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TEXT BOOK

OF

VETERINARY MEDICINE

BY

JAMES LAW, F.R.C.V.S.

Director of the New York State Veterinary College
Cornell University, Ithaca, N. Y.

VOL. II

SECOND EDITION
REVISED AND ENLARGED

DISEASES OF THE DIGESTIVE ORGANS, LIVER,
PANCREAS, AND SPLEEN.

ITHACA
PUBLISHED BY THE AUTHOR
1905

H

ie SEES
Copyright by

JAMES LAW
1900

PRESS OF
ANDRUS & CHURCH
ITHACA, N, y,

VETERINARY MEDICINE.

DISEASES OF THE DIGESTIVE ORGANS.

Second in importance to pulmonary complaints in solipeds ; equal in
ruminants. Extent of digestive organs and character of food, in carnivora,
herbivora, and omnivora. Ruminant’s stomachs. Gastric fermentation.
Foreign bodies. Torpor. Unwholesome fodder.

In the horse these maladies are only second in importance to
those of the respiratory organs, while in ruminants they are
equally frequent and important. The varying susceptibility of
the digestive organs to disease in different families and the special
proclivity of'different parts of these organs may be, in great part,
explained by the great variation in the food, by the relative ex-
tent of the gastro-intestinal surface, and by the amount of work
devolving on the respective viscera.

In carnivora the entire gastro-intestinal surface is little more
than half the area of the skin, for their rich animal food does not
require a prolonged retention and an elaborate series of intricate
processes to insure digestion and absorption. This system of or-
gans is accordingly less liable to disorder in carnivora than in
herbivora and omnivora. Add to this that the carnivorous
stomach is very capacious relatively to the intestine, that the di-
gestion of the great bulk of the food. (nitrogenous elements) is
nearly completed in this viscus, and that the contents of this or-
gan are easily and completely discharged by vomiting whenever
they prove irritating, and we have ample explanation of the com-
parative immunity of these animals from digestive disorders.

The herbivora stand at the opposite extreme, the gastro-intes-
tinal surface being over double the area of the skin in the horse,
and nearly three times that extent in the ox. The hard, fibrous
and comparatively inuutritious vegetable food of these animals
necessitates its prolonged retention in the alimentary canal in
order to the completion of digestion and the absorption of the
nutritive constituents. Hence the great liability of the herbivora
to diseases of the digestive organs.

2 Veterinary Medicine.

Omnivora occupy a place intermediate between these two
classes, as regards both the nature of the food and the extent of
surface of the alimentary canal, and they are in similar ratio little
liable to digestive disorders. ‘They have besides in common with
carnivora a great facility in the rejection of irritant matters by
vomiting, and in thus protecting themselves against gastric and
intestinal disorders.

A fair idea of the area of the intestinal surface may be given by
stating the length of the canal relatively to that of the body:—in the
dog: :6:1,in the rabbit: : 10:1, in the ass and mule :: 11:1,
in the horse: : 12:1, inswine :: 14:1, in theox:: 20:1, and
in the sheep: : 27:1. ‘The calibre of the intestine varies how-
ever and with it the capacity. Thus in the relatively shorter in-
testine of the horse, the capacity is much greater in ratio with
the size of the animal than is the relatively much longer intestine
of the pig. The ox’s intestine though twice the length of that
of the horse has little more than half the capacity.

Among herbivora the monogastric (horse, ass, mule), and
polygastric (ruminant) animals manifest varying pathological
susceptibility according to the relative development of the differ-
ent digestive viscera and the habitual character of their food.
The horse and other large solipeds have small stomachs (16 qts. )
and capacious intestines (196 qts.). Digestion is restricted in the
stomach and largely carried on in the spacious bowels. The
small stomach requires to be frequently replenished in moderate
amount, but, if this is secured, its liability to disease is slight
while that of the intestines is very considerable. In the ox the
stomachs have a total capacity of 252 qts., while that of the
intestines averages 103 qts. In this animal the capacious and
hard working stomach is a frequent seat of disorder, while the
comparatively small intestines are to a largeextent exempt. The
small stomach of the horse is easily overloaded and disordered or.
paralyzed by an unusually full feed of grain when hungry, or
one of some specially appetizing fodder, and the case is serious,
as relief can rarely be obtained by vomiting. For the same
reason fermentation of the gastric contents with evolution of gas
and tympany usually proves fatal to the horse since relief by
eructation is too often impossible. Cattle are fitted to live in
damp localities where the cloven foot prevents sinking and get-

Diseases of the Digestive Organs. 3

ting bogged, and where they may draw in with the tongue a full
mouthful of coarse herbage which they swallow with little masti-
cation or admixture with saliva. This lodges in the first two
stomachs, and if, from any cause, rumination is impaired, or sus-
pended, it finds itself in conditions especially favorable to fer-
mentation. The food too, as in the case of frosted roots, wet
clover or partially ripened grain, etc., is often charged with fer-
ments (bacteria) in a state of great vital activity, and hence the
frequent tympanies of the ox. The ruminant is no less liable
than the soliped to overload the stomach, and though the return
of food from the first two stomachs to the mouth is a normal pro-
cess, this is promptly arrested by the supervention of paresis in
.the overloaded and overdistended organs. ‘This overdistension
further tensely stretches and closes the lips of the cesophagean
opening. The rapid swallowing of the food, with only one or
two strokes of the teeth for each morsel, renders the large
ruminant more liable to take in poisons, pins, nails and other
injurious bodies, especially when hunger and the blunting of the
sense of smell have been brought on by traveling on dusty roads.
Again the large ruminants, cows especially, are wont to while
away the tedious hours by chewing and unwittingly swallowing
pieces of leather, cloth, bones, iron, etc. Once more the third
stomach in which the food is compressed and triturated between
the multiple folds, is normally comparatively dry, and is liable
under dry, fibrous, heating or stimulating aliment, or in case of
fever, to dry up in part or in whole, and to derange the whole
process of digestion.

All herbivora are liable to disease from unwholesome fodder
and the resulting affection may prove epizootic in connection with
unfavorable seasons, or more local, from faulty cultivation.

The symptoms vary so much in connection with the seat and
nature of the disease that it would be impolitic to attempt to
generalize them.

DISEASES OF THE MOUTH.

Relative susceptibility to disease of the mouth: Food; irritants; bits ;
ropes; speculum; sharp metallic bodies; micro-organisms; functional ;
nervous.

These are met with in all domestic animals, but are above all
common in horses, oxen and pigs, partly because of special sus-
ceptibilities and of the nature of the food, but largely by reason
of the exposure of this part to mechanical injuries, especially in
horses and cattle. Hard bits and the harder hands of cruel and
ruthless drivers; nooses of rope tied over the lower jaw and
tongue, iron stirrup, clevis, or balling iron used without cover
to force the jaws apart; a large drenching horn employed as a
lever for the same purpose; an extemporized Yankee bridle
rudely applied or used in breaking a colt ; the method of curing
a balking or jibbing horse by tying a rope to his lower jaw and
to a bar extending forward from the pole; pins, needles, thorns
and other sharp bodies, and irritants in food or medicine, are
among the causes of such disorders. Then there are the many
irritating microdrganismal ferments in food, water, mucus, etc.,
and irritant and hot medicines and food to account for local in-
flammations.

FUNCTIONAL DISORDERS.

Among these are the convulsive closure of the jaws in ¢efanus,
the flaccid state of the lips, cheek, and tongue in paralysis, and
the pendent state of the lower jaw in paralytic canine madness.
See these different subjects. :

STRUCTURAL DISEASES.
INFLAMMATION OF THE LIPS, CHEILITIS.

: Causes of Cheilitis ; Local injuries ; poisoned ; envenomed; secondary
disease. Symptoms: swellings; salivation ; difficult prehension ; cracks ;
blisters ; ulcers; indurations. Treatment: obviate causes; astringents ;
antiseptics; derivatives; gravitation ; for venoms antacid; antiseptic.
Iodine.

Causes. Blows, pricks, wounds and bruises with bits or twitch,
and other mechanical and chemical irritants, irritant vegetables,
bites of leeches or snakes, stings of insects, etc. It may bea
skin disease dependent on disorder of some remote organ, or a
local engorgement due to a constitutional state. (See, Urticaria
Surfeit, Purpura hzmorrhagica, Variola, Strangles).

Symptoms. Swelling, stiffness, heat and tenderness of the
lips, with or without local abrasion, or incised or punctured
wound. Food may be entirely refused from inability to take it
in with the rigid tender lips, and saliva drivels from the mouth
because of their imperfect apposition. Cracks, blisters and raw
sores or ulcers may or may not supervene. In old standing cases
the lips become indurated and comparatively immobile.

Treatment. Remove the cause whether irritants in food, or
drugs, sharp pointed bodies lodged in the tissues, injuries by bit,
twitch or otherwise. Local applications have comparatively lit-
tle effect, being promptly removed by the tongue, yet a lotion of
vinegar and honey ;—of borax 10 grains and honey or glycerine
1 oz.;—or of alum in a similar medium, will often prove useful.
A dose of laxative medicine will favor resolution, and if there is
great tumefaction, feeding thick gruels from high manger, and
tying to a high rack so as to prevent drooping of the head, will
favor recovery. In snake bites and stings the local application
of aqua ammonia and its administration internally (horse and
cow I oz., sheep 2dr. in 20 times its volume of water) should be
practiced ; or permanganate of potash ::1 : 100 may be used.

When the heat and tenderness subside, leaving much thicken-
ing and induration it may be repeatedly painted with a lotion of
one part of tincture of iodine in three parts of glycerine.

5

CANCROID OF THE LIPS. EPITHELIOMA.

Epithelioma : Animals susceptible ; accessory causes ; symptoms ; lesions.
Treatment : Warts and polypi. Actinomycosis: Wounds; abrasions ; in-
fection atria. Symptoms; treatment. Trombidiosis: infected regions;
not compulsory parasite ; European and American trombidia ; distinct from
chigoe. Symptoms. Treatment.

This has been observed in the cat and the horse, commencing
at the angle of the mouth and doubtless partially determined in
the latter animal by the irritation of the bit.

It is characterized by thickening of the tissues of the lips, in
the form of small irregularly rounded masses, and tending to the
formation of a spreading ulcer. The thickened tissues are in-
vaded, pushed aside and infiltrated by epithelial or epithelioid
cells, which, no longer confined to the surface as in the natural
state, grow in the interior of the tissues and destroy them.

Treatment. 'The disease has little tendency to cause second-
ary deposits in other organs and may often be arrested by local
measures. In its earliest stages it may be arrested by the thor-
ough removal of the diseased structures with the knife, the re-
sulting deformity being obviated by bringing the raw edges to-
gether by suture, so as to secure their adhesion, or the actual
cautery may be used. The tendency to irritation from putrefac-
tion products escaping from the mouth may be. counteracted by
occasional sponging with a weak lotion of carbolic acid (1 part
to 50 of water) or an ointment of one part of very finely pow-
dered boracic acid to two parts of simple ointment.

Leblane has repeatedly succeeded in these cases by the use of
chlorate of potash, locally and generally. The local application
may be a solution of two drachms in four ounces of water, while
the dose of the powder for the horse is 2 to 4 drachms daily.

Warts and Polypi. These are common on the outer and
even the inner side of the lips, especially in dogs. ‘They are
easily removed by the scissors, after which their roots should be
thoroughly cauterized with a pointed stick of lunar caustic or
chloride of zinc.

6

ACTINOMYCOSIS OF THE LIPS.

In the rich river bottom lands of northern Germany and Russia
where actinomyces abound actinomycosis is common in the form
of papille of greater or lesser size on the lips and nose of horse
and ox. The abrasion of these parts by thorns, thistles, stubble,
dry fibrous fodders and other irritants, appears to produce a raw
surface for the colonization of the germ, which is not slow to
avail of the opportunity. ‘The resulting lesions take the appear-
ance of warty looking elevations, more or less indurated, which
on section show the sulphur-yellow actinomyces tufts of club-
shaped cells converging to a central mycelial mass.

Treatment is simple as the disease is at first essentially local,
and is easily checked by the local application of iodine. ‘The
wart-like elevations may be shaved off with a razor or cut off with
sharp scissors and the surface painted once or twice daily with
tincture of iodine. If there is suspicion of distant or deep-seated
actinomycosis the internal treatment with potassium iodide will
be in order.

TROMBIDIOSIS OF THE NOSE AND LIPS. HARVEST
ITCH.

In different parts of Europe and America, and especially in the
warmer regions, or in sheltered gardens, shrubberies, and past-
ures, different species of the trombidium abound, and the young
hexapod larvee attack man and beast, burrowing under the cuticle
and giving rise to extreme itching and persistent and irritating
rubbing of the affected part. These parasites belong to the
family of acari or mites, so that the condition they produce is one
of acariasis or mange, only the offender is not a compulsory para-
site, but appears to survive in certain soils and in the vegetation
independently of animal hosts. Their parasitism js therefore
accidental and non-essential to their survival.

The trombidian parasite usually found in Europe is the Trom-
bidium Holosericeum or silky trombidium, so small (in its larval

. 7

8 Veterinary Medicine.

state) that it is just visible to the naked eye as a bright scarlet
point when moving on a dark background. It was formerly
called Leptus Autumnalis and is familiarly known as the red
beast, dete rouge, harvest bug, etc. ‘The common American species
is of a dull brick red, so that it is less easily detected even on a
dark background. It is familiarly known as the jigger, though
quite distinct from the chigoe or burrowing flea of the West
Indies.

The domestic herbivora get these parasites on the nose and lips
while browsing on the pastures and contract an intolerable itching
which may lead to violent rubbing, abrasions and scabby exuda-
tions. Theskin becomes thickened, scabby and rigid, and as new
accessions are constantly received the malady continues until cold
weather setsin. The affection is not in any sense dangerous, and
the attacks may be warded off by a daily application of one of the
common parasiticides—decoction of tobacco, tar water, solution
of creolin, naphthalin, etc. The mere seclusion of the infested
animal indoors, without green food, will cure, as the larvee pass
through their parasitic stage in a few days and drop off.

GENERAL CATARRHAL STOMATITIS. BUCCAL
INFLAMMATION.

Mature animals most subject: Causes in horse, mechanical, chemical,
microbian irritants—alkalies, acids, caustics, hot mashes, ferments, fungi,
rank grasses, excess of chlorophyll, clover, alfalfa, acrid vegetables, bac-
terial infection secondary, acrid insects in food ; symptomatic of gastritis,
pharyngitis, diseased teeth, specific fevers. Symptoms: Congestion and
tumefaction of buccal mucosa, lips and salivary glands; Epithelial des-
quamation; foetor; salivation; froth; papules; vesicles. Prognosis,
Treatment : Cool soft food ; antiseptics ; wet applications to skin; deriva-
tives.

This is much more common in the adult than in suckling
domestic animals. None of the domestic mammals or birds can
be considered immune from it, but as its causes and manifesta-
tions differ somewhat it seems well to consider it separately in
the different genera.

GENERAL CATARRHAL STOMATITIS IN SOLIPEDS.

Causes. ‘These may be classed as mechanical, chemical, micro-
bian and other irritants. In the horse it is often due to the reck-
less administration of irritant liquids as remedies. Owing to the
length of the soft palate the horse can refuse to swallow any
liquid as long as he chooses, and some of the worst cases of
stomatitis I have seen, resulted from the retention in the mouth
of caustic alkaline liquids given under the name of ‘‘ weak lye.”’
Strong acids and caustic salts dissolved in too little water or other
excipient, or suspended in liquids in which they cannot dissolve,
or made into boluses which are crushed between the teeth are not
infrequent conditions. "Too hot mashes given to a hungry horse
is another cause of this trouble. Fermented or decomposed food
is often most irritating. Coachmen will sometimes induce it by
attaching to the bit bags of spicy or irritant agents, to cause
frothing and make the animal appear spirited.

Fungi in fodders are among the common causes. The rust of
wheat (puccinia graminis), the caries of wheat (tilletia caries),
the blight (erysiphe communis), ergot (claviceps purpurea), the
fungus of rape (polydesmus excitiosus) and the moulds (penicil-
lium and puccinia) have all been noticed to coincide with stoma-
titis, and charged with producing it. On the other hand, at given
times, one or other of these cryptogams has been present exten-
sively in the fodder without any visible resultant stomatitis. The
apparent paradox may be explained by the fact that these fungi
vary greatly in the irritant or harmless nature of their products
according to the conditions under which they have grown, and
the stage of their development at which they were secured and
preserved. Ergot notoriously differs in strength in different
years, on different soils, under various degrees of sunshine,
shade, cloud, fog, etc. In different States in the Mississippi
valley it is not uncommon to find stomatitis in horses in winter,
fed on ergoted hay, while cattle devouring the same fodder have
dry gangrene of feet, tail and ears. Yet in other seasons the
ergot fails to produce these lesions. Rank grown, watery vege-
tation, especially if it contains an excess of chlorophyll is liable

*

10 Veterinary Medicine.

to cause stomatitis. Red and white clover, trefoil, hybrid and
purple clover, and alfalfa have all acted more or less in this way,
though in many cases, the food has become musty or attacked by
bacterial ferments. Some of the strongly aromatic plants, and
those containing acrid principles (cicuta virosa, cenanthe crocata,
mustard, etc.) cause buccal inflammation and salivation.

The irritation in many such cases is not due to one agent only,
the vegetable or other irritant may be the starting point, acting
but as a temporary irritant, the action of which is supplemented
and aggravated by the subsequent attacks of bacterial ferments on
the inflamed, weakened or abraded tissues. The bacteria present
in the mouth, food or water would have had no effect whatever
upon the healthy mucosa, while they make serious inroads on the
diseased. On the other hand the vegetable, mechanical or
chemical irritant would have had but a transient effect, but for
the supplementary a¢tion of the bacteria. Unknown alterations
of the buccal secretions lay the mucosa open to microbian attacks
of various kinds. The acidity of the saliva in cases of gout and
even in rhematism and the frequent tonsilitis in cases of rheu-
matism throw a side light on this subject.

In horses that have the bad habit of retaining masses of half
masticated food in the cheeks the growth of cryptogams is
greatly enhanced and such food often becomes violently irritating.

Among other mechanical causes may be named pointed or
barbed hairs or spines (barley awns, spikes, thorns, etc. ), which,
lodging in a follicle or gland orifice, or in a wound of the gum
or mucosa, form a source of irritation or a centre for bacterial
growth and abscess.

Again, irritants of animal origin must be named. These are
not taken by choice, but when lodged in fodder, orin the pastures
they are taken in inadvertently with the food. In this way
poisonous insects, and especially hairy caterpillars, cantharides,
potato bugs, etc., gain access to the mouth.

It must not be overlooked that stomatitis occurs as an exten-
sion, sympathetic affection or sequel of diseases of other organs.
Gastritis is usually attended by redness and congestive tenderness
of the tongue, especially of the tip and margins, and other parts
of the buccal mucosa, notably the palate just back of the
incisors, are often involved. In other cases it appears as a com-

General Catarrhal Stomatitis in Solipeds, II

plication of pharyngitis, laryngitis, of affections of the lower air
passages, of the teeth and periodontal membrane or of the
salivary glands. ;

It appears also in a specific form in certain fevers, as in horse-
pox, pustulous stomatitis, aphthous fever and even in strangles.
Mercurial stomatitis, rarely seen at the present time, is one of the
worst forms of the disease, and like the infectious forms will be
treated separately.

Lesions and Symptoms. At the outset and in the slighter forms
of congestion there is merely heat and dryness of the buccal
mucosa. Redness may show on the thinner and more delicate
portions of the membrane, as under the tongue, on the freenum,
and on the sublingual crest. But elsewhere it is hidden by the
thickness of the epithelium, and the manifestations are merely
those of suppressed secretion with local hyperthermia.

As the congestion is increased there is seen, even at this early
stage, a slight thickening or tumefaction of the mucosa, especially
on the gums, lips, the sublingual area, the orifices of the salivary
glands, and the palate back of the upper incisors. On the dor-
sum of the tongue, the cheeks and lips, generally the lack of loose
connective tissue tends to prevent the swelling,

With the advance of the inflammation the redness of the
mucosa extends, at first in points and circumscribed patches, and
later over the entire surface. The epithelium drying and degen-
erating in its surface layers forms with the mucus a sticky
gummy film on the surface, which, mingling with decomposing
alimentary matters gives out a heavy, offensive or even foetid
odor.

The different parts of the mouth are now tender to the touch,
and this, with the foetor and even bitterness of the bacterial
products combine with the general systematic disturbance in im-
pairing or abolishing appetite. In any case mastication becomes
slow and infrequent, and morsels of food are the more likely to
be retained, to aggravate the local condition by their decomposi-
tion.

The dry stage is followed by the period of hypersecretion, and
in this the salivary glands take a prominent part, so that ptyalism
(slobbering) becomes the most marked feature of the disease.
The saliva mixed with the increasing secretion of mucus and the

12 Veterinary Medicine.

abundance of proliferating and shedding epithelium, escapes
from the lips and falls in stringy masses in the manger and front
of the stall. When there is much motion of the jaws and tongue
it accumulates as a froth around the lips.

_A careful examination of the mucosa will sometimes detect
slight conical elevations with red areole, representing the tume-
fied orifices of the obstructed mucous follicles, and later these
may show as minute erosions. Even vesicles have been noticed
(Weber, Dieckerhoff, Kosters), but when these are present one
should carefully exclude the specific stomatites such as horse-pox,
contagious pustular stomatitis, aphthous fever, etc.

Erosions of the mucosa and desquamation of the epithelium
have been noticed in horses fed on purple (hybrid) clover,
buckwheat or ergot, and in some of these cases the inflammation
has extended (in white faces especially) to the skin of the face,
the mucosa of the nose, and the adjacent glands, and as compli-
cations icterus, constipation, colics, polyuria, albuminuria and
paresis of the hind limbs have been observed. ‘These latter are
common symptoms of cryptogamic poisoning.

Prognosis. In uncomplicated cases the disease is not a grave
one, lasting only during the continued application of the local
irritant, and recovering more or less speedily when that has been
removed. Complications are dangerous only when due to some
specific disease poison (glanders, actinomycosis, strangles, etc. ),
and even poisoning by the usual cryptogams of leafy or musty
plants is rarely persistent in its effects.

Treatment. This resolves itself into the removal of the irritant
cause and the soothing of the irritation. When the cause has
been definitely ascertained the first step is easy.

In the direction of soothing treatment, a careful selection of
diet stands first. Fibrous hay and even hard oats, barley or
corn may have to be withheld, and green food, or better still,
bran mashes, gruels, pulped roots or fruits allowed. Scalded
hay or oats, ensilage, sliced roots, or ground feed may often be
taken readily when the same aliments in their natural condition
would be rejected or eaten sparingly.

Medical treatment may often be given in the drinking water
which should always be allowed in abundance, pure and clean.
In the way of medication chlorate of potash, not to exceed one-

General Catarrhal Stomatitts.in Cattle. 13

half to one ounce per day according to the size of the animal,
may be added, together with an antiseptic (carbolic acid, borax,
_ permanganate of potash, common salt, naphthol, creolin, hypo-
sulphite of soda). In case of severe swelling, a cap made to fit
the head with pads wet in alum and vinegar or other astringent
solution maintained against the intermaxillary space may be de-
sirable. Support for the tongue may be necessary as mentioned
under glossitis.
In case of complications on the side of the bowels, liver or
kidneys, laxatives, diuretics and antiseptic agents may be called
for.

GENERAL CATARRHAL STOMATITIS IN CATTLE.

Dense resistant mucosa protective : Affection usually circumscribed. Ac-
tion of violent irritants, and toxins of specific fevers. Mechanical irritants.
Symptoms: Salivation ; congestion ; eruptions ; erosions ; ergot ; acrid vege-
tables ; caustics; Treatment: Astringents; antiseptics; refrigerants; de-
rivatives ; tonics. Removal of foreign bodies. Lesionsandsymptoms in sheep.

The mouth of the ox as Cadeac well says has a cuticular epi-
thelium too thick and resistant to be easily attacked by microbes.
It follows that infected inflammations are far more frequently cir-
cumscribed than in the thinner and softer buccal mucosa of the
horse. The more general buccal inflammations come more
particularly from the use of food that is too hot or that contains
strongly irritant agents. The thickness of the buccal epithelium
however, is no barrier to the local action of poisons operating
from within as in rinderpest, or aphthous fever, or in malignant
catarrh, nor is it an insuperable barrier to the local planting of the
germs of cow pox, anthrax, actinomycosis, or cryptogamic aphtha
(muguet). The wounds inflicted by fibrous food make infection
atria for such germs, hence the great liability to such local in-
flammations, in winter when the animals are on dry feeding. For
the same reason, perhaps, the prominent portions of the buccal
mucosa,—the papilla—are sometimes irritated themselves while
serving as protectors for the general mucous surface, and hence
they become specially involved in inflammation, which constituted
the ‘‘ darbs’’ of the old farriers. Utz records a buccal inflamma-

14 Veterinary Medicine.

tion occurring in herds fed on green trefoil, first cutting, showing
that even in cattle this agent may determine a general stomatitis.

Symptoms. ‘These do not differ from those of the horse, and
resemble, though often in a milder form, the buccal manifesta-
tions of aphthous fever. There is the difficulty of mastication
and indisposition to take in fibrous aliment, the drivelling of
saliva from the mouth, or its accumulation in froth around the
lips, the frequent movement of the tongue and jaws, and the con-
gestive redness, papular eruption, vesication, or even erosion of
the affected mucous membrane. It is always necessary to guard
against confounding the simple stomatitis, and the slighter
infected inflammations, from the more violent infections above
referred to. The special diagnostic symptoms must be found
under the respective headings. The aphthous fever is not to be
expected in American herds, but the stomatitis which is associated
with ergot in the food is met more particularly in winter and
spring, and must not be confounded with the specific disease, on
the one hand, nor with the simpler forms of buccal inflammation
onthe other. In the case of ergoted fodder the signs of ergotism
in other situations will be found, in the affected animals, such for
example, as necrotic sloughs and sores around the top of the hoof,
sloughing of the hoof or of one or more digits, or of the meta-
tarsus, of the tip of the tail or ear; abortions, convulsions, de-
lirium, lethargy or paralysis. If not seen in the same animals |
some of these forms may be observed in other members of the
herd. Then the buccal lesions are in themselves characteristic :
soft, whitish, raised patches of the epithelium (rarely blisters) are
followed by desquamation and exposure of the red, vascular sur-
face beneath, and this tends to persist if the ergoted fodder is per-
sisted in.

Treatment. Simple stomatitis of the ox generally tends to
spontaneous and early recovery. The simplest astringent and
antiseptic treatment is usually sufficient to bring about a healthy
action. Borax given in the drinking water, not to exceed four
ounces per day, or the same amount mixed with syrup or honey
and smeared occasionally on the tongue, or hyposulphite or
sulphite of soda, or weak solutions of carbolic acid will usually
suffice, after the itritant cause has been removed. Vinegar, or
highly diluted mineral acids may be used but are somewhat

Catarrhal Stomatitis in Sheep and Dogs. 15

hurtful to the teeth. Decoctions of blackberry bark or solutions
of other vegetable astringents may be used as alternatives.
When there is evidence of irritant matters in the stomach or
bowels, a saline laxative will be advisable to be followed by
vegetable bitters or other tonics. Thorns and other foreign
bodies imbedded in the tongue or other part of the mouth must
be discovered and removed.

CATARRHAL STOMATITIS IN SHEEP.

The more delicate buccal mucosa in these animals would ren-
der them more subject to inflammations, but this is more than
counterbalanced by the mode of prehension of aliments, not by
the tongue, but by the delicately sensitive lips, and further by
the daintiness and care with which these animals select their
food. The ¢reatment would not differ materially from that pre-
scribed for the ox.

GENERAL CATARRHAL STOMATITIS IN DOGS.

Causes: burns; spiced food; bones ; sepsis; ferments; pin caterpillar
dental and gastric troubles. Symptoms: careful prehension and mastica-
tion; congestion; swelling; eruption; erosion; furred tongue; stringy
salivation; foetor; swelling of lips, cheeks, intermaxillary space, and
pharynx. Treatment: demulcent foods ; antiseptics; derivatives; tonics ;
care of teeth and gums.

Causes. Hot food is a common cause in hungry dogs. Spiced
food in house dogs fed seraps from the table tend to congestion of
mouth and stomach alike. Irritation through wounds with
bones, especially in old dogs with failing teeth, and in exceptional
cases the impaction of a bone between the right and left upper
molars are additional causes. Putrid meat must also be recog-
nized as a factor, the septic microbes seizing upon the wounds
and spreading from this as an infecting centre. Lactic acid and
other irritant products developed through fermentation of particles
of food retained about the gums and cheeks soften the epithelium
and irritate the sub-epithelial tissue, causing congestion. Megnin

16 Veterinary Medicine.

draws attention to the fact that the pin caterpillar (bombyx
pinivora) found on the stalks of couch grass (Triticum repeus)
produces buccal irritation when chewed and swallowed to induce
vomiting. Asin other animals more or less buccal congestion
attends on gastric congestion and inflammation. Dental troubles
are often sufficient causes.

Symptoms. The animal becomes dainty with regard to his
food, picking up the smaller or softer pieces and rejecting the
larger or harder. Mastication is painful and selection is made of
moist or soft articles which can be swallowed without chewing or
insalivation. The mouth is red and hot, and at times the mucous
membrane eroded, or blistered, the lesions concentrating especially
on the gums and around the borders of the tongue. The dorsum
of the tongue is furred, whitish, yellowish or brownish. Saliva
collects in the mouth and escapes in filmy strings from its com-
missures, and the odor of the mouth becomes increasingly foul.
Swelling of the lips, cheeks or intermaxillary space marks the
worst cases.

Treatment. Withdraw all irritant and offensive aliments. Give
soups, mushes, scraped or pounded lean meat in small quantities,
washing out the mouth after each meal with a 20 per cent. solu-
tion of permanganate of potash or borax or a two per cent. solu-
tion of carbolic acid. Cadeac advises against chlorate of potash
on account of its known tendency to bring about hemoglobinzemia
in dogs. A laxative and bitters may be called for in case of
gastritis or indigestion, and any morbid condition of the teeth
must be attended to. Decayed teeth may be removed. ‘Tartar
especially must be cleaned off by the aid of a small wooden or
even a steel spud and a hard brush with chalk will be useful. A
weak solution of hydrochloric acid is usually employed to loosen
the tartar, but this is injurious to the structure of the teeth and
had best be avoided if possible. ‘Tincture of myrrh is especially
valuable both as a gum-tonic and as a deodorant and antiseptic.
This may be rubbed on the irritated gums as often as the mouth
is washed.

GENERAL CATARRHAL STOMATITIS IN SWINE.

Causes: Irritants; ferments; noose on jaw; specific poisons. Symp-
toms : Careful feeding ; thirst ; frothy lips; champ jaws: redness; swell-
ing ; foetor. Treatment: Cooling, astringent, antiseptic lotions; mushy .
food ; derivative ; tonics.

Causes. Swine suffer from simple stomatitis when exposed to
thermal, mechanical or chemical irritants. Food that is too hot,
or that which is hard and fibrous, or that which contains spikes
and awns, capable of entering and irritating gland ducts or sores,
or food which is fermented or putrid, food or medicine of an
irritant character. The habit of catching and holding swine with
a running noose over the upper jaw, and the forcing of the jaws
apart with a piece of wood in search of the cysticercus cellulosa
are further causes. In several specific infectious diseases inflam-
mation of the mucous membrane with eruption or erosion is not
uncommon. ‘Thus aphthous fever is marked by vesicular erup-
tion, muguet by epithelial proliferation and desquamation, hog
cholera and swine plague by circumscribed spots of necrosis and
erosion. Patches of false membrane are not unknown, and local
anthrax, tubercle and actinomycosis are to be met with. Inflam-
mation may start from decaying teeth.

Symptoms are like as in other animals, refusal of food, or a
disposition to eat sparingly, to select soft or liquid aliments, to
swallow hard materials half chewed or to drop them, to champ
the jaws, and to seek cold water. Accumulation of froth around
the lips is often seen, and the mouth is red, angry, dry, and hot,
and exhales a bad odor.

Treatment does not differ materially from that adopted in other
animals. Cooling, astringent, antiseptic lotions, honey and vine-
gar, and in case of spongy or eroded mucosa, tincture of myrrh
daily or oftener. Soft feeding, gruels, pulped roots, or well kept
ensilage may be used, and clean, cool water should be constantly
within reach. In case of overloaded stomach or indigestion a
laxative followed by bitter tonics will be in order.

2 17

CATARRHAL STOMATITIS OF BIRDS. PIP.

Causes: hurried breathing; local irritants; exposure; filthy roost.
Symptoms: gaping ; roupy cry; epithelial pellicle on tongue, larynx, or
angle of the bill, Treatment: pick off pellicle ; smear it often with glycer-
ized antiseptic. Remove accessory and exciting causes.

This form of inflammation of the tongue of birds is characterized
by the increased production and desiccation of the epithelium so
that it takeson a horny appearance. According to Cadeac it may
accompany various inflammatory affections of the air passages,
which cause hurried breathing with persistently open bill, and
thus entail evaporation of the moisture. More commonly it has
its primary cause in local inflammation of the surface in connec-
tion with damp, cold, draughty hen-roosts, and above all, the
accumulation of decomposing manure and the exhalation of im-
pure gas. Even in such cases the abnormal breathing with the
bill open is an accessory cause of the affection.

Symptoms. ‘The breathing with open bill should lead to ex-
amination of the tongue, but above all if at intervals the bird
with a sudden jerk of the head emits a loud shrill, raucous
sound, which reminds one of the cough of croup. The tip and
sides of the tongue are found to be the seat of a hard, dry, and
closely adherent epithelial pellicle, which suggests a false
membrane.

Treatment. ‘The common recourse is to pick or scrape off the
indurated epithelial mass, leaving a raw, bleeding surface exposed.
This is then treated with a solution of borax, or chlorate of
potash. Cadeac deprecates this treatment as useless and danger-
ous, and advises the disintegration of the dry epithelial mass
with a needle taking care not to prick nor scratch the subjacent
sensitive tissue, and to wash with a 5 percent. solution of chlorate
of potash. A still more humane and effective method is to make
a solution of hyposulphite of soda in glycerine and brush over
the affected surface at frequent intervals. "This may be con-
veniently applied through the drinking water.

In case of implication of the lower air passages or lungs, the
treatment must be directed to them, and soft, warm, sloppy food
and the inhalation of water vapor will prove of great advantage.
Secure clean, sweet dry pens, pure air, and sunshine. (See
pseudo membranous enteritis. )

LOCAL STOMATITIS.

Division of circumscribed buccal inflammations: palatitis; gnathitis
gingivitis ; glossitis, Causes: injuries ; acrid ; venomous or caustic agents ;
diseased teeth ; foreign bodies in gland ducts ; malformed jaws ; infections,
etc. Symptoms: salivation; difficult prehension and mastication ; drop-
ping half masticated morsels ; distinctive indications of different caustics ;
abrasion ; abscess; slough; infective disease lesions. Treatment: for
palatites, massage by hard corn ears, scarification, laxatives ; for guathitis,
care for teeth and ducts, astringent washes, eliminate mercury ; for glossztis,
remove Cause, use antidote to venom, or to chemical irritant, astringent,
antiseptic lotions or electuaries, evacuate abscess, soft, cool diet, elevate
the head, suspend the tongue.

Localized inflammations in the buccal cavity are named ac-
cording to the portion of the lining membrane attacked ;—
Palatitis if seated in the roof of the mouth ; gnathitis if restricted
to the cheeks ; g7mgzvitis if to the gums; and gdossdtis if to the
tongue.

Palatitis. Lampas. Congestion of the hard palate be-
hind the upper front teeth. This is usually seen in young
horses during the period of shedding the teeth and is caused by
the irritation and vascularity consequent on teething. ‘The red
and tender membrane projects beyond the level of the wearing
surfaces of the upper incisors, and may materially interfere with
the taking in of food. A common practice in such cases is to
feed unshelled Indian corn, the nibbling of which seems to im-
prove the circulation in the peridontal membrane and by sym-
pathy, in the adjacent palate. Superficial incisions with the
lancet or knife will usually relieve, and may be followed by mild
astringent lotions if necessary. If apparently associated with
costiveness or gastric or intestinal irritation a dose of physic will
be demanded. Nothing can excuse the inhuman and useless
practice of burning the parts with a hot iron.

Gnathitis. Inflammation of the Cheeks. Usually result-
ing as a distinct affection from irregular or overgrown teeth, or
the entrance of vegetable spikes into the gland ducts, these cause
local swelling and tenderness, slow imperfect mastication, drop-
ping of food half chewed, accumulation of food between the
cheeks and teeth, thickening, induration and sloughing of the

mucous membrane with excessive fcetor.
19

20 Veterinary Medicine.

Treatment. Consists in correcting the state of the teeth and
ducts and using one of the washes recommended for glossitis.

Gingivitis. Inflammation of the gums. ‘This is either
connected with the eruption of the teeth in young animals and to
be corrected by lancing the swollen gums and giving attention to
the diet and bowels ; or it is due to scissor-teeth or to the wear of
the teeth down to the gums in old horses; or it is dependent on
diseased teeth, or mercurial poisoning, under which subjects it
will be more conveniently considered. Barley awns or other irri-
tants must be extracted..

Glossitis, Inflammation of the Tongue. Causes. Mostly.
the result of violence with bits, ropes, etc., with the teeth, or
with the hand in giving medicine; of scalding food, of acrid
plants in the food; of irritant drugs (ammonia, turpentine,
croton, lye, etc.), or of sharp, pointed bodies (needles, pins,
thorns, barley and other barbs, etc.), which perforate the organ.
In exceptional cases leech and snake bites are met with especially
in cattle, owing to the tongue being exposed when taking in
food. Local infections and those of the specific forms, determine
and maintain glossitis.

Symptoms. Free flow of saliva, difficulty in taking in food or
drinking, and red, swollen, tender state of the tongue, which in
bad cases hangs from between the lips. ‘The mucous membrane
may be white, (from muriatic acid, alkalies, etc.), black, (from
oil of vitriol, lunar caustic, etc.), yellow, (from nitric acid, etc. ),
-or of other colors according to the nature of the irritant. It
may be raised in blisters, may present red, angry sores where the
epithelium has dropped off; may become firm and indurated
from excessive exudation ; may swell and fluctuate at a given
point from the formation of an abscess; or may become gan-
grenous in part and drop off. Breathing is difficult and noisy
from pressure on the soft palate. There is usually little fever
and death is rare unless there is general septic infection.

Treatment will depend on the cause of injury. In all cases
seek for foreign bodies imbedded in the organ and remove them.
If snake bites are observed use ammonia or potassium perman-
ganate locally and generally, or cholesterin as a local application,
If the irritation has resulted from mineral acids, wash out with
calcined magnesia lime water, or bicarbonate of soda or potass.

6

Aphthous Stomatitis. 21

If from alkalies (lye) use weak vinegar. If from caustic salts
employ white of egg, vegetable-gluten, boiled linseed, slippery
elm, or other compound of albumen or sheathing agent. In
ordinary cases use cold astringent lotions, such as vinegar and
water ; vinegar and honey ; borax, boric or carbolic acid, chlorate
of potash, alum or tannin and honey. Poultices applied around
the throat and beneath the lower jaw are often of great value.
The bowels may be relieved if necessary by injections, as it is
usually difficult to give anything by the mouth. If ulcers form
touch them daily with a stick of lunar caustic or with a fine brush
dipped in a solution of ten grains of that agent in an ounce of
distilled water. For sloughs use a lotion of permanganate of
potash, one drachm to one pint of water, or one of carbolic acid,
one part to fifty of water. If an abscess forms give a free exit to
the pus with the lancet, and afterward support the system by soft
nourishing diet, and use disinfectants locally. As in all cases of
stomatitis, the tood must be cold gruels or mashes, or finely
sliced roots will often be relished.

The mechanical expedient of supporting the tongue in a bag is
essential in all bad cases, as if allowed to hang pendulous from
the mouth inflammation and swelling are dangerously aggravated.

APHTHOUS STOMATITIS. FOLLICULAR STOMATITIS.

Causes : in horse, ox, dog; rough, fibrous food, blistering ointments, bac-
teria. Symptoms: general stomatitis, and special; papules with grayish
centres and red areole, vesiculation, ulceration. Treatment: Astringent,
antiseptic, derivative, tonic, stimulant.

This is a rare affection in ruminants where the thickness of
the epithelial covering appears to be a barrier to infection or in-
jury, while it is common in the more delicate and sensitive buc-
cal mucosa of the horse and dog. In the horse the ingestion of
irritant plants with the food and the penetration of vegetable
barbs (barley awns, etc.) into the mucous follicles may be charged
with causing the disease, while in both horse and dog the licking
of blistering ointments and the local action of fungi and bacteria
are factors in different cases.

22 Veterinary Medicine.

Symptoms. With the ordinary symptoms of stomatitis, there
appear minute firm, whitish, circular elevations representing the
openings of the inflamed mucous or salivary follicles, having a
reddish areola, and grayish white vesicular centre with barley
awns, etc. ‘They may amount to a line or more in diameter, and
on bursting leave red cores or ulcers. The whole mouth may be
affected or the disease may be confined to the lips, gums or
tongue.

Treatment. Beside removal of barbs and the general astringent
washes, this affection is greatly benefited by the local use of anti-
septics, as sulphite or hyposulphite of soda, 2 drachms in a quart
of water. Borax, permanganate of potash, carbolic acid or other
antiseptic in suitable solution may be substituted. Saline laxa-
tives are often useful to remove souces of irritation in stomach
and intestines, and iron salts (chloride or nitrate) in full and
frequently repeated doses may be given internally. Ulcers may
be cauterized and soft food and pure water given from an elevated
manger.

ULCERATIVE STOMATITIS. GANGRENOUS
STOMATITIS.

Causes: specific disease poisons; debility ; rachitis; cancer; chronic
suppuration , irritation—mechanical, chemical, thermic, venomous, etc.
Symptoms: difficult, imperfect prehension and mastication, salivation,
bleeding, swollen, puffy epithelium, blisters, extending erosions, deep or
spreading. Duration. Treatment: correct constitutional fault, tonics,
soft, digestible food, antiseptics, mild caustics.

This is characterized by the formation of necrotic spots and
patches of the buccal epithelium, with desquamation, and the
formation of more or less rodent ulcers of the sub-epithelial
mucosa. Like other ulcerative processes it is usually due to mi-
crobic invasion, and in this way it may supervene on other and
simpler forms of stomatitis. It also varies in its manifestations
and nature according to the genus of animal, and the specific
microbe present.

ULCERATIVE STOMATITIS IN SOLIPEDS.

Causes. Apart from the ulcerations and erosions of specific
diseases (glanders, horse-pox, pustulous stomatitis, aphthous
fever, etc.,) this condition is especially liable to appear in anz-
mic and debilitated subjects (Cauvet), as in rachitis (Friedber-
ger and Frohner), cancer (Cadeac) chronic internal abcess (Ca-
deac), etc. As an exciting cause and as a means of furnishing
an infection atrium for the microbes of ulceration all conditions
of simple lesion of the mucous membrane—mechanical, chemical,
thermic, venomous, etc., are operative. Dieckerhoff has described
it in connection with diphtheritic rhinitis, Friedberger with
a nasal and conjunctival catarrh, Zeilinger and Kohler with aph-
thous fever, Mobius and Hackbarth with trefoil poisoning.

Lesions and Symptoms. ‘There is the usual dainty feeding and
disposition to masticate imperfectly or even to drop the partly
insalivated morsels, working of the lips, the formation of froth
on their margins, and the driveling of saliva in long strings or
filaments. As the disease advances this becomes bloody and
feetid. The local lesions may be at first like white pulpy spots
of softened and degenerating epithelium, which is, exceptionally,
raised in blisters. This is followed by desquamation and the
formation of open sores which are indolent, and show a disposi-
tion to further erosion and extension. ‘They may be rounded
or irregularly indented in their borders, and contain a brownish,
blackish or greenish viscid debris. They vary widely, however,
in general appearance and in their disposition to speedy or slug-
gish healing, being apparently influenced by the nature of the
pathogenic microbe and the susceptibility of the subject. In
some cases the molecular degeneration extends deeply into the
mucosa, and even over the edges of the lips into the adjacent
skin. Recovery and complete cicatrization may take place in
one week, or successive outbreaks may take place in the same
animal lasting in all for months as in Cadeac’s case associated
with chronic abcess ef the mesentery.

Treatment. 'The first consideration is to correct the debility
on which the affection is based. Iron and bitter tonics, mineral

23

24 Veterinary Medicine.

acids, and nourishing food given in the form of soft mashes,
pulped roots, or farinas, which will require little mastication, and
the antiseptic cleansing of the mouth after each meal are the
main features of the treatment. As antiseptics, vinegar is inimi-
cal to the microbes of the mouth, which affect alkaline media,
borax, boric acid, carbolic acid, sulphurous acid, the sulphites
and hyposulphites, permanganate of potash, chlorate of potash,
creolin and sulphate or chloride of iron furnish a sufficient
choice of comparatively non-toxic agents. Ulcers may be touched
with tincture of iodine, lunar caustic, or sulphate of copper.

ULCERATIVE STOMATITIS (DIPHTHERIA) IN
CALVES.

Accessory causes. Infection. Experimental inoculation. Bacillus, grows
on blood serum. Lesions in mouth, nose, air passages, intestines, digits.

,. Symptoms: difficult sucking, fever, swollen, whitish spots on buccal mu-

cosa, phagadenic sores, foetor, symptoms of extending disease, anorexia,
debility, prostration. Duration: Diagnosis from foot and mouth disease,
from actinomycosis, from tuberculosis. Prevention: cleanliness, antisep-
sis, segregation, diet of dam, sterilized milk. Treatment: antiseptic and
eliminating ; locally antiseptic.

This has been observed at frequent intervals in calves, as a
serious, fatal, communicable disorder occurring in the first few
weeks of life.

Causes. It has been attributed to unhygienic conditions of
the dams, close, damp, impure stables, unwholesome or spoiled
food, and privations of various kinds, and these, in all proba-
bility, increase the susceptibility. The congestion and traumat-
ism connected with the cutting of the teeth is another predis-
posing cause. The ultimate cause is, however, the contagious
element and the disease has been conveyed to healthy lambs by
the introduction into their mouths of the necrotic products from
the diseased subjects (Dammann). Sheep inoculated in the con-
junctiva presented violent conjunctivitis in forty-eight hours.
Inoculated rabbits died of septicaemia. Mice showed the same
symptoms as calves, while guinea pigs showed an abcess only
at the seat of inoculation (Loffler).

Ulcerative Stomatitis (Diphtheria) in Calves. 25

The identity of the germ has not been fully demonstrated.
Dammann found a micrococcus, but testimony from the inocula-
tion of its pure cultures is wanting, and the buccal mucosa of the
sucking calf is full of varied germs some of which are irritating
and pathogenic to an injured mucosa.

Loffler found in the epithelial concretions (false membranes)
of the mouth and intestines, a bacillns of half the thickness of
the bacillus of malignant cedema, five times as long as broad and
usually connected with its fellows to form filaments. He failed
to obtain cultures of this in nutrient gelatine, but grew it success-
fully in blood serum from a calf. ‘Transferred to fresh serum the
culture failed. The pure culture does not seem to have been
tried on the calf.

According to Dammann the lesions occur indiscriminately in
‘the mouth, the nose, the larynx, trachea, lungs, the intestinal
canal and the interdigital space.

It has been suggested that the mouth of the calf rendered sus-
ceptible by the congestion caused by suction, is infected by
licking the previously infected umbilicus.

Symptoms.. There are the usual symptoms of indisposition to
suck, salivation, redness of the buccal mucosa, and general in-
disposition. In two or three days the mucosa shows raised,
pulpy, white or grayish patches about a line in diameter. These
gradually soften and break down and in four or five days leave
dark red angry sores one-sixth to one-third inch in diameter dotted
with grayish points and surrounded by a congested areola. These
exhale an offensive odor and tend to extend in superficial area
and in depth, invading indiscriminately the various subjacent
tissues. The lips may be perforated, the muscles, cartilages,
periosteum, and periodontal membrane invaded, the teeth may be
shed, and the alveoli filled with the offensive debris of ulceration.
Swelling of the throat may follow from implication of the
pharynx and its‘lymph glands, symptoms of laryngitis, bronchi-
tis, and pneumonia may succeed, also infective gastritis and en-
teritis. ‘These various parts may be infected by the direct trans-
ference of the infecting saliva, but the germ is also held to be
transmitted through the blood to implicate distant organs.

Appetite is gradually lost, a blackish, foetid diarrhoea, sets in
and the calf is sunk in a profound prostration and debility due

26 Veterinary Medicine.

partly to the enforced abstinence and colliquative diarrhoea, but
much more to the absorption of toxic matters. Death may en-
sue from the sixth to the twelth day. In case of recovery a
month may be requisite for the completion of convalescence.

Diagnosis. This has to be distinguished especially from
aphthous fever by the absence of the large, and clearly defined
vesicles of that disease, by the fact that the mammary region and
interdigital spaces usually escape, and especially by the immunity
of the dam and of other more mature animals. From actinomy-
cosis of the tongue it is diagnosed by its more rapid progress, by
the marked constitutional depression, and prostration, and by the
absence of the’ marked induration of the actinomycotic organ
(holzzunge) and by the sulphur yellow pin-head like nodules
of actinomyces. ‘Tuberculosis is rare in the first weeks after
birth in calves, and never makes the rapid progress nor causes
the profound depression of this disorder.

Prevention. ‘The first object must be to destroy the infection,
and the second to obviate the susceptibility of the young animal.
The clearing away of all accumulations of litter, filth, and even
fodder from the stable proper, including the stalls where the dams
lie, should be followed by a thorough whitewashing or disinfec-
tion, with sulphate of copper or of iron, or even mercuric
chloride, (1:500). If the disease has already appeared in astable
the calves should be penned singly to avoid the possibility of in-
fection through sucking each others navels. In all cases an an-
tiseptic (tannin, carbolic acid, iodine) should be applied to the na-
vel of the new born. The food of the dam and nurse should be nu-
tritive and free from any suspicion of mustiness or decomposition,
and when possible the calf should be allowed to draw its own
milk from the teat. When this cannot be allowed, artificial feed-
ing should be surrounded by all the safeguards, named under
acute indigestion of calves.

Treatment. Cadeac strongly recomends % oz. common salt
daily with the food, or alcohol 34 0z,, or a strong infusion of
coffee mixed with the milk. Lenglen advises quinia in the form
of tincture, % toroz. McGillivray sulphate of soda. Tincture
of chloride of iron 30 drops in an ounce of water with each meal
would be an excellent resort.

Locally antiseptics are our ‘main reliance. Naphthol, naphtha-

Ulcerative Stomatitis in Lambs and Kids. 27

lin, salicylic acid, or salicylate of soda, may be applied directly
to the diseased mucous membrane. ‘Tincture of chloride of iron
in water (1:2) is one of the best agents (James). Carbolic
acid 1 drachm in 6 oz. water, and 1 oz. alcohol has been used
safely and with excellent results (Lenglen). Like most other
antiseptics, however, this latter must be used with caution as re-
gards the amount. No actively poisonous antiseptic is admissible.
The antiseptic should be swabbed over the whole interior of the
mouth after each meal.

In case of deep gangrenous masses excision and antiseptics are
demanded.

ULCERATIVE STOMATITIS IN LAMBS AND KIDS.

Causes: Accessory, locality, youth, debility, unsuitable food, impure air,
parasitism, contagion. Bacteria. Symptoms: difficult sucking, frothing,
salivation, buccal redness and swelling, white, softened patches, suppura-
tion, granulation, foetor, emaciation, debility, bowel symptoms, respiratory.
Duration. Treatment: Artificial feeding, antisepsis, disinfection, mild
caustics, etc.

Causes. ‘This has been noticed as an enzootic affection in
young and debilitated animals, while the mature and more robust
ones escape. Anzemic lambs, those that are fed on watery, in-
nutritious materials (potatoes, grains, waste of sugar factories),
those kept in close confinement, indoors, and those that suffer
from distomatosis show the disease. Impure air, damp, dark
places and impure water have their influence. The disease is
manifestly contagious, but the infecting microbe has not been
demonstrated. It was formerly supposed to be the ozdzum albi-
cans, the fungus of muguet, but Neumann demonstrated its ab-
sence, and though he found Jeptothrix buccalis, bacilli, spirochete
and micrococct he failed to show that any one of these in pure
culture would cause the disease. Rivolta charged it on bactertum
subtile agnorum and Berdt on the polydesmus excitiosus which ac-
cording to him the sheep contract from eating rape cake. The
withdrawal of the cake led to a rapid recovery.

Symptoms. ‘The disease may begin insidiously without at first

28 Veterinary Medicine.

very marked symptoms. Sucking is painful and infrequent, an
acid froth collects about the mouth, and white patches appear on
the gums or other part of the buccal mucosa, with at times red-
ness and swelling, and the separation of the gums from the teeth.
The white epithelial patches soften and are easily detached, leav-
ing bright red patches, which bleed easily, and tend to extension
and coalescence. These are covered by a viscid mucopurulent
matter, and may become the seat of granulations, or they may
involve the subjacent tissues in ulceration causing evulsion of
the teeth, or necrosis of the jaw bone. The odor of the mouth is
foetid. Prostration and emaciation set in, and often bear a ratio
to the extension of the disease to the digestive and respiratory
organs. ‘This is manifested by uneasy movements of the hind
feet, shaking of the tail, frequent lying down and rising, consti-
pation or diarrhoea: or by cough, snuffling breathing, swelling
of the submaxillary and pharyngeal glands, and hurried, op-
pressed breathing. The complication of vesicular and pustular
eruption has been noticed. Death may occur in eight or ten
days, or more commonly recovery ensues.

Treatment must proceed on the same lines as in the calf.
Artificial feeding on gruels, with antiseptic washes for the mouth
at each meal are indicated. Chlorate of potash, chloride of lime,
borax, sulphites and hyposulphites of soda, carbolic acid, and
the salts of iron afford an ample field for selection. For ulcers,
a pointed stick of nitrate of silver, or a solution of muriatic acid
in three times its volume of water, applied by means of a glass
rod or pledget of cotton will serve a good purpose.

ULCERATIVE STOMATITIS IN SWINE.

Causes : improper food ; filthy pens; debility ; toxins of specific diseases ;
microbian infection. Symptoms: inappetence ; grinding teeth ; champing
jaws ; salivation ; foetor ; buccal swelling and redness; pulpy spots; des-
quamation ; ulcers ; pharyngeal, enteric and osseous complications. Treat-
ment: Segregation ; disinfection ; local antiseptic washes ; tonics.

This is the Scorbutus of Friedberger and Fréhner, the gloss-
anthrax of Benion.

Causes. It has been attributed to insufficient or irritant food,
to damp, close pens, and to chronic debilitating diseases and all
these act as predisposing causes. In gastritis and in infectious
fevers like hog cholera, swine-plague, and rouget (hog erysipelas)
the spots of congestion and petechiz on the buccal mucous mem-
brane may become the starting points for ulcerative inflamma-
tions. These conditions appear, however, to be supplemented
by infection from bacteria present in the mouth or introduced in
food and water, and as in the case of other domestic animals the
most successful treatment partakes largely of disinfectant appli-
cations.

Symptoms. oss of appetite, grinding of the teeth, champing
of the jaws, the formation of froth round the lips, fcetor of the
breath, redness of the gums and tongue, and the formation of
vesicles or white patches which fall off leaving red angry sores.
These may extend forming deep unhealthy ulcers, with increas-
ing salivation and fcetor. As the disease advances the initial
dullness and prostration become more profound, and debility and
emaciation advance rapidly. Unless there is early improvement
an infective pharyngitis, or enteritis sets in, manifestly determined
by the swallowing of virulent matters from the mouth, and swell-
ing, redness and tenderness of the throat, or colics and offensive
black diarrhcea hasten a fatal issue. Rachitis may be a promi-
nent complication, as it seems in some instances to be a predis-
posing cause.

Treatment. Isolate the healthy from the diseased and apply
disinfection to all exposed articles and places. Employ local an-
tiseptics as on the other animals and especially to the mam-
mz in nursing sows. Sulphuric or hydrochloric acids in 50

29

30 Veterinary Medicine.

times their volume of water, or tincture of iron, chlorate of
potash, or chloride of ammonia, or borax have been given
successfully. Bitters and aromatics have also been strongly
recommended.

ULCERATIVE STOMATITIS IN CARNIVORA.

Causes: dietary causes; constitutional debilitating diseases: dental dis-
orders; microbian infection: microbes. Symptoms: difficult sucking or
mastication ; salivation; dullness; prostration; mucosa red with gray
patches, erosions, and ulcers; foetor; loose teeth; excess of tartar. Ex-
tensions to face, throat, lymphatics, nose, eyes, stomach, liver, bowels.
Duration. Treatment: clean teeth; antiseptics; mild caustics; stimulants.

Causes. ‘This affection is more common in this class of animals
than in the herbivora, being apparently dependent in great part
on their artificial habits of life, the sweet and stimulating diet
and the derangement of the digestive organs. The lowering of
the general health in connection with privation or disease and
especially canine distemper, rachitism or indigestion must be
recognized as predisposing causes, while the accumulation of
tartar on the teeth, or the decay of the teeth themselves, consti-
tutes a potent exciting local cause. In connection with such cre-
taceous deposits the decomposing elements of the food collect,
and the irritant products of their fermentation lead to disease of
the gums, congestion and ulceration. Superadded to this is the
bacteridian infection of such diseased parts, through which the
ulceration is started, maintained and extended. ‘This infection is
not that of a specific microbe, but usually of a multiplicity of
germs, one or more of the bacteria that live habitually in the
healthy mouth, taking the occasion of the existence of a wound,
or of a reduction of vitality to colonize the mucosa which would |
otherwise have remained sound. The microbes actually found in
the ulcers are very varied. Pasteur isolated a spirillum, Fiocca
the bacillus salivarius septicus, others have found pus bacilli,
and in sucking kittens the bacillus coli communis.

But the attempts made to convey the disease to healthy mouths
by the transfer of the microbes have usually failed (Pasteur,
Netter, Cadeac). To establish their pathogenic action, therefore,

Ulcerative Stomatitis in Carnivora. 31

it appears to be necessary to furnish a susceptible mucosa as well
as an infecting microbe. This explains why the disease does not
spread as an infection, the average mouth is immune and it is
only when it becomes the seat of a wound, bruise or other injury,
or when the general system has become so reduced that the re-
sisting power is a minor quantity, that the hitherto harmless germ
becomes actually pathogenic.

Symptoms. ‘There is indisposition to suck or eat, the patient
leaves the teat or the food, and looks dull, depressed and disposed
to lie down apart. There is evident salivation and on opening
the mouth we may find the offensive odor, the tartar covered
teeth with red or ulcerated gums, and on the cheeks, lips and
tongue dark red patches of congestion, or whitish or yellowish
gray, soft, pulpy spots of disintegrating epithelium. This is
followed by shedding of these epithelial patches, and the forma-
tion of rounded ulcers of a line in diameter or less. These are
tender, and bleed readily. They may extend to the skin of the
lips, or deeply into the mucosa, the muscles or bones, and the
attendant morbid process may cause loosening and evulsion of
the teeth. Tthere may be implication of the pharynx, the lymph
glands, the nose, the eyes, the stomach, the liver, or the intestines
with corresponding symptoms. Death may supervene in from
six to thirty days, or a more or less speedy recovery may take
place.

Treatment. ‘The first step as a rule is to remove the tartar
from the teeth. This is often done with a wooden spud dipped
in a weak solution of hydrochloric acid. A steel scraper will
usually act well and without the solvent action of the acid.

Next will come the removal of all diseased teeth which are
operating as local irritants and as centres for infectious microbes
and their hurtful products.

Then antiseptics in the form of liquids applied as in the other
animals with each meal, will be necessary to counteract infective
action, and give the tissues an opportunity to re-establish their
integrity. Cadeac recommends a Io per cent. solution of oil of
thyme, as asafe and efficient application. Boric acid, borax,
salol, salicylic acid, tannic acid, sulpurous acid, or carbolic acid

largely diluted may be substituted. Internally iron tonics and
bitters are of great value in improving the tone of the system

32 Veterinary Medicine.

and securing antisepsis of the intestinal canal. The sulphites
too may be given with advantage internally. In depressed con-
ditions alcoholic stimulants may be used both as local antiseptics
and general stimulants. As in other animals ulcers may be
touched with a rod dipped in tincture of iodine, or a strong solu-
tion of chloride of zinc, or nitrate of silver.

MERCURIAL STOMATITIS.

Avimals suffering. Causes: mercurial baths, ointments, blisters and sur-
gical dressings ; mercurial vapors; deposits on vegetation ; rat poisons ;
malicivus poisoning. Lethal dose in horse, ox, sheep and goat. Mature
and old eliminate more slowly. Symptoms; Salivation ; red, swollen buc-
cal mucosa ; gingivitis; loosening of teeth ; foetor; ulceration ; anorexia ;
gastro-intestinal tympany; loose, fcetid stools; fever; weakness; dysp-
noea; languor; blood extravasation in nose, mouth, throat, bowels, womb,
skin ; abortion; skin eruptions. Lesions in mouth, stomach, intestines,
serosee, kidneys, muscles, encephalon. Treatment ; stop the introduction
of mercury; as antidote potassium sulphide ; emetic; cathartic; mucilagi-
nous and albuminous antidotes ; potassium iodide as an eliminating agent.
Locally potassium sulphide or chlorate. Iron tonics.

This has been especially seen in the sheep, dog and ox, and
less frequently in other domestic animals.

Causes. In sheep the use of baths containing corrosive subli-
mate, or of mercurial ointment for acariasis or other cutaneous
parasitism. In other animals it comes mostly from licking mer-
curial dressings applied to the skin—calomel, red precipitate,
mercurial ointment, protoiodide of mercury. The red iodide
being more irritating is less frequently taken in. ‘The modern
extensive usage of mercuric chloride solutions as surgical anti-
septics opens up a new channel of infection. In the injection of
the uterus or of large abscesses, or in the daily irrigation of large
wounds a dangerous amount may be absorbed. The application
of this agent as a caustic in cases of tumors is correspondingly
dangerous. Vapors froin metallic mercury in confined spaces as
in ships’ holds, or from fires on which the mercurial compounds
have been thrown, are ready means of poisoning, acting primarily
on the air-passages and lungs and later on the mouth. ‘The con-

Mercurial Stomatitis. 33

densation of mercury on vegetation and other food products in
the vicinity of factories where mercury is handled (Idria) affects
domestic animals directly. Finally the small animals are poisoned
by eating the mercurial rat poisons, and all animals are subject
to malicious mercurial poisoning, with sublimate especially.

Stomatitis with fatal pharyngitis and enteritis will result in the
horse from 2 drs. of corrosive sublimate. About one-half of this
may poison the ox, and one-fourth the sheep or goat. Rumi-
nants are more susceptible to the toxic action of mercury than
monogastric animals, one evident reason being the long delay of
the successive doses in the first three stomachs, so that finally a
large quantity passes over at once into the fourth stomach and
duodenum for absorption. The old too are more readily poisoned
than the young, as the functions of the kidneys are more im-
paired in age and the poison is not eliminated with the same
rapidity.

Symptoms. Mercurial stomatitis is a local manifestation of a
general poisoning. Salivation is one of the most prominent phe-
nomena, the watery saliva falling in streams from the angles of
the mouth. The buccal mucosa generally becomes red and
swollen and the tongue becomes indented at the edges by pressure
against the molars. The gums especially suffer and the teeth,
raised in their sockets by the swelling of the periodontal mem-
brane, become loose, and easily detached. ‘The mucosa of the
gums becomes soft and spongy, bleeds readily under pressure
and soon shows erosions and ulcers. This condition extends to
the lips, cheeks and lower surface of the tongue while the upper
surface of the latter organ, the fauces and pharynx commonly
escape. The breath and buccal exhalations are very offensive,
and the animal loathes food, and has little power of mastication
or deglutition. Sometimes the ulcers extend even to the bones.

Along with these local symptoms there are usually gastro-in-
testinal irritation, tympany, inappetence, continuous rumbling in
the belly ; badly digested foetid stools, often diarrhcea, small weak
pulse, hyperthermia, accelerated breathing, cough, and great
languor and prostration. A tendency to blood extravasation is
shown in sanguineous feces, epistaxis, bleeding from the mouth,
the throat or the womb and even into the skin. Pregnant fe-
males may abort. The eyes are dull and sunken, and the con-

3

34 Veterinary Medicine.

junctiva yellow. Eczematous or pustular eruptions may appear
on the skin on the nose, lips, neck, back, loins, croup or
perineum.

Lesions. In addition to the lesions described above, there are
usually gastro-intestinal inflammation, cedema of the peritoneum
and pleura, in the lung as well as in the serosee, (pneumonia is
not uncommon especially in sheep), intestines, kidneys and mus-
cles, haemorrhagic spots are not uncommon, the blood forms a
loose black coagulum, and the encephalon is anzemic and
softened.

Treatment. ‘The first consideration is to cut off the supply of
mercury. Mercurial applications on the skin should be washed
off with tepid water and if necessary soap. An application of
sulphide of potassium will precipitate the mercury in an insolu-
ble form. For mercurial agents in the alimentary canal an
emetic may be given (if the animal is one susceptible to emesis)
followed by a saline laxative. This may be combined with or
followed by raw eggs, mucilage, wheat gluten or other albumin-
oid, sulphide of potash or sulphur, to precipitate the mercury
and prevent its absorption. Later, when the bowels have been
cleared, iodide of potassium in small doses will serve to dissolve
and remove what mercury may be lodged in the tissues.

Locally one of the best applications is chlorate of potash as a
mouth wash, 2 drs. to the quart of water. To this may be
added tannic acid or other vegetable astringent and even alcohol.

Finally a course of iron and bitter tonics will serve a good
purpose in restoring the general tone.

STOMATITIS FROM CAUSTICS.

Caustic Alkalies; symptoms, lesions and antidotes. Caustic Acids;
symptoms, lesions and antidotes. Caustic salts; symptoms, lesion and
antidotes.

Caustic Alkalies. (Soda, potash, ammonia and their car-
bonates) often cause stomatitis. What is supposed to be weak
dye, given to counteract indigestions, colics and tympanies often
proves dangerously irritating, and some of the worst forms of
stomatitis we have ever seen in the horse originated in this way.
As the animal refused to swallow, the caustic liquid lay in the
mouth and virtually dissolved the epithelium and surface layers
of the fibrous mucosa. Thesurfacein such a case is usually of a
deep red, and where the cuticular covering remains, it is white
and corrugated. The antidote is a weak non-irritant acid, such
as vinegar, boric, citric, or salicylic acid. When the caustic
alkali has been thoroughly neutralized in this way the ordinary
treatment for catarrhal stomatitis may be followed. ‘The attend-
ant gastrititis must receive its special treatment.

Caustic Acids. Sulphuric, nitric and hydrochloric acids act
by abstracting liquids and charring the tissues. The lesions from
strong sulphuric acid turn black, those due to nitric acid, yellow,
(zanthoproteic acid, ) and those due to muriatic acid are white,
with the characteristic odor of chlorine. The antidote in such
cases is a non-irritant basic agent, such as chalk, lime water,
soapsuds, calcined magnesia, and mucilaginous liquids, albumen,
gluten, flax seed, with opium. The same agents are applicable
to the attendant gastritis and when the acids are thoroughly
neutralized the treatment is as for simple inflammation.

Caustic Salts. Among caustic salts may be named mercuric
chloride, sulphates of copper and iron, chlorides of iron and zinc,
tartar emetic. "These may be treated by albumen, blood, white
of egg, milk, gluten, mucilage and other sheathing, protecting
agents which will form with the salts insoluble and harmless
coagula. The subsequent treatment will follow the lines mark-
ed out for simple stomatitis. To prevent infection of the raw
surface Cadeac recommends: tannic acid 1 0z., benzonaphthol 3
drachms, powdered gentian 6 drachms, honey, sufficient to make
an electuary. 35

MYCOTIC STOMATITIS IN FOALS, CALVES AND
BIRDS, THRUSH. MUGUET.

Oidium (saccharomyces) albicans; a parasite of the young ; cultures ;
Symptoms in foals and calves; congested buccal mucosa; curd-like con-
cretions ; erosions Diagnosis from rinderpest. Treatment ; disinfection ;
sunshine ; open air ; exercise ; locally antiseptics.

This is a form of stomatitis manifested by a raised white patch
on the mucous membrane and determined by the presence of the
oidium albicans (saccharomyces albicans), a cryptogam dis-
covered by Berg in 1842 in thrush in children. It is closely allied
to the mucor, and attacks only the young and feeble. The white
crust consists of epithelial cells intermingled with an abundance
of the white mycelium and oval spores of the fungus. Audry in
his artifical cultures found that it was pearly white when grown
on gelatine, dirty white on potato, and snow white on carrot.

Foals and Calves. Symptoms. The buccal mucosa red,
congested and tender, shows here and there white curdy looking
elevations, or red erosions caused by the detachment of such
masses. These bear a strong resemblance to the concretions
seen on this mucosa in rinderpest, but are easily recognized by
the absence of the attendant fever, and by the discovery, under
the microscope, of the specific microphyte. The eruption may
extend to the pharynx and cesophagus and interfere fatally with
deglutition, but usually it merely renders sucking painful and is
not serious.

Treatment. It is always well to destroy floating germs by
cleansing and whitewashing the stable, and to invigorate the
young animals by sunshine, free air and exercise. Locally the
most effective agent is the old favorite remedy borax, which ar-
rests the growth of the parasite whether in artificial cultures, or
in the mouth. The powder may be rubbed into the sores or it
may be mixed with honey or molasses and used as an electuary.
As substitutes boric acid, salol, thymol, chlorate of potash, or
permanganate of potash may be used.

Birds. The affection has been twice observed as occurring in

36

Paralysts of the Tongue. 37

the cesophagus and crop of two chickens. Martin tried in vain
to inoculate it on other fowls, and Newman failed to convey it
from child to chicken by feeding. The element of individual
susceptibility was manifestly lacking. From its seat in the crop
the malady passed unnoticed during life. In cases that can be
recognized, treatment would be the same as in young mammals.

PARALYSIS OF THE TONGUE. GLOSSOPLEGIA.

Causes : Nervous lesions—central or peripheral, parasitic, inflammatory,
infectious, traumatic or degenerative. Symptoms: unilateral and bilateral,
Treatment : remove cause ; use nerve stimulants, embrocations, blisters,
frictions, galvanism, suspension of tongue.

Paralysis of the tongue depends on a lesion of the medulla ob-
longata, or of the 7th or 12th cranial nerve. The central lesions
may be connected with ccenurus or other parasites in the brain,
hydrocephalus, meningitis, cerebro-spinal meningitis, infectious
pneumonia, abcess, (strangles), and tumors. The distal or nerve
lesions may be due to neuroma, tumors, traumas, lacerations,
bruises, or violent distension of the tongue. Parotitis, abcess of
the guttural pouch and tubercle may be added as occasional
causes. As direct traumatic injuries those caused by wearing a
poke by a habitual fence-breaker, excessive dragging on the
tongue in operations on the mouth, and compression of the
tongue by a loop of rope passed over it, require mention.

Symptoms. In unilateral paralysis the affected half of the
tongue remains soft and flaccid and is liable to be crushed be-
tween the teeth, the active muscles of the opposite half pushing
the organ over to the paralyzed side. In bilateral paralysis the
tongue hangs out of the mouth, and being crushed and torn by
the teeth, it swells up, and may even become gangrenous.

Treatment. Will vary according to the cause. After removal
of the central or nervous lesions, the remaining functional
paralysis may be treated by strychnia, internally or hypodermi-
cally, by frictions or stimulating embrocations to the intermaxil-
lary region, or by electricity. The tongue must be suspended

38 Veterinary Medicine.

in a sling to prevent cedema, inflammation and wounds by the
teeth. In bad cases of bilateral traumatic glossoplegia in meat-
producing animals it has been advised to have the subject
butchered.

