is
no exudate; this is a verv common symptom. For further information
see page 149.

120

DISEASES OF THE RESPIRATORY ORGANS

Number and Character of the Respiratory Movements. — Normal
breathing is performed in the dog, as in other animals, through muscular ac-

.2 >>

a "

a ■-

y. a

>- rt
c u

*- a

•I ^

tion in inspiring, and the elasticity of the tissue of the lungs and the walls of
the chest in expiration; this is also aided by the pressure of the intestines

PHYSICAL DIAGNOSIS OF THE LUNGS

121

on the diaphragm. It is only when the respiration is obstructed that the
assistance of the muscles of respiration is required in expiration. The
works on physiology give more minute details on this subject. The nor-
mal respirations are from twelve to twenty-eight per minute, the size and

0) bO

-e.g

« a

o «>

^ a

"S 2

hi M

U5 53

age of the animal making a slight difference, in the smaller dog, of course,
being more f rec[uent. Various conditions tend to alter the above number,
such as running, physical excitement, atmospheric temperature, the pres-
ence of a stranger, particularly if they handle the animal, overloading of

122 DISEASES OF THE RESPIRATORY ORGANS

the stomach, and advanced pregnancy. While the respirations in the dog
are regular, yet they are disturbed more quickly by physical excitement
than in any other animal, and after any unusual exercise, the dog will open
the mouth.

A pathological lessening of the number of the respirations, may be
seen in all serious affections of the brain and its membranes, in acute infec-
tious diseases, such as septicaemia and distemper and in cases of contrac-
tion of the air-passages.

A slight increase in the I'espirations may follow any increase of tempera-
ture; they are also increased, when any pain is present, in circumscribed
pleuritis, in the commencement of peritonitis, in fractures of the ribs, and
in rheumatism of the intercostals. Laborious respiration (difficulty in
breathing, dyspnoea) is seen where there is any contraction of the phar-
ynx, larynx, or windpipe; for instance, from the swelling and inflammation
of the mucous membrane in those organs, foreign bodies, tumors, etc.
We see laborious breathing, with great increase of the number of respira-
tions, in any irritation of the bronchial tubes, where they become con-
tracted or filled with mucus, and in all diseases of the true lung-tissue, in
all exudates into the pleural cavity, or in diseases of the al)domen,
where there are collections of solids or fluids in the abdominal cavity that
press on the diaphragm in cramp or spasm of the muscles of respiration,
as in strychnia poisoning, tetanus, or eclampsia in nursing bitches, in
diseases of the heart where there is stagnation of the thoracic cir-
culation. In all cases of dyspnoea in the dog the animal rarely lies
down, but prefers to assume a sitting position with the front legs spread
wide apart.

Cough. — The nature and form of cough are very important symptoms
in all diseases of the respiratory organs. Cough is produced by reflex
action from all parts of the mucous membranes of the pharynx, windpipe,
bronchi, and also by an inflamed pleura. The pulmonary tissue never
produces cough by reflex irritation. The so-called "stomach cough" is
only imaginary; no such thing can truly be said to exist. Cough is gener-
ally absent in diseases of the brain or in certain cases of extreme weak-
ness, and just before death from poisoning, as well as in cases where the
glottis and the muscles of respiration are acutely inflamed. Where the
sensitive ends of the vagus and particularly the supra-laryngeal nerves
become paralyzed it is impossible to produce coughing liy manipulation
of the throat. Dogs do not cough intentionally, and if it is very painful
they can suppress it.

An animal may ])e made to cough by pressing the sides of the pharynx
between the fingers; if the throat is pressed hard an animal will cough and
make motions very similar to those of vomiting.

Occasionally an animal is found that the most severe pressure of the

PHYSICAL DIAGNOSIS OF THE LUXGS

123

larynx will not produce any signs of coughing, although it may make a
swallowing movement.

Several spells of coughing, after a slight pressure of the pharynx,
point to a diseased condition of that organ; if the same pressure is made on
the windpipe, and the animal coughs violently, it also indicates a diseased
contlition of those parts. In bronchitis and catarrhal pneumonia, cough-
ing can be produced by tapping on the wall of the chest, indicating dis-
eased conditions of the deeper air-passages, particularly bronchitis, bron-
chopneumonia or catarrhal pneumonia. Spells of coughing may be
produced as a result of unusual exercise, running, jumping, excitement,
or from going out into cold air.

In the beginning of acute bronchitis and in pleurisj^ the cough is dull,
w^eak, usually frecjuent, dry, and husky. In chronic em-
physema, bronchitis, catarrhal or croupous pneumonia the
cough is soft and frequent. The cough in emphysema and
oedema is very much the same, but not very frec[uent, and
in tuberculosis it is hollow and dull. There are many ex-
ceptions to this rule; for instance, in cases where foreign
bodies enter the lung through the mouth or following vom-
iting, the cough is convulsive and violent, resembling-
whooping-cough (chronic pharyngeal catarrh) in its inten-
sity. As a rule dogs cough more freciuently at night than
during the day.

The expectorations cannot be examined in the dog as
in man, as the animal generally swallows all the secretions;
in rare instances there may be a small portion of the mucus
thrown out of the mouth or nose in coughing. We can
often see the animal chewing or swallowing after a fit of
coughing, which indicates that the animal has brought up
a piece of mucus into the mouth or pharynx; this is seen
when the cough becomes loose, moist, or rattling, and is
what is termed "looseness" of the cough, being seen gener-
ally in pharyngeal, tracheal, and bronchial catarrh. The
largest amount of excretion is seen in bronchial and tubercular diseases,
while in catarrhal and croupous pneumonia, and also in certain forms of
bronchitis, we find the excretion is thick and firm and accompanied by
dry, laborious coughing spells, and at the end of the cough there is a
swallowing movement. In hemorrhage of the lungs the cough is accom-
panied by more or less foamy blood from the nostrils and mouth and
in some cases symptoms of choking; a slight hemorrhage may escape our
observation, as generally all the blood is swallowed.

Percussion of the Thorax. — Percussion (tapping) is performed by
means of a percussion hammer and an ivory or metal plate (pleximeter)

Fig. 57.— riex-
iinetcr.

124

DISEASES OF THE RESPIRATORY ORGANS

(Fig. 57). Lay the plate close to the wall of the chest, and, with the hammer
in the other hand, strike the plate a number of light, quick taps; the fingers
can also be used, and are preferred by some. Place the index or middle
finger of the left hand firmly on the chest wall, and with the index finger
of the right hand tap on the finger of the left hand.

The limits of percussion arc given in Fig. 58, but it must be taken into
consideration that on expiration the posterior limit of the lungs is carried
forward of the dotted line and not extending to the last rib and also that
when the stomach or intestines are very much filled with gas, and crowd
the diaphragm forward, the extent of the lungs is lessened. The per-
cussion area lies in a triangular space between the lower side of the mus-

FiG. 58. — Field of percussion; x, location of heart beat.

cles of the back, the posterior portion of the muscles of the forearm, and
the ends of the ribs, and by pulling the forelegs forward, the extent of the
chest wall can be increased for examination. In percussion we make the
distinction between a clear, loud, normal lung sound and a tympanitic,
dull, or solid sound of a diseased lung. The clear normal sound of the
healthy lung is heard all over the thorax, the volume of sound depending
on the thickness of the lung at the particular part being examined. The
muscular layers of the chest have a certain effect on the sound, very thick
walls lessening the sound to a certain extent; the soimd is more or less
dull over the shoulder-blade, sterum, and back; the posterior borders of
the lungs often have no perceptible sound, as they are so thin.

PHYSICAL DIAGNOSIS OF THE LUNGS 125

A dull, muffiod sound, which has been mentioned in the above classifi-
cation, is heard in the following conditions: In the tissues of the lung,
where the air cannot reach, as in hepatization; in croupous pneumonia; in
tuberculosis, provided that the diseased centre is not entirely surrounded
with tissue containing air; in tumors of the lungs; in hemorrhagic infarc-
tion; in sections of the lungs that are compressed by pleuritic or pericar-
dial effusions. (Edema of the lung is only accompanied with dulness
when it is well advanced.

The dull sound is present, when an abnormal medium is between the
lungs and the pleximeter, as in the various pleural diseases; tumors of the
pleura; pleuritic or dropsical effusions; and also in certain pathological
alterations of the chest, as in oedema, or tumors. The more the tissues
fill up near the walls of the chest and the greater the density of the
medium between the pleximeter and the lungs, the more in-
distinct and muffled the sound becomes.

The tympanitic sound is heard where there is any cavity
or hollow in the lungs, as in pneumothorax. In the alteration
of the tension of the parenchyma of the lungs, we find the
sound above pleuritic exudates and in the neighborhood of
large tumors of the lungs, or in compression of the lungs
from the pushing forward of the diaphragm due to tumors, or
ascites. It is also heard in moistening of the alveoli by fluids
and reduction of the contained air, as in the loose moist stage
of croupous pneumonia; and where there are many small tuber-
cular centres, in the tissue of the lungs, which are hollow in the
centre and contain air, and it is sometimes heard in oedema of
the lungs. Cutaneous emphysema of the walls of the chest ^^°- ^^•~*

• • 1 mi Tn Stethoscope.

gives a clear tympanitic sound. There are several modifica-
tions of this sound, such as the cracked-pot or metallic, tinkling percus-
sion sound, but these are not of much diagnostic value, as they appear
only when there may be large cavernous spaces in the walls of the
chest.

Auscultation of the Lungs. — This is performed, either by putting the
ear directly against the walls of the chest, over the affected region (direct
auscultation), or by using a stethoscope (Fig. 59) (indirect auscultation).
(A form of stethoscope called the " membranate stethoscope," a modifica-
tion of the phonograph, has lately been introduced and used in the larger
animals with considerable success, but the person using it must be thor-
oughly familiar with the chest sounds and also with the instrument to
get the best results, but the writer finds that on account of its size it is not
of much practical use in the dog.) The first method is the best, especially
with restless animals.

The ear distinguishes the true respiratory and accessory sounds. In

12G DISEASES OF THE RESPIRATORY ORGANS

the former we hear a vesicular respiratory bruit, which has a hipping char-
acter, and the bronchial respiratory bruit, which is a Jjlowing murmur,
and, lastly, an indistinct respiratory bruit, which is a slight soft murmur.

The vesicular respiratory bruit is heard when any portion of the lung
that is filled with air lies against the wall of the chest. In normal inspira-
tion the sound is a smooth, regular murmur, the air going directly into the
alveoli without any resistance. This sound can be increased very much
even during health by active movements or during excitement; it is also
much clearer and louder in emaciated animals where the walls of the chest
are thin. The vesicular murmur is always much louder in young animals,
and especially in puppies; the murmur is also noted in expiration in
animals under nine months. According to the amount of irritation, the
vesicular murmur is lessened in bronchial catarrh where there is much
swelling of the mucous membrane and secretions collected, in stenosis of
the upper air-passages, in emphysema of the lungs, in certain stages of
catarrhal pneumonia, in pleuritic or dropsical exudations, in thickening
of the pleura from the deposit of lymph-masses, tumors or oedema.

It disappears entirely in croupous pleuritic effusions, in pneu-
mothorax, and in closure of one of the large bronchial tubes.

The vesicular murmur is increased in dyspnoea in portions of the
lungs that are healthy when other parts are diseased, the healthy portions
doing all of the work; this is especially seen in bronchitis, where the
smaller bronchi are plugged up with secretions. We occasionally find
an irregular vesicular murmur in healthy dogs, but it is also heard in
cases of bronchitis; this murmur is heard only on inspiration.

The murmur of expiration is very slight; in normal cases it can hardly
be heard; it is quite plain when the breathing is strong after excitement,
action, etc., especially in young dogs and those animals that have a thin
chest wall. According to the diseased condition, the sound is strength-
ened, varied in tone, and prolonged.

The bronchial respiratory bruit (bronchial breathing, wheezing
sound) may be heard in the normal respiration of the pharynx, wind-
pipe, and the anterior part of the chest in diseased conditions; it appears
where any part of the lung is deprived of air, and the disease has plugged
up the smaller bronchi and extended to the larger-sized bronchi. This is
the case in the various pulmonary affections, where we find large sections
of the lungs are obstructed, or in compression of the lung by a pleuritic
exudate or by tumors, and in rare cases by the pressure of the diaphragm
where it is pushed forward from the collections of fluids in the abdomen.
It is also heard when a quantity of mucus is coming up the bronchial
tubes; this sound disappears when the mucus is coughed up. Lastly,
we find it in cases where the lung has large cavernous spaces in it.

Indistinct respiratory bruits are heard in lobular pneumonia, where

PHYSICAL DIAGNOSIS OF THE LUNGS 127

the diseased lolndes are located among clear tissue that the air is passing
into, and where the true character of the respiratory bruit is not heard on
account of the loud rattling of the air going through the contracted
bronchial tubes. Indistinct respiratory sounds are also heard where there
is more or less mucus in the bronchial tubes, and after the animal has
had a coughing spell the true bronchial sound is heard.

Irregular bronchial sounds (rattling bruits) are caused by the move-
ment of the mucus or fluids that are in the air-passages, being carried
to and fro by the passage of air. The}^ are dry (snoring, wheezing) where
a small ciuantity of sticky mucus collects in the bronchial tubes, as is seen
in some catarrhal affections and in cases where the mucous membrane is
considerably swollen. The snoring sound is generally heard in the large
bronchial tubes. The wheezing sounds occur in the smaller bronchial
tubes. A spell of coughing produces considerable change in the character
of the slight, rattling sounds of the chest. The rattling sounds are moist
Avhen the secretions are lic|uid; the thicker they are the duller the bruits
become. We hear moist, rattling sounds when the secretions are col-
lected in the large bronchi; this sound is also heard when there are caver-
nous portions in the lungs. We find much less when this is the case in
the middle bronchi, and a very low bronchial bruit when the small
In-onchi are involved. By this means we can distinguish in what posi-
tion the irritation lies in the bronchi; this is rather important in diagnos-
ing a case of bronchitis. AVhen the fine bronchioles are involved it has a
crackling or crepitant sound and sibilant bruits; these are only heard
during inspiration. This sound may sometimes be heard in the alveolar
passages and in the alveoli themselves, when they are filled with mucus
or closed up, and where the air can reach them only by strong inspiration.
This is seen in the first and third stages of croupous pneumonia, in oedema
of the lungs, and in capillary bronchitis; in the last, the crepitation is
mixed with an irregular rattling sound. We find also the friction sound
of the pleura; this is not heard in the normal condition, but in disease; it
is either crepitating, scraping, or scratching. It is heard in pleurisy; as a
rule it is louder on inspiration than expiration. This sound is produced
by collections of fibrinous accumulations on the pleura. These sounds
are not heard when the pleura is separated by an exudate. The sound is
plainest at the commencement of the disease, and when the exudate is
being absorbed. This sound is not altered by coughing, and in this way
can be distinguished from rattling sounds which are heard when it is a
case of pleuro-pneumonia. The rubbing sound caused by the broken
ends of a fractured rib is indicated by the crepitation on movement of the
ends of the rib.

128 DISEASES OF THE RESPIRATORY ORGANS

DISEASES OF THE NASAL CAVITIES.

Catarrh of the Nose.

(Cold in the Head; Coryza; Rhinitis; Nasal Catarrh.)

Etiology. — Catarrh of the nose (catarrhal inflammation of the nasal
mucous membranes) occurs very frequently and originates from local
causes (dust, smoke, pentastomum tsenioides, foreign bodies) or by cold.
Coryza is also a symptom of distemper, and may appear secondarily
in any inflammation of the other mucous membranes of the head. Where
a large number of dogs are kept together, it may occur as an epizootic or
may result from being bathed in cold weather and not being properly
dried, clipping or shaving the hair, or from ulceration of the nasal
passages.

Clinical Symptoms and Course. — These are sneezing, wiping the nose
with the paws, or rubbing it against some object. Later a nasal dis-
charge, which is watery and liquid at first and later becomes turbid,
thicker, and more tenacious; and it may become purulent, according
to the complications that may appear later on. If the cavities in the
upper chamber of the nose are affected, the discharge is very profuse and
there is more or less disturbance of the general system. When the catarrh
is confined to the anterior chambers the nasal cavities are often very
much contracted and we hear a snuffling nasal bruit; and if the chamber
is very much contracted we may see dyspnea, and the animal is then
compelled to breathe through the mouth. This is apt to occur more in
those dogs that have narrow, twisted, or curved nasal chambers, as in the
case of the pug and bull dog. True bleeding of the nose (epistaxis), or
mucus streaked with blood, is very seldom seen. The duration of a
case of nasal catarrh is usually short; although we may occasionally
see a case where there is a tendency to a chronic condition; in such a
case, the secretion becomes purulent and has a tendency to dry around the
nose, forming a dirty crust around the nostrils and the upper lip (see
later under Pentastomum tsenioides) ; in such cases the mucous membrane
is dry, corrugated and frequently gray in color, the breath may remain
foetid, resisting all palliative treatment, and may continue as a chronic
condition and affect the animal all through life. In very bad cases the
secretion is purulent, with a very bad odor, and in rare instances streaked
with blood. This is specially the case where the pentastomum tspnioides
is the cause of the diseased condition of the mucous membrane.

Therapeutics. — Xasal catarrh will generally disappear without any
special treatment. To protect the neighboring tissue from the excoria-
tion of the tissues caused by the discharge it is well to keep it clean
with tepid water and a little borax, or to coat the part with vaseline or

CATARRH OF THE NOSE 129

oxide of zinc ointment. In all mucous, purulent, or chronic catarrhs
spray the nose ^yith a 2 per cent, solution of creolin, or coat around the
nostril with vaseline or oil. In acute catarrh it is best to spray the
nostril with an atomizer, using either of the following solutions: creolin,
2 per cent.; carbolic acid, 2 per cent.; boric acid, 3 per cent.; the inhala-
tion can be given in the form of warm solutions, allowing the animal to
inhale the steam from them by the method described in the treatment of
chronic catarrh of the larynx on page 136, or with an atomizer; infusion
of chamomile, carbolated water, tar water, and oil of turpentine have
been used with good results. Foetid discharges from the nasal cavity may
be treated by injections or local applications but, as a rule, animals resist
treatment, and the excitement and irritation to the animal does much
more harm than good. The vapor apparatus described on page 136, is
much simpler and produces good results. Painting the nasal cavity
with a 1 to 5 per cent, solution of cocaine will anaesthetize the mucous
membrane and lessen the irritation of the animal; an atomizer maybe used
or powder applied by means of an insufflator is useful to make local appli-
cations to the nose; in making such local applications care must be taken
to have the patient's head dependent and use very little force in the appli-
cation, so the injection may traverse only the nasal cavity and not be
driven into the larynx and into the lungs. The mild albuminous solu-
tions of silver may also be used.

Other Diseases of the Nasal Cavities.
Bleeding at the Nose (Epistaxisj.

This is a result of traumatic or mechanical causes, such as blows, bites,
lacerations, or the entrance of foreign bodies into the nasal cavities; it
also results from acute or chronic catarrh, pathological growths, parasites
in the nasal cavity, congestion or rush of blood to the nasal region, infect-
ious diseases, parasites (pentastomes) , or hemorrhage from the lungs.

Violent bleeding at the nose can be controlled by injections of cold
water or a 3 per cent, solution of chloride of iron into the nostril. It is
very difficult to place a tampon in the dog's nose that will be efficient, on
account of the anatomical peculiarities.

AVhen the pentastomum is present, the only efficient way to get
at it is to trephine the frontal bones, so that agents can be injected
directly into the location of the parasites. For this operation refer to the
text-books on surgery.

Treatment. — Xo treatment is generally required, as the majority
of attacks of epistaxis stop spontaneously if the animal is kept quiet.
In persistent cases make applications of cold water to the head or solu-
tions of ec|ual parts of vinegar and alum are injected into the nose, or in-
9

130

DISEASES OF THE RESPIRATORY ORGANS

j(>ctions of vinegar and water, equal parts, 3 to 5 per cent, solution of
alum, tannin, chloride of iron or antipyrin. Tampons are rather difficult
to apply, but if the bleeding is persistent they can be used. Use small
pledgets of cotton steeped in chloride of iron, taking care the plug is not
pushed in entirely, so that it can be removed later by means of forceps.
The best means of applying the tampon is to use the rapid tampon. The
so-called internal styptics are useless. The injection of gelatine solution,
once so much in vogue, is not now used, as it is dangerous. Anaemia from
exposure and persistent epistaxis is considered in the chapter on that
subject.

Fig. 60. — Dog with chronic catarrh and pus in the frontal sinuses.

Tumors of the Nasal Cavities.

These may be indicated by a swelling or alteration of the nostril or
the adjacent structures; frequently osteo-sarcomas involve the nasal
septum, palate or superior maxilla, the new growth absorbing or dis-
turbing the normal anatomy of these structures and carcinomas convert-
ing the bones into soft cellular structures. Polyps are sometimes pres-
ent and are removed either by tortion or by removing the nasal bone
and getting into the nasal cavity.

Catarrh and Pus in the Frontal Sinuses.

This may result from traumatisms or from pentastomes (see later)
or new formations in the frontal sinuses, as a result of nasal catarrh,
indicated by swelling and dulness on percussion of the frontal sinuses
(see Fig. 60). Acute catarrh of the frontal sinus may result as a sequel
of influenza; as a rule, however, it is spontaneously absorbed. If it is

CATARRH OF THE NOSE

131

chronic, the pus may be lilxn-ated by trephining, and the cavities washed
out with astringent solutions, peroxide of hydrogen, zinc, lead, or alum.

Pentastoma and Pentastoma Influenza (Linguatula
Taenioides). — This ta-nia-like })arasite, which l)elongs to
the class of archnides, and ortler of Linguatukc, has a
flat, tongue-like body, which is indented at its borders
and composed of 90 to 100 segments, making the body
have a saw-like appearance, and is whitish-yellow in
color (see Fig. Gl). The female is 80 to 95 mm. and the
male 18 to 20 mm, long, both sexes about 1 to 2 mm.
wide.

These parasites are found in the sinuses of the fore-
head and the upper nasal chambers (Fig. 02) ; they may
also find their way into the pharynx, where they are
developed sexually. The eggs are yellowish-l:)rown, as
many as 500,000 being found in one female; these eggs
are attached to some vegetable substance eaten with the
vegetable food by a herbivorous animal or man. In the
stomach it becomes free when the shell is dissolved and
reaches the liver in various ways. It is found in the
spleen, kidneys, peritoneum, and in rare instances in the
lungs, where it becomes encysted; this is the sexless larval form,
pentastomum denticulatum (Linguatula denticulata) (Fig. 63). It re-
sembles the sexed parasite in general shape, except that it is much

Fig. 61.— Pen-
tastoma taenioides.

Fig. 62. — Cross-section of the head of a dog with pentastoma in the nasal cavity.

smaller, from 4 to 5 mm. long, and in its anterior part about 1.5 mm.
wide. It lies in a detached cyst which is about 5 mm. long. In
six months it becomes sufficiently developed to break through the
cyst-wall, and by direct migration finds its w'ay to the bronchial
tubes; it is coughed up from the lungs of the host and finds

132

DISEASES OF THE RESPIRATORY ORGANS

Fig. 63. — Pentasto
mum denticulatum.

its way into the nasal cavities of the dog through the food or is carried
into the nose in respiration and crawls up into the nasal cavities. While
the disease is rarely observed, numerous cases seem to occur in certain
districts.

The majority of observers consider the disease rather difficult to diag-
nose and generally it is only when it involves a number
of animals, such as a pack of hounds or carriers, or in
one of the districts where it is prevalent, that it is
noticed. The larger breeds of dogs are most frecjuently
affected and show the symptoms of chronic nasal
catarrh.

Pentastomum catarrh differs from ordinary
nasal catarrh, from the fact that in pentastomum
catarrh there is a more or less bloody nasal discharge
which is very purulent and putrid, and that the
animal is greatly depressed. There is marked inter-
ference with respiration, the animal appearing at
times to almost suffocate; the sense of smell is gen-
erally lost or is very slight; it becomes emaciated and
sneezes a great deal oftener than in ordinary catarrh.
An instance is recorded where the parasite pene-
trated the hard palate, causing a great flow of saliva.
In some cases the inflammation has extended from the nasal cavities to
the cranial cavity and produced meningitis with severe cerebral symp-
toms, great excitement, restlessness, and a tendency to biting or snap-
ping, and also paralysis of the lower jaw and several symptoms very
similar to those of rabies.

Friedberger and Frohner advise that in all cases where there are
symptoms of rabies, that the frontal sinuses he
examined, as there are often cases where the pen-
tastomum is present and it maj^ produce cerebral
symptoms, and even death, without any marked
alteration in the mucous membranes of the nasal
passages. At the same time it is possible in rare
instances to find a pentastomum in a dog that has ^^^ 64 —Egg of the pen-
died from true rabies. The writer may mention tastomum ta>noides magni-
that he has also found cerebral symptoms in an " " ""^^'
animal that has been suffering from purulent (non-parasitic) nasal
catarrh.

Treatment of pentastoma consists in the injection into the nose of
solutions (either by means of a syringe or ])y an atomizer) of boracic acid,
creolin, chloroforhi, lienzine, carbolic acid, or liy the application of the
vapors of chloroform, formaldehyde, etc. All these preparations are

ACUTE LARYNGEAL CATARRH 133

rather difficult to apply, on account of the narrowness of the nasal pas-
sage in the dog. In very acute cases, the best method of procedure is to
trephine the upper part of the nasal passage and going directly into that
cavity inject it with solutions of turpentine, chloroform, corrosive subli-
mate solution and wash out the parasite. This can be accomplished by
using a good sized syringe filled with the solution (creolin 1, water 15, or
emulsion of turpentine in linseed oil 1 to 10) and putting a small section
of rubber hose on the end of the syringe; insert it into the opening and
inject slowly, taking care to see that the animal's nose is depressed and so
allow the flow to go over the location of the parasites.

DISEASES OF THE LARYNX.

Acute Laryngeal Catarrh.

(Acute Laryngitis) .

This is generally observed in the spring and autumn, and at times
seems to be epidemic; it may be caused by lying in a draught, being
bathed in cold weather, cutting the coat too early, or sudden changes of
temperature. It is found more frequently in delicate or pampered
dogs, these animals catching cold much more easily than hardier animals.

Etiology. — The most common cause of catarrh of the larynx is cold;
laryngitis rarely originates from direct irritation by agents that affect
the mucous membrane of the larynx, such as inhalation of smoke, dust,
irritating gases, foreign bodies, etc. It may result from constant barking,
as when an animal is exhibited at a show and barks constantly, or through
lying near a fire and getting very warm and then going and lying at the
door, where the draught will come on the head and throat. Laryngitis
appears as a secondary symptom of acute inflammation of the nose,
trachea, and bronchi, and it is generally one of the precursory symp-
toms of distemper.

Pathological Anatomy. — The mucous membrane of the larynx is
partially or entirely reddened, inflamed, and swollen, and covered with
mucus over its entire surface; this mucus is rarely purulent; in serious
cases, the membrane is eroded or ecchymosed in spots.

Clinical Symptoms. — The first noticeable symptom is a cough;
this may be very loud, according to the condition; it is always coarse,
hard, and dry in the beginning; later it becomes softer and more moist
as it is accompanied with the secretions of mucus, and the animal may
retch and act as if going to vomit.

By a slight pressure on the glottis we can make the animal cough,
and the larynx seems to be painful on manipulation; running, excitement,
drinking cold water, or the administration of medicine all produce
coughing. Difficulty in respiration is seen in certain forms of laryngitis

134 DISEASES OF THE RESPIRATORY ORGANS

where there is intense inflammation and great swelling of the mucous
membrane; it is accompanied by more or less wheezy or rattling sounds,
which can be heard by placing the ear on the larynx. There is not much
constitutional disturbance in the milder forms of this disease; in more
acute cases, the animal is depressed and eats slowly; this is probably
caused by a certain amount of irritation extending to the muscles of
deglutition, and to swelling of the mucous membrane, or from some form
of pharyngitis, which may be present at the same time; if so, it is generally
accompanied by a slight rise of temperature and loss of appetite. This
condition in young dogs should always be watched very carefully, as
it may be one of the premonitory symptoms of an attack of distemper.

The disease generally lasts only a few days, but if a case is neglected
and does not receive care and proper treatment, it is apt to remain irri-
table and become chronic.

Therapeutics. — The first thing to do is to remove the animal from
cold draughts and apply friction, with some mild liniment over the larynx,
also the application of a moist warm compress over the larynx with the
inhalation of medicated vapors, a pinch of belladonna leaves or a tea-
spoonful of tincture of benzoin in boiling water, and internally the admin-
istration of some expectorant or narcotic. These medicines should only
be administered when the cough is persistent and the violence of it
tends to aggravate the irritated condition of the mucous membrane;
morphine is the best, as it lessens the cough and irritation; it can he
administered with potassium cyanide and syrup of wild cherry. The
following prescription is very useful where the animal is a small pet dog,
that is, one kept in the room; it tends to prevent the cough, which is
always worse at night:

I^. MorphiiB sulph., 0.1

Aq. amygdalis amarse, 24.0

Sig. — Half a teaspoonful three times daily.

I^. Morphise sulph., 0.12

Potassii cyanitU, 0.15

Syr. pruni virginianse, 9G.00
Sig. — One teaspoonful four times-daily.

I^. Ext. hyoscyami, 1.0

Liq. ammon. acetatis, 20.0

Sig. — Twenty drops every half hour.

I^. Heroin hydrocliloratis, 0.1

Aqua-, 150.0

S. — One to two teaspoonfuls every six hours.

Occasionally we may find a foreign body in the larynx presenting
the following symptoms: Dyspnoea accompanied by loud coughing or

CHRONIC CATARRH OF THE LARYNX 135

whistling sounds mingled with the coughing, great anxiety shown on the
animal's face; cyanosis of the mucous membranes. If the animal is
actually choking, perform tracheotomy immediately, then endeavor
to tlislodge the foreign body and if this is not successful laryngotomy is
indicated.

Chronic Catarrh of the Larynx.

{Chronic Laryngitis; Convulsive Cough; Chronic Irritable Cough.)

Etiology. — Chronic laryngitis generally results from one or repeated
acute attacks of laryngitis, or from chronic catarrh of some of the other
organs of the air-passages; the pharynx, trachea, or bronchi, etc. It
may also follow swelling or ulceration of the pharynx, or from the forma-
tion of a tumor in that organ.

Pathological Anatomy. — The mucous membrane is thickened, but
not so red as in acute laryngitis; it is marked with fissures and elevations
due to thickening, caused by the chronic inflammatory processes; and here
and there may be noticed a dirty bluish-red coloration. The surface is
granular, on account of the swelling of the inflamed mucous glands; in rare
cases, we may see small papilliform elevations or small eroded or ulcerated
places which mark a breaking-down of some of the mucous glands; the
secretion which covers the aff^ected parts is thick, slimy, and tenacious.

Clinical Symptoms. — The symptoms are similar to acute laryngitis
except that they are not so severe; the larynx is slightly sensitive to pres-
sure, sho\\ing that some irritation is present; the animal will cough after
manipulation, but not to such a marked degree, and he does not try to get
away from the pressure, as Would be the case in the acute form, and
there is no disturbance of the general system. The cough sounds dry,
hoarse, and rough, sometimes moist, and is frequent, quite loud, and ac-
companied by a wheezy inspiratory sound, with, in rare instances, retch-
ing or even emesis, night being the time it is mostly heard, or when the
animal runs about and plays and he is going to be taken out for a run.
In some cases the cough resembles the whooping cough of children (tussis
convulsiva). As a rule the respiration is not increased, but in chronic
cases where one attack follows another the respiration is greatly in-
creased with the slightest exertion. Some animals make a wheezy noise
as though there was a decided contraction of the larynx. This latter
condition may continue for years, and the cough in particular is con-
stantly present.

Therapeutics. — As a rule, the treatment of this disease is unsatis-
factory; this, of course, depends to a large extent on the animal. Being
removed from the conditions that have originally caused the disease, the
first thing to do is to keep the animal indoors, perfectly quiet and pro-

136 DISEASES OF THE RESPIRATORY ORGANS

tected from cold, with rest, and avoiding excitement or prolonged howl-
ing. Among the agents used in general treatment the following are best:
Inhalations of hot medicated solutions, carbolic acid, tar, oil of turpentine
or powdered salt, chlorate of potassium, alum, or tannic acid. Inhala-
tions with these agents by means of an atomizer, or by vapor bath should
be made twice daily for ten or fifteen minutes.

It is readily understood that inhalations are rather hard to admin-
ister in the dog, as the animal cannot be kept still while the medication is
being made, and also because the dog breathes through the nose, and if
prevented from doing so the vapor is carried into the throat and again
into the mouth. The only practical way to get an animal to inhale a
vapor is to put him in a close box and through an opening introduce
steam that fills up the apartment; then the animal has to inhale it. This,
however, can be practised only in a hospital. But where the animal is
at home, the best method of procedure is to place him on a cane-seated
chair, and having placed the medicated agent, steaming hot, under the
chair, cover the animal with a sheet and hold him for ten or fifteen min-
utes; or we may also hold the steaming vessel under his nose and cover the
head. It is only with the greatest difficulty that the laryngeal mucous
membranes can be painted with any medicinal agent. This is to be re-
gretted, as it is the only direct way that the membrane can be treated with
any certainty. In making local applications to the larynx an assistant
holds open the mouth by means of tapes, the tongue is pressed down-
ward by means of a spatula or the handle of a spoon, and the throat is
sprayed by means of an atomizer or a brush or a quill. The intratracheal
method of administration of medicinal agents is rather difficult to follow
out, particularly in animals that are fat or have short necks; insert the
needle beneath the larynx or through the crico-thyroid ligament, the solu-
tions to be used are 1 per cent, solution of morphine or codeine. These
injections should be made daily or every other day.

Frequently in chronic catarrh we use narcotics to stop the severe
cough produced by irritation of the membrane — morphine, codeine,
heroin, and in rare cases bromide of potassium or chloral hydrate.
Expectorants are not of much use in the dog.

As to other affections of the larynx, with the exception of tuberculosis
of the larynx and certain tumors described by Cadiot (both conditions
which are extremely rare), the only one of practical importance is

Hemiplegia Laryngis.

This is occasionally observed. In this affection the animal has a pe-
culiarly shrill bark, which is varied in tone, becoming harder and harsher
and spasmodic, accompanied by great difficulty in respiration, marked
dyspnoea and roaring sounds during respiration. The condition may be

W. McDougall, del.

MODE OF ADMINISTERING MEDICINAL VAPORS.

BRONCHITIS 137

produced by dragging on a collar, folloAv traumatisms, as in one case ob-
served, that is, fracture of the first rib on the left side, and it is also seen
following the pulmonary form of distemper. The treatment consists of
the application of a galvanic battery over the region of the recurrent
nerve, the administration of nux vomica internally, or of strychnia,
sulx'utaneouslv.

DISEASES OF THE AIR-PASSAGES AND BRONCHIAL TUBES.

Catarrh of the Windpipe and Bronchia; Bronchitis.

{Trachitis and Bronchitis Catarrhalis.)

Etiology. — Catarrh of the air-passages and of the bronchia occurs
very fretjuently in young, weakly, or debilitated dogs. It sometimes
originates primarily, but, as a rule, it occurs as a secondary disease. It
is caused by cold, especially by breathing cold air when the animal is
warm; and in pet dogs we see it cjuite often where the animals will lie
near the register or an open fire until they are very warm and then go to
the outside door and lie on the floor where the draught can strike on
them and so cool off very rapidly, and repeat this a number of times.
It is also caused by mechanical or chemical irritants, such as smoke,
dust, parasites, strong gases, or, secondarily, from the extension of in-
flammations from neighboring organs, as the larynx or lungs, or from
defective blood circulation of the lungs, produced by weakened heart
action. Catarrh of the trachea and bronchia is very often seen as a com-
plication of distemper, as well as many serious internal diseases, especially
in affections of the l:)rain. The latter condition is generally traced to the
fact that there is an accumulation of particles of food and secretions,
which collect in the mouth ami throat, decompose, and are respired into
the trachea and produce an irritation.

There is no doul)t that infectious influences play a certain role in
the cause of this disease.

Pathological Anatomy. — In describing any catarrh of the trachea it
should be classed under the head of bronchitis, as it is impossible to draw
the line of distinction between the two. In bronchitis the mucous mem-
brane is difi:"usely inflamed, swollen, and tears easily when touched. In
the ealier stages of the disease, there is little mucus found on it, but as
the disease goes on to the later stages the secretion becomes more copious
and turbid, purulent, and filled with pus corpuscles; later on it becomes
more or less colored with blood corpuscles.

Chronic Catarrh. — In this condition, the color of the mucous mem-
Ijranc is l^rownish-grey, and the membrane is frequently uneven and
thickened; in circumscribed spots or covering the entire membrane the

138 DISEASES OF THE RESPIRATORY ORGANS

secretion is clammy, slimy, or shining, in some cases it is bad-smelling or
even putrid, similar to atelekase.

In old cases of chronic bronchitis, there may be some stenosis of the
tubes, and also, from the constant irritation of the bronchia, emphysema
of the lungs. In regard to this the reader is referred to works on patho-
logical anatomy.

Stenosis (contraction) of the bronchia may be caused either by swell-
ing of the bronchial mucous membrane or by the collection of masses of
thickened secretion in the tulje. In some cases, the two causes acting
together exclude the air from the alveoli of that part of the lungs to
which the affected l^ronchia carry the air, causing the lung-tissue
to collapse. This condition, which originates in the manner de-
scribed, does not change its structure, but soon becomes solidly filled
with blood.

In all chronic conditions, we also find the opposite of stenosis, that
is, bronchiectasis (widening of the bronchial tubes) ; this is caused by a
relaxed condition of the bronchial walls, due to the chronic irritation and
also to the pressure of collections of the secretions. This dilatation of
the tubes may be either cylindrical or spindle-shaped.

Emphysema of the Lungs. — This is found near the atelectatic centres
and on the borders of the lungs; this condition is supposed to be caused by
violent coughing spells and also b}" bronchitis. The affected parts do not
collapse, but appear soft, clear and bloodless; they will, however, coh
lapse cpiickly on incision.

Clinical Symptoms and Course. — These vary, according to the
amount and location of the irritation, whether it is in the trachea, large,
medium, or small lironchia, and whether it is acute or chronic.

'1. Acute Catarrh of the Large Bronchia. — This commences with slight
and frequent chills, accompanied by fatigue, indfference, depression, loss
of appetite, and sometimes with a stiff and strained gait and slight rise of
temperature, which may rise to 40° C. Soon afterward the animal com-
mences to cough; this is one of the principal symptoms of the disease. In
the beginning it is short, painful and dry, later it becomes moist and more
frequent. It can easily be started by slight pressure on the trachea and
also by tapping on the chest close behind the shoulder.

Percussion, as a rule, does not reveal the full extent of the disease.
On auscultation, in mild cases, we hear an increased A'esicular respiration
in the trachea and large bronchia, and when the medium-sized bronchia are
affected there is an accumulation of mucus in the tubes and the A'csicular
murmur is increased. This is due to the fact that while the l:)ronchitis is
in the dry stage the sounds are roaring or snorting in character, and when
the fluid mucus has accunudated the sounds liecome rattling, as if the
air was passing through a thick mucus (mucous rales.)

BRO.XCHITIS 139

2. Acute Catarrh of the Smaller Bronchia ; Bronchitis Capillaris ; Bron-
chiolitis.— When the small bronchia are affected, these sounds are much
more decided, and in this condition there is high fever and general disturb-
ance of all the functions, and also a marked difficulty in respiration, and
the disease takes a much more serious course, particularly in young dogs
affected with distemper. One prominent symptom in the dog is the in-
flation of the cheeks with each expiration. Any pressure on the walls of
the chest will immediately produce a fit of coughing. The cough is first
dull and weak, and as the disease increases it becomes looser and easier,
the vesicular sounds being very wheezy. Capillary bronchitis in young
animals is very apt to terminate in catarrhal pneumonia, but even if this
grave complication does not occur, it is still a very dangerous disease and
is apt to prove fatal. The course of the disease is never less than two
weeks, and may often last several weeks before the animal makes a
recovery.

This disease, or the results of it, is what is generally termed asthma,
so often seen in old, well-cared-for dogs. The disease is characterized by a
certain amount of difficulty in respiration, which is increased by running
or ]3y any excitement, and is generally accompanied by a severe attack of
coughing, which in severe cases ends with every evidence of choking or
even vomiting. The cough is generally moist, and may be accompanied
by. a certain amount of rattling. In the majority of cases, where the
disease is not far advanced, the animals enjoy good health and rarely ex-
hibit any fever. In old cases, the expired air may be bad-smelling or f a?tid.

Percussion gives no definite results. Auscultation gives sounds that
depend on the number and size of the diseased bronchia and the character
•of the mucus accumulated in them. We may find cither moist or rat-
tling sounds, which vary in character, and a heightened vesicular respi-
ration or else an indistinct mucous sound.

Therapeutics of Tracheal and Bronchial Catarrh. — Keep the animal in
a moderately warm ])ut well ventilated place, where it is dry and free from
draughts. In the early stages of the disease give a mild expectorant,
such as syrup of tolu or wild cherry. Local inhalation of vaporized drugs
is not of much use, as very little of the drug is carried into the bronchial
tubes, especially the small ones. We may administer medicinal vapors by
putting a teaspoonful of tincture of benzoin, if the expressed air is foetid,
or a weak solution of creolin, lysol, or carbolic acid in a quart of boiling
water, and hold it so that the animal will inhale the steam, or a Priessnitz
compress may be put around the thorax; this should be taken off and
adjusted every three or four hours.

In the chronic cases, we generally get good results from the adminis-
tration of expectorants, such as apomorphia, ipecacuanha, and spirits
of mindererus; and where there is a violent cough, add narcotics, such

140 DISEASES OF THE RESPIRATORY ORGANS

as morphia, extract of hyoscyamus, or dilute hydrocyanic acid or
cyanide of potassium. When there is fever present, a few doses of antipy-
rine (0.5 to 1.0 gramme, twice daily) will generally suffice.

Tartar emetic, chloride of ammonium, and sulphuretted antimony are
of little use; in fact, do more harm than good, as they often destroy the
appetite and cause great depression. In the early stages of the disease
the cough does not amount to much, but in the later stages, it is constant
and very disagreeable, especially at night, and it is in such cases that
expectorants are useful to remove the accumulations of mucus. The
addition of morphia to the apomorphia solution has the tendency to
counteract the emetic effects of the latter drug.

One important factor in this disease is to keep up the general system
by giving easily digested food of a mixed character and in concentrated
form, and administer wine or brandy in small quantities. If the heart
should give evidences of weakness, use stimulants, brandy, spirits of cam-
phor, or digitalis.

In chronic bronchial catarrh where a permanent cure is not to be ex-
pected, we can alleviate the sufferings of the animal by inhalations of
tincture of benzoin or balsam of Peru, one teaspoonful to a cup of boiling
water, or by means of the vaporizer; inhalations of medicated vapors are
very useful, and especially the vapors of turpentine, where there is a
great accumulation of mucus and a foetid breath. Inhalations of the
vapors of tar and creosote are also useful. The action of tar is a little
irregular and occasionally destroys the appetite. Ichthyol and thiol are
given in doses of 0.2 to 0.5 gramme several times daily. Narcotics should
be administered only when the cough is very severe.

I^ Morphise svilphatis, 0.09

Potassii cyanidi, 0.13

Syr. pruni virginianse, 88. 0
Sig. — One teasijoonful four times daily.

I^. Tine, aconiti, 0.05

Tine, belladonnse, 0.03

Tine, bryonise, 0.02

M. F. Triturat No. 1.

Sig. — One tablet three times daily.

Parasitic Bronchitis.

The following parasites produce bronchitis; parasitic bronchitis, how-
ever, is very rare,

Strongylus Bronchialis Canis (Osier); Filaria Tracheo-bronchialis
(Blumberg Ral)e). — These parasites are very small and lodge in the mu-
cous membrane of the trachea forming greyish-red globular protuberances

CATARRHAL IXFLAMMATIOX OF THE LUXGS 141

ranging in size from that of a small pen to a coffee Ijean (Tracheitis veru),
Cosa verminosa (Rabe) . These parasites cause severe coughing, dyspnoea
great weakness, fever, vomiting, and colicky pains.

Strongylus Vasorum (Baillet). — These are long thread-like worms
which lodge in the right side of the heart and the pulmonary artery. The
eggs are carried by the blood into the lungs, and lie in the minute branches
of the bronchi (bronchioles) forming fine nodules resembling those of
tuberculosis; the embryo is liberated, gets into the bronchi, causing irrita-
tion and coughing, and the young parasite is expelled with the mucus
coughed up, or some of the parasites find their way into the alimen-
tary tract, then into the veins, and are carried back to the heart.
Animals afTectcd present the following symptoms: dyspncea, ascites, and
emaciation.

The Spiroptera sanguinolenta (see page 51) also find their way into
the air-passages, causing chronic bronchitis.

DISEASES OF THE LUNGS.

Catarrhal Inflammation of the Lungs; Pneumonia.

{Catarrhal Pntumonia; Lobular Pneumonia; Broncho-pneumonia.)

Etiology. — Catarrhal inflammation of the lungs generally originates as
a secondar}^ disease following Ijronchitis, by an extension of the inflamma-
tion of the small bronchia into the alveoli, or from the obstruction of the
bronchial tubes; it may originate primaril}' as pneumonia or in the pul-
monary form of distemper. Certain animals, such as very old dogs, or
young animals, undeveloped and underfed, as well as animals that have
gone through some acute illness, are predisposed to the development of
lobular pneumonia. Lobular pneumonia is caused by accumulations of
mucus in the trachea which may be only imperfectly coughed up, or in
very weak cases, lying in the tubes, become decomposed and putrid, and
so act as an irritant. These particles of mucus are carried into the deep
portions of the lungs, directly on the aveoli, and form a capillary bronchi-
tis; it may become converted into a catarrhal pneumonia. In some cases
particles of food, medicines, especially thick mixtures, get into the lar-
ynx when the animal is unconscious or where there is partial paralysis of
the throat. These substances penetrate into the lungs and are very
difficult to dislodge from the bronchia. This form of the disease is gener-
ally termed traumatic or aspiration pneumonia.

Roberts has described catarrhal pneumonia in an epidemic form at-
tacking all ages, developing a high temperature, and loss of 30 per cent.
8avaresc has described a specific pneumococcus, but in all probability
both observers have described a condition similar in nature.

142 DISEASES OF THE RESPIRATORY ORGANS

Pathological Anatomy.— In a lung affected with catarrhal pneumonia,
we always find all the characteristics of bronchitis, and as the disease ad-
vances, the group of alveoli that belong to the affected bronchia are
rapidly filled with the catarrhal deposit, preventing the air from penetrat-
ing into them. Soon we see an intense hypersemia of the walls of the
alveoli and the exudation of a thin, non-coagulating fluid, and numerous
white blood corpuscles, which soon become pus corpuscles, and the com-
mencement of a fatty degeneration and detachment of the alveolar cells.
The alveoli and the small bronchia become entirely filled with pus corpus-
cles and a certain number of blood corpuscles and broken-down epithelial
cells, and the inflamed portion of the lung can easily be distinguished
from its healthy surroundings, forming firm, tough, roundish or lobulatcd
lumps, which vary in size and number, projecting slightly above the sur-
face of the lung, and on making a cross-section of the diseased portions, in
the earlier stages of the disease, they are seen to be dark bluish-red and
later on become gray, while the surrounding tissue that is not diseased is
normal or, what is more frequent, is slightly congested with blood. The
detached centres, which show plainly in the early part of the disease, soon
become confluent, so that finally we find large sections of the lung in-
volved. In rare cases we find fibrinous (croupous) centres in connection
with the catarrhal pneumonic centres and extended vesicular emphysema
in the neighborhood of the affected centres, and at the borders of the lungs
it is often seen. We may also have subpleural and interstitial emphy-
sema and sero-fibrinous or pussy pleuritis about the broncho-pneumonic
centres.

Clinical Symptoms. — It is very difficult to make a sharp distinction
between capillary bronchitis and lobular pneumonia on account of the
close relation between these two diseases. If the disease has affected the
alveoli, there is a marked acceleration of the respirations, in some cases as
high as 60 per minute, and also inflation of the cheeks with each expira-
tion; the cough is short, frequent, and apparently very painful, the pulse
running from 150 to 170, temperature rises quickly and remains high.
On making a physical examination by percussion, there are a number of
dull centres though the lungs; in some instances the whole of the lung
gives dull sounds on auscultation. According to the stage of the disease,
we hear rales of various characters, strong vesicular breathing, snoring, fine
or loud bruits, and where there is extended infiltration, we hear bronchial
respiration and certain spots where there is no respiratory murmur at all.

The temperature often goes up to 40° or 41°; this high temperature
usually commences early in the disease or it often makes a rise when the
disease has become converted into catarrhal pneumonia. If this compli-
cation does not occur, the temperature will not make any marked change,
but will follow a regular course, which is to rise quickly at the onset

CHRONIC INTERSTITIAL PNEUMONIA 143

and gradually fall as the disease decreases and the animal goes on to
convalescenre.

Course and Prognosis. — The course of catarrhal inflammation of the
lungs is rarely less than three weeks, and is often prolonged over three
months, with varying degrees of intensity. Traumatic pneumonia is the
only form of the disease that runs its course quickly.

The evidences of termination of the disease arc: Recovery by
resolution, in which the inflammatory products, which fill the smallest
l)i'onchia and the alveoli, are changed into a form of emulsion and are
either reabsorbed or coughed up, or develop into a secondary disease,
for instance, chronic interstitial inflammation of the lung or, in rare cases,
the formation of purulent gangrenous centres. Third, death, which may
occur at any stage of the disease; in the early stages, as a conseciuence
of great extension of lobular pneumonia or at any time as a result of
cedema of the lungs, this is observed in very young animals that are
very weak, particularly in the pulmonarj' form of distemper, but it may
also occur in very old debilitated animals. Traumatic pneumonia, if
it is acute, generally results fatally and little or nothing can be done
to produce a favorable result.

Chronic Interstitial Pneumonia.

{Chronic Induration of the Lungs; Cirrhosis of ihe Lungs; Phthisis.)

When the disease terminates in this pathological condition we find
an inflammatory deposit in the interlobular and interstitial connective
tissue. This deposit compresses the alveoli and small bronchia, and
they lose their functions and are finally absorbed, and on section of the
affected portion of the lung it is found to be coarse, rough, and irregu-
lar on its surface, the tissue varying from yellow to yellowish-red in
color and the lobules surrounded by connective tissue. The bronchia
surrounding the affected portion are distended and pocket-shaped,
and there are also a certain number of spots of localized emphysema.

The clinical course of the disease shows very little fever, but the
animal is never entirely restored to health; the respirations are short,
labored, and with a quick, weak cough. The affected animal becomes
emaciated, the condition is complicated wdth dropsical effusions, and it
finally dies from exhaustion.

In some cases of lobular inflammation of the lungs the inflamed
portions form abscesses, or we may find portions of the lung that are
gangrenous. These terminations depend on the nature of the irritant,
and generally occur after traumatic pneumonia (foreign bodies). A^ hen
suppuration commences in the alveoli, an abscess is formed and a pear-
shaped body is found in the centre of the infiltrated lobule, and sur-

144 DISEASES OF THE RESPIRATORY ORGANS

roundino; it is a thin, delicate layer of yellowish tissue and over that
a tough layer of red inflamed fibrous tissue; large abscesses may be
formed by the fusion of all the infiltrated pulmonary tissue.

When gangrene has developed, the inflamed catarrhal centre be-
comes dirty greenish-brown in color, or in severe cases, almost black.
In the early stages the diseased portion is hard and fibrous, l)ut it
soon becomes soft and pulpy and filled with a turbid, foetid, greenish
serum. When the disease is slow and chronic, the gangrenous spots are
limited in size, but generally when the disease assumes the gangrenous
form, it becomes diffuse and the animal dies rapidly from exhaustion.

We recognize the gangrenous form when the breath becomes pu-
trid, for in the dog it is almost impossil^le to get any of the discharge that
is coughed up, the animal generally swallowing the mucus. Ausculta-
tion of the lungs may detect tympanic or metallic sounds, mucous rales
and increased bronchial sounds. When gangrene (necrotic pneumonia)
has developed, the animal has a putrid breath and a series of alarming
symptoms accompanying it — septic fever, chills, and a high tempera-
ture, with weak, irregular pulse. If the sputa were examined, we would
probaf)ly find numerous micrococci, bacteria, and portions of broken-
down lung-tissue.

(Edema of the Lungs. — This is apt to follow not only pneumonia,
but all debilitating diseases that weaken the left side of the heart, and
that organ is unable to force the venous blood through the lungs. There
is a regurgitation of the blood, and the alveoli and bronchia become filled
by a serous fluid which exudes from the blood vessels. The cedematous
lung is distended and much larger than normal; on pressure with the
finger the indentation remains some time. On section of the lung, a
large quantity of reddish foamy fluid exudes from the tissues and the
bronchial tulles.

When oedema of the lungs follows catarrhal pneumonia it gener-
ally begins with great difficulty in respiration, labored or stertorous in
character, a short, faint cough, and in rare instances a quantity of thin
reddish fluid comes from the nose or mouth. On making a physical
examination, percussion gives no results but those found in catarrhal
pneumonia. On auscultation, we hear rattling bruits all over the chest,
especially in the anterior part, and also in the trachea; the blowing sounds
may be very loud in some cases, and can be heard some distance from
the animal. Death occurs in a short time. Some time before the ac-
tual symptoms of oedema appear, the exhausted condition of the heart
is indicated by the pulse being irregular, that is, weaker at inspiration
than at expiration.

Therapeutics. — In treating l()l)ular ])neumonia we follow the same
eeneral course as we (,lo in broncliitis. Ihc writer obtained the best

CHROXIC INTERSTITIAL PNEUMONIA 145

results with Priessnitz's compress and from the remedies recommended
under the treatment for bronchitis. The good effects of moist, warm
compresses can be much increased by sharp friction with a small cjuan-
tity of mustard oil to the sides but it must be applied only in young,
strong, healthy animals. The best method of application is to make a
liniment of 3 parts of oleum sinapis aethereum in 45 parts of olive oil and
divide it into 2 parts and apply one-half to each side of the chest then
wind a dry bandage around the chest walls and ten to twelve hours later
apply Priessnitz's compress. Narcotics are to be given when the cough
is constant and distressing. Where there is much debility stimulants
such as wine or ether are indicated and the animal should be given small,
often-repeated quantities of chopped meat, juice of meat pressed from
raw beef, broth, milk, and the peptone preparations.

Some good is to be derived from inhalations in this disease. When
the breath is offensive we advise inhalations of benzoin, 4.0 to cup of
boiling water. Inhalations of creosote are recommended, but on account
of the danger of absorption and irritation of the kidneys by that drug
they are to be used with extreme caution. In septic fever, after the
appearance of gangrene of the lungs, give subcutaneous injections of
ether or camphor.

When oedema of the lung is recognized, it must be regarded as a
grave symptom for it is generally fatal. We must, therefore, take very
energetic measures — active stimulants, such as mustard oil to the sides,
and also injections of ether or camphor subcutaneously. Bleeding and
the use of cardiac stimulants, such as digitalis or caffeine, are useless.

Other Diseases of the Lungs.

Catarrhal pneumonia is the only important disease of the lungs in
the dog; the others which are here described are of small importance
and rarely seen.

Congestion of the Lungs, Acute Hyperaemia of the Lungs. — This dis-
ease is comparatively rare, generally being observed in the summer, as a
result of very severe exercise; for example, in hunting dogs, in warm
weather, or animals running after cars, wagons, or bicycles until ex-
hausted, or as a result of infiltration of the lung in ascites, or from cold
air, gas, great heat or smoke if the animal has been in a burning house
or kennel, etc.

The early acute symptoms are greatly accelerated respiration,
mouth open, tongue deep blue to purple and hanging out, animal restless
and excited, heart full, bounding, and easily felt through the chest wall,
hard full pulse, cyanosed mucous membranes, and if the acute condition
continues for any length of time, apoplectic cedema, apoplexy, or
10

146 DISEASES OF THE RESPIRATORY ORGANS

acute pulmonary hemorrhage follows and death occurs in a very short
time.

Therapeutics. — Keep the animal in the air or a well ventilated room
and let the animal rest, with no disturbing influences. In grave cases use
venesection, cold baths and clysters, or massage of skin. If oedema
threathens, treat accordingly.

Croupous Inflammation of the Lungs ; Fibrinous Pneumonia. — This
is a firm, hemorrhagic exudation in the alveoli of the lungs and small
bronchia. Is very rarely seen in the dog. The writer has never seen a
case of true lol)ular pneumonia, but has seen a few cases of croupal
lobular pneumonia, the course of which is very similar to that of catarrhal
pneumonia in all its symptoms, the difference being detected only on
post-mortem. Roll makes the statement that croupous inflammation of
the lungs is common in the dog, but he probably meant croupal lolnilar
pneumonia.

The clinical difference between croupal and catarrhal pneumonia
is the rapid course in the onset of the former, the bronchial murmur
is lost early, due to the filling up of the bronchial tulies, the frequent
complication of pleurisy and the quick formation of a pleuritic exudate.

Anthracosis pulmonum (blackening of the lungs), due to the inhala-
tion of coal dust or coloring matter found in animals living in cities or
kept as watch dogs in factories where dust is constantly in the atmos-
phere, is quite common in the dog, but it has no pathological significance.

Emphysema of the lungs is not such an important disease in the dog
as it is in man and the horse. That form of emphysema which appears
in bronchitis and pneumonia, characterized by an extreme distention of
the alveoli, has been mentioned under these diseases. If the irritation is
constant, the disease becomes chronic and a progressive atrophy of the
alveolar walls takes place until they are entirely closed up, the neighbor-
ing alveoli become absorbed or altered, and finally large cavities are
formed, and the blood vessels become atrophied. On section of the lung
the edges of the cavities are pale, soft, and the blood vessels are stained
with pigment. Sometimes, as a result of severe exertion, such as
vomiting, pregnancy, or laceration of the alveolar walls, air is allowed to
penetrate into the interlobular, interstitial, or subpleural connective
tissue; this is generally caused as a result of severe and continual cough-
ing spells and where animals have died from some form of suffocation.
Siedamgrotzky describes a case where an old emphysematous dog had a
severe fit of coughing and the lung was lacerated, causing pneumothorax.

Bronchial Asthma; Asthma. — Under tlie general term of asthma
we understand dyspnoeas, accompanied with continued cough and labored
spasmodic breathing. The true spasmodic asthma, as described in man,
in which there are acute attacks of spasmodic respiration, can hardly be

DISEASES OF THE PLEURA; PLEURISY 147

said to occur in the tlog. Temporary dyspna?a occurs in heart disease,
nephritis, and some other affections. In a general sense, asthma or
bronchial asthma, as we designate the disease in man, is characterized
by attacks of acute dyspnoea at irregular intervals, caused by temporary
spasmodic contraction of the bronchi. While it was once generally
thought that asthma was a pure neurosis (bronchiale neurosum), the
inclination of the present clay is to believe that in the majority of cases
reflex action from the nasal mucous membrane is one of the chief causes.
The attack generally begins by constant sneezing and drawing inhala-
tion with great effort as if the nose was entirely filled; o-are must be taken
not to confuse this condition with congestion of the turbinated bones or
nasal polypus.

Neo -formations of the Lung. — "With the exception of tubercular
alterations, changes in the lungs are exceeding rare. Carcinomas may
occur, generally associated with carcinoma of the thyroid or the mammary
glands; these appear in varying sized nodules in the lung tissue; those at-
tached to cartilaginous layers of the bronchi grow to quite a large size.
The clinical symptoms in the early stages of these formations are not very
pronounced and rarely observed, but may present symptoms similar
to chronic affections of the lungs, such as chronic bronchitis or interstitial
pneumonia. There may be difficulty in respiration, oedema of the head
and neck, due to pressure on the jugular. Frohner found one case of
carcinoma of the lungs where the animal had frequent hemorrhage.
Treatment is useless. Parascandolo, keeping up artificial respiration,
removed a carcinoma through the chest wall from a large dog.

DISEASES OF THE PLEURA.

Inflammation of the Pleura; Pleurisy.

{Pleuritis.)

Etiology. — The disease is divided into two forms — primary and
secondary pleuritis. The primary form may be caused by cold; it may
also occur as a metastasis, or from the presence of certain bacteria in the
l^lood, which find a favorable nidus in the pleura, lodge there and set up
pleuritis. The secondary form results from traumatic causes, such as an-
imal being kicked, stepped on, or receiving a violent blow on the thorax,
from the extension of inflammations from the surrounding organs, as
gangrenous pneumonia, pericarditis, or from peritonitis extendmg
through the diaphragm, fractured ribs, injuries to the walls of the thorax,
or perforation of the throat by foreign bodies. We also see it in all forms
of pytemia and tuberculosis. Cadeac thinks that in nine out of ten cases of
septicaemia following serous or fibrous pleuritis in the dog, it is of tuber-

148 DISEASES OF THE RESPIRATORY ORGANS

cular origin. Tumors of the pleura, chronic nephritis, and acute articuhir
rheumatism may also develop pleurisy. Piana found bacilli and
Hutyra and Marek found it caused by streptothrix (actinomyces) canis.

Pathological Anatomy. — The exudation which collects rapidly
crowds the lung of the affected side and finally presses it against the spinal
column and mediastinum, pressing the lung into an inert mass (lung
atelectasis). The opposite lung is the seat of considerable collateral
hyperaemia, which ma}^ lead to oedema, according to the severity of the
condition. When compression of a lung is continued for any length of
time, the alveoli lose their functional activity, their walls collapse and
become adherent even if the fluid exuded finally becomes absorbed.
After this has occurred, it can readily be recognized by the depressed
appearance of the ribs. In cases of primary pleuritis which have been
seen by the writer, the inflammatory process was always restricted to one
side, and that, as a rule, was the left side. The cases of secondary pleuritis
were generally double-sided, but the inflammatory conditions are never
of equal intensity on both sides, one side being always a little worse than
the other. Besides having the results of pressure shown on the lungs, we
also find the heart is pushed toward the healthy side of the mediastinum
or the diaphragm.

The conclusion of pleuritic inflammation depends on the intensity
and duration of the disease and the character of the exudate. In favor-
able cases the latter is reabsorbed and good results follow. In serious
cases, only part of the liquid portion of the exudate is absorbed, while a
fibrinous exudate covers the pleura; this becomes converted into a granu-
lar tissue containing numerous vessels and later into a stringy cicatricial
tissue, called a pleuritic sward, with more or less adhesions of the pleura
between the lungs and inner wall of the thorax and between the lungs and
diaphragm. Although the sward formations may be very extensive, it
is possible for the lung to regain its normal extension, but this takes a
long time. Thin adhesions sometimes tear; and extended adhesions offer
a constant hindrance to the unrestricted use of the affected part of the
lung. Purulent exudates are sometimes reabsorbed; but, as a rule, if the
pus is not removed at the proper time by surgical interference it breaks
out, either through the pleura into the lungs and then through the bron-
chia, or it forms an abscess somewhere in the cavity of the chest, generally
in the region of the sternum, by undermining the pleura and muscles of
the chest.

Clinical Symptoms. — In the primary form of pleuritis, when its
origin is from cold, etc., it is ushered in with a rapid rise in temperature,
the pulse increases in frequency, and at the onset the animal generally
has a chill; the temperature remains high, and the pulse is small, weak,
and thready. Primary pleuritis with purulent or putrid effusions is rare,

DISEASES OF THE PLEURA; PLEURISY 149

and when it does occur it is always accompanied by a high remittent
fever.

The general health is very much disturbed. The animal Is stiff
and sore on moving about; has little or no appetite, but intense thirst.
The visil^le mucous membranes are reddened and congested, and in cases
where there is much exudation, the membranes are dark bluish-red.
The faeces are dry and hard. The urine presents some symptoms that
are diagnostic; for instance, while the exudate is forming and collecting,
the urine is scanty and thick and albuminous in reaction. When the
exudate is commencing to be reabsorbed the urine increases very much
in quantity and is very clear or whitish-yellow (see chapter on Examina-
tion of the Urine).

There is also marked dyspnoea. In dry pleuritis the respiration is
superficial and rapid, and where there is great exudation the respirations
are short and painful and the animal has all the symptoms of smothering.
A characteristic symptom is the way the animal endeavors to assist
respiration by assuming a sitting position with the front legs spread out
as far apart as possible and using the abdominal muscles, with show of
pain on pressure of the abdominal muscles of the affected side. The
animal has a soft, dry, weak cough; this may, however, be absent.

The physical symptoms are characteristic. On percussion at the
onset of the disease there is little change of sound, but when the exudate
has reached a certain height, the lower parts of the chest give a dull
sound which seems to be limited in a straight line, according to the posi-
tion of the animal. Above the exudation the sound is tympanitic on
account of the retraction of the lung. Auscultation gives a friction bruit
in the onset, and when the fluid begins to be reabsorbed and the pressure
of the exudate against the lungs is lessened, the respiratory bruit is
altered. In the earliest stages of the disease the sounds are vesicular,
but as the exudate collects the sounds become indistinct or blowing and
finally only bronchial, and when the bronchial tubes are affected the
sound is lost entirely. In the healthier parts of the lungs we find in-
creased vesicular breathing.

Course and Prognosis. — Primary pleuritis is generally slow in its
course; the time taken by the exudate to become reabsorbed is very long,
except in very young animals, unless it is removed in an operative way.
When the exudate commences to be reabsorbed the percussion sound
becomes less dull and the respiration bruit more distinct, and if the exu-
date becomes quickly reabsorbed, the diseased side is lessened in cir-
cumference, or it can be better described as being flatter.

Death may occur during the critical period of the disease by col-
lateral hypera^mia and cedema of the non-affected sections of the lungs,
by carbon-dioxide poisoning, from defective function of the lungs, by

150 DISEASES OF THE RESPIRATORY ORGANS

total stagnation of the circulation of the blood, from pressure of the
exudate on the large blood vessels and the heart, or later on ljy exhaus-
tion and by seconclary diseases. To this class belong dropsy caused l)y
stagnation of the blood circulation, from weakness of the heart, and amy-
loid degeneration of the kidneys, liver, or spleen. Death may also occur
from complicating diseases, such as bronchitis and lobular pneumonia.

The prognosis is generally favorable; as a rule, very severe cases of
primary pleuritis make good recoveries, depending largely on the aninud
and character of the exudate and the realworption of the lymph, and there
may at times be adhesion of the whole or part of the pleuritic surfaces.
In secondary pleuritis the prognosis depends on the original disease.

Therapeutics. — The treatment of secondary pleuritis is the same as
the primar}', but in the former we must take into consideration the treat-
ment of the original disease. In the early stages of the disease, when
the exudate is collecting, we must apply counter-irritants, such as lini-
ments or plasters of mustard. When a copious exudate has been formed
we try to induce its real^sorption by stimulating the kidneys by means
of acetate of potassium, acetate of sodium, with the Priessnitz compress.
When the heart is weak we use digitalis and sciuiils. Small doses of
calomel are also useful.

1^. Hydrarg. chlor. mitis, 0.03

Digitalis pulv., ' 0.05

8accharum lactis, 0.5

M. et fiat pulv. No. vi.

Sig. — One i^owder three times daily.

Diuretics and cardiac stimulants have only an indirect influence on
the accumulations, and when the exudate is gradually absorbed one can
hardly credit these drugs with accomplishing the results, as the exudate
is usually reabsorbed, w^hen the acute inflammatory stage of the disease
has passed. The best method of treatment is the removal of the secretion
by surgical means, that is, by puncturing the chest wall. This operation
is not at all dangerous in the dog, and is generally sucessful, unless the ad-
hesions are too thick.

The operation must be performed where there is a very large exudate
and the dull sound can be heard over the entire lung, that is, where there
is oedema of the lung and intense dyspnoea caused by the pressure of
the exudate; or where there is deficient reabsorption as is seen where
the fever has entirely disappeared and the fluid does not show any signs
of becoming real^sorbed.

Puncture of the Cavity of the Chest. — This must be on the side
where the exudate; is higliest; this can be detected by auscultation.

The trocar used in this opei'ation is an ordinary sized trocar, seen
in Fig. 65, or, if we wish to make first an exploring punctvire, we use the

DROPSY OF THE CHEST

151

needle of the ordinary hypodermatic syringe. The needle, after having

been disinfected, is introduced into the lower third of the wall of the chest, in

any of the interspaces between the fifth and ninth riljs, the patient being in a

standing position or laid on a table and held by means of an assistant. The

entrance of air into the thoracic cavity must be avoided, and to prevent

this we must use a trocar that has a faucet, or else

Avhere we use the ordinary trocar and canula when

the flow of the fluid becomes stopped at any time

from some obstruction at the end of the trocar, it is

well to put the finger over the end of the opening

to prevent the air from being sucked into the cavity.

When the animal coughs violently the trocar must

be withdrawn or the finger kept on the opening of

the trocar or when the fluid becomes bloody or the

point of the trocar is felt resting on the pleura.

It is well to empty the cavity slowly and never

entirely, as the two faces of affected pleurae coming

in contact with each other and rubbing often causes

acvite hemorrhage. After withdrawing the trocar

it is well to paint the opening with some iodoform fig. 65.— Trocars for punL-

collodion. t"""*^ «^ ^^^ ^^°''=^^-

When the fiuid obtained is purulent, it generally requires several
punctures to empty the cavity. The animal should have a nutritive
but easily digested diet — soup, beef tea, or lean meat, and when the fever
is high, antijoyrine in doses of 0.5 to 2.0, according to the size of the dog.

Dropsy of the Chest.

(Hydrothorax.)

Any accumulation of serous fluid that is not dependent on an in-
flammation of the pleura (that is, of a transudate) in the cavity of the
thorax, is called hydrothorax. This is often a symptom of general dropsy
or it may arise from chronic disease of any of the organs (see ascites).
In such cases the effusion first shows itself in the chest when dropsy of
the skin (anasarca) exists, or as a result of disturbance of the venous
system, particularly of the portal.

Pathological Anatomy. — Hydrothorax, as a rule, affects both sides
of the chest, Frohner records a case where one side only was affected.
We find in the cavity of the chest, a clear j^ellow fluid, sometimes stained
with blood and distinguished from a pleuritic exudate by the absence
of fibrin, very little cellular elements, little albumen, and by a low
specific gravity. The pleura is oedematous and swollen, and in long-
continued cases it has a flaccid or macerated look. The lungs do not

152 DISEASES OF THE RESPIRATORY ORGANS

present any change except the signs of jDartial compression. The other
organs of the body are aneemic.

Clinical Symptoms. — The physical examination of this disease pre-
sents symptoms ver}- similar to pleuritic exudates, but the change takes
place quickly, and fever and cough are absent, but in dropsical transudates
both sides of the thoracic cavity are filled, and on changing the position
of the animal the fluid moves about much more quickly than a pleuritic
exudate would, and the sensitiveness of the animal to pressvire on the
Avails of the chest and the rubbing or crepitating bruit of pleuritis is
absent.

Therapeutics. — The treatment, as a rule, is of a palliative character,
as it is only in very rare instances that we succeed in removing the
original disease; but we may use the same agents as in ascites. The op-
eration of tapping the chest wall (see puncture of the cavity of the chest,
page 150) is only to be resorted to when the fluid has collected in large
quantities and the animal is threatened with suffocation; but this only
affords temporary relief.

Other Diseases of the Pleura.

Pneumothorax. — Etiology. — The cause of pneumothorax, that is to
say, the accumulation of air in the thorax, is produced in several ways;
by perforating wounds of the chest, by the breaking into the pleural
cavity of a collection of pus from the lung, by tearing of the lung tissue
from great exertion, and from perforation of the oesophagus or pharynx.
Careless puncture of the chest wall, fracture of ribs, perforation of the
bronchi by a foreign body, which finds its way into that part, or it may
also be caused by degeneration of the pleuritic effusion, causing the for-
mation of gas.

Pathological Anatomy. — On making an opening into the chest with
trocar and canula, the air escapes with a hissing sound; if the collection of
air is great, the lungs are pushed out of position, interfering greatly with
respiration. If this condition exists for any length of time, a purulent,
and, in rare cases, a sero-purulent, pleuritis is developed, caused by the
presence of some irritant agents that have gained admittance into the
cavity besides air.

Clinical Symptoms and Course. — There is great difficulty in respira-
tion, and the affected side of the chest wall is visibly distended, and during
respiration it remains almost stationary. When the heart is pushed out
of position there is a peculiar tympanitic sound, the pulsations have a
metallic echo, and the respiratory bruit is absent. In some rare cases
we hear a metallic bruit; this is caused by the entrance of air directly
into the pleural cavity with each inspiration.

PNEUMOTHORAX 153

Animals in this condition generally die rapidly, although we may
find rare cases where recovery takes place by an absorption of the air, or
is followed by the accumulation of a fluid (pneumohydrothorax) which
itself in turn becomes rapidly absorbed. The treatment consists in the
administration of camphor or alcoholic stimulants and in tapping the
chest wall.

Hematothorax. — In consequence of the destruction of some large
vessel or vessels in the lungs or the pleural cavity or from the presence
of growths we find extensive hemorrhage into the thoracic cavity. The
physical symptoms are similar to those of other pleural exudates, but
this condition comes on very rapidly and in this condition the mucous
membranes become very pale. When the symptoms are not pronounced
the operation of puncture will determine the condition positively. Nor-
mal hemorrhages are easily and quickly absorbed, but often where there
is great dyspnoea, puncture of the chest wall is always advisable.

Other Pathological Conditions of the Pleura.

Besides tubercular deposits we find endothelial papillomas which are
seen in the form of velvety or grape-like formations on both sides of the
mediastinal coats of the pleura and on the pleuritic coat of the diaph-
ragm. These formations frequently cause a low form of chronic pleuri-
tis (Kitt). The writer has observed an intrathoracic chondroma of
great size, which was attached to the ribs, filling up the left thoracic
side and pushing the left lung and heart to the right side. There was
severe dyspnoea and anasarca.

DISEASES OF THE CIRCULATORY APPARATUS.

EXAMINATION OF THE CIRCULATORY APPARATUS.

Examination of the Heart.

Anatomy of the Heart. — The normal position of the heart may
be seen in Fig. GG. It lies on the left side, but not so far as is seen in
other domestic animals. The direction of its axis is not vertical, l)ut
extends slightly in a posterior direction, with a slight curve toward the
left side. The base of the heart extends from the third to the seventh
rib; the apex extends backward toward the diaphragm. Superiorly the
heart lies close to the large vessels — the trachea and the oesoi3hagus —
and close on all sides to the lobes of the lungs. In its inferior portion it
lies close to the chest-wall, extending from the third to the seventh ril).
In the heart-sections we find the following arrangement: the right
section lies in a right anterior direction from its axis and the left lies
in a left posterior direction.

Fig. 66.— The heart in position: a. Right ventricle; b, left ventricle; c, left .auricle; d, right auricle;/,
pulmonary artery; g, aorta; k, cesophagus; /, diaphragm.

The size of the heart varies greatly in different animals, even when
in a normal condition, and it is, therefore, impossible to lay down any
relative rule as to its size or dimensions. According to Colan, the weight
of the heart compared with that of the body is 1 to 90; and according to

154

POSIT lOX AXD SIZE OF THE HEART 155

Rabe, it varies from 1 to 40 to 100, and taking relatively all the breeds
of dogs, and also of sex and age, the relative size is O.G and 2.2 to 100.

It is difficult to make an examination of the heart on account of its
position, lying as it does hidden between the lobes of the lungs, with only
a small portion of its surface exposed where it can be heard, and from
the fact that it varies in size not only in the various breeds, but also in
individuals. We find that in animals affected with the various heart
affections and also in perfect health the pulmonary bruit may be so in-
creased that it is impossiljle to detect when there are weak heart sounds,
as the largest portion of the heart is covered by portions of the lungs,
and as these parts also make sounds the ears cannot detect the sound.
The restlessness of the animal during examination and the movements
of the cutaneous muscles and the coat of the animal are all factors that
assist in preventing a proper examination of the heart.

The following details must, therefore, be looked upon to a certain
extent as theoretical in character.

In making an examination of the heart we must consider the posi-
tion and size of that organ, its palpitation sounds, and character of the
23ulsations.

Position and Size of the Heart.

Both are to be detected by percussion, but for the reasons above
explained it rarely answers our expectations. In percussion over the
position of the heart we find in normal conditions a dull sound which
lessens in deep respiration. The position, either standing or recumbent,
may make a decided difference.

In animals having a small heart, the sound is often entirely absent.
The sound of that section of the lung that lies between the heart and
the chest wall is also a factor that makes the sound dull, and it is only
by strong percussion that anj' sound can be detected at all, so that it
may hardly be said to be of much diagnostic value.

There may be an abnormal dulness in the heart's action in hyper-
trophy, in dilatation, in exudates and transudates around the heart, and
in retraction or contraction of the lobules of the lung surrounding the
heart; but we may often be deceived by abnormal processes that surround
that organ, such as thickening of the lung sections or swards on the pleura.

The dull sound is absent in enlargement of the lungs by emphysema,
when air has entered the pericardium, after injuries, in one-sided pleuritis,
and in pneumothorax. The sound is anteriorly situated in the chest
when there is intense metcorization of the stomach or intestines, and in
ascites.

156 DISEASES OF THE CIRCULATORY APPARATUS

Character of the Heart Pulsations.

The pulsations of the heart can be distinguished by putting the hand
on the inferior portion of the chest near the sternum, about the fifth rib
(on the right side the pulsation is situated a little more anteriorly) . The
pulsation makes a distinct vibration of all the adjacent parts, and in
emaciated animals there can be noticed with each pulsation a distinct
swelling or motion of the lower portions of the ribs; this vibration may
be greatly lessened by the presence of layers of fat on the sides of the
"chest. After great exertion or excitement the strength of the pulsation
against the chest- w\all is greatly increased.

The pulsations of the heart are increased by disease in the following
conditions: After considerable loss of blood, in any case of fever, in pal-
pitation of the heart, in some forms of heart disease, in hypertrophy of
the heart, or by the influence of some poisons, such as digitalis or aconite.
It is almost imperceptible in degeneration of the muscle of the heart,
in the later stages of acute diseases, in cases of poisoning, in fatty de-
generation of the heart, and when the heart has become compressed by
the effects of hydrothorax, pneumopericarditis, or emphysema of the
lungs. It is distinguished only on the healthy side in lateral pleuritis.

Character of the Heart Sounds and Bruits.

In order to distinguish the heart sounds we must put the ear close
to the side directly over the heart where the beats are loudest; it is better
to cover the place with a handkerchief or cloth, or we may use a stetho-
scope. We should hear two sounds in each heart beat — a systolic,
which corresponds to the ventricular contraction, and a diastolic, which
corresponds with the beginning of the diastole. Both these sounds follow
each other with short intervals between. The pause between the first and
second sound is short, but between the second and the next first the sound
is much greater. The first sound is a mixed muscular and valvular
sound of the mitrals and tricuspids, and the second is a semilunar val-
vular sound.

Unfortunately these sounds are indistinct and mcomplete in the
dog, even in perfect health. In very fat dogs we may not hear any heart
sound, or we may only hear the first one. In well-fed dogs it is not rare
to hear the first sound, which is a great deal louder than the second,
only on the left side. In thin animals we can hear the sound distinctly
on both sides. AVith the respiratory bruit we lose to a certain extent the
full strength of the sounds, and often only the first sound is heard. After
great activity the heart's action is increased so much, and the sounds

CHARACTER OF THE PULSE 157

follow each other so rapidly, that it is impossible to distinguish one from
another.

In pathological conditions the heart sounds may be increased l)y
a number of causes, as in the beginning of certain fevers; but generally it
is an indication of hypertrophy. A lessened heart sound is found in
any heart weakness, as in degeneration of the heart muscle, in accumula-
tions of exudates around the heart in the pericardium, or in emphysema
of the lung sections, etc. In such cases, as a rule, the heart sound is
imperceptible.

As can be readily seen, it is by no means easy to hear the heart beat
in its normal condition, and the condition becomes more complicated
when we have to distinguish pathological sounds — "heart bruits." We
distinguish between endocardial heart bruits, which originate in the heart
direct, and pericardial heart bruits, which come from the arterial part of
the heart and its envelope. The former are divided into organic and
inorganic bruits. The organic heart bruits are produced by stenosis
(contraction) of the ring and by insufficient or imperfect closing of the
valves, which may occvir either in systole or diastole, making the heart
sound indistinct, or it may be entirely absent, and the bruit takes the
place of the heart sound. The systolic bruit is buzzing or blowing in
character, and indicates an imperfect closing of an arterio-ventricular
valve (in most cases of disease of the mitrals). The diastolic bruit is
rushing or wheezing in character, and indicates a stenosis of the arterio-
ventricular ostia, or the imperfect closure of an arterial valve. The
inorganic heart bruit is seen in all forms of anaemia, and occasionally in
fevers. Pericardial bruits are very similar to pleuritic fi'iction sounds,
that is, a scratching or scraping sound. They are located in a sharply
defined locality and do not occur in direct rhythm with the heart sounds,
but seem to occur between them. They are noticed in pericarditis as
soon as there are any fibrinous deposits present and there is not sufficient
pericardial fluid present to keep the folds free from contact with the
heart. A change in the position of the animal makes quite a difference in
the character of the bruit, and it may easily be distinguished from
endocardial sounds. The pericardial friction sound is distinguished
from the pleural friction sounds by the fact that it is entirely inde-
pendent of the movements of respiration.

Character of the Pulse.

The pulse is best examined in the femoral artery, inside of the thigh,
and it may be felt also, in the radial artery, inside of the forearm. In
the examination of the pulse we must take into consideration its fre-
quency, its cadence, and its quality.

158 DISEASES OF THE CIRCULATORY APPARATUS

The normal pulse varies greatly, according to the breed, age, and
size of the animal, and is rapidly increased from such causes as phys-
ical efforts, fear, fright, pleasure, etc. The general pulse is from 70 to
120, in large animals being less and in very small animals having a cor-
respondingly freciucnt pulse rate. The rhythm, (cadence) should be reg-
ular in a healthy animal, and physical causes make it irregular; but an
irregular pulse in perfect health is very common in the dog; in fact, perfect
rhythm is rare, as can be easily demonstrated by taking the pulsations
frequently, the irregularity being well marked in very young or old
animals. In normal conditions the pulse must be similar in both thighs.

We find a lessening in the pulse in some forms of poisoning, fol-
lowing hemorrhages, in affections of the muscle of the heart, in starvation,
diseases of the brain, meningitis, in hepatogenous icterus, also in collapse
and in diseases characterized by a continued high temperature.

An increase of the pulse is found in all fevers, in cases of valvular
defects, in heart w*eakness and paralysis or collapse of that organ from
continued high fever. When the temperature increases the pulse rises.
The pulse is irregular (arhythmic) in some diseases of the heart (in-
compensated valvular defects, myocarditis) after large doses of digitalis,
and in heart weakness. It is only intermittent (as a forerunner of
entire irregularity) in slight cases of valvular defects, in some diseases
of the brain, and in gastricism. The pulse is full and bounding under
great physical exertion, small and collapsed after severe hemorrhage
and in enteritis. In intense heart weakness and collapse it becomes
thread-like and imperceptible.

The venous pulse — that is, the apparent increase in the amount
of l)lood in the jugular at its entrance into the chest — is often seen in
the dog. It is generally a symptom of some chronic heart affection, such
as imperfect closing of the tricuspid valves, and of heart weakness.

DISEASES OF THE HEART.

Acute Endocarditis. Endocarditis Verucosa ; Endocarditis Ulcerosa.

Etiology. — This disease is comparatively rare. Jensen ropoi'ts
that ovit of a clinic of 3,240 dogs, he found 13 with ulcerative endocardi-
tis. This condition may be caused by a sympathetic irritation of myo-
carditis or mediastinitis, but this is extremely rare, it being caused by
the presence in the blood of certain microorganisms which lodge on the
endocardium, particularly in the vah^es and the deeper portions between
the trabecule, causing inflammation of the tissues. Endocarditis can
l)e produced experimentally by the introduction into the blood of vari-
ous forms of bacteria (staphylococcus, streptococcus, etc.) particularly

ENDOCARDITIS 159

if the valves have been previously affected with inflammatory processes.
Consequently it is very apt to appear in such diseases as distemper,
septicaemia, pyemia, articular rheumatism, and in rare instances in tuber-
culosis; it may also follow wound abscesses, chronic ulcerated inflam-
mations of the skin (dermatitis), and as a consequence of some unknown
bacterial invasion. Frohner and Jensen have observed an infectious
malignant endocarditis.

Pathological Anatomy. — "While we differentiate between endocar-
ditis verucosa and endocarditis ulcerosa (endocarditis diphtherica, endo-
carditis maligna), one may follow the other. The former (the milder
form) commences with the formation of various sized wart-like protuber-
ances on the free edges of the valves and their attachments, and also on
the trabeculte and papillary muscles; when the latter are attacked, it
may cause necrosis and tumefaction of the endocardium. This condition
may cause the formation of eml)oli which get into the circulation, are
liberated, and produce grave conditions in various organs of the body.
The aortic and the bicuspid valves are more frequently affected; the
pulmonary and tricuspid valves, very rarely.

Clinical Symptoms and Course. — There may be little or no fever in
the onset of the disease, but if there is fever present it is generally high.
The general condition is greatly disturbed, increased irregular heart
action, pulse Aveak and irregular; on ausculation the pulsation is heard
and little change is noticed in the early stages before any material
alteration has been made in the valves. Later, when the deposits become
organized, the heart beat is muffled and the two sounds of the heart
become one, or an early systole and diastolic murmurs. The respirations
are more or less accelerated and labored, there is cyanosis of the visible
mucous membranes and with these symptoms there may be certain met-
astatic changes in other organs.

The course of the disease varies; in some cases death occurs in a
very short time, in the majority of cases, hoAvever, the disease progresses
slowly, the symptoms may increase in severity; they may decrease in
severity and the animal be comparatively well for w'eeks, and then the
acute symptoms may recur and the disease become chronic. In mild
cases animals may take complete recoveries, but this is comparatively
rare.

Therapeutics. — Rest, avoid any excitement, cold compresses, such
as an ice-bag over the region of the heart; where there is a small irregular
pulse we should administer digitalis, strophanthus, or caffeine. ^^ hen
dangerous symptoms appear, subcutaneous injections of camphor, ether,
or atropin. For the fever we should use salicylate of soda, aspirin,
cinchona, antipyrin or antifebrin.

160 DISEASES OF THE CIRCULATORY APPARATUS

Valvular Diseases of the Heart; Chronic Endocarditis; Valvular Defects.

General Notes on Valvular Defects. — By valvular defects we under-
stand such anatomical alterations in the valves and openings as lead
to an irregularity in the circulation of the blood, becoming apparent by
visible symptoms in the pulse or general condition; but those slight val-
vular defects so often seen in post-mortems and never noticed during
life are not to be considered.

Valvular defects appear in two forms: first, when the valves close
impei'fectly; second, when the openings become contracted, causing
stenosis. Imperfect closure of one valve causes a certain amount of
blood to flow back into the portion of the heart from which it has just
come; for instance, when there is imperfect action of the mitrals or of
the tricuspids in systole, part of the contents of the ventricles rushes back

Fig. 67. — Diagram of the blood circulation.

into the auricles, and when there is insufficient action of the semilunar
valve in the diastole, a part of the blood that has been thrown into the
artery returns into the chamber again.

Stenosis of one opening retards the passage of blood, when we have
a contraction of an arterio-ventricular opening. At the time of diastole
the blood is kept back at the entrance of the affected ventricle, and it
is imperfectly filled, while in the aortic opening in pulmonic stenosis the
exit of the blood out of the ventricles (Fig. 67) in the systole is retarded.
In any of these conditions there is imperfect heart action; every defect of
an arterial opening interferes with perfect ventricular action and every
defect in a venous opening causes a corresponding lessening of power in
the auricle.

An abnormal pumping of the blood in this manner is sure to cause
more or less disturbance of the entire organism, but there are certain
compensatory processes in the heart itself that tend to overcome this.
As a consequence of the impaired flow, the heart muscle is worked much
harder and becomes hypertrophied (compensating heart hypertrophy).

VALVULAR DEFECTS 161

We often see cases where defects of the fiorta become equalized by a hy-
pertrophy of the left ventricle. In valvular defects of the mitrals the
stagnation of the blood occurs in the veins, capillaries, and arteries of the
lungs, and as far back as the right ventricle, which becomes dilated and
hypertrophied while trying to take up the extra work thrown on it.
In course of time we also see hypertrophy and dilatation of the left
ventricle; during diastole the stagnated blood runs in great quantities
into it out of the dilated auricle.

These compensating processes of the heart are apt to prevent for a
long time any great functional disturbance provided the heart receives
its proportional nutrition. If this is not the case, for instance, in anaemic
and cachectic feverish animals, the compensating heart hypertrophy is not
present or is only developed to a slight degree, and also in cases of insufh-
cient nutrition, due to some alteration in the coronary artery, the heart
is no longer able to satisfy the demands claimed from it and tires out,
and all the effects of lilood-stagnation rapidly show themselves.

Etiology of Deficient Valvular Action of the Heart. — The most com-
mon causes of valvular defects are endocarditic processes, which are de-
veloped on the valves and take an acute course, according to the amount
of the irritation, and cause a fibrinous, rigid thickening of the valves.
Sooner or later we find an imperfect closure of the valvular openings
through cicatricial contractions and adhesions to the lobula of the valves
or in their neighl)orhood. This condition is quite common in old
dogs, and may appear as a result of great nervous excitement, cold,
articular rheumatism, distemper, and other infectious diseases. Car-
diac valvular changes are frequently seen as a result of chronic nephri-
tis. The mitral valves are most frequently affected. Cadiot and Ries
found out of thirteen cases, five of the mitral, four of mitral and tricus-
pid, two of the tricuspid alone, and one of the valve of the aorta and one
mitral and aorta. AVe may also see deposits of lime salts and a con-
traction of the opening belonging to the alTected valve. In rare cases
there is heart weakness and imperfect valvular action, which may be
caused by a dilatation of the opening, and, thus becoming abnormally
distended, the valves cannot meet and make a complete closure. Ath-
eromatous processes may also produce this condition. .

General Symptoms of Deficient Valvular Action of the Heart. — The
symptoms which a})pear at a certain time in all valvular troubles are
as follows: Increase of heart and pulse action (after slight exertion it is
al)normally increased); palpitation of the heart; difficulty in respiration;
vertigo after any exertion; cyanosis of the visible mucous meml)ranes,
especially of the head; venous pulse; dropsical effusions, such as oedema of
the legs, abdomen, or testicles; hydrothorax; hydropericartlium; ascites;
allDuniinuria, with lessening of the amount of urine; complications of the
11

162 DISEASES OF THE CIRCULATORY APPARATUS

digestive organs of various kinds, and, finally, general nutritive dis-
turbances, such as ananiia, emaciation, etc.

Symptoms of Valvular Deficiency in one Opening. Insufficiency
of the Mitrals. — The imperfect closing of two of the valves occurs very
frequently in the dog. Besides the alterations of the valves we find
hypertrophy and dilatation of the left auricle of the heart, and in the
later stages also of the right ventricle.

The clinical symptoms are: Increase of the pulse and distention of
the artery, systolic bruit heard on the left wall of the chest, increase of the
second (pulmonic) sound, weak, frequent pulse, shortness of breath, and
later dropsy, etc.

Stenosis of the Left Venous Opening. — This is generally accom-
panied by mitral insufficiency. It leads also to dilatation and hyper-
trophy of the left auricle and the right ventricle, and in such cases the
left ventricle is generally small, narrow, and contains little blood.

The clinical symptoms are: Slight increase in the pulse, diastolic
bruit (this is absent in some cases) ; considerable increase of the second
(pulmonic) bruit, very small, irregular pulse; great difficulty in respira-
tion, and dropsy makes its appearance early in the disease.

Disease of the Aortic Valves. — This condition of the semilunar valves,
causes a dilatation and hypertrophy of the left ventricle and flattening
of the papillary muscles.

The clinical symptoms are as follows: A very strong heartbeat;
increase of the heart dulness on the left side, and a full, bounding pulse,
is very frequently noticed. This character of the pulse is also noticed in
small arteries that in normal conditions have no distinct pulse. We also
find shortness of l)reath, oedema, and dropsy of the dependent parts.

Stenosis of the Aortic Opening. — Rare in the dog. The clinical
symptoms are a systolic bruit, a very slight sound of the aorta, small,
weak pulse, general amemia, etc.

Imperfect action and disease of the tricuspid valves cause distention
of the right auricle and also a systolic murmur on the right side and a
strong, venous pulse. Stenosis of the right venous opening and defects
of the pulmonary valves are extremely rare.

We very frequently have a combination of a contraction of an
opening and also a deposit on, or retraction of, the valve at that opening,
and also a single valvular defect; these two make a combination of symp-
toms that are rather hard to separate.

Prognosis and Therapeutics of Valvular Defects of the Heart. — A
diseased valve must ha considered incurable, but it may exist for a long
time without causing any decided disturbance of the general circulation.
It is impossible to predict how long a " compensating" state will continue.
Mitral defects seem to last the longest. This conculsion is arrived at

DISEASES OF THE HEART MUSCLE 1G3

from the fact that it is quite common to find serious heart defects
in post-mortems on dogs that have been apparently heahliy during
life.

Compensating heart defects do not require any treatment. We
try to aid the heart in its efforts by giving nutritive diet and removing all
exciting causes, such as great or prolonged exertion.

As soon as the heart begins to weaken and the difficulty in respiration
increases, accompanied by oedema, palpitation, etc., we must use heart
tonics, such as digitalis, strophanthus, caffeine, etc.

■7. Tine, strophanthus, 15.0

Sig. — Ten to twenty drops morning and evening.
J\. Caffeine nitricum, 0.5

M. F. charta Xo. x.

Sig. — One powder morning and evening.
I^. Caffeine citrate, .3.0

Tinct. digitalis, 4.0

AquiB, 64 . 0

Sig. — One teaspoonful twice daily.

If by medicinal treatment we succeed in reestablishing a compensat-
ing action, the anlema gradually disappears; if, how^ever, we do not get
the desired result and there should be any oedema remaining, Ave must
treat it symptomatically, using those diuretics mentioned under the
treatment of pleurisy, particularly theol:)romin (rather than calomel).
AVhere there is decided palpitation, we must use cold compresses in the
region of the heart, or subcutaneous injections of morphia. In milder
cases use the salts of In-omine. Great weakness of the pulse must be
treated with alcohol, ether, or camphor, etc. Tine, nux vomica may be
given in doses of one drop three times daily when the appetite is poor.

The symptoms alcove described are sometimes found in dogs that
do not present any marked alterations in the valves or openings, either
during life or on post-mortem; these are due either to simple idiopathic
hypertrophy and dilatation or to alteration of the heart muscle.

Diseases of the Heart Muscle.

Idiopathic Hypertrophy and Dilatation of the Heart. — We find on
post-mortem, as a rule, a hypertrophy of the left ventricle, but oc-
casionally it is of both ventricles. At the same time we do not find
any alteration of the lungs or kidneys which might produce secondary
hypertrophy of the heart muscle. The causes are extreme and constant
exertion, cold, abnormal excitability of the heart (in closely bred lap
dogs), overfeeding, and too much rich blood (as in pet animals).

164 DISEASES OF THE CIRCULATORY APPARATUS

Chronic Myocarditis, Indurative Degeneration of the Heart, Inflam-
matory Myocarditis. — This condition may follow an attack of acute
distemper and is often mistaken for valvular defects. In this con-
dition the heart is greatly enlarged and dilated, and the walls are
hypertrophied. The body of the heart muscle is filled with a number
of whitish hard bodies which on examination are found to be cicatricial
connective tissue.

The cause of the existence of these bodies has not been fully deter-
mined, but they are due either to myocarditis or to defective nutrition
of the heart muscle, as a consequence of contraction or atrophy of the
coronary artery.

The clinical symptoms presented are as follows: Weak heart,
palpitation, dizziness, vertigo, increase in the numljer of pulse, and drop-
sical effusions.

Auscultation gives nothing but pure heart sounds, and with the above
symptoms there may be a callous degeneration of the heart or a pure idio-
pathic hypertrophy, as during life it is impossil^le to determine which, and
treatment in both cases is the same. Treatment is of no practical value;
it consists of protection against excitement or great bodily exertion;
give nutritive, easily digested food, and, if the heart is irregular, heart
tonics.

Other Diseases of the Heart.

Nervous Palpitation, Palpitation of the Heart. — In this condition the
physical examination reveals no anatomical alteration of the heart. The
heart beats with great force, so that it can be noticed distinctly
on the external thoracic walls; the beat is clear and in cases where the
palpitation is great, the heart makes only one sound; the respirations
are accelerated and shallow, the animal is anxious and restless, but, as a
rule, if kept quiet, the attack soon passes off. If continued apply cold
compresses in the region of the heart and give a hypodermic solution of
morphine or administer sodium bromide, chloral hydrate, etc.

Tumors of the Heart. — These mentioned by a number of avithors are
cither of sarcomatous or fibrous nature, are usually never diagnosed
during life, but may be seen on the post-mortem of an animal dying
suddenly.

Parasite^ in the Heart Muscles. — Cysticercus or bladder worms are
foiuid 1x1 ine heart. Lindmere found in the external strata of the tissue
in the heart of a dog a number of cysts al:)out the size of a hazelnut
which were filled with a clear fluid, which seemed to be the cysticercus
cellulosse. There was nothing to indicate that these parasites caused the
heart the sliohtest irritation.

PERICARDITIS 165

DISEASES OF THE PERICARDIUM.
Pericarditis.

{Inflammation of the Heart Envelope.)

Etiology. — Inflammation of the pericardium may originate in a
primary way by traumatisms or cold, or, secondarily, in connection
with infectious or inflammatory diseases of the neighboring organs, es-
pecially pleuritis, or disease of the endocardium and myocardium. It is
a question whether this condition can originate from perforation of lung
abscesses or from foreign bodies coming from the oesophagus. Tul^er-
culosis seems to be the most frequent exciting cause of this disorder.
Traumatisms such as gunshot wounds, fracture of ribs, may cause peri-
carditis. Cold or rheumatism is said to be a predisposing cause of peri-
carditis, but this theory is very doubtful.

Pathological Anatomy. — Pericarditis occurs either in the acute or
chronic form. The anatomical alterations that it produces on both sur-
faces of the pericardium correspond to those on the pleura caused by
pleuritis and occur in the following forms, fibrous, hemorrhagic, puru-
lent or icteric. The most common form is serofibrinous pericarditis,
with copious liquid exudates in the pericardium and masses of fibrinous
Ij-mph attached to the surface of the pericardium; in very rare instances,
the folds are attached to each other. When this condition has been
present some time, the pericardium becomes dilated and relaxed and
the heart-muscle shows more or less atrophy.

Clinical Symptoms. — Slight pericarditis rarely shows itself to any
marked degree, but in severe cases there is decided palpitation, the pulse
becoming weak and indistinct, with marked irregularity in the rhythm.
On auscultation there is great dulness all over the region of the heart;
finally the heart sound is entirely lost or simply a pericardial rubbing
bruit is heard. "When the pericardial folds are attached or when they
are separated by effusions this sound disappears.

There may be an increase of temperature, loss of appetite, and the
slightest exertions cause marked increase in the respiration wuth cyanosis
of the visible mucous membranes. As soon as the disease .becomes ad-
vanced, the same symptoms that are seen in any case of defective heart
action are noticed; the lessened arterial pressure causes irregularity in
the action of the urinary apparatus, and from venous stagnation dropsy
shows itself in different parts of the body, especially in the extremities.
As a result of acute infectious diseases, pleuritis and pleuro-pneumonia,
we may have acute inflammation of the pericardium and death as a

166 DISEASES OF THE CIRCULATORY APPARATUS

result. Chronic pericarditis may also produce death; its action^ how-
ever, is slower.

Therapeutics. — Keep the animal as quiet as possible; give nutritive,
easily digested food (meat diet or milk) and such agents as will lessen the
fever and tone up the heart. The Priessnitz compress and cold-water
compresses might produce better effects, but they excite the animal and
thus do more harm than good. Laxatives, such as sulphate of magne-
sium or sodium, Epsom salts, calomel. As heart tonics give strophan-
thus or digitalis, etc. When the exudate accumulates to an alarming
extent, we must resort to surgical means and empty the pericardium by
means of the trocar, as in pleuritic effusions, and must be careful to
use as long and as thin a trocar as possible. (An aspirating syringe
needle is the best.) Select a space over the dullest part of the heart
and insert the trocar low down in the left .chest wall, taking care not to
put the point in too deep and thus injure the heart itself.

The treatment of pericarditis is generally symptomatic. If great
weakness of the pulse is observed administer wine, alcohol, ether, or
camphor; the latter seems to be best to use for this particular affection.

Dropsy of the pericardium (hydropericardium) is a collection of
fluid in the pericardium without any direct inflammation of the serous
pericardium.

In health the pericardium always contains a small amount of fluid,
and it is only when we recognize, by physical means, a very much in-
creased amount of fluid in the sac that it can be called hydropericarditis.
Dropsy of the pericardium may appear as a symptom of various diseases
(defects of the valves, inflammation of the heart muscle, diseased con-
ditions of the coronary arteries or of the kidneys, and acute anaemia)
as well as in connection with inflammation of the pericardium and is
generally accompanied with all the symptoms of general dropsy.

The clinical symptoms are those of pericarditis; the friction bruit
and the increase of temperature are absent; however, the treatment
consists in removing the original causes and, if this cannot be done, to
puncture. Diuretics (digitalis) are to be administered, but these, as a
rule, only produce temporary effect.

Hemorrhage of the Pericardium (Haemopericardium). — This is rarely
seen. It may be caused by gunshot wounds, by a bursting aneurysm, or
by laceration of one of the coronary arteries (see also spiroptera san-
guinolenta), rupture of heart, or the formation of tumors, etc., of the myo-
cardium. Death by compression of the heart generally occurs in a
short time. Where results are not fatal in a short time — that is, where
the blood oozes out slowly and fills the sac gradually — it is impossible
to make a certain diagnosis unless the diagnosis is based on the appear-
ance of acute anaemia. This is also the case when air (pneumopericarditis)

FI LABIA IN THE BLOOD 1G7

or blood penetrates into the cavity from the lungs in eases of some
traumatism of those organs.

FILARIA IN THE BLOOD.

Four kinds of parasites have l^een found in the lilood of the dog,
namely Filaria immltis, Hsematozoon lewisi, Strongylus vasorum, and
Spiroptera sanguinolenta.

Filaria Immitis, Filaria Haematica. — (Males 10 cm. and females 35
cm. long; both 1.5 mm. thick.) They lie inside of the heart; very rarely
in the left, generally on the right, where they multiply in great num-
bers, often hundreds massed in a ball (Megnin) ; they are rarely found
in any other part of the vascular system; on the other hand, the eml^ryos

Fig. 68. — Heart, with Filaria immitis in the ventricle (photograph) .

measure 0.25 mm. long and 5 mm. thick, are found in the circulation in
hundreds of thousands and can be readily seen under the microscope in a
sample of blood of the affected animal (Delafond, Xocard, Gruby, Renther,
Johne, Rieck, Deffe, and others). The mature filarise living in the
heart (Fig. 68), cause disturbances of the circulatory system, dilatation
and hypertrophy of the heart, endocarditis, formation of thrombi with
all its results, and even rupture of the heart. The embryo may plug up
the small arteries particularly of the lungs, brain, and spleen. The em-
bryos seem to be excreted through the kidneys. This parasite is gener-
ally found in Indian, Chinese, and American dogs, especially in the south-
ern states. Wheeler rarely made a post-mortem that he did not find
it, often without presenting any observable symptoms during life. It is
rarely found in Europe. The clinical symptoms are not at all character-
istic— emaciation, epileptiform convulsions, disturbance of the heart ac-
tion, intestinal hemorrhage, and excitement — but frequently the filaria may

1C8 DISEASES OF THE CIRCULATORY APPARATUS

exist in great numbers and none of these symptoms be present — uncon-
sciousness, cl3^spnoea, and rabiform symptoms. How the parasites find
their way into the blood is rather interesting. The embryo is passed in the
urine and carried by air or water into rice fiekls or swampy places, and
the parasite finds its way into the system through the dog drinking the
water. Some authors contend that the larvae get into the blood as the
larvse of the Filaria sanguinis of man by being first absorbed by the mos-
quito and then developed and passed again to the dog.

Frohner tried to reinoculate a dog intravenously with blood con-
taining the embryo, but with negative results.

As to prophylactic or therapeutic measures, nothing has as yet been
found to answer the purpose. In regions where the parasites exist, the
administration of boiled or filtered water could be carried out only in the
case of household pets; diuretics tend to wash the parasites from the
kidneys. Frohner says that in Japan, where the parasite is prevalent, ar-
senic is used with advantage.

Hsematozoon Lewisi. — These parasites are very small, resembling
Filaria immitis found in India, China, Italy, and France. Grassi thinks
the larvse develop in the fleas and lice that infest the dog.

Strongylus Vasorum (Haematozoon Subulatum). — These exist in
France and in certain parts of Italy. Leisering found them in the blood,
lungs, prostate, and the spongy portion of the penis. He considers
Ha?matozoon subulatum to be identical with Strongylus vasorum or
one simply to have taken a different form. These parasites produce
anaemia, gradual emaciation, irregularity of the heart's action, and
cough.

Spiroptera Sanguinolenta (Filaria Sanguinolenta) . — This parasite
has already been described on page 51. In its larval form it is found
forming aneurysms which burst and form hemorrhages into the pericard-
ium, or entering the pulmonary circulation incomplete are carried into
the lungs.

DISEASES OF THE URINARY AND SEXUAL APPARATUS.

EXAMINATION OF THE URINARY APPARATUS.

This comprises the examination of the prepuce, urethra, prostate,
bhickler, kidneys, the vulva in the female, and especially of the urine.

Examination of the Prepuce, Vulva and Urethra.

If a glossy or purulent discharge comes from the prepuce, it indicates
a catarrhal condition of the part (catarrh of the foreskin or gonorrhoea
of the prepuce). If the discharge is purulent, bloody, and has a foetid
odor, we will find wounds, ulceration, swellings, or new formations, on
the prepuce or the glans. To make an examination of the
penis, we must lay the animal on its side, take hold of the
base with one hand and with the other retract the foreskin,
so as to expose the penis as far back as the glans, and in
this way it is comparatively easy to make an examination.
If it is found impossible to expose the free portion of the
penis, it indicates phimosis or an abnormally narrow open-
ing of the prepuce, while paraphimosis is a condition in
which the greatly distended glans is outside of the open-
ing of the retracted prepuce. Catarrhal affections, (ure-
thral or gonorrhceal) of the urethra are very rare in the
dog. They are recognized by a discharge of purulent mucus
from the urethra, by difficulty in urination, and the animal,
on catheterization, may pass purulent mucus from the
urethra. In cases where there is great difficulty in passing
urine, or where it is retained entirely, it becomes necessary
to pass the catheter or sound. When this retention of urine
occurs, it is generally due to the presence of a stone in the
bladder, a collection of stones in the urethra, or swelling of
the prostate, but it may also indicate cicatricial strictures
of the urethra, irritants, acute cystitis, distention of the
bladder by prolonged retention of urine, stone of the bladder, or neo-
formations in the bladder.

Passing the catheter in the dog: It is best to use an ordinary rubber
catheter in the male dog (about 2 to 5 mm. in diameter and the ordinary

109

Fig. 69.—
Male catheter.

170 DISEASES OF THE URINARV AND SEXUAL APPARATUS

length), Fig. 69. The subject is laid on the left side or back and held in
that position by an assistant. The prepuce is pushed back behind the
swelling of the gians and held firmly with the left hand (see Fig. 70).
Now grasp the catheter with the right, of course, first seeing that it
has been well lubricated with some oil or cosmoline and that it contains
the wire-stylet, and introduce it into the urethra; if it is pushed forward
up the canal and meets with an obstruction at the posterior end of the
bone of the penis, it is due to a flexure of the canal and also to the fact
that the diameter of the urethra is less and the part at that portion
has slight contractile properties. By a gradual pressure the stricture is
overcome and the catheter passed upward to the arch of the perineum;
here the wire-stylet must he withdrawn from the catheter at least one-
third, so as to allow the catheter to round the curve of the ischial arch; a

" Fig. 70. — Passing the catheter.

gradual pressure soon brings it into the bladder, when the wire can be
removed entirely.

In the bitch catheterization is very difficult at times, for while the
instrument should be introduced along the middle line of the vestibule,
freciuently it is almost impossible to find the narrow opening of the
urethra, and a vaginal speculum is sometimes necessary to locate the
position of the opening; we generally use a metallic catheter, either
silver or German silver (Fig. 71). The instrument is passed up on the
floor of the vagina until it comes in contact with the urethral opening
(see Fig. 72) ; this is closed with a slight sphincter (the so-called "urethral
valve); this is soon overcome and the catheter passed into the bladder
without difficulty, except in cases where the urethral opening is extremely
small.

EXAMIXATIOX OF THE PROSTATE

171

In the bitch it is rare that an examination of the urethra is necessary,
but certain discharges from the vulva are of diagnostic vahie. During
the period of "heat" (menstruation), which occurs normally twice a year,
in June or July, and in December or January (this, however, is not a
hard and fast rule, as it may occur in April or May and November or
October), we have a copious bloody discharge, and during the preparatory
stages of labor we see a thick, clammy discharge, and the lochia com-

Fig. 71.—

Female catheter.

Fig. 72. — Median section through the pelvic cavity; a,
rectum; b, vagina; b', vulva; d, bladder; c urethr;a 1, pubic
symphysis.

mences with a non-foetid, serous, slimy discharge, which soon changes
to a thick, yellowish fluid. Purulent, putrid, and bad-smelling discharges
are generally found in inflammatory or ulcerative discharges from the
vagina or uterus. It may also be observed when a carcinoma is present.
In such cases it is best to introduce a mirror-speculum into the vagina
and make a specular examination. The instrument to use is the so-
called two-valved rectal mirror (Fig. 73). Digital examination of the
vagina is often productive of more certain diagnosis.

Examination of the Prostate.

This body varies in size, but in the dog it is large in comparison to
the relative size in other animals, varying from the size of a hazelnut
to that of a walnut. It is a round, ball-like body cut into two portions,
lying on the neck of the bladder where the urethra commences (Fig. 74).
It lies about the anterior portion of the pubic bone, and being free to a
certain extent, it can be pushed into the abdominal cavitj^ Avith the finger.
In hypertrophy of the prostate, we find a painless hard body varying
from the size of a walnut to that of a small orange. Acute prostitis is
extremely painful and we find increased local temperature, prostatic

172 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

abscess indicated by fever and fluctuation of the prostate. The pros-
tate may be covered by a number of irreguhxr knob-like bodies, in-
variably painless to the touch. A remarkable diminution of an enlarged
prostate invariably follows castration in the male.

Examination of the Bladder.

The bladder is almost entirely covered by peritoneum and lies just
anterior to the brim of the pelvis, or in some cases it lies entirely in the
aljtlominal cavity. When the bladder is very much distended, it extends
as far as the umbilicus and fills up the lower portion of the abdomen.

Fig. 73. — .Speculums. Fig. 74. — Section through the pelvis of the

male: 1, Bladder; 2, opening of the ureters into
the bladder; .3, spermatic ducts; 4, prostate gland;
5, urethra, showing Wilson's muscle; 6, arch of
the urethera; c, pelvis.

It can be distinguished by manipvilation. It is a round, distended, tumor-
like body, giving a dull sound on percussion. On examination of the
rectum we not only feel the neck of the bladder and the prostate, but
the bladder itself can be easily distinguished. Percussion in the region of
the bladder when it contains a very little urine or is empty gives a hollow
sound. Tumor or stones in the bladder can be felt by pressing down
toward the wall of the abdomen, provided the bladder is empty or only
partially filled; pain on pressure in the region of the bladder indicates
an inflammatory condition of the bladder (catarrh of the bladder), and
in this condition the animal evinces more or less pain even when the blad-
der is normally distended and any pressure put on it.

EXAMINATION OF THE URINE 173

Examination of the Kidneys.

The kidneys are bean-shaped and are almost entirely covered by
peritoneum; they lie in the lumbar region, the left kidney about the thir-
teenth rib, the right kidne}^ about the twelfth rib; posteriorly the kidneys
extend over the second, third, and fourth luml^ar vertel)rpe; in rare
instances the left kidney may be still further back, both kidneys
lying directly opposite each other. Frequently they are readily dis-
tinguished by manipulation through the abdominal walls, and espec-
ially one or the other kidney may lie free from its attachments or be ab-
normally enlarged during life. The left kidney is always much easier
to palpate than the right. The best position is to have the animal stand-
ing, holding the thumb on the vertebra and with the other fingers ma-
nipulating the abdominal walls until the outlines of the kidneys are
recognized. Pain on pressure may indicate nephritis, pyelonephritis,
or paranephritis; enlargement of the kidney would indicate tumors, ab-
scesses, pyelonephritis, hydronephrosis or purulent nephritis; abnormally
small kidneys may indicate a chronic interstitial nephritis. Change of
the position or remarkable mol^ility would indicate floating or migrating
kidney.

Examination of the Urine.

The urine has to be examined as to its amount, color, transparency,
reaction, weight, odor, and the presence of certain foreign or chemical
substances.

Amount of Urine. — The amount of urine passed in one day depends
largely, of course, on the size of the animal, the cjuantity of fluids it
drinks, and the temperature of the atmosphere. It is difficult to estimate
the exact amount of urine an animal A\'ill pass under normal circum-
stances, as one animal may remain indoors, is house-broken and retains
his urine until he is allowed to go outside, and other animals that are
free urinate small quantities at every street corner. Friedberger and
Frohner found dogs confined in cages urinated two or three times in
twenty-four hours, but the amount even in individuals varies, exercise
having great influence on the amount excreted. The average amount
of urine passed by the larger kinds of dog is from 0.5 to 1.5 kilogrammes
daily; in smaller breeds, one-half that amount. An increase in the fre-
quency of the act of urination may indicate some irritation of the blad-
der. A decrease in the amount of urine passed indicates that the water
of the body is being taken up through some other channel, as in violent
diarrhoea, great salivation, during the formation of pleuritic or pcrito-

174 DISEASES OF THE URINARY AND SEXUAL APPARATUS

neal exudates, or in dropsy, in fevers, in decrease of the pressure of the
heart, as in valvuhir defects, myocarditis, etc. An entire stoppage of
the urine may occur in acute or subacute inflammation of the kichieys,
in o]:)struction of the urethra, paralysis or rupture of the bladder, from
calculi in the bladder or urethra, from stricture of the urethra, or from
swelling and pressure of the prostate, or from certain poisons.

An increase of the amount of urine (polyuria) may be clue to the
presence of a large amount of water in the blood (anaemia, hydrsemia),
in atrophy of the kidney, where there is great reabsorption of exudates,
or in diabetes mellitus (a condition that corresponds to diabetes in-
sipidus in man). This, however, is extremely rare in dogs. We may
see it after the administration of the different diuretics. It is frec][uently
seen in convalescence from acute diseases.

Constant driljbling of urine indicates paralysis or weakness of the
blad<ler.

The Color of the Urine. — This varies in the healthy dog from pale
yellow, when it has few chemical constituents, to dark reddish-yellow
when it is concentrated and has a high specific gravity. Food also has
a certain influence on the color. After eating fat it is reddish-yellow,
and after meat it is light yellow; after eating sugar or bread it is dark
yellow, and when the animal is starved it is deep yellow. Disease has
also a great effect on the color. It is a deep yellow in fevers and jDale
or colorless in diabetes mellitus or insipidus and in chronic interstitial
nephritis. After the administration of diuretics it is light in color, and
in disease of the liver the coloring matter of the bile may change the color
of the urine to all shades of yellow, varying from lemon-yellow to deep or
even brown-yellow (see icterus). A red color is produced by the coloring
matter of the blood, general angemia, or atrophy of the kidneys; a green
or light brown, by diseases of the liver and catarrh of the duodenum.
Constant dril)bling or slow voiding of the urine without any apparent
pain (incontinentia urina^) indicates weakness or paralysis of the sphincter
or the bladder itself; it may occur from certain affections of the spine,
in acute cystitis, or from tumors of the bladder. Difficult or painful
urination (dysuria, retentio urinse) or even total retention of urine in-
dicates urethral calculus or certain poisons. Hsemoglobinuria is found in
piroplasmosis and following the administration of certain of the febrifuges
such as chlorate of potassium, pyrogallol, chrysarobin, naphthol, analine,
kairin, thallin, acids, etc. Also from intense burns, occasionally in
septicaemia and in infectious hsemorrhagic gastro-enteritis, in acute cases
of distemper, and from sudden chills. Rhubarb and senna turn the urine
yellow, while the addition of an alkali turns it red. Cascara sagrada turns
the urine greenish-yellow, santonin and cina produces a red-yellow.
Analine also produces a blood red. Xaphthalin a brownish-red; carbolic

EXAMIXATION OF THE URINE

175

acid, or cresote, salol, resorcin and the various coal-tar products produce
a greenish-black urine, which on exposure to atmosphere becomes dark
oilve-green. Thallin produces a bluish-green urine and a blue-red is pro-
duced by pyoctanin. The appearance of blood in the urine indicates-
grave conditions. In hsematuria we may see the urine like blood, the
color corresponding to the number of blood corpuscles present, and in
htemoglobinuria the coloring matter is granular or dissolved blood-coloring
matter, actual blood corpuscles rarely being present, the urine then being
dirty reddish-brown in color. Both the above conditions may exist
simultaneously in some cases.

Transparency and Reaction of the Urine. — When the urine has been
passed recently it is clear and transparent, and has an acid reaction.
After feeding with bread for some time it is turbid and
alkaline. After feeding with fat it is alkaline. In patho-
logical conditions when the urine has been passed recently
it is turbid and filled with mucus and epithelium, pus cells,
bacteria or triple phosphates. An alkaline reaction gener-
ally indicates catarrh of the bladder, or we may see this
condition in hsematuria, in reabsorption of exudates, trans-
udates, or in hemorrhage into the abdomen or thorax.

Odor of the Urine. — There is a slight penetrating odor
in normal urine; sometimes it is slightly garlicky. Sul-
phonal produces a fruity odor. In cases of catarrh of the
bladder the urine has a strong ammoniacal odor, and when
any amount of turpentine has been absorbed the urine has
a faint smell of violets. If much ammonia is present
when a glass rod is dipped in muriatic acid and held
over the urine, a white cloud-like vapor arises from the
urine.

Specific Gravity of the Urine. — This varies in the dog
between 10 IG and lOGO. It can be tested by means of the urinometer
or if we have only a small quantity we can test it readily by the area-
pikometer. This instrument the writer has found to be very useful. It
is shown in Fig. 75. Place the urine to be tested into the receptacle C.
Fill it full, taking care that there are no air bubbles in it. Close it and
then sink it in water at 15° R. The specific weight of the urine will
then be marked on the scale.

As a rule it will be found that dark urine has a high and light-
colored urine a low specific gravity. But there are exceptions to this,
for in diabetes mellitus the urine is clear and high in specific gravity,
while in nephritis it is dark in color and has a low specific gravity.
Dark urine seen during starvation has a low specific gravity.

Foreign Substances in the Urine. — The following substances appear

Fig. 75.—
Areapikometer.

17G DISEASES OF THE URIXARY AND SEXUAL APPARATUS

in the urine under pathological circumstances. jMucus, blood, particu-
larly red blood corpuscles, white and pus corpuscles, fat, epithelium,
and tissues, urinary cylinders, animal and vegetable parasites, crystals,
albumen, sugar, or coloring matter of bile and indican.

a. Mucus is found in the bladtler under all conditions, either in
health or disease of the urinary passages, and is found in particularly
large fiuantities in catarrh of the bladder.

b. Blood. — If the blood is mixed in the urine evenly and the corpus-
cles are reduced in size and cylinders are present, it indicates hemoi'rhage
from the kidneys. If blood is present it is called hsematuria and when
the urine is stained with blood or blood-coloring matter it is called hcemo-
globinuria or methtemogloljinuria. Heller's test or the spectroscope
can be used to test urine for blood or lilood coloring matter.

Heller's Test. — Add to the sample of urine a solution of caustic
sodium or potassium, rendering it strongly alkaline; the solution is then

Jfct Orange t^elh

^rim.

A aB C J) E b

Fig. 76. — Spectrum of uriue in haemoglobinuria.

Fig. 77 — Hsematin crystals.

l)rought to a boiling point, and a flocculent reddish-brown deposit is
thrown down.

Spectroscope. — The spectroscope examination is made by means
of an ordinary pocket spectroscope; it may be necessary to dilute the
urine slightly with water if too concentrated.

Microscopical examination will positively determine the presence of
blood cells.

Hsematuria is indicated by the presence of red blood corpuscles
in the urine, and if the urine has been allowed to stand some time con-
tracted or broken clown blood corpuscles may be found and the red
coloring matter disappears. This condition is present in all diseases of
the kidneys.

Hsematuria is found in all diseases of the kidneys, acute nephritis,
acute renal stasis, hemorrhagic infarction, travimatisms, tumors of the
kidneys, diseases of the urinary passages, particularly the pelvis of the
kidney, pyelitis, nephrolithitis, eustrongylus gigas, and in diseases of
the bladder, such as cystitis, neoformations, calculus, inflammation of
the prostate and urethra.

The location of the hemorrhage may be indicated in the following

EXAMINATION OF THE URINE 177

manner. If from the kidney, by the presence of large quantities of epithe-
lium and cylinder casts, while the absence of casts and the presence of epi-
thelium peculiar to the bladder, would indicate it came from that organ.
If the urine is bloody at irregular intervals, it indicates hemorrhage from
the pelvis of the kidney. When the blood is not mixed with the urine,
but comes down in a mass, the diseased condition must be in the blad-
der. This indication is not always certain, as we may see the blood
evenly mixed with the urine in diseased conditions of the bladder, such
as cystitis. When the blood is passed just before the urine or follows
after the last of the urine has passed, or is passed involuntarily, it indi-
cates hemorrhage from the prostate or urethra. Haematuria may re-
sult from certain infections or constitutional diseases, or as a result of
the presence of certain filaria in the blood.

c. White Blood Corpuscles, Pus. — White blood corpuscles are found
in the urine and are found associated with red blood cells; they are also
found in the majority of diseases of the kidneys and urinary organs.
When a considerable quantity of pus is passed, it indicates the opening
of an abscess in the prostate. When a smaller quantity is present it
indicates the presence of some inflammation of the mucous membranes
of the kidneys. We can obtain definite information as to this con-
dition by making a microscopical examination of the epithelium to see
whether any cylinders are present or not.

d. Fat may be seen in drops on the surface of the urine or shortly
after it has been passed. In very fat animals this may be seen as a
normal condition, and where animals have had large quantities of fat
given to them. It also indicates the fatty degeneration of epithelium
of the kidneys. Friedberger and Frohner have seen a pathological
lipuria associated with croupous pneumonia in animals with certain
anemic and cachectic conditions. It is also present in the various dis-
eases of the kidneys. Do not be misled, when you have passed a well-
lubricated catheter and see oil floating on the urine, into thinking that
it is a pathological condition.

e. Epithelium and Broken-down Tissue. — In health a few epithelial
cells are always passed, but when they are present in large quantities
it indicates some active inflammation going on in some part of the uri-
nary tract, and a microscopical examination of the cells to ascertain
their size and shape will indicate the section of the urinary system they
come from. Large quantities of squamous epithelium indicate an irri-
table condition of the bladder, but it may also come from the uterus or
pelvis of the kidney. Renal epithelium in any quantity indicates disease
of the kidney; large quantities of glandular cells, mixed with pus corpus-
cles and dumb-bell bacteria, indicate disease of the prostate. Broken-
down tissues in the urine indicate renal tumors, suppurative or septic

178 DISEASES OF THE URINARY AND SEXUAL APPARATUS

nephritis, severe inflammatory processes, or carcinoma of the bladder or
prostate (Fig. 78).

/. Renal Cylinders. — "Where we find hyaline cylinders, granular
cylinders, epithelial cylinders, or blood casts, then we can feel assured
that there is some disease of the kidneys. Blood cylinders indicate
hemorrhage of the kidneys. Epithelial cells in large numbers indicate
great desquamation of the epithelium, as in acute parenchymatous neph-

FiG. 78. — Epithelium found in the urine: a, From the bladder; b, from the ureters; c, fromthe pelvis of

the kidney.

ritis. Hyaline or epithelial cells when mixed with pus cells indicate
suppurative nephritis. Hyaline and granular cells are present in all
diseases of the kidneys and always in albuminuria and fevers (Fig. 79),
g. Vegetable and Animal Parasites. — Vegetable parasites may be
found in recently voided urine in the form of the split fungus, side by
side with triple phosphates (Fig. 80). Siedamgrotzky found numerous
ball bacteria and pus corpuscles in suppuration of the prostate. Animal

Fig.

79. — Uric cylinders; a. Hyaline cylinders; h, epithelial cylinders; d, granular cylinders; c, blood

cylindera.

parasites may l^c found, either the eggs of the eustrongylus gigas or the
eml;)ryonic forms of the filaria immitis.

h. Crystals. — We find collections of precipitates in the urine and in-
dications of alkaline fermentation, the urine being alkaline in reaction
and containing crystals of triple phosphate, phosphoric acid and am-
moniacal magnesia; these crystals develop in ammoniacal urine and are
coffin-shaped, they arc soluble in acetic acid, thus being distinguished

EXAMIXATION OF THE URINE 179

from calcium oxalate, and occur in large quantities in chronic cystitis.
There are a numl_)er of abnormal substances found in the urine. The
principal ones are albumin, sugar, and the coloring substances of the
bile.

i. Albumin. — The presence of albumin in the urine is always an
indication of disease. The two most important forms of albumin are
serum-albumin and serum-globulin; the two are generally in combina-
tion, and both give the same reaction.

Fig. 80.— Urine of a dog with cystitis, triple phosphate crystals, red and white blood corpuscles, and

cystic epithelium. Bacteria.

Koch's Test. — The urine to be examined must be carefully filtered
before proceeding with the test. The urine is boiled in a test-tube, hav-
ing been previously rendered acid in reaction by the addition of a small
quantity of acetic acid. The urine may become opaque from two causes;
from the presence of albumin or from phosphates; to this we add nitric
acid drop by drop until the phosphate is all dissolved and the albumin
remains opaque.

Heller's Test. — The urine is rendered acid; then pour a small quan-
tity of nitromuriatic acid down the side of the tulje, and if there is any
albumin present there will be a pronounced opaque ring or line where
the acid meets the urine.

Test with Acetic Acid and Ferrocyanide of Potassium. — The urine is
rendered acid with acetic acid and drop by drop a 5 to 10 per cent, solution
of ferrocyanide of potassium is added; if albumin is present, a white
turbidity indicates the presence of albumin. If the solution immedi-
ately becomes turbid on the addition of a very small quantity of the solu-
tion it is due to the presence of mucin and must be filtered immedi-
ately before proceeding. Very concentrated urine must be diluted with
a certain quantity of water. The quantitative test for albumin must
be made by means of an albuminometer; if this is required the methods
described in text-books on analytical chemistry should be consulted; as
a rule the simple proof of the presence of albumin is sufficient for diag-
nostic purposes.

180 DISEASES OF THE URINARY AND SEXUAL APPARATUS

A]])innin occurs in the urine from two causes: in false or accidental
albuminuria, and in true or renal all)uminuria.

The first occurs when there is free albumin in the urine from ac-
cidental causes, as where the albumin is added to the urine in its
passage from hemorrhage, inflammatory conditions in the passages,
or from purulent inflammations. In such cases the microscope will
easily make the differential diagnosis. The quantity is always small.

True all)uminuria is of much greater importance, as this condition
is always a symptom of pathological alterations in the epithelium cover-
ing the walls of the gland. Healthy epithelium wall always retain the
albumin in the blood.

We see true albuminuria in all forms of acute and chronic inflamma-
tion of the kidneys, in fatty degeneration of the kidneys, in amyloid
kidneys, and in any altered condition of the renal circulation, such as
stagnating hypei'semias as a consequence of heart disease, and in chronic
inflammatory conditions of the lungs, pleuritis, hydrothorax. The
horizontal position of the dog does not, however, cause such a great dis-
turbance in the posterior extremities when the smaller blood vessels
are congested as it docs in man.

Albumin will sometimes be found in the blood from ansemia, leu-
kaemia, in acute poisoning, and from high fevers, acute infectious diseases,
or violent muscular exertion. In acute nephritis a large amount of albu-
min is found to be present, in smaller quantity in chronic nephritis, while
in acute atrophy of the kidney very little albumin may be found, but
in the latter condition we generally find that there is present more or
less nephritis or a slight parenchymatous degeneration of the kidneys.
And it is well to examine the urine under the microscope to see if cylin-
ders are present.

Sugar. — The grape-sugar test is generally made when an animal has
a good appetite and polyuria and yet becomes generally emaciated, and
when the urine is pale but of a high specific gravity.

The tests are Trommcr's, the bismuth, and the fermentation test.

Trommer's Test for Sugar. — Put a few c.c. of urine in a reagent glass,
taking care to first see that there is no albumin in it, and if so coagulate
it and filter it out. Take the urine and dilute it with an equal bulk of
water, and render it alkaline with a small quantity of sodium hydrate;
then add drop by drop a 4 per cent, solution of cupri sulphas until the
li(piid is clear and the sediment dissolved, then heat it until it boils,
and if sugar is present we see a reddish-yellow vapor appear at the sur-
face of the fluid.

Bismuth Test. — Ten parts of urine from which all albumin is re-
moved has the following solution added to it: bismuth sul^nitrate 2 parts,
Rochelle salt 4 parts, and a hundred parts of 10 per cent, solution of

ACUTE INFLAMMATION OF THE KIDNEYS 181

caustic soda; this mixture is boiled five minutes, and if sugar is present
the mixture becomes bhick.

Fermentation Test. — This test is always to be preferred in dul^ious
cases; it is also useful to determine the quantity of sugar present. In
this test the saccharometer is used. The method consists in adding a
small quantity of yeast to a certain proportion of urine; for further de-
tails the reader is referred to works on the chemical analysis of urine.

In diabetes mellitus a large quantity of sugar is generally found
in the urine. This disease, however, is extremely rare in the dog. It
is also found when the animal has been fed on a pure sugar diet. A con-
siderable amount of sugar has been found in the urine of bitches that
were nursing, especially when the pups were prevented from nursing
for some time. The writer cannot say whether it is found in the dog
in certain cases of poisoning, or from some neurotic causes.

Coloring Substance of the Bile. — The coloring substances of the bile
are found quite frequently in the urine of the dog. The presence of
these indicates an obstruction in the excretion of bile. It may often be
seen in catarrh of the intestines and in the gastric form of distemper.
Icterus is the most common cause of this condition. (For further in-
formation, see icterus.) Frohner found this also in neurosis and bronchial
forms of distemper, in some diseases of the kidneys, in pleuritis, and in
great heart weakness. Voigt also found it in animals that were starved.
Bile acids in the urine are of no diagnostic value in the dog, and will not
be taken up in this work.

DISEASES OF THE KIDNEYS.
Inflammation of the Kidneys; Nephritis.

It is impossible to accurately separate the different inflammatory
conditions of the kidneys, and as a rule it is only on post-mortem that
the condition can be properly diagnosed. Consequently, the practi-
tioner has to be satisfied if he can recognize with certainty that the pnimal
has some affection of the kidneys, and whether it is acute or chronic.
In the dog it is only in chronic nephritis that we find a general atrophy
of the kidney.

Acute inflammation of the kidney may be traced to severe cold,
to traumatisms, or to sympathetic irritation from adjacent organs, or
to acute catarrh of an infectious or toxic character.

The diseases of the kidneys in the dog do not pos-<\''^ that impor-
tance that they do in man.

182 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

Acute Inflammation of the Kidneys.

(Acute Nephritis; Nephritis Acuta.)

Etiology. — The most common causes of this condition are infec-
tious diseases and poisons. By this is meant the effect produced l)y
the absorption of infectious noxious agents, such as the various septic
cUseases, or certain irritants that have originated in the body and are
passed into the kithieys and cause great irritation while they are passing
through these organs, and also certain micro-organisms that reach the
blood and become located in the capillaries of the kidneys. Certain
chemical substances, such as phosphorus, arsenic, lead, mercury, copper,
cantharides, turpentine, colchicum, male fern extract, strong spices,
carbolic and tar acids, naphthol, and chrysarobin, that are absorbed or
taken into the stomach pass through the kidneys and cause great inita-
tion. Some of these chemical substances are absorbed by the skin
from various ointments that are applied in mange, such as carbolic acid,
mercury, cantharides, balsam of peru, storax, etc.

Acute nephritis may also originate from an extension of inflamma-
tion from neighboring organs, and also from traumatic influences, such
as blows, shocks, etc., in the regions of the kidneys. There is a condition
called rheumatic inflammation of the kidneys that is supposed to origi-
nate from cold. This occurs generally in young dogs during severely
cold weather.

Pathological Anatomy. — The alterations in the structure of the
kidney depend on the intensity of the irritation, and the alterations
are more or less distinctly marked. In slight cases the epithelium seems
to be the only part affected, the connective tissue and the blood vessels
show no pathological alteration other than a reddish-gray coloration
of the covering, or sometimes a yellowish coloration (parenchymatous
degeneration). AMien the irritation is great, there is true parenchyma-
tous inflammation of the kidneys. The epithelium and the inter-
mediate tissue become affected, as do the blood vessels, and all the
exudation processes which accompany acute nephritis follow. The
anatomical alterations that are fovmd are as follows: The epi-
thelium has undergone extensive desquamation, as in parenchyma-
tous degeneration, Ijut more acute in its type. The capsules of the glom-
eruli and the small urinary canals are altered, and the connective tissue
is filled with a liquid infiltration forming numerous coagulated masses
containing large numbers of Icukoc^'tes rich in hydrogen and the urinary
canaliculi are filled with hyaline and epithelial cylinders. The vessels
are enlarged (hypenemic) and partially compressed by the surrounding

ACUTE IXFLAMMATION OF THE KIDNEYS 183

exudates. In the interstitial tissue and in MuUer's capsule we find small
circumscribed hemorrhages. There are a number of circular-shaped
inflammatory centres surrounded by liquid exudates.

The inflamed kidney may present a variety of different appearances.
It ma}" be enlarged or normal in size, soft or hard, reddened or very pale
or yellowish-white, and on the surface of the kidney there may be found
a number of hemorrhage spots that are slightly elevated from the sur-
face of the gland. The capsule can easily be stripped from the body of
the kidney. There are certain forms of acute nephritis and glomerulo-
nephritis that present so little visible changes that they may escape the
eye of the non-experienced practitioner. Concerning more accurate de-
tails refer to the variovis text-books on pathological anatomy, particu-
larly Kitt, who has made a special study of the pathological anatomy
of domestic animals.

Clinical Symptoms and Course. — Slight inflammatory conditions
of the kidneys are rarely recognized in the dog, as the only diagnostic
points are to be found on examination of the urine. This contains a
small amount of albumin, some hyaline cylinders, and a few epithelial
cells and leukocytes.

In acute inflammatory conditions the animal has a peculiar stiff
gait in w^alking, and in some cases staggering, with the hind legs carried
straight, and tenderness on pressure in the regions of the loins; there
may be pain on pressure in the region of the kidneys, and an exact knowl-
edge of the anatomy will aid to discover whether these organs are enlarged;
a quick full pulse, with loss of appetite, and persistent vomiting in the
early stages of the disease; great lessening in the amount of urine se-
creted, and what is passed is dark in color and contains small portions of
coagulated blood, but the animal may make frequent attempts to uri-
nate, and the faeces are dry and hard. The amount of urine passed in such
conditions is small and contains a large amount of albumin. The urine
is turbid, reddish-brown to dark red in color; if allowed to stand there is
a thick nuicus-like sediment of a red-brown or, in rare cases, opaque
red color, and the specific gravity is greatly increased; examined micro-
scopically, it is found to contain numerous tube-cylinders, epithelium,
and white blood corpuscles, also red blood corpuscles, which give the
urine a variable color, according to the number of corpuscles present;
chemically tested, large quantities of albumin are found to be present.
There is generally more or less pain on urination; this is probably due to
the acrid condition of the urine. There are also present more or less
symptoms of uraemia, with great weakness, fatigue, and temperature
generally subnormal, the pulse weak and thready, vomiting, dian-hcea,
oedema of the lim1)s, convulsions, coma, and death. The result in an
acute case is not often favorable if the disease lasts from 8 to 14 days.

184 DISEASES OF THE URINARY AND SEXUAL APPARATUS

AVhen the symptoms are milder and the animal recovers, this is indi-
cated by an increase in the amount of urine secreted and its becoming
clearer; liut this condition may be followed by chronic nephritis.

Therapeutics. — Medicine, as a rule, has little or no effect on these
cases. Tannin, 0.1 gm. several times daily; tinct. fol. uvaursi, 1.0., or
fuchsin, and iron preparations may all be used.

The dietetic treatment is the most successful and consists principally
of rest and food that is non-in-itating to the kidneys, such as milk,
mutton broth, rice and gelatine soups, are especially useful. Meat
may be given, in the acute stages, but only lean meat and in spare
quantities, avoiding anything that is spiced or salted. The symp-
tomatic treatment is to try to lessen the strain thrown on the kid-
neys by trying to carry the fluids out of the body by some channel
other than the kidneys, and we try to do this through the skin or the in-
testines. This can be accomplished to a certain extent by giving the
animal hot baths or using warm bandages (the Priessnitz compress)
around the body, particularly around the kidneys, and also by active pur-
gatives which have no action on the kidneys, such as cascara sagrada, also
jalap and calomel. Where there is great pain in the region of the kidney
and the animal moves about Avith the back arched, the application of a
warm linseed poultice in the region of the kidneys is particularly useful.
To relieve the kidney we can also try pilocarpine, which produces
great salivary secretion in the dog. This, however, must be used with
great care in'dogs that have any affections of the heart or lungs. Diuretics
must not be used in nephritis, as they increase the secretion of salts,
especially the alkalies. General debility should be treated by alcoholic
stimulants, such as brandy, whiskey, or sherry, in the case of very small
animals. Use inhalations of chloroform, clysters of chloral hydrate, or
salts of bromine to counteract convulsions. Where acute nephritis occurs
as a result of some infectious or toxic disease, the symptoms must be
treated in connection with the exciting; cause

Chronic Inflammation of the Kidneys.

(Chronic Nephritis; Xephritis Clironica.)

Etiology. — Chronic nephritis oi'iginates, as a rule, from acute nephritis
or starts in a mild form and gradually becomes chronic; this is seen particu-
larly when it originates from toxic or infectious causes, and in animals
that are subjected to repeated colds or lie in damp kennels, so that it is
very difficult to tell at times just how a chronic case may originate.

Pathological Anatomy. — There are two forms of chronic inflammation
of the kidneys; first the large white kidney (chronic parenchymatous

CHRONIC INFLAMMATION OF THE KIDNEYS 185

nephritis), and the atrophic or hard kidney (chronic interstitial nephritis).
The first contlition is generally the forerunner of the second, but, as the
hard kidney is most frequently found in post-mortem, it is possible
that it niaj' develop as a primary condition. The white kidney is en-
larged from the normal size, and has a smooth yellow or irregular yellow-
colored surface. The cortical portion is yellowish in color, while the
pyramids are red. In some cases we find the kidney large and red, or al-
ternated red and yellow, or covered with hsemorrhagic spots. The
atrophic kidney (shrunken or contracted kidney) results from an increase
of the interstitial substance and atrophy of the parenchymatous substance.
It is hard and tough on its surface, and has small, wart-like irregularities
and granulations. The capsule is thickened and it is hard to strip from the
body of the kidney; here and there we find small cysts of various sizes.
The cortical substance is lessened in diameter and striated wdth layers of
dark colored tissue. The pyramids are smaller and deep red in color.

Clinical Symptoms and Course. — As a rule, very little that can be recog-
nized in the clog during life. The quantity of urine passed is greatly in-
creased and at much shorter intervals; this increase of the amount of
urine passed is one of the first symptoms to attract the attention of the
owner. The urine is very light in color, almost like water, the specific grav-
ity being much lessened. Microscopically examined, we may find iso-
lated hyaline cylinders, and a few blood corpuscles; albumin is never present
in any great amount, frequently for a certain period small quantities of
albumin may be present and then it entirely disappears. Palpation of the
kidney may find it hard, and uneven on the surface. In such cases there
is generally hj-pcrtrophy of the left ventricle, which can be recognized
by palpitation of the heart (loud pulsations and a hard, full pulse). It
is presumed that this high arterial pressure tends to keep up the action
on the impaired kidney and prevent any serious disturbance in the secre-
tion of the kidney. As the disease advances we soon recognize a change:
the heart becomes weaker in its action, the pulse is small and frequent, the
urine is scant, dark and very albuminous. This is followed by chronic
inflammatory processes in various organs, especially the bronchia, and in
the intestinal canal; and finally we have symptoms of uraemia. In the
majority of cases the parenchymatous form can be recognized by the
urine. This is very similar to acute nephritis. It contains much albu-
min, and the urine is scant in quantity, and there are certain dropsical
symptoms in the dependent regions; death may occur as a result of gen-
eral dropsy or uraemia, or such complications as pneumonia, pleurisy, or
pericarditis. There is also loss of appetite, great fatigue on taking any
exercise, hypertrophy of the heart, which finally becomes weak, and then
symptoms of ursmia follow as stated above. In rare cases the condition
may change and the active symptoms cease; the urine gradually becomes

18G DISEASES OF THE URINARY AND SEXUAL APPARATUS

clean and of a lighter specific gravity, it increases in quantity and the
dropsical regions return to their normal condition.

Therapeutics. — The treatment of chronic nephritis is the same as in
acute. As the course of the disease generally covers a long period and the
affected animal suffers great loss of strength, the animal must be fed fre-
quently on milk, rice, or meat, being careful to use no salt or spices. But the
dropsical conditions can be treated by diuretics and aromatics; pilocarpin
is also sometimes used, and when there is great anaemia give iron salts to
assist absorption of the pathological neoformation resulting from the in-
flammatory processes. Iodine, iodide of potassium, or sodium may l)e
administered.

Other Diseases of the Kidneys.

There are in the dog a number of pathological conditions of the kidneys
Avhich are of very little importance; the most important of these will
here be described briefly.

Renal Hyperaemia. — This follows as a result of arterial hypersemia and
may be produced by the same causes as produced acute nephritis; fre-
quently certain diseases of the circulatory or respiratory organs, interfer-
ing with the venous circulation, produce passive hypersemia of the kidneys
(renal stasis). Thrombus in the renal circulation or tumors pressing on
the vessels may also cause it. In renal congestion there is a large amount
of urine secreted, which is light in color and of a low specific gravity,
whereas in renal stasis the urine is of high specific gravity, dark in
color and contains a certain amount of albumin, hyaline, cylinders and
blood corpuscles in small amount. The urine after standing some time
forms a thick red precipitate of urates, which are readily redissolved
by heat.

The treatment consists in endeavoring to remove the active ca\ise of
the hypersemia by treating the primary affection.

Amyloid Kidney.

Amyloid kidney gcncrall}' occurs in connection with amyloid degenera-
tion of some other organs of the body. The kidney is slightly increased in
volume, firm, smooth, with yellowish-white coloration of the cortex, and
in the parenchymatous form the condition can usually be recognized by
the character of the urine. This generally presents the same symptoms as
those of acute nephritis. The urine is loaded with albumin and much
lessened in quantity.

The amyloid condition is seen not only in the kidneys, but also in
the liver, pancreas, and intestines.

ABSCESS OF THE KIDNEYS 187

Pathological Anatomy. — A kidney thoroughly affected with amjdoid
disease is slightly enlarged, hard, smooth, and shows at the intersections a
deep yellowish-white coloration, easily distinguished on section. The
glomeruli are easily distinguished with the naked eye as small glossy spots.
On staining with Lugol's solution the affected parts are colored a mahog-
any-brown and with methyl are colored purple-red. For further details
see works on pathological anatomy.

Clinical Symptoms. — The extremities are dropsical, with complete
loss of appetite, coma, uraemia, and then death. In a case where the ani-
mal was unsteady and weak, with paleness of the mucous membrane, Zim-
merman found an amyloid kidney associated with hypertrophy of the
left side of the cord.

Therapeutics. — The treatment consists in following what is prescribed
in nephritis.

Abscess of the Kidneys.

(Suppurative Nephritis; Pyelonephritis.)

Etiology. — The direct cause of the formation of abscess of the kidney
is direct injury of the kidneys or in the region of them, causing the forma-
tion of purulent abscess in the urinary passages, the bladder, the urethra,
or the pelvis of the kidney. In certain cases this condition is associated
with ulcerous endocarditis, from the results of an embolus which may be
liberated and get into the circulation.

Pathological Anatomy. — Purulent nephritis occurs in various forms,
according to its origin. When this condition is caused by an embolus it is
seen in the shape of small abscesses which are easily distinguished by the
naked eye. When a section is made through the kidney, these abscesses
extending along the canaliculi present a peculiar appearance and are
grayish-yellow in color, round or oblong in shape, and are generally sur-
rounded by a red circle. When the spot is examined under the micro-
scope there are swarms of micrococci in the centre of the mass, and it is
reasonable to believe that these are the causes of the abscesses. Only in
rare cases do the abscesses become confluent, and when they do they form
large pus centres that, as a rule, cause death. When the abscess forms in
the pelvis of the kidney the pus extends into the straight urinary canals,
in some cases as far as the surface of the kidney, and is indicated by a pro-
trusion or elevation of the external surface, which is yellowish in the cen-
tre and surrounded by a circle of yellowish points. When large abscesses
are formed from these and become confluent, the whole kidney may
become altered into one large abscess. The covering capsule of the kidney
then becomes thickened and holds the abscess with its contents (pyo-

188 DISEASES OF THE URINARY AND SEXUAL APPARATUS

nephrosis). In the early stages, -where the micrococci have just collected
in the urinary canals and have started to form abscess centres, a very
interesting study is afforded.

Clinical Symptoms. — The symptoms of abscess of the kidneys may not
differ to any great extent from chronic nephritis, the diagnosis being
based on local manifestations, by means of palpation of the abdomen in
the region of the affected kidney; this may be greatly enlarged or even
fluctuating if the abscess has formed pus. An examination of the urine
may show it to contain numerous pus corpuscles, a large quantity of
micro-organisms, and an excess of albumin and pus, blood cylinders, renal
epithelium and, in rare cases, we may even find portions of broken-down
renal tissue. It is possible, however, to find an acute case in which none
of these symptoms are presented and where the urine is practically clear;
this is particularly noticeable when the irritation is due to an embolus.
The whole appearance of the animal presents all the symptoms of an acute
wasting disease; the fever is irregular or intermittent and there is gener-
ally rapid emaciation.

Perinephritic abscesses may become so large that they form a tumor-
like body in the lumbar region, and the pus can be detected under the
skin, in some cases so large that the enlargement fluctuates. When such
is the case, and we have confirmed our diagnosis by means of an exploring
needle, the sac should be emptied by an aspirator or by making a fairly
large opening and emptying the abscess of its contents. It should then be
washed out daily with an antiseptic solution. If the kidney itself is not
directly affected by the abscess, we may expect a quick recovery under
good antiseptic conditions (see treatment of wounds).

Treatment. — If the disease is confined to one kidney, the treatment
should be surgical and the abnormal kidney removed, care being taken,
however, to be sure the remaining kidney is normal and able to perform
the duties of both.

Inflammation of the Pelvis of the Kidney.

(Pyelitis.)

Etiology. — This is caused by the irritation or extension of certain in-
flammations from the body of the kidney, from poisonous irritants passed
from the blood through the kidneys, from foreign bodies that lie in the
pelvis, from nephritic stones, or strongylus gigas, and this condition is
also seen in infectious diseases that are acute in character, as well as in
the extension of inflammation from neighboring organs (nephritis, cystitis)
and from any of the various conditions that result in interference with the
flow of urine, stricture of the ureters, from the presence of calculi,

HYDRONEPHROSIS 189

tumors, or abscesses of the prostate, paralysis of the bladder, as in spinal
paralysis, or in hydronephrosis.

Pyelitis occurs in a number of forms varying according to the intensity
of the irritation and is generally part of other morbid processes. This
disease is recognized by means of the microscope, particularly when we
discover epithelium of the pelvis of the kidney in the urine, or by manual
examination of the kidneys through the abdominal wall, when enlarge-
ment of the pelvis ma}' be detected (see also parasites of the kidney) , or
there may also be present some symptoms of inflammation of the kidney
or catarrh of the bladder. The treatment consists in the attempt to
remove the original irritant.

Hydronephrosis; Dilatation of the Pelvis of the Kidney.

Etiology and Pathological Anatomy. — Whenever there is a stenosis or
stricture of the urinary passages and consequent obstruction, the urine
is dammed back and presses on all the canals behind the point of obstruc-
tion, and as a consequence the canals are distended and finally become
enlarged. If the obstruction is in the urinary tube, the bladder, ureters,
and the pelvis of the kidney become enlarged; but if one ureter only is
afTected, the corresponding kidney becomes enlarged; and where the pelvis
is much distended and after the condition has lasted some time, the body
of the kidney becomes absorbed. The whole kidney becomes converted
into a pouch-like mass of connective tissue, filled with liquid. This fluid
at first is urine, but soon becomes converted into mucous secretion. In
one case described by Siedamgrotsky, he observed, instead of a kidney, a
large bladder or cyst, with walls formed of connective tissue, filled with a
syrupy brownish fluid containing numerous cholesterin crystals. This
condition is produced gradually, for any sudden interference or stoppage
of the flow of urine would produce ursemia or rupture of the urethra and
uraemia and death in a short time, but in hydronephrosis the condition
comes on slowly and may result from periodic irritation and stricture of
the urethra, from tumors of the prostate, the presence of calculi in the
canals, or b}^ inflammation of the mucous membrane of the bladder.

Clinical Symptoms and Therapeutics. — The cystic kidney in slight
cases is rarely recognized; in more acute cases it is indicated by a fluctuat-
ing painless tumor in the region of the kidney; in certain cases there is a de-
cided enlargement in the size of the abdomen; by puncture and use of an
exploring trocar we find the fluid described by Siedamgrotszky, "When
there is double hydronephrosis the urine is suppressed and symptoms of
uraemia are shown very quickly. The disease can only be treated success-
fully when it is caused by obstruction of the urethra; for instance, where
the obstruction is due to a calculus in the urethra and it is removed by
surgical means.

190 DISEASES OF THE URINARY AND SEXUAL APPARATUS

Nephritic Stones.

(Nephroliihiasis; Renal Calculi.)

Nephritic stones are formed in the pelvis of the kidney and range from
the size of a mustard-seed to that of a pea. (Megnin found two stones
each weighing six and seven grammes in the pelvis of a dog.) They are
irregular, warty, or sharply irregular, and consist of phosphate and car-
bonate of calcium; in rare instances the so-called cystic calculi are found;
these, when first removed, are soft waxy bodies with a dull surface, com-
posed of triple phosphate and uric acid.

The formation of these collections is not thoroughly understood, but
they are probably formed by some foreign body, such as mucus, blood,
fibrin, epithelium, urinary cylinders, shreds of tissue, or collections of
bacteria; and the salts are deposited on this medium in successive layers,
so that finally a large mass is formed.

Nephritic stones may produce pyelitis, pyelonephritis, or hemorrhage
from the pelvis of the kidney. If the stone lies at the entrance of the
ureter or even passes into that canal and becomes lodged, it will retard
the flow of urine and even cause rupture of the ureter or pelvis of the kid-
ney and death from peritonitis. Frccjuently the calculus is forced along
the ureter, causing great agony, and finds its way into the bladder. These
stones are not, as a rule, diagnosed with any degree of certainty during
life. Symptoms of pyelitis wnth the continual passage of small stones from
the urethra are about the only indications that will guide the observer.

Tumors of the Kidneys.

These neoformations can be determined only by a manual examina-
tion of the kidney through the abdominal wall; they frequently cause an
enormous increase in the size of the kidney, particularly so in carcinoma,
the soft form of cancer being most frequently seen. In the pelvis of the
kidney and the ureters we find irregular papilla-like formations (carcinoma
papillomata, papilloma destruans (Kitt) ; these may obstruct the normal
flow of urine and cause a distention and enlargement of the pelvis of the
kidney and the renal ducts and an atrophy of the kidney itself. The
only possible relief to such a condition is the surgical removal of the
kidney.

Animal Parasites of the Kidney.

Of the various parasites of the kidney the strongylus gigas has a
special interest. This parasite is not unlike the common earth-worm and

CATARRH OF THE BLADDER 191

about the thickness of a lead pencil. It is generally blood-red in color, and
invariably found solitary. It is usually found in the pelvis of the kidney,
causing great irritation of its mucous membrane, the pelvis of the kidney
and even the kidney itself being converted into an enormous cyst in the
middle of which lies the parasite, twisted in a round spiral mass.

During life there are no symptoms which could be called characteristic
and recognized with any ease. The animal may show evidences at times
of great pain, quick respirations, moving from one place to another, utter-
ing occasionally short cries of pain, scratching or digging with the
paws in an aimless way, great depression, staggering gait, the back is
arched or bent laterally; in rare instances there are severe cramps of the
posterior extremities. The urine is generally turbid and contains pus;
under favorable circumstances we may find the eggs of the parasite, these
are brown in color, oval in shape, and their external surface is granular or
pitted; they are about 70/i long and 40/^ wide. The presence of the eggs
of the parasite is of course positive evidence of its presence. The parasite
may find its way into the bladder, producing a cystitis, or into the urethra,
obstruct that canal, or it may be passed out entirely. As a rule the para-
site causes so much irritation locally as to cause the death of the host.
Lacosta, however, had a case where the animal passed the parasite and
made a complete recovery. The treatment consists in the administration
of oil of turpentine in repeated small doses.

DISEASES OF THE BLADDER.

Catarrh of the Bladder; Inflammation of the Bladder.

{Cystitis.)

Etiology. — Catarrh of the bladder is generally caused by microbes such
as coli bacilli and their kindred bacteria, and also Ijy the pyogenic cocci,
staphylococci, streptococci, etc., which find their way into it, as a result of
certain infectious diseases and are eliminated by the kidneys or by certain
chemical irritants, such as oil of turpentine, cantharides, carbolic acid, or
creosote, and also calculi. Septic instruments, such as catheters, Avhen
introduced into the bladder, may set up an irritation of the mucous mem-
l>rane. Cystitis is caused by the extension of an irritation from the
urinary ducts. In septic or mycotic inflammations of the intestines, and
thus the kidney carrrying off waste materials, from irritation of the
pelvis of the kidney, from the uterus, and from retention of the urine,
caused by stones in the urethra in bitches. From hypertrophy of the
prostate, or in case of well "house-broken" dogs that retain the urine,
being unable to get oustide, and as a consequence of retention produce

192 DISEASES OF THE URINARY AND SEXUAL APPARATUS

a paralysis of the bladder, in bitches having a difficult or protracted
delivery, from traumatisms, such as penetrating wounds, or contusions as
a result of being run over by a wagon or automobile. Where the urine
becomes very alkaline from the excess of ammonia, it produces an irritating
effect on the bladder, as also does continual retention of urine, especially
when it is heavily charged with salts. It has been said that cold will
produce cystitis. Cystitis may also be produced by the extension of
inflammation from neighboring regions, or in grave infectious diseases
an irritation can be caused by the toxins of broken-down micrococci
being carried away

Pathological Anatomy. — There are quite a number of varieties of cys-
titis— mucous, muscular, serous, croupal, ulcerous, diphtheritic, and gan-
grenous— but, as a rule, it is very seldom that we can differentiate between
the various forms, and it is best from a practical standpoint to distinguish
the disease as acute and chronic catarrh of the bladder. In the acute
form the mucous membrane of the bladder is colored in an irregular way
by dark red spots. It is also more or less swollen and covered with mucus
and detached epithelium. In the later stages of the disease, the mucous
membrane may be covered with detached epithelium and covered with
small hemorrhagic spots. In very severe cases we find a croupous mem-
brane covering the bladder, and it may be so acute as to cause gangrene,
and mucous membrane is sloughed off and extensive abscesses are formed.
In such cases the muscular and serous coats of the bladder are also
greatly inflamed; and if the irritation is extensive enough, we may also
find evidences of peritonitis.

In the chronic form the mucous membrane becomes very much thick-
ened and covered with enlarged mucous glands. The surface presents a
peculiar greenish or slate-gray color. This is due to the hemorrhages that
occur in the tissues from time to time. On the surface we often find
raised papilla-like formations, and the submucous tissues and muscles
are hypertrophied.

Clinical Symptoms and Course. — The first symptom noticed in this
disease is the passage of an increased amount of urine, the animal empty-
ing the bladder frequently, but passing only a small quantity of urine each
time, at the same time showing evidences of pain. In rare cases there
may be a retention of urine due to cramp of the neck of the bladder from
irritation. On making an examniation of the bladder through the abdom-
inal wall, the animal shows pain on pressure of that region. An examina-
tion of the urine by the microscope will assist us in making a positive
diagnosis. If there should be some disease of the kidneys present, while
the specific gravity of the urine is not much changed, in the early stages of
the disease, it is somewhat darker than usual, and there is an increase in
salts and it contains only a normal amount of mucus, albumin, a few pus

CATARRH OF THE BLADDER ' 193

and perhaps a few blood corpuscles, and masses of bacteria and epi-
thelium of the bladder. This condition may continue for a long time.
The reaction of the urine depends on the nature of the bacteria present,
and it is generally alkaline but may be acid, as in cystitis produced by the
coli bacilli. Mild cases of cystitis are not diagnosed, but as the disease
continues the urine becomes thicker and turbid, and on making a micro-
scopical examination of the urine we find numerous pus cells and epi-
thelium of the bladder; the urine rapidly loses its acid reaction and soon
becomes neutral or alkaline, and has a strong ammoniacal odor. Urine
from an animal in this condition ferments very rapidly and contains num-
erous crystals of triple phosphate, ammoniacal phosphate of magnesia,
and, in rare instances, uric acid crystals and numerous bacteria.
(Fig. 81.)

Fever as a rule is present in this disease, but is never intense, but is of
rather an intermittent character. There is also severe depression and
loss of appetite. The course of the disease, generally, is rapid, and in

Fig. 81. — Urine of a dog with cystitis, triple phosphate crystals, red and white blood corpuscles, and

cystic epithelium. Bacteria.

slight cases the animal recovers in a few days; but in acute cases, the acute
symptoms may last for weeks, and then the animal is liable to have relapses
from time to time, and if the primary causes such as stone, urethral
stricture, paralysis of the bladder continue, the cystitis becomes chronic.
The chief danger in cystitis lies in the possibility of a complication of pye-
litis, pyelonephritis, suppuration, paracystitis, etc., and death may finally
be caused by perforation of the necrosed bladder and the animal dies of per-
itonitis, gangrene, or uraemia. The most frequent termination of the
acute form is into the mild chronic form.

In the chronic form the symptoms are much milder, and for a long time
the urine is the only guide to a diagnosis, as it is only in advanced cases
that the animal will show any pain on pressure of the abdomen; the change
in the urine characteristic in this condition is that it becomes strongly
ammoniacal. The contractile power of the bladder is gradually lost, and
the animal may present symptoms of incontinence of urine, passing small
quantities of urine without any effort; or this is seen in well-trained house
13

194 DISEASES OF THE URINARY AND SEXUAL APPARATUS

animals that pass small quantities of urine although making every effort
to retain it until they are outside; or it may pass away drop by drop when
they are moving about or asleep.

Therapeutics. — The treatment of cystitis may be dietetic, medicinal,
or local, according to the symptoms presented. In slight cases it is only
necessary to administer non-irritating agents, such as tartaric acid, dilute
muriatic acid, liquor potassii acetatis, or infusions of juniper; and a liquid
diet, such as milk or soups. This assists in increasing the amount of
urine and also in lessening its specific gravity, and by that means cleans
out the bladder. In the more acute conditions, we try to correct the con-

FlG. 82. — Apparatus and method of irrigating the bladder in the dog.

dition of the urine by means of disinfectants, such as salicylic acid, salol,
boric acid, naphthalin, chloride of potassium, or urotropin several times
daily in 0.5 doses, helmitol 1.0 three times daily, hetralin 2.0 three times
daily, or a decoction of fol. uva ursi. The writer has always obtained
good results from the administration of the last two agents.

In the treatment of this chronic form, besides the various alkaline
salts, we should use the resinous diuretics, such as oil of turpentine,
balsam of copaiba, or oil of sandalwood.

The local treatment of the bladder is very effectual. This is done
when the urine is found to contain large quantities of bacteria and pus
corpuscles, and when ammoniaeal decomposition appears very quickly.

DEBILITATED CONDITIONS OF THE BLADDER 195

This consists in introducing the medicinal agents directl}'' into the bladder
by means of the catheter. The catheter is introduced into the bladder and
the bladder emptied, and by means of a small hose the catheter is con-
nected with a small funnel (see Fig. 82) , and a medicinal douche allowed to
flow into the bladder, and then the hose is placed in a dependent position and
the liquid allowed to trickle out. This can be repeated several times with-
out removing the catheter. When the animal is very small and a very
fine catheter is used, the fluid may not flow freely; in such a case a syringe
is adjusted to the end of the catheter and the fluid forced into the bladder
and again drawn out by means of the syringe, or an aspirator bottle
may be used.

The writer first cleans out the bladder with clean water, then washes
with a solvition of boric acid, 2 per cent., or of tannin 2 per cent.; sulphate
of zinc 1 per cent., resorcin 1 per cent., nitrate of silver 1 to 2 percent.
Ginsiner recommends hydrargyrum oxycyanatum 1 to 100. Jahn had very
good results with adrenalin (suprarenin in 1 to 10,000) in hemorrhagic
cystitis. Pressnitz compresses or warm poultices to the hypogastric region,
and morphine or bromide of soda in cases where there is involuntary or
constant urination, also warm clysters to keep the intestines clear.
"Where there is extensive hemorrhage, give an injection of 2 per cent, solu-
tion of tannic acid. Creolin, 1 per cent., is also used, but is not as satis-
factory as the former. The liquids must be tepid. In the dog, of course,
this treatment is a little harder to perform than in the bitch, but with a
little practice it is very easily accomplished and produces very satisfac-
tory results. With the bitch a short metallic catheter can be used. It
must l^e remembered that house dogs must be allowed to go out fre-
quently as the retention of urine is a frequent cause of this condition.

Debilitated or Paralytic Conditions of the Bladder.
Paralysis and Paresis. Vesical Uremia.

Etiology, Clinical Symptoms, and Prognosis. — Weak bladders, due to
paralysis or paresis, are generally seen in old dogs, and are produced by a
number of causes. One frequent cause of this condition is that house dogs
that cannot get outside or are carried long distance on the trains, or are
benched at a show, retain the urine for a long time, producing extreme
distention of the bladder. Obstructions of various kinds which prevent
the passage of the urine, such as the presence of a calculus at the neck of the
bladder or in the urethra, as hypertrophy of the prostate, strictures of the
urethra, by weakness of the muscular coat of the bladder, caused by
chronic catarrh of that organ, and certain diseases of the nervous system
al.<o produce this condition.

196 DISEASES OF THE URIXARY AXD SEXUAL APPARATUS

This condition ma}' also bo the result of fracture of the vertebrae,
extensive hemorrhage of the spine, myelitis, spinal meningitis, tumors,
poison and general debility.

Clinical Symptoms. — There are two forms of this disease : Paralysis of
the detrusor and paralysis of the sphincter vesicae. It is c^uite common
to find both conditions present in one animal. In the first condition
(ischuria, retentio urinae) the bladder becomes so distended that its elas-
ticity is lost, and the muscular coat loses its power of contraction, and, fin-
ally, when the bladder is so distended that the connective tissue alone
holds it and presses on the sphincter vesicae and overcomes it, the urine
trickles out in small quantities, the animal is uneasy, makes frecjuent at-
temps to urinate and may or may not succeed in passing any urine; on pal-
pation of the abdomen the bladder is found greatly distended, and mere
manual pressure on the alxlominal walls in the region of the distended
bladder may cause evacuation of that organ; the urine passed is foiuid to be
highly concentrated and has a very unpleasant odor. The paralysis of the
spincter vesicae is termed overflowing of the bladder (urination Ijy incon-
tinence). When the sphincter is paralyzed the urine flows constantly or
at very short intervals, the slightest contraction of the depressor being
sufficient to expel it; this is painless to the animal. In this condition the
bladder is nearly always empty. In making an examination of the blad-
der through the abdomen, when paralysis of the detrusor is present, the
bladder will be found distended, even when the animal has passed some
urine only a short time before, whereas in paralysis of the spincter the
bladder will be found to be empty. As a rule there is no great change in
the animal's condition, except in these cases where the original cause is
some disorder of the spine; then the appetite is scanty and the animal
shows great disinclination to exercise.

When cystitis accompanies this condition the animal shows more or
less pain when it urinates. This, however, is seen only in rare instances.
In the majority of cases the prognosis is unfavoral)le; the only cases in
which a favorable termination is to l)e expected are those of simple dis-
tention of the ])ladder, as in house dogs, when from overdistention of the
bladder when the animal cannot get out, or when a calculus is in the blad-
der or urethra and the cause is removed surgically.

Therapeutics. — The treatment best adapted to relieve this condition is
to regulate the passage of urine, as in catarrh of the ])ladder, by pressing
the bladder through the al)dominal wall and emptying it, or catheteriza-
tion and by injections into the bladder of claret wine, solutions of tannin
1 to 2 per cent, internally, or tine, nux vomicae 5 to 10 drops once or twice
daily, strychnia muriate 0.001 to 0.003 subcutaneously, or fluid ext.
ergotae 0.50. We can also try faradization of the vertel)rae over the lumbar
region or massage of the abelomen in the region of the bladder.

STOXE IN THE BLADDER 197

Stone in the Bladdeio

(Lithiasis.)

Etiology and Pathological Anatomy. — The various lithic formations
found to originate in the pelvis of the kidney and the bladder are found
either in the form of fine sand-like or gritty substances, or formed calculus;
these may be s\i1)divided into urates, oxalates, phosphates, and cystates.

Urates. — These consist of uric acid or uric acid salts, or both in com-
bination. They are small, hard, yellowish or reddish-brown bodies, hav-
ing a smooth surface; on cutting through the centre they are found to be
formed in concentric layers or strata.

Oxalates are composed chiefly of oxalic acid and lime salts, and are
more or less mixed with uric and phosphoric acids. They are hard,
brown in color, and have an irregular mulberry-like surface.

Phosphates. — These are composed of phosphoric acid, lime, and triple
phosphates. They are gray-white in color and, as a rule, are soft and
friable.

Cystic Stones. — These are soft, wax-like bodies, having a shiny
crystalline, irregular surface.

All these lithic deposits contain besides their inorganic elements,
numerous organic elements, such as epithelium, blood cells, mucus, etc.

Klemmer found on careful examination of 3301 dogs that 12 or about
0.38 per cent, were affected with stone. The size to which these calculi
may grow is considerable. In Dresden there is a calculus taken from a
German boar-hound that is 11 cm. long and 7.5 cm. wide, 6 cm. thick,
which weighed 490 grammes Avhen fresh. They are generally started in
their formation in the pelvis of the kidney, and, generally, from some for-
eign body, such as a blood clot, a piece of mucus, epithelium, etc., around
which the sediment in the urine forms and gradually the crystalline ele-
ments accumulate. This deposit is formed very quickly in cases of
cystitis, Avhere the urine is undergoing alkaline fermentation and pro-
duces a copious sediment in the urine.

Paul Bert and Studensky found by experiments that the food and fluids
that the animal takes may have a certain influence on the formation of
stone in the bladder. The former mentions two cases in which one was
fed exclusively on meat and the other on vegetables. On post-mortem of
the animal fed on meat there was found a phosphatic calculus, but no
trace of inflammation of the urinary organs.

Studensky placed foreign bodies in the bladder and found that when
the animal was allowed to drink only water that was thoroughly impreg-
nated with lime salts that there was soon formed over the body a thick,

198 DISEASES OF THE URINARY AND SEXUAL APPARATUS

heavy deposit of lime salts, and that results differed greatly in animals
fed in the usual way, with pure water and meat. In the latter case the
concretion was much smaller and deposited much more slowly.

The irritation produced l^y stone in the pelvis of the kidney has
l^een already pointed out (see page 190.) Stones in the bladder, as will be
spoken of later, cause not only interference with the flow of urine, but
by their weight and position may cause a hypertrophy of the walls
of the l)ladd(>r.

Clinical Symptoms and Course. — When the uric calculus lies in the
bladder and has not attained any size, it may stay there a long time and
not produce any marked symptoms, with the exception of a slight
catarrh, and that is only noticed when the animal has had a long run,
the urine then being voided with great difficulty, perhaps mixed with
blood or mucus, and has a penetrating odor. Palpation through the
alxlominal wall, even when the liladder is partially filled, may discover
the stone as a hard l)ody lying in the bladder; in the Ijitch, the urethra
l)eing very short, it is easily detected by means of a catheter. When the
stone gets into the neck of the bladder or passes into the urethra and
lodges at the posterior end of the bone of the penis very severe symptoms
are noticed. Retention of urine is indicated by an entire suppression
(ischuria), or urine is passed in a thin stream or only by a drop at a time,
the animal showing great pain. A partial obstruction of urine is soon fol-
lowed by a complete obstruction.

The symptoms presented in the dog are very striking. The animals
are very restless, looking frecjuently towards the region of the kidney and
whining. They place themselves in the position to urinate and strain
violently without any result, or perhaps a few drops are passed and these
may be mixed with blood. The appetite is lost and the pulse is rapid and
thready; they stand with an arched back or walk with a staggering gait
and extended legs. The abdomen becomes distended and we can finally
feel the bladder through the abdominal walls like a hard, distended body
which is very painful on examination. When the catheter is passed it
goes in easily enough until the neck of the bladder is reached, when it
stops and cannot be passed any further, and no urine escapes from the
catheter.

Uric calculi lie on the floor of the bladder and can be felt through
the abdominal walls liy manipulation, that is, of course, when they have
reached a good size; the small ones escape detection, but they may be
suspected when the urine has a gravel or sand-like sediment.

The urine, when it is retained in the bladder, gradually accumulates,
and if it is not drawn off in three days the bladder is ruptured; it may even
burst in two days. AVhen this occurs it causes death in a few hours, with
tlie following symptoms: the animal liecomes dull or comatose, with

STONE IN THE BLADDER 199

shaking or trembling of the muscles, and the restlessness and pain seem to
have disappeared. Pressing on the abdomen may produce great evidence
of pain, but in the majority of cases this is absent. After the first two
hours the abdominal wall is covered with a cold sweat, and the bladder
cannot be felt on manipulation. Soon a deep coma /rom which the ani-
mal cannot be roused sets in and dies in a short time. In rare instances
the animal may have convulsions, which occur with short intervals be-
tween them. Death may also occur before the bladder is ruptured, as a
consequence of extensive gangrenous cystitis with pyelitis.

Therapeutics. — While the first procedure in treatment of stone is essen-
tially surgical, however in cases where the animal passes very small cal-
culi or sand-like particles and shows every evidence of the presence of
cystic calculi or where an animal passes small stones which lotlge at the
end of the penal bone and has to be operated on frequently, he should be
given large quantities of liquids or w^aters that are supposed to have
litholytic action — for instance, acids for dissolving phosphatic calculi,
alkalines for breaking up uric calculi, or lithia mineral waters, such as
A'ichy, Kissingen, Carlsbad. Or the l:)ladder may be washed out with
various solutions (see cystitis). In oxalate and cystic stone the animal
should be given all the water it will take. When the stone is present and
is causing retention of urine, there is nothing left then but to remove the
stone by means of an operation called urethrotomi) if the stone is lodged
in the urethra at the posterior end of the bones of the penis, or cystotomif
if the stone is located in the bladder; this operation is performed by open-
ing the urethra at the ischial arch, and by means of a small pair of forceps
introduced into the bladder, through the urethra, the stone is grasped and
crushed and afterward washed out of the bladder. In the ])itch an
incision is made into the short urethra and the stone is seized and
crushed in a like manner.

When ischuria or stoppage of urine is present, the treatment depends
to a large extent on the location of the calculus — that is, whether it is in the
neck of the bladder or whether it has gone into the urethra some distance
and lodged there. In the first instance we can sometimes introduce the
catheter and by a gradual pressure we can push the stone into the bladder;
or if it is further in the urethra, we can push a well-lubricated catheter
past the stone and allow the escape of urine and prepare for the operation,
for if the stone is in the urethra this must be performed immediately.

Urethrotomy. — This is usually performed from the posterior end of
the bone of the penis, as the great majority of uric calculi pass down the
urethra and lodge at the posterior end of the bone of the penis and can l)e
detected by the catheter; when this is passed and comes against the stone
there is a certain rough sound felt that resembles crepitation. Lay the
animal on tlie side or back, and after having injected cocaine into the skin

200 DISEASES OF THE URINARY AND SEXUAL APPARATUS

(or administered ether if the animal be very hard to handle, although this
procedure is rarely necessary) insert a well-oiled catheter, make an incision
about 3 cm, in length, cutting down on the median line on the skin making
a free opening, then cut a second longitudinal incision on the urethra on the
stone or on the end of the catheter (Fig. 83); calculus can then be pushed
back toward the opening in the majority of cases, and by means of a pair
of small forceps the stone is grasped and pulled out. In some cases it is
necessary to enlarge the opening in the urethra; as a rule, however, do not
make the opening any larger than is absolutely necessary. Occasionally
when the stone lies in the canal just under the bone of the penis, it is ex-
tremely hard to remove, and after making the incision it has to be forcibly

Fig. S3. — Urethrotomy. Catheter introduced and end seen at the incision.

dislodged by means of the catheter. It is well to leave the wound open
unless it is a very large animal or the stone should be exceptionally large; in
that instance do not put more than one stitch in it. For two days the
lu'ine escapes out of the external opening, but soon closes up, and in about
eight to ten days it has closed up completely and the urine is passed in the
natural way.

The wound of the operation is apt to leave a stricture in the course of
the urethra, and in an animal that is predisposed to the formation of calculi
examine the urethra occasionally with the catheter and if a stricture is
present dilate it with a bougie.

In cases where the stone is situated up in the urethra at the ischial
arch it is nuich more difficult to oj^erate on account of the well-developed

STONE IN THE BLADDER 201

bulbus cavernosum. The incision must be made down on the catheter,
which has been previously inserted as far up as possible. The higher op-
eration must never be attempted unless this latter precaution is taken, as
it is almost impossible to find the urethra unless the sound is in it.

Another mode of operation is to introduce a catheter into the penis
until it reaches the obstruction, and by means of a tape looped around
the free end of the penis it is drawn away from the prepuce, which is
held back ])y an assistant, and then cut down on the end of the catheter;
the catheter is pulled back a short distance, but not entirely, and the
penis bent over, and by means of a small pair of blunt forceps the stone
can be removed; when this is accomplished pass the catheter into the
bladder and wash out any calculi that may still remain in the bladder
or urethra; by means of a small hose attach the catheter to a syringe and
inject the bladder full of tepid water.

In the bitch the operation is much more simple. The urethra is
opened by means of a thin tenotome introduced on a grooved director
and the opening enlarged, and then the forceps passed into the opening,
the stone crushed, and the bladder washed out. It is generally necessary
to introduce one finger into the rectum to guide the stone into the forceps
before it can be grasped. Great care must be taken in such an operation
to avoid crushing the tissues. In the bitch there is no after-treatment
necessary.

Cystotomy. — Laprocystotomy, or cutting through the abdominal
wall is the only mode permissible on the dog, lithotripsy being pro-
hibited on account of the size and anatomy of the urethra of the dog.

Laprocystotomy, cystotomy suprapubica: Preparatory to the op-
eration the urine is removed from the bladder and the bladder washed
out with a 2 per cent, solution of boracic acid, the tissues in the neighbor-
hood of the incision thoroughly cleansed and disinfected, the animal is
put under ether and an incision is made in front of the pul^is parallel
with the prepuce and directly on the median line (in the bitch cut
directly on the linea alba); make an incision about 5 to 8 cm. long,
take up the hemorrhage by means of absorl)ent cotton, then draw
out the bladder, surround it with cotton compresses and an incision
about 1 to 3 cm, is made in the bladder and by means of a pair of
forceps the stone removed, if the stone is incysted it should be scraped
out; the bladder is then washed out with boracic acid solution, the
wound stitched with carbolized catgut, the muscular and serous coats
are sewed with the edges turned inward, the stitches must be put very
close together as distention with urine causes the very elastic bladder to
open and allow the escape of urine into the peritoneal cavity; return the
bladder after having first cleansed it with boracic acid solution, and
the abdominal wall closed and the wound covered bv a bandage. As

202 DISEASES OF THE URINARY AND SENUAL APPARATUS

l:)lood clots are apt to form in the course of the urethra, French advises
that the animal be catheterized at least twice daily until normal urina-
ation is established.

When the bladder is so distended that it is deemed dangerous to
operate before emptying the bladder of its contents, we may empty the
bladder by means of a fine trocar and canula. In the bitch the trocar
should be introduced on the median line, at the brim of the pelvis, and
in the dog, either on the right or left side of the flank, low down and as
near as possible to the brim of the pelvis.

Sometimes ruptures of the bladder are caused bj^ accidents, such as
being run over by wagons when the l;)ladder is full. The animal dies,
as a rule, in forty-eight hours, from collapse, before peritonitis has devel-
oped. On post-mortem, the !)ladder is found to be infiltrated with
blood and very much swollen at the lacerated i-egion only. In injuries
to the lumbar region, where the animal is dull or even comatose, it is
always well to consider the prognosis doubtful, and Siedamgrotzky
deems it advisable to consider the prognosis doubtful in injuries to that
region, even w^here there are no acute symptoms presented.

Stricture of the Urethra. — Indications of painful retention of urine
are often presented when there is a stricture of the urethra caused liy
injuries to the urethra from calculi or by cicatricial contraction following
the operator's knife, from intense nephritis, or by torsion following co-
itus. An examination by means of the catheter generally gives some
information as to the character of the stricture; the practitioner must,
however, rememl^er that there is always more or less normal stricture
at the posterior end of the bone of the penis. The sound must be passed
each day and allowed to remain about twenty minutes if the stricture
will admit of it. The size of the catheters must be gradually increased;
great care being taken to thoroughly disinfect the catheters after each
insertion. This method has been used with success in a number of cases
of stricture, but it must he continued for several weeks.

Hoffman cured a case of stricture of the posterior end of the bone
of the penis l)y opening the urethra at the spot of stricture and ampu-
tating al)Out 2 cm. of the bone of the penis with a pair of bone forceps.

Other diseases of the bladder.

The following are comparatively rare and unimportant diseases of
the l)ladder.

Cramp of the Bladder, Cystospasmus. — This is seen following severe
cystitis, calculi, diseases of the prostate, etc. This condition is also ob-
served as a symptom from the effects of certain poisons, decayed food,
from disease of the spine and from unknown causes. It is indicated by

OTHER DISESES OF THE BLADDER 203

persistant cramp of the sphincter antl retention of the urine (retentio
iirinse). The treatment consists in friction in the region of the bladder,
luke-warm clysters to Avhich chloral hydrate may be added, subcutane-
ous injection of morphia and the administration of boldine.

Neoformations of the Bladder. — The tumors of the bladder worth
special mention are papilloma villosum and the carcinoma papillomato-
des. The early symptoms are profuse hemorrhage which occurs from
time to time, producing acute anaemia and often causing death. These
tumors are generally associated with chronic cystitis. In the region of
the bladder we are sometimes able to detect these neoformations in the
form of a soft tumor-like mass and in rare instances we may find some
portions of the broken-down tissue in the urine. In some instances in-
stead of a solitary tumor we may find a diffuse mass spreading over the
wall of the bladder which on palpation feels like a hard irregular body.
Other pathological growths may be sarcoma, carcinoma or myoma. It
may be possible under very favorable circumstances, to remove these
tumors by means of cystotomy, but it is very rarely done, for generally
when we make the diagnosis the tumors have reached considerable size
and involve the entire bladder.

Retroflection of the Bladder. — This condition may be found as a
result of constipation or disease of the prostate, and from constant strain-
ing and tension, a distended bladder may be retroverted and lie be-
tween the rectum and the prostate and may cause the development
of a perineal hernia. If pressure is made on the soft fluctuating hernial
tumor, the animals are apt to place themselves in a position to urinate.
The treatment consists in attempting to remove the original cause by
means of laxatives, warm baths, rectal enemas (see Diseases of the
Prostate) . If these methods do not succeed and the distention of the blad-
der becomes very pronounced, first try to empty the bladder by means of
the catheter and if that cannot be accomplished, on account of the twist
in the urethra, then empty the bladder by means of a trocar; the punc-
ture is to be made in the upper part of the tumor. Generally when the
bladder is emptied it falls back into position, but the condition may re-
turn if the exciting causes return. To obtain a permanent fixture of
the bladder, we must perform cystopexia (after Hendrix). This con-
sists in making an incision into the abdominal wall on one side of the
penis as near the median line as possible; insert the finger into the cavity
and return the bladder to its normal position and suture it to the ab-
dominal wall, so that the centre of the posterior wall of the bladder will
.lie on the anterior margin of the pubis.

Inflammation of the Urethra — Urethritis. — This is very rarely ob-
served, being invariably caused by some traumatism, calculus or other
foreign bodies, improper catheterization, injuiies during coitus (see

204 DISEASES OF THE URIXARY AXD SEXUAL APPARATUS

gonorrhoea of the prepuce). The symptoms consist in the constant
flow of a muco-puriilent fluid from the urethra, redness and tumefaction
of the external orifice, the animal places himself in a position to urinate
and if he does succeed in urinating he shows great pain. On making
any pressure on the urethra, a few drops of a muco-purulent discharge
comes from the external opening. The treatment consists in the in-
jections of astringents, claret wine, sulj^hate of zinc, and 1 to 2 per
cent, solutions of nitrate of silver.

DISEASES OF THE MALE SEXUAL ORGANS.

DISEASES OF THE PROSTATE.
INFLAMMATION OF THE PROSTATE.

{Prostatitis.)

A number of causes lead to inflammatory processes in the prostate
which produce hypertrophy or neoformations of that organ; the enlarge-
ment may be temporary or permanent, but as a rule it invariably pro-
duces more or less interference with the evacuation of the faeces, and ob-
struction of the free passage of urine.

Inflammation of the Prostate. — This may result as a complication
of cystitis, urethritis, urinary calculi, from careless or ignorant catheter-
ization and from the pressure of hard masses of faeces lying in the rectum
in persistent constipation, proctitis, etc. Prostitis is also observed in
stud dogs that have served a large number of bitches within a compara-
tively short space of time or have been in the stud for a number of years,
and it also results from pyaemia.

Symptoms and Course. — The disease may occur in the acute or
chronic form; the latter is discussed under hypertrophy of the prostate.

The acute form is rare and causes the animal to walk with back
arched and a stiff, stilted gait, and show evidence of great pain when
either urine or faeces are passed. In cases where there is great enlarge-
ment of the prostate the animal may hold the faeces and cause constipa-
tion by not putting any pressure on the abdominal muscles or may also
retain the urine. On making an examination of the gland, by introduc-
ing the finger, well luliricated, into the rectum, we find it very much en-
larged, hot and painful to the touch, and the animal shows great de-
pression, loss of appetite and fever. The animal exhibits great pain
during catheterization when the instrument passes the prostate.

The terminations of this acute condition are as follows:

The prostate may break down and suppurate, forming a fluctuating

INFLAMMATION OF THE PROSTATE 205

tumor in the pelvic cavity; accompanied by great difficulty in urination,
or it may assume the chronic form and develop cysts; this latter condi-
tion, however, is rarely diagnosed during life. Sometimes these cysts
are seen on post-mortem, ami the animal previous to that was with-
out any fever or acute symptoms, or the inflamed prostate may ulti-
mately form abscesses which break through into the urethra, or the
rectum, and in very rare cases into the connective tissue of the pelvis.
In the latter termination we find a gradual tumefaction and formation
of an abscess in the perineal region, which suppurates and breaks,
or there may be the formation of small abscesses which become encapsu-
lated in the prostate.

Therapeutics. — This consists in giving the animal small quantities
of non-irritating food, cold clysters and cold or luke-warm applications
to the perineum; also the frequent passage of the catheter to prevent
overretention of urine in the bladder; and also the administration of
saline purgatives, such as sulphate of magnesium, Carlsbad salt, etc.
When pus has formed, which can be determined by digital examina-
tion per rectum, introduce a speculum into the rectum and cut down on
the fluctuation by means of a sharp-pointed bistoury. The hemorrhage
which follows is very slight, and no attention should be paid to it. Hen-
drix introduces the finger into the rectum and puts considerable pressure
on the fluctuating prostate and breaks the abscess into the urethra.
Where the swelling extends to the perineum and distends it, it is best to
apply warm applications until the pus has formed, and then cut down
and evacuate the sac.

Chronic Prostitis (Hypertrophy) of the Prostate. — This is the form
of the disease most frequently seen, and develops from the acute form,
but in the majority of cases the disease starts in at the onset, as the chronic
form. It is a common disease in old dogs, and is indicated by a hyper-
trophy of the whole organ; as a rule, the swelling is symmetrical, but
sometimes one side of the gland is larger than the other. It varies in
consistency; in some cases very hard, in others, soft; in the former case
it is due to a hyperplasia of the fibro-muscular tissue; in the latter it
is due to an infiltration of the gland with a purulent fluid as a consequence
of chronic purulent inflammation.

The symptoms of a hypertrophy of the prostate are irregular; in
some cases there is difficulty in urination (dysuria, strangury), and also
more or less cystitis and pyelitis, etc., or constipation due to the animal
making no effort to evacuate faeces. The surest means of diagnosis is to
make a digital examination of the prostate per rectum. It is dis-
tinguished from the acute form by the absence of heat and sensitiveness,
but is very much larger than the normal gland. Rossi contends that
hypertrophy of the prostate does not affect the urinary canal to any great

206 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

extent; the tissues of the prostate only are affected and situated as it is
on the floor of the pelvis, it has plenty of room to expand. Lienaux
observed one case where there were intermittent hemorrhages, and finally
interference in urination and evacuation.

Therapeutics are not productive of much good results. For the
constipation give saline laxatives; if the urine is retained, catheterize
the bladder and administer internally ergot or iodide of potassium. The
remedy that has given the best results has been the hypodermic injection
into the gland of a solution of iodine (iodide of potassium, 2 parts; tincture
of iodine, 2 parts; and water, 60 parts) at intervals of fourteen days. The
solution is injected through the rectum directly into the gland by means
of a small hypodermic syringe.

Castration has been repeatedly tried; in a number of cases it has pro-
duced very good results and the animal was greatly relieved from active
symptoms, the prostate being reduced to its normal size, but in certain
cases the animal steadily failed, lost flesh, and in three or four weeks
became a skeleton and died apparently from inanition.

Tumor of the Prostate. — Tumor of the prostate is generally carci-
nomatous in character, causing an irregular enlargement of the gland,
differing from the symmetrical enlargement seen in hypertrophy of the
gland; this aids materially in reaching a diagnosis. It is rather diflficult
at times to make a diagnosis where only the general indications of hyper-
trophy of the prostate are seen, that is difficulty in defecation and uri-
nation, and conclusions can only be based on the general health of the
animal, which shows a gradual want of nutrition. Lienaux recommends
extirpation of the prostate (prostotomy) even in simple hypertrophy.
Other anomalies, such as prostatic calculi, tuberculosis of the prostate,
have no particular interest and need not be taken up here.

DISEASES OF THE PENIS AND PREPUCE.

Phimosis and Paraphimosis. — By phimosis we mean a contraction
of the prepuce over the free end of the penis. It is often of congenital
origin, and is occasionally caused by injuries and consequent cicatricial
contraction; l;)ut as in the dog, the foreskin is rarely withdrawn, it is of little
importance; if , however, the contraction is so complete as to cause retention
of a certain amount of urine; the retained urine decomposes, and
acts as an irritant, causing inflammation and tumefaction of the pre-
puce. Phimosis prevents copulation, and as soon as the penis is erected,
causes paraphimosis. Treatment consists in making a longitudinal
incision on the median line of the prepuce and removing a certain amount
of the tissue and sewing back the mucous membrane. Paraphimosis is the

DISEASES OF THE PEXIS AND PREPUCE 207

condition where the penis passes through the narrow opening of the
prepuce the gLans becomes swollen, and the prepuce becomes tightened
behind the glans penis, the narrow ring of the prepuce causes venous
engorgement, becomes oedematous, causing a great swelling and purple
coloration of the glans, and if this is allowed to remain some time, causes
partial gangrene. The above phenomenon is seen during coitus or from
erection in attempting copulation, from traumatic causes, from neoforma-
tion, or paralysis of the penis.

The therapeutics of paraphimosis consists in reducing the glans as
soon as possible with friction and careful manipulation; this is accom-
plished by careful lubrication of the parts with some bland oil and putting
a steady pressure on the glans, at the same time pressing forward the pre-
puce over the enlarged part; with a little patience it is reduced. If this
is not successful, bathe the glans with cold water or alum applications,
lead water, sulphate of zinc, or wrap the protruding portion of the penis
in a cold bandage, beginning at the outer end and quickly wrapping it
around the distended penis, thus forcing the blood out of the engorged
glans, then as the bandage is removed the penis is returned, drawing the
prepuce over it. If we do not reduce it by this means, then cut the ring
with a curved probe-pointed bistoury or a pair of scissors. It can then
be returned immediately; scarification of the penis is rarely necessary.
In extensive necrosis of the glans, paralysis, tumors, etc., it may be neces-
sary to remove the penis; this is removed by a circular sweep of the knife.
If the penal bone is to be cut through it may be done by means of a
pair of bone forceps or sawed through. To overcome stenosis of the
urethra from cicatricial contraction of the wound the urethra is opened
about 0.5 cm. and sewed back of the wall of the penis. It is well, how-
ever, not to resort to this until you have tried every other method.

Gonorrhoea of the Prepuce. Preputial Catarrh. — By this term we
mean catarrhal or purulent inflammation of the mucous membrane of
the prepuce; it is rather common in dogs that are well fed; it is harmless
but unsightly from the discharge of yellow mucus constantly dripping
from the end of the prepuce, and some cases are extremely obstinate to
treat. It may be caused by retention of urine, phimosis, calculi of the
bladder, prolonged coitus, dirt, uncleanliness, or masturbation. It is
frequently observed in old dogs, due in their case to stagnation of the
veins of the prostate. The symptoms consist in slight redness, and
swelling of the prepuce and glans, and the secretion of a thin, purulent
mucus, which is generally licked off by the animal. On pushing back
the prepuce, the lymph-follicles are generally found to be swollen,
and can be felt on manipulation with the finger as small bodies about
size of a seed or pea. In rare cases the inner wall of the prepuce and the
bulbous portion of the glans are covered with papillary excrescences.

208 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

Rarely or over in this condition is there any pain on pressure of the
affected parts. The treatment consists in the injection of acetate of lead
water or 1 per cent, solution of zinci sulphas or argenti nitras, 1 per cent.,
or claret wine. Before making the medicinal injection it is well to
thoroughly clean out the prepuce, with repeated sluicings of luke-warm
water.

The disease has no correlation with the specific gonnrrhan of man, l)ut
in rare cases we may find an animal affected with gonorrhcsa which has
extended from the foreskin into the urethra and an enlargement of the
inguinal lymphatics, forming a bubo. In one of the cases observed by
Siedamgrotzky, the gonorrhoea was accompanied by intense inflammation
of the eyes.

Neoformations of the Glans and Prepuce. — Xeoformations are some-
times found on the dog and are either papilloma, carcinoma, or sarcoma.
These appear in a variety of forms — warty or corrugated, sometimes
pedunculated but generally with broad bases, hard or soft and bleeding
easily to the touch, situated on the penis or prepuce, visible only when
the prepuce is retracted except in rare cases when they are situated on the
external opening of the prepuce and protrude beyond the opening. There
may be a more or less abundant discharge of purulent mucus, stained
occasionally with blood. (For infectious genital tumors, see under that
head.) The papilloma can be removed by the scissors or a small pair of
forceps, and the blood stopped by compression or a solution of alum, or,
what is much better, the thermo-cautery. Albrecht recommends that
the tumor he touched daily with a solution of chromic acid 1 to 30. Car-
cinoma and sarcoma generally require the removal of a portion of the
glans. (See chapter on Neoformations.)

DISEASES OF THE TESTICLE AND ITS COVERINGS.

Inflammation of the Scrotum. — We frequently see inflammatory
conditions of the scrotal covering as a result of contusions; they may,
however, be caused by eczema, which sometimes causes great swelling
and sensitiveness, the animal walking with a peculiar stradling gait; this
condition may involve the entire scrotal sac, and on account of the irrita-
tion of the tissues from the animal constantly licking and biting affected
part, it is very slow in healing, and frequently covers over a long period of
time before making a complete recovery. Occasionally partial necrosis
occurs, followed by sloughing of a portion of the scrotum. (See Diseases
of the Skin, under Eczema.) Moller has also seen serpentine varicosis of
the scrotum with ulceration and accompanied with profuse hemorrhage.
Treatment: Keep the animal in a dry kennel or let it He on a cushion and

INJURIES TO THE TESTICLES AND SCROTUM 209

prevent the rulilnng on an}- rough ol)ject and apply oxide of zinc, talcum
powder, bismuth preparations, or boracic acid, and the animal must be
restrained from licking or irritating the affected portions, either by means
of a muzzle or the scrotum covered by a Priessnitz bandage. If necrosis
develops as a result of the condition just described or from traumatisms or
freezing, etc., and the sloughed portion is very extensive it may be neces-
sary to castrate the animal as well as remove the necrosed portion.

Inflammation of the Testicle — Orchitis. — Orchitis without any other
injury is very rarely seen in the dog; it may be caused by a kick, or a blow,
or from crushing or by metastasis from acute inflammatory conditions of
the adjacent urinary organs. The testicle is hot, swollen and smooth on
its surface and very sensitive to the touch; the animal walks with its hind
legs wide apart, and sometimes there is fever and loss of appetite. In the
majority of cases, the irritation subsides quickly, and the animal is well in
a few days; in rare instances, the irritation is followed by suppuration and
the formation of more or less pus, the abscess points, breaks through the
scrotum and discharges. In acute cases, on the subsidence of the acute
symptoms it is followed by induration of the testicle and that body becomes
firm and irregular on its surface. In one case that the writer observed the
epididymis was also greatly swollen (epididymitis). The therapeutics
consists of warm applications and rest, paint with tincture of iodine and
apply a well-padded suspensory bandage over the scrotum. When the
effects of the iodine have passed off apply salicylic acid ointment. If sup-
puration has commenced, it should be encouraged as much as possible with
warm applications and poultices and opened as soon as the abscess has
pointed, cleaned out with corrosive sublimate solution, and treated as an
open wound. There is no treatment that will have any permanent
effect in chronic orchitis.

Injuries to the Testicles and Scrotum.

As a rule, the wounds of these parts are caused by fighting with other
dogs, and are either lacerations or perforated wounds. In the majority
of cases, try to get drainage and keep the w^ound clean by means of anti-
septics; this is best accomplished by putting a piece of absorbent cotton
saturated with the solution on the scrotum, and by means of a long-tailed
bandage tied around the body the cotton can be kept in place. Where
the testicle is badly injured, the gland had better be removed by castra-
tion, as it is only in favorable cases that the animal makes a good recovery
and the seminal power is retained.

(For further details on the subject consult the chapter on Hernia of
the Testicles and Castration.)

Neoformations of the Testicles. — Omitting tuberculous deposits, we

210 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

find fibroma, sarcoma and carcinoma; the former can easily be felt on the
surface of the testicle as distinct circumscribed elevations; the latter two
on the other hand are indicated by a hypertrophy of the testicles and the
spermatic cord may be involved, and in rare cases both testicles are affected.
The testicle may be greatly enlarged, the surface smooth or it may
be uneven and irregular. Rarely do these neoformations involve the
scrotum; when they do, they form adhesions and if they make an external
opening in the scrotum Kitt has observed that it is extremely difficult to
distinguish by microscopical examination the true pathological character
of these hypertrophied testicles and place them in their proper class
(Orchidarm, Orchidoblastom). Fig. 84 represents one of these tumors.

Fig. 84. — Enlargement of scrotum. — Orchitis.

Castration is the only radical method to remove these malignant tumors
and it should be done early before the entire region becomes involved.

Castration of the Male. — The animal is prepared by washing the
region of operation with an antiseptic solution, put the animal under
ether or inject the region with 4 per cent, cocaine, turn him on his l:)ack, an
incision is made in a longitudinal direction through the skin of the scrotum
and vaginal tunic, and the posterior portions of the cord are cut through
and the anterior or vascular portion is ligated with silk and cut through
just below the ligature and the other testicle treated in the same manner
(Fig. 92); in young animals the cord is simply scraped through or
twisted off by means of tortion, and the opening in the scrotum closed by

INFLAMMATION OF THE VAGINA 211

means of a stitch, and covered with a (Hsinfectant dusting powder, and a
truss bandage apphed. The wound is dressed ch^ily, it heals up rapidly.
It is well not to allow the bandage to remain on too long, as it is apt to
irritate the animal. Another znode of procedure is to make an incision on
the median line of the scrotum, but before doing so tie a string around
the scrotum just above the testicles, so that when the incision is made the
testicle will not be tlrawn beyond reach; having made the incision on the
median line, cut through the tunica, draw out both testicles, twist them
round several times, making a spiral of the cords, then cut the cords as
high up as possible with the ecraseur or a pair of emasculating scissors.
The hemorrhage is slight and much better than the complication of the
ligature hanging in the wound.

Cuterebro Emasculator.

(Emasculating Bot Fly.)

This parasite which is frequently observed in squirrels and occasion-
allv in rabbits has been observed in two cases in the dog where the grulj of
the parasite was found imbedded in the scrotum. These were in English
setters and the dogs had been in the Southern states for some time.

The scrotum swells slowly, beginning at the dependent portion, until
a round, firm mass, resembling in size and shape of the ordinary " warble''
seen in cattle's backs, but not quite so large; it apparently gives the ani-
mal no discomfort unless the parasite should act as an irritant and form
an abscess; when this occurs it is followed by great irritation of the parts,
and subseciuently sloughing of a portion of the scrotum and destruction of
the testicle. The treatment consists in finding the opening or vent of the
parasite in the skin and carefully enlarging it, taking care not to penetrate
the larva, when it can be pushed out and the wound cleaned with a solu-
tion of peroxide of hydrogen. If the grub is punctured and it collapses,
the remaining portion of the parasite must be carefully removed, as it
causes great irritation if allowed to remain. Dress daily with a 1 to 3000
solution of corrosive sublimate.

DISEASES OF THE FEMALE SEXUAL ORGANS.

DISEASES OF THE VAGINA AND THE UTERUS.
INFLAMMATION OF THE VULVA AND VAGINA.

{Vulvitis and Vayinitis.)

Inflammation of the vulva and vagina results, as a rule, from difficult
labor or unskilled assistance during delivery, and in rare cases as a result
of improper copulation, or when young bitches or very delicate animals

212 DISEASES OF THE URINARY AND SEXUAL APPARATUS

are having their first littoi-s. In the acute form the Labia pudendi are
tumefied and painful to the touch. The condition is indicated by a
whitish, purulent discharge, in some cases being foetid, which is generally
licked off by the animal. The examination in the larger animals can be
made by means of a speculum (Fig. 85) . On examination of the vagina
we find it intensely red and inflamed and covered with a gray-
ish, mucous discharge; the mucus is also grayish in color, and
has in some cases striated lines or petechial patches. In
chronic cases there is a constant discharge from the vulva of
a whitish-yellow muco-purulent fluid which agglutinates the
hair in that region, and the animal is constantly licking the
discharge; the mucus is sometimes grayish in color, and car-
cinoma is often present. (8ce chapter on Tumors for further
details.)

The therapeutic treatment consists of daily injections and
irrigations of astringent or disinfectant washes of sulphate of
zinc (1 per cent.), or permanganate of potassium solution,
boric acid, or creolin, lysol, bacillol, etc., or a solution of acacia (mucil-
age) is useful. In chronic cases use nitrate of silver, 1 per cent, solu-
tion, or sulphate of zinc, 2 to 100 solution.

Prolapse of the Vagina and Uterus.

{Prolapsus Vagince; Prolapsus Uteri.)

Prolapse of the vagina is more common than prolapse of the uterus;
it is seen especially in young bitches, frequently at the termination of heat
and occasionally at the latter period of pregnancy; it rarely occurs as a
result of parturition. In some instances it is accompanied by serious
alterations of the vagina, especially hypertrophic alterations, and also in
rare cases we find polypus formations. As a rule there is more or less
protrusion of the vagina through the vulva, appearing in the form of pear-
or flap-shaped, red, inflamed tissue covered with mucus (Fig. 86). In
very rare instances the prolapse is so great that the os of the vagina can
be seen through the external opening. When the vagina has been parti-
ally prolapsed for some time, the exposed portion becomes so infiltrated
and hypertrophied that it becomes impossible to reduce it. Care must
be taken to differentiate between a pedunculated fil^roma and the pro-
lapsed vagina, and instances are not rare where the vagina is prolapsed
and a tumor whose existence is never suspected also accompanies it.

The prolapse of the uterus in the dog is practically impossible, for the
reason that the uterus itself is merely a body in name, and really the uterus

PROLAPSUS OF THE VAGINA AND UTERUS

213

consists in the horns, the true body of the uterus being a small body from
which the horns bifurcate almost at the os (Fig. 87).

The therapeutics of prolapse of the vagina is practically that used in
prolapse of the anus and rectum. In slight cases after copulation, the
animal should be kept quiet, and it will then soon disappear; the applica-
tion of vaseline or boracic acid ointment, however, may be used. The
retention of the vagina is much more difficult than returning it to its nor-
mal position; the protruded portion is carefully washed with warm water
and an antiseptic solution of boracic acid or creolin solution and the

Fig. 86. — Prolapse of the vagina.

animal placed so that the hind quarters are elevated for at least an hour.
If there is great tumefaction, the protruded portion must be massaged
for some time to lessen the volume of the enlargement before attempting
to reduce it. If that is not sufficient, and the protrusion recurs in a short
time, it is well to introduce a tampon into the vagina or pack the vagina
with antiseptic gauze or cotton and stitch the lips of the pudenda in such a
manner as not to interfere with the normal passage of urine, and assist
defecation and prevent straining by the administration of laxatives or
using glycerine suppositories. The writer generally uses the following
method: After returning the vagina to the normal position, he puts two
stitches in the pudenda and leaves them there for three days, when
they are removed.

In one case where there was great thickening of the walls of the vagina

214 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

and reduction of the prolapse was impossible, and another where the
vagina prolapsed immediately after the stitches were removed after being
there for several days, the writer performed a partial amputation, taking
out an elongated piece of mucous membrane and sewing it up by a continu-
ous stitch of cat-gut, which was followed by good results.

Fig. 87. — The genito-urinarj' organs of the bitch: a, ovary covered M^ith capsule; b, capsule of ovarj^;
c, ovary; d, horns of the uterus; e, body of the uterus; /, os uteri; g, vagina; g, opening of the urethra;
h, clitoris; i, i, vulva; /, bladder; ??;, urethra.

Reduction of the uterus is much more difficult, and in the majority of
cases it is impossible except by laparotomy. The prolapsed portion
should be lubricated and gradually worked back, and after the fingers can-
not reach any further, a tallow-candle must be inserted and the horn pushed
back as far as possible. If this method is not successful, laparotomy
should be performed in the manner spoken of in hernia. An incision is

DISEASES OF THE UTERUS 215

made into the abdominal wall and the finger inserted until the Fallopian
tube is felt, and then the animal is held up by the posterior extremities,
and by gradual tension the horn of the uterus is pulled back into position
and the opening in the abdomen is closed. The rules named for retaining
the vagina are then to be followed. The viterus can be retained in
position In' making an opening in the median line of the abdomen and
pulling the horn into position and then stitching the horn to the upper
part of the abdominal wall. It is needless to say that the stitch must be
of cat-gut.

Neoformations of the Vagina. — The tumors found in the uterus are
fibroma, papilloma, and carcinoma. The fibrous are frequently observed;
they may appear either singly or multiple, varying from the size of a pea
to as large as an egg; they are hard, smooth on the surface and usually
pedunculated, occasionall}' protruding from the vaginal opening, and are
not at all sensitive.

The papilloma are rarer, found generally at the interior of the vagina
and in the form of warty, irregular elevations resembling a raspberry, or,
if larger, a cauliflower; the tumors closely resemble true carcinoma, so rare
in the dog. Of true cancer the writer has observed only one case in a St.
Bernard; this neoplasm occupied the inferior lateral floor of the vestibule
of the vulva; it was soft and spongy, irregular in form, bleeding easily to
the touch, foetid in odor, the cancer had a broad base, was hard and indu-
rated, and extended some distance into the tissues. True cancer is very
rare and is indicated by a foetid ichorous discharge from the vagina. The
vagina can either be examined by the introduction of the index finger, or
using a speculum. Frohner advises digital examination. The cancers
occur in single or multiple groups, soft excrescences attached to the mu-
cous membrane of the vagina which are not painful to the touch but bleed
easily on manipulation. These cancers vary in form; some are rough
with irregular elevations like a cauliflower; they may be polypus in shape,
or they may occur as a diffuse mass of irregular infiltrations spread over
the mucous membrane of the vagina. Where it can be clone these
tumors should be removed as early as possible.

DISEASES OF THE UTERUS.

Inflammation of the Uterus (Metritis). — It is a common occurrence
to have inflammation of the uterus after protracted labor. The disease
can be subdivided into the following varieties, catarrhal and septic,
according to the exciting causes:

(1) Catarrhal Metritis. Superficial Metritis, Catarrh of the Uterus. — In
this condition the disease is limited to the mucous membrane and presents
the same symptoms as are seen in all catarrhal inflammations of mucous

216 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

membranes; the course may be acute or become chronic; the causes are
miechanical injuries which the uterus may be subjected to during labor
or immediately after; cold may be said to be a predisposing cause.

The clinical symptoms are as follows: The vulva is slightly red-
dened and swollen, and there is a copious discharge from the vulva; this is
purulent, sometimes bloody or slightly putrid, and is much increased in
quantity after the passage of feces or urine; but the animal licks it off so
soon that the observer must look immediately after each evacuation or it
may escape his notice. Some bitches carry their tails in a
curved position when suffering from this condition, are
uneasy and occasionally strain; some animals have com-
plete loss of appetite, and in some cases slight fever is
present. As a rule, the discharge lessens and disappears in
a few weeks or it may become chronic, and there is an abun-
dant discharge of white or whitish-yellow purulent creamy
fluid (leukorrlnea, fluor albus) ; the animal becomes emaci-
ated, loses flesh and has a stairy, rough coat. In some
cases there is a gradual swelling and obstruction of the os
uteri, the purulent material is held in the uterus (pyo-
metra), pyemia develops, and death occurs in a short time.
External manipulation through the abdominal wall may
find the uterus greatly increased in volume, and on digital
examination per rectum the vagina is found to be drawn
into the abdominal cavity.

The therapeutics consist in tepid injections of non-
Double catheter poisonous autiscptic fluids, such as permanganate of po-
^"th'e^'u'tiL"''^ tassium (1 per cent, solution), boric-acid (2 per cent.), and
creolin (1 per cent.), tannic acid (2 percent.), solution of
corrosive sublimate (1 to 2000.) In using these solutions it is best to use
the irrigator with the two catheters (Fig. 88) ; in one opening the fluid is
forced through into the uterus and allowed to circulate and flow out of
the other opening. The uterus must first be thoroughly rinsed out with
luke-warm water before the medicinal irrigations are applied. If the os
uteri is contracted, it can be dilated by means of a bougie. In the
chronic form (dysmenorrhcea) we should use injections of ergot or sabine
oil. In chronic cases, with persistent foetid discharge, the uterus should
be removed.