DISEASES OF THE SALIVARY GLANDS.

Modifications of the secretion are commonly simple excess or
deficiency, with a correspondingly high or low specific gravity of
the product. There may, however, be a virulent element as in
the case of rabies.

SUPPRESSION OF SALIVARY SECRETION.
XEROSTOMIA.

Causes ; fever; vascular vacuity, after bleeding, diarrhcea, etc. ; destruc-
tion of glands; Calculus. Symptoms; slow, difficult mastication ; digestive
disorder. Treatment; remove mechanical obstruction ; correct constitu-
tional disorder; employ stimulation to gland—pilocarpin, electricity.

Entire suppression of salivary secretion is usually the result of
some other disease. It may be a manifestation of the general
tendency to retain water in the febrile system, or it may be an
indication of vacuity of the vascular system as after bleeding,
profuse diarrhoea, diuresis, or diaphoresis, or it may be the result
of the entire destruction of a salivary gland or the obstruction of
its duct by some foreign body or calulus. In proportion to the
completeness of the suppression, mastication and deglutition be-
come difficult or impossible. The condition must be met by the
removal of the cause which is operative in the particular case.
The treatment may be surgical for the removal of obstructions,
or medical with a view of overcoming anzemia, fever, profuse
secretions from other emunctories, or the simple physiological
inactivity. ‘To meet the last indication small doses of pilocarpin,
or the application of a gentle current of electricity will usually
succeed.

EXCESSIVE SECRETION OF SALIVA. SALIVATION.
PTYALISM.

Causes; a symptom of other diseases, of the mouth, teeth, throat or
stomach; rank aqueous vegetation, lobelia, pilocarpin, muscaria, tobacco,
mustard, and other acrid vegetables; caustic alkalies, acids, salts; com-
pounds of mercury, gold, copper, iodine; palsy of lips; harsh bit; fungi
on clover, sanfoin, etc. Symptoms; salivary escape; frequent degluti-
tion ; thirst ; disordered digestion, etc. Treatment; remove cause ; astrin-
gent washes; sedatives ; embrocations to the glands.

This is often a symptom of some other affection such as aph-
thous fever, dumb rabies, epilepsy, stomatitis, pharyngitis, den-
tition, caries and other diseases of the teeth, wounds and ulcers
of the mouth, gastric catarrh, etc. In other cases it is due to
direct irritants in the food or medicine, as very rank, aqueous,
rapidly grown, spring grass, lobelia, pilocarpin, muscarin, to-
bacco, wild mustard, colchicum, pepper, garlic, ginger, irritant
and caustic alkalies, acids and salts, and the compounds of mer-
cury, gold, copper, or iodine employed locally or internally.
The application of mercurials to the skin is especially liable to
salivate cattle and dogs, partly because of a special susceptibility
to the action of this metal and partly from the tendency of these
animals to lick the medicated surface. Paralysis of the lips
causes a great flow of saliva from the mouth though no more
than the normal amount is secreted. The irritation of a large or
harsh bit will increase the secretion, and still more the former
habit of attaching to it small bags of spicy or irritant chemicals.
Certain fungi determine salivation. Mathieu saw profuse sali-
vation in horses, cattle and sheep fed on clover and sanfoin
which had become brown.

Symptoms consist in the profuse flow of saliva, either in long
stringy filaments, or if there is much movement of the jaws, in
frothy masses ; frequent deglutition ; increased thirst and disor-
dered digestion (tympany, inappetence, colics, constipation,
diarrhoea). In mercurial salivation there may be loose teeth,
swollen, spongy, ulcerated gums, tympany, rumbling and the
passage of fcetid flatus and soft ill-digested stools.

Treatment consists in removing the cause, whether this is to

39

40 Veterinary Medicine.

be found in faulty food or drink, diseased teeth or gums, disor-
dered stomach, or the irritant food, medicine or poison ingested.
If more is wanted simple astringent washes like those recom-
mended for stomatitis and a free access to pure water will often
suffice. Tartar emetic or opium has been known to succeed in
obstinate cases. Friction over the parotid or submaxillary gland
with camphorated spirit, tincture of iodine or soap liniment is
sometimes required. In mercurial salivation chlorate of potash
is especially to be commended, and when the bowels have been
unloaded of the agent, iodide of potassium will hasten its elimi-
nation from the tissues and blood.

DILATED SALIVARY DUCTS. SALIVARY CALCULUS.
SALIVARY FISTULA.

These are all surgical diseases and are to a large extent inter-
dependent. The impaction of the calculus in the duct leads to
over-distension of the duct posterior to the obstruction, and the
rupture or incision of the distended duct, determines the fistula.
It is only necessary here to point out the seat of these lesions :
the distended sublingual ducts constituting a more or less rounded
swelling to one side of the franum lingui, the Whartonian duct
forming a tense rounded cord from the papilla back of the lower
incisor teeth backward on the inner side of the lower jaw, and
the Stenonian duct forming a similar tense cord from near the
middle of the cheek down around the lower border of the jaw in
company with the submaxillary artery and backward on the inner
side of its curved border to the parotid gland.

For the more precise lesions, symptoms and treatment of these,
see a work on surgery.

INFLAMMATION OF THE PAROTID GLAND.
PAROTITIS.

Causes: traumatic; calculus; grains; barley and other beards; infecting
microbes. Symptoms: fever, dullness, buccal heat, salivation, difficult
mastication, swelling of gland and duct, protruded nose, stiff neck, fcetor,
dyspneea, facial paralysis, induration of gland, abscess. Diagnosis from
pharyngitis, abscess of guttural pouch or pharyngeal glands ; from tumors.
Treatment : avoidance of causes ; derivation; astringent, antiseptic washes;
wet antiseptic bandages to throat; cool pultaceous diet. Open abscess and
disinfect. For induration deobstruents. For sloughing antiseptics.

This may be caused by traumatism, such as incised punctured
or bruised wounds. Wounds inflicted by the goad, by horns,
and even by the yoke in cattle must be looked on as factors. _ It
occurs from obstruction of the salivary ducts by calculi, or by
grains, seeds, or pebbles introduced from the mouth ; from their
irritation by the beards of barley and other plants (brome, rye,
wheat, etc.); and from the localization in the gland of specific
inflammation like strangles, pyzemia, canine distemper, tubercu-
losis and pharyngitis. In most of these cases infective microbes
are prominent factors. They enter with penetrating bodies from
the skin; they extend through the weakened and debilitated
tissues in bruises, they penetrate the Stenonian duct with the
various foreign bodies from the mouth ; irrespective of foreign
objects they make their way up the duct by continuous growth
from the buccal orifice ; in case of calculus or other obstruction
their extension is favored by the local congestion and debility
and by the stagnation of the saliva above the point of arrest.
When present these microbes even favor the deposition of the
salivary salts and formation and increase of calculi so that the af-
fection may advance in a vicious circle, the microbes favoring
calculus and the calculus favoring the increase of microbes.

Symptoms. Inthe horse in particular there may be premoni-
tory symptoms of fever, dullness, heat of the mouth, ptyalism,
slow and imperfect mastication, and the retention of food in the
cheeks.

The Stenonian duct becomes swollen and painful. The
parotid becomes hard, hot, tender, and is surrounded by a softer

41

42 Veterinary Medicine.

pitting infiltration which may extend down around the entire
throat, and even along the intermaxillary region to the chin.
When the canal is obstructed it may stand out as a thick rope-
like resilient swelling extending around the lower border of the
jaw and upward toward the cheek as far as the point of obstruc-

tion. When one parotid only is involved, the contrast with the
other is quite marked. The head is extended and carried stiffly.

When the nose is depressed, or when the head is turned to one
side or the other, the patient gives evidence of suffering from
compression or stretching of the inflamed region. The breath
and mouth exhale an offensive odor, determined by the decompo-
sition of mucus and of the retained food products.

Among remote effects may be named dyspnoea and threatened
suffocation from pressure on the pharynx and laryngeal nerves,
and facial paralysis from pressure on the seventh nerve.

The disease may go on to induration and remain permanently
in this condition, or it may suppurate and discharge through the
skin, into the pharynx or through the duct of Stenon. It may
communicate with both the duct and the skin and determine a
fistula. When suppuration occurs there is an access of fever, a
chill may be noticed, the swelling becomes more tense, harder,
more tender to the touch, and even emphysematous, and finally
points internally or externally. This may take place from the
fifth to the tenth day or later. When it opens into the duct it
may be seen oozing from the orifice in the cheek when the mouth
is opened, and in case the jaws are suddenly parted, it may es-
cape ina jet. In such a case and especially if the microbes have
come originally from the food the odor is very foetid. ‘The ab-
cess is not always single and when multiple the pus may escape
externally by a variety of orifices. The pus is usually whitish,
yellowish or grayish and creamy, but it may be grumous or
bloody or serous and of a most offensive odor. In exceptional
cases the gland becomes more or less gangrenous and such parts,
exposed in the wound are hard, bloodless and insensible, and
add very materially to the feetor. This may lead to general
septic infection, or the necrosed masses may slough off and the
cavities ‘fill up by grauulations.

Diagnosis. Parotitis is distinguished from pharyngitis and

abscess of the guttural pouch by the absence of cough and nasal

Inflammation of the Parotid Gland. 43

discharge ; from abscess of the pharyngeal glands it is differenti-
ated by the limitation of the hard swelling to the parotid gland
and by the superficial seat of the resulting abscess. The coexist-
ence of active inflammation serves to distinguish it from ordinary
tumors.

Treatment. By way of prevention, the avoidance of injuries
by yokes, forks, pokes, and goads is important. Also the disin-
fection of the mouth by a liberal supply of pure water and even
by antiseptic washes :—borax, boric acid, creolin, tannin, chlorate
of potash. Also by the removal of foreign bodies or calculi from
the canal.

When the inflammation has set in, a saline laxative is often of
value. Wash the mouth with a solution of vinegar and salt, or
other antiseptic, repeating this at least after every meal. The
swollen, painful gland may be covered with a damp compress or
anointed with vaseline to which may be added a little creolin,
naphthol, carbolic acid or salicylic acid, together with lead acetate
and belladonna or other anodyne. ‘The diet must be soft, cool
mashes, sliced or pulped roots or any bland agent that will de-
mand little or no mastication. Cool, fresh water should be al-
lowed ad libitum. When the laxative has set, it may be followed
by cooling diuretics such as nitrate or acetate of potash.

If suppuration occurs it should be opened as soon as the pus
can be definitely recognized, and the cavity treated antiseptically
to prevent further local or general infection by the microbes. In
deep abscess there is a certain danger of wounding blood vessels
and salivary ducts, but this can be to a certain extent obviated
by making an incision through the skin only and then boring the
way into the abscess with a grooved director or the points of
closed scissors. When the cavity is penetrated the pus will ooze
out through the groove or between the scissor blades. When
the pus has been evacuated the cavity should be washed out two
or three times a day with mercuric chloride solution (1 : 1000),
or permanganate of potash solution (1 : 100).

When the gland becomes indurated and indolent, seeming to
merge into the chronic form it may be stimulated to a healthier
action by a cantharides blister, or it may be subjected to daily
massage, or to a daily current of electricity for ten or fifteen
minutes. If the inflammation is slight or unrecognizable, the

44 Veterinary Medicine.

surface of the gland may be daily painted with tincture of iodine,
and iodide of potassium may be given internally, in daily doses
of % to 1 drachm.

Gangrene, the result of septic microbes, a weak system or too
severe treatment, may be met by astringent and antiseptic agents
locally, and by tonics, stimulants and a generous diet internally.

In cattle the disease usually responds readily to local antisep-
tics, and stimulating germicidal embrocations. Camphorated
spirit, alone or combined with tincture of iodine ; cantharides
ointment with carbolic acid; and camphor and phenol may be
cited as examples.

SUBMAXILLARY ADENITIS. MAXILLITIS.

Mostly in solipeds and unilateral. Causes; traumatic; calculus; infec-
tions; ablation of papille. Symptoms; tardy mastication; salivation ;
buccal heat and fcetor; submaxillary swelling and tenderness; morsels
retained under tongue; papilla and duct swollen, tender and firm ; abscess.
Treatment ; remove causes ; dislodge foreign bodies ; antiseptic lotions and
packing.

This is rarely seen in other animals than solipeds, is mostly
unilateral, and due to the introduction of microbes along with
vegetable spikes (barley awns, brome, wheat or oat spikes or
glumes) or other foreign bodies. It may also be caused by cal-
culi obstructing the duct. ‘The orifice of each duct, to one side
of the freenum lingui, is imperfectly closed by a triangular valvu-
lar projection, which in some countries is erroneously cut off asa
diseased product (barbs), thus opening the way for the introduc-
tion of foreign objects. ‘The microbes are usually pus germs and
tend to abscess of the gland. Asin the case of the Stenonian
duct the presence of. these germs tends to the precipitation of the
salivary salts and the formation of calculi.

Symptoms. ‘The animal may seem hungry, but masticates
tardily and imperfectly, and may even drop morsels partly
chewed. He prefers ground feed to whole, and soft mashes to
ground feed, while hay and other fibrous aliments may be alto-
gether rejected. Salivation may be excessive, the secretion
drivelling from the lips, the mouth may feel hot and the sub-

Submaxillary Adenttis. Maxilitis 45

maxillary salivary gland swollen and tender. This may be de-
tected in the intermaxillary space, but is especially noticeable
along the lower and lateral aspect of the tongue. If the mouth
is opened and the tongue drawn to one side a mass of food may
be found to one side of the freenum lingui, and beneath this the
projecting, red inflamed papilla which covers the Whartonian
orifice. Extending backward from this the duct is felt as a
thickened cord, and when this is compressed a purulent liquid
flows from the orifice. The mouth becomes offensively foetid.

The tendency is to suppuration, and if this is determined in
the Whartonian duct only, by the presence of foreign bodies, cal-
culi, or microbes it may recover in connection with an abundant
mucopurulent discharge and a free secretion of saliva. If it
occurs in the gland tissue itself by reason of the penetration of
the microbes into the follicles, the tendency is to circumscribed
abscess, which may point and burst by the side of the root of the
tongue, or externally in the intermaxillary space. In the first
case the tongue is displaced upward and to the other side of the
mouth by the hard, firm swelling, which is felt on one side be-
neath the back part of that organ, and later there is the wound,
the profuse mucopurulent discharge, and intense foetor. If on
the other hand the abscess forms nearer the skin, there is the
firm, painful intermaxillary swelling, which finally points and
bursts: discharging pus of a septic odor. It may be mixed with
the foreign bodies that have penetrated through the canal, with
morsels of necrosed gland tissue and with blood.

Treatment. ‘The first consideration is to extract any foreign
bodies which have lodged in the duct causing irritation and in-
fection. The finger passed along the line of the swollen duct
may detect the seat of such foreign body by the extra swelling,
and may extract it by manipulation from behind forward. This
may sometimés be assisted by the introduction of a grooved
director as far as the foreign body, or even by a catheter which
can be made to distend the canal in front of the object and open
the way for its easier passage. In case of failure and in all cases
of the introduction of small bodies like vegetable awns or spikes
pilocarpin may be given to cause an excessive secretion and thus
as it were purge the canal of its offensive contents. Incision
of the canal over the foreign body is the dernier resort.

46 Veterinary Medicine.

This accomplished, the injection of antisepticsolutions (per-
manganate of potash, boric acid), and the liberal use of pure
water and detergent lotions in the mouth (vinegar, borax, car-
bolic acid or salicylic acid in solution) will go far to establish a
cure. In case of an abcess bursting internally the antiseptic
solutions should be injected into the cavity. When the abcess
bursts internally this is doubly demanded, as the introduction of
zerial germs tends to produce very unhealthy action. The cavity
may be stuffed with carbolized iodoform, or acetanilid cotton,
or with boric or salicylic acid.

SURGICAL LESIONS OF THE SALIVARY GLANDS.

Among these may be named calculi of the Stenonian and
Whartonian ducts, ranula, stenosis and fistule of these ducts,
tumors, special infections like actinomycosis.

TONSILITIS IN PIGS, AND OTHER ANIMALS.

Causes ; debilitating, climatic, microbian. Symptoms; fever, dullness ;
lies under litter; ears and tail droop ; watery eyes ; anorexia; vomiting ;
pharyngeal swelling ; buccal redness and fcetor; tonsils swollen with pus
or caseous mass in follicles, cough dry and hard, later loose. Abscess.
Calculus. Course. Treatment; antiseptic electuaries; embrocations ;
laxatives ; diuretics ; tonics.

This is seen in both the acute and chronic form. In the
former it has the general causes and symptoms of pharyngitis.
There is more or less fever, dullness, a disposition to lie with
head extended and buried in the litter, ears drooping, eyes water-
ing and red, carelessness of food, deglutition painful, and liable
to be followed by vomiting. The mouth is red and hot, the
breath fcetid and the tonsils swollen, and their alveoli filled with
mucopurulent matter or at times with a foetid cheese-like pro-
duct. The cough is at first dry and hard and later loose and
gurgling.

Tonsilitis in Pigs, and Other Animals 47

In the chronic form there is general swelling of the tonsils
with the over-distension of the follicles by the above mentioned
whitish putty-like masses, which are often even calcareous.
These are due to the proliferation of microbes which find in
these alveoli a most favorable field for their propagation. A
similar condition is found in the carnivora and to a less extent in
the horse, in keeping with the restricted development of the
amygdalee in these animals. It may be attended by ulceration,
or in rare cases by the formation of veritable calculi in the folli-
cles of the tonsils.

The gravity of the disease is largely determined by the nature
of the infecting microbe and the debility and susceptibility of the
animal attacked. ‘The affection usually ends in recovery, but
may go on to grave local ulceration, and general infection.

Treatment consists largely in astringent and antiseptic applica-
tions to the buccal mucous membrane. In the acute forms fre-
quent smearing of the mouth with electuaries of honey or
molasses and borax, boric acid, salammoniac, chlorate or per-
manganate of potash, and the application of stimulating embro-
cations to the skin around the throat. In other cases solutions
of tincture of chloride of iron, or of tincture of iodine can be
used with profit. The iron can be swallowed with advantage,
but it is objectionable to pour liquid rapidly into the mouth of
the pig, because of the danger of its entering the lungs and set-
ting up fatal pneumonia. A better way is to apply it to the in-
terior of the mouth and fauces on a swab or sponge dipped in the
liquid. Short of this, one of these agents may be mixed with the
drinking water, or muriatic acid may be used in the same way,
though at some detriment to the teeth. The general health must
at all times be attended to. Any costiveness may be corrected
by Glauber salts or jalap, and elimination through the kidneys
must be sought through the use of nitrate of potash or other
diuretic.

CALCULI IN THE TONSILS.

Diagnosis and treatment of tonsilar calculi; spud; acid dressings.
Trauma of soft palate by stick, probang, file, molar. Abscess of palate.

Treatment ; laxative; expectorant; antiseptic; lancing. Cleft palate and
hare lip.

Rudimentary as these organs are in the equine race they are
important enough to have become the seat of hard calculous
masses. These have been found by Goubaux and Blanc in old
asses, and by the author in old horses. They vary in size from
a pin’s head to a pea and consist of concentric layers of a granu-
lar material arranged around a central nucleus, which is usually
a foreign body introduced with the food. ‘This nucleus is usually
of a vegetable nature, while the enveloping material is made up
largely of the imprisoned and degenerated epithelium of the fol-
licle. Both diagnosis and treatment are difficult in such cases.
The adventitious masses should be dislodged by the aid of a
smooth, blunt metallic spud, and the surface thereafter washed
or swabbed with an antiseptic and astringent solution. Swab-
bing with a solution of hydrochloric acid will tend to dissolve
and remove them.

INJURIES TO THE SOFT PALATE AND FAUCES.

The region of the fauces is sometimes injured by sharp pointed
bodies swallowed in the food, by the giving of boluses on the end
of a pointed stick, or by the careless use of a probang, or of a file
upon the posterior molars. An overgrown last molar will some-
times lacerate the velum. In other cases the inflammation of
sore throat is especially concentrated on this part, giving rise to
cough, difficulty of swallowing, redness, infiltration and swelling
of the parts, and even abscess. In the dog it is often associated
with tonsilitis.

Treatment. A laxative is usually desirable to be followed by
sal-ammoniac or chlorate of potash. In case of actual traumatic

48

Catarrhal Pharyngitis. 49

lesions, the astringent and antiseptic lotions advised for tonsilitis
will be in order, and if abscess is recognized it should be opened
promptly.

CLEFT PALATE.

In exceptional cases the soft palate has failed to unite in the
median line, and is represented by two lateral flaps separated by
a v-shaped hiatus in the middle. In a specimen in the
N. Y. S. V. College, taken from a trotting colt, the fissure is
continued forward for several inches between the palatine bones
and the palatine processes of the superior maxillary, establishing
a direct communication between the mouth and nasal chambers.
In still other instances the fissure is continued forward between
the maxillary and anterior maxillary bones, throwing the whole
length of the buccal and nasal chambers into one irregular cavity,
and forming hairlip.

It would be possible to remedy some of these conditions by
plastic operation, but the value of the young animal will rarely
warrant any such resort.

CATARRHAL PHARYNGITIS.

Causes : traumatic; thermic; gaseous; medicinal; chemical; physio-
logical irritants ; in solipeds, cattle, swine, dogs ; debility ; exposure; cold
baths ; youth ; age. Microbes in solipeds, cattle, dogs, birds; facultative
microbes. Symptoms: constitutional ; difficult swallowing; nasal rejec-
tion of water; pharyngeal swelling and tenderness ; extended head carried
stiffly ; cough loose ; salivation ; in cattle, grinding of teeth ; in dogs, rub-
bing of chops ; buccal heat and redness ; often foetor. Course. Duration.
Diagnosis from parotitis, from abscess of guttural pouch, from pharyngeal
tuberculosis, from actinomycosis, from adenitis and phlegmonous pharyn-
gitis, from specific fevers affecting the pharynx. Lesions: redness and
swelling of mucosa, epithelial degeneration, elevations, erosions, and ulcers ;
lesions of tubercle, glanders, rabies, anthrax, actinomycosis, etc. Preven-
tion. Treatment : soothing ; dietetic ; laxative ; expectorant ; eliminating ;
locally antiseptic astringents in solid, liquid, or vapor; embrocations and
blisters ; tonics.

4

50 Veterinary Medicine.

Causes. As in stomatitis the starting point of pharyngitis is
usually in a local injury or a systemic condition which lowers the
vitality of the pharyngeal mucous membrane. It may come in
all animals from the hot air of burning buildings, from acrid
gases inhaled, food, drink or medicines given at too high a tem-
perature, from caustic alkalies, acids or salts, from physiological
irritants like croton, euphorbium, cantharides, from barley and
other spikes entangled in the follicles, from drinking freely of
iced water. In solipeds there are the injuries caused by giving
boluses on pointed sticks, and the wounds caused by tooth files
in careless hands, and by coarse fibrous fodder, which has been
swallowed without due mastication. In cattle injury comes from
foreign bodies impacted, from the rough use of probang, rope or
whip and even of the hands in relieving choking. Swze have
the part scratched and injured by rough or pointed objects which
they bolt carelessly with the food. Dog's and especially puppies
are often hurt by solid and irritant bodies that they play with,
and swallow accidentally or wantonly. They also suffer at times
from the pressure of a tight or badly adjusted collar.

The system is debilitated and rendered more susceptible by
chills consequent on exposure to cold blasts, or draughts, or rain
or snow, when heated and exhausted, by cold damp beds, by pre-
existing disease, by underfeeding and by overwork. In the
larger animals this may come from the excessive ingestion of
iced water, while in dogs the plunging in rivers, ponds or lakes
may chill.

‘The weakness of early age and old age has a perceptible pre-
disposing influence especially in solipeds and carnivora.

Finally as in other catarrhal inflammations the local action of
disease germs on the mucous membrane must ever be borne in
mind. These may be the germs of specific diseases localized in
the pharynx ;—in Solipeds the streptococcus of strangles, the
bacillus of glanders, the diplococcus (streptococcus) of conta-
gious pneumonia, the germ of influenza, and actinomyces ;—in
Cattle the bacillus tuberculosis, the bacillus of anthrax, actino-
myces, the germs of aphthous fever and of pseudomembranous
angina; in dogs canine madness and distemper ;—in birds the
bacillus of pseudomembranous pharyngitis.

In addition to such specific germs the micrococci, streptococci

Catarrhal Pharyngitis. 51

and bacilli which are normally present and harmless in the
mouth and pharynx, enter. colonize and irritate the debilitated
tissues in case of trauma, inflammation or constitutional disorder
and serve to perpetuate and aggravate the affection.

Symptoms. Acute pharyngitis is manifested by impaired or
lost appetite, dullness, weakness, by difficulty in deglutition, by
the rejection through the nose of water or other liquids swal-
lowed, by swelling over the parotid and above the larynx, and
by a disposition to keep the head extended on the neck and the
nose raised and protruded. Fever is more or less marked ac-
cording to the severity of the attack the temperature being raised
in mild cases to 100°, and, in the more violent, to 104° or 106°.
The pulse and breathing may be excited, amounting sometimes
to dyspnoea, the throat is tender to the touch and its manipula-
tion rouses a cough, the nasal mucosa is congested and the buccal
membrane, and especially along the margin of the tongue may
be red and angry. Salivation is shown more or less, in solipeds
the saliva accumulating especially during mastication in froth
and bubbles at the commissures of the mouth, while in ruminants
the grinding of the teeth or frequent movement of the jaws in
the absence of food or actual mastication leads to a free escape of
the filmy liquid at the same points. Dogs will rub the jaws with
the foot as if to remove some irritating object from the mouth.
In the last named animals the swelling of the tonsils, fauces and
pharyngeal mucous membrane, may be seen marked by patches
and spots of varying redness and swelling, covered with glairy or
opaque muco-purulent secretions, or particles of food, or even
showing erosions.

The cough of pharyngitis is painful, paroxysmal, and softer
and more gurgling (even in the early stages) than that of laryn-
gitis or bronchitis. It is roused by handling the throat, by swal-
lowing, by a draught of cold air or by passing out of doors, in
dogs by opening the mouth, and in cattle by pulling on the
tongue which causes pain and resistance. The cough is followed
by the rejection, mainly through the nose in solzpeds, but also
through the mouth in other animals, of a glairy mucus or an
opaque muco-purulent discharge often mixed with and discolored
by the elements of food or in bad cases by blood.

The course of the disease is comparatively rapid, and it usually

52 Veterinary Medicine.

ends in recovery in seven to fifteen days, in cases that are not
complicated by dangerous local infections.

Diagnosis is mainly based on the stiff carriage of the neck
with the nose elevated, the swelling and tenderness of the throat,
manipulation above the larynx rousing the cough, the soft or
rattling nature of the cough, the ejection of liquids and foods
through the nose, the movements of the jaws apart from masti-
cation and the salivation. From favofitis it is distinguished by
the concentration of the swelling and tenderness to the deep-
seated region above the larynx, by the abundance of the dis-
charge, by the ejection of liquids through the nose, and by the
readiness with which the cough is aroused. From abscess of the
guttural pouch it is differentiated by the more continuous discharge
from the nose, rather than the intermittent one. From tuberculous
pharyngeal glands by its acute nature, by the absence of the
glandular swellings in which the tuberculosis is concentrated, also
by the absence of tubercles in other parts of the body. From
actinomycosts by its more rapid progress and by the absence of the
hard indurated cutaneous or subcutaneous swellings, and of the
open sores with minute sulphur colored granules that mark that
affection. From adenztis and phlegmonous pharyngitis it is dis-
tinguished by the absence of the glandular swelling and dyspncea
which attend on that affection. From the various fatal fedvzle
affections, the germs of which may be localized in the throat, it
may be diagnosed by the absence of the more profound constitu-
tional disturbance, and of the more characteristic local symptoms
of these which are seldom altogether awanting, though often
greatly modified.

Lesions. Beside the thick covering of muco-purulent and
alimentary matters, the pharyngeal mucosa, when washed, shows
redness, ramified or reticulated, more or less swelling amounting
at times to cedema, a soft friable consistency, which like the
cedema may in bad cases extend into the submucous tissue,
granular elevations, and raw abrasions caused by the destruction
and removal of the epithelium. In some instances the ulcers
may become quite extensive.

In the more specific inflammations (tubercle, glanders, rabies,
aphthous fever, contagious pneumonia, anthrax, actinomycosis),
the lesions will vary according to the specific nature of the
disease.

Catarrhal Pharyngitis. 53

Prevention. Avoid the various thermal, chemical, mechanical,
and unhygenic causes already referred to, and the exposure to
such infectious diseases as are liable to localize themselves in the
throat.

Treatment. A piece of blanket or sheepskin placed round the
throat with the wool turned inward, a moderately warm stall with
pure air, and a diet composed of soft, warm or tepid mashes, (all
hard or fibrous food, oats, hay, etc. being withheld) are important
conditions.

If costiveness exists a dose of Glauber salts for the larger
animals, and of jalap for the small, may be useful. Or pilocar-
pine 3 grs., oreserine 2 grs. may be given hypodermically. Fol-
lowing this, mild saline diuretics will serve at once to elimin-
ate offensive products of the disease and lower the general tem-
perature.

The most important resorts however, are the local applications
of dilute acids, astringents and antiseptics to the pharyngeal
mucosa, mouth and nostrils. In severe cases benefit may be de-
rived from inhalation of water vapor, but this is rendered far
more effective by the addition of vinegar, carbolic acid, creolin,
camphor, tar, or sulphurous acid. The last may be obtained by
the frequent burning of a carefully graduated quantity of sulphur
in the stall, the others by mixing them with hot water, saturating
cloths hung in the stall, or sprinkling them on sand laid on the
floor.

Chlorate of potash or borax may be dissolved in the drinking
water, care being taken not to exceed the physiological dose.
Mercuric chloride (1:2000) may be used to wash the lips and
nostrils, but cannot be safely injected into mouth or nose,
Powdered alum or tannic acid may be used by insufflation.

As a mouth wash and general medicament a saturated solution
of chlorate of potash in tincture of muriate of iron, diluted by
adding thirty drops to the ounce of water, may be given every
hour or two. Ora solution of chlorine water diluted so as to be
non-irritating, may be substituted with somewhat less effect.
Even a weak solution of hydrochloric acid may be employed.

Borax may be used in a solution of 2 per cent., or carbolic
acid in one of 1 per cent., or bisulphite of soda in the proportion
of % oz. to the pint, or salicylate of soda % oz. to the pint of
water. The same agents may be made into electuaries with

54 Veterinary Medicine.

honey or molasses and smeared every hour or two on the tongue
or cheek. In such cases the addition of powdered liquorice, and,
if the suffering is acute, of extract of belladonna will serve an
excellent purpose.

The danger of infection of the stomach and bowels may be
met by combining with the above or administering separately
salol in doses of 2 to 3 drachms or napthol in doses of 4 to 5
drachms to the larger animals. For sheep or swine one-fourth
df these doses may be given, and for a shepherd’s dog one-six-
teenth to a twentieth.

As alternate antiseptics may be named, boric acid, permanga-
nate of potash and salicylate of bismuth. These from their com-
parative absence of taste are especially useful in carnivora.

Local applications may be advantageously made on a pledget
of cotton firmly bound on the end of a staff or wire loop bent at
145” to 160° near the freeend. Thisis inserted with the bent por-
tion downward toward the tongue, until it has passed the soft
palate when it is turned upward by rotation so that the dressing
is applied on the pharynx and upper surface of the palate. The
bent point is again turned down for withdrawal.

Counter-irritants to the throat are useful. For the horse,
sheep, dog and cat, use equal parts of strong aqua ammonia and
olive oil. For the solipeds a cantharides blister. For cattle or
swine equal parts of strong aqua ammonia and oil of turpentine
with.a few drops of croton oil, or grains of tartar emetic.

Finally during convalesence a course of iron and bitters may
be useful, especially in debilitated subjects.

PHLEGMONOUS PHARYNGITIS.

Submucous inflammation and abscess. Solipeds especially. Specific or
due to microbian pus infection. Traumatism, from foreign bodies in tonsil-
lar and mucous follicles, from rough, fibrous food, instruments, etc.

As a sequel of catarrhal pharyngitis. Symptoms: as in catarrhal form,
with more swelling and tenderness, glandular swelling, dyspnoea, and diffi-
culty in swallowing ; local induration followed by fluctuation and pointing.
Complications ; asphyxia, laryngeal cedema, purulent or inhalation pneu-
monia, pharyngeal fistula, palsy of vagus, secondary abscesses, septicaemia,
Lesions, local, general. Treatment: General and local, fomentation—hot
or cold and antiseptic. Embrocations. Lancing. Tracheotomy.

Phlegmonous Pharyngitis. 55

As distinguished from catarrhal pharyngitis this is inflamma-
tion of the submucous tissue and adjacent lymph glands, tending
to abscess.

It is especially common in solipeds and rather rare in other
classes of domestic animals. Asa specific infectious disease it
has its type in strangles (infectious adenitis), also in cattle in
the complicated infection of purulent tubercle, but apart from
such it is often the result of the penetration of the pus microbes
from a catarrhal pharynx into the lymph plexuses and lymph
glands. Traumatism may play an important part in causation as
when vegetable barbs, awns, chaff or seeds, or strong hairs or
bristles enter the open mouths of the mucous follicles, or the
tonsillar cavities. Similarly trouble may arise from scratches by
tough, fibrous fodder, from pricks by pointed or cutting instru-
ments, by fractures of the hyoid, or by bruises by probangs, or
tooth rasps. An overgrowth of the last molar, and a resulting
wound and ulcer of the soft palate, and the presence of local de-
posits like those of glanders and actinomycosis, are other oc-
casions of the entrance of the pus organisms. It will be recog-
nized that this affection is not necessarily due to a difference in
the infecting organism, but rather of the tissue involved, the
microbes gaining the submucous tissues and expending their
violence on these instead of confining their ravages to the surface
layers of the mucosa. For this reason the deeper or phlegmonous
affection may supervene on a catarrhal inflammation which may
have already persisted for several days.

Symptoms. Beside the general phenomena of catarrhal pha-
ryngitis, this form of the malady is characterized by a greater
swelling and tenderness of the throat, extending from ear to ear,
and from the trachea forward in the intermaxillary space ; by
nodular and painful swellings of the pharyngeal lymph glands,
by the greater difficulty of deglutition, the muscular tissue being
involved ; by wheezing breathing amounting at times to violent
roaring and threatened asphyxia. Perspiration on the throat,
the ear, the side of the head or neck, of the fore arm, or of the
dorsal region is not uncommon, and has been attributed to the
compression of the vagus, or of the superior cervical ganglion of
the sympathetic by the swelling. Fever usually runs higher
than in simple catarrhal pharyngitis, which may be partly ac-

56 Veterinary Medicine.

counted for by the implication of the deeper and important
structures but also in no small degree by the entrance into the
circulation of the ptomaines and toxins, which in the catarrhal
affection escape largely from the inflamed surface.

The resulting abscess is usually in or near a gland or group of
lymph glands. ‘The part passes through the usual succession of
changes, of soft pitting swelling ; firm, tense, painful condition
in which the exuded lymph has coagulated ; and softening and
fluctuation which progresses from the centre toward the circum-
ference. ‘The abscess points variously according to its seat. If
in the intermaxillary space it opens externally. If sub-parotidean
or peripharyngeal it may burst inwardly into the pharynx or
outwardly through theskin. If supra-pharyngeal (retro-pharyn-
geal), it may be so thickly encapsulated in unyielding walls that
it may remain long indolent and inactive becoming a cold or
chronic abscess. When an abscess opens into the pharynx, there
is a sudden and copious flow of pus by the nose, and it may be
by the mouth and a simultaneous subsidence of the inflammation.

Among the complications of the affection are asphyxia, cedema .
glottidis ; abscess of the guttural pouch; rupture of an abscess
into the larynx, and the descent of pus into the lungs; the en-
trance of saliva and alimentary matters into the lungs; gan-
grenous pneumonia ; pharyngeal fistula; pressure on the vagus
and paralysis of the pharynx or larynx ; secondary abscesses ;
septiczemia.

Lesions. Besides the general inflammatory lesions some rather
remarkable ones have been observed. Fractured hyoid, dissec-
tion of the mucous from the muscular coat, by aliments, for
nearly the whole length of the cesophagus (Briickmiiller), puru-
lent infiltration of the supra-pharyngeal muscles (Wakefield),
niceration of the pharyngeal or guttural sac mucosa, or even
gangrene, purulent effusion in the tonsils, around the hypoglossal
nerve, the lingual branch of the fifth, or the vagus, embolic
inflammations, suppurations or gangrene of the bronchia, and
implication of the lung tissue and pleura. Catarrhal enteritis
and fatty liver and kidney are common. ;

Treatment. Besides the general measures advised for catarrhal
pharyngitis, this type demands especially measures to moderate
the intensity of the suffering, and when abscess appears inevitable

Phlegmonous Pharyngitis. 57

to hasten its maturation. The first demand is met by hot fomenta-
tions persistently applied to the throat. This may be done by
spongio-piline, or simply by well washed wool or cotton bound
upon the throat and wet at frequent intervals with water rather
hotter than the hand can bear. The addition of a little carbolic
acid will secure at once some local anzesthesia and a measure of
antisepsis. In warm weather the substitution of cold water has
been resorted to with apparently good effect. If adopted it should
be frequently renewed so as to keep up the constant action of cold
and moisture. These have been especially recommended in dogs
injured by a tight or ill-fitting collar.

When suppuration appears imminent as shown by the dense,
hard, circumscribed plegmon, stimulating embrocations may be
used to hasten its progress. Camphorated spirit is suitable for
carnivora and sheep. It may be combined with tincture of can-
tharides for horses. For cattle and swine, oil of turpentine may
be added, the three being used in equal proportions. A liniment
of ammonia and oil may be used more or less frequently and
energetically according to the relative thickness and insensibility
of the skin of the animal affected.

When matter has formed and fluctuates, it should be at once
evacuated and the cavity treated by antiseptic dressings. In this
way secondary abscesses, septic infections, molecular ulcerations
and other injurious sequelz may be largely obviated.

In case of threatened asphyxia the dernier resort tracheotomy
is always available, and this often acts very favorably in improv-
ing the zeration of the blood, in restoring the flagging vital func-
tions which depend on hzmatosis, and in removing the friction
and irritation consequent on the passage of air through the
narrowed and tender passages.

SUPRA-PHARYNGEAL (RETRO-PHARYNGEAL)
ABSCESS.

A sequel of phlegmonous pharyngitis. Symptoms; masked by its depth ;
pharyngeal wheezing or roaring with little local swelling ; difficult swallow-
ing ; resisting tissues tend to chronicity. Results; pharyngeal fistula, bur-
rowing along cesophagus, rupture into chest or blood vessels, lymphade-
nitis, compression of vagus, or jugulars, permanent infected cavity with
small orifice. Diagnosis from pus in guttural pouches. Treatment ; exter-
nal opening ; antisepsis. :

This is a natural result of phlegmonous pharyngitis, but it is
possessed of so great importance alike in its chronicity and its
results that it seems to deserve a special article. Like its initial
morbid condition it is especially common in the soliped, and like
that may be traceable to strangles, influenza, and local trauma-,
tism.

The symptoms are at first those of phlegmonous pharyngitis,
and, if the local swelling, induration and tenderness are less
marked than in other cases, it is due to the location of the in-
flammatory lesion deeply between the pharynx and the atlas and
occiput. Indeed the moderate aspect of the external swelling,
conjoined with the noisy wheezing or violent roaring, may be
taken as important diagnostic indications. The supra-pharyn-
geal region is so closely confined on its lateral aspects, by the
union of the fascia of the sternomaxillaris and mastoido-humeral
muscles, that the swelling is confined in the eatly stages just as
the pus is later. As this resistant fascia prevents any relief by
lateral. expansion, the engorged tissues press downward on
the softer and less resistant upper wall of the pharynx and
seriously impair both respiration and deglutition. Similarly
when pus has formed, these lateral fibrous barriers, reénforced
by organized lymph, stand in the way of the advance of the pus
toward the skin, and lead it to dissect its way downward toward
the pharynx. Even here the thickening of the tissues by the
organized products of the lymph will often interpose a serious
bar, and the pus remains pent up indefinitely, a source of wheez-
ing, roaring and impaired deglutition, and a constant threat of
secondary abscess or septic infection. Even the dense fibroid

58

Supra-Pharyngeal (Retro-Pharyngeal) Abscess. 59

tissues may soften and degenerate and the pus may make its way
spontaneously to the pharynx, or less frequently through the
skin of the parotid, or intermaxillary region, or into the cesopha-
gus or larynx. A fistula of the pharynx opening externally and
allowing the escape of alimentary matters has been often noticed.
These are especially liable to follow puncture of the abscess.

Among the less common sequele are fistula of the cesophagus ;
purulent pneumonia in connection with the purulent dissection of
the cesophagean walls and rupture into the chest (Fichet, Schnei-
der); ulceration of the blood vessels in the cow (Jonge); adenitis
and lymphangitis of the neck, and the thoracic glands, followed
by pericarditis and pleurisy (Cadeac); multiple embolic abscesses
of internal organs (Dieckerhoff); compression and degeneration
of the vagus nerve, with consequent respiratory and digestive
troubles (Baudon); and compression and obstruction of the jug-
ulars with passive congestion of the brain and vertigo. (Dela-
motte, Debrade). Even when the abscess opens into the pharynx
the orifice is usually small, the pus escapes imperfectly, and food
materials enter and the fistula may thus persist for a length of,
time. ‘The same imperfect discharge is liable to take place with
an external orifice and the pent up pus becomes inspissated,
caseated and even calcified.

Diagnosis. Supra-pharyngeal abscess is to be distinguished
from pus in the guttural pouches, by the lack of coincidence of
the discharge with the dependence of the head in grazing, eating
roots or drinking from a bucket; by the absence of the inter-
mission when the head is elevated ; and by the fact that the dis-
charge is less frequently limited to the one nostril. The hearing
too is less likely to be affected.

Treatment. As soon as the presence of pus can be recognized
it should be evacuated. This is often attempted through the roof
of the pharynx, but with such an opening there is always danger
from the entrarice and decompositson of alimentary matters. If
fluctation can be felt externally, it is better to be opened through
the skin. The integument may be incised with a lancet, and the
tissues further penetrated by manipulations with the finger nail,
a grooved sound or the point of closed scissors. In this way
the vessels and nerves are pushed aside and the dangers of
hemorrhage, fistula and paralysis avoided. The cavity must be

60 Veterinary Medicine. q

irrigated with an antiseptic solution (carbolic acid 3:100; or
acetate of aluminum 1:20).

PSEUDOMEMBRANOUS (CROUPOUS) PHARYNGITIS.

False membranes not due to a common microbian cause. Accessory
causes in solipeds; caustics, smoke infection. Lesions; Congestion, ne-
crosis: croupous exudate, extending to patches on bowels and bronchia ;
kidney infarctions; blood altered. Symptoms: fever, dyspnoea, mucous
rattle in throat, swelling, painful, difficult deglutition, yellow or cyanotic
mucosz, pinched face, weakness, prostration. Duration. Diagnosis. Treat-
ment, as for catarrhal pharyngitis with antiseptics by inhalation and elect-
uary. Iron.

Pharyngites attended by the formation of false membranes are met
with in all the domestic animals and may be grouped together
as a special class. The collection of these in one group, however,
must not be taken to imply that all of these, as met with in the
different animals have the same pathology, and are due to one
invariable cause. Above all it must not be inferred that they are
identical with the malignant diphtheria of the human being.
The bacillus diphtherize hominis isolated by Klebs in 1883, and
proved pathogenic by Loffler in 1884, has not been successfully
inoculated upon any of the larger domestic animals, and has not
been found in any of the casual pseudomembranous pharyngites
of these animals. The common feature of the group is to be
found in the formation of the false membrane, and the fact thata
given disease is placed in the group must not be held to apply to
any special character, of microbian origin, nor communicability
by infection.

PSEUDOMEMBRANOUS PHARYNGITIS IN SOLIPEDS.

Cases of ‘pharyngitis with false membranes have been seen in
horses by Delafond, Targue, Rey, Bouley, Riss, Sonin, Robert-
son, Dieckerhoff and Schneidemitihl.

They have been attributed to various causes, as caustic alkalies
and acids, the smoke of a burning building (Bouley, Rey, Riss),
to an infection which operated on dogs and horses (Robertson),
to bacteria and other irritants.

Lestons. ‘The mucous membrane of the mouth, pharynx and
even the nares presents active inflammation with branching red-
ness, petechize, circumscribed foci of necroses, and false mem-
branes of a grayish, yellowish, reddish, greenish or blackish
color. ‘These are formed of a pellicle consisting mainly of fibrine
and epithelium, pus globules and numerous cocci, and ovoid
bacteria. The false membranes have been found on other parts
of the intestinal canal (colon, caecum).; and broncho-pneumonia
and pulmonary dropsy have been concomitants. The effect of
the toxic products is seen in hemorrhagic inflammation and in-
farctions of the kidneys, and in a black color of the somewhat
diffluent blood.

Symptoms. Besides the usual phenomena of pharyngitis,
‘there is intense hyperthermia (105°-106°), hurried breathing
threatening suffocation, painful cough roused by the slightest
pressure on the swollen throat and often causing the discharge
from the nose of shreds of false membrane. Auscultation of the
pharynx gives a loud gurgling sound. Deglutition is very diffi-
cult and painful, liquids and even solids being rejected through
the nose. The face is pinched and anxious and the mouth is
often held open and the tongue pendant. Weakness and prostra-
tion are marked symptoms from the first, and the walk may be
unsteady and swaying. The visible mucous membranes are con-
gested and usually have a more or less deep tinge of yellow.
The disease makes rapid progress and may prove fatal under six
days. When it takes a favorable turn, recovery and convales-

cence may be equally prompt.
Unless the expectoration of false membrane is detected, such

61

62 Veterinary Medicine.

cases are difficult of diagnosis, though a fair inference may be
deduced from the extreme severity of the symptoms, and the un-
usual degree of prostration which is present. Whena pharyngeal
speculum, passing through the nose, can be availed of, it may
become possible to reach a more definite conclusion.

Treatment. Beside the measures advised for catarrhal pharyn-
gitis (poultice, counter-irritants, laxatives, antithermics, alkalies,
etc. ), the main reliance must be placed on antiseptics. Persistent
inhalations of warm water vapor with carbolic acid, creolin, tar,
lysol, camphor or sulphurous acid are in order: also a mixture of
one or other of these agents or of boric acid, bisulphite of soda,’
or salicylic acid in honey or molasses to be frequently smeared
on the teeth. One of the best agents is the saturated solution
of chlorate of potash in tincture of muriate of iron, of which a
drachm may be added to three ounces of water and given every
hour or two. Calomel may be injected through the nose during
inspiration, by means of an insufflator, care being taken not to
exceed the physiological dose. Applications may be carefully
made on a bent staff as advised under catarrhal pharyngitis.

PSEUDOMEMBRANOUS PHARYNGITIS IN CATTLE.

Most common in calves. Inoculations successful on rabbits, mice and
sheep. Bacillus: its cultural characteristics. Predisposing causes. Symp-
toms: nasal mucosa congested; false membranes; snuffling, wheezing
breathing ; painful, rattling cough ; agonized expression ; salivation ; bowel
disorder. Course. Duration. Lesions : intensecongestion and false mem-
branes. Treatment: as for horse ; special antiseptics ; solvents ; anodynes ;
tracheotomy.

This has appeared especially in calves, and though apparently
readily transmissible among the young, it rarely attacks aged
cattle. Cadeac and others inoculated it on guinea pigs and rab-
bits without success. Dammann, on the other hand, had his
inoculated rabbits die in twenty-four hours with hemorrhages in
the seat of inoculation. Loffler inoculated it hypodermically on
mice and produced extensive infiltration of the entire walls of the
abdomen, and often of the peritoneum including the surface of
the liver, kidneys and intestines, on which was formed a thick,

Pseudomembranous Pharyngitis in Cattle. 63

yellowish exudate containing the microbe. Dammann claimed to
have successfully inoculated the sheep as well.

Causes: Microbe. Uoffler found in the deeper layers of the
exudate a long delicate bacillus, five or six times as long as
broad, and about half the thickness of the bacillus of malignant
oedema. Several bacilli were usually joined so as to form long
filaments. These failed to grow in nutrient gelatine, or sheep
blood-serum, but grew readily in the blood-serum of the calf.

Beside the specific microbe Cadeac enumerates as predisposing
causes : sudden chills, rapid changes of temperature suppression
‘of perspiration, inhalation of irritant gases, swallowing of irri-
tant liquids, and traumatic injuries.

Symptoms. ‘The nasal mucosa is violently congested, reddened,
thickened, and covered at intervals by false membranes which
block the normally narrow passages and produce snuffling,
wheezing, and dificult breathing. The throat is swollen, and
tender, the slightest touch producing a painful gurgling cough
which leads to the discharge of muco-purulent matter, shreds of
false membrane and even blood. These membranes may be seen
on the nose or mouth. ‘There is high fever, rapid, small pulse,
cyanosed mucous membranes, pinched countenance, and usually
open mouth, pendant tongue and drivelling saliva. There may
be either constipation or diarrhcea.

The course of the malady is rapid, death sometimes super-
vening in 24 to 48 hours. Recovery and convalescence may be
prompt, or the disease may last for weeks.

Lesions. ‘The congestion is intense and may invade the mouth,
nose, pharynx, larynx and bronchia, with at intervals the patches
of yellowish white false membranes. These may be soft and
diffuent when recent, and tough and resistant when of longer
standing. The deeper layers are often blood-stained. Preitsch
has seen them extend to the gullet, paunch and manifolds, and
attended with considerable ulceration of the subjacent mucous
membrane.

Treatment. This does not differ materially from that recom-
mended for the horse. Among the additional antiseptics em-
ployed have been, iodoform, oil of turpentine, sulphide of cal-
cium, silver nitrate and coal tar. To loosen and detach the false
‘membranes ipecacuan and sulphates of soda and magnesia have

64 Veterinary Medicine.

been largely resorted to. Papayin and pepsin might be tried.
Also as anodynes digitalis, morphia, aconite and belladonna.
Finally tracheotomy has been employed when asphyxia seemed
imminent.

PSEUDOMEMBRANOUS PHARYNGITIS IN SHEEP.

Cause: infected dust on susceptible subject; inoculation. Symptoms:
movement of jaws; frothy lips; salivation ; viscid nasal discharge ; diffi-
cult swallowing and breathing ; swollen tender throat; extended head,
anorexia ; cyanosis ; open mouth ; cough expels shreds of false membrane ;
asphyxia. Lesions. Treatment: Glauber salts or muriatic acid in water ;
antiseptic fumigation and drinking water ; antisepsis of the pharynx.

Roche-Lubin speaks of this disease as common in flocks, as
the result of moving them around for twenty-four hours in a
narrow enclosure covered with dust which is raised in a cloud
and settles in the fleece so as to increase its weight. The fever
and excitement caused by the constant driving and the local
action of the infected dust on the respiratory mucous membrane
is said to bring about the intense exudative inflammation. It
has been seen especially in the spring in young lambs shortly
after weaning. Dammann claims that he transmitted the disease
to sheep by inoculating the diphtheritic exudate of the calf.

Symptoms. ‘There were constant movements of the jaws, with
the accumulation of frothy saliva round the lips or the drivelling
of this secretion from the mouth, the discharge of a viscid white
material from the nose, difficulty of deglutition, hurried, panting,
snuffling breathing, swelling and tenderness of the throat, and
the occurrence of cough aud the discharge of mucopurulent
matter whenever it was pressed. The head and neck are held
rigidly extended, the eyes are dull or glazed, the appetite is com-
pletely lost, the mucosz red and cyanotic and the animal weak
- and unsteady upon its limbs. By the third or fourth day respi-
ration has become so difficult that the mouth is held constantly
open, the tongue protruded and the painful convulsive cough
leads to the expulsion by the nose and mouth of shreds of false
membrane. Careful examination of the nose or of the fauces
may detect the grayish or yellowish patches of false membrane
at an earlier stage. Death by asphyxia is common.

Pseudomembranous Pharyngitis in Swine. 65

Lesions do not differ materially from those seen in the calf.
The inflammation and pseudomembranous exudate may extend
as far as the trachea and bronchia in which case the indications of
death by asphyxia are clearly marked.

Treatment is the same as for the calf. Tepid drinks slightly
acidified with muriatic acid, or the addition to the drinking water
of one pound of sulphate of soda to every fifty sheep has been
especially recommended. Fumigation with sulphurous acid or
chlorine is easy of application in flocks. As alternatives for ad-
dition to the water may be named hyposulphite or bisulphite of
soda, borax, carbolic acid, or spirits of turpentine. For treat-
ment individually swabbing the throat with antiseptics and dilute
caustics, electuaries and hot poultices to the throat may be tried.

PSUEDOMEMBRANOUS PHARYNGITIS IN SWINE.

Prevalence in herds, in close pens, and in young. Relation to swine
plague and hog cholera. Symptoms: sore throat, prostration, hoarse
cough, yellowish discharge with shreds of false membrane, pellicles on
mouth, fauces, tonsils. Diagnosis from swine plague. Treatment : Isola-
tion, disinfection, antisepsis to throat, febrifuges.

This has long been recognized as a contagious affection, oc-
curring especially where the animals were kept in herds and too
often in close and filthy pens. ‘These are more liable in youth
than in maturity, partly no doubt because the older animals have
already suffered and attained to an immunity. Modern observa-
tion has shown that pharyngitis with formation of false mem-
branes is especially common in swine plague, and the present
tendency is to refer all such cases to that category. It is however
altogether probable that the occurrence of local irritation with
the addition of an irritant or septic microbe altogether distinct
from those of swine plague or hog cholera, gives rise at times to
this exudative angina. Certain it is that septic poisoning with
the food is not at all uncommon in the hog, in the absence of
these infectious diseases.

The symptoms are those of severe sore throat with profound

5

66 Veterinary Medicine.

prostration, a hoarse, painful cough, a yellowish discharge from
nose and mouth, and great muscular weakness. The base of the
tongue, tonsils and soft palate are red and tumid with here and
there grayish or yellowish patches of false membranes. The
identification of swine plague may be made by the history of the
outbreak, the number of animals affected, the tendency to pul-
monary inflammation, the enlarged lymph glands, the presence of
the non-motile bacillus which does not generate gas in saccharine
media, and which readily kills rabbits and Guinea pigs with
pure cultures of the germ. ‘

Treatment will depend largely on the nature of the attack—
swine plague or simple pseudomembranous infection. Isolation,
cleansing and disinfection will be demanded in both cases. In
swine plague all additional precautions to prevent its spread must
be resorted to. In the simpler exudative inflammations the anti-
septic local treatment and general febrifuge measures will be
demanded.

PSEUDOMEMBRANOUS PHARYNGITIS IN DOGS.

Relation to diphtheria in man and horse. Symptoms: fever, prostration ;
swollen throat ; cough ; vomiting ; false membranes on fauces and tonsils ;
cyanosis. Treatment: local antisepsis ; febrifuges.

Rossi and Nicholski claim that dogs contract diphtheria by
swallowing the excrements of diphtheritic infants, but these
observations lack confirmation, and the infrequency of such an
occurrence argues against it. Robertson records cases of canine
angina with false membranes occurring at the same time as a
similar affection in the horse. The victims were puppies and the
mortality was high. Exact observations are, however, lacking.

The symptoms were dullness, prostration, anorexia, a hard
cough, swollen throat, vomiting, diarrhoea, and the presence of
grayish or yellowish false membranes on the fauces and tonsils.
The breathing was difficult and painful and the mucosze cyanotic.

Treatment has been essentially local, consisting of swabbing
with solution of boric acid (1:200), chlorate of potassa, per-
chloride of iron, or nitrate of silver.

PSEUDOMEMBRANOUS STOMATITIS OF PIGEONS
AND CHICKENS.

Contagious and destructive nature of the disease. Mode of extension
from the mouth and pharynx. Causes: bacillus diphtheriz columbarum ;
its characters : pathogenesis to birds, mice, rabbits, Guinea pigs ; dogs, rats,
and cattle immune ; diagnosis from bacillus diphtherize. American disease.
Incubation. Symptoms : prostration ; wheezing breathing ; sneezing ; diffi-
cult deglutition ; false membrane on fauces; necrotic changes in mucosa ;
perforations ; lesions of internal organs ; blood infection ; nostrils stuffed ;
bill gapes ; lesions on eye, tongue, gullet, crop, intestine ; diarrhoea ; vomit-
ing. Skin lesions. Course, acute, chronic. Paralysis. Mortality. Prog-
nosis. Diagnosis from coccidiosis, from croupous angina of Rivolta, from
aspergillus disease. Treatment : isolation ; destruction of carcases ; hatch-
ing ; destruction of dead wild birds and rabbits; exclusion of living ; quar-
antine of new birds ; disinfection ; locally, antiseptics by inhalation, swab-
bing, and internally, iron in water.

This affection prevails in certain countries and causes heavy
losses among young pigeons, so that it might with great propriety
be included among animal plagues, which should be dealt with
by the State. The malady is a local inflammation leading to the
formation of false membranes and its usual course is to progress
from the mouth and pharynx, to the nasal passages, lachrymal,
ducts and sacs, the larnyx, trachea, bronchia, intestines and skin.

Causes. The essential cause of the disease is held by Loffler
to be the bacillus diphtheria columbarum, which is a short bacillus
with rounded ends, a little longer than the bacillus of fowl
cholera and not quite so broad. It is usually found in irregular
clusters, especially in the interior of the hepatic capillaries. It
is zerobic, non-motile, non-liquifying, and grows on nutrient gela-
tine, blood serum or potato. In gelatine it forms a white surface
layer, and spherical colonies along the line of pnncture, which
show a yellowish brown tint under the microscope. On blood
serum and potato it forms a grayish white layer,

Pathogenesis. ‘The bacillus is inoculable on other pigeons and
as it usually appears in the young birds in the nest, still fed by
the parent bird, it is probable that no inflammation nor abrasion
is necessary to make it take. Pure cultures inoculated in the
mouth gave rise to the usual local type of the disease. When
inoculated subcutem it caused a local necrotic inflammation.

68 Veterinary Medicine.

In mice subcutaneous injections proved fatal in five days with
general dissemination ofthe bacillus. There are congested and
hemorrhagic spots on the lungs, enlarged spleen, and the liver is
marbled by numerous necrotic white masses, in the centre of
which the capillaries are found to be blocked with the bacilli.
This is so pathognomonic that Loffler looks on the inoculation of
mice as the best means of diagnosis.

Inoculated rabbits showed inflammation in the seat of inocula-
tion and sometimes fibrinous peritonitis and enlarged spleen.

Inoculation on the cornea produced a false membrane.

In Guinea pigs induration and ulceration occurred in the seat
of inoculation but recovery followed in 14 days.

Sparrows inoculated in the pectoral muscles died in three days
with yellowish necrotic tissue highly charged with bacilli.

Inoculation of the chicken by Loffler and Megnin produced
a circumscribed redness which soon disappeared. On the other
hand Krajewski, Colin, Loir and Ducloux seem to have inocu-
lated chickens successfully, and Cadeac says that the cultures
are infecting for sparrows, pigeons, turkeys, chickens, and
ducks. It rests uncertain therefore whether the pseudomem-
branous pharyngitis of hens is a distinct disease as alleged by
Loffler and Megnin or if the chickens used by these observers
were not already immune by reason of a prior attack.

Loffler’s experiments showed that dogs and vats were immune.
Loir and Ducloux failed to infect cattle.

In infected dove-cots a comparative immunity is attained by
the older pigeons, which continue to harbor the germ, but do not
suffer materially from its presence. They however communicate
it to the susceptible young in the milky secretion produced in the
crop and with which they feed them, and these accordingly perish
in large numbers. Thus pigeons that are themselves in fine condi-
tion become the propagators of the bacillus to the more impressible.

Sparrows and other small birds are also held to be common propa-
gators of the germ, and if they too can secure an individual
immunity and yet harbor the bacillus, their passage from yard to
yard may be attended with great danger. The grains soiled by
their bills and not swallowed are common media of transmission.

Loir and Ducloux found the affection transmissible between
man and pigeon. The identity of the bacillus with that of

Pseudomembranous Stomatitis of Pigeons and Chickens. 69

genuine diphtheria in man appears to have been thoroughly dis-
proved by the observations of Roux and Versin.
The following differential characters have been noted :

Bacillus Diphtheria ( Klebs-Léfiler).| Bacillus Diphtherie Columbarum.
1. In gelatine cultures grows only|1. In gelaiine cultures grows at 15-
above 23° C. 17°C.

2. Kills Guinea pig and dog. 2. Guinea pig and dog nearly im-
mune.

3. Mice immune. 3. Mice usually die with hepatic
necrosis.

4. Does not grow on potato. 4. Grows luxuriantly on potato.

It may be accepted as demonstrated that the common diphtheria
of birds is essentially distinct from the genuine diphtheria of man,
and that when such diphtheria of the bird is conveyed to man as
has been often alleged (Richter, Gips, Bonig, Gerhart, etc.),
it is one of the forms of pseudo diphtheria that is produced, and
not that which is caused by the Klebs-Loeffler bacillus. Dr. V.
A. Moore, who has cultivated specimens of the bacillus diphtheriz
columbarum obtained from Germany, considers the germ as
belonging to the group of the bacillus coli communis, and as not
the cause of the chicken diphtheria in America, Further inves-
tigation must settle whether the bacillus diphtherize Columbarum
is the one cause of this affection in Europe, and what is the
microbian cause or causes of the disease in America.

Extensive investigations by Dr. W. B. Mack, of this college,
show that special conditions, not yet clearly defined, are neces-
sary for infection from bird to bird.

Incubation. This is very variable. False membranes may
form in twenty-four hours in some cases; in other cases they
may be delayed from four to fourteen days (Colin, Babes,
Puscarin, Marinescu).

Symptoms. There is dullness, prostration, sunken head, ruf-
fled feathers, altered hoarse voice, drooping wings, wheezing
breathing, difficult deglutition, sneezing, and patches of dark red
congestion in the fauces covered with a thin film, at first translu-
cent, but soon becoming dense, adherent, opaque, whitish or
yellowish. As it becomes older this deposit becomes granular,
wrinkled, dry and friable. It is more adherent in chickens than
in pigeons and causes bleeding when detached. Necrotic changes
may take place in the mucosa leading to considerable loss of

70 Veterinary Medicine.

tissue, and even to perforations of the soft palate, pharynx or
cesophagus. It may remain circumscribed by the region of the
mouth and end in an early recovery, or it may extend to the
organs of the chest and abdomen, or the germs may proliferate
largely in the blood and induce fatal results. On the other hand
it may become subacute or even chronic, and, as already noted in
the case of the parent pigeons, it may persist as an infecting
disease without materially injuring the general health of a
comparatively immune animal.

The affected zasal passages become filled by frothy liquid and
blocked by false membranes, so that the bird is driven to breathe
through the open mouth. The skin around the nares, and eye-
lids and the cavity beneath the eye may be covered with the false
membrane, by the increase of this product the bones may be
driven out of place, so that the palatines press downward, the
eyeball is pressed outward and the root of the beak may seem
swollen. ‘The false membranes that form on the skin or reach
the surface are soft, creamy, cheesy, or dry, granular and friable.

When the eye is specially affected there are swelling of the
lids, profuse lachrymation, closure of the lids by adhesion, and
formation around their borders or on their inner surface and on
the membrana nictitans of false membranes which press the lids
outward more or less unevenly, and may be easily recognized
when the lid is everted. ‘The cornea and even the interior of the
eye may suffer, leading to perforation, internal tension, and in
some cases atrophy, with permanent blindness.

The songue may suffer on the tip as in zp, or on its dorsum,
from which the disease extends to the larynx, trachea and even
the air sacks, which become filled with false membranes, that are
coughed up, and decomposing in the mouth, add to the infection
and fcetor. Dyspncea and cyanosis of comb and wattles are
marked features.

The extension may take place downward along the alimentary
track, the false membranes forming on the gudlet or crop and in-
terfering with swallowing or digestion, or on the zzfestine and
determining a fcetid, often greenish or bloody diarrhcea with
indications of false membranes. Vomiting may be a marked
symptom. =

The skzz is usually attacked secondarily around the margin of

Pseudomembranous Stomatitis of Pigeons and Chickens. 71

the beak, the eyelids, the nares, the ears, the comb, the wattles,
the anus, but it may develop at any point where the infecting
material has touched an abraded surface.

Trinchera found that in acute cases the acme was reached in
fifteen days after which improvement might be looked for. A

chronic form affecting the gullet might however persist inde-
finitely in pigeons without proving incompatible with good health.

Paralysis of the wings or limbs may remain after the healing
of the local lesions.

Mortality. Prognosis. The disease is very fatal to both
pigeons and chickens, 50, 70 or even 100 per cent. perishing
when a flock is attacked for the first time. In flocks that have
previously suffered, on the other hand, a large number are prac-
tically immune, and even if they contract the disease it assumes
a mild form, and they survive but may retain the germ and con-
tinue to communicate it to others. Even the young of such
immune flocks suffer less severely, coming as they probably do
from less susceptible and therefore surviving birds, or having
already perhaps contracted a mild (non-fatal) type of the disease
from their parents.

Differential Diagnosis. From psorospermosts (coccidiosis) it is
distinguished by its origin on the mucous membranes, and not on
the skin, the skin lesion being a secondary one. In psorosper-
mosis the primary lesion is usually on the skin, from which it
extends to the mouth and especially along its floor. In psoro-
spermosis the morbid deposit assumes the form of rounded warty-
like masses, on comb or wattles ; is easily propagated by inocula-
tion, is promptly checked by antiseptics, does not tend to produce
internal extension nor generalization, and on microscopic exami-
nation shows numerous spheroidal coccidia intermingled with the
epidermic cells and possessing amceboid movement. By virtue
of this automatic movement they make their way between and into
the epidermic cells in which they multiply.

From the croupous angina of Rivolta it is distinguished by the
absence of the infusoria (monocercomonas gallinze) to which he,
Delprato and Pfeiffer attributed that affection. The monocerco-
monas is a flagellate organism 14 » to 25 » in length and 5 » to
7 in breadth. Its rounded end bears one flagellum as long as
the body, and its acute end three flagella which give it active

73 Veterinary Medicine.

motions. ‘These are found in the yellowish white swellings of
the mucosa, which vary in size from a millet seed to a pea,
covering a hyperzemic spot and composed of epithelial cells, blood
globules—white and red,—leucocytes, granules and the infusoria.
The false membrane is remarkable for its lack of consistency and
its tendency to invade the mouth and gullet rather than the air-
passages. These infusoria are not colored by picrocarminate of
ammonia, but stain by methyl-violet and then appear as round or
slightly irregular hyaline bodies.

From aspergillus disease of pigeons, by the absence of the
characteristic miliary, white nodule of that disease showing
caseated contents intermixed with an abundant mycelium of
aspergillus fumigatus. The aspergillus disease attacks especially
the mouth but may also implicate the gullet, lungs, liver, in-
testine and kidneys. The microscopic examination of the exu-
date is conclusive, by reason of the presence of the bacillus diph-
theriz columbarum, and the comparative absence of the fila-
mentous mycelium.

Treatment. ‘This is mainly prophylactic. The first step must
be to separate the sick and healthy, destroying the former, or
shutting them up in a special enclosure apart from all other birds.
In the case of valuable chickens, their eggs may be set under
other hens and the young raised apart from the suspected flock.
This may even be attempted in pigeons, the common eggs being
removed and the valuable ones put in their place under a healthy
sitting dove. In the case of pigeons that have been recently
through the disease they should be kept strictly by themselves,
even though they may appear to have regained perfect health.
The dead bodies must be burned or deeply buried. Sparrows and
even rabbits dying in the vicinity must be similarly disposed of,
and where the disease prevails sparrows and small birds may be
exterminated as probable bearers of infection.

The purchase of strange birds must be carefully guarded, none
being taken that show weeping eyes, nasal discharge, labored or
wheezing breathing, and all new birds should be placed by them-
selves in quarantine for ten to fifteen days. Finally a thorough
disinfection of the place where the sick have been is of first im-
portance. ‘Thorough cleaning of the poultry house, followed by
a coat of white-wash, every gallon of which contains four ounces

Chronic Pharyngitis. 73

of chloride of lime, or one drachm of mercuric chloride will
usually prove effective. The poultry runs should be liberally
sprinkled with a solution of sulphuric or hydrochloric acid, one
part to 1000, The same may be used on the building, which
may further be fumigated by burning sulphur.

Poultry shows should be kept under the most rigorous sanitary
supervision.

Curative treatment is only profitable in the case of specially
valuable birds, and even then only, as a rule, when the disease is
confined to the nose, mouth, larynx and pharynx. ‘The affected
parts may be brushed with a solution of chloride of iron (1 dr.
of the tincture to 1 oz. water), nitrate of silver (2 grs. to 1 oz.
water), sulphide of calcium (% dr. to 1 oz. water), tannin (10
grs. to1oz.). Tincture of iodine may be applied direct, or a
solution.of carbolic acid or of creosote or creolin (1 part to 50)
will often succeed. Thomassen recommends the removal of the
false membranes and the application of boric acid followed by dry
sulphur. Benoist says the majority recover when made to inhale
the fumes of oil of turpentine evaporated at a gentle heat twice
a day.

As internal medication, or to correct the intestinal affection,
sulphate of iron may be dissolved in the drinking water or
salicylic acid may be given in pill form with molasses.

CHRONIC PHARYNGITIS.

Sequel of acute; or sub-acute from the first. Due to cestrus, in cattle
to summer catarrh, tubercle or actinomycosis. Lymphatic horses predis-
posed ; attends chronic indigestion ; inswine tonsilitis. Symptoms : chronic
cough, easily roused, wheezy or mucous ; nasal discharge ; low condition ;
lack of spirit. Lesions: congestion ; softenings ; erosions ; cicatrices ; ton-
silitis ; abscesses ; specific deposits. Treatment: hygienic ; antiparasitic ;
astringent ; antiseptic ; derivative ; counter-irritant ; tonic inhalations and
electuaries. Bitters. Iron.

Causes and Nature. Chronic pharyngitis in animals may be a
simple continuation of the acute, ina milder form, or it may
assume a subacute or chronic type from the first aid never rise
to the intensity that would characterize the acute. It may be
a simple catarrhal affection or it may become more or less follicu-

74 Veterinary Medicine.

lar or glandular. Again in horses it is not infrequently a result
of the hibernation form of the cestrus (bot) attached to the
delicate pharyngeal mucosa, and in cattle from the extension of
the chronic summer catarrh, or from the local development of
tubercle or actinomycosis in the walls of the pharynx or in the
adjacent lymph glands. Horses of a soft, lymphatic constitution,
with a heavy coat, confined in close warm stalls, and which per-
spire abundantly are especially liable to the affection. It may
also be an accompaniment and result of chronic gastric indiges-
tion. In swine the affection is commonly associated with tonsilitis.

Symptoms. In many cases the main symptom is a chronic
cough which is aroused by any cause of irritation, feed, especially
dry or fibrous fodder, cold drinking water, sudden passing from
the hot stable to the cold outer air, reining in, pressure on the
throat, or sudden active exertion. If the cartilages are calcified
it may be impossible to rouse the cough by pressure. The
cough is often dry and wheezy, rather than soft and gurgling as
in the second stage of acute pharyngitis, and is repeated several
times paroxysmally. In the intervals there is more or less stertor
or wheezing, or a distinct rattle especially when the neck is
curved by drawing the nose inward. Deglutition may be inter-
fered with but this shows most with the first swallow, which in
the case of liquids may be returned through the nose, whereas
those that follow go down without difficulty. A lateral swelling
of the parts above the larynx or a bulging of the parotids is not
uncommon. Discharge from the nose of a mucopurulent char-
acter is usually present, but often so scanty as to be overlooked.
There is usually loss of flesh and lack of vigor even if the sub-
ject is well fed.

Lestons. In the simple catarrhal form the mucous membrane
of the lateral pharyngeal walls, the posterior pillars of the palate
and the back of the soft palate, is red, congested, with arbores-
cent vessels, thickening, and puckering into rugee. The epithe-
lium has lost its translucency, become opaque and granular, and
its desquamation in spots and patches may leave erosions, ulcers
more or less deep, and white drawn cicatrices. When the folli-
cles and mucous crypts are involved (follicular) they stand out
like millet seed, peas or beans, and may show ulceration or.
minute abscess. In pigs especially, tonsilitis is liable to be

Chronic Pharyngitis. 75

present, and the tonsilar follicles are filled and distended with
tenacious mucous, a caseous granular debris, or evena cretaceous
material. In the vicinity of the tonsils, minute abscesses may
exist in or beneath the mucosa.

Ulceration may be the result of tubercle, glanders, actinomy-
cosis, aspergillus, sarcoma, or some local infection, and attendant
symptoms of one or other of these diseases will guide the
diagnosis. ‘Thus in tubercle there will be the implication of the
adjacent lymph glands and usually of distant ones ; in glanders
the deposits in the nose, submaxillary lymph glands and lungs
will enable one to diagnosticate ; in actinomycosis the hardness
of the neoplasm and the presence of the yellowish tufts which
present under the microscope the concentrically arranged club-
shaped elements, will show its nature; and in sarcoma or carcinoma
the structure of the new tissue will decide its character. The
pharyngeal muscles are the seat of granular or fatty degenera-
tion or of fibroid change. Friedenreich speaks of a fold from
the vault of the pharynx which had nearly closed the passage
and had killed the horse by inability to swallow.

Treatment. Chronic pharyngitis is usually a very obstinate
affection and demands careful hygenic as well as medicinal treat-
ment. Hot, foul stables, unduly thick coats, unwholesome food,
irregular feeding, excessive meals at long intervals, overwork,
undue exposure to cold and wet, lack of sunshine or of grooming
are to be corrected. Next, the removal of mechanical irritants
such as pharyngeal bots, actinomycosis growths, etc., will be in
order. Then the use of astringents and antiseptics internally
and of derivatives externally will be demanded. An occasional
embrocation of mustard, or the application of ammonia and oil,
will often serve a good purpose, and in obstinate cases the hot
iron in points will sometimes prove effective.

Internally the inhalation of the fumes of tar, carbolic acid,
creolin, oil of turpentine, or of burning sulphur kept up con-
tinually or frequently repeated. Giving all drink in the form of
tar water will often have a good effect. Electuaries made with
boric acid, salicylate of soda, ammonium chloride or iodide,
borax, with honey, molasses, liquorice, Iceland moss, or gum
arabic will often prove beneficial. Agents that stimulate the mucosa
may follow, such as balsams of Peru or Tolu, copaiba, cubebs,

76 Veterinary Medicine.

pilocarpin, wild cherry bark, or these may be combined with the
former. Finally a course of tonics are usually of the first im-
portance ; iron sulphate, copper sulphate, arseniousacid, arsenite
of strychnia may furnish examples.

DEPRAVED APPETITE. STUMP SUCKING. PICA.
LICKING DISEASE.

Common features of group. Ruminants; depraved appetite; objects
swallowed; hair balls. Sheep eating wool in winter. Pigs eat bristles.
Puppies swallow marbles, etc., wantonly. Solipeds swallow hair, plaster,
earth, sand, and lick manger or rack. Fowls eat their feathers. Causes:
soil exhaustion, lack of lime, soda, potash, phosphorus ; relation to osteo
malacia ; granitic or sandy soils, peak, muck, causative ; digestive disorder ;
faulty food ; yearly breeding and heavy milking; constant stabling; dry
seasons. Course: chronic. Lesions, emaciation ; anzemia : serous exudate ;
catarrh of the bowels. Treatment: soil; good fodder; salts of soda, pot-
ash and lime, phosphates ; tonics; apomorphia. Wool eating; example;
digestive disorders ; emaciation. Treatment : open air; good fodder ; salts
of the bones and soft tissues ; clip nurses ; apomorphia.

Definition. We have here a class of morbid habits, which
cannot be referred to any constant lesion or group of lesions, and
which appear in certain cases to result from example and to con-
stitute nothing more than a bad habit.

Symptoms. Ruminants without any appreciable cause, lick the
clothes of their care-takers, chew and swallow articles of cloth-
ing of all kinds, bones, old shoes, gloves, socks, cuffs, collars,
small forks, pocket-knives, nails, wires, needles, coins, stones,
lumps of clay, hair, which may give rise to secondary troubles of
a more or less serious kind. Pregnant cows are especially subject
to this infirmity. The small pointed objects like pins, needles,
ends of wires, etc., which are mostly taken by accident with the
food are especially apt to be entangled in the alveoli of the reticu-
lum and make their way to the heart, with fatal effect or through
the abdominal walls creating a fistula. Hair aggregates with
saliva, mucus and phosphates, to form balls in the first two or
three stomachs. Other indigestible objects may also become en-
crusted and prove sources of irritation. Licking the skin of another

Depraved Appetite. Stump Sucking. Pica. 77

animal is doubtless at times encouraged by the taste of the salts
of perspiration, but in other cases it has all the appearance of a
mutual kind service as the cow with itching head will walk up
and present it to its fellow which rarely fails to respond to the
invitation. Stump licking is not uncommon.

Sheep shut up in the winter get in the habit of chewing each
other’s wool, thus virtually depilating their fellows and accumu-
lating wool balls in their stomachs.

Pigs when running at large eat human feces often infecting
themselves with the cysticercus cellulosa, and devour their own
or their fellows’ bristles, which form ovoid and irritating aggre-
gations in the stomach.

Puppies are proverbial for swallowing every small object that
comes in their way, coal, pebbles, marbles, leather, hair, etc.,
with the result of inducing nausea and vomiting, or more
seriously, wounds of the stomach, gastritis and enteritis. In
older dogs the habit is more likely to imply rabies.

Solipeds will lick and swallow each others hair, eat off the
hair from each other’s tails and manes, eat their clothing, lick
the wall plaster, earth or sand, and even the manger or rack.
The last named habits are usually connected with disease.

Fowls can digest almost anything they swallow, but if they
take to picking their feathers, they create serious injury to the
skin and indirectly to the general health.

Causes and Nature. In general terms it may be said that the
causes of depraved appetite are very numerous, so that the
trouble must be looked upon as a symptom of many morbid con-
ditions in place of a disease suz generis.

Heredity has been invoked as a cause, mainly, it would appear,
because the disease appears enzootically on certain exhausted
soils, or in herds kept in the same unhygienic conditions. In
such cases the real cause is usually to be found in faulty condi-
tions of soil, water, buildings, food, etc., on the correction of
which the trouble disappears. When, however, from a long con-
tinuance of unhygienic conditions, a weakness of constitution is
transmitted from parent to offspring, such hereditary debility
may be accepted as a predisposing factor.

An exhausted soil, lacking especially the elements of lime and
phosphorus, is a common cause, though by no means the only

78 Veterinary Medicine.

one. Nessler who analyzed the hay and water, furnished to
cattle suffering from this disease in the Black Forest found a
notable absence of the soda salts. In others in which osteo
malacia was the prominent symptom the lack was in phosphate
of lime as well. In the nature of things the soil that has been
continuously cropped to exhaustion is robbed of both earthy and
alkaline salts, and the animals fed on its exclusive products suffer
not only as regards the nutrition of the bone, but also of the soft
parts. Hence Trasbot says that in osteo malacia, pica is never
absent. Roloff and R6ll hold that it is the first symptom of
osteo malacia. In South Africa where the land has been cropped
with oats year after year without manure and as long as it will
bear, the disease became prevalent in the street car horses fed on
the oats, and was corrected by the addition of phosphates, or
phosphate bearing food, to the ration. In the older dairying
farms of New York which have been kept under grass for a
great length of time, and all the milk products sold off, depraved
appetite in all its forms is qnite frequent. Where the land is
originally light and sandy and naturally deficient in lime, osteo
malacia is often a concurrent disorder. ‘The two conditions may
however occur independently of each other, and especially may
pica appear alone, in keeping with the greater solubility of the
soda and potash salts and the readiness with which these can be
washed out of the soil, while the less soluble lime salts in part
remain. :

Lemcke, Haubner and Siedamgrotzky attribute the disease to
a nervous disorder. Lemcke indeed traces the disorder to a lack
of phosphorus, and claims that osteo malacia only supervenes
where the rheumatic diathesis is also present.

It may be shortly stated that the disease prevails especially on
granitic or sandy soils, or on those which are mainly composed
of organic debris (peat, muck). Limestone soils and those
which contain any considerable proportion of potash or soda are
usually exempt.

Digestive disorder though starting from a different point may
tend to the same end. A hyperacidity of the stomach has been
observed to coincide with the malady, and by interfering with
easy and normal digestion, it may stand in the way of such
assimilation as is necessary to vigorous health.

Depraved Appetite. Stump Sucking. Pica. 79

Faulty food operates in a similar manner. /The exhausted
soils, and their products deficient in alkaline and earthy salts
have been already referred to; we must also note the evil effect
of fibrous fodders, the main nutritive elements of which have
been washed out by intemperate weather after they were cut, the
rank aqueous products of wet or swampy soils, the fibrous and
siliceous plants (rushes, carex, equisetums, etc.) which grow on
poor, wet or soured soils, the innutritious and fermented products
of beet sugar factories, and generally the spoilt food which has
undergone fermentation.

Yearly breeding and constant milking, by undermining the
general health, predisposes so strongly that in many cases the
affection is seen in dairy cows, while oxen and young cattle
escape. The last period of gestation when the demands for the
growing calf are greatest, is the period of especial danger.

Permanent stabling which denies the invigorating influence of
sun, exercise and pure air contributes toward the general debility
and therefore, in animals that are closely stabled for the winter
the spring is especially to be feared, when compulsory inactivity,
poor feeding, gestation and milking have combined to reduce the
system.

Dry seasons have been noticed to increase the affection, mani-
festly by reducing the supply of food.

Course. The affection is chronic and unless arrested by the
supervention of more favorable conditions, may last for a year or
more. Spontaneous recovery may set in when turned out to
pasturage and open air life, and especially if a rich grain feeding
is added. Without change in the conditions, however, the ten-
dency is to a fatal result.

Lesions. 'The victims of the disorder are emaciated, the fatty
tissue contains a yellow serum, there is little blood, and that is
thin and watery and coagulates loosely, the muscles are pale and
flabby, and the gastro-intestinal mucous membrane is the seat of
catarrh.

Treatment. To treat rationally and successfully we must adapt
the measures to the obvious causes. When the soil has been
sscourged and exhausted, a change of pasture, and of land to be
used for hay or soiling crops is the first consideration. If these
cannot be secured then grain and seeds rich in protein, and alka-

80 Veterinary Medicine.

line and earthy salts should be added to the ration. Wheat bran,
middlings, peas, beans, cotton seed meal, linseed meal, rapecake,
may be named among available resorts, or in their absence, daily
doses of phosphate of lime, and sodium chloride or bicarbonate,
or potash salts may be allowed, or even bone dust.

If imperfect digestion is a manifest factor, sodium chloride, or
potassium chloride, calcium phosphate, iron and bitters will serve
a good end. In hyperacidity, limewater, chalk, or magnesia may
be given. If the digestion is torpid, hydrochloric acid with bit-
ters may be resorted to.

Feser and especially Lemcke strongly recommend apomorphia.
It is used hypodermically in doses of 2 grains for horse or cow
repeated daily for three days. :

Secondary Symptoms in Wool-eating Lambs. Lambs.
from two to six weeks old, especially such as suck ewes with
woolly udders (merino, Cotswold) first swallow the wool inad-
vertently, and then acquire a liking for the saline matters in the
abundant yolk (merino), till finally the accumulating wool balls.
produce digestive and nervous disorder and a craving for the in-
dulgence. Thus the breed must be considered in estimating the
symptoms. For the same reason the wool about the hips or else-
where soiled with salts of the urine or liquid feeces prove attract-
ive to the victim. The proximity of other wool eaters is another
cause which starts others to follow the bad example. The gen-
eral conditions of debility, exhausted soil, and the absence of
alkaline and earthy salts must be borne in mind. So, too with
prolonged confinement indoors in winter, the absence of invigor-
ating exercise and the restriction of the animals (dams) to food
which is deficient in saline matters.

Beyond the mere eating of the wool and the destruction of
fleeces, the lambs do not usually suffer seriously. But if the
consumption of wool is excessive the accumulating balls of the
size of marbles in the stomach, and the blocking of the pylorus.
and small intestine, may give rise to intermittent constipations.
and diarrhceas, deranged digestion, muco-enteritis, mucous.
covered stools, loss of condition, emaciation and retarded devel-
opment.

Treatment consists first in the securing of a more healthy
regimen. This is but one of the evils of the close winter con-

Laceration of the Pharynx. 81

finement of an animal preéminently adapted to freedom and
exercise. Turning out in a wide range, especially if pasture is
available, is a prime consideration. The separation from the
flock, of the first wool eaters, will check the propagation of the
vice by imitation. Food that is defective in one or more con-
stituents must be supplemented by that which will correct the defi-
ciency. Salt, potassic salts and above all phosphate of lime or
bone meal will sometimes benefit. May recommends the separa-
tion of the lambs from the ewes except when nursing, three
times a day. Finally, Lemcke claims for apomorphia the same
curative effect as in other animals. The dose is 2 grains, sub-
cutem, as in the cow and may be repeated three days in succes-
sion.

LACERATION OF THE PHARYNX.

Trauma of pharynx from objects swallowed ; from whip or other instru-
ment in choking; lesions. Symptoms: swelling; rapidly extending;
dysphagia; salivation; retching; dyspnoea; roaring; asphyxia. Treat-
ment; as for pharyngitis ; open pouch, suture laceration ; use antiseptics ;
liquid diet.

Laceration of the velum palati has been already referred to,
and the remaining walls of the pharynx sometimes suffer in the
same way and from identical causes. Pins, needles, and other
sharp-pointed bodies taken with the food sometimes perforate the
walls and determine an advancing ulceration which furnishes a
way for their escape externally in the region of the throat. In
other cases a rigid staff, a whip, or even a probang introduced to
overcome choking, is forced through the walls of the pharynx
forming a pouch for the accumulation and septic fermentation of
ingesta, and extensive ulcerative and gangrenous lesions.

Lestons and Symptoms. These depend mainly on the extent
of the laceration. If there is a mere abrasion, superficial lacera-
tion or prick of the mucosa, it determines a prompt inflammation,
with exudation which covers or closes the wound and a speedy
healing may ensue. When, however, the whole thickness of the
mucosa has been extensively lacerated and a pouch has been
formed beneath it, it becomes filled with decomposing mucus and

6

82 Veterinary Medicine.

ingesta, and the resulting septic products determine ulceration,
abscess, or gangrene. ‘The result is too often a general and fatal
septic infection.

In the milder forms there are only the common indications of a
moderate pharyngitis. In the more severe form, the throat
swells at first on the lacerated side and later all around. This
swelling soon fills the intermaxillary space and extends over the
face and the entire head. From the first, deglutition is extremely
difficult or impossible, liquids are returned through the nose and
saliva flows abundantly from the mouth. Retching is not un-
common and saliva mixed with alimentary matters is discharged
by the nose (solipeds) or mouth (other animals). The swelling
of throat and head has a doughy, cedematous feeling, it is very
tender, and soon causes rattling, wheezing breathing, roaring,
dyspnoea and asphyxia.

Necropsy shows the general cedematous exudate, the lacer-
ation of the pharyngeal walls, and the collection of debris
and pus in the lacerated cavity. The pus may have ex-
tended between the muscles following the course of the gullet
and trachea as far asthe chest. Extensive patches of necrosis
may also be shown. TZyveatment. In the slighter cases the ordi-
nary treatment for catarrhal pharyngitis is demanded. In the
more severe, the lesions are so redoubtable and their progress so
rapid that a fatal result is virtually inevitable. As a desperate
resort the septic pouch may be opened from without, its contents
removed, the pharyngeal wound sutured if possible, and a
thorough irrigation with antiseptics (acetate of aluminium solu-
tion) employed at frequent intervals to check the septic pro-
cess. The animal should be fed with well boiled milk or other
liquid which will not add to the fermentation, and this may be
given through a stomach tube, or by the rectum when degluti-
tion is impossible.

PARALYSIS OF THE PHARYNX.

From nervous bulbar lesion, or toxic from pathogenic bacteria. Tran-
sient or permanent and fatal. Symptoms : dysphagia ; liquids expelled by
nose or enter lungs. Inhalation pneumonia. Facial palsy. Roaring,
laryngeal thrill. Atrophy. Gangrene. Treatment: remove cause; com-
bat bulbar hyperzemia and cephalic congestion ; cold ; derivatives, electri-
city ; blisters ; antiseptics.

This has been described as a rare affection, yet it is often a
marked symptom of cerebro spinal meningitis, and it has been
observed in infectious pneumonia, and influenza of the horse
(Cadeac, Palat) as well as in rabies, and traumatic injuries of the
brain.

The existence of the condition usually implies disease of the
bulb at the roots of the vagus and glossopharyngeal nerves, or
swellings affecting these nerves or the sympathetic along its
course. ‘The morbid condition may be transient in which case a
speedy recovery may follow, or it may be permanent and end
fatally.

Symptoms. Swallowing is impossible and the animal refuses
food or drink or if the latter is forced on him it is rejected by
the nose or mouth when the head is lowered or still worse, it
enters the larynx and descends into the lungs. The larynx in-
nervated by the same trunks is usually involved and the ali-
mentary solids and liquids determine gangrenous bronchitis and
pneumonia, with labored breathing, fcetid breath and violent
dyspnoea. In other cases the facial nerve is involved, the nos-
trils and lips are flaccid on one or both sides, and the eyelids and
ears may droop. There may be snuffling breathing from the
closure of the alze nasi, or roaring from the approximation of
the arytenoids and vocal cords. If the affection is unilateral the
difficulty of breathing is greatly diminished and even deglutition
may be effected with some effort. There is usually, however,
the obvious unilateral paralysis of the face, and especially of the
larynx, with the distinct thrill, during inspiration, conveyed to
the finger placed on the larynx.

Complications in the form of gangrene and atrophy of parts

83

84 Veterinary Medicine.

supplied by the same nerves, or those adjoining the pharynx,
have been recognized in different cases.

Treatment. ‘This must depend on the obvious cause of the
affection. If due to an infectious disease the first attention must
be given to that. If due to tumors or abscesses pressing on the
nerves they may be removed. If there is bulbar hyperemia
or effusion attention must be devoted to derivation and other
means of combating that. Cephalic congestion and heat may be
met by cold applications. Derivation toward the bowels may be
secured by eserine, pilocarpin or physostigmine administered sub-
cutem. Reabsorption of exudate may be sought by pilocarpin,
or diuretics—the latter administered by the rectum. Electricity
in weak current may be tried when the acute febrile symptoms
have moderated, accompanied by hypodermic injection of strych-
nia (2 grs.). Frictions around the throat with essential oils or
even acantharides blister may be used to advantage. Antiseptic
washes may be injected into the mouth,—vinegar, boric acid,
borax, sulphite of soda. Finally the animal must be nourished
by rich gruels and soups given by the rectum, or in the smaller
animals by the stomach tube.

TUMORS OF THE PHARYNX.

Varieties of neoplasms. Malignant, invade adjacent and distant parts.
Symptoms : sore throat ; stertor; dyspncea: dysphagia. In cattle, lymph-
adenoma. tubercle, actinomycosis. Cause cough, ptyalism, discharge,
foetor, dysphagia. Dogs and pigs vomit. Treatment : medical ; surgical.

Tumors of the pharynx are not common in the horse yet they
occasionally appear as either primary or secondary neoplasms.
They are of various kinds, as epithelioma (Labat, Mathis), car-
cinoma (Casper, Dupuy, Mathis), sarcoma (Siedamgrotzky,
Johne), lipoma (Fricker), cystoma (Degive) and melicerous
(Lesbre). The malignant forms tend to invade the surrounding
tissues and spread widely into the nose, palate, tongue, pharyn-
geal glands, and, secondarily, ‘into the small intestines. The
simple tumors like the lipomata and fibromata tend to detach

Tumors of the Pharynx. 85

themselves and hang by a pedicle (see pharyngeal polypi). The
same is true of the melicerous cyst which originating in an ob-
structed mucous or salivary duct projects as a mass as large as
a hen’s or a pigeon’s egg into the fauces or pharynx.

Symptoms. ‘There are symptoms of intense sore throat with
stertor continuous or intermittent, increasing to dyspnoea at
intervals or on exertion. In case of pediculated tumors these at-
tacks correspond to the displacement of the tumor into the glottis.
Deglutition is difficult or impossible, liquids or even solids re-
turning through the nose, mixed with mucus and at times tinged
with blood. Nasal discharge and ptyalism are present.

In cattle pharyngeal tumors may be of the same nature as
mentioned for the horse, but they are far more frequently lymph-
adenoma, and above all tubercle or actinomycosis. Zimmer
found that of seventy-three such tumors fifty-four were actino-
mycosis.

The symptoms are wheezing breathing, cough, nasal discharge
ptyalism, bleeding from the nose, fcetid breath, difficult degluti-
tion, attended by cough and rejection of the ingesta through the
nose, and the presence of a solid body in or on the pharynx
which may be manipulated from without or within and tends to
increase in size.

In dogs there are the same general symptoms with vomiting.
The vomited material is usually remasticated and swallowed.
The swelling in the pharynx can be felt from without, or seen
through the open mouth. The tonsils are usually enlarged.
Pressure on the pharynx or gullet produces instant regurgitation.

Treatment consists in the removal of the tumor when possible.
Malignant growths and multiple tumors are not favorable for
treatment. Actinomycosis can be treated throughout by iodides,
or these may supplement the surgical measures. In the short-
faced animals an ecraseur, or a wire-snare passed through a tube
may be employed. (See pharyngeal polypi.)

ESOPHAGITIS. INFLAMMATION OF THE GULLET.

Causes: Alimentary and therapeutic; parasitic and accidental trauma-
tisms; mechanical irritants; acrids; caustics; parasites—gongylonema,
coccidia, spiroptera. Extension inflammations. Lesions; hypereemia;
epithelial degeneration and desquamation ; erosion; petechize ; suppura-
tion ; fibroid contraction; sacculation; polypi. Symptoms: dysphagia,
difficult deglutition ; eructation ; cough ; upward wave motion in jugular
furrow ; colicy pains; probang arrested; fever. Treatment; liquid or
semi-liquid food ; for caustics, antidotes ; cold water ; ice; antiseptics ; de-
rivatives ; open abscess ; potassium iodide.

Causes. This usually arises from injury to the mucous mem-
brane and in the milder forms remains confined to this structure.
In the more severe, it extends to the muscular coat and even to
the pericesophagean tissues. The causes may be divided into
alimentary and therapeutic irritants; parasitic or accidental
traumatisms ; and extension of inflammation from the pharynx
or other adjacent part.

Among irritants taken as food, may be named hot mashes,
bolted by a hungry and gluttonous horse, and temporarily arrested
in the gullet by reason of the resulting irritation of the mucous
membrane. In other cases, coarse fibrous fodder is bolted without.
previous mastication, and scratches and abrades the cesophagean
mucosa leading to transient or progressive inflammation. In
other instances diseases of the teeth, jaws, temporo-maxillary
joint, or salivary glands prevent the necessary trituration of the
food, and it is swallowed, in a rough, fibrous, or even a dry con-
dition. Again the impaction of a solid body (turnip, apple,
potatoe, egg) or of a quantity of finely divided grain or fodder
so as to obstruct the lumen of the gullet, is an occasional cause.
The density of the epithelium reduces these dangers to the mini-
mum, yet a too rough morsel, or an undue detention of the less
irritating material will determine hyperzemia and even inflamma-
tion and infective invasion. Acrid and irritant vegetables in the
food are less injurious when thoroughly insalivated, as their con-
tact with the cesophagean walls is then very slight and transient.

[Irritant and caustic chemical agents given for therapeutic pur-
poses, attack the mouth, pharynx and stomach, more severely

86

Esophagitis. Inflammation of the Gullet. 87

than the gullet through which they are passed with great
rapidity. In some cases, however, the agent will adhere by reason
of its powdery, gummy or balsamic character and will then act as
a direct irritant. Solutions of caustic alkalies (weak lye) given
to correct acid gastric indigestion in the horse, and ammonia to
remedy tympany in cattle, when insufficiently diluted, will
dangerously attack the cesophagean mucosa.

Parasitic irritation is not so common here as in other parts of
the intestinal canal where the contents are longer delayed and are
passed with less friction, yet certain parasites are found in this
region and may even produce considerable irritation. The gon-
gylonema of the thoracic cesophagean mucosa of ruminants and
swine are apparently harmless. The psorospermia of the
cesophagean muscles of the same animals are alleged to cause
cedema of the glottis, asphyxia and epilepsy. The spiroptera
microstoma of the horse has in one instance known to us caused
extensive denudation of the muscular coat within a foot of the
cardiac end of the gullet. Finally we have found bots hooked
on to the cesophagean mucosa close to the cardia, causing much
irritation and spasm. The spiroptera sanguinolenta is often
present in chambers hollowed in the cesophagean mucosa of the
dog, and the sp. strongylina in that of the pig.

Traumatic causes appear in the form of contusions and bruises
from without, but much more frequently from foreign bodies,
and probangs operating from within. The use of a whip or of a
rope without a cup-shaped end for the relief of a choked animal.
Short of the occurrence of laceration this often produces contu-
sion and abrasion which results in local inflammation. Even the
too forcible dislodgment of a solid body by a probang of approved
pattern, may bruise and scratch the gullet when the seat of violent
spasm. Pins, needles, wire, thorns and other sharp bodies are
liable to do serious damage during their passage in an ordinary
bolus and when they transfix the mucosa violent infective in-
flammation may ensue.

Extension inflammations from the throat, and from phlegmons,
abscesses, tumors, etc. in the jugular furrow need only be men-
tioned in this connection, as the primary disease will be clearly
in evidence.

Lesions. ‘These are usually circumscribed when due to a trau-

88 Veterinary Medicine.

matic injury and extended when caused by caustics or irritants.
The affected section is swollen, and surrounded by some serous
effusion. When the muscular coat is involved it is often paler
than normal, and microscopically shows extensive granular and
fatty degeneration. ‘The mucosa usually sloughs off its epithelial
layer, sometimes over an extensive area (thoracic portion,
Renault ; whole gullet, Bertheol), and the exposed raw surface
is of a deep red or violet. When the epithelium is not shed, it is
infiltrated, swollen and friable breaking down under the slightest
manipulation. Petechiz and slight blood extravasations are
abundant, and diffuse suppuration is not uncommon. In trau-
matic injuries necrosed areas are found in the muscular and mu-
cous coats. Strictures, dilatations, and polypoid growths are
liable to follow as sequelee. .

Symptoms. ‘These usually manifest themselves from two to
four days after the operation of the cause. There is much
difficulty in deglutition, the effort to swallow either solids or
liquids causing acute suffering, with extension of the head on
the neck and strained contraction of the facial muscles. If the
liquid succeeds in passing the pharynx, it is arrested at the seat
of inflammation and regurgitated through the nose and mouth, or
in solipeds through the nose only. This takes the appearance
of emesis even if nothing actually comes from the stomach. ‘The
animal shakes the head violently, breathes hurriedly, and has fits
of paroxysmal coughing, A wave extending from below up-
ward along the jugular furrow and followed by nasal discharge
is a marked symptom, as the violence of the inflammation in-
creases. Uneasy movements of the limbs, pawing and lying
down and rising, indicate the existence of colic, and this is aggra-
vated by the administration of anodynes or antispasmodics by
the mouth. In cattle, rumination is arrested, froth accumulates
around the lips, the rumen becomes tympanitic, and colicy move-
ments appear. Oftentimes a swelling extends upward in the
jugular furrow, and even in its absence, pressure with the fingers
along the furrow will often detect an area of tenderness with or
without local swelling. Fever with more or less elevation of
temperature, is a general symptom. There may be wheezing
breathing or loud stertor. The passage of a probang is arrested
by the swelling or spasm at the diseased part and when withdrawn

Esophagitis, Inflammation of the Guillet. 89

may be covered with pus or fcetid debris. In the horse a small
probang may be passed through the nose.

Treatment. In a slight congestion at the seat of a recent
‘obstruction and which tends to renewed obstruction, little more
is necessary than to restrict the feed for a few days to soft mashes
so that irritation of the sensitive surface, spasm and the arrest
of the morsel may be obviated. Plenty of pure water or of well
boiled linseed or other gruel should be allowed.

In cases in which the obstruction is still present in the gullet,
its removal by probang or looped wire is the first consideration,
to be followed by the measures mentioned above.

In case of the swallowing of a caustic agent, no time should
be lost in giving an antidote. For the mineral or caustic organic
acids, lime water, magnesia, or other bland basic agent is de-
manded. For caustic alkalies or basic agents, bland acids,
such as vinegar, citric acid, or even a mineral acid very largely
diluted will be in order. In both these cases and in that of
caustic salts, albuminous and mucilaginous agents, eggs, linseed
tea, slippery elm, gums, and well boiled gruels are indicated.
To these may be added small doses of laudanum when the
irritation is great. Iced drinking water, iced milk, or iced
gruels are often soothing to the suffering animal, and cold com-
presses, snow or ice’applied along the jugular furrow is often
valuable. To counteract the septic developments on the affected
mucous membrane, chlorate of potash, boric acid, salol, naphtha-
lin, naphthol, pyoktannin, or even weak solutions of phenic
acid or creolin may be used. In the slighter forms of inflamma-
tion or when the acute form threatens to persist, an active
counter-irritant of mustard or cantharides may be applied along
the jugular furrow.

In case of abscess, as manifested by fluctuation following a
hard, indurated, painful swelling, a free incision should be fol-
lowed by frequent injections of antiseptic lotions or by the
packing of the cavity with such bland antiseptics as salol, boric
acid, or iodoform on cotton.

As inflammation subsides, potassium iodide may be given, both
as an antiseptic and a resolvent, to counteract the tendency to
fibroid: contraction and stricture of the gullet.

SPASM OF THE CGESOPHAGUS. CESOPHAGISMUS.

Causes : nervous disorders or lesions, pharyngeal, cesophagean, or gastric
disease, cesophagean parasites, choking, tumors, ulcers, cold drinks. Symp-
toms: extended drooping head, working jaws, frothing, pawing, attempts
at swallowing, alkaline regurgitation, cries, rigid gullet, tenderness. May
be paroxysmal with intervening dullness. Treatment: by sound; by re-
moval of obstruction ; by antispasmodics. Embrocations. Tonics.

Causes. This has been noticed as a concomitant of certain
diseases of the nervous centres, such as rabies, tetanus, or
epilepsy, and those of the pharynx orstomach. Cadeac has seen
it in connection with stricture, and the present writer has ob-
served it as a result of larvze of cestri hooked on to the mucosa
above the cardia. It is an important factor in most cases of
choking, and may depend on tumors, ulcers, or even cold
beverages. Animals with a specially nervous organization are
particularly subject to it and it may thus be an hereditary family
trait. It has been especially noticed in solipeds and calves.

Symptoms. A feeding animal suddenly ceases to eat, extends
the head on the neck, drops the nose toward the ground, moves
the jaws constantly, froths at the mouth or lets the saliva drivel
to the ground, moves the fore feet uneasily pushing the litter
under the belly, makes efforts at deglutition during which, waves
may be seen to descend along the jugular furrow, followed by
regurgitation and discharge of the liquid as by emesis. The act
is often followed by a slight cry. Manipulations of the left
jugular furrow detects the gullet as a firm, rigid cord, unless
when liquids are passing as above, and auscultation reveals a
rattling or gurgling noise as if in jerks. Pressure on the gullet
is often very painful, increasing the spasm and rigidity, and
causing the animal to cry out. Wheezing breathing may attend
the discharge of saliva through the nose, and violent paroxysms
of coughing may be caused by the entrance of this liquid into
the larynx.

In the majority of cases no food is swallowed and nothing but
saliva is disgorged, which together with the absence of an acid
odor distinguishes this from true vomiting. Inan exceptional case
of the author’s, occurring in a colt, the animal continued to mas-

go

Spasm of the Gesophagus. Csophagismus. gI

ticate and swallow green food which gradually filled the whole
length of the gullet, practically paralyzing it. In ordinary cases
a small sound can usually be passed into the stomach. In cases
of obstruction, however, by a solid morsel, or by an accumula-
tion of soft solids, the probang will enable one to detect the con-
dition. The acute symptoms may occur in paroxysms of a few
minutes in length, between which, the animal remains dull and dis-
spirited until the new attack supervenes. Recovery is at times
as sudden as the onset, though there remains, for a length of
time, liability toa relapse. Cadeac has seen a succession of such
attacks which extended over a year and a half.

Treatment. In many cases the passage of a probang or sound,
will, by the mere distension of the gullet, overcome the local
spasm, though it may be necessary to repeat the operation several
times. In case the sound causes much pain the end of the in-
strument may be well smeared with solid extract of belladonna,
and after passing this as far as the obstruction a short time may be
allowed, before its passage is again attempted. In case obstruc-
tion by soft solids has taken place, the passage of the wire loop
will serve to break up the mass and even to draw it up toward
the mouth.

The administration of antispasmodics is the next indication.
Chloroform or ether by inhalation or in solution in water, chloral
hydrate as an enema, morphia or atropia hypodermically may
be used according to convenience. Bromide of potassium and
other antispasmodics given by the mouth, too often fail to pass
the obstruction and thus prove useless, except in the intervals of
the spasms.

Fomentations of the lower border of the neck with warm water,
and frictions over the region of the gullet with camphorated spirit,
essential oils, ammonia, or in calves with oil of turpentine, often
contribute to relieve the spasm.

Finally, after the severity of the attack has passed, a course of
bitter tonics and above all, of nux vomica will fortify the system
against a relapse.

PARALYSIS OF THE GSOPHAGUS.

Causes: nervous lesions and disorders ; arytenectomy ; over distension ;
stricture ; parasites. Symptoms: dysphagia; regurgitation; cough; dys-
pncea ; hard packed gullet. Inhalation pneumonia. Lesions. Treatment:
remove cause; liquid food; dilatation; nerve sedatives and stimulants ;
electricity ; counter-irritants.

Causes. This has been noticed in a number of cases in soli-
peds, and attributed to central nervous lesions, cerebral concus-
sion (Straub), encephalitis (Hering, Bornhauser), paralysis of
the fore extremities (Meier), pharyngeal paralysis (Puschmann).
Moller has seen it several times consequent on arytenectomy,
while Dieckerhoff and Graf have seen it occur without any
clearly defined cause. In a case referred to above, the present
writer found it connected with the attachment of larvee of cestri
in the lower end of the gullet. Stricture and impaction may be
a further cause.

Symptoms and lesions. ‘There is more or less interference with
deglutition, culminating in complete inability to swallow, and the
rejection of morsels of masticated food by the nose. Cough may
also occur from the descent of food toward the lungs, with more
or less dyspnoea and oppression of the breathing. Manipulation
along the left jugular furrow, detects the cesophagus as a promi-
nent hard, rope-like mass which fills up the groove unduly.
When death occurs rapidly the gullet is found gorged with masti-
cated food throughout its entire length. In certain instances
gangrenous pneumonia is found, the result of the penetration of
food into the bronchia. In other cases there are lesions of the
medulla oblongata, or of the vagus or glosso-pharyngeal nerves
or their cesophagean branches.

Death usually results from obstruction, inanition, or, in case
the paralysis is partial, from pneumonia or exhaustion.

Treatment. First, remove or correct the existing cause of the
disease. Impaction may be broken up by the use of the wire
loop, or pincer probang ; parasites may be expelled by passing a
cupped probang ; the impactions following arytenectomy can be
obviated by feeding gruels, milk and other liquid foods only,
and from a bucket set on the ground; stricture may be dilated

92

GBsophagean Tumors. 93

by the use of graduated sounds; and nervous diseases may be
dealt with according to their specific nature in each several case.
When any definite cause of this kind has been overcome the per-
sistent use of strychnia, subcutem, or by the mouth, may be
effectual in overcoming the paresis of the gullet. Hypodermic
injections are best made along the left jugular groove, and fric-
tions, stimulating embrocations, and galvanic currents may be
employed with excellent effect.

CESOPHAGEAN TUMORS.

Forms of neoplasm in gullet of horse, ox, sheep, pig, dog. Symptoms:
dysphagia ; eructation; vomiting; bloating ; cough; dyspnoea; stertor ;
foetor ; palpitation. Treatment.

'

These have been often noticed in the lower animals. In the
horse have been noticed melanoma (Oliver, Roll, Kopp, Besnard,
Pouleau), 74roma (Dandrieu, Dickerhoff), Carcinoma (Chouard,
Lorenz, Cadeac, Laurent), epithelioma (Blanc, Lorenz),
Leiomyoma (Lucet, Lothes), cystoma (Caillau Legrand),
mucous cysts (Lucet).

In cattle papilloma is especially common, having been noted
by /Johne, Mons, Fessler, Schtitz, Lusckar, Gratia, Beck, Cadeac
and Kitt. Tubercles, and fibroid masses with cystic purulent
centres are not uncommon. Actinomycosis is also frequent,
sometimes hard and warty and at others soft and vascular.

In the Sheep, Dandrieu found between the muscular and mu-
cous coats a hard tumor as large as a hen’s egg, the removal of
which put a stop to a persistent choking. In both cattle and
sheep, swellings from coccidiosis are common ; in cattle and
swine from gongylonema, and in sheep from filaria (Harms)
or spiroptera (Zurn).

In pigs; fibroma is met with in the walls of the gullet
(Raveski) and in dogs fibroma, papilloma, and the tumors of
spiroptera.

Symptoms. ‘The coccidia and spiroptera usually cause few
symptoms or none, but neoplasms usually develop symptoms of

94 Veterinary Medicine.

obstruction, dysphagia, eructation, vomiting, and all the indica-
tions of choking according to their seat. These do not come on
suddenly and recover as in simple choking, but even though there
may be periodic obstructions, spasms and paroxysms, there is a
slow, progressive advance as the neoplasms increase. Ster-
torous or mucous breathing, cough, dyspnoea and foetid exhala-
tions are common, the symptoms may be aggravated when the
head is bent, and the tumor may even be felt on palpation of
the throat or left jugular furrow. In ruminants tympany occurs
after feeding.

Treatment is surgical and consists in the removal of the tumors
by incision and ecraseur or otherwise. Thoracic cesophagean
tumors are usually inoperable.

IMPACTION OF THE CROP. INGLUVIAL
INDIGESTION.

Gallinaceze and Palmipeds, Causes: Overfeeding after privation ; fer-
mentation ; lack of water; green food in geese and chickens; food con-
taining paralyzing element. Symptoms: dull; motionless; erect plumes ;
drooping wings and head; gapes ; ejects liquid from bill ; firm cervical
swelling. Treatment: manipulation ; incision ; surgical precautions. Con-
valescent feeding.

The cervical dilatation of the cesophagus known as the crop is
well developed in all granivorous birds, (Gallinacez, etc.;) and
like the macerating cavities of the ox (first two stomachs) is sub-
ject to overdistension and paralysis. In the palmipeds (ducks,
geese) there is no distinct crop but in its place the cervical por-
tion of the gullet has a fusiform dilatation, and under given
conditions this may be also the seat of impaction.

Causes. The impaction may result frorn overfeeding when the
bird has been starved, or when it suddenly gains access to food
of a specially appetizing kind and to which it has been unaccus-
tomed. The crop like every other hollow viscus is rendered
paretic by overdistension. Then the food undergoes fermenta-
tion still further distending the cavity, affecting the brain by

Impaction of the Crop. Ingluvial Indigestion. 95

reflex action, and paralyzing the vagus and its peripheral
branches in the lungs, heart, stomach, liver, intestines, etc.
When the food is dry as in the case of beans, peas, bran, farinas,
it may be a simple firm impaction which the muscular walls of
the crop are unable to break up or move onward. When green
food is taken there is often superadded the additional evil of
active fermentation from the great number and activity of the
bacterial ferments contained in it and the soft aqueous fermentes-
cible nature of the food (See tympany in ruminants). Dupont
states that young geese led out to fresh spring grass may lose
two-thirds of their number in a few hours from such overloading
and that some species of Carex and cynodon dactylon are particu-
larly injurious. Chickens also gorge the crop with clover, etc.
In all such cases, plants that contain a paralyzing principle like
lolium temulentum, ripening lolium perenne, chick vetch, etc.,
are to be specially dreaded. (See Trichosoma Contortum).

Symptoms. ‘There are first dullness and sluggish movements,
followed by indisposition to move, the bird standing in one place
with ruffled feathers and drooping wings, and at intervals, pro-
jecting the head forward with open beak and in some cases a
little liquid is rejected. If the bird is now caught and examined
the crop is found to be firmly distended, and more or less com-
pressible or indentible according to the nature of the food im-
pacted. In-most cases and especially if the food has been green
or aqueous, there is a certain resiliency from the presence of gas
outside the solid impacted mass.

Treatment. 'This must be in the line of seconding the physio-
logical efforts of regurgitation which is a normal and common
act in birds. The duck which has gulped a mouse half-way down
the cervical part of the cesophagus will readily disgorge it when
he finds it impossible to pass it further. The carnivorous birds
often reject by vomiting the indigestible debris such as feathers
and bones, after all the more soluble parts have been disposed of
in the stomach.. The pigeon even feeds its young by disgorging
into their open bills, the semi-digested food and milk from its
crop. Following these indications we must break up the contents
of the crop by manipulation and force them in small masses up-
ward into the bill and downward to the proventriculus. The
rejection by the bill may be further stimulated by introducing the

96 Veterinary Medicine.

finger into the fauces to rouse the reflex active emesis. Usually
the crop can be quickly and satisfactorily emptied in this way.

When this proves impossible there remains the operation of
direct incision through the walls of the crop and the evacuation
of its contents. This can be done by a pocket-knife or even a.
pair of scissors. ‘The crop is punctured in its lower part and the
incision is continued upward as far as may be necessary to allow
the escape of the contents. Usually half an inch will suffice.
Then the crop is squeezed so as to press the contents through this.
opening and it is emptied by a process of enucleation. If the
contents are fibrous it may be necessary to employ forceps to
dislodge the material. The empty crop may be washed out with
tepid water, any food attached to the raw edges of the wound
must be removed and the skin stitched accurately together.
The wound rarely fails to heal by first intention. To avoid
stretching it, the food for a day or two should be restricted to.
milk, gruels, or a little soft mash.

Lerein notices jaundice as a sequel of impacted crop, and
recommends treatment by sulphate of soda in the water.

TYMPANITIC INDIGESTION IN THE RUMEN.
BLOATING.

Definition.’ Susceptible Genera. Causes: gastric paresis, overloading.
cold, fear, exhaustion, poisons, fermentescible food,—new grain, legumi-'
nose, frosted vegetables,—rumenitis, foreign bodies in rumen, microbian
ferments. Symptoms: abdominal, general. Gases formed under different
aliments—carbon dioxide, marsh gas, hydrogen sulphide, nitrogen, oxygen.
Lesions, rupture of rumen or diaphragm, compression or rupture of liver or
spleen, petechiz, congestion of lungs and right heart, of cutaneous and
cerebral vessels. Prevention, avoid indigestible and fermentescible ali-
ments, correct adynamic conditions, tonics, avoid injurious ferments, make
alimentary transitions slowly. Treatment: exercise, bath or douche of cold
water, rubbing and kneading, rope round abdomen spirally, gag in mouth,
dragging on tongue, movement of a rope in fauces, probang, stimnlants,
antiseptics, alkalies, ammonia, oil of turpentine, oil of peppermint, alcohol,,
ether, pepper, ginger, soda, potash, lime, muriatic acid, carbolic acid, creo-
sote, creolin, sulphites, kerosene, chloride of lime, chlorine, tar, common
salt, hypochlorite of soda, magnesia, eserine, pilocarpin, barium chloride,
colchicum, lard, trochar, Epsom salts, rumenotomy. Treatmeut of diseased
gullet, mediastinal glands, stomach or intestines.

Tympanitic Indigestion in the Rumen. Bloating. 97

Definition. 'The condition is a combination of paresis of the
rumen and gaseous fermentation of its contents. ‘The initial
step may be the paresis, or in the more acute forms the fermenta-
tion.

Genera susceptible. While all ruminating animals are subject
to this disorder, it is much more frequent in cattle and sheep
than in goats.

Causes. It commences in paresis of the rumen in the weak,
debilitated, convalescent or starved animals which are suddenly
put on rich, and appetizing food. Hence it is common in
animals that break into a cornbin, a store of potatoes, a field of
growing corn Or small grain, or that are turned out on green
food in early spring. Cadeac maintains that paresis of the
rumen is the essential cause in all cases, while the nature of the
aliments ingested fills a secondary and comparatively insignifi-
cant réle. According to this view the torpid stomach can
neither relieve itself through regurgitation for rumination, nor
expel through the cesophagus the constantly evolving gas which
therefore distends the viscus to excess. In support of this view
may be adduced the occurrence of tympany through fatigue,
fear, cold, enlarged (tubercular) mediastinal glands pressing on
the gullet and vagus, obstruction of the cesophagus by a solid
body (choking), impaction of a morsel of solid food in the demi-
canal of the calf as noticed by Schauber, and the cessation of the
normal vermicular movements of the rumen in connection with

inflammation of its coats, or extensive inflammation elsewhere or
finally of fever. Even in paralysis of the stomach by poisons

like lead, tympany may be a result. Cadeac attributes tympany
following the ingestion of green food wet with a shower, or
drenched with dew, of frosted potatoes or turnips, or of iced
water, to the paralyzing action of the cold on the rumen. This
view is manifestly too extreme, as the bloating occurs often after
a warm summer shower, or after the consumption of potatoes
and other roots and tubers which have been spoiled by frost but
which are no longer at a low temperature when consumed.
Tympany may also start from the ingestion of certain kinds
of food which are zz a very fermentescible condition. Green food,
especially if the animal has been unaccustomed to it, is liable to
act in this way. Clover and especially the white and red varieties,

98 Veterinary Medicine.

lucern (alfalfa), sainfoin, cowpea and other specially leafy plants,
which harbor an unusual number of microbian ferments, and
which contain in their substance a large amount of nitrogenous
material favorable to the nourishment of such ferments are par-
ticularly dangerous in this respect. All of these are most dan-
gerous when wet with dew or when drying after a slight shower,
partly no doubt at times by reason of the chilling of the stomach,
but mainly because the ferments have been stimulated into activity
by the presence of abundance of moisture. Drenching and long
continued rains are less dangerous in this respect than the slight
showers and heavy dews, manifestly because the former wash off
a large portion of the microbes, which under a slight wetting
multiply more abundantly.

Frosted articles act in a similar way, partly when still cold by

the chilling and paralyzing of the stomach, but cold or warm, by
reason of the special tendency of all frozen vegetables to undergo
rapid fermentation when thawed out. ‘This is true of green food
of all kinds when covered by hoar-frost, of turnips, beets, pota-
toes, carrots, apples, cabbage, etc., which have once been frozen,
and of frosted turnips and potato tops, though, in the case of
the latter agent, a narcotic principle is added.
_ In the case of Indian corn, the smaller cereal grains, and cer-
tain leguminous plants (vetches, tares, peas, beans) which have
the seed fully formed but not yet quite hardened nor ripened,
there is the double action of a paralyzing constituent and an
aliment that is specially susceptible of fermentation.

Inflammation of the rumen, already quoted as a cause, may
be determined by hot as well as cold food, by irritant drugs and
poisons, and by narcotico-irritant and other acrid plants in fodder
or pasture. In the same way the inflammation caused by the
introduction of foreign bodies into the rumen, such as nails,
tacks, needles, pins, wires, knife blades, and masses of hair or
wool may at times cause tympany.

The two main causative factors, of paresis of the rumen on the
one side and of specially fermentescible food and a multiplicity
of microbian ferments on the other, must be recognized as more
or less operative in different cases, and in many instances their
combined action must be admitted. The tympany is the
symptom and culmination of a great variety of morbid causes

LTympanitic Indigestion of the Rumen. Bloating. 99

and conditions, and its prevention and treatment must corre-
spondingly vary.

Symptoms. The whole left side of the abdomen being occu-
pied by the rumen, its distension leads to an uniform swelling of
that side, differing from that caused by simple excess of solid in-
gesta in being more prominent high up between the last rib and
the outer angle of the ilium, and in giving out in this region a
clear tympanitic or drumlike resonance on percussion. It has
also a tense resiliency, like that of a distended bladder, easily
pressed inward by the finger but starting out to its rotundity the
moment the pressure of the fingeris withdrawn. The distension
caused by overloading with solids bulges out lower down, is not
resonant but dull or flat when percussed, and yields like a mass
of dough when pressed retaining the indentation of the finger for
some time. The swelling of tympany, when extreme, rises above
the level of the outer angle of the ilium and even of the lumbar
spines on the left side, and if no relief is obtained the right side
may undergo a similar distension.

Auscultation detects an active crepitation over the whole
region of the rumen, finer in some cases and coarser in others,
according to the activity of evolution and the size of the bubbles
of gas. The crepitation is especially coarse and loud in fer-
mentation of green food, and of spoiled potatoes or other tubers
or roots.

In all acute or severe cases, there is anorexia, suspension of
rumination, and the normal movements of the compressed bowels
seem to be largely impaired, though the anus is protruded and a
little semi-liquid feeces or urine may be expelled at intervals.
The breathing is accelerated, short, and labored. The nostrils
are dilated, the nose extended, the face anxious, the eyes blood-
shot and the back arched. Froth may accumulate around the
lips, or the mouth may be held open with the tongue pendent.
Sometimes a quantity of gas may suddenly escape with a loud
noise, but without securing permanent relief. The heartbeats
are violent and accelerated, the pulse encreasingly small and
finally imperceptible, and the visible mucous membranes are con-
gested and cyanotic. Pregnant females are very liable to abort.

When the right flank as well as the left rises to the level of the
lumbar spines death is imminent, and this may take place as early

100 Veterinary Medicine.

as fifteen or thirty minutes after the apparent onset of the attack.
Death may result from nervous shock, from suffocation, or from
the absorption of deleterious gases, or from all of these combined.

In the less acute cases the animal may live several hours before
the affection terminates in death or recovery. Asarule he stands
as long as he can and finally drops suddenly, the fall often lead-
ing to rupture of the diaphragm or stomach, to protrusion of the
rectum, or the discharge of ingesta by the mouth and nose.

In still slighter cases relief comes through vomiting or more
commonly through frequent and abundant belching of gas, the
swelling of the flanks subsides, rumbling of the bowels may
again be heard, and usually there is a period of diarrhcea.

Gases present. When the rumen is punctured before or after
death so as to give exit to the gas in a fine stream it proves
usually more or less inflammable, the lighted jet burning with a
bluish flame. The usual inflammable ingredients are carbon
monoxide, hydrogen carbide (marsh gas) and hydrogen sulphide,
yet the relative proportion of the gases varies greatly with the
nature of the food and the amount of gas evolved, carbon dioxide
being usually largely in excess. The following table serves to
illustrate the variability :

: Lameyran

Gas. Pfliiger. ee oe Lassaigne. ene Fremy, Vogel. Raiset.

CO,. ----] 60-80 5 29 5 27 74.23
CO __---| 28-40 a>, eee a sees bee ey ies Saks ee ee

CH coos soncweeees 15 6 15 48 23.46
HS) 52262 eee 86 jasaeeeeeee 80° ‘|Soeetscec2 | cote:
(0 eeeaeers |S Seeeeeeee sae ce eee TAG) Wswieeweseds |e eeis ates eo ee eee

IN Gaya Ee eee Ons ifeee esses 25 2.22

The most elaborate observations on this subject are those made
by Lungwitz on the different aliments kept in closed vessels at the
body temperature, and on similar agents fed for days as an
exclusive aliment to oxen provided with a fistula of the rumen
for purposes of collection. He found carbon dioxide to be the
predominating gas in all cases, but that it was especially so in ex-
treme tympanies and varied much with the nature of the food.
The following table gives results :

Lympanitic Indigestion in the Rumen. Bloating. IOI

Percentage
ran of CO.
Plant and Condition.

Buckwheat (Polygonum fagopyrum).__________.______- 8u
Alfalfa (Mendicago Sativa).____-_____-....- 70-80
Clover (Trifolium pratense)_____.______________-______ 70-80
Meadow" grass 224-2 2c0 seo te 70-80
Indian corn (Zea Mais)_____________...___-______._-_-_ 70-80
Spurry (Spergula arvensis)___._________________-______ 70-80
Hay of alfalfa or clover pe fice 2 70-80
Oats with cut straw ent ---..-. 70-80
Yellow lupin (Lupinus luteus) _________._.________-.._ 60-70
Vetch (Vicia sativa) ___.__ _-___.--....________--_.___ 60-70
Oats Cutigreen ons oe et le 60-70
Potato tops 2s 2s ob a ces eae 2 GO296
Potatoes _______________ pees Sete hs oS 60-70
Meadow hay ___________-___-_--__-_-----------_---._._ 60-70
Leaves of beet 2 2 -.222csccsee ne cee eke 50-60
Leaves of radish ___________--_-- eee Wee 50-60
Cabbage 624.35 i 73 tc teh eer ae ee tb OS 40-50

The marsh gas varied from 16 to 39 per cent., being especially
abundant in cases of abstinence. It should, therefore, be in large
amount in the tympanies which accompany febrile and other
chronic affections. Hydrogen sulphide was found only in traces,
recognizable by blackening paper saturated with acetate of lead.

Oxygen and nitrogen were in small amount and were attributed
to air swallowed with the food. In the work of fermentation the
oxygen may be entirely used up.

Lesions. ‘These are in the main the result of compression of
the different organs, by the overdistended rumen. Rupture of the
rumen is frequent. The abdominal organs are generally blood-
less, the liver and spleen shrunken and pale, though sometimes
the seat of congestion or even hemorrhage. Ecchymoses are
common on the peritoneum. The right heart and lungs are
gorged with black blood, clotted loosely, and reddening on
exposure. The right auricle has been found ruptured. Pleura,
pericardium and endocardium are ecchymotic. The capillary
system of the skin, and of the brain and its membranes, is
engorged, with, in some instances, serous extravasations.

Prevention. 'This would demand the avoidance or correction
of all those conditions which contribute to tympany. In fevers
and extensive inflammations, when rumination is suspended, the
diet should be restricted in quantity and of materials that are

102 Veterinary Medicine.

easily digested (well boiled gruels, bran mashes, pulped roots,
etc..) and all bulky, fibrous and fermentescible articles must be
proscribed. In weak conditions in which tympany supervenes
on every meal, a careful diet may be supplemented by a course of
tonics, carminatives and antiseptics such as foeungrec, oxide of
iron, hyposulphite of soda and common salt, equal parts, nux
vomica 2 drs. to every 1 lb. of the mixture. Dose 1 oz. daily in
the food, or % oz. may be given with each meal.

Musty grain and fodder should be carefully avoided, also
mowburnt hay, an excess of green food to which the stock is un-
accustomed, clover after a moderate shower, or covered with dew
or hoarfrost, frosted beet, turnip, or potato tops, frosted potatoes,
turnips or apples, also ryegrass, millet, corn, vetches, peas with
the seeds fairly matured but not yet fully hardened. When
these conditions cannot be altogether avoided, the objectionable
ration should be allowed only in small amount at one time and in
the case of pasturage the stock should have a fair allowance of
grain or other dry feed just before they are turned out. Another
precaution is to keep the stock constantly in motion so that they
can only take in slowly and in small quantity the wet or other-
wise dangerous aliment.

When it becomes necessary to make an extreme transition
from one ration to another, and especially from dry to green
food, measures should be taken to make the change slowly, by
giving the new food in small quantities at intervals, while the
major portion of the diet remains as before, until the faces indi-
cate that the superadded aliment has passed through the aliment-
ary canal. Another method is to mix the dry and green aliments
with a daily increasing allowance of the latter. Some have
avoided the morning dew and danger of fermentation by cutting
the ration for each succeeding day the previous afternoon and
keeping it in the interval under cover.

Treatment. Various simple mechanical resorts are often effect-
ive in dispelling the tympany. Walking the animal around will
sometimes lead to relaxation of the tension of the walls of the
demicanal and even to some restoration of the movements of the
rumen with more or less free eructation of gas. The dashing of
a bucket of cold water on the left side of the abdomen some-
times produces a similar result. Active rubbing or even knead-

Tympanitic Indigestion in the Rumen. Bloating. 103

ing of the left flank will sometimes lead to free belching of gas.
‘The same may be at times secured by winding a rope several
times spirally round the belly and then twisting it tighter by the
aid of a stick in one of its median turns.

A very simple and efficient resort is to place in the mouth a
block of wood 2% to 3 inches in diameter and secured by a
rope carried from each end and tied behind the horns or ears.
This expedient, which is so effective in preventing or relieving
dangerous tympany in choking, appears to act by inducing move-
meuts of mastication, and sympathetic motions of the cesophagus,
demicanal and rumen. It not only determines free discharge of
gas by the mouth, but it absolutely prevents any accession of
saliva or air to the stomach by rendering deglutition difficult or
impossible. A similar effect can be obtained from forcible drag-
ging on the tongue but it is difficult to keep this up so as to
have the requisite lasting effect. Still another resort is to rouse
eructation by the motions of a rope introduced into the fauces.

The passing of a hollow probang into the rumen is very
effective as it not.only secures a channel for the immediate
escape of the gas, but it also stimulates the demi-canal and ru-
men to a continuous eructation and consequent relief. Fried-
berger and Frohner advise driving the animals into a bath of
cold water.

Of medicinal agents applicable to gastric tympany the best are
stimulants, antiseptics and chemical antidotes. Among stimu-
lants the alkaline preparations of ammonia hold a very high place.
These, however, act not as stimulants alone, but also as antacids
and indirectly as antidotes since the alkaline reaction checks the
acid fermentation which determines the evolution of the gas.
They also unite with and condense the carbon dioxide. Three
ounces of the aromatic spirits of ammonia, one ounce of the
crystalline sesquicarbonate, or half an ounce of the strong aqua
ammonia may be given to an ox, in not less than a quart of cold
water. Next to this is the oil of turpentine 2 0z., to be given in
oil, milk, or yolk of egg. But this too is an antiferment. The
same remark applies to oil of peppermint (%4 oz.), the carmina-
tive seeds and their oils, and the stronger alcoholic drinks
(1 quart). Sulphuric or nitrous ether (2 oz.) may be given in
place. Pepper and ginger are more purely stimulant and less an-

104 Veterinary Medi tine.

tiseptic. Other alkalies—carbonate of potash or soda, or lime
water may be given freely.

Among agents that act more exclusively as antiseptics may be
named : muriatic acid 1 to 1% drs. largely diluted in water :
carbolic acid, creosote or creolin, 4 drs. largely diluted ; sulphite,
hypo-sulphite or bisulphite of soda 1 0z; kerosene oil % pint ;
chloride of lime 4 drs.; chlorine water 1 pint ; wood tar 2 oz.
The latter agent is a common domestic’ remedy in some places
being given wrapped in a cabbage leaf, and causing the flank to
flatten down in a very few minutes as if by magic. The extra-
ordinarily rapid action of various antiseptics is the most conclu-
sive answer to the claim that the disorder is a pure paresis of the
walls of the rumen. ‘The affection is far more commonly and
fundamentally an active fermentation, and is best checked by a
powerful antiferment. Even chloride of sodium (% lb.) and
above all hypochlorite of soda or lime (% oz.) may be given
with advantage in many cases.

Among agents which condense the gasses may be named
ammonia, calcined magnesia, and milk of lime for carbon dioxide,
and chlorine water for hydrogen.

Among agents used to rouse the torpid rumen and alimentary
canal are eserine (ox 3 grs., sheep % gr. subcutem), pilocarpin
(ox 2 grs., sheep } gr.), barium chloride (ox 15 grs., sheep
3 to 4 grs.), tincture of colchicum (ox 3 to4drs.). Trasbot
mentions lard or butter (ox 4 0z., sheep % 0z.), as in common
use in France.

In the most urgent cases, however, relief must be obtained by
puncture of the rumen, asa moment’s delay may mean death.
The seat for such puncture is on the left side, at a point equi-
distant from the outer angle of the ilium, the last rib and the
transverse processes of the lumbar vertebrae. Any part of the
left flank might be adopted to enter the rumen, but, if too low
down, the instrument might plunge into solid ingesta, which
would hinder the exit of gas, and would endanger the escape of
irritant liquids into the peritoneal cavity. In an extra high
puncture there is less danger, though a traumatism of the spleen
is possible under certain conditions. The best instrument for the
purpose is a trochar and cannula of six inches long and % to %
inch in diameter. (For sheep Y% inch is ample.) This instru-

Lympanitic Indigestion in the Rumen. Bloating. 105

ment, held like a dagger, may be plunged at one blow through
the walls of the abdomen and rumen until stopped by the shield
on the cannula. The trochar is now withdrawn and the gas
escapes with a prolonged hiss. If the urgency of the case will
permit, the skin may be first incised with a lancet or pen knife,
and the point of the instrument having been placed on the ab-
dominal muscles, it is driven home by a blow of the opposite
palm. In the absence of the trochar the puncture may be suc-
cessfully made with a pocket knife or a pair of scissors, which
should be kept in the wound to maintain the orifice in the rumen
in apposition with that in the abdominal wall, until a metal tube
or quill can be introduced and held in the orifices.

When the gas has escaped by this channel its further formation
can be checked by pouring one of the antiferments through the
cannula into the rumen.

When the formation of an excess of gas has ceased, and the
resumption of easy eructation bespeaks the absence of further
danger, the cannula may be withdrawn and the wound covered
with tar or collodion. :

When the persistent formation of gas indicates the need of ex-
pulsion of offensive fermentescible matters, a full dose of salts
may be administered. If the presence of firmly impacted masses
can be detected, they may sometimes be broken up by a stout
steel rod passed through the cannula. If the solid masses prove
to be hair or woolen balls, rumenotomy is the only feasible means
of getting rid of them.

In chronic tympany caused by structural diseases of the cesoph-
agus, mediastinal glands, stomach or intestines, permanent
relief can only be obtained by measures which will remove these
respective causes.

CHRONIC TYMPANY OF THE RUMEN.

Causes : catarrh of rumen, impaction of manifolds, debility, paresis, peri-
toneal adhesions, neoplasms, concretions, sudden change in diet, gastric
congestion, lesions of gullet, or of mediastinal glands. Symptoms are
usually after feeding only, inappetence, rumbling, costiveness, rumen
indentable. Treatment: obviate causes, give salines, acids, bitters, and
water, laxative food, carminatives, antiseptics, electricity, emetic tartar,
eserine, pilocarpin, barium chloride, apomorphin.

Causes. 'The persistence of causes of acute tympany may lead
to the appearance of the condition after each meal, or even in the
intervals between meals. Among the more specific causes may
be named catarrhal inflammation of the rumen, impaction of the
third stomach, paresis of the rumen, general debility, peritoneal
adhesions affecting the viscus, tuberculosis, actinomycosis or
other morbid productions in its walls, hernia of the reticulum into
the chest, hard stercoral, hair or wool balls, or masses or foreign
bodies in the rumen, and the ingestion of a very fermentescible
quality of food. When the rumen is affected by catarrh or paresis
or debility, even ordinary food will lead to tympany, but much
more so any food to which the animal has been unaccustomed
(green for dry, or dry for green, grain for grass or hay, or beans
or peas for grain). Also food in process of fermentation, or the
seat of fungoid growth.

Again, so intimately related are the different stomachs that
derangement of one instantly impairs the functions of the other,
and thus a slowly progressive impaction of the third stomack
leads to torpor of the first, and the aggregation of more or less or
its contents into solid, fermenting masses. In the same way con-
gestion of either the third or fourth stomach impairs the func-
tions of the rumen and induces tympany. :

Morbid conditions affecting the functions of the cesophagus and
interfering with rumination and eructation of gas are familiar
causes. For example, strictures and saccular dilations of the
tube,and enlargements—tubercular,sarcomatous,actinomycotic,—
of the mediastinal glands.

The symptoms do not differ from those of acute tympany
excepting that they are less severe ; and are continuous or remit-

106

Chronic Tympany of the Rumen. 107

’ tent, suffering a material aggravation after feeding. Rumination
may be suspressed or tardy, the bowels also are torpid, the feeces
glazed, and the ordinary intestinal rumbling little marked. When
the tympany has temporarily subsided, the knuckles, pressed into
the left side, can often be made to strike against the hard, solid
impacted mass of ingesta. Symptoms of impacted manifolds may
also be patent and the patient steadily loses condition.

Treatment must be directed toward the removal of the special
cause of the trouble, and if this cannot be secured, as in tubercu-
losis, the case is hopeless. In cases of solid masses in the rumen
the free use of common salt with a drachm of hydrochloric acid,
and one grain strychnine with each meal, and a free access to
water may succeed. The food had best be restricted to gruels
and sloppy mashes. The daily use of electricity through the
region of the paunch is an important accessory. The common
salt may be increased as required, so as to keep upa very relaxed
condition of the bowels.

In obstinate cases of this kind puncture may be resorted to and
an attempt made to break down the impacted masses with a steel
rod introduced through the cannula. Should this also fail the
solid masses or foreign bodies may be extracted by rumenotomy.

In simple catarrh of the rumen the continued use of strychnine
with gentian, and sulphate of iron, may prove successful under a
carefully regulated diet. Oil of turpentine, balsam of copaiba, or
balsam of tolu may also prove useful, or in other cases extract of
hamameelis, or of wild cherry bark. While strychnine and elec-
tricity are to be preferred to rouse the muscular activity of the
viscus, such agents as tartar emetic, emetine, apomorphia,
eserine, pilocarpin, and barium chloride are recommended and
may be resorted to in case of necessity.

OVERLOADED (IMPACTED) RUMEN.

Definition. Causes, excess of rich unwonted food, gastric torpor, paresis,
starvation, debility, partially ripened, poisonous seeds, paralyzing fungi or
bacteria, lead, cyanides, congestion of rumen, chlorophyl, acrids, dry fibrous
innutritious food, lack of water, enforced rest on dry food, over-exertion,
salivary fistula or calculus, diseased teeth or jaws, senility. Symptoms,
suspended rumination, inappetence, anxious expression, arched back, bulg-
ing pendent left flank, impressible, no friction sounds, excessive crepitation,
hurried breathing, colics, grunting when moved, diarrhoea, stupor, cyanosis.
Signs of improvement. Phrenic rupture. Diagnosis from tympany, pneu-
monia, or gastro-intestinal catarrh. Treatment, hygienic, antiseptic, stimu-
lants, puncturing, purgation, ramenotomy.

Definition. ‘The over.distension of the rumen with solid food
is characterized by two things, the excess of ingesta which pro-
duces the torpor or paresis which is common to all over-filled
hollow viscera, and the comparative absence of fermentation and
evolution of gas. If the ingesta is of a more fermentescible na-
ture the rapid evolution of gas occurs before this degree of reple-
tion with solid matters can be reached, and the case becomes one
of tympany, but if the contents are comparatively lacking in
fermentability they may be devoured in such quantity as to cause
solid impaction.

Causes. Overloading of the rumen is especially common as
the result of a sudden access to rich or tempting food to which
the animal has been unaccustomed. Accidental admittance to the
corn-bin, breaking into a field of rich grass, clover, alfalfa, corn,
sorghum, vetches, tares, beans, peas, or grain, or into a barrel of
potatoes or apples will illustrate the common run of causes. A
pre-existing or accompanying torpor or paresis of the stomach is
a most efficient concurrent cause, hence the affection is especially
common in animals debilitated by disease or starvation, but which
have become convalescent or have been suddenly exposed to the
temptation of rich food. For the same reason it is most likely to
occur with food which contains a paralyzing element, as in the
case of the following when they have gone to seed but are not
yet fully ripened: Rye grass, intoxicating rye grass, millet,
Hungarian grass, vetches, tares and other leguminose, and to a
less extent, wheat, barley, oats and Indian corn. The same may

108

,

Overloaded (Impacted) Rumen. 109

come from the paralyzing products of fungi or bacteria in musty
fodder or of such chemical poisons as.lead, and the cyanides.

A catarrhal affection of the rumen, and the congestion pro-
duced by irritant plants, green food with an excess of chlorophyll,
and the whole list of irritants and narcotico-acrids, will weaken
the first stomach and predispose to overdistension.

Anything which lessens the normal vermicular movements of
the rumen and hinders regurgitation and rumination tends to im-
paction, and hence an aliment which is to a large extent fibrous,
innutritious, and unfermentable, such as hay from grass that has
run to seed and been threshed, the stems of grasses that have
matured and withered in the pastures, fodder that has been
thoroughly washed out by heavy rains, sedges, reedgrass, rushes,
chaff, finely cut straw, and in the case of European sheep, the
fibrous tops of heather contribute to this affection. Lack of
water is one of the most potent factors, as an abundance of water
to float the ingesta is an essential condition of rumination.
Hence pasturage on dry hillsides, prairies or plains, apart from
streams, wells or ponds is especially dangerous unless water is
supplied artificially, and the winter season in our Northern states,
when the sources of drinking water are frozen over, and when
the chill of the liquid forbids its free consumption, is often
hurtful.

Gerard attributes the affection to constant stabulation. This,
however, has a beneficial as well as a deleterious side. It under-
mines the health and vigor, and through lack of tone favors gas-
tric torpor and impaction, but it also secures ample leisure for
rumination, which is so essential to the integrity of the rumen
and favors the onward passage of its contents. With dry feeding
and a restricted water supply it cannot be too much condemned,
but with succulent food and abundance of water the alleged
danger is reduced to the minimum.

Active work and over exertion of all kinds must be admitted
asa factor. At slow work the ox can still ruminate,. but in rapid
work or under heavy draft this is impossible, and the contained
liquids may pass over from rumen to manifolds conducing to im-
paction of the former, or fermentations may take place, swelling
up the mass of ingesta and distending the walls of the first
stomach. Similarly, cattle and sheep that are hurried off ona

110 Veterinary Medicine.

rapid march with full stomachs are greatly exposed to both
tympany and impaction.

In speaking of dry, fibrous food and lack of water as factors,
we must avoid the error of supposing that succulent or aqueous
food is a sure preventive. Ina catarrhal condition of the rumen
or ina state of debility, impaction may readily occur from the
excessive ingestion of luscious grass, wheat bran, potatoes,
apples, turnips, beets, or cabbage.

Finally defects in the anterior part of the alimentary tract may
tend to impaction. Salivary fistula or calculus cutting off the
normal supply of liquid necessary for rumination, tends to re-
tention and engorgement. Diseased teeth and jaws interfering
with both the primary and secondary mastication has the same
vicious tendency. Old cows, oxen and sheep in which the molar
teeth are largely worn out, suffer in the same way, especially
when put up to fatten or otherwise heavily fed. In this case
there is the gastric debility of old age as an additional inimical
feature.

Symptoms. ‘These vary with the quantity and kind of ingesta
also to some extent with the previous condition of the rumen,
sound or diseased. They usually set in more slowly than in
tympany. On the whole the disease appears to be more common
in the stable than at pasture. The animal neither feeds nor ru-
minates, stands back from the manger, becomes dull, with anxious
expression of the face, arching of the back and occasional moan-
ing especially if made to move. The abdomen is distended but
especially on the left side, which however hangs more downward
and outward and tends less to rise above the level of the hip bone
than in tympany. If it does rise above the ilium this is due to
gas and it is then elastic, resilient and resonant on percussion at
that point. The great mass, and usually the whole of the paunch
is non-resonant when percussed, retains the imprint of the fingers
when pressed, and gives the sensation of a mass of dough. The
hand applied on the region of the paunch fails to detect the in-
dication of movements which characterize the healthy organ.
The ear applied misses the normal friction sound, but detects a
crepitant sound due to the evolution of bubbles of gas from the
fermenting mass. ‘This is especially loud if the impaction is one
of green food or potatoes, even though the gas remains as bub-

Overloaded (Impacted) Rumen. III

bles throughout the entire fermenting mass, instead of separating
to form a gaseous area beneath the lumbar transverse processes.