(2) Septic Metritis. Gangrenous, Ichorous Inflammation of the Uterus
{Puerperal Fever). — Septic inflammation of the uterus should be con-
sidered a disease of wound infection in which we find intense irritation of
the uterus and vagina, accompanied by violent constitutional disturbances.
During and after labor septic materials find their way into the uterus
and, owing to the condition of the uterus at that time, when it is practi-

Fig. SS.

DISEASES OF THE UTERUS 217

call}^ in the same condition as an open wound, the septic materials are
taken up very quickly and every condition is favorable for their propaga-
tion. Collections of blood, decidual tissue, etc., exposed to the air decay
very ciuickly, and where there is any erosion of the mucous membrane of
the vagina or the cervix, or even the uterus at the points of placental at-
tachment, the poison is taken up and enters the tissues and is carried into
the circulation. The eroded portion of the uterus that has taken up any
of the septic material soon presents an ulcerated surface which is covered
by a necrotic or diphtheritic coating, and in some cases the vagina be-
comes intensely swollen, is dark brown or reddish-brown in color, and
covered with spots of diphtheritic ulcerations.

The inflammatory process extends rapidly from the mucous mem-
])rane into the deeper tissues, affecting the muscular and the pelvic cellu-
lar tissues, and also the lips of the pudenda, and from the internal surface
of the uterus it extends to the uterine muscles and the broad ligament,
and in acute cases to the serous covering of the uterus and the peritoneum.
When the acute symptoms are present (perimetritis and parametritis)
ptomaines and septic material enter the circulation and cause acute septic
fever. The prognosis is generally unfavorable.

Clinical Symptoms. — The vulva and the mucous membrane of the
vagina are swollen and livid red, and discharge copious masses of dis-
colored, fcEtid pus. In the earlier stages the animal shows great pain on
pressure to the abdomen; the pulse is very fast, thready and finally be-
comes imperceptible. The respirations increase in number. The tempera-
ture in the early stages is increased, but soon falls, becoming subnormal
toward the end. The mucous membranes of the mouth and conjunctiva
are livid, an offensive diarrhoea commences, and the expired air from the
lungs smells of decayed tissue.

When the animal presents the acute symptoms early and does not eat
or drink from the onset, it soon becomes comatose and dies in from twelve
to twenty-four hours.

Therapeutics. — In such cases to get any favorable results treatment
must be prompt and energetic. The uterus and the vagina must be
thoroughly irrigated with antiseptic fluids, and also the general treatment
indicated in septicaemia. For antiseptic irrigating fluids we use creolin,
2 per cent, solution; lysol, 1 to 100; actol (1 to 1000) ; formalin (2 to 50);
corrosive sublimate, 1 to 2000 solution. First irrigate the uterus with warm
water using the double catheter shown in Fig. 88, and clean it thoroughly
until there is no discoloration in the escaping fluids; then inject the medi-
cated solution into the uterus several times; repeat this several times daily.
As a stimulant, use whiskey, brandy, camphor, either internally, or sub-
cutaneously; the latter is best, as you are apt to get quicker results, and
you also avoid the danger of the animal vomiting it, which it is very apt to

218 DISEASES OF THE URINARY AND SEXUAL APPARATUS

do. Ergot or caffein are used with some success where there is great
weakness of the heart.

I^. Camphor pulv., 0.2

Gummi acacia, 0.6

F. chart. No. xii.,
S. — One powder every two hours.

Prolapse of the Uterus. Prolapsus Uteri. — This condition is ex-
tremely rare and occurs only during or immediately after delivery. From
very severe traction during labor or awkward assistance, particularly of
the last foetus, the horn of the uterus everts, passes beyond the os uteri
and vagina (invertio uteri without prolapse, incomplete prolapse of the
uterus) or passes entirely beyond the vulva and generally carries also a
portion of the uterus with it. It protrudes out of the vulva in the form of
a tumor-like mass, the mucous membrane being tumefied and livid
in color. The membrane may be excoriated in places and in ex-
treme cases gangrenous.

Treatment. — This is practically the same as prolapse of the vulva or
rectum. The protruded portion is carefully bathed with mild antiseptic
solutions such as boracic acid and endeavor to return it to its normal
position by even pressure of the fingers; if this succeeds, place the
animal so that the hind quarters will be slightly elevated, inject a solution
of boracic acid into the uterus, and followed by a hypodermic injection of
morphia which tends to overcome straining on the part of the animal. If
the prolapse recurs it may be reduced and a sponge or oakum tampon
inserted into the vagina and the orifice closed with sutures (see page. 213).
If the uterus persists in resisting the above mentioned treatment, the
animal should be etherized, the abdomen opened on the median line, and
the uterus or Fallopian tube drawn down to the opening and tied to the
abdominal opening by means of sutures, taking care not to include the
mucous coat of the intestines in the stitch. If gangrene has set in, the
exposed uterus must be amputated. The exposed portion of the uterus
is drawn out, ligatured with strong silk thread, and the dependent portion
cut off just below the suture; care must be taken not to include the
bladder or the urethra, and the stump pushed back into the pelvic cavity;
some operators advise an elastic ligature. Cutting off the prolapsed, por-
tion by means of an ecrasour is not to be advised.

Neoformations of the Uterus. — Fibromas are found most frequently in
the uterus and sometimes reach to a considerable size. Cyst sarcoma and
carcinoma are also seen; the latter are generally found in the form of soft,
loosely organized masses, filling up the entire lumen of the uterus, occasion-
ally involving the adjacent organs (the intestines and bladder) . The only
radical means of treatment is to extirpate the entire uterus. The sub-

OBSTETRICS 219

cutaneous injection of ergot in had been found to check the growth of
myofibroma and in some cases to remove it.

Obstetrics.

As a rule, the Intch has her pups without any difficulty. The period
of pregnancy varies from fifty-eight to sixty-two days (Dun kept a
record of 189 bitches and found the average period Avas 03.28 days, the
maximum being seventy-one days and the minimum being fifty-three
days) when she generally seeks a cjuiet place and drops from one to eight
(sometimes more) blind pups, which open their eyes in from ten to twelve
days, the period of whelping being from one to six hours (quite frequently
lasts ten to twelve hours), in rare eases eighteen to twenty-four hours.
The labor pains generally appear from three to ten hours before birth, and
are indicated by the bitch being very restless, going into dark corners, or
scratching as if to make a bed, she whimpers, moans, groans, assumes the
position as if urinating or defecating, and frequently passes small amounts
of urine, and on putting the hand on the abdominal walls, the foetuses are
found to be showing considerable movement. The retention of the whole
or a portion of the placenta is very rare in the bitch, and when it does occur
it is indicated by the following symptoms: — great depression; no milk in
the mammse; the bitch pays no attention to the pups; frequent contraction
of the uterus similar to labor pains; entire loss of appetite; pain on pres-
sure of the abdomen. The temperature was normal at first, l;)ut gradually
increased; the pulse was c^uick and hard, and a fcetid discharge from the
vulva.

The short but strong umbilical cord is torn during labor or bitten off by
the bitch immediately after birth, and the entire mass of placenta and
amnion is eaten by the mother. After the birth of the pups there is slight
lochial discharge, bloody in the onset and finally purulent; this discharge
lasts for several days.

The normal course of birth may be changed by the following condi-
tions: 1. The labor pains may not be strong enovigh. 2. There may be a
narrow, contracted pelvis. 3. The vagina may be lessened in diameter
])y cicatricial contractions, tumors, etc. 4. The foetus may be very
large, a monstrosity. 5. Foetus may be presented in an irregular posi-
tion. 6. Torsion of the horn; this is extremely rare. As a rule, the
bitch does not require the assistance of the veterinarian, although very
small animals and the higher bred animals may need some assistance,
Init it is best to leave the bitch as quiet as possible and not to interfere
with her in any way. Small bitches sometimes have very large pups,
the size of the male has also an effect on a litter. When the labor pains
are weak or entirely absent, an examination of the uterus is made by

220 DISEASES OF THE URINARY AND SEXUAL APPARATUS

introducing the index finger, well oiled, into the vagina, the other hand

putting pressure on the abdominal wall; and if we find the foetus is in

position, the head is felt in the dilated os (the breech presentation is

also seen, but is rare) and the pelvic cavity normal, artificial assistance

is contraindicated, at least for an hour or two; if at the end of that time

the head has not advanced, ergot must be given inter-

'tfT a^ nally or, subcutaneously, massage of the uterus through

ij the abdominal wall, and applications of warm cloths to

' ' the abdomen.

One writer speaks very highly of glycerine in 1 to
10 solution with warm w'ater as an agent to encourage
the contraction of the uterus in cases of difficult part-
urition; it is injected directly into the uterus. If the
animal is depressed and weak, administer stimulants —
whiskey, wine, or alcohol or spirits of camphor internally
or subcutaneously — and if these fail to produce the birth
of the foetus it may have to be removed by forceps, of
which there are a variety, the simplest of which are the
most useful, hooks — (Fig. 89). — or the foetus may be
noosed by means of a coj^per wire or cotton cord held in
a tube (see Fig. 90) .

Fluid extract of ergot 1.0 to 2.0 every half hour, or
if the animal vomits give 0.50 to 0.75 of ergot hypoderm-
ically every half hour.

In some cases where the bitch is observed by the
veterinarian, it is well to irritate the vagina and uterus
between the birth of each puppy, and particularly so
after the animal has delivered the last foetus; the best
solution is a mild solution of corrosive sublimate 1 to
3000, or boracic acid solution. "When the foetus is dead
and the membranes are commencing putrefaction, the
constant application of antiseptics must be made until
either the foetus and memln-ane are expelled or removed surgically.

When the foetus is in an irregular position, and after failing to remove
it by means of forceps, finger, loop, etc., or if the foetus is so very large
that it is impossible to get it through the pelvic opening, or if it cannot be
reached, so that it can be cut into sections, or if the pelvis is contracted,
due to permanent cicatricial contractions, or a tumor present in the
uterus or vagina, we must perform the Caesarean section.

Caesarean Section, Hysterotomy, Secto Caesarea. — This is a very
dangerous operation. To have any chance of success the operations
should be performed before the animal is in a state of collapse, or the
foetus is dead and commencing to decay, or the temperature has not

Fig. S9. — Retrac-
tors, single and
double.

OBSTETRICS

221

risen much above normal. Empty the bladder and the lower bowel; and
having washed out the genital passages with an antiseptic solution, put
the animal under ether. The bitch is laid on her back, the legs are held
by an assistant, the forelegs together and the hind legs wide apart. The
region where the incision is to be made should be thoroughly washed and
the hair removed from the part. Make an incision on the median line of
the linea alba anterior to the umbilicus with a sharp-pointed bistoury,
and cut into the abdominal cavity, taking care not to injure the intestines
or uterus; then insert a probe-pointed bistoury and make the opening

Fig. 90. — Apparatus for the extraction of the foetus and method of extraction: a, Brulet's apparatus;
b, method of application.; c, Defay's apparatus.

larger, cutting toward the pubis; then cut through the omentum; the
uterus is now visible and can be lifted out and the foetuses can be felt in
the uterus, separated by a constriction of the body of the horn. Pull the
uterus out of the opening as far as possible and have an assistant keep the
opening of the abdominal wall closed, so as not to allow the intestines to
escape, and also to avoid any of the fluids from the uterus falling into the
cavity; and by means of a bistoury open the uterus by making an incision
through its wall; the opening should not be any larger than is necessary to
get the foetus and the membranes out. It is not necessary to make an
incision in the horn over each foetus, but after one foetus is removed the
others can be pushed toward the opening and removed through it, taking
care to remove the membranes also. The uterus is now thoroughly dis-
infected with corrosive sublimate solution (1 to 5000) or boric acid, 2 per

222 DISEASES OF THE URINARY AND SEXUAL APPARATUS

cent., or creolin; and close the incision by means of a Laml)erts' suture
(using the stitch illustrated in Fig. 20, page 70), using catgut ligature.
If the other horn of the uterus contains fcetus, it must be treated in a
similar manner, irrigated and closed, then sew up the abdominal muscles
by an interrupted suture, using silk. The abdomen is covered with a
piece of absorbent cotton soaked in a mild solution of corrosive sublimate
and held in position by an eight-tailed bandage of muslin tied over the
back. This has to be dressed daily. The animal must have absolute rest
and be fed on food that is easily digested and not apt to constipate or
ferment. Meat juice or extract is the best; vegetables are contraindicated.
Removal of the Uterus, Hysterectomy. — This operation is performed
in inguinal hernia of the l)itch, with strangulation, in uterine tumors,
and chronic catarrh of the uterus, and when after the abdomen is
opened as in tlie operation just described and it is found that the
uterus is either lacerated, necrosed or that the uterus is in such condi-
tion that if it is not removed it will endanger the life of the animal.
Open the abdomen on the linea alba or the flank, the former is much more
satisfactory and to be preferred, and the uterus is brought down out of
the opening, and a douljle ligature is put on the horn close to the ovary,
or, better still, remove the ovary, then a double ligature is put on the uterus,
close to the vagina. When the uterus is filled with foetus, it is best to
empty the uterus, taking care not to allow the escaping fluids to flow into
the abdominal cavity; the ligated horn and uterus are cut between the
doul)le ligatures, and the broad ligament separated, and it is wise to
apply the thermo-cautery to the stumps of the horn and the uterus, then
close the abdominal wound, bandage the abdomen and treat the animal
as in any grave surgical case.

Irregularities of Sexual Instinct.

Absence or Loss of Sexual Desire. — This condition may result from
a variety of causes: (1) general debility, (2) ana?mia, (3) irregular or
improper food, (4) phlegma, especially in over-fed animals, (5) too fre-
ciuent sexual intercourse, as dogs in the stud, that have suddenly become
popular and have a great number of bitches sent to them, (G) onanism,
where animals have no intercourse, and learn to masturbate on objects
slightly elevated from the ground, a rung of a chair, the shaft of a wagon,
and in the kitchens of families, where small pet animals are kept, the
servant maids hold vip their foot and encourage the dog to masturbate
on that until they are exhausted, (7) from disease of the spine or of the
genital organs. In the l^itch sterility may result from catarrh of the
uterus or vagina, causing a discharge of acid mucus, that destroys the
spermatozoa. In certain male dogs they become so violently excited

CASTRATION OF THE BITCH 223

that the}' arc unable to perform the act properly, or there may be partial
loss of erectile power in the corpus cavernosum and the dog does not hold
long enough, for the sperm to be secreted and it is ejaculated after they
separate.

Therapeutics. — If there are any pathological alterations they should
either be alleviated or the case may be such as to be impossible to alle-
viate, or we may administer an aphrodisiac to the animal for some time
previous to the time the animal is to serve the bitch. Tincture of can-
tharides 2 to 10 drops once or twice daily in wine or barley water or hydro-
chlorate of yohimbin two or three times daily, a fourth to a half tablet
which contains 0.01 in solution of acacia. In the bitch yohimbin should
be administered for five days and then the bitch is put with another bitch
in heat, this as a rule, produces sexual excitement in ten days. If ster-
ility is due to acidity of the secretion of the vaginal mucous membrane,
irrigations of alkalines are advised such as carbonate of soda, 1 per cent,
bicarbonate of soda 2 to '3 per cent.

Excessive Venereal Excitement. Satyriasis and Nymphomania. —
This may occur as a result of certain diseases of the genital organs, but
frequently occurs in the male, from unknown causes, (see also priapismus).
Venereal excitement is a common thing in male dogs, their actions, in
play or in excitement all tend toward stimulation of the sexual act, and
frequently dogs learn to practice onanism, gradually becoming emaciated,
accompanied by dulness of the senses, weakness or loss of sexual power,
and frequently, partial or complete paralysis.

Therapeutics. — If the venereal excitement is not due to any patho-
logical alteration of the genital organs, the animal should be kept on low
diet, very little meat, and the administration of saline laxatives, and the
salts of bromide of soda or potassium, and if these methods fail, resort to
castration.

Castration of the Bitch {Ovariotomy).

This operation is generally performed to avoid the trouble that
owners have when a bitch is in " heat," and also tends to make them good
quiet house clogs. The operation is a very simple one and not attended
by any great danger if the proper antiseptic rules are followed, provided
the animal is not too fat, pregnant or in ''heat" at the time of operation,
or there are no tumors of the ovaries, that by either greatly increasing the
size of the ovary or adhering to the adjacent tissues interfere with their
removal. Xormally the ovaries are small, elongated, somewhat irregular
bodies about the size of a small bean, lying posterior to the kidney and
cncapsuled in a pouch and generally surrounded by fat. The operation is
either performed through the flank or on the linea alba, while the animal is

224 DISEASES OF THE URIXARY AND SEXUAL APPARATUS

either narcotized with morphia or ana?sthotizecl with ether. Before operat-
ing the animal shoukl have food withheld for twenty-four hours, and the
region of the incision carefully prepared, first by shaving all hair in the
immediate region, and then carefully disinfecting it.

Operation on the Linea Alba. — The bitch is given a narcotic, or ether-
ized, or both, and placed on a table on her back and an incision made
in the linea alba at the umbilicus, with a sharp-pointed bistoury, and
then the opening is enlarged by means of a probe-pointed bistoury, cutting
toward the diaphragm, the size of the opening is just large enough to
freely admit the index finger. Some operators introduce a sound into
the uterus previous to the operation, but this as a rule, is unnecessary, as
familiarity with anatomy, will easily detect the difference Isetween intes-
tine and the fallopian tubes. The finger is introduced into the abdomen
close against the wall and the horn of the uterus is felt, the end of the
finger is hooked under it and drawn toward the opening, and by careful
traction, the ovary is drawn toward the opening and cut ofT with the
scissors; sometimes it is necessary to tear the ovary from its attachments
to get it to the surface. The same procedure is followed in the other
ovary and the wound closed with an interrupted silk stitch.

Many operators perform castration in very young and even in older
dogs, by opening the abdominal cavity at the linea alba and ligating the
uterus by two catgut ligatures about an inch apart on the body of the
uterus, and cut through between the ligatures. This method has the
advantage of being very simple, and there is little or no danger connected
with it, but the writer has tried a number of cases for experiment and
found in a short time a great collection of creamlike matter, gathered at
the ligated end of the uterus toward the ovary, and distended that portion
very much, which was noticeable by an enlargement of the abdomen.
This result can be prevented to a great extent, by ligating and cutting each
horn separately, and as high and near the uterus as possible. This compli-
cates the operation, and as the prime ol;)ject of the operation is to pre-
vent the recurrence of the periods of ''heat," as the ovary is not removed
• by this mode of operating the phenomenon recurs at the regular periods
and while it is true it is impossible for the animal to become pregnant,
it still is not an operation to be desired.

Castration by Flank Operation. — Many operators advise castration
through the flank, and jM'ocecd in the following manner: Make an inci-
sion in the flank about 4 cm. long, midway between the last false rib and
the thigh and the transverse process of the vertebra, in an anterior direc-
tion, cutting through the skin and muscular layer; then tear the peri-
toneum by means of the finger or knife, or lifting the peritoneum by
means of a pair of forceps, cut it through with a scissors, then the index
finger is introduced into the abdominal cavity, the fallopian tube is

MAMMITIS MASTITIS 225

found, hooked with the finger the ovary is pulled down to the opening
and cut off either by scissors or twisted off with forceps, care being taken
to remove the ovary entirely. Some authors recommend removing a
portion of the horn with the ovary; this, however, is not really necessary.
After removing the ovary, the Fallopian tube is traced back to
the bifurcation at the uterus, the other tube found and followed back to
the other ovary, which is removed in the same manner. In cases where
the remaining ovary cannot be reached, laparotomy is made on the other
flank, and the ovaries pulled through the opening and then cut off with
the scissors, and the wound sewed up as described in the other operation.
Friedberger has operated on hundreds of bitches in the above-described
manner; he removes both ovaries through the one opening in the left
flank. Gunther makes an opening in both flanks, taking one ovary out
of each. The subsequent treatment consists of feeding the animal on
small quantities of easily digested food, and treating the wound with the
regular antiseptics.

DISEASES OF THE MAMMARY GLAND.

INFLAMMATION OF THE MAMMARY GLAND.

MAMMITIS. MASTITIS.

True inflammation of the mammary gland, due to bacterial infec-
tion is extremely rare. It may occur, however, in an acute or chronic
state as a result of traumatisms, kicks, blows, cuts, orinjuries incident to
suckling puppies, or congestion of the udder from caking or drying of the
milk, and consequently retention and tumefaction, and finally, the for-
mation of abscess of the gland. This condition may be caused by sudden
removal of the puppies, or the pups born dead and the udder filled with
milk.

The udder may be swollen through its entire length or certain sec-
tions may be affected. It is warm and painful to the touch, the affected
part is deep red or in white animals, purple red, and the swelling cede-
matous. Pressure on the nipple causes the milk to flow, and it is thin, gray-
ish white, sometimes very thick and creamy, the latter generally containing
pus or is streaked with blood. In more acute cases, there is fever, loss of
appetite, the tissues become purple red and it forms an abscess, which
fluctuates, points and allows the escape of creamy pus, streaked with
blood; it may in some cases become gangrenous and a portion slough out,
and in rare cases cause death. Occasionally cases become chronic and
certain portions of the gland atrophy, or become corded or nodulated.

Treatment. — The puppies must be removed as soon as possible, the
gland bathed frequently with warm water and lead water solution applied,
15

226 DISEASES OF THE URINARY AND SEXUAL APPARATUS

or an ointment of extract of belladonna, 0.05 lanoline 3 . 0. This is to be
rubbed in or if the abscess is commencing to form pus, apply poultices or
hot-water cloths, by means of the Priessnitz compress; when the abscess
forms pus open freely. The resulting hardening of the gland after an
acute attack of inflammation maybe removed by the application of iodine
painted on once daily for several days, then apply an ointment of
iodide of potassium in lanolin one to twenty. This is to be rubbed in and
daily massaging of the gland is recommended. If the gland is swollen
and hard from loss of puppies, or if one gland is not emptied by the pups,
rubbing with camphorated oil, or an ointment consisting of belladonna
extract one part and lanolin fifteen parts, with low diet, and mild saline
laxatives. The gland may be milked slightly, this procedure must be
done very carefully, and then only when absolutely necessary, as it is not
advisable to stimulate the secretion of milk. Bitches that are not preg-
nant frequently have a swelling and enlargement of the udder, six to eight
weeks after the "heat" is over. This invariably disappears without any
treatment and it is not necessary to treat it in any way, but in very rare
cases, if the udder should become congested, it is to be treated as if
it were a case of congestion of the gland. Very rare cases have been
known where bitches suck the nipples and stimulate the milk, a haint
that is impossible to control, except by putting on a spiked muzzle, or
getting the bitch pregnant will sometimes overcome the habit.

Neoformations of the Mammary Gland.

Various tumors and enlargements form in the mammary gland, such
as fibroma, lipoma, chondroma, osteoma, adenoma, myxoma, sarcoma

Fig. 91. — Tumor of the mammary gland.

and carcinoma, and frequently mixed tumors, such as adenosarcomas
fibrochondromas, fibrosarcoma, chondrosarcoma, etc., and there may

NEOFORMATIONS OF THE MAMMARY GLAXD 227

also be cyst formations. Some of these mammary tumors reach enor-
mous sizes, hang down and sometimes touch the ground, (Fig. 91). As
a rule these tumors are round; flat tumors as a rule, are rare, these tumors
may be round or apple-like externally or they may be nodulated and
irregular and fluctuate at certain parts of the tumor. These fluctuating
portions may or may not open, and discharge their contents and form an
ugly, raw, unhealthy cancerous ulcer, which is constantly licked by the
animal and generally we find enlarged infected lymphangitis in the sur-
rounding tissues. Carcinoma is frequently found on bitches that are
beyond middle age, in the form of carcinoma fibrosum, or carcinoma
schirrosum, or partially as carcinoma medullare or myxomotodes and
calcification, or ossification, as well as cyst formations.

Treatment. — These must be operated on when the tumor is well de-
fined, they can be operated on and removed with comparative ease.
When the tumor infects the interior of the gland and is malignant, the
entire gland should be removed, and also any infected lymphatics.
Frohner found that some of the tumors (carcinoma) become calcareous
and unless they are very large are best left alone. Small benign tumors
should not be interfered with if they are not growing.

DISEASES OF THE NERVOUS SYSTEM.

EXAMINATION OF THE NERVOUS SYSTEM.

Disturbances of the nervous system are marked by impairment of
consciousness, sensitiveness, and motility. Besides these, there are
complications in the functions of the eyes, ears, taste and smell, and also
the digestive system.

1. The Disturbances of consciousness are variously defined according
to their intensity. Dulness (indifference to any external influences),
somnolence (drowsiness, sleepiness, when the patient is awakened easily),
stupor (deep sleep, with difficulty in arousing the patient), coma (entire
unconsciousness, where the animal is not disturbed by external influences) .
In extreme cases of unconsciousness, all sphincters of the body become
relaxed. Such cases are found in the various diseases of the brain and
its coverings and in cases of injury and concussions of the brain; it is also
seen in poisoning by narcotics, in uraemia, in acute anaemia, and in all
diseases accompanied by intense fever and pain. Short attacks of un-
consciousness may occur in the form of dizziness, and are seen occasion-
ally as the result of great excitement or pain (in operations) ; and also
idiotism, which occurs in rare instances as a result of distemper, when it
assumes the nervous form.

2. . Disturbance of Sensitiveness. — This is not easily recognized in
the dog. In all instances it is advisable to cover the patient's eyes, and
compare the sensitiveness of the affected side with that of the healthy one.
In cases of haemaphraic diseases, we test the sensitiveness of the skin by
pricking it slightly with a needle or letting cold water drop upon it, so as to
produce some irritation or symptom of pain. A test may also be made
by means of a battery; still this method is not as reliable and practical as
the needle and cold-water test.

Total anaesthesia occurs, as a rule, from poisoning, and must not be
mistaken for a want of reaction, when in a comatose condition. Local
anaesthesia — that is to say, a more or less circumscribed or disturl)ed
zone of sensibility — may be found in any part of the body. In such a
case, if anaesthesia corresponds with a region of a special nerve or mixed
nerve, or if it is extended over several nervous regions, or if it is
even double-sided, we can distinguish it as peripheric amesthesia. Periph-
eric anaesthesia indicates an injury of the terminal ends of the sensitive
nerves and originates through local influences, intense cold, acids (es-

228

EXAMINATION OF THE NERVOUS SYSTEM 229

pecially carbolic), also alcohol and certain narcotics (especially cocaine).
Peripheric aniPsthesia may be caused by some traumatism, compression,
malformation, or inflammatory exudates; also through inflammations,
such as degenerating process, etc., of the peripheric nerves. Spinal
anaesthesia is seen and, as a rule, is double-sided; due to compression of
the nerve or the spinal cord. Cases of cerebral ansesthcsia are caused by
hemorrhages, tumors, inflammations, etc., in the zone of the sensitive
nerves. It may also be caused by the effects of various poisons — chloro-
form, ether, alcohol, morphia, or bromine.

Hyperaesthesia. — This is an increased sensitiveness of the cutaneous
nerves, and is, as a rule, found in the early stages of certain diseases of the
spinal cord. It is very rarely seen in the later stages of such diseases. In
rabies it is indicated by gnawing of certain portions of the body, and in
neuritis and secondary paralysis.

3. Disturbances of motility appear in paralysis and convulsions of
the affected muscular system.

Paralysis. — We generally make a distinction between paralysis
and lameness, that is to say, an entire loss of movement, and paresis or
weakness, which is simply due to debility. In the first ease there is not
the slightest movement performed in a muscle or a whole group of muscles.
In some cases, there are slight muscular movements, but they are weak,
wit hout strength, and do not last very long. In order to determine the origin
of paralysis, it is necessary to have some knowledge of the psychomotor
centres. These centres are located in the cerebrum, and are called the
cortico-muscular leading tracts. Up to the present time they have
definitely located the following motor centres in the external surface of
the cerebrum, the position of which is indicated in figure 92: 1 is the centre
for the movements of the muscles of the neck; 2 is that of the extensors
and adductors of the anterior limb; 3 is for extending and turning the
anterior limbs; 4 controls the movement of the posterior limbs; 5, the
facial muscles; and 6, the lateral movement of the tail; 7, for the re-
traction and adduction of the anterior limbs; 8, for elevating the shoulders
and stretching the front legs (walking) ; 9, for dilating and contracting the
orbicularis palpebrarum and zygomaticus muscles. In the front of 9 we
also find the centre for the movements of the tongue. Between the
anterior and middle portion of 9 is for closing the jaw. On irritating
9 we have a retraction and elevation of the corners of the mouth. By
irritating 6 the mouth is opened and the tongue is moved. c,c causes a
retraction of the corners of the mouth; c lifts the corners of the mouth
and half of the facial muscles as far as the closing point of the eyelids.
The middle e (on irritation) opens the eye and dilates the pupil.

Any disease which becomes located in any portion of this cortico-
muscular brain centre and inflames or stops the power of these centres

230 DISEASES OF THE NERVOUS SYSTEM

must lead to paralysis of the centre which it controls. "VVe therefore can
locate any disturbance in the motor centres of the brain by the paralysis
which occurs in certain parts of the body. A diseased condition of the
covering of the brain, if not very extensive, generally causes the paralysis
of one part of the body, as the single motor centres are separated and
very distinct from one another. Diseases of the brain, when they occur
in the inner surface between the capsules and the pyramids, where all
the motor fibres are close together, cause a more or less complete paralysis
of one side of the body. That is to say, a hemiplegia (affecting one side
of the brain) causes the paralysis of the muscles of the other side of the
body. For instance, if the disease is located on the left side of the brain,
the muscles of the right side become paralyzed. In diseases of the spinal
cord the muscles affected are on the same side, except in the case of
diseases of the cervical portion of the spine, when, as a rule, paralysis is
seen in all the extremities, and in disease of the lumbar region paralysis
of the posterior extremities is seen. We therefore summarize in a general
way that hemiplegia is usually a form of cerebral paralysis (of the con-
trolling centres); paraplegia indicates a diseased condition of the spine;
and monoplegia is due to a paralysis of the brain as well as the spine.
This description gives only the fundamental theories on this subject.
Concerning more precise details we would direct our readers to some one
of the various physiological text-books.

The most important peripheric paralyses which have been observed
in the dog (by traumatism, compression, or exudation, inflammatory or
degenerating processes of the affected nerves) are as follows:

1. Motor Trigeminal Paralysis. (Paralysis of the lower jaw.) —
The lower jaw hangs down; mastication is impossible; saliva runs out
of the mouth. This condition occurs very frequently as a symptom of
rabies. In rare instances it has been observed as a result of some other
disease.

2. Paralysis of the Anterior Limhs. — The front legs hang inert and
all the joints flex very easily.

3. Paralysis of the Posterior Limbs. — The hind legs are dragged along
the ground, the paws being flexed and drawn backward. If the paws
are drawn forward and this flexion overcome, the animal is able to stand
on its legs if the body is held.

4. Paralysis of the Cruralis. — In this condition the animal does not
use the posterior limb. All the joints become flexed abnormally, and
the thigh bends backward. This condition may also be due to some
disease of the spine.

The electrical current is very useful to determine how much certain
muscles and nerves can be excited by the current and is particularly
useful in the diagnosis of paralysis of the nerves and muscles and nutritive

EXAMINATION OF THE NERVOUS SYSTEM

231

Fig. 92. — /., shows superior portion of the cerebrum; II., the lateral surface; and /., //., ///., IV.
are the four convolutions.; .S', is the sulcus cruciatus; F, the fissure of Sylvius; o, the bulbus olfactorius;
p, is the optic nerve. The motor centres are; 1, for the muscles of the neck; 2, for the extensors and
adductors of the anterior limbs; 3, for the flexors and rotators of the anterior limb; 4, for the muscles
of the posterior Umbs; 5, for the facial muscles; 6, for the lateral movements of the tail; 7, for the re-
traction and adduction of the anterior limbs; 8, for the lifting of the shoulder and extension of the front
limb (walking); 9, 9, for the orbicularis palpebrarum, zygomaticus, and closing of the eyelid; /., t, the
heat-centre of Eulenberg and Landois. (Landois.)

Fig. 92. — //., a, a, retraction and elevation of the corners of the mouth; b, opening of the mouth
and movements of the tongue; d, the opening of the eyelids.

232

DISEASES OF THE NERVOUS SYSTEM

disturbances of the same. The faradic or the open circuit can be used.
One electrode is placed on the body, generally along the spine and the
other is placed on the muscle to be stimulated. The first electrode,
that is placed along the spine should be of large size and the other that
is to be placed on any particular nerve of muscle, must be comparatively

31 3^ 33 3*3^

Fig. 93. — Motor centre points of the clog (after Nahrich): 1, caninus muscle; 2, levator; labii super-
ioris; 3, orbicularis oris; 4, levator naso labialis; 5, currugator supercilii and orbicularis palpebrarum;
6, corrugator supercilii and orbicularis palpebrarum; 7, orbiculo-palpebralis nerve; 8, masseter; 9,
zygomaticus muscle; 10, superior lateral retractor of the ear; 11, sterno-hyoideus; 12, sterno-cephalicus;
13, trapezius; 14, omotransversarius; 15, cleidocervicalis; 16, thoracic portion of the trapezius;
17, scapular portion of the deltoid; 18, axillary nerve; 19, acromian part of the deltoideus; 20, anconeus
longus; 21, anconeus lateralis; 22, ramus profundus with radial nerve; 23, extensor digitalis communis;
24, adductor poUicis longus; 25, extensor digitalis lateralis; 26, extensor carj^i ulnaris; 27, anconeus
brevis; 28, cutaneus maximus; 29, latissimus dorsi; 30, obliquus abdominalis externus 31, illiohy-
pogastric nerve; 32, illioinguinalis; 33, sartorius; 34, tensor fascia lata; 35, gluteus medius 36, gluteus
superficialis; 37, biceps femoris; 38, semitendinosus; 39 peroneus nerve; 40, extensor digitalis
lateralis; 41, peroneus brevis, 42, tibial nerve.

small so as not to cover more than the part to be stimulated. The
electrode must be covered with linen or woolen cloth and moistened with
a weak solution of common salt. The reflex movements are prompter
when the electrode is placed on the so-calletl motive points which (Fig. 93)
will give some idea of their location.

When a muscle is in normal condition it will answer promptly, when

EXAMINATION OF THE NERVOUS SYSTEM 233

the electrode is put on it, by a quick quiver. In a degenerated or atrophied
muscle, the reaction is a slow vermicular cjuiver or in old cases where
the paralysis has existed for a long time there may be no motion at all.
The constant or open current will frequently stimulate muscular con-
traction, when the faradic current will give no movements whatever.
AMien degenerative muscular atrophy has set in for any length of time
no reaction can be obtained from either current. For further details
see special work on this subject.

The most important test of paralyzed muscles is their size. In all
cases of prolonged paralysis the muscles atrophy ciuickly. The muscle
gradually becomes smaller and smaller until it resembles a cord or tendon.
In cerebral paralysis this does not occur, while in spinal paralysis it is
always present. Of course, in some instances an inactive muscle will
atrophy without any actual disease being present. The amount of
atrophy which may occur in certain cases is indicated by a communication
given to the author l^y Goubaux. In this instance the paralyzed anterior
limb of a dog weighed 103 grammes, while the perfect limb weighed 148
grammes.

Convulsions. — Convulsion of the controlling muscles is the very
opposite of paralysis. Convulsions are diseased contractions of the
muscles which are independent of the will. There are several varieties
of them. Clonic convulsions are short muscular contractions that occur
at intervals, and between the intervals the affected portion of the body
quivers constantly. Tonic convulsions are muscular contractions in
which the muscle remains constantly contracted. It may occur for a
minute or two, or may last several days. Tonic clonic convulsions are
the medium form of the two conditions before described. A mild form
of clonic contractions is noticed in the original muscular twitchings.
Trembling and shaking convulsions, seen in chill, fear, or sudden cooling
after being very warm, epileptiform convulsions, or eclamptic convul-
sions, are seen and extend over the whole body. In very rare instances
they may be restricted to one portion, such as the head or neck. These
generally come on suddenly and disappear in a few minutes. They
are generally seen in the early stages of distemper, in teething, in
irritated conditions of the bowels, or from noxious and poisonous food
and from parasites; in cases of pentastomum in the nasal cavities, in
encephalitis, meningitis, or uremia, and occasionally in acute ansemia;
they also occur from some injury or irritation of the peripheric centres,
and are very prominent in epilepsy. Rhythmic twitchings are seen in
some muscular regions where the afTected part of the body makes regular
motions; for instance, in the muscles of mastication, in the muscles of
the chest during sleep, and also in the twitching of certain limbs. They
are very often mistaken for chorea, and appear as a result of distemper

234 DISEASES OF THE NERVOUS SYSTEM

or some disease of the I)rain. They may also occur from disorder of the
spine. These so-called cataleptic attacks consist of a rigid and contracted
condition of all the muscles of the body, but are subject to passive move-
ments. Nothing is known concerning their etiology. Tetanic convul-
sions are tonic convulsions of the whole muscular system of the body,
They appear in tetanus and in some cases of poisoning (strychnine,
brucine, caffeine, etc.). A variety of these tetanic convulsions is some-
times observed in the so-called cases of eclampsia in bitches who are
nursing a large litter of puppies. Forced irregular actions of the body,
such as walking backward or in a circle, or the animal rotating on its
own axis, are seen as a rule in diseases of the cerebellum and in some
cases of poisoning (cocaine). In rare instances we see, in the above
mentioned, symptoms of '' ej^ileptif orm attacks," w'hich we will refer to
further on.

Ataxia is due to disturbance of motility or an interference in the co-
ordination of muscular action. Animals are unsteady on their legs,
stagger from one side to another, and their action in walking is irregular.
Ataxia is undoubtedly found in some diseases of the cerebellum, and may
also be seen in disease of the pons and the fore ventricles, and, in very rare
instances, of the spinal cord. Ataxia occurs very often as a result of dis-
temper, and it occurs without any previous brain or spinal symptoms.

Concerning disturbances of vision, hearing and the action of the
sphincters, they will be described under their special chapters.

Disturbance of Reflex Irritability. — Reflex action is those movements
that arc caused by some stimulus or irritation that produce a movement
that is entirely independent of the will, unless the will is concentrated to
oppose the movement. In this instance we call particular attention to what
is known as patellar reflex. The animal is laid on his side with the hind
leg to be examined on the upper side, the leg is slightly flexed and with
the index finger or a percussion hammer a cpick blow is made on the
patellar ligament below the patella; under normal circumstances the
quadriceps femoris muscle makes a quick contraction, the muscles of the
leg contract and the leg is sprung forwards. The same reflex but to a
lesser extent is also seen at the anterior face of the carpal articulation, the
Achilles tendon, skin of the sole of the foot and the abdominal wall. An
increase of the reflex is seen in the course of chronic diseases of the brain,
in myelitis transversalis, spinal paralysis (first observed by Dexter) pois-
oning with strychnia, tetanus. A diminution of the reflex is sometimes
found in acute diseases of the lirain, which have been verj' rapid in their
development, in certain diseases of the spinal substance, in disease of the
peripheric nerves (in which case it is confined to the territory of the corre-
sponding nerve) and in coma. The brain reflexes to be particularly con-
sidered are the conjunctival and corneal reflex seen by the closure of the

HYPEREMIA OF THE BRAIN 235

eyelids on touching the conjunctival ]nill)i or the cornea and the puj^il
with 'its contraction or dilatation on the impression of light.

DISEASES OF THE BRAIN AND ITS COVERINGS.
Hyperaemia of the Brain.

Etiology. — There is an active and passive hyperaemia. Active hy-
pera?niia of the brain is caused by an increase of the circulation as the
result of increased heart-action. This occurs in hypertrophy of the left
ventricle, from excitement, in young animals, from heat (sunstroke), in
great bodily exertion, in teething, high temperture; blows, nervous tem-
perament, from overeating, the effects of certain narcotics, and as a
secbndary symptom of certain diseases.

Passive hyperaemia (stagnation) occurs in compression of the jugular
veins by tumors, such as large goitres, by obstructed respiration, from
tight collars, in acute bronchitis, and in compressed conditions of the lung
due to hydrothorax, extended indurations of the lungs, defects in the ve-
nous openings of the heart. Hypersemia of the brain accompanies various
acute internal diseases, and as a secondary symptom of a large number of
disorders; it is also seen as a result of various poisons, such as alcohol,
certain narcotics, etc.

Pathological Anatomy. — As a rule, hyperemia of the brain occurs in
connection with congestion of the coverings of the brain, especially the
pia mater. When hyperaemia is very intense, or where it has existed
for a long time, we cannot definitely separate the conditions. We find
the dura mater distended, but very little changed. The vessels of the pia
mater are much injected, the torsions of the vessels are flattened, and the
sulci are perfectly flat as if pressed out of shape. We find the gray matter is
darker than usual, while the white brain substance is dull gray or yellow-
ish red, and presents numerous bloody spots which may be easily removed.
In chronic conditions of this disease, we find venous hyperaemia. The
brain appears in such cases pale and anaemic, very moist and soft, and on
section has a brilliant, mirror-like lustre. It is lessened in size and doughy
in consistence and the subarachnoidal fluid is increased.

Clinical Symptoms. — The symptoms of active hyperaemia of the
brain are characterized by a sudden development of excitable symptoms.
These consist in great restlessness, running around, making frequent
changes of position, irritability, a tendency to biting and attacks of de-
lirium, partial or general convulsions, and an increased activity of the act-
ion of the heart. The pulse is quick and irregular; the respirations are
short. There is congestion of the mucous membranes of the head, and the
upper portion of the head is warm to the touch. There is contraction of

23(3 DISEASES OF THE NERVOUS SYSTEM

the pupils and sometimes vomiting. These symptoms of excitement
rarely last very long, and generally disappear quickly; although in rare
instances, they may last some time without leaving any trace on the gen-
eral system. They may, however, alternate with periods of apparent rest
to recur again in a short time. The writer has observed this in cases of
apoplexy of the brain. In this condition there is dulness, unsteady gait
and if there is entire stupor, stertorous respiration is apt to be present
with this last symptom. It is doubtful in such cases, if we have to deal
with actual hypcrsemia; more likely, a more of less serious alteration in
the brain.

Therapeutics. — Bleeding, as a rule, is contraindicated on account of
the debilitated condition of most dogs when they develop hyperaemia.
We would, however, recommend enemas (soap and water) and purgatives
with quick action, such as sulphate of magnesium in large dcses, senna
leaves, or castor oil. Cold compresses (ice bags) around the head are also
useful, while violent purgatives such as croton oil, are not advisable, as
they excite the animal, produce great irritation and generally do more
harm than good. The animal should be put in a cool room and kept as
quiet as possible, avoiding excitement or heat and also feed the animal
very light. In cases where marked symptoms show themselves, an
injection of morphine is generally indicated.

Anaemia of the Brain.

Etiology. — The most common cause of anaemia of the brain, is im-
poverished blood, acute hemorrhage, prolonged debilitating disease, or
from some obstruction of the arterial system, such as tumors, hemor-
rhages, or inflammatory exudations within the skull; also compression of
the carotid arteries by emphysema, and in some instances from contrac-
tion of the small arteries of the brain, caused by excitement. Chronic
anaemia of the brain may be caused by the presence of intercranial tumors,
or hemorrhage, chronic hydrocephalus pachj'^meningitis.

Pathological Anatomy. — The white substance in rare instances has a
few bloody points. As a rule, however, the brain appears on section dull
white, the gray matter being unusually bright, without any trace of col-
oration. The meninges and coverings of the brain may possess their nor-
mal quantity of blood, even in intense anaemia.

Clinical Symptoms. — Acute anaemia, especially when it has been
caused by hemorrhages, is indicated by a small, weak pulse, dilatation of
the pupils and a coldness of the extremities, with attacks of dizziness, and
loss of conciousness. Convulsions are rarely present in chronic anaemia
of the brain, and very often stupidit}', (luivering of the muscles, great

CEREBRAL HEMORRHAGE 237

fatifiTio on the slightest exertion, loss of appetite, and a tendency to vom-
iting is noticed, and even general convulsions.

Therapeutics. — The therapeutic treatment consists in stimulants,
such as wine, ether, camphoi', atropia, caffein, friction to the skin, smelling
spirits of ammonia, stimulation of the phrenic nerve by the faradic
battery, etc. In the chronic form nutritive diet, blood-producing food,
and tonics.

Cerebral Hemorrhage.

(Apoplcxia Sanguitiijc; Hemorrhagica Cerebri.)

Etiology. — The chief cause of cerebral hemorrhage is an increased
pressure on the vessels containing the l)lood, and where the walls of these
vessels present some abnormal condition by which they are debilitated or
weakened. This condition of the walls of the vessels may be caused l^y
atheromatous degeneration, or by some disturbances in the nutritive
process of those parts, as in serious diseases of an infectious nature, such
as distemper, leuka?mia, and also in certain forms of poisoning. Great
exertion, intense physical excitement, or great heat may also produce this
condition.

Pathological Anatomy. — Hemorrhages appear, as a rule, on the cere-
brum, and occur from a capillary hemorrhage and are indicated by a slight
red coloration which cannot be wiped off; but in the most serious forms
you may find a distinct number of spots which Ijecome confluent. In
some cases there is a considerable bloody discharge, indicating the l)reak-
ing down of some large blood-vessel. If the blood-vessel is located in the
hemisphere near the surface, the dura mater appears distended at the
affected location; the convolutions of the brain are flattened and the fur-
rows depressed. The substance of the brain is always more or less de-
stroyed, and, if the animal does not die quickly, the discharged blood lying
in the tissues forms clots very rapidly. Its fluid parts become absorbed,
fibrinous substances are formed, and the blood-corpuscles destroyed,
being altered into a chocolate-colored emulsion which finally becomes ab-
sorbed. The coloring matter of the blood remains on the brain as a rose-
colored pigmentation. The centre becomes smaller and smaller, until the
development of numerous connective-tissue adhesions unite it to the
wall, or an apoplectic cyst is formed, which has a smooth inner wall filled
with serum. This cyst takes the shape of the surrounding tissues.

Clinical Symptoms. — Capillary hemorrhage appears occasionally in
some of the grave infectious diseases, and may cause little or no disturb-
ance of the general system that can be recognized during life, or there may
be slight manifestations of the condition, such as dizziness, partial loss of

238 DISEASES OF THE NERVOUS SYSTEM

consciousness, staggering or giddiness, and in some cases, vomiting; these
however, are only temporary. In extensive hemorrhage, on the contrary,
there is the sudden appearance of grave cerebral symptoms. The animal
falls down without any premonitory symptoms, or else shows, for a short
time, dizziness, staggering, trembling and uncontrollable movements,
or convulsions, and then loses entire consciousness. The pulse becomes
weak or irregular, or rapid and very small. The respirations are deep,
stertorous, and irregular. The mucous membranes of the head are in-
tensely reddened, and in the early stages of the attack, convulsions are
very frequently noticed and involuntary evacuation of urine and fseces.
This is followed by partial or complete paralysis, which is due partially
to destruction of the brain substance, and partially to the blood pressing on
the brain. This paralysis may affect the extremities, both anterior and
posterior, that half of the body which is opposite to the extravasation in
the brain being the one affected. The animal may also become blind.
This disease may result: 1, in death, which occurs either in a few mo-
ments or may take days; 2, in complete recovery — this however, only
occurs where there is a small hemorrhage, and in one of the centers of
the hemispheres; 3, in complete recovery, with partial or complete
paralysis, according to the amount of hemorrhage.

Great hemorrhages of the cerebral membranes are marked by the
same symptoms as apoplexy of the brain. Apoplexia meningia, occurs
generally in connection with violent traumatisms of the skull, such as
shocks, concussions, fractures, etc. The blood is generally found in the
cerebral membrane, between the dura mater and the skull. It may
also be observed in the subarachnoidal chamber and in the brain-
cavities. The symptoms are similar to those of apoplexy of the brain,
but, as a rule, convulsions appear earlier, and the animal, while he may
present symptoms of coma, makes a much quicker recovery.

Therapeutics. — Absolute rest, cold compresses on the head, stimulants
when the pulse is weak, ether and camphor, either internally or subcu-
taneousl}^ after the coma disappears, purgatives and injections of soapy
water per rectum to stimulate evacuations of the bowels. To relieve
congestion of blood vessels, administer iodide of potassium.

Traumatic Lesion and Concussion of the Brain.

Concussion and Commotis Cerebri.

Etiology and Pathological Anatomy. — The cause of this condition is
some traumatism to the skull bcjiics, such as butting the head against a
wall when running fast, Ix'ing hit with a stone or quoit, or struck with
some vehicle, or falling on the head out of a window. 8ome portion of the

INFLAMMATION OF THE BRAIN 239

skull is depressed, cracked or splintered, pressing on the brain substance,
and causing more or less extensive hemorrhage of the interior of the cavity
of the brain. The hemorrhage is generally most extensive in the dura
mater, between it and the cranium, but it may also be observed between
the pia mater and the cerebral cortex or even in the brain substance itself,
and while under the microscope we may not find any change in the brain
substance in spite of the fact that there is grave cerebral disturbance, it
has been called concussion of the brain and is due to a mechanical displace-
ment of the brain substance and the fluids of the brain are compressed in
the ventricles.

Clinical Symptoms and Therapy. — Any pronounced traumatism of this
kind generall}' causes death. There may be bleeding from the nose or ears,
with acute congestion of the conjunctiva. Give the animal absolute rest,
cold local applications, surgical treatment of the injured portion of the
skull, and also the injured soft tissues, evacuation of the faeces and the
administration of stimulants.

Inflammation of the Brain.

From a pathological standpoint we have to make a distinction be-
tween inflammation of the hard cerebral substance (pachymeningitis)
and that of the soft cerebral membrane (leptomeningitis). This classi-
fication, however, need not be used in a clinical way, because in the dog,
the described forms run their course with the same symptoms.

Etiology. — Inflammation of the brain may be the result of some trau-
matism, or from sunstroke, great physical excitement, over-exertion, etc.
This condition also occurs secondarily from disease, such as distemper and
pyaemia, causing suppuration within the skull, in inflammation of the frontal
cavities as a result of the irritation caused by the presence of parasites; in
purulent inflammation of the ear (in connection with external otitis),
and from abscess of the middle ear and orbital cavity. Inflammation of
the brain is seen in certain infectious diseases, especially distemper, and is
also associated in rare instances with pharyngitis, bronchitis, gastritis,
and also from unknown causes. In dogs that died from inflammation of
the brain, Trolldenier found a pathogenic streptothrix, allied to the group
of actinomycetes. Over-exertion and great physical excitement are also
said to be predisposing causes of this disease.

Pathological Anatomy. 1. Inflammation of the Dura Mater. Pachy-
meningitis.— The tlura mater is covered with a numl)er of small hemor-
rhages. It is loose, easy to tear, and over the surface is a collection of
bloody, purulent masses of exudation. In the later stages of the disease
we see a circumscribed or extended thickening and adhesion of the cov-
ering to the base of the skull or to the soft cerebral-membrane.

240 DISEASES OF THE NERVOUS SYSTEM

2. Inflammation of the soft Cerebral Membrane. Leptomeningitis. —

The arachiiuicl is looseiu'd aiul dull. The subarachnoid chambers are filled
with more or less turbid fluid. The pia mater is hypersemic, loosened,
and covered by fibrinous exudation. The coverings of the brain are al-
most always infiltrated and detached from the pia mater with difficulty
and in some cases we find a serous or purulent fluid in the ventricles. In
a chronic case we find a circumscribed thickening of the cerebral mem-
branes and adhesions uniting the coverings with the brain, etc.

3. Inflammation of the Brain Mass. Encephalitis. — This disease, as
a rule, involves single centres and causes a general irritation of the healthy
tissue without any distinctly marked limit. In the affected regions the
substance of the brain is swollen, hypenemic, and frequently filled with
small hemorrhagic centres. In the course of time, the inflamed cerebral
substance becomes softened and pulpy. This condition may be present
without any hemorrhage, but as a rule, the brain matter becomes red and
finally yellowish. This latter color is due to metamorphosis of the color-
ing substance of the blood or to fatty degeneration. These conditions are
divided into white, red, or yellow — softening of the brain. Finally cic-
atrices and cysts are formed, as in apojDlexy, or an abscess may be devel-
oped which is filled with thick yellow or greenish pus, which later becomes
encysted and sometimes solidified (calcareous). In some cases small en-
cephalitic centres may heal without leaving any trace. Occasionally we
see the development of a (non-inflammatory) softening of the brain with
thrombosis and embolus of the arteries; and, as a general rule, we find
symptoms which resemble apoplexy.

Clinical Symptoms. — The symptoms of inflammation of the brain in
its early stages resemble those of hyperaemia. The animals are excited;
they run aimlessly from one side to the other, and are fretful and irritable.
They whine and howl constantly. The head is hot; the conjunctiva is
more or less reddened, the pupils are contracted, and reflex action is very
slight. The appetite is lost; constipation is generally present, with more
or less vomiting. The patient is indifferent to the impressions of external
objects, being sleepy and apathetic. Soon the disease changes in char-
acter. We see acute convulsions, especially those of the jaw, or eclamptic
convulsions. The animals cry and howl. At the same time the sphinc-
ters are relaxed, the animal apparently having no control of them.
Then there is an interval of quietness, in which the animal falls back into
a deep semicomatose contlition, and between these periods of quietness,
we very often see automatic movements, such as ([uivering or twitching of
one or two of the legs; also the corners of the mouth may be retracted.
Many cases either howl constantly, and at the same time seem to be semi-
comatose, or tliey may bark hoarsely (delirium). As a rule, the temper-
ature is a little above normal. Within a short time the aninuil becomes

COMPARATIVELY RARE DISEASES OF THE BRAIN 241

gradually paralyzed, losino; all power of the muscles. The patient is dull
and unconscious of external influences. The breathing is rattling and
stertorous. The pulse is increased a number of beats, but is almost im-
perceptible to the touch. The temperture now begins to rise. In some
cases the temperature may remain normal, and in rare instances falls below
normal. As a rule, the animals die shortly after the convulsions make
their appearance. Complete recovery is very rare, and slight attacks ter-
minate as a rule either with paralysis (partial or complete), idiotism, or
blindness.

The course of this disease varies greatly in affections of the cere-
bellum. If the hemispheres are affected, we may have extensive altera-
tions of the brain, which may run their course without any decided symp-
toms being shown; but as soon as the cerebellum and one or both hemi-
spheres become affected, we then see the various symptoms peculiar
to this disease, and a diagnosis can be made with almost absolute certainty.
In disease of the cerebellum there is generally an unsteadiness of the
gait in walking and peculiar movements, such as walking around in a
circle and rolling on the ground, when both hemispheres are involved.
We may also find paralysis of the posterior extremities. In rare instances,
however, these symptoms may also be presented in cases of poisoning
(by cocaine or apomorphia).

The differential diagnosis betw^een inflammation of the brain, con-
gestion of the brain and rabies is taken up under another head.

Very similar symptoms to those already described appear in cases
W'here the cysticercus cellulosse is present in the brain or its membranes.

Therapeutics. — The treatment of inflammation of the brain cor-
responds with that of hypersemia of the brain. Rest, confinement in a
dark, but not warm, room, cold applications to the head, clysters, laxa-
tives, especially calomel and in cases of great excitement, sedatives (mor-
phia sulphas 0.02 subcutaneously, chloral hydrate 2.0 to 4.0, by the
mouth, or per rectum, in the form of clysters). The violent irritants
which were formerly used on the skin, such as croton oil or cantharidal
ointments rubbed on the inner fascia of the thighs and along the spine,
are of no particular benefit, in fact do more harm than good. Food
should be light, and easily digested, such as soup, broth, etc., and to as-
sist in the reabsorption of the exudate, iodide of potassium may be ad-
ministered internally.

Comparatively Rare Diseases of the Brain.

The following diseases of the brain are rarely seen, but a description
may be useful to the practitioner.

Chronic Hydrocephalus. — This condition is similar to what is known
IG

242 DISEASES OF THE NERVOUS SYSTEM

as a " dummy " in the horse, and it may be congenital or it may follow dis-
temper. Frohner found twenty-nine cases in 70,000 dogs. The follow-
ing symptoms are observed: dulness, head inclined to one side, uncertain,
irregular gait, with a tendency to go to one side, amaurosis, deafness, and
loss of the sense of smell. On post mortem, the brain on section is
found to have a sero-lepto-meningitis, with large collections of fluid
in the ventricles; in some cases only a pachymeningitis has been observed.
The treatment consists in giving laxatives. Injections of pilocarpin, as a
rule, only produce a slight amelioration of the symptoms.

Sunstroke. — This is very rare, but it is occasionally seen in the
working dogs of European countries, wdiere on extremely warm days the
animals pull very heavy loads. In cases where the animals die, we find
the same phenomena observed in congestion or inflammation of the brain.
In one case the entire muscular system was filled with small hemorrhagic
centres, much hypenemia, and a considerable quantity of sero-sanguinous
fluid. Between the dura mater and the arachnoid the surface of the brain
was covered with small hemorrhages, the lungs were congested, the heart
dilated and flabby, and full of dark coagulated blood. Occasionally an
animal may die without any premonitory symptoms, or may collapse
suddenly, having a very strong throbbing pulse, dyspnoea, mouth open and
tongue hanging out, and an increase of temperature.

Treatment. — This is similar to the treatment of congestion and in-
flammation of the brain; rest, cool room, cold compresses to the head and
if there is great depression, stimulants may be administered.

Turning Disease. — This condition is indicated by the animal turning
in circles. These movements are involuntary and are due to some morbid
process of the brain particularly in the cerebellum, especially its peduncles,
such as hemorrhage, inflammation, embolus, etc., and it may also result
from blows, injuries to the skull, it may result from nervous distemper, or
it may also be from some reflex action. Frohner observed it in constipa-
tion, and he also found this disease in twenty-nine animals in an observa-
tion covering 70,000. The treatment consists in keeping the animal
perfectly (juiet and the adminstration of sulphonal, hypnon and urethan.

Edema and Parasites of the Brain. — Edema is generally found on
post mortem and is especially interesting, for as a rule there is not the
slightest indication of this condition seen during life; in rare cases edema
is found to be the cause of a variety of symptoms during life, such as
monoplegia, hsemiplegia, hemianaisitasia, involuntary muscular move-
ments, ataxia, convulsions, and from the increased pressure on the brain
we may find stupidity, clumsiness, giddiness, and fainting spells.

Parasites produce certain ])rain phenomena and particularly from the
presence of the cysticercus cellulosa', such as great nervous excitement,
attacking persons without cause, involuntary movements, great depres-

INFLAMMATIOX OF THE SPINAL CORD AXD MEMBRANES 243

sion, coma and hlindnoss, and frecjucntly every sign of rabies is present.

Progressive Paralysis of the Medulla Oblongata. — This is called in
man a progressive atrophy of the medulla oblongata. This condition
presents partial paralysis of the tongue, of deglutition, of the larynx,
of the lips. It is extremely doubtful if this condition does, per se, occur
in the dog, it being due to some other condition being present in the
brain. Hutyra and Marek have, however, seen a number of cases of
acute paralysis of the medulla, particularly paralysis of deglutition and
paralysis of the tongue (see further under that head).

Cerebro -spinal Meningitis (Meningitis Cerebro -spinalis). Etiology. —
Nothing is definitely known of the causes of this disease. It is extremely
rare in the dog. Renner and Kempen have made several observations
on the subject, and the writer had one case of his own.

The anatomical foundation of the disease seems to be an acute
suppurating inflammation of the brain and spinal membranes, a purulent
exudation in the arachnoid, especially on the hemispheres and the base
of the brain, which is infiltrated by a quantity of serous fluid. The same
condition is also found in the spine.

The symptoms are disturbances of the sensory nerves, in some
cases the animal becoming unconscious. There were loss of appetite,
fever, and after a few days a marked unsteadiness of the gait, beginning
with a slow, dragging walk, and difficulty of deglutition, becoming com-
plicated with tonic convulsions which finally became epileptic, staggering
gait, convulsive movements of the muscles of the neck, opisthotonos, and
lastly stupor, coma, and death.

The treatment consists in the administration of sedatives such as
chloral hydrate, sulphonal or hedonal.

DISEASES OF THE SPINAL CORD AND ITS MEMBRANES.

Inflammation of the Spinal Cord and Its Membranes.

{Myelitis and Spinal Meningitis.)

Etiology. — A common cause of myelitis and spinal meningitis is trau-
matisms of some kind causing direct injuries to the spine, such as violent
blows, shocks to the vertebral column by falling out of a window, etc.,
and further by concussions of the spinal cord, such as being struck by an
automobile or wagon. Violent muscular exertions frequently produce
this condition. In very rare instances, the disease may follow the pres-
ence of an abscess on the outside of the spinal canal, liy extension of the
suppurating process through an orifice of the vertebra, and occasionally

244 DISEASES OF THE NERVOUS SYSTEM

you see it originate, in connection with some infectious or toxic disease
(distemper, rabies, pyaemia) due to the specific toxic material locating
in the cord. It may also be caused by cold, being continually wet and
frozen, as in retrievers.

Pathological Anatomy. — The inflamed pia mater appears thickened,
infiltrated, and may be injected in some places and, as a rule, adherent to
the vertebra, due to the organization of the exudation. It is covered
on its upper surface by a serous, fibrinous, or purulent exudation. The
arachnoid exudation is covered by a milky, false membrane and greatly
thickened. The dura mater is rarely involved, but when such is the case
it becomes thickened and loosened and covered with a thin serum. The
spine itself shows the inflammatory process either extended over large sur-
faces or else confined to small centres. In the early part of the disease,

Fig. 94. — Paralysis of the posterior extremities.

the cord is slightly swollen; the gray substance is somewhat reddened,
dark and soft. Later the cord becomes a yellowish-red, breaks down and
undergoes white, yellow, or red degeneration. In the chronic course of
the disease we see atrophy of the nerves as a conscc{uence of nuilforma-
tions of the connective tissue.

Clinical Symptoms. — As a rule the symptoms of alteration of the spinal
cord appear gradually and become more intense as the disease progresses.
Where the disease is due to violent traumatisms, producing a direct
destruction or laceration of the nervous centres, or pressure, caused by
hemorrhage and blood l)eing discharg(Ml and pressing upon the spine the
symptoms are immediately seen or appear in a very short time. In all
diseases of the spinal cord it is very inij)ortant to recognize the fact that
consciousness is rarely affected. We will take up all these symptoms in

INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 245

the following description, which may be observed in affections of the
spinal cord:

Motor symptoms of paralysis are, as a rule, the first symptoms pre-
sented. The patients have a dull heavy look, staggering gait, but not
irregular (in this the condition differs from disease of the cerebellum).
Finally, they begin to drag their hind legs after them (Fig. 94), the poste-
rior extremities are invariably the parts paralyzed. When they are placed
on their legs they stand with them spread apart, or they may simply drop
sideways on their hind cjuarters. In rarer cases, not only the posterior ex-
tremities but also the anterior are paralyzed, and it is evident that in
cases of paralysis of all the members the spinal substance of the cervical
region must be affected, while paralysis of the posterior extremities follows,
no matter what part of the cord is affected. In these cases we always
have the double-sided paralysis, and in very rare cases the paralysis may
be more intense on one side than the other; but in such a case we can
only suppose that in one-half of the spinal cord the disease is more ad-
vanced than in the other.

In the early stages of the disease there are slight, irregular twitchings
of the extremities, rarely of any great consequence, and seldom leading
to convulsions. There may be marked hypersesthesia and the animal
gnawing continually at certain points of the body, muscular twitchings,
drawing in of the hind legs toward the abdomen. There may also be a
continual erection of the penis, and the evacuation of the urine and faeces
may be interfered with on account of the convulsive contraction of the
sphincter or paralysis of the detrusor urinae and muscles of the intestine.
We also observe disturbances of sensitiveness either in the form of hy-
persesthesia or of anaesthesia. The former is invariably observed in the
early stages of the disease; the patients show intense pain, especially when
touched, lifted, or pressed upon the spinal cord. (This they indicate by
biting, howling, etc.) In the latter case they do not show the slightest
reaction in the affected regions, even when subjected to serious irritations
of the skin. It must be remembered, however, that symptoms similar
to hyperaesthesia may also be present in rheumatism.

In mild stages of this disease the sphincters, such as the bladder
and rectum, appear slightly affected. In the more serious stage we ob-
serve complete paralysis, loss of control of the sphincters, and frequently
complete paralysis of the sphincter vesicae. More details will be found on
this subject under Diseases of the Bladder. Such paralytic conditions of
the bladder may occur in all diseases of the spine. There is difficulty in
the passage of faecal matter, producing constipation, caused to a certain
extent by the loss of abdominal pressure. Paralysis of the sphincter is
evinced by a gaping rectum and the involuntary escape of faecal matter
which accumulates in the lower bowel. Through want of active exercise,

246 DISEASES OF THE NERVOUS SYSTEM

the muscular system of paralyzed animals, especially the extremities, be-
comes flabby, soft and atrophied. The temperature is reduced in the par-
alyzed portion, the extremities being cold and anaemic. In cases
where there is paralysis of the spinal cord caused by compression, and in
cases of atrophy due to hemorrhage on the spinal cord, and also in certain
luxations or fractures of the vertebrae, we practically see the same symp-
toms. Paralysis of the extremities, particularly the posterior, may result
from the following conditions:

a. Paralysis of the spinal cord caused by compression may result
from thickening of the membranes and pressure on the spine itself. It
may also occur in some diseases of the vertebra?, for instance in exostosis,
but both of these conditions are very rare. In such cases the symptoms
come on very slowly and gradually increase in intensity.

d. Apoplexy may occur, due to the presence of some blood escaping
on the spine and causing pressure. In these cases the paralysis appears
very suddenly, but may gradually disappear after some time.

c. Luxations of the spinal column only happen in the vertebra of the
neck, and cause a peculiar oblique position of the head, as if it were twisted
to one side. This is due to displacement of the ligaments. At the
same time there is present a series of what might be called " special symp-
toms," which are not very pronounced in any of their characters.

b. Fractures of the spine: These are generally recognized by some
change in the position of the region in which they are located (bending
inward, flattened depressions, and in rare instances slight distortions of
the spinal cord), and also by the extensive sensitiveness to pressure in
this location. In certain instances there may be an al^normal mobility of
the part. Crepitation, as a rule, is absent. In fractures of the cervical
vertebrae, we generally notice an ol^liciue position of the head. If the
symptoms just described are absent, when an animal has had a severe fall
on the spine, unless paralyzed, or remains without loss of consciousness,
it is always doul)tful if there is a fracture of the vertebnp or a hemorrhage
within the vertebral canal. In such cases we simply have to await develop-
ments, or if paralysis docs not immediately follow the injury, but comes
some time afterward, it is due to compression of the spine from a grad-
ually increasing hemorrhage, ^^'e must I'emember, however, that a fall,
shock, or blow upon the back, or ordinary irritations of the spinal sub-
stance may occur, like a concussion of the brain, in which there is not the
slightest alteration to be found in the spinal substance or its memliranes.
In many cases we may expect a recovery as long as there are no myelitic
complications.

Chronic Inflammation of the Spinal Cord. — This condition follows as
a sequence to the acute foi'm or it commences at the onset as a gradual
progressive affection. It has been contended that overstimulation of the

INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 247

sexual organs is an exciting cause, but this is not admitted by all ob-
servers. Chronic inflammation of the cord is indicated by disturbances of
mobility, the animal is easily tired on very slight exertion, shows a want
of coordination in walking, great difficulty in rising after lying down for
some time, regular or irregular twitching of the muscles in the affected
extremities, or complete paralysis of the hind quarters and in very rare
instances of the anterior limbs, more or less disturbance of the sphincters,
and gradual atrophy of the affiected muscles. The appetite is invariably
good and there is no rise of temperature.

Pachymeningitis spinalis ossificans, that peculiar disease indicated by
a gradual ossification of the spinal membranes, is not at all uncommon in

Fi3. 95. — ParalysLs of the cord.

dogs of an advanced age. This disease consists of a gradual inflamma-
tory process of the dura mater, in which that tissue gradually becomes
filled with numerous irregular or massed collections of tolerably firm
bony scales, situated on the ventral surface of the tissue, particularly
in the region of the cervical and lumbar regions of the cord. The
whole dura mater may become converted into a hard bony tube, and in
exertion of the body the roots of the nerves may be torn from the spine.
The ossific hardening of the dura may be present for a long time be-
fore any actual clinical symptoms are present (Cadeac) and are gener-
ally produced by laceration of the sensory nerve fibres, by violent or
unusual movements, or movements in a certain direction of the spine. The
voluntary movements of the animal are cautious, stiff, or stilty, either on
walking about, lying down, getting up or climbing up stairs; the latter he
may refuse to do, and on forcibly bending the spinal column the animal

248

DISEASES OF THE NERVOUS SYSTEM

may evince pain. The back is turned or crooked to one side, the hind legs
being carried forward under the abdomen (Fig. 95). Frec^uently the
animal may cry out, howl or show great pain on certain movements or
positions of the body, the same movement apparently he may have done
a few moments before without showing the slightest pain. This condition
is frequently mistaken for acute muscular rheumatism. In rare cases the
animal carries the hind quarters in the air and balances the body on the
anterior limbs (Fig. 90) , and gradually there is a great increase in the mus-
cular development of pectoral and thoracic muscles; as a rule there is a
tendency to retention of the fseces and urine, but there may also be invol-
untary passage of urine and faeces. The appetite is generally impaired,
the reflexes are impaired and the penis may either be erected or protruded

Fig. 96. — Dog with pachymeningitis ossificans. Characteristic position of body in walking.

beyond the prepuce. The disease may vary to a certain extent in inten-
sity, but sooner or later the paralysis increases, either involving one leg
more than another or the entire hind quarters are affected; gradually the
sensibility decreases and the animals show entire loss of muscular power
and pain in the affected parts.

Therapeutic Treatment of the Diseases of the Spinal Cord. — In the
early stages of the disease when fever, hypersesthesia, and convulsions
give pronounced evidence of the disease, it is advisable to give anti-
phlogistic treatment, consisting of cold compresses (ice bags) upon the
spinal cord, and vigorous purgatives (calomel), saline purgatives, and
lastly enemas. In cases where the paralytic symptoms predominate,
we use irritants along the spinal column, such as painting with can-
tharidal, collodion, or dilute croton oil, viz., oleum crotonis 0.5, ol. tere-
binthin 15.0; this j^reparation is rubbed into the skin along the vertebral

INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 249

column by means of a woolen cloth; blistering with biniodide of mer-
cury or the use of the actual cautery, in the form of pin-point firing
along the spine. Sometimes in mild cases use an inunction of mustard
oil. If great pain is present use morphine, chloral hydrate, or sul-
phonal. If we succeed in lessening the convulsions, or if the paralytic
symptoms predominate, we must use stimulants such as strychnia and
electricity. The first should be used internally in the form of tincture of
nux vomica, from five to twelve drops, or subcutaneously in a strychnia
solution; the latter method is better. We must remember that one daily
injection is sufficient, and that a medical pause of from thirty-six to
forty-eight hours ought to be made every four or five days in order to
prevent the cumulative influence of this drug.

TJ. Strychnia muriate, 0.005

Aqua, 5.0

Electricity is applied in the following method: after having pre-
viously dampened the region with a concentrated saline solution one
pole of the battery is placed on the spine and the other at the termination
of the paralyzed limb. For instance, one is put on the foot and the
other in the middle or side of the spine, gradually increasing the current.
In such cases, besides administering a purgative and cleansing the bowels,
we must also see that the bladder is emptied by means of a catheter.
Electricity is also a useful agent in peripheral paralysis, which has been
mentioned. The faradic current is preferable. Place one of the poles as
close as possible to the point of central location of the affected nerves
and gently run over the paralyzed muscles with the other pole. This
treatment should be renewed every day for ten or fifteen minutes.
Alcoholic frictions, such as spirits of camphor, tincture of arnica, bay rum,
opodeldoc liniment, are to be recommended when used in connection
with true massage (pinching, friction, and massage of the paralyzed
muscle in its proper direction). Warm baths are said to be useful. As
a means to promote reabsorption, administer iodide of potassium 0.09
internally. Subcutaneous injections of eserine and pilocarpine, or pilo-
carpine alone may be used if it is suspected that a large amount of fluid
exudate is on the cord. On account of the toxic properties of these
drugs, great care must be used in their administration. The bladder
must also be emptied by either pressure on the abdominal wall or by
catheterization, and the rectum emptied by means of clysters and the
food must be such as will digest easily.

In cases of ossific pachymeningitis, Cadeac and others recommend
friction with strong liniments, actual cautery, or setons, along the spinal
column as well as painting the spine with tincture of iodine, and also
the internal administration of iodide of potassium, salicylate of soda,

250 DISEASES OF THE XERVOUS SYSTEM

salol, salophen, antipyrin, etc. As a tonic strychnia should be used in
combination with arsenic or quinine and lastly the galvanic current
has produced good results in some cases.

I^. Strychnine muriate, 0.005

Aqua distil., 5.0

M. F.
Sig. — As a hypodermic of 1.0 to be injected once daily.

I^. Physostigmin sulph., 0.05

Pilocarpin muriate, 0.1

Aqua distil.. 20.0

M. F.

Sig. — 1.0 injected every three days.

Certain Diseases of the Spinal Cord.

The following diseases are caused directly and indirectly by some
change or morbid condition of the spinal cord.

Compression of the Spinal Cord. Myelitis by Compression. — By
this name is understood a slow compression of the cord; due to a patho-
logical process which alters and straightens the vertebral canal; this may
be due to thickening of the membranes as in pachymeningitis spinalis
ossificans, already mentioned, from tumors of the vertebra or meninges,
exostoses or inflammations of the intervertebral discs. As to tumors in
the vertebral column very little is known in dogs; sarcoma; cholestea-
toma, and melanoma have been found by a number of observers, ex-
ostoses projecting into the vertebral column may be caused by periostitis
of the intervertebral discs of the lumbar region; this is frequently seen in
old clogs. Inflammation of the intervertebral discs is caused by violent
and continued jumping, particularly in performing dogs. These forma-
tions are at first soft formations, which later become hard and project
into the vertebra and in advanced cases project from one vertebra to
another in spine-like processes. While the dorsal lumbar vertebrae are
the most frequently afTected, it has also been observed in the cervical
portion of the column.

Clinical Symptoms. — The symptoms are those we would find as a re-
sult of compression of the spinal cord and the origin of the nerves. The
animal at intervals shows pain, moaning, barking or howling, stiff cautious
movements, and evidence of partial or complete paralysis of certain mus-
cles of the body, also motive disturbance of the bladder and rectum, erec-
tion of the penis. Certain valvular diseases of the heart, causing a venous
hypersemia, arterial anaemia of the medulla spinalis or thrombus of the
femoral arteries produce symptoms similar to this disease, and it is well
to carefully examine the heart in a case of spinal paralysis. The treat-
ment is useless, as it is incurable.

CERTAIX DISEASES OF THE SPINAL CORD 251

Hemorrhage of the Spinal Cord. Apoplexia Spinalis. — Hemorrhage
maj' occur between the membranes of the cord as well as in the cord itself,
and in most instances is due to traumatic influences. One observer found
in a dog that fell while running very fast a profuse subdural hemorrhage
extending from the second cervical vertebra to the sacrum; there was
also more or less hemorrhage in the central sections of the spine of the
cervical and lumbar regions; the animal lived three days.

The clinical symptoms either as convulsive twitching or paralysis
appear, but may disappear very quickly if the blood is reabsorbetl, or
the animal dies in a short time. In some cases partial or complete paraly-
sis may follow as a result of the hemorrhage.

The treatment consists in absolute rest, cold compresses to the spine,
and the internal administration of iodide of potassium. Much better
results are to he expected if the case is treated at its onset.

Fractures, Luxations, Diastasis of the Vertebral Column. — Fracture
of the vertebral column is caused by blows, falls, being run over by a
wagon or automobile, and is detected by deformity or curve of the
vertebral colunni, by pain on pressure and want of mobility of the spine.
It is extremely difhcult in fracture of the spine to get actual crepitation.
In fracture of the lumbar vertebra and of the sacrum, the place of fracture
may sometimes be felt by introducing the finger into the rectum and
feeling along the column. Fracture of the cervical vertebra invariably
causes death in a very short time, that is if the arch of the vertebra is
broken, but frecjuent recoveries are made where the fracture is of the
transverse or oblique processes. If the latter are injured, the}- heal
leaving a torsion or crookedness (torticollis). Fractures of the lumbar
or sacral region, while not necessarily fatal, cause such helplessness and
misery that the animal should be mercifully destroyed.

Luxations (diastasis) of the spine without fracture are extremely
rare, although we may occasionally find distortion or sprain of the cord
with compression and tearing of the vertebral discs. In such cases the
prominent symptoms are great rigidity of the vertebral column, stilted
gait, local pain on pressure. The symptoms may disappear quickly or
they may increase rapidly and develop into acute inflammation of the
intervertebral discs (see page 250). Rest, Priessnitz compress on the
lumbar region, later on local friction or massage of the afTected part.

Concussion of the Spinal Cord. Commotis Medullae SpinaUs. — This
is apt to occur from the same causes as produce commotis cerebri. This
condition may be present and the animal be completely paralyzed and no
change is found in the vertebral column. Frequentl}'' animals affected
in this way make a very speedy recovery and it is not wise in doubtful
cases to destroy the animal too hastily.

Tabes Dorsalis. — This disease is a degeneration and atrophy of the

252 DISEASES OF THE NERVOUS SYSTEM

spinal cord, found as a result of syphilis in man. Friedberger and Froh-
ncr thought they found it in the spinal cord of several dogs that had
ataxia. The writer is of the opinion that it does not occur in the canine
race, for among the thousands of dogs he has posted he has yet to see a
case that he could consider was affected with the disease.

Syringomyelia. — Lienaux describes one case of this peculiar disease,
which is characterized by fissures and hollows in the cord. The disease
developes very slowly; at the onset we find disturbances of mobility,
weakness, paralysis of the posterior extremities, the animal has a peculiar
hyena-like walk, urination and defecation remain normal, the appetite
is good, sensation in the posterior extremities and later in the anterior
extremities is gradually lost. On examining the spine, it is found to
contain a number of cavities filled with clear serum; these cavities are in
the gray matter, particularly in the posterior section, and in the com-
missures of the anterior section of the cervical and dorsal regions.

Paralysis of the Nerves.

Paralyzed nerves may be due to some morbid process of the central
nervous system, also to traumatisms, such as tearing or bruising of the
nerves, or compressing the nerves by neoformations, hemorrhagic ex-
travasations, exudates, enlarged lymphatic glands, swollen tissues, dis-
located bones, etc. Inflammation and subsequent paralysis of the nerves
may also be caused by cold (neuritis rheumatica), by paralysis or paresis,
causing an atrophy of a muscle or group of muscles, and in the case of a
mixed nerve going to a certain part, to have disorder of sensation, neu-
ralgia, or anaesthesia. Convulsions are extremely rare and if they appear
would indicate some central pathological process.

We will take up particularly paralysis of the peripheric nerves.

Paralysis of the Facial Nerve. — The most frequent cause of this
condition is disease of the middle ear, caries of the petrous bone, neo-
formations or inflammatory processes of the region of the parotids,
traumatisms at the place where the nerve goes around the maxillary
or the periphery of the nerve, cold — this latter cause, however is rare;
also to pathological processes in the skull and base of the brain, or it may
follow as a result of distemper. Generally the affection is unilateral
(monoplegia facialis). A bilateral paralysis (diplegia facialis) is in-
variably of central origin.

In the case shown in the accompanying figure (Fig. 97) the symptoms
were as follows: The end of the nose, the superior and inferior lip and
the chin turned to the right side, the left eye was wide open and could
not be closed, the left cheek was relaxed and sunken, the left ear hung
downward and backward and could not be lifted by the animal, as was

PARALYSIS OF THE NERVES

253

the right ear when the animal was called, or his attention attracted, the
animal ate with difficulty but drank water normally. The cause of this
condition was not defined. The animal was treated with the faradic
current and in ten days was discharged cured. A number of observers
report favorable recoveries.

Motor Paralysis of the Trigeminus. Paralysis of the Masseter Muscle.
Submaxillary Paralysis. — This form of paralysis is a common symptom
of rabies; therefore all cases of this kind must be regarded with suspicion.

It is observed following distemper, in hemorrhagic gastro-enteritis,
and also as a result of certain forms of bacterial poisons, and also in some

Fig. 97. — Facial paralysis of the left side.

affections of the brain, morbid processes at the base of the cranium, such
as hemorrhages, neoformations, gliosarcoma. It would appear at times
as if the motor nuclei of the trigeminus are sciueezed by the muscles of mas-
tication, for instance when great effort is made to bite and crush partic-
ularly large bones. Rheumatic influences are also said to cause it.

The chief symptoms are as follows: the mouth remains open, the in-
ferior maxillary hanging limp; if paralysis continues for any length of
time, the muscles atrophy. Recovery is rare.

Paralysis of the Radial Nerve. — This is very rare and occurs as a re-
sult of traumatism or a sequela to distemper or cold. As the radial nerve
controls the muscles of extension of the leg, the anconeus muscle and
extensor muscles of the forearm the animal is unable to extend the leg but

254 DISEASES OF THE NERVOUS SYSTEM

keeps it bent with the foot turned back and steps on the front of the foot
in walking as it is dragged along, the muscles of the leg become atrophied,
and the animal stumbles and staggers when walking. Partial paralysis
may result from tumors or fractures of the scapula or to injuries to the
region of the shoulder, particularly when an animal going at great speed
strikes the shoulder against some hard object. Recoveries from this
condition are quite common.

Paralysis of the Ischiadicus. — This is rare and occurs as a result of
blows, falls, as a result of distemper, and from unknow^n causes; there may
also be observed a cross paralysis of the hind quarters and also one ante-
rior limb. The hind leg is dragged and the skin worn off the dorsal face of
the toes, but the animal can sit on the affected leg if it is brought into
position. One observer has seen paresis of the peroneus in a hunting dog;
in walking about every ten or twelve steps the animal made an extra long
step and when the animal sat down the hind leg was turned backward and
upwards. One case was caused by the animal being injured while creeping
under a Ijed.

Paralysis of the Cruralis Nerve. Paralysis of the Femoralis and Quad-
riceps.— In this case the animal cannot step with the hind leg as the
articulations flex abnormally; this condition is quickly followed by
atrophy of the quadriceps. One observer could define no cause for the
condition, and the animal made a good recovery in five weeks.

Paralysis of the Obturator Nerve. — One case of this kind was described
by .Schimmel in which a ladder fell on the animal. When the animal
walked, the one leg was curved and at each step it was thrown outw^ard
and forward and there was great atrophy of the adductor muscles. Reg-
ular exercise led to a gradual improvement of the condition.

Prognosis and Treatment of Paralysis of the Nerves. — The prognosis
can never be regarded as favorable; it is true certain cases already men-
tioned have recovered, but the majority of cases are always to be regarded
as doubtful, particularly when their peripheric nerves have undergone
some pathological change.

The first thing to endeavor to do is to try and remove the cause of
the irritation of the nerve; if this is due to the presence of a tumor, ex-
travasation of blood or serum, cicatricial tissvie or dislocation of an
articulation we endeavor to remove the exciting cause or lessen the in-
flammatory or purulent conditions in the neighborhood of the nerve.
If a rheumatoid cause is suspected, administer salicylic acid, salol, aspirin,
or antipyrin. Massage may also be used combined with a certain amount
of well regulated exercise. The electric current may be eniployed, the
negative electrode being applied as near the root of the nerves as pos-
sible, and the positive pole is moved along the branches of the nerve and
the affected muscles.

, EPILEPSY 255

Polyneuritis Infectiosa. — Under this name Sellman describes a case
of an adult terrier which is similar to primary multiple neuritis in man.
The posterior extremities of the animal were completely paralyzed, and
their temperature was slightly lower than the rest of the body, the spinal
reflexes were gone, with slight opisthotonos, and hyperesthesia in various
parts of the body, the heart being weak. As the disease advanced, a herpes
eruption appeared, and nodules appeared along the course of the following
nerves: tibialis, ischiadicus, peroneus and cruralis. The animal was given
warm baths, later cold showers and massage, and gradually the symptoms
disappeared and in three months the dog had entirely recovered.

Facial Twitchings. Facial Spasms. — Muscular twitchings occur in
the region of the facialis, as a sequence to distemper and also in chorea;
and occasionally they occur in meningitis and certain forms of en-
cephalitis; one case described by Cadiot, Gilbert and Rogers was named
"Tic de la face," where the twitching followed distemper, and was cured
by the removal of the bulbus (original nuclei) of the facialis. There is no
relationship between facial twitchings of the dog and the *' tic convulsiva "
of man.

Epilepsy.

(Falling Sickness.)

Epilepsy is a disease of the brain, which is not rare in the dog. It is
chronic in its course, and appears to be hereditary. Its chief symptoms
are irregular attacks of unconsciousness and in older cases accompanied by
acute characteristic muscular convulsions. True idiopathic epilepsy, gen-
erally incurable, is frequently confounded with the so-called symptomati-
cal epilepsy, that is the epileptiform convulsions which appear as a
symptom of grave pathological conditions of the brain, or some other
change in the skull such as reflex irritation of the peripheral nerves.

Etiology and Pathological Anatomy. — The causes of epilepsy are un-
known, but at the same time there is no doubt that certain diseases of the
brain and its membranes, especially chronic diseases, have recently been
demonstrated by Otto to be hereditary. This disease may appear at any
time during life, and even in advanced age; great excitement and fear
seem to play some part in its development. Wasting diseases very fre-
quently cause epileptiform seizures which are similar to true epilepsy, and
we may also observe in some cases a reflex epilepsy which does not re-
semble true epilepsy in any way except in some general symptoms. These
will happen after traumatic lesions of the peripheral nerves, in animals
harboring intestinal parasites, and in animals having poisonous sub-
stances in the intestines. We may also observe epileptiform convulsions
in distemper.

256 DISEASES OF THE NERVOUS SYSTEM

In true epilepsy there are no anatomical alterations to be found in
the brain itself. Whenever they are found they cause epileptiform con-
vulsions. It is therefore certain that in a case of epilepsy it is only due to
some temporary irritating condition, and that the membranes of the
brain are the starting-point of the irritation.

The experiments which have been made upon dogs in connection with
this disease by Ferrier, Eulenberg, Landois, and others, are very interest-
ing. They found that with great irritation of the motor regions of the
large brain (the cerebrum) a complete attack could be produced. This
begins with twitching of the muscles which belong to that centre. It
then becomes extended over the corresponding group of muscles on the
other side, producing shocks and twitching of the whole muscular system
of the body from tonic and, later, clonic convulsions. The convulsions
extend from centre to centre, and they never miss any region, but run
consecutively from one to the other. If the chief centre is cut out, the
convulsions will not be present in that region during the epileptiform
attacks. Irritation of the subcortical white substance of the brain also
causes epilepsy. This begins, however, in the muscles of the same side.
Bromide of soduim administered for some time has been found very
valuable in preventing epilepsy caused by membranous irritation.

From the above experiments it can be readily understood that the
cortex of the cerebrum is the original centre of epileptic attacks. It is
hard to explain, however, the actual cause of this irritation. Epilepsy
can hardly be caused by overstimulation or feeding, for, as a rule, the
largest number of true epileptic subjects are weak, delicate, and anaemic;
but at the same time we often see vigorous, well-fed dogs of all ages suffer-
ing from this disease. There are many cases in anaemic animals which,
under treatment, gradually improve, at the same time the epileptiform
attacks becoming less and less as the animal improves. It is doubtful if
these cases can 1)0 called true epilepsy.

Clinical Symptoms and Course of the Disease. — In acute attacks of
epilepsy the symptoms begin suddenly, or they may start with slight
premonitory symptoms, or we may see both forms alternately in dif-
ferent seasons in the same individual. In the early stages the animals
run in a circle, are restless, have a staring look out of their eyes, or remain
standing with outstretched legs and shake their heads from side to side.
We have seen clonic convulsions followed by loss of consciousness, and in
some cases a rapid change into tonic convulsions. The muscles of masti-
cation are especially affected, the jaws are clamped, the saliva turned to
froth, the tongue may be bitten, and the l)lood turns the saliva red. Single
muscle contractions follow one another with astonishing rapidity, so
that the saliva which lies in the mouth is turned into foam. The convul-
sions which are now tonic extend over the whole muscular system. The

EPILEPSY 257

body and neck are drawn backward or sideways; thei'e is twitching of the
ears, the legs are stretched ; the respirations seem to cease. This tonic form
of convulsion lasts but a short time. A few seconds after its appearance it
has altered into clonic cramps of the muscles, especially noticed in the legs,
which are frequently twitched, and the legs may move rapidly as if the
animal was running. After a few minutes these twitchings stop; the ani-
mal lies on the ground for some time; it finally rises and recovers very
quickly; some animals, however, are dazed and everything seems strange,
they are afraid of their owner, or do not recognize him. They creep
around and hide in dark corners, and after the attack has passed off they
are greatly fatigued, frequently sleeping several hours at a time, and in rare
instances show a tendency to bite. The pulse and temperature during
an attack of this kind present no alteration of any consequence. The
mucous membranes of the head are reddened and congested, sometimes
cyanotic. This is noticed at the termination of an attack, and is probably
due to the interruption of respiration, and the slight respiratory move-
ments, and frequently an involuntary passing of faeces and urine is noted
during these convulsions.

There are also certain forms in which the animal is restless, running
from side to side, or having fainting spells (dropping on one side), slight
muscular twitchings of the head or extremities, and occasionally, in mild
attacks, a very slight twitching of the jaw, rolling or winking of the eyes.
The duration of these attacks varies, as a rule not lasting very long,
generally only a few minutes, although severe attacks have been known to
last for five or six hours. Their frequency is very uncertain; some animals
have had several attacks daily, while in others they have appeared at
intervals of months. A peculiar feature of some cases of true epilepsy
■was the frequent attacks on the slightest excitement. In the interval
between the attacks, the animal seems perfectly normal, and only in very
rare instances are the animals subject to these attacks dull or stupid.
This disease is rarely fatal but an animal may either injure itself during an
attack or a very severe attack may cause death by suppression of respira-
tion or paralysis of the heart. The differential diagnosis between this
condition and a simple fit, or convulsion, is easily made on getting an
exact history of the case.

In connection with this disease we must devote a few words toepilepti-
form convulsions in young animals. We very often see epilepsy in weak,
debilitated animals which are backward or poorly fed, and which have
rickets; they also occur as a consequence of reflex irritability during the
course of catarrhal diseases of the digestive tract and of the nasal cavi-
ties. We also notice them after the absorption of large quantities of
fermenting, indigestible food, in constipation, from the presence of pen-
tastoma, and in cases of intestinal parasites, at the time of teething,
17

258 DISEASES OF THE NERVOUS SYSTEM

in acute affections of the car, or parasites of that organ, and also as a conse-
quence of great physical excitement. We often see spontaneous convul-
sions; these are very similar to epilepsy, and are probably of reflex origin.
In some of these cases we may have to deal with true epilepsy, but, as a
rule, they may be ascribed to an undeveloped form of distemper, or to
some poisons, or uraemia. In some cases it may be due to some brain
affection, such as congestion of the membranes. It cannot be denied,
however, that there are a great number of convulsive attacks for which
the cause remains obscure.

We may therefore conclude that we can only obtain an approxima-
tive insight into these convulsions by the symptoms which are presented.
Frec^uent occurrence of eclamptic attacks with a short interval between
must be considered as a very serious symptom.

Therapeutics. — No agent seems to have any decided effect upon
epilepsy. The writer has tried a number of remedies, one after another,
without result. Bromide of sodium seems to be the best (this is prefer-
able to bromide of potassium, as it has no detrimental effect upon the
appetite) , provided it is given in substantial doses and kept up for months.
With this drug it is always possible to prolong the interval between
attacks; they are also shortened and relatively less serious. Sometimes
bromide of potash, soda, and ammonia are administered together in the
proportion of 2-2-1 and seem to have a more desirable effect. Other
agents such as oxide of zinc, arsenic, nitrate of silver, belladonna, hyoscya-
mus, valerian, bromohydrate, cold water, and electricity are now rarely
used.

The therapeutic treatment during the convulsions consists in the use
of applications of cold water to the head; prevent the animal from injuring
itself. If one attack follows closely after another, use inhalations of
chloroform, or clysters of chloral hydrate; and give internally large doses
of bromide of sodium, morphia, or similiar sedative agents, and endeavor
to keep the animal as quiet as possible after the attack.

J\. Bromide of sodium, 15.0

Afiua, 150.0

S. — One tablespoouful three times daily.

In epileptiform convulsions in young animals we endeavor to remove
the cause and administer the salts of bromine, chloral hydrate, sulphonal
(0.5 to 4.0), hedonal (1.0 to 4.0), hypnon (0.5 to 2.0), veronal (0.5 to 1.5).

I^. Chloral hydrate, 5.0

Mucilage acacia,

Syr. aurcnti cort., aa, 20.0

Aqua distillata, 100.0

F. M.
Sig. — A tablcspoonful every two hours.

CHOREA 259

I>. Hedonal, 12.0

F. M. capsule ct divid. No. 12.
Sig. — One daily.

Chorea.

(St. Vitus's Dance.)

Etiology. — Chorea we no longer consider an independent disease, but
the result of a number of complications which should really be classed
under other heads; for instance, in young dogs that are insufficiently fed,
or from obscure cerebral diseases. It is also seen in myelitis, and some
cases of symptomatic chorea, but in the majority of cases it must be
attributed to some pathological change as a result of distemper.

In true chorea of man we do not see any pathological alterations of
the lirain, and in the few cases which the writer had to consider as true
chorea on account of the anaemia, absence of any symptoms of distemper,
or other diseases of the brain and spine. The toxic effect of bacteria
present in the intestines has been advanced as a possible cause by some,
but there is little probability that the convulsions were restricted to cer-
tain special muscular groups, and not, as in human chorea, to irregular
regions — that is to say, in the various muscular centres of the body. In
some of these cases the animals were destroyed, and their post-mortems
gave an entirely negative result, there being no apparent pathological
change in the central nervous system. As a rule, the affected animals are
in an ansemic condition and show all the effects of bad nutrition, and,
after some ol)servation, we are convinced that with improvement in the
general system the choreic symptoms become very much lessened.
Joest in the Zeitschrift fur Tiermedizin, 1904, gives a detailed account of
the disease.

Clinical Symptoms and Course. — We define this disease as a persistent
clonic convulsion of some muscular group in certain parts of the body.
For instance, we see shaking of the head, twitching movements with one
or two legs, regular, and also an automatic opening and closing of the
mouth, irregular movements of the tongue, and an undulating action or
movement of the whole body. If the patients are left to themselves, the
twitching action is generally less marked, and under physical excitement
becomes much more aggravated; and are also increasetl when eating, and
during catarrhal conditions of the air-passages, or the intestines, stomach,
etc. The clonic movements lessen during sleep and under the influence
of ether, chloroform, and bromo-ether, but morphia and chloral have
little or no influence upon them. The course of this disease is slow, and
may extend for months and years; but, as a rule, the symptoms lessen

260 DISEASES OF THE NERVOUS SYSTEM

and in very rare instances may disappear entirely. A fatal termination
is only to l)c feared when complications arise.

Therapeutics. — The author has tried all the various agents recom-
mended in this disease, but without any decided results. Arsenic, either
in the form of Donovan's or Fowler's solution, or alternated with some
preparation of iron, has given the best results. Schimmel recommends
cacodylate, but these di'ugs must be given for some time, and it is only
after prolonged administration of salines that any favoral^le result is ob-
served. The writer thinks that more benefit is derived from quiet and
nutritive diet, particularly meat, than anything else.

Antipyrine, which is used in man, is of not much service in the dog.
Electricity in one case produced decided lessening of the symptoms after
regular application of slight galvanic stimulation of the head and along
the vertebral column.

Eclampsia.

Eclampsia, which is not a very good definition, is a tonic-clonic con-
vulsive spasm which is olxserved in bitches, and, as a rule, during the
attacks the animal is perfectly conscious.

Etiology. — The causes of this disease are very little known. Accord-
ing to Hertwig it ma}' be caused by cold, stagnation of the milk in the
udder, taking away the young too soon, and sometimes by worry. In
two-thirds of the cases of true eclampsia all the young are still with the
mother, and invariably we find the animals attacked to be excellent
mothers, and the litters are generally strong, and healthy, and lay on
flesh very quickly while the mother loses it. The onset of the disease is
generally seen at the end of the second or third week, but the animal may
be dull and not right for several days before the acute symptoms show
themselves. In some cases observed, the disease developed after either
one or more pups had been taken away from the mother. In the onset
of the disease the mammary glands contain much milk, and the bitches
most frequently attacked are small, delicate (house dogs and pet animals),
and, as a rule, have a light coat. Friedberger and Frohner are of the
opinion that the disease may originate from anaemia of the spinal cord or,
in a reflex way, from the mammary glands and uterus, as they found
anaemia of the papilla of tlu^ nerve by making an examination of the retina
with the ophthalmoscope. Hutyra and Marek state it may also be pro-
duced by the direct action of toxines on the sexual organism or on the
motor cells of the antei-ior horns of the spinal cord, and other observers
think that there is a similarity between this condition and puerperal fever
of the cow. With this last theory the writer is inclined to agree. Accord-
ing to the statements of several authors, severe anatomical disturbances

ECLAMPSIA 261

of the brain may be caused directly from the mammary ghmds. Fried-
berger has observed two bitches that had echimpsia without having
puppies.

Clinical Symptoms. — The disease may appear in from forty-eight
hours to thirty days after whelping; very rarely later than this time; in
the majority of cases appearing at or about four weeks. In one case of
Friedberger's fifty days elapsed. It comes on suddenly without any
marked symptoms. The aninuils become restless and anxious; they have
a staring expression of the eye, short, rapid respiration, reddened mucous
membranes; they show no pain on pressure on the walls of the chest, neck,
or abdomen. After a short time (about a quarter of an hour after the
appearance of increased respiration) they become paralyzed, are no longer
able to stand on their feet, and remain for some time with their legs
stretched from them. A slight increase of temperature has been observed
in several instances at the onset of the disease. The dog lies on her side
with her legs firm and tense; the muscles of the body hard and quivering
to the touch; the joints are stiff and hard to bend; and at intervals we see
clonic convulsions of all the muscles, especially those of the extremities,
and the respiratory muscles are especially involved. The respirations
become more rapid as a consequence of this, and finally the mouth is opened
and the tongue protrudes, while the animal breathes with great difficulty.
The pulse is small, firm, and sometimes irregular, and always cpiick; the
e3'es are staring and protruded, and there is an anxious look in the face.
All the visible mucous membranes are cyanosed. The saliva which ac-
cumulates in the mouth is either swallowed convulsively at certain in-
tervals, or, as is generally the case, it dribbles out of the corners of the
mouth. As a rule, consciousness is not disturbed. The pupils are normal
in size; reflex action is present. The animal seems to notice external ob-
jects or impressions, such as calling the patient, or noticing one it knows
coming into the room. The appetite is lost; the normal discharges are en-
tirely suppressed; although the urine and fseces may be involuntarily
voided during the attack; the urine, after such an attack, gives an album-
inous reaction. The attack may last for twenty-four hours, but generally
varies a little in intensity. If the attack is very acute, the animal falls
into a deep comatose condition and dies in about forty-eight hours after
the onset of the disease from apoplexy and paralysis, or the cases
commence to recover, regain consciousness, and frec^uently make good
recoveries.

Therapeutics. — Taken in time and treated energetically the animal
invariably makes a good recovery. The first thing to do is to remove the
puppies, and either feed them artificially or get a foster mother for them.
Any of the narcotics can be used, and, as a rule, produce good results.
Give morphia, 0.002 to 0. 005 gm. of the muriate, diluted with water.

262 DISEASES OF THE NERVOUS SYSTEM

As a rule, a few minutes aftei- the hypodermatic is administered the animal
becomes quiet and rests easily. Inhalations of chloroform, chloral hydrate,
bromide of potassium, etc., are also recommended. Warm baths and
friction produce relaxation of the tense muscles; the ''cold pack" is also
particularly useful; take a bed sheet or some such large piece of muslin,
saturate it with cold water, wring it out thoroughly and wrap the animal
up in it, enclosing the whole body, of course, letting the head free, allow
the animal to lie in this for two or three hours. Valerianate of zinc in 05.
gm. dose evei'y two hours. Urethane 5 to 20.0. Hypnon 0.25.

Divers Diseases of the Nerves.

Diseases of the nerves in which there is no anatomical change.

Catalepsy. — Catalepsy, or "cataleptic rigidity," is a rare disease in
which there is a peculiar rigidity of the muscles, and the animals may l)e
placed in certain positions and remain perfectly rigid. Consciousness and
sensitiveness seem to be suppressed entirely. Such an attack lasts for hours
and recurs daily, this condition lasting for weeks. The rigidity may start in
the muscles that are in action at the time the animal is seized with the
attack, and rapidly extend to all the muscles of the body, until the animal
remains fixed like a statue, and may finally die of starvation, being unable
to eat or drink. In many cases they finally relapse and die in a short
time, or they have been known to die in six or seven days, or the condition
was followed by general muscular weakness, in which the muscular walls of
the bladder and intestinal tract were also involved. There is invariably
subnormal temperature and coma. If this is really a disease, or merely a
symptom of some br-ain complication, the writer has not been able to
positively determine.

Hertwig mentions as causes of catalepsy, cold, fright, overloading the
stomach with indigestible food, and metastases in various diseases.
Frohner considers this disease as a purely functional neurosis of the brain
and spine; he could not find any definite alterations in the central organs,
in catalepsy, but he found occasionally certain secondary alterations in
the muscles; namely, hemorrhages, dark venous swellings, and fatty
degeneration of the muscles, also degeneration of the fibres of the heart.

No practical thcrapevitic treatment is known. Sedatives such as bro-
mide of potassium and morphine, electricity and cold douches, are used as
a means of restoring the disturbed reflex irritability of the nervous system.

Psychosis. — It is a question whether psychological disturbances can
occur in the dog which has not intellectual elements of the cerebrum
possessed by man, but it is reasonably certain this question can be an-
swered in the negative. It is evidently some disturbance in the sphere of
the will. In one case of a dog ten years old, the muscles affected were the
limbs and those of mastication. If the animal had a portion of food in his

DIVERS DISEASES OF THE NERVES 203

month and an attack came on, he couhl not masticate it, but if it was small
he would swallow it. The attack lasted about a minute and during that
time the animal kept his eyes half closed, and the pupils remained normal,
as was sensation and consciousness. The attack could be produced if the
animal was struck on the lumbar region. Gradually the attacks became
more frequent, until the animal lost power of the limbs, became emaciated
and was finally destroyed. Careful microscopical examination of the
cerebrum failed to find any change from normal.

Convulsions of the Diaphragm, Convulsive Hiccough. — A convulsion
of the diaphragm, similar to hiccough in man, may be caused by a central
or peripheral irritation of the phrenic nerve, or by reflex irritation from
the digestive tract. It is rarely seen in the dog; in one case the animal had
catarrh of the stomach, and the contractions of the diaphragm were the
same in number as the heart beats, certain muscles of the head, neck, and
extremities were also affected. The treatment consisted in the sub-
cutaneous administration 0.01 of morphia, if the convulsion continues
over any length of time, but as a rule, the attack lasts only from fifteen
to thirty minutes.

Basedow's Disease. — A disease similar to that found in man, has
been observed several times in the dog. The three following symptoms
are characteristic: Exopthalmus (staring or bull's eye), tachycardia
(palpitation and acceleration of the pulse) and struma (enlargement of
the thyroid gland, with an altered secretion of that organ). It must be
regarded as a general neurosis. In an animal not quite a year old, the
eyes protruded from the orbit, movement of the eyelid (lowering and eleva-
tion) was absent; the patient was restless, moving from place to place, the
pulsations were 130 and the respirations 30 to 35. The pulsations of the
heart could be easily felt through the thorax. The appetite was irregular.
The animal had quite a large, goitre. After being treated eight days the
animal was destroyed. The brain was anaemic and the thyroid gland
was greatly increased in volume and there were three secondary glands,
and the right ventricle of the heart was greatly dilated.