The respiration is hurried, labored and accompanied with a
moan, the visible mucosz are congested, the eyes are protruded
and glassy from dilatation of the pupils, the feet are propped out-
ward, and the head extended on the neck. ‘There may be signs
of dull colicy pains, movements of the tail and shifting of the °
hind feet, in some cases the patient may even lie down but never
remains long recumbent. There may be occasional passages of
semi-liquid manure, though usually the bowels are torpid and
neither passages nor rumbling sounds on the right side can be
detected. When moved the animal usually grunts or moans at
each step, and especially when going down hill, owing to the
concussion of the stomach on the diaphragm. In cases due to
green food the irritation may extend to the fourth stomach aud
intestines and a crapulous diarrhcea may ensue. ‘The tempera-
ture remains normal asarule. The disease is more protracted
than tympany, yet after several hours of suffering and continual
aggravation the dullness may merge into stupor, the mucosz be-
come cyanotic and death ensues from shock, asphyxia, or
apoplexy.

Course. Termination. Many cases recover in connection with
a restoration of the contractions of the rumen, the eructation of
gas, in some rare cases vomiting or spasmodic rejection of quanti-
ties of the ingesta, and the passage of gas by the bowels. This
may be associated with a watery diarrhoea, and loud rumbling of
the right side, which may continue for twenty-four hours or
longer. With the subsidence of the diarrhoea there comes a re-
turn of health, or there may remain slight fever, inappetence,
suspended or impaired rumination, dullness, listlessness, and a
mucous film on the feeces. This indicates some remaining gastro-
enteritis.

In some instances there is rupture of the diaphragm with
marked increase in the abdominal pain and the difficulty of
breathing. In others there is a laceration of the inner and middle
coats of the rumen so that the gas diffuses under the peritoneum
and may even be betrayed by an emphysematous extravasation
under the skin.

Diagnosis. From tympany this is easily distinguished by the

112 Veterinary Medicine.

general dullness on percussion, the persistence of the indentation
caused by pressure, the outward and downward rather than the
upward extension of the swelling, and the slower development of
the affection.

It is far more likely to be confounded with pneumonia, which
it resembles in the hurried, labored breathing, the moans emitted
in expiration, in the dullness on percussion over the posterior
part of the chest, it may be even forward to the shoulders, and in
the cyanotic state of the mucose. The distinction is easily made
by the absence of hyperthermia, and of crepitation along the
margins of the non-resonant areas in the lungs, by the fact that
the area of chest dullness covers the whole posterior part of the
thorax to a given oblique line, and by the history of the case and
the manifest symptoms of overloaded stomach, not with gas but
with solids. From gastro-intestinal catarrh it may be dis-
tinguished by the more rapid advance of the symptoms and by the
absence of the slight fever which characterizes the latter.

Treatment. Slight cases may be treated by hygienic measures
only. Walking the animal uphill, injections of cold water, fric-
tion on the left side of the abdomen to rouse the rumen to
activity, antiseptics as in tympany to check further fermentation,
and stimulants to overcome the nervous and muscular torpor,
may be employed separately or conjointly. When it can be
availed of, a rubber hose may be wound round the abdomen and
a current of cold water forced through it.

When further measures are demanded we should evacuate any
gas through the probang or cannula, as in tympany, and thus
relieve tension and then resort to stimulants and purgatives.
Common salt 1 lb is of value in checking fermentation, and may
be added to 1 tb Glauber salts in four or five quarts of warm
water. A drachm of strong aqua ammonia of 2 oz. oil of turpen-
tine and % drachm of nux vomica may be added. Bouley advo-
cated tartar emetic (2 to 3 drachms), and Lafosse ipecacuan
(1 oz. of the wine) to rouse the walls of the rumen, and more re-
cently pilocarpin (ox 3 grs.), eserine (ox 2 grs.) and barium
chloride (ox 15 grs.), have offered themselves for this purpose.
The three last have the advantage of adaptability to hyperdermic
use, and prompt action. The repetition of stimulants and nux
vomica may be continued while there appears any prospect of re-

Overloaded (Impacted) Rumen. 113

storing the normal functions of the paunch, and when all other
measures fail the only hope lies in rnmenotomy.

Rumenotomy. ‘The warrant for this operation is found in the
entire lack of movement in the rumen, the absence of eructation,
the cessation of rumbling and motion of the bowels, and the
deepening of the stupor in which the patient is plunged. The
longer the delay and the deeper the stupor and prostration the less
the likelihood of a successful issue from the operation. The
animal is made to stand with its right side against a wall, and its
nose held by the fingers or bulldog forceps. If judged necessary
a rope may be passed from a ring in the wall in front of the
shoulder around the animal to another ring behind the thigh
and held tight. Orastrong bar with a fulcrum in front, may
be pressed against the left side of the body, and well down so as
to keep the right side fast against the wall. A line may be
shaved from the point of election for puncture in tympany down
for a distance of six inches. A sharp pointed knife is now
plunged through the walls of the abdomen and rumen in the
upper part of this line, and is slowly withdrawn, cutting down-
ward and outward until the opening is large enough to admit
the hand. The lips of the wound in the over-distended stomach
will now bulge out through to the wound in the abdominal walls,
and three stitches on each side may be taken through these
structures to prevent displacement as the stomach is emptied and
rendered more flaccid. A cloth wrung out of a mercuric chloride
solution may be laid in the lower part of the wound to guard
against any escape of liquid into the peritoneal cavity. The
contents may now be removed with the hand, until the organ
has been left but moderately full. T'wo or three stable bucketfuls
are usually taken, but it is by no means necessary nor desirable
that the rumen be left empty, as a moderate amount of food is
requisite to ensure its functional activity. Asa rule at least fifty
pounds should be left. Before closing the wound and especially
in cases due to dry feeding, it is well in a tolerably large animal
to introduce the hand through the demi-canal to ascertain if im-
pactions exist in the third stomach and to break up these so far
as they can be reached. ‘This done, the edges of the wound in
the stomach are to be carefully cleansed, washed with the mer-
curic chloride solution and sewed together with carbolated cat-

8

114 Veterinary Medicine.

gut, care being taken to turn the mucosa inward and to retain
the muscular and peritoneal layers in close contact with each
other. It will usually be convenient to cut first the two lower
stitches through the abdominal walls, and suture from below up-
ward. When finished the peritoneal surface of the gastric wound
may be again sponged with the mercuric chloride solution, to-
gether with the edges of the wound in the abdominal walls.
Finally the abdominal wound is sutured, the stitches including
the skin only or the muscular tissues as well. The smooth sur-
face of the paunch acts as an internal pad and support, and with
due care as to cleanliness, antisepsis and accuracy of stitching, it
is rare to find any drawback to continuous and perfect healing.
It is well to restrict the animal for three days to well boiled
gruels, and for ten days to soft mashes in very moderate amount
lest the wound in the paunch should be fatally burst open before
a solid union has been effected.

RUMINITIS. INFLAMMATION OF THE RUMEN.

Prevalence in different genera. Causes, as in tympany and impaction,
irritants, specific fevers Symptoms: impaired rumination, tympanies, im-
pactions, depraved appetite, fever, nervous disorders. Lesions: hyperemia,
petechize, exudates, ulcers, desquamation, swollen or shrunken papille.
Treatment : remove cause, mucilaginous food, or gruels, sodium sulphate,
or chloride, bismuth, bitters, mustard cataplasm, electricity.

This is not a prevalent disease but affects animals at all periods
of life and is a cause of tardy and difficult digestion and rumina-
tion. It usually shows itself as a catarrhal inflammation and by
favoring fermentation in the food, and torpor of the muscular
walls of the organ contributes to tympany and impaction. It is
more common in the ox than in the sheep owing, perhaps, to the
more habitual overloading of the stomach and to the hurried,
careless manner of feeding. In the goat it is rare.

Causes. Among the causes may be named tympany and over-
loading, so that all the dietary faults that lead to these may be set
down as causes of inflammation. Irritants taken with the food,
whether in the form of acrid plants (ranunculaceze, euphorbiaceze,
etc.), musty fodder, irritant products in spoiled fodder, aliments

Ruminitis. Inflammation of the Rumen. 115

which are swallowed while very hot or in a frozen state, and
foreign bodies of an irritating kind are especially liable to induce
it. Congestions of the paunch are not uncommon in specific in-
fectious diseases like Rinderpest, malignant catarrh, anthrax,
and Texas fever, and specific eruptions sometimes appear in
aphthous fever and sheep-pox.

Symptoms. Rumination is slow and irregular, appetite capri-
cious, tympanies appear after each feed, and there isa marked
tendency to aggregation of the ingesta in solid masses, which
resist the disintegration and floating which is necessary to rumina-
tion, and favor the occurrence of putrid fermentation. ‘There is
usually a tendency to lick earth, lime from the walls, and the
manger, and a depraved appetite shown in a desire to chew and
swallow foreign bodies of many kinds. Vomiting or convulsive
rejection of the contents of the rumen is not unknown (Vives,
Pattaes). There is slight fever with heat of the horns and ears,
dry muzzle, and tenderness to pressure on the left flank. The
bowels may be alternately relaxed and confined, and bad cases
may end in a fatal diarrhoea. In other cases the disease may be-
come acute and develop nervous symptoms, as in tympany and
impaction. When the disease takes a favorable turn, under a
careful ration, recovery may be complete in eight or ten days.

Lestons. ‘These are violet or brownish patches of hyperzemia
on the mucosa of the rumen, circumscribed ecchymoses, exudates
in the sense of false membranes and even pin’s head ulcerations.
On the affected portions the mucosa is swollen, puffy, dull and
covered with mucus, and epithelium may desquamate. The
papillze are often red, and thickened or shrunken and shortened.
In the specific affections like aphthous fever and sheep-pox the
lesions are rounded vesicles containing liquid. The ingesta is
more or less packed in masses.

Treatment. If irritant foreign bodies have been taken rumen-
otomy isdemanded. If caustic alkalies, acetic or other mild acid.
If acids, lime water or magnesia. Feed well-boiled flax seed, or
farina gruels, and wheat bran or middlings in limited quantity.
Solids may be at first withheld, coarse or indigestible food must
be. It may be necessary to rouse the organ by ro or 12 ozs. of
sulphate of soda with a little common salt and abundance of thin
gruels as drink. As a tonic the animal may take nitrate of

t

116 Veterinary Medicine.

bismuth % oz., powdered gentian % oz., and nux vomica 20
grains, twice a day. ‘The application of a mustard pulp or df oil
of turpentine on the left side of the abdomen may also be resorted
to. A weak current of electricity through the region of the
paunch for twenty minutes daily is often of great service.

HAIR BALLS IN THE RUMEN AND RETICULUM.
EGAGROPILES.

Balls of hair, wool, clover hairs, bristles, paper, oat hair, feathers, chitin,
mucus and phosphates. Causes: Sucking and licking pilous parts, eating
hairy or fibrous products. Composition. Symptoms: Slight, absent, or
gulping eructation, vomiting, tvmpany, in young putrid diarrhoea, foetid
exhalations, emaciation. Diagnosis. Treatment.

Definition. 'The term egagropile, literally goat-hair, has been
given to the felted balls of wool or hair found in the digestive
organs of animals. The term has been applied very widely,
however, to designate all sorts of concretions of extraneous
matters which are found in the intestinal canal. In cattle the
hair licked from their skin and that of their fellows rolled into a
ball by the action of the stomach and matted firmly together with
mucus and at times traces of phosphates, are the forms commonly
met with. In sheep two forms are seen, one consisting of wool
matted as above and one made up of the fine hairs from the
clover leaf similarly matted and rolled into a ball.

In pigs the felted mass is usually composed of bristles, (excep-
tionally of paper or other vegetable fibre), and in horses felted
balls of the fine hairs from the surface of the oat, mingled with
more or less mucus and phosphate of lime make up the concre-
tion. These are found in the stomach and intestines. In preda-
tory birds the feathers and in insectivorous birds chitinous
masses are formed.in the gizzard and rejected by vomiting.

Causes. Suckling animals obtain the hair from the surface of
the mammary glands hence an abundance of hair or wool on
these parts favors their production. The vicious habit of calves
of sucking the scrotum and naval of others is another cause. In

flair Balls in the Rumen and Reticulum. 117

the young and adult alike the habit of licking themselves and
others especially at the period of moulting is a common factor.

Composition. air, wool, and the fine hairs of clover are the
common predominant constituents, but these are matted together
more or less firmly by mucus and phosphates, the ammonia-
magnesian phosphate uniting with the mucus and other matters
in forming a smooth external crust in the old standing balls of
adult animals. The centre of such balls is made up of the most
densely felted hair. In balls of more recent formation the ex-
ternal crust is lacking and the mass is manifestly hairy on the
surface, and the density uniform throughout. These have a
somewhat aromatic odor, contain very little moisture, and have
a specific gravity approximating .716 (sheep) to .725 (ox).
Ellagic, and lithofellic acids, derivatives of tannin, are usually
present, and are abundant in the egagropiles of antilopes.

In the balls of recent formation, as seen especially in sucking
calves, the hair is only loosely matted together. and often inter-
mixed with straw and hay, and is saturated with liquid and
heavier than the old masses. These are usually the seat of active
putrefactive fermentation, and being occasionally lodged in the
third or even the fourth stomach, the septic products act as local
irritants, and general poisons. They are therefore far more in-
jurious than the consolidated hairballs of the adult animal, and
often lay the foundation or septic diarrhceas and gastro-enteritis.

The balls may be spherical, elliptical, ovoid, or, when flattened
by mutual compression, discoid.

Symptoms. Generally these balls cause no appreciable disturb-
ance of the functions of the stomach. ‘This is especially true ‘of
the large, old and smoothly encrusted masses. The museum of
the N. Y. S. V. College contains specimens of 5% inches in
diameter, found after death in a fat heifer, which had always had
good health and which was killed for beef. This is the usual
history of such formations, they are not suspected during life,
and are only found accidentally when the rumen is opened in the
abattoir.

The smaller specimens, the size of a hen’s or goose’s egg, or a
billiard ball, have produced severe suffering, with gulping, eruc-
tation, vomiting and tympany from obstruction of the demicanal
or gullet, and such symptoms continued until the offending agents

.

118 Veterinary Medicine.

were rejected by the mouth. (Caillau, Leblanc, Prevost, Giron).
Again they may block the passage from the first to the third
stomach (Schauber, Feldamann, Adamovicz, Tyvaert, Mathieu).

In calves on milk they are especially injurious as beside the
dangers of blocking the passages already referred to, the unen-
crusted hairs and straws irritate the mucous membranes and still
worse, the putrid fermentations going on in their interstices,
produce irritant and poisonous products, and disseminate the
germs of similar fermentations in the fourth stomach and in-
testine. Here the symptoms are bloating, colics, impaired or ir-
regular appetite, foetid diarrhcea, foetor of the breath and cuta-
neous exhalations, and rapidly progressive emaciation.

Diagnosis is too often impossible. Tympanies, diarrhcea,
colics, etc., may lead to suspicion, but unless specimens of the
smaller hair balls are rejected by the mouth or anus there can be
no certainty of their presence. If arrested in the cervical por-
tion of the gullet they may be pressed upward into the mouth by
manipulations applied from without. The looped wire extractor
may be used on any portion of the cesophagus. If lodged in the
demicanal the passage of a probang will give prompt relief. If
retained in the rumen and manifestly hurtful, rumenotomy is
called for as soon as a diagnosis can be made.

FOREIGN BODIES IN THE RUMEN AND RETICULUM.

Common. Harmless or injurious. Perforating objects. Traumatisms
of contiguous organs. Causes; hurried primary mastication, morbid appe-
tite. Bodies found. Lesions; catarrh, perforations, congestions, ulcera-
tions of mucosa, abscess, trauma of liver, spleen, diaphragm, abdominal
and thoracic walls, lung, pleura, pericardium, heart. Symptoms ; absent,
or, indigestion, tympany, eructations, hepatic, respiratory or circulatory
disorder, colics, local tenderness, crepitation, substernal exudate, costive-
ness, difficult urination or defecation, bloody feces, nervous disorder.
Treatment ; Prevention ; avoidance of causes, gravitation methods, incision.

These are so frequent that they can hardly be looked on as ab-
normal, but they must be accepted as pathological when they
cause serious irritation or digestive disorder. ‘This result is seen

foreign Bodies in the Rumen and Reticulum. 11g

especially in the case of cutting or sharp pointed bodies, which
beside wounding the walls of the rumen, show a marked tendency
to advance to the heart and penetrate it, or to perforate the liver,
diaphragm or abdominal walls and even to cause a fistula through
which the ingesta escapes.

Causes. ‘The common cause in cattle is the habit of swal-
lowing, after one or two strokes of the teeth, any small object
that is mixed with the provender. Next to this comes the habit
of stabled cows, and of such as suffer from a lack of phosphates
or other important element in the food, of licking, chewing, and
swallowing articles that can in no sense be considered as ali-
mentary.

Among the rounded or smooth bodies found in the rumen and
reticulum may be named coins, rivets, fragments of wood, cords,
pieces of rope, leather, gloves, cloth, small garments like vests or
caps, ribbons, bones, pieces of lead, dried paints, cotton waste
used as packing for machinery, shot, and even small animals
such as frogs, toads, and snakes ; also sand and pebbles.

Among sharp or pointed bodies the most common are nails,
pins, needles, baling wire, pieces of iron or other metals, knives,
scissors, forks, fragments of glass, thorns, etc.

Lesions. These are as varied as the nature of the traumatic
agent, the seat and nature of the trauma. The rounded bodies,
if nonpoisonous, act merely by attrition of the walls and tend to
induce a local catarrhal inflammation. Yet even sharp pointed
bodies may prove comparatively harmless. The museum of the
N. V. S. V. College contains a pocket knife which had remained
open in the rumen for a length of time without producing any
visible injury.

Sharp and pointed bodies are especially liable to be entangled
in the cells of the reticulum; so that this viscus is the most
common seat of the resulting trauma. Around this there occur
hyperemia, exudation, thickening and centrally ulceration,
which may lead into a fistula or abscess, confined it may be to
the wall of the viscus, or continued into the surrounding organs.
In this way may be implicated, the liver, the spleen, the dia-
phragm, the abdominal or thoracic walls, the lung, the peri-
cardium or the heart. ‘The pus is always fcetid and usually
mixed with alimentary matter. If it approaches the surface it

120 Veterinary Medicine.

may burst and allow exit to the offending body. If it encroaches
on the liver, symptoms of hepatic disorder supervene. Its pro-
gress through the lung or pleura is marked by objective symp-
toms of pulmonary or pleural inflammation (crepitation, flatness
or percussion, creaking or friction sounds), but without the
customary amount of hyperthermia, and with some evidence of
gastric disorder. When the pericardium is reached there are
the usual signs of pericarditis, attended by comparatively little
fever, and a doughy swelling beneath the sternum is added to
the objective signs of exudation in the pericardium.

- Among the peculiar routes followed by such bodies may be
named the following: to the side of the ensiform cartilage ;
through an intercostal space ; into a chondro-costal articulation ;
through the muscles of the flank ; and even in the region of the
croup. If the attendant abscess or fistula bursts into a serous
cavity it determines septic peritonitis or pleurisy, while in the
lung it may cause septic pneumonia. Asa rule, however, this
is prevented by the excessive quantity of exudation.

Symptoms ‘These are extremely variable according to the seat
and nature of the lesion. So long as the foreign body is con-
fined in the rumen there is usually no symptom. Even when it
has penetrated surrounding organs the symptoms are usually for
a time very obscure. A few years ago a cow entered the prize
ring, at the New York State Fair, was awarded first prize, and
died a few minutes later from a piece of baling wire penetrating
the pericardium. When symptoms are patent there are usually
early indications of indigestion in the rumen, capricious appetite,
sluggish and imperfect rumination, dullness, tardy movements,
frequency and fcetor of eructations, colicy pains, grunting when
moved, and wincing under pressure in the left hypochondrium.
Pressure below, to the left of the ensiform cartilage is sometimes
particularly painful.

If the object is advancing toward the heart a broad area or line
of dullness may often be detected by percussion on the left side
of the chest and under the acts of respiration or walking, gurgling
sounds may be heard along this line. ‘The movements of the
ribs on the same side are limited as compared with the other side,
and straining in defecation or urination may be manifestly painful
and accompanied by groaning. For the same reason costiveness
is liable to set in.

N

foreign Bodies in the Rumen and Reticulum. 121

When the body approaches the skin there is formed a large,
hot, phlegmonous swelling similar to that which marks the ad-
vance of an intercostal abscess.

In special cases there are symptomis of disease of the particular
organ penetrated. Hepatitis, splenitis, and peritonitis are oc-
casionally seen. Eggeling notes a fatal hemorrhage from, the
wounding of the cesophagus by a nail, and Brauer bloody feeces
from penetration of the pylorus by a piece of glass. In other
cases fatal results have followed on trauma, thickening and
obliteration of the pylorus. (Oliver).

In cases of the ingestion of shot, the spray of bullets, white or
red paint or other form of lead, the special symptoms:of lead
poisoning supervene. (See lead poisoning).

Treatment. Asa rule this is unsatisfactory and especially in
cases implicating the pericardium, as the symptoms may be en-
tirely overlooked until sudden death occurs. Hence the great
value of preventive measures, and above all the careful removal
of all nails from the vicinity of fodders. Bailed hay is always
dangerous, and when used, each bale should be carefully freed
from its wires and any short pieces removed. Pointed metallic
bodies of all kinds should be removed from the pastures and
stables.

In case the migrating foreign body leads to the formation of a
superficial phlegmon at any point, this should be freely opened
and the offensive agent extracted.

If the lesion in the reticulum has been diagnosed, the combined
methods of Kolb and Schobert should be tried. Turn the animal
on its back with the head and shoulders up hill, and employ
strong pressure, with the foot, in jerks, over the ensiform carti-
lage. The object is to slide the foreign body back into the viscus,
and success is claimed in seven cases out of nine.

Failing in such methods there remains only the operation of
rumenotomy and the removal of the offending bodies so far as
they can be reached.

TUMORS OF THE RUMEN AND RETICULUM.

Tumors: Papilloma, Chondroma, Sarcoma. Treatment—palliation or
surgical.

Tumors of different kinds have been found in the walls of
these organs, though by no means frequently. Epithelial hyper-
trophy and papilloma have been found in the ox, the former
undergoing necrotic changes. Chondroma is reported by Kitt,
Sarcoma by Cadeac and Beylot. ‘There seems to have been a
special tendency to invade the demicanal, and to interfere with
deglutition, rumination, and the passage of food into the third
stomach. ‘The impairment and loss of appetite and of rumina-
tion, the presence of tympany, and the general loss of condition
are suggestive. If the disease of the demicanal leads to anti-
peristaltic movements of the cesophagus which can be felt by the
hands pressed on the jugular furrows the diagnosis may possibly
be made.

Treatment is manifestly hopeless. To be effective it must be
surgical and would too often entail excision of the affected part
of the viscus and careful suture of its walls. ‘This would be even
more hopeless when the demicanal was the seat of disease.

Temporary palliation might be secured by a sloppy diet, the
withholding of all rough food which would demand rumination,
and the use of common salt, saline laxatives and abundance of
water.

ANIMAL PARASITES OF THE RUMEN AND
RETICULUM.

Infusoria Amphistomum Conicum. Actinomycosis.

Colin describes and figures as many as eight varieties of in-
fusoria found habitually in the first two stomachs. All appear to
be introduced with the food, in the infusions of which they also
appear, and they find in the fermenting mass of ingesta in the
first two stomachs a favorable medium in which to grow and
multiply. It cannot be shown that they are in any way detri-
mental and they have even been supposed to be beneficial to

digestion as glycogen has been demonstrated in their protoplasm.
122 ¢

Impaction of the Omasum ( Third Stomach). 123

Like the bacterial ferments they doubtless assist in the disintegra-
tion of the mass of food.

Amphistomun Conicum. "This is a trematode worm about the
size of an apple-seed (10 millimetres long by 2 millimetres thick),
rounded at both ends, slightly curved on itself, and, as usually
found, of a bright red color. It attaches itself by its sucker, (on
thick end), usually in the vicinity of the demicanal. Its life
history is closely allied to that of the distomata, but as it is not
known to prove at all injurious to its host, it possesses no patholo-
gical importance.

Actinomycosis of the Rumen and Reticulum. Tumors
of this fungus are sometimes found in the walls of the two first
stomachs projecting in the form of polypi, or imbedded in the
thickness of the coats. Where they are completely covered by
the mucous or serous membrane their true nature is not readily
recognized. When incised they show the characteristic yellow
granules made up of club-shaped cells, though the usual stellate
arrangement may be somewhat imperfect. From the serous sur-
face the growth may invade the different adjacent organs. It is
impossible to diagnose a primary actinomycosis of the rumen, if
unaccompanied by more superficial lesions, but, if the disease is
recognized elsewhere, the same general treatment with iodide of
potassium will dispose of these formations as well.

IMPACTION OF THE OMASUM (THIRD STOMACH).

Definition. Synonyms Causes, torpid action, defective insalivation, in-
active rumen, fever, inflammation, spinal paresis, dry, fibrous, innutritious
food, fungi, ergot, smut, privation of water, or of succulent food, microbian
ferments and their products, chronic heart disease, dry farinas, extreme
changes of diet, brain disease. Symptoms: slight or violent; ill-health,
impaired appetite and rumination, grunting, tympany, diarrhcea, constipa-
tion, baked coated feces, percussion signs, separation from herd, red eyes,
stiffness, agalactia, foetid eructations, paralysis, drowsiness, stupor, de-
lirium, nervous symptoms mostly in acute cases. Course in chronic and
acute cases. Diagnosis; from pneumonia, and overloaded rumen.
Lesions ; solid impacted omasum, baked contents, shedding of epithelium,
congestion, petechiz, ulceration, empty, and congested abomasum and small

124 Veterinary Medicine.

intestine. Treatment: laxative food, purgatives, stimulants, antiseptics,
enemata, stimulants of peristalsis, counterirritants, mucilages, laxative
diet, tonics.

Definition. This may be defined as a form of indigestion of
which the prominent feature is the drying and impaction of the
ingesta between the folds of the third stomach. It may seem to
be a primary disease, but in very many cases it occurs as a result
of some acute or febrile or inflammatory affection.

Synonyms. As the disease has been long popularly known it
has received a variety of popular names which are more or less
characteristic. Dry murrain, Clewbound, Fardelbound, Stomach
staggers, Grass staggers, Vertigo, Chronic dyspepsia, and
Chronic indigestion may serve to illustrate these.

Causes. Torpor of the manifolds and the suppression of
secretion of saliva, together with the absence of a continuous ac-
cess of waves of liquid floating the finely divided food from the
mouth or rumen to the third stomach are prime conditions of
desiccation of the contents. ‘The third stomach, like the two
first, has no provision for liquid secretion, but is dependent for
its supply on constant flushing from in front. If therefore
feeding and rumination are interrupted as the result of a febrile
disease, if the secretion of saliva isin great part suppressed, if
the vermicular movements of the rumen and resulting overflow
into the third stomach are checked, and if in addition the
omasum itself is rendered torpid, the ingesta compressed between
its folds becomes drained of its liquid, and in no great length of
time, to such an extent that it may be rubbed up into a dry
powder. All this is a necessary result of an acute febrile condi-
tion, and therefore all febrile and inflammatory affections tend to
drying and impaction of the contents of the omasum. If there-
fore the observer were to go no further than this he would have
a very simple pathology, for all or nearly all fevers and inflam-
mations would be to him simply impacted omasum. In the
great majority of cases this condition is to be looked on as a
secondary and subsidiary affection, while the real primary disease
has still to be sought for.

Some explanation of the special susceptibility of the third
stomach in such constitutional troubles, is found in the source of
innervation of the viscus. Colin and Ellenberger could rouse the

Impaction of the Omasum (Third Stomach). 125

movements of the first two stomachs but not of the third by
electric stimulation of the vagus, while the third stomach was
excited to action by excitation of the spinal cord and of the sym-
pathetic twigs proceeding from this to the manifolds. Ellen-
berger indeed avers that the walls of this viscus are abundantly
furnished with ganglionic cells which are called into action by
this sympathetic stimulus. ‘The innervation being derived from
an independent source, derangement of the third stomach may
be quite independent of any primary disorder of the first, and the
omasum deriving its motor supply from sources so closely related
to the vaso-motor ones, may give an additional explanation of
the intimate connection of its disorders with febrile and inflam-
matory diseases.

But while acknowledging the controliing influence of torpor or
paresis of the omasum, it would be an error to follow Cadeac in
denying the influence of food as a cause of impaction. It has
long been notorious that impaction of the omasum is preémi-
nently a disease of winter, or of the period of dry feeding. It
occurs in cattle fed on dry, fibrous, innutritious fodder, and
especially when there is a scarcity of water, or when in connection
with severe frost the usual water supply has been frozen up. It
prevails in stock turned in spring or autumn on pastures in
which the fresh green grass grows up among the dead, dried and
withered stems of a previous growth and tempts them to eat them.
It appears when the stock consumes corn or cornstalks affected
with smut or certain other fungi, or the cereals or grasses suffer-
ing from ergot or smut, but this is especially the case when there
is also a privation of watar, whereas, with an abundant water sup-
ply or a partial ration of roots, potatoes or ensilage the danger is
greatly reduced. Sometimes a change from soft to very hard
water appears to act as a cause but whether from a special astrin-
gent action or a disinclination to consume the usual amount has
not been made clear.

It must be allowed that the sheep and goat which habitually
drink little, suffer far less from this affection than the ox which
drinks freely, yet allowance must be made for the constitution
and long settled habits of the genus, and we must not forget
that it is usually under privation of water or a restricted supply
that the ox suffers.

126 : Veterinary Medicine.

Among other causes must be named fermented food, the micro-
bian ferments and their products, serving to render the organ
torpid, but also to produce fever, lessened secretion and an arrest
or retardation of liquid supplies from the.mouth or rumen.

Chronic heart disease, causing blood stasis in the omasum, ap-
pears to induce torpor and favor impaction.

The ingestion of lead has a very direct action in producing
paralysis and consequent impaction.

Finally, finely divided dry food like meal or bran, swallowed
hastily, tends to pass in large amount directly into the omasum,
and, before the animal has become accustomed to the ration, is
liable to clog the viscus and induce impaction.

In nearly all cases, the commencing impaction ‘entails a certain
rise of temperature and suppression of secretions, so that the
malady tends to move in a vicious circle, each new step tending
to aggravate the already existing condition. In chronic cases,
which are very common, a careful record of bodily temperature
shows oscillations, above and to the normal, at irregular intervals,
each rise tending to add to the impaction.

The most acute and fatal forms of the affection occur in con-
nection with a sudden change from dry to rich, luscious, green
food in spring, the unwonted stimulus giving rise to general irri-
tation of the whole gastric mucosa, with disordered and impaired
function of all four stomachs, but especially of the third. Such
cases are usually congestive and inflammatory and the suspension
of the gastric movements is a grand cause of impaction. Insuch
cases too the brain or spinal cord, or both, are seriously involved,
and the early death is preceded by torpor, paralysis, violent
delirium or convulsions, following largely the type of acute lead
poisoning.

Symptoms. 'These vary according to the degree of impaction
or gastric torpor, from simple, irregular, or suspended rumination
(loss of cud) to the most severe gastric and nervous disorder.

The slighter or less acute cases are marked by a failure to
re-establish regular rumination on partial convalescence from a
fever or inflammation. The hyperthermia subsides, but the ap-
petite remains poor and capricious, the muzzledry, the eyes dull,
the spirits low, breathing quickened and occasionally accompanied
by a moan, especially when moving down hill, slight tympanies

Impaction of the Omasum (Third Stomach). 127

of the rumeu may appear and the contents of the organ seem
consolidated and may be felt as solid masses when pressure is
made by the hand. The mouth is hot, clammy and fecetid, and
the bowels costive, the feeces being passed in small amount and
in the form of hard, black pellets, covered by a film of mucus,
or streaks of blood, and containing particles of undigested food.
This not unfrequently merges into a transient diarrhoea to be
followed in turn by renewed constipation, and such alternations
may repeat themselves again and again. The omasum is so
deeply seated under the ribs on the right side that exploration
is unsatisfactory, especially in the milder cases, yet pressure of
the closed fist upward and forward below the middle of the chest
will give the impression of a specially solid resistance and the
patient may indicate suffering by a moan. Percussion with the
closed fist has the same effect. There may be slight tremors of
the body, the horns, ears and limbs are cold, and the hair erect
in patches, dry and lustreless.

In cases occurring independently of previous disease, diarrhoea
may be the first symptom noted, the malady being preceded by
local irritation and congestion, but this soon gives place to con-
stipation and alternating diarrhcea and the general train of symp-
toms above mentioned. The animal leaves the herd and is found
lying apart on its left side with the nose in the right flank, the
pulse and breathing quickened, the eyes congested, and a moan
emitted occasionally inexpiration. This is increased if the patient
is raised and driven, especially down hill. He walks with stiff,
arched back, unsteady gait and dragging limbs. Appetite may
not be entirely lost at first, but only impaired and irregular, and
as rumination ceases, grinding of the teeth becomes common.
The secretion of milk is diminished or altogether arrested and
emaciation advances day by day. Fcoetor of the eructations, the
result of prolonged and septic fermentation in the rumen is often
a marked symptom.

This form may last from ten to fourteen days and merge finally
into paralysis of the hind limbs, drowsiness and stupor, or delir-
ium and convulsions.

In the more acute cases resulting from a sudden acccess of green
food, a change of water, or the ingestion of irritant plants, the
affection partakes more or less of the nature of congestion or in-

128 Veterinary. Medicine.

flammation of the viscus, and may run a rapidly fatal course.
The animal may be seen apart from the herd in the characteristic
recumbent position, with eyes red and glassy, eyelids semi-closed,
and much drowsiness and stupor, but when raised he may still
feed in a sleepy, listless manner. The bowels may be loose or
confined, the pulse and breathing accelerated, the right hypochon-
drium firm and tender, and as in the other forms the crepitating
sound of fermentation is slight or absent over the region of the
manifolds. Soon nervous disorder appears, the eyes glare wildly,
the animal seeks relief in motion, it may be in a straight line, or
to one side, and being blind and unconscious of obstacles he may
fall into pits, or ditches, dash against trees, fences or buildings,
and if they offer sufficient resistance he will continue pushing,
breaking teeth or horns, and subject to violent muscular contrac-
tions, causing even the grubs to start from the back. ‘The ner-
vous disorder is often further shown in loud and terrified bellow-
ing as if chased by a dog or gored by one of its fellows.

Course. Chronic cases may continue almost indefinitely the
victims showing merely poor health, impaired digestion, and
steady loss of condition. After death the omasum is sometimes
found to contain dried materials, such as the animal has not had
access to for from three to five months.

In those which end in an early recovery there occurs a free and
abundant diarrhcea, the feeccs containing solid flattened masses
with black baked or polished surface, the result of the detach-
ment of the impacted layers from between the folds of the third
stomach. The tympany of the rumen subsides, crepitation is
renewed in the rumen and omasum, there is free rumbling in the
bowels, and the appetite gradually improves. The softening
and removal of the desiccated contents are slow, and it may be
weeks before there is a complete restoration to normal conditions.

Diagnosis. The hurried pulse and breathing and the grunting
with expiration may be mistaken for pneumonia or pleurisy, but
the distinction can be made as in impacted rumen. ‘There is at
first no fever, the tenderness is confined to the right side, the
percussion dullness of the chest is in the posterior part and dis-
tinctly referable to the loaded abdominal viscera, it is attended
by no pulmonary crepitation, indeed crepitation in rumen and
omasum is lessened or abolished, there is no pleural effusion, but

Lmpaction of the Omasum (Third Stomach). 129

there are the unquestionable signs of gastric and intestinal dis-
order.

It may be confounded with overloading of the rumen, but in
the latter case the distension occurs rapidly, there is little or no
indication of movement of the viscus, appetite and rumination are
usually early suspended and the gaseous eructations are not
putrid.

Postmortem Appearances. These are essentially connected
with the impaction of the omasum. This organ is gorged to
twice its normal size or larger, firm, solid and resistant, not
easily taking an impression of the finger, and having at times an
almost stony hardness. When incised the intervals between the
folds are sure to be packed with desiccated food, often so dry in
the upper part that it may be rubbed down into a grayish powder,
and it has been compared to the cakes of linseed as they come
from the press. The surface of such cakes is smooth and dark,
and usually covered by a layer of epithelium which has detached
itself from the surface of the fold. This is usually quoted as a
morbid desquamation, but inasmuch as we frequently see it in
perfectly healthy conditions in animals killed in abattoirs, it must
be admitted to occur also as a normal physiological exfoliation.
The exposed mucosa shows spots and patches of congestion,
extravasation, and even at times ulceration, or slight areas of
necrosis.

The rumen shows the result of torpor and inactivity. The in-
gesta is largely packed into solid masses, which have advanced
from the simple acid fermentation, to evident putrefaction with
offensive emanations. The abomasum is empty or nearly so of
ingesta, but contains abundance of mucus and shows patches of
congestion as in prolonged abstinence.

The small intestine is also empty and collapsed, with con-
siderable redness and congestion. The larger intestine contains
asmall quantity of feculent matter, dry, massed in small pellets
and with smooth glistening surface. Mucus is abundant and
dense.

Treatment. ‘This must follow the same lines as in impaction of
the rumen with the understanding that the response is less cer-
tain and the result somewhat more tardy in reaching complete
convalescence. In mild and chronic cases a liberal allowance of
flaxseed tea, several bucketfuls per day, will often succeed.

9

130 Veterinary Medicine.

In using purgatives those are usually the best which lead to
drinking abundantly. For the ox a pound each of Epsom and
common table salt, with an antiseptic stimulant like aqua am-
monia (3 to 4 drachms) or oil of turpentine (2 oz.) will often
act favorably. The sodium chloride is antiseptic, and induces
ardent thirst and if there is free access to water, tepid or not too
cold, purgation is early secured and the impacted cakes in the
manifolds are slowly softened, detached and removed. But un-
less water is given freely the salt will prove irritating and even
injurious.

In obstinate cases, and in the absence of indications of gastric
or cerebral congestion the addition of 20 croton beans or 20 drops
of croton oil will be excellent. Nux vomica (% drachm) is also
of value in rousing the torpid nervous action. Injections
are always in order, and it is recommended to use these cold
so as to rouse the muscular action of the intestine and
stomach.

Some of the newer remedies which rouse the contractility of
the digestlve organs and at the same time stimulate secretion
serve an excellent purpose in these cases. Eserine 1% grain,
veratrine 1 grain, barium chloride 10 to 15 grains, or pilocarpin
3 grains may be given hypodermically in addition to the usual
purgative. The pilocarpin is theoretically the best as its tendency
is to cause free secretion from all mucous surfaces, and even a
slight secretion from the omasal folds will greatly favor detach-
ment and discharge of the impacted plates. These as well as
the stimulants may be repeated as the effects pass off. The pur-
gatives, on the other hand, should be given at first in a large dose,
and not repeated except under the stress of necessity as their
constant repetition in small doses seems to nauseate the anima
and even to retard action. In the case of profuse secretion from
the kidneys however it may be supposed that the saline agents
have passed off in that way and a purgative may be safely re-
peated. It may be well however to use one which is less likely
to stimulate the kidney, such as castor, olive, or raw linseed oil
or senna.

The patient may be several days or even a week without alvine
discharge and yet do well. If there are fever and other indica-
tions of gastr.c congestion a blister to the right hypochondrium

Inflammation of the Omasum., 13!

may be of value. Rub well with oil of turpentine and then with
a pulp of the best ground mustard and tepid or cold water and
cover with sheets of thick paper to prevent evaporation.

If nervous, symptoms are manifested by dilated pupils, blind-
ness, congested conjunctiva, hot horns and ears, and drowsiness,
or excitability apply cold water or an icebag to the head and con-
tinue as long as may be needful. If the patient should become
violently delirious he may be fastened to a beam overhead in the
centre of the stall so as to prevent him from injuring himself or
others.

In these cases the more violent and irritant purgatives are to
be avoided, and decoctions of slippery elm, linseed or gum may
be given to sheathe and protect the irritated membrane.

Even though a free action of the bowels has been secured it is
not to be assumed that all impacted material has been removed.
A specially laxative diet of roots, ensilage, or succulent green
food, with a liberal supply of salt, and free access to water should
be kept up for some weeks to secure a complete softening and
expulsion of the impacted material. Repeated small doses of
laxative medicine may be requisite to bring this about. Asa
rule a course of tonics, and above all of nux vomica is valuable
in reéstablishing the normal tone of the stomachs and intestines.

INFLAMMATION OF THE OMASUM.

Involved in rinderpest, Texas fever, malignant catarrh, etc. Diphtheritis,
Tuberculosis, Irritant poisons, Traumatisms, Impactions, change to green
food, etc. Lesions: Congestion, ramified redness, petechize, desquamation,
softening, necrosis, false membranes, ulcerations, pigmentation, papillary
growths, impaction. Symptoms: those of impaction with fever. Course,
Treatment: demulcents, laxatives, blisters, bismuth, eserine, veratrine,
pilocarpin, electricity, careful diet.

Like the rumen the omasum is the seat of local inflammatory
lesions in certain specific fevers. Thus in Rinderpest, and Texas-
fever it is almost always the seat of patches of congestion and
blood extravasation, and in the latter of necrosis and perforation
of the folds. Similar lesions sometimes appear in malignant

132 Veterinary Medicine.

catarrh and anthrax. Dieckerhoff describes exudates, ulcera-
tions and even perforations in pseudo-diphtheritis, and Brtick-
mtiller, congestions and ecchymoses in connection with a cutane-
ous rash. Tuberculosis of the organ is somewhat rare and is
held to be due to the swallowing of bronchial secretions in cases
of pulmonary tuberculosis.

Cases of primary inflammation are rare, in keeping with the
soft finely divided condition in which the food reaches the organ.
It may, however, occur in case of the ingestion of arsenic and
other irritant poisons, or of goring, kicks and other injuries on
the right hypochondrium, or from the irritation attendant on im-
paction, or again from the stimulus of a sudden change to rich
green food.

The /estons in such a case are congestion of the folds with
patches of ramified redness, blood extravasations, desquamation,
softening or even gangrene. False membranes, perforating
ulcers, and erosions are sometimes present. In the chronic forms
grayish or slate colored pigmentation of the mucosa, congestions
and papillary growths are common.

In both acute and chronic forms the congestion entails loss of
contractility and thus impaction and drying of the ingesta be-
tween the folds of the organ are constant.

Symptoms. These are the symptoms of impaction of the
manifolds, impaired appetite and rumination, formation of solid
masses in the rumen, tympany, tenderness on pressure on the
right hypochondrium, irregularity of the bowels, arching of the
back and grunting when made to walk. ‘The addition of fever,
as evidenced by rectal hyperthermia, hot horns, ears, legs and
muzzle, serves to diagnose it from simple impaction.

The course of the malady is the same as in impaction, but with
an even greater tendency to aggravation and a fatal result as the
inflammation entails a paresis of the walls of the viscus which
favors a constant accumulation and desiccation of the interlaminar
material.

Treatment, ‘This must be largely on the same line as in im-
paction, laxatives of sulphate of soda, a diet of flaxseed or barley
gruel, and drinking water rendered demulcent with slippery elm.
These must be supplemented by a mustard or other blister to the
right hypochondrium, by soothing doses of nitrate of bismuth

Tumors of the Omasum. 133

(% ounce), and hypodermic injections of eserine (1% grain),
veratrine (1 grain), or pilocarpin (3 grains). A current of
electricity sent through the right hypochondrium once or twice a
day, will further be desirable. When convalescence has set in,
mashes of wheat bran and middlings may be allowed, to keep up
the flagging vigor, and the patient should be returned to solid,
fibrous food by slow degrees only.

TUMORS OF THE OMASUM.

Papiloma. Sarcoma. Actinomycosis.

Tumors of the omasum have been seen only as papilloma, and
sarcoma,

The papillomata result from hypertrophy of the normal
papille, and their general appearance resembles those of the
pharynx, gullet and paunch. They sometimes grow to the size
of the fist or larger, with a cauliflower appearance, their increase
and the formation of pedicles being favored by the active con-
tractions of the muscular coat of the manifolds. They may be
red and vascular if recent, are usually white if older, and may
become somewhat horny on the surface, but soft and friable
within. When they attain a large size they may obstruct the
passage to the fourth stomach, tending to impaction of the mani-
folds and arresting digestion and nutrition.

Sarcoma of the third stomach has been recorded by Paule,
Kitt and Schutz as developing in the subserous tissue and form-
ing a layer on the surface of the organ. This bulges out in
rounded swellings of irregular sizes, and may show various de-
generations—caseous, calcic or necrotic. The structure shows
fusiform and rounded cells more or less numerously imbedded in
a fibrous stroma.

ACTINOMYCOSIS OF THE ABOMASUM.

This has been seen once by Professor Axe. Its true nature is
unrecognizabie during life, but if other formations of the same
kind betray the nature of the lesion, the treatment by iodide of
potassium may be resorted to with good hope of success.

INDIGESTION OF THE ABOMASUM.

Causes : excess of water—ice cold, or after privation. Symptoms : colicy
pains, local perspirations, right flank gurgling, diarrhoea, arched back,
anorexia, or nervous symptoms. Prevention: Treatment: stimulants, car-
minatives, exercise, electricity, friction, stimulants of peristalsis.

This has been observed as the result of ingestion of an excess
of water, and especially ice cold water, by work oxen, or over-
driven animals which have been long exposed to the heat of the
sun and subjected to violent exertions without drink. The habit
of allowing water only at long intervals, though it is being abun-
dantly eliminated not only by kidneys and bowels, but also by
the accelerated breathing and the sudation, causes consuming
thirst, and when brought to the drinking place, the subject
drinks inordinately before eating. Much of this liquid is passed
at once into the abomasum, which with a capacity of 20 to 25
quarts, becomes overdistended and irritated. Much of the
water passes speedily into the bowels, rousing these also into un-
wonted action. The sudden distension appears to cause spas-
modic contractions of the abomasum which are aggravated if the
liquid is cold, and a violent though transient suffering is induced.

Symptoms. ‘These appear suddenly after the drinking of the
cold water and consist in the most violent colicy pains, twisting
of the tail, kicking at the belly, lying down and rising at short
intervals, moaning, looking at the flanks, anxious countenance,
and the breaking out of perspirations around the ears, on the
neck or belly. There is no tympany of the rumen but there are
some fullness and active gurgling on the right side of the
abdomen. ‘The attack does not usually exceed one or two hours

134

Indigestion of the Abomasum. 135

in length, and .a profuse diarrhcea brings relief, the alvine dis-
charges being very watery with considerable mucus and some
undigested food principles.

In exceptional cases it has lasted for six hours and even in the
more transient cases, there is liabie to remain for a time dullness
and prostration, advancing of the hind legs under the body,
anorexia and suspended rumination. Cruzel records two cases
in which the small intestine was ruptured as the result of too
vigorous driving of the patients. Other cases have perished
from the coexistent diarrhcea. Nervous symptoms also may ap-
pear as in other gastric disorders. The usual result is recovery
after a very transient illness. This short and favorable course,
and the evidence of cause and symptoms sufficiently identify the
disease.

Treatment. Prevention should be sought by avoidance of cold
water in excess, when the animal is heated, fatigued and thirsty.
A little food, an occasional mouthful of water, or a drink of
warm water and meal will act prophylactically. When the
animal is attacked alcoholic drinks, ammonia, carminatives
(pepper, ginger, fennel, caraway, peppermint, chamomile) or
even strong tea or coffee may be used to advantage. Careful
walking exercise is also useful with friction to the abdomen, or
the use of electricity. Cadeac advises stimulants of the peri-
stalsis—eserine, veratrin or pilocarpin sub-cutem; senna,
podophyllin, or castor oil by the mouth.

INDIGESTION OF THE FOURTH STOMACH IN
THE YOUNG.

Causes: Symptoms: Dullness, recumbency, inappetence, colic, acid
eructations, abdominal tension, costiveness, diarrhoea, emaciation. Lesions:
Sour coagula in stomach, puffy or congested mucosa, undigested casein in
bowels and feces. Prevention as in infective gastro enteritis. Treatment:
Elimination, antacid, antiseptic, carminative, stimulant, rennet.

While the fourth stomach in the mature animal is protected
against danger by the preparatory work of the first three, and by
their action in retarding the food in its progress, and allowing it
to pass into the fourth only when thoroughly comminuted and
then only in small quantity at a time; in the suckling on the
other hand the milk passes at once into the abomasum, which is
thus rendered as susceptible as in the monogastric animal.

Causes. "The causes are almost identical with those set forth
under zufective gastro-enteritis of the suckling, acting however
with less force, or on aless susceptible system. Overloading and
the resulting paresis ; unsuitable milk from another genus, or
from unhealthy, over-worked, or over-fed specimens of the same
genus ; the ingestion of hard, insoluble, indigestible or toxic
aliments, and exposure to cold and wet are among the most com-
mon direct causes. As secondary causes are over-feeding of the
cows, and bringing up the calves on the pail with all kinds of
substitutes for the milk of the mother.

Symptoms. Dullness, lack of sportiveness and of appetite.
The patient lies down a good deal, but is nervous or restless, and
when up shows colicy pains by movements of the tail and hind
limbs. He may moan gently or bellow frequently. The muzzle
is dry, the mouth clammy, hot and sour, the abdominal muscles
rigid and the belly often somewhat swollen, and resonant on
percussion. Acid eructations are common. At first there is
costiveness, but in a few hours diarrhcea sets in and usually proves
critical, clearing away the offensive and irritant materials and
paving the way for recovery. The tension of the belly lessens,
by degrees, the appetite returns, the bowels resume their normal
tone and in twenty-four or forty-eight hours health may be fully
restored.

136

Indigestion of the Fourth Stomach in the Young. 137

There is, however, always danger of the supervention of gastro-
enteritis of which in many instances the above-named symptoms
indicate the first stage. In all cases it interferes with the growth
and fattening of the subject.

Lesions. We observe the presence in the stomach of masses
of coagulated milk, undigested, mixed with an excess of mucus,
and exhaling a sour or even a septic odor. ‘The mucosa is more
or less red and congested with swelling and opacity of the epithe-
lium. The bowels also contain the undigested flocculi of casein,
more or less fermented and which have escaped the action of the
peptic liquids.

Prevention. ‘This consists in the avoidance of the causes, and
as these are in the main the accessory causes of infective gastro-
enteritis in the suckling, it will save repetition to refer to the
article on that subject.

Treatment. In an attack which is caused and maintained by
undigested and irritant materials in the stomach, the first con-
sideration must be the elimination of these offensive matters.
An ounce of castor oil with a teaspoonful of laudanum for calf or
foal will usually effect this purpose. Or % oz. calcined magnesia
or carbonate of magnesia, or of manna 2% drs. or cream of tartar
may be substituted for the oil. The addition of a carminative or
stimulant (1 dr. syrup of anise, or tincture of cinnamon, 1 oz.
whisky or brandy, or ¥% oz. oil of turpentine for calf or foal) will
often check the diarrhoea and fermentation.

In weak subjects the stimulant may be used with a drachm of
chalk or of bicarbonate of soda, and 5 grains powdered nux
vomica.

In all cases alike the use of rennet is very advantageous.
One-eighth of a calf’s rennet being steeped in a bottle of sherry
wine and the liquid given to the amount of a tablespoonful
(% oz.) with each drink. This secures proteid digestion and
checks fermentation thereby hindering the formation of the of-
fensive products which maintain the irritation and disorder.

INFECTIVE GASTRO-ENTERITIS IN CALVES, LAMBS
AND FOALS. WHITE SCOUR.

Causes: early life, exclusive activity of fourth stomach, faulty milk, ab-
sence of colostrum, milk from advanced lactation, milk of other genus, or
altered by excitement, or unwholesome food, excess on hungry stomach,
soured, fermented, feverish milk, putrid milk, leucomaines, overdistension
of stomach, farinaceous food, hair balls, morning and evening milk, milk
after first calf, composition of milk by genus, ruminant’s milk to mono-
gastric animal, infectious microbes—bacilli, micrococci. Symptoms: cos-
tiveness, inappetence, listlessness, tense abdomen, acid eructations, foetid
diarrhoea, becoming yellow or white, general fcetor, staring coat, pallid
mucosz, tucked up tender abdomen, weakness, emaciation, fever, bloating,
frothy dejections, arthritis, peritonitis, pneumonitis, hepatitis, ophthalmia,
laminitis, etc. Mortality: in foals, calves, lambs. Lesions: gastric and
intestinal congestions, exudations, necrosis, incoagulable blood in foals,
anaemia. Prevention: normal feeding, expulsion of meconium, care of
nurse, adapt composition of cow’s milk to genus of nursling, warmth, lime
water, rubber teat, Pasteurizing, disinfection, separation from infected
animals and places, breed from robust parents. Treatment: elimination,
antiseptics, boiling milk, rennet, ipecacuan, carminatives, astringents, tar,
calomel and chalk, gum, flaxseed, elm bark.

Causes. ‘The abomasum in the adult is protected against dis-
order, by the normal activity of the first three stomachs, macera-
ting the food, presiding over the second and more perfect masti-
cation, grinding it between the omasal folds into a finely attenu-
ated pulp and delaying its progress so that it arrives at the fourth
stomach at short intervals and in small quantities only at a time.
It follows that this organ is rarely involved in serious disorder
unless as the result of the ingestion of poisons, or of excess of
water, or from the presence of parasites. In the very young
ruminant, however, the condition is reversed, the first three
stomachs are as yet undeveloped, and incapable of receiving
more than the smallest quantity of food or of retaining the same,
and the abomasum alone is functionally active and receives at
once practically everything that may be swallowed. In the first
few weeks of life therefore the ruminant is exposed to almost the
same dangers, from overloading, indigestion, inflammation and
poisoning as is the monogastric animal. For the time, indeed,
the undeveloped ruminant is in its physiological and pathological

138

Infective Gastro-Enteritis in Calves, Lambs and Foals. 139

relations, a monogastric animal. For this early life therefore
whatever applies to the soliped applies equally well to the
ruminant.

When allowed to suck at will from a healthy nurse, which
completed its gestation about the time the young animal was born,
indigestion is rare. But whatever interferes with the normal
supply is liable to cause derangement. ‘The withholding of the
first milk—colostrum—the laxative properties of which are
essential to clear away the intestinal accumulations of foetal life—
meconium; the placing of new-born offspring on the milk of
nurses that bore their young many months before ; bringing up
of foals on cow’s milk ; working, over-driving, hunting, shipping
by rail, or otherwise exciting the dams ; allowing too long intervals
between the meals—feeding morning and night only, or morning,
noon and night, the nurse being kept at work or pasture in the
interval ; feeding unwholesome food to the nurse ; bringing up by
hand, on cold and even soured milk, or that which has become
contaminated by putrid leavings in the unscalded buckets. Some
of these causes should be emphasized, for example the milk of
excitement and fever, milk that is soured or putrid, and milk
suddenly swallowed in excess. The nurse which is fevered or
subjected to over-exertion has produced an excess of tissue waste
and leucomains which largely escape from the system in the
milk. This milk is therefore at times unwholesome and even
poisonous. Mares subjected to severe work or that fret much
under lighter work, cows carried by car or boat, or driven violently,
and any nursing animal which has been thrown into a fever from
any cause whatever, is liable to yield toxic milk. This would
include the milk of all severe diseases, as being liable to become
charged with toxins and ptomaines and thus poison the young
animal, which subsists upon it as an exclusive diet, even though
the actual pathogenic microbe may not be present in the secretion.

With regard to fermented milk, that which has been simply
soured, relaxes the bowels and the attendant congestion con-
tributes‘to further derangement and even infection by any patho-
genic germ which may be present, or by microbes which are
habitually saprophytic, but take occasion to dangerously attack
the weakened mucosa. If the milk has undergone putrefaction
in the feeding bucket, the co-existence of the septic germ and the

140 Veterinary Medicine.

septic ptomaines and toxins, often determines indigestion and irri-
tation of the mucosa. These poisons may further be absorbed
and produce general constitutional disorder which reacts most
injuriously on the stomach and digestion.

Milk swallowed rapidly and in excess by a hungry calf or foal,
over-distends the stomach, which, like other hollow viscera in
such conditions, is rendered paretic or paralytic, and suffers from
suspension of both the vermicular contractions and the peptic
secretions. Under these conditions the milk, which is one of the
most admirable culture media for bacterial ferments, undergoes
rapid decomposition, with the production of a series of toxins
and ptomaines varying according to the different kinds of microbes
that may be present. Under such conditions microbes which are
normally harmless, vigorously and destructively attack the
mucous membrane and determine some of the worst types of
juvenile diarrhcea. In mild cases reducing the milk to one-half
is one of the best measures.

In artificial feeding there is another serious danger. Calves in
particular are brought up largely on gruels made from farinaceous
material. These contain a large quantity of starch which re-
quires the action of the saliva (ptyaline) to resolve it into glu-
cose, and fit it for absorption. But in the early days of life the
salivary glands are almost entirely inactive, and it is only as the
first three stomachs develop that this secretion becomes normally
abundant. This is sought to be met by fixing in the feeding
bucket a rubber teat, which the young animal is made to suck so
as to solicit the secretion of saliva. The benefit obtained is how-
ever more from the slower ingestion of the milk than from any
material increase of saliva from the as yet functionally inactive
glands.

The presence of hair balls in the stomach, derived from the
skin of themselves or others is one of the most injurious of the
causes of juvenile indigestion. Lying as these do at this early
age in the one well developed stomach they interfere with its
normal secretions, and being at first open in texture they become
saturated with putrefying ingesta, which gives out the most
poisonous products.

The milk is materially affected by the food eaten by the nurs-
ing animal and such variations in the milk tend at times to de-

Lnfective Gastro-Enteritis in Calves, Lambs and Foals. 141

range a weak stomach. The following table from Becquerel and
Vernois gives the results of dry and succulent food on the amount
of the different proximate principles in the milk.

Casein
Water. eee oe: Butter. | Salts.
Nature of Food. Parts in ss rit oa tA Parts in| Parts in
1,000, : 1,000 I,000

Parts in| 1,000
1,000

Cows on winter feed :
Trefoil or lucerne 12-13 lbs.;
oat straw, 9-Io lbs.; beets,
7 \bs.; water, 2 buckets___| 871.26 | 47.81 33-47 | 42.07 5.34
Cows on summer feed :
Green trefoil, lucerne, maize,
barley, grass and 2 buckets

Water. 2202-2 - Ss ccescee: 859.56 | 54.7 36.38 | 42.76 6.30
Goats milk on different rations:

Straw and trefoil_______ ____ 858.68 | 47.38 35.47 52.54 5-92"

Beetsiio oo ses she eee ee 888.77 | 33.81 38.02 33.68 5-72

The decrease of the solids but especially of the casein, sugar,
and salts is very marked in the cow on poor winter feeding. In
the goat fed on beets alone the increase of sugar and decrease of
other solids is striking.

To the same effect speaks the following table giving the results
of an experiment with a ration of corn and cob meal, in contrast
with one of sugar meal. Each cow had a common ration of 12
lbs. corn fodder and 4 Ibs. clover hay, in addition to the test diet
which was 12% lbs. corn and cob meal in the one case, and 10
lbs. sugar meal in the other. To avoid the misleading effects of
a sudden transition from one food to the other, each special ration
was fed for seven days before the commencement of each test

period.

142 Veterinary Medicine.

: mite, | Fat: |Sotids| pot, |sotias| “fat to
Animal and Ration. Lbs. on eat Lbs. | Lbs. sole not
at.
Grade Shorthorn Cow:
Ist 21 days: Corn and cob
mea) ene sa Seis ee eaoe 631 25| 3.43 | 11.57 | 21.67 | 73.02 |422. : 1000
2d 21 days: Sugar meal____|641.50] 4.04 | 12.53 | 25.93 | 83.38 |476.2 : 1000
3d 21 days: Corn and cob .
Meals 2a os oes. Cas 559.00] 3.22 | 11.86 | 17.97 | 66.32 |371.7 : 1000
Grade Shorthorn Cow:
Ist 21 days: Corn ard cob
meal: sto 252 cee 604.75; 3.57 | 11.95 | 21.56 | 72.28 |425 I : 1000
2d 21 days: Sugar meal____|582.00) 3.91 | 12.37 | 22.74 | 72.57 |456.3 : 1000
3d 21 days: Corn and cob
meal... 2-2. eo ee 527.00} 3.37 | 12.05 | 17 78 | 63.48 |389.1 : 1000
Grade Shorthorn Cow :
Ist 21 days: Sugar meal____| 753.50] 3.97 | 12 43 | 29 94 | 93.67 |469.8 : 1000
2d 21 days: Corn and cob
MEA) ose scews cose oes cs 601 50] 3.15 | 11.45 | 18.97 | 68.89 |380.0 : 1000
3d 21 days: Sugar meal____| 560.50] 3.85 | 12.16 | 21.58 | 68.16 |463.3 : 1000
Grade Shorthorn Cow:
Ist 21 days: Sugar meal____| 457.50] 4.15 | 13.27 | 20.25 | 64.69 |455.6 : 1000
2d 21 days: Corn and cob
meal _________-_-_-_----]379 00] 3.51 | 12.00 | 13.30 | 48.09 |382.3 : 1000
3d 21 days: Sugar meal____| 374.50] 3.72 | 13 OL | 13.95 | 48.74 |401.0 : 1000

Here we find a material increase of the solids and particularly
of the fat whenever the sugar (gluten) meal, rich in fat and al-
It is interesting to note the relative
amount of fat albuminoids in the corn and cob meal mixture as
compared with the sugar meal.

buminoids was furnished.

Constituents.

Fat). oncS esses ecsacssctescss
Carb hydrates ___.-------___ ------
Woody ‘fi bréva <2 wens cee
Proteids:.---— 22222225 hsssive wees

Corn and
cob meal,
Per Cent.

8.37
—Bulletin. lowa Agricultural Experiment Station.

Sugar meal,
Per Cent.

6.10
1.17
11.16
52.66
8.64
20,27

‘Such variations in the quality of the milk under different
rations, occasionally affect the weak stomach of the new born
and as the same constitution is likely to predominate in the same
herd, a number may be attacked together as a result of some

change in feeding.

Lnfective Gastro-Enteritis in Calves, Lambs and Foals. 143

Other conditions, however, lead to variation in quality. Hassall
_ found that the morning milk of the cow furnished 7.5 per cent.
of cream, while the evening milk gave 9.5 per cent. Boedecker
found that morning milk had ro per cent. of solids and evening
milk 13 per cent. The first drawn at any milking is poorer in
cream than that which is drawn last. The first may have only
one-half, or in extreme cases one-fourth of the cream that the
strippings have. When the cow is in heat the milk not only
contains more of the solids, but has granular and white blood
cells like colostrum and often disagrees with the young animal.
The milk of the young cow with her first calf is usually more watery
than that of the adult, and that of the old one has a greater ten-
-dency to become acid. The longer the period which has elapsed
since calving the greater the tendency to an excess of salts.
Certain breeds like the Channel Island cattle produce an excess
of butter fat (4—5 per cent.), whereas others like Holsteins,
Ayrshires and Short Horns have less on an average (3—4 per cent. )‘
the casein and, it may be, the water predominating. Hence Jersey
and Guernsey milk will scour calves which do well on that of
one of these other breeds.

Overkept, fermented and soured food tends to produce acidity
and other changes in the milk. Old brewers’ grains, swill, and
spoiled gluten meal, or ensilage, especially such as has been put
up too green, are especially injurious to the milk. The milk of
cows fed on raw Swedish turnips or cabbage acquires a bitter
taste and odor.

The milk of different genera of animals offer such strong
contrasts that it is always dangerous to attempt to bring up the
young of one genus upon the milk of another. The follow-
ing table giving the composition of the milk in woman and each
of the domestic mammals serves to illustrate this and to furnish
.a basis for adjustment :

Woman| Cow. | Goat. | Ewe. |Camel.! Mare. | Ass. Sow. | Bitch,

Density . . | 1032.67 } 1033.38 | 1033-53 | 1040.98}. =. . | 1033.74 | 1034.57 |. . . . | 1041.62
Water... . | 889.08 | 864.06} 844.90 | 832.32]... .| 904.30] 890.12] 854.90) 772.08
Solids. .... 110.92 | 135.94] 155-10 | 167.68/ 134.00 95 70| 109.88 | 145.10 | 227.92
Butter .. .. 26.66 | 36.12 56.87] 51.31] 36.00] 24.36 18.53} 19.50| 87.95
Casein and ex-

tractive mat-

FETS cw 8 39.24 55-15 55:14 69.78 | 40.00] 33.35 35-65| 84.50] 116.88
Sugar..... 43.64 38.03 36.91 39.43 | 58.00 32.76 50.46] 30.32 15.29
Salts (by incin- .

eration)... 1.38 6.64 6.18 7.16 |. i 5.23 5.24] 10.90 7.80

—Becquerel and Vernots.

144 Veterinary Medicine.

Not only does the milk vary so widely with the genera, but
that of the ruminating animal with its great excess of casein
coagulates in the stomach into large dense clots which are not
easily penetrated and digested by the peptic juices while that of
woman or soliped forms loose clots, easily permeable by the gastric
fluids and therefore much more readily digestible. Indeed the
milk of these monogastric animals often forms loose floating
flocculi only, instead of solid clots. As cows are usually selected
for foster-mothers to the orphaned animals of other genera this
becomes a source of danger to the young and must be obviated
by modifying the milk more in keeping with that of man or
soliped.

As predisposing causes, must be named a weak constitution
and damp, dark, filthy, or otherwise unwholesome buildings.
Buildings with no drainage nor ventilation beneath the, floors,
standing on filth-saturated soil, and those with double walls.
holding dead rats and chickens are especially to be dreaded. In
breeds of inconstant color the lighter colored calves (light yellow,
light brown) are more subject to such attacks than the darker
shades (dark browns, reds, blacks). The weak constitution may
be the result of close breeding, without due consideration of the
strength and vigor of the parents. Then young animals kept
indoors in impure air, damp and darkness are more susceptible
than those that are kept in pasture and are invigorated by exer-
cise, pure air and sunshine.

Aside from the general run of causes, predisposing and exciting,
we must recognize the contagious element. Jensen has sought to
identify the microbe as a small ovoid bacillus united in pairs, or
in long chains. This was present not only in the ingesta, but in
the lesions of the mucosa, and inthe lymph glands. Its cultures.
ingested in milk, or injected into the rectum sometimes produced
the affection. Microscopically it resembled the bacillus fcetidus
lactis, but the latter failed to produce the disease. He looks upon
it as a sport of the bacillus coli communis.

Perroncito found micrococci, usually arranged in pairs and com-
parable to the cultures of those obtained from the blood in the
pneumonia of calves. The injection of the cultures into the
thorax of a Guinea-pig caused pleuro-pneumonia with or without
dysentery. The rabbit proved immune. At the necropsy the

L[nfective Gastro-Enteritis in Calves, Lambs and Foals. 145

Guinea-pig like the calf showed the diplococci in the blood.
Nikolski who studied the affection in lambs seeks to incriminate
both micrococci and bacilli.

It is premature to specify any particular microbe as the sole
cause of the affection. It seems not improbable that bacterial
ferments of one or more specific kinds, which in a healthy animal
have no injurious effect, may by special combination, or by growth
in a mucosa in a given morbid condition, acquire properties which
render them not only violently irritating, but may retain such
properties so as to render them activefy contagious. . In this con-
dition they may overcome the resistance of the most healthy
stomach and bowels and attack all young animals into which they
may secure an entrance. Certain it is that the infection may
persist in the same stable for years, will enter a new herd with a
newly purchased cow or calf bought out of a previously infected
lot, and will follow the watershed and affect in succession the
different herds drinking from a stream as it flows downward.

The similarity of the germ found by Jensen to the bacillus coli
communis, suggests that in this as in a number of other con-
tagious affections a pathogenic sport from this common saprophyte
is at least one of the microbian factors in this disease.

Symptoms. ‘These may set in just after birth but usually the
disease occurs within the two first weeks of life. When delaycd
for a few days after birth it may be preceded by some constipation,
the feeces appearing hard, moulded, and covered with mucus,
This is especially the case when the meconium has been retained
and has proved a cause of irritation. The young animal is care-
less of the teat or refuses it (or the pail if brought up by hand),
yawns and seems weary. The abdominal muscles are tense and
the belly msy be swollen if fermentation has already set in but
this is rarely excessive. Straining to defecate usually causes
eructations of an acid odor, and sometimes vomiting of solid sour-
smelling clots. Abdominal pain may be manifested by uneasy
movements of the tail and hind limbs, by looking toward the
flank and even by plaintive cries. This is followed within six
hours by liquid dejections, at first merely soft, slimy and sour
but soon complicated by a peculiar odor of rotten cheese which
becomes increasingly offensive as the malady advances. The
tail and hips become soaked with the discharges and as the

ite)

146 Veterinary Medicine.

putrid fermentation goes on after their discharge of the fecal
matters, the air becomes more and more repulsive. The same
odor pervades the mouth and the breath and tongue is coated
with a whitish, grayish or yellowish fur.

The faeces become more watery and slimy, with much casein
in course of putrefaction, and the patient is rapidly run down
by the profuse discharge and the general poisoning by absorbed
putrid products. In the worst cases this may prove fatal in one
or two days.

When the illness is more prolonged the alvine passages which
at first number five or six per day, increase to fifteen or twenty.
and are passed with more effort, usually leaving the anus in a
liquid stream. The color of the stools changes from a yellow to
a grayish yellow or dirty white, hence the common name of
white scour, and the fcetor is intensified.

Appetite may be in part preserved for a time but is gradually
lost, and the subject becomes dull, listless and weak, indisposed
to rise and walking unsteadily when raised. A general appear-
ance ol unthriftiness, staring coat, scurfy, unhealthy skin, pallor
of the mucous membranes, arching of the back, tucking up and
tendernsss of the abdomen, excoriation of the margins of the
anus, and congestion of the rectum as seen everted during de-
fecation, mark the advance of the disease. Emaciation becomes
very marked, and weakness and prostration extreme.

Fever usually sets in as the disease advances, as marked by
hyperthermia, hot dry muzzle, hot ears, accelerated pulse and
breathing.

When the intestinal fermentation is extreme there may be
distinct bloating, more acute colicy pains, rumbling of the bowels
and a frothy and even bloody condition of the dejections. The
prostration may become extreme and the temperature reduced to
the normal or below.

Death may result from inanition and exhaustion, or from
nervous prostration and poisoning.

The affection may be complicated by purulent arthritis, peri-
tonitis, pneumonia, hepatitis, keratitis or laminitis. It may
prove fatal in from three to ten days.

Mortality. This is always high. For foals it has been set
down at 80 per cent. of the numbers attacked, for calves at 54

Lnfective Gastro Enterltis in Calves, Lambs and Foals. 147

to 90 per cent., and for lambs at 66 per cent. In 500 lambs
Beresow found 300 attacked and 200 died. Kuleschow sets the
losses at 30 to 40 per cent. of the lambs, and Cadeac advises that
even the survivors should be fitted for the butchers as they are
unfit for production.

Lesions. In foals these are mainly confined to the intestines
which show a more or less extended area of redness and conges-
tion with catarrhal or pseudomembraneous exudate on the mucosa,
and the submucous connective tissue is infiltrated, softened and
marked by intense punctiform redness. The epithelium is swollen,
opaque and easily detached, and Peyers patches infiltrated and
prominent. The blood in the intestinal vessel is incoagulable.
Exudation into the peritoneum and softening of the liver are not
infrequent.