Treatment of this disease, which is generally chronic, consists in rest,
the animal must be kept aw^ay from any excitement given food of a nour-
ishing and substantial kind, and must be easily digestible. Administer
iodide of potassium, bromide of potassium or iodide of sodium. In one
case in an old pug dog, the animal made a good recovery after four months
treatment. Iodine in the form of tincture of iodine by inunction, has
given good results in some cases. Iron preparations. Fowler's solution,
thryoid serum or rodagen, both prepaired in animals that have had the
cultivated serums of the thyroid gland, injected intravenously. If this
method of treatment does not produce results either remove the enlarged
thyroid (struma) or ligate the thyroid arteries.

264 DISEASES OF THE NERVOUS SYSTEM

Cachexia Strumipriva. — When the thyroid gland is removed, there
appear certain pathological phenomena that are the opposite to Basedow's
disease. In two or three days after removal of the gland, sometimes a
later period, the extremities become stiff, clonic muscular twitching and
convulsive movements of the muscles of mastication are seen with trem-
bling, dyspnoea, acceleration of the heart, stupor, albumen in the urine,
emaciation and death in al)out a month. In cases where only one-half
of the gland was removed, there is no systemic disturbance, and the same
occurs if there should be secondary thyroid glands which perform the func-
tions of the extirpated gland. It is possible to prevent a fatal termina-
tion by injecting the animal with thyroid preparations, or administering
the preparation internally.

Bronchocele, Hypertrophy of the Thyroid Gland, Goitre, Struma.

As Morbus basedowii and Cachexia strumipriva belong to the group
of true diseases of the nerves, and Goitre has so many characteristics in
common with these diseases, it, will be classed with them. Goitre is a
chronic hypertrophy of the thyroid gland. It may either be a simple hy-
perplasia of the gland (struma simplex, struma parenchymatosa, struma
f ollicularis) or it may be more or less of a cystoid degeneration with the
formation of cavernous cysts, filled with gelatinous contents (struma
cystica) or it may be of a fibrous character, united by connective tissue
(struma fibrosa) , or an enlargement of the veins (struma vasculosa, struma
varicosa) or finally we may have a carcinomatous or even sarcomatous de-
generation of the gland (struma maligna). One observer found ossifica-
tion of the gland (struma ossea). In young dogs when the first named
condition, simple hyperplasia, is found to be soft, it is termed struma
mollis, and it is said to be congenital, while in older dogs we more fre-
Cjuently find the hard fibrous goitre and the struma carcinomata. In
Switzerland 30 to 40 per cent, of all dogs over middle age are affected
with goitre, and generally of the cancerous type. Goitrous degeneration
generally involves the whole gland, but in fibrous or the malignant types
■\ve frequently find only one-half is affected, or may be unequally distributed
over both halves of the gland. Malignant forms frequently involve not
only the gland but also the surrounding tissues, affecting the lungs, called
struma aberrans. In two such cases, the enlargement was in the mediasti-
num in one, and in the other, in the middle third of the neck. These growths
Avhich originated from the secondary thyroid were cancerous in structure.

Etiology and Clinical Symptoms. — The true cause or origin of goitre
has not as yet been defined: In man, horses and cattle, it is supposed to
be due to the effect of mountains and the absence of sun in deep valleys, or
to the soil (rich in calcium and magnesia, and the absence of the iodides),
but in the dog this cause can hardly be said to hold good, as in canines, it

BRONCHOCELE, GOITRE, STRUMA

265

occurs in all countries and conditions, and appears where goitre in other
species is extremely rare. One observer is inclined to think it is caused by
the straining of a collar in harness, or to any active exercise; chronic
heart disease seems to have some bearing on the disease, but why, has not
up to the present time been definitely stated. Without a doubt, heredity
is a predisposing cause (struma congenita). Young animals have propor-
tionately a very large thyroid and it becomes reduced gradually as the
animal grows older, but occasionally the opposite occurs, and instead of
growing less it gradually increases.

Goitre is very easily recognized, directly below the larynx on both
sides of the trachea. It is painless, there is no local increase in tempera-

&Ps<--V.^

Fig. 98. — Malignant struma.

ture, it may be hard or soft, sometimes irregular, sometimes as large as
a closed fist, and in extremely large ones from its weight it hangs down
from the throat. If the goitre is very large it may interfere to a certain
extent with deglutition. In cystic goitre the cysts can be easily distin-
guished on manipulation. The malignant forms are frequently uneven,
irregular and nodulated, and vary in consistence (Fig. 98).-

Treatment. — It is either medicinal or operative. Medicinal treat-
ment is only useful in the parenchymatous or cystic goitre, the latter only
when it is not too far advanced and consists in the administration of
iodine either internally in the form of iodide of potassium, or iodide of
sodium in moderate do.ses, (0.1), or friction externally, iodine or iodide of
potassium ointment, oleates of iodine, or Lugol's solution of iodine. In

266 DISEASES OP THE NERVOUS SYSTEM

one case a 10 per cent, solution of papayotin (vegetable pepsin) was in-
jected into the tumor and in forty-eight hours the digested parenchyma
of the gland was aspirated in the form of a milk-like liciuid. The inter-
parenchymatous injection of Lugol's solution of iodine are rather
dangerous, but the writer has found a solution of iodoform 1.0 in ether
and olive oil 7.0 much better.

Recently, preparations have been made from the thyroid gland of
cows, thyroidin tablets (Merck) , thyradin taljlets (Knoll) ; these tablets are
prepared commercially, each tablet contains 0.3 of normal thyroid gland,
and we give 1 to 3 tablets daily. In weak animals at first give the smallest
dose and carefully watch the animal. In the administration of too large
doses you may have all the symptoms of Basedow's disease. Frequently,
when the treatment is continued for some time and with favorable results,
if the treatment is stopped, immediately the gland commences to enlarge
again.

When medicinal ti'eatment has no results, or the struma is malignant,
surgical treatment is necessary. In cystic goitre that is well developed,
it can be opened, drained and filled with iodoform gauze. The malig-
nant and fibrous goitre must be removed, but it must always be remem-
bered that entire removal of the gland generally causes death in a short
time (see Cachexia strumipriva). Only one-half of the gland must be
removed, and in a case of bilateral, the one that is affected the more, as
it is a question if iodothyrin or any of the thyroid preparations will arrest
cachexia strumipriva, if it follows removal of the gland. On account of
great vessels, recurrent nerve etc., in the neighborhood of goitre, the
operation must be classed as one of the most dangerous operations in
the dog.

Inflammation of the Thyroid Gland. Thyroiditis, Struma Acute. — This
condition is extremely rare, and is generally of traumatic origin (bites,
gunshot wounds, etc.). It forms large c{uantities of pus. This condi-
tion must not be confounded with those enlargements of the thyroid that
occur in young dogs and are the result of catarrh of the larynx and
pharynx. The periodical swelling of the thyroid that is seen in very young
dogs, that swells and in a few days returns to normal size, is not in any way
related to thyroiditis. The treatment of inflammation of the thyroid
gland is to treat it as a surgical wound.

DISEASES OF TRUE INFECTION.

Distemper and Contagious Catarrhal Fever.

The definition of the word ''distemper" describes a disease which is
peculiar to the canine race, and it is caused by a specific poison which
finds its way into the system, as a rule, through the lungs and air-pas-
sages. It generally attacks young animals and runs its course as a
catarrhal fever, affecting all the mucous membranes of the body, and is
almost invariably accompanied with certain nervous symptoms, and
pustular skin eruptions.

Etiology. — Distemper is a disease which is contagious in the highest
degree, and is only communicated by infection. It does not seem to have
been recognized or described by the ancients or the writers of the middle
ages. An animal aflfectecl with distemper can remain but a short time in
any locality and affect every animal there, or it may be transmitted from
a person or object that has been in contact with an affected animal. As a
rule, few young animals escape distemper, generally contracting it before
they are a year old, and dogs over that age very rarely take the disease.
That, however, may be accounted for from the fact that dogs having
arrived at that age have either come in contact with, the disease previous
to that and they have had it in a mild form, or the system was in such a
condition, that they did not contract it. The disease affects animals but
once during life, although a few exceptions are presented where animals
have contracted it a second time. As a rule, delicate, weak, poorly-fed
animals (vegetable diet), or animals which have been affected by some
catarrhal disorder of the respiratory mucous membranes, contr!ict the
disease in its acute form; while, on the other hand, dogs which have lots of
exercise, especially animals in the country or small cities, are mildly
affected with the disease, and the rate of mortality is much less.

Distemper exists in all countries of the world. In the large cities it is
found at any season of the year, while in the country it is generally more
prevalent during the warm weather. The specific poison of distemper is
not definitely known. It is undoubtedly a fixed and volatile virus*
which enters the system by the mouth and nose, and it exerts its first

*By a " fixed and volatile virus" we understand a fixed virus that when secreted in the
lungs, is carried out in fine division, in the particles of moisture in the expired air, and easily-
held in suspension in an atmosphere that contains a slight quantity of humidity.

267

268 DISEASES OF TRUE INFECTION

influence on the res})iratorv passages. Vaccination of young animals l)y
means of the mucous secretions from animals affected with the disease
has been tried, and, as a rule, reproduces the disease.

Semmer believes that he has definitely defined the contagious germ in
the blood, and also found it in the lungs, liver, and spleen, in the form of
small, dagger-shaped microbes, which he calls the "bacilli of distemper."
Rabe has found in the secretion of the nose and connective tissue, also in
the blood, small cocci, which accumulate in heaps, or were connected
together in small groups of three or four in a line, or they may hang to-
gether like a string of beads. These he considers the specific conta-
gious matter of distemper; but Friedberger does not agree with this
theory. Mathis found in the contents of the pustule a diplococcus which
could be colored with fuchsin. He used bouillon cultures of this diplo-
coccus for the inoculation of ten dogs. These dogs were affected by
symptoms which resembled very closely those of distemper. Marcone
and Meloni found a micrococcus in a dog which was affected by distem-
per, and considered that this was the true pathogenic agent, as it
produced the skin eruptions, broncho-pneumonia, and gastro-enteritis
in dogs which had been inoculated with pure cultures. Legrain and
Jafjuet obtained pure cultures of micrococci, Avhen held in certain media,
from fluid obtained from the pustules in the exanthema of distemper.
These were gathered together in the form of diplococci and chains. In
dogs vaccinated with these cultures only the skin eruption, with the
development of pustules, was seen, but the subjects so treated seemed to
enjoy immunity from the disease. Millais made cultures from the nasal
excretion of the dogs affected by distemper upon gelatinous media, of two
different bacilli, which mixed together, on inoculation, produced distem-
per. Galli-Valerio has isolated ovoid bacilli, 1.25-2.5/t. in length, which
grows freely in gelatin. These he found in abundance in the lungs and
central nervous system, but did not find them in the blood. The inocula-
tion of the cultivations produced characteristic distemper in puppies, but
did not give the same results in adult dogs. Jensen is of the opinion that
the pneumonia of distemper is caused by a streptococcus, but he has found
in the bronchial mucous membranes other bacteria, particularly the bac-
terium coli. Babes and Bazanesco, in two cases isolated from the lung,
liver and blood, found a very fine short motile bacillus, about 0.3 to
0.4/i. long. Nine young dogs were inoculated and seven died in from
ten to eighteen dayc of typical distemper, and the various oi'gans con-
tained the bacilli inoculated. Zelinski, Xeucki, and Karapinski, maintain
they are positive distemper is communicable to man, and give as the
mediary cause a microorganism similar to the white staphylococcus of
Resenbach, but differing from the same in its bio-chemical properties.
Taty and Jaccjuine have found in the spine and cord of a dog that died

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 2G9

of nervous distemper a peculiar diplococcus to which they ascribe import-
ant pathogenic action. Jess cultivated a bacillus, found in the conjunc-
tival, nasal and other mucous membranes and organs of the body, which
was 1.3//. long and 0.6u. wdde. Injections of the culture were made both
intraperitoneally and subcutaneously; three or four days afterwards a
fever appeared which was accompanied by great flow of tears, and diar-
rhcea, and in the vicinity of the inoculated spot there appeared isolated
red spots. Petropawloski found, in all cases of distemper, a bacillus which
resembled that described by Galli-Valeris, and also that described by
Babes and Barzanesco but differed from the first by its negative action to
Gram's coloring method and, from the latter by its easy cultivation on
potato. j\Iari thinks that the baccilli of Petropowlowsky as well as those
of Schantyro are in all probability coli-bacilli and really not related in any
way etiologically to the baccilli of distemper. Casol claims to have
found a micrococcus, which is both isolated and in groups, and claims it is
colored by Gram's method. From these he made pure cultivations and
transmitted it successfully. Lignieres places distemper among the
hemorrhagic septicaemias and calls it Pasteurellosis canum, and is due to
a particularly virulent bi-polar bacillus (Pasteurella canis). Trasbot, on
the other hand, thinks that the microorganism cultivated by Lignieres is a
pneumo-inciter and only produces the secondary phenomena in the disease
and is not the original cause of the development of the disease. Wunsch-
heim has isolated a short rod, very similar to the bacteria of chicken
cholera. Piorkowski found in the spleen and lung a small staff bacillus, the
cultivations of which when inoculated, developed the disease and death
in two or three w^eeks. Ceramicola cultivated an ovoid polymorphus
taken from dogs which had died, particularly of virulent distemper, and
the bacteria possessed all the morphological properties of the inciter of
hemorrhagic septicaemia, and the animal inoculated died with all the
characteristics of true distemper. Carre is of the opinion that none of
the organisms visible to the microscope can be considered the exciters of
distemper in the dog; he took nasal mucus from an infected dog, passed
it through a filter, the filtrate when spread on different nutritive media
remained sterile, and the defibrinated blood of an animal inoculated with
the filtrate produced fever of the nostril and pustules. This blood was
also spread on various nutritive media and also remained sterile. Cadiot
and Breton and others are of the opinion that in distemper there is an
ultra-microscopical organism which can be filtered, and with this microbe
there is also a microorganism which may have some influence on the course
of the disease (foetid bacillus and Pasteurella canis).

Direct vaccinating methods have been practised by various practi-
tioners. For instance, Trasbot transferred secretions from the nose and
pustules of animals affected with the disease, by means of a number of

270 DISEASES OF TRUE INFECTION

small incisions in the abdominal wall of healthy young animals. The
disease appeared after eight days.

Krajewski vaccinated numerous young animals with secretions of
the nose and pustules, these inoculations being on the mucous mem-
brane of the nose, and under the skin, and arrived at the following
conclusions:

1. The contagious germ of distemper is confined to the secretion of
the nose and eyes, and the blood.

2. The germ does not lose its virulent properties in any degree when
dried at a normal temperature, or frozen at 18° to 20° of cold. However,
its virulence becomes attenuated when kept for any length of time in a dry
place.

3. The disease, when it is produced by vaccinating, runs a very mild
course, and kills, as a rule, from 10 to 15 per cent, while the ordinary
disease kills from 32 to 70 per cent. Laosson has obtained the same results
after vaccinating ninety-eight animals, and found also that the contents
of these pustules are generally inactive, and that the nasal secretion
loses its virulence after eight days. Friedberger's observations are dia-
metrically opposite, for he contends that he has caused infection by means
of the contents of the pustules. He also recognized in cases where the
disease originated from vaccination that there was a short intervening
stage of incubation and, as a rule, was much less in intensity, ran a veiy
rapid course, and that the groups of pustules were confined to the region
of vaccination.

Schantyr has lately published certain observations concerning the
microbes of distemper. He agrees with Putz that distemper of the dog
resembles distemper in horses to a remarkable degree, and his theory of
the subject is that distemper may be classified into three diseases, accord-
ing to the presence of three microorganisms of different characters.
These diseases are: Abdominal typhus, true distemper of the dog,
and canine typhoid. Their clinical as well as their pathological
symptoms have a great similarity with one another, and it is only
with a careful microscopical examination that the specific microorgan-
isms can be separated. The bacilli of typhoid (small, slender bacilli,
which are almost exactly like the typhoid bacilli in man) are generally
found separate in the blood, while the bacilli of distemper (small, and
somewhat curved) and the bacilli of typhoid (typhoid are very small and
slender) are generally arranged in groups. The bacilli of typhus are hard
to color with fuchsin, and become colorless with Gram's test. This is
not the case with distemper and the bacillus of typhoid. Typhus and
typhoid bacilli give characteristic cultures upon agar, gelatin, and potato,
while the bacillus of distemper is extremely hard to cultivate under any
circumstances. Megnin divides distemper into two groups. Cadiot and

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 271

Breton describe another contagious broncho-pneumonia, but present no
pustular rash, probably In'ing infectious bronchial catarrh.

Clinical Symptoms and Course. — The stage of incubation of distemper
is generally from four to seven days. In rare cases it may linger, for
eight to twelve days, after contact with the diseased animal, and
Krajewski states that cases of infection through cohabitation may some-
times take from two to two and a half weeks to develop. The first actual
symptom is an increase of temperature. In the initial stage it rises to 40°,
and in some cases 41° and over. An increase in temperature has been oIj-
served by the writer in all cases of distemper, when the examination was
made early in the disease. Later on the temperature falls slightly, but in
some cases very rapidly, and it may even go below the normal point, ac-
cording to the individuality of the anmial, and to the intensity of the at-
tack. Yery mild cases have little or no elevation of temperature, but as a
rule there is a regular increase and decrease of temperature, as the disease
runs its course. In fatal cases toward the end the temperature is invari-
abl}- subnormal. In cases developed by inoculation we occasionally find a
marked increase in temperature. The next symptom is the disturbance
of the general condition. The animal is depressed, restless, has little or
no appetite, seeks the heat, becomes easily fatigued, is chilly and shivering,
the nose is hot and dr}^ the skin is inelastic, and the hair becomes harsh
and dry, the animal refuses to play or to go out for a walk, lies most of
the time and gets into dark places. In some instances vomiting occurs,
but can hardly be called a characteristic, initital symptom of the disease.
This stage of the disease is short, from 24 to 48 hours; the symptoms in-
crease rapidly, and develop the four characteristic forms, which are as
follows:

1. Catarrhal distemper (eyes and nose and lungs), muco-purulent
discharge of the nose and eyes, cough, which is very persistent and may be
so severe as to cause great depression or vomiting, more or less increase of
respiration, which in some cases may be labored.

2. Gastric distemper (intestinal distemper), coated tongue, loss of
appetite, thirst, vomiting mucous in thick tenacious masses, diarrhoea,
yellow in color and fseces that are muco-purulent, and may even contain
blood.

3. Nervous distemper (irritation of the brain and spinal cord).
Fear, uneasiness, great irritability, dulness or sleepiness, twitching of the
muscles of mastication, or epileptiform convulsions, chorea and complete
paralysis.

4. Exanthematical distemper (distemper pustuia, dog pox), pustules
on the abdomen and internal surface of thigh.

The following phenomena of distemper may appear during the course
of the disease:

272 DISEASES OF TRUE INFECTION

1. Symptoms on the External Membranes. — These appear in the ma-
jority of cases and are of great importance in diagnosis. We see a number
of small red spots upon the inner fascia of the thighs, the abdomen and, in
rare instances, the mouth and eyes, on the internal surface of the ear flap
or even on the vestibule, and still more rarely covering the entire body.
They are generally scattered, very rarely confluent. They rapidly form
small bladder-like blisters filled with serum, and later on this serum
changes to pus. They are about the size of a lentil or small bean, and
soon dry up, forming yellowish scabs and crusts. When the eruption is
very extensive, the animal gives off a very unpleasant odor from the
affected parts. These pustules are rarely itchy, and if so, it is only to a
very slight degree. After these scabs fall off (generally in about one
week) , they leave a red circular spot on the skin which disappears slowly.
In other cases we find more or less depth to the cicatrix, leaving pit-like
ulcerations. They are probably due to the animal scratching or gnawing
the sore. In rare cases the rash has appeared on the lips, extended over
on the mucous membrane and caused extensive ulcerative processes of
the mouth or it may spread all over the body and in occasional cases it
is found in the prepuce causing purulent catarrh of that organ. This is
the only skin eruption that characterizes this disease and it dries up very
quickly, so that in from eight to fourteen days we see no other marks
except those light, granulating spots (exanthema of distemper, distemper
pox). Hertwig and Friedberger have observed some cases in which this
eruption made its appearance without any other symptom of distemper.

2, Symptoms Indicated by the Eyes. — There is generally more or less
purulent catarrhal conjunctivitis. The animal avoids the light. There
is redness and swelling of the conjunctiva. In the early stages the secre-
tion is serous and very fluid. Later on it becomes a muco-purulent se-
cretion, either light gray or yellowish in color. This sometimes occurs in
large masses (blennorrhoea of the eyes). This fluid collects in the corner
of the lower eyelid or trickles down over the face, drying in yellowish
crusts in the edges and borders of the eyelids, frec|uently gluing them to-
gether. The corrosive action of these secretions, and also the inflamma-
tion of the surrounding membranes, may cause lesions of the cornea, some-
times from the animal scratching and rubbing the eye, especially in ani-
mals with prominent eyes (such as pugs and King Charles spaniels). In
some cases it may be due to deficient nutrition of the cornea. This
ulceration starts with a slight swelling on the external surface of the
cornea and the subsecjuent formation of an ulceration. (Other details
will be found in the chapter on Diseases of the Eye) .

We see cases where there is a deep pericorneal injection of the cornea, (ker-
atitis parenchymatosa), in which a blue grey, blue white, or milky white
opacity commences at the outside edge of the cornea and spreads over its en-

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 273

tire surface. It may affect one or both eyes at the same time, and the opac-
ity may disappear leaving no trace or it may go away slowly and in rare
cases leave permanent white star-like spots on the surface of the cornea. In
rare cases keratitis parenchymatosa and some fever may be the only
symptoms observed during the course of the disease The ulcerations are
apt to appear in the middle or most prominent part of the cornea, and pene-
trate into the corneal tissue, and the pit-like depression on the cornea may
become vascular, and it may also perforate the cornea, evacuate the con-
tents of the anterior chamber, cause prolapse of the iris, and formation of
staphyloma. Loss of the eye, by purulent panophthalmitis, is very rare,
the eye clearing up and leaving more or less pigmentation of the cornea.
Diseases of the interior of the eye, by extension of the inflammation
of the cornea, are very rare in distemper. This may be complicated
with a permanent opacity of the sclerotic membrane, and in rare cases the
whole eye becomes acutely inflamed and breaks down (see Diseases of
the Eye).

3. Symptoms of the Respiratory Apparatus. — These are generally a
catarrhal inflammation of the mucous membranes of the upper air pass-
ages, and, if the disease is acute, the finer sections of the bronchi become
inflamed. The first symptom is a catarrh of the nose, which is marked
by sneezing and the animal rubbing or wiping his nose with his front paws.
This discharge increases. In the early stages it is simply serous; later it
becomes mucous, grayish-white or grayish-yellow, sometimes bloody, and
in some cases even purulent, with more or less odor. We also see a " snift"-
ling" respiration. This is particularly noticeable in short-headed dogs
(such as pugs or bulldogs) . In all cases there is catarrh of the larynx, and
bronchioles. Catarrh of the larynx is generally marked by a loud,
hoarse, dry cough, which is particularly distressing to the animal, especi-
ally at night. As the disease advances it becomes moist and looser, and is
easily produced by a slight pressure on the larynx. Where there is
simple laryngitis, we do not generally see any visible increase or difficulty
in respiration. This is changed, however, as soon as the large bronchial
tubes become involved. In such cases we see a marked increase in res-
piration, wdiich gradually becomes more intense as the inflammatory pro-
cess goes downward into the finer bronchi. Any pressure on the sides or
tapping upon the walls of the chest causes a very distinct, painful, dis-
tressing cough. On auscultation we hear an increased vesicular breath-
ing, as well as dry and moist rattling bruits, which are of various forms
and intensity.

If the inflammatory process has extended to the fine bronchi it is
not rare to see the formation of lobular pneumonic centres — that is to say,
catarrhal pneumonia. Difficulty in respiration now appears more pro-
nounced; respiration is superficial but laborious, as is proved by the infla-
18

274 DISEASES OF TRUE INFECTION

tion of the cheeks. The number of respirations may increase from GO to
80 or even more. The cough is very painful, dull, and weak; the pulse is
greatly increased, and the temperature may increase to a marked degree,
but it is remittent. On ausculting we hear in the lungs, snoring, groan-
ing, and wheezing sounds and rattling bruits (these last are moist and
numerous), also more or less blowing sounds in different regions. We
notice an increased vesicular respiration with sharp, prolonged, expir-
atory bruits, of a mixed character. In the same region we may notice
bronchial respiration. Percussion, as a rule, is not very instructive.

4. Symptoms of the Digestive Tract. — The chief of these is catarrh of
the stomach, which may vary in intensity. There is entire loss of appetite,
vomiting of a thin, frothy, turbid lic{uid Avhich is shiny or muco-puru-
lent. There are frecpient discharges from the bowels of a thin, muco-
purulent fluid, occasionally streaked with blood, and always accompanied
by a painful tenesmus. We may also find the abdomen very painful on
pressure, and, as a rule, contracted and tense. Yellow coloration of the
visible mucous membranes (icterus) is occasionally observed.

5. Symptoms of the Nervous System. — The animal is very dull, espe-
cially its senses. There is a marked apathy and depression, and in some
cases deep coma. In a great many cases this condition may be accom-
panied by periods of excitement, nervousness, great restlessness, and even
true delirium. These periods, which might possibly be mistaken for rab-
ies, are not of any great length, as a rule, the animal sooner or later show-
ing signs of marked depression. Motor disturbances, such as twitching of
various groups of muscles, mostly the head and extremities, are noticed,
and, in some cases, convulsions or true eclamptic attacks. These follow
one another at long intervals, or keep the animal irritated for days.
Clonic convulsions of the maxillary muscles are very frec{uently seen.
They consist of a rapid and regular twitching of the muscles of the lower
jaw, sometimes confined only to chattering of the teeth, and occasionally
sufficiently strong to make a foam of the saliva. Besides this, we may see
symptoms of motor paralysis. The patients are unsteady and irregular
in their actions. In some instances they drag their hind legs, or occa-
sionally their posterior extremities lose their power and the animal is un-
able to stand; in rare instances, due to paralysis of the sympathetic, the
bladder and the lower bowel lose the power of their sphincters and urine
and fgeces are evacuated involuntarily.

Other General Symptoms. — As has already been observed, the tem-
perature may rise or fall, and follow an irregular course, and it is apt to be
subnormal in the majority of fatal cases. When bronchitis increases in
intensity and a catarrhal pneumonia develops, it is apt to be accompanied
by considerable increase in temperature. In some cases, due to paren-
chymatous degeneration of the cardiac muscle, the pulse is small, thready

DISTEMPER AND COXTAGIOUS CATARRHAL FEVER

2/0

and irregular. The urine frequently contains more or less bile coloring
matter, sometimes albumin and tube casts are found. In some cases the
general nutrition and condition may* keep up well all during the disease and
in other cases the animal at the onset of the disease rapidly loses his vital
force, even when it is eating a fair amount of nutriment, goes down in
strength each day. Frequently the expired air has a particularly
unpleasant penetrating odor.

The anatomical alterations of the nervous system, produced by this
disease, which are shown in the section of the brain, are sometimes very
slight, and it is rather remarkable to find such acute nervous symptoms
with so little pathological alterations. The microscopical examination
shows little change, or few alterations you might expect from many of
the infectious diseases of other animals. We must, therefore, admit that
the microbes of distemper are not as yet well known. Like all other path-
ogenic micro organisms, they prodvice "ptomaines." It has been proven
that the severity of the nervous symptoms depends to a certain extent
upon the natural disposition of the animals, and also their bodily health.
When they take the disease, as weak, anaemic, poorly fed animals, they
are very apt to be severely attacked with a nervous form of the disease.
Occasionally symptoms appear in this disease which should be mentioned,
such as serious weakness of the heart. This may be due to a parenchyma-
tous degeneration of the heart muscle. It is generally fatal, as it
produces oedema of the lungs. Albuminuria is produced by paren-
chymatous degeneration of the kidneys, and in rare instances from true
nephritis; decubitus is seen occasionally in severe cases in the elbow-
and knee-joints, also at the femoro-tibial articulation. This sometimes
causes septicaemia and produces death.

The large number of the above-described symptoms show how com-
pletely the whole body may be affected with this disease; generally, how-
ever, the gastri-catarrhal forms predominate and run a regular course.
We also observe in some instances peculiarities and symptoms which may,
to a large extent, come from a general want of nutrition, or want of resist-
ance in some cases, while in others, especially in the terrier classes, they
seem to be able to throw off the disease and stand more acute attacks than
other animals. There are some forms of the disease which are so mild in
character as to almost escape observation. Thus we may have a mild
exanthema or a slight respiratory or intestinal catarrh which may be
difficult to recognize. The duration of this mild form of the disease may
be from half to one week. Of the different forms of the disease the catar-
rhal and gastric forms are most frequently seen, the nervous next, and the
exanthema least.-

Coui-se and Prognosis. — Distemper generally runs its course in two or
three weeks, although we occasionally see cases where the disease is, as we

276 DISEASES OF TRUE INFECTION

have just stated, particularly mild which runs its course in one week to a
week and a half, and in severe cases is prolonged for a much longer period.
In such cases this prolongation is not due to the influence of the disease
directly, but rather to secondary complications. We may count among
these, certain nervous diseases which frequently remain or appear after
the disease has run its course. For instance, paralysis of some of the mus-
cles, of the hind-quarters, or of all the extremities, and rhythmic move-
ments resembling St. Vitus's dance in some of the muscular groups,
especially the muscles of the face or of the legs, and is indicated by a con-
stant twitching, clonic in character, sometimes severer at one time than
another, but more especially after excitement. Blindness, loss of sense
of smell, or bark may also result from alteration of the nerves; or the an-
imal becomes an idiot, has hallucinations (thirion), difficulty in respira-
tion, persistent anaemia, and a chronic catarrh. Amaurosis and deafness
may occur in some cases.

Prognosis. — The prognosis of distemper, as a rule, should be regarded
as unfavorable even in those cases which are apparently mild, for in this
disease the symptoms may change in one day, from the mildest to the
most acute. Of course, the danger of the disease increases with the in-
tensity of the nervous symptoms, and especially if the symptoms are pro-
longed, and with them a persistent high temperature, and even in cases
where we have a subnormal temperature. Another series of cases which
must be regarded as unfavorable are those which are in their course com-
plicated by serious nervous symptoms or by symptoms of catarrhal pneu-
monia. Young dogs which are delicate (especially when not fed on meat)
anaemic, or rachitic, will succumb to the disease sooner and, as a rule,
present severer symptoms than those which have been fed with meat and
have had plenty of open-air exercise. A marked decrease of temperature,
without a similar improvement in the general condition, is always to be
looked upon as an extremely serious symptom. Death may occur in two
ways: through paralysis of the brain or oedema of the lungs, and occasion-
ally from septictemia or from general exhaustion. From the experience
of the writer, the death-rate is from 20 to 30 per cent. It depends to a
great extent whether there are a number of cases together or solitary cases
— in the former the percentage is much higher; but at the same time it is
impossible to give any positive statistics, because in cities the death-rate
is much higher, and in small towns and in the country, where distem-
per runs a comparatively mild course, the death-rate is much smaller.
The writer finds that in a large city the death-rate amounts to 60 to 70 per
cent.

Pathological Anatomy. — The most prominent and constant anatom-
ical alterations found at post-mortem are those in the respiratory and
digestive organs. In the former there are all the phenomena of an acute

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 277

catarrhal inflammation of the Larynx, trachea and bronchi, and also of
lobular pneumonia and catarrhal inflammation of the stomach and intes-
tines. For details, see under their respective chapters.

We find also more or less pathological alteration in the central ner-
vous system, such as hypersemia and small hemorrhages in the coverings of
the brain; cedema of the brain is sometimes present with flattening of the
convolutions and serous infiltration into the subarachnoids. In the ven-
tricles and base of the skull we have more or less marked venous hyper-
semia. As a rule, the spinal cord shows nothing abnormal except that it
is pale and seems soft in consistence.

Under the miscroscope decided changes have been noticed in the
brain. Kolesnikoff detected an infiltration of brain-matter and walls
of the brain vessels with lymphoid cells as well as a distention of the
capillaries and smaller arteries. These were filled with red and white
blood corpuscles. In the infiltrated walls of the vessels of the brain were
found dark-colored, homogeneous granulations and accumulations.
Krajew^ski found also the perivascular spaces and the ganglionic cells
filled with lymphoid corpuscles, and he mentions particularly that those
cases had died without showing any prominent nervous symptoms.
Muzulewitsch found inflammation of the spinal cord in acute nervous
distemper, in which there w^as marked hypersemia. He also found al-
terations in the walls of the vessels, and an albuminous exudation in the
upper third part of the spinal cord along the blood vessels, as well as in
the interstitial tissue of the gray substance. As a sequence of the acute
nervous form we have a chronic interstitial myelitis with partial atrophy
of the spinal cord.

Carougeau found an infiltration of leucocytes in the gray matter of
the entire cord, particularly in the anterior horns, a myelitis disseminate
which he believes was originated by the toxic action of distemper contagio-
sum ; this observation was made on a dog affected with chorea as a sequence
of distemper. Bohl and Rexter have reached the same conclusion from
their observations of the central nervous systems of dogs affected with
distemper.

Other abnormal conditions are found in distemper, such as anaemia,
parenchymatous or fatty degeneration of the heart, liver, kidneys, and
an abnormal swelling of the lymphatic glands and changes in the skin
and eyes.

Prophylaxis. — The animal affected with the disease should be kept
away from all animals that have not already had the disease, j^articularly
young animals; strict disinfection of the kennels or sleeping places of the
affected animals and also the various articles used by them. Prevent-
ive vaccination, while it cannot be called a success, is worth considera-
tion. Dogs that are not too highly bred, but bred on rational lines, and

278 DISEASES OF TRUE INFECTION

are well kept and substantially fed, are better al^le to stand the disease
and, after it has run its course, come out of it stronger and make quicdc
I'ecoveries; it cannot be said, however, that in this disease this always
holds good, for frequently an animal that is in perfect health and fine
physical shape may contract the disease and die, and another animal in
not nearly so good condition throws off the disease and makes a very
c|uick and prompt recovery.

Preventive Vaccination. — In the last century numerous attempts
have been made to find some inoculating material which would produce
immunity to distemper, either entire immunity or at least for a certain
period, and the results of certain observers have been mentioned already,
notably Krayewski. Ligniere, who considers distemper should be classed
among the hemorrhagic septicaemias, recommends a serum which he
prepares and calls polyvalent immune serum. Phisalix vaccinates with
greatly diluted cultures of the bacilli of distemper. The immunizing
action of the vaccine has been confirmed by Grey, Spiccr, Howtakcr,
who claim that this vaccine when injected into the animal at the time
it is affected with the disease has to a certain extent the property
of lessening both the intensity and course of the disease. Ligniere,
Jewell, Hobday, Parker and a committee appointed in England to test
this vaccine obtained unfavorable results. An immunizing agent called
antidistemper serum, prepared by the Jenner Institute of London, has
been sold commercially. Meyer, who has used a large quantity of the
serum, reports that after the animal is vaccinated it produces a mild form
of distemper which is catarrhal in form, and after the acute symptoms
disappear there may be nervous del)ility, unstead}- g'^it, and in one
case the animal became deaf. The vaccinated dogs, when brought in
contact afterward with dogs affected with acute distemper, either did
not contract it at all or they had a very mild attack. This serum in-
jected into an animal affected by distemper seems to have in certain
cases a decided beneficial effect.

An antidistemper serum prepared by the bacteriological insti-
tute of Piorkowski in Berlin, does not seem to produce the results
claimed for it. This serum is recommended not only for immunization
(5 to 10 c.c. is injected subcutaneously in any part of the bod}', the best
location being the neck) but also for curing the disease (in doses of 20
to 50 c.c), and according to the statement of Piorkowski 85 per cent, of
animals having both catarrhal and nervous forms are cured.

Baden used a large quantity of this serum and came to the conclu-
sion that in some cases it produced very good results, but these were
generally in the mild catarrhal gastric forms and when the treatment
was commenced immediately after the onset of the disease. In moi-e
acute cases when the disease had gone on for some time, and there were

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 279

either convulsions or chronic twitchings or catarrhal diarrhtea, the injec-
tion of the serum produced no effect whatever.

Wagner and Pinkammer declare it is valueless, while Lange and
Creutz claim to have had very good results when used in the early stages
of the disease. Opinions are also divided in regard to other serums,
for instance that of Gans, as well as what is known as Dutchman's serum,
obtained from animals fed with yeast. This latter serum is used only as
a therapeutic agent; some observers claim good results from it.

Numerous tests have been made by the writer, but it cannot be said
positively that the results are such as to say the serums are of any prac-
tical value, and when we consider that up to the present time the active
agent in the production of the disease has not been definitely isolated, or
its actual nature and structure known, we can hardly cultivate a serum
to combat it.

Some of the agents mentioned as being specific for distemper are
Gurnine (ganglionary serum) which has not been found to produce any
beneficial results. Yeast and yeast preparations, furonculine (dis-
temper antigurmine, creolin, etc.) , seem to have some influence in control-
ling intestinal catarrh. Calomel has also a certain effect in the early
stages of gastric distemper. Creolin inhalations are good in pulmonary
and bronchial forms of distemper, as also inhalations of benzoin and
balsam of Peru. Trichloride of iodine which Ellerman, de Brun and
others injected subcutaneously, 3 to 5 cm. in a solution of 1 to 100, has
a very favorable influence when administered in the early stages of the
disease, but in the more advanced stages of the disease it has little or no
influence. Ichthargan in 3 per cent, solution, iodipin, tallianine, 1 to
5 cm. intravenouvsly.

Therapeutics. — No special therapeutic treatment can be given for dis-
temper— that is, no agent has been found up to this time which has the
property of destroying or rendering harmless the specific micro-organisms
present in this disease. Certain antiseptic and antibacterial remedies,
like quinine, salicylic acid, antipyrine, etc., may generally reduce the
fever, but they produce no influence on the general course of the disease.
The use of agents for reducing the temperature is objectionable, as they
not only deprive us of the symptom of temperature, which is of the great-
est importance during the course of the disease, but cause more or less
depression of the heart. According to Frohner's experiments, calomel
is supposed to have a slight claim as a universal agent, but this is on the
same order as black coffee, which was formerly advocated by Trasbot.
Common salt has been recommended by Zippelius, and ergotin was
highly recommended and frequently used a few years ago. None of
these remedies, while they prove beneficial in some cases, is to be laid
down as a specific for the treatment of the disease, therefore we must

280 DISEASES OF TRUE INFECTION

continue to treat it in a purely symptomatic manner. Antipyrine, which
was advocated as an absolute specific, does not in the least deserve this
recommendation. The diet must be easily digested food, but at the same
time as nutritious as possible. Milk, bouillon, soup, and scraped raw
meat (which is generally taken with a relish) have much to commend
them. In grave cases where there is entire loss of appetite, we must use
concentrated food, such as peptonized meat, extract of beef, and clear
broth. This may be given with some mild alcoholic stimulant, wine, etc.
There are some forms of extract of beef which are not to be recommended,
on account of their slight nutritive value and as they also contain a
large proportion of sodium salts. When the temperature rises above
40° we must try to reduce it by means of frictions of alcohol and mild
antiseptics.

The "antipyretic'' treatment can only be used in rare instances in
the dog. The chief medicinal agents are quinine, salicylate of sodium,
antifebrine, and antipyrine. The older remedies (digitalis, veratrum, etc.)
have been abandoned for some time on account of their direct action on
the heart. This is also the case with kairin, thallin, and phenacetin.
The writer, as a rule, does not advise the use of Cj[uinine on account of
its action upon the heart.

It must be said, however, that in this disease good nursing, attention
to dietetics, fresh air and cleanliness are the greatest factors in producing
good results. The animal must be kept in a dry, clean, warm (not hot)
well lighted and ventilated kennel, but avoid the slightest suspicion of a
draught or dampness, and to prevent the spread of the disease through
contagion, disinfect the place when the animal has recovered, as well as
the surroundings used by the animal from time to time. The food should
be substantial and easily digested, such as milk, sago, egg and milk,
mutton broth and eggs, thick soups and small quantities of raw meat
must be given at short intervals.

When the animal refuses to eat, he must be given food in concentrated
form, such as thick meat broth, with a yolk of egg in it, extract of meat,
extract of malt, hamatogenc, hsemo-albumen, or use some of the various
extracts of beef.

To maintain the strength, or when the acute symptoms have sub-
sided but the animal is weak, the digestion poor, or the mouth sore and
solid particles of food cannot be eaten, we use concentrated food, such as
some of the various meat extracts and peptonized products, commercial
meat juice and liquified peptone; nutritive preparations containing
albumen, such as samatose, plasmon, etc. If the stomach cannot retain
food but is vomited up immediately after it is given, nutrition can be
administered by means of clysters. This can be meat broth, yolks of
egg, and thick starch water, to make it of enough consistency to be

DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 281

retained in the rectum. Very frequently by this means an animal can
be carried over the grave stages of the disease, and it is surprising how
long an animal's life can be sustained by this means. Albrecht mentions
one dog that had chronic nephritis, and was nourished for forty-two days
by this means. In the administration of a nutritive clyster, the rectum
must be first cleansed by an injection of luke-warm water, and in about
ten minutes, not sooner, the nourishing clyster is given; the amount
varies from a tablespoonful to a cupful, according to the size of the animal.
The injection must be made slowly and carefully, care being taken not to
excite the animal any more than is necessary, and when the nozzle of
the injection pipe is withdrawn the anal opening must be held closed
for a short time, and, if possible, elevate the hind cjuarters of the
animal.

The following nutritive clysters are recommended:

1. Two or three beaten up eggs, 250.0 thick bouillon.

2. Two beaten up eggs, 200.0 concentrated bouillon and a spoonful of
starch.

3. Two beaten eggs, 10.0 peptonoids, 120.0 sherry wine, 250.0
bouillon.

4. One beaten egg, 600.0 bouillon, 150.0 port wine, 0.5 bicarbonate of
soda, 0.02 common salt, and 60.0 peptonoids.

5. Two beaten eggs, 4.0 salt, 20.0 port wine, 250.0 milk.

6. Two or three eggs beaten up with a little cold water, and a pinch
of starch; these are laid to one side, then a tablespoonful of sugar, a half
cup of milk and a wineglassful of port wine are mixed together and boiled
for a short time, when it is allowed to cool. When it is nearly cold add the
combination to it with a small pinch of salt, care being taken to see that
the solution is not warm enough to coagulate the milk.

In the early stages of the disease, the stomach can be emptied by
means of an emetic, such as the subcutaneous injections of apomorphia,
antimonial wine, etc. It is a ciuestion whether an emetic by its subse-
cjuent depression does not do more harm than good. As a rule, constipa-
tion is not present and the bowels had better be left alone; if the animal
commences to eat and the intestinal canal returns to its normal condition,
the lower bowel will be emptied naturally without the assistance of drugs;
if, however, it is necessary to evacuate the rectum, use a glycerine sup-
pository.

Other therapeutic measures will have to be employed as the symptoms
arise, and we would refer you to the diseases of the nose, larynx, bron-
chia, and air-passages, also to those of the stomach and intestine, par-
ticularly where there is persistent diarrhoea, and lastly diseases of the
brain, spinal cord, and eyes. As a rule, no treatment should be used for
the skin eruption in distemper. If any irregularity arise, however, this

282 DISEASES OF TRUE INFECTION

may be treated according to the methods recommended under Diseases
of the Skin.

Conjunctivitis is general!}' treated by a solution of sulphate of zinc
(1 to 100), or painting the diseased membranes with a solution of nitrate
of silver (1 to 70). This must be followed afterward by a 1 per cent, so-
lution of chloride of sodium. " Blennorrhoea of the eyes" should be
treated by bathing the parts with some antiseptic solution, such as creolin
(1 to 100), corrosive sublimate (1 to 2000), or boric acid (1 to 40), or by
painting the mucous memlirane by means of a camel's hair pencil with a 2
per cent, solution of sulphate of copper. Ulceration of th^ cornea should be
treated with a 3 or 4 per cent, solution of boric acid. Parenchymatous
keratitis may be treated with a few drops of a 1 to 100 solution of atropine.
After the acute inflammatory symptoms of the eye have subsided blowing
calomel directly on the cornea produces good results.

Infectious Bronchial Catarrh.

(False or Bench-show Disteinj)cr.)

Within the last twenty years bench shows have become very numer-
ous, and kennels both large and small ai-e legion, and from each kennel one
to ten or more of the dogs are being exhibited from time to time, we
freciuently observe in these kennels shortly after dogs return from the
shows a disease that resembles and is frecjuently taken for distemper.
This disease for a better name has been called " Bench-shoAV Distemper."
It is decidedly infectious and attacks the large bronchi producing catarrhal
bronchitis and a muco-purulent discharge from the nostrils and eyes;
with this there is also catarrh of the intestines. The writer has also felt
that there may possibly }:)e such a condition, and has intimated that fact
under the head of Catarrh of the Bronchia (page 137).

Etiology. — It is generally seen in large kennels, attacking one animal
after another or several at once. It may also be o])served where several
dogs have been sent to a bench show, developing shortly after they return.
The period of inculjation is three to five days. Another peculiarity is that
one attack does not insure immunity from another. The writer has ob-
served several dogs that have developed this disease, and the next year
repeated the attack after returning from a show.

Pathological Anatomy. — The lesions found are very similar to those
of true distemper, but milder in character. The alterations in the lungs
are those of catarrhal i)neumonia. The most frequent condition oljserved
is great irritation of the nnicous membrane of the intestines, with more or
less swelling of the whole intestinal tract. The follicles and glands of the
intestines may be swollen or enlarged, and in rare instances ulcerated, but
not to the marked degree seen in distempei'.

INFECTIOUS HEMORRHAGIC GASTROENTERITIS 283

Clinical Symptoms. — The animal is dull and listless for two days,
when the temperature will be found to be 39° or 40°; slight running fi-om
the eyes; and invariably diarrhtea. This last symptom is generally olv
served from the first, the stools being liciuid the first few days, and later
filled with gelatinous mucus. At the end of a week there way be some
passed in the stools, but this is not commonly seen.

The appetite may be very poor or even lost, but generally in three or
four days the animal will commence to eat, but stop again if the diarrha-a
should be severe, or eat very small quantities. Vomiting is rarely seen
except at the onset.

The discharge from the nose and eyes is difficult to distinguish from
distemper, except that it is thinner and muco-purulent. The cough is
stronger, and not the soft, shallow cough observed in distemper. Fre-
quently we find acute laryngitis or bronchitis. The exanthema of dis-
temper is absent but the hair is dry and harsh, and freciuently the hair
falls out very rapidly in the long-coated dogs, especially collies.

The mouth very frequently becomes sore and the gums may ulcerate.
In rare cases a series of aphthous ulcers are seen on the lips and around the
free end of the tongue. This condition rarely causes death unless the
diarrhoea is persistent and the animal will not eat; and any attempt at
forced feeding is folloAved by vomiting.

In some cases shortly after the acute symptoms commence there may
be evidences of congestion of the brain, accompanied by severe and con-
tinued convulsions, which frequently cause death.

The treatment is practically the same as in distemper. Keep the ani-
mals warm and dr};, give easily digested food, lean meat, carefully remov-
ing all fat, and quinine, iron, and some of the pepsin preparations, and
allow them to run if they are not too weak. Penning them up closely
does harm.

I^. Ferri et quininae citras, 12.0

Elixir simplex, 96.0

S. — One teaspoonful three times daily.

If the diarrhoea is severe, give

I^. Bismutli subgallate, 0.75

F. cliarta No. xii.
S. — One powder three times daily.

Infectious Hemorrhagic Gastroenteritis.

{Canine Typhus, Stuttyort Day Disease, Dog Plague.)

This disease may be descril)ed as a grave infectious disease, having
some of the characters of distemper. The characteristic lesion being an

284 DISEASES OF TRUE INFECTION

acute hemorrhagic inflammation of the intestinal mucous membrane
and frequently accompanied l)y an ulcerative stomatitis. This disease
attacks animals of all ages; occasionally a milder form is observed, in-
dicated by severe pharyngitis and gastric catarrh and is differentiated
from simple gastric catarrh by the more acute symptoms and the fact
that it does not respond to the ordinary treatment used in simple catarrh.

The disease was described by Hoffer in 1850 as dog typhus; and dur-
ing the latter portion of the nineteenth century it spread over the greater
part of Europe and destroyed numlicrs of animals. Then the outbi'eak
lessened in severity and only sporadic cases were observed, but recently
it appears with increased severity.

Etiology. — The disease attacks animals of all ages, but seems to pre-
dominate in older animals. Klett made a record of 100 cases and found
five cases in animals under one year, sixteen in second year, twenty-one in
third year, eleven in fourth year, nine in sixth year, seven in seventh
year and eighth year, two in ninth, six in tenth, etc. Sex, constitution
and breed do not seem to hinder or have any bearing on the course or
severity of the disease although Rabus observed the delicate, highly
nervous animals that are very carefully housed seem to be more suscepti-
ble and succumb to attacks of the disease.

The actual cause of the disease or medium of infection has not been
definitely described. Some oliservers think the faeces is the medium of
the infection, some the urine, some the vomited material, others the
urine, blood, or other tissue fluids, but the majority of observers agree
that the disease gains entry into the system by means of the digestive
tract. It is not definitely known if it is directly transmissible to
another animal, and the direct inoculation of the disease is only accom-
plished with great difficulty and after repeated experiments, and even
then it is governed l)y certain favorable circumstances. Albrecht injected
a healthy dog with blood taken from an animal affected with the disease.
Into a second dog he injected subcutaneously a certain amount of bile
from the gall-bladder of another infected animal. Into the third animal
he administered a quantity of the contents of the stomach of a diseased
animal. The animal that had the subcutaneous injection of bile developed
a severe abscess at the point of puncture and made a good recovery.
The other animals were not afTected at all. Scheibel fed finely cut up
portions of the stomach and intestines of affected animals without any ill
affects, but when he had given an animal a solution of bicarbonate of soda,
rendering the mucous mem]:)rane of the stomach alkaline, the animal
developed the disease two days later. Scheibel came to the conculsion
that a mixed infection of the coli-bacteria and micrococci was more apt
to reproduce the disease. Pirl found in the blood taken from the heart
of the diseased animal an oi'ganism which was similar to the bacterium

INFECTIOUS HEMORRHAGIC GASTROENTERITIS 285

hemorrhagiciim. Zschokke found in the serum of the kichieys of an
animal that had just died numerous sk^nder cocci-bacteria. The majority
of French observers beheve that the disease must be classed under the
head of the pasteurellas. Bimis and Seris contend that this disease is
simply a very malignant form of distemper. Hutyra obtained from the
mucous glands of the mucous meml^rane of the intestine and from the in-
testinal contents virulent coli-liacilli. The intravenous injection of an
experimental bouillon culture produced fatal hemorrhagic gastro-enteritis,
whereas, if the stomach was previously neutralized, the bouillon could be
fed to the animals and produce no effect whatever.

Pathological Anatomy. — Severe inflammatory alterations will be
found along the digestive apparatus. The stomach is found to be
be contracted to very small compass and rarely contains any food of any
kind. The mucous membranes are swollen, red to black-red, containing
more or less hemorrhagic spots and covered with a foetid brown colored
mucus which is alkaline in reaction. Similar changes but not so severe
are found in the duodenum. The rest of the intestinal tract may be
affected but it is the exception; the rectum, however, is freciuently in-
flamed. The peritoneum is injected, the liver and kidneys are more or
less hyperoemic. Zschokke found the kidneys presenting all the symp-
toms of metastatic suppurative nephritis. The bladder is usually dis-
tended and filled with urine, the mesenteric glands and spleen are gener-
ally slightly enlarged. The cavity of the mouth is ulcerated with necrotic
processes in various places, particularly about the gums, and there are more
or less inflammatory changes of the mouth and swelling of the tonsils.

Clinical Symptoms and Course. — The first symptom is a want of
appetite, which is soon entirely lost, great depression and want of anima-
tion, frequent vomiting and great thirst. The vomited matter is at first
streaked with bile but frequently it is brownish-red or the color of blood
and in the latter stages the vomited matter is very foetid, brownish in
color. The animal defecates with difficulty, and if the temperature is
taken the thermometer is found to be streaked with l^lood. After a few
days the animal has a bloody diarrhoea with an intensely offensive odor.
The urine is decreased in quantity and frequently the urine is passed with
more or less difficulty. It is found on examination to contain albumin
and bile coloring matter. The abdomen is drawn and tucked up and
palpation of the abdomen, particularly in the region of the stomach, is
very painful. The eyes are sunken deep in their sockets. The conjunc-
tiva is intensely injected and in severe cases the congested conjunctiva is
brownish-red and the pupils are fixed and dilated. There is more or
less discharge of tenacious yellow mucus from the nostrils, the pulse is
small and thready, and the heart has a full throbbing beat. The tem-
perature is not particularly high, generally about 40 degrees; only in

286 DISEASES OF TRUE INFECTION

rare instances it rises above that and in cases of a fatal termination it is
invariably subnormal. The mouth is frequently kept tightly shut by
the animal and efforts made to open it cause the animal great pain. The
mouth and breath have a particularly fcetid odor, particularly when the
disease is well developed, and we find the gums and jaws and cheeks covered
with deep ulcerous patches. The tongue varies; it may be brownish-
red, bluish-gray, or extremely pale and on the upper surface of the tongue
it is coated by dirty brownish-red mucus. Frequently the tongue lies
on the floor of the mouth apparently paralyzed. In some cases the
mouth, throat, and mucous membrane of the tongue are covered by sticky
moist, purulent mucus and occasionally we find necrosis of the tip of the
tongue. In some fatal cases we find little change in the mouth and
pharynx other than deep redness of the mucous membranes.

When the disease goes on rapidly to a fatal termination, the animal
becomes emaciated very rapidly, lies motionless in one position and dies
within a week. In rare instances the animal may have convulsions before
death. Mettel found pneumonia and haematuria and Richta found hem-
orrhage in the anterior chamber of the eye. If the disease lasts over ten
days without fatal results, the mouth commences to clear up, the ulcers
become covered with a brownish scab, the vomiting ceases, the appetite
returns, and in two or three weeks the animal has fully recovered. Par-
alysis of the body and extremities may result, and deafness may occui- as
an after-result of this disease. In milder cases there are generally all the
symptoms of acute gastric catarrh with pharyngitis. It is rather difficult
in sporadic cases to diagnose between this disease and simple attacks of
gastric catarrh and pharyngitis, but when we find a number of cases and
where the odor from the mouth is particularly offensive and also the faeces,
the chances are it is hemorrhagic gastro-enteritis.

The prognosis is very unfavorable. The mortality is from 50 to 70
per cent., and even the milder forms of the disease seem extremely
hard to treat and frequently terminate fatally; young animals seem to be
able to throw off the disease better than older animals, and young animals
are much more apt to have a milder attack.

Therapeutics. — Treatment in well-developed cases is generally hope-
less. As a rule it is well to give the animals easily digested food, keep
the animal in a warm place free from draughts, and if there is abdominal
pain apply the Priessnitz compress. In case of persistent vomiting, use
hot applications to the region of the stomach, or wash out the stomach
with weak solution of creolin, alum, borated water or .8 per cent, sodium
chloride. Small quantities of broken up ice frequently administered may
check the vomiting, also morphia (-Klett), tincture of iodine and chloform,
aa5.0 in 3 to 10 drop doses in water or milk (Cadiot). Creasote solution,
(one drop in ess. of pepsin). For stomach and intestinal irritation, salicylic

SEPTICOPY.EMIA 287

acid, salol, tincture of rhul-);!!'!), iclitargan, calomel and opium, bismuth sub-
nitrate, adrenaline solution, all have been recommended for this condition.
For lessening the fever, phenacetin and quinine have been recommended.

For the local treatment of the ulcerated mucous meml^rane, washes
of permanganate of potash, 1 to 200, creolin 1 to 100, peroxide of hydrogen
solution.

To combat extreme weakness give camphor, caffeine, atropia. Klett
used a subcutaneous injection of physiological salt solution. Alcohol,
pure or in spirits, is not recommended. For violent foetid diarrho'a give
pinch of tannoform, tannothymol or xeroform. For intestinal cramps or
colic give salts of bromine, morphia or sulphonal.

The treatment of the paralysis that may follow as a sequel is taken
up under Diseases of the Spine and its Coverings.

SEPTIC AND PYEMIC DISEASES.

Septicopyaemia.

Etiology. — This disease is caused by staphylococci or streptococci,
frequently by the bacterium coli, and occasionally by proteus or micro-
organisms related to them. The microbes may collect in a wound or they
may accumulate in some centre in the body, later find their way into the
blood and give rise to the characteristic symptoms of the disease, that is,
high fever and great depression and these pus-forming organisms settle in
the capillaries and form metastatic abscesses which appear in different
organs of the body, and pyiemia when accompanied by the formation of
abscesses and suppuration. It is termed septicaemia when there is high
fever and general depression. It is extremely hard, however, to make a
sharp distinction between the two, for undoubtedly the nature and in-
tensity of the disease depends not only on the nature of the bacteria, but
also on the toxic effects of the same and the individual resistance of the
animal affected.

This condition can originate from purulent, ichorous, or gangrenous
wounds, ulcers, circumscribed or diffuse phlegmons, complicated frac-
tures, decubitus, puerperal diseases, putrid abscesses of the stomach
and intestines, acute inflammation and sloughing of the buccal cavity and
pharynx, abscess of the prostate. In many cases the original cause can-
not be discovered.

Clinical Symptoms. — Fever, ushered in by chills, high temperature —
this may fluctuate and towards the end it may be subnormal — small ac-
celerated pulse, great weakness of heart, livid red mucous membranes; in
rare instances the mucous membranes are yellowish (icteric) ; sometimes
hemorrhages of the mucous membrane and skin, great dulness and then

288 DISEASES OF TRUE INFECTION

complete prostration, no appetite, skin cold and inelastic. When the
skin is drawn from the body it remains in position instead of flying back
as healthy elastic skin will do; foetid stools, albuminuria. As a rule death
comes quickly. In less acute cases we find symptoms of nephritis,
hepatitis, endocarditis, or evidences of localization of the condition in
the formation of abscesses of the lungs, liver, or in the articulations.

Therapeutics. — There has been no specific serum that seems to have
any effect on the disease, so the symptoms must be treated as they appear.
Try to keep up the strength of the patient, administer alcohol in the form
of wine, whiskey, or brandy frequently, and strong liquid foods. Digi-
talis and strophanthus have not given good results in keeping up the heart's
action in septic diseases; to cut down the fever use antipyrin, antifebrin or
Cj[uinine; the latter should not be given if the heart is particularly weak.
To assist in eliminating the microbes, administer a hypodermic injection
of from 30 to 300.0 c.c. of an 8 per cent, solution of chloride of sodium.
It is well to keep in mind the importance of antiseptics in all wounds and
operations, and any ^^I'ocess of disease that will tend to produce
septicopysemia.

Malignant CEdema.

{CEdemu Maligna.)

This disease is extremely rare in the dog. It is an acute infectious
disease caused by a specific bacterium (bacillus oedematis malignae). It
begins at a certain infected point in the form of a hot, painful oedematous,
pitty swelling which afterwards becomes an emphysematous (crepitating)
swelling which extends very rapidly into the surrounding tissues. This
crepitation is peculiar to the disease, and can be separated from simple
emphysema by the fact that in simple emphysema there is no fever pres-
ent. Immediately after death the bacilli are found in the serum of the
oedematous swellings and in the blood.

This Bacillus oedematis malignse is not only found in animals but also
in garden soil, dust, putrid organic materials, excrement of herbaceous
animals, etc. It has been demonstrated recently that the oedema bacillus
only develops when in combination with other bacilli such as the staphylo-
cocci, diplococci, etc.

The treatment of malignant oedema must be very energetic, as the
disease causes death in a very short time. It consists in opening and
breaking down the infected connecting tissues and thoroughly disinfecting
them, first cleaning them out with peroxide of hydrogen, and then
washing with a 1 to 3000 solution of corrosive sublimate.

ANTHRAX 289

Anthrax.

{Charhon. Malignant Pustule. Splenic Fever.)

Anthrax is rare in the dog, and when it occurs it is generally caused
by the animal eating portions of cadavers of animals that have had this
affection. This is an acute infectious disease which is caused by the
Bacillus anthracis, and is accompanied by high fever and local mani-
festations in the skin and mucous membranes. All forms of anthrax
have been observed in the dog, but generally the seat of the disease is in
the mouth, throat and in the intestines, and generally there is more or
less tumefaction of the head. One observer saw a typical case of anthrax
of the tongue and lips caused by an animal licking the l^lood of an animal
that had that disease. Another case observed was where a terrier had
eaten a bone of an animal affected with anthrax. Lupke found on the
inferior wall of the throat a carbuncle, which was probably caused by an
erosion of the epithelium, in which there was great inflammatory oedema
of the adjacent regions. In regard to the susceptibility of the dog to an-
thrax, one case is cited where 150 dogs ate the flesh of a horse that had
died of anthrax; 100 had swelling of the lips, throat, forehead and head,
and sixty of them died. Young dogs seem much more susceptible than
older animals. Different breeds of dogs are said to be less susceptible
to anthrax than others; this, however, is a question. When a number of
animals are affected wdth symptoms of anthrax, particularly packs of
hounds, when the dead cadaver is fed to the hounds, the proper method
of diagnosis would be to examine the blood microscopically and make
a trial inoculation of an animal that had not been near the infected
animals.

Therapeutic treatment is generally useless on account of the rapid pro-
gress of the disease. If any treatment is attempted it may be in the line
of the internal administration of antiseptics, creolin, carbolic acid, salicylic
acid, and preparations of iodine particularly Donovan's solution. AVhere
the carbuncle is formed then local incisions and the injection of corrosive
sublimate solution, 1 to 1000, and tincture of iodine. The actual cautery
has been recommended to destroy the tissue of the carbuncle. Concern-
ing sanitary laws, the following apply to this disease:

Animals which suffer from or are suspected of anthrax cannot be
slaughtered for consumption.

Any operation that will cause bleeding of the animal suspected of
anthrax can only be performed under the supervision of the official
veterinarian.

All cadavers of animals which are affected or suspected of having
19

290 DISEASES OF TRUE INFECTION

anthrax must be rcnderetl harmless by burning the cadavers. Skinning
the animal is strictly forbidden.

Rabies.

{Hijdrophobia.)

This is an acute disease of the entire nervous system caused by a
specific poison, and distinguished by a variable period of incubation, as
well as by an absence of any marked anatomical alteration.

Etiology. — Rabies is a true infectious disease, and never occurs
spontaneously, but is only transmitted by direct infection through the
bite of affected animals. This disease, as a rule, is confined to the canine
race (dog, wolf, fox, hyena, and jackal). It is seen in rare instances in
the cat, horse, cattle, sheep, goat, deer, guinea-pig, rabbit, rat, mouse,
chicken, pigeon, and in man. The dog is the animal that contracts the
disease quicker than any other. Country, climate, care, nursing, age,
and sex do not seem to have any influence upon it. The disease is more
frequently seen in central Europe and in New England and Middle States
than anywhere else. This may be accounted for by the fact that dogs in
large numbers run at large, and also to the fact that the owners do not
conform to the rules of sanitary police. Rabies does not seem to be in-
fluenced to any great extent, by the seasons of the year, but cases are more
frequently seen in the spring and summer than in the autumn and winter.
The poison of rabies is as yet unknown, or at least it has not been definitely
described. It is reproduced in the body of the animal only; never outside
of it. It is mixed with blood, saliva in the salivary glands, and in the
secretions of the lachrymal glands. It is also said to occur in the mam-
mary glands. From direct inoculations, this disease appears in its most
concentrated form in the brain, spine, and in the ganglionic nerves.

This poison is virulent in the spine and brain, during the incubative
period, and retains its full strength for several days after the death of the
affected animal. Roux and Nocard have found that the saliva is infectious
two or three days before any symptoms of the disease appear, and one
case recorded by Pampouki, in which a woman was infected by a dog
eight days before the actual symptoms appeared in the dog. The actual
excitant of the disease does not appear to be present in the muscles, the
lymphatic glands, liver or spleen, and the urine or spermatic fluid has not
been found virulent and the rabic poison has been found in very rare
instances in the aqvicous humor. The true cause of rabies has not as yet
been isolated and described, probably it is an ultra-microscopical organism,
at least it seems so to a large number of observers (Rimlinger, Riffet,
Rey, Schander, C'clli, Blase, etc.) , who have passed a brain emulsion through

RABIES 291

specially fine filters, and an inoculation with the filtrate has successfully
reproduced the disease.

In 1903 Negri found both in inoculated and rabid street dogs, in certain
parts of the cerebral nervous system, particularly in the horns of the amnion,
in the Pur kin je cells of the cerebellum, in the nerve cells of the pons, in the
cord and the central cortex, when sections of these parts were stained by
Mann's method, (methyl blue-eosin), certain bodies which took up the
stain, and appeared a brick red, these bodies being round or slightly
oval, periform, or even irregular triangles, and varying greatly in size,
from 1 to 27 tx; either isolated or grouped in the cells. These were found
in dogs affected with rabies, as well as other rabid animals and man.
They retain their characteristics even when the cadaver was in a
state of advanced putrefaction and remain perfect in glycerine. Negri
regards these as the various stages of evolution of a parasite which
should be classed with the "protozoa" and claims these as the true
excitors of rabies. It is true that for some time before Negri had an-
nounced his theory, a number of observers thought that the origin of rabies
must be due to the protozoa, particularly Dijestal, who had described
having seen in the spine and ganglionic nerves, small bodies like
protozoa.

These bodies are to-day generally known as Negri's corpuscles or
bodies, (see plate) , and have since been observed and described by a num-
ber of other observers, and studied particularly with regard to their
minute structure ( Volpino, Williams, Bohn) , and it must be admitted that
they are found with great regularity in rabid dogs and their presence is
regarded as diagnostic.

In 1903 to 1905, 457 dogs suspected of rabies were examined
by Italian scientists; 297 were proved by inoculation to be rabid and in all
but nine the corpuscles of Negri were found.

The claim of Negri that this specific parasite (protozoon) is the true
and only cause of rabies is a question that is opposed by those observers
who have filtered the emulsified brain substance of an affected animal
and the filtrate reproduced the disease by inoculation; there is a possibility,
however, that certain of these corpuscles may be so infinitesimal as to
pass through the filter and so small as to be beyond the power of the
microscope to render them visible.

Pasteur has demonstrated that a rabid brain loses its infectious
virulence only when that part has become partially decomposed, that is
to say, after four or five days; while it remains virulent in air-tight tubes
or in moistened carbolic gauze. Neustube found that the brain of a
rabid dog retained its virulent properties when kept under a slightly
elevated temperature for ten or twelve days. Mergel found the virulence
as strong as ever in the putrid brain of a rabid wolf fourteen days after

292 DISEASES OF TRUE INFECTION

the animal had ])een killod. Galticr noticed the same conditions in the
decayed brain substance of a rabid dog, when kept under a low tempera-
ture (12° Celsius). An affected brain was not rendered harmless even
when exposed for three weeks at a time, but its virulence was attenuated
wdien kept some time at a temperature of 61° Celsius. Bluml)erg found
that an affected brain is rendered harmless when it has undergone a freez-
ing process at 20° or 30°. Galtier was able to destroy the virulence of af-
fected cerebral matter in four to twenty days by placing it upon plates and
allowing it to become dry. Saliva and blood are much less resistant than
brain matter. Both su])stances as a rule, lose their harmful properties
twenty-four hours after leaving the animal. Dried saliva is inactive
fourteen hours after it comes from the mouth of the animal, the gastric
juice destroys it in five hours; bile kills it in a few minutes, and it is de-
stroyed quickly by corrosive sublimate, chlorine water, permangate of
potash, sulphuric acid, creolin, etc. The X-rays seem to retard the
development of the virus.

As a rule, it is necessary to make a natural or artificial inoculation in
order to obtain any successful transmission of the rabid poison, as no in-
fection will take place if an animal is given the saliva, flesh, brain or spinal
cord of an affected animal, or if the inoculation is simply rubbed on the
cutaneous or mucous membranes; but if the mucous membrane is scarified
first it can be reproduced. The most certain method to reproduce the
disease is to introduce the virus directly on the dura mater of the brain
or spinal cord, or in the anterior chamber of the eye. Heredity — that is,
transmission of rabies by the mother to puppies or the production of the
disease by infected saliva being in food — is very questionable. The most
common method, of course, is the bite of the rabid animals; more rarely
licking of a wound. In many cases the bite may not be severe enough to
cause its development in dogs or in man. Deep bites, however, are
certainly the most dangerous, especially when made on the unprotected
parts of the body (hands and face in man). Wounds which bleed much
are less dangerous, as the poison may be washed out of the wound by the
flowing blood. Bites of dogs which have bitten numerous others are
less dangerous than the first or second bite made by a rabid animal.

Infectious wounds which were made by biting or inoculation, accord-
ing to Hertwig's observations, showed only 37 per cent, of positive results,
and Renault's 67 per cent. Of 137 animals which were bitten by rabid
dogs under observations for the last five years at the Veterinary College of
Berlin, six only ultimately developed the disease. Zundel finds that
about 25 per cent, of inoculated animals become affected, while Haubner
found 40 per cent. At Alfort they have found the proportion to be about
33 per cent., and at Lyons, 26 per cent. In man 50 per cent, of the
bitten subjects develop the disease, but if we sum together the cases of

RABIES 293

true rabid and ''suspected" dogs, the proportion is reduced to about 8
per cent.

The most dangerous bites seem to be those directly into a nerve or upon
nerve tissue, even if it is on the smaller branches of nerves, whereas a bite
on blood vessels or the lymphatic system is less so, and artificial inoculation
proves that if it is made as near to the central nervous system as possible
the disease makes its appearance more quickly, and the injection directly
on the dura mater produces the disease in shorter time and more certainly
than any other part of the bod}-. Pasteur claimed that if there is the
largest proportion of virus in the brain, it produces furious rabies, and if
the virus predominates in the spine it causes dumb rabies. It is possible
that the results of the material changes on the animal economy produced
by the disease ''toxines" may have some effect on the character and
severity of the disease, the nature of which is at present really not
known. Anrep prepared a serum from the brain of guinea-pigs affected
with furious rabies; this serum injected into animals produced lowering of
temperature, paralysis of the extremities, salivation, and death by para-
lysis of the respiratory centres.

Pathological Anatomy. — The post-mortem results are generally nega-
tive and vary in different animals, but, as a rule, specific alterations are
noticed. These are as follows:

Great emaciation with very distinct muscular rigidity and a rapid
tendency to decay; collections of mucus upon all the natural orifices,
such as the mouth, nose, and the prepuce; prominence of the cutaneous
veins, which are found to be filled with thick, imperfectly clotted blood;
redness and swelling of the mouth and mucous membranes. The throat
is covered with a whitish-gray mucous exudation; intense inflammation of
the glands of the pharynx; in some cases slight swelling and hyperaemia of
the salivary glands. In the cavity of the throat and mouth we find for-
eign bodies, such as hair, straw, coal, wood, etc.; they may also be found
in the oesophagus, which is frequently very red and covered with clammy,
gray mucus. This condition is seen in the stomach which contains little
or no food but, as a rule, numerous indigestible objects of various kinds
and sizes — straw, hair, wood, stones or pieces of leather or rags. The
mucous membrane is reddened and swollen, especiall}' on the surface of its
folds, and marked with hemorrhagic erosions, which Johne describes as
sepia-colored. The intestine may be empty or it may contain some of the
foreign bodies. The mucous membrane of the pharynx is always very
red, swollen, and covered with mucus in its anterior portions. These alter-
ations are also seen in the trachea and the large bronchia. The lungs are,
as a rule, filled with blood, but otherwise normal. In rare instances we
find circumscribed centres of irritation due to foreign bodies being inhaled
through the bronchial tubes. The heart and its envelope are generally

294 DISEASES OF TRUE INFECTION

normal. The inner surface of the pericardium may show hemorrhagic
spots. The chambers of the heart, as well as the large blood vessels, are
filled with dark, imperfecth^ clotted l^lood. The liver and kidneys are
hypersemic. The spleen is always filled with blood, enlarged, and oc-
casionally streaked with hemorrhagic spots; the bladder is found to contain
little urine, and this on test is found to contain svigar. Cadiot was inclined
to consider glycosuria as a regular symptom of rabies and of patholog-
ical importance, but Rabreaux and Nicholas took the ground that while
sugar is apt to be in the virine of rabid animals, still its absence did not
mean the animal did not have rabies.

The condition of the brain and spine was formerly supposed to pre-
sent some reliable indications of the disease, but according to the investi-
gations of the last few years it cannot be said that they present any constant
pathological alterations. They vary greatly and in some cases may pre-
sent no noticeable change at all. We frequently find hypersemia of the
covering of the brain and spinal cord, accompanied by slight hemorrhages,
and the brain and spinal matter itself contains more blood than usual and
is in a more or less oedematous condition.

Kolesnikoff found on microscopic examination of the walls and neigh-
boring vessels of the brain (of dogs which have died with rabies) an accu-
mulation of lymphoid cells and extravasated red blood corpuscles. The
accumulation of discolored cells and red corpuscles in the small blood ves-
sels of the walls and perivascular chambers indicates to a certain extent a
condition which in rabies is of pathological importance. They are un-
doubtedly symptoms of inflammation. These changes vary in different
cases. According to Czoker, it was noticed to a very slight degree in dogs
affected with the furious form of rabies, but it was noticed to a marked
degree as soon as the disease developed the dumb form (the perivascular
spaces and their neighliorhood were filled with leukocytes).

Babes found nodulated infiltration in the spinal cord of dogs that he
called nodules rabirjues (rabid nodules). Other observers have, however,
found them in distemper, ^'an Gehuchten and Xelis found in the cerel^ro-
spinal and sympathetic ganglion of a street dog that died of rabies defi-
nite lesions, such as infiltration, tumefaction and ecchymosis, and great
proliferation of the endothelial cells of the capsule that covers the gang-
lionary cells, and emigration of the mononuclear cells and a destruction
of the ganglionary cells (ncurophagy). The plexus nodus vagi is fre-
quently attacked. These alterations in the nerve tissues are not always
present in the disease and cannot be used as positive evidence of the dis-
ease. Valleea and Manonelian found similar infiltrations of the ganglia
in very old dogs, and other observers found these modifications in less
degree in other diseases, i^imilar alterations have been noticed in other
diseased conditions, such as chorea, tetanus, distemper and meningitis.

RABIES 295

Clinical Symptoms and Course. — The period of incubation lasts in
the majority of cases from three to six weeks. In very rare instances the
disease maj^ appear in one week. According to Haubner's observations
upon nearly 200 dogs, in 83 per cent, of the cases the disease developed in
two months; in 16 per cent, of the cases within three months; and in 1
per cent, four months, or even later. Zundel has calculated that in 264
dogs 1 per cent, became affected within twenty-four hours after being
bitten; 11 per cent, between the second and third day; 33 per cent, be-
tween the fifteenth and thirtieth clay; 19 per cent, between the thirtieth
and forty-fifth day; 10 per cent, between the forty-fifth and sixtieth day;
16 per cent, between the sixtieth and ninetieth day, and 10 per cent,
after three months. The longest period of incubation was observed by
Leblanc; this case developed in 364 days. The period of incubation is
shorter in young than in older dogs. In the human race it is generally
admitted that the average period of incubation is seventy-two days
(this average covers over 510 cases).

There are two forms of rabies — a furious and mute (or dumb) form.
The first is more frequent, but there are numerous transitions between
the two forms; dogs that are at liberty or vagrant dogs are more apt to
have the violent or furious form, while dogs kept as house pets or who
are restrained are more frequently affected with the mute or dumb
form, and in dogs that are well trained and under control and have lived
in close contact with man, the tendency to bite is only present when they
have reached the point of true delirium and mental control is gone.
Pasteur found that intracranial injection produced furious rabies, while
subcutaneous injection almost invariably resulted in the dumb form.

Furious Rabies. — This comprises three distinct stages, between which
there is a very distinct line of demarcation — namely, the prodrome or
melancholic, the stage of irritation, and the paralytic stage.

In the melancholic stage the dogs seem to change in their disposition.
They are capricious, and at other times irritable or depressed. They show
symptoms of anger, are easily excited, fretful, change from one place to
another, are easily frightened on the slighest cause or may become very
affectionate. They soon show a tendency to gnaw or swallow indigestible
substances. They refuse their usual food, or they may take such food as
they have a special taste for, holding it in their mouth for a few moments
and then let it drop out of the mouth again. They will lick and gnaw, in a
greedy manner, various objects, such as wood, coal, furniture, and eat sti'aw,
earth, stones-, wood, blankets, and even their own fieces. In one case
observed by Govard, the animal would howl loudly, have an evacuation
of faeces and immediately eat it. There is commencing evidence of
paralysis in difficulty in deglutition, cough, and labored respiration.
The sexual desire is very much increased, and we see in the first stage an

29G DISEASES OF TRUE INFECTION

uncertainty in the gait and a weakness in the hind-quarters. Constipation
is invariably present. After a short space of time, generally from one to
three days, the second stage appears. This is the irritable or maniacal
stage. This is characterized: 1. By a tendency to escape and run away;
2. by a great irritation and an inclination to bite animals, objects, or
man; 3. by a strange alteration in the voice, or bark.

The inclination to run off is very marked. They will eat through
wooden boxes or floors, tear chains apart, or dig great distances through
earth. As soon as they get their liberty they will run about aimlessly,
covering very much ground in a short space of time, and return in one or
two days, showing every indication of great excitement or of having
travelled long distances. When they return they are covered with dirt
and utterly exhausted, and may be very quiet and well behaved for a
short time. During this condition they bite any object that comes
in their way. Soon the delirium increases and they run around in an
insane way, attacking and biting anything that is within their reach,
snarling or biting all the time, and if they are confined they bite at the
bars and frequently break their teeth, and if a stick is held toward them
they attack it furiously. As a rule these cases do not tear or mutilate
their own bodies, and, if they do, they generally bite the region of the
wound where they were formerly bitten or the toes of the posterior ex-
tremites. In the first stage of the disease we have often noticed that they
will lick and bite places where they have had wounds before. The
patients snap frequently, as if they were catching flies, and, as a rule, will
bite any animal that will come within their reach.

The biting and delirium are not constant, but appear after alternate
periods of rest, followed by uncontrollable delirious attacks, especially
if another dog should come near. These attacks may occur at intervals
varying from one to four hours. The peculiar change in the voice is due
to a paralysis of the vocal cords, and the sound of the bark is prolonged
into a higher vocal sound, so that it makes a combination between a howl
and a bark, which has been described by different authors as a "howling"
bark. This is harsh and shrill. Repugnance to water does not exist
in the dog as in man, but toward the end of the second stage, from
paralysis of the muscles of deglutition, we see great difficulty in swallow-
ing, and very often see an animal pick up some indigestible object, at-
tempt to swallow it, and, not svicceeding, drop it from its mouth. Fre-
quently the animal will lap out of his bowl, but it is seen if observed
closely that he does not swallow any of it, on the other hand animals
may cower and draw away from water that has been spilled on the floor
of the cage. Vomiting sometimes occurs. There is great difficulty
in defecation, which seems to produce evident pain. There is very little
alteration in respiration, l)ut it may Ix' slightly increased. The pulse is

RABIES 297

increased; the temperature also rises, but falls toward the end of the
course of the disease.

The duration of the second stage, which does not always present
all of the characteristic symptoms of this condition, may last from
three to four days. After the paroxysms have increased in intensity
and the intervals between them grow shorter, the paralytic, or last,
stage begins. The animals rapidly become emaciated; the eyes are
staring, dull, and the eyeball is retracted into the skull. The conjunc-
tiva is generally hypersemic, the cheeks are sunken; the hair is erect;
and we begin to see symptoms of paralysis. As a rule, the first sign of
this is a paralysis of the muscles that close or raise the lower jaw. This
allows the saliva to run out of the corners of the mouth and form threads
which hang down, and we easily recognize the fact that the tongue and
lower jaw have lost their power. The tongue becomes lead-colored and
hangs out of the mouth. Soon we see paralysis of the posterior extrem-
ities. This begins with a staggering, unsteady gait, and finally total
inability to use the posterior half of the body. Then the animals stretch
themselves out and become completely paralyzed, or in the last stage
we may see convulsions, but that is very rare. Death, as a rule, occurs
in the fifth to the seventh day after the onset of the disease. In rare
instances it may last ten days. Variations may occasionally occur in
the regular course of the disease; for instance, paralysis of the posterior
extremities has been the first symptom observed, and in others the
paralysis of the jaw has not been observed, and dyspnoea has been
observed for hours before death.

Dumb Rabies. — The mute or dumb form of rabies, according to Bol-
linger, comprises about 15 to 20 per cent, of all cases. The average
given of this form of rabies is entirely too small, and should be at least
50 per cent., the great majority of cases observed being the dumb form.
This is distinguished from furious rabies by the fact that the irritating
or nervous symptoms are less marked, and in very rare cases entirely
absent, also that the paralytic symptoms appear early in the disease.
First, we see paralysis of the muscles of the lower jaw. The mucus or
saliva runs out of the opened mouth, and an inclination to bite is entirely
absent, although under certain conditions when the mouth is forcibly
opened the animal will be able to bite. The voice is also changed, but
it is very rarely heard. We see a loss of appetite, the animal being
unable to seize or swallow foreign bodies. In this quiet form the three
stages follow very closely on each other, the course of the disease being
very rapid, and death, as a rule, appears in two or three days, never
over five.

These two forms of rabies in rare instances may merge one into
the other so that it is intensely difficult at times to separate the different

298 DISEASES OF TRUE IXFECTIOX

forms, for instanco a case which we will cite illustrates this. The affected
animal twenty-four hours l^efore his death had a hoarse bark, no appe-
tite, and the muscles of the mouth appeared normal, he allowed the
mouth to be examined and the tongue pressed down to see the throat,
there was not the slightest inclination to bite or show any signs of deli-
rium or mental aberration; when the animal died he showed great
sexual excitement. On post-mortem the stomach was found to contain
hay, straw, as well as hair that did not come from his own coat.

This disease must always be considered fatal.

The diagnosis of rabies may be complicated by certain conditions
present, due to other diseases. This is especially noticed in the mild
form and in well-trained affectionate animals which obey their masters
to the last. Two instances in which the English setter was under com-
plete control; hunted in the field, obeying the whistle and call instantly,
and at the same time had every symptom of dumb rabies. Often we
see cases where the history is either insufficient or the owner can give
none at all. On the other hand, in the furious form, a history, as a rule,
is not required, as the disease can be instantly recognized from the
appearance of the animal. Great excitement- and restlessness, a ten-
dency to escape, biting and delirious actions, rapid emaciation, and
debility are characteristics of the furious form of this disease, while
great depression and paralysis of the lower jaw are characteristic of the
dumb form. In both forms there is a great inclination to gnaw objects.
Sexual desire, in the early stage, is prominent. A depraved appetite and
altered l^ark, more or less rapid symptoms of paralysis, and the cases
being invariably fatal. The post-mortem confirms the disease when
we find acute hypersemia of the throat, pharynx, and hemorrhagic
erosions on the mucous membrane, also foreign bodies, etc., in the
stomach.

Regarding the presence of sugar in the urine of rabid dogs, that
cannot be said to be of special significance, as it is found to be present
in other diseases. The presence of the corpuscles of Negri in a suspected
animal, on the other hand, must be regarded as a diagnostic symptom of
great importance, particularly as it is a means of making a quick diag-
nosis. The horn of Ammon is where these corpuscles are found in the
largest quantities, and it requires one to be thoroughly familiar with
these bodies to recognize them quickly and easily. They are
found in particles of the horn of Ammon fixed in Zenker's fluid, and
treated with a 10 per cent, solution of osmic acid, then washed thoroughly
and then laid in absolute alcohol; this method has the disadvantage of tak-
ing some time to accomplish it . The method of Bohne seems to be the most
desirable. Mode of procedure: sections one-half to three-fourths mm.
thick are cut from the horn of Ammon and put in 15 c.c. of acetone and

A SMEAR PREPARATION OF THE HIPPOCAMPUS MAJOR SHOWING NEGRI BODIES,
STAINED BY THE METHOD OF VAN GIESEN, ENLARGED looo DIAMETERS.

[St-e RaHes].

Pink : Stained tissue.
Blue : Cells.

Brick : Negri bodies.
Red : Blood corpuscles.

RABIES 299

left at a tcmporatiiro of 37° until they become hardened^ then the sec-
tions are transferred to liquefied paraffine and left there for an hour at a
temperature of 60°, then the sections are put in cold water to which a
small quantity of gum aral3ic is added and put in a stone and the paraffine
carried off, then the sections are colored by means of Mann's process,
which is to put the sections for one-half to four minutes in a coloring
solution consisting of 35 c.c. of 1 per cent, aqueous solution of methylene
blue and 35 c.c. of 1 per cent, aqueous solution of eosin and 100 c.c.
of distilled water. The sections are rinsed with water and then put
in absolute alcohol for 15 to 20 seconds, to which has been added
some caustic soda (to 30 c.c. of alcohol add 5 droi>? of 1 per cent,
solution of absolute alcohol). The sections are again put in alxsolute
alcohol for a few moments and then washed in water for a minute; the
sections are now put in water slightly acidulated with acetic acid,
drained and sealed with canada balsam.

The following procedure has been the method employed for the
rapid diagnosis of rabies in the laboratory of the Veterinary school of
the University of Pennsylvania for several years: As soon as the
animal's head arrives at the laboratory the entire brain and the
plexiform ganglia, with the adjacent sympathetic ganglia are removed.
A portion of the cerebellum is placed in sterile glycerine, in which the
})rain tissue may be preserved and retain the virus for many weeks.
These glycerine-immersed specimens are only referred to for the animal
inoculation test when the microscopic examination is unsatisfactory.
Aside from preventing decomposition, the glycerine will also destroy
bacteria and check decomposition of the specimens. From the fresh
brain tissue, smears are usually made from the hippocampus major and
cerebellum. A piece 1 mm. thick and several millimetres in diameter
cut from the freshly exposed surface, after an incision is made through
the hippocampus major at right angles to its length, or of the cerebellum
in which an incision has been at right angles to the convolutions, is
placed upon a slide near one end. Instead of using a cover-slip, another
slide is placed over the small piece of tissue and gentle pressure is applied
and the opposite ends of the slides are moved toward one another. The
smears are then placed in alisolute alcohol for two to five minutes,
whereupon the alcohol is allowed to evaporate and the smears then stained.
The stain as recommended by Van Giesen is used.

Loeffler's alkaline methylene blue, 1 part.

Distilled water, 1 part.

Saturated alcoholic solution of fuchsin added in drops
until the mixture has a purple tinge, or initil a metallic
scum is seen on the surface.

The mixture kept at a low temperature can be used for an unlimited

300 DISEASES OF TRUE INFECTION

length of time, ])ut it is apt to change quickly at room temperature, and
for this reason a new l)atch of stain is usually made each day or as each
specimen is prepared for examination. A smear properly fixed on a
slide is taken up with a pair of forceps and completely covered with
stain. The slide is passed through the flame of a Bunsen burner several
times until steam arises from the heated stain, which is permitted to
remain on the smear for five to thirty seconds. The smear is then
washed in running water, and if the color of the smear is blue where the
brain tissue is thickest, and red where the smear is thin, the slide is
placed between filter-paper and dried. As soon as the slide is dry a
search is made for large nerve cells with a low-power lens under the
microscope. The protoplasm of the nerve cells should be stained a light
blue, the nucleus a shade of purple, and the nucleolus a dark blue. If
the cells are stained too deeply the stain may be weakened by the
addition of more distilled water or in heating the staining fluid on a
smear for a longer time, the intensity of the staining of the fuchsin will
be increased at the expense of the blue of the Loeffler's alkaline methylene
blue. "When a nerve cell is found properly stained, it is examined with
an oil immersion lens. Xegri bodies with this staining fluid show the
inner bodies a bluish black and the structure around the inner bodies a
maroon-red. They are found within the cell, outside of the nucleus of
the cytoplasm in the nerve cells of sections, but not infrequently in the
smear preparations, a few Negri bodies not Avithin the nerve cells are
seen, which have been forced out of the nerve cell as the smear is made.
In searching a smear for Negri bodies, only those bodies within the nerve
cells should be considered.

In doubtful cases the disease can only be accurately diagnosed by
vaccination — that is to say, by the injection of small quantities of horn
of Ammon or a section of the cord, which have been diluted with distilled
water, and emulsified and filtered through fine linen. The following
methods are used at present:

(1) The Intercranial Subdural Inoculation (Pasteur). — The inoc-
ulating material (1 or 2 drops of the emulsion) should be injected into
the dura mater of a dog or rabbit, after it has been trephined, by means
of a small hypodermic syringe, and the wound sewn up. The operation
is easily performed, and is especially valuable when the suspected animal
may have bitten not only other dogs, but man. As this inoculation
from the spinal matter of a suspected dog takes at least two or three
weeks, sometimes longer, the animal develops all the phenomena of the
disease, paralysis, etc., on the quiet. Leclainche recommends intra-
cerebral inoculation, that is, direct injection of the inoculating substance
into the brain itself; the persons bitten should not delay, while waiting
for development, but all measures should be taken as soon as possible.

RABIES 301

(2) The Intraocular Inoculation (Gibier, Nocard, Johne). — The

emulsion (1 to 2 dropt^) wliit-h is thus obtained is filtered through a
piece of linen antl injected directly into the anterior chamber of the eye
of the animal which is to bo inoculated. They do this by means of a
small hypodermic syringe, having first placed cocaine on the cornea,
and then inject the solution directly into the anterior chamber. If the
suspected animal is raliid, we will see the development of the disease in
from twelve to twenty-three days, even if the chaml)er should suppurate
from the irritation of the injected solution. Gal and Klimmer oppose
this procedure by pointing out the fact that the stage of incubation
may be much longer than this.

(3) The Intraspinal Method (Labell). — The emulsion is injected
directly in the cord; this method takes somewhat longer to develop than
the subdural inoculation.

(4) Intramuscular Inoculation. — One c.c. of the emulsion is
injected into the masseter, the dorsal or the posterior crural. Klimmer
finds that the active symptoms are developed somewhat earlier than by
the intraocular method.

There are other methods of inoculation used l3ut they are much
less reliable, such as nasal, subconjunctival, subcutaneous and intravenous.

It is always w^ell to inoculate two animals, because it frequently
happens that an animal is immune to the disease or dies shortly after
the inoculation (cerebral hemorrhage, etc.).

The following diseases are sometimes mistaken for rabies: Certain
affections of the brain, such as teething, epilepsy, eclampsia, distemper,
angina, intestinal parasites, inflammation of the intestines, pentastoma
in the nose and frontal cavities, foreign bodies in the mouth (between
the teeth) or in the throat, paralysis of the lower jaw, luxation of the
lower jaw, due to irritation of the tiigeminus, intense excitement in
latches that have had their young taken from them, great sexual excite-
ment in male dogs, long confinement in cages or kennels, and from
certain poisons. The course of the disease, however, and the after-
symptoms always enal^le one to make a differential diagnosis.

Therapy and Prophylaxis. — As soon as the disease has reached a
point where there is no question as to its character, the animal should
be destroyed as soon as possible. When man is bitten it is a question
whether thorough disinfection or cauterization of the wound is of much
benefit unless it is done within a few minutes. In reference to the pre-
ventive inoculation of Pasteur, it is not necessary to enter into detail in
this work, beyond the fact that it is the inoculation of an attenuated virus
cultivated from rabies. A large number of experimenters have made
repeated inoculations with a view of obtaining immunity to the disease,
but they have not had very satisfactory results.

302 DISEASES OF TRUE INFECTION

The most effective method of preventing the spread of rabies is to
register all dogs claimed by owners, and all stray dogs should bo destroyed,
and when there is a case of rabies or a suspicion of such, all dogs should
be put under observation, nuizzknl or put on a leash, and any dog
known or suspected of having been bitten by a rabid dog should be
confined and watched by a competent veterinarian and if found to
develop the active symptoms it should be immediately destroyed and
the head sent to the local live stock sanitary board laboratory for
examination.

In the largo cities all dogs, if they are worth keeping as pets, should
be taxed and all vagrant mongrels taken up and destroyed. In America
and England where they have made a close study of the spread of rabies
and have reached the conclusion that while muzzling is a protective
measure, it is by far the least point of danger, for an owner that Vvill
take the trouble to muzzle his dog is one who closely observes his animal
and at the first sign of the disease has him examined. Invariably the
outbreaks of disease originate either in the slums of cities or little villages,
where the low class of ignorant shiftless masses live, who protect and
have around their places a number of mongrel curs that are valueless;
the owners or protectors of these pariahs will neither observe their animals
nor restrain them when they develop rabies, but drive them off, or
allow them to go on their travels to bite and tear every animal that
comes in contact with them. Taxation has been tested out in Europe and
in every case where mongrels were gathered up and destroyed rabies
decreased one-half or more — in some cases not a single case was recorded.

Tuberculosis.

Under this name we class all affections w^hich owe their origin to a
peculiar specific bacterium known as "tubercle bacillus," discovered by
Koch. These are found in all tubercular deposits in man or in animals,
whether they occur spontaneously or are inoculated. Under the micro-
scope they appear in the shape of very narrow non-flagellated rods often
slightly curved, fi-om 2 to 4/( long. The organism shows many variations
in its morphology under different conditions. It often occurs in isolated
clumps, either in cultures or in tissues. In certain cultures and in ani-
mal tissues it grows in the form of longer or shorter branching threads
(Ricketts).

The tubercle bacilli should be considered as true parasites which
multiply and live in the body only, but they also seem to possess the
property of living outside of the body for a certain length of time, as
the excretions of tuberculous animals can be used successfully to in-
oculate other animals. ^^'e therefore conclude that tuberculosis is only

TUBERCULOSIS 303

produced In' infection, or a better term would be transmission of tubercle
bacilli, direct or indirect, from one subject to another.

While it is well known that tuberculosis of man and of certain
domestic animals, such as cattle, is very common, it is rather rare in dogs.
A number of schools have found that only from 2 to 5 per cent, of all of the
animals brought to the clinics were affected with tuberculosis. Dogs seem
to possess more power of resistance and are able to throw off the disease.

Certain experiments by inoculation and inhalation have demon-
strated the fact that one-third of the cases develop the disease, and the
feeding of tubercular matter in the food invariably produced negative
results. Considering the rarity of this disease in the dog, we will not
give any detailed explanation of any length concerning its etiology,
pathological anatomy, etc.

Etiology and Pathological Anatomy. — A number of observers agree
to the fact that, as a rule, an animal affected with tuberculosis has been
at some time near or in the vicinity of some person who was in an ad-
vanced stage of consumption. In such cases the bacilli may be intro-
duced in the form of fine dust and be respired into the lungs or may be
taken up by the intestines, finding their way into the bowels mixed with
food. In one ease which the writer observed there Avere tuberculous
ulcers in the parotid region, and also tubercular deposits in the lymphatic
glands of the neck. The disease appears in the dog in the form of an
acute or local tuberculosis. The disease may be found in the lungs,
the mesenteric glands, the intestines, liver, kidneys, and peritoneum, and
in rare instances affecting the entire body.

Pulmonary Tuberculosis. — This presents numerous anatomical alter-
ations: over the entire lung we may find firm round gray nodules (miliary
tuberculosis), or they may break down, forming caseous nodes and
cavernous hollows or there may lie a chronic indurated broncho-pneu-
monia; more rarely we find chronic interstitial indurating pneumonia
with secondary alterations, acute and chronic bronchitis, peribronchitis,
bronchiectasis, pulmonary hypera^mia, emphysema, and frecjuently
adherence of the lung to the pleural wall.

In nearly 50 per cent, of all cases, the lymphatic glands of the
thorax, especially the bronchial glands and the glands which are located
above and behind the mediastinum, are invariably infected to a marked
degree with tubercular deposits, and are found to be very often enlarged,
forming large tumor-like masses. These consist of a lardaccous tissue,
grayish-white in color, and generally contain a centre cavity filled with
a cheese-like mass. True cheesy tuberculosis is rather rare in the dog,
but, on the other hand, we find a peculiar process of absorption of the
tissues, foi-ming white masses, which on examination are found to be
tuberculous deposits.

304 DISEASES OF TRUE INFECTION

Pleural Tuberculosis. — "When the process of breaking down, or
disintegration, has gone on to any marked degree, the tuberculous
mass forms a tumor-like body containing in its centre a whitish fluid
held in fibrinous tissue. This was noticed in 50 per cent, of the cases
observed in the dog where the lymphatic glands had undergone this de-
generation. In the other half of the cases, the serous meml)ranes of the
abdominal cavities were covered with tubercular masses, the pleura being
the most common seat of the disease. In the majority of cases of pleural
tuberculosis it takes the form of what is known as the " pearl " tubercular
masses. These are found to be deposits of soft connective tissue,
occurring in the form of numerous conglomerating granulations or in
large round tumors. In some cases there is extensive exudative in-
flammation present (sero-fibrinous and purulent pleuritis). Tubercular
inflammation is found in the pericardium, with extensive adhesion to the
heart, and a very pecviliar alteration of the mediastinum has been
deserved in several cases. The heart rarely presents any tubercular
formations.

In the digestive organs, the lymphatic glands of the head and neck
are rarely invaded; and the writer found the submaxillary and retro-
pharyngeal lymphatics to l)e afTected in only one instance. On the
other hand, the mesenteric glands were particularly affected, some cases
presenting large tumor-like masses containing broken-down centres.

Tuberculosis of the intestines is rare, and is restricted to slight
ulcerations or abscesses. The liver, as a rule, is generally involved to a
marked degree, its substance being filled with small nodules or large
granular masses which are milky W'hite in color. In the centre of these
is found a broken-down opaque fluid, the result of fatty degeneration.
The spleen was found by the writer to be tubercular in two cases, and that
only to a slight degree. In the liver are found numerous firm white
fibrous nodules ranging from the size of a pea to the size of an egg. The
kidneys are frequently the seat of more or less tubercular deposits, and
in twelve cases scattered granulations were found in the spinal and mem-
branous substance, but cheesy abscesses and centres were also found.
These were accompanied by chronic indurative nephritis. Ulceration of
the pelvis of the kidney w^as observed in one case. One dog showed Init
a slightly tubercular ureter and bladder. The sexual organs are, as a
rule, found healthy and very rarely attacked by the disease. In rare
instances a tubercular testicle is noticed.

Tuberculosis of the prostate has been o]:)served, also in the ovary,
the bones, articulations and in the brain. A tuberculous ulceration of
the skin has also been seen. For further particulars as to the patho-
logical character of tuberculosis, consult the numerous works on the
subject.

TUBERCULOSIS 305

Clinical Symptoms and Course. — On account of the various ways
in which tuborcuhj.sis ai)])ears, no postive line of symptoms can be made.

Acute miliary Tuberculosis is very rare and runs its course with
intense rapidity, and generally it is only by the presence of the tuber-
cular bacilli in the blood that it can be recognized.

Chronic Tuberculosis. — The animal is easily fatigued, short breath,
particularly after any slight exertion, irregular appetite, there is a dry
hollow cough, generally on rising after resting or after eating, later the
cough becomes more frequent and painful, and there may be a muco-
purulent discharge from the nose, difficulty in respiration — this at first
is slight, but sooner or later it is very pronounced; on auscultation
there is a vascular murmur, and later bronchial rales of diverse forms and
intensity; later a pleuritis and a hydrothorax. Valuable animals pre-
senting these symptoms may have the diagnosis made positive by in-
oculating a rabbit (intraperitoneally) with the pleural exudate, and if
the exudate was tubercular, three weeks afterward the spleen and the
peritoneum of the rabbit will show the tubercular lesions, or w^e find a
tubucular mass on the liver.

Tuberculosis of the lungs only will show marked symptoms after
it has made considerable progress, and as the symptoms are ver}^ similar
to chronic catarrh of the lungs or chronic lobular pneumonia, it is apt
to be confounded with these two diseases (see this disease). Notwith-
standing a good appetite, when there is rapid emaciation and a quick
loss of strength we should suspect the animal has tuberculosis of the lungs
but we can only be positive of our diagnosis by recognizing the tubercle
bacilli in the secretions, although it is very difficult to find the bacilli as
it is not only extremely difficult to obtain sputa from a dog, but to find
the bacilli if we do get some of the sputa (see later, tuberculin test).

Tuberculosis of any of the abdominal organs is very difficult to
recognize. The only way we might succeed is by manipulation of the
abdominal cavity, recognizing swollen lymphatic glands or tubercular
masses on the liver. We do find, however, great emaciation and symp-
toms of chronic catarrh of the intestinal tract. These last two symptoms
are generally sufficient to make us suspect intestinal tuberculosis. In
one case of tubercular ulceration of the intestines which was observed
by the writer, the dog was very thin and had shown this emaciation for
some time. There were also present symptoms of catarrh of the lungs,
and upon the upper portion of the neck a deep abscess had formed.
This was ciuite large and contained ciuantities of thin pus. In the region
of the neck near the abscess we observed a granular mass the size of a
chestnut. This could be pushed under the cutaneous membrane and
moved about freely. There were also present a few enlarged lymphatic
glands in the upper portion of the neck.

306 DISEASES OF TRUE INFECTION

A very important and constant symptom of tuberculosis is the grad-
ual emaciation of the affected animal, accompanied by exhaustion on
the slightest exertion, the hair is hard, dry and bristly, the eyes are
sunken, the face drawn and wrinkled, the visible mucous membranes
pale or yellowish, the mucous membranes are dry, the pulse small,
accelerated, and the heart throbs, the temperature is elevated from
time to time, the appetite is irregular but generally small, constipation
alternates with obstinate diarrhoea, and finally the animal becomes a
skeleton and dies in a state of collapse; at this stage the temperature is
apt to be subnormal. The average duration of the disease is from six to
eight months.

Microscopical Demonstration of the Tubercle Bacilli. — The tubercular
matter is placed on a glass and allowed to dry in the air; it is then covered
with Ziehl's carbol fuchsin solution (1.0 fuchsin, 10.0 absolute alcohol, 5.0
carbolic acid, 95.0 distilled water) and heated over the flame for two
minutes. Then it is allowed to cool, then washed with distilled water
and then put in Gabbet's solution (2.0 methylene blue, 100.0 of 25 per cent,
solution of sulphuric acid) ; after lying in this for two minutes it is rinsed
with water and is ready for examination. The tubercle bacilli are
stained red, the other substances being blue; an oil immersion lens gives
the best results. Where the examination must be made as soon as pos-
sible, if the preparation is thoroughly dried, it gives almost as good
results (see Plates).

Tuberculin Test. — The inoculation of Koch's tuberculin to deter-
mine whether a dog is affected with the disease may be tried, but as a
rule is unsatisfactory, the reaction is seldom very pronounced in char-
acter, and in the acute stages of the disease it may even give a subnormal
temperature; in several instances an animal gave a reaction, but careful
examination failed to give any evidences of tuberculosis. Recently the
ophthalmic test has come into popular favor in diagnosing tuberculosis
in the dog. The method is quite simple. It consists in dropping into
the conjunctival sac 1 or 2 drops of tuberculin, especially prepared for
this test. If the animal is suffering from tuberculosis, a reaction will be
manifest by the development of a conjunctivitis in from eight to twelve
hours. There will be excessive lachrymation, injection of the capil-
laries of the conjunctiva and even slight suppuration at the inner
canthus. In chronic cases the reaction may be overlooked unless the
animal is kept under close observation, inasmuch as the acute symp-
toms come on and pass off very rapidly. In cases of recent infection
the reaction may last for at least twenty-four hours.

Therapeutic Treatment. — When you have once established the fact
that the aninuil is aff(H-t(Ml with the disease, it is the duty of the veterin-
arian to warn the owner of the tubercular or suspected dog, of the danger

HEMOGLOBINURIA AND PIROPLASMOSIS

307

of infection, and advise him to destroy the animal. In the early stages
of the disease and when there are no other animals kenneled with it,
the animal can be fed with highly nutritious food and given inhalations
of creolin or l^enzoin.

Hemoglobinuria and Piroplasmosis.

When there is any decomposition of red corpuscles in the body
(hemogiol)inannia) the coloring substance is eliminated through the
kidneys, staining the urine and producing hemoglobinuria. In this
condition the urine is characterized by a dark red, dirty brownish or
brick-red coloration.

This condition occurs when from some cause the coloring matter
of the blood becomes liberated, either from destruction of the blood
corpuscles or separation of the coloring matter from the stroma of the
corpuscle or a delixiviation of the erythrocytes. If only a small quantity
of coloring matter is freed it is taken up by the liver, but if a large

Fig. 99. — Blood of a clog affected with piroplasma canis, magnified 350 times. (Kastner.)

quantity is free in the circulation, it is also taken up by the urine.

The hemoglobin test consists of drying a certain quantity of urine in
a small saucer, and with the dry mass we mix a small quantity of finely
pulverized chloride of sodium, placing it on a plate. Then add two
drops of cold glacial acetic acid. Now slowly heat the cup over an alcohol
lamp and allow it to cool. As it does so, you will see a quantity of dark-
brown crystals. If these are not easily distinguished by the eye, they
are with a magnifying glass. While we cannot distinguish the presence
of the coloring matter of the blood in the urine with the aid of the micro-
scope, we may detect the presence of blood corpuscles in the fluid. Wo
may also find by this means uric casts and epithelium of the kidneys, and
small red granulations. These may be considered hiemoglobin. As to
the causes of this condition we will mention piroplasma.

308 DISEASES OF TRUE INFECTION

Piroplasma Canis, Malignant Jaundice. — This is an infectious,
not contagious disease, due to the presence of a protozoon, piroplasma
canis, in the red corpuscles; this disease is generally found in warm
climates, particularly South Africa; it is very rare in Europe.

Etiology. — The cause of this disease was first described JDy Plana and
Gali-Valerio as a protozoon of the order of hemosporidia, and was carried
into the blood of the dog by means of ticks — in France by the Dermacenter
reticulatus, in South Africa by the Hemophysalis leachi, and in Germany
and Hungary by the Ixodis ricinus reduvious. The disease appears
about thirty-six hours after infection of the red blood corpuscles; the
corpuscle being colorless, the protozoa can easily be recognized if the
blood is fixed with absolute alcohol and stained with methylene blue (Fig.
99). The size of the parasite varies from 0.7 to 3.4/i. They multiply
very rapidly, particularly when the fever is high. After the destruction
of the erythrocytes, the parasites appear in the plasma, and are more
rounded in form, and then they appear in greater numbers in the in-
ternal organs, particularly in the lung tissue, than in the blood. Trans-
mission, either by subcutaneous or intermuscular injection of the de-
fibrinated blood containing the parasites, reproduces the disease and
the animals die in a week; recoveries are very rare. The blood if kept
in a cool place retains its full activity for twenty-five days, in warm
weather the infected blood loses its activity in fourteen days, at a
temperature of 44° it loses its power in one and one-half hovirs, and at 50°
in one-half hour. Young dogs seem more receptive of the disease
than older animals; bitches which have had the disease give their
puppies a certain amount of immunity from the disease.

Pathological Anatomy. — If the disease is very acute, and runs a
short course, with the exception of the alteration of the blood, very little
change is noticed. In more gradual cases there is anaemia, jaundice and
great enlargement in the volume of the spleen — it is frequently found
to be four times its natural size — hypersemia of the liver, kidney and
marrow of the bones, extravasations in the pericardium and in the lungs,
catarrh of the stomach and of the intestines, especially the duodenum.
In the kidneys, spleen, marrow of the bone, as well as the blood,
numerous piroplasma are found.

Clinical Symptoms. — The disease occurs in both acute and chronic
forms. The acute form is ushered in by listlessness, depression, want
of appetite, and increase of temperature to 40-43°, and a few days
later by a rapid fall of temperature to sulmormal; the visible mucous
membranes are cyanotic, sometimes yellow, icteric; the pulse and
respirations are increased and frequently labored; the gait sluggish
and staggering, and finally there is complete paralysis. The urine con-
tains albumin and biliary i)igment, and in the majority of cases from

TETANUS 309

3 to 5 per cent, of haemoglobin. The blood is thin, light red, and coagulates
very slowly; the number of erythrocytes is diminished by half,
and the leukocytes are greatly increased in number. Death occurs in
from three to ten days.

In the chronic form the temperature is slightly increased or may even
remain normal, the animal shows great muscular weakness, lassitude,
want of appetite and rapid emaciation, urine contains albumin and
biliary pigment, while haemoglobin is rarely found, and there is a diminu-
tion of the red blood corpuscles and a corresponding increase of the white
corpuscles. The duration of this disease is from three to six weeks;
recovery is not at all rare. The diagnosis is easily ascertained by the
presence of the piroplasma in the blood. Nocard suggests that where
there is every evidence of the disease, but microscopical examination
fails to detect the piroplasma, a young animal should be inoculated
experimentally.

Therapeutics. — As there is no specific agent that can be said to
have any beneficial effect on the disease, we must give good nursing,
careful but nutritious diet. When animals, particularly hunting dogs,
are taken to regions infested with ticks, such as woods, wet swampy
ground, or low scrub pasture, the animals should be rubbed with emul-
sions of lysol, creolin or petroleum to protect them from invasions of the
tick.

Preventive Inoculation. — When a dog has overcome the disease
and become immune, the l^lood of this animal possesses the property
of destroying the piroplasma; these immune animals are inoculated
repeatedly with the virulent blood, and a serum is obtained w^hich is
used. Care must be taken to see that this serum retains its activity.

Tetanus.

(Lockiaw.)

This is a specific infectious disease characterized by tonic muscular
contractions and caused by the tetanus bacilli. These organisms are
rather long, slender — from two to four microns long — with a globular spore
at the end; this is larger than the bacillus and gives the latter a drumstick
shape. The organism is strictly an anaerobe and is obtained in pure cul-
ture with some difficulty; morphologically it is difficult to distinguish from
the bacilli of malignant oedema and systematic oedema (Ricketts) . These
spores possess great powers of resistance and are found in soil, particularly
in garden earth and rich meadows, and in the excrement of healthy
horses, dogs, cattle and other animals; this explains why animals are
so, prone to develop the disease from wounds of the extremities, tail, etc.

310

DISEASES OF TRUE INFECTION

"\Micn these microbes invade a wound they midtiply with great rapidity
and produce toxines which cause a strychnine-like convulsive contraction
of the muscles. The virulence of the bacilli is in all probability influenced
by the simultaneous invasion of other germs.

This very rarely occurs in the dog. The figure here presented (Fig.
100) is the only one the writer has seen, and was taken twenty-four
hours l:)efore death; the muscles w^ere contracted to such an extent
that the animal could be lifted bodily by holding up one anterior limb.
Tetanus may originate from a wound in any part of the body. No special
class of wound can be said to be favorable to the production of tetanus.

Fig. 100. — Dog with tetanus.

It may originate from a scratch or from a very large wound. The
temporary trismus seen in young animals that have eaten decayed meat
should be classed under ptomaine poisoning, and not under tetanus.
The anatomical examination is almost always negative; hypera^mia
and congestion of the cord which is occasionally seen is of secondary
importance as it seems to have no actual bearing on the true cause of the
disease.

Symptoms. — The period of inctd)ation in a dog is not known posi-
tively, as the cases are so rare, but probably it is about the same as a
horse — from five to twenty days — depending probably on the vir-
ulence of the bacilli. The general symptoms are stiff stilty gait, the neck
and head are extended, the expression is staring and anxious, the ears are
drawn forward and pointed, the membrana nictitans is draw^n over the
eye, wrinkling of the skin of the f9rehead, retraction of the angle of the

TETANUS 311

mouth, with difficulty in eating and drinking, the penis is erect and the
muscles of the body are hard and outlined, the animal is nervous and
anxious; the pulse and temperature are generally little altered. In one
case there was an elevation of temperature; the case recovered. The
duration of the disease is about a week, but it may vary. As recoveries
are recorded from time to time, it cannot be regarded as always incurable.

Therapeutics. — The treatment is generally palliative. The wound
must be examined and treated with antiseptics, and use such sedatives
as morphine, dilute hydrocyanic acid, chloral; it must be remembered
the most important matter is to keep up the animal's strength with
easily digested food — scraped meat, beaten up eggs. Where the trismus
makes it impossible to administer food by the mouth, it should be given
in the form of nutritive clysters.

Tetanus antitoxin may be tried; the dose is 5 c.c. daily.

CONSTITUTIONAL DISEASES.

Anaemia and Chlorosis.

By ansemia in the strict sense of the word, we mean a lessening or
thinning of the blood. This is especially noticeable after great hemor-
rhages. At the same time much greater importance must be placed on
that condition of the blood where the number of red corpuscles is very
much decreased. This diminution of the number of red blood corpuscles
is the most important form of anaemia.

Etiology. — The disease occurs frequently in young, delicate animals
of the improved or closely bred classes, in animals that are weaned too
early, or when they are not properly nourished when puppies. It seems
to be hereditary in some of these animals — litters from feeble, delicate
bitches — and may depend to a certain extent on the defective development
of the arterial system and an abnormally small heart. Anaemia occurs
most frequently from the lessening in c^uantity of the vital fluids, such as
the albuminous, or after a large or long-continued slight hemorrhage;
from prolonged suppuration of the kidneys; and lastly a want of proper
nutrition — for instance, young animals in a poor condition should be fed
on meat. Very often impaired digestion prevents an absorption of
certain nutritive substances in chronic disease, in fever, intestinal worms,
dochmius, taeniae or ascarides, or parasites in the blood (filaria), piro-
plasma, and from certain poisons in the blood, etc.

Clinical Symptoms. — The symptoms of the disease consist in a re-
duction of the coloring elements of the blood and a general condition
of debility, showing every indication of loss of blood. The skin and
visil:)le mucous membranes are very pale in color.

The animals are easily fatigued and have a draggy w^ay of walking;
the pulse is often small and generally rapid. The temperature in many
cases is below normal; in other cases it may be normal or even higher.
Auscultation of the heart at times gives a soft, booming, systolic murmur.
The respiration is increased with the pulse, and especially after very
slight physical exercise. Reflex excitability of the brain in anaemic
subjects is increased to such an extent that the animal will go into con-
vulsions on the slightest provocation. Impaired digestion is a frequent
symptom and naturally assists in complicating the disease. It is gen-
erally chronic, but proper treatment will often produce very good
results.

312

LEUKAEMIA 313

Therapeutic Treatment. — The treatment must all tend to one
object — that is, the formation of more blood. This may be obtained
by proper hygienic measures, feeding with light, easily digested sub-
stances, especially meat (not milk, which does not agree with the animals
for any length of time), as well as medicinal substances — that is to say,
ferruginous preparations. Among the latter, carbonate of iron, saccha-
rated oxide of iron, and lactate of iron. These should be given in 0.4
to 0.5 gramme three times daily. Tincture chloride of iron, 10 to 20
drops daily. In many cases these iron preparations do not agree well
with the patients, as the drug irritates the stomach and their appetite
becomes impaired. These preparations should have some vegetable
tonic added to them, the bitter principle stimulating digestion and
counteracting the irritant effect of the iron. A very useful preparation
in this disease is citrate of quinine and iron. This preparation is valu-
able not only for the iron it contains, but the tonic properties of the
quinine, and also the very slight tendency it has to irritate the stomach.
Arsenic, either in the form of Fowler's solution or the red sulphide, is
useful as a general tonic.

Leukaemia.

This disease, which is generally chronic, is one that is characterized
by an altered condition of the blood, due to the presence of an increased
quantity of white blood corpuscles, which is the result of some path-
ological change in the blood-forming organs, viz.: the lymphatic glands,
spleen, and marrow of bones. Formerly the disease was classified in
three divisions: Lymphatic, lineal and myelogenic forms; according to
the origin of the disease, the lymphatic glands, the spleen or the marrow
of the bones. This, however, is now classified by Ehrlich into two
chief divisions, namely (1) lymphatic leukaemia, which is the result of
some pathological change in the lymphatic glands and causes the appear-
ance in the blood of numbers of lymphocytes, i.e., isolated cells the size
of a red l)lood corpuscle, and (2) myelogenic leukaemia in which thereis some
pathological activity of the marrow of the bones in which there is an
enormous increase of the ordinary polynuclear leukocytes and also
large mononuclear cells which are only found in the marrow of bones.
These distinctions are of no special value to the practitioner, and both
these forms, as a rule, are combined in the dog as in other domestic
animals. The myelogenic form has never been observed alone (Seidam-
grotsky and others).

Etiology. — The cause of this disease is not definitely known at present.
In the human race we find that middle-aged men are mostly affected
with the disease; in the dog, while the middle or advanced period of age

314 CONSTITUTIONAL DISEASES

seems to show the greatest number of cases, still young animals are
frequently attacked, and the disease invariably runs an acute course.
It is apt to follow certain traumatisms, but whether, in dogs, it follows
as a result of grave infectious disease is a question. Attempts to produce
the disease by transfusion of leukaemic blood in healthy animals gave
negative results but produced a swelling of the gians penis and the
lymphatic glands in its immediate neighborhood, and catarrh of the
prepuce.

Pathological Anatomy. — The most important alteration always
observed in this disease is an increase of white blood corpuscles and a
lessening of the amount of the red corpuscles in the blood. This may
become so great in the dog that we find the proportion of white to red
blood corpuscles is 1 to 5 (Bollinger). "We find the blood possesses a
much lighter color than it does normally, has a lighter specific gravity.
We also notice a great tendency to emaciation and a characteristic
alteration of the spleen, which is greatly enlarged, and increased pro-
portionately in weight. It is not rare to find it weighing at least 1000
grammes, and we find on section of the enlarged spleen, marks of
true hyperplasia. Fenereissen found in a bulldog affected with this
disease a spleen that weighed 3 kilogrammes. We also see at times
enlargement of the lymphatic glands due to circumscribed hyperplasia
of the glandular tissues. The marrow of the bones is occasionally
involved and appears dark red. In serious cases the color is yellowish-
gray, becoming soft and plastic. In very rare
cases hyperplasia is seen in other organs, such as
the tonsils, liver, and lungs.

Clinical Symptoms and Course. — The symp-
toms of the disease are similar to those of intense
anaemia. First, there is a characteristic alteration
of the blood, and, second, the symptoms presented
by the spleen and lymphatic glands. In mild
Fig. 101.— The blood in cases a microscopic examination of the l^lood and

leukocythaemia. . <■ i i i mi •

counting the number of blood corpuscles will insure
a diagnosis. The best way to obtain a small quantity of blood for the
purpose of making an examination is to make a slight slit in the upper
surface of the outside of the ear. Place it under the microscope without
adding any other substance to it, and we will recognize not only an
enormous increase in the number of white blood corpuscles, but a differ-
ence in their normal size (Fig. 101).

While we may be able to correctly diagnose the disease from the
condition of the blood during life, we may also notice certain alterations
in the size of the spleen and lymphatic glands. In the glands of the"
head and neck we frequently find considerable enlargement. Normally,

LEUK.^MIA 315

the proportion of blood corpuscles in the blood is one white l)lood cor-
puscle to three or four hundred of the red blood corpuscles, but in
leukiemia the proi)0]'tion is frequently one white to fifty red nnd in
extreme cases one to five. In making a count of the white l)lood cor-
puscles there is one point that must not be forgotten, and that is that
there is a normal physiological increase of the white blood corpuscles
when the animal has had a great loss of blood, immediately after the
digestion of a heavy meal, where there is chronic inflammation and
suppuration and in the bitch during pregnancy; hence a marked increase
in the number of white blood corpuscles, unless there are other symptoms
that confirm it, does not mean the animal has leukaemia. The altera-
tion in the lymphatic glands is easily detected in those glands that are
near the surface of the body. The lymphatic ganglions are found to l)e
enlarged, round, and sometimes irregular and are generally painless on
pressure. In some cases we may find solitary enlarged lymphatics in
different parts of the body. Frequently the region of the enlarged
lymphatics is oedematous. It is only when the spleen has reached a
considerable size that it can be outlined by palpation of the abdomen.
Another symptom of leukaemia is the marked increase in the pulse.
There is redness of the mucous meml^ranes oi the mouth, coated tongue,
disordered stomach, irregular attacks of diarrhoea, dropsical swellings,
ascites or chyle stasis, as a result of the acute hypertrophy of the
abdominal lymphatic glands, and we may occasionally see intestinal
haemorrhage.

The course of this disease is invariably chronic with a gradual
increase of the severity of the symptoms, the condition of the animal
continually getting worse until finally the animal dies of exhaustion.

Therapeutics. — The treatment of leukaemia is practically the same
as that of anaemia. Give very nutritious food and arsenic, iron or
quinine. The inhalation of oxygen as well as the transfusion of
blood recommended in the treatment of this disease in man has been
tried in the dog and found unsatisfactory. The administration of certain
organic therapeutical preparations, such as spleen (lienaden) tablets,
lymphatic gland tablets, or bone-marrow tablets, has also been found
to be valueless.

I^. Ferri et quininse citratis, 0.2

Saccharum, O.G

M. F. pulv. divid charta, No. xx.

Sig. — One jjowder three times daily.

Pseud oleukaemia. Lymphadenia, Hodgkin's Disease. — This disease
appears more frequently in the dog than leukaemia. It is due to a
hyperplasia of the blood-forming centres, particularly the lymphatic

3 1 G CONS TI T U TIONA L DISEASES

glands; these become greatly enlarged. The proportion of white over
red blood corpuscles is also greatly increased. Cadiot found four cases
where the proportion was 1 to 183 to 1 to 200. The cause of this disease
has not been clearly demonstrated. Some observers ascribe it to tuber-
cular processes in the lymphatics. The course is generally rapid, and
while in the early stages there is no great alteration in the general con-
dition; anaemia soon commences, and in consequence of the hyperplasia
of the bronchial lymphatics we find dyspnoea, and as a result of the
abdominal glands being in the same state of hyperplasia we have
dropsy of the abdomen, later general cedema, and finally death.

Treatment is the same as anaemia and leukaemia. Arsenic is gen-
erally used; if it has no effect, iodide of potassium.

Diabetes Mellitus.

Etiology. — By diabetes mellitus we understand a peculiar chronic
abnormal condition of the urine wdiich contains a large quantity of grape
sugar. The true cause of this peculiar disease is not exactly known,
but from recent observations which have been made on dogs and other
animals this disease seems to have some connection with diseases of the
pancreas. Minkowski found that on removal of the entire pancreatic
gland, sugar appeared in the urine in twenty-four hours — the amount of
sugar was 10 per cent. — and death in a few weeks. A removal of a
portion of the pancreas caused slight traces of sugar in a short time, and
if the greater part of the gland is extirpated, leaving only a very small
portion, sugar was immediately formed in the urine in large quantities,
and resulted in death in a very short time. Lepine seems to think the
pancreas has the property of taking up the sugar in the blood and when
this gland is destroyed or its functions become impaired in any way, the
sugar in the blood is eliminated by the kidneys. This is further con-
firmed by diabetic dogs, where one part of the pancreas is invariably
found to be atrophied, either from functional loss of power or from car-
cinoma. Gebier mentions a case of transitory glycosuria, where a bitch
of a very affectionate disposition and accustomed to be with other
dogs, when separated from the other dogs and confined by herself, imme-
diately had sugar appear in large amount in her urine.

While this disease is comparatively rare, and is more frequently
seen in old dogs, occasionally large number of cases may be seen in
certain localities; sex seems to have no influence on the disease, as it is
seen equally in ])oth sexes. Eber found it to occur most frequently in
small pet dogs that have little or no exercise.

Clinical Symptoms and Course. — The disease develops gradually; the
most important symptom is the gradual emaciation notwithstanding

DIABETES MELLITUS 317

the fact that the animal may have an enormous appetite and be fed
with the most nutritious food. The animal is easily fatigued, is made
to take exercise with effort, and in some cases moves about with more
or less difficulty. The animal shows great thirst and drinks enormous
quantities of water, at the same time passing large quantities of urine,
which in most cases is pale and colorless and, as a rule, the specific
gravity is particularly high (1030 to 1060) and it is only in very rare
cases that the specific gravity is as low as normal. The odor of the
urine is very characteristic; it resembles that of fresh fruit (aceton).
The tests already described can be used to demonstrate the presence of
sugar in the urine, the fermentation test being the best to use. Consult
special works. The quantity of sugar present in the urine may vary in
amount. Eichhorn states that in one case he found 11 per cent, and
Haltenhof found 12 per cent, in another case. When an animal is fed
on a pure meat diet it seems to lessen the amount of sugar in the urine,
although there are certain cases where even this diet has little or no
effect on the amount of sugar present. Albumin is sometimes found in
the urine in this condition.

In many cases cataract may develop (opacity of the lens, gray
cataract), appearing simultaneously in both eyes, causing total blindness,
in some cases we find ulcerative keratitis. In other cases the hair falls
out; vomiting, persistent diarrhoea, falling out of the hair, and some have
noticed an inflammation and ulceration of the skin and bleeding of the
mucous membrane terminating in chronic bronchial catarrh of the
lungs. The course of the disease is gradual; emaciation and debility
increase until finally the animal sinks into a deep coma, accompanied, as
a rule, with convulsions, and finally death. The prognosis in all cases
should be unfavorable. Post-mortem generally shows atrophy of the
pancreas and hypertrophy and fatty degeneration of the liver.

Therapeutics. — The treatment of diabetes consists of feeding the
animal on food which does not contain any carbon, or as little as possible.
This may be accomplished to a certain extent by a meat-diet, and even
this diet cannot be followed up for any great length of time. Give eggs
and bran bread, vegetables and in cases where it cannot be avoided, milk;
but wheat bread, sweets, sugar in the form of candy, cakes, rolls, rice,
peas, lentils, potatoes, or any food containing starch in large quantity,
must be avoided. A pinch of carbonate of soda must be given three
times daily in the drinking water. Other preparations such as arsenic,
salines, salicylate of soda, carbonate of ammonia or acetate of ammonia
are useful. Where the animal is in a state of coma, use subcutaneous
injections of ether or camphor in combination with the intravenous
injections of normal saline solutions. It is always wise not to change the
animal's abode, because animals sent to a hospital, affected with this

318 CONSTITUTIONAL DISEASES

disease, show the effects of worry immediately, by the increase of the
amount of sugar, if sent away from their habitual surroundings.

Diabetes Insipidus.

This condition is a chronic one in which there is no elevation of
temperature, and a marked increase in the amount of clear urine secreted,
which is of a low specific gravity and contains no sugar. The animal is
constantly thirsty, drinking large quantities of water. This disease is
less frequently seen in the dog than diabetes mellitus and must not be
mistaken for ordinary polyuria which is seen where an animal drinks very
large quantities of water, or as a result of the administration of diuretics
or certain poisons or spices, or from atrophy of the kidneys after the
rapid reabsorption of extensive exudates or transudates. It is also seen
in a more or less pronounced degree in convalescence of an animal from
many acute diseases, and it is also observed in certain organic diseases
of the central nervous 'system. In this last group of sympathetic dia-
betes belong the case described by Holzmann; this dog was a very much
emaciated hound three years old, having a pale mucous membrane and
rectal temperature of 38.° The animal drank 12.57 c.c. of water daily,
and passed about 12.79 c.c. of urine. The urine was yellowish, had a
weak acid reaction, its specific gravity was l.OOG, and contained nothing
abnormal. On post-mortem nothing of any great consecjuence was
found, except a myxoma hyalinum, which appeared in the shape of a
yellowish, transparent, coagulated mass between the periosteum and
the dura mater, entirely surrounding the spine with the exception of a
small portion of the neck. There was also some hyperemia and slight
bleeding in the gray substance of the lumbar region. Five elongated
osteoid sarcoma masses were found pressing on the dura mater. Holz-
mann could not decide which of these two conditions was the true cause
of the disease. If we eliminate polyurias due to some organic alteration
of the cerebral nervous system, as a result of chronic interstitial inflamma-
tion of the kidneys, then polyuria is distinguished from diabetes insipidus
l)y the fact that the former is transitory in its character, and still it is
only by close observation, lasting for some time, that Ave can distinguish
between the two conditions; polyuria lasts only for a short interval
and does not produce any great tissue changes, whereas, diabetes insipi-
dus gradually progresses, becoming chronic, and is accompanied by
great emaciation. The urine is pale, of low specific gravity, and contrary
to chronic nephritis, contains no albumin. In all the cases observed by
the writer which he took at first for genuine diabetes insipidus, he
found where he could follow them closely, that after some time the
polyuria and increased thirst gradually disappeared. Schindelka de-

OBESITY. ADIPOSITAS UXIVERSALIS 319

scribed one case where the animal developed cataract and abscesses in
different parts of the bod}', and other complications which are seen in
diabetes mellitus.

Therapeutics. — The animal should be put on a strong easily digested
diet and be more or less restricted in the quantity of fluid that it drinks;
of course it is not only cruel but almost impossible to restrict the animal
as to the quantity of water that it drinks if it is thirsty, but the food
should be dry, and soup or other liciuid foods should not be given.
Medicinally the following drugs are recommended: bromide of soda,
preparations of iron, opium, boldo root, antipyrin, ergot, extract of
hydrastis, hydrastin and other vascular alteratives. Tannopin may
also be tried. The treatment of symptomatic polyuria consists in
attempting to remove the cause.

Obesity. Adipositas Universalis.

Etiology. — This disease is due to the absorption of large quantities
of carbohydrates, and also to a lack of proper exercise, and in some cases
as a consequence of improper oxidizing processes in the body. It may
also be hereditary in some cases. This disease is especially seen in lap-
dogs or pet animals, and is also noticed in bitches after ovariotomy,
and in dogs that have been castrated.

Clinical Symptoms. — The common location of fatty deposits is in
the panniculus adiposus, around the region of the abdomen, and sur-
rounding the internal organs — for instance, in the mediastinum, the
pericardium, and the capsules of the kidneys. The circumference and
weight of the body increase very much, and round prominences form in
different parts of the body, especially the neck, shoulders, back, and hips.
The abdomen is round and distended. The animals are lazy, dull,
awkward, and tired on the slightest physical exertion. When this con-
dition becomes very marked, and there is a large deposit of fat in different
parts of the body, especially when it has accumulated in the thorax and
neighborhood of the heart, we have a lessened heart-action and more or
less difficulty in respiration, sometimes from the pressure of quantities
of fat on certain blood-vessels, decreasing their size and thus requiring
gi-eater effort of the heart 's action, until finally the heart becomes over-
taxed, and we have symptoms of heart-failure, bronchitis, chronic
catarrh of the stomach, and oedema.

Therapeutic Treatment. — The most important factor in the treatment
of obesity is abundant and regular exercise in the open air and restricted
feeding^ the food must be albuminous, and fat and carbo-hydrates
avoided. Sugar in any form, candy, sweets, etc., must be prohibited.
Meals must be given at regular intervals, in a young dog three times

320 CONSTITUTIONAL DISEASES

daily, a dog over a year, two meals daily; a small meal in the morning
and the good meal at night; dogs that have very little exercise, one meal
daily is sufficient, and as a rule they seem to do very nicely on it. Slight
laxatives, especially the salines, such as Apenta, Hunyadi, or Veronica
waters, in teaspoonful doses once daily, and a pinch of phosphate of
soda in the morning. There seems to be some value in the administration
of the preparations of the thyroid glands (thyroid, thyroidin, or iodothyrin
tablets), these tablets contain the equivalent of 0.3 of fresh thyroid
gland and are to be given according to the size of the animal, from 1 to
3 tablets daily. Seven clogs were treated with thyroidinum depuratum
in doses of 0.15 daily, and in from one to four weeks the animals were
reduced in amounts varying from 350 to 3460 grams. But these prepara-
rations must be used with great care, beginning with a very small dose
and gradually increasing it. Iodide of potassium, boracic acid and borax
are not to be recommended as they are apt to cause disorder of the
digestion.

Uraemia.

As a consequence of this disease and impaired activity of the kid-
neys, certain substances, that should be thrown out in the urine, remain
in the blood; also the watery excretions of the body, acting as a poison,
produce a condition known as ''ursemia." The exact nature of the
materials that cause this disturbance is not definitely knowai, but in all
probability it is not due to one, but to several substances, such as albu-
minous decompositions and certain end-products. Ursemia is usually
Been as a result of acute inflammation of the kidney, hydronephrosis,
obstruction of the neck of the bladder, or urethra, by calculi; from
tumors of the prostate, paralysis of the detrusor, and rupture of the
bladder. The disease may be acute or chronic, and one form may merge
into the other. The acute form is seen in acute inflammation of the
kidney and retention of urine in the bladder, in this case there is j^er-
sistent vomiting, convulsive twitching of the muscles, convulsions, coma
and subnormal temperature. The chronic forms may appear following
chronic nephritis, and from partial retention of the urine, it is seen par-
ticularly in stone in the urethra, when the passage is not completely
obstructed, but only allows a very small quantity of urine to escape,
when this is present there is depression, loss of appetite, irregular vomit-
ing, occasional convulsions, diarrhcra. Certain experiments have been
made on the dog to artificially produce these ura}mic symptoms —
for instance, by removing both kidneys or ligitating the ureters. Voit
observed that when healthy animals were fed on food containing uric
acid, and at the same time deprived of water, these conditions pro-

SCURVY 321

duced the disease. Grehant and Qiiinwuaud produced death in dogs
when urea was injectetl into them subcutaneously to the amount
of 1 per cent, of the whole weight of the body. This produces convul-
sions, apparently from suppression of respiration. Feltz and Ritter
produced uraemic symptoms in the dog with injections of salts of ammo-
nium. It is of practical interest to know that uraemia may also occur in
acute nephritis, in cases of enlargement of the prostate and obstruction
of the passage of urine, or from uratic stones filling up the urethra or the
neck of the bladder.

The clinical symptoms have been described by Roll and others as
high temperature alternating with chills, constant vomiting, convulsions,
paralysis, coma, decrease in the temperature, and death within a few
days. Roll also states that dogs which have suffered with hypertrophy
of the prostate showed the same symptoms of this disease, but these were
produced gradually and the symptoms were not so acute. In such cases
we find dulness, disturbance of the intestinal canal, and convulsions.

Treatment. — The treatment of uraemia is based on an endeavor to
remove or lessen the original cause (nephritis, etc.). If there is a calculus
present, it must be removed as soon as possible; and to eliminate the
poisonous materials from the blood, use mild saline laxatives and treat
symptoms.

Scurvy.

It is doubtful if true scurvy occurs in the dog — that is to say, a
hemorrhagic diathesis marked by a spontaneous bleeding of the mucous
membranes of the mouth, and also from the muscles, joints, etc.
This may occur as an epidemic; sporadic cases are extremely rare.
It is a question, however, whether true scurvy does occur and whether
it is not an attack of ulcerative stomatitis, which in the older text
books was described as pesu do-scurvy, or it is possible that it is dis-
temper, or septic or some condition due to the toxins in the blood. It
may result from the feeding of tainted or decayed meat or particularly
in packs of hounds where the dogs are fed, entirely on meat, and
never any vegetables. Seltzner described one case that in some re-
spects resembled Basedow's disease; a haemorrhagic diathesis and in
other respects it was similar to rickets.

There were numerous haemorrhagic centres in the skin and cellular
tissues. The buccal mucous membrane was somewhat swollen and
filled with haemorrhagic spots, or even necrotic. The gums were also
in the same condition. There was loosening and falling out of the teeth,
horrible odor from the mouth and salivation, bleeding from the mouth,
bloody urine, and sometimes blood was vomited, in one case there was

322 CONSTITUTIONAL DISEASES

blood in the anterior chamber of the eye, and an extravasation of the
epiploon. Animals generally die of exhaustion, and post-mortem may
show extensive hemorrhage of the intestinal tract, pneumonia and
pyaemia.

Treatment. — Local treatment of the mouth with astringents, lis-
terine, permanganate of potash, regulation of diet. Where animals like
packs of hounds have been fed on nothing but meat, a combination with
vegetables seems to be advantageous; the regular diet of cooked meat
should have greens such as spinach or the ordinary dandelion, root and
leaves cooked with it. General tonics, such as gentian or nux vomica,
and when there is general hemorrhage the internal administration of
hemostatics is useful.

Priessnitz's Bandage or Compress.

This compress is mentioned a number of times in the work, and as
it has special advantages in the treatment of dogs, the translator will
attempt to describe it, as the author has not done so, probably due to the
fact that it is so very well known in German therapeutics that it needed
no explanation, but to English-speaking veterinarians this is the reverse.

The object of the compress or bandage is to keep up a continual
heat, either dry or moist, to certain parts of the animal's body. We
first apply against the part afTected a piece of absorbent cotton, thick
W'ool, or dry felt; or if moist heat is recfuired, it is soaked in warm water
or a medicated solution and wrung out to remove the excess of fluid;
this is then held in position by a covering of some light material — a wide
bandage of cheese-cloth is the best — and next a layer of oiled silk or
rubber cloth (the object of this is to retain the heat and in case of a wet
compress, the moisture), and finally over this is placed a compress or
bandage of flannel. This last is to prevent loss of heat by radiation.
Sometimes the inner layer of cheese-cloth is omitted, or else it is put on
the outside of all.

The above procedure may seem to the hurried practitioner a rather
long and unnecessary method, but after one has tried it and found the
great advantages it has in the retention of heat, especially in diseases of
the lungs, in hastening the maturing of an abscess, or in the lessening of
a tumefaction by the constant and direct application of heat and moisture,
he will realize its benefits.

DISEASES OF THE ORGANS OF LOCOMOTION.

DISEASES OF THE BONES.

Rachitis.

(Rickets.)

Etiology. — The different theories -which have been advanced con-
cerning the origin of rachitis do not seem to answer in all cases. These
theories are as follows; it is due to a deficiency of lime-salts as a conse-
quence of disturbances of digestion; to excessive formation of lactic acid,
in the blood and to salts of potassium in the milk or to a lack of hydro-
chloric acid in the gastric juice, which would dissolve the lime-salts; an
alteration of the general nutritive condition on account of abnormal
influences in young animals; inflammatory hypersemia and an increase in
the number and size of blood-vessels in the osteogenetic tissues, so that
the lime-salts continue to circulate in the blood instead of being deposited
in the bones. Xone of these theories stands the test of close observation,
we therefore do not know positively anything relating to the character
and origin of rachitis. It is, perhaps, better to admit that it is a specific
etiological change (which has not as yet become positively known). We
know positively, however, that rickets can be developed in the dog by
deficient, improper food, by want of meat, and especially bones, as it has
been demonstrated that animals with this disease if given these articles
of diet seem to improve immediately. Insufficient food to the bitch
during gestation, or trying to raise too large a litter, or early weaning,
improper food, keeping animals in cellars or in dark, damp places are all
factors that tend to cause rickets. A proper amount of exercise is
especially important for puppies kept in a small place.

Rickets generally appears in young animals in the first few months
of their life. It is often hereditary, as is frequently seen as a result of
very close breeding and also in breeds where color or conformation is the
chief object, such as bull terriers, collies, or great danes, and where a
breed is not old enough to be established, as Boston terriers. The
symptoms appear relatively in proportion to their growth. If the puppy
grows quickly, rickets appears quickly; if it grows slowly, the disease
comes on gradually.

Pathological Anatomy. — Rickets consists of a peculiar disturbance

323

324

DISEASES OF THE ORGANS OF LOCOMOTION

of the bones of the whole system, which can easily be distinguished on
looking at the animal. It seems to be due to a deficiency of lime-salts
in the bones, making them soft and flexil;)le. At the same time the
nutritive process in the periosteum seems to be changed. The bones are
light and soft enough to cut with a knife, and the epiphyses of the long
bones are very much thickened; the marrow and periosteum are reddened.

When the periosteum is forcibly removed from
the bones of the animal in this condition, cer-
tain portions of the bony tissue come away
and remain attached to the membrane. This
is especially noticeable between the epiphyses
of the vertebrse. The inner layer of the peri-
osteum is thickened and the diseased tissue
seems to have undergone a spongy degener-
ation. Inside of the bone we find it soft and
cavernous. In the normal dog the bones of the
skull are joined evenly, but in the rachitic dog
interosseous spaces (fontanels) have been
found.

Clinical Symptoms and Course. — Omitting
the animals that are born with rickets, the first
appearance of rickets is gradual, and generally
the veterinarian is not consulted in the early
stages, but only when the skeleton shows
marked alterations of form, especially the
bones of the extremities and back. The ani-
mals are dull, walk very carefully and with
more or less effort, have no desire to run about,
but lie down as long as they can. We find peri-
osteal alterations in the frontal bones and
bones of the temple, so that the head shows
a peculiar marked alteration in conformation.
Schutz has found that in rachitic animals the
bones of the skull are extremely thin and the
sutures separated. In the thorax there is a
weakening of the walls of the chest, and the
animals present that one-sided or " chicken-
chest" condition. There is a peculiar knot-like swelling of the ribs both
at their upper extremities where they unite with the vertebrae, and in their
inferior extremities where they unite with the sternum and false ribs.

In this latter condition there forms a series of small, round nodules
known as ''rachitic rosary." In acute forms of this disease the spinal
cord is twisted or bent in different directions (kyphosis, lordosis or

Fig. 102. — Radius and ulna of a
dog afifected with rickets.

FRACTURES OF THE BONES 325

skoliosis). The most striking alterations are ol)served in the extremities.
The long bones are thickened at both ends and bent on account of the
softness of the bone and pressure of the weight of the body, when stand-
ing (Fig.. 102). The upper portion of the front legs bends inward, rarely-
outward, and the animals have a peculiar, unsteady, awkward gait.
The}' stand on the hind legs with the leg twisted under them, and in
aggravated cases, the bones are bent in a circle, the bend of the astragalus
coming down on the ground (Plate, Rachitis). As a consecpience of the
altered position of the bones, the ligaments Ijecome distended and stretched,
causing an inflammation of the joints and consequently more or less
enlargement of them. At the same time we ol^serve emaciation, loss of ap-
petite, and in some cases, catarrh of the stomach and air-passages, changes
in the shape of the teeth, which are aljnormally small and frequently
devoid of enamel, or placed irregularly in the gums. The disease, as a
rule, is chronic and the prognosis unfavorable. If the disease is taken
early, it may be checked to a certain degree by means of proper feeding;
but when the deformity is once formed, it is only in extremely rare cases
that it does not show as the animal grows to an adult age either in the
form of a peculiar bending or bow-legged appearance of the front legs,
or a twisting, or show halt-shape in the hind-legs.

Therapeutic Treatment. — The treatment of rachitis consists of
improving all the nutritive conditions and encouraging digestion as
much as possible. Give the animal plenty of meat and bones, adding
to them certain amount of phosphate of calcium, egg-shells, and lime-
water in the drinking water. Phosphorus, while medicated, generally
causes irritation of the intestines. Improve the digestion as much as
possible by tonics, nux vomica, gentian, etc.; keep the animal in a clean,
dry place and see that there is good ventilation. If there is diarrhoea,
give bismuth subnitrate. To avoid bending of the articulations, the
animal must be prevented from taking unusual exercise, running, jump-
ing, etc. Splints are sometimes used to correct the curving of the long
bones.

I^. Ferri lactis 5.0

Calcium phos.,

Calcium carbonate,

Saccharum lactis, aa 20.0

F. M. pulv.

Sig. — One small teaspoonful in the food twice daily.

Fractures of the Bones.

By a "fracture of the bone'' we mean a breaking or disunion of a
bone or a bony cartilage; fracture is quite common in the dog, particu-

326 DISEASES OF THE ORGANS OF LOCOMOTION

larly the bones of the extremities, femur, radius, tilna and filuila, uhia
and humerus and metacarpus and pelvis being the commonest, less
frequently seen are the metatarsus; the sternum, ribs, cranium, vertebrae,
and scapula are very rarelj' seen.

Etiology and Prognosis. — IMost fractures are caused by external
forces, and the bone fractured is at the region where the force or shock
has expended most of its force — for instance, from blows or being run
over, hit with a stone, or in some instances a fracture may be some
distance from the region where the greatest amount of force has been
made, such as falling for some distance, or concussions. We also see
fractures of small projections of bones caused Ijy great muscular exertion.
Very old and very young dogs have a predisposition to fractures and
rickets, or a tendency that way may also produce fractures from a
weakened or softened condition of the bone.

We separate fractures under different names according to their
position, severity, and the complications accompanying them.

In the first class belong infractions, splits or cracks, impressions or
depressions.

In the second class belong obliciue, transverse, longitudinal, and
fissure fractures.

In pups the epiphysis and diaphysis are sometimes fractured through
the symphysis, due to traumatic influences. This fracture, which is
rather common, especially in the humerus and radius, is always confined
to the immediate neighborhood of the symphysis. The general course
of these fractures is the same as ordinary fractures, and no special men-
tion is necessary regarding fractures of the soft bone, which in the young
animal has not yet hardened.

The condition of the soft tissues in the neighborhood of the fractures
and the amount of injury that they have had are of great importance
in the prognosis. All fractures in which the soft tissues are not very
much injured, and where the skin has not been torn, heal very much more
quickly than those where there is an open wound extending into the
fractured end of the lione. The first are termed simple fractures, and
the latter, compound fractures. Where the fracture has involved a joint,
it is called an intra-articular fracture. The compound and intra-articular
fractures are very slow and difficult to treat, and present such symptoms
as synovitis, either with or without serous or purulent inflammations.
In such fractures, even when we have union of the broken ends of the
bone we may have as an after result a stiff joint or ankylosis from com-
plications in the joint.

Clinical Symptoms. — The symptoms of fractures are generally
indicated by partial or complete loss of the use of the whole or part of a
limb. There is pain on pressure, deformity in the symmetry of the broken

FRACTURES OF THE BONES

327

bones of that part of the body, and on moving the fractured ends
there is a rubbing sound (crepitation) similar to rubljing two hard,
rough surfaces against each other. The amount of loss of power in a
broken bone depends to a great extent on the amount and s(n-crity of
the fracture. This is ver}^ marked in fractures of the extremities; great
pain on pressure, especially on the line of the fractured bones. This
may also be of especial diagnostic importance in case of cracks or fissures
of the bone. In such a case, while the symptoms are all present, the
ends of the bones are not displaced. This is generally seen in the longi-
tudinal form and in very young animals where the bone pi^'ots on the

Fig. Wo. — .Skiagraph of fracture of the humerus.

fractured epiphysis. Crepitation and an abnormal movement are
easily recognized by taking hold of the part above and below the frac-
ture and moving it in different directions. Both of these symptoms
are absent in incomplete fractures and in such fractures where the bones
will close together with very little displacement. This is especially seen
in longitudinal fractures of the short compact bones. We occasionally
find a mild, rubbing loruit or sound produced by dry blood-extravasations
or fibrinous coagulations between the surfaces of joints. In cases of
fracture where the periosteum has not been torn, we will have a certain
amount of swelling in the fractured region, pain on pressure, loss of
appetite, and a certain amount of fever. This last symptom, however,
is rarely noticed. When there is any uncertainty about the cUagnosis

328

DISEASES OF THE ORGANS OF LOCOMOTION

it is well to have a skiagraph (X-ray) made of the affected part (Fig. 103).
Where there is an external wound which becomes rapidly closed
by the blood and the purulent agents cannot penetrate between the
fractured ends of the bone, we have a form of fracture that is not so
difficult to treat; but if any septic materials should have penetrated
into the wound and found their way between the ends of the bones,
the condition is generally indicated in the following manner: There is a
marked inflammatory sweUing in the neighborhood of the wound. At
first the discharge from the wound is blood-colored, then rapidly becomes
pus-like, and finally purulent in character. If the discharge becomes
ol)structed in any way, we quickly notice a purulent, oedematous swelling
all around the part, which is always a very grave symptom. If the

course is favorable, the injured part becomes
rapidly filled with red, granulating tissue,
which finally dries, becomes hard, and forms
a scab. By means of strict antiseptic treat-
ment this is possible, and we can reduce
the danger and time of an open fracture by
strictly following the usual antiseptic forms
of treatment. In the dog, however, this is
always rather difficult to accomplish, as the
animals are hard to confine, moving about
constantly and pullirtg or tearing the band-
ages.

The Phenomena of Union in Fractures.
— The healing and union of the fractured
ends of a bone are very similar to those of
wounds, either by first intention (primum
intentionem) or by second intention (secun-
dum intentionem) . In simple fractures we
generally get union by first intention, and in compound fractures, unless
the union be extremely small, we get union by second intention (Fig.
104). In both cases the union is accomplished by means of a callus
growing around the ends of the bone — that is to say, a soft cellular
tissue which forms an envelope surrounding the bone and gradually
becoming hard through the ossific action of the periosteum and the
marrow of the bones. The ring-shaped or external callus surrounds the
fractured parts. This cellular tissue is formed of osteoblasts. The
inner callus is formed by the marrow, forming a peculiar plug-shaped
body and filling up the open ends. The periosteum is the true factor
in making union between l)roken ends of bones. This is especially noticed
in fractures where the periosteum is exposed, and where that envelope
is torn or injured, union is almost twice as long as where the peri-

FiG. 104. — Diagram of union of frac-
ture in the tibia of the dog: a, outer
callus; b, periosteum; c, inner callus: d,
inflammatory deposit.

FRACTURES OF THE BONES 329

ostcum is prcsorvetl. Tho extravasation of blood found in the early
stages of a fracture which hes in the surrounding parts does not in any
way assist in the actual union, but helps to a certain extent in holding
the bones together until the callus is formed. The callus, in the begin-
ning, is a spongy mass, especially in bones containing a large quantity of
marrow. This gradually changes into a bony cicatrix or callosity. This
becomes thinner and denser, lessening in diameter, and finally becomes
smooth on its surface, forming what is known as ''final callus." Reab-
sorption commences at the same time until the body masses, which
are useless after the bone is united, finall}' disappear, l)ut there is always
a certain amount of enlargement around the fractured ends of a bone
at the point of union. Cracks and fissures undergo the same process.

Period of the Process of Union in Fractured Bones. — The time required
to obtain complete union of a fracture — that is to say, until the animal
can use the part without any pain or difficulty — depends largely on the
size and position of the bone, the age of the animal, and the amount of
use the patient makes of it. According to the observations of the
writer and others, in fractures in which the periosteum is not torn, or
simple fractures of the large bones containing marrow, the time is from
eighteen to twenty-four days in adult healthy animals. Fractures of
the ribs unite in from ten to fifteen days; in metacarpal and metatarsal
bones, ten to eighteen days. In young animals the process is a few days
shorter; in very old animals it is much longer. After the union of the
fracture, as a rule, the affected leg is not used with as great freedom as
it was before. This is especially noticeable in young animals that are
growing. Very often there is a subsequent atrophy and impaired
development of the muscles of that part. While this may be due to a
certain extent to the inactivity of the muscles, when tied up in the splint,
and also to pressure of the dressing, it is often noticed after the dressing
is removed, and sometimes for weeks afterward, the animal walks stiff
or is even lame; massage of the affected leg is useful.

Therapeutic Treatment. — In simple fractures the treatment con-
sists of returning the broken ends of the bone to their proper anatomical
position, and holding them securely in place.

The bringing together of the fractured ends of the bones must be
done as soon as possible, and it is accomplished by pulling or extending
them in a longitudinal direction until the fractured ends fit together. In
some instances where the tissue is loose they have to be pressed back in •
their normal position. The animal should be held by an assistant while
the operator manipulates the ends into position. In cases where there
is extreme pain and in order to keep the animal from struggling, it is
advisable to etherize, or better, give the animal a sulx-utaneous injection
of morphine. In such cases as fractures of the metacarpal bones, bones

330

DISEASES OF THE ORGANS OF LOCOMOTION

of the face, etc., reduction can be made without an assistant. ^Vhen
the bones have been placed in position as neai- as possil^le to their normal
shape, we must then apply a dressing which will keep the fractured ends
in their position until they have united.

The best dressing for fractures in dogs are those which dry rapidly,
such as plaster or silicate of sodium solutions. In some cases it becomes
necessary to apply a temporary splint apparatus for a few days. This
temporary splint apparatus must be used where there is great swelling, or
where the condition of the wound or part w^ould lead you to expect much
swelling. The writer finds the best thing for fracture dressings is a

Fig. 105. — Plaster splint on fracture with support around body.

broad pasteboard splint. This should be dipped in water and kneaded
by the hand until flexible. There are various other materials for making
splints — gutta-percha, wire gauze, spongio-piline, felt, sheet tin or zinc,
wood, etc. In some cases where there is an open wound wire gauze may
be used, fastened above and below the fractured ends of the bone,
leaving the wounds exposed. This gives it sufficient support, and
admits of proper antiseptic methods being followed. A plaster-of-Paris
or silicate of sodium dressing may be applied immediately after the frac-

FRACTURES OF THE BOXES 331

tiire, provided thci'c arc no wounds. Where there are wounds or swellings
we must wait until the swelling is absorbed.

\\'c apply a permanent dressing, or a temporary dressing may be
put on in the following manner: Cover it thoroughly with cotton wadding
and apply the ordinary bandage, taking care not to make it too tight.
In plaster-of-Paris dressings, the ordinary gauze, crinoline, or cheese-
cloth may be used, and the plaster, in powder form, rubbed into the
bandage while it is being rolled. Then rub a small amount of oil (swdet)
into the skin about the point of fracture to prevent the bandage
sticking. At the same time place the plaster bandage in water for a
few minutes and then wrap it carefully around the splint, following the
methods adopted in ordinary bandage rolling, being careful not to place
it too tightly. Smoothe the water out of the part, making the bandage
as level as possible. In some cases where you want a very stiff ban-
dage, it is advisable to put a certain amount of plaster between the
folds of the bandage and finally give a good coating over the
entire bandage. After the dressing has been applied, the animal
must be kept perfectly quiet for at least ten to twenty minutes
to allow the dressing to become hard. A plaster dressing will dry
and harden a little more quickly by the addition of a small quantity of
alum or common salt; a little glycerine added to plaster makes it much
harder. A pair of curved scissors are the most practical for the removal
of the dressing. Tripolith dressing (a mixture of plaster-of-Paris and
soot) can be applied in the same manner as the plaster. Its composition
is said to be much lighter and it dries much more rapidly. Silicate of
sodium dressing has the advantage of lightness, durability, and of being
removed easily, but it has one disadvantage, and that is it dries slowly,
sometimes taking a couple of hours. The writer likes this form of
dressing best, and to overcome the drawback of slow hardening has
placed thin layers of wire gauze between the dressings. Flannel may be
used as an under layer. Another dressing is a mixture of benzoate of
sodium and silicate of sodium. In fractures situated in the upper
sections of the leg where the extremity is cone shaped, it is necessary to
build up the bandage in numerous layers to give it body so as to hold to
the position of the leg, in other cases the bandage should be carried around
the bod}^ so as to make the bandage firmer (Fig. 105).

The starch bandage (common boiled starch) is very useful, easily
made and can be used in the. smaller dogs, the bandage being put on first
in one layer, this carefully covered with the starch, this covered with a
layer of muslin, then starch over this and finally the third layer covered
with starch and allowed to dry. This bandage takes longer to di-y than
the plaster.

Pitch plaster bandages are put on those parts of the body where an

332

DISEASES OF THE ORGANS OF LOCOMOTION

ordinary bandage cannot be applied, as in fracture of the scapula, femur
and humerus. The pitch can be spread on strips of coarse muslin, and
heated and applied to the injured part (Fig. 106). Burgundy pitch
100.0 wax 50.0, mix this into a plaster. The dressing may be left in
place until we feel sure that union has taken place. In cases where the
dressing has been too tight, or if the patient shows restlessness, whining,
crying, loss of appetite, or fever, indicating that something is wrong in
the fractured region, the dressing must be removed at once (Fig. 107).

"When the average period of union of fracture has passed remove
the dressing carefully and see that the fragments are united. If we
recognize any mobility in the fractured region, we then understand that
we have a slow, callous formation, and nothing else is to be done but to

renew the dressing as soon as possible, hav-
ing first rendered the parts antiseptic by
means of sublimate, soap and Avater. Put
on the l^andage again and let it remain
for two or three weeks more. If we do
not obtain a cure at the end of that time

Fig. 106. — Pitch plaster put on
in layers. (.Cadiot- Breton.)

Fig. 107.— Effects of tight
bandaging of a splint.

we may conclude that we have a false joint (pseudarthrosis).

The methods pursued in man of introducing ivory or bone pins into
the Ijone or screwing it together by means of clamps or resecting the
ends with a saw, is hardly practicable in the dog. If, however, we dis-
cover that there is any danger of the formation of a false joint, we may
daily irritate the ends of the wound by rubbing the broken ends together,
and tying a thick elastic band around the leg above the fractured ends
of the bone for one-half to one hour each day to allow an engorgement of
blood around the fracture, this bandage should not be made too tight so
as to interfere with the arterial circulation but sufficient to cause venous
engorgement aliout the fracture; others recommend injections of 3 per
cent solution of carbolic acid, or GO per cent, of alcohol, and appl3dng a
dressing, giving the animal phosphate of lime or phosphoric acid.

FRACTURES OF THE BONES

333

In complete fractures we follow the same rules as in the subcutaneous
forms — that is to say, we endeavor in one way or another to hold the
broken ends of the bone together while the wound is healing, and at the
same time to dry up the wound with antiseptic applications. This is
rather difficult to do in the dog, but it may be accomplished by making
a " window " or hole in the dressing. The wound must first be thoroughly
cleansed, dressed antiseptically, and then we apply a plaster dressing,
according to the usual method, and place a piece of wadding upon the
Avound. "When the dressing becomes hardened, we cut a hole over the
wound by means of a probe-pointed bistoury, coating the edges of the
opening with a small quantity of plaster-of-Paris or collodion in order
to prevent the discharge of pus, etc., from running under the dressing.

Fig. 108. — Different methods of amputation: a, straight section; b, flap operation; c, method of sewing

the wound.

The rest of the operation is performed according to the general rules
followed in the treatment of wounds. In cases where the fracture is
fresh and the wound is very small, we cover it with an antiseptic dressing
(for instance, tincture of iodine and several layers of corrosive sublimate
gauze). Then apply the closed dressing of plaster-of-Paris entirely
over it. If the wound is slight, as a rule you do not have to remove
the bandage. Care must be taken, however, to take the temperature
and watch the leg to see if it swells, and if the animal is restless and uneasy.
In cases where there is a wound and several broken bones, makmg a
compound, comminuted fracture, the patient can only be saved by
amputating the leg. Amputation of the leg, as well as exarticulation,
has been performed a number of times in the dog, and generally success-

334 DISEASES OF THE ORGANS OF LOCOMOTION

fully, the animals soon becoming accustomed to the loss of the leg, using
the other three with almost as much ease as they did the four.

Amputation. — Before the operation clean the affected leg with soap

and with a Inrush; then disinfect with powerful antiseptics (5 per cent.

solution of carbolic acid, 1 to 1000 solution of corrosive sublimate, or

2 per cent, solution of creolin). In operating, the animal is put under

ether or narcotized in some way; do so with as little loss of blood as

possible. To accomplish this, use a rubber bandage as a tourniquet.

All of the rules of antisepsis must be strictly adhered to, and at short

intervals, during the operation the wound must be irrigated \\\i\\ some

antiseptic. Avoid any serious manipulation or compression of the soft

parts, The skin must always be cut in such a manner as to cover the

stump when the two ends or flaps are united. All the vessels, arteries

as well as the veins, which have been cut must be taken up separately

with the forceps, and ligated with catgut or silk. All stumps of nerves

which lie loose upon the wound are to be drawn out with the forceps and

cut off as close as possible. The bandage must not be removed until all

the blood vessels have heen ligated (Fig. 108). The wound and its

neighborhood are then thoroughly irrigated with an antiseptic solution

and closed with stitches, as illustrated on page 333, Fig. 108, c; and 307,

Fig. 118, a and b. The whole wound is to be covered with a permanent

antiseptic dressing. For further details, see Treatment of Wounds.

There are three methods at the disposal of the operator.

(1) Amputation by Means of a Circular Section. — Cut through the

skin of the affected extremity to the fascia, making a complete circle

around the member. Pull back the skin and have it held by an

assistant, he pulling the skin toward the body as far as possible. It may

be necessary in some instances to dissect a small portion of the skin and

the cellular tissue from under the layer of the skin. After that make a

sharp, clean circular cut, close to the edge of the skin which is pulled

back, amputating all the muscles, and then cut the bone with bone forceps

(Fig. 108, a), or saw through the bone. "While cutting through the bone

it is necessary for the assistant to pull back the soft tissues as far as he

possibly can toward the body, either with his hands of by means of a

linen compress which has been dipped in an antiseptic solution. In

cases where amputation of the extremities is to be performed, where

there are two bones, as in the forearm, it is necessary to cut the soft

tissues that are located between the bone.

Flap Amputation. — This is made by cutting two half-moon-shaped
flaps of the skin and separating them from the fasciie in which they are
located as far as their base, turning them upward and backward. The
muscles are cut close to the flaps, the tissues pulled back, and the bones
sawed through and the ends of the fjap carefully stitched (Fig. 108, h).

MINOR DISEASES OF THE BONES

335

Exarticulation. — Separate the soft parts exactly as in amputation
by means of a circular or flap operation. Then open the affected joint
by bending it, producing a tension of the ligaments which are located in
front of it; then cut through them with a bistoury. To get quicker
adhesion of the tissues it is best to scrape the cartilage on the face of the
articulation. Exarticulation is finished by separating the other liga-
ments and the capsule of the joint; then proceed exactly as we do in
ordinary amputation. The operation of removal of the tail is taken
up later.

Minor Diseases of the Bones.

Other disease of the bones in the dog are of slight importance but
the following are mentioned:

Fig. 109. Fig. 110.

Fig. 109. — Skiagraph of osteosarcoma of the radius with opening in the upper part

of the bone.
Fig. 110. — Skiagraph of the ulna with middle and lower third of the bone nearly gone.

Osteomalacia. Softening of the Bone. — This condition has no con-
nection with rickets, but a softening of a l:)one after the bone has become
hard and perfectly formed. It is a question if this disease really ex-
ists in the dog. Zscholke states he has seen numbers of cases where
there was great loss in the substance of the bone, but at the articulatory
surfaces there was no evidence of rickets; another observer treated a dog

33G DISEASES OF THE ORGANS OF LOCOMOTION

■with an enormous swelling of the inferior maxillary and on minute ex-
amination of the bone there was lacunary atrophy.

Ostitismus Universalis and Hyperostosis et Myostosis Universalis
Progressiva. — This is a peculiar affection of young clogs. It is indicatetl
])y numerous nodules of bone at the insertion of many muscles of the body,
and great increase in the lime salts of bones and also of weight of the
skeleton. It has been observed by Kitt where an animal had an enor-
mous swelling of the head the lower jaw and the bones of the legs partic-
ularly the bones of the forearm, while the other bones of the body were
entirely free from any sign of the disease. The animal suffered no in-
convenience from the condition, had no fever, appetite good and general
health was excellent. The deformity of the skeleton made walking
irregular and difficult, and the animal moved around with a wave like
motion of the body.

Multiple Periostitis. — This condition is extremely rare, there is
generally more or less rheumatism and deposits in the articular ends
of the bones, probably a complication of gout.

Neoformations of the Bones. — Osteophytes and exostoses, so often
seen in other of the domestic animals, are extremely rare in the dog.
Sarcomata (osteo sarcoma), on the other hand, appear in a variety of
ways developing from the periosteum or directly from the marrow canal
of bones, or in the inferior maxillary causing a tumefaction of the gum.
The writer has observed two cases in the radius and ulna, which were
illustrated by means of the Rontgen rays (X-rays), the destruction and
alteration of the bones could be readih^ distinguished, numerous cases
have been observed by other observers.

DISEASES OF THE ARTICULATIONS.
INFLAMMATION OF THE JOINTS.

General Pathological Anatomy of Inflammation of the Joints. — A

common aft'cction of the joints is synovitis. In a simple case of in-
flammation of the joints, we see an increase of blood vessels, an in-
filtration of the small cells, and even disintegration of the endothelial
cartilage; the tissue under it becoming granular. We find cjuite freciuently
an accumulation of fibrinous or " croupal-like " membranes, followed by
a cicatrization of the synovial membrane. In all acute forms of synovitis
we see hemorrhages in the form of small, tick-like bodies. In inflamma-
tion of the joints, when it takes a chronic form, the synovial membrane
becomes thickened, is tougher, with marked indentations on the membrane
which are tree-like in form. The synovia appears in large quantities,
is yellowish, clear, or slightly turbid, and dulled l^y cells or fibrinous
flakes. If the synovia is gathered in a large quantity, we find a dis-
tention of the capsule, producing a hernia-like protrusion of those parts
of the joint, where there is the least resistance. Occasionally we find
the synovial membrane covered with thick clotted masses. These oc-
cur from the excessive secretion of synovia in the joints. Sometimes
small bodies appear in the joints due to some parts of the hard cartilage
becoming detached and in rare instances by a breaking off of small
pieces of bone, and, finally, we may see the development of a cicatricial
contraction of the synovial membrane; which is due to an acute or
chronic inflammation of the joints, or when for any cause (for instance,
dressing of fractures) a healthy joint is rendered immovable for some
time. This condition may produce a temporary stiffening of the joint,
but this, as a rule, is overcome in a short time.

The fibrous capsule of the joint is occasionall}^ inflamed, but, as a
rule, in acute and chronic inflammation of the joint it remains unaffected.
"Where there is suppuration present the capsule may become detached
from the periosteum with the bone, and also may be perforated by the
pus. The ligaments also become impregnated with the pus from a
purulent inflammation, but, they are rarely destroyed. Occasionally,
however, we may see chronic inflammation of the joints in which there
is a cicatricial contraction, where the joints become firm and united,
and their mobility is lost. Sometimes from traumatisms we find only the
soft parts which surround the joint, such as the external ligaments or
the neighboring tendons, become involved in the inflammatory process,
while the inner joint seems to be very little affected.
22 337

338 DISEASES OF THE ARTICULATIONS

The cartilage of the end of the joints is rarely affected by the various
inflammatory conditions. In acute cases of suppuration of the joints,
the cartilage may he softened, perforated, or partially destroyed, so
that the bone is bare in some places. In many chronic cases of inflam-
mation of the joints the cartilage becomes macerated and dissolved into
fibres, or it may be overgrown with abnormal synovial extensions. As
soon as the bone proper becomes involved in the inflammatory process,
extensive granulations form, causing a peculiar spongy growth on the
cartilage. These granulations crowd and perforate the bone here and
there and also affect a cartilage of the opposing bone, leading to a cic-
atricial growth on the end of the joint. In some cases we also see the
fibres and cells of the cartilage becoming soft and finally growing up with
numerous raised cartilaginous cells, and presenting an acute inflammation
of the ends of the joints. From these periodical conditions we may find
a marked alteration in the form of the joint in which the edges of the
joint protrude, and the inner surface is hollowed and grooved. A
peculiarity of deforming inflammation of the joints is an inflammation of
the synovial membrane, with abnormal excretion of synovia and a great
enlargement of the free or loose portion of the membrane which may
develop into papilla-shaped masses.

The bone, as a rule, does not become affected in acute inflammation
of the joint; but if it should become uncovered from suppuration of the
cartilage, the inflammation extends to the spongiosa, and we see occasion-
ally the formation of purulent or granular centres on the surface of the
bone. In rare cases the periosteum becomes covered with osteophytes.

Acute Synovial Inflammation of the Joints.

{Synovitis Acuta Serosa.)

The joint is swollen and hot, and the animal shows pain on pressure
or movement of it. These symptoms indicate an inflammation of the
synovial membrane and a lessening of the secretion of synovial fluid
in the joint. It is very rare that we see intense fibrinous excretions
(synovitis sero-fibrinosa) , and still more rare are those cases of colorless
blood-cells mixed with detached epithclia. The animals are lame when the
joint is moved, especially at the beginning and toward the end of any
movement of the joint. Very frequently small dogs will only walk on
three feet, carrying the inflamed member.

The following causes may produce synovitis: Crushing or con-
cussion of the joint, ])lows, sprains (such as falling from a height). In
cases of injuries of the joints, we may expect only a simple synovitis
when the injuring object is clean and the wound is cleansed immediately
after the injury (removing the blood-clots and applying antiseptic

INFLAMMATION OF THE JOINTS 339

dressing). According to tho olx-^orvations of the writer, acute synovitis
occurs most frequently in the carpal joint, joints of the toes, in the knees,
and hip-joints. Paint the affected joint with iodine and keep the leg at
rest as much as possible. After the acute symptoms have subsided, mas-
sage the joint and allow light exercise.

There are several irritations of the joints that are observed in the
work dogs of Europe that are not of interest to the English speaking
reader.

The course of synovial inflammation of the joints is, as a rule, rapid.
If the patient receives proper treatment, in a short time we see an im-
provement (especially if the animal gets complete rest) . In other cases
the disease takes a chronic form — that is, it may form one of the follow-
ing conditions: (1) Chronic Serous Inflammation of the Joints (Synovitis
Chronica Serosa). In this the joint is slightly swollen and painful,
also very feverish. In some cases we may see a fluctuating sw^elling as
a result of enlargement of the capsule by serous secretion. If the disease
is still more acute, we may have a thickening of the fibrous capsules, and
very frec^uentl}' qviite an enlargement starting from the edge of the joint.
Chronic synovitis may appear in the onset of the disease, but, as a rule,
it results as a consequence of the acute form. The writer has seen
these cases in the carpus and knee-joint. The lameness is not especially
marked, l^ut any active movements increase it very much. (2) Purulent
Inflammation of the Joints: Suppuration of the Joints (Py arthrosis).
While the two forms which have before been descriljed are rarely accom-
panied by fever, it is quite different in suppuration of the joint. In this
there is great fever from the onset, which is ushered in by a chill. We
may see a more or less rapid swelling of the joint, which is extremely
painful. The joint is kept in a bent or flexed position, and the patient
walks on three feet. We may also see an oedematous swelling extending
both above and below in the neighborhood of the joint. The temperature
is considerably increased in some cases; the skin appears either normal or
reddened, sometimes even bluish red. The pus may eventually break
through the skin in the neighborhood of the joint or it may lie in the
joints, become absorbed, and cause pya'mia.

This termination will occur even when the pus has broken out ex-
ternally, and in some cases where the inflammation has been very acute
we may have a subsequent adhesion of the joint (ankylosis).

Suppuration of the joints is frequently produced by infected wounds
at or near the joint. In rare instances it may be the result of a phleg-
monous inflammation in the neighborhood of the joint; concussion or
crushing may also cause it, or it may occur in a metastatic way. Such
inflammations of the joints may also occur as a purely suppurative in-
flammation; but, as a rule, the inflammations are sero-fibrinous or sero-

340 DISEASES OF THE ARTICULATIONS

purulent, and with it we may see purulent centres of abscesses, and
followed by pyteniia; or the development of the disease in several joints
at the same time, or developing one after the other at short intervals.
The writer saw metastatic suppuration of the joints of the knee, carjDus,
and toes.

Rheumatic Inflammation of the Joints.

(Rheumatic Arthritis.)

Articular Rheumatism, Polyarthritis Rheumatica.

This condition is evidently an infectious disease accompanied by
more or less fever, being rare in the dog, and indicated by a sero-fibrinous
synovitis of several of the articulations.

Etiology. — The actual cause of the disease has not been separated
and described, some observers are inclined to think that it is not due to a
specific microorganism^ but that it is produced by a series of different
bacteria, particularly the streptococci and staphylococci, and these
produce a mild septic infection. If this theory is correct, then this
disease is closely related to these inflammations of the articulations
which occasionally follow infectious disease. It is caused by cold, es-
pecially in shooting clogs, if used in cold weather or during winter,
when they become very wet and lie around in a draught or from cutting
the hair off in cold weather and keeping animals in cold kennels.

Clinical Symptoms and Course. — There are two forms of this disease:
an acute and a chronic form. The former appears suddenly, the animal
becoming very lame in one or more of the articulations in which there
appears a serous, but more rarely sero-purulent synovitis accompanied
by great pain, high fever, loss of appetite, great depression, and consti-
pation. The lameness is much greater than in any other form of joint-
irritation, Very often several joints become diseased at one time, or
the disease may go from one joint to another; if the joint is moved, or
the animal disturbed it causes great pain, sometimes agony; and while
any articulation in the l)ody may he attacked, the elbow and the carpal
articulations seem to be attacked most frequently, less so the ankle and
hip. Occasionally we find as complications of this disease, pericarditis,
pleuritis and peritonitis.

When the disease takes a chronic form, either from the onset, or
merges into the chronic from the acute stage, it resembles very much
chronic sero-synovitis. There is gi'eat thickening of the capsule, and
sometimes the formation of adhesions between the surfaces of the joints
and the connective tissue, and in I'ure instances we may have ankylosis
of the joint. AVhile the diagnosis is rather difficult where the disease
is confined to one joint it is easily distinguished when you see it appear

MALFORMATION OF THEJOINTS 341

in several joints at once, and also from the fact that it may move from one
joint to another.

Therapeutics. — The treatment is the same as in muscular rheum-
atism. Keep the animal warm, quiet, and wrap the affected joints
in flannel, raw cotton, and frictions of spirits of camphor, oil of camphor,
ichthyol, or thigneol ointments. Internal adminstrations of salol, salipy-
rin, salophen, plenacctin, and mild saline laxatives. When the case is
chronic, joints may be painted with tincture of iodine, and when the
fever lessens daily massage the joints. A careful examination of the
heart should be made from time to time during the course of the disease.

Disease Producing Malformation of the Joints.

(.1 rthritis DeJ'onnans.)

The cause of this disease is very little known. It is very probably
due to a chronic rheumatism, or to some inflammation of the joint. It
may also be due to great exertion, and is especially seen in Holland or
Canada and Alaska where animals are used to pull carts and vehicles or
sleds and in coach dogs that run after carriages, and occasionally seen
in pointers and setters that are constantly hunted. The first symptom of
this disease is a slight lameness in the diseased joint. This lameness
may be overlooked, as it is generally very slight, and after the animal has
taken a little exercise it gradually disappears, although in some rare
cases the lameness may continue, or even with exercise become ag-
gravated. In the early stages of the disease there is no indication of
pain on movement or pressure of the joint, but later on, pain on pressure
and motion begins to show itself. At the same time there is a gradual
swelling and thickening of the capsule of the joint, with apparently a
loss of the normal amount of synovia. Sometimes we notice a slight
heat. A peculiar symptom of this disease, which is noticed from the
very onset, is a peculiar creaking or crepitating sound when the joint is
moved. After a time stiffness of the joints becomes more marked.
There are hard swellings on the cartilaginous borders, also a tendency
of the ends of the joint to enlarge, and finally marked alteration in the
form of the joint. By these changes we are enabled to distinguish be-
tween arthritis deformans and chronic serous inflammation of the joints.

The anatomical alterations have already been mentioned. Ar-
thritis deformans, as a rule, occurs in the knee-joint, the elbow and
shoulder. The prognosis of this disease is always to be unfavorable, be-
cause it seems to defy medical treatment, going on until finally the
joint becom<'s a large unsightely mass.

Therapeutic Treatment of Inflammation of the Joints.— In all cases,
except those of slight synovitis, the joint must be kept as quiet as pos-

342 DISEASES OF THE ARTICULATIONS

silile. In simple cnses the animal should be kept in a kennel or in a
room for several days. In serious cases where no operation seems to
be required, and there is no danger of poison breaking through the joints,
and where the inflammatory swelling is not very great, it is best to ap]:)ly
the l)andage of cotton and dress over that with a plaster or silicate of
sodium bandage, treating it. the same as a fracture. The writer has
ol)tained very good results with this method in the carpal, tarsal, and toe-
joints. Albrecht advises that the joints should be rubbed with a thick
layer of citrine ointment before applying the dressing. (For further
details, see under head of Dressings, etc.)

It is well, however, to take into consideration one point: that the
dressing must be in such a position as not to interfere with the use of the
leg. With the alcove treatment we generally obtain good results in a
short time. In the serious forms of the disease, and where the tlressing
cannot be used on account of the position of the joint, we must apply
such local applications as will al)ate the inflammation. As a rule, the
best treatment is cold-water applications containing lead or arnica. In
cases where there are great pain and acute rheumatic inflammation of the
joint, it is better not to apph' too much cold water, but use instead
Priessnitz's compress. Wrap the joint in a piece of linen which has been
folded several times, similar to. a handkerchief, and then cover it with
some impervious object, such as oil-cloth, silk, rubber, or a woolen cover.
If, for some reason, neither the cold nor moist treatment is practicable,
we must paint the part with tincture of iodine once or twice daily, and the
fluid must be rubl)ed into the skin by means of a rag. The writer has
never had very good results from this method of treatment, but painting
with iodine produces better results than any of the liniments, such as
camphor or soap liniment. Massage has been found to produce good
results in many diseases of the joints in dogs, although it has not been
used very extensively by canine practitioners. In chronic cases where
there are great thickening and a large qiuintity of secretion of the capsule,
as in cases of acute inflammation of the joint, or in purulent arthritis,
massage with cocoanut oil is particularly adapted. In cases of rheumatic
inflammation of the joint, which have been recognized as such, we
must use internal remedies, such as recommended in muscular rheu-
matism.

In many traumatic and purulent inflammations of the joint we can
only get good results by an operation which varies acconling to the con-
dition. The general procedure is as follows:

Puncturing. — This method of treatment is indicated in all chronic
serous secretions of the joint. As soon as we find that the measures
which encourage reabsorption, such as tight dressing and massage, do
not produce good results, and where the secretion causes great distention

MALFORMATION OF THE JOINTS

343

of the capsule, and where there are great lameness and indications of
suppuration, we proceed in the following manner:

(a) The part to be punctured must be rendered strictly aseptic; (b)
the part must have a particularly tight dressing over it for a few days
after the o])eration.

If this latter method is not practicable on account of the position of
the joint or some other circumstance, puncturing the joint will not give
favorable results and maj^ even lead to very serious conditions (suppura-
tion, etc.). The method of operation is very simple.

After having removed the hair from the region of the joint and wash-
ing with sublimated soap, disinfecting it with a 5-pcr cent, solution of
carbolic acid and 2 per cent, of creolin or 1 per cent,
of corrosive sublimate, we then puncture the part with
a good-sized hypodermatic needle and slowly evacuate
the sac by drawing it into the syringe. If the syringe
becomes filled and the joint is not entirely emptied, the
syringe must be detached from the needle and the
opening closed at once by means of the finger, as any
air that may find its way into the joint will produce bad
results. Empty the syringe and proceed as before.

This method, as a rule, is absolutely harmless,
evacuating the sac in cases of serous secretions. If,
however, we find in the fluid withdrawn from the joint
many cellular elements — that is to say, if it possesses a
marked purulent character — we must use at the same
time an injection of antiseptic fluid directly into the
joint, so as to make it aseptic. For that purpose we
use a slightly warm solution of corrosive sublimate 1
to 1000 or a 2-per cent, solution of carbolic acid and a
Lugol solution of iodine (1 per cent, tincture of iodine, , ^°: ^^^■~' ^^^^

~ ^ i ' hypodermatic syringe

2 per cent, of iodide of potassium, and 5U per cent of for puncturing en-
water). Either of these solutions ma}' be injected ^'^^^ jomts.
through the needle into the joint; then, by manipulation, try to work
this solution inside of the capsule by means of careful pressure,
allowing it to flow out through the needle in one or two minutes. The
needle is then withdrawn and the perforated opening is closed at once
by means of an iodoform tampon, and over that an antiseptic dressing-
is placed. This should be allowed to remain on the wound for a few
days.

(For further particulars, see the chapter on Treatment of Wounds.)

In chronic inflammations or great secretions we may also use simple

injections of disinfecting solutions, such as iodide of potassium, as a means

of reducing the inflammation or destroying its products. "We perforate

344 DISEASES OF THE ARTICULATIONS

directly into the cavity of the joint by means of a hypodermatic needle and
with a syringe inject a quantity of fluid in proportion to the size of the
joint. This operation has to be repeated every three or four days, fol-
lowing the same procedure before and after the operation as has been
already described.

The joint may he opened by means of a puncture ivith a lancet. This is
advisable where there is extensive suppuration going on in the joint and
where the diseased part shows every indication of a septic condition.
The joint to be opened should be punctured by means of a lancet or bis-
toury, making a wound just sufficient to empty it freely. It must then l)e
cleansed with an antiseptic solution and any clots or detached portions of
tissue washed out; then close the wound by means of sutures. In some
cases it is well to leave one corner open for drainage, that, of course, being
the lower one. We then place an antiseptic dressing over the whole part.

Injuries of the Joints.

These may l^e divided into several groups — true wounds of the
joints, contusions, distortions, and luxations.

Wounds of the Joints. — Wounds of the joints — that is to say,
injuries which expose the joint proper to the atmosphere — are divided
into perforating or cutting wounds, being produced by laceration, con-
tusion, and shot.

Clinical Symptoms and Course. — The first symptom of injury to the
joint, as a rule, is a discharge of synovia from the wound. This, however,
may be absent in cases where the wound is very fine, or where the punc-
ture runs in an oblique direction; the amount of discharged synovia, as a
rule, is very slight at the beginning, and of normal consistency. If the
wound is not closed immediately, it increases in amount and becomes
thinner. In some cases it is difficult to tell positively whether the syno-
via comes from the joint or from the sheath of a tendon. In the latter
case, however, the amount of synovia is generally very slight. Blood
may accumulate in the cavity of the joint and develop a haemarthrosis.
In some cases where there is hemorrhage, the wound may be very small
and close up quickly, or it may lie in an o]:)lique direction and prevent
the escape of blood. This flows into the joint and ffils it up. Hannar-
throsis is distinguished from serous or purulent secretions by appearing
shortly after the injury, and the absence of all inflammatory symptoms —
that is, at the onset of the disease.

The other symptoms of wounds of the joints are acute sensitive-
ness, the animal limping and showing great pain, holding its leg in a
flexed condition. Generally the external opening of the wound can
also be distinguished.

IXJURIES OF THE JOIXTS 345

The course of this disease differs greatly according to the character
of the wound and whether the object that caused it was clean or not.
ymall perforating wounds heal quickly, and the animals limp only for a
few days. In serious wounds where the joint has been exposed, and
dirt or other foreign l^odies have obtained entrance into the joint, the
prognosis is less favorable. In such cases we notice a great discharge of
synovia. This is clear in the early stage of the disease, but soon be-
comes turliid by the addition of pus-corpuscles and fibrinous clots. It
then becomes flaky and finally purulent. At the same time there is
great fever around the joint, which is swollen very much, and the neigh-
boring tissues become cedematous, extending in all directions. We may
see numerous abscesses forming all around the joint or in the inter-
muscular connective tissue, and finally the animal dies from general
exhaustion or pyaemia.

According to the circumstances and condition of the wound, the
course may be much more rapid. The synovia becomes purulent in a
short time; septic fever shows itself ciuickly; there is a rapid pulse; the
animal sinks into a coma, and dies from septicsemia. This may even
occur in slight wounds, if they have not been treated properly, and
where thorough disinfection has not been followed.

Therapeutic Treatment. — The first thing to do after an injury has
occured is to thoroughly disinfect the wound and its immediate neighbor-
hood. Clip the hair from all around the part, then wash it with a solu-
tion of corrosive sulDiimate, and, in cases where the puncture is very
narrow, clean it out by means of a syringe with a 2 per cent, solution of
creolin and a 5 per cent, solution of carbolic acid, or a 1 per cent, solution of
corrosive sublimate. If you find the object which caused the puncture
was very dirty, the wound must be enlarged and thoroughly washed with
any of the above-named solutions. The wound should then be closed
by means of sutures, taking care when stitching it up not to include the
synovial membrane or any part of the joint in the sutures. It is well,
however, in some cases, to place a small piece of catgut or silk in the
lower surface of the wound in order to assist in emptying the joint. We
then place the joint in an antiseptic dressing and cover it up.

If we have to deal with a wound that has been neglected and where
suppuration has been going on for some time, and the owner does not
wish to destroy the animal, we must enlarge the wound at once, and
all pockets, or sacs, in the joint must be emptied and washed with a solu-
tion of corrosive sublimate. Any clots, masses, or pieces of tissue must
he removed, and the operation finished as before described. In all
these cases the animal must have absolute rest, and the dressing be
renewed frequently.

Contusions of the Joints. — Under this head we class injuries to the

34G DISEASES OF THE ARTICULATIONS

joints which have Iseen caused by compression of the soft parts against
the bones or from shocks, such as jumping or leaping from a height,
kicks, and where the extremities have been run over by vehicles. In
this we may have a series of results, such as crushing or laceration of the
capsule of the joint, with formation of ha^narthrosis, or a concussion or
crushing of the bone with little escape of blood. In rare instances we
may see a laceration of the cartilage.

Clinical Symptoms. — The animal shows great sensitiveness and pain
on manipulation of the joint, and, as a rule, carries it in the air. There
is a rapid swelling of the joint and oedema of the surrounding parts, also
a high temperature.

Therapeutic Treatment. — The treatment consists in cold-water
applications, if the position of the joint admits, renewed constantly.
The best method is to soak a piece of absorbent cotton in water, lay
it on the joint and bandage it up lightly, moistening it in cold water
from time to time. In old cases use friction (massage) of the joint
in a circular direction (twice daily for ten or fifteen minutes), or use a
tight bandage. Any stimulating liniments, such as camphor, soap, or
arnica, may be used, but it is questionable whether the good effects are
not due more to the massage than to the drugs themselves.

Distortions of the Joint (Sprains). — By this is meant a twisting or
temporary displacement of the joint, as a rule, in a lateral direction,
caused by slipping or sliding, or falling out of a window and landing on
the feet, tumbling over the side of a chair, bed or step. The capsule and
the ligaments may be partially torn and in some cases entirely ruptured
on one side. The round ligament of the hip-joint is sometimes torn,
as are also the tendons of the knee-joint; there is extravasation of blood
in the injured region. "NMth rest, the disease may disappear in a few
days, or it may remain, causing partial loss of power of the legs for the
rest of the animal's life.

Clinical Symptoms. — When the sprain occurs there is violent pain.
The animals use the joint irregularly, or may carry the member. The
lameness increases, and in the region of the joint swelling soon appears.
Any manipulation of the joint produces great i)ain, and we may be able to
recognize a laceration of some of the ligaments, and the joint shows
greater mobility on one side than the other. Where there is tearing
of the broad ligaments of the hip-joint there is nothing indicated l^eyond
the lameness and symptoms of pain when the joint is turned or twisted.

Therapeutics. — The treatment of distortions, or sprains, is the same
as that for contusions — compresses of cold water, lead water, lead
water and laudanum, fuller's earth or antiphlogistine and wraj) up the
joint in warm flaimel. If the swelling is gnnit, paint it with tincture
of iodine, and when the swt'Uing subsides, use massaging and rul)l)ing

INJURIES OF THE JOINTS 347

with spirits of camphor or soap Hniment, ak-ohol, etc., but it must be
borne in mind that rest is the most important treatment.

Luxations of the Joint (Dislocations). — While distortions of the
joints disappear in a short time when the luxation is reduced, if it is not
reduced it is lasting, for soon some anatomical change occurs that it is im-
possible to reduce. If both surfaces of the joint are no longer in contact,
it is called an entire dislocation. If they are partially in contact, it is
called an incomplete luxation (subluxation).

The causes of dislocation are, as a rule, mechanical, from falling out
of windows, jumping from high objects, getting the foot caught, and
hanging, as in jumping over a fence; concussions and blows by being
run over by vehicles, etc. In all dislocations there is invariably laceration
of the capsular ligament. This membrane only remains intact in dis-
locations of the lower jaw. As a rule, the accessory ligaments are seldom
torn except in such cases where a portion of the bone is torn with them.
The cartilage of the joint may be torn or detached in some cases by
the subsequent inflammation. The ends of the bones may be unaffected
and in some cases broken. Other alterations are seen in the muscles and
tendons in the neighborhood of the joint. They are abnormally ex-
tended on one side and flabl^y on the other side. They may be torn,
lacerated, or even crushed. It is only in rare instances that the large
blood vessels and nerves are lacerated. The joints which are dislocated
are surrounded by a large quantity of blood which infiltrates the tissues
and is gradually reabsorbed.

When the reduction is not performed quickly — that is to say, the
displaced end of the joint remains in its abnormal position — we have
what is called nearthrosis as a consequence of the irritation which it
produces in the immediate neighborhood of the joint. In such a case
there is slight immobility due to partial adhesions of the affected part,
and also due to a certain extent to atrophy of the muscles surrounding it.
In some cases motion of the joint is entirely lost.

Clinical Symptoms and Prognosis. — When a dislocation has just
occurred, and Avhen it has been there for some time, the symptoms are
more marked than they are in the intermediate stage, for the reason
that the hemorrhage produces so much swelling as to render obscure,
to a certain extent, the position and character of the luxation. In
some cases the condition can be very easily recognized by comparing it
with the perfect joint on the other side; at other times, it is only by
careful manipulation in the region of the joint that the alteration can l)e
felt. We may find a projection of bone at one place and depression in
another, where they do not occur in the healthy side. We may even feel
the luxated end of the joint. In some cases where the deformity has been
concealed by the rapid swelling of the surrounding tissues, the leg may

348 DISEASES OF THE ARTICULATIONS

he shorter, or it may be on a longitudinal axis with the other leg. An-
other characteristic symptom is the loss of movement in the luxated
joint, especially when the case is seen early, although in some cases
where the ligaments have been lacerated or torn, or where a piece of
bone has been broken off, there is abnormal flexion in that part. This
is especially important, as it enables us to locate a fracture of the bone
that is in the neighborhood of the joint. There is also a slight crepita-
tion. This, however, is soft, and not the hard, rough crepitation that
we find in fractures.

Luxations are not dangerous to life except those of the vertebrae,
but they are very troublesome, and, as a rule, make slow recoveries.
Dislocations can be reduced quickly where the animal is seen a short
time after the injury; but in rare cases, on account of the lacerated
condition of the capsule and ligament, it is rather difhcult to hold the
injured joint in position after it has been reduced.

Therapeutic Treatment. — The treatment consists of: 1. Reduction
of the dislocation. 2. In holding the joint in position after the reduction
has been made.

It is rather hard to lay down any rule to be followed in all cases,
but try if possible to return the joint to the same position as before,
comparing it with the joint of the opposite leg, following, as a rule,
the same procedure as that followed in fractures of the bone. As soon
as the reduction is made the joint must he dressed and allowed to remain
if possible for a period of three weeks (further particulars will be found
in the chapter relating to fractures of the bones and wounds), so that
the soft parts which are lacerated — the capsule and the ligaments — may
have an opportunity to grow together and return the joint to its normal
position. If the dressing cannot be applied in cases of dislocation of the
hip, the animal must be kept in a cage or in a small room, in order to
keep it as quiet as possible. We may find more or less stiffness of the
joint when the dressing is removed. This can be assisted to a certain
extent by means of massage.

The following dislocations appear more frequently in the dog and
require special mention:

Dislocation of the Lower Jaw. — This is extremely rare, and may
occur in some instances where a setter or retriever endeavors to carry
a very large bird, opens his mouth, and distends it in such a way that it
is dislocated. In some cases this luxation is confined to one side, and
in others both articulations are out of joint. The lower jaw projects
forward, the incisors project beyond the upper incisors, giving the animal
an "undershot" appearance, while in a lateral direction the jaw is pushed
to one side, the mouth remains wide open, and cannot be closed except
with great exertion. In many cases, on account of the pressure which is

INJURIES OF THE JOINTS 349

caused by the coronoid process pressing on the posterior portion of the
eye, it is bulged, causing what might be termed an incomplete prolapsus
of that organ. Other symptoms are salivation, great pain, restlessness,
blue coloration of the tongue. (For differential diagnosis of paralysis
of the lower jaw, see Diseases of the Mouth.)

Therapeutic Treatment. — According to Stockfleth, the animal must
be held by an assistant. The best method is to hold him between the
legs and steady his head while the operator by means of a lever-like
action upon the lower jaw endeavors to reduce the dislocation. To
accomplish this, wrap a cloth around the hand, place the thumbs on
both teeth of the lower jaw, and by means of external pressure attempt
to reduce the bone into its normal condition. Another method which
the author finds is not so reliable, consists in placing a strong stick
between the jaws, as far back as possible, then by
pressure on the anterior portion of the jaws, allow-
ing the stick to act as a fulcrum, the jaw will
very often fly into position. In order to prevent
a recurrence of this, the dog for some time should
w^ear a particularly (Fig. 112) tight-fitting muz-
zle and should receive nothing but soft food.

Dislocation of the Elbow. — In the dog the bone of the forearm
forms a pivot joint with the elbow. Each of these joints has a capsular
ligament. The upper is fitted with a ring-like band, and in the lower
portion the radius is kept in position by means of transverse ligaments.
A slight rotation of the radius may occur independent of the elbow-joint
itself. A dislocation of this articulation may occur from jumping
from tallies, chairs, falling from some height. In the former case the
bone of the forearm is dislocated backward and outward. In dislocation
of the lower pivot joint the bone of the forearm way project forward as
well as backward. If dislocation of the upper joint occurs in the dog,
the forearm is kept flexed; it becomes immobile in the elbow-joint, the
animal using three legs and carrying one in the air. The joint is wider,
and the dislocated portion of the forearm may be felt distinctly, also
more or less marked sensitiveness or swelling may be seen. If, on the other
hand, we have a certain amount of movement on extension of the elbow-
joint and great elasticity in the joint, too much for the normal condition,
the animal evinces great pain on movement. This dislocation is easily
corrected. The joint may be moved freely, but as soon as the animal
stands upon its feet again the displacement occurs. This is due to the
annular ligament, which holds the joint to the forearm in place, being
torn. If this dislocation is not reduced and left for some time, the leg
will be held constantly in a flexed position, and the animal will not use it.

In cases of lower dislocation of the joint the animal walks upon

350 DISEASES OF THE ARTICULATIONS

three legs, and on examination we find that the lower end of the bone
of the forearm is displaced in a posterior direction, and more rarely in
an anterior direction. This dislocation is easily reduced, but on the
slightest movement reappears again. The prognosis is not favorable,
as it is a rather difficult condition to treat. The weak ligaments (the
annular ligament and transverse ligaments) do not heal quickly, and the
dislocation has a tendency to become chronic, especially in the upper
joint.

Treatment. — In the treatment of the upper joint the forearm
becomes extended and the legs should be crossed and an attempt be
made to push the forearm backward and outward into its normal position.
It must then be held there by means of a tight bandage. This bandage
must be changed once a clay, as it is apt to produce tenderness of the
skin from being so tight. If the dislocation affects the lower joint, the
bone of the forearm will have to be pushed into its normal condition
with more or less force and a silicate of sodium bandage applied.

Dislocation of the Patella. — This is only seen in small dogs. Stock-
fleth states that the patella may become dislocated on both sides, but
not upward, and that the dislocation is generally on the inner side, on
account of the forced extension of a very much flexed tarsus and a ten-
dency of the muscles to turn inward. This is seen occasionally in circus
dogs (grayhounds) making high jumps. In cases of inside dislocation the
patella lies on the inner side of the joint where it moves on the tibia, and
in external dislocation it lies on the outside of the external condyle.

Inner Dislocation of the Patella. — In the early stages, shortly after
the dislocation occurs, the animal holds its leg in a very flexed position.
The hock is flexed and the heel turned outward. At the joint the jDatella
may be found lying sideways, and is easily moved laterally. If we take
hold of the foot and flex or extend it, the animal evinces great pain. The
leg must be bent backward and straightened as much as possible, then
by means of manipulation of the fingers the patella can be made to slip
into position. This is very easily performed, and the animal walks away
as if nothing had occurred. This dislocation, however, may recur when
the animal jumps any distance. When the disease becomes chronic and
dislocation occurs often, the animal runs on three legs, or walks lame on
the affected leg. The stifle-joint is uneven, thick, and the patella can
be dislocated, or put into position simply by pressure of the fingers. If
the dislocation affects both legs, these are kept in a flexed position,
the animal making peculiar jumping movements, using both legs at the
same time, when he attemj^ts to walk. If he lies down, the hind legs
are extended backward and crossed. The prognosis is favorable in new
cases, but unfavorable in old ones.

Treatment. — The tarsus must be extended in order to overcome

INJURIES OF THE JOINTS

351

the tension in the straight ligaments and extensors, and the patella may
be easily shoved into position. If the animal is then kept quiet for
several days, as a rule, no after-treatment is required. If the disloca-
tion of the patella is old, treatment is useless.

Stockfleth has used a dressing in this disease which he describes as
follows :

He attached a broad linen bandage around the tibia, and fastened
a wide girth around the abdomen, and a breast-piece to prevent it from
slipping backward. The bandage w^as then fastened to the tibia, close
to the girth around the abdomen. The affected leg was then pulled up
close to the abdomen, so that the animal must stand on three legs. The
dressing remained on for twenty days, and when it was removed the

Fig. 113. — Dog with dislocation of the hip.

animal was entirely cured. In another case he had a double-sided
dislocation of the knee. After returning the patellie to their position,
the knee- and ankle-joint were covered with thick wadding, and a capsule
of gutta-percha, which had previously been soaked in hot water, was
applied to each leg, surrounding the leg from the knee to the toes. In
order to prevent l^ending of the gutta-percha, before it was sufficiently
hardened, a wooden support was fastened to the outside. The dog,
which had formerly crept upon its hind legs, walked upright as if on
stilts. The dressing was left on the animal for two weeks, and on
removal of the dressing the dislocation did not recur.

External Dislocation of the Patella.— This accident is very rare.
Stockfleth saw Init one chronic case in both legs in a small dog. The
subject was lively, walked rapidly, but had very flexed ankle-joints,
giving him very much the appearance of a weasel. The tarsus appeared
thick and uneven; the patella, which was located in the muscles of the

352

DISEASES OF THE ARTICULATIONS

outside, could easily be pushed back into its normal position; but if left,
it immediately slipped out of position, and became dislocated again.
This was due to the fact that the crest of the joint had disappeared,
offering no resistance to dislocation. Treatment is useless, as the tissues
are relaxed and will not hold the patella in place.

Dislocation of the Hip. — Other luxations occur in the dog — for
instance, in the hip-joint. In this the head of the femur becomes pushed
upward after laceration of the capsular ligament, and out of the acetab-
ulum, and being drawn upward and by the muscular contraction the
leg is shortened (Fig. 113).

The animal must be held by the assistant, keeping the body firm,
then grasping the leg at the tarsus and drawing it along from the body

iM^

Fig. 114. — Skiagraph of luxation of the hip upwards and backwards.

downward and outward as far as possible, and keep moving the leg
forward and backward; at the same time, with the other hand, seize the
trochanter major in the finger, or use the flat of the hand, to manipulate
the joint into position. It is impossi])le to keep a bandage on this part
unless it is a pitch plaster, which should be applied and the animal kept
as cpiet as possible.

The joints of the phalanges sometimes become dislocated. These
do not possess any special symptoms that may not be easily recognized
by the indications stated under Clinical Symptoms of Luxations.

DISEASES OF THE MUSCLES.

Muscular Rheumatism.

(Muscular Pains, Rhcuniatismus Musculoruw.)

Muscular rheumatism is a primary affection with more or less
complication of the muscular system. In some cases there is little or no
inflammation present, no fever, and the only indication of rheumatism
being present is stiffness of gait and pain on pressure; it may occur as
acute, subacute, and chronic.

Etiology. — The cause of rheumatism, which has been described as
a certain poisonous substance, may also be due to cold, atmospheric
influences, etc., or dampness, animals lying in kennels that do not get
the sun, or being kept in the cellar, particularly with asphalt floors
hunting dogs becoming wet, and after great exertion, sleeping with wet
coats. We have, undoubtedly, a number of diseases of the muscular
system which do not develop from rheumatism — for instance, abnormal
muscular exertion and consequent laceration of some of the muscular
fibres — also from disturbances of the circulation, from chronic toxic
influences, etc., from some infectious agent as in acute articular rheuma-
tism, certain affections of the spinal cord, also pleuritis, nephritis and
other affections. It would be much better to discard the name ''mus-
cular rheumatism" and simply call it "muscular pain." Experience
has taught the writer that muscular rheumatism is seen frequently in
old, delicate, or fat dogs, and is oftener observed in winter than in
summer.

Pathological Anatomy. — It is very difficult to make any definite
statement as to the cause of rheumatism. We speak of rheumatic
muscular inflammation, but at the same time we do not, as a rule, find
any different muscular alterations on post-mortem from animals which
have suffered from muscular rheumatism. VCe may find slight altera-
tions which have occurred from other causes, such as hyperaemia, slight
exudations in the muscles, tendons, and fascia. Deposits occur in the
connective tissue (rheumatic callosities). These occur in a man who
has suffered for a long time from muscular rheumatism, and in old
rheumatic dogs we may also observe characteristic alterations in acute
or chronic inflammations and the' connective tissue between the muscular
fibres has increased.

CUnical Symptoms and Course. — Muscular pain is a most marked
symptom. This is observed in slight cases by the muscles in an affected
23 353

354 DISEASES OF THE MUSCLES

animal having a contracted appearance, or when by pressure upon them
they are found hard and tense. We also observe that dogs affected with
this disease move with fear, showing great disinclination for any move-
ment, and occasionally they cry out with pain when touched or lifted in
certain parts of the body or if any portion of a particular muscle is
touched. If compelled to rise, they do so in a slow, fatigued way.
Their movements are stiff and strained, and when foeces are passed the
animals do so with pain, frec^uently crying or howling, or it may be they
make no effort to evacuate the bowels, which results in obstinate
constipation.

As rheumatism is generally located in the regions of joints, these
symptoms become modified in certain parts of the body and intensified
in others. We very often see rheumatism of the back and loins, when
rising and stretching of the extremities and all movements of the trunk
are very painful. The region of the back and loins is very sensitive, so
that the animals cry at the slightest movement. The muscles in the
neck are also subject to this disease (myalgia cerviculis, torticollis
rheumatica). Animals show great pain while eating on account of
being compelled to bend their neck in stooping down to reach their
•food. The muscles are distended and painful to the touch. If the
head is bent, the animal shoAvs great pain. In rare cases we see rheuma-
tism in the masseters (a great difficulty in mastication). Only in very
rare cases is any fever noticed.

The course of the disease is sometimes acute and occasionally
chronic. In the former case the disease runs its course very quickly,
and may disappear without any special treatment, but there is always
a tendency to relapse. In the latter form the disease may be prolonged
for months, varying in degrees of intensity, also showing a tendency for
the pain to move from one part of the body to another, this peculiarity
enables one to readily distinguish the condition from one of traumatic
origin.

Therapeutics. — When the disease is limited to a certain group of
muscles, it is only necessary to keep the animal in a warm dry kennel,
and feed with easily digested food and rub the affected parts with
stimulating ointments such as oil of camphor, aconite and soap liniment.
In rare instances the animal requires to be muzzled to prevent it from
biting the affected part. Where the pains are violent, morphine should
be administered hypodermically. As far as the use of electricity
is concerned, the opinions concerning it are much divided. The
writer has never been able to obtain any very marked results by using
this form of treatment. "N'ibratory massage, however, seems to produce
very good results in the milder and chronic cases. Internally the agents
recommended for the dog are salicylic acid, salol or salipyrin, aspirin,

CYSTICERCUS AND T RICH IX A 355

tinctvire of colchiciim, or antipyrin. The first three drugs produce the
most favorable results.

In the chronic form of the disease, various cutaneous stimulants
have been used, such as spirit of camphor, opodeldoc, spirit of mustard,
but we must remember that their influence is more due to the massage
than to anything else. It is advisable to rub the stimulating embroca-
tion into the skin, either by the hand or with a woolen rag. Albrecht
has found that this therapeutic treatment may be greatly improved by
putting the patient into a bath of 28°, rubbing it dry and wrapping it in
hot blankets.

Cysticercus and Trichina.

Cysticercus. — Reference has already been made to the presence of
cysticercus in the brain and they also appear in numerous other organs,
particularly the muscles, and there is special interest in the fact that
their presence in large numbers in the muscles may cause symptoms
very similar to those of muscular rheumatism. One dog which was
very stiff during life and kept the head bent to one side after death, in a
section of the psoas muscle about an inch square there were found eight
or ten cysticerci the size of a pea. Trasbot found in a dog that during
life showed violent pain on touching the skin, pressing the muscles and
on making certain movements of the body, after death numerous cysti-
cerci of the Taenia solium in the entire muscular system. (For further
details concerning cysticercus, see Internal Parasites).

Trichina. — Trichina is extremely rare in the dog. It is observed more
in some countries than in others. Of 858 dogs examined in one clinic, 11
or i per cent, were found infected with trichina. In 2910 post-mortems
one-half of 1 per cent, were found effected with trichina. The symp-
toms which appear after a dog has eaten meat containing trichina
in large numbers are for two weeks a bloody diarrhoea, loss of appetite,
pain, convulsions, and after the animal was destroyed on microscopical
examination of the muscles they were found to contain numerous mi-
grating trichina. Leistikow fed three dogs with trichinous meat which
afterward developed diarrhoea, great exhaustion and then became normal;
they were killed six weeks later and the flesh was found to contain
incapsulated trichina. Paroncito obtained similar results from feeding
dogs with meat containing trichina, and two were killed after a few days
and the others died in four weeks. In all cases trichina was found in
the muscles.

356

DISEASES OF THE MUSCLES

Diseases of the Tendons and Bursa Mucosa.

Of the pathological processes of the tendons and Inirsa mucosa, we
will onl}' take up the laceration of the achilles tendon and hygroma.

Laceration of the Achilles Tendon. — This condition is occasionally
met with as a result of violent exercise or injuries caused by falling out of a
window, or having the tendon cut either by jumping on glass, particularly
on green-house sash, scythes, reaper knives, or maliciously cut by some
person, etc. Occasionally it results from the bites of other dogs, causing

r-*'

Fig. 115. — Laceration of the tendo achillis.

wounds which are followed by necrosis of the tendon. On the tendon
being completely severed, the ends are drawn violently apart and the
animal cannot step or put any weight on the other leg without putting
the posterior surface of the astragalus as well as the whole of the meta-
tarsus flat on the ground (Fig. 115). On local examination we may find
either an open wound or the skin intact, but there is a complete separation
in the continuity of the tendon. The appearance of the animal is very
similar to congenital plantigrade or in cases of general rickets. The
articulation of the knee is excessively extended (Fig. 115).

Boyer saw in a mastiff a complete severance of the tendon just at
its union with the gastrocnemius muscle. The ends of the ruptured
tendon were drawn apart al)0ut 5 cm. In incomplete laceration we
find more or less exaggeration of the a.stragulas and bending of the knee.

The prognosis is generally favorable. In case of a wound with
severance of the tendon, the wound should be thoroughly disinfected,

DISEASES OF THE BURSA MUCOSA

357

the two ends should be sewed together by means of catgut or silk, and
the joint should be covered by a splint, plaster or silicate of soda, so as to
hold it imniova])le. "Where there is no injur}^ to the skin, l)ut a rupture
of the tendon, a splint should be put on and the leg held in the normal

Fig. 116. — Dog with elbow boil (hygroma).

position for at east two weeks. If this is not successful the skin should
be opened over the lacerated tendon, the ends freshened by scarification
and united by a stitch. This is generally successful.