In calves the lesions are very similar, but the fourth stomach
is usually implicated, the congestion and epithelial desquamation
being most marked in the pyloric region. The contents of the
intestines are mucopurulent, grayish, yellowish or red, and in-
tensely foetid. The follicles of the small intestine are red and
projecting with an areola of congestion. Softening and even
necrotic centers are found in the liver and kidneys and the
mesenteric glands are swollen, red and softened.

In lambs the lesions are nearly the same in the fourth stomach,
intestine, lymph glands, liver and kidneys. There is usually
marked emaciation and the spleen and nerve centers are anzemic.

Prevention. "The first consideration is to avoid the various
causes which have been enumerated. Give the young the warm
milk of its dam or of a nurse of the same species and at the same
time after parturition. If it is necessary to give older milk to
the new born don’t fail to clear out the bowels by a tablespoonful
or two of castor oil (foal, calf,) or two teaspoonfuls (lamb), or
to add manna or linseed decoction to the milk. Protect both
nurse and nursling against cold storms, overheating, overwork,
excitement, and sudden changes of diet, (dry to green, etc.)
If the nurse has been overheated or overexcited draw off the first
milk by hand and let the nursling have only that which is se-
creted later. Avoid the milk of diseased and especially fevered
animals. If the milk of one nurse disagrees, correct any obvious
cause in the food or general management, and if none can be

148 Veterinary Medicine.

found get another nurse. If fungi appear in the milk (inducing-
ropiness or not) withold the food or water from which they have
been probably derived and give bisulphite of soda (cow or mare
2 to 4 drs.,ewe % dr. daily). When an animal of one genus has
to be brought up on the milk of another, let the milk be so modi-
fied by the addition of water, sugar, cream, etc., as will approxi-
mate it somewhat to the normal food. The milk of the cow may
be given unchanged to lambs or kids, while for the foal it should be
diluted by adding 2 of boiled water, and sugar enough to render it
perceptibly sweet. Even more sugar is wanted for the young
ass. In place of simple water, barley water may be used, as this
not only loosens the coagulum formed in the stomach, but ren-
ders it especially open and permeable to the digestive fluids.
Another method of special value to puppies is to let the cow’s
milk stand for several hours and then take only the upper half
containing most of the cream) for feeding. This must be
watched lest it should unduly relax the bowels. In all cases,
the milk artificially prepared should be given milk warm. To
retard the acid fermentation which is liable to occur early and
injuriously in adapted milk, the addition of an ounce of lime
water to each quart of milk is of great advantage. Pigs and
puppies can usually adapt themselves readily to the milk of the
cow. Inall cases in which a young animal is raised by hand
and especially if on the milk of another species, it is desirable
to provide against sudden overloading of the stomach. ‘The arti-
ficial rubber teat fixed in the feeding pail serves a good purpose
in this respect. Pasteurizing is admissible but boiling of the
milk is objectionable, as rendering the milk constipating and
thereby favoring irritation. In condensed milk this tendency is
largely reduced by reason of the excess of sugar and consequent
looseness of the clot, only care should be taken to dilute it suffi-
ciently with boiled water.

Among the most important measures of precaution, is the
separation of the sick from the healthy, and to disinfect
thoroughly the buildings in which the infected have been.
Straw, and when possible dung should be burned; if not, they
should be buried together with the urine. The stalls should be
thoroughly cleansed and then saturated with mercuric chloride °
(1: 1000), or sulphuric acid (3: 100), or a saturated solution of

Infective Gastro-Enteritis in Calves, Lambs and Foals. 149

sulphate of copper. Here, as elsewhere chloride of lime (4 0z. to
the gallon) with as much quick lime as will make a good white
wash, does admirably, as it is at once seen if any part has been
missed.

Esser remarked that the calves of cows that had been removed
to another stable some time before parturition, usually remained
‘healthy, provided they were kept from the other and sick calves.

Lastly, it is important to use for breeding purposes such
animals only as have a strong, vigorous constitution, and to
furnish a healthful, abundant aliment and to allow a sufficient
amount of exercise during gestation. Vigor and stamina are the
great desiderata, but these are usually found with the darker
colors.

Treatment. ‘The old treatment of eliminating offensive matter
by a laxative is still good, and thus castor oil (2 ozs. for a foal
or calf, 2 drs. for lamb), or rhubarb (1 dr. foal or calf, 1 scr.
for lamb), or manna (% oz., foal or calf, 1 dr., lamb), may
be given with laudanum (1 dr., foal or calf, 10 drops, lamb), and
salicylate of soda (16 grs., foal or calf, 5 grs., lamb). The
milk should be given boiled and in small amount. An old and
excellent remedy to follow the laxative is solution of rennet
made by adding 4 of acalf’s abomasum to a quart of 20 per cent.
alcohol (or sherry). A tablespoonful may be given with each
meal. The value of this as an antiferment is liable to be over-
looked, yet both the hydrochloric acid and pepsin are strongly
antiseptic, and neither of these is produced to any extent in the
diseased stomach. In addition to this ipecacuan has been used
and by its stimulant action on both stomach and liver it fur-
nishes the two most important natural disinfectants of the ali-
mentary canal (foal or calf 1 dr., lamb, 1o drops ipecacuan wine,
thrice a day).

In addition to these or separately, antiseptics, carminatives
and astringents may be employed. An excellent preparation is
prepared chalk 1 0z., white bismuth 1 oz., tincture of cinnamon
8 ozs., gumarabic % oz. A tablespoonful thrice a day will often
check the disorder.

Cadeac advises subnitrate of bismuth 5 grains, salicylic acid 5
grains, naphthol 20 grains, syrup 150 grains, distilled water 100
grains. One or two tablespoonfuls in the mouth after each drink
(foal or calf).

150 Veterinary Medicine.

Filliatre obtained excellent results in calves, with a solution of
tar 150 grams in 6 litres of boiling water, given in the dose of 4
litre every half hour. It may also be used asanenema. The
diarrhoea is promptly checked, and the tar water may then be re-
stricted to 14 litre mixed with the milk of the next two days.
One-tenth of the dose may be given to lambs.

Among other antiseptics in use may be named salicylic acid and
tannin, salol, boric acid, betol, dianaphthol, benzonaphthol, salicy-
late of bismuth, creolin, naphthalin, and lactic acid.

When icteric membranes, white discharges and extreme fcetor
indicate hepatic disorder, calomel 1 part and chalk 12 parts may
be resorted to three or four times a day (foal or calf 6 grs., lamb
I gr.).

Among the carminatives may be named anise, fennel, dill, cin-
namon, and chamomile. Beside their stimulant action these are
all more or less antiseptic.

In addition to the boiling of the milk, and in certain cases asa
temporary substitute, may be used sterilized mucilaginous agents,
gum arabic, flax seed, and slippery elm.

GASTRO-ENTERITIS IN CALVES FROM UMBILICAL,
INFECTION.

Under this heading will be noticed the peculiarly fatal affection,
which starts by infection from the umbilicusin the first or second
day after birth and proves fatal after a few days dysenteric gastro-
enteritis, or later after an extension to other organs—lungs, liver,
kidney, joints.

Causes. As predisposing causes, may be accepted all conditions.
of hereditary debility, and post-natal exposure, which contributes
so strongly to the common wézte scour. In the more rapid cases,
occurring just after birth, the evil effects of the milk cannot well
be invoked, but in those which occur some days later, any un-
wholesome or poisonous quality in that secretion, as well as the
overloading of the stomach with good and wholesome milk can-
not fail to contribute to the fermentation of the gastric and intes-
tinal contents and the production of a complex infection and in-
toxication.

Gastro-Enteritis in Calves. 151

In the deadly outbreak in Ireland, Nocard found in the blood
and lesions of the most acute and fatal cases, a bacterium of the
colon group, showing the characters of those causing haemorrhagic
septiceemia and classed as pasteurellas by Trevisan. It wassmall,
nonmotile, ovoid, taking a polar aniline stain, bleaching in Gram’s
solution, and failing to liquefy gelatine, or form indol, or grow
on potato. This organism was formed usually in pure culture,
in the blood and lesions of the most acute cases in their early
stages. In milder cases and in advanced stages it was often un-
detectable or absent. This is explained by Lignieres on the

- hypothesis that its early presence debilitated the tissues and laid
them open to the attacks of the more common bacteria of whzte
scour, which being more prolific and hardy crowded out and elim-
inated the septicaemia bacterium, but themselves carried on the
disease to a speedily fatal issue.

In his earlier cases Nocard found these common bacteria only
in complex cultures, but later he detected the pasteurella (cocco-
bacillus) in impure culture in a diseased femoro-tibial joint of one
of the subjects, and growing this cocco-bacillus in pure cultures,
he found them to be very virulently infective.

A few drops, injected into the peritoneum of a Guinea pig, or
veins of a rabbit, killed in six to eighteen hours with the lesions
of Septicaeemia heemorrhagica which characterize the most acute
cases of white scour. The blood and viscera swarmed. with the
microbe.

A calf oue day old received in the jugular 3 cc. of the culture,
had hyperthermia in six hours and in twenty hours lay with
sunken eye, retracted abdomen, a temperature of 95° F., and a
profuse, yellowish, foetid, feecal discharge. Death took place
30.5 hours after the injéction and all the lesions of acute white
scour were met with.

A second calf four weeks old, which had already suffered from
white scour and recovered had an injection into the jugular of
10 cc. of the same culture. In six hours it suffered a slight rise
of temperature, was dull and breathed short, but in twenty hours
he was completely recovered, full of life and appetite.

In other casual and experimental cases, Nocard found that,
when death occurred within one or two days after birth, the
symptoms and lesions were mainly those of haemorrhagic septi-

152 Veterinary Medicine.

ceemia and whzte scour, whereas, if the calf survived several days,
the impaired resistance of the tissues invited the invasion of a
variety of other germs from the intestines, and infective inflam-
mations of the lungs, joints and other organs were brought about
by such secondary invasions.

An important question is as to the direct source of the primary
(Pasteurella) infection. The concentration of the morbid process
on the alimentary canal in acute cases strongly suggests infection
through the food (milk). But careful bacteriological examina-
tion of the milk taken with thorough antiseptic precautions from
the dam of a calf which had just died of whzte scour, and of other
cows in the same infected stable showed that both were free from
the germ. Inoculations' and culture experiments were equally
fruitless.

This does not exclude the possibility of the contamination of
the milk, obtained under ordinary conditions, with the germ con-
tained in the floating barn dust, or that which was adherent to
the teat and udder.

Another suggestion is that the germ is derived from the in-
fected womb, prior to birth, but in such a case, Nocard claims
that abortions would be much more prevalent, as the rapidly
fatal issue of the disease would determine the prompt death of
the foetus and its expulsion. The foetus is, however, in a meas-
ure protected by the absence of any infection atrium in the shape
of an open wound, and by the comparative absence of culture
media in stomach and intestines, as well as by the antiseptic
nature of the contents owing to the presence of biliary products.
Back of this is the antagonism of the maternal system which
would be liable to suffer first in case the cocco-bacillus were
propagated in the blood of the dam. ‘The coincidence of abor-
tion and whzte scour in a herd is not uncommon, and in such cases
intrauterine infection of the foetus is not improbable but in the
great majority of epizodtics no such coincidence exists.

We are thus thrown back on infection through the raw wound
of the ruptured umbilical cord, as the rule in such cases. It may
be that this has come from the vagina or vulva, but, in the great
majority of cases it is manifestly derived from the infecting bowel
dejections and the dust caused by their desiccation. The extra-
ordinarily rapid progress, and fatal result of the acute disease,

Gastro-Enteritis in Calves. 153

and the early abundance of the germ in the blood, suggest that
‘the microbe traverses the umbilical vein to the liver, and finding
a congenial home in the blood is quickly distributed through the
entire body.

Prevention must be based mainly on the destruction and exclu-
sion of the microbe, and the fortifying of the system of the calf.
‘The general measures mentioned under white scour are still
applicable. The thorough disinfection of the stable by mercuric
chloride has not given us uniformly satisfactory results, even
when the building has been kept apparently almost immaculately
clean. The microbe hidden away in the intestinal contents of
the dam, still mixes with the stable dust, litter, etc., and infects
as before. A more effective method is to remove the cow toa pure
(new or disinfected) stable for a week or ten days before calving,
and then turn her into a third pure stable or field for parturition.
“The second and third stable, like the first, must be thoroughly
disinfected at short intervals. Parturition in a clean pasture, if
weather permits, is the preferable course.

When the disease has entered a herd, the precautions should
not stop with the attempt to secure an aseptic parturition.
Nocard prescribes as follows to secure antisepsis of parturition
and of the offspring :

‘* Cows ready to calve should be provided with dry and clean
bedding until after the birth of the calf.’’

“* As soon as labor sets in, the anus, vulva and perineum should
be cleaned with a tepid solution of lysol in rain water: 20
grammes of lysol to each litre of water. The vagina should also
be cleansed by injecting, with a large syringe, a great quantity
of the same solution tepid.”’

‘“‘ As far as possible, the calf should be received on a clean
cloth, or on thick, fresh bedding, not soiled by urine or faeces.”’

‘‘The cord should be tied immediately after birth with a liga-
ture kept in a lysol solution, and the cord amputated below the
ligature.’’

‘The stump of the cord and the umbilicus should be washed
with the following solution :

Rain water-_----- -------------------- I litre
Jodine crystals_----------------- 2 grammes
Potassium iodide-------------- 2 grammes.”’

154 , Veterinary Medicine.

“‘The disinfection of the umbilicus and cord should be com-

pleted by coating them with
Methylic alcohol -------------------- 1 litre
Iodine crystals__-------------- 2 grammes.’’

‘‘ When the alcohol has evaporated the cord and umbilicus
should be covered with a thick layer of iodine collodion (1 per
cent.) applied with a brush. When the collodion has dried the
calf may be left to the care of the dam.’’

Considering that the feeces of the dam are the usual source of
infection it would be safer to keep dam and! offspring strictly
apart. In such a case, the precaution should be taken to feed
more than twice a day and in small quantities only (half the
usual amount).

This treatment may be modified by substituting other fanti-
septics.

Any indication of scouring or illness on the part of a calf
should be the signal for its instant removal, and the thorough
disinfection of its pen or of the entire calf-stable. Best leave
such pen unoccupied for some time.

The claim is made that the injection of the new-born calf,
subcutem, with the blood serum of a mature bovine animal will
confer on it the immunity which comes to it after the first week
of life, and in advancing life.

ACUTE GASTRIC INDIGESTION IN SOLIPEDS. TYM-
PANITIC STOMACH.

Definition. Causes: overloading, lessened secretion, mastication or in-
salivation, frosted food, fermenting food, appetizing food, cooked food, de-
bility, disease, starvation, overwork, fatigue, violent exertion after a meal,
anemia, parasitism, injury to vagi or their centres, iced water, wading or
swimming in iced water, food with excess of proteids, drink after grain,
alkaline waters. Symptoms: in slight cases, in severe, violent colic, weari-
ness, pinched countenance, acid mouth, bloating of abdomen, anorexia,
dysphagia, no rumbling of bowels, no feces, tries to eructate, dullness,
stupor, coma, vomiting. Rupture of stomach. Recovery. Lesions: over-
distended stomach, ruptured, peritoneal hemorrhage, ruptured diaphragm»
small bloodless liver andspleen. Diagnosis. Treatment: Aromatics, stim-
ulants, antiferments, laxatives, stimulants of peristalsis, exercise, friction,
electricity, chloral hydrate, puncture of stomach and colon, probang,
stomach pump, dieting, tonics.

Acute Gastric Indigestion in Solipeds. 155

Definition. Suspension of the normal functions—motor and
secretory—of the stomach and the supervention of fermentation
in its contents.

Causes. ‘The small size of the stomach in the soliped (16
quarts) and the rapidity with which the alimentary matters
normally traverse it, render this organ much less subject to dis-
order than the complex stomachs of ruminants. In his native
state the horse eats at frequent intervals and digestion is con-
stantly going on, so that the viscus is never distended to paresis,
nor the secretions, nor vermicular movements retarded by excess
of ingesta. But the limited capacity of the viscus becomes in its
turn a cause of indigestion whenever the animal is tempted by
hunger to hurriedly swallow too great a quantity of food ; when
the decreased secretions fail to act with sufficient promptness on
the contents and leave them to undergo fermentation ; when from
imperfect mastication and insalivation the food is left in large
masses comparatively impermeable to the gastric juice, and ac-
cumulates in firmly packed masses; when frosted food (roots,
potatoes, apples, turnip tops, etc. ), taken in quantity temporarily
chills and paralyzes the stomach, and starts a speedy and gaseous
fermentation ; when the food swallowed is already in process of
fermentation (musty or covered by cryptogams) and full of toxic
fermentation products which tend to paralyze the stomach. Old
animals are especially liable because not only are the teeth and
salivary glands ineffective, but the functions of the stomach are
habitually below par.

The paralysis of the stomach by overloading is seen especially
in animals that have been fasting for too great a length of time,
and are then furnished with a food, rich, appetizing and abund-
ant. Few horses are proof against the temptation to overeating
when they get to the cornbin, the ripening grain or maize, or the
field of rich red clover. Some are natural gluttons and on gain-
ing access to grain or green food, will suddenly overload the
stomach beyond its power of active contraction on its contents,
and without sufficient mastication or insalivation. The food is
literally bolted whole, with no admixture of saliva, and no facility
for admixture of gastric juice, even if the overloading had left
the stomach capable of secreting the latter. Cooked food is
especially dangerous by reason of its bulk, the facility with which
it is swallowed, and the rapid and excessive dilatation of the

156 Veterinary Medicine.

stomach caused by it, rather than from lack of trituration and
saliva. If fed judiciously, cooked food is more fattening for
both horse and ox, any lack of ptyaline being counterbalanced
by the presence of amylopsin in the intestines.

Such paresis and indigestion, however, are more common as
the result of a general debility or a special gastric atony caused by
disease, starvation, overwork or fatigue. In all acute febrile and
inflammatory diseases the gastric functions are weak or sus-
pended, and if the animal is tempted to eat, the ingesta is un-
affected by the digestive fluids and forms a suitable fluid for
injurious fermentations. In convalescence especially, when the
starved system once more craves support, tempting food is liable
to be taken to excess, unless the attendant is especially judicious
and careful in grading the feed as the stomach can dispose of it.
The horse that has been starved must be fed little and often, of
easily digested material until the gastric functions are restored.
Long continued severe work, exhausts the motor and secretory
power of the stomach, as it debilitates the system at large, and
the animal may be at first unable to digest a feed of grain even
if he will take it. In such a case as in that of the very hungry
glutton a drink of gruel or a handful of hay which he must
masticate will often obviate the danger.

Violent exertion immediately after a meal arrests digestion,
and tends to a fatal indigestion. An animal fed grain and im-
mediately put to severe work, or subjected to confinement for a
painful operation, may die in two hours from tympanitic indiges-
tion.

This weakness of the digestion may come from profuse bleed-
ing, from the aneemia caused by parasites (sclerostomata), or
from injuries to the pneumogastric nerves or their centres. It
can be produced experimentally by cutting both vagi; the gastric
contents then remain packed and solid, without peptic juices and
without digestion.

Iced water, like frozen food, may temporarily arrest the gastric
functions and entail fermentation. It acts most dangerously on
the overheated and exhausted horse, and though the indigestion
may not prove fatal, it may induce a sympathetic skin eruption
or laminitis. The mere exposure to external cold is less to be
dreaded as there is a compensating stimulus which drives the
blood to internal organs, the stomach included. Standing in cold

Acute Gastric Indigestion in Solipeds. 157

water or wading or swimming a cold river, is commonly less in-
jurious than a full drink of iced water, when heated and fatigued.

Certain kinds of food are far more dangerous than others, and
especially such as should be digested in the stomach. ‘Thus the
different grains—barley, rye, buckwheat, wheat, oats, Indian
corn, and even bran, have been especially objected to. The
amount of proteids in oats, for example, is 11.9 per cent., while
those of hay are but 7 per cent. The same bulk of oats, there-
fore, demands nearly double the work of the stomach to reduce
its nitrogenous constituents to peptones than does hay. But
when fully insalivated the difference is even greater, for oats
take but the equivalent of their own weight of saliva, whereas hay
takes four times its own weight. There is one part of proteids in
16.7 parts of insalivated oats, and but 1 in 71.4 of insalivated
hay. If the oats are bolted without mastication, which can
never be the case with hay, the discrepancy becomes greater still.
Grain is best fed often, in moderate amount, and without further
loading of the stomach immediately with either solids or fluids.
Above all, never feed grain to a thirsty horse and then lead him
direct to the watering trough. Even should he fail to have the
stomach paralyzed by the cold water, and indigestion developed,
yet much of the proteids will be washed out into the small intes-
tine to threaten indigestion there.

Selenitic waters may induce indigestion by neutralizing the
hydrochloric acid of the stomach and interrupting digestion.

Finally, all forms of gastritis—catarrhal, toxic, and phleg-
monous—induce atony, fermentation and indigestion.

Symptoms. There may be simply tardy digestion or grave
disorder with impaction or tympany.

In the former case there is impairment or perversion of appe-
tite, refusal of food, irregular feeding, licking earth or lime, or
eating filth, even feeces, with some dullness, apathy, or signs of
pain such as pawing with the fore feet, or looking round at the
flanks. ‘There is rumbling of the bowels, followed in favorable
cases by the passage of flatus, of softened feeces containing im-
perfectly digested food, and distinct diarrhoea which proves
curative.

The more violent attacks set in suddenly, usually within one or
two hours after feeding. There are usually colicy pains, pawing,
looking back at the flank, kicking at the abdomen with the hind

158 Veterinary Medicine.

feet, lying down, rolling, rising again quickly, yawning, anxious
pinching of the countenance, rigid loins insensible to pinching,
and heat and dryness with an acid odor in the mouth. ‘There is
soon observed some swelling and tension of the belly with tym-
panitic resonance on percussion in the left hypochondrium.
There is no elevation of temperature as in gastritis, and no com-
plete intermissions of pain as in spasmodic colic, but pain is con-
tinuous, though worse at one time than another. There is an
utter indisposition to eat or drink and if liquids are given by
force there is manifest aggravation of the sufferings. Asa rule
there is no rumbling of the bowels, and though the animal may
strain violently, little or nothing is passed, except at the first a
few moulded balls of dung. The bowels like the stomach are
paralyzed. In some cases there are attempts at regurgitation,
the fore feet are placed apart, the neck arched, the lower cervical
muscles are contracted and the nose drawn in toward the breast.
In some instances relief is obtained by belching gas or by actual
vomiting of solid matters. Vomiting in the horse is always
ground for suspicion, since it usually occurs when the muscular
coat of the stomach is ruptured. An important hindrance to
vomiting lies in the loose folds of the mucosa covering the cardia,
in the flaccid condition, and as these folds may be entirely effaced
in hernia of the mucosa through the muscular coat as well as in
the overdistended condition, vomiting may be either a fatal or a
favorable indication. If vomiting takes place, without attendant
prostration and sinking, and if on the contrary there is manifest
improvement after it, it may be looked on as a beneficent out-
come.

If no such relief is obtained the patient becomes increasingly
dull and stupid ; the breathing is accelerated, short, moaning or
wheezing ; the nostrils dilated ; the nasal mucosa dark red ; the
superficial veins, especially those of the face, are distended and
prominent.

The nervous symptoms may vary. Usually the dullness in-
creases to stupor, the animal rests his head on the manger or
against the wall, or if at liberty he may move forward or around
blindly until some obstacle is met and he stumbles over it or
pushes against it. In some instances there is champing of the
jaws, or irregular motions of the limbs, but more commonly the

Acute Gastric Indigestion in Solipeds. 159

dullness goes on to stupor or coma, the animal falls helpless
and dies in a state of profound insensibility.

If the stomach should become ruptured there is often vomiting,
the ingesta escaping by the nose, without any relief of the general
symptoms, but with an increasingly haggard expression of coun-
tenance, sunken eye, accelerated, weak, and finally imperceptible
pulse. Cold sweats, which may have been already present, be-
come more marked and the prostration becomes more extreme
and the abdominal tenderness more marked. ‘There are muscular
tremblings of the shoulders and thighs, dilatation of the pupils,
rapid breathing and stupor which presages death.

Recovery may be hoped for if rumbling in the bowels com-
mences anew, if defecations continue and become soft and liquid,
if urine is passed abundantly and if the general symptoms are
improved. Complete relief may be had in five or six hours, and
even in protracted cases in two days.

Lesions. 'The body is swollen, tense and resonant ; the rectum
usually projects somewhat and is dark red; the intestines, small
and large, are tympanitic; the stomach is double or triple its
usual size, tense and resistant, and with its contents may weigh
as much as 4o pounds. When cut open its contents are seen to
be disposed in the order in which they were eaten, in stratified
layers, the motions of the stomach have not operated to mix
them. There is no sign of digestion, unless it be in a thin sur-
face layer or film which may be white, pulpy and chymified.
‘The cuticular mucosa is usually unchanged further than its at-
tenuation by stretching, the alveolated mucosa also attenuated is
congested, opaque or slightly inflamed. The great curvature
may be the seat of a rupture the edges of which are slightly
swollen, congested and covered with small blood clots. The
escaping ingesta usually remains enclosed in the omentum, which
thus looks like a larger stomach with extremely thin gauze-like
walls. If this is ruptured then the food floats in masses among
the convolutions of the intestines. The peritoneum is red, hem-
orrhagic and covered with more or less exudation.

Another occasional lesion is rupture of the diaphragm. ‘The
liver and spleen are usually small and comparatively bloodless,.
owing to the compression.

Diagnosis. This is largely based on the speedy supervention
of the attack on a feed, the animal having been apparently well

160 Veterinary Medicine.

before, on the onset by slight colics, rapidly passing into great:
and continuous suffering and stupor, with tympanitic tension of
the abdomen, and suppression of the intestinal movements, in the
absence of any distinct or marked hyperthermia. The rapid pro-
gress to death or recovery is equally characteristic.

Treatment. In mild cases the prompt use of aromatics will
sometimes succeed ; tincture of pimento, anise or coriander 2 to-
3 ounces, oil of peppermint, 20 to 30 drops. Stimulants, aqua.
ammonia, 1 to 2 drachms, largely diluted, ether 1 ounce, brandy
or whisky 1 pint, will sometimes succeed. A good combination
is dilute hydrochloric acid, 1 drachm, oil of turpentine 1 ounce,
olive oil % pint.

Still more effective in the rousing of the torpid vermicular’
movements are eserine sulphate 1.5 grains or pilocarpin 2 grains,
or barium chloride 7 grains sub-cutem or intravenous and tepid.

These largely replace the old plan of giving a dose of aloes in
bolus, but in case of need aloes may still be given in ounce doses.
in cold water rectal injections. The cold serves to rouse the
vermicular movements of the bowels and sympathetically of the
stomach.

Walking exercise, friction over the abdomen, and even electric:
currents through the epigastrium and left hypochondrum may be
helpful.

In very urgent cases, 1 to 2 ounces chloral hydrate is often.
effective. It acts as a powerful anti-ferment, checking further’
extrication of gas, and counteracts spasms of the bowels, so that
gas passes more freely per anum, vermicular movements are re--
sumed and recovery may be hoped for.

Puncture of the stomach through the external abdominal wall
can only be effected by transfixing the transverse colon above:
which it lies and few have the hardihood to undertake this. It
may, however, be punctured with comparative safety through the-
fourteenth to the seventeenth intercostal space in its upper half.
(Scammel). The overdistended stomach pressing forward on the:
left half of the diaphragm, applies that against the inner surface
of the ribs, the lung being driven forward out of the way, and the-
liver and colon are also displaced, so that the trochar transfixes.
the skin, intercostal muscles, costal and phrenic pleura, diaphragm,
peritoneum and stomach. The marked drum-like resonance on
percussion indicates the best point for the puncture, and the:

Acute Gastric Indigestion in Solipeds. 161

trochar should be directed inward and slightly backward and
_ pushed until solid resistance at its point ceases. As the intestines
are usually tympanitic as well it may be requisite to puncture also
the czecum and colon, to restore the peristalsis of the alimentary
tract generally. Antiseptics such as sulphurous acid, the sulphites,
or hyposulphites, calcium chloride, bleaching powder, potassium
permanganate or chloral hydrate, may be introduced through
the cannula or by the mouth.

As far as the stomach is concerned, an effective relief can be
had through the probang or stomach pump. A small one-half
inch hollow probang may be safely passed through the nose and
gullet into the stomach, and any gas or liquid allowed to escape.
This may act as a syphon or with proper attachments this may
be fixed to a stomach pump and the viscus exhausted of all avail-
able liquid, after which an equal amount is pumped in and again
withdrawn, until the contents are reduced to a normal amount.
The water pumped in may be rendered antiseptic by sodium chlo-
ride, sodium bisulphite, or other antiferment, so that further ex-
trication of gas will be prevented. Ifit is necessary to use the
ordinary probang or stomach tube introduced through the mouth,
great care must be taken in introducing it to see that the soft
palate does not deflect it downward into the larynx. Its presence
in the gullet above and beyond the larynx can_be felt by manipu-
lation from without, and until this is ascertained it should on no
account be pushed onward.

The importance of a measure of mechanical rellef such as this,
is the greater that the stomach of the soliped is non-absorbing,
and relief from undue pressure of contents can only be had by
their passage upward or downward. Then again, the horse
cannot vomit like the carnivora and omnivora, nor regurgitate
like ruminants, and if left to himself with engorged stomach, his
case is hopeless indeed.

The contingent weakness in cases of recovery may demand
careful feeding and a course of bitter tonics.

II

GASTRIC INDIGESTION IN CARNIVORA.

Causes: too frequent feeding, indigestible food, epidermic products,
bones, tendons, rubber, cords, marbles, pebbles, catarrh, inflammation,
intestinal lesions, fever. Symptoms: dullness, restlessness, eating grass,
vomiting, seeks seclusion, colics, giddiness, tense, tender abdomen. Treat-
ment: emetic, diluents, dieting, tonics.

Causes. Unintermittent work of the organ wears out its tone
and indigestion follows. The more indigestible the food, and the
admixture with the food of indigestible materials the greater the
tendency to this fatigue and atony. ‘Thus epidermic materials,
hair, horn, wool, bristles, feathers are often injurious ; also bones,
tendons, and above all pieces of rubber, caouchouc, cords, mar-
bles, pebbles and other small objects. Fortunately such agents
are usually rejected by vomiting, but if retained, the movements
of the viscus become tardy and its secretions defective, and fer-
mentation, indigestion and irritation ensue. The evil effects
however mostly come of catarrhal and other inflammations of the
stomach, and serious lesions of the intestines, (inflammation,
obstruction, volvulus, intussusception, tumors, strangulated her-
nia,) or acute fever. In any such case the stomach ceases to act,
and its contents become a center of active fermentation with
more or less irritation.

Symptoms. In transient cases the dog wlll appear dull and
restless, moving about, and, if opportunity affords, perhaps eat-
ing grass so as to hasten emesis and relief, With this relief the
subject may remasticate and swallow the very materials he has
vomited.

If relief is not secured by vomiting, the animal remains dull,
anxious, retiring, seeking perhaps seclusion and darkness, is taci-
tnrn, moves continually, lying down first on one side and then
on the other, or successively in different places, looks round at
the belly, starts up suddenly with a piercing cry, and may appear
giddy and uncertain in his gait. The abdomen is usually tense
or even full and tender to touch.

Treatment. ‘The first resort is the evacuation of the stomach
by vomiting. Give tepid water and tickle the fauces with a
feather or the finger. Or % to 1 gr. tartar emetic in a teaspoon-

162

Acute Gastric Indigestion in Swine. 163

ful tepid water, or a teaspoonful of ipecacuan wine. Or % dr.
of a zhy Solution of apomorphia hypodermically. Beyond this,
little is wanted except careful feeding as regards quantity and
quality. Nux vomica % gr. twice a day will serve to restore
tone. Further treatment will come naturally under catarrhal
gastritis.

ACUTE GASTRIC INDIGESTION IN SWINE.

Causes: fermented or putrid swill, spoilt vegetables, frozen aliments,
caustic alkalies (powdered soaps) from kitchen, indigestible materials,
poisons. Symptoms: dullness, grunting, restlessness, seeking seclusion,
colics, vomiting, rumbling, tense, tucked up abdomen, diarrhoea. Treat-
ment : emetic, bland acids, laxative, dieting, bitters, iron.

Causes. Swine have such a varied dietary, are so constantly
fed swill containing all manner of ingredients and often kept in
barrels, etc., that are never emptied and cleansed, and therefore
so often the seat of septic fermentation, that both gastritis and
enteritis are often produced. Spoilt turnips, potatoes, apples and
other succulent vegetables, or those that have been exposed to
frost, or which are devoured while frozen are additional causes of
irritation. The various caustic alkaline powders used in washing
the table dishes and the product added to the swill.is another
cause of such outbreaks which, attacking a whole herd at once, is
attributed to hog cholera. Then indigestible materials (hoofs,
hair, bristles, tree bark, etc.) when they fail to be rejected by
vomiting cause gastritis and indigestion. Finally a long list of
medicinal and toxic substances act in this way.

Symptoms are like those seen in dogs, dullness, arching of the
back, drawing the feet together, erection of the bristles, hiding
under the litter, grunting, restlessness, frequent movement from
place to place, lifting of the hind feet, grubbing in the litter with
the snout, tension of the abdomen, and often abdominal rumbling
followed by diarrhoea and recovery. More commonly, however,
relief comes from early rejection of the irritant matters by
vomiting.

Treatment. Induce emesis as in the dog. Give vinegar in
case of alkaline poisoning. Follow this by a laxative if the irri-

164 Veterinary Medicine.

tants have gained the intestines, and finally a course of iron or
bitters. Careful dieting is absolutely essential.

ACUTE CATARRHAL GASTRITIS IN THE HORSE.

Causes : wet fermented food, cryptogams, bacteria, sprouted green pota-
toes, sand, irritants, hot food, frosted food, ill health, starvation, anzemia,
siliceous plants, diseased teeth or salivary apparatus, parasites, calculi,
specific inflammations. Symptoms: depraved appetite, licking soils, walls,
filth, etc., clammy mouth, red bordered tongue, eructations, colic, rumbling,
tympany, icterus, costive, coated feces, tender hypochondrium, anorexia,
emaciation. Lesions: stomach full or nearly empty, pyloric sac congested,
mucosa thickened, petechiated, with excess of mucus and desquamated
epithelium, cells swollen opaque, congested duodenum, pale yellow liver,
with excess of pigment in celis, also in urine, ruptured stomach, hemor-
rhagic infiltrations. Treatment: careful dieting, laxative, stomachics,
pepsin, antiferments, bitters, ipecacuan.

Causes. This is a much less common affection in horses than
dogs and is usually charged on some fault in diet. Fodders that
have been badly harvested or wet from any other cause and are
musty, dusty, rusty, or covered with any irritant or poisonous
cryptogams or bacterial ferment, sprouted oats, or potatoes that
have become green by exposure to the sun, sand and gravel in the
grain, irritant plants like ranunculus, euphorbium, veratrum, etc.;
cooked food given too hot, or vegetable food given frosted ; putrid
water, and indeed all the causes of indigestion tend to produce
gastric catarrh. Weakness of the stomach and gastric functions
from any cause isa concurrent factor. Thus extensive inflamma-
tions and violent fevers, prolonged abstinence, starvation, anzemic
and parasitic affections, the action of frozen food on the viscus,
are to be feared. A horse which has been for a week or more
without food is extremely subject to such attacks unless fed with
the greatest caution at first. Irritant plants like carex, equise-
tum, etc., which act mechanically by reason of the contained
silica, food imperfectly masticated on account of disease of the
jaws, teeth or salivary glands, parasites like spiroptera and bots
and phosphatic and oat-hair calculi, act mechanically. Finally
certain affections like petechial fever, influenza, pneumonia,

Acute Catarrhal Gastritis in the Horse. 165

pustulous stomatitis and horse pox may develop local foci of in-
flammation in the stomach. When once started, microbian
infection tends to maintain and aggravate it.

Symptoms. These are very indefinite, depending very much
on the complications. Some loss or perversion of appetite, a
licking of the soil and walls, eating litter, filth and even manure, a
clammy mouth, a redness along the margin of the tongue, eructa-
tions or attempts to eructate, or actual vomiting, colicy pains
which are usually dull until the bowels are implicated, more or
less rumbling in the bowels, sometimes icterus, in other cases
tympany, and nearly always tardy passage of hard and scanty
mucus-covered fzeces. The colics may be intermittent, appearing
only just after food is taken, or they may be continuous, the
animal pawing incessantly hour after hour. A slight hyperther-
mia and a distinct tenderness of the epigastrium and left hypo-
chondrium to pressure are valuable symptoms. Percussion causes
even keener suffering.

If the gastric contents are abundant and fermentation active,
death may ensue from gastric tympany. In other cases, the
persistence of colic at the time of feeding, of impaired appetite,
constipation and loss of condition are the main symptoms. In
the last named cases the patient may die of marasmus.

Lesions. Incases terminating in fermentation and fatal tympany
the stomach is full; in other cases it is empty of all but water,
mucus, and perhaps some irritant contents, or decomposed food.
The alveolar mucosa of the right sac and above all of the pylorus
is red, congested, petechiated, macculated, thickened to double
its normal thickness or more, thrown into ruge, and covered with
tenacious mucus. This mucus is highly charged with detached
epithelial cells, and. at different points the mucosa is abraded by
their desquamation. The epithelium generally shows swollen,
opaque cells. The red congested spots show active engorgement
of the capillaries, and this is especially marked around the gland-
ular follicles, with more or less formation of embryonic cells.
The duodenum is often implicated with similar lesions of the
mucosa and its epithelial layers, which may block the orifices of
the pancreatic and especially of the biliary duct. In this case
there is a yellowish discoloration of the liver, excess of pigment
in the hepatic cells, and hemorrhagic spots in the liver and even

166 Veterinary Medicine.

in the kidneys. The urine may be yellow or reddish brown from
the presence of bile or blood pigment. In ruptured stomach,
spiroptera, bots, and other irritants, we find their characteristic
lesions, and in petechial fever there is excessive and partly
hemorrhagic infiltration of the mucosa and sub-mucosa. In
protracted cases ulcers may be present on both stomach and in-
testine. When it is a localization of some specific fever the
characteristic lesions of that affection will be found.
Treatment, If appetite continues, diet should be restricted to
a very moderate allowance of green food, pulped roots, bran
mash, boiled flaxseed, boiled middlings, with pure water or whey.
If there are irritants in the stomach they may be got rid of by a
laxative (aloes 4 drachms, or sulphate of soda % pound),
Sodium bi-carbonate (% drachm 2 or 3 times daily) is desirable
tostimulate peptic secre tion and check acid fermentations. Pepsin
(2 drachms) should be given at equal intervals. Fermentations
should be checked by the use of salol (1 to 2 drachms), naphtha.
lin (1 to 2drachms), benzo-naphthol (1 to 3 drachms), or calcium
salicylate (2 drachms), .
In this connection bitters are of value to improve the tone of
the gastric mucosa, nux vomica, gentian, quinia and quassia in
combination with ipecacuan giving good results.

PHLEGMONOUS (PURULENT) GASTRITIS IN THE
HORSE.

Definition : deep inflammation tending to abscess. Causes: invasion by
pus microbes, infectious diseases, parasitism, traumas. Symptoms: hyper-
thermia, colic, tenderness, icterus, coincident disease, hamatemesis. Le-
sions : submucous or subperitoneal abscess, parasites, peritonitis, exuda-
tion, thickening, neoplasm of mucosa, catarrhal complications. Treatment :
careful diet, antiseptics, bitters, laxatives.

Definition. ‘This is a gastric inflammation affecting the mem-
branous layers, and tending to submucous or subperitoneal
abscess. It is much less frequent than the catarrhal form.

Causes. It may be attributed to invasion of the gastric walls
by pus microbes, and appears as secondary abscess in pyeemia and

Phlegmonous (Purulent) Gastritis in the Horse. 167

above all in strangles. The microbes are introduced more di-
rectly through the wounds inflicted by the larvee of cestrus, or
by the burrowing of these (Argus, Schlieppe, Schortmann), or
of spiroptera (Argus). Wounds by sharp pointed bodies taken
in with the food, furnish other infection—atria, and in their turn
ulcers connected with catarrhal or toxic inflammation may furnish
a means of entrance.

Symptoms. 'These resemble those of catarrhal inflammation,
but are usually attended by greater hyperthermia, and the colicy
symptoms are more marked. ‘There is also greater tenderness in
the epigastrium and left hypochondrium, and icterus is more
marked. When it occurs as an extension of strangles or pyzemia
the symptoms of these affections elsewhere are pathognomonic.
When the abscess bursts into the stomach there may be vomiting
of bloody mucus (hzematemesis) which is not necessarily followed
by a fatal result.

Lesions. As these are seen only in fatal cases, the presence of
an abscess is the characteristic feature. This is usually sub-
mucous, or less frequently subperitoneal, and may vary in size
from a hazelnut upward. The tendency appears to be to open
jnto the stomach, though it may burst into the peritoneum and
cause general infection of that membrane. In case of parasites,
the spiroptera or cestrus larva may be found in the abscess cavity
having a narrow opening into the stomach. In certain cases the
abscess on the pyloric sac has been found opening into the
duodenum. Congestion, thickening, puckering into ruge and
laceration of the adjacent mucosze may be a marked feature, a
circumscribed catarrhal gastritis complicating the local phlegmon.

Treatment. 'This is less hopeful than in catarrhal gastritis,
but should be conducted along the same lines. The same careful
diet, with daily antiseptics and bitters may prove valuable in
limiting the inevitable suppuration, and, if the pus should escape
into the stomach, in healing the lesion. Sulphites of soda,
sulphide of calcium, chamomile, and quinia, are to be commended
and pepsin may be added to secure at once proteid digestion and
antisepsis. Laxatives may be required to counteract constipation
or expel irritants, and these may be combined with the antisep-
tics already named or with salol, eucalyptol, sodium salicylate
or other non-poisonous agent of this class.

TOXIC GASTRITIS IN SOLIPEDS.

Causes : caustics or irritants acting on mucosa, accidently, or maliciously.
Symptoms: colics, pinched face, small rapid pulse, hurried breathing,
hyperthermia, sometimes salivation, color of buccal mucosa, odor, con-
gestion of tongue, thirst, urination, icterus, albuminuria, analysis of urine
or vomited matter. Lesions: congestion, corrosion necrosis or ulceration
of gastric mucosa, discoloration. Treatment: antidote, stomach pump,
demnlcents coagulants.

Causes. Toxic gastritis in solipeds is peculiar in this that it
must be due to one or other of the more caustic or irritant agents,
which act chemically on the tissues, while those agents that re-
quire to be absorbed to establish a physiological irritation are
comparatively harmless. This depends on the fact that few or
none of the poisonous agents are absorbed by the gastric mucosa
of the soliped, and if ingested they must pass on into the duo-
denum before they can be absorbed into the tissues and blood-
vessels. Hence the horse is injured mainly by actual caustics
like mercuric chloride, zinc chloride, ferric or cupric sulphate,
the caustic alkalies or earths, or alkaline carbonates, and the
mineral acids. "These may be taken accidently or administered
maliciously, or as medicines.

Symptoms. Morbid symptoms vary according to the agent
swallowed. There are colics, anxious countenance, small
accelerated pulse, rapid breathing, hyperthermia, and salivation,
especially marked with mercuric chloride. The buccal mucosa
may give valuable indications, becoming white with muriatic
acid, or zinc, or antimony, or mercuric chloride, yellow with
nitric acid, and white changing to black with sulphuric acid or
silver nitrate. Ferric or cupric sulphate may give their respective
colors to the saliva, and the former will blacken the feeces.

The mouth is usually dry, hot, and clammy, and the edges: of
the tongue red. Temperature is usually elevated, yet with tartar
emetic it may be distinctly reduced. Thirst is usually marked,
and urination frequent. Icterus and albuminuria attend on
phosphorus poisoning. When vomiting takes place the appear-

168

Toxic Gastritis in Solipeds. 169

ance or analysis of the matters rejected, or otherwise of the
urine, will often indicate the nature of the poison.

Lesions, ‘The gastric mucosa is congested and discolored, but
the corrosion and even the ulceration are especially characteristic.
Patches of necrotic mucous membrane may be more or less de-
tached exposing a deep red submucosa. The coloration other-
wise varies ;—white or black with sulphuric acid or silver nitrate ;
white with muriatic acid, the caustic alkalies, or zinc chloride;
yellow with nitric acid ; or green with salts of copper.

Similar lesions are found on the buccal, cesophagean and in-
testinal mucosz, and even at times on the respiratory.

Treatment. In the treatment of this form of gastritis the first
consideration is toexpel, or use an antidote to, the poison. In
the soliped, emetics are useless. The stomach pump or tube may,
however, be applied with good effect in nearly all cases, alternately
throwing in water and drawing it off. Demulcents and coagu-
lants are also universally applicable. Milk, eggs beaten up in
milk, blood albumen, flaxseed tea, well boiled gruels, or slippery
elm bark, may be used as may be most convenient. Next come
the other chemical antidotes the use of which however demands
a previous knowledge of the poison present. For the mineral
acids one can make use of calcined magnesia, lime water, chalk,
or carbonate of soda in weak solution. For alkalies the appro-
priate antidote is vinegar. For carbolic acid, vinegar, alcohol, or
failing these a weak solution of soda or oil. For tartar emetic,
gallic or tannic acid. For bichromate of potash or chromic acid,
calcined magnesia, magnesia carbonate, or lime carbonate. For
phosphorus, old oil of turpentine and demulcents—no oil. For
ammonia, vinegar followed by almond, olive or sweet oil. Incase
of cedema glottidis, tracheotomy. For copper salts yellow prus-
siate of potash, which precipitates the copper in an insoluble form,
and demulcents. For mercuric chloride, demulcent drinks can
be resorted to, there is no other reliable antidote. In all cases
after the evacuation of the stomach and the use of the antidote,
mucilaginous agents must be given freely with morphia or other
anodynes.

CATARRHAL INFLAMMATION OF THE FOURTH
STOMACH.

Usually a complication. Causes, predisposing, exciting, changes of food
or water, spoiled, frosted or fermented food, green potatoes, caterpillars,
Nitrogenous food, irritants. Symptoms: Separation from herd, grinding
teeth, eructation, depraved appetite,'fever, tender epigastrium, coated dung,
red eyes, fixed or retracted, dilated, blind eyes, drooping ears, nervous
symptoms, reckless, unconscious movements, bellowing, tender skin, tremors,
Lesions : Congestion and exudate in gastric mucosa, hemorrhagic discolora-
tion, desquamation, excess of mucus, resemblance to rinderpest, Texas
fever and malignant catarrh. Treatment: Empty stomach by bland laxa.
tives, stimulants of peristalsis, calmatives, cold to head, counter-irritants,
enemata, bitters.

This affection is by no means rare in cattle, though it is usually
complicated with inflammation of the first three stomachs or of
the intestines. Nevertheless, when the disease appears to be
concentrated on the fourth stomach mainly, it may well take its
name accordingly.

Causes. A predisposition to the affection occurs in the weak
and debilitated, the over-worked oxen, under-fed cattle, in those
that are just recovering from a severe illness and in which the
gastric secretions and functions are still poor. The usual excit-
ing cause is some fault in the food, it may be a sudden change
from one kind to another, and especially from dry to green, or
from one kind of green food to another and more tempting one,
as when the animal breaks into a field of grain which is advanc-
ing to maturity. Even a sudden change of water, as from soft
to hard has seemed in our experience to contribute to its develop-
ment. Next come spoiled aliments, frosted or frozen turnips,
beets, carrots, potatoes, apples, turnip tops, fermented grasses,
musty hay, sun-exposed potatoes, putrid vegetables, and cater-
pillars on cabbages, tree leaves and other vegetables. Next come
products that are highly nitrogenous, like vetches, alfalfa, sain-
foin, clover, and the cakes of linseed, rape and cottonseed. Irri-
tant plants such as colchicum, digitalis, yew, raddish, etc., have
been charged as causative agents.

Symptoms. ‘These are often difficult to distinguish from those
of indigestion or acute lead poisoning, and they vary in different

170

Catarrhal Luflammation of the Fourth Stomach. 171

cases according to the severity of the attack. In the milder cases
there may be loss of appetite and rumination, some tympany,
arching of the back, uneasy movements of the hind limbs and
tail, a disposition to leave the herd, grinding of the teeth, and
frequent gaseous eructations. Some show a depraved appetite,
picking up and chewing various non-alimentary substances.
Somewhat more characteristic are the dry, hot muzzle, the hyper-
thermia of the body, the tenderness to pressure of the epigas-
trium, and the baked appearance and glistening surface of the
feeces. In the more severe forms the suffering is increased and
the nervous system participates in the disorder. The eyes are
congested, fixed or rolled back, the pupils dilated, the vision
appears to be abolished, the ears are pendant, if tied the subject
attempts to get loose, if at liberty he moves steadily in some one
direction regardless of obstacles or dangers, he bellows, pushes
against walls or other obstructions and may seriously injure him-
self or others. There is, however, no mischievous purpose, he
is simply impelled to blind motion, and no regard is had to any-
thing which may be in his way. In some instances the nervous
disorder is manifested by a sensitiveness of the skin, so that the
animal shrinks when handled or pinched along the chine or back.
Tremors is another marked symptom.

Lesions. These consist mainly in congestion and swelling of
the gastric mucosa, which is further covered by a thick layer of
mucus. The folds are especially thickened and discolored, and
the seat of hemorrhagic extravasations (petechize) and exuda- .
tions in spots and patches. Desquamation of the epithelium may
be met with at points and even distinct ulcers. Exudation in the
submucous tissue, and petechize in the peritoneum are common.
The condition may bear a close resemblance to what is seen in
Texas fever, rinderpest or malignant catarrh.

Treatment. ‘The first desideratum is the elimination of the
irritant ingesta from the stomach. But for this purpose emetics
are useless and we must fall back on laxatives. Again we are
met by the consideration that the inflamed stomach will neither
readily absorb nor respond to a stimulus. Yet as a rule the
viscus is not equally inflamed throughout, and even the affected
parts do not necessarlly have the whole muscular coat involved
and paralyzed. We can therefore hope fora measure of response

172 Veterinary Medicine.

which once started will deplete and improve the adjacent and
more violently affected parts. But irritant and drastic purgatives
like croton, podophyllin or gamboge are proscribed as very liable
to aggravate the inflammation. Pilocarpin 3 grs. hypodermi-
cally may be given or in default of this, 1 lb. each of Glauber and
common salt in not less than six quarts of water, free access
being allowed to pure water until it shall have operated. Bis-
muth may also be given asa calmative. Active rubbing of the
abdomen will assist in rousing the stomachs to action, and hasten
the action of the purgative. If there should be any sign of
cerebral disorder, cold water or ice may be applied to the head,
and oil of turpentine, followed by a pulp of the best ground mus-
tard may be applied to the epigastrium and right hypochondrium.
This may be accompanied and followed by copious enemata, and
doses of quinia, gentian or, still better, nux vomica three times a
day.

CATARRHAL GASTRITIS IN SWINE.

Definition. Causes, irritants, fermented, putrid swill, spoiled vegetables,
irritant molluscs or larve, hot or cold food, alkalies, indigestible food,
specific germs or toxins, parasites. Symptoms: inappetence, restlessness,
vomiting, colic, constipation, diarrhoea, fever, stiffness, tender abdomen:
arched back, chill, plaintive grunting, drooping tail. Lesions. Treatment,
change diet, mucilaginous, milk, protection from saprophytes, change pen,
emetic, laxative, calomel, bismuth, cleanliness, washing.

Definition. Inflammation of the gastric mucosa with muco-
purulent discharge.

Causes. Irritants of various kinds, fermented or putrid swill,
spoiled vegetables, irritant molluscs or larvze, too hot or too cold
aliment, excess of brine, excess of alkalies, in swill (dishwash-
ings), indigestible food of all kinds. ‘The stomach may also be
the seat of catarrhal inflammation in hog cholera, swine plague,
rouget, diphtheritic affections and in the case of gastric parasites,
so that it is very important to distinguish the affections due to
simple irritants, from those dependent on plagues and parasitism.

Symptoms. There is inappetence, vomiting, restlessness and
constant movement, colics, vomiting, constipation or diarrhcea,

Catarrhal Gastritis in Swine. 173

hyperthermia, stiffness, tenderness of the abdomen to handling,
arched back, a disposition to hide under the straw, plaintive
grunting when roused, drooping of the tail. ‘The tendency is to
a rapid recovery after’the evacuation of the stomach by vomiting,
though it may persist under a continuance of the irritating
ingesta.

In these last cases the /estons may closely resemble those of the
contagious affections of the abdomen, but the disease may be dis-
tinguished by its indisposition to spread beyond the herd which
is subjected to the unhealthy dietary.

Treatment. Change the diet to one of pure and easily digesti-
ble materials, soups, mush, fresh whey or buttermilk, boiled
farinas or flax seed, and even fresh grass. If there is violent
diarrheea boiled milk is often of great value.

Whatever food is given should be furnished in a vessel into
which the animal can’t get his feet, as these are usually charged
with septic germs which are pathogenic to the diseased stomach,
though they may have started from ordinary saprophytes.

For the same reason it is usually desirable to change the pen,
as the animal grubbing in the ground charges the snout with
the same offensive microbes.

If vomiting is not already established, 30 grains of ipecacuan
may be given, or tepid water may be used to assist the process.
If constipation is present 10 to 30 grains of calomel (according
to size) may be given. In case of diarrhcea a combination of
calomel 1 part and chalk 12 parts, may be given in 3 grain doses,
two or three times a day. Or % to 1 drachm nitrate of bismuth
may be substituted.

Cleanliness in food and surroundings is among the most im-
portant measures, and if the skin has been filthy, repeated washing
with soap and warm water may be resorted to with great benefit.

CHRONIC GASTRIC CATARRH IN SOLIPEDS.

Causes ; Debility, age, anseemia, leuczemia, lymph gland, kidney, heart
or lung disease, parasitism, dental or salivary disease, coarse, fibrous food,
spoiled food, putrid water, gastric neoplasms. Symptoms; Impaired appe-
tite, eating lime or earth, weariness, costiveness, coated drug, tympanies,
diarrhzeas, fatigue, sweating, unthrifty hide, pallid mucose, emaciation,
colics. Lesions; Thickened right gastric mucosa, discoloration, mucus,
petechiz, opaque granular epithelium, gastric dilatation. Treatment:
Remove causes, diet, watering, exercise, sunshine, bismuth, pepsin, acids,
bitters, electricity, antiseptics, stomachics.

Causes. ‘These are in the main the causes which operate in
producing the acute affection. In most chronic cases they act
continuously on a system rendered susceptible by debility or
otherwise. Among predisposing causes may be named: The
debility of old age, anzemia, leuczemia, chronic’ diseases of the
lymph glands, of the liver, kidney, heart, or lung, parasitic
diseases, diseases of the jaws, teeth, or salivary glands which
interfere with proper mastication and insalivation. Among ex-
citing causes may be named: A coarse, fibrous innutritious diet,
a too bulky diet, spoiled fodders of all kinds, putrid drinking
water, and stomach parasites (spiroptera, cestruslarva). Actual
disease of the stomach—papilloma, cancer, actinomycosis, tumors,
and oat-hair or other concretions are further causes.

Symptoms. Impaired or capricious appetite, a disposition to
lick the walls or earth, or to drink impure water, yawning, con-
stipation with glossy mucus-covered feces, and slight tympany,
alternating with diarrhoea, small, acelerated pulse, susceptibility
to perspiration and fatigue on slight exertion, unthrifty skin and
hair, hide-bound, dry, hot mouth, coated tongue, pallor of the
mucous membranes, loss of condition, and increasing weakness.
Slight colics may occur at intervals, and the sluggishness may
deepen into stupor or vertigo.

Lesions. ‘The right sac is usually the seat of more or less
hypertrophy of the mucosa, which is thickened, rugose, with
patches of dark red, gray and slate color, and covered with a
layer jof tenacious mucus. The surface may show warty-like
elevatiqns, or papillary projections, with here and there patches
of blood extravasation. The epithelial cells are increased, opaque
and contain many fatty granules.

174

Chronic Gastritis in Ruminants. 175

Dilatation of the stomach is not uncommon especially in old
horses, and then the mucosa may be attenuated and smooth.

Hyperthermia may be present, but is so slight that inflamma-
tion cannot be predicated from it and it is difficult to establish a
diagnosis from chronic dyspepsia.

Treatment. It is important to first correct any curable predis-
posing disorder, in teeth, jaws, salivary glands, blood, or internal
organs, to carefully regulate feeding, watering and work, to se-
cure as far as possible an outdoor life, and to employ bitter and
other tonics. All overexertion or fatigue must be carefully
avoided. The food may be as advised for the more acute affec-
tion. Costiveness may be best met by boiled flaxseed, or in case
of necessity by bran mashes, or green food. ‘The irritation of
the stomach may be benefited by nitrate of bismuth (3 to 4 drs. )
and pepsin and dilute muriatic acid with each meal are often of
value. Nux Vomica (10 to 25 grs. twice daily) will help to
restore the lost tone, and a current of electricity may be sent
through the epigastrium daily. As alternatives, sulphate of
‘quinia or gentian may replace the nux, and salol or salicylate of
bismuth may take the place of the nitrate. Bicarbonate of soda
in % dr. doses, common salt in % oz. doses, and fennel in ¥% oz.
-doses are sometimes useful in re-establishing gastric functions.

CHRONIC GASTRITIS IN RUMINANTS. |

Causes: As in acute form, parasites, gravid womb, insufficient ration,
overwork, exhaustive milking, chronic diseases. Symptoms: deranged
appetite, rumination, pica, eructations, regurgitations, tympanies, colics
after feeding, coated dung, diarrhoea, fever, hot clammy mouth, sunken
eyes, small weak pulse, palpitations, emaciation, weakness, tender hypo-
chondrium. Lesions: hypertrophy of gastric mucosa, grandular epithelium.
Treatment : tonic regimen, diet, green food, roots, sunshine, bismuth, salol,
strychnia, pepsin, muriatic acid, common salt, counterirritants.

Causes. These are in the main the causes of the acute affec-
tion. ‘There may, however, be special persistent factors like
parasites (strongylus contortus and filicollis, spiroptera) in the
stomach, the pressure of a gravid womb, an alimentation deficient

176 Veterinary Medicine.

in lime or phosphorus, overwork, exhausting milking, or chronic
disease of important organs (heart, liver, lung, kidney).

Symptoms. These are indefinite and not easily distinguished
from those of disorders of the third stomach. ‘There is impaired
or capricious appetite, a disposition to eat lime, earth, and all
sorts of non-alimentary objects, rumination is rare or altogether
suspended, efforts to regurgitate are ineffectual, or result in
gaseous eructations only, there are tympanies and abdominal
pains especially after feeding, and constipation with a firm glazed
appearance of any feeces passed, may alternate for a short time
with diarrhcea. The mouth is hot and clammy, the eyes sunken
and semi-closed, the pulse small and weak, though the heart may
palpitate, and there is a constantly progressive emaciation and
prostration. Among the more characteristic symptoms are
tenderness of the right hypochondrium to manipulation and per-
cussion, and the presence of slight hyperthermia.

Lesions. ‘The changes consist mainly in hypertrophy of the
gastric mucosa, with changes in the epithelium and submucosa
such as are already described in the horse. The pyloric region
suffers most, and here ulcers are not at all uncommon.

Treatment. ‘The main aim must be to remove the causes, and
to build up the general health, so that the patient may rise above
the debilitating conditions. More is to be expected from the
change of diet to green food, roots, mashes, etc., and an outdoor
life than from the action of medicines, which are liable to dis-
appear by absorption in the first three stomachs, so that they can
only act on the fourth through the system at large. Yet benefit
may be expected from the use of nitrate of bismuth, and salol, as
calmatives and antiferments, nux vomica asa tonic and even
from pepsin and muriatic acid as digestive agents. The two last
are not dependent on the fourth stomach for their activity but
will digest the contents more or less in the first three, and the
finely disintegrated and partly peptonized ingesta coming to the
fourth stomach in a less irritating, and less fermentescible condi-
tion, lessens the work demanded of that organ and gives a better
opportunity for recuperation. Small doses of common salt and
one or other of the carminative seeds may be added. The appli-
cation of mustard or oil of turpentine to the right hypochondrium
will sometimes assist in giving a better tone to the organ.

CHRONIC GASTRITIS IN SWINE.

Causes. Symptoms: Inappetence, dullness, arched back, colic, irregular
bowels, fever, emaciation. Treatment: diet, green food, milk, mashes,
cleanliness. bismuth, salol, sodium bicarbonate, strychnia, pepsin, muriatic
acid, sunshine, washing.

Causes. These are like those producing the acute affection
which may easily merge into this by a continuation of such
causes.

The symptoms too are alike. Inappetence, dullness, prostra-
tion, arched back, vomiting, colic, constipation, with alternating
diarrhoea. There is hyperthermia with hot dry snout, thirst,
increasing emaciation and anzemia.

Treatment. An entire change of diet, to green food, roots,
fresh milk, and soft mashes in limited quantity. Allow pure’
water freely. Adopt all precautions against contamination of
the food by the feet or snout. The stomach may be quieted by
oxide of bismuth (20 grs.) or salol (10 grs.) two or three times
daily, and the tone and secretions of the stomach may be stimu-
lated by bicarbonate of soda (1 dr.) and mux vomica (1 to 2 grs. )
thrice daily. In addition pepsin and muriatic acid may be given
with each meal in proportion adapted to its amount. A life in
the open air, and an occasional soapy wash will do much to re-
store healthy gastric functions.

CHRONIC GASTRITIS IN THE DOG.

Causes : faults in diet, musty food, foreign bodies, poisons, lack of sun-
shine, retained faeces, parasites, ill health, chronic diseases, icy bath, septic,
drink, Symptoms: irregular appetite and bowels, fever, foul breath, red
tongue, tartar on teeth, dullness, prostration, vomiting of mucus or bile,
tender epigastrium, arched back, fcetid stools, emaciation. Treatment :
regular diet, sunshine, pure water, scraped muscle, soups without fats, anti-
septics, calomel, pepsin, muriatic acid, strychnia.

Causes, 'Theirregularity and variability of the food, over-feed-
ing, highly spiced foods, putrid or spoiled food, musty food, the
swallowing of pieces of bone, and of indigestible bodies, the con-

12 } 177

178 Veterinary Medicine.

sumption of poisons, the absence of open air exercise, the com-
pulsory suspension of defecation in house dogs, and the presence
in the stomach of worms (spiroptera, strongylus), are among the
common causes of the affection. As in other animals, ill health,
debility, lack of general tone, and chronic diseases of important
organs (liver, kidney, heart, lungs) must be taken into account.
The plunging into cold water when heated and the licking of
septic water must also be named.

Symptoms. Appetite is poor or irregular, the nose dry and
hot, the mouth fcetid, the tongue reddened around the borders
and furred on its dorsum, the teeth coated with tartar, the animal
dull and prostrate, vomits frequently a glairy mucus mixed with
alimentary matters or yellow with bile, and there is constipation
alternating with diarrhcea. The epigastrium is tender to the
touch, the back arched the feeces glazed with mucus or streaked
with blood, and offensive in odor. Emaciation advances rapidly
and death may occur from marasmus.

Treatment. Adopt the same general plan of treatment. Stop
all offensive and irritating food, give regular outdoor exercise,
free access to pure water, and every facility to attend to the calls
of nature. Give plain, easily digestible food in small amount.
In the worst cases pulped or scraped raw meat, in the less severe
mush, or well prepared soups with the fat skimmed off, and bread
added. Check the irritant fermentations in the stomach by salol,
bismuth, salicylate of naphthol. In case of constipation give 8
to 10 grs. calomel. Then assist digestion by pepsin (5 grs.) and
hydrochloric acid (10 drops) in water with each meal. If the
bitterness is not an objection 1 gr. nux vomica may also be
added.

ULCERATION OF THE STOMACH.

Causes : peptic digestion, paresis, caustics, irritants, acids, alkalies, salts,
mechanical irritants, hot food, parasites, thrombosis, embolism, specific
disease poisons, aneurism, tumors, infective growths, nervous disorder, de-
bility, toxins of diphtheria, staphylococcus, etc. Symptoms: slight colics,
tympany, emaciation, vomiting blood, tender epigastrium, dark or bloody
stools, irregular bowels; in carnivora abdominal decubitus, arched back,
bloody, mucus, acid vomit, colics after meals. Lesions: in horse erosions,
ulcers, parasites, neoplasms, discolorations, extravasations; in cattle and
dogs on folds; nature of ulcer. Treatment: restricted, digestible diet,
lavage, anodynes, bismuth, antacids, antiseptics, salol, naphthol, chloral,
pure water.

Causes. Gastric ulcers may arise from quite a variety of
causes which determine necrotic conditions of the mucosa and
the gradual invasion of the resulting lesion by destructive mi-
crobes. One of the simplest factors is the peptic juice, the
stomach, being struck with paresis (in inflammation, fever, ner-
vous disorder), while containing a quantity of its secretion, un-
dergoes an autodigestion which affects particularly the lowest
(pyloric) portion, toward which the liquid gravitates, and the
free edges of the folds which are the most exposed to its action.

The swallowing of irritant and caustic agents (the mineral
acids or alkalies, mercuric chloride, tartar emetic, antimony
chloride, Paris green, arsenious acid, etc.) by corroding or
causing destructive inflammation of the exposed mucous mem-
brane may similarly operate. This is especially the case with
monogastric animals, (horse, pig, dog, cat), as in the ruminants
such agents tend to be diluted in the first three stomachs and
rendered more harmless.

Mechanical irritants may cause the lesion and infection atrium
in any of the domestic animals, pins, needles, nails, pieces of
wire and other sharp pointed bodies being swallowed by horse
and ox, and small stones, pieces of bone, and all sorts of irritant
objects picked up by the puppy or rabid dog.

Cooked food swallowed hurriedly at too high a temperature is
especially liable to start necrotic changes in the single stomach of
horse, pig or dog, the ruminant being in a measure protected by
the food passing first into the rumen.

179

180 Veterinary Medicine.

The wounds caused by gastric parasites may become the start-
ing points of molecular degeneration and ulceration. In the
horse the spiroptera megastoma, s. microstoma, and the larve of
the various oestri; in cattle and sheep the strongylus contortus,
s. convulutus, s. filicollis and s. vicarius ; in swine the spiroptera
strongylina, Simondsia paradoxa, and gnathostoma hispida ; in
dogs spiroptera sanguinolenta, and in cats the ollulanus tricuspis
act in this way.

Gastric catarrh debilitates the affected mucosa and lays it open
to necrotic microbian infection especially in the pyloric sac and
on the summit of the folds.

Interruption of the local circulation in the deeper parts of the
mucosa as in inflammation and capillary thrombosis, arterial em-
bolism, venous thrombosis, may lead to local sloughing and ul-
cerous infection. ‘This may be seen in the petechial fever of the
horse, malignant catarrh, rinderpest, and anthrax in cattle and
sheep, and in canine distemper in dogs. Vogel found ulcers
resulting from a gastric aneurism in the dog.

Tumors and infective growths in the walls of the stomach may
prove an occasion of ulceration. Thus sarcoma, epithelioma,
actinomycosis and tubercle may be the primary morbid lesions in
different cases.

Gastric ulcers have also been attributed to morbid nervous in-
fluences as in dogs they have been found associated with lesions
of the dorsal myelon, and the corpora quadrigemini, and faradi-
sation of the vagus has apparently led to their production.

General constitutional debility has been alleged as a factor,
and experimentally in dogs, the hypodermic or intravenous in-
jection of various microbes or their toxins (diphtheritic toxin,
Enriquez and Hallion, staphylococci, Panum, Lebert. Letulle,
and a bacillus of dysentery in man, Chantemesse and Widal),
have produced gastric ulcers.

Symptoms. In horses and cattle these are very obscure, being
mainly in the nature of chronic gastritis. In both there are re-
current attacks of slight colicy pains, with tympany in cattle, and
gradual emaciation. Vomiting has been exceptionally seen in
both class of animal and if the rejected matters are very acid and
above all if mixed with blood it is more suggestive of ulcer. In
the horse the attacks of colic are mostly in connection with eating,

Ulceration of the Stomach. 181

or (in case the ulcer is duodenal) an hour or two after a meal.
In this animal it is possible to withdraw liquids from the viscus
by the stomach pump, and any hyperacidity or blood may be
almost diagnostic. ‘Tenderness to pressure on the epigastrium or
hypochondrium is often present, yet the colics of ulceration are
often relieved by pressure and friction. Blood is sometimes pres-
ent as such in the excrements, but more commonly these are
simply blackened by the exuded blood as acted on by the gastric
acid and intestinal liquids. The bowels may be alternately con-
stipated and relaxed. A gradually increasing feebleness is a
characteristic feature and in cattle paraplegia may precede death. -

In the carnivora the symptoms are less obscure. The animal
is dull, prostrate, weak, lies on its belly, but rarely long in one
place, and when up has arched back, stiff movements, and tucked
up abdomen. The epigastrium is painful to touch, which tends
to arouse vomiting of food or bloody mucus. Asin the horse the
rejected matters are very acid. Constipation may alternate with
diarrhoea, the feeces being blackened (melzena) or even streaked
with blood. The occurrence of suffering after meals, the con-
stancy and persistency of the symptoms and the steadily advanc-
ing emaciation and weakness are very characteristic. If the
tenderness is referable to a given point, it is even more distinctive.

Lesions. In the horse ulcers and erosions occur in the cardiac
sack in connection with «estrus larva and spiroptera which de-
stroy and remove the cuticular covering, or with sarcoma or epi-
thelioma growing in the gastric walls. In the right sac there
may also be round ulcers from the hooklets of the cestrus, or ir-
regular excavations on the summits of the folds in connection
with catarrhal inflammation. Ulcers from auto-digestion are
usually in the right sac, in the most dependent part of the viscus,
between the folds, and of a more or less circular outline. The
raw surface is black, brown, slaty gray or white. The ulcers,
which result from petechial fever are irregularly notched and
marked by a mass of dark blood coagulated in their depth.

In cattle and dogs the ulcers are most frequent near the pylorus,
and when of catarrhal origin may be round or irregular, and on
the summit of the fold, or if peptic, may be round and between
the folds. In malignant catarrh and rinderpest, they are mostly
formed on the summits of the folds. They may vary in size

'

182 Keeterinary Medicine.

from a pea to a quarter of a dollar. The surrounding mucosa is
usually congested, swollen and projecting, and the surface of
the ulcer itself of a dark red, black, yellowish, slaty or gray.

The round ulcer is usually marked by surrounding infiltration
and by a tendency to become deeper and to perforate the gastric
walls, with the result of inducing an infective peritonitis. This
is more common in cattle and carnivora than in solipeds.

Treatment. Tf a reasonably certain diagnosis can be made the
patient should be put on a restricted diet of easily digested ma-
terials, given at regular intervals. For the carnivora scraped or
pulped raw meat, and milk, and for the herbivora milk and well
boiled flax seed or other farina are appropriate.

Violent emesis in carnivora may demand washing out of the
stomach with tepid water with or without the aid of a stomach
tube. This may be seconded by anodynes, chloral, cyanide of
potassium, or even morphia.

Bismuth trisintrate or oxide is appropriate in all animals, also
sodium bicarbonate, chalk or magnesia to neutralize the muriatic
acid.

As antiseptics calculated to obviate the formation of irritant
products from the gastric contents and to check the progress of
the microbian infection in the wound such agents as the following
may be used: Salol (horse or ox 1 dr., dog 5 grs.) naphthol or
naphthalin (same doses), chloral (horse 2 drs., dog 5 grs.).

Sometimes it is well to relax the bowels by small doses of
Glauber salts, and in all cases an abundance of fresh water,
butter milk, or other bland drink.

Cases of the kind are slow in their progress and unless the
animal is specially valuable, treatment may be a source of loss.