Hygroma of the Elbow. — Large heavy dogs, particularly mastiffs,
St. Bernards and Great Danes, have a habit, when recumbent, of lying
on the point of the elbow, causing pressure and a gradual thickening
and swelling of the skin and frequently serofibrinous inflammation of
the bursa olecrani. This is shown in a round oval protuberance at the
elbow, varying in size from a hazel nut to a goose egg. It is generally hot,
painful and frequently fluctuating and contains a cpantity of serous
sometimes serofibrinous fluid (Fig. 116). As it is a great eye-sore,
affecting the appearance of the animal and at the same time interfering
more or less with the animal when in a. recumbent position it generahy
is emptied by making an incision in a dependant part of the serous
sac, and heals very rapidly with local treatment. It is very apt, however,
either to fill up again as soon as the opening closes, or to leave more or
less thickening of the skin or a hard fibrinous mass. If, however, it fills
up again it should be injected with dilute tincture of iodine, or Lugol 's

358 DISEASES OF THE MUSCLES

.'Isolation. Sometimes it is necessary to open the tumor and to curette the
inside of the sac to get it to heal properly. If the tumor still remains,
it should be removed by complete extirpation of the enlargement. The
operation is not particularl}^ difficult, the only thing to contend against
is that some animals by extreme flexion of the elbow are apt to burst the
stitches. The operator must first shave off all the hair in the immediate
region of the tumor, thoroughly disinfect it and make a long incision in
a longitudinal direction through the skin over the body of the tumor,
taking care not to penetrate into the body of the tumor. The tumor is
now carefully dissected out and the inside of the wound carefully washed
with an astringent solution, such as lead or zinc, and having cjeaned out
the blood clots, the freshly cut surface should be carefully touched with
a pledget of cotton soaked in pure carbolic acid; this application tends to
lessen slow hemorrhage and frequently heals the wound very quickly.
The edges of the opening are then united by sutures. In dissecting out
the tumor, care must be taken not to remove the periosteum of the ulna.
A l^andage should l^e applied if possible: it is, however, very difficult to
hold it in position. The animal should rest on deep straw or some other
elastic material.

WOUNDS AND THEIR TREATMENT.

By a wound we mean any injury which lacerates or punctures the
skin, no matter what is the depth. Wounds are chissified according to
various authors in the following manner:

1. Their location, whether they are in the head, neck, chest, or
extremities.

2. According to their depth into the muscles or l^ones, they are
called penetrating or non-penetrating. Those that injure the skin
slightly are called lacerations or excoriations.

3. They are also termed longitudinal, transverse, or oblicjue, accord-
ing to their direction or length. Regular or irregular — that is, indented
or -flap wounds.

4. Their cause is also considered, whether produced by cuts, blows,
lacerations, concussions, bites, or gunshot. These causes, however, are
of no special importance.

Clinical Symptoms. — All wounds are accompanied by three symp-
toms: the open, gaping condition of the edges of the wound, hemorrhage,
and pain. As a rule, the wider the wound the deeper it is. If the wound
is long but does not gape, it corresponds with the direction of the muscle or
the tissue beneath it. On the other hand, wounds across muscles are
much wider and gape more, this being due to the retraction of the
muscles.

The bleeding is either arterial, venous, or capillary. The former may
be recognized by the fact that the blood from the wound is mixed with
more or less light-colored arterial blood. The danger of such arterial bleed-
ing depends on the size of the arteries and how severely they have been
injured. In small arteries the bleeding generally stops of its own accord,
due to contraction of the severed blood vessels; but in large arteries the
animal will frequently bleed to death unless surgical interference stops
it. In cases where the artery is cut in a transverse wound the hemorrhage
is more severe than when it is in a longitudinal wound. There is more
bleeding in cleanly cut wounds than there is in those produced by lacera-
tion or concussion, but the latter present more complications than the
former, due to consecutive hemorrhages. In venous bleeding dark-red,
evenly colored blood flows out of the wound. Hemorrhages in small and
medium-sized veins generally stop without any surgical interference,
but the large veins, especially those in the neighborhood of the heart,
are dangerous and should ])e taken up cjuickly. Capillary bleeding

359

300 WOUNDS AXD THEIR TREATMENT

consists in a slow tricklino- of blood, which, as a rule, lasts for a very
short time and is of no great importance.

A serious hemorrhage endangers the animal 's life, and the more
rapid it is the greater the danger. The following symptoms are pre-
sented: general coldness of the skin and extremities; paleness of the
mucous membranes, especially the mouth and eye; great prostration;
staggering gait; and often inability to rise from weakness. In some
cases we have unconsciousness, dyspnoea, enlargement of the pupils,
uncontrollable evacuation of urine and fseces, finally slight convulsions,
and death. This conclusion is to be expected if about half or even one-
third of the blood contained in the body is lost in a very short time.

Many experiments have been made upon the dog in order to find
what are the consequences of slight hemorrhages. One-fourth of a
dog's blood may be withdrawn without causing any appreciable lessening
of the blood-pressure in the arteries. The pulse may become very
indistinct while the l;)lood is withdrawn, but it is soon restored to its
ordinary pressure if the hemorrhage is stopped, from the fact that the
arteries contract in proportion to the smaller quantity of blood. The
rapidity of the current and the number of contractions of the heart
remain the same as before the hemorrhage. Any loss of blood amounting
to more than one-third of the blood-mass reduces the blood-pressure
very much. The current becomes slow and contractions of the heart are
much less. At the same time the composition of the blood is changed.
At first we observe a compensation of the water of the blood, and
the salts which are thereby being reabsorbed from the tissues when this
is exhausted; then albumin is drawn into the blood. It requires a much
longer time to form new blood cells after the animal has been bled an
amount of blood ec^ual to one-fourth of the weight of the body. The red
l)lood corpuscles become normal and return to their original number in
from seven to thirty-four days.

The pain of a wound is indicated in the dog liy howding and crying
when the injury occurs, or later when the wound is examined. The pain
evinced by the patient also depends upon the individuality of the animal.
Some dogs are great cowards and show great sensitiveness to the slightest
pain, while others will stand any amount of it; and we must, therefore,
always carefully examine a wound, seeing its depth, situation, and
character, and not in any way be guided in making a diagnosis by the
symptom of pain indicated by an affected animal. Wounds of the lips,
lower extremities, external genitals, and of the bones are the most
painful. In the dog we see occasionally a series of symptoms which are
identical with what is known in man as "shock." This, as a rule, occurs
immediately after any painful injury, such as extensive crushing of
tissues or bone, and during or after operations. The visible mucous

DISEASES FROM SEPTIC INFECTION OF WOUNDS 301

membranes in the skin become pale, then cold; the eyes are fixed, the
pupils dilated; the pulse becomes irregular, reduced in volume; and the
respiration weak and irregular. The animal appears indifferent or
unconscious. These symptoms may disappear very rapidly or in some
cases go on until the animal dies without rallying in spite of any form
of treatment that may be tried.

Symptoms of a very similar character, as a result of extensive
hemorrhage, are sometimes presented, and must not be mistaken for
"shock." The same may be said to occur occasionally in the dog when
under the influence of chloroform. It is believed that the symptoms of
"shock" presented are due to an irritation or concussion of the sensitive
nerves, producing reflex paralysis of the vasomotor center of the medulla
oblongata.

The Course of the Healing Process in a Wound.

The healing of a wound depends to such a large extent on its form,
condition, location, and treatment, that from a practical standpoint we
may generally separate the processes into, first intention, or healing by
primar}' union; second, healing by second intention or suppuration;
third, healing under a dry scab; fourth, healing under a moist scab; the
various processes of wound healing can be studied in works on surgery.

Diseases Resulting from Septic Infection of Wounds.

There are a number of conditions which appear in wounds that are
due to microbes or germs, producing certain irritations of the tissues
surrounding the wounds, especially the blood vessels and the lymphatics.

Phlegmon. — By this we mean the inflammation of the soft tissues
which has a tendency to formation of pus, especially in the loose sub-
cutaneous connective tissue between the muscles and under the fasciae.
There are two forms of this condition — a circumscribed and a diffused
phlegmon.

Circumscribed Phlegmon. — The symptoms are very prominent,
especially Avhen it is near the skin. We find in a certain circumscribed
region a hot, painful, very red swelling, firm and tense in the early stages,
but soon becoming soft, doughy, and finally fluctuating, due to the tissue
breaking up and forming a purulent licjuid. From the pressure of the
pus the skin becomes gradually thinner and thinner, until the pus finally
makes its exit through the skin and escapes. If, for some reason, the
skin is too tough, or if the pus has not been allowed to escape by means
of an incision, it may cause a purulent infiltration of the surrounding
tissues, which is very serious and ends with necrosis of the parts, espe-

3G2 WOUNDS AXD THEIR TREATMENT

{■[ally of the fasciee, tendons, muscles and bones, and it may be taken up in
the blood, and portions of the diseased tissues are carried in the circula-
tion to different parts of the body.

Diffuse phlegmon is generally a very serious condition. The local
symptoms are the same as the circumscribed, but the fever is much
higher, and the purulent pus rapidly extends in all directions in the
loose connective tissue, undermining and frequently causing extensive
necrosis of the skin, fasciae, muscles, tendons, etc. Death occurs, as a
rule, from septicamiia or pyaemia.

The treatment of diffused phlegmon consists of scarification and
incisions. Numerous slight incisions are made to reduce the inflamma-
tory tension of the tissues and to encourage the pus to escape, also to
prevent it from burrowing in different directions, and to make an opening
into the parts so that they can be disinfected by means of injections or
irrigations of 1 to 1000 solution of corrosive sublimate, 3 to 5 per cent,
of carbolic acid, or 2 per cent, of creolin. In circumscribed phlegmon
it is better, as a rule, to wait until the abscess is in that condition known
as "ripe," or until it" points." This can be distinguished from the fact
that the swelling fluctuates or is soft in the centre. In a light skin it may
be even yellow. As soon as the incision is made it should be emptied and
irrigated and injected with an antiseptic solution, afterward treated as
an ordinary wound.

Inflammation of the Lymphatics {Lymphangitis). — This is caused
by poison absorbed from an unclean, unhealthy wound, although in
some instances it may be caused by a high nitrogenous condition of the
blood due to overfeeding. The author has observed several cases in
dogs where one or more of the legs was hot, painful, and swollen, and
there were also lameness and an increase of temperature. On examining
the subcutaneous lymphatics they were found to be enlarged, presenting a
peculiar corded appearance and running in the direction of certain of
the lymphatics. These were enlarged and very tender to the touch.
In cases of this kind we may see two terminations: first, a rapid recovery;
second, the formation of an abscess containing a large amount of purulent
pus in the swollen lymphatic glands, producing extensive inflammation,
blood-poisoning, and the animal eventually dying from septicaemia.

The therapeutic treatment consists first in the iri'igation of the parts
with cooling applications, and, if the glands show indications of forming
abscesses, apply hot poultices and open as soon as possible.

Inflammation of the Walls of the Blood Vessels (Phlebitis). — This is
especially interesting to the veterinarian, as it is quite frequently seen in
the dog. Purulent inflammations of the blood vessels are seen in con-
nection with infectious purulent wounds, and originate as a secondary
symptom by extension of the suppurating process from the surrounding

DISEASES FROM SEPTIC INFECTION OF WOUNDS 363

tissues. This is especially noticeable where the wall of the vessel is
crushed, forming a thrombus, and this thrombus, lying in the IjIoocI vessel,
becoming infected from the wound, produces suppuration and breaks
down, and is carried into the general circulation and deposited in some
part or organ of the body, setting up an irritation, and a consequent
formation of an abscess. This condition is termed "metastatic abscess."

The therapeutics are the same as those of lymphangitis. Open
the wound as soon as possil)le and thoroughl}' disinfect the abscess.

Fever. — Concerning the clinical symptoms of fever, we have giA^en
all necessar}' details on page 9. The fever which accompanies wounds
varies greatly in intensity according to the cause. The following are
the different varieties of wound fever:

1. Aseptic Wound Fever. — This is produced by entrance into the
circulation of the blood of harmless substances (water, irrigating fluids,
non-decomposed wound secretions, and fibrinous ferments). This
occurs in the majority of cases shorti}' after the animal receives the
wound, and causes very slight disorder in the general condition. The
rise of temperature is generally the only visible symptom in the dog.
There is no alteration in the appetite, and the temperature is reduced
within a few hours; in very rare cases it may be slightly increased for
two or even three days.

2. Septic Wound Fever and Septicaemia. — As soon as putrid or
decayed sul)stances find their way into the system by means of a wound
the symptoms of fever appear rapidly. If they are mild in character,
it is called "septic wound fever;" if they are acute, presenting symptoms
which may endanger the life of the animal, it is called "septicaemia."
Septic wound fever and septicaemia are only separated by their degree of
intensity, otherwise they are similar. There is one difference that we
will point out between septic poisoning and septic infection, and that is,
in the first form, the micro-organisms which produce putrefaction are to
be found only in the centre of infection and not in the blood, while in the
second form the centre of infection is in the blood and in the tissues.

Septicaemia appears, as a rule, thirty-six to forty-eight hours after
the injury with an increase of temperature as high as 40.5°, rarely above,
and showing a remittent character marked by depression, fatigue, and
loss of appetite, the last being very rare. If the wound is treated quickly
and rendered thoroughly antiseptic, the symptoms rapidly disappear.
The most dangerous forms of septicaemia which occur most frequently in
the dog ajDpear two to four days after the injury, showing a general disturb-
ance of the system, and frequently without presenting any unusual
symptoms in the wound itself. The temperature is rarely increased to
any extent. Move often it is normal or subnormal. "We are not able, there-
fore, to place any dependence on the temperature as far as prognosis

304 WOUXDS AXD THEIR TREATMENT

is concerned, the onh' value being when the normal temperature is pre-
sented and the acute symptoms already described begin to abate.

We sometimes see very peculiar cases — for instance, the author has
observed a case of septicaemia with normal temperature the first day
accompanied by weakness, depression, loss of appetite, etc. In the next
few days the temperature gradually increases; sleepiness, fatigue, and
rapid emaciation; the symptoms increase in intensity; the pulse becomes
weak, rapid, and much slower, until it falls below the normal rate, and
finally ends in the death of the animal. In many cases diarrhoea is
present, and in rare cases convulsions.

Therapeutics. — Antiseptic solutions must be used vigorously and
the wound irrigated frequently. If there is any dead tissue that is hard
to loosen, the thermo-cautery should be used to render it aseptic. The
animal must be stimulated by means of ether, alcohol, and camphor.
The writer finds subcutaneous injections (4.0 to 6.0 doses) of spirit of
camphor or camphorated ether, 1 to 10, of great value in such cases.
This drug he is inclined to call a specific agent in septicaemia. It must
be injected every two or three hours under the skin until the alarming
symptoms have disappeared. Slight muscular contractions which
sometimes follow the use of camphor are not to be regarded as anything
especially serious.

3. Purulent Fever and Pyaemia. — When a suppurating wound
becomes very much inflamed and infects the surrounding tissues, it is
generally followed by the entrance into the blood of some microorganisms.
If the symptoms of fever are slight, the patients may recover, wdth only
a chill and a slight increase of temperature. If the fever is very serious
and the temperature rises high, it is called pyaemia. In this disease you
will find that the majority of cases are follow^ed by metastatic suppura-
tion in various organs of the body. This is due to the fact that the throm-
bus undergoes purulent destruction in the blood vessels, breaks down,
and the infectious matter is carried into the circulation, and from there
it fintls its way to different organs or locations in the liody. The symp-
toms of pyaemia in the dog are not very easily distinguished from those
of septicaemia, and it is very hard in the majority of cases to make a
positive diagnosis. Very frequently we see symptoms of septicaemia
and pyaemia combined, forming what is known as septico-pyaemia. In
this case the animal dies before any deposit of the suppurating poison
has produced abscesses. In pyaemia the symptoms are marked by chills
in the early stages, and by intermittent fever. The appetite is often
good, and, as a rule, rarely cntii'ely absent, as in septicaemia. Later the
disease presents much more serious symptoms: the fever loses its inter-
mittent character, the temperature remaining high; the appetite disap-
pears; fatigue and weakness may occur; the patients become rapidly

DISEASES FROM SEPTIC INFECTION OF WOUNDS 305

emaciated and finally die. AVith these symptoms we see metastatic
suppuration in the internal organs.

The therapeutic treatment of pysemia is similar to that of septicaemia.

Treatment of Wounds. — In the treatment of wounds we must pursue
the following directions to obtain good results: 1. That the edges of the
wound must be brought together as soon as possible to encourage union.
2. That in the treatment of wounds we must protect them from all kinds
of irritation, and especially from the invasion of micro-organisms.

A wound may be infected with microl:)es through the hair, or by
direct infection from unclean hands, instruments, dressing materials,
or septic fluids. It is also possible to infect a wound from the blood.
The main point in the treatment of wounds should be to prevent the
direct entrance of microbes into it, or to destroy the infectious substances
which have entered the wound, and finally to put it in such a condition
as to prevent the fui'ther development of any microbes that may still
remain there. The first is rather difficult in the dog even under ordinary
circumstances; the last can be followed out to a certain extent, as the
treatment of wounds is greatlyinfluenced in the dog by two facts : first, many
dogs will not allow a dressing to remain in place; and, second, a wound is
interfered with to a certain extent by the tendency that all dogs have to
lick the injured part. For this reason we frequently have to modify the
treatment of wounds in the dog. We must, however, apply a dressing
in all cases where we can keep the patient quiet and prevent him from
removing it. The veterinarian has t^^■o powerful agents at his disposal
for the treatment of wounds: the first is, primary disinfection of the
wound and its neighborhood; second, keeping the wound as dry as possible.

1. The First Disinfection of Wounds. — This is of special importance,
and especially during and after operations where there is much blood lost.
The wound and everything coming in contact witli it, also the tissues
surrounding it, should be carefully rendered antiseptic. The hair has to
be shaved or cut very close, the skin washed with ether or benzine in
order to remove all the fatty matter lying in the skin. Follow this by
washing with antiseptic fluids (1 per cent, solution of sublimate, 3 per
cent, carbolic acid, 2 per cent, crcolin). Any existing wound has to be
treated in the same manner. If there is a wound the shape of which
forms a cavity, an antiseptic solution must be injected into it and come
in contact with all parts. The irrigator shown in Fig. 117 is especially
adapted to that purpose. For cleansing wounds do not use sponges
unless they are thoroughly aseptic, also disinfect the gauze and dressings
(tampons). Instruments and the operator's hands must also be care-
fully attended to. The former should be placed in an antiseptic solution
of carbolic acid, 5 per cent., or a 2 per cent, solution of creolin. Do not
use corrosive sublimate solution for instruments, as it leaves an insoluble

366

WOUNDS AXD THEIR TREATMENT

coating of mercury on the steel. The hands and nails have to be brushed
and washed with carbolic solution, or sublimate soap. During the
operation the wound should be disinfected from time to time — that is to
say, it should be washed or wiped with the solutions referred to above.
2. Future Treatment of the Wound. — This consists of various
measures, according to whether there is hemorrhage and the condition
of the wound.

Stopping all Hemorrhage. — If the blood which runs into a wound is
left there, it has a bad effect, preventing an adhesion of the surfaces of
the wound, and also being a favorable ground for
the development of microbes.

Drainage of the Wound. — By this we mean the
removal of wound secretions, especially pus, by
means of drainage-tubes. The regular drainage-
tubes are made of rubber, having numerous holes
cut in them. These are placed in the deepest part
of the wound, and fastened by means of a stitch
in the skin, or the wound closed around it. In
small wounds, instead of the rubber tube we use
small pieces of silk thread or catgut which have been
twisted together in the shape of a cord. In wounds
which are not deep, but cavernous, and where it is
difficult to get ciuick adhesion in order to insure pro-
per drainage, it is best to leave the wound open,
covered with antiseptic powder, such as sulphonal,
boric acid, naphthalin, salicylic acid, etc. The first-
named agents possess special properties for the
treatment of surgical wounds, drying them rapidly
and depriving the microbes of a proper medium to
develop in, and thus rendering it impossible for in-
fection to extend.

It is advisable to use some material that wall take up the secretions
of the wound c{uickly, and assist in drying them. For this purpose, we
cover the wound with salicylic- or carbolic-acid or corrosive sul)limate
gauze. In a wound where there is a deep cavity, it is well to fill it for
twenty-four to forty-eight hours after the operation with a tampon of
sublimate gauze, then, having removed the gauze, clean the wound and
by means of sutures bring it together and cover it with antiseptic gauze.
The following is the ordinary treatment of wounds:
I. Controlling the Hemorrhage. — This may be accomplished in various
ways. The best method is by means of a ligature. As a rule, this is
performed by carefully ligating the bleeding blood vessel, either directly
on the vein or artery, or taking up a certain portion of the tissue wdth a

Fig. 117. — .\pparatus
for the antiseptic irriga-
tion of wounds.

DISEASES FROM SEPTIC INFECTION OF WOUNDS

367

pair of forceps, including the blood vessels, and tying it behind the
point of the instrument with a ligature. When the bleeding end of a
blood vessel is located in very firm tissue, out of which it cannot be
drawn far enough to ligate, we pick up the blood vessel with the end of
the forceps, draw it out as far as possible, and twist it in a spiral direction;
by this means we usually succeed in controlling the hemorrhage. If,
however, the above does not answer, we pass a thread through the
tissue underneath the blood vessel and tie it tightly, and by this means
close the opening.

Compression is sometimes used as a means of stopping hemorrhage.
This we can accomplish by pressure of the finger above the bleeding
region, or, if it is an extremity, ligate the member above the part by

Fig. 118.— Different forms of stitches used in the dog and method of tying: a, head-stitch; 6,
cjntinuous oblique stitch with cross-stitch; c, deep continuous cross stitch; d, mattress-stitch; e, but-
ton and interrupted stitch.

means of a rubber band or tube, or even a handkerchief. Another means
of stopping a hemorrhage is by using a cauterizing iron (thermo-cautery).
These, however, should only be used in wounds where you do not expect
healing by first intention. All agents which have the property of stopping
hemorrhages, as a rule, coagulate or draw the tissues in such a way as to
prevent healing by first intention.

Capillary or slight subcutaneous hemorrhages can be stopped by
pressure or irrigation with cold water. Hot water is also sometimes used
to control hemorrhage.

368 WOUNDS AND THEIR TREATMENT

Wounds which can heal by first intention, such as all operative
wounds which have been thoroughly disinfected according to the method
described above, and where the hemorrhage has been stopped, we
bring together by stitches or ligatures (Fig. 118). As a rule, the
ordinary knot-stitch with antiseptic silk is used, although we may con-
nect it with other forms, such as the extension stitch (Fig. 1 18). Small
wounds do not, as a rule, reciuire drains. The wound should be com-
pressed for several minutes by means of an antiseptic sponge, and after
that covered with collodion. If the position of the wound allows, we
must apply a firm, compact dressing over every wound that is stitched;
if it is a simple one, the dressing may remain until it is entirely healed — •
that is, for about one week. If we have a large wound, however, with
flaps, caverns, etc., it is advisable to place drains in the wound and
change the dressing after three or four days. Instead of collodion dress-
ing in such wounds, use antiseptic powders, such as sulphonal, der-
matol, bismuth subnitrate and boric acid. These should be dusted on
the wound itself, directly on the line of the severed skin.

The writer has been in the habit of covering ordinary sewed wounds
with a thin layer of antiseptic gauze, and covering over that a dry,
antiseptic muslin bandage, and finally over these two covers a damp
starched gauze bandage. The latter has the advantage of forming a
stiff envelope, becoming dry on account of its starchy contents, and
exerting a certain hold on the injured member. If a serious rise in
temperature takes place, the dressing must be immediately removed and
the directions followed which are given under the head of "Wound
Fever." When the bandage has been displaced,
and when it has been moistened by the wound
secretion, it must also be changed.

Wounds which heal under a dry scab are gen-
erally superficial. These do not require to be
closed by means of stitches, and they seldom are
119.—. uzzc. hcked or irritated by animals. In these cases

we use the following method of treatment.

After thoroughly disinfecting the wound and its neighborhood with
some antiseptic solution — dilute corrosive sublimate or creolin solution —
allow it to dry, and b}^ means of a camel's hair brush paint the irritated
dermis. We produce an artificial scab, or we cover the wound surface
with collodion. The latter is recommended in common lacerations. As
a rule, no dressing is used. The scab loosens after some time and falls
off. When we are obliged under certain circumstances to leave a wound
open it is advisable to muzzle the animal (Fig. 119), not only to prevent
the patient from licking the wound, l)ut in order to properly apply a
sprinkling powder, and get good results from it. The best powder to

DISEASES FROM SEPTIC INFECTION OF WOUNDS 369

use is boric-creolin (1 part of ci-eolin to 40 or 50 parts of boric acid),
naphthalin or sulphonal (1 part to 5 parts of starch), dermatol, airol,
aristol, bismuth subnitrate or zinc oxide. An open wound generally
recpires antiseptic washings daily. It frequently happens that granu-
lating wounds, especially when they have been subjected to exposure to
air or are constantly irritated by the animal, may at some period lose
their power of healing and become converted into ulcers.

Ulcers or Ulcerations. — By this we understand a granulating surface
which does not heal on account of the purulent destruction of the granular
tissue. Wounds are changed into ulcers when they are continually
irritated by some mechanical or chemical irritant, or as a consecjuence of
the skin becoming inflamed or necrosed from pressure (muzzling, etc.).
Callous ulcers and fistulous ulcers are the most difficult to treat. The
former are superficial ulcers with hard, callous centre, having raised
edges, and a whitish, hard, bacon-like surface. This is covered with a
thin unhealthy secretion. They may form sinuses or canals, which very
often contain, at the bottom of the sinus, a foreign body or necrosed
tissue. They may also lead to some of the glands. These pipes are
called fistulse or fistular canals.

The treatment of ulcers is, to a certain extent, the same as that of
wounds — that is, to follow all the antiseptic rules. The use of dermatol,
airol, aristol, subnitrate of bismuth, salicylic acid, naphthalin, powdered
camphor, or boric-acid ointment is advisable. We may also remove
callous ulcers by surgical means and convert them into fresh wounds by
taking a knife, paring the tissue at the bottom of the ulcers, and treat
them as indicated in cases of fresh wounds. Caustic agents produce
little or no good effects. If the tissue surrounding the ulcers is hard and
rigid, preventing contraction of the ulcerated area and the healing
process, we must perform circumcision of the part, as transplantation
is not practicable in the dog. We cut about 1 cm. from the border of the
ulcer over its entire thickness, keeping the wound open by means of
vaselin. When we treat a fistulous canal and the location of the fistulous
sinus admits of it, we split open the fistulous passage and convert it into
an open wound. When the fistulous canal is not very deep we may also
try to produce healthy granulations by means of actual cautery, or the
injection of caustic fluids or the introduction of crayons of caustic
(nitrate of silver or caustic potash). Always try to slit open the canal,
if possible, as it produces the best effects. Nitrate of silver or any of
the mineral acids, and in obstinate cases a small piece of corrosive sub-
limate, is pushed down into the bottom of the wound; these caustics
produce more or less irritation and consequent sloughing of the wall of
the canal and allow the growth of healthy granulations.

Contusions. — In subcutaneous wounds of the soft tissues (bruises
24

370 WOUNDS AXD THEIR TREATMENT

and contusions) we find a different condition of the tissues. These
injuries are generally caused by some blunt object — for instance, a blow,
kick, shock, or fall. The soft parts are bruised and injured according
to the intensity of traumatism; very slight resistance is offered by the
loose connective tissue; small blood vessels are ruptured from crushing
or bruising the soft parts, and the hemorrhage that follows percolates all
through the torn tissues. The greatest amount of resistance is found in
the skin, face, sinews, and large blood vessels.

Clinical Symptoms of Contusions. — One of the first symptoms of
a subcutaneous bruise is a swelling in the region of the injury. This
appears, as a rule, immediately after the injury, and is due to the blood
running out of the torn vessels. The fluids in the enlargement always
contain lymphatic substances on account of the laceration of certain
lymphatic glands. In rare cases Ave see a lymphatic secretion only,
which is distinguished from the blood secretion by being very slowly
absorbed. The fluid which appears lies either in. the loose connective
tissue under the skin or between the muscles, and, as a rule, is irregularly
divided, or we may find the condition presented in a number of ways;
for instance- we may find a ''doughy" swelling in one case, or it is accu-
mulated in centres in another, or we see a fluctuating swelling or a
"blood boil" (hematoma), or it may run into a cavity, and we have a
bloody secretion of the joint (hemarthrosis) , or we find a bloody secre-
tion in the cavity of the chest (hematothorax). The swellings, as a rule,
occur shortly after a contusion, and in the early stages rarely show any
inflammatory symptoms. Later, however, inflammatory symptoms
may appear.

Beside the swollen condition of the tissues, the animal may present
symptoms of pain, especially at the time of the injury, and later on we
find the injured region very tender to the touch.

The further course of the wound depends to a great extent on the
amount of the injury. If the skin is crushed in such a manner that all
the vessels are torn, it will become necrosed from deficient nutrition, and,
as a result, is indicated in the discharge, which contains septic blood and
broken doAvn tissue.

In the treatment of contusions, to get good results we must have one
object in mind — that is, the rapid reabsorption of the secretion. For
that purpose we use cooling compresses soaked in lead-water (Goulard 's
extract), or arnica-water, or we may try to get absorption by means of
massage — that is to say, make a centrifugal friction with the thumbs,
fingers, or hand for fifteen or twenty minutes at a time. We may also
squeeze the excreted blood into the tissues and lymphatic passages, and
apply a tight bandage immediately afterward to prevent any recurrence
of the subcutaneous bleeding. This latter treatment is not to be

DISEASES FROM SEPTIC INFECTION OF WOUNDS 371

practised unless the swelling is very small and there is very little fluid
in it.

The therapeutic treatment is not simple in all contusions. In large
"fluid-boils" we rarely can wait for an absorption of the secretion, Init
are compelled to open the swelling at the point where it is soft and where
the skin is thinnest. In animals we must always try to make an opening
in the dependent part of the enlargement, so as to get perfect drainage.
After having opened the tumor, clean it out, removing all clots, etc., and
treat the inner surface of the wound according to the usual method,
applied in such cases. If the location of the wound prevents such a pro-
cedure, the fluid may be emptied by means of a hypodermic syringe, and
an antiseptic solution injected in its place, and, if possible, this should
be followed up afterward by a compress-dressing.

In all cases where the skin is very much injured, or w^here extensive
destruction of the soft parts has taken place, or even fracture of the bone
has occurred, we cannot use massage, but instead compressing antiseptic
dressings must be applied. As a rule, treat the slightest injuries of the
skin according to the l:)est antiseptic methods.

Inflammatory symptoms are observed as soon as fever appears.
The skin becomes hot and painful; finally fluctuation is found in some
parts. Then we must immediately remove the secretion, clean out the
wound, and by drainage keep the cavity empty, at the same time inject
into the wound a 1 to 1000 solution of corrosive sublimate or a 5 per cent,
solution of car])olic acid, and use an antiseptic bandage.

Bums and Scalds. — In cases where a high degree of temperature acts
on the skin it causes hypersemia in milder cases, to necrosis and sloughing
in severe cases. For convenience of descriptions, we divide burns into
three classes or degrees. The first degree of burning is indicated by
great pain, redness and swelling of the skin; the second degree causes
violent serous exudation in the stratum mucosa and is indicated by the
formation of blisters containing a yellowish serous fluid which dries or
may bui*st the vesicle when it is followed by more or less suppuration.
Burns of the third degree are indicated by more or less extensive necroses
of the skin. The necrosed portion of flesh forms a scab which is separated
from the surrounding healthy tissue by a demarcating line of granulating
tissue. Extensive burns may cause death in a few hours. In such cases
the animal shows violent pain, is greatly excited and restless, the pulse
is very high, hard and wiry. The respirations are increased, subnormal
temperature and death follows in a short time. Sometimes there is violent
vomiting, followed by convulsions; the prognosis depends on the severity
of the burns or scalds. Very frequently a scalded animal is disfigured
for life as a result of the extensive destruction and subsequent necrosis
of the epidermis, which destroys the han- bulbs and prevents future

372 WOUNDS AXD THEIR TREATMENT

growth of hair. Treatment in all cases consists in applying cooling
applications that prevent the air from reaching the burned surface,
such as flour, starch, boracic acid, or talcum powder, applications of solu-
tions of lead water, acetate of alum or cresol, or unction of petrolatum,
zinc or lead oxide ointments, also ointments of ichthyol or thigenol (1 to
10), lead liniment 1 part of acetate of lead and 10 parts of olive oil,
calcium liniment (so-called carron oil), lime water and linseed oil equal
parts, or mixture of equal parts of carron oil and carbolized oil (1 to 20)
or a mixture of a beaten up egg and linseed oil. Blisters of very large
size should be opened with a fine needle, taking care to make a very small
opening in the covering of the blister and endeavor to prevent it from being
rubbed off. In case the epidermis — that is to say, the covering of the
blister — is rubbed off, the above-mentioned salves and liniments can be
used, but drying powders such as dermatol, airol, aristol, subnitrate of
bismuth, oxide of zinc are much to be preferred. These drugs are
generally rubbed up with starch or talcum and dusted on the sore by
means of a pledget of absorbent cotton, a perforated tin dusting box or
blown on by means of an insufflator. Powders of salicylic acid or
magnesia in combination with talcum powder should be employed where
there is suppuration or scalding of the third degree. Some recommend
a solution of picric acid 1 to 100, or a 5 per cent, solution of nitrate of
silver. Where the animal is in very violent pain, we should use cocaine
in solution as a local application. A bandage of absorbent cotton is
put over the scalded portion. This is rather difficult, however, to keep
in position, as in cases of severe scalding the animal constantly moves
or twists the body in endeavoring to lick or bite the wounds. This must
be prevented if possible. In cases of acute or extensive scalds the animal
must be covered with cotton batting and given some of the various
stimulants such as alcohol, camphor, or ether, and also the subcutaneous
solution of common salt is to be recommended.

Frost Bites. — Freezing is comparatively rare, prol^ably due to a
certain extent to the fact that frost bites, if they happen to be mild in
character, are either overlooked or mistaken for other affections. Frost
bites occur in hunting dogs, in the work dogs of Europe, and also the sled
dogs of Canada and Alaska. Freezing generally appears in the feet.
Muller and Frick found freezing to be rather common in hunting dogs,
but, except when it is more or less extensive, is not observed by the
attendants of the animal. Schneidermuhl observed a bitch that had a
frozen udder. Schindelka saw one case where a clog had his ear frozen.
As in burning, we divide freezing into three degrees depending on the
severity of the symptoms. In freezing of the first degree we find
in the frozen portion slight dark red or blue colored swellings. In
freezing of the second degree, there appear a number of bladders or

DISEASES FROM SEPTIC INFECTION OF WOUNDS 373

blisters, containing yellow hemorrhagic serum, and after the vesicles
burst there is more or less loss of tissue and the wound heals very slowly
leaving a very pronounced cicatrix. Freezing of the third degree is
accompanied by more of less gangrenous mortification of the frozen portion.
Chilblains (perniones) are seen occasionally in dogs that are kept
chained in yards and pointers that hunt in the snow or over frozen
ground. The treatment of frost bites of the first degree consists in
attempting to remove the venous stasis by means of friction or a liniment,
such as spirits of camphor or aconite or paint the affected portion with
tincture of iodine. The application of moist, warm compresses is also
beneficial. For freezing of the second degree, in which blisters have
been formed, apply drying powders already mentioned and if gangrene has
commenced, the wound must be treated with antiseptics. Where the
animal is completely frozen, as is indicated by the rigidity of the body,
avoid warming the animal too quickly. The animal must first be rubbed
with a cloth which has been dipped in cold water or given a bath in cold
water and gradually the heat of the water increased up to the bodily
temperature; at the same time the body is to be rubbed constantly.
Subcutaneous or intervenous injections may be administered, such as
ether or camphor. Artificial respiration may also be resorted to.

Snake Bites. — In Europe there are three species of venomous snakes
which may bite dogs. They are the common viper (vipera berus), the
asp (vipera aspis radii) and the sand viper (vipera ammodytes). The first
serpent is found all over Europe, the asp in Switzerland, the sand viper
in Dalmatia. ■ In America we find the rattlesnake (crotalus) and the
copperhead (trigonocephalus contort rix) and moccasin (toxicophis
piscivorus) and puff adder. The poison of the snake lies in two glands
which lie at the base of the long teeth. Sporting dogs and shepherd dogs
are generally bitten on the legs and sometimes on the mouth. A short
time after the animal is bitten, we find about the bitten portion a bluish-
red tumefaction which is extremely painful and has a doughy-like feel to
the finger. The pulse is small and thready, the respirations frequent.
The animal attempts to vomit and finally may become totally paralyzed.
As a rule the animal makes a good recovery and it is only in rare instances
that it results fatall3^ The treatment consists in putting a tight ligature
immediately al)ove the affected portion and this must be left on until
the effects of the poison have passed off. Subcutaneous injections of spirits
or ammonia diluted with three parts of water. The following drugs are
also recommended to be applied directly to the wound: calcium chlorate,
chloral water, tincture of iodine, hydrate of potassium or nitrate of silver.
The thermocautery can also be used. It is to be understood that any
of the preparations to be of any service, must be used immediately after
the animal has been bitten. Karlinski recommends subcutaneous

374 WOUXDS AXD THEIR TREATMENT

injections of solution of cliromie acid (1 to 100). Lacerda advises sub-
cutaneous injections of pei-manganate of potash (1 to GO). Where the
animal exhibits great weakness, we should administer alcoholic stimu-
lants— Ijrandy, whiskey, or sherry — and to these add a few drops of spirits
of ammonia. Ether, camphor, atropia are all advised as stimulants.
A serum has been prepared to combat the effects of a snake bite.

Wounds of the Tip of the Tail. — Wounds or injuries to the tip of the
tail are generally found in short-haired dogs with long tails, particularly
great danes, pointers, and beagles. Wounds of this character are caused
l\v the dog shaking the tail and hitting against solid objects, particularly
where dogs are kept in narrow kennels and wag their tails and strike the
sides of the kennel. It is a peculiar fact that while injury of the tip of the
tail is insignificant, it is one of the most difficult to treat and cure. This
is caused by several facts; first dirt and scabs collect on the wound which
causes the animal to constantly lick and gnaw the sore. Another fact
i':; an animal will keep gnawing at the tail when there is apparently no
reason for it. The tail seems sometimes to be intensely itchy, due prob-
ably either to neuritis or to itching eruptions of the skin. The animal
gnaws and bites the tail as if in a fury of pain or irritation until the vertebra
is exposed causing necrosis of the bone and slough of portions of the tissue
or even one or two bones of the coccyx. Sometimes we find certain ecze-
matous eruptions that extend from the back and root of the tail along the
entire body of the tail, and the animal is constantly licking and biting it.

The first line of treatment is to endeavor to lessen the irritation and
to heal the sore. First clean the tail carefully and thoroughly with warm
Avater and soap and remove all dirt, scabs, etc., from the injured or
irritated portions, and after drying the tail, dust on antiseptic powders
such as boracic acid, airol, dermatol or tannoform or even paint the
injured portion with collodion or compound tincture of benzoin. Where
there is an ulcerated portion of the skin, it should be stimulated with a
stick of' nitrate of silver or in cases where there is deep ulceration it may
be necessary to touch the affected portions with the thermocautery.
After applying the antiseptic dusting powder it is necessary to apply a
bandage on the tail and for this purpose there is nothing better than a
bandage held in place with carpenter's glue. This is applied in the fol-
lowing way: Strips of muslin or linen are covered with glue (ordinary
glue that is warmed slightly to render it more liquid) then the affected
portions are covered with tlie antiseptic dusting powder and a small
portion of absorbent cotton filled with the powder is applied. The
strip of muslin covered with the glue is laid on lateral sides of the tail
from the root of the tail around the tip and back and the glue-covered
side directly on the hair (Fig. 120). Another strip may be put on, cover-
ing the superior and inferior surfaces of the tail, then strips are wound

DISEASES FROM SEPTIC INFECTION OF WOUNDS

375

around the tail to hold on these strips, either at the root and tip, as shown
in Fig. 120, or along the entire tail as shown in Fig. 120. Care should
be taken not to wind the circular strips too tight as the bandage is apt to
contract c^uite consideral)ly when the glue dries. The bandage sticks
closely to the hair and has many advantages over adhesive plaster. It
is impo8sil:)le for the animal to shake it off, and if he should show an
inclination to gnaw at it a muzzle should be put on the animal. The
bandage should be changed every five or six days. The bandage is
removed by putting the tail in warm water or covering the bandage with

Fig. 120. — Bandage for injuries or amputation of the tail.

a cloth saturated with warm water and allowing it to remain for ten
minutes, when the strips are easily taken off; the tail washed, dressed
and another bandage "applied, taking the precaution to have the tail dry
before re-applying the glue bandage. A leather cone for the protection
of the tail, called a "tail-muzzle," generally causes great irritation and the
animal is in a constant state of irritation while it is on and is constantly
trying to get it off.

Amputation of the Tail. — The necessity of amputation of a portion
of the tail may not only originate from the causes already enumerated
but from the tail being run over by a wagon wheel, from being caught

37G WOUNDS AND THEIR TREATMENT

between swinging doors, or being tramped on. It may also be caused
from fracture of the tail or from malformations. Occasionally it may
be the seat of a diffuse swelling as a result of phlegmons or from septi-
caemia from the wound of the end of the tail becoming infected. In such
cases, however, it is best to make a series of longitudinal incisions in the
tail where the swelling is greatest and allow the serum to escape and at
the same time give an energetic course of antiseptic applications and
if these measures do not succeed, then we have to resort to amputation.
Amputation of the tail is also performed in pointers to shorten the tail
and prevent them from getting the tail sore going through brush and
lacerating the end. And lastly certain breeds of dogs have their tails
amputated when young as a matter of fashion.

When local applications do not have the desired effect and the tail

Fig. 121. — Amputation of the tail (circular operation).

becomes gradually worse or the vertebra becomes necrosed the only
means left is to amputate the affected part.

The operation is a form of exarticulation. An amputation between
two of the vertebrae is much better than cutting through one of the bones.
The operator must distinguish the slightly enlarged portion (Fig. 121)
where the articulation lies. Put the animal under ether or give a hypo-
dermic injection of morphine or a subcutaneous one of cocaine; have tied
an elastic band around the tail above the point of operation, then proceed
by means of the flap or round operation, whichever is preferred. As the
vessels bleed slightly they can easily be stopped by means of a thermo-
cautery. The circular operation, cutting posterior to the bony pro-
tuberances of the articulation; pull the skin back, cutting through the
muscles and tendons just below the articulation; then, with the help of
an assistant, pull up the tissues and cut between the cartilaginous discs.
Then bandage the tail as shown in Fig. 120. In cases in older dogs
where there is much hemorrhage the artery may be taken up by means
of a catgut ligature or touched with the thermo-cautery. The edges of

DISEASES FROM SEPTIC INFECTION OF WOUNDS 377

the skin are united l)y interrupted suture and an antiseptic dressing is
applied, talving care not to make it too tight. The flap operation is the
same as has ah-eady been described.

The operation of cutting puppies' tails in fox terriers, spaniels,
poodles, is best done just before the puppies are weaned. When, after
judging the proper length the tail is to be, in proportion to that of the
body, the tail should be cut through with a sharp knife. It is not neces-
sary at that age to attempt to cut exactly through the articulation.

DISEASES OF THE CLAWS AND FOOT PADS.

The claws, the third phalanx, of the toe (the bone of the claw)
articulates with the second phalanx; near the articulatory surface is an
annular fold (claw fold) which receives the free border of the claw.
The phalanx tertia is covered by the cutis vera. This develops and
grows from the matrix of the claw plate (coronet), the claw bed, and the
muscular sole which is an extension of the corium which extends over
the third phalanx after dipping into the circular furrow at the base of
the bone (Fig. 1 22) . In order to protect the ends of the claws when not

Fig. 122. — Nail. Longitudinal section of
nail. «, Matrix of nail horn; a', papillary
zone of nail horn: b, bed of na^l; c, mnt'ix
of cushion; d, cushion; e, nail. (.Siedain-
grotzlcy.)

Fig. 123. — Diagram of the first and
second phalanx. a, Tubercle of pad;
b, horn groove; c, groove of sole; d,
third phalanx; e, dorsal ligament.
(Siedamgrotzky.)

in use there is an elastic tendinous band which draws back the nail and
when the foot is on the ground the nail is retracted (Fig. 123) and the
v/eight of the body carried on the pads, those pillow-like elastic bodies, a
large one in the centre and four radiating in front of it, corresponding to
each toe, the thumb toe being too high up, does not get pressure (Fig. 124).

Ingrowing Claws. Incarnatio Unguis. — Animals that are house pets
and have little or no exercise do not wear the nails properly and they
become long and are apt to strike the ground when walking. Occasion-
ally these nails l)ecome so long as to turn under and the weight of the
animal presses the claw into the pad and the claw is gradually buried in
the flesh. The dew or spur claws on the posterior extremities frequently
grow entirely round and grow into the pad, causing great irritation,
swelling and suppuration. It is extremely painful, the animal constantly
licking the affected pai't. It can be cut through by a pair of jeweler's
wire clippers, care being taken not to cut it too close and involve the
matrix.

Splintei'ing, cracking and breaking of the claws are generally due to
some traumatism, although occasionally the claw falls off from purulent

378

DISEASES OF THE CLAWS AND FOOT PADS

379

Fig, 124.— Pads of foot.
a, Carpal pad: b, .sole; c,
1 to 5, toe pads.

inflammation of the matrix. The broken ends of the claws must be filed

or pared down to make the surface smooth and prevent it catching in

carpets, rugs, etc., and tearing it further. Occasionally a dog with long

crescent-like nails, due to want of wear, catches it in a carpet or rough

boards in a floor when he is running and the claw is

torn loose from the matrix, hanging l^y a small piece

of very sensitive flesh, and every time the animal

moves or it touches an object, it causes extreme

pain. As it is generally hanging by a small portion

of flesh it can be seized by the fingers and quickly

torn off, or if it is more firmly fixed, it can be cut off

by means of a pair of small wire cutters, care being

taken not to cut too close to the matrix.

Where there is extensive injury to the matrix,
it may be necessary to exarticulate the part.

Where the nail is torn from the matrix and that
is exposed, it is not advisable to bandage it. Paint
it once daily Avith compound tincture of benzoin.

Inflamed Claw. Panaritium. — This may origin-
ate from traumatisms, such as being stepped on,
crushed between doors, or the extension of inflam-
matory process from the leg, from unknown causes

which develop an inflammation of the matrix of the claw, and is
also seen in dogs that are very highly fed and are plethoric.
There frequently appears a gouty inflammation of the second phalanx
and the matrix, causing considerable congestion, pus and sloughing of
the nail. Eczematous eruption of the local epidermis is also com-
mon in overfed dogs; the two conditions are apt to recur in
these plethoric dogs from time to time. In rare cases pus is found
and may burrow under the tissues, causing fistula or after the
acute inflammation subsides, a thickening of the toe. Occasionally one
toe is attacked and when the acute symptoms sulxside, then another is
attacked; it has been thought to be contagious, but this condition is so
frequently seen in overfed animals that it evidently is gouty in character.
Frick found that salt water produced irritation of the claws in animals
that were at seashore places during the autumn and winter. Ral:)e
ascribes this condition to a microbe which he calls Cladothrix canis.

In acute inflammation of the claw the animal is very lame and on
examination of the toe it is found hot, swollen and very tender to the
touch; the skin surrounding the affected toe is tumefied and congested;
the claw is very painful; the animal gives evidence of acute agony if it is
touched; the claw is dull, the natural lustre having entirely disappeared,
and frequently the claw may have changed its position, that is, it may

380

DISEASES OF THE CLAWS AND FOOT PADS

curl under or turn to one side; in one case observed the claw was flattened
like the nail of a man.

Treatment. — Fomentations and poultices, painting the affected toes
with tincture of iodine. It generally is best to repeat this application
two or three times. If the claw is purulent, it must be treated with an
antiseptic dressing of corrosive sublimate, 1 to 2000 solution; when the
claw is loose, it must be removed, taking care not to injure the matrix

Fig. 125. — Dog's shoes: Laced leather shoe showing shape of sole, and rubber shoe.

or the skin at the edge of the nail and destroy the secreting power of
the claw. Frick has prevented the further extension of the disease by
intraparenchymatous injections of tincture of iodine, the internal
administration of Fowler's solution, and touching the affected claw with
nitrate of silver. The nail can be protected by means of the shoe illus-
trated in Fig. 125.

Contusions and Wounds of Pads. — Contusions of the pads are most
frequently ol:)served in sporting dogs, particularly in animals that have
not been used for active work or when they are first trained, going over
stubble fields, or in dogs going over long distances on snow or frozen roads.
Occasionally we find extensive oedema and sloughing caused by the
presence of an clastic band placed around the foot or toes by a child in
play.

The animals walk very stiff, or in some cases it may be almost
impossible to get them to walk. The pads are hot and painful on
pressure; if the pad is very much worn the dark external skin is worn off
antl the red tissue shows on the surface; in cases of extreme wear there

ABDOMINAL HERNIA 381

is suppuration and sloughing of the pad. Occasionally foreign liodies,
nails, glass, stones, tacks, splinters of brass wire, etc., stepping in acids,
particularly when emptying electrical batteries, or stepping in fresh
slacked lime. In the latter case the external portion of the pad is fre-
quently entirely sloughed of!".

Treatment. — In simple contusions rest is all that is needed; in more
severe conditions, paint the pad several times daily with compound tincture
of benzoin, or use compresses of sugar of lead water or acetate of alum.
"When the skin is separated, clean it with an antiseptic wash and remove
the loose portion of tissue and cover it with tincture of benzoin and apply
a compress. In the first examination of an animal in this condition it
is always necessary to make a careful examination of the part to see if
there are any foreign bodies buried in the pads. When the soles are
very tender the shoe shown in Fig. 125 is very useful. Sole protectors
are also made of chamois leather.

HERNIAL RUPTURE.

Abdominal Hernia.

By the word ''hernia" we understand a protrusion of a certain
portion of the abdominal contents through a normal or abnormal open-
ing in its walls, and where the displaced portion is covered, or partially
covered, by the peritoneum. In the majority of cases hernia appears
under the external skin, although we may find it in other parts, such as
hernia of the diaphragm. There are several different forms of hernia.

We distinguish the following parts in a hernia: first, the intestines
or contents which protrude from the abdominal cavity; second, the
hernial pouch; third, the envelope, or covering of the rupture; and,
fourth, the entrance or constricted portion of the rupture, or where the
intestine passes through the abdominal wall. By "hernial pouch" we
mean that part of the peritoneum which is around the part protruding
from the abdominal cavity, and we distinguish it where it is near the
constricted portion by forming at the neck. The portion which lies in
the hernial sac is the body and lower portion. The hernial pouch is
absent in some cases — as a result of some injury, and the injury has been
severe enough to tear the peritoneum, or where the hernial pouch col-
lapses or draws together. Hernial coverings of the pouch are the names
given to that portion of the skin and subcutaneous cellular tissues which
cover that part; in some instances we also include the muscles and apo-
neuroses. The contents of the hernia consist of some portion of the
abdominal organs enclosed in the hernial pouch. As a rule, it is the
intestines, in most cases the duodenum, and in some cases the jejunum.
Very frec^uently the duodenum may be found lying in the hernia with

382 HERNIAL RUPTURE

some portion of the large intestine or uterus, and more rarely the bladder
or stomach. Under certain conditions we find a certain cjuantity of
fluid lying in the sac. This is generally serum and originates from
venous stagnation.

According to the location of the hernial orifice we distinguish
umbilical, ventral, inguinal, scrotal, and hernia of the diaphragm.

The causes of hernia are generally described as dii-ect and indirect.
In the former we have a certain number of abnormalities which are due
to diseased conditions. For instance, an umbilical hernia is due to an
imperfect closure of the opening of the umbilical ring. The latter may
occur from the abdominal walls being flaccid, from cicatricial contrac-
tions after operations, and occasionally from great abdominal pressure in
prolonged straining, vomiting, etc., the muscular wall is ruptured, or
from kicks or blows on the abdomen.

In traumatic hernia which has been caused by blows, the hernial
pouch is sometimes absent and its contents are surrounded by a hernial
envelope — in most cases by the skin — and in rare instances certain
muscles are included in the sac.

Clinical Symptoms and Course. — The symptoms as well as the
course show a marked difference, according to the character of the hernia,
and it depends to a large extent on the ''possibilities" — that is to say, if
the hernia can be reduced and replaced in the abdominal cavity or not.

Reducible Hernia. — This is generally seen in the region of the wall
of the abdomen. AVe find a swelling which does not present any inflam-
matory symptoms, and is especially prominent when the animal is
walking or standing. It is also seen during abdominal pressure, espe-
cially after the dog has eaten a hearty meal. If the animal is turned
in such a way that the hernia occvipies a superior position, as a rule it
immediately disappears, as the contents fall back into the abdominal
cavity, or they may do so on a slight pressure of the hand. If we exam-
ine the abdominal walls the orifice of the hernia can be distinctly felt,
and we may even be aljle to penetrate the abdominal cavity with the
finger.

Further symptoms depend upon the nature of the prolapsed intes-
tines. This intestine will l)e recognized as a soft, elastic swelling,
having to a certain extent the round or tubular form of an ordinary
intestine. It may also l)e further distinguished by a slight distention
wdiich is generally due to gas or air. The omentum is soft and doughy
to the touch, having an uneven surface and dull on percussion. Hernias
of the horns of the uterus are only distinguished from a loop of intestine
after conception and during whelping.

Mechanical influences, such as bites, blows, contusions etc., may
cause inflammation of the hernia with a thickening of the pouch, and

ABDOMIXAL HERXIA 383

an adhesion between it antl the contents of the hernia. If the injury
is severe enough, we may have suppuration in the pout-h. In such
cases we may have a subsequent mechanical contraction and reduction
of the hernia, especially when the pouches are small, or in some cases
the hernia has only been large enough to admit a fold of the omentum.

Irreducible Hernia. — This may be due to an adhesion of the intes-
tinal contents with the hernial pouch, the union of the intestinal
contents with each other (for instance, adhesion of the intestines),
from thickening of the omentum which lies in the hernial pouch,
or from strangulation of the hernia. This is especially important, as it
may occur in all cases of abdominal hernia and at any time.

Concerning the causes of strangulation there are three important
groups: Strangulation by extreme distention of an intestinal tube by
fiecal matter; a distention of the opening of the hernia, which subse-
quently closes on the intestine and strangulates it; by the intestines
becoming twisted in the sac. Invagination is very frecpently seen in
young animals.

In many cases we distinguish three stages of hernia, according to
the anatomical alterations produced as a consequence of strangulation
in the prolapsed parts. First, we have a venous hypersemia, then
inflammation, and lastly suppuration. In the first stage the veins and
capillaries are engorged with blood, and serum is exuded in different
directions. In the second stage we observe inflammation of a septic
character, which extends from the mucous membrane to the serous
membrane, as a consecjuence of the noxious or poisonous contents of the
intestines. In the third stage the prolapsed parts become necrosed,
due to the stricture of blood circulation. The intestinal portion becomes
lilack, easily torn, dull in color, and covered with gray or greenish spots
on its surface; the hernial fluid becomes purulent, and the inflammatory
processes in the intestine above the strangulation cause septic peritonitis.

The clinical symptoms of strangulated hernia are very marked
in most cases. The hernia can no longer be reduced or pushed back
into the cavity, or a swelling suddenly appears after any traumatism,
or after great abdominal pressure, and cannot be reduced even with
careful manipulation. The hernia is distended, harder and fuller than
usual, becoming very sensitive to pressure, and especially so as the in-
flammation becomes more intense. The skin covering the hernia is normal
in the beginning, but later becomes red, swollen, and warm to the
touch. Another symptom generally present is vomiting. This may
be so constant and violent toward the later stages that the animal will
vomit faeces. At that period symptoms of severe intestinal obstruction
present themselves. The hernial swelling becomes cold, insensilile to
pressure, and symptoms of collapse appear, and death occurs in from

384 HERNIAL RUPTURE

twenty-four to forty-eight hours after strangulation first appears. The
temperature can hardly be said to have any diagnostic value, as we very
often find it normal or even subnormal up to the time of death.

In rare instances we have the formation of a fsecal abscess; this is
caused by the sloughing of a certain portion of the intestine, allowing
the contents of the intestine to escape into the sac; this is due to the
circulation being cut off and subsequent mortification of the part; this
is quickly followed by purulent inflammation of the hernial covering.
If an incision is made in the hernial swelling, faecal matter and pus flow
out externally without being followed by any grave symptoms, except
that it may svibsequently form a false anus in the cavity.

Fsecal fistula, intestinal fistula, or preternatural rectum is seen in
very rare instances. The expression "fsecal fistula" or "intestinal
fistula " is used where there is an external intestinal orifice, but the greater
mass of fsecal matter is passed through the rectum. The term " preter-
natural rectum" (anus praeternaturalis) is used when all the fsecal matter
passes through this opening. Such an opening may also be produced
by penetrating wounds or the entrance of foreign bodies.

In strangulation of the omentum the symptoms are less marked,
but there is great pain on pressure. We frequently find adhesions
between the omentum and the orifice of the hernia. This inflammation
produces a complete immobility of the hernia and gangrene, followed
by the formation of an abscess, and finally the escape of pus externally.
Death is rare in such conditions, and if it should occur it is caused by
septicsemia.

The prognosis of irreducible hernia depends greatly on the length
of time that the strangulation has been present and also on the character
of the contents of the hernia. In cases where a loop of intestine is strangu-
lated and is gorged wuth fsecal matter the results are generally serious;
but, on the other hand, strangulation of the omentum is not serious.

Therapeutics of Hernia. — In cases of reducible hernia we cannot
use a truss, which is the favorite mode of treatment in man, it being
impossible to keep a hernial bandage steady in any position for any length
of time on the dog. AVhen hernia has been caused in a traumatic way,
and followed by a subcutaneous rupture of the abdominal wall, or in
umbilical hernia of very young animals, we may close the orifice in such
cases by means of a dressing, and the hernia may be entirely removed
by the following method:

Place the animal on its back or in such a position that the hernia
is placed as high as possible. Then reduce the sac by working the con-
tents back into the abdomen. In some cases this is accomplished very
easily, but in others it requires a certain amount of careful and patient
manipulation. Then place a tampon of wadding or a small piece of

ABDOMINAL HERNIA 385

cardboard upon the hernial orifice. This will have to extend over the
borders of the hernia far enough to entirely cover the opening. Now
fix small pieces of adhesive plaster across the cardboard and attach
them in a circle around the piece of cardboard. These will adhere easily
if the skin has l)een cleansed and any fat or other material has been
removed by means of ether or benzine. [Ordinary shoemaker's wax
made liquid is put on the end of the plaster strips.] We now place a
gauze bandage around the adhesive-plaster dressing and the whole
posterior part of the body, in order to protect the dressing from being
torn or shifted by the animal. The dog should be fed on light, easily
digested food, avoiding any that has a tendency to flatulency or consti-
pation, at the same time assisting defecation by means of laxatives. The
safest and most certain method, however, of removing hernia is the
operation of herniotomy, or hernial section.

Where we have strangulated hernia we must attempt to reduce it
by pushing the contents of the hernia back into the abdominal cavity.
This may be accomplished either by means of taxis or by hernial section.
The former method is only to be used when the strangulated intestines
have not yet undergone any serious alterations, namely, when they are
not affected by gangrene, and when there are no serious symptoms of a
local or general character. In the operation of taxis the patient must
be placed in such a position that the hernia occupies the highest region
in the abdomen and assists the relaxation of the abdominal covering
and the orifice of the hernia as much as possible. We first try by manip-
ulation upon the orifice of the hernia with one hand, and by pressure of
the flat of the other upon the periphery of the swelling to push the contents
of the hernia back into the abdominal cavity. When the animals are
under the influence of ether or a narcotic, the reduction is easier. Taxis
must be considered successful when the swelling of the hernia has dis-
appeared and when the aperture of the hernia can be felt, and also when
the symptoms of distention have gone. If the latter still continue,
notwithstanding the fact that the contents of the hernia seem to have
disappeared, we have a false reduction — that is to say, the hernial con-
tents and pouch have been shoved entirely through the orifice into the
al)dominal cavity, or we have to deal with a volvulus or invagination
of the intestinal portion in the cavity; or it may be that the hernial
contents are crowded between layers of the abdominal muscles. In the
first instance the orifice of the hernia seems free, and in the latter instance
it is closed.

If the attempts at taxis to produce reduction fail, or if the above-
mentioned contraindications are present — that is, where the hernia has
been left too long — we must proceed at once to perform herniotomy,
which must be done under the strictest antiseptic rules.

386 HERNIAL RUPTURE

Herniotomy is, as a rule, a rather easy operation in the dog. It
may be performed in two ways: with or without opening the hernial
pouch. The former is especially used in recent eases of hernia with
wide orifices and in old cases of hernia wdth extended adhesion of the
hernial contents, where the whole mass is firmly fastened together. The
latter method of operation is used in cases of hernia which are not com-
plicated with a hernial pouch, in strangulated hernia with considci-alile
alteration of the contents, or with a very narrow hernial opening. These
conditions, however, are only distinguished during the course of the
operation, and we are then forced to change from the first to the second
method of operation. In both methods the skin of the operated region
must be shaved and carefully disinfected. We then lift up a fold of the
skin corresponding with the axis and the length of the hernia and split
it open with a longitudinal incision. This must be made very carefully
until we reach the hernial pouch. This is recognized by its irregular
surface, which is of a grayish-yellow color; also by the fact that it is
impossible to get an ordinary sound directly into the abdominal cavity,
and when the sac is pressed by the fingers, the hernial contents will
slip back, if the hernia is an old one, it is whitish-gray in color but if
strangulated, it is deep purple-red in color.

Having carefully dissected out the sac until it is completely sepa-
rated from the surrounding tissue, taking care not to injure the contents,
we follow one of the two methods before spoken of — that is, not opening
or opening the hernial pouch.

In the former case we introduce by means of the index finger a
probe-pointed bistoury or herniotome between the neck of the hernia
and its orifice, turning the cutting edge of the knife toward the neck or
restricted portion, the dull side of the knife being toward the hernia
pouch. By means of a very small incision the tension becomes greatly
relaxed, and reduction is easily accomplished. If the opening of the
hernial pouch is required, we hold up one of its folds with a pair of forceps
and split it by means of a knife held flat or a pair of scissors. After the
discharge of the fluids in the hernial sac a notch is cut in the hernial
pouch by means of the herniotome. The exposed loop of intestine is
reduced by the method just described, by cutting through the constricted
portion and working the intestine back in such a way that the portion
of the intestine which was prolapsed last must be reduced first.

If the intestine is much distended by gas, it may be emptied by
means of a puncture of a very fine trocar (or the canula of a large hypo-
dermic syringe). Any degenerated portions of the epiploon must be
amputated after being ligated. If the intestine is intensely inflamed or
gangrenous, we must either resect it or make an artificial anus.

After reducing the hernia we must close the hernial orifice. This is

INGUINAL AND SCROTAL HERNIA

387

forcibly drawn out and twisted round and round in a spiral direction, and
a single or doul)le ligature applied as high up as possible. In cases where
no hernial pouch is presented or it has been shoved back into the abdom-
inal cavity it is advisable to freshen the borders of the orifice by means
of a blunt knife or curette; then stitch it up by a continuous suture of
catgut. After thoroughly disinfecting it for the second time, the external

Fig. 126. — Scrotal hernia of right side.

wound is to be stitched and covered with an antiseptic dressing held in
position by niBans of a bandage (eight-tailed) around the body.

Inguinal and Scrotal Hernia.

{Hernia Inguinalis and Scrotalis.)

The inguinal canal of the dog is located in the abdominal muscles
with the seminal cord, and runs from the testicles into the abdominal
cavity. In the bitch we find a round ligament from the end of the Fallo-
pian tube toward the subcutis. Inguinal hernia may be produced by a

388 HERNIAL RUPTURE

portion of the intestine passing from the abdominal cavity into the
inguinal canal. If this is the case in the dog, and the loop of the intestine
goes as far as the scrotum, we call it scrotal hernia. If it simply lies in
the canal, it is called inguinal hernia.

Clinical Symptoms of Inguinal and Scrotal Hernia in the Male Dog.

This condition is very rare in the male; most cases are congenital;
the contents are generally small intestine and omentum. In an ordinary
case of inguinal hernia, we must understand that from the external
abdominal ring as far as the scrotum the canal is almost cylindrical,
and we find tnat when this canal is filled either with a loop of
small intestine or omentum it has a peculiar elastic softness and
"doughy" feel under the skin. There is generally no local increase
of temperature. In large hernias we may reduce this partially or alto-
gether by placing the animal on its back and holding up the hind
quarters and gently pressing or rul^bing with the finger upon the hernial
swelling. If the intestine has entered the scrotum (Fig. 126) , the affected
side appears full and large, and may be reduced by the manipvdations
indicated above. In hernias of this character the testicle is apt not to
descend into the scrotum, and is soft, immature, and can be distinguished
in the canal. The abdominal ring is found to be larger than natural.
In cases of strangulation the symptoms which have been descril^ed before
become apparent, and, if the symptoms are very acute and all attempts
at reduction are futile, we must perform the operation of castration.

Castration of the Male. — In normal conditions — that is to say, when
no hernia is present — castration of the dog must be performed by laying
the animal on his side, rendering all the parts aseptic, and holding the
skin tightly over the testicle, compressing it between the finger and
thumb. Then make an incision the entire length of the scrotum, cutting
through the scrotum, the tunica dartos, and tunica vaginalis, so that
the testicle is exposed (compare with Fig. 127).

The testicle is drawn out and then the common intersecting membrane
is opened up as far as possible by means of a pair of scissors; then place
a strong silk suture around the seminal cord, close up to the inguinal
ring, and ligate it. "When this is done, the seminal cord, with all the
superfluous portions of the interstitial membrane, is amputated aliout 1
cm. below the ligature. The other testicle must be removed in the same
manner. After carefully cleansing the wound with a strong non-irritant
disinfectant, the wound of the scrotum has to be closed Avith an ordinary
stitch, and it is advisal)le to place a small drain, like a silk thread, into
one of the corners of the wound. No dressing is recjuired provided the
animal is muzzled. Ilealing occurs generally within a few days. If,
however, we have a case in which we wish to operate for inguinal or

INGUINAL AND SCROTAL HERNIA

380

scrotal hernia, we deviate from the above-described method of castration
by ligating the intersecting membrane externally and as close as possible
to the external inguinal ring, having first twisted the sac several times,
the wound is sewed up and a bandage put on for several days. In valu-
able breeding animals the testicle of the affected side only is removed.

Inguinal Hernia in the Bitch. — This is generally observed in bitches
that have had puppies, although it has also appeared early in life from
no apparent cause. It is also congenital. Gutman saw a bitch three
months old that had an inguinal hernia. This condition is either lateral

Fig. 127. — Genital organs of the dog: 1, Scrotum opened; 2, right testicle; 3, body of the epididy-
mis; 3', globus major and, 3", globus minor; 4, spermatic cord; 5, vas deferens; 6, prepuce (partially
dissected); 7, free portion of the penis; 7', posterior attachment of the penis; 8, erectile masses (bulbous
bodies); 8', size of erectile masses when distended by blood.

or bilateral. The hernial sac in this condition is doul^le, the internal
being peritoneum, the external the skin and part of the mammary
gland. In a hernia of any size we find it invariably contains the
uterus, particularly when that organ is heavy with foetus, or other
abdominal organs, for instance the bladder, loops of intestine, or the
omentum. Cadeac found in a unilateral inguinal rupture the size of
a child 's head on the right side, the entire intestinal tract and on the
left side the omentum, the spleen, uterus and the bladder. An

390

HERNIAL RUPTURE

inguinal hernia in the l)itch if it is of any size is easily recognized (Fig.
128) . It is found in the posterior part of the mammary gland, an enlarge-
ment varying in size, elastic, painless, with no increase of the local tem-
perature. When the animal is placed on her back, it either returns to
its normal position by natural gravitation or else it is reduced with very
little manipulation. On the return of the contents of the hernial sac the
abdominal ring is found to be very much dilated above normal. In
rare instances it may be found impossible to reduce the hernia entirely,
and this is found to be due to certain adhesions of the abdominal contents
to the pouch or else to a pregnant uterus; in the latter case the fcBtus can

Fig. 128. — Inguinal hernia of bitch.

easily be detected by manipulation. In certain cases where there is a
doubt as to the exact nature of an enlargement in the position of inguinal
hernia, if it is the uterus in the sac, on introducing the finger into the
vagina, that is found to be elongated and deviated to one side, due to
the stretching and weight of the uterus, and it is also found that it is
impossible to reach the os uteri with the end of the finger. In very rare
cases when the round ligament of the uterus (false inguinal hernia) is
greatly hypertrophied, it might be possible to mistake it for inguinal
hernia. (False inguinal hernia.) As a rule inguinal hernia in the bitch
is rarely involved in strangulation, and if s^hc should be in whelp, she
has her puppies without trouble.

A bitch affected with inguinal hernia nuist be carefully fed, avoiding

UMBILICAL HERNIA 391

food that is hard to digest, or has a tendency to cause flatulence or to con-
stipate. If it becomes necessary to remove the hernia, either from size or
strangulation, herniotomy should be performed with the animal under an
anajsthetic, and operated on as already described (see Herniotomy).

Sarcocele. — This is a collective name for all kinds of tumors of the
testicles, especially for sarcoma, carcinoma, enchondroma, and cysts.
The testicles are swollen, the swelling, as a rule, being hard, tough, and
sometimes fluctuating; never warm or very painful. The condition
can only he remedied by castration.

Hydrocele. — By this we define an accumulation of fluid (serum) in
the scrotum. The affection is often associated with oedema of the lower
extremities and of the scrotum. It is frequently seen with ascites,
hydrothorax, etc., appearing in the shape of a fluctuating swelling of
the testicular pouch, Avhich disappears when the animals lie on their backs.

Therapeutic Treatment. — This consists of puncture and emptying
of the sac, also injection with any of the following stimulating fluids;
alcohol, Lugol's solution, carbolic acid (1 to 40), etc. Of course, these
are only to be used when castration is not performed.

A variety of hydrocele is seen where we have oedema of the spermatic
cord. This appears as a fluctuating swelling which may be easily moved
from one side to the other. It occupies the whole length of the spermatic
cord, and, as a rule, is never interfered with. When the fluid of the
hydrocele, which is discharged by puncture, consists of bloody serum,
we call it haemorrhagic hernia, or hsematocele. Any other complications
of the testicles and their membranes may be found on page 208.

Umbilical Hernia.

{Hernia U»ibiliculiti).

The hernia ring is formed by the umbilical ring. The contents
may consist of the omentum, duodenum, and in rare cases of the large
intestine. In the hereditary form the intestines are located in the
umbilical cord, and are not covered by the abdominal membrane (hernia
of the umbilical cord). In accidental hernia of the uml:)ilicus, we always
have a hernial pouch, originating from the peritoneum. As a rule,
umbilical hernia occurs a few days after birth. It may increase gradually
and beeome eventually strangulated, but it often disappears without any
surgical interference. Hernia of the omentum we see occasionally, but
generally it cures itself by an adhesion between the hernial pouch and
the hernial ring. Umbilical hernia is easily recognized (Fig. 129). We
find a swelling under the umbilical ring, which may vary in size from a
hazelnut to a walnut.

Therapeutics. — Treatment consists, as a rule, in very young animals,

392

HERNIAL RUPTURE

of the application of a bandage over the hernia and kept there for three
or four weeks, thus holding the abdominal contents back and allowing
the opening to close spontaneously. The bandage consists of a tampon
of lint which is fixed to a piece of rubber adhesive plaster or, better still,
the round top of a bicycle repair plug with the stem cut off, then adhesive
rubber plaster is placed in strips in a circle, as per Fig. 130. Before
applying the plaster it is wellto clean off the skin on the region of the

X-^UdiLJiiA^^^^

Fig. 129. — Umbilical hernia.

umlnlicus with ether or benzine to get better adhesion. Shoemaker's
wax is also used as an adhesive substance. It is best to put a strip band-
age around the body to retain the bandage in position.

Another more certain method is to place the animal on his back,
reduce the hernia; the hernial pouch is pulled away from the body, and
a needle carried through the centre of the base of the sac, the thread is
cut through at the needle and then each side of the ligature knotted,
dividing the tumor. Almost immediately the tumor dries and mummi-
fies, and in a w^eek or ten days falls off with the stitches, leaving a raw

Fig. 130. — Plaster on umbilical hernia.

surface which is painted with compound tincture of benzoin daily and
soon dries up. Care is to be taken to prevent the animal licking or
chewing the part until it is healed.

Injections of corrosive substances, such as solution of chromic,
nitric, or sulphuric acid, are not to be recommended, as likewise are
salves of cantharides, collodion, subcutaneous injections of absolute
alcohol, chloride of zinc or chloride of sodium.

FEMORAL HERNIA

393

Femoral Hernia.

{Hernia Cruralis.)

Femoral hernia is extremely rare in the clog. The ring is formed
by the upper end of the so-called femoral canal, and is formed by the
crural fascia, the external membrane forming the hernial covering. The
femoral canal of the dog is a long, three-cornered cavity in the median
surface of the upper part of the leg, which is surrounded front and back
by the inverted muscles of the upper thigh — that is to say, in front by
the sartorius muscle, and back by the long abductor, the large and short
abductor, and on its upper surface by the ilio-psoas, while the floor of
the cavity is formed by a portion of the muscles of the thighs and by the
crural fascia. Below the borders of the sartorius the abductors run
together at an acute angle (Fig. 131). This canal, as a rule, is filled with
masses of fat, nerves, and blood vessels. In cases of fracture of the
pelvis the intestines which leave the abdominal cavity, after having
followed the direction of the large blood vessels, locate themselves in this

Fig. 131. — Middle section through the pelvis, showing the organs: a. Pelvis; h, coccygeal vertebra;
c, broad pelvic ligament; (/, anterior and, d', posterior portions of the rectum; e, bladder; /, /, seminal
vesicles; g, fold of the peritoneum.

cavity and are covered by the peritoneum, the crural fascia, and external
membrane; but they may also under certain conditions penetrate
directly under the skin through an opening of the crural fascia.

In the inner fascia of the thigh we find a soft swelling which has
more or less pain when the condition is examined and the disease has
been of recent origin, and in cases of strangulation. In the latter cases,
however, we see also a peculiar dragging motion of the thighs, with
lameness and symptoms of intestinal obstruction, such as vomiting, etc.
Herniotomy has to be performed according to the rules mentioned

394

HERNIAL RUPTURE

before, but must only he attempted in extreme cases. In making incisions
into this region great care must be taken to avoid the large blood vessels
which pass into and through the femoral canal.

Perineal Hernia.

Perineal hernia occurs in both dogs and bitches. In the former it
is recognized by a peculiar bulging or lifting of the recto-vesicalis, and in

Fig. 132. — Double perineal hernia.

the latter by a bulging of the vesico-uterina. In both cases we observe
prolapse of the duodemmi or lower bowel, and sometimes in the dog we
observe a prolapse of the bladder.

In the dog we recognize perineal hernia by a soft swelling the size
of an egg or the size of the hand. This appears in the side and above
the anus, between the root of the tail and the tul^er ischii (Fig. 132).
In the bitch this hernial swelling is seen under the vulva and on the
peritoneum. This hernia can only be removed by means of an operation,
and unless it is either very large or shows indications of strangulation, it
had best be left alone. To operate the parts should be thoroughly
cleaned with antiseptic washes, the skin shaved, the animal etherized,
and an incision made in the skin, then the hernial sac is emptied of
its contents and ^the sac pulled out as far as possible, and ligated and
the free part of the sac cut off. In case there are adhesions between
the contents of the sac and the sac itself, the pouch must be opened and
the adhesions carefully torn away, and pushed back into the abdominal
cavity, the pouch ligated as already described.

DISEASES OF THE EYES.
AFFECTIONS OF THE EYELIDS.

Adhesion of the EyeUds. Ankyloblepharon.

It is a well-known fact that puppies are born blind — that is to say,
the palpebral fissure is closed at birth (atresia palpebrarum). This is
not a simple agglutination of the eyelids, but a true adhesion of the
membranes. This has been proven from the fact that if they are forcibly
separated after birth, the cornea has an opaque look and the edges of
the eyelids bleed. As a rule, the fissure opens in from seven to twelve
days. It is very rare that we have an obstinate closure of the eyelids.
If this should be the case, we try to produce separation by means of emol-
lients, tepid water, and normal tension upon the eyelids. If these are
not successful, the eyelids must be separated l)y means of a pair of scis-
sors or a probe-pointed curved bistoury. Then we rub the edges of the
wound with vaseline or, if they persist in uniting, with caustics, nitrate
of sdver pencil, in order to prevent an adhesion. In very rare instances,
as a consequence of traumatisms, burns or excoriations, we may find
more or less adhesion and narrowing of the lids (ankyloblepharon, bleph-
arophimosis) .

Entropion — Turning In (Inversion) of the Eyelid.

By this term we understand a turning or wrinkling of the eyelid in
such a manner that the edge of the lid is directed toward the eyeball
and the eyelashes come in contact with the conjunctival tissues and
cornea. Entropion occurs cjuite frequently, especially in bulldogs,
Newfoundlands, setters. Great Danes and spaniels, although it may be
present in all breeds. In some cases it is present at birth, or it may be
developed by constant convulsive closing of the fissure of the e)'e
(blepharospasmus) , due to some chronic in-itating conditions of the
cornea or conjunctiva (conjunctivitis chronica, conjunctivitis follicu-
laris). It is occasionally caused by cicatricial contraction of the con-
junctiva of the lid, after injuries, such as the result of caustic substances
getting in the eyes, burns, or some chronic inflammatory condition, or
to atrophy of the eyeball. The more relaxed the cutaneous tissue may
be in the neighborhood of the eyelid, the more obstinate the diseased

395

396

DISEASES OF THE EYES

condition is to treat. Haltanhoff considers that the tendency to entropion
is hereditary.

Clinical Symptoms. — As a rule, the inversion of the lid occurs more
frequently in the upper than the lower eyelid, but we may also see both
affected at the same time. Sometimes we see a lateral inversion of the
eyelid. This is extremely rare, however. A symptom observed is
constant irritation, which is caused by the hair of the lashes being
directed toward the cornea. We also see a marked increase in lachrymal
secretion, a twitching and convulsive compressing of the eyelids, and a
thick, gray, purulent mucus accumulates in the corners of the eyes.
The hairs of the eyelashes become adherent, and the eyelids may become
completely glued together. Besides this we see an intense inflammatory
condition of the connective tissue, and in some cases inflammation of the
cornea, and in extremely bad cases ulceration (ulcerative keratitis).

The prognosis may be favorable when we operate at the proper

Fig. 133. — Entropion operation of lower eyelid.

time, but relapses are not rare, especially in dogs which show a peculiar
wrinkled condition of the facial membrane. We may expect a relapse
in such cases where we do not entirely remove the conjunctivitis (primary
or secondary) at the same time as the entropion.

Therapeutics. — It is only in fresh and very mild forms of the disease
that we may expect to obtain any favorable results by means of medicinal
treatment, and this must be directed toward removing the conjunctivitis
which exists in conjunction with entropion, otherwise an operation alone
will answer.

The following methods of operation are suggested:
The best method is to carefully remove the hair and thoroughly
disinfect the surrounding tissue, and a fold of tissue running parallel to
the edge of the lid is picked up by means of a pair of entropion or ordi-
nary artery forceps, the fold of skin lifted ]:)eing sufficiently large to
make the lid lie in its normal position, care being taken not to include
the conjunctiva, and this fold is cut at the edge of the forceps; there

ECTROPION—TURNING OUT OF THE EYELID

397

must be at least 0.5 cm. between the edge of the wound and the edge of
the eyelid; the hemorrhage must be completely controlled before the
wound is closed with several silk sutures (Fig. 133). Where there is
extensive inversion of the lid, it is ])est not to attempt to remove too
large a portion of the lid, but divide it into two portions and equalize
the tension, as illustrated in the accompanying figure. The portion may
be removed either on the upper or lower lid, and also at the lateral
corner of the eye a portion in a vertical position can be removed, and in
extreme cases of entropion, all three excisions can be performed (Fig. 134).
Another method recommended by Schleich consists in removing a piece
of skin in the form of an arrow-head (see Fig. 135) and uniting the
edges with sutures.

Fig. 134.

Fig. 135.

Fig. 134. — Diagrammatic position of sections and mode of stitching in the operation for entropion.

(C. Miiller.)
Fig. 135. — Diagrammatic position of section in operation of entropion. (Schleich.)

The simple removal of the inverted eyelid by means of scissors,

is undoubtedly the simplest method, but it is very evident that not
only is the appearance of the animal very much impaired by it, but that
the eyeball may be constantly irritated and there is a constant flow of
tears on account of the insufficient closure of the lid.

Tying up small portions of the lid, by means of needles, or the
method recommended by Brennen of burning a series of lines on the lid
by means of thermo-cautery, which afterward heal and by cicatricial
contraction draw the lid back, are not as efficacious as the proceedings
first described.

Ectropion — Turning Out (Eversion) of the Eyelid.

This condition is, as a rule, in the lower lid, the free edge of the lid
being turned out from the eyel)all toward the external side of the eyelid.
This is generally noticed in bulldogs, St. Bernards, and setters, especially
so in animals that have sunken eyeballs. It may be due to an alteration

39S

DISEASES OF THE EYES

or partial paralysis of the palpebral muscles. Sometimes it may occur
from the shape of the cartilage, which does not consist of a firm disk, but
of bunches or collections of connective tissue mixed with elastic fibres.
In some cases it may be caused by a contraction of some of the tissues of
the face, especially from cicatricial contraction, as a result of wounds or
burns. It may also be due to a loosening or softening of the tarsal cartil-
age as a result of prolonged conjunctivitis.

Clinical Symptoms. — The affected eyelid is turned up and out, so as
to show the conjunctiva. The latter is inflamed from the action of the
air and is more or less reddened, and at the same time there is consideraljle
secretion of mucus and tears along the cheeks (lachrymal eyes).

Therapeutic Treatment. — If it is due to conjunctivitis, we must first
endeavor to I'educe it by ''touching" the connective tissue of the eyelid
with a pencil of nitrate of silver or sulphate of copper, or by removing a
portion of the mucous membrane of the lower eyelid. This, however

Fig. 136. Fig. 137.

Figs. 136 and 137. — Entropion operation and mode of .stitching. {Cadiot-Breton.)

is extremely hard to do, and as a rvile it is not advisable. If these
measures are useless, or if they seem doubtful from the onset, Moller
recommends to excise from the external half of the affected lid an
arrow-shaped or nearly triangular piece of skin and unite it by means of
sutures (Figs. 130, 137). Frick's method of excising two crescent-shaped
pieces of skin whose concavities are toward the lid and meet at an
angle, 2 to 3 cm. from the edge of the lid, and uniting the edges by
means of button sutures, has not been found to be as satisfactory as the
first-mentioned operation.

Inflammation of the Eyelids. Blepharitis. — This condition appears
as an inflammation of the external covering of the lid (B. superficialis),
inflammation of the cellular tissue of the lid (B. profunda), and inflam-
mation of the edge of the lid (B. ciliaris). Superficial inflammation of
the lid is generally caused by some irritation that involves the skin of the
surrounding tissues, such as eczema or parasitic mange, particularly

ECTROPION— TURNING OUT OF THE EYELID 399

sarcoptic or dermodectic mange (B. acarica). General inflammation
of all the structures of the lid is caused by direct traumatisms, bites,
tears from sharp objects, and is invariably accompanied with pro-
nounced tumefaction and subsequent suppuration; sometimes it may
even terminate in an abscess. Inflammation of the edge of the lid is
generally confined to the affected edge and is covered by a tenacious
purulent mucus that sticks the edges of the lid together; this secretion
varies in color, at first graj'ish-yellow, then light brown and finally dark
reddish-brown.

The treatment consists first, in frequent fomentations of boracic
acid solution, or strong infusions of ordinary tea, with a pinch of borax
in it, and the edges of the lid should be covered with ointment of red
oxide of mercury. General inflammation of the lid (B. profunda)
should be treated with warm fomentations and if an abscess forms it
should be opened as soon as it points. B. acarica is taken up under
parasitic skin diseases.

Hordeolum. Sty. — Sty is due to an inflammation of one of the
glands of the hair follicles of the eyelash or of a Meibomian gland. It
is indicated Ijy a small bright red globular tumor on the edges of the lid,
with more or less redness and tumefaction of the surrounding tissues.
It may be chronic (chalazion), but that is extremely rare.

The treatment consists in warm application of boracic acid solution
applied frequently, and if an abscess has formed it must be carefully
opened by means of a fine needle; forcil)ly squeezing the lid to evacuate
the contents does more harm than good. In chronic cases remove the
tumor.

Diseases of the Lachrymal Organs and the Membrana Nictitans. —
The lachrymal organs are very rarely affected in the dog. Inflammation
of the lachrymal duct generally appears as a secondary complication of
catarrh of the conjunctiva. It appears as a round circumscribed tumor,
which is immovably fixed in the corner of the eye, and on pressure a
cjuantity of mucus or muco-purulent fluid exudes from the lachrymal
opening. In acute inflammation of the duct, if the end of the duct is
closed by inflammatory processes, it is apt to break out through some
portion of the duct, which may discharge a muco-purulent fluid for a
time or else form a permanent fistula; this condition is extermely rare,
and occasionally we may find that an abscess at the root of one of the
molars has caused a fistulous opening near the canal; careful probing
with a sound will generally enable one to make a correct differential
diagnosis.

Stenosis and obstruction of the lachrymal canal is due to inflamma-
tion of the mucous membranes, traumatisms, foreign bodies, tumors.
Closure of the opening of the canal is indicated by the constant flow of

400

DISEASES OF THE EYES

tears from the internal angle of the eyes, irritation of the skin, and loss
of hair below the opening.

Hypertrophy of the lachrymal canal is duo to various inflammatory
processes or neoformations.

The treatment of closure of the lachrymal canal is a very difficult and

Fig. 13S — Protrusion of the membrana nictitans.

delicate operation to handle. It consists in trying to establish a new
opening into the nasal cavity and direct the tears into it.

Diseases of the Membrana Nictitans. — Irritation of this organ may
result from various pathological processes which affect the conjunctiva, the
membrana nictitans being covered on both surfaces by that membrane.

Fig, 139. — Removal of the membrana nictitans.

Follicular conjunctivitis frcqviently causes the formation of various sized
nodules (hypertrophied follicles) round bodies about the size of a millet
seed, deep red in color, and may sometimes produce a tumor which is
visible in the internal canthus of the eye. When the memlirane is
picked up and examined by means of a pair of forceps, and enlargement
of the meml)rane is indicated by a pink red tumor in the internal corner
of the eye, which moves over the eyes on slight pressure on the eyeball;

INFLAMMATION OF THE CONJUNCTIVA 401

this tumor not only originates from follicular conjunctivitis, but from
traumatic causes and neoformations such as adenomas of Harder's gland,
lipomas or papillomas. A prolapse of the membrane without any hyper-
trophy is seen frequentl}' in St. Bernards, retrievers and mastiffs, when
the enlarged membrane lying over the eye gives the animal a sleepy look-
ing eye, or ''dead eye" (see Fig. 138).

Treatment. — Astringent washes of boracic acid, zinc, lead, etc., may
reduce this irritation, but, as a rule, if this hypertrophic condition of the
membrana nictitans is once established, removal of it by surgical means
is the only way to establish a permanent cure. The eye is first treated
by a few drops of 4 per cent, solution of cocaine, and then the enlarge-
ment is seized by a pair of forceps and by means of curved scissors
clipped off (Fig. 139). Putting a thread through the tumor by means
of a curved needle enables the operator to make a much evener removal
of the tumor and is preferred to holding it with forceps by some operators.
The hemorrhage is insignificant and is controlled in a few minutes. If
it should persist for some time, put a few drops of acetate of lead solu-
tion on the eye and keep the lid closed for a few moments by means
of a pledget of cotton.

DISEASES OF THE CONJUNCTIVA.

Inflammation of the Conjunctiva — Conjunctivitis.

{Co nj uncti vitis; Sy ndcs »! it is . )

Inflammatory conditions of the conjunctiva are the most frequent
affections of the eye in the dog, and appear in various ways according
to their cause. Under ordinary circumstances we see the development
of a simple catarrh of the conjunctiva, which, like all catarrhs of the
mucous membrane, causes swelling, great redness, and formation of loose
folds of tissue. The redness may vary from a slight injection to a dark
or bluish-red coloration. This is, as a rule, regular and rarely spotted
with blood extravasations. The secretion of the mucous membrane is
sero-mucous in the beginning, but later on becomes muco-purulent, and
in some cases there is a peculiar grayish secretion. This secretion becomes
agglutinated to the interstices and corners of the eyelids, producing a
gluing together of the lashes, and during the night, when the animal is
asleep, it dries up, forming a grayish-yellow adhesive mass. The inflam-
mation is usually restricted to the conjunctiva of the lid, the transition
fold and the bulb of the conjunctiva being very rarely affected. The
follicles of the connective tissue are generally swollen in all prolonged
forms of catarrh of the eyes. Sometimes they protrude here and there

402 DISEASES OF THE EYES

from the reddened connective tissue in the shape of a millet-seed or a
sago granule.

In cases where the irritation is due to the influence of some infectious,
pathological microorganism or bacteria, which are always present on
the conjunctival membrane, we notice a marked cellular infiltration of
the tissues of the mucous membrane, with proportional swelling of the
connective tissue, and the production of a copious thick, yellowish-green
secretion. Under the influence of chemical irritants we have the forma-
tion of grayish-white or transparent membranous accumulations upon
the surface of the mucous membranes, and sometimes ulcers which may
lead to trichiasis (turning in of the hair of the lashes toward the bulbs;
the mildest form of entropion). In some cases it may cause a natural
entropion or symblepharon adherence between the lid and bulbs of the
conjunctiva. The cornea and the conjunctiva being in such close
proximity to each other, an inflammatory process in one is very apt to
produce a similar condition in the other.

The following forms of conjunctivitis are observed in the dog:

Catarrhal Conjunctivitis {Conjunctivitis Simplex). — By this we mean
an acute catarrh with intense redness and loosening of the conjunctiva,
also copious mucous or muco-purvdent secretion. The local disturbances
do not seem to be very marked, but we see in rare cases irritation with
itching, the patients attempting to rub their eyes with their paws.

Etiology. — Catarrh of the eyes may occur at any period of the
animal's life, and, as a rule, affects both eyes; in very rare instances only
one. It is generally the result of exposure to cold or the influence of
sharp, cold winds. It is, .therefore, apparent why it appears at certain
seasons of the year more than at others, that is, in the spring and fall.
Mechanical and chemical influences also produce a certain effect, such as
foreign bodies (dust, hair, etc.), turning in of the eyelashes (trichiasis),
smoke of soft coal, etc.

Catarrh of the conjunctiva is intimately connected with catarrh of
the respiratory organs, such as nasal catarrh, distemper, and all serious
internal diseases which have a prolonged course.

Symptoms and Course. — Pain and t^\4tchingof the eyelids, which is
more pronounced if foreign Ijodies are present in the conjunctival mem-
brane. In the early stages there is aslight increase of the flow of tears, later
it becomes mucous and finally we observe a muco-purulent discharge
which is very tenacious and frequently the eyelids stick together, the
discharge frequently flowing down the face, and the conjunctival mem-
brane becomes greatly swollen and injected. This condition may become
chronic, lasting in a modified form the whole course of the animal's life.
Frequently there is intense itching, causing the animal to continually
scratch the affected eyes with his paws, and rub them on the ground, pro-

INFLAMMATIOy OF THE CONJUNCTIVA 403

diicing consideral)le increase of the irritation already present. When
the atiection extends to the cornea, it may become opaque, and in more
severe cases cause uh-eration of the cornea (see Keratitis).

Conjunctivitis follicularis of the membrana nictitans is a variety of
this disease (catarrhal conjunctivitis) that is generally chronic. This
is indicated by the appearance of large numbers of lymphatic follicles
upon the internal surface of the membrana mictitans. These follicles
stand out distinctly in the form of millet-seed bodies upon the surface
of the meml^rane. They are dark red and transparent, consisting of
ball-shaped accumulations of lymphoid cells. Soon they appear in
numerous masses, giving the membrane the appearance of a granulating
M-ound surface, and in such cases the membrana nictitans is pushed out
from the bulbous and extended over the cornea. The ciuestion whether
this condition is a form of follicular conjunctivitis or it is to be accepted
as a disease sui generis, we have not been able to determine fully, but we
know that the presence of numerous lymphatic follicles prolongs indefi-
nitely the course of a case of conjunctivitis. We ought, therefore, to
always expose the membrana nictitans by means of a pair of forceps;
evert the mem1)rane and examine it to see if there are any enlarged
follicles, or a foreign bod}^ present, especially in catarrh of the conjunctival
tissue. According to Frohner, 40 per cent, of all dogs are affected more
or less by conjunctivitis follicularis.

Purulent Conjunctivitis; Conjunctival Blennorrhoea.

Etiology. — It is generally admitted that this disease is due to a
specific infectious organism developed in the course of some epizootic
disease, particularly distemper, and a specific form of this disease may
occur as an epidemic, the cause of which up to the present time has not
been definitely described. It is possible to produce the same form of the
affection by inoculating the conjunctiva of a healthy dog with this
purulent material. Guilmot observed that by placing dogs in a kennel
which had been previously used by a dog affected with, this disease that
they soon became similarly affected, and it has been found to be carried
by the benches where dogs are exhibited. Frohner has seen it in
many cases of distemper, and thinks that the development of this form
of conjunctivitis is due in all probability to the transmission of gonor-
rhceal secretion from a human being placed on the conjunctiva of the
dog. Guilmot says that gonorrhoea! secretion of the dog itself is the
cause of this disease, but this assertion is combated by Moller whose
experiments with secretions of preputial gonorrhoea in the dog have
always given negative results.

This form of conjunctivitis is marked by considerable swelling of
the membrane. The membrane is sometimes spotted red b3' hemorrhages;

404 DISEASES OF THE EYES

there is sensitiveness to light, and jDhotopholjia, the animal constantly
winking or convulsively closing the eye. The secretion of the eye is
changed into a muco-purulent mass, becoming filled with a thick,
yellowish-green fluid mixed with pus, which agglutinates the lids, partic-
ularly during the night, when the animal is asleep, and there is great
itching and irritation causing the animal to rub the eyes continually
with his paws, and in this condition complications of the cornea are
generally present. The latter becomes cUdl in the centre, showing ero-
sions in some cases. This capacity of the cornea gradually increases,
becoming darker, more opaque, and then taking a yellowish-gray colora-
tion. We may see in some cases, ulceration of the cornea (see Keratitis).
A common occurrence is to find eczema of the eyelid and the skin around
the eye.

This blennorrhoea of the conjunctiva is a rare and dangerous disease,
causing extensive inflammation and ulceration of the cornea, the con-
dition being prolonged in some cases from four to eight weeks, and in
extremely bad cases the eye is apt to be destroyed.

Therapeutic Treatment of Conjunctivitis. — If the disease is produced
by foreign bodies, an eruption, etc., or caused by trichiasis or entropion,
we have to remove the cause first. If we have to deal with dirt, coal
dust, or small bodies, it is sufficient to wash out the eye with a little soft-
rubber syringe. If the bodies are adherent, such as iron fragments,
sand, etc., accompanied by convulsive movements of the lids and intense
secretion of tears, we must apply a certain amount 4 per cent, solution
of cocaine to the eye, remove the foreign bodies, or wipe them off by
means of a blunt probe or sound covered by a handkerchief or cotton.
Then keep the animal away from strong light, smoke, etc.

First, foment the eye thoroughly with boracic acid solution, and to
thoroughly clean the eye the membrana nictitans must be lifted, as that
membrane is pulled down close on the eye as soon as the fomentation is
started; the eye must, however, always be cocained previous to doing
this, as the membrane is too sensitive to do it otherwise. The cocaine
solution can be applied by means of an atomizer.

I^. Cocaine muriate, 0.25

Aqua distil, 5.0

Sig. — A few drops in the ej'e.

I^. Acoin, 0.1

Aqua distil, 10.0

Sig. — A few drops in the eye.

In catarrhal conjunctivitis we must use astringents, such as sulphate
of zinc, sulphate of copper, or nitrate of silver. These solutions must
be used mild, such as 0.2 to 0.75 per cent. They may be applied by
means of a camel's hair pencil or atomizer put between the lids and

INFLAMMATION OF THE CONJUNCTIVA 405

washed off in a short thiie with clean water; or we may apply nitrate of
silver, following it up a few minutes afterward with a 2 per cent, solution
of chloride of sodium. Alum solutions are also useful for washing or
painting the inflamed membrane. In pronounced photophobia we may
paint the conjunctiva with a solution of cocaine or tincture of opium and
gum arabic. In chronic cases apply ointments of calomel, 10 to 20 per
cent., oxide of mercury, 3 to 5 per cent. It is not well to keep up too
long with one preparation, but substitute another drug after a certain
period has elapsed.

In chronic catarrh of the eyes a very effective method of reducing
the irritation is to blow small quantities of calomel directly on the
membrane. Follicular conjunctivitis may be treated with astringents,
but in the acute forms which occur on the surface of the membrana
nictitans we can only remove them by surgically removing the membrane.

]^. Zinc sulphate, 1.0

Acid boric, 3.0

Aqua distil., 150.0
Sig. — Eye drops.

I^. Argenti nitras, 0.1

Aqua distil., 10.0

Sig. — A few drops in the eye for several days.

I^. Hydrarg. sesquioxide, 1.0

Ung. petrolati 4.0

M. F. ung.

Sig. — Apply to the edges of the lids twice daily.

The influence of cocaine upon the conjunctiva and cornea renders
these parts insensitive and permits a number of small operations without
producing any feeling of pain or convulsive irritation of the eyelid. We
pour a little 5 per cent, solution of cocaine into the eye and obtain in
this manner, in from two to three minutes, an absolute insensibility to
pain, both in the cornea and conjunctiva. This does not, as a rule,
last more than ten minutes and must therefore be renewed every five
minutes if necessary. In order to reduce blepharospasm, as a conse-
quence of conjunctivitis, we should apply s lutions of cocaine every two
or three hours. In the milder forms of follicular conjunctivitis that is
seen on the inner surface of the membrana nictitans, the stronger solu-
tions of sulphate of zine, sulphate of copper, or nitrate of silver are used.
It is best to apply a solution of cocaine to the eye and then lift up the
membrana nictitans and apply the solution directly to the inside sur-
face of the membrane by means of a camel 's hair brush. These cases
are generally very obstinate to treat and it is best, when after some time
the condition does not improve, that the membrana nictitans be removed

406 DISEASES OF THE EYES

by surgical means (see i)age 401). This operation invarialjly removes
the irritation.

In ophthalmic blennorrhoea we must endeavor to prevent it before
it goes too far, particuhuiy if it appears as an epizootic. We must treat
it with antiseptic agents, and it is especially important to keep the con-
junctiva clean with water or some non-irritating antiseptic fluid, such
as boric acid, 3 per cent.; corrosive sublimate, 0.02 per cent.; perman-
ganate of potassium, 0.05 per cent.; creolin, 1 per cent.; salicylic acid,
1 per cent.; carbo-sapo-cresol or lysol, 1 to 100. These must be intro-
duced under the lid l)y means of a syringe, brush, or sponge. "When it is
necessary we must irrigate the eye with strong solutions of nitrate of
silver (1 to 3 per cent.) , taking care to observe the rules already mentioned,
that is, neutralizing the silver solution b}" means of salt solution. A
solution of itrol 1 to 4000 has been found very useful in these cases.
Covering the conjunctiva with calomel, dermatol, tannoform, is also
useful. This is applied by means of an insufflator or blown through a
cylinder of paper or a c{uill. Aniline (pyoktanin), advised by some
authors, is of little benefit.

The treatment may also be materially altered ])y complications of
the cornea, for which we would refer to Keratitis for further details.

Neoformations on the Conjunctiva.

Beside the inflammatory condition which has just been described,
we may have tumors, fibromas, papillomas and lipomas of the conjunc-
tiva, but, as a rule, these occur on the membrana nictitans. Thej^ are
generally painless, sometimes extending over the eye and preventing the
closure of the eyelids. A peculiar case of hair formation has been
observed by the writer, situated in the conjunctiva of the upper lid, in
which a tuft of long, white, silk-like hair grew out of it, and a few isolated
hairs in the vicinity of the spot. On examination the hair spot was found
to contain hair Indbs, sel)aceous and sudoriferous glands. It was found
that several animals of the same strain in that breed had similar anomalies.

DISEASES OF THE CORNEA.

Inflammation of the Cornea.

(Kcratiiis).

Notwithstanding the fact that the corneal coat does not contain
any blood vessels, it is frequently the seat of inflammatory processes
which become present through a pericorneal injection due to intense
irritation of the blood vessels which surround the border of the cornea,
and further by an opacity of the cornea forming an obstruction that
prevents the admission of rays of light into the eye itself. This clouding
or opacity may extend over the entire cornea, or it may only involve a

DISEASES OF THE CORNEA 407

small portion. It varies in color from a grayish-blue to a pure gray. It
is yellowish-gray in some cases (purulent inflammation), but never
pure white in color. On careful examination it seems to 1)e diffuse,
forming spots or stripes. The lustre of the membrane is dull on its
surface and a partial loss of the epithelium is noticed. The other symp-
toms are avoidance of light, convulsive movements of the eyelids, and
discharge of a thin watery mucus from the corner of the eyelids, visual
deficiencies, and in some cases the animarl may be partially or even
totally blind. This is especially seen when the opacity of the sclerotic
membrane is in the region of the visual line that is opposite the pupil.

Pathological Anatomy. — We have in other cases of keratitis the
appearance of large quantities of round cells in the corneal tissue. These
come from the blood vessels of the neighboring membranes, the sclerotic
membrane, and the conjunctiva. These are wandering cells which find
their way into the cornea. As long as the round cells in the cornea are
not crowded together it remains unaltered in its true structure (in-
filtration of the cornea), and complete recovery follows after the cells
have disappeared. But as soon as the cells are packed too closely to-
gether the corneal tissue is partially destroyed by maceration and ne-
crosis, followed by a loss of actual substance. If this is surrounded by
intact tissue of the cornea, it forms an abscess; if it is open externally,
it forms an ulcer. We consider as ulcers, small superficial openings in
the cornea which are always round in the early stages, and are caused
by infiltrations located closely under the epithelium, forming little
blisters or sacs, and finally bursting through the epithelial covering.
In the dog, as a rule, they heal without leaving any cicatrix. Still,
many cases are seen where they finally close up, leaving a white cicatrix,
or else they lead to perforation of the cornea or to a total destruction
of the eye by extending into the anterior chamber.

We find the following forms of inflammation of the cornea:

(1) Keratitis Super ficialis. — Etiology. — Superficial inflammation of
the sclerotic membrane is caused by slight irritations of various kinds
(superficial injuries, inversion of the eye-lashes (trichiasis) or entropion).
It may also originate, secondarily, from acute conjunctivitis, the in-
flammation extending from the conjunctiva to the cornea, irritating
eye washes or salves, or from foreign bodies. Keratitis superficialis
may also appear as a secondary symptom of distemper, but generally
in this case the entire parenchyma is involved.

The cornea is clouded, opaque and lustreless, having a diffuse
grayish-blue or grayish-white coloration, with a slightly irregular surface,
but under certain circumstances it may also be covered with small
epithelial masses, easily distinguished with the naked eye. In this
affection the eyes are watery, which may disappear in a few days

408 DISEASES OF THE EYES

or last for weeks. In the latter case we observe the formation of blood
vessels at the border of the cornea and the sclerotic membrane. These
blood vessels increase in size and the edges become very vascular, and
during vascularization of the cornea it is not rare to see hemorrhages
in that tissue followed by a number of brownish-black pigment spots,
and occasionally the cornea remains permanently opaque and even
vascular. Froehner describes a superficial purulent affection of the
cornea as an effect of purulent keratitis or as a secondary symptom of
distemper; this is indicated by a roughened appearance of the cornea,
and a yellowish opacity of the cornea due to pus corpuscles.

Therapeutics. — The treatment is the same as in inflammation of
the conjunctiva — that is, washing and painting with a solution of sul-
phate of zinc, corrosive sublimate, alum, or sulphate of copper, boracic
acid, or the oxide of mercury salve; where there is great pain and photo-
phobia use solutions of cocaine or acoin. Avoid all use of lead solutions
in such cases where there is any loss of substance of the cornea, as the
lead is deposited in the ulcer and produces black-colored spots which are
permanent. If there is any ulceration, we must apply the therapeutic
treatment as indicated in ulcerative keratitis, and in cases where the
spots on the cornea remain use the treatment given under the same
heading.

Peritomy. — This operation is recommended in pannus, that con-
dition where there is vascularization of the cornea, and after massage,
stimulating salves and hot-water compresses have been tried and failed.
The animal must have a few drops of a 4 per cent, solution of cocaine
put into the eye, and the lids held back by an assistant; then the affected
surface of the cornea is carefully scarified, or curetted by means of the
edge of a sharp knife. Great care must be taken to hold the knife at right
angles to the eye, as the slightest slip or struggle on the part of the animal
misplacing the position of the knife will cut through the cornea. The
surface must be carefully scraped until all of the vessels are removed from
the surface of the cornea. Frick recommended making a direct incision
in the cornea. He fixes the eye and by means of a very sharp knife, pares
off the aljnormal formation, even cutting down half through the body of
the cornea, treats it with boric acid solution, and generally has a cure
in a few days.

(2) Keratitis Profunda or Keratitis Parenchymatosa. Deep Paren-
chymatous Inflammation of the Cornea. — This affection may be circum-
sicribed or diffuse. In the former it is due to some external traumatism
directly on the corneal membrane; in the latter, the diffuse condition is
due to some infectious disease such as distemper, or, in certain cases,
fever is the only other symptom present. The surface of the cornea
has an opaque, dull, slightly grooved condition, the color bluish-gray

DISEASES OF THE CORNEA 409

or gray, rarely grayish-white, either covering the entire cornea or only
certain portions, accompanied by watery eyes, sensitiveness to light
(but only to a slight degree), and also the formation of new vessels
which extend from the borders of the cornea toward the centre. In the
keratitis of distemper the opacity covers the entire eye, and is blue-gray
or even milky in color. Abscesses and ulcerations, as a rule, are rare.
This form, however, must not be mistaken for ulcerative keratitis. In
mild cases the opacity may disappear without leaving any trace; in
more severe cases it may run a protracted course, with vascular infiltra-
tion from the border of the cornea. These cases are very difficult to
treat, running on sometimes for months and at times resist all forms
of treatment, in some cases terminating in ulceration (see Keratitis).

The course of this disease is generally favorable. After several
weeks the dulness disappears and the new vessels become thinner, dis-
appearing entirely in a short time.

Therapeutics. — We attempt to remove the irritation to a certain
extent by applications of compresses. Also irrigate with warm w^ater or
boric acid, and drop atropia into the eyes. Bandages over the eyes.
If the inflammatory symptoms are reduced, we then follow it up by
stimulant irritants, such as calomel powder or ointments of red oxide
of mercury. As to massage of the cornea and treatment of ulceration see
Keratitis.

(3) Abscesses of the Cornea. — Etiology. — Abscesses of the cornea
appear after some traumatism, especially contusions or bruises of the
membrane, also after non-septic operations, in connection with blennor-
rhoea or conjunctivitis, or during distemper, and very frequently appear
without any appreciable cause, which some ascribe to lymphatic in-
fection.

When there is intense dread of light and great increase of tears,
and when we see a pericorneal injection and the cornea colored a gray,
yellow, or straw-yellow, and a certain spot on that part which is sharply
defined from the tissue of the normal cornea, or it is surrounded by a
more or less dull zone, we then can safely conclude that it is the com-
mencing formation of an abscess. Its location varies; sometimes it is
on the edge of the cornea, at other times in its centre; then, again, we
may find it close to the surface of the membrane or deep in the centre of it.
It may be very small in dimension, such as the size of a pin-head, or it
may even include the whole sclerotic membrane.

The course varies also. In small abscesses it may disappear by
simple absorption, while in large ones the acute inflammation subsides,
frequently leaving an intensely white spot, or it may break out exter-
nally, forming an open ulcer. This latter conclusion, or termination, is the
most common, and in rare instances it may break in a posterior direction

410 DISEASES OF THE EYES

toward the anterior chamlier of the eye, causing an accumulation of pus
in it (hypopyon) and producing further infiammatoiy processes in the
internal part of the eyeball.

Therapeutics. — This is closely related to that of ulcerations of the
cornea — that is, to open, puncture, or cauterize the abscess after first
using cocaine in the cornea. It is then dried with corrosive suljlimate
or iodoform gauze antl washed out with a solution of corrosive subli-
mate, and afterwards dusted with calomel until it dries up; in certain
cases touching the edges with the actual cautery seems to bring about
jjrompter resolution.

(4) Ulceration of the Cornea. — Ulcus Comeae. — This results from
traumatisms, irritations, and an accompaniment of distemper; it also
appears in diabetes mellitus and certain breeds, such as toy spaniels and
Boston terriers, seem to be prone to it, with no appreciable cause; ap-
parently it is due to a certain cachexia and after maceration or necrosis
of the corneal epithelium, as a consequence of blennorrhoea of the cornea.
In this condition we find a loss of substance in the cornea which vaiies
in size and depth, showing a grayish-white or grayish-yellow ground, and,
as a rule, has short, abrupt liorders with a bluish-gray, gray, or grayish-
yellow opacity in the immediate neighborhood of the ulceration and
accompanied by great dread of light; the eyelids are practically closed
and the membrana nictitans drawn over the eye. "When the ulceration
of the cornea begins to heal it is indicated by a lessening of the infiltra-
tion in the immediate neighborhood of the ulcer, the dull circle sur-
rounding it becomes clearer, the pericorneal injection less, and the
dread of light begins to disappear. In rare instances blood vessels
will shoot from the edge of the cornea toward the ulcer, and the cornea
in appearance very much resembles the normal tissue of the sclerotic
membrane. If the ulceration has not been veiy deep, the dulness
gradually disappears, leaving only a very thin white veil of opacity; or,
if the ulceration is deep, we have as a result a distinct white spot which
remains permanently (cicatrix of the sclerotic membrane, macula cornea).
This cicatrix of the membrane may become clearer in the course of time,
but, as a rule, it never disappears entirely. AMien the ulcer does not
take a favorable termination we find the inflammation increases, the
ulceration becomes deeper, reaches the membrane of Descemet, and we
have a perforation of the meml)rane in a few days. The contents of the
anterior chamber escape through the opening, and in rare instances
the iris and the lens push forward and maj' also protrude if the opening
is large enough. After jiorforation occurs the ulcer begins to heal, and
we are very apt to have an adhesion of the iris and lens to the posterior
wall of the corneal membrane, the pupil is drawn to the edge of the
cicatrix and the sight greatly impaired. In othei- cases where the opening

DISEASES OF THE CORNEA 411

of the ulcer is very small the anterior chamber fills up again, is forced
forward, forming a clear bladder-like body, forming corneal prolapse or
dropsy of the cornea (keratocele). If the ulcer is large, the membrane of
Descemet pushes throvigh the ulcer from internal pressure and the whole
ground of the ulcer becomes embossed — that is, it stands out from the
surrounding membrane. As a consequence of perforation of the cornea
we may have a series of alterations to the iris. Externally the iris,
which is drawn into the orifice, becomes covered with cicatricial tissue,
and by its contraction forms a lobule of the iris. This finally contracts
into a peculiar club-shaped body over the anterior surface of the mem-
brane (iris staphyloma), ^^'e must not confound this condition with
staphyloma pellucidum, by which we mean a change of form in the
corneal membrane, due to a non-inflammatory condition, where
it becomes more or less opaque and is forced outward in the shape of a
grape-like body by the dropsical condition of the anterior chamber.
"When there is great irritation of the corneal membrane, in some cases
we ma}' have a prolapsus of the lens, and the whole eye]:)all subsequently
collapses, forming an opening in the centre of the eye which finally
becomes closed up by a whitish-gray cicatrix.

Besides the causes alread}' mentioned in the formation of abscesses,
the following also produce them: cauterization, foreign bodies which
adhere to the membrane, wounds in some cases, etc. This disease
may appear in the epizootic form with or without distemper, and gen-
erally in connection with blcnnorrhoea of the whole eyeball (purulent
panophthalmitis) .

Prognosis and Therapeutic Treatment, — The prognosis depends to a
large extent on the irritation of the ulcer and the rapidity of its progress.
Ulcers which are small and located on the borders are easier to treat
than those which are larger and located in the centre of the cornea. In
weak, badly fed young animals and in pugs the prognosis is more un-
favorable than in healthy adult animals.

The treatment requires cleanliness and strict antiseptic remedies.
The use of a dressing is of great advantage, but few dogs can be made to
submit to one. In canine hospitals, as a rule, they use a specially
constructed leather cap; it is not to be used except in extreme cases,
where it is impossible to keep the animal from scratching or rubbing the
eye. It is always well to leave the affected eye without covering, as all
bandages or covei'ings are apt to press on the eye and cause intense
pain, which irritation the animal generally increases by rubbing or pulling
constantly at the covering. The various antiseptic agents which are
used are corrosive sublimate, 1 to 2000, or chlorine water (either pure or
mixed with two or three parts of water), to be applied with a brush and
calomel powder blown from a ciuill directly on the eye. The writer has

412 DISEASES OF THE EYES

obtained very satisfactory results with hot fomentations of boric acid
(3 parts to 100). These shoukl be applied three times daily, ten minutes
at a time. They are far better than cauterizations with nitrate of silver
or painting with pyoktanin.

Besides the antiseptic treatment we can use atropine or eserine
solution, of which a few drops are put in the eye. The first-named
agent should be applied when the ulcer is located centrally, as it dilates
the iris, and consecjuently the pupil is enlarged, and the latter when
the ulceration is located on the borders as it contracts the pupil and
draws it away from the seat of irritation. There is an objection to
atropine in that it increases the internal pressure by widely dilating the
pupil. The iris is dilated or contracted by these drugs and removed
from the neighl^orhood of the ulcer, so that if the perforation does not
occur the iris will be drawn far enough out of the road to prevent any
adhesion.

Good results have been obtained with cocaine, alternating with
atropine :

J\. Atropine sulphate, 0.1

Aqua distil., 10.0

M. S. In order to produce a dilatation of the pupil we
must introduce five drops of this remedy into the
conjunctiva, drop by drop, by means of a brush or a
dropper.

I}. Eserine salicylate, 0.05

Aqua distil., 10.0

When a keratocele is developed we may prevent rupture by punc-
turing the membrane with a needle and allowing the water in the chamber
to escape. In prolapsus and adhesion of the iris we can do very little,
as it is impossible to push back the iris into place. We must dust the
protruded portion with calomel; at the same time we may reduce the
enlargement by means of nitrate of silver or sulphate of copper solutions,
or a powder of oxide of mercury blown on the eyeball. In iris staphy-
loma, where the tissue does not wedge and contain a portion of the con-
tents of the anterior chamber, the eye may be cocained and by means
of a very sharp pair of scissors the staphyloma may be carefully cut
down; if, however, the protruded portion is filled with the fluid portion
of the anterior chamlier, a threaded needle is carried through the centre
of the protruded portion and the thread cut at the needle and thus
making two ligatures which are tied right and left dividing the enlarge-
ment into two poi'tions, the ligatcd portion of the cornea will dry and pull
off in a few days with the ligatures, leaving a surface which dries up very
quickly with the ordinary antiseptic treatment.

DISEASES OF THE CORNEA 413

"We must try to remove any spots on the sclerotic membrane l)y
means of irritants, such as the mihl chloride or oxide of mercury or
massage. According to Bayer, massage of the cornea has to be per-
formed in the following manner: The points of the fingers are placed on
the closed-up eyelids and by a constant circular or centrifugal friction
move the eyelid for sometime. In some cases we may also apply the
above-mentioned ointments and powders. The writer has obtained
far the liest results from calomel than anything else. He placed daily
a small amount of powder composed of equal parts of calomel and sugar
(grape sugar) on the cornea and massaged the eyelid for ten minutes.
Very good results by painting the enlargement several times daily with a
solution of pyoktanin (1 to 100).

The following alterations are also seen in the cornea of the dog:
Dermoid of the Cornea. — This condition has already been de-
scribed under neoformation of the cornea. We find a peculiar ab-
normal collection of true epidermal tissue on the cornea Avhich is covered
with hair and interferes with the direct action of light, and also produces

Fig. 140. — Dermoid of cornea.

irritation in the cornea and conjunctiva (Fig. 140). The hair should
be cut off by means of scissors. Thierry observed the same a]3normality
on the sclerotic membrane of both eyes in a three months' old dog.
There was a slight swelling and enlargement above the surface of the
membrane which was covered with fine hair.

The treatment consists in the removal of the almormality, the eye
is cocained, the dermoid is lifted with a pair of fine curved forceps and
removed by means of a pair of curved scissors. An opacity of the cornea
follows as a result; no attempt should be made to remove this for at
least two months, as any friction or manipulation shortly after the
operation is apt to set up great irritation. In removing the dermoid
great care must be exercised not to cut entirely through the cornea and
allow the escape of the contents of the anterior chamber; if any part of
the dermoid seems to involve the deep structure of the cornea, it had
better be left alone. French advises that during the operation a stream

414 DISEASES OF THE EYES

of -u-arm water should run over the eye to carry off the blood and
facilitate the operation.

Pterygium. — By this we mean a more or less triangular proliferation
of the connective tissues containing numerous blood vessels and branching
over the cornea toward the centre. This growth is very loosely connected
with the corneal structure and can be removed by means of caustics or
by an operation; the animal is narcotized or the eye cocained, the growth
seized by means of a pair of curved forceps, raised from the surface of the
globe, and carefully dissected out, and the hemorrhage controlled by
astringents.

Injuries to the Cornea. — It is not uncommon to observe injuries to
the cornea of dogs where the epithelium is slightly injuried or where there
is a deep penetration of the membrane or it is entirely perforated, such
as injuries from cats' claws or sticks mischievously pushed into the eye
or from the lash of a whip. Immediately after the injury we observe a
great fear of light, closing of the eye, and copious tears. Wounds which
have not entirely perforated the cornea are rapidly followed by an
opacity and swelling in the neighborhood of the injury. When the
membrane is perforated the symptoms and results are very similar to
ulceration. Superficial or very small wounds which penetrate deeply
heal ver}' quickly after a few days, leaving scarcely any opacity. This,
of course, must be expected in wounds that have been caused by some
object that was clean, while septic large wounds, caused by some unclean
object, frequently produce great irritation, and penetrating ulceration
results, ending in panophthalmia and destruction of the eye.

The therapeutic treatment of wounds of the cornea is identical
with that of corneal ulceration.

Desiccative Keratitis. Xerosis Corneae. — This is a particularly rare
condition described by Bayer that occurs as a result of acute distemper;
it is seen particularly in pugs. The animal has a wide open staring
look of the eye, the cornea is dull and lustreless, there being no reflection
in it; the conjvmctiva is tumefied, corrugated and deep purple-red in color
and covered with a thick tenacious secretion. After a short time the
cornea commences to slough small portions of its substance, and it
finally becomes reddish-brown in color. The treatment consists in
moist fomentations and compresses of boracic acid solution, followed
by astringents such as acetate of lead or sulphate of zinc solutions.
If the acute symptoms of distemper have not shown themselves they
are apt to appeal- shortly after this condition is developed.

Corneal Spots or Opacities. Maculae Corneae. Leucoma. — By this
is meant more or less turbidity or opacity of the cornea, due to injuries,
ulcerative keratitis and certain opacities that are not accompanied by
fever or other phenomena. These spots may vary from complete

DISEASES OF THE CORNEA

415

opacity of the cornea to cloud-like spots, dull white, chalky white,
or pigmented (Fig. 141). Calomel blown on the cornea by means
of a small cylinder of paper or a quill, salves, such as calomel
1 part and petroleum salve 4 parts; a piece the size of a pea is put
on the cornea and the lid gently massaged for several minutes. Calo-
mel and sugar of milk, equal parts, is also used; a small portion is put on
the eye by means of a camel's hair pencil, and the lid is gently massaged,
moving the lid by a circular motion of the finger for ten or fifteen minutes.
Red and yellow precipitate of mercury ointment or a few drops of iodide
of potassium, 3 per cent, solution, are sometimes found useful as an ab-
sorbent. When there are elevations or encrustations on the cornea due
to the deposit of chemicals from eye washes, they can be curetted
(scraped) off by means of a sharp knife. The cornea is, as a result of this

Fig. 141. — Leucoma.

irritation, apt to be slightly denser in its structure. Certain permanent
opacities of the cornea that disfigure the animal can be modified by
means of tattooing; the eye is cocained and a tattooing needle used.
The punctures are made in an oblique direction to avoid any possibility
of puncturing the cornea; a great number of small punctures are made
in the body of the opacity, covering its entire surface, and sepia or india
ink rubbed into punctures. This is done by putting the color in solution
on the eye and massaging the lid for ten or fifteen minutes at a time.
This tattooing may have to be repeated several times.

416 DISEASES OF THE EYES

DISEASES OF THE CRYSTALLINE LENS.
Cataract.

All diseases of the lens, either of its membranes or its capsule, as a
rule cause a certain amount of opacity, and may form one or more star-
like gray bodies in the centre of the lens itself (cataract). It is not
possible to enter into a description of the various forms of cataract
and its pathological alterations, but we will only take up one form (gray)
of cataract that can be subdivided into two forms — soft, which may
be congenital; or traumatic and hard or contracted cataract, which is
senile. The softening process generally begins in the equator of the
lens, and becoming diffused soon causes a total opacity of light gray
color. This may be streaked with darker lines or it may have a mother-
of-pearl discoloration, with enlargement or distortion of the lens and a
contraction of the anterior chamber. This is very often seen in young
animals. The contracting process, on the contrary, begins in the shape
of a number of small whitish striae, or dull opacities, in the peripheric
layers of the lenticular nucleus, and extend gradually over the cortical,
giving the lens a yellowish-white or yellow aspect after some time.
This is generahy observed in old dogs (hard nuclear cataract, senile
cataract). The so-called capsular cataract does not, as a rule, depend
on true opacity of the capsule, but on an accumulation of proilucts
of the same, which have been developed from disease processes which
have gone on in its immediate neighborhood. For instance, the in-
flammation of the iris. In some cases they appear in small, star-like
or streaked pigmented dull spots, which are distinctly marked.

Etiology. — Gray cataract, as a rule, is a senile or old-age affection,
but it appears Ciuite frequently in young dogs; in this case the opacity
is deep-seated, and brilliantly white star-like opacities appear in the poste-
rior part of the lens, and now and then it is congenital. The writer saw one
case of hereditary star cataract in connection with microphthalmus.
Meleval observed in the progeny of a pair of poodles, where the dog had
a double cataract, that the pups had lenticular opacities. The develop-
ment of cataract which occurs in advanced age — that is to say, after
ten or twelve years — is what is known as senile cataract; this is slow in
its development, while cases of opacity of the lens, which are observed in
young animals, appear frequently without any marked cause, and run
their course very rapidly, the opacity forming in a few weeks, and even
in a few days the wliole lens has been completely covered. Traces of
sugar are found in the urine of dogs which become very thin and anaemic
in a short time, cataract frequently developing in this condition. Frohner
thinks that the lens becomes saturated with grape-sugar, which is present

DISEASES OF THE CRYSTALLINE LENS 417

in diabetes, and the lens undergoes a retrogressive metamorphosis due
to disturbance of its nutrition.

There is no doubt that cataract is also caused by inflammatory-
processes of the eye, and the nutritive supply of the lens becomes dis-
turbed and its normal condition impaired, such as ulcerations of the
cornea with central perforation, inflammation of the meml^rane of the
lens and iris, and also bleeding into the anterior chamber. Injuries
of the lens and concussions of the eye also cause a number of cases of
cataract.

Certain conditions are developed as the result of concussion of the
eye and appear quite frequently; they may be thus briefly described:
The lens either sinks downward with the capsule or becomes laterally
displaced. It may lean against the iris or it may drop forward into
the anterior chamber of the eye, and it may finally crowd into the

Fig. 142. — Gray cataract of both eyes.

vitreous humor. If the lens has undergone but slight displacement
(subluxation), it may remain clear for some time, but the vision is
much impaired. If it has fallen into the anterior chamber or has been
forced into the vitreous humor, we see a rapid development of the
cataract, and in the later stages considerable inflammation of the choroid
membrane of the iris, or of the whole eyeball.

Clinical Symptoms. — In cases where the disease is somewhat ad-
vanced, and the cataract is fully developed into one of the following
forms — punctiform, streaked, spotted, or complete opacity of a whitish-
blue, brownish-blue, or mother-of-pearl color — it is easily recognized
(Fig. 142) ; but, on the other hand, where there is a mere cloudy dimness
and small spots of cataract, we must use candle-light or some illumi-
nating power such as an ophthalmoscope and a strong light to see the
27

418

DISEASES OF THE EYES

action of the lens in the eye itself. Before doing so, however, we must
dilate the pupil with atropia.

Discoloration of the lens may be caused by violent concussion, con-
tusion of the eyeball, and by various pathological conditions in the
interior of the eye. It may be congenital, the lens being in a variety of
positions in the eye, sometimes it is necessary to dilate the pupil by
means of atropine to ascertain the exact position of the lens.

The prognosis is rather difficult to make, and, as a rule, it should
be an unfavorable one. Hereditary cataract shows little inclination to
enlargement, as is also the case in senile cataract. In soft cortical cata-
racts seen in young animals, we may see a rapid opacity of the lens in a
few days or weeks. The sight is entirely lost and medical treatment
is of little use.

Therapeutic Treatment. — In the early stages of senile cataract very
good results have been obtained with iodide of potassium, 1 per cent.

Fig. 143. — a. Stop discission needle; b, Graefe's cataract loiife; c, DavieFs cataract spoon.

solution, few drops in the eye daily. A gray cataract may be removed
by an operation, and this is much more advisable in the dog because
it is, as a rule, particularly in young dogs, attended with no great
danger, and its results are generally beneficial, producing a partial res-
toration of the vision. It is advisable to perform the operation of
cataract after having first dilated the pupil by means of atropia, and
then performing the operation under ether. The writer has tried
cocaine alone, but he finds it unsatisfactory. The animal must be
tied up, placed on a table, and ether or chloroform administered. The
operation is performed by one of the following methods:

Opening of the Capsule. — The anterior capsule of the lens has to be
opened in a transverse way with what is known as a discission needle

DISEASES OF THE CRYSTALLIXE LENS 419

(Fig. 143, a). The fluid in the anterior chamber causes a gradual break-
ing up and reabsorption of the lens. An assistant holds the eyelids open
and the operator seizes a fold of the conjunctiva with a small tenaculum,
holding the eye firmly with the left hand, while holding the needle in
the right hand, placed on the animal's head to steady it. The needle
is then introduced into the cornea, in the middle of the lower external
quadrant, in such a direction as to meet the ciliary insertion of the iris
and as far as the upper internal quadrant. Before the point of the
needle has reached this latter point, however, it is placed firmly on the
capsule of the lens, and this is cut through in a transverse direction with a
lever-like movement of the needle (Fig. 144) . The instrument must then
be removed in the same way that it was introduced in perforating the
cornea. After the operation the animal must be placed for some time

b
a.

Fig. 144. — Discission of the lens: a, Form and size of the cross-incisions; 6, method of insertion

of the needle.

in a dark place and the eye treated twice a day with atropine. We must
treat all irritating symptoms of the eye by means of cold compresses,
and sometimes we must use mild laxatives. After six or eight weeks
the reabsorption of the lens is complete. We generally perform dis-
cission in young animals affected with soft cataract. The result of this
operation, however, is not always satisfactory, as reabsorption is slow
and in many cases requires a second operation. Several months may
also elapse before the cataract is absorbed. Schlampp advises in such
cases puncturing the cornea, and by this means slowly allowing the
fluid of the anterior chamber to escape, leaving the lens untouched.
Anterior displacement of the lens enlarges or ruptures the opening
which has been made in the capsule. Reabsorption follows, as a rule,
more quickly when this is performed, probably due to the fact that the
fluid which contains the elements of the lens has been discharged and
replaced by fresh fluid. The process is not dangerous, and may be
repeated much oftener than discission.

Linear Extraction. — This operation is used where there is complete
opacity of the lens and enlargement of the lens and contraction of the

420

DISEASES OF THE EYES

anterior chamber. After liaving prepared the dog as in the operation
for discission, an assistant holding the eyelids apart, with another
forceps seize the conjunctiva of the eyeball in the neighborhood
of the median line of the eyeball, at the same time everting the upper
eyelid. We then make an incision by means of Graefe's cataract knife
(Fig. 143, b), about 5 mm. broad, through the cornea, about 2 or 3 mm.
from the border of the sclerotic membrane. We then pass a discission
needle through the wound, split open the lenticular capsule, as in discis-
sion, and empty the soft parts of the cataract by means of Daviel's
spoon (Fig. 143, c). Any remnants of the cut capsule which may not
be removed at the time are left to be reabsorbed. If during the operation
Ave observe prolapsus of the iris, we must try to restore it to its position

' ■%//#fMii;m'#

Fig. 145. — Lobular extraction of leii.s. {Cadiot and Breton.)

by means of Daviel's spoon (Fig. 143, c). If this is not possible, we
may cut it off close to the wound of the cornea.

It is very evident that linear extraction is only to be performed in
cases of complete softening of the lens. This may be recognized liy
total opacity of the lens and alteration of the iris, and also when the
anterior ca])sule is pushed toward the cornea.

Lobular Extraction. — Lobular extraction is indicated in hard cata-
ract, which is generally senile, where the lens may be prolapsed into the
anterior chamber and where discission will only produce an imperfect
result — that is to say, where reabsorption of the lens does not progress
properly. It is performed in the following manner:

Make an incision into the cornea exactly as in linear extraction, by
means of Graefe's cataract knife, but it must be enlarged to 8 or 10 mm,
(Fig. 145). After that the capsule of the lens is split by the discission
needle, the fluid of the anterior chamber is allowed to escape, and at the

DISEASES OF THE CRYSTALLINE LENS

421

same time the lens must be detached by means of an even, but not too
energetic, pressure upon the other side of the eye from the wound, and
then by means of the Daviel 's spoon the lens is pushed out of the opening

Fig. 146. — Lobular extraction of lens. (Cadiot and Breton.)

(Fig. 140) . The subsequent treatment is the same as in linear extraction.

Dislocation of the Lens. — This operation is undertaken in hard
cataract, and is performed in the following manner:

By means of a cataract needle pushed through the sclerotic mem-

FiG. 147. — Dislocation of the lens. (Cadiot and Breton.)

brane, or the cornea, steady pressure was made on the upper part of the
lens, and it was pushed down into the lower posterior part of the vitreous
chamber of the eye. The needle is held like a penholder and is introduced
into the sclerotic membrane at the side of the eye about 2 to 4 mm.

422 DISEASES OF THE EYES

distant from the corneal border and is pushed underneath the iris,
between it and the lens to the median line, until it is visible in the pupil.
When the needle has reached the inner or nasal border of the pupil, the
needle is pushed back against the lens and by steady pressure the lens
is dislocated from its supports and pushed backwards into the vitreous
humor. The lens must be held in position to endeavor to prevent its
return, but it is very apt at times to partially re-enter the pupillary
opening.

DISEASES OF THE SCLEROTIC MEMBRANE, OF THE

NERVOUS PORTION OF THE EYE, AND ALSO

OF THE VITREOUS HUMOR.

These diseases are generally not of any great importance compared
with the diseases before described, and therefore we will not go into
minute details.

Anomalies of the Iris. — Of this organ there are two kinds: Persistent
papillary nieml)rane and iris coloboma.

Persistent Papillary Membrane {Memhrana Papillaris Perservatrs) . —
The foetal papillary membrane extends in the shape of threads or strings
from the anterior surface of the iris to the capsule or over the pupil, or
their free ends may also float in the aqueous humor. Calve saw a young
dog, twelve months old, afTected like this and saw a similar condition in
the mother, and several of her offspring were blind from persistent
papillary membrane Moeller has seen a number of young dogs affected
in the same manner.

Iris Coloboma. — This is a congenital split or division of the iris,
which is not at all rare. In the iris are found circular split-like openings
and there appear to be two and sometimes three pupils (Fig. 148).
There are also associated with this condition alterations in the ciliary
body of the choroid membrane.

Inflammation of the Choroid. — This condition is very similar to
iritis, and the synii)toms are similar. Treatment consists in keeping
the animal in a dark place and solutions of cocaine to the eye.

Inflammation of the Iris {Ii'itis). — This affection is very rare in the
dog and is apt to be associated with keratitis, cyclitis, or choroiditis. It
may also be due to extension of inflammatory processes and to trauma-
tisms, and is also said to be associated with rheumatoid conditions and
distemper. It may be recognized by contraction and difficulty of move-
ment of the iris, change in the color of the iris, fibrous accumulations in
the shape of a gray veil-like coating, and dulness of the fluid of the
anterior chamber, and slight dimness of the cornea. The cure for this
disease consists in complete rest, keeping the animal in a dark place,

INFLAMMATION OF THE SCLEROTIC COAT

423

and solutions of cocaine and atropine, and the administration of saline
laxatives.

Purulent Inflammation of the Eye (Panophthahjiitis). — This is
produced by serious concussion of the eye itself. It may also be due to
septic wounds of the cornea and sclerotic membrane, as well as to the
large perforating ulcers of the cornea. "We recognize the following
acute symptoms:

The eyelids are constantly closed; great redness of the conjunctiva;
total opacity of the cornea; purulent accumulations in^the anterior
chamber of the eye (hypopyon) ; great hardness and enlargement of the
bulbus. After a short time we may have perforation through the cornea,
and, in rare cases, through the sclerotic membrane. The lens and vitre-

^ \ ^\'< J' /

Fig. 148. — Iris coloboma.

ous humor are ejected through the opening with the purulent mass; the
eyeball collapses, becomes contracted, and forms a knob-shaped mass in
the eye; the lids completely collapse and form a hollow in the face. The
only thing to do in such a case is to perform enucleation, or removal of
the eye. See Removal of EyelDall.

Glaucoma and Hydrophthalmus. Dropsy of the Anterior Chamber. —
It is impossible to draw a distinct line between these two conditions.
The anterior chamber is very much enlarged, hard and tense, so much
so that the eyelids cannot be closed (goggle eye, exophthalmus). The
blood vessels of the conjunctiva and the sclerotic membrane are injected,
the cornea more or less opaque, the pupil much contracted and greenish
in color, insensibility of the cornea, and dilatation of the pupil. The
animal has partial or total loss of eyesight, congestion of the conjunctiva,

424 DISEASES OF THE EYES

and greenish coloration of the i)upiL Treatment consists of a few drops
of physostigmin sohition 1 to 100, which tends to reduce the intraocuhir
pressure, and puncture of the cornea. In chronic hydrophthahiius the
entire eyeball had best be removed. Iridectomy is performed in man
for glaucoma and Gra>fe has recommended it for the dog.

Diseases of the Vitreous Humor. — These are generally congenital
and are observed with the ophthalmoscope. The vitreous humor is found
on examination to be filled by a filiform or striated opacity; in some cases
the vitreous humor is found to be a mobile liquid. There are a number of
other changes, but this condition is incurable, and merely for diagnostic
purposes, consequently, works on the eye are to be consulted. Of these
diseases there are a number of anomalies, but the most important are
hemorrhage of the retina, inflammation of the papilla of the optic nerve,
and detachment of the retina, total cataract and a partial luxation of the
lens, licpefaction of the vitreous humor of the eye, swelling of the papilla,
and injection of the vessels of the retina.

Hemorrhage of the Retina. — This may be caused by violent trau-
matism and from certain diseases such as scurvy, ptomaine poison and
from poisoning from male fern extract given for tape-worm. Those
which are only visible with the ophthalmoscope are round, irregular line-
like bodies, brownish-yellow, which gradually become light yellow or
white. Treatment is generally useless. Rest, moist, warm compresses,
the application of a 1-per cent, solution of iodide of potassium, a few
drops in the eye once or twice daily.

Inflammation of the Papilla of the Optic Nerve (Papillitis, Neuritis
Intraocular is). — This is apt to be found associated with pathological con-
ditions in the other structures of the eye from certain infectious diseases — ■
distemper, septicaemia, ptomaine poisoning, and rarely traumatisms.
The papilla when examined by the ophthalmoscope is found to be hyper-
aemic, with more or less projection of the papilla, and congestion of
the surrounding vessels. When the active symptoms subside the
papilla atrophies, becomes grayish-white and becomes oval or circular.

The treatment consists in keeping the animal in a dark room,
administering strychnine and local applications of sedatives, and small
doses of calomel.

Detachment of the Retina {Amotio Retincr). — This is indicated by
more or less separation of the choroid and opacit}^ of the vitreous humor
when there is complete separation of the retina; the whole body becomes
converted into a funnel-like body. This condition has been observed
quite frequently. Moeller has found numerous cases of detachment of
the retina, and could find no predisposing cause. 8ubretinal cysts are
occasionally found in the retina? of old dogs, and present the same symp-
toms as this disease. Treatment is useless.

PROLAPSE OF THE EYEBALL 425

Amaurosis. Black Cataract. — Under this title we class all of those
morbid states where there is partial (amblyopia) or complete loss of
eyesight or blindness (amaurosis) without any change in the external
portion of the eye. In the majority of cases it is due to pathological
process in the retina or the optic nerve, namely retinal hemorrhage,
separation of the retina, papillitis, retinitis, or atrophy of the optic nerve.
In rare instances it is due to direct pressure of hemorrhages on the optic
nerve, or to inflammations to neof ormations in the orbit, or at the entrance
of the optic nerve, or it may be due to certain lesions in the cranial
cavity, such as inflammation, hemorrhage, tumors, parasites, which are
located in the base of the brain near the optic centre. Certain poisons
have a specific effect on the optic nerves and cause permanent or tem-
porary blindness such as nicotine, salicylic acid, extract of male fern,
santonin, carbon dioxide, or decayed meat toxines. The sight is some-
times affected by sporting dogs working in the field when it is covered
with snow. Congenital amaurosis cannot be said to be extremely rare,
it being rather common in toy terriers and particularly so in Boston
terriers.

Symptoms. — "When a dog is blind in both eyes it is not difficult to
determine the condition, on observing the careful method of walking,
the absence of fright when menaced with a stick or hand, and the very
much increased use of the sense of smell, or of hitting obstacles or
walking into them, and, in addition, the fixed, stary look, and the dilata-
tion of the pupils which do not contract in the presence of strong light.
Cases have been observed where there was pronounced amaurosis and
W'hile the pupil was ordinarily dilated, when the animal was brought
into strong light the pupil contracted. Where there is partial or com-
plete loss of sight in only one eye, it is more difficult to determine the
condition. Blind one eye w'ith some dark material and try to see
whether the pupil dilates and contracts with the light. A peculiar form
of blindness is hemeralopia (night blindness) , In such animals the sight
is perfectly good in the day, but at night the sight is partially lost and
the animal has no confidence in walking about. This condition is found
to be due to a peripheral opacity of the refractory mediums. The treat-
ment consists in the attempt to remove the exciting cause, if possible.

Prolapse of the Eyeball.

(Exophthalmus; Prolapsus Bulhi Oculi.)

There are a number of causes that produce prolapse of the eyeball.
It may be crowded out of the cavity of the eye, or exposed in its external
circumference by the swollen and distended eyelids which are closely
adherent to its posterior surface (Fig. 149). This condition occurs

426 DISEASES OF THE EYES

especially in bulldogs, pugs and the toy spaniels, although it may occur
in any breed. The dog does not possess a complete bony arch of the
eye (zygomaticus), the space being filled up by a ligament, and the
muscles are also very weak. Occasionally, from some mechanical force,
such as blows in the region of the eye, or bites in its neighborhood
causing hemorrhage and a large amount of blood to collect in the posterior
part of the orbit, it is pushed out of position. Frec|uently the entire
eyeball is crowded out, standing out on the face clear of the orbit, (tumors,
etc.)- Simple pressure of the fingers on the supraorbital cavity of pugs
or spaniels is sufficient to make the eye protrude, opening the eyelids
mechanically; luxation of the inferior maxillary also causes protrusion
of the eyeball. It is also observed in that rare affection called Basedow's

-tr-^i^

1 ,

' $'i.^

• '' '^- ;

It:

Fig. 149. — Dislocation of the eyeball.

disease. This condition has been noticed in very rare instances to be
due to inflammatory processes inside the eye, and by the formation of
tumors in the orbits.

The prognosis of a prolapsed eyeball depends largely upon the cir-
cumstances and condition of the organ. If the prolapse is of recent
origin, if the muscles of the eye and optic nerve are not torn, and if the
eye itself has not been very much injured, we may expect complete
recovery in a short time without any disturbance of sight. If the pro-
lapse is recent and the muscles are not torn, or only partially so, but the
eye is al)normally distended, we must expect there is some irritation of
the optic nerve, and while the eye may be restored the animal may
remain blind. If the muscles of the eye and optic nerve are lacerated
and the eye proper is injured, or if any of the chambers of the eye are
filled with blood, or if the prolapse has been sufficiently long that the
irritating influence of the air is marked by an opacity and a dry look of

PROLAPSE OF THE EYEBALL 427

the cornea, which assumes a horny appearance, the eye must be con-
sidered as lost.

The therapeutic treatment consists in returning the eyeball as soon
as possil)le, especially when the organ appears to be in such a condition
as would encourage you to think it can be saved; but if otherv.-ise, it
must be removed as soon as i3ossible.

We try to return the eye to its position as soon as possible.

First, clean it thoroughly by means of an antiseptic that is not
irritating, such as a 2 per cent, solution of boric acid or a 1 to 2000
solution of corrosive sublimate. Place the fiat of the hand or the points
of the fingers on the eyeball, at the same time an assistant distending the
eyelids as much as possible, and by gentle pressure endeavor to push the
eye l^ack into the orbital cavity.

If it is impossil)le to return it by this means, the fissure of the eye
must be enlarged by making a small incision in the external corner, or
the anterior chamber of the eye may be perforated by means of a cataract
needle or sharp l^istoury, so as to empty the eye to a certain extent and
thus allow it to return to the chamber. After returning the eye we must
try to prevent another prolapse by placing a bandage over the eye,
taking care not to compress the eyeball too much. If the animal will
not allow it to remain, we must join the eyelids with one or two stitches.
After stitching the eye we generally see great inflammation of the lids
and the eye itself, but the writer has found that these bad effects may be
easily prevented by taking care not to carry the stitch through the entire
lid, but only through the external membrane. At the same time it is
advisable to keep the animal without food for at least twenty-four hours,
for the use of the jaw, and especially the pressure of the prolongation of
the crown of the inferior maxillary, may push the injured eye out of
position. Cold applications are useful if the eyeball cannot be saved, or
if reduction is impracticable for some reason or other, on account of
tumors in the orbit, etc., there is nothing left to do but enucleate the
eyeball.

Enucleation. Removal of the Eyeball. — Removal of the eyeball
should be performed under a narcotic or ether, or continual applications
of 4 per cent, solution of cocaine. We pull out the eyeball by means of
a tenaculum or a thread is put in the body of the eye, cut through the
conjunctiva with a pair of small curved scissors closely behind the cornea,
snipping the scissors around the eye, keeping as close to the bulb of the
eye as possible, and by this means separate the muscles and then cut
through the optic nerve. The author thinks it is advisable to remove
the membrana nictitans at the same time (Fig. 150).

After enucleation, the cavity of the eye is washed out with an anti-
septic fluid and the bleeding is stopped by means of a tampon; and the

428

DISEASES OF THE EYES

cavity should he powdered with boracic acid or sulphonal. Pack the orbit
with absorbent cotton and put two stitches in the eyelids. The stitches
and packing must be removed in twenty-four hours. The further treat-
ment consists in cleaning out the cavity with corrosive sublimate solution
(1 to 3000) twice daily. Dogs are not badly disfigured by the loss of
one eye, as the orbit becomes contracted and partially filled with granula-

FiG. 150. — Muscles of the left eye: a, Superior; b, external; c, inferior straight muscles of the eye; 1
eyeball; 2, orbital arch cut through.

tions. It is not advisable to use artificial eyes, as the animal generally
rubs them out, and such operations as tattooing the stump, only removing
the anterior portion of the eye, or cleaning out the contents of the eye-
ball and stitching up the sclerotic membrane are not only invariably
impracticable but very apt to act an as irritant and cause a constant
discharge from the cavity, and the empty orbit always presents a dis-
gusting appearance.

DISEASES OF THE EAR,

Serous Cyst.
{Othematoma; Hanatonia.)

By this term we mean a blood or lymphatic excretion lying between
the skin and cartilage of the ear, and forming a tumor in the external
or internal part of the lobe. It generally occurs on the inside of the lobe.
In rare cases it has been found in the external side, and in still rarer cases
both inside and outside. This swelling is fluctuating, and when the skin
of the animal is white it may have a bluish coloration.

Etiology. — This condition is probably due to some irritation or
traumatic cause; for instance, by striking the ear against the collar or muz-
zle, pulling the ear, concussions, and injuries through biting; or from con-
stant shaking the ear due to the continuous itching and irritation of disease
of the middle ear and from irritation of parasites, or ulceration of the edges
of the lobes. It is alwaj-^s seen in the lobe of the ear; it is general in dogs
with long ears. If the sac is not emptied by surgical means, the secretion
remains fluid and to a certain extent is reabsorbed, but rarely is the
secretion entirely reabsorbed and it may leave quite a thickening and
even malformation of the external ear, and when the sac is emptied by
surgical means after the collection has been there some time we find that
there is very little serous fluid left, but organized masses of filiform
neoformations. In some cases when the fluid suppurates it may perfor-
ate the skin externally. This, however, is very rare, being generally
associated with some later traumatisms.

Clinical Symptoms and Prognosis. — The swelling, as a rule, is on the
internal part of the ear. This enlargement varies in size from a pigeon
to a chicken egg, spherical or oval in shape. The lobe, which generally
hangs downward, is pushed upward in a peculiar manner (Fig. 151).
The swelling is hard, and in white animals it has a blue color. It is very
sensitive to pressure and shows a distinct fluctuation. The animal
carries its head in an oblique manner, the affected ear being held down-
ward, and when the collection is of some size the ear stands out from the
head, and the fact that it gives the dog more or less pain is indicated by
the careful way that the animal shakes its head or scratches its ear.

The prognosis is favorable provided proper treatment (incision, etc.)
is applied, although it may take some time before they are entirely cured.
Compression of the ear by means of bandages has been found to induce
the course of healing very materially.

429

430

DISEASES OF THE EAR

In many cases where no dressing is applied, we may have as a
sequence a slight thickening of the lobe of the ear. This, however, is
of very little importance.

Fig. 151. — Hematoma oi the ear.

Therapeutic Treatment. — The methods of treatment which the
waiter considers advisable are as follows:

We perforate the swelling with a large-sized hypodermic syringe
or aspirator. The secretion is then removed and a solution of iodine 1,

Fig. 152. — Ear-cap.

iodide of potassium G and alcohol IG is injected into the cavity. We
then apply a compressing dressing in the following manner:

The ear is covered with antiseptic wadding on both surfaces. It is

SEROUS CYST 431

then held in position bj- means of an ear-cap (Figs. 152, 153). This dress-
ing must not be clisphiced, but allowed to remain for days. This method
has been an element of uncertainty; in some cases it acts perfectly and
in others, beyond setting up considerable irritation, it does not destroy
the secreting surface and the abnormal condition returns.

McQueen's method is very simple and produces good results. He
carefully removes the hair from the ear and renders it antiseptic, and
either paints the ear with cocaine or administers chloroform, empties the
sac by means of an aspirator syringe, and makes sure that it is com-
pletely emptied. Sutures are then inserted radiating from the centre
of the sac, about one-third of an inch apart, directly through the ear and

Fig. 153 — Ear hood or net.

tied on the outer or hairy side, thus producing a firm pressure between
the two surfaces of the sac and by that means get prompt union. The
ear must then be irrigated with an antiseptic solution, carefully remov-
ing all blood, etc., and dressed with antiseptic wadding, and further
covered with an ear-cap. It should be dressed every day, and the sutures
removed at the end of a week.

Another method consists in taking a scalpel and making a free
incision from one end of the sac to the other, then filling it in with
tincture of iodine, and then keeping it clean and using an ear-cap.

Simple emptying by means of a trocar or making a small incision
never produces any good results, as the opening closes immediately and
it soon fills up again. Sutures are not advisable, causing great irritation.
In order to prevent the too rapid closing of the incision, the removal of
a small crescent-shaped piece of flesh from the edge of the opening has
been recommended.

432

DISEASES OF THE EAR

Ulceration of the External Concha. — External Canker.

By this we mean a purulent or ulcerative process on the edge of the
external ear. This, however, is not contined to the edge, but may spread
over different parts of the lobe.

Etiology. — The chief causes of this trouble are injuries and lacerations
of the skin. Dogs are liable to scratch or shake the ears violently against
the muzzle or collar, producing an inflammation. It may also be devel-
oped from the ear itself, as in cutaneous inflammations of the external

Fig. 154. — Mode of bandaging the ear.

auditory passages. We may also see this as a re.sult of wounds or lacera-
tions of the ear caused by bites of other dogs, which from neglect or
improper treatment become ulcerated and do not heal readily on account
of constant shaking of the ear. This affection is almost entirely confined
to animals with long ears and short hair.

Clinical Symptoms. — The animals hold their heads to one side,
shaking the ear frequently, sometimes keeping it up so long that the
ulcerated surface bleeds and the blood is thrown in all directions. They
attempt to scratch the affected ear with their paws, and are very sensitive
about having them touched. On makinu- an examination we find at the

EXTERNAL CANKER 433

edf^e of the external ear, generally at its extreme end, an ulcer or a
number of them which are covered with a blackish loose scab with
turned-up edges, and the tissues of the immediate neighborhood are
oedematous.

Therapeutic Treatment. — The first procedure is to ascertain if there
are any evidences of internal otitis; if so, heal that and lessen the irritation
and itching. Xext prepare an ear-cap (Fig. 152), which is so very
essential in this affection. Dress the inflamed edges first with an anti-
septic solution and get all the scab-dirt, broken down tissue and hair
away, then paint the edges with compound tincture of benzoin and
apply this daily, keeping on the ear-cap. Other ointments, such as airol,
benzoin and lanolin, or stimulant counter-irritants, such as iodine or

nitrate of silver may be employed. The writer has found the following
method very efficacious : Clean the ear thoroughly, then apply freely
some drj'ing powder, such as dermatol or boric acid, on both sides and
the edges of the ear. Have prepared an oblong piece of linen or muslin
as in the accompanj-ing illustrations (Figs. 154, 155) , cover this with liquid
glue and apply it as seen in the Fig. 155; this is held in position until dr>-.
When it is to be removed the ear can be steeped in warm water and it is
easily removed. It is best, however, to let it remain until it falls off, as
by that time the ulcers have healed and the scabs and hair come off with
the bandages. In very small animals silicate of soda solution or rubber
adhesive plaster can be substituted for glue, but in ordinary- sized dogs
the glue is the most efficacious. When there are a series of deep tears
or chronic separations of the ears, and the edges of the ears are in a
chronic state of inflammation, with more or less induration of the tissue,
28

434 DISEASES OF THE EAR

there is no doubt that the quickest results may be obtained l^y cutting
off a portion of the diseased IoIdc of the ear; this, however, disfigures the
animal very much. This operation is generally performed on animals
under the influence of ether. First remove the hair and thoroughly
disinfect the parts and cut off a circular piece from the ear that will
include the torn portion, being careful not to remove any more of the
lobe than is actually necessary. Another method is to cut off the edges
of the slit ear a thin section about one-eighth of an inch in thickness,
so as to insure two raw fresh surfaces. The two edges of the wound
must then be drawn together by means of sutures. These should not
be inserted too close to the edge of the wound, as they are apt to tear
through. The stitched line is then powdered with sulphonal. The
external ear is covered with wadding, turned over the top of the head,
and held in position by means of a bandage, as indicated in Fig. 152
and 153.

The writer has been able to obtain satisfactory results in slight cases
of external otitis and canker by covering the ulcer with oxide of mercury
and tying the ear in a cap.

Inflammation of the External Auditory Canal — Internal Canker.

{Otitis Externa.)

This consists of an inflammatory irritation of the external canal of
the ear. It occurs most frequently in dogs with long ears. It is gen-
erally of an eczematous nature and appears in a diffuse form, extending
over a larger part of the lining of the ear. It is accompanied by redness,
swelling of the membrane, and an exudation of a serous, and, later in
the chronic course, a purulent secretion. It involves the papillary
body and the wax secreting glands of the ear. The skin is tumefied, red
and warm; there is abundant epithelial desquamation; the ceruminous
glands secrete a very much increased amount of al^normal wax, which
collects with the secretion of the ear. In some cases the discharge becomes
purulent and is found lying in the ear in the form of a viscous fluid, vary-
ing in color from yellowish-brown, gray-brown, yellow-brown, or dark
brown. This discharge may irritate the skin of the lower part of the ear,
causing an erythema. We may also have the formation of abscesses
and contraction of the meatus (caused by thickening of the cutis, by
granulations, and by polypus malformations). We may have acute
inflammation of the canal extending deep into the lining, and perforations
of the tympanum and irritation of the Eustachian canal and discharge of
pus into the pharynx. Abscesses of the parietal bone have been observed.

Etiology. — The causes are similar to those mentioned under eczema.
It is due to an accumulation of cerumen, dirt, cutaneous scabs, and

IXFLAMMATIOX OF THE EXTERNAL EAR

435

foreign l:)odies; also too frequent bathing with soajD is a common canse of
irritation. Sporting dogs, such as spaniels, setters and retrievers and
Chesapeake Bay dogs, from going into icy cold water. It may accompany
or follow distemper, or by extension of inflammatory processes from the
surrounding tissues, such as injuries, bites, etc. It is also recognized
that otitis is produced by acari. (See Parasitic Otitis, page 439). Hoff-
mann states that he has observed serious suppuration in cases where
dogs' ears have been clipped too close to the head.

Clinical Symptoms and Prognosis. — Great care must be used in
making the first examination of the ear to distinguish between superficial
and deep external otitis. In the former form it may rapidly become
chronic. The animals shake their heads, and, as the disease is almost
invariably located in one ear only, they hold their head in an oblic{ue
position, trying to scratch the head about the base of the ear or to rub
it against some object. They carefully avoid any attempt which is
made to touch the ear, and show great pain when the base
of the concha is touched. Milder cases rather encourage
manipulation of the ear and if the ear is gently rubbed they
show every sign of pleasure. In examining the external ear
we use a forceps-shaped speculum or ear-mirror (Fig. 156).
If we distend the canal we generally find it filled with a
foetid, grayish-green, or reddish liquid consisting of gland-
ular secretions, fungi, cutaneous scabs, pus, acari, etc.
After the organ is cleaned out we find an intensely red,
swollen, sometimes ulcerating surface of the skin. In the
deep-seated cases the meatus is almost entirely closed by
thickening of the cutis and an abundant purulent dis-
charge from the ear (otorrhcea). Numerous granulations
appear cjuickly and in some cases where both ears are
affected we may have symptoms of impaired hearing or
deafness. A characteristic smacking or sucking liciuicl
sound is produced by side pressure or rapid compression on the base of
the ear.

The general condition of the animal is ver}' seldom affected. Vomit-
ing is only observed in exceptional cases; this is said by Froehner to be
due to pressure on the auditory branch of the vagus. Vertigo, spasms,
and epileptiform convulsions sometimes follow where acari are present
in enormous numbers.

Therapeutic Treatment. — The treatment which corresponds with
that of eczema is generally followed. We must thoroughly clean the
external ear. This can be done by tying a piece of absorbent cotton or
a piece of sponge on the end of one of the ordinary orange sticks used in
manicuring (Fig. 157), dipped in alcohol or ether; warm water, made

Fig. 156.

Kramer's ear

speculum.

436

DISEASES OF THE EAR

slightly alkaline, can also be used — the two former, however, are to be
preferred. "When the condition is chronic a syringe must be used to get
into the deep parts of the ear and the best for this purpose is one made
entirely of soft rubber with a long flexible point that can be pushed into
the meatus without any great danger of injuring the canal; the flexible
point adapts itself to the turns of the external ear canal, and by using
applications of warm water injected into the meatus the latter can be
thoroughly cleansed of accumulated cerumen, crusts, etc. The canal is
then dried with absorbent cotton introduced into the ear on the end of a
small pair of forceps. In some chronic cases great benefit is to be had
from injecting peroxide of hydrogen into the ear, as it cleans it out thor-

FiG. 157. — Ear swab and mode of using it.

oughly, but under no circumstances must this be repeated frequently as
the peroxide solution, while it has great cleansing properties, if repeated
frequently, attacks the normal structure of the ear and frequently the
writer has had brought to him cases where the whole inside of the ear and
concha was a mass of granulations, in what was originally a very mild
case, caused by the action of the peroxide solution.

Syringings with water and fluids of any kind must not be used for
any length of time, as they are apt to carry the debris of the condition,
such as wax, pus, mucus, scab, etc., down into the middle ear. On the
other hand, it is well to clean out the ear thoroughly once or twice with
a syringe with a flexible point. As the meatus is elongated, narrow, and
slightly curved, there is not much clanger of injuring the tympanic
membrane. In very slight affections of this character, wdiich may be
recognized by a slight redness of the membrane, itching, and the presence

INFLAMMATION OF THE EXTERNAL EAR 437

of a certain amount of fluid, it is only necessary to clean the meatus
once or twice, using solutions of lead-water. The writer has found that
simply powdering with lycopodium, amylum, talcum, or boracic acid
and filling up the ear, and then massaging the base of the concha to work
the powder well down into the ear, is much preferable to any of the
above-mentioned liquids.

A mode of procedure suitable to most cases is to clean the ear with
wood alcohol, filling in the cavity and working the alcohol into the canal
by manipulation of the base of the ear. It is then to be dried thoroughly
with absorbent cotton until all trace of brown coloration, characteristic
of this condition, is removed. Then fill up the ear with powdered boric
acid, working it thoroughly into the canal, and covering all the inflamed
portions. This should be repeated every third day until the irritation is
lessened, and then after that, once a week. With this treatment also
prescribe a laxative, such as a tablespoonful of saturated solution of
sulphate of soda (glauber salts) or some of the saline laxative waters.
If there is eczema present, add to the treatment two drops of Fowler's
solution, morning and evening.

In serious diseased conditions where there is much ulceration, we
may treat them in two different ways:

By syringing the ear with solutions of disinfecting and astringent
agents, such as salol in alcohol (1 to 10), tannin in glycerin (1 to 10),
This must be repeated several times, and we may also dry up the secre-
tion by means of oxide of zinc or boric acid; the latter is to be preferred.
Hoffmann advises us to use subnitrate of bismuth or sulphate of copper
in starch. As a rule, the general treatment with powders is preferable
to that with liquids, but the latter must be used when the meatus is
much contracted and the ulcers located deeply — dermatol in starch
powder, 1 to 10; salicylic acid and talcum powder, 1 to 15; tannoform,
thioform, dymal, itrol, etc. An ear-cap is only necessary when the
animal is constantly shaking its head and the organ is very sensitive.
Where there is great pain a few drops of 4 per cent, solution of
cocaine is useful. We remove the numerous granular accumulations
by means of nitrate of silver. If there are polypus enlargements they
may be touched with a thermocautery or cut off with a wire ecraseur.
When the auditory canal is narrowed by extreme tumefaction of the
tissues, frequent syringing with warm salicylic acid solution, 1 to 35,
is very useful.

T$. Zinc oxide, 3.0

Talc, 12.0

M. F. Pulv. No. I.

Sig. — Ear powder twice daily.

438 DISEASES OF THE EAR

I^. Bismuth subgallate, "3.0

Amyl nitrite,

Talc, aa G.O

Sig. — Twice daily.

I^. Phenyl salicylate, 2.0

M. F. Spts. vini rect., 80.0

Sig. — Put a small jjortion in the ear once daily.

Hoffmann states that in a very obstinate case he excised the entire
lower region of the meatus, introduced a drainaoe-tulie, and treated the
Avound ^vith disinfecting powder.

Deafness, Partial or Complete.

External otitis may sometimes produce either partial or entire
deafness. Both of these conditions are clue to the entire closure of the
external auditory canal either by swelling and filling up with granulations
or by polypus formations, collections of wax, etc., and more rarely liy
extension of the inflannnatory process in the middle ear, destroying the
tympanic meml)rane, or up the Eustachian tube from the pharynx or
inflammation of the lal)yrinth, or paralysis of the auditory nerve, as
well as certain pathological processes in the cranium, and as a result of
certain infectious diseases, particularly distemper. Of course, any dis-
turbance of the sense of hearing or entire deafness which comes from old
age or is hereditary will not show any of the symptoms already described.
Breeding a pure white-coated dog may produce a congenital deafness.
This is particularly seen in bull terrier puppies; in certain strains of
this breed it is a conmion occurrence. The examination generally showed
atrophy of the auditory nerve. When a dog is getting deaf he changes
his manner very much. He seems strange, does not answer to the call
of his master. In certain cases, when an animal is deaf, the loudest call
has no effect on him, but a slight blow on the floor immediately attracts
his attention. This should be carefully noticed, as certain kennel men,
when a dog is protested at a bench show, know this and when they call
on their dog at the same time they give a sharp tap on the floor with
their heel, which immediately attracts the dog's attention.

When dogs are ])orn deaf they either do not attempt to bark or, if
they do, it is a peculiar cry more like a howl.

As a general rule there is very little result from treatment. Where
deafness is due to paralysis of the auditory nerve, the administration of
strychnine or the faradic current should be tried. Treatment in con-
genital deafness is hopeless. Where thei'e is a contraction of the external
meatus, we may try to dilate it b}- means of the introduction into the
canal of cylindrical compressed tampon sponges.

PARASITIC CAXKER OF THE EAR 439

Parasitic Canker of the Ear.

{Parasitic Otitis.)

Dermatophagus Canis.

The symbiotes auriculans (canis) is a parasite that inhabits the ear
of the dog, causing an aggravated form of canicer (Nocard and Sewell).
The parasite which is common to the dog and cat is said to produce a
peculiar form of vertigo.

The parasite differs from the common symbiot by the absence of
abdominal lobes in the male, which are represented by a notch which
has three bristles. The pubescent female has four pairs of legs which
are simple knobs. The male is 30 mm. long and 23 mm. wide, and the
female is 42 mm. long and 29 mm. wide (Neumann) (Fig. 158).

Hering found moths (dermatophagus canis) in an ulcer of the ear
Avhich was accompanied by a deep-seated otitis. Nocard describes
minutely certain epileptiform fits in which the dog had a peculiar husky
cry and rushed about violently, running into various obstacles, and
finally fell insensible, and after a number of such attacks became totally
deaf. Sewell describes the condition as finding a collection of brown or
sooty-colored cerumen in the ear. If the inside of the ear is examined
closely a number of tin)^ white specks, the size of the eye of a needle, are
seen to be rapidly moving about the ear, and he believes that the tickling
sensation caused by these movements and the biting of the parasite are
what produce the irritation of the lining membranes of the ear. Boden
examined every case brought to the Dresden canine clinic, but failed to
find a case due to parasites. Frick after numerous examinations had
the same result. Cadiot and Newmann describe a parasite which causes
parasitic otitis (acariasis auricularis, otacariasis).

Symptoms. — The ear is hot and slightly swollen, and on examination
it is hard to distinguish it from ordinary otitis. There is, however, less
discharge in this condition. The head is carried to one side, and the
animal will scratch the base of the ear very gently with its paw and whine
in a plaintive way. After having observed a number of animals infected
with the parasite, the writer is inclined to think that the carrying of the
head on one side and the gentle scratching of the ear are characteristic
of the disease, although it is quite as frequently seen in non-parasitic
otitis. The epileptiform symptoms described by Nocard have never
l)een observed.

Treatment. — Nocard recommends naphthol 1 part, ether sulphuric 3
parts, and olive oil 10 parts. This should l)e injected into the external
auditory canal once daily, and the ear plugged up with cotton to prevent
the escape of the ether. The latter procedure is not advisable, for if the

440 DISEASES OF THE EAR

ether is confined in the ear it causes great irritation, and the author has
found from experience where he has followed this procedure that while he
may not have observed epileptiform fits before the treatment, he has had
symptoms simulating them very much after the ear was injected with
ether and the cotton plug put into it.

Sewell advises the application of the following liniment:

I^. Ung. hydrarg. nit., 4.0

Oleum airiygd., 32.0

M. S. Apply a small amount to the inner surface of the
ear with a camel's hair pencil.

The ear should be first cleaned out with wood alcohol, and then
apply the above.

DISEASES OF THE SKIN.

INFLAMMATORY CONDITIONS OF THE CUTANEOUS MEMBRANE.

Inflammatory symptoms of the skin vary according to their intensity,
character, or location. The slightest irritation may produce redness,
either with or without swelling — this is defined as erythematous inflam-
mation; or we may have a formation of circumscribed, solid, firm pro-
tuberances, papillae, pustules, boils, or granulations. These are ascribed
to exudations originating partially in the papillary body, in the Malpighian
membrane, and also in the neighborhood of the follicles.

The inflammatory exudation may become reabsorbed in certain
cases, so that after the acute period of the disease has passed, the epidermis,
which has become loosened, is gradually desquamated in the form of
scabs or crusts. We also occasionally see a dark pigmentation after the
disease has run its course. This originates from the haemoglobin of the
extravasated red blood corpuscles. If the inflammatory processes and
exudations increase gradually in the cutaneous tissue, we may observe
two different results. The inflamed location may become covered with
a moist, liquid exudation, or the horny layer of the epidermis is raised up
by the fluid, and we may have vesicles which raise the granular layer of
the mucous strata, and also the deeper layer of the membrane becomes
destroyed in the affected region. In the first case it is covered by the
deep layers of the membrane; in the latter case the upper surface of the
corium is exposed, having lost its vesicular covering.

The liquid w^hich fills the small or large vesicles is deficient in cells
in the early stages of its formation, and the liquid is clear or slightly
yellow. Later it becomes turbid by the addition of leukocytes, and a
number of whitish-yellow cells fill the fluid. In some cases it has this
appearance from the very onset. When the liquid contained in the
vesicle is yellow and filled with cells it is called a pustule. Sooner or
later the covering of the pustules becomes ruptured, and the fluid dries
up in a yellow, gray, or brown crust, under which the regeneration of the
lost epidermic layer goes on rapidly.

Now and then the inflammatory process shows it Is in the neighbor-
hood of a follicle and its sebaceous glands, and we have the formation of
a dark red, very sensitive nodule, and finally suppuration of the same
membrane and its adjacent tissues. As a consequence of this we find

441

442 DISEASES OF THE SKIN

that the glands and canal of exit are filled with purulent or bloody matter.
Soon the internal follicles become involved; the masses of matter can be
easily pressed out of the orifice of the follicle, and we may have an elas-
ticity of the purulent cavity surrounded by infiltrated cutis in which we
find the hair has become entirely detached from the follicle and falls out.
This condition is generally a rather serious affection in the dog, as in this
animal there are always several follicles which are accumulated into
one group with a common orifice, and in every case of cutaneous disease
we find a group of affected sebaceous glands.

In very bad cases peri-glandular and peri-follicular inflammation
may become so acute that we see the formation of an extended nodule-
shaped, dark red swelling, forming a so-called "boil." This is marked
after a certain period by a yellowish-green, necrotic thrombus, which
becomes detached by purulent disintegration of the surrounding tissue,
and is sloughed after the pus has been discharged. In such cases we
find that not only is the external surface of the skin impaired, but the
corium is affected, and as the follicles are destroyed the hair does not
return. The formation of abscesses and ulcerations, also inflammations
of the skin, will be discussed further on.

In chronic cutaneous inflammation we may see the formation of
hypertrophic as well as atrophic conditions. In the former case we find
as a consequence of the constant increase and congestion of blood in the
part the formation of sui^erfluous connective tissue, whereby the skin
may be thickened several times its normal size and may form large folds
or collosities, and in rare cases club-shaped or warty elevations. In the
latter case the corium becomes thinner. This is also the case with the
epidermis. Its tissue is either greatly reduced or greatly increased in
size, and in the latter case the epidermic cells which proceed from the
deep part of the tissues do not undergo any horny degeneration, but
rather a drying, mummifying process, covering the membrane in the
shape of numerous whitish or white-gray scabs.

NON-PARASITIC DISEASES OF THE SKIN.

Erythema.

{Redness of the Skin.)

Erythema, due to disorders of the circulation, is the mildest form
of inflammation of the cutaneous membrane and consists either of
normal hypera>mia of the corium in its upper layers (erythema simplex,
erythema congestivum) , or it may be due to a slight sero-cellular infiltra-
tion of the membrane of Malpighi — erythema exudativa (dermatitis
erythematosa).

ERYTHEMA 443

Etiology. — Erythoma is a local irritation of the skin and originates
as the result of various external cutaneous irritations "which may be
mechanical, chemical, or thermic — for instance, animals with thick,
■\vooly coats, having their coats cut short or shaved to the skin; from
irritation of the skin between the toes, caused by running through sand;
by friction of the collar upon the skin of the neck; bathing in strong
creolin mixtures — coal oil, benzine^ — lyiiig on rough boards; bites of in-
sects; on the abdomen from ammoniacal urine (in catarrh of the bladder) ;
in catarrh of the prepuce, and by slight burning or freezing. Erythema
may also appear in connection with various cutaneous diseases, such as
eczema, scab, and canine varioloid, and the presence of an enormous
number of fleas.

Clinical Symptoms and Course. — The symptoms consist of a bright
arterial redness of the cutaneous membrane, which disappears under
pressure of the finger, but reappears immediately after, and may be
complicated in some cases by slight swelling of the epidermis. As a rule,
the affected portion is reddened, but not irritable, although, as a rule,
the animal evinces pleasure on gentle rubbing of the skin. The
course is usually short, depending to a large extent on the cause. When
this is suppressed or removed, especially after the itcliing and rubl^ing
have discontinued, erythema disappears, and in certain conditions it is
followed by desquamation of the upper membrane. There is, however,
a more or less dark red spot left after the acute symptoms of the disease
have lessened. These finall}^ disappear, but very slowly. This is par-
ticularly noticeable when the irritation is due to preputial secretion or
ammoniacal urine.

Therapeutic Treatment. — There is not, as a rule, any great irritation.
It will be sufficient to remove the cause in order to remove the erj-fhema.
If there is a certain amount of irritation, we must lessen it by bathing
the animal with lime water and sponging the affected parts with any of
the following solutions: lead-water; solutions of alum; bay rum; cologne;
benzoin 1 part, alcohol 30 parts; ichthyol or salicylic acid soap; rublnng
with salicylic oil (1 part of salicylic acid dissolved in 35 to 40 parts of
olive oil and heated slightly) ; or a mixture of 1 part of glycerine and 5
parts of water; or 1 part of carbolic acid, 10 of alcohol, 10 of water; or
4 parts of creolin, 100 of water; or 1 part of ichthyol, 10 of glycerine, 30
of water; or 10 parts of nitrate of silver, 100 of water (Friedberger) .
Frecjuent dustings of talcum powder is one of the most efficient remedies.

In very obstinate cases we may also use laxatives or purgatives
(aloe, jalap, salines, etc.), also the internal administration of arsenic in
the form of Fowler's or Donovan's solution.

444 DISEASES OF THE SKIN

Urticaria.

{Nciile-rash.)

This disease is an acute irritation of the skin, indicated by the
formation of circumspect elevations from one to one and a half inches in
diameter, and due to a vasomotor neurosis (angioneurosis) of the skin.

Etiology. — This disease is comparatively rare, and except where
we can trace it as being due to some known external irritation, such as
stings of insects — leptus autumnalis — or turpentine. The real cause of
the majority of cases of urticaria is not understood, being due to some
internal irritation, the cause of which is unknown. This is classed under
the general head of idiopathic urticaria. In the majority of cases it
certainly is due to some disorder of the intestines (catarrh of the intes-
tines, constipation, etc.), and it is supposed that faulty assimilation
caused the admission into the circulation of certain toxic substances
which get into the circulation and are eliminated by the skin, causing
local irritation. Schindelka saw a mastiff bitch which was affected
with vaginal catarrh and condylomas of the vagina and accompanied
by general urticaria, and also saw the same condition in a poodle bitch,
during her period of heat. Urticaria may also follow rapid cooling after
the animal has been in a great state of excitement. It has also been seen
during dentition of the permanent molars.

Clinical Symptoms and Course. — The manifestations of nettle-rash
generally show themselves without any previous fever or other phenom-
ena, such as want of appetite, depression. There appear over the entire
body circumspect flat hemispherical elevations, varying in size from a
pea to a large bean, on which the hair is ruffled and staring. When two of
these elevations become confluent the elevations are much larger; the
skin may be itchy, but this is rare. The course is rapid, frequently
twenty-four hours after the eruption appears the rash has entirely dis-
appeared, but occasionally a new crop of elevations appears or the disease
may take a chronic course (urticaria chronica) , but this is only in very
rare instances. The eruption may last for a number of days, and when it
disappears it leaves a peculiar pigmentation of the skin, Schindelka has
called this urticaria pigmentosa.

Treatment. — In the acute cases, the condition disappears before
treatment can be of use. In slower cases, as a rule, saline laxatives,
saturated solution of sulphate of soda, Hunyadi Janos, Apenta; and when
there is itching use some of the local preparations recommended in
erythema.

ECZEMA 445

Eczema.

{Red Mange.)

By this Ave mean fat mange, summer mange, phagedenic scab, scale
scab. It is a cutaneous disease which appears in all breeds; it is non-
contagious and is an inflammatory condition of the cutaneous membrane
indicated by redness, swelling, nodules, pustules, fissures, scabs, and
crusts, which are generally accompanied with more or less itching. In
the first stages development of a hyperaemia is seen, thus reddening the
skin superficially, and accompanied by a serous exudation. If the inflam-
matory irritation stops, or if proper therapeutic measures are taken,
recovery may occur at once, and we have a more or less prolonged desqua-
mation of the epidermis. In the majority of cases, however, the irritation
increases and we find the formation of numerous pale red, tough, itching
nodules, accompanied by serous swellings and slight cellular infiltration
of the papilla}, but generally it is connected with the cutaneous follicles.
This condition may become retrogressive; the* nodules become depressed,
forming scabs. In other cases the serous exudation increases constantly
inside the papule, and, as a consequence, we have a rising of the external
cutis in these locations; or, in other words, numerous vesicles are formed
(eczema vesiculosum) . If the external cutis is strong enough to resist the
accumulated exudation for some time, the contents of the vesicles grad-
ually become milky and pus-like, on account of the entrance of colorless
blood-cells into the tissues (eczema pustulosum).

In other cases the vesicles burst or are scratched open; the skin is
dark red in large blotches, and is marked by fine furrows which corre-
spond with the location of the ruptured vesicles. The eczematous exu-
dation oozes freely out of the upper surface (eczema rubrum). It is a
common occurrence to see the detachment of small portions of tissue
which are located between the numerous furrows in the epidermis.
Thus the whole surface of the skin is stripped of its ornyh layer and
may become filled with pus. The oozing liquid dries rapidly and be-
comes a scab or crust (eczema impetiginosum) , which is pushed away
gradually by the consecutive exudation, and finally becomes hard, dry,
and firm. Inflammation and swelling become gradually lessened under
the crust, and we have the formation of a firm epidermic cover, from
which the crusts gradually become detached. The diseased membrane,
which is now exposed, is not swollen to any great extent, but very red
(sometimes marked with dark, livid pigmentations) and covered with
numerous loose scabs which constantly fall off and are renewed from time
to time (eczema squamosum).

Etiology. — The etiology of eczema is of great importance for es-

446 DISEASES OF THE SKLY

tablishing the correct prognosis, as no cure can be obtained until after
the cause of the trouble is removed. The first thing we must do is to
lessen the mechanical irritations, such as appear under the collar and
on the testicles. But the lesions which the patient inflicts upon himself
are of very much more importance, for we see it in all forms of itching
eruptions of the skin, in erythema, in cases of parasites of the cutaneous
membrane — flies, lice, acari — ^in great accumulations of dirt, scabs, and
falling out of the hair. "We also find attacks of eczema which extend
very fast, and in some cases may go all over the body.

As regards the second group of agents which cause eczema, they
are chemical irritants, especially those which have an influence upon the
tissues, such as acids, alkalies, mixtures of mercury, also tar and car-
bolic salves, combinations of ether and oil of turpentine, of mustard,
and also tar-soap.

The third group is formed by a number of thermic irritations,
namely, excessive high temperature, but not high enough to produce
vesicles.

Eczema appears more frecpently in summer than in winter, and we
have a great deal more difficulty in healing it during the summer weather.
We also have a number of eczematous formations for which we can find
no cause. In such cases the disease has been ascribed to acids in the
blood or diseases of the nervous apparatus, and also to vegetable para-
sites, and as the sensible perspiration in the dog is so slight, it is very apt
to cause irritation when the skin becomes congested, checks the secretion
of the glands and retains the natural excretions. There is no doubt
that- various fermentative and toxic processes occurring in the intestinal
tract are factors in the production of eczema rubrum, and that dogs
have the disease annually, and associated with constipation. Ep-
pinger contends that too much meat is not the actual cause as he
has cases where the animal has had moist itching eczema and treated
the animal with various drugs without result, and finally gave the
animal a meat diet, and in two weeks the animal was entirely recovered.
This, however, must have been an individual case as experience is that
a strong meat diet is invariably one of the causes of this disease.

Clinical Symptoms and Course. — Eczema may appear in any breed
of dogs and in any region of the body without regard to age, sex, etc.
It is usually seen on certain regions of the body (back, head, neck, and
external surface of the extremities).

There are three general forms of eczema without taking into con-
sideration the changes which may be produced by irritation, scratching,
or rubbing.

(1) Acute Moist Eczema. — This may develop year after year and
in dogs of all breeds. The longer haired clogs seem, however^ to be more

ECZEMA

447

liable to it. It affects certain localities of the body more than others —
the neck, jaws, elbow, on the back anterior to the tail, and the outside
of the thigh. The first type is restricted to small, irregularly circum-
scribed regions, but has a tendency to extend to the neighboring tissues.
The eruption begins as eczema papulosum with close nodules. The skin
becomes red in irregularly circular patches varying in size from a
quarter (shilling) to the palm of the hand (Fig. 158); there is increased
heat and the skin thickens, the hair stands up, and soon a number of
small vesicles are seen, which burst and discharge a pale yellow viscid fluid,
and in from twelve to twenty-four hours there is partial or complete

Fig. 158. — Moist eczema of the shoulder, and muzzle to jjrevent the animal biting it.

loss of hair. This rapidly changes into the vesicular layer by alteration of
the nodule, and finally we see the appearance of the median stage.
This has a more or less extended surface without skin or hair, and shows
a bright red, serous, sero-fibrinous or purulent exudate, very painful
to the touch, and having a great tendency to extend to the adjacent
tissues (phagedenic scab). The stage of crustation follows A^ery slowly;
the exudate dries, forming a yellow-green to brownish crust which is
firmly fixed to the skin and if not rubbed by the animal forms a thick
scab that may fall off in a few days, but generally it is two or sometimes
three weeks before it finally comes off, leaving a glossy, hairless, deep
red or pigmented surface, with more or less gray scales. The surface
soon becomes covered with fine hair, which soon grows very rapidly,
covering the spot very quickly. This termination is frequently altered

448

DISEASES OF THE SKIN

by the animal scratching, biting or gnawing the itchy surface, particu-
larly when the sore is on the side where the animal can scratch it with
the hind legs, or on the thighs or back where he can bite it. In rare in-
stances the animal may so lacerate the affected portion as to cause
permanent loss of hair. The course of this disease depends on whether
it is treated early, for if neglected its course is apt to be slow or it is
apt to degenerate into the chronic form, particularly in older animals.

Chronic Eczema. Dry Eczema. Scab Mange. — The second type
shows from the beginning an inclination to extend. In is generally

Fig. 159. — Chronic eczema of the back.

observed in sluggish, well nourished dogs, and while it may occur in all
breeds of dogs, it is more apt to be seen in short-haired dogs. It com-
mences on the back at the root of the tail and extends gradually up the
centre of the back, each succeeding attack going a little further forward
until it finally reaches the neck. It is sometimes observed at the base
of the ear, around the anus and the extremities; the scrotum is also a
seat of the disease, and in exceptional cases the entire body is attacked
(general eczema).

In the early stages we see it as eczema erythematosum with for-
mation of scattered papules. These are scratched open on account of the

ECZEMA 449

great itching they cause, or they become altered into pustules. Later
we see the appearance of small scabs under which regeneration of the
epidermis occurs, the hair falls off or frequently long solitary hairs are
found, the skin is thickened, developing wrinkles, crevices which fre-
quently are raw, and the surface dull, lead colored, ''elephant hide"
in appearance (Fig. 159). In the other regions desquamation of the
epidermis follows, particularly in summer; the animal, from the intense
itching, scratches and tears the skin, converting the entire surface into a
raw bleeding space with spots of pigmentation. There is more or less
itching, but the irritation is not nearly so great as in sarcoptic mange,
and is limited to the affected skin.

In chronic eczema the condition gradually creeps up the back,
becoming broader and assumes a dull dark lead colored ''elephant hide"
look, with long unhealthy hairs here and there, or else this condition
may prevail during the summer months, defying all forms of treatment,
and when the cool autvimn months come the irritation gradually sub-
sides, the hair begins to return, becomes thick and normal by January
or February and remains so until July or August comes, and the con-
dition returns.

The following is a list of remedies useful in eczematous eruptions:

Ichthyol ointment, 2 to 5 per cent., with equal parts of lanolin and
cosmoline.

Ichthyol tar-soap moistened and rubbed on the itching parts and
allowed to dry.

Permanganate of potash solution of the strength of 1 to 3 per cent,
where the skin is peculiarly irritable.

Where the surfaces are widespread and moist, dust with equal parts
of talcum, lycopodium, and boric acid.

For use in the house on pet-dogs that have the range of the parlor
and lounge on the rugs and furniture, try a 15 per cent, solution of
hyposulphite of soda.

Creolin baths of the strength of 5 per cent, will give very great relief
for many hours.

In the finer toy varieties, try a 1 per cent, solution of trikrcsol; ten
grains of boric acid to the ounce of this solution adds to its efficacy in
some cases.

Chloro-naphtholeum, two ounces to the gallon of water, is a useful
medicated bath for the large varieties of dogs, and is destructive to
parasitic forms of life.

Trikresol soap is far safer and better than carbolic acid soap for
bath purposes when washing dogs frequently.

Do not use bichloride of mercury solutions in moist eczema.

Starch and oxide of zinc may be used separately or in combination
29

450 DISEASES OF THE SKIN

as a dusting-powder alone, or after any of the watery solutions and
tend to hasten healing of broken or denuded parts.

In chronic and long-standing cases, where fissures of the skin have
formed and the animal tends to bite the affected parts, causing bleeding,
touch them a few times with Monsel's solution of iron, and then use one
of the powders.

For softening the parts, equal portions of lanolin and pure cosmoline,
with ten per cent of ])oric acid, will be found useful and cleansing.

Itching of the Skin Without Presence of a Rash. — This condition may
extend over the entire boily or it may be limited to the back or abdo-
men, or the internal surface of the thigh. Frequently there is intense
itching, with little or no evidence of change in the skin. The skin ap-
pears red in some cases with only the slightest evidence of papules. In
some cases the animal will scratch constantly, and at night the itching
is apt to be particularly violent (this is seen generally in animals that
are particularly well fed, house pets that are bathed often) . They scratch
their sides with the paws, bite different portions of their anatomy with
the teeth, and rub under or against furniture until there is great irrita-
tion of the skin. A similar condition is also seen in dogs that have been
clipped, and the short stubby hairs sticking in the folds of the skin cause
great irritation, l)ut in this condition, while the itching is intense just
after the animal is clipped, in a short time the hair grows and, becoming
more flexijjle, does not cause irritation and the itching soon disappears.

Seborrhoeic Eczema. Eczema Seborrhoeicum. — This generally origi-
nates from a seborrhoea sicca; it may be local or general, and is distin-
guished by a number of eczematous calculse or oval disks which are
either solitary or in groups, each elevation being clearly outlined from the
other. There is no itching, as a rule, and if there is, it is insignificant.

Eczema of the Toes. Interdigital Eczema. — Eczema between the
toes is quite common. It is apt to occur in well-fed, well-taken-care-of
house pets, and also a certain numlier of cases originate from actual
external influences, such as sporting dogs in the field working through
stubble, short grass and weeds; generally, however, it is due to good
feeding and want of exercise, and may occur in any of the various forms —
eczema vasculosum, eczema medidans, or eczema pustulosum.

Therapeutic Treatment. — In the treatment of eczema we must con-
sider the following facts:

(«) That in many cases the tar preparations which have been
used almost exclusively are very harmful, as is also the method of
systematically washing the animal with strong alkaline or carbolic
soaps. The first thing to do is to give attention to the causes and find
out from what cause the itching really occurs, as many cases of eczema
disappear as soon as the irritation has been suppressed.

ECZEMA 451

We must first remove any cause of irritation that would tend to
aggravate the condition — such as dust, scales off dandruff, parasites — or
anything that would tend to prolong the condition. Filthiness of the
skin and hair nuist be removed by bathing the animal thoroughly,
taking care to use a clean superfatted soap that does not contain too
much alkali, and particularly avoid various soaps that contain crude
carbolic acid or the irritating coal-tar products, so frequently seen in
the ''dog soaps" sold. It must he borne in mind, however, that too
frequent bathing is apt to act as an irritant in eczema and while it should
be used to remove dirt, it must not be used frequently, but as an actual
necessity. In acute squamous eczema, the irritated spots can be dried
up by pressing absorbent cotton on the sore, which has been saturated
with carbolized oil, lime w^ater, boracic acid solution, creolin solution,
acetate of alum, or thiol mixed with corn starch. In the acute form of
eczema the hair should be clipped not only over the affected parts, but
also cut a clear space in the tissues surrounding the sore. Excessive
scratching must be avoided by putting on muzzles, bandages or covers over
the body, or chamois boots on the hind legs, etc. Finally, care must be
taken to prevent the animal licking off the medicine, which may either
act as an intestinal irritant, or actually poison the animal; with the addi-
tion of muzzles, the means already mentioned should be employed.
We dust the affected parts with oxide of zinc, cerussa, sulphur, or thiol,
talcum powder, corn starch, magnesia containing l)ismuth subnitrate,
dermatol; salicylic acid in talcum powder is particularly useful. If the
affected parts are very moist, they may be dusted with lycopodium or
smeared with vaseline.

In cases of extensive redness of the skin we must apply compresses
of lead-water or thymol (1 per cent.), creolin (1 to 2 per cent.), carbolic-
acid water, thiol water (20 per cent, thiol liciuid, 30 per cent, glycerine,
and 50 per cent, water); and where the skin is di-y, an ointment of sul-
phate of lime, or sugar of lead in lanolin, dermatol (1 to 5) or tannin
(1 to 10); but powdering is preferable as every skin is not benefited by
liquid or oily preparations in the early stages. As soon as the marked
symptoms of the disease have decreased we may replace the use of
powder by ointments of zinc or lead, white precipitate ointment, or
cold cream, lanolin, benzoin and glycerine, and benzoin and lanolin, 1 to
30, or use mild ichthyol soaps.

(6) In very moist eczema with an acute course the use of powder is
not always successful. In those cases we must apply drying fluids,
such as corrosive sublimate solution (1 to 1000), nitrate of silver solution
(2 per cent.), 1 per cent, solution of picric acid twice daily by means of a
brush or cotton tampon, and at the same time use the powders already
mentioned in conjunction with these liquids. Great care must be taken

452 DISEASES OF THE SKIN

when using the sublimate to avoid poisoning, also the application of both
nitrate of silver and picric acid are apt to leave more or less black or yellow-
stain on the skin. Oxide of zinc and sugar are recommended by Bis-
sauge, to be dusted on several times daily. Sublimate ointments (1 per
cent.) or subiodide of mercury (2 per cent.) are beneficial, but strong
solutions of blue-stone or crude sulphate of iron and tormentilla root are
not to be recommended.

I^. Hydrarg. l^ichlorid., 1.0

Glycerinum, 10.0

Spts. vini rect., 90.0

F. M.
Sig. — To apply upon eczematous surfaces.

Zinc oxide,

5.0

Amyl. pulv.,

Talc,

aa 10.0

F. M.

Sig. — Dusting powder.

Bismuth subgallate,

3.0

Talc,

20.0

F. M.

Sig. — Dusting powder for

moist

eczema.

(c) In cases of pustula we may use the same treatment as is in-
dicated in b, after having pressed out and emptied the pustules. The
writer has also obtained good results v/ith ichthyol liniment and salicylic
ointment (see Acne).

(rf) In chronic eczema, when it has reached the scaly stage, we must
first clean the skin thoroughly with some mild, non-irritating soap, but
not carbolic or tar soap. The best kind to use is Castile, ivory, green
German soap, or the pure potash soap of the Pharmacopoeia. The
writer has had good results from "Hebra's" alcoholic potash soap:

I^. Saponis kalin. venal., 200.0

Alcohol, 100.0

Hebra's soap is poured or rubbed upon the surface which is thickly
covered with crusts, and on the following day they are removed easily
without subjecting the animal to much pain. After careful cleansing
we use the same agents as are used in the moist forms of eczema — zinc
powder, corrosive sublimate, or nitrate of silver.

(c) In chronic eczema, we use tar and ichthyol and resorcin. The
first is used either in the form of solutions of tar or combinations with
oils. These preparations are used with good results in the chronic forma
of eczema where there is considerable cutaneous thickening, with cracks,

ECZEMA 453

fissures, etc. Ichthyol is especially useful, and when used in concentrated
form in ointments or liniments, it is much more valuable than tar prep-
arations, because it relieves the itching or irritation in a very short
time. Its high price bars its use to a certain extent when it is to be used
in a kennel of dogs. Resorcin is also used in spiritous solutions. It has
the disadvantage of staining the hair of light colored animals yellowish-
or brownish-green, wdiich takes a long time to wear off. In chronic
eases, alcoholic preparations of benzoin, 1 to 30, are very useful, to be
well rubbed into the skin daily.

I^. Oleum picis, 3.0

Spts. villi rect., 2.0

Ether sulphuric, 1.0

F. M. S.— Rub into the parts every third day.

I^. Picis Hquidse,

Saponis kalin. venal,

Spirit dilut., aa 50.0

Sig. — Apply once daily.

T^. Creolin,

Sapo kalin venal, aa 100.0

Spts. vini rect., 50.0

F. M.

Sig. — Rubbed in daily. (Frohner.)

I^. Ammon. sulfo-ichthyolic, 12.0

Aqua calcarise,

Oleum olivarum, aa 60 . 0

Sig. — Apply upon the thickened membrane once
daily. (Frohner.)

^■

Resorcin,

3.0

Spts. vini rect. dil.,

120.0

F. M.

Sig. — Rub into skin daily.

Acid salicylic,

5.0

01. Fusci,

25.0

Sapo. viridi,

1.50.0

Sig. — Soap for chronic seborrhoeic eczema.

Acid salicylic.

3.0

01. olivae,

100.0

F. M.

Sig. — Rubbed into the skin

daily.

That form of eczema described under the head of itching of the
skin without the presence of papules generally resists treatment. Fre-
quent bathing with the various strong soaps, sold as "dog soaps" con-

454 DISEASES OF THE SKIN

taining active irritants, such as tar, crude carbolic acid, and various
other chemicals supposed to destroy fleas, tends to irritate the skin and
increase the itching. First, the blood which is generally too rich from
overfeeding, or too little exercised, must be purified by the internal
administration of salines, such as a tablespoonful of saturated solution
of sulphate of soda (giauber salts), once daily, or the same amount of
Hunyadi or Apenta water, and when the animal is bathed it must be
with the mild superfatted soap, containing little alkali and some soothing
preparation, such as benzoin or ichthyol. Frequently bathing has been
found to aggravate the condition. The animal should be rubbed daily
with bay rum, spirits of camphor, or benzoin, 3 parts, lanolin 1, and
alcohol 2 parts, or salicylic acid and alcohol (1 to 30), or resorcin and
lanolin (1 to 50), and internally the regular adminstration of some of
the arsenical combinations — sulphuret of arsenic, 1-200, Fowler's or
.Donovan's solution, in 1-, 2-, or 3-drop doses. These arsenical prepara-
tions must be always given in the food, for when given on an empty
stomach are very apt to cause vomiting; at the same time the animal
must be exercised, the amount of meat must be lessened to a minimum,
and the diet be soups containing vegetables and stale hard bread or
toast.

(/) If there is considerable thickening of the skin, and if the latter
is covered at the same time with scabs, we can obtain good results by
rubbing salicylic oil (1 part salicylic acid in 35 parts of warm olive oil)
over it daily for a week. If this does not succeed, which, however, is
very rare, we must first use tar or ichthyol preparations and follow it up
by the other. Some authors advise friction with soft soap, chrysarobin
ointment, or naphthalin, and washing with potash.

For internal treatment, use saline laxatives, and where there is
general disorder of the digestive tract, such as gastro-intestinal catarrh,
constipation, or foetid black stools, regulate the diet, put the animal on a
mixed vegetable and meat diet, and two meals daily. The amount should
be just as small as possible until the animal regains his appetite; in fact
w^ait until he is ready to eat every meal when it is offered, before putting
him back on his regular food. Yeast preparations, such as brewer's
or baker's yeast, are recommended on account of their properties for
stimulating the intestines.

Administer arsenic in the form of red sulphuret, 1-200 grain, or
Fowler's or Donovan's solution, 1, 2 or 3 drops in the food twice daily.
The theory that the gradual increase of the dose of arsenic until you have
reached the point where the physiological effects were beginning to show
on the teeth, vomiting, etc., is an error. Small regular doses continued
over some time is the best mode of treatment. Care must be taken,
however, not to start on too large a dose.

ACNE

455

Acne. Furunculosis.

Under the name of ''acne" we mean an inflamimation of the hah--
follicles and sebaceous glands resulting in suppuration. This form of
skin disease is not produced, however, by follicular acari. This condition
is classed as folliculitis or perifolliculitis, and in the dog is regarded as a
rather grave condition, as the various follicles in the dog are freciuently
connected by one common follicular duct, particularly in the hair bulbs
where they have a very complex arrangement with the sel)aceous
glands, and the irritation of one duct involves the whole hair bulb and
sebaceous gland, causing extensive elevations, painful nodules, or dark
bluish-red tumefactions (furuncle, dermatitis furunculosa).

This condition generally appears on the nose, cheek, side of the face,
external fascite of the extremities, between the toes, and in some cases
over the entire body.

Etiology. — ^"er3^ little is known of the actual cause of this disease.
Local irritations have been thought to be the cause, such as constant
pressure of the muzzle, licking or rubbing the affected parts, and in certain
cases to some hereditary predisposition due to alteration in the character
of the sebaceous glands, to waste products or pus that breaks down and

Fig. 160. — Acne of the nose.

tends to encourage the growth of bacteria which invade the hair-follicles
and sebaceous glands. Dogs affected with chronic constipation are more
liable to have acne.

Clinical Symptoms and Prognosis. — This disease which seems to

45G DISEASES OF THE SKIN

attack certain portions of the Iwdy more than others, particularly on the
skin of the snout between the stop to the nostril (Fig. 100), cheeks,
side of the skull, and between the toes; more rarely on the outside of
the legs, and in exceptionally rare instances it extends all over the body,
develops very slowly, beginning with redness and loss of the skin and
hair. It is indicated by a series of red spots which are painful, irregular,
swollen, and extend over the surface the size of a dollar to the palm of
the hand. These spots are caused by the formation of a large number
of pea-like nodules which are hard and firm. In some cases we find the
whole surface of the skin red, hard, and very painful to the touch. After
a short time the nodules become soft, discharge spontaneously a more

Fig. 161. — Acne muzzle.

or lesser amount of bloody pus, and contain in some cases cores of necrotic
tissue.

Occasionally we see the coalescence of a number of these acne nodules,
so that the skin presents a bluish-red discoloration and becomes purulent
or sometimes necrosed, as if the skin was undermined by purulent
collections. This may appear all over the body.

The "non-acarian" acne often presents symptoms similar to the
parasitic acne (dermodectic mange) and in every instance it is always
well to make a careful microscopical examination of some of the pus
sc^ueezed out of nodules to see if any of the acari are present. It has a
great tendency to extend in almost all directions, and the cicatrices
which appear after healing of the disease leave bare spots in different
parts of the body, pink in color, streaked with lines of black pigment
deposits.

Therapeutic Treatment. — The treatment consists in the removal of
any known cause of the disorder — when the disease is located on the nose,

ACNE 457

which is one of the commonest locations of the disorder, due to pressure of
the muzzle, the accompanying figure shows a muzzle recently put on the
market (Fig. 1(51), which obviates the pressure on the nose, the ordinary
nose strap being replaced by a snooth metallic arch. The ordinary
muzzle can be covered b}^ ra^vhide, leather or wadding or, better still,
the portion toward the nose faced with patent leather. The treatment
consists in the energetic local application of various external preparations.
If the aeneous nodules are in the early part of their development, we
must puncture them or open the follicles by some strong antiseptic, such
as salicylic or balsam of peru ointment. In cases where purulent dis-
integration has gone on it is advisable to open the pustules. This is
l)est performed by means of a small bistoury or short strong needle,
and then fill in the opening with iodine or paint it with disinfecting
solutions, such as pyroktanin solution (1 to 10 of alcohol), or a 1 to 1000
solution of corrosive sublimate, compound tincture of benzoin, or dusted
with boracic acid, or bismuth-formic-iodide. This should be used once a
day when the acne is developing.

I^. Acid, salicylic, 20.0

Oleum olivse, 40.0

Lanolin, 80.0

Sig. — Put a small portion on the parts once daily.

I^. Naphthol, - 10.0

Sulphur sub., 50.0

Ung. petrolati,

Sapo. viridis, aa 25.0

F. M.
Sig. — Apply daily.

The following should be used when the pustules have been emptied :

I^. CreoHn, 1.0

Acid, boraci, 30.0

F. M.
Sig. — Dusting powder.

Frohner advises curetting the cavities and the use of the creolin
ointment just mentioned, and in some cases cauterization with nitrate
of silver, or powdering with sulphonal and tannic acid. In cases of
circumscribed acne it is advisable sometimes to cut out the diseased
portion of the skin.

The scales or scurf must be removed daily, until the pus is cleared
out and granulation has commenced, then encourage the formation of a
scab by using one of the various antiseptic dusting powders or the daily

458 DISEASES OF THE SKIN

painting of the part with compound tincture of benzoin, until a thick
scab is formed which protects the sores while healing goes on.

Alopecia. Falling Out of the Hair.

By this term we mean a falling out of the hair which is not caused
by actual disease of the hair. We make a distinction, however, between
general alopecia and alopecia areata. The former is an extensive
falling out of the hair, often recognized after serious disease and during
the period of convalescence, as in the latter stages of gestation and during
and after nursing a large litter. The latter is a symptom of bad nutritive
condition (alopecia symptomatica), and is characterized in some cases
by a circumscribed or rounded herpes; this may become confluent and
is especially developed on the back, tail, and external fascise of the thighs.
In both forms it is not rare to find the skin pigmented. Siedamgrotsky
has proved that alopecia of the dog if circumscribed or diffuse, depends
on the atrophic condition of the hair and infiltration of the upper cu-
taneous layers, and it is especially seen in dogs wdth silky, white or grayish
hair. Black-tipped hair, if the body of the hair is gray, is also notice-
able. This condition is very apt to be confounded with herpes, in
the form of a trophoneurosis, either from a disturbance of the cir-
culation, or the irritation of parasites.

It has been thought that certain forms of this disorder might be
due to some specific microorganism, but it has not been as yet isolated
and described. There is seen in two breeds, Pomeranians and York-
shires, a peculiar condition due to atrophy of the hair bulbs, in which
young clogs, rarely over six to eight months, changing from the puppy
hair to the first coat, loose the hair gradually or it falls out in spots or
large areas become bare, invariably one side of the body being in perfect
symmetry with the other, leaving the animal permanently bald in the
affected portions. It rarely covers over the entire body, but is seen in the
hind quarters and body as far up as the anterior limbs. The skin is
bluish-black, perfectly smooth, soft and pliable, with no signs of erup-
tion. That it is due to some pathological change in the central
spinal system is very evident as there is a perfect symmetry
of the affected sides. It is evidently due to too close breeding, when
the object is to get miniature animals, as it is only seen in these toy
breeds.

Therapeutic Treatment. — Find the cause; if any, remove it by treat-
ment. The treatment consists of washing with alcoholic soap, bay rum,
benzoin and alcohol (1 to 30) , and a diluted tincture of cantharides or
balsam of Peru with alcohol, 1 to 10, or some of the various hair tonics
recommended for man. In alopecia areata when it is possibly due to

ALOPECIA 459

vegetable parasites, we should use the treatment recommended for
favus and herpes.

I^. Tincture of cantharides, 5.0

Balsam of Peru, • 10.0

Spts. vini rect., 100.0

M. D. T.

Sig. — Hair tonic.

It is advisable in alopecia areata to use antiparasitic agents, such
as diluted tincture of iodine (Friedberger and Frohner), or an alcoholic
salicylic acid (10 per cent.). The principal therapeutic agents, however,
are rubbing with a strong brush, increasing the nutrition of the skin,
plenty of exercise, and, above all, patience.

Pruritus (Pruritus Cutaneous). — This is an anomaly of the skin in
which there is intense itching without any apparent cause, either from
parasites or visible anatomical alterations of the skin. In man a
similar condition is observed in icterus, diabetes mellitus, chronic
affection of the kidneys and intestinal tract; also from the administration
of some medicinal substances or certain kinds of food. It is also seen in
old age. Intense itching has been observed in rabies, from the presence
of large numbers of intestinal parasites shown by anal itching (pruritus
ani), in certain affections of the spinal cord, distemper, neuritis, disorders
of nutrition, and in some instances no true cause can be found. Fre-
quently old dogs that have been extremely healthy, suddenly begin to age
rapidly and show intense itching of the skin. The treatment of these
nervous conditions depends on finding the true cause of their origin, and
treating these causes. Where it is due to unknown causes, consult the
chapter under the head of itchiness of the skin without the formation of
papules.

Prurigo {itching vesicles) is a disease of the skin which appears at
an early age. It is generally incural)le. There is the formation of a
rash which is intensely itchy. Sometimes Ave may find a prurigo exan-
thema which is indicated by the formation of numerous nodules, followed
later on with pigmentation of the skin and tumefaction of the lymphatic
glands (prurigo bubo). This disease, as a rule, appears only in young
dogs, commencing with an eruption similar to urticaria. The treatment
consists in thorough cleaning with mild sulphur soaps and sulphur, tar,
and ichthyol ointments.

Seborrhoea {Greasy Skin). — This disease is characterized by an
extraordinary secretion of the sebaceous glands. We find two forms,
seborrhoea oleosa and seljorrhcea sicca et pitj'roidis. These two forms
may both be present in fat, overfed dogs. The seborrhoea sicca is
especially found in long-haired dogs, like poodles, as an accompaniment

4 GO DISEASES OF THE SKIN

of eczema. More rarely it is found following distemper. It appears
1)ehind the ears, on the neck, and at the root of the tail, from which
locations it may gradually extend. The animals give off a slightly
rancid or foetid odor and are slightly itchy in the early stages. There
may be a bran-like dandruff which increases in amount, later accompanied
by desquamation of the external epithelium. The hair feels oily and
unhealthy, imparting to the hand a peculiar, foetid, unpleasant odor,
characteristic of this disease. The hair gradually falls out, and the
animal becomes bald. The treatment consists in bathing with strong
sulphur soap, or soaps containing benzoin, and the application of sali-
cylic and sulphur ointments.

Seborrhoea Oleosa. — This appears, as a rule, in the parts having the
most hair, yet it may also be observed in the crural surface and folds.
It frec{uently develops after distemper and is sometimes observed as a
result of the irritation caused by acari. The skin feels as if it were
oiled, and leaves the hand oily after having stroked the animal. Want
of cleanliness may occasionally produce a modification of this condition.

Seborrhoea praeputi has been described by Schindelka as appear-
ing in dogs with very narrow contracted foreskins, and has no similarity
or connection with phimosis. The preputial orifice continually dis-
charges a foetid, oily-like fluid, greenish in color, and has much more
consistency than the discharge in blenorrhcea of the prepuce. The
treatment consists in cleansing of the penis with an antiseptic soap and
followed by dusting the affected parts with dermatol powder. If phi-
mosis is present, the opening must be enlarged by an incision.

Pemphigus. — This appears in man as a result of a number of diseases,
and is indicated by the appearance of a series of vesicles which reappear
from time to time and are apt to become chronic. In one case observed
by Frohner, a male poodle dog not yet a year old gradually lost flesh
and became ansemic. His back and both sides of the body up to the
scapula, as well as the upper part of the legs, were denuded of hair, and
certain raw spots on the skin about 2 mm. deep, varying in size. They
w'ere light rose-red on the border, shiny red in the centre, smooth, glossy
and slightly moist on the surface. On the neck and upper sections of the
anterior limbs were a number of vesicles the size of a hazelnut covered
with dirty brownish-green crusts. These vesicles gave out, when
pressed, a yellowish-white pus. The head, tail and posterior parts of
the legs were free from vesicles or spots. The appetite was very good,
but the animal grew weaker and weaker, and finally was destroyed.

Impetigo. — This is a condition understood as an eruption of pus
vesicles. It is noticed frequently in distemper, and has been observed
in old bitches in an advanced state of gestation. Some of them are also
afflicted with endometritis.

CUTAXEOUS AFFECTIONS OF PARASITIC ORIGIN 461

On the external portions of the anal organs, on the skin of the
internal surface of the legs, and the mammary glands were a number
of pustules the size of hemp-seed, filled with thick yellowish pus Avhich
dried, leaving a brown scab, followed by a gradual succession of new
pustules at the periphery of the affected regions. There was also more or
less general disturbance and fever. These cases, as a rule, make a favor-
able termination.

Canina Bubo. — Frohner describes a purulent follicular inflammation
of the lips, with lymphangitis and lymphadenitis on the head. This
he observed in young dogs. There was swelling of the skin on the face;
the lips became covered with bluish elevations which upon pressure
yielded a bloody purulent fluid.

The Ij'mphatic glands of the larynx and the region of the larynx
and the parotids became tumefied, swelling to the size of a pigeon's egg.
One dog died of pyemia. Frick has seen a similar disease in an old dog,
which he does not think was a specific condition, but due to an extensive
eruption of acne pustules.

Noma. — Moeller compares this with the noma (water cancer) of
children. It is a spontaneous gangrenous formation of the jaw, which
is extremely rare in the dog. The affection is situated in the corner of
the jaw. The gangrenous condition developed very rapidly, reaching
the size of a dollar in a very few days. The skin is grayish-brown in
color, exfoliates and can easily be lifted from the healthy tissue. The
submaxillary lymphatic glands were tumefied; there was also fever and
salivation. The condition finally healed, but only after the greater
portion of the jaw had been lost, the wound healing from the periphery.
The treatment consisted in the application of a thermo-cautery, followed
by corrosive sublimate solutions, 1 to 3000, and the animal was fed by
means of liquid nourishment, being unable, on account of the jaw, to pick
up the food and chew it.

Cutaneous Affections Which are Caused by Animal Parasites.

The changes produced in the skin from disease caused by animal
parasites are divided into two conditions — primary and secondary.

The primary appears as a superficial inflammatory process, produced
directly by irritations of the parasites upon the skin, and this condition
depends to a large extent upon the amount of irritation and the depth
that the parasites have penetrated in the skin.

The secondary symptoms are the result of this penetration into the
cutis, causing more or less itching and irritation, and, as a rule, scratching
and rubbing on the part of the animal, producing heat, redness, papules,
vesicles, pustules, hemorrhages, or excoriations. These irritated spots

4G2 DISEASES OF THE SKIN

may not be restricted entirely to the affected region in which the parasites
are located, but may spread to other localities. This form, which is

nothing more or less than eczema, pos-
sesses two peculiarities which may distin-
guish it at once from the common form
of eczema which is not produced by a
parasite :

1. It invariably appears in single,

isolated eruptive spots, and it is only

after the disease has been present for

some time, or where there is extensive

Fig. 162.— Head of dog flea (Puiex irritation, that we may find the surface

canis). (Megmn.) connected together.

2. "We see the ajipearance of these eczematous eruptions in certain

locations which are especially preferred by the parasites, and showing

their greatest development of the eruption in those regions, even when

the whole body is affected.