PERFORATING ULCER OF THE STOMACH.

Causes: réund ulcer, foreign bodies, parasites. Symptoms: those of
ulcer, followed by infective peritonitis, fistula, pleuritis, pericarditis,
Treatment : of fistula,

This may be the result of the gradual deepening of the round
ulcer, yet in the domestic animals it mostly comes from the
presence of sharp pointed bodies. ‘These may be enumerated as
needles, pins, nails, wires, sharp bones (dog), whalebone (horse),
forks, knives (cattle), and even gravel. ‘The burrowing of the
spiroptera has seemed to cause perforation in the horse. All
causes of ulceration may, however, lead to perforation.

The symptoms are those of gastric ulcer, already given, fol-
lowed by the more specific ones of perforation. These in their
turn differ according to the parts involved. In the horse and
dog the perforating ulcer usually opens into the peritoneum, in-
ducing a fatal infective peritonitis. In cattle the foreign body
sometimes passes toward the heart, enveloped in a protecting mass
of new formed tissue and proves fatal by heart disease. In other
cases it has been found to proceed downward toward the sternum
and to escape by a fistula formed beside the ensiform cartilage.
In other cases it has taken a direction toward the right wall of
the abdomen where it formed a fistula, discharging alimentary
matters. In still other cases it has opened into the peritoneal
cavity with fatal effects.

Treatment in the case of external fistula, without implication
of the peritoneum, consists in the removal of the foreign body,
and the stimulation of granulations along the tract of the fistula
by the application of an ointment of tartar emetic to the interior.
Should this fail the fistulous tract may he scraped to make it raw,
and the edges may then be drawn together with sutures taking a
deep hold of the skin.

183

DILATATION OF THE STOMACH.

Adaptability to bulk of food. Dilatation with atony. Eructation. Crib-
biting. Vomiting. Age. Rare in cattle. Catarrh, overloading, nervous,
lesions, intestinal obstructions, tumors, calculi, volvulus, invagination,
hepatitis. Symptoms: overfeeding, pot belly, unthrifty hide, emaciation,
eructations, cribbiting, fatigue, perspiration, indigestion, colic after meals,
tympanic resonance. Lesions : varying distension, contents, action of cal-
culus or pebbles, cardiac dilatation. Treatment: nutritive, digestible,
concentrated food, lavage, strychnia, iron, faradization, antiseptics. _

The stomach has a great power of accommodation to the
amount of food habitually taken. In the horse fed mainly on
grain with only a little hay, it is habitually small, while in one
fed on cut straw with a little grain, on hay alone, or on green
food, it is very much more.capacious though within the physio-
logical limits of health. The cow wintered on grain alone, has
all four stomachs lessened in capacity, and though she maintains.
good condition she is ill fitted to change at once to the bulky
grass diet of spring. The heavily fed swine, and the farina fed
dog and cat, have both stomach and intestines increased in
capacity over those of the wild boar, or the purely carnivorous
wolf or wild cat.

The condition becomes pathological when associated with atony,
and this may occur directly from over distension. It is especially
common in the horse by reason of the difficulty of relieving the
over distension by eructation or vomiting, and also by reason of
the habit of swallowing air (cribbiting). The dog, which has
great facility in vomiting, should be correspondingly protected
from the condition, yet it is very common in old dogs, doubtless
from their common vice of gourmandizing and lack of exercise.
Cattle are rarely attacked, the fourth stomach being protected by
the others which stand guardian over it and prevent the sudden
access of excess of food even if that is rapidly swallowed.

Other causes are: chronic catarrh which renders the stomach
atonic, lessens its peptic secretion and determines indigestions and
over distensions : habitual overfeeding which results in chronic in-
digestions and fermentations ; lesions of the brain, and tumors of
the jugular furrow or mediastinum which interfere with the

184

Dilatation of the Stomach. 185

functions of the vagus nerve; obstructions of the intestines
which force the contents back into the stomach or hinder their
exit. Thus tumors on the duodenum, calculi in stomach or in-
testines, volvulus and invagination have been charged with pro-
ducing overdistension. Chronic hepatic disorder has also been
quoted as a cause.

Symptoms. The subject may eat naturally or excessively yet
is unthrifty, the belly is habitually distended, the hair dry and
rough, there is loss of flesh, there may be eructations or (in the
horse) swallowing of air, lack of endurance, a disposition to per-
spire easily, a tendency to indigestion and colics after meals, and
hurried breathing sometimes marked by a double lifting of the
flank in expiration. In the dog which has the stomach more ac-
cessible to examination its outline may be followed by percussion,
a tympanitic resonance being produced from the eighth rib back
to the umbilicus or further. If there is any difficulty the organ
may be emptied of water by a stomach tube and then pumped
full of air by means of a Davidson’s syringe, and percussed in
each condition. Ora half a teaspoonful of bicarbonate of soda
may be given in a little water followed by an equal amount of
tartaric acid, and the stomach percussed.

Lesions. 'The distension of the stomach may reach ten times
its normal size in the horse (Leisering). Kitt found a stomach
with a capacity of 84 quarts. Fitzroy Philipot took from a di-
lated equine stomach 140 lbs. of contents. The contents of the
viscus are usually largely of solids which the weakened and at-
tenuated walls failed to pass into the duodenum. On the con-
trary and as if by compensation, the pylorus and duodenum are
constricted and the latter has liquid contents which pass from the
stomach with very little of the solids.

Special dilatations are sometimes met with, thus an equine
stomach has been found largely dilated at the greater curvature
where concretions formed in the viscus or pebbles introduced with
the food had habitually lodged. In other cases the cardia has
been dilated like a funnel, so that the animal could eructate or
vomit with great facility. This last dilatation is especially com-
qnon in cribbiters.

Treatment. ‘This must necesssarily be prolonged as time must
be allowed for a tonic contraction of the viscus. Food must be

186 Veterinary Medicine.

given often in small quantity, of easy digestion, and of aqueous
composition. For dogs, milk, eggs and soups, or pulped raw
meat furnish examples. For horses milk gruels, boiled flax seed,
pulped roots may suffice. If the stomach is loaded as is usually
the case, it should be washed out with the stomach tube, which
when passed into the stomach should be raised at its free end
and filled with tepid water ; it is then suddenly lowered so as to
act as a syphon in evacuating the liquid contents of the stomach.
This may be repeated again and again, the stomach in the case
of the dog being manipulated so as to mix and float the solids
and favor their exit through the tube. Daily washing out of the
stomach by the tube before meals is of the greatest possible value.

Meanwhile we should seek to improve the tone of the stomach
by strychnia (horse 2 grs., dog gy gr. daily), by salts of iron,
and by faradisation.

To counteract fermentation, antiseptics (salol, naphthol,
freshly burned charcoal) may be given with each meal, along
with pepsin and hydrochloric acid.

RUPTURE OF THE STOMACH IN SOLIPEDS.

Mainly in solipeds. Causes: overloading, fermentation, impossibility of
eructation, violent concussions, falls, galop, concretions, dilatation, catarrh,
ulcers, cicatrices, abscesses. Symptoms: Anamnesis, colic relieved, fol-
lowed by prostration, sinking, complete anorexia, tender abdomen, vomit-
ing, no abdominal rumbling. Lesions: tear in greater curvature, most
extensive in outer coats, shreddy, bloody edges with clots, contents in
omentum, other seats, partial ruptures. Treatment: in partial ruptures,
stomach pump, diet. Prevention.

This is pre-eminently a disease of solipeds for the reason that
they alone of domestic animals are especially liable to overload
the comparatively small stomach and are mostly unable to relieve
the overloaded viscus by eructation or vomiting.

Causes. ‘These are in the main overloading of the stomach and
overdistension, by the gases of indigestion. ‘To this are usually
added violent concussions when the animal throws itself down
violently. The stomach distended to the fullest possible capacity,
and lodged in a cavity which is not all equally tense, is compar-

Rupture of the Stomach tn Solipeds. 187

able to a very tense bladder which is liable to burst when forcibly
struck, or suddenly compressed.

Apart from such indigestion, cases are recorded in which the
full stomach has been burst by a sudden fall in the shafts or else-
where. Miles even records a case which oocurred during a
rapid galop after a full dririk of water.

The presence of solid bodies (calculi, gravel) in the stomach
or even in the intestines has appeared to cause rupture by block-
ing the outlet of ingesta and determining indigestion.

Certain conditions predispose to rupture, notably dilatation of
the stomach with attenuation of its walls, cribbiting, old standing
catarrh of the viscus, pre-existing ulcerations, cicatrices and
abscesses.

Symptoms. ‘There is usually the history of a full feed of grain,
followed by violent colic, and indications of gastric overdisten-
sion, tense abdomen, dullness, then the rejection of the gastric
contents by vomiting, the matters escaping by the nose, and then
collapse. The violence of the colics may cease, but the pulse
becomes rapid, small, and finally imperceptible, the breathing
hurried, the head depressed, eyelids, ears and often the lower lips
drooping, the face becomes heavy and expressionless, the belly
distended and tender, the skin covered with cold sweat, and the
temperature exalted above or depressed below the normal. There
is never any disposition to eat or drink. Death follows in a few
hours.

In the vomiting which is independent of rupture, the symptoms
are usually at once relieved, when the emesis occurs, since not
only liquid and solid matters escape but also gaseous material.
The pulse retains its fullness, the facial expression is that of in-
telligence and comfort, rumbling may be resumed in the bowels,
feeces and urine may be passed, and colics are less acute. In
favorable cases the animal may even desire to eat or drink.

Lesions. ‘The usual seat of rupture is on the great curvature
and may extend longitudinally for from six to ten inches. The
laceration is usually most extensive in the outer coats, and the
mucosa is carried outward with the escaping ingesta, which helps
to efface the normal mucous folds at the cardia, and to render
vomiting possible. The edges of the wonnd are more or less
shreddy, and of a dark violet color from blood extravasation and

188 Veterinary Medicine.

clots. The escaping contents are rarely diffused in the cavity of
the abdomen, but remain enclosed in the omentum through the
thin meshes of which they can be easily seen, and which has
sometimes been mistaken for the walls of the stomach reduced to
this attenuated condition by disease. When the omentum gives
way the contents are at once diffused through the abdominal
cavity between the convolutions of the intestines. In exceptional
cases the rupture has its seat in the lesser curvature, or even at
the cardia. In still others the laceration implicates the muscular
and peritoneal coats only, and the looser mucosa, filled with
ingesta bulges outward as a hernia. In such a case a recovery
seems possible if the viscus could be relieved of its contents.

Treatment is virtually hopeless. Yet a moderate laceration of
the two outer coats only, might be followed by recovery through
the formation of a ciatrix. The first consideration would be the
unloading of the stomach spontaneously or by the aid of the
stomach pump, and thereafter the adoption of a rigidly restricted
diet of easily digestible food (such as gruels) in small quantities
at a time.

Prevention is much more available. In violent colics with
overloading or tympany of the stomach, employ anodynes to
keep the animal from throwing himself down violently, give a
soft bed of litter where the shock on lying down will be lessened,
employ antiferments to prevent gaseous distension, and whenever
possible relieve the plentitude of the viscus by the stomach pump
or tube.

TORSION OF THE STOMACH IN THE DOG.

Causes : mobility of dog’s stomach when empty, leaping, running down
stairs. Lesions : viscus doubled forward, pylorus in front of cardia, duo-
denum compresses cardia, liver, spleen and omentum displaced, stomach
tympanitic, lungs and heart compressed, latter gorged with dark blood.
Symptoms : tympanitic abdomen, and half thorax, no rumbling, murmur
in front of thorax, abdomen tender, patient stands, dyspnoea, emesis im-
possible. Course : violent symptoms in twelve hours, death in thirty-six.
Diagnosis : sudden, severe seizure, complete anorexia, tympany, tenderness,
dyspnoea. no vomiting, arrest of peristalsis. Obstruction. Peritonitis,
Choking. Treatment : tapping, laparotomy, replacing the viscus.

Torsion of the Stomach in the Dog. 189

This has been demonstrated by Kitt and Cadeac who believe
that it is quite a common occurrence.

Causes. ‘The predisposing cause is the extreme mobility of the
canine stomach which hangs from the cesophagus like a pear from
its stalk, the remainder of the viscus being only attached to the
loose omentum, spleen, and commencement of the duodenum all
of which it can carry with it easily when it rolls on itself. Its
mobility is, however, very restricted when full, the liver on the
one side and the spleen and intestines on the other proving almost
insuperable obstacles to rotation. But when empty it moves with
great freedom and by a sudden shock in leaping, gamboling or
running rapidly down stairs the pylorus is carried forward and to
the left until it and the commencement of the duodenum are
jammed in front of the cardia. The result is the obstruction of
the cardia and duodenum by their mutual pressure in crossing
each other, and the interruption of the gastric circulation and
functions.

Lesions. As just stated the stomach which would normally ex-
tend from the cardia downward and to the right is bent forward
and doubled upon itself, the pylorus lying in front of the cardia,
the duodenum extending from before backward above the cardia
and tightly compressing it, the liver drawn to the left by the
hepato-duodenal peritoneum, and the spleen displaced to the right
by the traction of the omentum. The stomach enveloped in its
omentum is distended by gas to perhaps ten times its normal
dimensions and appears to fill the entire abdominal cavity while
the intestines are pushed aside and concealed. The chest is com-
pressed by the strong pressure on the diaphragm, and the lungs
are congested of a deep blue and the right heart distended with
dark blood. The animal appears to have perished of apneea.

Symptoms. In fully developed cases the abdomen is greatly
distended and tympanitic. The drumlike resonance is met with in
the anterior part of the abdomen including the umblilical region.

It extends forward over one-half of the thorax, excepting only
a space of 5 or 6 inches square in the right hypochondrium,
which represents the situation of the liver and spleen. Aus-
cultation furnishes no sound in the abdomen, and only in the an-
terior portion of the thorax is there a distinct respiratory
murmur. ‘The heart may beat strongly and rapidly, or weakly

190 Veterinary Medicine.

and slow, and the pulse is small and thready. The abdomen is
tender. The animal stands, dull, and breathes with great effort.
If made to walk it is done slowly, stiffly and with head extended,
mouth open and tongue protruding. ‘There is no sign of vomit-
ing and this cannot be brought about by tickling the fauces, or
even by giving apomorphia subcutem, though retching may be
induced.

Course. ‘The disease may develop into dullness and anorexia
in two hours after boisterous health ; in twelve hours there may
be considerable tympany and dyspnoea; and a fatal result is
reached in about thirty-six hours.

Diagnosis. ‘This is based on the transition from vigorous
health to sudden illness, with complete anorexia, inability to
swallow or to vomit, tympany of the stomach as shown by per-
cussion, tenderness of the abdomen, dyspnoea, disturbed ‘heart-
functions, and inactivity of the bowels. With intestinal obstruc-
tion, on the other hand, there is free vomiting of bilious and fecu-
lent matters. With peritonitis there is much greater and more
uniform abdominal tenderness, vomiting and high fever, but
less tympany in the anterior abdominal region, and no such com-
plete suspension of defecation. With choking there is no such
progressive tympany, appetite and defecation are not so com-
pletely suspended, and liquids may often pass the obstruction in
small quantities in both deglutition and vomiting. Choking is
by no means so speedily fatal.

Treatment is essentially surgical. When tympany is already
established the gas must be evacuated by a small cannula and
trochar. Then resort is had to laparotomy, the incision is made
on the right side large enough to introduce the fingers, which
must follow the great curvature of the stomach as far as the
pylorus which is pulled back into its normal position on the,
right. The incision is now closed by an ordinary contingous
suture.

FOREIGN BODIES IN THE STOMACH. HAIR, WOOL,
BRISTLES, CLOVER AND COTTON BALLS.

Hair balls, wool balls, bristles, cotton balls, clover hair balls, oat-hair
balls, paper balls, phosphatic calculi, sand and gravel, nails, wires, needles,
pins, etc,, cloth, leather, whalebone, playthings, etc. Symptoms: of
catarrh or colic, dullness, restlessness, arched back, in dog vomiting of
blood, fistula. Diagnosis. Treatment; emetic, feed potatoes, laparotomy.

Hair Balls. These are common in the rumen of cattle and
have been found in the fourth stomach. They are especially
injurious to young animals by reason of their irritating the gastric
mucosa, but they also occaslonally block the pylorus, producing
indigestion, gastric dilatation, gradually advancing emaciation
and even a fatal result.

Wool Balls. These are found in sheep and are especially
injurious in young lambs.

Bristle Balls. ‘These are found in swine as round, or ovoid
balls or long ellipses bent upon themselves. The sharp projecting
ends of the bristles render them very irritating, especially to
young pigs.

All of these are caused by licking themselves or their fellows,
and particularly during the period of moulting or as the result of
some skin affection. Lambs which are nursed by ewes with an
excess of wool on and around the mamme, and old sheep with a
disposition to eat wool are frequent victims.

Cotton Balls. These have been found in lambs fed on cotton
seed cake. A certain amount of the cotton fiber is incorporated
in the cake, and this is rolled together and felted by the move-
ments of the stomach and agglutinated by mucus.

Clover-hair Balls. The fine hairs from the clover leaf have
been found rolled into balls in the abomasum of lambs producing
all the evil effects of the other pilous masses.

Oat-hair Balls. The fine hairs which cover the seed of the
oat are found matted together and cemented by mucus in the
stomach of horses fed on the dust of oatmeal mills. "They are
especially common in Scotland, where oatmeal has been so exten-
sively used.

191

192 Veterinary Medicine.

Paper-ball. In the museum of the N. Y. State Veterinary
College is a conglomerate ball of paper taken from the stomach
of a hog by Dr. Johnson, Sioux City.

Phosphatic Calculi have been described as found in the
stomach, but this is evidently an error, as the acid secretion would
have speedily dissolved them. The error doubtless came from
mistaking the transverse colon for the stomach.

Sand and Gravel arrive in the stomach of the horse from
pasturing on loose sandy land, the plants being pulled up by the
roots and swallowed together with the sand adherent. Also from
drinking water from shallow streams with sandy bottoms. Feed-
ing of grain from the ground is a cause of swallowing sand, earth
and pebbles. Licking the soil in acidity of the stomach is another
cause. Fodder that has been packed down and mixed with earth,
and that which has been blown full of sand or dust, and roots
eaten from the ground in wet weather lead to the ingestion of
much sand or earth. Shetland ponies taken from the islands pass
sand for some weeks. Dogs taught to fetch and carry, swallow
stones, pebbles, marbles, etc., accidentally.

Nails, Wires, Needles, Pins, etc. More or less pointed me-.
tallic objects are often taken in with the food by gluttonous
horses and though usually arrested in the intestines they some-
times irritate and wound the stomach.

Fragments of cloth, leather or whalebone are similarly
taken with the food, or in case of depraved appetite are deliber-
ately chewed and swallowed.

Playthings and small household articles are especially
taken by puppies through mere wantonness. Rubber balls, pieces
of metal, thread, cord, cloth, bits of leather, sponge, horse hair,
human hair, corks, bits of wood, and everything obtainable of
small size may be swallowed and found in the stomach.

Pigs swallow pieces of wood and other objects.

Birds habitually swallow pebbles and ordinary objects are
ground down in the gizzard. They also readily vomit feathers,
bones and other offensive matters that have proven indigestible.

Symptoms. In horses there are no especial symptoms, though
the foreign bodies sometimes cause gastric catarrh, and in
other cases produce wounds and ulcers or block the pylorus
causing violent colic. Most commonly the foreign bodies pass

Foreign Bodies in the Stomach. 193

on into the intestines, where they may directly wound the walls,
form nuclei for the deposition of earthy salts in the form of cal-
culi, or in case of fibrous materials (cords) roll into firm balls.

In dogs the foreign bodies may cause gastric catarrh, or punc-
ture or abrasion of the mucosa, and they may be rejected by
vomiting. The more rounded, smooth bodies may lie for a
length of time in the stomach without doing any manifest injury,
as in the case mentioned by Nichoux in which a dog carried in
its stomach for twelve years a four franc piece and a large sou.
Sometimes the objects block the pylorus. Then the subject is
dull, depressed, inclined to lie on the right side but continually
changing his position, gives a stifled yelp when he lies down or
occasionally when he stops walking. He carries the back
arched, and the abdomen tucked up, and drags his hind limbs.
Vomiting is frequent and accompanied by violent and painful
retching. The vomited matters may be mixed with blood. The
epigastrium is tender to pressure. Death may ensue in twenty-
four hours or not until after weeks or even months.

In other cases there is gastro-enteritis with vomiting, colic,
anorexia, trembling, hyperthermia, constipation or diarrhea,
and finally the passage of the offending agent per anum, when
recovery ensues. :

In other cases sharp pointed bodies perforate the walls of the
stomach, and determine the formation of abscess or fistula open-
ing at any point around the abdominal cavity. This may be
followed by recovery, by gastric or intestinal fistula, or by chronic
disease of some important organ like the liver.

In dogs, diagnosis is often possible by manipulation of the
stomach through the walls of the abdomen. If the belly is very
lax it may be compressed between finger and thumb, or between
the two hands; if more tense, pressure with both hands just
behind the sternum may detect the resistance of a solid body.

Treatment. In the horse this is hopeless.

In the dog much may be expected from the use of emetics,
(ipecacuan, tartar emetic, apomorphia, tepid water, tickling the
fauces). In some cases of sharp pointed bodies an exclusive and
abundant diet of well boiled potatoes proves successful. The
object is to pass much of the starchy matter through the small
intestines undigested, so that it may envelop a sharp body and

13

194 Veterinary Medicine.

protect the mucosa. When it reaches the colon, the ingesta as a
whole becomes more solid and invested by this, the body is often
passed without danger. Other methods failing laparotomy re-
mains. ‘Téhe dog is stretched on his back on a table with the
forelimbs held well apart. The skin of the epigastrium is
denuded of hair and washed with antiseptics (mercuric chloride
solution 1:500). Hands and instruments are also made aseptic.
Then an incision is made in the epigastrium or in the situa-
tion where the offending body has been felt, and the finger
is introduced to locate the body. At this point a thread is
passed through the walls of the stomach, and these are drawn
well out through the abdominal wound and incised to the extent
of aninch or more. ‘Through this orifice the foreign body can
be easily felt and extracted. Then in case the stomach is over-
filled it may be emptied, and the edges washed with the antiseptic
and carefully sutured with sterilized catgut. The usual care
must be taken to turn the mucosa inward and bring the muscular
and serous coats in accurate opposition. Finally the abdominal
wound is closed by a continued suture of silk or catgut.

The greatest care must be taken to prevent the escape of any
of the gastric contents into the abdominal cavity, to render both
wounds aseptic and to protect the external wound especially
against infection. A wash of carbolic acid (1:100) with a little
of some intense bitter (quassia) will often succeed in preventing
licking or gnawing.

Even greater care must be given in the matter of diet. At
first a few teaspoonfuls of cold water only need be given. After
twenty-four hours a little well strained beef tea ; later milk or
gruel may be added, and by degrees more solid food. In three
weeks.the ordinary food may usually be resumed.

In case the foreign body has escaped into the peritoneal cavity,
the same method may be pursued, the edges of the gastric or
intestinal wound being made raw, treated antiseptically and care-
fully sutured, and the abdomen washed out with an antiseptic
solution (aluminum acetate solution) and closed.

TUMORS OF THE STOMACH.

In horse—sarcoma, papilloma, lipoma, adenosarcoma, epithelioma, in
cattle—scirrhus, in dog—sarcoma, lipoma, epithelioma, Symptoms : chronic
gastritis, periodic indigestions, colics, vertigo, salivation, impacted gullet,
blackened feeces, eructations, vomiting, rumbling, stiffness, emaciation.
Treatment : laparotomy in dog.

The peptic stomach in the different animals is subject to a great
variety of tumors. In many of the recorded cases, however, the
true nature of the tumor has been left uncertain.

Sarcoma. In the horse this is the common tumor of the
pylorus, and less frequently it is found also on the cardia and body
ofthe stomach, especially on the greater curvature. These are
usually firm and resistant, though sometimes soft and friable ;
they tend to swell out in lobules, and show areas of ulceration, or
even suppurating excavations opening through the mucosa. In
some instances, however, they start under the serous coat, and
the ulcerous surface may open into the peritoneum. At other
times they are but a local manifestation of a general affection.

In the dog multiple sarcomata have been found on the stomach
varying in size and easily mistaken for recent tubercles. In these
cases the small round cells were especially numerous in the centre
of the tumor rendering it soft and predisposing to degeneration.

Papilloma. In the horse these are found as branching or
filamentous dependent projections from the mucosa of the left sac
having evidently started from the sores formed by the attachment
of the cestrus larve. They are also found around the pylorus
and of such size as to seriously obstruct that orifice (Stadler).

Lipoma. Fatty tumors have been seen on the stomach of the
dog and horse in the submucosa.

Adenosarcoma. ‘This formation in the horse leads to a
thickening of large patches of the mucosa. It also grows out in
mushroom like masses, or is irregularly lobulated.

Epithelioma. Inthe horse epithelioma has been found at
the pylorus and on the great curvature of the stomach. It
usually grows out as a rounded mass varying in size from an egg
to an infant’s head, and may even be a diffuse thickening of the
mucosa. Microscopically the individual lobules, are composed

195

196 Veterinary Medicine.

of cylindroid cells surrounding a central mass of epidermoid cells.
The stomach may be greatly contracted, and the surface of the
neoplasm, ulcerated or even excavated. In the dog similar for-
mations are found.

Carcinoma. Incattle Scivrhus of the abomasum is described.
Small tumors rise to a height of % to 3 inches, and are closely
packed together so as to assume polygonal forms. The surface
is smooth, or perforated by orifices leading into ulcerous or sup-
purating cavities. On section the mass shows a fibrous or a larda-
ceous consistency. ‘They are most common in the pyloric region,
and may partially obstruct this orifice.

Symptoms. These are necessarily obscure. In the horse
periodic gastric indigestions and colics may be the sole indications,
which are certainly not pathognomonic. In other cases have
been noticed : vertigo, salivation, impacted gullet, and blackish,
sanguinolent feeces due to ulceration and hemorrhage from the
tumors.

In cattle have been observed variable and capricious appetite,
imperfect rumination, tympany, eructations, vomiting, rumbling
of the bowels, constipation, slow painful walk, progressive
emaciation and debility. When blood is discharged by emesis or
defecation the suspicion of gastric tumor may be strenghtened.

In the dog there are the usual signs of chronic gastritis, thirst,
anorexia, stiffness, a disposition to lie, sunken eye, dyspneea,
vomiting, often of blood. The discharge of blood by mouth and
anus, the distended abdomen, the tumor usually easily detected
by manipulation, and the progressive loss of condition are
strongly suggestive.

Treatment of these cases is hopeless. In the dog alone for a
circumscribed tumor, laparotomy, the removal of the tumor and
closure of the wound may be tried.

ACUTE INTESTINAL INDIGESTION IN THE HORSE.
INTESTINAL TYMPANY.

Definition. Causes: Debility—general and local, and its causes, fer-
mentescible food, legumes, new grain, paralyzing seeds, musty fodder,
defective teeth, jaws and salivary glands, iced water after grain, verminous
embolism, chill. Symptoms: Anamnesis, colic, gaseous distension, stupor,
dgath, diagnosis from spasmodic colic. Course: Fatal in two hours, or
more. Recovery. Lesions: Distension of bowels with carburetted hydro-
gen, carbon dioxide, and nitrogen, redness of intestinal mucosa, anzemia of
abdominal organs, congestion of cutaneous and surface vessels. Treatment .
Stimulants, antiseptics, enemata, chloral hydrate, puncture, eserine, pilo-
carpin, friction, massage, exercise, dieting, bitters.

Definition. A gaseous overdistension of the intestines, from
fermentations in the ingesta, but also in part from air that has
been swallowed, and from carbon dioxide exhaled from the blood
circulating in the intestinal mucosa.

Causes. These are to a large extent the same as those of gas-
tric tympany. General and degestive debility resulting from
former disease, from spare diet, from unsuitable or indigestible
food, from anzemia, from parasites, from hemorrhages, is a potent
predisposing cause.

Weakness of the alimentary canal from catarrh, or other per-
sistent disease, from impaired innervation, from embolism of the
vessels and imperfect circulation also predisposes, or again the
lack of vermicular movement and of the mingling of the digestive
fluids with the food, leaving the matter in a specially fermentes-
cible condition. As direct exciting causes may be named:

Very fermentescible food in excess, such as the leguminous pro-
ducts (beans, peas, vetches, cowpea, alfalfa, sainfoin, clover) in
their green condition. These contain an excess of protein com-
pounds, which should be mainly digested in the stomach, and if
passed rapidly in large quantities into the intestines, they fail to
be sufficiently acted on by the trypsin, and are specially liabie to
fermentation. Very rapidly grown and aqueous grasses are
similarly liable to decomposition.

New grain is specially liable to fermentation the more so that
it sometimes contains a paralyzing agent, which acts like intoxi-

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198 Veterinary Medicine.

cating ryegrass. The ripening seeds of many forage plants often
act in this way, (annual and perennial ryegrass, millet, Hun-
garian grass, chick vetch, vetches generally). The same has
been observed of the leaves of growing maize, grape-vine leaves,
and potato plants.

Musty and spoiled fodders of all kinds are very dangerous, the
toxic principles of the fungi and bacterial ferments paralyzing
the sympathetic nervous filaments.

Fodders that are imperfectly masticated and insalivated owing to
defective teeth or diseased jaws or glands are liable to prove
hurtful in a similar way.

A full drink of water and especially of ice cold water after a
feed of grain is one of the most potent factors. The stomach and
intestines are both roused to violent peristaltic action, the undi-
gested food is washed on into the bowels, and too often the action
of the cold induces congestion and partial paresis, and exposes
the undigested mass to the uncontrolled action of ferments.

Circulatory troubles caused by verminous embolism (see intes-
tinal congestion) is another very prolific factor. A sudden chill
in an animal that is perspiring and fatigued may precipitate an
attack, by causing a retrocession of blood from the skin to the
intestines, with resulting paresis of their coats.

Symptoms. ‘The condition is usually complicated with gastric
tympany, so that we havea complication of symptoms. The
history of the case is often diagnostic, showing one of the above,
mentioned causes, and above all a full drink after a feed of grain,
speedily followed by abdominal pain, gaseous distension of the
abdomen, causing death in two hours or upward. The distension
of the abdomen usually shows more on the right than the left,
and the resonance on percussion is greater. Colics are usually
less violent than in intestinal congestion, and the actions of the
animal are less precipitate or disorderly. He may lie down, roll
and rise, but the constant restless movement, the sitting on the
haunches, and the frequent agonized turning of the nose toward
the flank are rarely shown. ‘The animal is rather dull and
prostrate, passing finally into a stupor, the face is pinched and
anxious, the back arched, the head pendent, the walk slow and
unsteady, and respiration and pulse accelerated. There is no
complete intermission of pain, though it is more acute at one

Acute Intestinal Indigestion in the Horse. 199

time than another, for some time there is rumbling in the bowels
followed by complete silence, as they are fully paralyzed, feces
may be passed at first, but this ceases as the floating colon is
emptied and the gaseous distension becomes extreme, and urina-
tion which may take place in the early stages is no longer effected
in the advanced ones. The compression of the thorax causes
severe dyspncea, accompanied, when the patient is down, by a
slight groan.

Course. In the advanced stages the animal may sink to the
ground oppressed by the shock, poisoned by the carbon dioxide
which can no longer be exhaled through the lungs, and by hy-
drogen sulphide and other toxic products of intestinal fermenta-
tion. Death may follow two hours after a hearty meal and is
rarely long delayed in fatal cases.

Improvement may be recognized by the termination of the
paresis, the lessening of the abdominal tension, the return of the
rumbling in the abdomen, the passage of feeces and flatus, and of
urine and by general relief. ,

Lesions. In case of death the over-distension of the intestines
and abdomen is the most marked lesion, the composition of the
gas varying with the rature of the ingesta and the duration of
the illness. Carburetted hydrogen compounds abound as a rule
in the early stages, while carbon dioxide predominates later.
Pinner found 4g per cent. of carburetted hydrogen, 8 per cent. of
carbon dioxide, and 42 per cent. of nitrogen.

The contents of the large intestines are usually in considerable
amount and in an undigested condition. The walls of the dis-
tended bowels are greatly attenuated and may show congestion,
petechiz, or rupture. Rupture of the diaphragm is not uncom-
mon, Congestion of the lungs, but especially of the skin and
superficial structures of the body, and of the brain are natural
results of the expulsion of blood from the abdominal cavity.

Treatment. 'The desiderata are: relief from existing gaseous
tension ; arrest of further fermentation ; and the restoration of
the vermicular movement of the intestine.

The two first indications may sometimes be successfully met by
stimulants and antiseptics. Formerly, mild cases were success-
fully treated by oil of pepperment and oil of turpentine in oil,
and a free use of enemata. A more modern resort is a large

200 Veterinary Medicine.

(virtually soporific) dose of chloral hydrate (1 oz.) given in so-
lution. This is at once a powerful antiferment and an antispas-
modic. It is moreover highly volatile and in the heat of the
stomach is readily passed on into the duodenum and absorbed.
Employed early it not only checks the production of gas, but it
relaxes the whole intestinal tract and allows the free passage of
accumulated gas which passes off rapidly per anum.

But in severe cases the gaseous distension is too great to hope
for relief by such measures and puncture of the ceecum or double
colon is the only hopeful resort. This is made with a small
trochar and cannula not more than ¥ inch in bore, which is
inserted at the point of greatest resonance. The point usually
advised, as in the ox, is the centre of the space circumscribed by
the last rib, the ilium and the transverse processes of the lumbar
vertebrze. A better plan is to percuss and puncture the point
where the drum-like resonance is greatest. The higher the
puncture the more promising as the cannula is less likely to be
blocked by the ingesta which accumulates in the lower part of
each viscus. The cannula may be left in place for some time to
keep the bowel flaccid and allow time for the restoration of its
contractile functions. The cannula may be utilized to inject
antiferments (chloral) and peristaltic stimulants (eserine, pilocar-
pin, barium chloride). In cases in which puncture is not im-
perative these agents may be used hypodermically, or in the veins
eserine 1% gr., pilocarpin 2 grs. or barium chloride 7 grs.

Enemata of soap-suds, with or without stimulants prove
effective in emptying the floating colon and soliciting the action
of the large intestines generally and the passage of flatus.
Friction of the abdomen and walking exercise are desirable.
After recovery a restricted diet, laxatives and bitters serve to
restore the lost tone of the alimentary canal.

ACUTE INTESTINAL INDIGESTION WITH IMPACTION
OF THE LARGE INTESTINES IN THE HORSE.

Definition. Causes : desiccation of ingesta in colon, sacculation, constric-
tion at pelvic flexure, debility, ill health, local peristalsis, diseased teeth,
jaws or salivary apparatus, excess of food. heating grain, hard fibrous indi-
gestible fodder, green leguminosz, privation of water, inactivity, verminous
aneurisms, tumors, strictures, obstructions. Symptoms: colics after meals,
becoming more severe, tension and firmness of right side, sitting on
haunches, stretching, small, hard, dry coated stools, obstruction felt on
rectal exploration, frequent attempts to urinate, tympany. Course: six
hours to six days or more, signs of aggravation and improvement. Lesion :
large intestines tympanitic, impaction often at pelvic flexure, or other con-
striction, adherent mucosa has thick mucus or blood, is discolored, friable,
necrosis, perforation, liquid contents of distended bowel in front, rupture,
invagination, volvulus. Treatment : laxative diet, injections, aloes, pilo-
carpin, eserine, barium chloride, chloral hydrate, morphia, henbane, bella-
bonna, puncture, cold or oleaginous enemata, empty or knead rectum and
colon, cold compress, electricity, friction, laparotomy.

Definition. ‘This is an impaction and obstruction of the colon,
and usually of the pelvic flexure with dried and badly digested
alimentary matters,

Causes. Certain anatomical and physiological conditions con-
tribute to this disease in the horse. The ingesta as it leaves the
stomach is liquid or pultaceous and throughout the small intes-
tines it remains so, so that they are little liable toimpaction. But
by the time the caecum is reached much of the liquid has been
absorbed, and as the contents pass into the double colon they are
usually a soft solid, which gradually becomes dried as it ad-
vances through the double and floating colon. The sacculation
of cgecum and colon tends to delay the masses and favors absorp-
tion. The pelvic flexure, the narrowest part of the double colon,
is formed by an acute bend of the viscus on itself so that the dried
masses advancing from in front are especially liable to become
arrested and impacted at this point. Impaction may, however,
occur at any part of the large intestine.

Any debility or atony of the intestines predisposes to the con-
dition. The ingesta accumulates in the portion which does not
contract sufficiently to pass it onward, and this soon becomes

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202 Veterinary Medicine.

distended to a state of absolute paresis. All conditions of de-
bility, and all prolonged ill health tend to operate in this way by
lessening vermicular movement.

Again in cases of nausea or intestinal disorder the supervention
of antiperistaltic movements, will tend to accumulate the ingesta
at one point and favor impaction (Ernst).

As in the case of other indigestions the imperfect preparation
of the food is an active factor. Diseased teeth, jaws or salivary
glands, actin this way and a functionally weak stomach con-
tributes to this as to other intestinal disorders.

An excess of food and especially indigestible food will con-
tribute to impaction. Heating grain, like corn, wheat, buck-
wheat, passed rapidly through the stomach in an imperfectly
digested condition, tends to accumulate in the larger intestines.
Hard, fibrous fodders like hay and straw that have run to seed,
or which have been washed out by rains, bleached or heated,
rye-straw, the stalks of beans, peas, vetches, which have been
similarly spoiled, and clover hay affected with cryptogams or
other ferments act in the same way. Even clover eaten green,
produces in foals impactions to which the hairs of the leaves and
chalices materially contribute (Verrier). The allied plants alfalfa
and sainfoin when passed rapidly through the stomach tend to
impaction of the large intestines. But any fibrous, indigestible
and innutritious fodder, taken inexcess to make up the deficiency
of nutriment is liable to act in this way.

Other conditions that contribute to impaction are lack of
water, especially at night when much hay is consumed, and lack
of exercise which tends to torpor of both liver and bowels.

Finally verminous aneurism and embolism of the iutestinal
arteries induce congestion, paresis, spasms, and other disorders
which tend to aggregation and impaction. Also tumors, stric-
tures and abstructions of all kinds tend to impaction.

Symptoms. A certain amount of impaction is not incompatible
with ordinary health, but as this increases all grades of colic
may be met with from the most simple and transient to the most
persistent and severe.

In the milder forms slight and transient colics come on after
meals, for days in succession, before any serious attack is sus-
tained. These are especially marked under dry bulky fodder

Acute Intestinal Indigestion with Impaction. 203

(hay), less so on grain, and less on green food or roots. The
animal paws, moves the hind limbs uneasily, looks at the flanks,
he may even kick at the abdomen, lie down and roll, rise, pass a
little manure or flatus, and seeming relieved may resume feeding,
until the next attack. The intermissions may last a few
minutes, a quarter of an hour or longer, and they gradually be-
come more prolonged until spasms disappear for the time. Sooner
or later, however, the obstruction becomes more complete and
the colic more severe and persistent. - To the ordinary symptoms
of violent abdominal pain there are added symptoms which point
to bowel impaction or obstruction. There is a special tension of
the right side of the abdomen, with flatness on percussion.
When down there is a tendency to sit on the haunches to relieve
pressure on the diaphragm and lungs. When standing there is
a disposition to stretch the fore limbs out forward and the hind
ones backward. Feces may be passed at first in a few small
round balls at a time, but this soon ceases, and very little or
none can be obtained even by the use of enemas. The straining
is usually so violent as to expel the enemata as soon as intro-
duced. ‘The hand introduced into the rectum can easily detect
the solid impacted pelvic flexure of the colon pressing backward
into the pelvis or impinging on the right pubis. Another com-
mon symptom is the frequent passage of urine in dribblets, due
to the irritation of the bladder by the pressure upon it of the im-
pacted colon during straining. In cases of this kind the colon
and cecum become tympanitic as first shown by a resonant dis-
tension of the right flank obliterating the hollow in front of the
ilium, and later by a similar condition of the left flank.

The abdominal pain is usually less acute than in simple spas-
modic colic or intestinal congestion. The face is less pinched
and anxious, the eye less frightened, the kicking at the belly less
violent, and the lying down more deliberate and careful. Very
commonly the patient merely rests on his belly or side without
attempting to roll.

Course. ‘The disease may last six or twelve hours, or even as
many days before it ends in recovery or death. The colicy symp-
toms usually increase, with the complication of dyspnoea when
tympany becomes well marked, hyperthermia in case of the
supervention of enteritis, and signs of general peritonitis and

204 Veterinary Medicine.

collapse in case of rupture of the bowel. A sudden increase of
the pain may otherwise indicate the occurrence of invagination.

As indicating a favorable termination there may be restoration
of the rumbling, the passage of faeces at first perhaps in the form
of solid cylindroid masses, and later as a mixture of broken up
ingesta, liquid and gas, the tension of the abdomen disappears,
the pains lessen and cease, and there is a gradual restoration to
health.

Lestons, ‘The abdominal walls are tense and more or less drum-
like, and when these are cut through the large intestines pro-
trude strongly. When punctured there is a free discharge of
gas. The most common seat of obstruction is the pelvic flexure,
but it may occur in the floating colon, or rectum, in the double
colon even at other parts than its pelvic flexure, in the czecum or
in the ilio-czecal opening. The impacted mass is firm, rather
dry, covered with mucus and sometimes blood, and manifestly
only partially digested. Its size and form vary greatly as it is
moulded into the affected viscus. The mucosa in contact with
the impacted mass is covered with a thick layer of viscid mucus
sometimes streaked with blood. The mucosa itself is congested,
thickened, friable, and marked with spots or patches of various
colors (white, gray green, ) indicating commencing necrosis. In
old standing cases this may extend to the other coats of the bowel
determining perforation or laceration.

The portion of the bowel immediately in front of the obstruc-
tion is filled with liquid which has been forced down upon the
barrier by the active peristaltic movements, and the distension
by liquid and gas may have increased until rupture has ensued
with the escape of the contents into the peritoneal cavity’
Invagination, volvulus and peritonitis are common.

Treatment. "This will vary according to the stage and degree
of the illness. In slight cases with transient colics only after
meals, a more laxative diet may suffice. Boiled flaxseed, roots,
potatoes, apples, green cornstalks, silage, or even sloppy bran
mashes, with an abundance of good water and active exercise
may prove efficient. Copious injections of warm water, soap-
suds, or linseed oil emulsion may be added.

In the more violent cases we must resort to more active
measures and yet drastic purgatives are full of danger. ‘The free

Acute Intestinal Indigestion with Impaction. 205

secretion from the vascular small intestines and the active ver-
micular movements, lead to a speedy over-distension of the
bowel just in front of the obstruction, the current being strong
and active all around the contracting gut in contact with the mu-
cosa, while a weaker return current sets in in the centre, but is
effectually checked and arrested at no great distance in front of
the impaction by the strong backward peripheral stream. If
therefore the impaction is not broken up, it is inevitable that the
gut above must be more distended until a rupture ensues.

Yet in acertain number of cases a moderate dose of aloes or
castor oil supplemented by frequent enemata and other measures,
succeeds in safely overcoming the obstruction. The solid impacted
mass is gradually softened and removed, and finally after perhaps
three or four days of complete obstruction the feeces begin to
pass and recovery ensues.

With or without the aloes, the hypodermic use of pilocarpin or
eserine or both will often succeed in obtaining successful
peristalsis. Barium chloride, while inducing more active per-
istalsis is, on that account, somewhat more dangerous.

Pain may be moderated and fermentation checked by chloral
hydrate (% oz.), or an anodyne, morphia (2-4 grs.), may be
given hypodermically. In the absence of these, extract of
hyoscyamus or belladonna (2 drs.) may be given by the mouth,
and repeated as may be necessary. If tympany is dangerous use
the trochar and cannula. Enemata and other accessory measures
must not be neglected.

W. Williams has resorted to rectal injections of 2 0z. aloes
forced into the rectum by a syringe furnished with a long elastic
tube, and repeated when expelled. Brusasco has used copious
liquid injections poured into a rectal tube the end of which is raised
at least ten feet above the croup, so as to gain the requisite force.
Schadrin uses injections of cold water to stimulate the bowels to
contractions. Injections of oils or mucilaginous matters when they
can be carried far enough lubricate the walls and favor the passage
of solid matters. Castor oil which acts toa large extent locally is
especially applicable.

Mechanical applications are often valuable. If the obstruction
is lodged in the rectum or floating colon it can usually be reached
by the oiled hand and carefully extracted. If this is not suc-

206 Veterinary Medicine.

cessful, impactions in the floating colon or pelvic flexure may still
be to a large extent broken up and loosened by the knuckles of
the oiled hand inthe rectum. I have often resorted to this with
excellent effect. Impactions in the czecum or elsewhere in the
double colon are, however, inaccessible to such treatment. For
these, external measures are available. Wilhelm wraps the ab-
domen in cold compresses. Causse and Lafosse recommend the
electric current. Friction to the skin of the abdomen is a
common resort. Rudofsky turns the animal on his side or his
back, to remove the weight of the small intestines from the im-
pacted czecum or colon, and favor the exit by gravitation of the
contents from the czecum into the colon. Kneading of the ab-
domen with the fists or knee when in this recumbent position
may also be resorted to.

As a dernier resort, Gaullet performed laparatomy but with no
success as the animal died the following day. The horse was,
however, in extremis at the time of the operation and a portion
of the intestinal wall was blackish and gangrenous. To be
successful such an operation should be practiced before there is
any probability of gangrene, and while the patient is still in good
condition for recuperation. But these are just the cases in
which success is to be hoped for from less dangerous measures.
Again, the conditions for its success are best in case of obstruc-
tion of the pelvic flexure, as that could easily be drawn out
through a spacious abdominal wound, incised, emptied and
sutured with careful antiseptic precautions, and with little risk
of infection of the peritoneum. But this is just the point where
an obstruction can be efficiently dealt with in a less dangerous
way, by kneading through the rectum, for example. The opera-
tion, however, is not one to be utterly condemned, but in any
case in which it is certain that the obstruction is otherwise irre-
mediable, it should be adopted at as early a stage as possible,
under aneesthesia, and with antiseptic precautions. The after
treatment would consist in a restricted diet of milk or gruel with
antiseptics to prevent fermentation and bloating.

IMPACTION OF THE COLON IN RUMINANTS.

Causes: Debility, hard fibrous food, dry winter feeding, privation of
water, astringents, smut, ergot. Symptoms: Hard, moulded, coated dung,
blood-streaked, and in small quantity, tympany, dullness, debility, splashing
sound when right flank is pressed, rectal exploration. Treatment: Laxative
food, water, salt, strychnia, eserine, barium chloride, enemata, oils.

This is not a common affection in cattle, yet it does occur in
weak and debilitated conditions, and in animals fed on fibrous
and innutritious aliments. The ingesta are delayed in the gut,
the liquid portion absorbed and the remainder accumulates in a
hard mass, which distends and weakens the bowel. Dry winter
feeding, with a scarcity of water strongly contributes to its pro-
duction. Astringent plants in the hay, or smut or ergot may
add to the tendency.

Symptoms. ‘The feeces are hard and firm, glazed on the sur-
face, coated with mucus and sometimes stained with blood. They
are passed in small quantity and with much effort and straining,
and finally the bowels become completely blocked, nothing what-
ever being passed. Tympany of the rumen now appears, espec-
jially after feeding, appetite and rumination fail, there is much
dullness, debility, and loss of flesh and unless relieved, the ani-
mal dies in marasmus. Pressure on the right ‘side of the abdo-
men made suddenly and forcibly produces a sound of liquid
splashing in an air space, derived apparently from the accumula-
tion above the obstruction. The oiled hand introduced into the
rectum may feel the solid impaction, but in any case causes pain
and moaning when the seat of the impaction is pressed upon.

Treatment. In the milder cases and earlier stages a change to
sloppy food, green food, or boiled flaxseed, with plenty of salt,
free access to water, and scruple doses of nux vomica may prove
successful.

In the more advanced conditions with complete obstruction,
give % Ib. to 1 lb. each of sodium chloride, and sodic sulphate,
and % dr. nux vomica, inject hypodermically 3 grs. eserine or
intravenously 7 grains barium chloride, give water ad dzbitum, and
frequent and large injections of soapsuds. If these latter are given
cold they will still further stimulate the missing peristalsis. In

207

208 Veterinary Medicine.

obstinate cases a second dose of the salts, or 1 quart of castor oil
may be given with the addition of 20 drops of croton oil.

When relief has been obtained, a laxative and nutritive diet
and a course of bitters should follow.

INDIGESTION WITH OBSTRUCTION OF THE COLON
IN SWINE.

Causes: green leguminosz, dew, rain, dry indigestible food, lack of water
or exercise, debility, torpid liver. Symptoms: firm, small, coated stools,
obstruction, straining, tympany, rumbling, vomiting, anorexia, lies on belly,
secludes himself, restless, grinding teeth, diarrhoea. Diagnosis from hog
cholera. Treatment: laxatives, enemata. antiferments, rubbing, massage,
mechanical unloading of rectum, puncture, dieting, bitters.

Causes. ‘The leguminosz in their green state are liable to pro-
duce indigestion and flatulence in the pig. If covered by dew or
rain this tendency is increased. Dry, fibrous or indigestible
food with privation of water and of exercise tends to intestinal
impaction. Debility from any cause, by weakening the con-
tractility and secretory power of the bowel strongly predisposes.
to this condition. Torpid liver with diminished secretion of bile
is another common factor.

Symptoms. The defecations are infrequent, and small, and
covered by a mucus film on a glazed surface. This i.creases.
steadily until they cease altogether, when straining, tympany,
rumbling and vomiting follow. The animal refuses food, and
lies on its belly, hiding under the straw when that is available.
Restlessness with frequent change of place and grinding of the
teeth are noticed. A spontaneous cure may take place by a free
secretion of liquid in which the impacted mass is loosened, disin-
tegrated and floated off, the costiveness being succeeded by diar--
rhoea. Once established this diarrhcea may become persistent,
causing serious loss of condition, and simulating hog cholera.
It may be distinguished by the fact that it occurred without
the introduction of a contagium, is easily accounted for by the
nature of the food and is not communicated to adjacent herds.
treated in a different way. There is also the absence of the

Intestinal Indigestion in the Dog with Constipation. 209

numerous petechize on the skin, and, on post mortem, of the spe-
cific round necrotic intestinal ulcers of hog cholera.

Treatment. ‘The first object is to rid the intestines of the irri-
tating impacted masses, and this may be secured by giving 1 oz.
castor oil, 2 drs. jalap, or 3 grs. croton farina toa 150 lb. pig.
This may be seconded by frequent and copious injections of soap-
suds. If fermentation and tympany are troublesome 30 grs.
chloral hydrate may be given and repeated as circumstances de-
mand it. Active rubbing of the abdomen or kneading of the
same will prove useful. If tympany becomes dangerous the gas
may be safely evacuated by trochar and cannula, the point of
puncture being selected by the clearness of the resonance. When
the impaction has reached the rectum and prevents the use of
enemata, it may be extracted with the oiled fore finger. An in-
jection of sweet oil may then be given and the finger may be
used again and again as the impacted feeces come within reach.
When diarrhoea has set in it may be checked by doses of 30 to
60 drops of laudanum, and a diet of boiled milk, well boiled
flaxseed or other starchy gruel or mush. A course of bitters
with chalk, bismuth or antiseptics will prove serviceable during
convalescence.

INTESTINAL INDIGESTION IN THE DOG WITH
CONSTIPATION.

Usual seat. Causes: house life, neglect of call to defecate, lack of exer-
cise, overdistension, atony, watch dogs, over feeding, obesity, ill health,
debility, loss of teeth, paraplegia, spiced and sweet food, matting of hair
over anus, tumors round anus. Symptoms: small, hard, white, glazed
stools, straining, no stools, hot, tender, swollen, bulging anus, abdominal
manipulation, dullness, laziness, seeking seclusion, colics, tender abdomen,
stiffness, arched back, drooping head and tail, vomiting—sometimes fecu-
lent, fever. Lesions: impacted mass of hard, gritty particles, catarrhal
congested or necrotic mucosa, and outer coats, perforating ulcers. Treat-
ment: air, exercise, laxative diet, mechanical extraction, purgatives,
enemata, demulcents, laparotomy, enterrectomy.

In the dog atony and impaction are common especially in the
rectum, where the feces are unduly retained in connection with
house life until accumulated and dried. The impaction tends to

14

210 Veterinary Medicine.

extension forward, the new material adding continually to the
old, and the over-distended rectum becoming more and more
atonic in proportion to the increase of the distension.

Causes. The most prominent factor is denial of nature’s call
to defecate, on the part of house dogs trained to habits of cleanli-
ness. ‘The accumulated mass distends and weakens the rectum,
enabling it to hold more without suffering, making the call of
nature less imperious, and diminishing the power of expulsion.
Lack of exercise usually operates in the same animals, as it also
does'in watch dogs, the movements of which are limited by the
length of their chains.

Overfeeding contributes, in various ways, by increasing the
amount of feculent matter passed on into the rectum, by hasten-
ing the food through stomach and small intestine imperfectly
digested and therefore in a more irritating condition, and by con-
tributing to obesity and lack of tone.

In mastiffs, hounds, bull-dogs, etc., which are naturally
gluttonous and swallow animal food in large masses without tear-
ing apart, or mastication, portions pass into the intestine undi-
gested and tend to disturb and block the terminal bowel.

Dogs that are out of health, and which lack tone in general
have usually torpid bowels and suffer from delay and impaction
of contents. Hence all chronic and debilitating diseases are
liable to become aggravated by this troublesome complication.

Old dogs with the teeth worn out and the general tone of the
stomach and intestines low are habitual sufferers.

Paralysis of the posterior limbs is usually associated with
paresis of the rectum and accumulation, and various other atonic
nervous disorders act in the same way.

The sympathy between the skin and alimentary tract shows
itself in common disorders, indigestions and catarrh becoming
complicated by skin eruptions acute and chronic, by indigestions
and impactions. To both conditions the nature of the food of
house dogs largely contributes, the habit of eating abundantly at
each meal time of the master, the consumption of highly spiced
meats, of sweet cakes, pastry and puddings, and even the exclu-
sive diet of white bread or farinaceous and starchy aliment.

In long haired dogs, the matting of these hairs together across

Intestinal Indigestion in the Dog with Constipation. 211

the anus proves a factor by rendering defecation difficult and
painful.

The formation of tumors around the anus, or inflammation and
swelling of the anal glands are additional causes.

Symptoms. As in other animals this condition may be chronic,
lasting for a long time without leading to complete obstruction.
The fzeces are passed in hard fcetid, whitish masses, often partly
divided, in pellets, dry, and polished on the surface and covered
with a film of mucus, sometimes blood. They are passed at con-
siderable intervals, slowly and with painful effort and straining.

In the more advanced and violent cases defecation becomes ab-
solutely impossible, though the animal strains violently and fre-
quently. The anus and rectum bulge as a rounded swelling and
the congested and bleeding mucous membrane may be exposed,
but nothing is passed. The anus is hot and tender to the touch
and the anal glands swollen. Manipulation of the abdomen be-
tween the two hands can detect the impacted gut extended for-
ward for a considerable distance, and even implicating the colon.
The oiled finger in the rectum may detect the impacted matter as a
conglomerate mass of gritty materials. If the appetite continues
this becomes all the more entensive. The affected animal is dull,
prostrate and indisposed to exertion, seeking a dark retired place
where he can rest undisturbed curled up intoa ball. Sometimes
he starts with a sharp yelp. Especially does he shrink and com-
plain when the belly is handled. If made to walk, he does so
stiffly, hangs head and tail, arches the back and tucks up the
belly. The face and eyes express severe suffering. Vomiting is
a frequent complication, the rejected matters being often feculent.
Colicy pains are indicated by yelping or moaning, enteritis and
peritonitis by hyperthermia and extreme abdominal tenderness.
The acute disease may last from one to two weeks, and death
may be preceded by auto-infection, by nervous symptoms of
various kinds or by enteritis or peritonitis.

Lesions. ‘These may be stated shortly as impaction, catarrh
or necrotic changes of the mucosa, more or less extensive inflam-
mation of the bowels and peritoneum, perforations, and conges-
tions of the liver and kidneys.

Treatment. Inthe milder cases plenty of open air exercise
and a,laxative diet may succeed. In the more severe cases it is

212 Veterinary Medicine.

usually requisite to unload the rectum mechanically. The dog
is laid on a table, and the oiled finger introduced through the
anus, lubricates the mucosa as far as it can be reached. ‘TMhen
little by little the frm mass may be disintegrated and removed
being steadied by the other hand applied on the abdomen. The
handle of a teaspoon or a special spoonshaped curette may at
times replace the finger to advantage, but must be used with due
judgment, in view of the thinness and friability of the walls of
the gut.

When the gut has been emptied in this way, or in the less
severe cases without this preliminary, purgatives and frequent
injections can be tised to advantage. Jalap % dr. and calomel 5
grains, or castor oil % oz., or syrup of buckthorn have been
usually employed. The impaction is usually too firm for the
transient action of eserine or pilocarpin. As injections, castor
oil, soapsuds, decoctions of flaxseed, mallow or elm bark may be
employed being repeated as often as they are expelled and supple-
mented by the mechanical removal of all solid matters that come
within reach.

In cases so extensive as to resist the above measures we can
resort tolaparotomy. ‘The incision can be made close and parallel
to the linea alba, the rectum or floating colon drawn out through
the wound, the other intestines being carefully held hack by an
assistant, the gut is then incised longitudinally and its solid con-
tents removed. The wound is thoroughly cleansed, washed with
an antiseptic (mercuric chloride 1 : 2000), and sutured with cat-
gut, the mucosa being carefully turned in and the muscular and
peritoneal coats kept in accurate contact. Finally the abdominal
wound is closed by silk sutures. The patient must be placed for
a weekfor ten days on well boiled gruels and the rectum fre-
quently emptied by injections of tepid water.

In case the (bowel is found to be necrotic, the gangrenous
section mayjbe excised and the ends brought together by Mur-
phy’s button,sor simply sutured with catgut over a hollow tube
of raw potato.

INTESTINAL INDIGESTION AND OBSTRUCTION IN
BIRDS.

Causes: Age, debility, atony, matting of feathers, dry or indigestible
food, lack of water, diseased oviducts, sand or gravel, lack of pebbles or
power in gizzard. Lesions; masses of egg, uric acid, or faeces in cloaca, im-
plicating colon and ceeca, Symptoms: dullness, stupor, vertigo, staggering,
erect plumage, trailing wings and tail, bulging anus, covered with matted
feathers, impaction felt by finger. Treatment: extract mass, castor oil,
laudanum, chalk, bismuth, pepper, demulcents, phenol, exercise, silage,
green food, pebbles.

Causes. ‘These resemble those already noted for the dog. Old
age, debility, and atony of the bowel, the matting together of
feathers across the anus, dry feeding, indigestible food, scarcity
of water, and lack of exercise are especially to be noted. Mal-
formations or other changes lead to obstruction of the cloaca,
and of defecation. Sand and gravel passing from an atonic
gizzard accumulate in the small intestine or in the caca distend-
ing them to great excess. Imperfect trituration in the gizzard,
from lack of pebbles, may prove a factor in stoneless prairies.

Lesions. ‘The most common seat of obstruction is at the cloaca,
and the impacted matter may be yellow partaking of the nature
of yolk of egg, or it may consist of feculent matters and uric acid
in various proportions, white, hard and fcetid. As in the dog
this distension may be continued forward blocking the colon and
ceca aswell. Lucet mentions a case in which the impacted mass
measured seven inches long, and eight in circumference at its
posterior and larger end.

Symptoms. The bird is dull, sluggish, stupid, giddy or un-
steady on its limbs, with feathers erect, wings, tail and head
pendent and loses flesh rapidly. Often a felted mass of feathers
and feeces cover the anus. In its absence there appears the
rounded swelling or on manipulation the impacted cloaca or rec-
tum can be felt firm and resistant.

Treatment. Soften and remove the external mass of feeces by
the aid of tepid water, clip off the feathers, which would tend to
restore it, then by the oiled finger and warm water injections break
up and extract the contents of cloaca and rectum. If impaction

213

214 Veterinary Medicine.

remains farther forward give a teaspoonful of castor oil. If
diarrhcea has already set in, give 5 drops laudanum, and mix
chalk or bismuth and pepper in a mush to be fed to the patient.
Injections of slippery elm containing a teaspoonful of carbolic
acid in the pint will prove useful.

The bird should be allowed plenty of exercise, its grain being
fed on a floor covered lightly with straw to encourage scratching,
and silage or green food should be allowed. On the prairies.
where pebbles cannot be secured, imported gravel or vitrified
brick broken into small pieces should be allowed.

COLIC IN SOLIPEDS FROM VERMINOUS EMBOLISM.
INTESTINAL CONGESTION.

Definition. Causes: presence of sclerostoma in arteries, form, habit,
nature, immature, biology, life in bowel, in submucosa, in arteries, outside
the mammal, pathogenesis, blood-sucking, verminous cysts, verminous.
aneurisms, seats of latter, coagula, embolism, stagnation of blood, cedema,
and thickening of intestine, mesentery, fermentations, tympany, infective
inflammations, blood extravasations, infection of liver and spleen. Symp-
toms; sudden attack, violent colics, reckless movements, frequent defeca-
tion followed by its arrest, palsy of peristaltic movement, of pain, prostra-
tion. Course: two to twenty four hours, death from indigestion, tympany,
obstruction, hemorrhage, poisoning, recovery, sequelee, laminitis, intestinal
catarrh or atony, debility. Treatment: aneurism worms beyond reach,.
treat lesions, venesection, anodynes, stimulants of peristalsis, antiseptics,
compresses, sinapisms. Prevention: expel intestinal worms, exclude em-
bryos, tartar emetic, iron sulphate, arsenic, phenol, pure water, occasional
vermifuges.

Definition. Congestion and spasms of the intestines in con-
nection with blocking (thrombus or embolism) of the mesenteric
arteries, and verminous aneurism.

Causes. ‘The essential cause is the migration of the sclerostoma
equinum (strongylus armatus, Rud.) into the mesenteric arteries.
in its agamous condition. It seems appropriate therefore to here
notice the life history of this parasite.

The sclerostoma equinum (sétrongylus armatus) is one of
the common pin worms of the horse. It is distinguished by its.

Colic in Solipeds from Verminous Embolism. 215

dull gray or reddish brown body, thickest at the cephalic end and
tapering off toward the caudal, but ending in a blunt point; by
the round, open mouth furnished with several firm chitinous
rings, of which the outer bears six short symmetrically arranged
papille, an zxtermediate row of rounded blunt tooth-like pro-
jections and the zzzermost a row of fine, closely aggregated and
very sharply pointed teeth for penetration of the mucosa. Male
34 to 1% inches long, with caudal membranous alz in two
lateral lobes, joined by a rudimentary central lobe: two delicate
spicula. Female 34 to 2 inches long, blunt pointed tail, vulva
in posterior half of the body. Eggs ovoid with slightly raised
ring around the centre: oviparous.

Habitats. They are found in solipeds in two stages of ex-
istence, the mature worms in the czecum and colon, and the
immature in the same organs encapsuled in little pellets of
manure, and in cysts in the mucosa but also apart in the arterial
system especially in the anterior mesenteric artery and other
gastric or intestinal trunks.

The mature sclerostomata are found attached to the mucosa
of the large intestine into which the head is sunk for the purpose
of sucking the blood, and they may be gray, brown or red ac-
cording to the quantity of blood which they have imbibed. ‘The
author has found them in little hernial sacs of the mucosa hang-
ing from the peritoneal surface.

The sexually immature sclerostomata are found in little
pill-like masses of ingesta in the large intestines and from which
they project part of the body through a narrow opening.
Another habitat is in cysts of the mucosa of the cecum and
colon and less frequently of the small intestine, individual cysts
varying in size from a pin’s head to a hazel nut, and containing
the young worm rolled upon itself, and varying in size but al-
ways less than the intestinal worm and always asexual. In
some cases the cyst is found empty but with a small opening
toward the lumen of the bowel showing the means of escape of
the parasite. A third habitat of the immature worm is in the
blood-vessels, especially the posterior aorta and its divisions, and
still more constantly the anterior and other mesenteric arteries.

Biology. The ova of the sclerostoma are segmented in the
oviduct but are hatched out after they have been laid. The

216 Veterinary Medicine.

hatching may be effected in the intestine or in manure or water
external to the body. When hatched out in the intestine they
may pass out at once with the manure or they may envelop
themselves in pellets of the finer ingesta and remain for a time
in the bowel and finally pass out in this condition. Baillet has
traced their development out of the body. Ina watery or damp
medium they are hatched out in a few days as a cylindroid worm
¥% to % mm. long, thick in front and with a filiform tail. In
moist environment but especially in damp manure they grow to
I mm. or 1.5 mm. and continue for months in this condition, but
remain small and asexual, until taken in, in the drink or green
food of the soliped. Reaching the intestine and especially the
czeum and colon they bore their way into the mucosa and encyst
themselves, or if they happen to perforate a blood-vessel they
make a habitat of that. In the cyst, development proceeds and
when it has reached acertain stage the worm once more bores
its way through the mucosa and reaching the intestine becomes
sexually mature.

In this last migration the young worm is liable to perforate a
blood-vessel in which case it is destined to a period of existence
in the blood. It may, however, have blundered upon a blood-
vessel at an earlier stage when seeking a temporary home in the
mucous membrane, so that the sclerostomata of aneurisms may
be derived from two separate sources. In the blood-vessels the
parasite attains a length of 1 to 8 lines, whereas in the mucous
cysts it does not exceed 3% lines. Yet Neumann holds that
after leaving the blood-vessels they may again encyst themselves
in the mucosa before escaping into the intestine.

Several moultings take place in the asexual condition.

Other views have been advanced as to the development of the
sclerostomata. Colin believed that the ova deposited in the ducts
of the mucous glands and in the perforations made by the para-
site in blood-sucking, hatched in this situation and the embryo
at once encysted itself in the mucosa.

Leuckart imagines that the embryo found in the feeces or in
water outside the body of the soliped, should pass through an
intermediate host before it can return to gain sexual maturity in
the horse. But no evidence of the existence of such intermediate
host is furnished, and the encysted intestinal worms show no in-

Colic in Solipeds from Verminous Embolism. 217

dication of a special development which would have been accom-
plished in such host.

Willach holds to a hermaphrodite stage passed in the intestine
of the soliped. He found in the bowel small worms apparently
related to the sclerostomata by the appearance of the head and
the caudal membrane, but not exceeding three to five lines in
length. Some were evidently females and contained not only
eggs with soft shells, but in one case embryos. Others had the
caudal membrane of the male, yet contained also a few eggs.
There is no vulva and the embryos escape by rupture of the ovi-
ducts. These embryos he supposes are developed in the same
host into the familiar mature sclerostomata.

Whatever may be said of those alleged modes, the first
described series of changes and migrations may be taken as the
usual and regular method of development.

Pathogenesis. Lesions. ‘These embrace perforations of the
mucosa, cysts, aneurisms, embolisms and congestions.

Irritation of the mucosa. The adult worms, like so many
leeches are continually biting and sucking blood from the mucosa
and when present in large numbers, hundreds, thousands, or a
million create an aggregate of irritation which may determine
violent indigestions and congestions.

Verminous Cysts. These are like a pin’s head, a pea or
hazel nut, containing the asexual worm in a mass of purulent
debris, or if empty, presenting a small orifice where it made its
exit.

Verminous Aneurisms. ‘These are perhaps the most im-
portant lesions caused by the sclerostome as they are the stepping-
stone to the dangerous embolisms, and too often fatal colics and
congestions of the intestines. They are very common in some
localities, and rare in others following the distribution of the
sclerostomata. Bollinger found them in 90 to 94 per cent. of
adult horses, and Ellenberger in 84 out of 85 horses dissected.
They are found in all ages from six months up, and are nearly
always in the short, stubby trunk of the anterior mesenteric
artery. Often two or three exist in the same animal, the whole
length of the posterior aorta showing patches of disease, exuda-
tions, neoplastic elevations alternating with depressions, and
aneurisms and thrombosis in its different branches. In 100

218 Veterinary Medicine.

horses Bollinger found 168 aneurisms, 153 in the anterior mesen-
teric, and its divisions, 4 in the coeliac axis and its divisions, 3 in
the hepatic artery, 3 in the posterior mesenteric artery, 3 in the
renal arteries and 2 in the posterior aorta.

The special predisposition of the anterior mesenteric artery is.
variously accounted for: 1st. There is the obvious fact that its.
branches are distributed to the caecum and double colon, the
home of the mature parasite, and to the small intestines which
are first reached by the young parasites that are taken in with
the water and the food. These are therefore most likely to get
into the branches of this vessel and to follow them up toward its.
origin. 2nd. The anterior mesenteric artery distributes its.
branches to the small intestines the most motile portion of the in-
testinal tract, and the czecum and colon the most heavily loaded
with solid ingesta, it is therefore the most subject to traction,
and distensions, and the more so that the parent trunk is ex-
tremely short and the divisions pass in all directions and toa
large extent at right angles, so that there is a dragging of the
walls apart as well as an obstruction to the blood flow and an in-
crease of internal tension. The distension, laceration, inflamma-
tion and softening of the internal coat have accordingly been re-
garded as the starting point of an endarteritis upon which the
parasites have been implanted as a further cause of trouble.
The teeth of the worm are absent in the larva in the artery.

The irritation of the intima determines here as elsewhere
exudation, and coagulation, and the inflamed walls losing their
tone yield more and more readily to the internal tension. Some-
times the coagulum lines the aneurism or vessel all round, leav-
ing a narrow central passage through which the blood still flows;
in other cases the clot extends into the adjacent smaller vessels,
completely blocking them and disturbing circulation and innerva-
tion in the parts which they supply. Asa rule the parasites are
found in galleries hollowed out in the clot, and heads or tails may
be seen to project into the circulating blood. Sometimes they
are found imbedded in the arterial coat, or in an adjacent small
abscess. The formation of aneurisms in the other arterial trunks

may follow the same method.
Embolisms. ‘These come very naturally from the formation

of thrombi in the various arteries. The coagulum determined

Colic in Solipeds from Verminous Embolism. 219

by the presence of the worms, tends to undergo retrogressive
changes notably fatty degeneration, to which germs brought on
the worms or in their alimentary canals contribute. ‘This to-
gether with the movements of the parasites tends to break up
the mass, and minute portions are washed on into the different
smaller vessels. Soon these reach divisions which are too small
to admit them, which are accordingly occluded and the circula-
tion through them abolished. The presence of microbes as well
as fibrine contributes to cause further coagulation, more absolute
embolism and arrest of the circulation.

It is further alleged that the sexual instinct in the summer
months (May to August) leads the worms to leave the aneurisms,
to pass through the smaller divisions to the czecum or colon where
alone full sexual evolution is possible. In these migrations they
cause the thrombosis of the smaller trunks and determine the
verminous congestion of the bowels which are especially com-
mon in these months.

Disturbances ofthe Intestinal Circulation. Asthese usually
occur in the lines of distribution of the anterior mesenteric artery
a knowledge of its divisions and their destination and anastomoses,
is essential to an intelligent understanding of the pathogenesis
and lesions. As first pointed out by Lecoq the anterior mesen-
teric artery is divided into three primary bundles: (a) a deft of
15 to 20 trunks which are destined to the small intestine; (b) a
right which gives off czecal branches, one to the double colon,
and one to the ileum to anastomose with the last trunk of the left
bundle ; and (c) an anterior which gives one branch to the second
division of the double colon and anastomoses with the colic branch
of the right bundle at the pelvic flexure ; and a second branch to
the floating colon to anastomose with the posterior mesenteric
artery.