A microscopical examination of the scales of the skin will furnish
definite information as to the character of the cause of the eruption.
We distinguish two groups of cutaneous parasites: First, those which
live upon the external surface of the skin, and, second, those which enter
the tissues of the membranes, penetrating deeply into the tissues. In
the first group we have the following:

Ceratopsyllus Canis, Pulex Canis, the Dog Flea.

The true dog flea, as well as the human flea (pulex irritans), is
found in the dog. The former is distinguished from the latter b}^ its
size, by the different length of its tentacles, and by the presence of a
number of sharp hairs arranged in a comb-like layer along the side of
the head (Fig. 1(32). Coarse breeds of dogs are not particularly affected
by the bites of fleas, but pet clogs and delicately bred animals scratch
and rub to such an extent as to cause irritated splotches and redness
over the entire body, and lead the owner to believe that the animal is
affected with mange. The skin is also filled with the small brownish-
black excrement of the flea. If the fleas are removed from the skin by a
bath or in some other manner, we may relieve the itching and irritation
by the application of some soothing solution.

Therapeutic Treatment. — Fleas are best removed by means of
Persian insect powder (Flores pyrethri). This must be moistened with
alcohol and rubbed into the hair. The animal must stand on a sheet of
paper while this is being done, as the flea is not killed, but is only tem-
porarily stupefied by the action of the drug, and falls on the paper. The

CUTANEOUS AFFECTIONS OF PARASITIC ORIGIN 463

paper with its contents must be burned. Another method is to take the
dog out in a fiekl away from the kennel and rub him thoroughly with
spirits of camphor, and the fleas fall on the ground and soon die. The
placing of cedar shavings, walnut leaves or pine shavings, in dogs' ken-
nels tends to keep away the parasites. Parsely seed and absinthe powder
are also useful. In fine pet animals the daily rubbing into the skin of
spirits of camphor drives away the fleas and the camphor left on the skin
after the alcohol evaporates has a tendency to keep the fleas away.
Rubbing with laurel oil, or a mild solution of creolin (2 per cent.) may
be tried, the latter, how^ever, being apt to roughen the hair in soft-haired
dogs. The blankets or cushions where the dog sleeps should occasion-
ally be subjected to heat. The best plan is to put the blankets or
cushions in an oven that is moderately warm, and leave them there for
ten or fifteen minutes. This destroys the parasites and kills the germ
in the eggs. In a kennel the washing of the floor wdth corrosive sublimate
solution 1 to 300, or creolin 1 to 100, and allowing the solution to go
down between the cracks where the eggs lie is particularly useful.

Pulex Penetrans, Sarcopsylla Penetrans (Sand Flea). — This is some-
what smaller than the dog flea and is found in America and since 1872
in certain parts of Africa. It lives in sand and on weeds. It lives on
man as well as the dog, and while the mature male and virgin female
cause little or no inconvenience, the pregnant female burrows into the
skin, burrowing until the head is in the skin, leaving the body protruding.
In a few days the body, in consequence of the development of numerous
eggs, grows to an enormous size in propor-
tion to its normal size, sometimes getting as
large as a pea (Fig. 163). It causes more or
less itching while it is in the skin, and if the
dog should gnaw and kill the insect, it is apt
to act as an irritant, causing suppuration and
in some cases necrosis of the skin. Great care
must l)e used in removing these ticks, as care-
less removal, as has iust been said, causes Fig. les.— Female puiex pene-
trans greatly enlarged,
irritation and abscess. Saturate a pad of

cotton with chloroform or ether and lay it over the parasite which im-
mediately liberates its holding hooks in the skin and falls off.

Haematopinus Piliferus (Dog Louse) and Trichodectes Latus.

{Dog Parasites.)

Description of Haematopinus Piliferus. — This parasite is distinguished
by an egg-shaped head fitted with fine, short hairs and fleshy sheath-trunk
with hooks at the edge. This when lifted shows a sucking tube and two

4G4

DISEASES OF THE SKIN

movable knife-shaped stilettos. The thorax is wrinkled and possesses
three pairs of scissor-like claws. The posterior portion of the body is
large and possesses nine rudimentary legs. The length of the body is
about 2 mm. (see Fig. 1()4 ti).

Description of the Trichodectes. — In this parasite the head is l)roa(l,
quarter-shaped, with three manacle feelers and a tooth-shaped mouth.
The thorax is contracted, the posterior part of the body has nine distinct
members, and the length of the body is from 1 to 2 mm, (see Fig.
164 b).

The former parasites are the most disagreeable, as they suck the
blood from the body, live particularly on those parts of the skin where
the hair is thick and which are not exposed to the cold, such as the neck,
flanks, and around the base of the tail. The trichodectes feed, as a rule,
upon the hair and epidermis, and are found particularly on the head and

Fig. 164a. Fig. 164b.

Hsematopinus piliferus. Trichodectes latus.

The accompanying small lines give the natural size of the parasite.

neck. Both skin parasites produce intense irritation and rubbing,
causing inflammatory efflorescences which look very much like squamous
eczema, with partial loss of hair and formation of scabs. The diagnosis
is usually easy, as we can see the parasites and their eggs by separating
the hair.

Therapeutic Treatment. — This consists of destroying the parasites
and their eggs. For that purpose it is often requisite to clip the animals.
The safest and least harmful agents are decoctions of tobacco (5 to 10
per cent.), solutions of creolin (3 to 6 per cent.), petroleum (crude, or
mixed with benzine, lysol or sapo-cresol) , and in small dogs anise-seed
oil (1 to 10 per cent, of olive oil). Mercurial ointment may be rubbed in
the neck around the collar, but we must not apply more than a piece the
size of a bean, as it is apt to cause salivation. Washing with corrosive
sublimate solution has been tried, but it must be carefully done, as the
same precaution has to be taken as with mercury ointment, the animal
not being allowed to lick the body, as it is very apt to produce mercurial

CUTANEOUS DISEASES DUE TO ANIMAL PARASITES 465

symptoms of salivation. Insect powder (pyrethrimi), mixed with
alcohol, can also be rubbed into the body.

Ixodes Ricinus. — This parasite, which is about 2 mm. in length, and
sometimes when full grown almost 3 mm., looks very much like an
acarus. It penetrates into the skin and sucks
the blood, and is generally seen in setters or
pointers, and dogs when working through the
woods and underbrush become filled with them.
Turpentine and petroleum will destroy them in-
stantly, or, better still, a small quantity of chloro-
form or ether sprayed on the skin makes them
loosen their hold immediately. They should never
be forcibly pulled away from the skin as they leave

. . . . Fig. 165. — Ixodes ncinus.

the mandibles m the skm and cause great irrita- The accompanying line is
tion and frequently an abscess. ^^'^ natural size of the

Leptus Autumnalis. — This is what is known
as a "harvest bug" or acarus. It is about 4 mm. in length,
and is the red larva of thrombidium holosericeum. While human
beings are c{uite frequently affected with this parasite, it is only
rarely found in the dog. Pustular inflammations of the skin of the
dog are sometimes produced by this parasite. The rash was very
prominent on the abdomen and the inner fascia of the legs, and was
healed quickly by an application of carbolic acid and glycerine, or
carbolated cosmoline.

Dermatophagus Canis. — This is very rarely found in the dog, and is
a parasite which affects the ear, producing otitis externa. For further
details refer to Parasitic Otitis (page 439).

CUTANEOUS DISEASES DUE TO ANIMAL PARASITES.

Sarcoptes Scabiei.

{Sarcoptic Manyc; Scabies Sarcoptica.)

Sarcoptic mange (common mange, scab) is a disease of the skin
which is very common, particularly where a large number of animals
are together. It is accompanied by violent itching, and is due to the
presence in the integument of the sarcoptes scabiei squamiferis.

Description of Sarcoptes Scabiei. — This parasite is about 0.2 to 0.3 mm.
broad and from 0.2 to 0.5 mm. long. It has a rounded, turtle-like shape
and a horseshoe-shaped head, with well-developed club-shaped scissor-
like jaws. It has short rudimentary feet, and tulip-shaped suction cups
which are attached to the first, second, and fourth pairs of feet in the
male, while in the female they are found in the first and second pairs only.
In the back we see six elongated acorn-shaped scales or thorns, and four
30

40(3

DISEASES OF THE SKIN

rows of lance-shaped scales on the upper surface of the back. The skin
.shows transverse folds and we find four elongated hairs on the posterior
end of the body (Fig. 166).

The male acari and the young parasites generally inhabit cavities
in the skin which they have made for themselves
(Fig. 167). These cavities are connected extern-
ally by short ducts, the entrances of which may be
marked by small vesicles or pustules, while the fe-
male may move to different parts of the body
when sexually ripe, burrowing ducts through the
upper layers of the epidermis down as far as the
membrana Malpighii, which contains a great deal
of fluid. At the end of the duct, that is, the place
of entrance of the acari — w^e see the development
of a small, somewhat moist nodule, or a vesicle,
which dries up ultimately, leaving a scar. This
digging of the parasite may produce more or less
separation of the epidermis. "We generally find that the parasite has a
preference for certain parts of the body, such as the head, neck, abdo-
men, and chest, at the root of the tail, and the paws. It is very hard

Fig. 166. — Female sar-
coptes of the dog, magni-
fied 75 times, giving the
a'jdominal view. {Siedani-
grotzky.)

Fig. 167. — Female sarcoptes burrowing in the skin; also eggs and excrement.

to detect it with the microscope. The best may is to remove some of the
membrane with a scissors or scrape the upper portion of the skin to the
corium. If parasites have been present for some time, a secondary
eczema is soon developed, which is produced by scratching and rubbing,
also by itching of the scabs and scales. This " mange eczema " appears in
various forms, according to the sensitiveness of the skin, and is either
papular, vesicular, or pustular, and sooner or later produces decided
thickness of the skin and leads to the formation of a number of folds,
■wrinkles, and ulcerated points between the clefts of the wrinkles. There
is always a certain characteristic appearance about these affected local-
ities which makes it easy to distinguish between the parasitic and simple

CUTANEOUS DISEASES DUE TO AXIMAL PARASITES 4G7

eczema. The surface finally becomes confluent, forming large eczema-
tous areas. It is very improbable that a mistake will be made in diag-
nosis, except in the early stages, when there is only a very small spot
affected, because the parasitic eczema produces rapid characteristic
changes, accompanied by scratching, twitching, rubbing, and licking,
which are very much aggravated as soon as the animal is placed near any
warm object, for instance in the neighborhood of a stove or if covered up
with a blanket, and also the evident pleasure which the animal gets if
the affected part is rubbed or scratched, and finally, if the animal is
kept with other clogs, the disease is carried to them and developed very
quickly.

In making a differential diagnosis between sarcoptic and follicular
mange we may frecjuently find that in follicular mange the eruption
may be very similar to sarcoptic, but the itching is very slight in follicular
mange; in fact, in some cases of follicular mange scratching or rubbing
an affected animal very frequently causes the animal pain, and there is
rarely any pus in the pustules of sarcoptic mange, whereas in follicular
mange the pustules contain pus and when squeezexl out and examined
under the microscope, the matter is filled with acari. Of course it is not
impossible to have both sarcoptic and follicular mange present in the
same animal.

The prognosis is not unfavorable, as vigorous treatment usually
cures an animal in a short time, provided the disease has not covered
the whole body. If it has extended over the body in young animals, it
may cause great emaciation, and in some cases great alteration of the
skin, and if the animal is greatly run down, it is a question whether they
can stand energetic treatment. When the parasites are destroyed,
frequently we find an eczema follows that is very obstinate and it takes
some time before the skin returns to its normal condition.

Therapeutic Treatment. — In order to produce good results in mange
we must kill or remove the parasites, their larva and eggs, as the itching
and scratching ceases as soon as they are destroyed, and naturally the
artificial eczema also disappears rapidly. A large number of anti-para-
sitic agents are used — creolin, carbolic acid, coal-tar, anthracol perugen,
ichthyol, sulphur, petro-sulphol, septoform, formaline. The prepara-
tions generally used are creosote, wood-tar, creolin, sulphol-cresol, styrax,
and epicarin, lysol, salicylic acid, and Peruvian balsam. They are all
useful, and may be applied according to the following directions:

It is always necessary to make a general application of the agent,
even in such cases where the disease seems to be restricted to one region
of the body. The dog must have the hair shaved off, if necessary; be
covered all over with a layer of soft soap or with Hebra's alcoholic
potash soap, which is to be shampooed into the skin with the hands or a

408 DISEASES OF THE SKIN

stiff brush, and cleansed thoroughly in clear tepid water. The agent
which is to be used is then applied with the hand or with a brush, covering
only one-third of the body at a time, repeating the operation in two or
three days. If the whole body is affected in spots, cover the whole body.
A good general plan is to give one thorough application to the body, three
days later another, then three days after that a third application, and
three days after that the application may be removed by soft soap and
water, then if the animal is at all suspicious repeat the whole cycle a
second time. The best ointments for mange are:

1. Picis liquid a, sapo potassii viridis, spiritus vini rect., equal parts,
q. s. Ft. linimentum.

2. Creolin, sapo potassii viridis, of each 1 part; spiritus vini rect.,
10 parts.

3. Creosoti, 1 part; picis liquida, sapo viridis, spiritus vini rect., aqua,
of each 7 parts.

4. Creolini (lysol bacillol, liq. cresolis saponat) ; petrolatum 12.

5. Two to 5 per cent, solution of creosote or carbolic acid in olive oil.

6. Peruvian balsam 1 part, spiritus vini rect. 3 parts.

7. Peruvian balsam 1, sapo viridis 1 part, spiritus vini rect. 5.

8. Styrax 2, alcohol 1, olive oil 2.

9. Sulphur sublimed, pix Carolina each 3, creta preparata 2, saj^o
viridis, adeps, of each 6.

10. Epicarin, oleum ricini, ether sulph. 1, alcohol 9.

The first five agents which are mentioned are very energetic, but
more or less dangerous, so it is advisable to use them in healthy or not
too young or delicate animals, and if the animal is greatly depressed, no
appetite, and has either slight convulsions or dark-colored urine, or both,
the preparation must be washed off immediately, and at the same time
administer small quantities of sulphate of sodium in their drinking-
water in order to prevent carbolic poisoning. Peruvian balsam is harm-
less and very useful, but, unfortunately, it is expensive, and is only
adapted to very fine pet dogs. At the same time if it can be procured
and it is not adulterated, it is by far the cheapest in the end, as it is not
dangerous and it can be applied liberally. The coal-tar products are
always more of less dangerous on account of the ready absorption of
such preparations, Styrax renders the hair very sticky. The solution
of epicarin is used for very delicate house dogs in the early stages of
the disease; the hair need not be shaved off when using this combination,
and should be rubl)ed in thoroughly every third day. It is apt to sting
and smart the animal and they may become greatly excited. During
the treatment it is well to give strong nourishing food, and as the animals
are either shaved or the body covered with an oily preparation, to keep
them in warm houses or kennels.

ACARUS DEM ODE X FOLLICULORUM

4G9

Prevention Methods. — The owner of the dog must have his attention
called to the fact that the sarcoptes are highly contagious, and may pro-
duce similar complications in other dogs and in man; and while this in
man may be of a very mild character, it has been observed in the acute
form in several cases.

The contact of many dogs with healthy animals must be prevented
and covers, blankets, bedding, etc., which have been used by the affected
animals must be subjected to a thorough cleansing by washing with hot
solutions of soda and a high degree of heat. The straw, of course, must
be burned.

FOLLICULAR MANGE. ACARUS MANGE. ACARIASIS.
Acarus Demodex Folliculorum.

Follicular mange is a very serious affection due to the presence of
the acarus demodex folliculorum in the skin and particularly the hair-

1:100.

Fig. 168. Fig. 169. Fig. 170.

Fig. 168. — Development of the acarus folliculorum: Egg; six-legged larva; eight-legged larva, and
developed larva.

Fig. 169. — Acarus folliculorum greatly magnified.

Fig. 170. — Hair-follicle invaded by demodectes folliculorum.

follicles. It differs from sarcoptic mange in that it is rarely itchy, and
if so, only very slightly.

Description of the Acarus. — This parasite is about 0.3 mm. in
length and about 0.045 mm. in breadth, elongated, lanceolate, with a

470 DISEASES OF THE SKIN

lyre or horseshoe head, provided with a broad, scissors-like masticatory
apparatus, a mobile anterior trunk, arul three articulated tentacles
(Fig. IGy), It has an oblong or worm-shaped, wrinkled abdomen, with
eight triple-jointed, clawy, thick, short feet attached to the thorax.
The elongated oval larvae have only six legs (Fig. 168). The eggs are
spindle-shaped, and the larvae escape from the eggs, almost fully devel-
oped. The exception is that the newly born larvse have only six feet
(Fig. 168). _

These parasites are found in the hair-follicles and sebaceous glands,
their head toward the bottom of the sac, and the caudal end toward the
external opening (Fig. 170). Their number may be large in a sebaceous
gland, even as many as 200 have been found there. They generally average
from twenty to thirty. The larvse and eggs lie beside the parasite. The
irritation of the parasite, causes the follicles and sebaceous glands to become
dilated and the subsequent atrophy of the hair papilla causes falling out and
permanent loss of hair and where there is a great number of parasites
present, pus is produced and a purulent inflammation of the perifollicular
and periglandular tissue ensues, with the formation of pustules. The re-
lapses, after the disease appears cured, may be due to temporarily encysted
units. It may be that these parasites may have been in some inac-
cessible place, such as the eye, ear, or prepuce. In very severe cases
with numerous pustules of the sebaceous glands, death may occur
from general septic infection. The secbaeous glands are also de-
stroyed, causing aeneous pustules. The demodex acne shows itself
in certain preferred parts of the body, especially the head, throat,
neck, and paws, but it may extend over the entire body. It is not very
easily transmitted from one animal to another, as has been proven by the
attempts made by Weiss, Martemucci, and others, who were unsuccess-
ful. The writer had four dogs, two adults and two pups, and kept them
for months with a bitch that was badly affected with acari, but failed
to get any signs of transmission. When the animals have been experi-
mentally inoculated Haubner reported a case in which twenty-four hours
after inoculation there were all the marks of the disease and the sac
contained eggs and larvse. A second inoculation cured itself spontane-
ously. Other observers have had similar experiences. It seems that to
propagate the disease the animal must have a certain predisposition, the
nature of which has not been satisfactorily explained. Young dogs when
exposed to infection seem to take it more readily than older dogs, but
whether it is congenital is a question. The natvu-al method of contagion
is the contact of healthy dogs with diseased ones, but there is no doubt
that some individuals ai-e immune.

Clinical Symptoms and Course. — These are distinguished by a pustu-
lar and sc^uamous form of eruption, but both forms are apt to be united

DERM(JDKCTES K(JLl,lCUl-ORUM {.hrmodeUk mange.)

ACARUS DEM OBEX FOLLICULORUM 471

in the same animal. The pustular form is the most common, and may
be recognized by the hair falling out, by hypenemic and swollen skin,
which becomes thickened and in folds, and red from lack of pigment,
forming nodules often the size of a millet seed, which change from
bluish-red to yellow pustules, and finally the purulent bloody contents
escape, and in it and under the membrane we find hundreds of acari.

The itching, as a rule, is never very great, as in sarcoptic mange,
and in some cases not even present. When the affected cutaneous
regions are scratched or rubbed, the patients, as a rule, resent it and do
not derive the pleasure that scratching gives in sarcoptic mange. The
disease spreads very slowly, the eruption starting at the head and between
the toes, and in only very rare instances does it cover the whole body
(see Plate). The parts that are affected finally heal, l)ut the skin
remains thick, denuded of hair, marked in some places by scars or cica-
trices, and also by cracks and wrinkles. In some cases we may have a
dark pigmentation marked with warty projections. When there is any
itching present the appearance of the cutis may be changed materially
by secondary eczema. The appetite is very rarely afTected, the animal
eating well, although some cases, in spite of good food, have shown the
animal to have an impoverished, unhealthy look.

The squamous form is seen in the neighborhood of the eyes, the
In-idge of the nose, forehead and the anterior surface of the neck (Fig. 171)
and breast, but it may show itself in other parts of the body. It is a
normal cutaneous inflammation accompanied by falling out of the hair
and great accumulation of scabs, and isolated bare spots resembling
alopecia areata. The hair drops from the afTected places. The skin is
only slightly reddened, but covered with thick scabs. If these places
are squeezed, the parasites can be pushed out of the skin very rapidly.
The easiest way to obtain the parasites is to rub the blunt end of a knife,
previously clipped in oil, over the affected parts, and the microscope will
aid you in distinguishing this disease from simple scaly eczema. In any
suspicious bald spots on an animal, it is always well to scrape off a portion
of the affected part and give it a close examination under the microscope.
The pustular form seems to be more frequently observed in the last few
years. This form of the disease appears as a series of hard nodules in the
skin, ranging in size from a millet seed to that of a pea, and when they
appear in numbers they are apt to become confluent and merge into one
nodular mass, and the tissue in the affected region assumes a reddish-
blue color. On pressure of one of these nodular masses there exudes
from it a purulent sanguineous fluid which, when examined under the
microscope, is found to contain numerous dermodectic acari. After the
nodules empty or are evacuated, the skin becomes covered with scales
or crusts. The animal is not itchy in this condition, or if so it is in very

472

DISEASES OF THE SKIN

slight degree, and not in any sense at all like the intense itchiness of
sarcoptic mange; generally the animals when scratched or rubbed in the
affected region evince pain and endeavor to get away. In case the animal
should show a certain amount of itchiness it is not at all impossible that
the animal may have sarcoptic mange as well as dermodectic even if
all the symptoms of follicular disease are present. The pustular form
of the disease seems to attack the head and neck more frequently than any
other part of the body; that is, it commences there, as a rule, and grad-

Fig. 171. — Head of dog affected with demodectes foUiculorum.

ually spreads from that point to other parts of the body. The disease
goes through the phenomena of developing the nodules, accompanied by
acute local inflammation of the skin. This is followed by purulent
inflammation of the nodules and the discharge of a serous purulent or
sanguineous fluid. The abscess gradually dries up and the skin as a
consequence of the local thickening of the cuticle becomes traversed by
grooves and fissures and is covered with crusts and scales, assuming a
gray-blue color in some places and copper-red in others (see Plate), and
looks like elephant hide. As the nodules dry, there is apt to be a
secondary eczema, causing the animal to scratch more or less.

ACARUS DEMODEX FOLLICULORUM 473

The prognosis is generally unfavorable, as it is almost impossible
to reach the parasites, and it is necessary to continue vigorous treatment
for months, and then, when apparently the animal seems to have gotten
entirely well and remains so for a certain interval, invariably it suddenly
bursts out and the disease appears with increased violence. The cases
which are successfully treated are those that are limited to a very much
restricted area, but it must be borne in mind that every recovered case
must be closely watched for months after the active symptoms disappear.
This is especially the case with the squamous form, which is always
considered the worst form of follicular parasitic mange.

Therapeutics. — The hair must be shaved off in the diseased portion
and to include a good portion of the surrounding tissues, or if the animal
is affected generally, the whole body should be clipped. This can be
done by means of a scissors, clippers, or even lathered and shaved with
a razor, and the hair removed should be burned and the instruments
thoroughly disinfected. The animal is then bathed in warm water and
soft soap, to which is added in the proportion of 1 to 10, creolin, pix
liquida, or styrax. Sulphuretted baths are then to be repeated twice a
week. Fill a large tub or barrel and add from 50.0 to 200.0 of sulphuret
of potash, and to prevent the too free liberation of sulphuretted hydrogen
5.0 of sulphuric acid should be added. The toxic properties of the
hydrogen gas makes it necessary to keep the tub in an open shed or out
in the air.

(a) Treatment of the Pustular Form. — When pustules are present
they must be squeezed and emptied every day. In some instances it is
necessary to open the hard nodules by means of a sharp scalpel, and at the
same time apply the antiparasitic agents already mentioned with a brush
twice daily. The animals, as a rule, show great pain and object to it,
but to obtain any good results this must be followed up patiently. Any
of the solutions may be used, as one is as good as another, but we must
remember that where we have an opening directly into the deep portions
of the skin that reabsorption of poisons through the membrane is much
easier, consequently it is better to select a non-poisonous remedy, such
as Peruvian balsam or warm preparations of salicylic acid (1 part of
salicylic acid to 40 parts of olive oil). Both agents may be replaced by
styrax (in oil solution). Solutions such as tincture of iodine, Lugol's
.solution, corrosive sublimate are all more or less dangerous and never
can be used with the same freedom as the balsam.

(6) Treatment of the Squamous Form. — In this condition we must
first try to reach the parasites, and this we do by systematic rubbing
with acid ointments or strong concentrated salicylic ointments (1 to 5),
and also with soft soap or lye. When we have removed the scabs and
scales with this form of treatment we must apply the same treatment

474 DISEASES OF THE SKLY

as prescribed in the pustular form. The prophylactic measures must
be the same as in sarcoptic mange. No transmission of this disease has
ever been observed in man. The following are some of the remedies
with their formulas: Cerate of cantharides and lard, 1 to G; tincture of
iodine and chloroform; oil of turpentine and chloroform; styrax, oleum
petrse and alcohol; endermol, 1 per cent, solution; zymoidin in the form
of ointment; naphthol 10.0, sulphur 50.0, green soap and lard; ung.
sulphur comp. with creolin baths or decoction of tobacco; silver nitrate,
5 per cent, solution; ichthargen, 10 per cent, solution alternated with
iodine 10 per cent., and tar 25 per cent., each well rubbed in; styrax
salve and bathing with liver of sulphur; formaline in 2 per cent, solution;
dermaform, oleoformaldehyde; creolin and alcohol, equal parts; licjuor
creositi saponis; creosote diluted with alcohol or sweet oil; creolin, balsam
of Peru and alcohol, equal parts; ichthyol, soft soap and alcohol, equal
parts; oil of juniper; scraping the affected parts wath a blunt knife and
applying balsam of Peru; xeroform; endermal injections of iodine, or
2 per cent, solutions of carbolic acid; superficial cauterization of the skin
with the thermo-cautery; carbonate of sulphur as a bath and then
frequent applications with the powder and follow^ed by an ointment,
formaline 3.0, vaseline 50.0, oxide of zinc and almond powder, each 24.0.
Where the skin is greatly thickened carbonate of sulphur should be used
in conjunction with sulphur or neutral soaps.

And to sum up the treatment, when you find an animal that is
slightly affected with the disease, clean the skin thoroughly with a
strong soap and then apply the balsam of Peru liberally as directed and
keep up the treatment for some time, and if you find an animal that is
very badly affected then you had better destroy him, as he is not only
a menace to every other clog he comes in contact with, but the chances
of a permanent cure are extremely slight.

Skin Diseases Caused By Worms.

Rivolta has described having seen in the neck of a dog a herpetical
eruption which he found to be due to the presence of certain embryos
which he thought were the embryos of the Filaria inedinenHis. Seid-
amgrotzky also found in a large hound dog, a pustulous eruption on the
external surface of the shank of the leg which was accompanied by
A'iolent itching and in every pustule he found from 1 to 3 small embi-yos
0.04 to 0.07 mm, long and having a peculiar awl-shaped caudal appendix.
The embryos newly born and solitary, the females were found in the
bedding of the animal. Schneider found a similar condition in a pointer,
but there was little or no itching. The case observed by >Scidamgrotzky

AFFECT lOXS CAUSED BY VEGETABLE PARASITES 475

was cured spontaneously in three weeks; in the case described by Schnei-
der it was necessary to use a oU per cent, sohition of balsam of Peru in
alcohol, to destroy the parasites.

The Filaria immitis and Filaria medinensis are found encysted in
the subcutis. The embryos of the former are found in the blood and
also in the connective tissues in the encysted form, and it may also be
found free. The latter, Filaria medinensis or guinea worm, is found on
the west coast of Africa and Arabia, and produces abscesses and tumefac-
tions in the man and the dog.

The treatment is simply cleanliness.

Cutaneous Affections which are Caused by Vegetable Parasites.

We know at the jDresent day of two skin diseases in the dog which
are ascribed to the presence of vegetable parasites. These are favus
and herpes. These ectophytes belong to the filiform fungi class (hypho-
mj'cetes) and may be simple or ramified, membranous or non-membran-
ous, double contoured, cellular threads (hyphae), which become mixed
in their growth and form a real fungous bed or fungous turf (mycelium).
These fungous growths produce at their ends and at the point of their

Fig. 172. — Fa\'U3 spores, magnified 450 times, (von Diiben.)

short side branches bead- or string-like spores, uniting and ligating each
other, which are considered as sexual or multiplying organs. We
cannot make a strong distinction between the fungi of favus and those
of herpes, but there is a difference, as is seen in the disease in its local
form, and we have given a description of both.

1. Favus. — This fungus is called achorion Schonleinii, and is devel-
oped upon the skin, between the epidermic layers in the hair-follicles,
and also in the hair itself, and the secreting tissues of the claws. It is
very rare and generally affects young animals. The determination of
the fung-us is the same method followed in trichophyton. It may he
transmitted to the cat, horse, rabbit, mouse, and human beings, causing
a characteristic skin affection.

Clinical Symptoms. — Favus is found in special regions of the body,

47G

DISEASES OF THE SKIN

namely, upon the forehead, back of the nose, abdomen, and external
surface of the hind legs, as gray, gray-yellow or even saffron-yellow, dry,
brittle crusts or eschars. These are about the size of the head of a pin
in the beginning, but gradually by their growth cover the entire surface,
and may finally become from 2 to 5 mm. in thickness. They appear in
the shape of round or elliptical scutula, depressed in a saucer-like manner,
generally perforated with a dull, lustreless hair, which drops out later on.
If the escharous mass is removed we find a corresponding depression
with exposed, very red epidermis. As a rule, this is followed by bleeding
and more or less itching, and where the disease is extensive, the animal
has an odor likened to the urine of cats or old cheese. The claws,
when affected, become thickened, loosened, reddened, brittle and are
shed.

Therapeutic Treatment. — The treatment of this disease is easy,
consisting of removal of the scutula and a daily application of anti-

COCQs

'^F^-;

Fig. 173. — Trichophyton tonsurans, after treatment with potassium solutions. Enlarged 300 times.

parasitic agents, especially tincture of iodine, carbolic acid and creosote
solution, sublimate or salicylic acid (10 per cent, solution with alcohol),
and tar soap. Chloride of sodium (common salt) has recently been
advocated in the treatment of ring-worm. It is either to be applied in
saturated solution or else made into an ointment with vaseline.

Concerning the prophylaxis, we refer you to the indications which
are given later in herpes.

2. Herpes Tonsurans. — Debilitating herpes, herpetic ring, herpetic
eschar, bare herpes. This fungus, which is said to be the cause of herpes,
is called trichophyton tonsurans, and is found in large masses lying on
the upper portion of the epidermis, and especially in the hair and its
follicle.

Trichophyton has a much more rapid growth than achorion. It

AFFECTIONS CAUSED BY VEGETABLE PARASITES 477

not only grows from one centre, as in the other form, but it may make
its appearance in a number of new centres scattered all over the body,
until finally the whole is strewn with numerous, isolated, round-shaped
bare spots. The parasite may be transmitted to dogs, man, cattle, goats,
cats, pigs, and rabbits. This mushroom, which attacks the skin, spreads
to the hair follicle. ^Mien the hair and scales are put in a caustic potash
solution, and examined under the microscope with a low power, large
masses of spores are found massed like strings of beads (Fig. 173). In
isolated cases sometimes, where all the appearances point to Tricho-
phyton, it is not found to be present. Boden and Almy describe an
eruption resembling herpes, which resembled round or oval gray-white
stains, covered with scales, seen on the back, flanks and the lower parts
of the extremities caused by the micro-spores audouini, the cause of head
fungus in children. This condition heals very rapidly. The French
authors claim that all herpes is due to various forms of fungi. Schindelka
claims that the majority of cases of herpes that originate in man are due
to contact with diseased dogs.

Clinical Symptoms. — The eruptions which start generally in the
head, region of the lips and eyes, and more rarely on the neck and legs,
are marked by small, round, or elongated herpes, which vary in shape and
size between a lentil and a large bean. The spots are hairless and
distinctly circumscribed. The blotches are arranged at intervals and
are generally very regular. They become confluent in some cases, and
extend over the entire body. Affected regions show peculiar grayish-
white or dirty gray asbestos-like scabs and in old cases yellowish-brown
crusts about 2 mm. in thickness. These crusts may have some hair
adhering to them. The skin under the crust is copper-red in color and
covered with numerous millet-like nodules (swollen hair-follicles).
After a certain time, if the disease ceases to spread, the scab drops off
gradually, and we see a bare, scaly herpes upon which the hair slowly
returns; it is very similar and might easily be mistaken at this stage for
alopecia areata. In other cases we find the formation of nodular eleva-
tions, semiglobular in shape, very sensitive to the touch, rough on the
surface and brown in color. They generally appear on the head, par-
ticularly on the cheeks, and are generally very difficult to treat, follow-
ing a protracted course covering over one or two months. Itching is
constantly present, l:)ut mild in character. After the acute symptoms
have subsided the scales fall off, leaving a bare space, smooth or with a
few scales on it, and the hair returns gradually.

R. Ac. salicylic, 3.0

Alcohol,' 30.0

Sig. — Salicylic ointment.

478 DISEASES OF THE SKIN

Ac. salicylic,

Sulphur sublini.,

Sapo virid.,

01. rusci,,

aa 10.0

Atlep.s.

40.0

Sig. — Salicylic sulphur salve.

Picis Carolina,

Sulphur suhhm.,

Sapo kali,

aa 10.0

Adeps,

50.0

Sig. — Tar and sulphur salve.

The afflicted animals are often affected with secondary eczema.
This, however, is produced by constant scratching, due to the irritation
of the disease.

Therapeutic Treatment. — The treatment' of herpes depends on the
removal of the favus. We must, therefore, clean the affected part, lift
and remove all scabs and eschars by means of a thin knife, or shampoo
with soft soap, following it up by a dressing of some of the agents men-
tioned under the head of jNIange.

Prophylaxis. — The animals must be separated, as the danger of
infection to both clog and man is very great. The kennels are to be
cleaned, and all straw, etc., l)urned, and the animals kept away from
children.

Trypanosomiasis.

Under this term we class numerous infectious diseases peculiar to
tropical countries. These various conditions are, generally speaking,
due to a flagellate protozoon present in the blood (protozoa flagellata).
Some of the diseases, such as the nagana of Africa and the surra of
India, are easily transmitted to the dog by inoculation. The parasite
of the nagana and the surra (trypanosoma brucei) is transmitted by the
sting of certain insects (tsetse fly of Africa and the tropical horse fly of
India). Under the microscope it is easily recognized by the low power.
It is worm-like in form, having a blunt posterior extremity, its length
depending on the animal it inhabits. In the dog it is extremely short.

The symptoms of the disease are elevation of the temperature,
which may be intermittent, oedematous swellings, especially of the
posterior extremities and of the thigh, scrotum, and face; pustular erup-
tions of the skin which may heal up and leave the animal bald; opacity
of the cornea, and finally paralysis of the posterior extremities. Death
generally occurs in three to four weeks. Blin states that when dogs im-
ported into India and China, contract the disease it is almost invariably
fatal, but native dogs generally make good recoveries.

TRYPANOSOMIASIS 479

African Horse Sickness. — Dr. Arnold Theiler finds as a result of his
observations that dogs are susceptible to African horse sickness and
further that the canine species constitutes a very important medium
through which horses can he infected with the disease. This statement
is combated by McFadyean who after a series of observations has
reached the conclusion that dogs positively resist inoculation and that
it is highly improbable that dogs act as a reservoir in propagating the
disease to the horse.

TUMORS, PARTICULARLY THOSE OF THE SKIN.

A thorough description of tumors, with the different varieties and
forms, cannot be discussed here as explicitly as the writer would like,
and he therefore will confine himself to such tumors as are met with in
general practice, and for further details would direct the reader to books
on general pathology and morbid anatomy.

Tumors are rather common in the dog. Of the various neoformations
carcinoma seems to be the most frequently seen. Next is the fibroma,
then the papilloma and the sarcoma, and the lipoma, the latter being
comparatively rare. Regarding the frecjuency of cancer, out of over
twelve hundred dogs only about 5 1 /2 per cent, were affected with
cancer, and of the organs attacked they were in the following order:
Respiratory apparatus, 26 per cent.; urino-generative apparatus, 26
per cent, digestive apparatus, 25 per cent., and the skin, 20 per cent.
As regards age, Frohner found that 15 per cent, were in animals under
five years of age, 25 per cent, between the ages of five and six, 34 per
cent.; between seven and eight years, and 18 per cent, l^etween nine and
ten years, while 4 per cent, were between eleven and thirteen years.
No animal under two years was found to be affected with cancer.

The following tumors are found in the dog:

1. The Fibroma. — This neoformation occurs rather frequently in
the dog, the most frequent location being in the skin and subcutis of the
head, neck, abdomen and spine. Fibromata are also found on the chest
and extremities. They may occur singly or in large numbers. They
may be hard or soft according to the amount of intercellular tissue they
contain. They are usually clearly outlined, rounded with a smooth
surface (fibroma durum), more rarely soft in consistence, and not so
w^ell circumscribed (fibroma molle, fibroma moUuscum). The latter
is frequently bluish-red with a network of veins on its surface. The
filjroma frequently hangs down, particularly when it is in an inferior
portion of the body, like the abdomen (fibroma pendulum) (Fig. 174).
In parts where there is slight movement of the skin, and the cutis is
firmly fixed, such as the ear or metatarsus, the fibroma assumes a flat,
circular, coin-like appearance, and has a rough or granular surface. In
some cases there is tumefaction of the skin, as on the edge of the nose,
elbow, tuberosity of the ischium, the outer part of the forearm, knee and
legs. These callosities are usually called recumbent, bed or kennel
tumors. They are generally bluish-gray or grayish-red in color, rough-

480

TUMORS

481

ened externally, and irregularly circular. They vary in size from a
small pea to the palm of the hand, are generally devoid of hair, their flat
surface being smooth, furrowed, or irregularly elevated. The skin
occasionally develops acne from pressure or alteration of the tissue.
Fibromata, both hard and soft, are not malignant.

Many pathologists are not inclined to regard the callosities known
as bed or kennel tumors as fibromata. Most definitions of the term
tumor include the clause that thev are without demonstrable cause.

Fig. 174. — Dependent fibroma.

This would exclude these callosities, as their cause is obvious, usually
growing on prominent parts, exposed to friction and pressure whenever
the animal assumes the recumbent position.

2. The Lipoma. — These fatty tumors of the subcutis are rarer than
fibromata. They are generally round or oblong in shape, very distinctly
circumscribed, being separated from the surrounding structures by a
layer of connective tissue. Sometimes they are of considerable size,
but as a rule they are of very slow growth, and often pedunculated or
lobular in outline and diffused in different directions. The mixed forms
of lipoma and fibroma (fibrolipoma) sometimes grow to an enormous
31

482 TUMORS

size, and are seen as nodular collections under smooth skin. As a rule
lipomata are found on the tendons and their sheaths, the chest, shoulders,
and tail. Frohner found a lipoma that surrounded the anus in a half-
circle. Lipomata may be multiple but are not malignant.

3. The Sarcoma. — A tumor made up of embryonic connective
tissue, originating in various parts of the body, such as cartilages, bones,
periosteum, adipose tissue, and in fact any of the connective tissues of
the body. Depending upon the size, shape and disposition of the com-
ponent cells, sarcomas are classified as small and large round cell, small and
large spindle cell, giant cell, melanotic and lympho-sarcomas. Sarcomas
are generally considered as malignant tumors (1) because they usually
show a tendency to become large, (2) because they are apt to reappear
after removal, and (3) because under certain conditions they are apt to
form in other parts of the body by metastasis. Their malignant char-
acter is generally much greater in proportion to the size of their cells
and the softer their intercellular substance.

The external anatomical appearance of a sarcoma does not always
present characteristic symptoms. In most cases these tumors are round,
distinctly circumscribed, and sometimes they form encysted knots, which
vary in color and consistency. Their color depends, as a rule, on their
blood vascular supply, and any blood extravasations which may have
occurred also produce certain alterations, so that on section a sarcoma
may appear white, yellow, brown, gray, dark red, and even entirely black,
as the melanotic variety. This pigment sarcoma, or melanoma, is
extremely rare in the dog, although Gray asserts that it is very common
in Yorkshires, where it is seen in the form of small black excrescences
the size of a pea. Troutman describes an interesting melanosis of the
toe of a three-year-old setter.

The metamorphoses which occur in the sarcoma are of some diag-
nostic value, especially the mucous softening, which leads to the forma-
tion of cysts and sometimes to bony deposits. This is frequently noticed
in sarcomas, and the ulceration of the adjacent skin and mucous mem-
branes occurs without producing any active disintegration of the tumor.
Notwithstanding the malignant character of the sarcoma, it may remain
in the same condition for years, and never inconvenience the animal, or
after lying quiescent for years it may suddenly begin to grow with
incredible rapidity.

The myeloid or medullary sarcoma is a rare form of tumor which
grows in the marrow cavity of the bones. They have been noticed in
the forearm, shoulder-blade, arm, femur, maxilla and penis. Circum-
scribed nodules are developed in the medullary cavity which generally
crowd out the bone by their growth, and when new bone is formed from
the periosteum, fill up the entire cavity. In this manner we find enormous

TUMORS

483

lumps, or masses, possessing the firmness and hardness of bone, and in
the centre is found a soft tumor surrounded by a bony cyst. Sooner or
later the soft parts penetrate the bony envelope and certain of the fluid
escapes.

4. The Papilloma. — A benign tumor originating from a hyperplasia
of the fibrous stroma of the cutaneous and mucous membrane, with a
proportionate formation of connective tissue. Papillomata are divided
into the hard and soft varieties.

The hard papilloma or wart is a neoformation of the papillae of the
skin and of the epidermis. Warts differ very much in size, from a lentil
to the size of a large pea. The external covering of a wart is very often
hard and firmer than that of the connective tissue, so that the surface is
surrounded by a firm, hard, horny covering (horny warts). The reverse

Fig. 175. — Multiple formation of warts.

is found in the case of the soft, fleshy warts. These little growths are
found on the skin of dogs of all ages; as a rule on the head and back, but
also in other regions, and they frequently disappear without any treat-
ment (Fig. 175). Now and then the horny warts grow to a very large
size and form what are called "cutaneous horns." Such are found on
the forehead, the ear, and the flanks. They are generally seen in old
dogs, and at times have a tendency to be malignant. Enormous nvimbers
of warts are sometimes seen in the mouth, on the buccal mucous membrane
and tongue, and that they can be reproduced by inoculation has been
proved by McFadyean and Holding.

A variety of the papillomata is the flat condyloma. These are
certain marked malformations which have the shape of a papilla, but as
a rule are ramified and divided, forming coxcomb-like or cauliflower
collections. In some cases they appear as true papillomata, particularly
as a sarcomatous formation. As a rule they appear on regions other
than the skin, such as the lips, cheeks, and prepuce, and also upon the
buccal mucous membrane. They are generally salient and bleed easily,

484 TUMORS

due to the large niiml)cr of ])lood vessels they contain, their softness,
and very thin epithelial covering. The writer has noticed that dogs
affected with condyloma of the vulva or penis also show these formations
quite frequently on the edges of the lips. Gratin has often seen the
obscure transmission of condylomata from one dog to another. This
would tend to establish the fact that this variety of tumor is contagious.
(See Infectious Genital Tumors.)

5. The Carcinoma. — By the term carcinoma we designate that neo-
formation the essential feature of which is the overgrowth or accumula-
tion of epithelial cells, some of which have penetrated the basement
membrane, by root-like projections, into the underlying or neighboring
structures. It is the commonest of all neoplasms. These cells possess
the peculiar property of forming metastases, by way of the lymph
channels, producing a general cancerous infection of the body (carci-
nomatosis), and are, therefore, considered malignant. Any organ or
structure in the body having epithelium in its make-up may be the seat
of carcinoma. Most cancerous forms are distinguished by their tendency
to regressive metamorphoses. These include mucoid, colloid and fatty
degeneration, with cystic formation, calcification, cicatricial contraction,
and in superficial carcinoma of the skin and mucous membranes, ulcer-
ative processes, with the formation of purulent foci. Those showing
a strong tendency to spread over the surface are termed "phagedenic."
Necrotic changes are frecjuent, the ulcerating portions discharging a foul,
sometimes bloody, material. In cases of some standing the dog may
show the effect of this process, losing flesh and showing a general condition
of cachexia. Carcinomata are generally divided into:

(a) Squamous epithelioma, sciuamous cancer, or cellular epithelioma.
This variety occurs in the cutaneous membrane, and in all mucous

membranes containing squamous epithelium, as the mouth, throat,
larynx, eyelids, ears, cheeks, external genitalia, bladder and urethra,
rectum, vagina and uterus. This form of cancer is frequently seen in
old animals. It is a peculiar fact that this cancerous growth may accu-
mulate rapidly for a short time, and then remain stationary without
increasing further in size. Squamovis epitheliomata appearing in the
mucous membranes, especially the vagina, which deserves special men-
tion, have a great tendency to extend superficially, followed by a cancer-
ous disintegration, also by a constant, bloody, purulent discharge.
Ulceration usually takes place in these cancers, sooner or later. Some
parts may be covered with a scab-like crust, while other parts may be
raw and bleeding. Fistula:' frequently form.

(b) Adeno-carcinoma, or malignant adenoma.

This variety may originate in any organ containing glandular
epithelium. It is probably most often seen in the mammary glands of

TUMORS 485

old bitches. This cancer of the mammaries is marked by the following
characteristics: It is of slow growth, particularly hard and firm, and has
a tendency to remain stationary for a long time. In some regions of the
glands we may see a small, hard knot developed, which is not sensitive
to pressure and shows no signs of inflammatory action. This enlarge-
ment gains slowly and may be accompanied by other knots in the imme-
diate neighborhood, which finally unite and form one mass. The carci-
noma at this stage is found to be a hard, irregular, circumscribed tumor,
and united, as a rule, with smaller masses by a thin cord-like enlargement
that lies in the integument. When this enlargement is located very
near the skin it shows a peculiar cicatricial contraction, and especially
if it is near the teat this may be drawn entirely into the skin. This is
quite common. We also observe great distention of the cutaneous
veins, which may even be varicosed. As a rule, the enlargement is
rarely confined to one, but we may find scattered through the gland
numerous lumps or knots of various sizes. We also see in the mammaries
of the dog fibromas, chondromas, adenomas, sarcomas, and cysts, but
these are much rarer than carcinoma.

It is hardly possible to confound these tumors of the mammaries
\vith inflammation of the lacteal gland. True acute mammitis occurs
very rarely in the bitch, and is indicated by a circumscribed, painful,
very sensitive reddened swelling of a definite glandular section. The
section may undergo complete disintegration, forming an abscess and
sloughing, or w^e see chronic inflammation with a formation of knotty
lumps, and a peculiar cicatricial contraction. True mammitis must not
be confounded with inflammation of the lacteal glands, which may
appear in bitches that are nursing and deprived of their young. The
swelling disappears in a few days by itself, but it may be hastened by a
light diet and saline purgatives. In very rare instances there is a peculiar
condition of the lacteal glands that is seen in bitches that have had
several litters of pups. About forty-five days after they have been in
"heat" we may find a general enlargement and filling up of the entire
glands, also the appearance of a thin milk or colostrum in the glands,
and every appearance of active lactation. This might lead the prac-
titioner to believe that the bitch was in whelp.

The tendency of carcinoma to become malignant and cause a general
infection of the whole body is especially marked in the soft forms of
cancer, particularly those having a tendency to ulceration and degenera-
tion, while the hard forms, such as above described in cancer of the mam-
maries, may remain months and even years after producing no other
eff"ect than a gradual enlargement. The process is generally developed
in the lymphatic glands, but we may see the appearance of secondary
tumor centres which swell up without being accompanied by any pain or

48G TUMORS

inflammation. A large part of the body may become affected in this
manner, that is to say, there is a gradual development of the process
through the entire body, these various tumors being supplied from the pri-
mary tumor or carried into the circulation and scattered in all directions,
forming new centres of development. We may see this occur in cancerous
masses in the liver, kidneys, and lungs, producing very little irritation
of the surrounding tissues beyond the central tumor, but we find that
the animal falls away quickly, becomes emaciated, has weak heart-action,
and presents all the symptoms of what is known as cancerous cachexia.
The prognosis is always unfavorable. Removal of a cancerovis
tumor may only be made when the neighboring lymphatic glands have
not become affected, and where the animal is in good nutritive condition.
Cases of ulcerated carcinoma must always be considered unfavoral^le,
except in the form of cancroid, which has been already described. The
treatment of cancer consists of speedy removal and keeping the animal
in as healthy condition as possible.

6. The Myxoma. — A tumor made up of mucous or gelatinous connec-
tive tissue. They are apt to appear on the head and back, more than
any other place. They are frecpently multiple primarily, and sometimes
attain great size. The myxoma is a benign tumor, but it may recur after
incomplete extirpation. Usually these tumors are round or oblong,
clearly outlined in the tissue, are elastic on pressure, and they stand out
in the skin in semi-hemispherical elevations. The cut surface is pale,
moist, and exudes a thin, stringy mucous material when squeezed.
They are frequently found combined with fibroma and sarcoma. A
very characteristic example of myxoma is described by Velmalage, in
which he found from the neck to the root of the tail, as well as on both
sides of the thorax, the outer surface of the hind legs, and the anterior
region of the sternum, great numbers of nodules varying in size from a
pea to a hazel nut, or even as large as a walnut.

7. The Adenoma. — One of the parenchymatous group of tumors,
composed of glandular epithelium, which may assunie either the type of
a tubular or an acinous adenoma. They always originate in some gland,
are either single or multiple, and can be distinguished from simple glan-
dular hypertrophy by the fact that they stand out prominently from
their surroundings, are knotty or scirrhous, or sometimes quite soft.
Their growth is slow and they are seen most frequently in the breast,
rectum, thyroid and ovary. Adenomata are not malignant, primarily,
but just as soon as the basement membrane is penetrated by the tumor,
it then becomes a carcinoma, malignant in character. Cystic degenera-
tion is probably the most common of the retrograde processes. When
they are superficial, we may have ulcei'ation taking place.

8. The Angioma. — A tumor composed of blood vessels and their

TUMORS 487

contents. According to the kind of vessel present, angiomata are
designated either capillary, cavernous or aneurysmal. The capillary
type is the most common. In the dog these tumors may frequently
escape notice, on account of the color of the skin and the hair obscuring
them. They may occur in any part of the skin, and some attain the
size of a hen's egg. They are non-encapsulated, but usually only involve
the corium. They are flat, but slightly elevated, and the color varies
from a light to a dark red. Shindelka observed a nsevus vasculosum
(birth-mark) on the right side of the head of a white poodle, the formation
being irregularly outlined, bluish-red in color, and involving the forehead,
temporal region, and a portion of the eyelids. The author saw a similar
condition on the chest of a Russian wolf-hound. Simple enlargement
of the veins has been observed on the scrotum.

9. The Myoma. — A tumor made up of muscular tissue. According
to the variety of muscle making up the tumor they are designated leio-
myoma (smooth or involuntary), or rhabdomyoma (striated or volun-
tary. Myomata are rare, but may originate in any structure containing
muscular fibres, voluntary or involuntary. However, these tumors
may exist in structures normally having no mucsular fibres in them, but
these cases are rare. When a myoma exists in normal muscle, it some-
times so closely resembles the normal muscle as to be distinguishable
with difficulty.

10. The Osteoma. — A bone tumor, either compact or spongy, and
usually developed on the body of a bone. As a rule it occurs on the
periosteum, but more rarely in the muscles, fasciae, tendons, and still
more rarely in the thyroid glands. (This last condition was described
by Siedamgrotsky.) They are usually recognizable by their location
and consistency. They frequently occur in combination with sarcomata
and chondromata. The size varies, the author having seen an old dog
in which he found osteomata nearly as large as a hen's egg. These were
remarkable for their extremely regular surface, and were attached by
distended tendinous tissue to the left of the transverse prolongation of
the fifth cervical vertebra, but were removed without any bad results.
As a rule osteomata are removed only when they are closely connected
with the bone, and when they are likely to cause a great deal of trouble.

11. The Chondroma. — A tumor made up of cartilage cells, usually
of the hyaline variety, but sometimes they are observed to be of the
fibrous or yellow elastic type. They may arise from any structure con-
taining cartilage, such as the trachea, nasal septum, ribs and the ends
of bones. They are frequently met with in the shafts of long bones
(enchondroma) . Usually they do not grow to a very large size, and are
non-malignant, although they may be multiple primarily.

488 TUMORS

Infectious Genital Tumors.

This condition seems to be almost entirely confined to the higher
bred animals. Particularly since careful selection in breeding has been
made, and the best bred dogs are apt to be infected. It was first observed
on the continent and later in Great Britain, and then from the large
number of dogs that have been imported into the United States, it made
its appearance in America. Its peculiar character of reaching its highest
development in three months or about that time and then commencing
a retrograde degeneration and healing up, has to a certain extent checked
its development and has a tendency to keep it within bounds, and also
that it is rarely seen in common bred dogs. Its chief mode of dissemina-
tion seems to be from the male, for when a particularly good stud-dog
is affected numbers of bitches become inoculated, thus the disease is
carried in all directions.

The disease commences by a circumscribed tumefaction, deep red
in color and by a gradual elevation of the tissue and develops into round
nodular tumors, these become lobular masses, are grayish-pink, varying
to purplish red; they bleed easily on th-e slightest manipulation. There
is more or less discharge of bloody muco-purulent fluid from the prepuce,
and that organ is sw^ollen and deepened in color at the free portion (see
Plate). If there is a chance to observe the disease from the onset, it is
found to commence with a slight tumefaction of the tissues and formation
of small firm nodules, which increase slowly and finally develop into
rounded masses; then these masses become softened, break down and
leave a deep ulcer with raised edges from which a thin tenacious discharge
flows.

In the bitch the tumors are rarely noticed until a discharge is seen
at the vagina, or she shows great pain during copulation and will generally
refuse to take the male. A digital examination shows a number of
tumors in the form of elevations either sessile or pedunculated, in severe
cases the walls of the vagina are covered with them. The sessile seems to
be commonest in the bitch; they lie, as a rule, well up in the anterior
portion of the vagina.

The tumors will break down and disappear, but in the bitch they
invariably leave a cicatricial contraction so that while the bitch may
become pregnant she has great difficulty in parturition, the vaginal walls
in that particular portion becoming inelastic. In other cases if the
bitch becomes inoculated ])y the dog the tumors grow so rapidly that
they practically close the vagina so as to produce dystocia.

That this disease is contagious there is not the slightest doubt, and
that it is easily transmitted experimentally has been shown by Wash-
burn and Smith, who state that, "For the first few days after inoculation

INFECTIVE TUMOR OF DOGS {natural size.)
Circle I includes area slunvn belo~M. Circle a shows fully developed stage.

■#*^

>\ "^^M^

??f

INFECTIVE TUMOR OF DOGS {the initial stage.)
Camera drawings, lo7u power. Clarke, Protozoa and Diseases. Bailliere, Tindall ^r' Cox, London.

INFECTIOUS GENITAL TUMORS 489

a swelling can be felt, partly due to the fragments of the tumor introduced
and partly to inflammatory exudation. In some cases this swelling
completely subsides, so that nothing can be felt until the appearance of
a small nodule indicates that inoculation has been successful. In other
cases the swelling persists, and it is difficult to decide whether the inocu-
lation has been successful until a definite increase in the size of the
swelling has taken place. The usual time at which there is distinct
evidence of the first appearance of the growth after inoculation is about
three weeks, but it varies between twelve days and a month. * * *
The small firm nodules which first appear gradually increase in size, and
form rounded lobulated masses. At the commencement they are freely
movable beneath the skin, but at a later period the latter become thinned
out, of a bluish-red color, and firmly adherent to the growths. * * *
The maximum growth is attained in about three months. A curious
regularity obtains in this respect. * * * Having reached this stage,
retrograde stages are not long in appearing; the growth becomes soft
and flabby, and slowly dwindles until nothing is left to indicate its
former presence. * * * j^ nearly half the cases the subsidence of the
tumor was accompanied by ulceration; the thinned-out reddened skin
giving way over the growth, which has previously undergone softening,
and there results a deep ulcer, from which a thin grumous discharge flows.
Even when these retrograde changes are occurring, fresh growths occa-
sionally take place at the periphery of the tumor. "

Clake, who has carefully examined the tumors, likens them to the
alveolar sarcoma of the human breast and classes them as granulomata.
He describes three stages and shows marked changes in each. And
concludes that they may be divided into three stages:

1. "The early granulation-tissue stage — i.e., a filling out of the
shrunken connective-tissue cells.

2. "A stage in which the granulation-tissue cells have assumed the
character of sarcoma-cells. Some of these cells exhibit a mitotic activity
comparable to that seen in the earlier stages of invasion of the cells of
the cornea by the protozoa of vaccinia in their hyaline or chromidial
phase. Among the tumor-cells in this stage are bodies of typical proto-
zoon characters; and —

3. ''A final stage in which chromidial parasites escape from the
nuclei of the tumor-cells, rapidly enlarge, become nucleated, and subdi-
vide; this process terminates in the formation of minute bodies, most of
which are in the chromidial condition."

Treatment. — In the male it is comparatively easy. If the tumor
has not broken down it should be removed by filling the prepuce with
cocaine solution, then have an assistant retract the prepuce and expose
the free portion of the penis. The tumors must be freely cut away with

490

TUMORS

a pair of curved scissors; then to the excised portion of tissue apply the
thermo-cautery, or with a camel's hair brush apply pure carbolic acid
which should be neutralized immediately with an alkaline solution.
There is always considerable hemorrhage, but this is easily controlled.
French advises, if there should be great hemorrhage, to take one or two
stitches in the mucosa. This is to be done only where the hemorrhage
is extreme and the stitches to be removed not later than twenty-four
hours afterwards as the sutures cause great irritation. The non-irritating
substitutes for nitrate of silver such as the silver proteids and albuminates
are particularly useful in this condition and should be applied locally in
the male and injected freely in solution in the bitch.

Fig. 176. Chronic ulcer.

The male, if treated early, generally recovers in three or four months,
in the bitch if the vagina is involved to any great extent it is not wise to
breed her. If asked to give an opinion as to her i3urchase as a brood
bitch it would he well to advise against it.

General Therapeutics of Tumors. — The treatment of tumors of the
mouth, anus and mammar}' glands has already been taken up and
the reader is referred to those conditions under their respective titles.
The internal medicinal treatment of tumors by preparations of iodine
may be used in cases of goitre. In carcinoma and sarcoma we may give
arsenic in the form of a solution of mercury, iodine, and arsenic (Fowler's
or Donovan's solution).

Surgical Treatment. — This is generally palliative in cases where the
tumor is difficult to reach, being restricted to the prevention of hemor-
rhage, suppuration, and a fetid odor.

INFECTIVE TUMOR OF DOGS {the fully developed stage.)

I. Cells dhtetided by cell-inchisions. 2 and 3. Cells ivith acth/e nuclei. 4. Cells luith amcehoid bodies

close to empty nuclei. Camera draiving, lo7v power. Clarke, Protozoa and Diseases.

Bailliere, Tindall &' Cox, London.

SURGERY OF TUMORS 491

Tampons of tow which have hoon saturated in a solution of chloride
of iron and injections (where there is an opening) of subsulphate of iron,
1 to 90.

This palliative method is only indicated where a radical operation
cannot be performed from some cause or location of the tumor and where
the owner wishes to keep the animal alive as long as possible without
surgical interference.

The methods of radical removal of a tumor are as follows (these do
not include torsion or twisting) :

Ligation. — This method may be applied in all cases where the base
of the tumor is not too broad and if it has not penetrated deeply into
the tissues. It is useful in many forms of warts, fibromas, and sarcomas;
but, as a rule, it is objectionable because it acts slowly, is extremely
painful, produces great inflammation with suppuration, and the tumor
has a tendency to return. The general mode of procedure in this opera-
tion is to ligate the base of the tumor with a strong silk thread or rubber
band wound several times. These growths can also be subdivided by
means of the ecraseur, using either the chain or wire. The chain of the
ecraseur is put around the base of the tumor and greatly tightened by

Fig. 177. — Wire ecraseur.

means of the instrument, when the tissues are gradually crushed. The
writer has used the wire-loop shown in its simplest form in Fig. 177
for the removal of epulides. The bleeding, as a rule, is very slight if
the crushing is done slowly, but there is always clanger of a recurrence
of this condition. We must, therefore, touch the open space left after
the removal of the tumor with a thermo-cautery.

Cauterization. — We may destroy tumors of the cutaneous or mucous
membrane, flat warts, etc., by means of the thermo-cautery, or we may
use some of the various cauterizing substances. The thermo-cautery
has the advantage of being kept at an even heat for a long time, and on
account of this steadiness is especially valuable in controlling hemorrhages

The caustic chemical substances, such as burnt alum, caustic potash,
sulphate of copper, chromic acid, chloride of zinc, and nitric acid, are not
especially valuable in the therapeutic treatment of tumors.

Removal — Extirpation. — This method is the best one to follow in
all large tumors which are easily reduced. Various modifications are
possible, according to the form and location of the tvimor, but the follow-
ing is the general mode of procedure:

In making the incision the cut should be made by an ordinary
scalpel between the tumor and soft parts, making the incision, if possible,

492

TUMORS

in the direction of the hair and of the large blood vessels. After the
extirpation of the tumor, the cavity should be cleared of all loose tissue
by means of a pair of scissors or scraped with a curette. Ligate all
the blood vessels. Clean the wound of blood clots, and touch the
whole freshly cut surface with pure carbolic acid, as it frequently facili-
tates healing by first intention. Then bring together the edges of the

Fig. 178. — Manner of tying the mouth.

wound by means of sutures. Place over the wound an antiseptic
dressing.

Anaesthesia. — We have already given information as regards the last
three points of the operation. We must confine the animal, in all opera-
tions, in such a way as to prevent him from biting or moving that part of
the body which is operated upon. It is best to place a leather strap or
broad cotton tape bandage around the mouth (see Fig. 178) and have
an assistant to hold it. This method is preferable to strapping with
cord, etc. Hobday, Gray and Berdez have constructed special hobbles
and operating-tables which are to be used in hospitals.

In very serious operations, accompanied by great pain, it is advisable
to place the animal under the influence of some anaesthetic (except in
slight operations of the eye, in which local anaesthesia with cocaine is
sufficient). For general anaesthesia we use ether or chloroform, or in
cases where small tumors or warts, etc., are to be removed. In that case
for local anaesthesia we use the spray of ether or ethyl chloride or local
subcutaneous injections of solutions of cocaine hydrochlorate. The
inhalers used in anaesthesia consist of modifications of cones or cylinders,
the commonest being a cylinder of tin with open perforated tin or wire
at one end and containing a sponge to hold the anaesthetic. This is
placed over the nose of the animal. A large number of modifications of
this simple apparatus are used, varying from a wire muzzle or an
ordinary tumbler or a flower pot to the elaborate apparatus advised by
Hobday and described in the "Surgical Diseases of the Dog and Cat.'*
This apparatus consists of a mask that has the form of an elongated blunt
cone, having a stopcock at one end where the tube enters that carries

SURGERY OF TUMORS 493

the anaesthetic into the apparatus. This is fixed on the head by means
of a collar, and a circular continuation of the cone made of soft cloth,
which is adjustable, is fitted over the face. A container with a broad
base to prevent any chance of it being overturned contains the anaes-
thetic. This container has two openings — one to connect the tube and
the other to allow the admission of air to mix with the vapor of the
anaesthetic. Connecting the container and the mask is a bulb apparatus
usually seen on the thermo-cautery.

The muzzle apparatus is fixed on the animal's head, and by means
of the bulb the mixed vapor is blown into the muzzle and directly on the
animal's nose, thus preventing the irritation of the direct contact of the
ether or chloroform. By means of the stop-cock the supply of vapor
can be stopped instantly, or, if need be, the whole apparatus can be
slipped over the animal's head or the rubber tube can be pulled from
the container and a supply or pure air blown directly on the animal's
nostrils.

In the administration of the anaesthetic we must take care that a
certain amount of air is inhaled with the vapor of the anaesthetic. The
pulse, respiration, and reaction of the eyelids must be watched at the
same time. After a few inhalations we notice a period of excitement
which is marked by great restlessness, howling, groaning, and, in rare
cases, delirium. This is followed in a short time by a period of depression,
and after that the narcotic condition is completely established. The
cornea has now become insensible — that is to say, there is no reflex
action or closing of the eyelids when touched. The muscles are now
entirely relaxed, faeces and urine are discharged involuntarily. This
result is not always even or regular, but depends to a large extent on
which of the above-mentioned remedies is used. For instance, in using
ether the stage of excitement is usually prolonged (twenty to forty
minutes) and in the stage of depression reflex excitement does not dis-
appear immediately. Chloroform produces much quicker results, and, as
a rule, answers fairly well, but it has one disadvantage — the attendant
or administrator must be very careful not to push it too far, or it is apt
to produce paralysis of the lungs or stop the action of the heart, causing
death. We prefer to use a combined narcotic in the form of a subcutane-
ous injection. This injection consists of 0.01 to 0.5 of morphia muriate
dissolved in water, and in order to prevent the possibility of too large a
dose causing paralysis of the heart 0.002 to 0.005 of atropia sulphate
should be added one-ciuarter to one-half an hour before the operation.
Afterward the writer has found it necessary to carefully administer
chloroform until the animal is completely anaesthetized, then follow up the
operation with ether alone or alternating with the inhalation of ether and
then chloroform. The narcotic stage is mild, the period of excitement

494 TUMORS

short. Some prefer Billroth's mixture (chloroform 3 parts, ether and
alcohol 1 part of each) ; there is also Wachsmuth's mixture (chloroform 5
parts, oleum terebinthinae recti 1 part). In England the A. C. E. mixture
(ethyl alcohol 1 part, chloroform 2 parts, and ether 3 parts) is largely used
In America the morphia-ether procedure, that of giving from one-half to
one grain of morphia twenty-five minutes before the operation and then
giving ether during the operation is largely used. It is safe, its chief
objection being that it induces more of less preliminary excitement and
salivation. Cocaine for local application as in the eye is harmless as a
rule, but subcutaneous injections of a large amount of concentrated
sokitions for local anaesthesia should be avoided as they are liable to
cause grave symptoms of intoxication or even death. This may also
occur in the administration of cocaine in suppositories in tenesmus and
prolapsus of the rectum in young dogs, and in very small dogs a dose of
cocaine ranging from 0.025 to 0.05 may produce indications of cocaine
poisoning; consequently in weak young animals of the smaller breeds it
should be used with great care. Milder local anaesthetics, such as acoin,
eucaine, stovaine, novocaine, are recommended. As to the so-called lumbar
anaesthesia of the spinal cord, it has been recommended for painless
operations of the abdomen. The operation consists in putting the hyper-
dermic needle in the lumbo-sacral fossa, which is between the median
iliac angles. Pfeiffer uses a 2 to 3 per cent, solution of stovaine; the
weight of the dog determines the dose (0.007 to each kilo.).

The use of various animal sera, such as the anti-streptococcic and
polyvalent sera, have been offered as a possible means of preventing
wxnmd infection. These sera undoubtedly are valualjle and will ulti-
mately, when better understood, be of great benefit therapeutically. At
present, however, they are still in a state of evolution.

INDEX

A BDOMEN, fatty deposits in, 101
■*^ puncture of, 103

Abdominal dropsy, 99

hernia, 381
Abscess of the anal glands, 80

of the kidneys, 187

of the liver, 109

of the neck, 45

of the parotid, 44

of the sclerotic membrane, 409
Abscesses, perinephritic, 187
Absence or loss of the sexual desire, 222
Acarus demodex folliculorum, 469

raystax, 82
Acetic acid test, 179
Acne, 455

Acute catarrh of the bowels, 52
of the bronchia, 138
of the stomach, 52

diffuse peritonitis, 96

dyspepsia, 52

endocorditis, 158

inflammation of the kidneys, 181

intestinal catarrh, 58

laryngeal catarrh, 133

laryngitis, 133

miliary tuberculosis, 303

nephritis, 181

parenchymatous hepatitis, 108

peritonitis, 95

synovial inflammation of the joints,
338
Adenoma, 486
Affection of the eyelids, 395
African horse sickness, 479
Air-passages, diseases of, 115
Albumin, digestion of, 22

in urine, 179
Alopecia, 458
Alveolar Periostites, 38
Amaurosis, 425
Amblyopia, 425
Amount of urine, 173
Amputation of bones, 324

of tail, 375
Amyloid kidney, 186

Hver, 110
Anaemia, 312

chlorosis, 312

of the brain, 236
Anaesthesia, 480
Anal glands, abscesses of, 80

pouches, inflammation of, 78

tumors of, 78
Angina catarrhalis, 46

Angioma, 486

Animal parasites, cutaneous affections
caused by, 461

of the kidney, 190
Anterior chamber, dropsy of, 423
Anomalies of the iris, 422
Anthracosis pulmonum, 146
Anthrax, 289
Anus, imperforate, 78

prolapsus of, 74

stitching of, 77
Aortic valve, disease of, 160

opening, stenosis of, 162
Aphtha;,^ 34
Apoplexia, 237
Areca nut, 92
Arsenical poisoning, 111
Arthritis deformans, 341

rheumatic, 340
Articulations, diseases of, 337
Ascites, 99

Aseptic wound fever, 361
Asthma, 146
Ataxia, 334
Atresia ani, 75

Atrophic conditions of cutaneous mem-
brane, 458
Auscultation of the lungs, 125

of the thorax, 110
Auditory canal, 424

DACTERIA in the urine, 159, 172
^ Basedow's disease, 263
Bench-show distemper, 282
Bile color in urine, 181
Bismuth test, 180
Bitch, castration of, 223

inguinal hernia in, 337

menstruation of, 171

passing the catheter in, 170
Bite, frost, 370

snake, 373
Black cataract, 425
Bladder, catarrh of, 191

cramp of, 202

debility of, 195

dilatation of, 196

diseases of, 191

examination of, 172

neo-formation of, 203

paralysis of, 195

retroflection of, 203

stone in, 197

urine in, 173

49^

496

INDEX

Bleeding at the nose, 129
Blennorrhoea of the eyelids, 103
Blood-boils, 317

-corpuscles in urine, 158

filaria in, 167
Bloodvessels, inflammation of, 308
Boils, 385
Body, increased temperature of, 7

structure and constitution of, 3

subnormal temperature of, 9
Bones, diseases of, 323

fractures of, 325

neo-formations of, 33G

softenino; of, 325

tumors of, 336

union of fractured, 328
Bothriocephalus, 82

l)ubius, 82

cordatus, 82

fuscus, 82

latus, 82

reticulatus, 82
Bowels and peritoneum, physical ex-
amination of, 25

acute catarrh of, 59

chronic catarrh of, 62

distention of, with gas, 88
Brain, anaemia of, 236

concussion of, 238

diseases of, 235

cedema and parasites of, 242

hyperaemia of, 235

inflammation of, 239

rare diseases of, 241

traumatic lesions of, 238
Brom-ether, 348
Bronchia, acute catarrh of, 138

chronic catarrh of, 121, 122
Bronchial asthma, 146

breathing. 111

catarrh, infectious, 235

tubes, diseases of, 137
Bronchitis, 137

parisitic, 140
Bronchocele, 264
Broncho-pneumonia, 141
Bruises, 317

Bruits, of the heart, 156
Buccal fungi, 43
Burns and scalds, 369
Bursa mucosa, diseases of, 356

/CACHEXIA stnimipriva, 264
^^ Cesarean section, 220
Calculi, uric, 197
Cancerous tumor, 482
Cancer of prostate, 206

of stomach, 57
Cania bubo, 461
Canker, external, 432

internal, 434

of the ear, parasitic, 439
Carbolic-acid poisoning, 98

Carcinoma, 484
Caries" of the teeth, 38
Cartilaginous tumor, 333
Castration, 210, 388
in the bitch, 223
of the male, 210
Catarrh, acute, of bronchia, 138
laryngeal, 133
of intestines, 58
chronic, of bowels, 60
of bronchia, 137
infectious bronchial, 283
nasal, 128
of frontal sinusis, 130

of larynx, 133
of the bladder, 191
of the nose, 128
of the stomach, 52
of the windpipe and bronchia, 137
Catarrhal conjunctivitis, 402

inflammation of the lungs, 141
jaundice, 104
metritis, 215
ophthalmia, 403
pneumonia, 141
Catalepsy, 262
Cataract, 416

black, 425
Catheter, passing of, 169
Cavity of the mouth, malformations of,

41
Ceratopsylus canis, 462
Cerebral hemorrhage, 237
Cerebro-spinalis, 243

-spinal meningitis, 243
Cerebrum, inflammation of, 239
Cestodes, 84
Chest, dimensions of, 49
dropsy of the, 151
puncture of the cavity of the, 150
shape of the cavity of the, 119
sensitiveness to pressure, 119
Chloroform, 483
Chlorosis, 312
Chorea, 259

Chronic catarrh of the liowels, 58
of the bronchia, 137
of the larynx, 135
of the nose, 128
of the stomach, 53
constipation, 72
dyspepsia, 53
eczema, 448
hydrocephalus, 241
induration of the lungs, 143
inflammation of tlie kidneys, 184

of the spinal cord, 246
interstital hepatitis, 108
pneumonia, 143, 145
nephritis, 184
laryngitis, 133
nephritis, 184

parenchymatous nephritis, 184
peritonitis, 98

INDEX

497

Chronic prostatis, 204

serous inflammation of the joints.
338

tuberculosis, 305
Circulatory apparatus, diseases of the,

154
Circumscribed peritonitis, 97

phlegmone, 359
Cirrhosis of the liver, 108
Claws and foot-pads, diseases of the, 378
Claws, inflamed, 379

ingrowinji, 378
Closure of the evelids, 395
Cold in the head, 128
Collections of urine in the abdomen after
rupture of the bladder, 198
in the bladder, 195
Color of urine, 174
Com])ression of the spinal cord, 250
Concussion of the brain, 238

spinal cord, 251
Condition of the mouth and throat, 12

nutritive, 3

the physical, 1
Condroma, 487
Congestion of the brain, 238

of the liver, 104

of the lungs, 145
Congestive hypersemia of the liver, 109
Conjunctiva, diseases of, 401

inflammation of, 401
Conjunctivitis, 401

catarrhal, 402

foUicularis of the membrane nicitans,
399

in distemper, 234

purulent, 403
Consciousness, disturbance of, 228
Constipation, 29, 64

hcronic, 72
Constitutional diseases, 312
Contagious catarrhal fever, 267
Contraction of the intestines, 65
Controlling hemorrhage, 364
Contusions, 367

and wounds of the pads, 380

of the joints, 345
Convulsions, 233

of the diaphragm, 263
Convulsive cough, 135
Cornea, abscesses of the, 409

diseases of the, 406

dermoid of, 413

injuries of, 414

parendrvmatous inflammation of
the, 408

ulceration of the, 410
Coryza, 128
Costiveness, 64
Cough, 122

chronic irritable, 135
Coverings of the brain, diseases of, 235
Cramp, cvstic, 202

of the bladder, 202

Croupal memljranes, 46

pneumonia, 146
Croupous inflammation of the lungs, 146
Crystalline lens, diseases of, 416

extraction of, 419
Cutaneous affections caused by animal
parasites, 465
caused by vegetable parasites,
475
membrane, inflammaotry conditions

of, 441
membranes, atrophic conditions of,

458
tumors, 480
Cuterebro emasculator, 211
Cystic stones, 197
Cysticerous and trichina, 353
Cystitis, 191
Cystotomy, 201
Cysts,, serous, of the ear, 429

DE.\FNESS, partial or complete, 438
Debility of the bladder, 195
Decayed meat poisoning, 63
Deep parendryinatous inflammation of

the cornea, 408
Deformans, arthritis, 34
Dentition, 40
Dermatophagus canis, 465
Dermoid of the cornea, 413
Detachment of the retina, 424
Diabetes insipidus, 318

meUitus, 316
Diagnosis of the larynx and windpipe, 117
Diaphragm, convulsion of the, 236
Diastasis of the vertebral column, 251
Diffuse peritonitis, 95

phlegmone, 360
Digestive apparatus, disease of, 11
Digestion of albumin, 22

of hydrocarbonaceous food, 22

of meat, 22

of milk, 22

of the stomach on a meat diet, 22
Dilation of the bladder, 196

of the heart, 163
Dilatation of the pelvis of the kidney, 189

of the (esophagus, 51
Dimensions of the thorax, 119
Dipylidium canerium, 87
Discission, 418

Diseased malformations of the joints, 341
Diseases, constitutional, 312

of the air-passages and bronchial
tubes, 137

of the aortic valve, 162

of the articulations, 337

of the bones, 323

of the bladder, 191

of the brain and its coverings, 235

of the bursa mucosa, 287

of the circulatory apparatus, J54

of the claws and foot-pads, 378

498

INDEX

Diseases of the conjunctiva, 401
of the cornea, 406
of the crystalline lens, 416
of the digestive apparatus, 11
of the ear, 429
of the eyes, 395

of the female sexual organs, 211
of the heart, 158
muscle, 163
Hodges, 315
of the intestines, 58
of the joints, 337
of the kidneys, 181
of the lachrymal duct, 399
of the larynx, 133
of the lens, 416
of the liver, 404
of the lungs, 411
of the male sexual organs, 204
producing malformation of the

joints, 337
of the mammary glands, 225
of the membrane nicitans, 399
of the mouth , tongue, and salivary

glands, 34
of the muscles, 353
of the nasal cavities, 128
of the nervous portion of the eye, 422
of the nervous system, 228
of the oesophagus, 48
of the optic nerve, 422
ofthe organs of locomotion, 323
of the penis and prepuce, 206
of the pericardium, 165
of the peritoneum, 95
of the pleura, 147
of the prostate, 202
of the respiratory organs, 115
of the retina, 423
of the sahvary glands, 34
of the sclerotic coat of the eve,

422
of the sexual apparatus, 152
of the skin, 441
of the spinal cord and its coverings,

243
of the stomach, 52
of the teeth, 37
of the tendons, 356
of the testicle and its covering, 208
of the tongue, 36
of the urinary and sexual apparatus,

169
of the vagina and the uterus, 211
of the vitreous humor, 423
of true infection, 267
resulting from the septic infection of

wounds, 359
septic and pysemic, 287
Disinfection of wounds, 363
Dislocation of the elbow, 349
of the lower jaw, 348
of the patella, 350
Dislocations, 347

Disicative keratitis, 408
Distemper, 267

bench-show, 282

false, 282
Distoma echinatum, 94

heterophytes, 94
Distortions of the joints, 341
Disturbance of consciousness, 228

of motility, 229

of reflex irribility, 234

of sensitiveness, 228
Diuretics in dropsy, 89
Diverticulum of the rectum, 80
Dochmius, 93

duodenalis, 93

stenocephalus, 93

trigonocephalus, 93

uncincoriasis, 94
Dog flea, 462

lice, 463

passing the catheter in the, 152

parasites, 461
Drainage of the wounds, 364
Dropsy, abdominal, 99

of the anterior chamber, 423

of the chest, 151

of the pericardium, 166
Dyspepsia, 52

chronic, 53

pAR, diseases of, 429

*-' inflammation of external, 432

parasitic canker, 439
diseases of the, 439
Eclampsia, 260
Ectropion, 397
Eczema, 445

chronic, 448

moist, 446

parasitic, 465

of the toes, 450

seborrhoeicum, 450
Elbow, dislocation of, 449

hygroma of the, 357
Emasculating bot-fly, 185
Emetics, 21
Emphysema, 6

of the lungs, 138, 146
Endocarditis, acute, 158

ulcerosa, 158
Enteritis catarrhalis, 59
Enterotomy, 71
Enterectomy, 72
Entero-anastomosis, 72
Entropion, 395

operation for, 396
Enucleation, 370
Epilepsv, 255
Epistaxis, 129

Epithelium in the urine, 158
Epulides 41
Erythema, 442
Ether, 493

INDEX

499

Examination, general, 1

of the bladder, 172

of the digestive apparatus, 11

of the circulatory apparatus, 154

of the heart, 154

of the kidney, 173

of the mouth and throat, 2

of the nervous system, 228

of the nose, 115

of the oesophagus, 16

of the prepuce and urethra, 1 69

of the prostate, 169

of the stomach, 17

of the urinary apparatus, 169

of the urine, 173

physical, of the lungs, 115
Exarticulation, 376
Excessive venereal excitement, 223
Exophthalraus, 425
External canker, 432

concha, ulceration of the, 432
Eyeball, prolapse of, 425
Eyes, diseases of the, 395
Eyelids, 350

affections of, 395

blennorrhoea of, 403

closure of, 395

inversion of, 395

turning in of, 353

turning out of, 397

inflammation of the, 398
Eye, dropsy of the anterior chamber, 423

enucleation of, 427

inflammatory processes of, 422

opening the capsule of, 418

purulent inflammation of, 423

removal of the, 427
Expansion of the stomach, 54

■pACIAL nerves, paralysis of the, 253

*■ twitching, 255

Falling out of the hair, 458

False distemper, 282

Fat in urine, 117

Fatty liver, 109

Favus, 475

Feces, 28

Female sexual organs, diseases of, 211

Femoral hernia, 393

Fermentation test, 181

Fever, 308

aseptic wound, 361

puerperal, 216

purulent, 362

septic wound, 361
Fibrinous pneumonia, 146
Fibroma, 480
Filiaria, hoematica, 167

immitis, 167, 475

in the blood, 167

mediunsis, 475

tracheo-bronchialis, 140
Filix mas, 91

Flea, dog, 462

Follicular mange, 469

Foreign bodies in oesophagus, 48

in the stomach, 55

in the tongue, 36
Fractures, general classification of, 292

of the bones, 325

union of, 328
Frontal sinusis, catarrh of the, 130
Frost-bite, 370
Furunculosis, 455

pALLSTONES, 110

^-^ Gangrene of the tongue, 36

Gastricismus, 52

Gastritis catarrhalis, 52

Gastro-intestinal inflammation, 63

General classification of fractures, 326

examination, 1
Gestation, 219

Glands, anal abscesses of, 79
Glaucoma, 423
Goitre, 264
Gonorrhoea, 207

of the prepuce, 207
Gums, tumors of, 40

LJ^MATOZOON, Lewisi, 168
*• * subulatum, 168
Hair-follicles, inflammation of, 455
Hair, falling out of, 458
Hardening of the liver, 108
Harvest bug, 465
Head, cold in, 128

mucous membranes of, 4
Healing process of a wound, 366
Heart, dilation of the, 163

diseases of the, 158

muscles, parasites in the, 164
disease of the, 163

nervous palpitation of the, 164

palpitations, 164

sounds of the, 156

tumors of the, 164

valvular defects of the, 160
diseases of the, 160
Hsematoma, 429
Hsemaeopinus piliferus, 463
Hsemoglobinuria, 307
Hebra's potash-soap, 391
Heller's test, 179
Helminthiasis, 82
Hemathorax, 153
Hemiplegia laryngis, 136
Hemoglobinuria and piroplasmosis, 307
Hemorrhage, 358

cerebral, 237

controlling of, 364

of the pericardium, 166

of the spinal cord, 251

of the retina, 424
Hemorrhoids, 81

:oo

INDEX

He par, adiposum, 109
Hepatitis, 108

acute parenchymatous, 108

interstitial, 108
Hernia, 381

abdominal, 381

femoral, 393

inguinal 387

in the bitch, 389

irreducible, 383

perineal, 394

pseudo-perineal, 80

reducible, 382

scrotal, 387

umbilical, 391
Herniotomy, 386
Herpes tonsurans, 476
Hiccough, 263
Hip-dislocation of the, 252
Hobday apparatus, 492
Hodge's disease, 315
Honey cysts, 45
Hordeolum, 399

Hydrocarbonaceous food digestion of, 22
Hydrocephalus, 241
Hydrocele, 391

Hydrocyanic-acid poisoning, 112
Hydronephrosis, 189
Hydrophobia, 290
Hydrophthalmus, 423
Hydrops abdominalis, 99
Hydrothorax, 151
Hygroma of the elbow, 357
Hypersemia of the brain, 235

of the liver, 107
Hypersesthesia, 229

ICTERUS catarrhalis, 104
■^ Imperforate anus, 78
Imptegio, 460
Increased temperature, 7
Induration, chronic, of the lungs, 143
Infectious bronchial catarrh, 232

genital tumors. 486

hemorrhagic gastroenteritis, 383
Inflammatory conditions of the cuta-
neous membrane, 441
Inflammation, mycotic, of the stomach
and intestines, 63

of the anal pouches, 78

of the brain, 239

of the brain-mass, 239

of the cerebral matter, 239

of the cerebral membranes, 239

of the choroid, 422

of the conjunctiva, 401

of the external ear, 432

of the eye, 422

of the eyelids,_ 398 _

of the gastro-intestinal, 62

of the hair-follicles, 455

of the iris, 422

of the joints, 337

Inflammation of the joints, purulent, 339
rheumatic, 340

of the kidneys, 181

of the liver, 108

of the lungs, 141

of the lymphatics, 360 .

of the mammary gland, 225

of the mucous membranes of the
mouth, 34

of the mucous membranes of the
throat, 46

of the papilla of the optic nerve,
424

of the pelvis of the kidney, 188

of the peritoneum, 95

of the pleura, 147

of the prostate, 204

of the scrotum, 208

of the salivary glands, 43

of the sclerotic coat, 422

of the spinal cord, 210

of the testicle, 209

of the uterus, 216

of the urethra, 203

of the vagina, 211

of the vulva and vagina, 211

purulent, of the liver, 109

toxic, of the stomach and intestines,
63
Inflammatory processes of the eye, 422
Inflamed claws, 379

hemorrhagis gastro-intentes, 283
Inguinal hernia, 387

in the bitch, 389
Ingrowing claws, 378
Injuries of the cornea, 414

of the joints, 344

to the testicles and scrotum, 209
Inoculation, Pasteur's method, 305
Internal canker, 434

parasites, 82
Interstitial hepatitis, 108

nephritis, chronic, 184

pneumonia-chronic, 145
Intestinal parasites, 82

catarrh, 58
Intestines, contraction of, 65

diseases of, 58

mycotic inflammation of, 63

obstruction of, 65

physical examination of, 25

stenosis of, 63

toxic inflammation of, 63
Inversion of the eyelid, 395

of the stomach, 55
lodoform-poisoning, 112
Irreducible hernia, 383
Irregularities of the sexual instinct, 222
Iris, anomalies of the, 422

colobroma, 422

inflammation of, 422
Irritalile cough, chronic, 135
Iritis, 422
Ischiadicus, paralysis of the, 254

INDEX

501

Itching skin without presence of rash, 450
Ixodes ricinus, 405

lAFXDICE, catarrhal, 104
*-' malignant, 307
Jaw, dislocation of, 348
Joints, acute, synovial inflammation of,
338

chronic serous inflammation, 338

contusions of, 344

distortions of, 341

diseases of, 337

inflammation of, 337

injuries of, 344

luxations of, 347

malforn^ation of, 341

puncturing of, 342

purulent inflammation of, 339

rheumatic inflammation of, 340

suppuration of, 339

wounds of, 344

1<-AMALA, 91

' *• Kennel distemper, 267

Keratitis, 406

disiccative, 414

parenchymatosa, 408

profunda, 403

superficialis, 407
Kidneys, abscess of, 187

acute inflammation of, 181

amyloid, 186

animal parasites of the, 190

chronic inflammation of, 184

dilatation of the pehis of the, 189

diseases of, 181

examination of the, 173

inflammation of, 181
of the pelvis, 188

tumors of the, 190
Koch's test, 179
Kusso, 92

T ARDACEOUS liver. 110
^ Laryngeal catarrli, acute. 133
Lachrymal, diseases of the, 399
Laryngitis, acute, 133

chronic, 135
Laryngoscope, 118

Larvnx, and \\'indpipe, phvsical diagnosis
"of the, 117

chronic catarrh of, 135

diseases of, 133
Left venous opening, stenosis of the, 162
Lapro-enterotomv, 70
Leptus autumnalls, 465
Leucoma, 415
Leukaemia, 313
Lice, dog, 463

Linear, extraction of thecrys talline lens,
419

Linguatula taenoides, 131
Lipoma, 481
Lithiasis, 197
Liver, abscess of, 109

amyloid, 110

cirrhosis of, 108

congestion of the, 104

congestive hypersemia of, 109

diseases of, 104

fatty, 109

hardening of, 108

hypersemia of, 109

inflammation of, 108

lardaceous, 110

neoformations of, 110

parasites of, 110

physical examination of, 32

purulent inflammation of, 109

stagnating hypera^mia of, 107
Lobular extraction of the crystalline
lens, 419

pneumonia, 141
Local temperature, 7
Lockjaw, 309

Locomotion, diseases of organs of, 323
Lower jaw, dislocation of, 348

paralj^sis of, 253
Lungs, acute hypersemia of, 145

auscultation of the, 125

blackening of the, 129

catarrhal inflammation of, 141

chronic induration of, 141

cirrhosis of, 143

congestion of the, 145

croupal inflammation of the, 146

diseases of, 141

emphysema of, 146

neo-formations of the, 147

oedema of, 141, 144

physical diagnosis of, 119
Lunguatula denticulata, 131
Luxations of the joints, 347

of the spine, 251
Lymphadenia, 315
Lymphangitis, 360
Lymphatics, inflammation of, 360

MALE, castration of the, 210
fern, 91

sexual organs, diseases of, 204
Malformation of the joints, 341
of the rectum and anus, 48
Malformations of the cavity of the

mouth, 41
Malignant jaundice, 307

oedema, 288
Mammary gland, diseases of the, 225
inflammation of, 225
neo-formation of the, 226
Mammitis, 225
Mange, follicular, 467
red, 445
sarcoptic, 465

502

IXDEX

Meat-diet, digestion, 22
Medulla obllongata, paralysis of, 243
Membrana nictitans, diseases of the,
399

removal of, 400
Meningitis, 239
Menstruation of bitch, 219
Mercury-poisoning, 113
Metritis, 215

catarrhal, 215

septic, 216
Milk-digestion, 22
Moist eczema, 446

scab, healing under, 359
Motor paralysis of the trigeminus, 253

symptoms of paralysis, 229
Mouth and throat, condition of the, 12

examination of, 12

diseases of, 34

the mucous membrane of, 34

malformations of, 41

ulcerous inflammation of, 34
Mouth-gag, 13
Mouth, warts in, 42
Mucous cysts, 45

membrane of the mouth, disease
of, 34

membranes of the head, general
examination of, 14

membranes of the throat, inflamma-
tion of, 46

ulcerous inflammation of, 34
Multiple periositas, 336
Mumps, 43

Muscles, diseases of the, 353
Muscular rheumatism, 353
Mycotic inflammation of the stomach

and intestines, 63
Myehtis, 243
Myoma, 487
Myxoma, 486

MASAL catarrh, 128

*^ cavities, diseases of, 128

tumors of the, 130
Neck, abscess of, 45
Necrotic stomatitis, 34
Neoformation of the bladder, 203

of the bones, 336

of the glans penis and prepuce, 208

of the liver, 110

of the lungs, 147

of the mammary glands, 226

of the testicles, 209

of the uterus, 218

of the vagina, 215
Nephritic stones, 190
Nephritis, 181

acute, 182

chronic, 184

interstitial, 184

suppurative, 187
Nerves, paralysis of the, 252

Nervous palpitation of the heart, 164

portion of the eye, diseases of, 422

system, diseases of, 228
examination of, 228
Nettlerash, 444
Noma, 461
Nose, Weeding of the, 129

catarrh of, 113, 128

examination of, 115
Number and character of the respiratory

movements, 120
Nuritive condition, general examination

of, 3 _
Nux-vomica poisoning, 113
Nymphomania, 223

OBESITY, 319
Obstetrics, 219
Obstipation, 65
Obstruction of the intestines, 65

of the oesophagus, 50
Obturator nerve, paralysis of the, 254
Odor of urine, 175
ffidema, and Parasites of the brain, 242

of the lungs, 144 malignant, 288
(Esophagotomy, 50
ffisophagus, diseases of, 48

dilitation of, 51

examination of, 16

foreign bodies in, 48
Opening of the capsule of the eye, 418
Operation for entropion, 395
Ophthalmia, catarrhal, 403

purulent, 403
Optic nerve, disease of, 424
Orchitis, 209
Osteoma, 487

malaria, 325
Ostitismus universalis, 336
Otitis externa, 432

parasitic, 439
Ovariotomy, 223
Oxalates, 178
Oxyuris vermicularis, 93

PACHYMENINGITIS, 239

* Panophthalmitis, 423

Pads, contusion of the, 280

Pancreas, 33

Papilla of the optic nerve, inflammation of

the, 424
Papilloma, 483
Paralysis, 229

of the anterior limbs, 230

of the bladder, 195

of the cruralis, 230

of the facial nerves, 252

of the lower jaw, 253

of the ischiadius, 254

of the medulla oblongata, 243

of the nerves, 252

of the obturator nerve, 254

of the oesophagus, 51

INDEX

503

Paralysis of the posterior limbs, 244

of the radial nerve, 253

of the sphincters, 245
Paraphimosis, 206
Parasites, 82

dog, 463

internal, 82

in the brain, 242

in the heart muscles, 164

intestinal, 82

of the kidney, 190

of the stomach, 57

tapeworm, 84
Parasitic, bronchitis, 140

canker of the ear, 439

cezema, 445

otitis, 439
Parenchymatous hepatitis, 108

inflammation of the tongue, 36

nephritis, chronic, 184
Parotid, abscess of, 44
Parotitis, 43

Passing the catheter, 169
Pasteur's method of inoculation, 300
Patella, dislocation of, 350
Pelvis of the kidney, inflammation of,

188
Pemphigus, 460
Penis, diseases of, 206
Pentastoma denticulatum, 131

influenza, 131

tsenioides, 131
Percussion of the thorax, 123
Pericardium, diseases of the, 165

dropsy of the, 166

hemorrhage of the, 166
Pericarditis, 165
Perineal hernia, 394
Periostitis alveolar, 38
Perinephritic abscesses, 187
Persistant papillary membrane, 422
Peritonitis, 95

acute diffuse, 95

chronic, 98

circumscribed, 97
Peritoneum, diseases of, 95

inflammation of, 95

physical examination of, 25
Pharyngitis, 46

chronic, 47
Phimosis, 206
Phlegmone, 359
Phosphorus-poisoning, 112
Phthisis, 143

Physical diagnosis of the larynx and
%\'indpipe, 117
of the bowel and peritoneum,
25

condition, the, 1
of the liver, 32
of the lungs, 119
of the pancreas, 33
of the spleen, 33
of the respiratory apparatus, 115

Piroplasmosis and hemoglobinuria, 307
Pleura, diseases of, 147

inflammation of, 147
Pleural tuberculosis, 304
Pleurisy, 147
Pleuritis, 147
Pneumonia, 141

broncho-, 141

catarrhal, 141

chronic interstitial, 143

croupal, 146

filirinous, 146

lobular, 141

traumatic, 141
Pneumothorax, 152
Poisoning by arsenic. 111

by carbolic acid, 112

by caustic alkalies. 111
acids. 111

by chloroform, 113

by gas, coal, carbondioxide or
illuminating, 114

by hydrocyanic acid, 112

by iodine, 114

by iodoform, 112

by mercury, 113

by nux vomica, 113

by phosphorus, 112

by prussic acid, 112

by strychnine, 113
Poisons, 111
Pomegranate, 82
Polyneuriti'^ infectiosa, 255
Posterior chamber of the ej-e, diseases of,
422

limbs, paralysis of, 244
Potash-soap, Hebra's, 391
Prepuce, diseases of, 206

examination of, 169

gonorrha?a of, 207

neoformations of, 208
Priessnitz's compress, 322
Probang, 49
Proglottides, 85
Prolapse of the eyeball, 425

of the rectum, 74

of the uterus, 216

of the vagina, 212
Pulsations of the henrt, 156
Prolapsus bulbi, 425

of rectum, reduction of, 74

uteri, 212

vaginae, 212
Prostate, cancer of, 206

diseases of, 204

examination of, 204

inflammation of, 204

tumors of, 206
Prostatitis, 204

chronic, 205
Prurigo, 459
Pruritis, 459

Prussic-acid poisoning, 112
Pseudo-leukaemia, 315

504

INDEX

Pesudo-perineal hernia, 80

Psychosis, 262

Pterygium, 414

PtyaUsm, 36

Puerperal fever, 216

Pulcx, 462

Puncturing; the abdomen, 103

the joints, 342
Purulent conjunctivitis, 403

inflammation of the eye, 403
of the joints, 339
of the liver, 109

ophthalmia, 403
Pus in the frontal sinuses, 130
Puncture of the cavity of the chest, 150
Pyajmia, 362
Pyarthrosis, 339
Pyelitis, 188
Pyelonephritis, 187

DABIES, 290

*^ Radial nerve, paralysis of, 253

Ranula, 42

Rare diseases of the brain, 241

Reaction of urine, 175

Rectum, and anus, malformations of, 78

preternatural, 78

prolapsus of, 74
Reflex irritability, disturbance of, 234
Red mange, 445
Reducible hernia, 382
Removal of the eye-ball, 427

of the membrana nictitans, 408
Renal cylinders, 179

hypergemia, 186
Respiratory apparatus, physical exami-
nation of, 115

movements, number and character
of, 120

organs, diseases of, 115
Retina, detachment of, 424

diseases of, 424

hemorrhage of, 424
Re+roflection of the bladder, 203
Reversion of the stomach, 55
Rhachitis, 323
Rheumatic arthritis, 340

inflammation of the joints, 340
Rheumatism, muscular, 353
Rhinitis, 128

muscular, 353
Rickets, 323
Round worms, 82
Rupture, 381

of the bladder, 198

CAINT Vitus dance, 259

^ Salivary glands, inflammation of, 43

Sarcocele, 391

Sarcoma, 482

melanotic, 335
Sarcoptes scabiei, 465

Sarcoptic mange, 465
Scalds, burns and, 369
Sclerotic coat, diseases of, 422
Scrotum, injuries of, 209
Scurvy, 321
Seborrhoea, 459
oleossa, 460
prolputi, 460
Septic and pysemic diseases, 287
infection of wounds, 359

metritis, 216
-wound fever, 361
Septicopyjemia, 287
Serous cyst of ear, 429

inflammation of the joints, chronic,
338
Sexual apparatus, diseases of, 169
desire, irregularities, 222
loss c-f, 222
Shape of the cavity of the chest, 119
Skin affections caused by animal para-
sites, 461
caused by vegetable parasites,
475
and subcutaneous membranes, gen-
eral examination of, 5
atrophic conditions of, 407
diseases of, 441

non-parasitic diseases of, 442
caused by worms, 474
inflammatory conditions of, 384
Snake bite, 373
Softening of the bones, 325
Sore-throat, 46
Sounds of the heart, 156
Specific gra\aty of iirine, 175
Speculum, 13,' 28. 212
Sphincters, paralysis of, 245
Spinal cord, chronic inflammation of,
246
compression of, 250
concussion of, 251
hemorrhages of, 251
inflammation of, 243
membranes, inflammation of, 243
myelitis, 243
Spine, nutritive disorders of, 212
Spiroptera sanguinolenta, 51, 168
Spleen, 33
Sprains, 346

Stagnating hyperaemia of the liver, 167
Stenosis of the aorta opening, 162
of the oesophagus, 50
of the intestines, 65
of the left venous opening, 162
Stitches, 365
Stomacace, 34

Stomach, acute catarrh of, 52
cancer of, 57
chronic catarrh of, 53
digestion of milk, 22
dilatation of, 54
diseases of, 52
examination of, 17

INDEX

505

Stomach, expansion of, 54

foreign bodies in, 55

inversion of, 55

meat diet, digestion of, 22

mycotic inflammation of, 03

parasites of, 57

reversion of, 55

-pump, 20

toxic inflammation of, G3

ulceration of, 57
Stomatitis, 34

necrotic, 34

ulcerative, 34
Stone in the bladder, 197
Stones, nephritic, 190
Stricture of the urethra, 202
Strongylus bronchialis lanis, 140

vasorum, 141, 168
Structure and constitution of the body, 3
Struma, 264

Strychnine-poisoning, 113
St. Vitus's dance, 259
Sty of the eye, 399
Sugar in urine, 180
Sunstrok , 242
Suppuration, of the joints, 339
Suppurative nephritis, 87
Syndesmitis, 401
Synovitis acuta serosa, 338

chronica serosa, 338
Synovial inflammation of the joints, 338
Syringomyelia, 252

•pABES dorsalis, 251
*■ Tsenia, 84

ccenurus, 89
cucumerina, 87
echinococcus, 89
lineatu, 89
litterata, 89
marginata, 87
serialis, 89
serrata, 85
Tseniafuges, 91
Tail, amputation of, 375

wounds on the tip of, 374
Tapeworms, 84
Tapping the abdomen, 103
Teeth, caries of, 38
diseases of, 37
Temperature, 7
increased, 7
subnormal, 9
Tendons, diseases of, 356
Test, acetic, 179
bismuth, 181
fermentation, 181
Heller's, 176
Kochs' 179
Trommer's 180
tuberculin, 306
Testicles, diseases of, 208
inflammation of, 209

Testicles, injuries of, 209

neoformations of, 209
Tetanus, 309

Therapeutics of tumors, 490
Thorax, auscultation of, 125

dimensions of, 119

percussion of, 123
Throat, inflammation of the mucous

membranes, 46
Thyroid gland, inflammation of, 266

hypertrophy of, 264
Tobacco-bag stitch, 77
Toes, eczema of, 451
Tongue, diseases of, 36

foreign bodies in, 36

gangrene of, 36

parenchymatous inflammation of, 37
Toxic inflammation of the stomach and

intestines, 63
Trachea, physical examination of, 117
Traumatic lesions of the brain, 338
Treatment of wounds, 357
Trichocephalus, depressiusculus, 94
Trichodectes latus canis, 463
Trigeminus, motor paralysis of, 253
Trommer's test, 180
True infection, diseases of, 267
Trypanosomiasis, 478
Tuberculin test, 306
Tuberculosis, 302

pleural, 304
Tumors, 480

cancerous, 484

cutaneous, 267

infectious genital, 488

of the gums, 40

of the heart, 164

of the nasal cavities, 130

of the prostate, 206

of the kidneys, 190

particularly those of the skin, 480

therapeutics of, 490
Turning in of the eyelid, 395

out of the eyelid, 397
Twitching, facial, 255

T TMBILICAL hernia, 391
^ Ulceration, 367

of the cornea, 410
of the stomach, 57
Ulcerations of the external concha, 432

of the stomach, 57
Ulcerative stomatitis, 34
Ulcers and ulceration, 367
Ulcerous inflammation of the mouth,

34
Union of fractures, 325
Uraemia, 320
Urethra, examination of, 169

inflammation of, 203

stricture of, 202
Urethrotomy, 200
Uric calculi, 197

506

INDEX

Urinarjf apparatus, examination of, 109

diseases of, 169
Urine, albumin in, 179

amount of, 173

color of, 174

crystals, 178

epithelium in, 177

examination of, 173

fat in, 175

in the abdominal cavity, 198

odor of, 175

reaction of, 175

specific gravity of, 175

sugar in, 180

transparency of, 175
Urticaria, 444
Uterus, diseases of, 215

inflammation of, 215

neoformation of, 218

prolapse of, 212, 216

removal of, 222

WAGINA, diseases of, 211
* inflammation of, 211

neoformations of, 215

Vagina, prolapse of, 212

Vaginitis, 211

Valvular defects of the heart, 160

diseases of the heart, 160
Vegetable parasites, cutaneous affections

caused by, 175
Vertebral column, diastasis of, 251
Vitreous humor, diseases of, 424
Vulva and vagina, inflammation of,

211

VWARTS in the mouth, 42
^^ Windpipe, physical diagnosis of,

117
Worms, intestinal, 82
Wounds and their treatment, 357

diseases resulting from the septic

infection of, 359
treatment of, 364
on the tip of the tail, 374

"VELLOW mucous membranes, 104

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■;iimmings School of Veterii=:...> ...ouicine at
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