The divisions of the left bundle anastomose so freely with each
other in the mesentery and immediately above the intestine that
the blocking of any one branch cannot entirely arrest the circu-
lation in the corresponding part of the intestine. It may how-
ever produce a partial local stagnation in the vessels of a short
loop of intestine, resulting in cedematous infiltration and thicken-
ing with resulting induration and stricture of the gut. Chronic
and permanent lesions are produced by such blocking, but only

220 Veterinary Medicine.

rarely actually fatal ones. Acute and fatal congestive lesions of
the small intestine from verminous embolism, occur only when
several adjacent divisions of the artery are blocked at once, and
this is a rare occurrence.

The right bundle of branches furnishes the only two arteries
which are supplied to the ceecum and the only artery furnished
to the first half of the double colon. The ileo-czecal branch is
less involved, first, because being less dependent and smaller, it
is less likely to recieve an embolus, and, second, because any lack
of blood supply is counterbalanced by the free anastomosis with
the last ileac division of the left bundle. When the embolus
blocks the undivided trunk of the right bundle this same princi-
ple comes into play, the free supply of blood from the posterior
bratich of the left bundle supplying blood through its anastomosis
with the ileac and czecal branches of the right.

But when the emboli are lower down, in the czcal branches of
the right bundle, or in these and the colic branch, arrest of the
circulation in the intestinal walls ensues, followed by paresis,
passive congestion and hemorrhage. The czecum and double
colon thus become the seats of the grave and fatal lesions of ver-
minous embolism. In a specimen in the N. Y. S. Veterinary
College a chain of aneurisms extends about six feet.

The resulting lesions are to be variously accounted for. ‘The
stagnation of the blood in the vessels below the embolus, deter-
mines a speedy exhaustion of its oxygen and increase of its carbon
dioxide, so that it is rendered unfit to maintain the normal nutri-
tion and functions of the part, and the capillary and intestinal
walls are alike struck with atony or paresis. The blood filters
into the stagnant vessels slowly from adjacent anastomosing
trunks, and the liquor sauguinis exudes into the substance of the
tissues and lumen of the intestine, leaving behind the greater
part of the blood globules so that the stagnant blood is rendered
more and more abnormal in composition. The walls of the capil-
laries soon lose their cohesion as well as their contractibility, and
giving way at different points, allow the escape of blood into the
tissues, bowels and peritoneal cavity. It has been further claimed
that the emboli already infected and in process of degeneration
communicate this to the walls of the vessels and to the stagnant
blood, hastening the process of degeneration and rupture.

Colic in Solipeds from Vermtnous Embolism. 221

Another series of circulatory disorders are liable to take place.
The blocking of the vessels of the right bundle, tends to increase
the blood pressure in the left bundle and the anterior one, and
thus to determine congestions, paresis and inflammations in the
small intestines, the second division of the double colon and the
floating colon. The resulting inflammation and increased vascular
tension may lead indirectly to implications of the brain and lung.

Extravasations so extensive as to appear like blood-clots may
be present between the layers of the mesentery or in the mucosa
and sub-mucosa and blood, liquid or coagulated, may have
accumulated in the abdominal cavity. Blood effusion into the
intestine gives a dark red coloration to the contents which are
further mixed with distinct clots.

The atonic bowels are always the seat of extensive fermenta-
tionsandtympany. The microbes engaged in these fermentations
and their toxins, are accountable for toxic changes occurring in
the locally diseased parts and in distant organs. ‘To this may be
attributed the congestion and softening of the liver and the
engorgements and hemorrhagic centres in the spleen.

Symptoms. An animal, perhaps known to harbor the sclero-
stoma equinum, is suddenly attacked with violent and persistent
colic. He trembles, paws, moves his hind feet uneasily, kicks
the abdomen, throws anxious looks at the flanks, crouches, lies
dcewn, rolls, gets up, and at once gets down again. The intensity
of the suffering rapidly increases, the face is drawn and pinched,
the eye is extremely anxious, the patient no longer lies down, but
throws himself down reckless of consequences, when down he is
not quiet for an instant, but now on his breast, then on his side,
then on his back, the limbs struggling and jerked violently, the
head turned first to one side and then to the other, he is a picture
of extreme agony. If made to walk the same indications con-
tinue ; he walks with head down and limbs semiflexed ready to
drop at any moment, and often he will drop suddenly in spite of
every effort to keep him on his feet. The pulse is at first strong
and full, but as extensive effusion takes place into the bowels or
abdomen, or as the animal is poisoned by toxins, it becomes small,
weak, and it may be imperceptible. Breathing is quick and catch-
ing, and the mucous membranes are dark red. Sweating which
shows first about the elbows or flanks or back of the ears finally

222 Veterinary Medicine.

becomes general, the surface cold and the limbs especially so.
Feeces may be passed at first, a few dry balls at a time from the
floating colon or rectum, but soon they are suppressed entirely.
Some patients strain frequently to micturate but pass little at a
time.

In some instances the acute pain seems to suddenly cease, but
there is no general improvement, the patient stands with head
depressed, eyes sunken and expressionless, ears lopped, cold per-
spiration, chilly limbs, unsteady gait and imperceptible pulse.
It implies merely a paralysis of the affected bowels in connection
with the extensive congestion and extravasation.

Course. Duration. ‘The more acute cases reach their acme
with great rapidity, death may occur after two hours illness, and
in other cases it may be delayed ten or even twenty-four hours.
It may be caused by indigestion and tympany, by volvulus or in-
vagination, by excessive hemorrhage, or by poisoning with toxic
matters.

Recovery occurs when the vessel blocked is an unimportant
one as a branch of the left bundle so that circulation may be re-
established from collateral trunks; or when a more important
trunk has been but partially blocked, and after a time it either
clears itself, or collateral circulation comes in with sufficient com-
pensation. There isa more or less rapid disappearance of the
colics and other symptoms, a free passage of urine, the rejection
of feeces, it may be in a liquid, semi-liquid or sanguineous condi-
tion, yet enough to indicate the restoration of intestinal tone.
The patient begins to pick morsels of tood and soon acquires his
former appetite.

In some instances, however, the recovery is not complete.
Trasbot has noted a case of laminitis occurring within fifteen
hours after the improvement, and in other cases there remain
chronic debility and catarrh of the intestines. The appetite re-
mains poor, there are occasional colics, the bowels are irregular,
loose or costive, and the faeces are dry, glossy and covered with
mucus. The back is arched, the belly tucked up, strength and
vigor are both lacking, and the patient spends much time in the
recumbent position.

Complications of various kinds may follow as in other diseases
of the intestines. After even the best recoveries, a relapse is

PRO e

Colic in Solipeds from Verminous Embolism. 223

always to be apprehended as the original cause remains and the
animal is liable to be cut off at any time.

Treatment. ‘This is very unsatisfactory as the original source
-of trouble, the worms, being in the bloodvessels, cannot be
reached by vermifuges that would be harmless to the host, and
clots blocking the smaller intestinal vessels, cannot be dissolved
and removed. Moreover, although we could compass the death
of the worms in the aneurisms, we would leave their dead bodies
as sources of septic change, blood coagulation and embolism.

A certain number of cases, however, are not necessarily fatal,
and the worms of the blood-vessels have not an indefinite period
of life, so that there is some encouragement for both therapeutic
and preventive treatment. During the attack we must be con-
tent to treat symptoms. French veterinarians still trust largely
to general bleeding, adopted at the very outset and to the extent
of 6 to 10 quarts. It willtemporarily lessen the vascular tension,
more permanently dilute the blood, and calm nervous excitement
and in the most violent cases, as a kind of forlorn hope, it might
‘be tried with the view of tiding over the acute stage untila freer
collateral circulation could be established.

The use of anodynes will be more generally acceptable to
American practitioners. Two to four grains of sulphate of mor-
phia or codeine may be given hypodermically in combination
with 1% gr. eserin, 7 grs. barium chloride, or 2 grs. pilocarpin,
to secure a movement of the bowels.

To counteract intestinal fermentation perhaps no better agent
can be got than chloral hydrate, % oz. of which may be given
by the mouth in water, and 34 oz. more by the rectum.

Wet compresses to the abdomen, or fomentations with water
rather hotter than the hand can bear or even the application of
mustard is sometimes useful as a soothing or derivative agent.

In the absence of morphia or chloral, laudanum, ether, chloro-
form, camphor or assafeetida have been recommended.

It is important to keep the patient on a soft, littered floor to
‘prevent injury from his throwing himself down, and walking him
around may be resorted to for the same purpose.

Prevention. After a non-fatal attack and in every case in
which a horse is found to harbor the sclerostoma equinum in
quantity, measures should be taken to expel those present in the

224 Veterinary Medicine.

bowels and to prevent the entry of embryos. Theinfested horse
may be purged and put on twodrachms each of tartar emetic and
sulphate of iron every morning in a handful of feed half an hour
before the first meal. After six doses he may take a second
active purgative. In case of need the addition of 6 grains
arsenious acid, 2 drams of areca nut and a drachm of carbolic
acid to each dose will render them much more effective. All!
water must be withheld that comes from streams running by
farm-yards, from ponds or open wells in barn-yards, from un-
covered cisterns and from any source which receives drainage or
leaching from land occupied by solipeds or spread with their
manure.

A course of vermifuge medicine should be given at intervals of
two or three months to get rid of the worms which have passed
in the interval from the cysts of the colon, into the intestine.

NON-VERMINOUS INTESTINAL CONGESTION IN
SOLIPEDS. ;

Causes : sudden changes to green food, or leguminous fodder, newly
harvested fodder, frosted food, iced water, microbian infection, toxin poison-
ing, intestinal fermentations, experiments, volvulus, invagination, strangu-
lation, compression. atony, Symptoms: as in verminous aneurisms.
Diagnosis : absence of worms, presence of other causes. Treatment.

Causes. Acute intestinal congestion apart from verminous
aneurisms is ascribed to a variety of causes. Sudden changes of
food especially to green food, in spring, or to some of the
leguminous fodder plants (alfalfa, cowpea, clover, tares, vetches),
newly harvested grain or hay, fodders covered with hoarfrost,
iced water, and microbian infection or poisoning with toxins or
other irritant products of intestinal fermentations. Experi-
mentally the injection into the circulation of pyogenic toxins.
and putrid matters has determined intestinal congestion and
hemorrhage. In the same way musty hay or grain have proved
the occasion of these attacks. Finally mechanical blocking of
the circulation of the intestine as by volvulus, invagination,
strangulated hernia, or even compression by bulky food has.
seemed to operate in this way.

Pseudo-Membranous (Croupous) Enteritis in Solipeds. 225

It ought to be borne in mind that the habitual microbes of the
healthy bowel may become pathogenic when brought in contact
with a mucosa which is the seat of irritation, atony or any con-
dition of debility.

Symptoms and Lesions. The verminous aneurisms and throm-
bosis aside, the symptoms and lesions of this form of congestion
so closely resemble those of the verminous affections that it
seems needless to repeat them.

Diagnosis. is difficult but the absence of worms in the affected
animals and their fellows, and the presence of some one of the
other recognized causes may lead toa fair conclusion.

Treatment of the affection is more hopeful than in the vermi-
nous affection, and may be conducted on the same general lines.

PSEUDO-MEMBRANOUS (CROUPOUS) ENTERITIS
IN SOLIPEDS.

Definition. Causes: As in ordinary enteritis, with added infections or
toxins. Symptoms: As in enteritis, nervous symptoms, diarrhcea. Lesions:
Congested mucosa, whitish or grayish false membranes, in patches or tubular
casts, granular, mucous, albuminoid, fibrinous. Diagnosis: False mem-
branes in stools. Treatment : Glauber salts, calomel, alkaline carbonates or
tartrates, oils, antiferments, demulcents, careful diet, bitters.

Definition. An inflammatory infection of the bowels charac-
terized by the ejection with the feeces of false membranes.

Causes. It has been long attributed to the causes which pro-
duce other forms of enteritis and indigestion, as youth, rich
stimulating feeding, sudden change to green food in spring,
sudden chills, over-fatigue, confinement in-doors, and prolonged
costiveness. In man it is found as a sequel of infectious diseases
(pneumonia, pyzemia), in Bright’s disease, cirrhosis of the liver
and cancer, and in poisoning by lead, mercury or arsenic (Osler).
Cadaec, who found great numbers of streptococci in the false
membranes in animals, is certain it is a microbian disease, and
this is doubtless true, if qualified by the statement that the
microbe as is so often the case with other intestinal affections,
requires an occasion in the form of a diseased or debilitated con-

15

226 Veterinary Medicine.

dition of the mucosa to enable it to become pathogenic. The
disease is not known to propagate itself indefinitely or without
such a predisposing occasion.

Symptoms. ‘There are dullness, prostration, languor, hyper-
thermia, accelerated pulse, and colics which may be slight or very
severe. In some cases nervous symptoms have been observed,
such as irritability or stupor and somnolence with icterus and
fetid stools. The feeces are generally semi-liquid, implying an
excessive liquid secretion as well as the exudation of the mem-
branous matter.

Lesions. ‘There is a pink congestion of the intestinal mucosa
more or less generally distributed. Whitish false membranes
cover patches chiefly on the terminal portion of the small intes-
tine, but frequently also on the ceecum and colon, covering an
especially red and angry mucosa. They may occur as simple
patches, as ribbon shaped pieces, or as hollow cylinders lining the
entire circumference of the intestine. They appear as if fibril-
lated, but contain abundance of granular matter and seem to be
composed mainly of mucus with albuminoid matter and probably
a little fibrine. The deeper layers, in contact with the inflamed
surface are soft and gelatinoid. It is alleged that co-existing
wounds on other parts of the body become covered by a soft
pultaceous false membrane.

Diagnosis is based on the presence of the false membranes of
a considerable thickness, so that they can be distinguished from
the film of mucus which covers the fecal balls in constipation or
enteric catarrh.

Treatment. Facilitate the secretion from the mucosa, and the
separation of the false membrane by giving 1 Ib. Glauber salts,
or give this agent in doses of 5 or 6 ozs. per day. Calomel 1 dr.
may be used instead and has the additional advantage of acting.
as a disinfectant. The alkaline carbonates or tartrates or even
olive or castor oil may be used as substitutes. Antiferments like
salol, naphthol, salicylic acid, and salicylate of soda have been
prescribed to check the multiplication of the germ. Flaxseed
tea, elm bark, and other mucilaginous agents may also be given,

An easily digestible and laxative diet and a course of bitters may
follow.

PSEUDO-MEMBRANOUS (CROUPOUS) ENTERITIS IN
CATTLE.

Causes : as in solipeds, youth, overfeeding, plethora, dietetic blunders,
temperament, over-exertion, chill when heated, gestation, foul water,
irritants, drastics, infecticns. Symptoms: as in enteritis with false mem-
branes, complications. Duration. Lesions: false membranes, extent,
color, structure, composition, congested mucosa. Treatment : Glauber and
other salts, pilocarpin, potassium iodide, antiseptics, sulphites, sulphides,
borax, bismuth, naphthol, creolin, muriatic acid, bitters.

Causes. ‘The same causes are quoted as in solipeds, youth,
extra high condition, rich feeding, sudden change to the green
food of spring, climatic vicissitudes of the same season, a san-
guineous (Reynal) or lymphatic (Friedberger and Fréhner)
temperament, overwork, exhausting travel, suppressed perspira-
tion, gestation, plethora, foul drinking water, special irritant
plants (chicory, Huzard), and drastic purgatives. Cadeac sug-
gests bacteria, quoting instances of a fifth or a fourth of a herd
suffering at once. The same would come from any other cause
acting on the whole herd and it seems probable that a microbian
factor is present but can find occasion for its pathogenesis only
in given morbid conditions of the mucous membrane. ‘This
would explain the failure of the affection to propagate itself like
a plague, and at the same time its tendency to manifest itself
extensively in given herds with a common predisposing condition.

Symptoms. ‘There are indications of enteric inflammation and
fever, rigors, slight hyperthermia, drying up of the milk secre-
tion, impaired or suspended appetite and rumination, constipa-
tion, colicy pains, increasing dullness and prostration. As the
disease advances the excrements become soft, pultaceous or
watery, with floating hard baked pieces, dark and even glisten-
ing on the surface and more or less false membranes. ‘These are
sometimes stained with blood, which may also be mingled with
the liquid débris. As in solipeds these membranes constitute
the only true diagnostic symptom. They may appear as shreds,
bands or complete cylindroid casts of the intestine.

Other complications, like pseudo-membranous exudate on
wounds, abortions and profound weakness are sometimes noted.

227

228 Veterinary Medicine.

The disease may last eight days before ending in recovery.
When death takes place it is about the fourth or sixth day.

Lesions. 'She false membranes are found on the ileum and
colon, in thin films or in thick masses, or tubular casts. In ex-
treme cases the membrane has covered an extent of 24 feet in
length, and if recent it is soft and friable. If older it may be
firm, consistent and yellow or stained by the blood or ingesta.
As in solipeds it shows a reticulated network and a fine granular
structure, and is composed mainly of inspissated mucus with al-
buminoids and fibrine. The exudate covers a surface of extreme
redness, with points of darker blood-staining and even abrasion
or ulceration. The surrounding mucosa is also congested, the
villi hypertrophied, the mucous follicles swollen.

Treatment. In the early stages a laxative of soda sulphate is
of especial value in depleting from the inflamed mucosa, liquefy-
ing the secretions and dissolving and loosening the false mem-
branes. Epsom salts, cream of tartar, Rochelle salts, calomel,
and pilocarpin are more or less valuable substitutes. Iodide of
potassium is most valuable in dissolving the exudate and acting
as a microbicide (dose 3-4 drs. ).

Other alkaline salts may be substituted or as antiseptics the
sulphites, hyposulphites, or sulphides of potash or soda. Borax,
bismuth, naphthol and creolin have also been recommended.
Enemata of warm water are desirable.

In very adynamic conditions, muriatic acid (% dr. doses) may
be given with vegetable bitters and the same may be allowed
during convalescence.

PSEUDO-MEMBRANOUS (CROUPOUS) ENTERITIS IN
SHEEP.

Causes: As in cattle, draughts in folds, over-feeding. Symptoms : fever,
inappetence, weakness of hind parts, diarrhoea, tenesmus, false membranes,
blood in stools, tympany. Treatment: change diet of dam, exercise, Glau-
ber salts, potassium iodide, bismuth, flax-seed, elm-bark, mallow, gum,
carminatives, bitters, antiseptics.

Causes. ‘The same causes are claimed as for cattle. Clavel

Pseudo-Membranous (Croupous) Enteritis in Dogs. 229

attributed it to.too rich milk, and exposure to cold draughts, in
folded lambs. .

Symptoms. 'To the general symptoms of fever are added
refusal of the teat, weakness or paresis of the hind limbs, loose-
ness of the bowels and the ejection of false membranes with an
unusual amount of straining. The dejections may be watery and
mixed with blood. In some cases defecation is suppressed, the
intestines being blocked by the membranes, and then acute indi-
gestion and fatal tympany may follow.

The pathological anatomy and lesions resemble those seen in
the ox.

Treatment. Change the diet of the ewe, and allow more out-
door exercise. Give the lamb Glauber salts (% to 1 oz.) with
potassium iodide (10 grs.), and bismuth (1 dr.). Decoctions of
flax-seed, or solutions of elm-bark, mallow or gum arabic are
desirable, and infusions of aromatic plants or oils of peppermint,
anise, or fennel may be added with quinia. As in the other ani-
mals such antiseptics as salol, naphthol, naphthalin, boric acid, or
salicylate of soda may be administered.

PSEUDO-MEMBRANOUS (CROUPOUS) ENTERITIS IN
DOGS.

Complications of other diseases like distemper. Symptoms: fever, retch-
ing, vomiting, tense, tender, tympanitic abdomen, irregular bowels, false
membranes. Lesions: stomach empty, congested. croupous exudate, ex-
travasations. Treatment: sodium sulphate, boric acid, sodium salicylate,
salol, bismuth, by mouth or enema, strychnia, vermifuges.

In dogs the formation of false membranes on the intestinal
mucosa seems to have less of an individual character, and is
found associated with other affections, like canine distemper and
parasitism. In the absence, however, of accurate knowledge of
the specific cause of croupous enteritis in other animals it seems
permissible for the present, to arrange the whole in one class
characterized by the presence of false membranes.

Symptoms. Along with the general symptoms of fever and the

230 Veterinawy Medicine.

special ones of the existing specific disease there is more or less
disturbance of the digestive organs, anorexia, vomiting, tense,
tender, perhaps tympanitic abdomen, irregularity of the bowels
and the passage of the false membranes. A morose disposition
and tendency to snap has been noticed by Roll.

Lesions. ‘The stomach is empty with red or dark mottled
mucosa, the intestinal mucosa is congested, covered with a layer
of muco-purulent exudate, and at intervals patches of false mem-
branes which are also found in shreds floating in the glairy con-
tents. The exudates are of a yellowish gray color, more or less
streaked with blood, and the mucosa infiltrated, swollen, highly
congested and with spots of extravasation of blood.

Treatment, Small doses (1 to 2 drachms) of sulphate of soda
may be given by the mouth, or boric acid (1 scruple), salicylate
of soda (10 grains), salol (5 grains), or bismuth nitrate (%
drachm). Injections of boric acid, borax, sodium hyposulphite,
or even Glauber salts prove useful, and powdered nux vomica
(1 grain twice daily) may be added.

In case of intestinal parasites vermifuges may be resorted to.

PSEUDO-MEMBRANOUS (CROUPOUS) ENTERITIS
IN BIRDS.

In pigeons: Aerobic, non-motile bacillus, in lesions, membrane and in-
ternal organs, pathogeriesis, in chickens pathogenesis differs, also in man,
parts attacked, exudate, other symptoms, mortality early and late in out-
break, American form, pathogenesis to rabbits and Guinea-pigs. Prevention :
Avoidance of infection, quarantine of birds, separation of sick, disinfection,
accidental bearers of infection, pigeons, buzzards, carrion crows, dogs, men,
cleanliness. Treatment: Locally antiseptics, phenol, boric acid, generally,
phenol.

This has been especially seen in pigeons in which it has been
studied by Loffler, Cornil and Megnin, and Babes and Puscarin.
Loffler found an aerobic, non-motile, non-liquefying bacillus in the
false membranes, inflamed tissues, liver, lungs and blood, even in
the leucocytes. It formed irregular masses, and grew in nutrient
gelatine, blood serum and potato. It proved pathogenic to

Pseudo Membranous (Croupous) Enteritis in Birds. 231

Pigeons, linnets, rabbits and mice, but not to hens, Guinea-pigs,
rats or dogs. Chickens, however, suffer from an acute diphther-
itic affection caused by a nearly allied bacillus, and it remains to
be seen whether the varying pathogenesis may not be due to the
habit of long-continued growth in a particular genus and an ac-
quired unfitness for growing in the other. ‘The pathogenesis is
also different from the bacillus of diphtheria of man, and the two
diseases are not usually inter-communicable, in spite of the fact
that in rare instances infection has appearsd to have taken place
from man to birds.

In pigeons and fowls the upper parts of the air passages and
digestive tract are mainly involved, the tongue, fauces, corners
of the mouth, nares, larynx, and conjunctiva. ‘The bowels suffer
less frequently and mostly concurrently with the mouth, nose
and throat. The mucosa is deeply congested and in part covered
by a yellowish exudate which may accumulate in masses, and
dry into a firm substance. The disease affects particularly high
bred birds, kept in close warm houses, and is often imported by
prize animals returned from a show. ‘There may be dullness,
listlessness, sunken head, trailing wings and tail, erect plumage,
diarrhcea, and, if the nose and throat are affected, a modification
of the voice as in roup. Death may occur from asphyxia from
the second to the fourth day near the beginning of an outbreak
or the illness may last twenty days, after the more susceptible
birds have been killed off.

In investigating a series of outbreaks of roup in chickens in
America, Dr. V. A. Moore found a non-motile bacillus allied to
the colon bacillus which proved much more deadly to rabbits and
guinea pigs than to chickens, and which was not found in the
blood nor internal organs but only in the local lesions where
inoculated. The disease tended to assume a chronic type in
place of the acute form as seen in Europe. Three inoculated
chickens escaped the disease altogether. It would appear there-
fore that we have here a disease distinct from that described by
Leeffler, or that there was an absence of some unknown predis-
posing or contributing conditions that were present in the
European outbreaks. In both diseases however infection is an
undoubted factor and similar measures of prevention and even of
treatment may be followed.

232 Veterinary Medicine.

Prevention. ‘The first consideration is the seclusion of flocks
from outside animals in affected localities. Newly purchased
birds or those returning from a poultry show should be placed
in strict quarantine for a few weeks until the absence of infection
shall have been demonstrated. Different flocks should not be
allowed to mingle, nor the members of a healthy flock to wander
where the manure of another flock has been laid. Birds having
diarrhoea, or any discharge from eyes, nose or beak, or any false
membrane on such parts should be excluded from the flock, and
the house and yard disinfected. It should not be forgotten that
rabbits, guinea pigs and mice may be bearers of the infection,
and that it may be introduced on the feet of dogs or their masters.
Pigeons, buzzards, and carrion crows are especially dangerous as
possible bearers of the infection. Cleanliness as regards food
and water, buildings and yards is of vital importance.

Treatment. ‘The sick birds should be strictly secluded and
handled by a special attendant. When the lesions appear on
visible mucosz they should be painted several times a day with
a 5 per cent. solution of phenol, or a saturated solution of boric
acid, or salicylic acid, potassium permanganate, iodine, or some
other germicide may be used. For the bowel affection one
or two drops phenol in water may be given daily, and the drink-
ing water should be slightly charged with the same. Cleanliness,
pure air, warmth, dryness and sloppy food are all important.

ACUTE CATARRHAL ENTERITIS IN SOLIPEDS.

Definition. Causes: Irritants swallowed, debility, improper, insufficient
food, congestions, parasitisms, impaired innervation or circulation, iced
water, chills, perspirations, fatigue, hot, damp weather, over-feeding,
cryptogams, bacteria, newly harvested fodder, septic, or fermented food,
leafy fodder, toxins, stagnant, septic water, lack of pepsin, muriatic acid
and bile, diseased teeth or jaws or salivary glands. Lesions: Gastritis,
congestion of smallintestine and colon, in strie, thickening, ecchymosis,
ulceration, necrosis, excess of mucus with pus, villi, follicles and glands
swollen. Symptoms: Fever, high colored urine, costiveness, coated tongue,
red eyes, inappetence, sluggishness, emaciation, weakness, unthriftiness,
colics, rumbling, diarrhoea ; or more fever, suffering, anorexia, icterus,
hurried breathing, pleuritic ridge, arched back, tender abdomen, rumbling,

Acute Catarrhal Enteritis in Solipeds. 233

flatus, diarrhcea, critical or bloody, anxiety, debility, prostration, collapse.
Prognosis, Treatment: In mild cases, careful diet, and laxatives with anti-
ferments, in severe cases, laxatives, anodynes, antiseptics, demulcents,
stimulants of peristalsis, enemata, counter-irritants, fomentations, com-
presses, mustard, in profuse diarrhcea antiseptics, anodynes, demulcents,
calomel and chalk, bismuth, astringents, boiled flour or starch, gums.
Dieting during convalescence.

Definition. Inflammation of the intestinal mucosa.

Causes. Irritants of all kinds taken in with food, or as medi-
cine or otherwise and acting on the mucosa. Debilitating con-
ditions (chronic disease, starvation, over-work, close indoor life)
which lower the tone of the system at large, and local debilitating
conditions like coarse, dry, fibrous, innutritious food, conges-
tions, parasitisms, impaired innervation and troubles of the circu-
lation are strongly predisposing. Drinking iced water may
operate by lowering the tone of the intestines but seems to habit-
ually act rather by inducing reaction and congestion. Chills of
the surface, especially when perspiring and fatigued, act in the
same way. The relaxation and atony attending on long con-
tinued hot weather, predisposes to enteritis, but is doubtless even
more injurious by the abundance of ferments which it propagates
in food and water.

Over-feeding and stimulating aliments thrown on an alimentary
canal in such an atonic condition become especially hurtful. The
injury, however, comes most commonly from food that contains
an excess of cryptogams or bacterial ferments or from water
similarly charged. Newly harvested fodders in which the mi-
crobes are still in a state of vigorous life, when added to the
poisonous principles in certain immature seeds (leguminosz,
graminez, etc.); fodders that have undergone fermentative
changes (rotten potatoes, turnips, musty hay or oats) ; fodders
that are leafy and harbor an excess of microbes (alfalfa, sainfoin,
cowpea, clover) are especially dangerous at times. If musty or
otherwise altered they often contain besides, dangerous toxins.

In taking into account the fungi and microbes in spoiled foods,
we need not give exclusive attention to the particular species of
microbe present. An extended observation shows that the same
ferments may be present in the dry, well cured, wholesome
fodder, and in the musty or spoiled specimen, the main difference
being in the excess found in the latter case as compared with the

234 Veterinary Medicine.

former. With the excess too, there is always present a large
amount of toxins, ptomaines and other more or less poisonous
products, which, acting on the intestinal mucosa or even on the
system at large, tend to reduce its vitality and to lay it open to
the attacks of bacteria which had otherwise remained perfectly
harmless. Porcher and Desoubry, Achard and Phulpin and
Wurz have shown experimentally that intestinal microbes can
enter the chyle and blood from even a healthy bowel. The
streptococcus of pneumoenteritis equi of Galtier and Violet
appears to be a common fodder and intestinal microbe, which has
become pathogenic, because of its excess or on account of a lack
of resistance on the part of the animal. In the same way the
various intestinal cocci and the common colon bacillus may be-
come pathogenic when the normal antagonism of the bowels and
their contents is lessened.

In the same way stagnant and septic water may be harmless to
one animal of great vigor and good tone and pathogenic to
another which lacks these qualities ; or the excess of the ferment
and its toxins may overcome the natural resistance of the animal.
The lack of the natural antiferments of the intestine, pepsin and
hydrochloric acid, on the one hand and bile on the other, will
also conduce to multiplication of the microbes and their products,
so that they can successfully attack the mucous membrane.

Other accessory causes operate more or less, thus any impair-
ment of the process of mastication, through diseased teeth or
jaws tends to the escape of undigested food through the stomach,
as a specially favorable culture media for the microbes, and irri-
tants of the mucosa.

Lesions. As the disease very often implicates the stomach
(gastro-enteritis), the usual lesions of gastritis will be seen.
Most commonly the lesions are best marked in the small intes-
tine, and again in other cases in the colon, but usually there is
more or less change in all parts of the intestinal canal. The
small intestine is almost devoid of aliments and the mucosa
deeply congested in patches or strize, with at points thickening,
softening so that it crushes under the finger, hemorrhagic dis-
coloration, and even ulceration, and necrotic changes. It is
covered with a layer of mucus, thin and mucilaginous or thick
and glutinous, containing many granular and pus cells. ‘The

Acute Catarrhal Enteritis in Solipeds. 235

villi are swollen, the follicles of Lieberkuhn puffed up, and the
agminated and solitary glands widely dilated, filled with exudate,
and surrounded by an area of congestion. Proliferation of small,
round cells has produced embryonic tissue in the mucosa and
especially between the glands.

Symptoms. In the mildest form there is hyperthermia, thirst,
insensible loins, scanty, high colored urine, costive bowels, a few
small pellets only being passed at a time, hard, dry and covered
with a mucous film, hot, clammy mouth, coated tongue, with
redness along the edges and tip, yellowish red eyes, impaired
appetite, dull, sluggish habit, a tendency to hang back on the
halter, and a steady loss of flesh and increased dryness and un-
thriftiness of the coat. Slight, intermittent colics occurring es-
pecially after meals and attended by loud rumbling of the bowels
are marked features. This may be followed by slight relaxation
of the bowels and recovery in about a week, unless it should be-
come complicated by intestinal indigestion or impaction, or
should merge into the acute form.

In the more intense forms all symptoms are aggravated. There
is anorexia and even refusal of water, dullness and prostration
are well marked, the head carried low, and the gait is unsteady.
The mouth is hot with tenacious mucus, and a fcetid odor; the
tongue is furred and red at the tip and margins, the eye is
sunken, the conjunctiva icteric, the face pinched, and the pulse
accelerated. Hyperthermia may reach 104° F. Breathing may
be almost normal, or with fever, may become rapid and accom-
panied by a pleuritic ridge on the flank. The back is slightly
arched and rigid, the belly drawn up and tender, after meals it
‘thay be tympanitic, and colics set in or are aggravated, pawing,
uneasy movements of the hind limbs, and lying down to rise
again shortly, with frequent looking at the flanks being notice-
able.

Defecations are at first abundant and coated with mucus, later
the balls are small and scanty and expelled with much effort.
From the first the everted rectum is of a verydeep red. Toward
the end of the first day or later the intestinal rumbling increases,
flatus passes freely, and diarrhcea may set in and prove critical,
This usually indicates disease in the colon and tends to recovery ;
it may be entirely absent if the inflammation is confined to the

236 Veterinary Medicine.

duodenum, the effused liquid being reabsorbed from the czecum
and colon. If the diarrhoea should prove critical there is a re-
turn of appetite and spirit, the faecal discharges become firmer
and recovery takes place in a week. If, however, the diarrhcea.
becomes more profuse and bloody, the colics more intense, the
eyes more sunken and hopeless, the face more pinched and
anxious, and the temperature reduced to or below the normal,
with great weakness and debility, the near approach of death
may be feared. ‘This state of collapse may be further marked by
extreme coldness, or dropsy of the limbs, increased icterus, hur-
ried breathing and rapid loss of flesh.

A prominent icterus indicates implication of the liver from the
ascent of the infecting germs through the bile ducts, or the pas-
sage of microbes or their products or both through the portal
vein. In either case it is a serious complication.

Prognosis. In its uncomplicated form the disease is not very
fatal to vigorous, mature horses, though more trying to the
young. If infective germs or their products implicate the liver
producing marked jaundice, or if the general system is poisoned
by the microbes or their toxins, producing marked depression
and prostration the danger is enormously enhanced.

Treatment. In the mildest cases a limitation of the food to
moderate bran mashes, and a dose of % Ib. of sodic sulphate,
with salicylate of soda (3-4 drs.) or bismuth will usually suffice.

In severe cases, at the outset, while constipation exists give 3
or 4 drs. of cape aloes, or % lb. Glauber salts or % pint olive oil,
combined with 2 drs. of extract of hyoscyamus or belladonna
and 3 drs. salicylate of soda. This serves to deplete from the
inflamed vessels and the whole portal system, to sooth suffering,
to expel much of the offensive and infective matters from the
bowels, and to check fermentation in that which remains. They
should be given with, or followed by mucilaginous liquids like
solutions of slippery elm or gum arabic, flaxseed tea, or well
boiled farinaceous gruels.

Pilocarpin, 3 grs., or eserine, 2 grs., or both have been recom-
mended and may be resorted to when action of the bowels is
urgently demanded. They need not supersede the other laxa-
tives. In manifest impaction of the large intestines, salts, aloes,
pilocarpin and eserine may form an effective combination.

Acute Catarrhal Enteritis in .Solipeds. 237

Copious enemata with mucilaginous liquids or warm soap suds
should be given at frequent intervals.

Counterirritants and derivatives to the abdomen are most im-
portant. Hot fomentations may be persisted in for an hour at a
time, or a damp compress around the abdomen covered closely by
dry blankets and held in place by elastic circingles. Mustard
pulp made with cold water rubbed in against the hair and at once
covered by paper and a thick blanket is often of great value as
drawing blood and nervous action to the skin and relieving the
suffering intestine.

In all cases the diet. and drink must be carefully supervised.
A little thoroughly scalded wheat bran, or farina, and decoctions
of flaxseed, farinas, slippery elm or mallow, or a solution of gum
arabic will refresh the animal without overloading the digestive
organs or favoring further fermentation.

In case of the onset of diarrhoea which threatens to prove ex-
cessive and persistent, the giving by mouth and anus of
antiseptics and anodynes with mucilaginous agents may be
resorted to. Calomel may be given in ro grain doses twice daily
mixed with five times the amount of chalk. Or 2 drs. each of
nitrate of bismuth and salicylate of soda and % oz. of laudanum
may be given three times a day. Or quinine, 2 drs. and nux
-vomica 10 grs, may be added to the above. A choice may be
made of other anodynes, (hyoscyamus, belladonna), antiseptics,
(salol, chloral, naphthol, naphthalin, creolin), and bitters,
(gentian, calumba, cascarilla).

Antiseptic and even astringent injections must be given, and
-well boiled farinas and mucilaginous agents may be given by the
‘mouth. Wheat flour boiled for several hours; starch prepared
with boiling water as for the laundry, (1 pint) ; gum arabic, or
slippery elm may suffice as examples.

The patient should have a dry, comfortable box and warm
.clotHing according to the season of the year. He must be kept
for a week on linseed gruel or other equally simple demulcent
agent and brought back to his customary food by slow degrees.

CHRONIC CATARRHAL ENTERITIS IN SOLIPEDS.

Causes: As in acute: troubles of circulation, heart, lungs, verminous
embolism, parasitism, skin disease. Lesions: thickening of mucosa, pig-
mentation, rigidity, hypertrophy of villi, follicles and glands, ulceration,
polypi. Symptoms: impaired appetite, buccal fcetor, retracted flank,
unthrifty skin, pallid mucose, colics, tympanies, rumbling, irregular
bowels, emaciation, perspiration, fatigue. Treatment: dietetic, tonic,
bitters, salines, aromatics, enemata, bismuth, laudanum. calomel and chalk,
iron, astringents, counter irritants, electricity, sunshine

Causes. ‘This may occur from a continuance of the same causes.
asin the acute, or from an imperfect recovery from the acute form.
It may result from troubles in the circulation, as valvular disease
of the heart, or emphysema of the lungs, which forces the blood.
back on the venous system, including the liver and portal vein.
Or the lesions that come from verminous embolism may leave
such alteration in the intestinal walls as entail chronic congestion
of the mucosa, or intestinal parasites may be the cause. Severe
and inveterate skin diseases appear to affect the intestinal mucosa
by sympathy, just as diseases of that mucosa usually entail skin
diseases.

Lesions. Attenuation of the coats of the small intestine and
thickening of the mucosa of the large have been noticed. The
mucosa is darkly pigmented and covered with excess of mucus.
The thickening of the mucosa may extend into the sub-mucous
tissue, giving a firm leathery feeling to the part, and entailing a
loss of elasticity. The villi are hypertrophied and the follicles of
Lieberkuhn and Peyers’ patches may be congested, ulcerated or
otherwise altered. Polypoid growths are not uncommon on the
mucosa, and the mesenteric glands are enlarged and pigmented.

Symptoms are by no means very definite. Disturbance of the
digestive functions, capricious or impaired appetite, dry fcetid
mouth, tucked up abdomen, dry hair and skin, pallor of the vis-
ible mucous membranes, slight intermittent colics and tympanies,
loud rumblings in the bowels, and relaxed bowels, or alternate:
costiveness and diarrhoea, with some tenderness on manipulation
of the abdomen are the usualsymptoms. The animal loses flesh,
has dry, unthrifty coat, and sweats and is easily exhausted at
work.

238

Acute Catarrhal Enteritis in Cattle. 239

Treatment. Dietetic care is the first essential. Boiled oats,
barley, rye or bran, in small amount and flaxseed tea may indi-
cate the kind. These should be given in small amount often,
and at regular intervals.

A failing appetite may be stimulated by nux vomica (10 grains)
twice daily, or by gentian or other bitter, along with common
salt and aromatics.

Constipation may be combated by fresh green food in small
quantities, or by an ounce each of Glauber salt and common salt
given every morning before feeding, in a drink of water (half to
a bucket, if possible), and 10 to 20 grains of nux vomica may
be advantageously added. Soapy injections with salt or glycerine
may also be given.

Diarrhcea may be moderated or checked by nitrate of bismuth
(2 drachms), with laudanum (1 ounce), repeated as may be de-
manded. A combination of calomel and chalk (1:12) will often
serve a good purpose in drachm doses several times a day. For
persistent diarrhcea Cadeac recommends the following: Iron
carbonate 4 drachms, lime water 10 ounces, alum 1 drachm, pow-
dered oak bark 1 ounce, given in water and farina.

Sepsis and fermentation must be combated by the same means
as in the acute type, and the same counter-irritants may be re-
sorted to. A life in the open air or sunshine, but without undue
exertion is of great importance.

ACUTE CATARRHAL ENTERITIS IN CATTLE.

Causes: atony, debility, starvation, overfeeding, innutritious food, close,
foul buildings, ill health, over-exertion, hot weather, sudden changes, chills,
privation of water, irritants, spoiled and newly harvested grain, foul water,
parasitism, chest diseases, thrombosis. Lesions: in small intestine mainly,
tympany, congestion, thickened mucosa, epithelial degeneration, des-
quamation, enlarged villi, follicles and glands, erosions, ulcers, perfora-
tions. Symptoms: solid masses in rumen, impaired rumination and appe-
tite, rumbling, tenderness, costiveness, fever, arched back, tender, tucked
up abdomen, colics, in severe cases, agalactia, tremors, rigors, drooping
head, ears, eyelids, tender abdomen, straining, expulsion of mucus, foul
eructations, later diarrbcea, critical or exhausting. Death from tympany,

240 Veterinary Medicine.

bleeding, infection, inanition. Diagnosis: by concurrence of symptoms,
hyperthermia, tender abdomen, no blood nor coccidia in stools, no frothy
bloody mucus with tenesmus. Treatment: dietetic, friction, synapism,
atropia, chloral hydrate by rectum, salines, demulcents, nux, tartar emetic,
eserine, pilocarpin, sulphites, salol, sodium salicylate, naphthol, etc., bitter
tonics, carminatives, stimulants, sodium chloride, ipecacuan, hygiene dur-
ing convalescence.

Causes. As in solipeds the various conditions which lower the
general tone, and those which especially debilitate the bowels
predispose to catarrhal inflammation. Underfeeding and over-
feeding, fibrous, innutritious, indigestible food, an indoor life in
close, foul stables, chronic and debilitating diseases, overwork,
overdriving, long continued hot weather, sudden changes of
weather, chills, long railway journeys without water, exposure
in hot:stockyards in midsummer, all lessen the resisting power of
the system and of the bowels.

As more direct irritants, may be named irritant plants, weed-
ings and culls from gardens, musty and spoiled fodders of all
kinds, newly harvested grain, and putrid drinking water. Also
intestinal parasitism, diseases of the heart and lungs, and throm-
bosis of the mesenteric arteries.

Lesions. ‘These predominate in the small intestine in catarrhal
enteritis as they do in the large intestine in dysentery. The
small intestine and ceecum may be distended by gas, and red-
dened more or less deeply on their outer surface. The mucosa
is the seat of congestion, punctiform and ramified redness, thick-
ening, infiltration and softening so that the epithelium breaks
down into a pulp under the pressure of the finger. Desquama-
tion may be extensive leaving a raw angry surface. The villi
are infiltrated, erect, and ulcerated showing dark bloody points,
and ecchymoses, and circumscribed sloughs and eschars are
present. The solitary glands are congested, hypertrophied and
projecting. The submucosa is infiltrated with a gelatinoid
material and the same may be found around the swollen and con-
gested mesenteric glands. Perforations have been met with in
some cases, and coexistent inflammatory lesions in the stomachs
are common.

Symptoms. In the mildest forms there is inactivity of the
rumen, aggregation of the contents into hard masses, easily felt

Acute Catarrhal Enteritis in Cattle. 241

through the surrounding gases, appetite and rumination are
greatly impaired, and there is much rumbling and considerable
tenderness of the right side of the abdomen, and more or less
costiveness, with hard, glazed mucus-covered feces, There is
some rise or temperature, ardent thirst, injected mucous mem-
branes, dry, hot muzzle, weeping eyes, a small, hard, weak pulse,
arched back, tender to pinching, and tucked up abdomen. There
may be slight colicy pains, uneasy movements-of the hind feet
and tail, and sometimes lying down and rising at short intervals.

In more severe cases the impaction and tympany of the rumen
are more marked, the hyperthermia runs high, appetite and
rumination cease, the milk dries up, rigors and tremors appear,
the head and ears droop, the eyes are sunken, the mouth is
clammy and fcetid, the colicy pains are severe or extreme, the
right side of the abdomen is very tender, defecation may be
altogether suspended and rumbling in the right side of the
abdomen ceases or becomes rare. Straining may continue but
seldom is anything but mucus passed. Eructations from the
rumen are distinctly fcetid.

After the third day the violence of the pains may abate, and
sometimes diarrhcea sets in and may. be regarded as critical, and
portending recovery. If rumbling in the right side is resumed,
if the fever subsides, the spirits revive, and some appetite and
rumination return they will herald improvement.

If on the other hand the pulse becomes smaller, the tempera-
ture higher, the eyes sunken and fixed, the urine scanty, red and
acid, the animal constantly recumbent on its left side, if when
raised it omits the healthy stretching of its hind limbs, and walks
sluggishly and painfully with frequent moaning, if when down it
rests its head on the ground, the prospects ars very unfavorable.

Death may occur early from tympany and asphyxia; it may
follow profuse intestinal haemorrhage ; or it may be the result of
general infection and inanition.

Diagnosis must depend on the combination and succession of
the above-named symptoms. From acute intestinal congestion it
is distinguished by the more moderate type of the colic, and the
more gradual advance of the disease. From acute indigestion
and tympany of the rumen by the early and marked tenderness of
the right side of the abdomen, and the decided hyperthermia.

16

242 Veterinary Medicine.

From hemorrhagic enteritis by the absence of the black san-
guineous discharges from the bowels at an early stage of the
malady, and of coccidia from the droppings. From dysentery it
is distinguished by the absence of the mucous and bloody dis-
charges, which are passed with much straining in that affection
from the beginning.

Treatment. ‘The first consideration is dietetic and hygienic.
If the animal will still eat, he ought to have boiled flax seed or
other well-boiled gruel, rendered palatable by salt. Even if he
refuses food, this may be diluted largely and will be taken on
account of the thirst. If he refusesall, a bottle may be given at
intervals to refresh him. Or better—milk may be given from a
bottle in the same way. Active friction to the abdomen with
straw, or the application of oil of turpentine or mustard may
abstract blood to the skin and favor the restoration of the intesti-
nal functions. To calm the pains and control spasms, sulphate
of atropia (% gr.) may be given subcutem and repeated if there
is no action on the pupil in fifteen minutes. Or extract of bella-
dona (2 drs.), or chloral hydrate (1% oz.) may be given by rectal
injection.

To overcome the intestinal torpor 1 Ib. each Glauber and com-
mon salt may be given in four to six quarts of warm water and
followed by frequent mucilaginous drinks, as much as the animal
will take, but only two or three quarts at a time. The addition
of % dr. nux vomica will serve to rouse peristaltic action. Harm
advises 1 % dr. tartar emetic by rectal injection for the same end.
Next to Glauber salts, Castor oil (1 qt.) is to be recommended.
Along with these or independently of them sulphate of eserin
(1% gr.) or pilocarpin (2 gr.) may be employed subcutem.

Frequent rectal injections of soap or mucilaginous liquids,
with or without laxatives will be useful.

As antiferments beside the salt may be used bisulphite of soda
in % oz. doses, salol 334 drs., salicylate of soda 3 drs., betol 334
drs., or naphthol 34% drs., by the mouth and rectum.

When free movement of the bowels has been secured, attempts
should be made to restore appetite and rumination by tonics and
stimulants: gentian %4 oz., nux vomica ¥f dr., ipecacuan 2 drs.,
common salt 1 0z., may be given three times a day.

The diet should at first be restricted to flax seed gruel or that

°.

Chronic Catarrhal Enteritis in Cattle. 243

of other farinas, with a mere handful of fresh grass or bran mash
and the restoration of the previous diet should be slow and grad-
ual, care being taken meanwhile that no costiveness of the bowels
supervenes.

CHRONIC CATARRHAL ENTERITIS IN CATTLE.

Causes: As in acute chest diseases, abdominal tuburculosis. Lesions:
Thinning, discoloration, degeneration of mucosa, foetid, mucous contents,
black, baked masses, lymph glands pigmented. Symptoms: Impaired
appetite, irregular bowels, tympanies, lies with nose on right flank, un-
thrifty coat, prostration, emaciation, weakness, tender flank. Treatment:
Dietetic, laxative, stimulant of peristalsis, bitters, antieeptice, aromatics,
muriatic acid, treat concurrent disease.

Canses. ‘This may result from a continuence of the causes that
are operative in the acute, or from the latter merging into the
chronic form. Chronic diseases of the heart and lungs, local
disturbances of the circulation, and tumors or tubercles of the
intestines or mesentery are additional causes.

Lesions. ‘These embrace attenuation of the intestinal walls at
Peyers’ patches, a dark, slaty discoloration of the mucosa, more
or less congestion, an accumulation of foetid mucus in the small
intestines, of mucus and black baked fecal matters in the large,
and discoloration of the mesenteric glands. Inter-dependent
diseases of the heart, lungs and liver are not uncommon.

Symptoms. Following the acute form there remain impaired
or capricious appetite and rumination, costiveness alternates with
relaxation of the bowels, intermittent slight tympanies occur, the
subject inclines to lie much with his nose in his flank, has dull
coat, erect on back and neck, sunken eyes, drooping ears, and
rapidly loses flesh and strength. Tenderness of the right side of
the abdomen when the fist or knee is pressed into it is a marked
feature.

Treatment. ‘The diet must be cared for asin the acute form,
yet fresh green grass, a little at a time, is calculated to stimulate
appetite and rumination and to prove laxative to the bowels.
The same purgatives may be given in one-fourth the doses and
repeated daily or reduced as may be found best to secure a

244 Veterinary Medicine.

moderate secretion and discharge from the bowels; eserine or
pilocarpin may be used for the same purpose; the bitters and
antiseptics may be given in the same way. As calmative aroma-
tics, oil of peppermint 30 drops, powdered anise % ounce, or
ginger %4 ounce, may be given twice or thrice daily.

Cadeac strongly recommends a drink slightly acidulated with
hydrochloric acid to assist the digestion and stimulate the stomach
to action. :

Attention must of course be given to any curable concurrent or
inter-dependent disease.

DVYSENTERY OF CATTLE.

Defintion. Attacks ox mainly. Causes: accessory causes, chills, rain.
storms, night dews, hoar frost, foul or iced water, alimentary irritants,
spoiled fodder, over exertion, hot damp weather, odors of carrion, crowding,
swamps, foul stables, germs or pathogenic ferment, in man catarrhal, diph-
theritic and amcebic, amceba dysenterica, bacillus dysenterize, other microbes,
effect of better hygiene. Symptoms: attack sudden, languor, trembling,
weakness, weeping eyes, fever, buccal epithelial softening, erosions, tenes-
mus, foetid, liquid stools, involuntary defecation, hemorhoidal congestion,
open anus, colics, tender right flank, splashing on handling, anorexia, saliva-
tion, unthrifty skin, hide-bound, cracked muzzle, later prostration, low tem-
perature, sunken glazed eyes, drooping head, ears, eyelids, weakness, emaci-
ation, alkaline, foetid, frothy, bloody, mucous stools, with sloughs, saliva
acid, gastric liquids alkaline, bile suppressed. Duration : three days to three
weeks orchronic. Mortality 50to 80 percent. Complications : mostly septic,
abscess, gangrene of other organs, lungs, joints, glands, etc. Lesions : rapid
sepsis, blood deep red, coagulum loose, venous congestion, large intestines
congested, tumefied, softened, desquamated, eroded, sloughing, necrotic,
folds perforated, cicatrizing, contents mucopurulent, bloody, putrid, microbes,
glandular lesions, implication of small intestines, stomach, mouth, liver,
spleen, hepatic abscess. Diagnosis : from rinderpest by tardiness and com-
parative weakness of contagion, absence of general mucons congestion and
epithelial concretions, from toxic enteritis by same. Prevention: avoidance
of causes, separation of sick, disinfection, careful feeding. Treatment :
Demulcents, antiseptics, astringent tonics, opiates, ipecacuan, calomel,
sodium sulphate with antiseptics, antiseptic enemata of glycerine, phenol,
creoline, iron sulphate, silver nitrate, salicylic and boric acids, rest, gravi-
tation, careful dieting.

Definition. An infective, ulcerative inflammation of the large
intestine but especially of the colic and rectal mucosee.

Dysentery of Cattle. 245

It is well recognized as a disease of the ox, and the older writ-
ers allege its existence also in horses, swine and dogs, though
this is not admitted in all modern veterinary works.

Causes. It was formerly ascribed to improper hygiene, chills,
cold rain storms, night dews, hoar frost, malarious emanations,
putrid, stagnant or iced water, irritants in food, green, fermented
or musty food, a too liberal diet after starvation, overtaxation in
very hot weather, and bad odors from decomposing carcasses.
These can only be accepted as predisposing causes begetting a
general debility, or debility of the alimentary canal and laying
that open to the attacks of specific microbes. The close aggrega-
tion of cattle on ship-board, in besieged cities, and in the parks
of armies in the field, has apparently contributed to the propaga-
tion of the dysentery. The removal of a victim to a herd with
free healthy range seldom starts a new center of the disease. In
all infected herds huddled in small compass there is every facility
for a propagation of a germ already present, and especially in
the commissariat of a belligerent army there are enough privations,
over-exertions and other trying conditions to favor predisposition.
Faulty food like stale bread, musty hay, have been supposed to
cause it. For man and beast alike dvsentery is preéminently a
disease of the tropics, and of hot seasons, and will often subside on
the advent of cold weather.

Its propagation on given (swampy ) soils, and in particular (foul)
stables strongly suggests a special germ, though for the cow this
has not been perfectly identified. Gerlach vainly attempted
to inoculate it, and it does not often propagate itself beyond
the foul and infected localities or stables, yet its persistence in
them for years bespeaks unequivocally the operation of a special
pathogenic ferment.

It may also be fairly assumed that it is not necessary that the
same factor should be present in all cases alike, but that one
operates predominantly in one case and another in another. In
other words dysentery must be recognized as not one disease, but
several, of which the true pathogenic microbes have not yet been
fully demonstrated, but which are classed together because of the
similarity of the attendant lesions.

In man three distinct forms are recognized. 1. Catarrhal
dysentery, with frequent small stools of rosy mucus, and blood ;

246 Veterinary Medicine.

‘

and later pus, scybala, passed with tenesmus, but no sloughs and
little odor ; 2. Diphtheritic dysentery, with thin watery bloody
discharges having a pronounced cadaveric odor ; also tenesmus,
sloughs, and increasingly offensive smell ; 3. Amcebic dysentery
with frequent bloody mucus stools, tenesmus sloughs and fcetor,
but with distinct remissions or intermissions. With this latter,
amcebe are found abundantly and more so in the more acute cases
with alkaline stools. ‘They are found in the fresh warm stools,
5 to 8 times the size of a red blood globule and oval, pyriform
or irregular in form, with nucleus and nucleolus. Kartulis and
Hlava succeeded in inducing dysentery in cats and dogs by
injecting pure culture of the amceba, and the former testifies
that dogsin Egypt take the disease spontaneously and their stools
contain the same ameeba coli as is found in man.

Cunningham who investigated the subject in India found
amceba in the bowels of healthy men, and also abundantly in the
feeces of horses and cows, which have naturally the requisite
alkaline reaction.

The mere presence of the amceba therefore may not be sufficient
to cause the disease, but with the requisite predisposition and an .
alkaline condition of the intestinal contents, it is manifestly an
important factor in the disease.

Bacillus dysenterie (Shiga) a main cause of dysentery in Japan,
grows freely in weak alkaline bouillon at 37°C., produces potent
toxin in three weeks, .1 cc. of which kills a Guineapig in 24 to
48 hours. The horse and rabbit are very susceptible to this toxin.
Allied forms, in other epidemics differ in fermenting sugars (man-
nite, maltose and saccharose) producing gas and indol, while
Shiga’s bacillus does not.

The causative microbes in other forms of dysentery have not
been identified, but under the requisite irritation and local debility
one can easily conceive of the ordinary bacterial ferments of the
intestine, concurring with others introduced from without, in de-
termining the morbid condition. With better hygiene the disease
is steadily diminishing in man and beast, though violent epizootics
(in cattle) still appear in connection with wars (siege of Belfort,
1870, Zundel), and carriage by sea in hot climates (Mediterranean
trade, Bouley).

Symptoms. ‘The disease sets in suddenly, yet prodromata may
occasionally be observed, such as dullness, languor, trembling over

Dysentery of Cattle. 247

the flanks and elbows, weakness, prominent, weeping, congested
eyes, and low moans when moved. Then follow hyperthermia,
at first slight, heat of the mouth without injection, epithelial
concretions or erosions and diarrhoea (sometimes there is strain-
ing without passage at first). Then follows a period of profuse
and fcetid discharge, with relaxed or open anus, the liquids
escaping involuntarily and smearing the tail, perineum, thighs
and hocks, and the protruded mucosa showing dark red conges-
tions and even commencing erosions. Colicy pains, slight at first,
have now become intense, and the right side of the abdomen is
very tender to the touch and fluctuates noisily when manipulated.
Appetite and rumination are lost. Salivation may be present, the
saliva falling in films to the ground. The buccal epithelium is
softened, loosened and easily detached by the finger, leaving raw
sores. ‘The temperature which has risen slowly (not as in rinder-
pest abruptly) may reach 106°. The hair becomes dry, the skin
harsh, rigid, and firmly adherent to the deeper parts, and often
cold, while the muzzle is hot, dry and even cracked.

At a still more advanced stage, the pulse is small, the tempera-
ture lowered, the animal very weak and unsteady and inclined to
lie, great emaciation, sunken glazed eye, drooping head, ears and
eyelids, and a general foetor from the skin as well as the dejec-
tions, which attracts crowds of flies. By this time there may be
passed only bloody mucus mixed with eschars, and having a
most repulsive odor. 5

It is a noticeable fact that the faeces are alkaline, and in man
the saliva is acid and destitute of its glycogenic properties, the
stomach secretions are alkaline and no longer peptogenic, and
the secretion of bile is arrested until improvement sets in.

Course. Duration. Some mild cases recover in two or three
days, and in violent cases death may occur at this early date.
More commonly the disease continues for two or three weeks
before ending in death or recovery. Some merge into the chronic
form and may last for months and die in a condition of marasmus.
These last cases become mere walking skeletons, with pallid
mucose, sunken eyes, scurfy hide-bound skins covered with
vermin, and the frequently everted rectum is congested: and
covered with ulcers and eschars. Mortality is from 50 to 80 per
cent.

248 Veterinary Medicine.

Complications. Most complications are in the direct line of
septic infection. Among the most common are hepatic abscess,
gangrenous pneumonia, and extensive gangrene of the intestinal
walls. In man arthritis, paralysis, parotitis and other secondary
affections are seen. In the animal as well we may expect ne-
crotic centres in any organ, from the supervention of a general
septiceemia.

Lesions. ‘The carcasses putrefy with extraordinary rapidity
being as a rule pervaded by septic microbes and their toxins.
The blood is of a deep red, loosely and imperfectly coagulated,
and accumulated in the veins and subcutaneous connective tissue.

The large intestines are the special seat of the disease, the
walls being found hypereemic, with concentration especially on

- the mucous surface which is red, congested, infiltrated, tumefied
so that it is easily detached under pressure by the finger, or
broken down intoa putrid pulp. At other points the epithelium
or the whole mucosa has been detached leaving ulcers, varying
from mere erosions to the deep and even perforating sores,
through which the putrid contents escape into the abdominal
cavity. At other points the surface is covered by necrotic
masses surrounded bya swollen margin of living mucosa.
Elsewhere the eschars have been detached and the granulating
base and margin have contracted into more or less perfect
cicatrices. The contents of the affected bowel may be largely
muco-purulent, or it may be mixed with blood, with eschars and
putrilage from the sores and at times with small packed masses
of food, but in all cases it is very putrid and repulsive. It al-
ways contains the elements of blood and exudation, together
with many microbes, the predominance of individual species sug-
gesting the main factors in the pathogenesis. Peyers’ patches
and the solitary glands are often the seat of infiltration and
ulceration. Virchow points out that in man the lesions are
largely concentrated in the flexures of the colon in which the
ingesta is longer delayed, and the very convoluted arrangement
of the viscus in cattle may be one reason of their special pre-
disposition to the disease.

The small intestines are exceptionally implicated, and the
abomasum red, congested, ecchymosed and even ulcerated. The
mouth and pharynx are often congested, with erosions and
ulcerations on the gums and tongue.

Dysentery of Cattle. 249

The mesenteric glands are red and swollen or pigmented
of a dark gray color, and these or the adjacent connective tissue
may be the seat of abscess. ‘The liver is enlarged, congested, of
a yellowish red color, with granular degeneration and softening.
Hepatic abscess is rare in cattle. The spleen 1s engorged with
black blood and distinctly enlarged.

Diagnosis. Dysentery is distinguished from rinderpest by the
slower advance of the hyperthermia, by the absence of buccal
concretions of epithelium, and of vaginal congestion, and above
all by the absence of the virulent contagion by which the rinder-
pest spreads widely and rapidly, irrespective of special unwhole-
some environment. ‘The lesions of dysentery are concentrated on
the large intestines, while in rinderpest they are extended over
the whole alimentary canal, and do not spare other mucosze.

From toxic gastro-enteritis it is distinguished by the absence of
any history or lesions showing the ingestion of a poison and by
the concentration of the lesions on the large intestines whereas
in poisoning by irritants, the stomach and small intestines are
the most liable to suffer.

Prevention. Precautions against overcrowding on board ship
in hot seasons, and the maintenance of cleanliness are prime
considerations. In commissariat herds close crowding must be
avoided, feeding should be done at different points for six or
eight cattle at each, the yards should be frequently changed, or
carefully cleared of manure and sprinkled with a solution of
3 per cent. sulphuric acid. In case an animal is attacked it
should at once be removed and killed, and its offal and the yard
where it has been disinfected. Food and drinking water should
be specially wholesome.

Treatment. Mild cases may be successfully treated by the use
of mucilaginous draughts, (boiled flaxseed, mallow, slippery elm,
gum arabic) with antiseptics (salicylic acid or salicylate of soda
2to 3 drs., salol 1 dr., creosote 1 dr., sulphate or chloride of
iron 1 dr.) every three hours.

In the more severe cases the most varied treatment has been
resorted to. Formerly opiates and astringents were largely
employed, practically shuttiug up the poison in the intestine.
Ipecacuan in large and frequently repeated doses had the ad-
vantage of soliciting the action of both liver and bowels, but
however useful, it has gradually declined in public confidence.

250 Veterinary Medicine.

An eliminating and antiseptic treatment has at present the
most general acceptance. Seven grains of calomel has been given
every two hours for two or three days in succession. Still more
recently 2 to 4 ozs. sulphate of soda every three hours with hot
water and antiseptics (salicylates, sulphites, salol, boric acid,
creolin, naphthol) have been substituted. Even more important
is the washing out of the large intestine by antiseptic enemata.
‘These should be very copious and frequently repeated so as not
only to render the contents of the rectum and colon antiseptic
but to secure the discharge of the offensive matters as they are
produced. The agents may be glycerine, carbolic acid, creolin,
sulphate of iron, nitrate of silver, salicylic or boric acid. If the
animal can be made to stand on an inclined plane with its hind-
parts elevated it will favor the penetration and retention of the
liquid. Perfect rest is a most important accessory.

In case of recovery the return to ordinary diet should be
gradual.

CATARRHAL ENTERITIS IN SHEEP AND GOAT.

Causes : Symptoms: Moping apart, inappetence, tympany, hard masses
in rumen, constipation, colics, straining, stretching fever, no rumbling nor
defecation, diarrhoea, critical, or exhaustive. Treatment: Laxative, an-
tiseptic, counter-irritant, demulcent antiseptic injections, in diarrhcea
antiseptics, carminatives, bitters, diet, well boiled farinas.

Causes. 'These are unknown apart from those given for the ox.

Symptoms. Moping alone in place of following the flock,
inappetence, suspended rumination, tympany, hard masses in the
rumen, cold ears, horns and limbs, obstinate constipation, weary
movements of the hind limbs, lying down and rising, looking
at the flanks, and tenderness of the right side of the abdomen,
frequent straining, stretching, hyperthermia, rapid pulse, and
suppression of movement and rumbling in the bowels are promi-
nent symptoms. The constipation may be followed by diarrheea,
which may presage recovery or hasten death, the symptoms of
improvement or aggravation indicating which. ‘The diarrhcea
may be simply serous or muco-purulent and inoffensive or it may
be black, blood-stained and fcetid. It may cause extensive losses,
with pathological changes as in the ox.

Catarrhal Enteritis in Swine. 251

Treatment in the early stages with inactive bowels, must be
laxative and antiseptic, sodic sulphate 4 ounces with 1 drachm
chloral hydrate ina quart of warm water will serve largely
to expel offensive ingesta and bacterial ferments and pave the
way for recovery. A counter-irritant of aqua ammonia to the
abdomen, under the wool, will have a good effect, and soapy or
mucilaginous and antiseptic injections are desirable.

If the bowels are already acting freely, 1% drachm each of
boracic acid and nitrate of bismuth may be given at least thrice
daily, with the addition of 60 drops of laudanum, and antiseptics
(salol, naphthol, naphthaline). Carminatives like chamomile,
anise, cardamons, peppermint, may be added, and bitters such as
quinia or nux vomica.

Well boiled gruels of barley, oats, linseed, or rye should be
given and little or no solid food until appetite and digestion have
been restored.

CATARRHAL ENTERITIS IN SWINE.

Causes : decomposing swill, ferments from snout and feet in swill, toxins,
salt, brine, powdered soaps, etc. Symptoms : dullness, inappetence, fever,
burrowing under litter, stiffness, drooping head, ears and tail, arched back,
tender abdomen, constipation, diarrhoea, petechiz, rumbling, tympany,
weakness, emaciation, paraplegia, not actively infectious. Duration: one
to eight days or more. Lesions: mucopurulent exudation in alimentary
canal, congestion, extravasation, hemorrhages, ulcerations, congestion of
peritoneum, mesenteric glands and other organs. Diagnosis: presence of
alimentary causes, many attacked at once, no spread to better kept herds,
no germ fatal to guinea pigs nor rabbits. Treatment: eliminate, oil, cal-
omel, flaxseed, gruels, enemata, antiseptics, revulsives, diet during conval-
escence, antidotes.

Causes. ‘The enteritis of swine has been long considered as
infective or septic, yet this is perhaps mainly due to the nature of
the food too often furnished to this animalin a state of domestica-
tion. Not only is he fed on swill containing all kinds of over-kept
food, in a state of more or less advanced decomposition, but he is
kept in a pen or yard which soon becomes offensive, and follow-
ing his natural instincts he roots around with his nose in the

252 Veterinary Medicine.

accumulating filth. When fed he plunges his foul snout in his
liquid food, and as if this were not enough the fore feet follow,
and if the trough is long enough the hind feet as well. Every
available saprophytic microbe therefore finds its way down his
throat, and the toxins from their growth outside the body accom-
pany them to irritate or benumb the mucosa and fit it for the
attacks of bacteria, which would otherwise have proved harmless.
But in addition to all this, chemical irritants get into the swill
aud pave the way for the microbes. Salt, brine, and the various
caustic washing powders used in washing dishes and tables find
their way into the swill barrel often in quantity sufficient to irri-
tate and poison. In experiments conducted at the N. Y. State
Veterinary College the washing powders have been proved to be
most deadly, and upon different farms, a mortality attributed to
hog cholera, has again and again been arrested by preventing the
entry of these powders into the swill barrel.

Symptoms. ‘There is dullness, inappetence, hyperthermia
(105°), a tendency to lie under the litter, leaving the herd, when
raised the pig arches his back, moves stiffly with grunting, the
tail and ears pendent, and the belly tender to the touch. ‘The
bowels are at first constipated, the thirst ardent, later diarrhcea
may set in, and the skin and snout may have red blotches or
patches as in hog cholera. Tympanies and abdominal rumblings
are frequent. The animal becomes very dull, weak, emaciated,
staggers in walking or is completely paraplegic.

It may end fatally in twenty-four or forty-eight hours, or
death may be deferred for six or eight days or the disease may
merge into the chronic form, or recover. The usual foul sur-
roundings of the pig and the abundance of microbes and toxins
taken in, serve to make enteritis in this animal much more re-
doubtable than in other domestic animals.

The /esions are usually common to stomach and intestine, and
consist in abundant mucopurulent discharge, extensive conges-
tion, points and extensive patches of blood extravasation, and of
lymph infiltration, ulcers, congested peritoneum and mesenteric
glands, and congestions and ecchymosis in distant organs.

The déagnosis between this affection and hog cholera on the
one hand and swine plague on the other is not always easy, but
it occurs in herds where no introduction of infection can be

Catarrhal Enteritis in Swine. 253

shown, there is always the evidence of a foul or unwholesome
food, drink or environment, and the history of a number having
been attacked at once and not one by one at varying intervals, as
in infection, the disease does not spread to neighboring herds
kept in better conditions, and there is an absence of the specific
germ of hog cholera, motile, zrobic, non-liquefying, asporo-
genous, gas producing with glucose and fatal to guinea-pigs; or
of that of swine plague, non-motile, erobic, non-liquefying,
asporogenous, not gas producing and not fatal to guinea-pigs,
but fatal to rabbits.

Treatment. If the bowels are costive give castor oil 2 ounces,
with great care to avoid choking, or shake 15 to 30 grains of
calomel on the tongue and give flaxseed tea, or solution of slip-
pery elm or gum which the animal will usually drink to slake its
thirst. Or well boiled gruels may be substituted. Injections of
soapsuds or Glauber salts with salicylate of soda should be added
until the bowels respond, after which the salicylate alone may be
given by both mouth and anus, or it may be replaced by one of
the other non-poisonous antiseptics. Oil of turpentine alone or
with ammonia may be applied on the abdomen and covered up
until the skin is red and angry.

When appetite returns, gruels, linseed tea, boiled milk and
other easily digested food may be given for some days until the
stomach reacquires tone, when the patient may be slowly returned
to its accustomed diet.

If the disease can be traced to alkaline washing powders, these
should be first neutralized by vinegar, after which laudanum,
antiseptics and mucilaginous gruels will be in order.

CATARRHAL ENTERITIS IN DOGS.

Causes: faulty feeding, close confinement, youth, distemper, overexer-
tion, meat diet, chills when heated and fatigued, ferments, bacteria, debility,
ill-health. Lesions: congested, softened, ulcerated, thickened mucosa,
mucopurulent exudate, swollen intestinal and mesenteric glands, byper-
plasia, polypi, follicular degeneration. Symptoms: dullness, segregation,
inappetence, fever, arched back, abdominal rumbling, tenderness, retraction,
constipation, diarrhoea, colics, vomiting, tenesmus, swollen red excoriated
anus, icterus, weakness, debility, paralysis, if chronic, unthrifty skin, with
eruptions, pallor, foul breath, tongue and gums, emaciation. Course : may
recover in vigorous, or run down and die in old, young, weak, debilitated
orill. Relapses. Treatment: dietetic, laxative, in icteric, calomel, manna,
enemata, warm bath, synapism, antiseptics, bismuth, sodium salicylate, in
diarrhoea, bitters astringent antiseptic tonics. Demulcents.

Causes. The dog is susceptible because of its varied, irregular
stimulating, often excessive diet, and its close confinement and
lack of wholesome outdoor exercise. The conditions which pre-
dispose to or excite gastritis tend equally to enteritis. Youth,
canine distemper, overexertion, an exclusive meat diet, and chills
from plunging into cold water when exhausted with hunting are
to be specially noted. Spoiled meats charged with the germs of
infection, or with putrefactive bacteria and their toxic products
are common causes. Then any old standing disease or other
cause of general debility will predispose to the attacks of such
otherwise harmless germs. ‘The irritation caused by intestinal
parasites is an occasional factor.

Lesions. The mucosa is congested, ramified, spotted or dark
and slaty ; it together with the submucosa is swollen and infiltrated
and with points of ecchymosis, extravasation or even ulceration.
The surface has a thick layer. of mucopurulent matter. ‘The
solitary glands are swollen and charged with small lymphoid or
pus cells and have a congested areola. The mesenteric glands
are congested and the liver usually congested, softened or mottled.
In chronic cases there may be hyperplasia, polypi, cystoid degen-
eration of the follicles, etc.

Symptoms. There may be dullness, drowsiness, a seeking of
seclusion, inappetence, hyperthermia (102 to 104°) ardent thirst,
arched back, abdominal rumbling, tympany or tucked up tender

254

Catarrhal Enteritis in Dogs. 255

abdomen, and a very temporary constipation, early giving place
to diarrhcea. If however the inflammation is confined to the
rectum and floating colon, constipation may persist. There are
intermittent colics, frequent lying down and rising, or rising on
the hind limbs only and when the belly is handled the patient
may whine. The mouth is sour, hot, clammy, and red, and the
dorsum of the tongue furred. The nose is dry and burning, the
eyes congested, sunken and watery.

The faeces may be early soft or liquid and bilious, then as the
defecations increase they pass through shades of gray to black or
reddish black from the admixture of effused blood, and show
bubbles and foetor. Vomiting is usually an early symptom (sep-
tic matters in septic poisoning) and as the disease advances there
is much fruitless straining and even protrusion of the congested
and excoriated rectum. Icterus is common from infection of the
gall ducts or the absorption of toxins into the portal vein.
Weakness and debility amounting even to paresis may appear in
the end.

In chronic cases there are emaciation and debility, unthrifty
hair and skin, cutaneous eruptions, pallor of the mucose, foetid
breath, foul teeth and tongue, with irregular appetite, alternate
constipation and diarrhoea, and, in case of implication of the
duodenum and liver, icterus. The abdomen is retracted and
tender.

Course. Instrong vigorous dogs a spontaneous recovery is the
rule, which is greatly favored by elimination through vomiting
and purging. Fatal cases occur in puppies, in old, debilitated
animals, or in such as have disease of the heart, lungs, or liver.
Relapses are common and dangerous.

Treatment. Mild cases may respond to a purely dietetic treat-
ment. Boiled milk, hot soup, or well cooked mush, and biscuit,
are indicated, and with % oz. castor oil and 5 to 10 drops lauda-
num may suffice for treatment.

In the more severe cases, with some icterus, calomel 1 to 2 grs.
with the oil, or with manna 5 drs. may be followed by emollient
or soapy injections, and a warm bath or fomentations, the body
being afterward carefully dried and warmly covered. This may
be followed by a mustard poultice.

The usual antiseptics (salol 10 grs., naphthol 20 grs., creoline

256 Veterinary Medicine.

20 drops, cresote 7 drops, or naphthaline 20 grs.) may be given
with the laxative and should be given by both mouth and anus
several times daily, in combination with nitrate of bismuth. In
case of icterus give a mixture of calomel 5 grs., chalk 60 grs., in
doses of three to five grains three or four times aday. Or salicy-
late of soda (10 grs.) may be given at the same intervals.

Quinia sulphate 5 grs., nux vomica I gr., tannic acid 1 gr., or
silver nitrate 4% to 1 gr., or iron chloride 3 to 5 grs., may be em-
ployed when the bowels are much relaxed. Injections of well
boiled rice or starch, or of gum or slippery elm, may be employed
as adjuvants.

HEMORRHAGIC GASTRO-ENTERITIS OF THE DOG.

Definition. Causes: Spring, toxins, irritants, inflammation. Symptoms:
Vomiting, diarrhcea, pendent head, arched back, retracted belly, black,
bloody glairy frothing faeces, circulation excited, mucose red, yellow, or
brown, death in two or three days. Diagnosis. Lesions: Stomach and
intestines empty, mucosa of a dark blood red, thickened, liver and kidneys
congested. Treatment: Little successful, intestinal disinfection, elimina-

tion, laxatives, wet compresses, enemata, heart stimulants, ergot, iron
chloride.

Definition. A special form of septic enteritis, occurring as an
epizootic and not transmissible by ingestion.

Causes. ‘These are not well known. Occurring in a few dogs at
one time in the same place, and time (by preference in spring)
and then disappearing for months, and not being appreciably
communicable by contagion or ingestion, it has the aspect of
being caused by poisons, probably of the nature of toxins taken
in with the food or water. Preéxisting inflammation has been
alleged as a predisposing cause, the attack having followed super-
purgation or the administration of a handful of salt. Guinard
found that the intravenous injection of tuberculin, mallein and
other products of microbian growth produced lesions analogous
to those of this disease.

Symptoms. ‘The attack is usually sudden. The dog is seized
with vomiting and diarrhcea and stands with head depressed,
back arched and belly tucked up. The vomit is at first of
alimentary matters, then of glairy mucus, or black and blood-

.

Hemorrhagic Gastro-Enteritis of the Dog. 257

stained material. The feeces are black, bloody, glairy, frothy,
and abundant, fouling the tail and the hips. The abdomen is at
first tense and extremely tender. The pulse is accelerated, the
heart beats tumultuous, the breathing slow and temperature
elevated. Redness of the visible mucosz, often tinged more or
less deeply with yellow, implies hepatic disorder or destruction of
blood globules. Death may occur in two or three days.

The abruptness and violence of the attack, the violent vomiting
and purging and the staining of the discharges with blood are to
a large extent diagnostic.

Lesions. These are most noticeable in the stomach and intes-
tines which are empty and of a dark blood red. The mucosa is
thickened, gorged with blood, and showing deeper shades here
and there where extravasation has occurred. The liver and kid-
neys are also deeply congested.

Treatment has been almost constantly a failure. Cadeac
recommends disinfection of the intestinal canal, with salol, cresyl
or dinaphthol, but in the absence of contagious germs this seems
the less called for. The indications would seem to point to
elimination of the chemical poisons, the soothing of the irritation
and the tiding the animal over the period of weakness. Agents
that will at once eliminate the poisons and sustain the heart’s,
action appear to be called for, hence digitalis 2 grs. or tincture of
strophanthus 10 drops are particularly indicated. Laxatives are
rather hopeless considering the congestion and paralysis of the
bowels, and yet if they can be made to operate on any compara-
tively healthy part of the intestine they will serve a good purpose
in eliminating the poisonous contents, in securing secretion and
elimination of poison from the blood, and in depleting from the
overcharged portal system. Glauber salts by mouth and anus,
or jalap, or castor oil may be resorted to. In the absence of
these a free use of watery enemata and the ingestion of water by
the mouth may be resorted to. A damp compress around ab-
domen and loins will be at once soothing and stimulating to the
secretions of both kidneys and bowels.

To counteract congestion and extravasation Cadeac advocates
ergotine 2 grs. subcutem, or iron perchloride, 2 ozs., to 1 quart
of water to be given in doses of two or three tablespoonfuls every
two hours. It might also be used in enema. Bismuth, pepsin,
muriatic acid, gentian and ammonia proved of no avail.

17

CATARRHAL ENTERITIS IN BIRDS.

Causes: microbes, diagnosis from fowl cholera, less virulent, rapid and
deadly, and comparatively harmless to the rabbit, debility, youth, age, un-
suitable food, ill-health : bacillus gallinorum, bacilluscoli communis, bacillus
of duck cholera, spirillum Metchnikowi. Symptoms : dullness, fever, languor,
inappetence, thirst, pale comb, greenish faeces, erect plumage, drooping
wings and tail, sunken head, gaping, staggering, somnolence, bloody faces,
violet comb, low temperature, death in one to three weeks. Diagnosis: by
restriction to one flock or species, and immunity of rabbits. Mortality
80%. Prevention: separation of sick and healthy, disinfection of roosts and
yards, pure food and water boiled or acidified, immunization. Treatment :
boiled food with antiseptics, antiseptic enemata, stimulants, tonics.

Causes. A number of different microbes are implicated in pro-
ducing and maintaining catarrhal enteritis in the domestic
poultry. All forms of the disease are therefore closely related to
the well known fowl cholera, which is, however, to be differen-
tiated, by its more intense virulence, rapid progress, and its deadly
effect when inoculated on the rabbit. Asin other forms of micro-
bian enteritis, that of fowls is undoubtedly favored by general
and local debility, youth, old age, unsuitable food and other
health depressing causes, yet as the specific pathogenic microbe

-has been in many cases identified, it is well to consider some of
the different species.

Bacillus gallinorum found by Klein (1889) in the blood of
chickens suffering from an infective diarrheal enteritis, is ovoid,
with rounded ends, from 0.8 to 2u long and 0.3 to o.4p thick ;
often in pairs. Stains in aniline colors. Afrobic (facultative
aneerobic) non-liquefying, non-motile, asporogenous. Culture
easy in neutral, alkaline or slightly acid media at room temper-
ature, or better in thermostat. On gelatine plate films, it forms
grayish white, superficial colonies, becoming flat homogeneous
white discs, brownish under transmitted light. The deeper
colonies are small spherical and brown or yellowish by trans-
mitted light. On agar it forms a thin gray layer with irregular
margins, which extends over the entire surface. In bouillon it
causes turbidity and in 24 hours a precipitate of bacilli to the
bottom.

258

Catarrhal Enteritis in Birds. 259

Pathogenesis. Chickens inoculated hypodermically or in-
travenously die in 1 to 5 or 6 days with peritonitis and intense
intestinal congestion. Fed in vegetable food it is harmless, but
with animal food virulent. Rabbits and pigeons are immune.

Pond water is a common source of casual infection, also dung
heaps in which carcasses of little chicks have been buried. Sum-
mer is the period of greatest prevalence, as there is the best op-
portunity for the multiplication of the germ, and the drying of
the ponds concentrates the product.

The bacillus is found on the intestinal mucotis membrane, and
in the mucus and in advanced stages, in the blood, spleen, liver
and kidneys.

Bacillus Coli Communis, the familiar bacillus of the healthy
bowel, is charged by Lignieres with causing a fowl enteritis and
probably does so as in mammals when the mucosa has become
diseased and non-resistant. At the same time there are so many
closely allied forms or varieties of this bacillus found in different
intestinal diseases, that it may well be that the pathogenic agent
is a modified form or ‘‘sport’’ from the parent microbe, though
no clearly defined peculiarities can be established by cultures.

The typical colon bacillus is 2 to 34 long by 0.4 to 0.6m broad,
with rounded ends, but it may be ovoid or even round, or it may
be 54 long. It stains readily with aniline colors, bleaches with
iodine. It is zerobic, facultative anzrobic, non-motile, non-liqui-
fying, and asporogenous. It ferments all sugars producing gas,
acidifies its culture fluids, and coagulates milk. It grows freely
at room temperatures in peptonized gelatine, agar and bouillon
and on potato. Stab cultures in gelatine have a moss-like tufted
appearance.

Pathogenesis. Injections subcutem, and into the veins and
ingestion with food all failed to infect the chicken, while the
pigeon died in 24 hours from intravenous injection and in 12 to
18 days from 1 c.c. given subcutem. In rabbits and guinea-pigs
hypodermic injection caused abscess, while pleural and peritoneal
injections killed in 24 to 48 hours. Rabbits are unaffected by
intravenous injection, while guinea-pigs die in 1 to 3 days.

Bacillus of Duck-Cholera found by Cornil and Toupet in
the blood of ducks suffering from a diarrhceal enteritis, is 1 to
1.54 long, by 0.5 broad, with rounded ends. It is erobic, non-

260 Veterinary Medicine.

liquifying, non-motile and asporogenous. Stains in the aniline
colors and bleaches in iodine.

Pathogenesis. In morphology and cultures it resembles the
bacillus of fowl cholera, but it fails to infect chicken, pigeon or
rabbit. It infects ducks readily by ingestion or hypodermic
inoculation.

Spirillum Metchnikowi was found in 1888, by Gamaleia in
the ingesta of chickens dying in Russia of a cholerzic enteritis.
It resembles the cholera spirillum, but is shorter, broader, and
more curved. Its size varies, being twice as broad as the cholera
spirillum, when found in pigeons. It may be 0.8 long, by .5¢
broad, furnished with one polar flagellum and very motile. It
stains in aniline colors and bleaches in iodine. Grows readily in
common media at room temperature, and is killed in five minutes
by 122° F.; renders milk strongly acid, coagulating it, and per-
ishes in the acid. In eggs turns the albumen yellow and the
yolk black. In gelatine it forms transparent colonies and in
potato pale brown. ;

Pathogenesis. By inoculation it infects chickens, pigeons,
and guinea-pigs, while rabbits and mice are refractory except to
large doses. By ingestion it infects chickens and guinea-pigs
but not pigeons. Infection takes place easily by the air passages.
In all cases alike the lesions are concentrated in the intestines.

Lesions, ‘These are very similar in the different forms. The
intestine is violently congested and contains a quantity of yel-
lowish green mucopurulent or serous fluid. The mucosa is in-
filtrated, softened and even abraded by the desquamation of epi-
thelium. ‘The liver is greatly enlarged and softened and gorged
with, blood, and the gall bladder filled. The spleen is enlarged
and pale, contrary to what is seen in fowl cholera, and the kid-
neys are congested. The heart is flaccid, soft, petechiated, and
the pericardium is the seat of serous effusion.

Symptoms. Inthe acute form there is dullness, languor, inap-
petence, ardent thirst, pale comb, and greenish feeces. Later
the feathers are erect, the wings and tail droop, the head sinks,
the patient gapes frequently, walks unsteadily, and a liquid
bluish green diarrhoea sets in, which later becomes yellow and
bloody. ‘The somnolence increases, the walk becomes more un-
steady, or the patient sinks down with eyes half closed and re-

Catarrhal Enteritis in Birds. 261

fuses to rise. As the disease advances the comb becomes violet,
the dark shade constantly increasing and a glairy grayish mucus
is discharged from the nose and bill. The temperature which
was at first raised 1° or 2°, falls 2° or 3° below the normal prior
to death, which may be deferred to near the end of the second
week.

In the chronic cases the disease may drag along for three
weeks, the emaciation, pallor and weakness constantly increasing
and the feathers around the anus soiled and matted together by
the foetid liquid discharges. There may be remissions which go
on to complete convalescence but more commonly an exacerba-
tion occurs which proves fatal in a day or two.

Diagnosis. From fowl cholera this may be distinguished by
the fact that it is confined to one farm or flock of turkeys, chickens
or ducks, proving most deadly in early summer, to the broods of
the same spring, and at the commencement of the epizootic, and
proving less and less so as time passes. The immunity of rabbits
even when inoculated is a further distinguishing feature. From
intestinal parasitism it is distinguished by the color of the dis-
charges, and the absence of worms and their eggs from these
liquids.

Mortality is often very high. Klein found it 80 per cent.

Prevention. Remove the infected from the flock (with ordinary
fowl it is often best to kill and burn or bury them), keep the
poultry house and yard scrupulously clean of droppings and
sprinkle it occasionally with a 3 per cent. solution of sulphuric
acid. ‘The poultry house may be fumigated with sulphur (1
ounce to the cubic yard), or the walls and roosts may be washed
with a solution (1:12) of bisulphide of carbon in liquid vaseline.
‘The diseased must be removed as soon as they are detected and
food and water must be given pure. If pure water is not avail-
able, boil it or render it acid by sulphuric acid (1:33), and feed
grain, cooked roots, bran and bread with more or less green food.
_ In the case of valuable birds immunization may be secured by

inoculating with the virulent blood or culture so diluted that not
more than one or two of the germs shall be inserted in each case
or the virulent liquid may be heated for 20 minutes to a tempera-
ture of 55° C (121° F) and then injected in a dose of 2 drops.

262 Veterinary Medicine.

Treatment. Tf it is decided to treat the sick they should be
placed together in safe seclusion from all others. Feed with
mush or cooked roots or vegetables adding salol % dr. naphthol
1 dr. and quinia 1 dr. to the food of 15 or 20 fowls. Nitrate of
bismuth and powdered charcoal may be added in moderate quan-
tities. As drink give water containing 2% of sulphuric acid.
Antiseptic enemata may be added in the case of very. valuable
birds, salol, naphthol, boric acid, salicylate of soda, or solution of
carbolic acid or creosote. Stimulants and tonics are highly
esteemed by some, and Cadeac recommends the free use of the
following mixture : powdered fennel, anise, coriander and quinia
of each 5 drs., gentian 10 drs., ginger 12 drs., ferric sulphate
2% drs.

COCCIDIAN ENTERITIS IN CATTLE. COCCIDIOSIS.
RED DYSENTERY.

Definition. Distribution: Switzerland in summer. Causes: weakness,
debility, youth, cold, heats, spoilt fodder, protozoa, coccidium oviforme,
coccidium perforans. Lesions :reddening, thickening and desquamation of
alimentary mucosa and lungs, congested mesenteric glands, liver and spleen,
coccidia in discharge and epithelium, staining, anzemia, Symptoms ; chill,
fever, grinding teeth, foetid diarrhoea becoming bloody, tenesmus, stiffness,
red ulcerated ‘rectum, emaciation, false membranes. Duration: death in
one to fourteen days or more. Complications. Diagnosis by coccidia.
Prevention : avoidance of affected soils, water and fodder. Treatment:
antiseptic, by mouth and as enemata, demulcents. Flesh safely eaten by
man. Coccidium bigeminum in dogs, coccidium oviforme in rabbits,
coccidium tenellum and gregarina avium intestinalis in birds.

Definition. Enteritis affecting chiefly the colon and rectum,
and due to the presence of the protoza, coccidium oviforme, and
coccidium perforans.

Distribution. This affection was found in 1885 in the cantons
of Berne, Lucerne and Argovi where it attacked 5 per cent. of
the cattle and destroyed from 2 to 4 per cent. of those that
suffered. It prevailed mainly in the summer (May to October)
on the pastures, though not unknown at other seasons. Sucking
calves were immune and the ages of a year to two and a half
years were the main sufferers.

Coccidian Enteritis in Cattle. 263

Causes. Predisposing causes embrace such as induce weakness
or debility, youth, low condition, cold intemperate weather, ex-
treme heats, musty or spoilt fodders.

The essential cause, the coccidium, appears to be taken in with
food or water as sucking calves are largely exempt. The para-
site is found in the gastric and intestinal epithelium of the dis-
eased animals, in numbers proportionate to the severity of the at-
tack, being very abundant when the disease is at its height,
diminishing during convalescence, and disappearing entirely on
recovery. ‘Two species are found in this disease.

Coccidium Oviforme is 40 to 50m long by 22 to 28m thick,
ovoid, with a double outlined limiting membrane inclosing a re-
frangent protoplasm with a nucleus two or three times as large as
that of an epithelial cell, and staining with hematoxylon or ani-
line colors. The young coccidia appear as round granular proto-
plasmic masses, without a capsule but provided with a nucleus.
At first of a diameter of 9 to rou they increase to 26m retaining
the spherical form and acquiring the membrane of the mature
parasite. As it grows the protoplasm separates from the wall
and forms a globular nucleated mass, which after fifteen days di-
vides into two and later into four masses or sporoblasts. Each
sporoblast in its turn divides into two falciform corpuscles lying
in contact but in an inverse sense to each other. Each of these
under favorable conditions becomes a new amceboid individual
capable of invading an epithelial cell and passing through the
same stages of development as its predecessor.

The coccidium oviforme is found in the epidermis in cutaneous
psorospermosis of birds, and in the coccidian hepatitis in rabbits.

Coccidium Perforans. In its mature form this is 254 to 35p
long, by 14 to 20m broad. Its different stages of evolution are
essentially the same as for the Coccidium Oviforme. It is a cause
of intestinal Coccidiosis in both dog and rabbit as well as in cattle,
usually killing the rabbit in from eight to ten days.

Lesions. In the first reported cases in calves in 1877 (Proger
and Zurn), there was catarrhal inflammation of the upper air
passages as well as the bowels. There was thickening, redness
and desquamation of the abomasum near the pylorus of the small
intestine and colon. In the intestines there were patches of
thickening and softening of the mucosa and miliary ulcers with

264 Veterinary Medicine.

yellowish contents. The mesenteric glands, liver and spleen
were enlarged, softened and ecchymosed. In all the lesions
coccidia were found. In the cases reported by Hess, Zschokke,
Guillebeau and Cadeac the abomasum and large intestine princi-
pally suffered. There was a diffuse inflammation of the mucosa
and in the rectum and portion of the colon a great degeneration
and desquamation of the epithelium. The columnar cells of the
mucous glands especially suffered. A single cell would contain
five or six psorosperms, in different stages of development. If
the parasites have escaped, the cell walls are pressed together.
Among the diseased glands others with healthy epithelium were
found, their orifices plugged with mucus. Both forms of coccidia
above described are found in two conditions, in the epithelial
cells with granular nuclei staining in hematoxylon, and violet
or black with iodine (Lugol’s), and outside the cells with granular
nucleus or simple hyaline contents which do not stain. Zschokke
considers the latter as in process of degeneration. Other organs
are anemic.

Symptoms. The disease is ushered in by cold extremities,
weakness, dullness, suspended rumination, ardent thirst, hyper-
thermia, 102° to 104° and even 106°, small, weak thready pulse
beating 100 to 140 per minute, sunken eyes, grinding of the
teeth, and defecation in small quantity only. Toward the fourth
day or earlier a fcetid diarrhoea sets in, watery, bloody and fibri-
nous. The bloody discharges last to the seventh day, the
diarrhcea to the end of the second or fourth week. Straining
may be violent, exposing or everting the irritated or ulcerated
rectum, the hind parts may be stiff, the patient rises with diffi-
culty, he winches if pressed on the back or right side of the
abdomen, loses flesh rapidly and becomes a walking skeleton,
when the discharges are less profuse cylindroid croupous casts
are sometimes expelled.

Course. Duration. In the weak and young a violent attack
may prove fatal in 24 hours. In others the malady lasts for two
or more weeks and sometimes relapses, and the patient becomes
very weak and anemic. Complications of various kinds may
also supervene and cut off the animal, the lesions and debility
alike favoring the introduction of the germ. Thus black quarter,
bronchitis, pneumonia, convulsions, paralysis, phthiriasis and
ring-worm have been noted as sequelz.

Cocctdian Enteritis in the Dog. 265

Diagnosis can always be made by microscopic examination of
the fresh warm feeces.

Prevention, ‘This will consist in the avoidance of water and of
green food from soils where the disease has been found to prevail.

Treatment, Antiseptics given by the mouth have proved of
very little avail having asa rule lost their power through dilution
in the contents of the stomachs. They may still be given to
keep in check the propagation of the coccidia in the fourth
stomach. Silver nitrate, iron sulphate, lead acetate, tannic acid,
oak bark, carbolic acid, cresol, lysol, salicylic acid, hydrochloric
acid, sulphuric acid, hyposulphite of soda have been used in this
way. The same agents may be used with better effect as enemata
being forced as far as is consistent with safety and frequently re-
peated. Quinia and iodide of potassium may also be given as par-
asiticides. Mucilaginous gruels and decoctions should be given
at first, followed by mashes as they can be borne, but the food
must be moderate and easily digestible until full convalescence
has taken place.

The flesh of animals killed while suffering from this affection
has been eaten by man with impunity. ,

COCCIDIAN ENTERITIS IN THE DOG. INTESTINAL
COCCIDIOSIS.

Causes. ‘Two parasites have been found in connection with this
disease in the dog ; the Coccidium perforans, already described,
and the Coccidium bigeminum.

Coccidium Bigeminum, var. Canis. This is elliptical and
from 12 to 15u long by 7 to rou broad. They are usually found
in pairs lying side by side, and sometimes both in the same en-
velope indicating multiplication by division along the longitudinal
axis.

The bigeminum is held to be harmless, but the perforans, as in
the cow and the rabbit is very injurious and even fatal. The symp-
toms are those of digestive disturbance, dullness, loss of appetite,
retching, vomiting, colic and foetid and bloody diarrhoea. Irrita-

266 Veterinary Medicine.

bility, and a morose disposition and loss of control over the hind
limbs have been set down as rabiform indications.

Diagnosis depends on the inveteracy and sanguineous nature
of the diarrhcea, but especially on the discovery of the amceboid
organisms in the recent, warm discharges.

Treatment should be along the same line as in cattle.

COCCIDIAN ENTERITIS IN RABBITS. INTESTINAL
COCCIDIOSIS.

Causes. In rabbits the coccidium perforans is the psorosperm
which usually attacks the bowels. The coccidium oviforme
which produces hepatic coccidiosis is also occasionally found in
the intestines. The perforans is smaller than in cattle being 15
to 25u long, by 12 to 15 broad, approximating to the variety
found in man.

Lesions. ‘There is extensive congestion of the intestinal mu-
cosa, with thickening and softening of the epithelium so that it
breaks down into a pulp under pressure, also free desquamation
with the formation of abrasions, sloughs and ulcers. In some
instances extensive croupous casts of the intestine are found.
As in the other animals the coccidium is found abundantly in the
epithelial cells of the affected parts which swell up and de-
generate. When the parasite has escaped from the cells it lives
free in the abundant mucopurulent and sanguineous secretions of
the bowels.

Symptoms. ‘There are loss of appetite, swelling of the ab-
domen, profuse diarrhcea, the faeces yellowish in color and contain-
ing mucopurulent matters and blood. The disease may prove
fatal in a few days without much loss of flesh, but if protracted
it leads to extreme anzemia, emaciation and debility and the ani-
mal dies of marasmus.

Diagnosis is always to be certified by the profusion of coccidia
found in the fresh liquid discharges.

Prevention must be secured if possible by the removal of the
healthy rabbits from the infected and from the hutch or warren

Coccidian Enteritis in Birds. 267

in which the latter have been. ‘The greatest care must be taken
to prevent them from obtaining access to the droppings of the sick,
or to streams, ponds or wells, into which the drainage from such
manure can have found its way. ‘The safest course is to destroy
the sick and burn up them and all their droppings, as the latter
ground into powder can blow on the wind.

Therapeutic treatment has proved unsatisfactory but may be
attempted along the same lines as for the larger animals.

COCCIDIAN ENTERITIS IN BIRDS. INTESTINAL
COCCIDIOSIS.

Two sporozoa are known to be pathogenic in the intestines of
birds: the coccidium tenellum and the gregarina avium
intestinalis.

Coccidium Tenellum. This hasa nearly globular body 21
to 25 mm. long by 17 to 19 mm. broad, a very thin, delicate in-
vesting membrane, and has been found in the mucosa of the ceeca
of birds, producing a fatal typhlitis. The sporoblasts are de-
veloped in water outside the animal body and when taken in with
the food colonize in the intestinal mucosa.

Gregarina Avium Intestinalis. When mature this is in
form of a granular body with hollow spaces or utricles, is oval, or
globular and measures 40 to 484 in diameter. The spores are 11
to 144. ‘They are found in the submucosa of the intestines in
chickens, being taken in with food or water, and attack not the
intestines only but the skin, the buccal and pharyngeal mucosa
and even the liver and lungs. They traverse the mucous mem-
brane and become encysted in the submucosa as white isolated or
confluent points, disturbing the circulation and nutrition and
destroying the nutritive and other functional activities of the
mucosa.

Lesions. From the coccidium tenellum these are mainly found
in the ceca and consist in intense inflammation, white lines
formed by the parasitic colonies, desquamations of the epithelium
and erosions and ulcers. In the early stages and in the absence
of diarrhcea there may be simply thickening and induration of

268 Veterinary Medicine.

the mucous membrane and whitish colonies of the parasites.
When there has been diarrhoea the contents are serous, or sero-
purulent, brick red, and filled with epithelial cells, red globules,
leucocytes, fat globules and coccidia.

The gregarinz are not confined to the czeca but scattered over
the whole intestinal canal as white spots in the submucosa sur-
rounded by congestion and degenerative changes. It has been
found complicated with false membranes.

Symptoms. Dullness, anorexia, ruffled feathers, sunken head,
trailing wings, slow uncertain gait, plaintive cries, with diarrheea,
passing through serous, brick red, and bloody. In small chicks
it may be whitish and followed by constipation. Death is usually
an early result.

Treatment. Hyposulphite of soda with carminatives (fennel
anise, coriander, ginger, and gentian) has been given in boiled
milk or bread. Quinia and iodine might be tried.

Prevention. Avoidance of infected roosts and runs, and above
all of infected streams, wells and ponds, and the removal and
cremation of the sick, followed by thorough disinfection, are
much more promising than therapeutic treatment.

GASTRO-ENTERITIS FROM CAUSTIC ALKALIES AND
ALKALINE SALTS.

Ammonia: Counter-irritation, fauces, larynx, bronchia, congestion and
softening of the gastric mucosa, loose blood clots, solution of globules,
dysphagia, salivation, in carnivora and omnivora vomiting, diarrhcea, white
fumes with muriatic acid.—Ammonia carbonate: less corrosive, same
symptoms,—Potash lye, deep corrosion, gastric congestions, fluid, blackish
red blood.—Soda lye,—Carbonates of potash and soda, less violent, tests for
potash and soda. Treatment weak acids, demulcents, anodynes.

Aqua Ammonia. Lethal dose pure, horse 1 oz. and upward ;
cattle 2 ozs.; dog %dr. There may be sudden death from
abstraction of water and cauterization of the fauces and larynx in-
cluding at times the bronchial mucosa. In other cases death oc-
curs later from gastro-enteritis, the mucosa of the alimentary canal
being congested, softened and covered with bloody mucus. The

Gastro-Enteritis from Caustic Alkalies. 269

blood in the vessels is of a dark red, coagulates imperfectly and
the blood globules are dissolved changing the color to black, and
then brownish red. Prior to death there is great distress, saliva-
tion, inability to swallow, swollen tongue, frequent pulse and
respiration, cough, spasms, and sometimes the odor of ammonia.
Retching and vomiting may be a feature in carnivora and omni-
vora, and diarrhcea if the case is not promptly fatal. ‘The urine
is not rendered alkaline. White fumes with muriatic acid indi-
cate ammonia. ‘

Ammonia Carbonate gives rise to the same symptoms and
lesions with the exception that there is less corrosion of the
mucosa, and no pure ammonia exhales in the breath.

Caustic Potash, Lye. Lethal dose, 5 grs. dog intravenous.
In strong solution this is one of the most potent caustics, which
penetrates deeply into the tissues and abstracting water cauterizes
everything with which it comes in contact. It therefore pro-
duces the most destructive changes on the walls of the stomach,
and intestines, with violent gastro-enteritis, retching or vomiting
of alkaline matters. The congested, ashen and even black color
of the tongue, and (post mortem) of the gullet, stomach and
intestines, and the intense alkalinity of contents are characteristic.
The blood is fluid, gelatiniform, and blackish red. Later, ero-
sions and strictures are common.

Caustic Soda is only less destructive than potash, and pro-
duces the same general lesions and symptoms.

The Carbonates of Potash and Soda have the same general
properties only they act with very much less energy. Potassium
can be recognized by its purple color in an alcohol or Bunsen
flame and sodium by an intense yellow.

Treatment. Weak acids (acetic, vinegar, citric, malic, lactic,
boric, benzoic, salicylic) or the stronger mineral acids largely
diluted. Mucilaginous solutions (flaxseed, elm bark, gruel,
mallow). Anodynes (opium).

GASTRO ENTERITIS FROM CAUSTIC ACIDS.

Sulphuric acid, corrodes, blackens, dysphagia, salivation, retching, vomit-
ing, colics, collapse. Lesions. Test, barium nitrate. Nitric acid, corrodes,
stains yellow, or brown. Test, reddish fumes with copper and sul-
phuric acid. Muriatic acid, corrodes, whitens. Test, chlorine odor, white,
curdy precipitate with silver nitrate. Oxalic acid, colic, emesis of black
bloody matter, gastric mucosa red or black, blood bright red, lowered res-
piration, innervation, temperature. Acetic acid, congestion, softening of
gastric mucosa, may stop heart. Treatment : weak bases, magnesia, lime or
their carbonates, soap, lime water, demulcents.

Sulphuric Acid. This acts on stomach and intestine as on
the mouth abstracting water and blackening the tissues. It pro-
duces dysphagia, salivation, retching, vomiting in carnivora and
omnivora, colics, and collapse. Sometimes the urine becomes
albuminous and bloody. The post mortem blackness of the con-
tents and walls of the stomach and intestine and their intense
acidity are characteristic. Nitrate of baryta will precipitate the
insoluble sulphate. ;

Nitric Acid. In concentrated state this acts in the main like
the sulphuric acid, but stains the lips yellow, and the mucosze
white changing to citron yellow or brown and does not precipi-
tate baryta. It gives reddish fumes with copper and strong sul-
phuric acid.

Muriatic Acid. This is less caustic than nitric or sulphuric
acid, and may be recognized by its white cauterized patches on
the mucosa of the mouth, stomach and intestines, its chlorine
odor, and the curdy precipitate which it throws down with silver
nitrate. It does not corrode the skin. In the stomach this acid
is normally present in the free state.

Oxalic Acid. Lethal dose, dog 15 grs., cat 2 grs. When
swallowed this causes colics, emesis in vomiting animals, the
rejected matters being black and perhaps bloody. After death
the gastric contents and walls and those of the bowels are con-
gested and more or less blackened, and the blood of a bright red
color. Heart is arythmic, respiration slow, paresis of limbs,
spasms, temperature subnormal.

Acetic Acid. This causes congestion and softening of the
270

Poisoning by Sodium Chloride. 271

gastric and intestinal mucosa, colics, emesis in vomiting animals.
It may kill by suddenly arresting the heart’s action.

Treatment for the acids consists in alkaline or basic antidotes ;
magnesia, or its carbonate, lime, or its carbonate, soapsuds, car-
bonates and bicarbonates of potash and soda. Lime water is the
one appropriate antidote to oxalic acid, precipitating the insolu-
ble oxalate. Mucilaginous drinks may be added freely.

POISONING BY SODIUM CHLORIDE.

Poisonous with privation of water. Dose: horse, ox, pig, dog, hen.
Symptoms: anorexia, thirst, emesis. culics, diarrhcea, dysuria, weakness,
spasms, palsy, death in six hours to two days or more. Lesions gastric
congestion, ecchymosis, blood fluid, bright red, cerebral congestion. Treat-
ment: emesis, water, demulcents, enemata, oils, cold to head. Brine:
salt, ptomaines, toxins, from salt meat and fish. Strongest at three months
old. Dose, horse, pig, dog. Symptoms: nervous, disorder, mainly spas-
modic. Lesions: congestion of encephalon. Treatment: anodynes,
stimulants, wine, camphor. +

Common salt is especially irritant if given in concentrated solu-
tion and with subsequent deprivation of water. The poisonous
dose for the horse is 2 to 3 lbs. (Gohier), for cattle 4 to 5 lbs.
(Hertwig), for the pig 7 to 8 ozs. and for the dog 6 to 7 ozs.
Chickens are poisoned by picking up broken up pieces of salt in-
stead of pebbles, or by salted food.

Symptoms. Anorexia, intense thirst, dullness, emesis in
vomiting animals, colics, watery diarrhoea, frequent urination,
muscular weakness, spasins, paralysis, weak pulse, red buccal
mucosa, dilated pupils. Death may take place in six hours or it
may be delayed two days or longer. In chickens giddiness and
rotary movements are common.

Lesions. Congestion of the stomach and intestines with points
of ecchymosis. The mucosa of the bladder is reddened. The
blood is fluid and of a bright red. There is more or less con-
gestion of the cerebellum and medulla and their meninges.

Treatment. Emetics (tepid water, tickling fauces) and the
stomach pump. Abundance of water or of mucilaginous drinks.

272 Veterinary Medicine.

The same liquids by the rectum. Bland oils may be given as
emollients and eliminating agents. Cold to the head is usually
desirable.

POISONING BY BRINE.

This is partly due to the toxic effects of common salt but also
to the ptomaines and toxins formed in old brine. It has been
seen most frequently in hogs fed on salted kitchen waste and on
the liquids from salt meats, beef, pork, fish). Herring-brineisa
common source of poisoning for hogs and dogs, also the brine
from the salted meats of the butchers’ shops. Reynal found
it to be especially poisonous when at least four or five months
old. He gave as the fatal doses for horse 3% pints, for pig 4%
pint, for dog 6-7 ozs. The lethal dose, however, will vary with
the concentration of the fluid and its age.

Symptoms. In addition to the direct irritation caused by the
sodium chloride there are marked nervous symptoms, nervous
irritability, spasms, rolling of the eyes, convulsive winking,
dilated pupil, blindness, vertigo, staggering gait, epileptiform
seizures, trismus, oposthotonos, pleurosthotonos, stupor.

Lesions. In addition to those of the stomach and intestines.
there is marked congestion of the encephalon, especially the
medulla and cerebellum.

Treatment, In addition to that for common salt, anodynes and
stimulants (wine, camphor) may be demanded.

NITRATES OF POTASH AND SODA.

Lethal dose. Symptoms: Colics, tympany, emesis, salivation, pupillary
dilatation, diarrhoea, diuresis, hyperthermia, stupor, palpitations, trembling,
spasms, palsy. Lesions: Congested gastro-intestinal mucose, erosions,
ecchymosis, congested kidney and bladder. Blood fluid, bright red. Treat-.
ment: Emesis, stomach pump, water and mucilaginous liquids, stimulants.

Nitrate of soda being used largely as a top dressing for grass.
and other crops is more liable to be taken in toxic doses than

Acute Arsenical Poisoning. 273

nitrate of potash. The former is also given in mistake for com-
mon salt. The toxic dose is high. Morton gave 2 pounds ‘salt-
peter toa horse with only a temporary purgative and diuretic
effect. Huzard found that 3 doses of 16 ounces each, given at
intervals of 8 days sufficed to kill a horse. Cattle are said to
have died from taking 5 to 6 ounces.

Symptoms. There are colics, tympany, emesis in vomiting
animals, salivation, dilated pupil, diarrhcea, diuresis, hypothermia,
stupor, palpitations, weak pulse, trembling, convulsions, tetanic
symptoms, paralysis.

Lesions. Congestion of a cherry red, brown or purple of the
gastric mucosa and that of the small intestine, erosions and
ecchymosis, congestion and ecchymosis of the kidney and of the
mucosa of the bladder. Blood uncoagulated and of a bright red.

Treatment. Favor emesis or use stomach pump according to
the species of animal. Give abundance of water or mucilaginous
fluids by mouth and anus. Stimulants may be resorted to in
case of sinking or collapse.

ACUTE ARSENICAL POISONING, ARSENIOUS ACID,
PARIS GREEN.

Acute poisoning. Sources. Lethal dose, horse, ox, sheep, dogs, pigs.
Endermic. Symptoms: colic, weak pulse, rapid breathiug, red eyes, dilated
pupils, purging, weakness, trembling, stupor, convulsions, paralysis, green
or yellow vomit, test of urine. Lesions: gastro-intestinal inflammation,
ropy, bloody mucus, ecchymosis, extravasation, ulceration. Treatment ;
emesis, stomach pump, hydrated iron oxide, calcined magnesia.—Chronic
poisoning. Excessive administration, arsenical fumes from smelting fur-
naces. Symptoms: indigestion, emaciation, hidebound, depilation, red
eyes, diarrhoea, agalactia, weakness, paraplegia, salivation Lesions: as in
acute, fatty liver, test of urine. Tests: on hot charcoal garlic odor, Marsh’s
test by zinc and sulphuric acid. Treatment: avoidance of cause, antidotes,
demulcents, diet.

Arsenious acid given recklessly as medicine, rat poison, arsenite
of soda made into a sheep dip and left within reach of animals,
and arsenite of copper used for potato bugs, or other insect pests
and carelessly left where animals can get it are the most common

18

274 Veterinary Medicine.

sources of acute arsenical poisoning. Horses die from 140 grains
in solution, or 3% drs. in the solid form, cattlé from 3% to 7 drs.,
sheep are killed by 2 drs., dogs may die from 2 grs., but larger
doses usually cause vomiting and the animal is saved. Hogs
may die from 15 grs. but they often save themselves by vomiting
with much larger doses. The poisonous effects may be induced
by putting arsenic on a raw sore.

Symptoms. Violent colic, quick, feeble, irregular pulse, hur-
ried respiration, emesis in vomiting animals, ardent thirst, purg-
ing, tenesmus, lowered or unevenly distributed temperature, red
eyes, dilated pupils, and nervous symptoms, weakness, trembling,
stupor, convulsions and paralysis. The urine is albuminous and
may be bloodstained. In case of Paris green, the green color of
the vomit, and of arsenious acid, a yellow color may be looked
for. Test urine for arsenic.

' Lesions. Inflammation of the stomach and small intestine,
with ropy, often bloody mucus. Ecchymosis, and extravasations
appear in the stomach. Ulceration is not common in very acute
cases, but in protracted cases, it is usually present in the stomach
(abomasum in cattle). Petechize may be met with in different
internal organs and in protracted cases, fatty degeneration of
liver, heart or kidney.

Treatment. In vomiting animals encourage emesis by tepid
water, tickling the fauces or giving ipecacuan. For non-vomit-
ing animals the stomach pump may be tried. The available
antidotes are hydrated oxide of iron, or a solution of calcined
magnesia. ‘To make the first, mix roo parts sulphate of iron in.
solution with 250 parts magnesia in solution. This should be
given liberally and often: horse or ox 1 qt., sheep or pig 2 ozs.,
dog 10z. A simple aqueous solution of calcined magnesia also
forms with arsenic an insolubie combination.

CHRONIC ARSENICAL POISONING.

This comes from continuous injudicious dosing with arsenic, or
from the condensing on the grass of the vapors from the smelting
of ores containing arsenic.

Symptoms. There is chronic indigestion, emaciation, hide-
bound, depilation, red or weeping eyes, chronic diarrhoea, sup-
pression of milk in cows, muscular weakness, paraplegia, soreness
of the gums, salivation.

The Zesions are essentially the same only less intense than in
the acute form. Hugo found in the intestines of poisoned animals
a slimy, serous, grayish white fluid, and a false membrane like
a frog spawn streaking the intestine. Later this may be dense
like a diphtheritic membrane. There was fatty degeneration of
the liver and of the gall bladder epithelium. Injection of the
capillary vessels of the brain and pia, and effusion into the
ventricles and on the surface of the brain were found in dogs.

” Elimination. Arsenic is eliminated mainly in the urine, but
also in part in the bile and perspiration.

Test for arsenic. ‘When taken in the solid form it may be
found undissolved on the gastric mucosa.

If burned on red hot charcoal or iron it gives out the odor of
garlic.

Marsh’s test consists in evolving arseniureted hydrogen from
zine and sulphuric acid to which a little of the suspected liquid
has been added. A flask is taken having a cork conveying two
tubes, one a funnel reaching nearly the bottom of the flask, and
the other a delivery tube of some length and provided with a
chloride of calcium bulb, and at its end turned up at right angles
and drawn out to form a narrow orifice. Pieces of zinc are placed
in the bottom of the flask, and sulphuric acid is poured upon
these through the funnel. This causes the evolution of hydrogen.
The suspected liquid is now added, and the gas issuing from
the delivery tube having been lighted, a piece of cold white
porcelain is held above and a short distance from the flame. A
dark metallic spot of arsenic is obtained. ‘The stain obtained by
antimony differs in being formed more closely to the flame, in

275

276 Veterinary Medicine.

volatilizing less rapidly under heat, and in forming a black or
orange instead of the canary yellow sulphide when subjected to a
stream of H,S with gentle heat. Chloride of lime dissolves the
arsenic stain but has no effect on the antimonial one.

Treatment. Avoid the causes. Employ the antidotes in small
doses once or twice daily. Check the diarrhoea by mucilaginous
agents, and nourish the animals well.

POISONING BY PHOSPHORUS.

From matches, rat poisons, fatal dose, horse, ox, pig, dog, chicken.
Symptoms: Anorexia, dysphagia, swelled tongue, thirst, colic, emesis,
vomit phosphorescent, or bloody, diarrhoea, icterus, agalactia, trembling,
weakness, choreic spasms, hemorrhages. Lesions: Buccal-gastro-intestinal
inflammation, fatty degeneration of epithelium, liver, kidneys, heart and
muscles, black blood, ecchymosis, hemorrhage, phosphorescent ingesta.
Treatment : Emesis, stomach pump, oil of turpentine in mucilage.

Phosphorusvis usually taken in the form of matches or more
frequently as one of the pastes sold for the destruction of vermin.
Almost all of the latter contain 1 to 2 per cent. of phosphorus,
in combination with flour, sugar, and fatty or oily matters. The
lethal dose of phosphorus is: Horse or ox 7 to 30 grains; pig 2
to 4 grains; dog 34 to 1% grain; chicken ¥% grain.

Symptoms. Anorexia, dysphagia, swelling of the tongue,
intense thirst, colic, emesis in vomiting animals, vomited matters
may shine in the dark, and may be tinged with blood, diarrhoea
is common though not constant, icterus, and suppression of the
milk. Trembling, weakness, acceleration of the pulse and breath-
ing and hyperthermia may be noted. Chickens have been
noticed to have choreic movements in walking. Hemorrhages
are common.

Lesions. Inflammation of the mucosa of the alimentary canal
from the mouth to the stomach and intestines. Fatty de-
generation of the epithelium very noticeable in the gastric glands.
Enlargement and fatty {degeneration of the liver and kidneys,
and degeneration of the heart and muscles. ’ The blood is black

Poisoning by Tartar Emetic. 277

and ecchymosis and hemorrhages appear on various internal
organs. The contents of stomach and bowels shine in the dark.
Phosphorus may be recognized by its luminosity when distilled
at a very low heat. from an acid solution and received into a
refrigerated condenser. This must be done in perfect darkness,
and the phosphorescence will be seen in the condenser or connect-
ing tube.

Treatment. Empty the stomach by emetic or stomach pump,
and then give oil of turpentine in mucilaginous liquid: Horse 1
to 2 ounces ; 0x 2 to 3 ounces; pig 1% ounce; dog 20 to 30 drops;
chicken 5 to 1o drops. This may be repeated several times and
if used early enough will probably succeed.

POISONING BY TARTAR EMETIC.

Fatal doses, large in herbivora. Symptoms: vomiting, diarrhoea, ulcera-
tive stomatitis, salivation, thirst, colic, tremors, palsy. Lesions: gastro-
intestinal inflammations, ulcerations, lunginfarctions. Treatment: emesis,
antidote tannic acid.

This is mainly seen in the smaller vomiting animals. To kill
horses or cattle much larger doses are necessary than are likely
to be taken. Barlow and Dun gave 4 drs. to a horse thrice a day,
and in all ro ozs. in 10 days, yet it improved in condition. Ten
and a half ounces given in 6 days proved fatal. An old sow was
killed by 2 drs., a 5 months pig by 80 grs., (Hertwig). Dogs
were killed by 3 to 7 grs.

Symptoms. Vomiting, diarrhoea, ulcerative stomatitis, saliva-
tion, vertigo, thirst, dullness, cold surface, colicy pains, tremb-
ling, paralysis of the hind quarters, and early death.

Lesions. General inflammation of the gastric and intestinal
mucosa, sometimes ulceration especially if the agent has been
takenjin;the solid form. Congestions and infarctions of the lung
are’not unknown.

Treatment. Encourage vomiting by tickling the fauces, and
by the ingestion of tepid water. The best known antidote is
tannicjacid in any one of its combinations. Solution of tannin,

278 Veterinary Medicine.

decoctions of oak bark, oak galls, catechu, kino, rumex, sumac,
or even strong tea will serve to render it insoluble and non-
irritant.

POISONING BY CORROSIVE SALTS OF MERCURY.

Calomel with muriatic acid, corrosive sublimate, mercuric chloride,
iodide, nitrate, cyanide. Fatal dose. Symptoms: anorexia, salivation,
thirst, emesis, colic, diarrhoea, rumbling, debility, tremors, stupor, death.
Lesions : corrosive whitening of gastro-intestinal mucosa, congestion, ulcer,
ation, blackening, bloody, glairy ingesta. Treatment: albumen, emesis,
demulcents, chlorate of potash, bitters, iron sulphate. Test: copper and
muriatic acid.

Calomel in itself cannot be looked on as corrosive, but in
ruminants in which it is retained in the system for 3 or 4 days it
is largely resolved into mercuric chloride by the free gastric acid
and alkaline chlorides. It has therefore been largely excluded
from the materia medica of these animals. When in these or
other animals it produces corrosive action, the operation is essen-
tially that of corrosive sublimate.

The corrosive salts of mercury likely to be taken by animals
are corrosive sublimate now so largely used as an antiseptic, the
nitrates and iodides, and cyanides of mercury used as local appli-
cations or as antiseptics.

Mercuric chloride may be taken as the type. It has proved
fatal to the horse in a dose of 2 drs.; to the ox in 1 to 2 drs.; to
the dog in doses of 4 to 6 grs.

Symptoms. Loss of appetite, salivation, thirst, emesis in vom-
iting animals, colics, diarrhcea, often bloody, weak perhaps im-
perceptible pulse, hurried breathing, much rumbling of the abdo-
men, debility, trembling, stupor and death.

Lesions Escharotic whitening in patches of the mucosa of the
mouth, throat, gullet, stomach and intestines, with acute conges-
tion, ulceration and ecchymosis, and sometimes blackening by
the formation of the sulphide. The contents of the bowels may
be serous or bloody and more or less glairy. Like arsenic, mer-
curic chloride concentrates its action on the intestinal canal by
whatever channel it may have entered the body.

Poisoning by Sulphur. 279

Treatment. The mercury should be precipitated in an insol-
uble form and then eliminated by emesis or by the stomach pump.
White of eggs is usually the most available agent producing the
albuminate of mercury. This is, however, still soluble in acid
and alkaline liquids, in chlorides of potassium, sodium or calcium
and even in excess of albumen. Vomiting may be favored by
tickling the fauces, or by hypodermic injection of apomorphia.
This may be followed by boiled flaxseed or copious drinks of rain
water. When the mercury has been largely eliminated the sali-
vation may be controlled by chlorate of potash, and the digestive
disorder met by bitters and iron sulphate.

Test for Mercury. Place a few drops of the suspected solution
on a clean surface of copper; acidulate with muriatic acid ; then
touch the copper through the liquid with a piece of zinc; a silver
colored stain will be formed, easily dissipated by the heat.

POISONING BY SULPHUR.

Fatal dose, horse 16 ozs. Symptoms: dullness; anorexia, colic, diarrhcea,
sulphur odor. Lesions: congestion, desquamation, ulceration of gastro-
intestinal mucosa, sulphur odor in flesh, blood nearly fluid, blackens silver.
Treatment : chloride of lime, oil, puncture rumen or colon, stimulants.

In excessive doses this is irritant. The horse is poisoned by 16
ozs. (Tabourin) : violent colics follow a dose of 12 ozs. (Collaine).
Cattle are less susceptible.

Symptoms. YDullness, anorexia, colic, pulse small and quick,
skin cold and clammy. Fcetid flatus and profuse diarrhcea, are
marked symptoms.

Lesions. Injection of the gastro-intestinal mucosa, shedding
of the epithelium, ulceration, and sometimes gangrene. Sulphur
is found in the ingesta and feeces and a sulphur odor is prominent,
not only in the bowels but also in the flesh. Tympany from H,sS
iscommon. ‘The blood is mostly fluid, and ecchymosis is shown
on heart, lungs and other internal organs. The tissues blacken
silver.

Treatment. Chloride of lime, oleaginous laxatives, use trochar
and cannula for tympany. In prostrate conditions give stimu-
lants (alcohol, ether).

.

POISONING BY BROMINE AND IODINE.

Poisoning by these agents is rare in domestic animals. Bro-
mine 2 drs. killed a dog in 5 hours: 10 to 12 drops in 1 oz.
water intravenously killed a dog suddenly, and 5 to 6 drs. of
iodine by the mouth killed in a few days (Orfila). A horse had
colic from taking % oz. iodine (Tabourin), others died from the
effect of 2 dr. doses intravenously (Patu).

Symptoms. Violent colicy pains, salivation, emesis in vomit-
ing animals, diarrhoea, iodine or bromine odor, acute coryza, red
eyes, dilated pupils, weakness, debility, vertigo, convulsions.
If the patient survives the glandular system undergoes atrophy,
with emaciation and scaly skin eruptions.

Lesions, After large doses there are congestion, ulceration,
corrosion and sloughing of the cesophagean, gastric and intestinal
mucosa, and more or less yellow discoloration of the parts. The
odor is characteristic. With iodine there may be blue iodide of
starch in the ingesta.

Treatment. Favor emesis by tickling the fauces and giving
tepid water, or apomorphia subcutem. Boiled starch is the best .
antidote and may be given freely, both by mouth and rectum.
Opium is often called for to relieve suffering.

POISONING BY COPPER.

Copper sulphate: Fatal dose, horse, dog. Symptoms: Dullness, colic,
blue or green vomit, diarrhoea, straining, weakness, spasms, palsy, albumin-
uria, icterus, hemoglobinuria, impaired appetite, emaciation, spasms.
Lesions: Redness, softness, ulceration, sloughing of alimentary mucosa,
methe- globinzemia, fatty liver, enlarged spleen, ingesta give copper film on
polishediron, Treatment : Albumen, milk, mucilage, iron filings, sulphur,
magnesia, laxatives, opium. Avoid acids.

The common copper poisons are the sulphate and acetate.
Copper alum, oxide or carbonate of copper and paints with a
copper base are less frequently taken.

280

Poisoning by Zinc. 281

Sulphate of copper 1 ounce has proved fatal to the horse.
In dilute solution or with mucilaginous liquids it is much less
injurious. Ten grains to 2 drachms subcutem have killed the
dog. (Tabourin. )

Symptoms. Dullness, colics, emesis of blue or greenish mat-
ter in vomiting animals, diarrhcea, tenesmus, weakness, trembling,
spasms, trismus, paralysis, small, weak pulse, hurried breathing.
In experimental chronic poisoning in the sheep, albuminuria,
icterus, heemaglobinuria, hematuria, impaired appetite and rumin-
ation, constipation followed by diarrhoea, great emaciation and
weakness and finally convulsions. (Ellenberger and Hofmeister).

Lestons. Redness and softening of the alimentary mucosa,
ulceration, sloughing, perforation. In the chronic forms methe-
globinzemia, free hzematin as crystals in liver, spleen and kidney,
nephritic extravasation, fatty degeneration of the liver, enlarged
spleen, and catarrhal changes in the intestinal mucosa. Polished
iron placed in the gastric or intestinal contents becomes coated
with copper.

Treatment, White of egg, milk, mucilage, iron filings, sul-
phur, calcined magnesia, laxatives. Opium may be required to
calm suffering, but acids must be carefully avoided.

POISONING BY ZINC.

Sulphate and chloride poisonous, less potent oxide and carbonate. Symp-
toms: colics, emesis, congested alimentary mucosa, diarrhcea, cramps,
weakness, paresis, anzemia, emaciation. Lesions: white, leathery, slough-
ing or ulcerated alimentary mucosa, strictures. Treatment : emesis, demul-
cents, tannic acid, sodium carbonate.

The sulphate and chloride are the most likely to be taken in
dangerous amount, the former being mistaken for Glauber salts.
Three ounces of sulphate intravenously in the horse has proved
fatal, or 10 to 50 grains in the dog. In the vicinity of zinc ore
furnaces the agent is taken in on the fodder as oxide or carbonate.

Symptoms. ‘There is much abdominal pain, emesis in vomit-

282 Veterinary Medicine.

ing animals, quick pulse, congested mucosz, diarrhoea, cramps,
weakness and paresis, and if the patient survives, anemia and
emaciation.

Lesions. ‘The mucosa of mouth, gullet, stomach and perhaps
duodenum is white, opaque, hard, corrugated, leathery, slough-
ing, or ulcerated. Congestion is well marked. Strictures may
appear in chronic cases.

Treatment. Give tepid water and tickle the fauces. Use
white of egg or milk freely and mucilaginous agents. Tannic
acid, or carbonate of soda are antidotal by tending to precipitate
insoluble compounds.

POISONING BY SILVER.

Toxic doses of silver come mostly from materials used in the
arts. The photographer uses chiefly the nitrate, iodide, bromide,
cyanide and chloride. Taken into the stomach the silver salts
are less poisonous because they are largely precipitated as in-
soluble chloride or albuminate. The chloride and albuminate
are, however, soluble in solutions of alkaline chlorides and hence
even they may poison.

Symptoms. Colic, emesis in vomiting animals the vomited
matters blackening in the light, diarrhoea, great muscular weak-
ness, paresis, weak clonic spasms, and disturbed respiration.
The nervous symptoms are very prominent (Rouget and Curci).
Chronic poisoning produces emaciation and fatty degeneration
of liver, kidneys and muscles (Bogoslowsky).

Lesions. Patches.of congestion and of white corrosion on the
buccal, cesophageal and gastric mucous membrane, the presence
of the curdy white chloride of silver adherent to the gastric niu-
cosa. In chronic cases the visible mucosze and white skin may
have a slaty color.

Treatment. Emetics in vomiting animals. White of egg,
common salt largely diluted and followed by milk as antidotal,
demulcent and nutritive agent.

POISONING BY BARIUM.

Poisonous salts. Symptoms: spasms, peristalsis, defecation, urination,
restlessness, prostration, emesis, weak pulse, coma. Lesions: Moderate
congestion of gastro-intestinal mucosa. Treatment: alkaline sulphate,
anodynes, demulcents.

The salts of barium are irritant with a special action on the
nervous system shown by weakened action of the heart and
spasms or paresis of the muscles. ‘The chloride is used in
staining wool, the nitrate and chlorate in producing green colors
in fireworks, the oxide and carbonate in glassmaking, the chro-
mate by painters, and the sulphate for giving weight and body to
various white powders. The chloride is now largely used to
stimulate intestinal peristalsis in animals.

Symptoms. Barium chloride hypodermically produces tonic
and clonic convulsions, increased peristalsis, discharges of urine
and feeces, great restlessness, muscular prostration, emesis in
vomiting animals, hurried, shallow respiration, weak, thready
pulse, asthenia, coma, and death. :

Lestons. ‘There is congestion of the gastric and intestinal
mucosa, but thisis rarely violent, and corrosion and ulceration
are almost unknown. The agent indeed seems to act more
energetically upon the nervous system than on the mucosa of the
alimentary tract.

Treatment. 'This consists in giving an alkaline sulphate (sul-
phate of soda, potash, or magnesia), to precipitate the insoluble
barium sulphate, with anodynes (opium) and mucilaginous
agents. Or very dilute sulphuric acid may be used.

POISONING BY IRON.

Sulphate and chloride on empty stomach poisonous. Symptoms ; Colic,
emesis, rumbling, purging. Treatment: Alkaline or earthy carbonates,
tannic acid, albumen. Opium.

Sulphate and chloride are the principal poisonous compounds,
Both are comparatively harmless even in large doses taken on a
full stomach, while on an empty stomach they may cause violent
gastro-enteritis.

283

284 Veterinary Medicine.

Symptoms. Colicy pains, purging, emesisin vomiting animals,
more or less tympany and rumbling of the bowels and surface
coldness.

Treatment. Give carbonates of the alkalies, magnesia or lime
to precipitate the comparatively insoluble carbonate or oxide ; or
tannic acid or infusion of oak bark or galls. White of egg, milk
and mucilaginous agents. and opium may be required to allay
irritation.

POISONING BY CHROMIUM.

Chromic acid; chromate and bichromate of potash. Corrosive. Cause :
Gastro-intestinal inflammation, albuminuria, hamaturia, emaciation, digital
ulcers and sloughs, colic. Diarrhoea, vertigo, stiffness, weakness. Lesions.
Treatment : Emesis, stomach pump, demulcents.

Bichromate of potash is used extensively in dyeing, calico
printing, in the manufacture of porcelain, in chemistry and
photography, and to a slight extent in medicine, while lead
chromate (chrome yellow) is a valuable pigment. Chromic acid
is one of the most potent caustics, at a moderately high tempera-
ture dissolving all animal products that may be subjected to it.
The chromate and bichromate of potash are only less violently
caustic, producing deep and fistulous sores on the hands of the
dyers, and acting in a similar manner on the mucosa of the
alimentary canal. Twenty-eight grains of the bichromate given
by the stomach killed a rabbit in two hours, while 45 grains of
the chromate had no such effect (Gmelin). Pelikan found that
the bichromate acted like arsenic or mercuric chloride, producing
violent irritation of the stomach and intestines, followed by
albuminuria hematuria and emaciation: 1 to 5% grains proved
fatal to rabbits and dogs.

Workmen inhaling the bichromate dust, have inflammation,
ulceration and finally, destruction of the nasal septum, together
with skin eruptions and ulcerations.

Horses working at the factories have intractable ulcers of the
skin and sometimes shed the hoofs (B. W. Richardson).

Symptoms. ‘Taken by the mouth the bichromate causes colicy

Poisoning by Carbolic Acid. 285

pains, emesis in vomiting animals, diarrhcea, great prostration,
cold extremities, vertigo, stiffness or weakness of the hind limbs,
dilated pupils, weak pulse and death. If protracted the urine
may be bloody and albuminous.

Lesions. There is more or less intense congestion of the
stomach and intestine, yellow shrunken mucosa, abrasions,
sloughs, and ulcers, and congested kidneys with yellow cloudi-
ness of the epithelium of the convoluted tubes and congestion of
the glomeruli.

Treatment. Wash out the stomach by emesis or the stomach
pump and use albuminous and mucilaginous agents freely.

POISONING BY CARBOLIC ACID.

Susceptibility of cat and other animals. Fatal dose. Effect of dilution
and gastric plenitude. Concentrated is corrosive. Symptoms: Salivation,
dysphagia, anorexia, thirst, emesis, colic, arched back, odor of the acid,
dark, greenish brown, albuminous urine, tremors, lowered temperature,
debility, stertor, stupor, coma. Lesions: Whitened corroded mucosa, in-
flammation, ecchymosis, dark, liquid blood, brain effusions or extravasa-
tions, nephritic congestion. Treatment: Vinegar, alcohol, emesis, demul-
cents, Glauber salts.

The cat is the most susceptible to this poison. For dogs, cats
and rabbits from 3 to 4 drops per pound, is the minimum fatal
dose. For an ordinary dog the lethal dose is % to 1 drachm.
The horse has taken 3 ounces without fatal results, and 15 ounces
in a week (Munk). Much depends on the dilution of ‘the agent
and the plenitude of the stomach. In a concentrated state it acts
at once on the mucosa as a caustic abstracting the water and
forming a white eschar.

Symptoms. 'The concentrated acid causes salivation, dysphagia,
anorexia, thirst, emesis in vomiting animals, colics, arched back,
retracted abdomen, odor of the acid in the breath, dark or greenish
brown albuminous urine, trembling, lowered temperature, de-
bility, stertorous breathing, clonic or tonic spasms, paralysis of
the hind limbs, stupor, coma and death.

Lesions. In the mouth, throat, stomach and intestines are

286 Veterinary Medicine.

whitish, cauterized patches, with active inflammation beneath and
around them, and ecchymosis. ‘The blood is fluid and’ dark
colored, extravasations or effusions on the brain or in the lateral
ventricles, with pulmonary congestion and parenchymatous
nephritis.

Treatment. If available, give vinegar proportionate to the
amount of carbolic acid taken. Alcohol is a good substitute.
Emesis should be encouraged when available. Next mucilagin-
ous agents and bland oils to dilute the acid are required. Glauber
salts may assist in neutralizing and expelling the acid.

POISONING BY CREOSOTE.

Irritates, coagulates albumen, and blood, arrests heart, colic, emesis,
salivation, labored breathing, vertigo. Lesions: Congestion, corrosion,
dark clotted blood, odor. Treatment: Mucilaginous agents, emesis, oily
laxatives.

On the mucous membrane creosote has a very irritant action,
coagulating the albumen, causing violent inflammation. It also
coagulates the blood and when injected into the veins, stops the
action of the heart. Taken by the mouth it causes violent colics,
emesis in vomiting animals, salivation, laborious breathing, con-
vulsions, vertigo and death. At the necropsy the stomach is found
congested of a dull red color, and corroded, and the vessels contain
dark clotted blood. A dog died from a dose of 2 drachms. The
odor of creosote is marked.

Treatment. Emesis, white of eggs, mucilaginous liquids, and
oily laxatives.

POISONING BY SEEDS OF RICINUS COMMUNIS.

Superpurgation. Poison inseeds. Diluents, demulcents, stomach pump,
laxatives if necessary.

An over-dose of castor oil may kill by gastro-intestinal con-
gestion and superpurgation. Apart from the oil, however, the

Poisoning by Croton Seeds and Oil—Euphorbia. 287

seeds contain a very active poison, which has been fatally ingested
by horses with grain or otherwise. Five and a half ounces of
the seeds have proved fatal. (Pelletier. Wende).

The symptoms are those of acute colic and gastro-enteritis.
The indications are to wash out the stomach by abundant demul-
cents and the stomach pump, and if necessary to hasten the ex-
pulsion of the offensive matters by bland laxatives (olive oil,
Glauber salts).

POISONING BY CROTON SEEDS AND OIL.

Fatal dose without water. Vomiting animals. Superpurgation. Lesions.
Treatment : diluents, demulcents, stomach pump. Opiates.

One drachm of croton seeds given to a horse, without water
proved fatal in 24 hours (Morton) ; 2 drachms followed by all
the water the horse would drink produced most violent catharsis
followed by recovery (Hughes). Twenty to thirty drops of
croton oil proved fatal ; 8 drops in the jugular vein caused death
(Hertwig). It is much less fatal to cattle. Dogs and pigs vomit
it so readily that they usually survive with profuse catharsis.

The symptoms are profuse watery diarrhoea with tenesmus,
congested mucosz, rapidly increasing weakness and small pulse,
becoming imperceptible.

The /esions are violent congestion of the mucosa of stomach
and intestines, concentrated very largely on the czecum and
colon.

Treatment consists in abundance of mucilaginous liquids, which
the animal readily drinks, and washing out the stomach with the
stomach tube or pump. Opiates may be demanded to calm the
pain.

POISONING BY EUPHORBIA.

In Europe euphorbia lathyris has been found to produce in
animals, colic, constipation, tympany, followed by bloody
diarrhoea, stupor and hematuria. In America the euphorbia
corollata (large flowering spurge) and euphorbia ipecacuanhee
(ipecacuanha spurge) though less potent have a similar action.

288 Veterinary Medicine.

E. marginata and E. bicolor furnish a milky juice which has
been used to brand cattle, as it deters the screw-fly from infesting
the raw sore. ‘The euphorbia render poisonous water into which
it may be thrown.

Treatment consists in favoring elimination by emesis, and
abundant mucilaginous and demulcent agents.

SPURGE NETTLE.

Jatropha stimulosa, the spurge nettle of the southern states
proves very poisonous. Stock avoid it on account of its stinging
hairs.

POISONING BY BOX LEAVES.

The leaves of buxus sempervirens, used as a border in gardens,
contains an acrid principle. After eating 114 Ib. a horse had
colic, tympany and enteritis. After death the lesions of gastro-
enteritis were found (Weiss). Zveatment would be by stomach
pump, laxatives, demulcents and anodynes.

STAFF-VINE.

Celastrus Scandens, or climbing bittersweet, proved poisonous
to a horse that ate its leaves.

*

HORSE CHESTNUT.

Esculus hippocastanum, AX. Californica, and AB. pavia are
claimed to be poisonous to stock. The nuts are robbed of their
bitterness and rendered wholesome by steeping in an alkaline
solution and boiling.

POISONING BY DAFFODILS. (NARCISSUS POETICUS,
AND NARCISSUS PSEUDO NARCISSUS).

These common denizens of gardens produce intense gastro-
enteritis, profuse diarrhcea, spasms, stupor and weakness. Tyeat-
ment will not differ materially from that advised in box poisoning.

POISONING BY RANUNCULUS.

The vanunculus acris (tall crowfoot), repens (creeping crow-
foot), sceleratus (cursed crowfoot), and dx/bosus (butter cup), are
all more or less acrid and liable to produce gastro-enteritis when
taken in quantity. They are usually avoided by animals but will
sometimes be taken by accident with other vegetation. Sheep are
said to eat ranunculus bulbosus with impunity (Daubenton).
Both cattle and sheep suffered from the other species (Delafond,
Lipp, Brugnone, Delplanque). There were salivation, colic,
emesis in vomiting animals, diarrhcea, vertigo, spasms, grinding
of the teeth, arched back and staring coat. Zveatment would be
emesis or the stomach pump when available, mucilaginous drinks
andenemata. Johnson (Medical Botany of North America) had
a herd of cows abort for years on a field thickly set with ranun-
culus acris, but which ceased to abort when removed to a field
from which this weed was absent.

Delphinium Tricorne (stagger weed) has proved fatal to
cattle in Ohio in April when the fresh leaves appear.

D. Consolida (field larkspur) is deadly to cattle that eat the
seeds with grain.

D. Menziesii (purple larkspur) common in North Western
States may destroy sheep. Dr. Wilcox in Montana met with a
mortality of 250 out of 600 sheep from this cause. An extract
made from an ounce of the dried leaves killed a yearling lamb.
Yet, in May, in ‘Washington, Dr. Nelson fed 5 lbs. of the fresh
green leaves, and in 5 days no less than 24 lbs. without a fatal
result. The stage of growth of the plant has manifestly a con-
trolling influence.

D. Geyeri which forms tempting dark green tufts in the bare
Wyoming fields in spring often proves deadly to stock.

D. Recurvatum is a deadly growth of the wet, alkaline soil
in Southern California.

D. Trolliifolium growing along the coast from N. California
to Washington is very destructive to stock at all stages of its
growth.

Aconitam Napellus and A. Columbiana are especially
deadly to sheep, other animals avoiding them more.

Actea Alba (white baneberry) and A. Rubra (red baneberry)
are very toxic but usually repulsive to stock.

19 289

POISONING BY VERATRUM. VIRIDE. AMERICAN
HELEBORE.

Used in the early days by New England farmers to destroy
birds in the cornfields (Osgood). Taken internally it reduces the
fullness and frequency of the pulse, and if the dose be large
excites nausea, vomiting and purging with great prostration. In
the horse I have found anorexia, irritahility of the bowels, and
frequent retching. ‘The action is primarily on the heart and
nervous system and incidentally as an irritant on the gastro-
intestinal mucosa. Zyeatment consists in evacuation of the
stomach and the free use of mucilaginous drinks and diffusible
stimulants. Helleborus Niger, viridus and fcetidus have analo-
gous effects. Veratrum Californicum has killed horses.

Zygadenus Venenosus (death camas), unlike the esculent
camas, is deadly to man or beast that eats the bulb. Another
species (Zygadenus Elegano) ‘has proved destructive to cattle.

POISONING BY CICUTA MACULATA, ETC.

The American water hemlock is an energetic poison acting not
only as a narcotic but as a violent irritant to the gastro-intestinal
mucus membrane.

Cicuta Vagans (Oregon water hemlock) is comparatively
harmless in Summer, but its new fleshy roots in the Fall (No-
vember) are very poisonous to cattle (Knowles, Chestnut).

Cicuta Bolanderi found in swamps in California is also
poisonous.

Ceonium Maculatum (Spotted hemlock) common in the
Northern States, as in Europe, is deadly to stock in its fresh
condition, but much less so when dried in hay, having parted
with its volatile poisonous ingredients. :

POISONING BY COLCHICUM AUTUMNALE.

This agent expends its energy mainly on the digestive and
urinary systems. The symptoms are suppression of appetite and
rumination, thirst, ptyalism, grinding of the teeth, colic, emesis

290

Poisoning by Savin. Heath Family. 291

in vomiting animals, profuse, watery fcetid and often bloody
diarrhoea, the frequent passage of a clear urine, abortion in preg-
nant females, with short difficult breathing, weak pulse, pale
mucosze, coldness of the extremities, trembling, muscular weak-
ness, sunken eyes, dilated pupils, spasms and death. The activity
of the plant is greatest in July and August. On post mortem
examination the gastric and intestinal mucosz are violently
congested and the lumen of the bowel filled with a thin bloody
mucus. Congestion of the kidneys and bladder is usually present.

Treatment. Evacuation of the stomach, and abundance of
demulcents.

POISONING BY SAVIN.

The tops of the juniperus sabina when powdered and given to
dogs produce violent colic, vomiting, bloody feeces and urine,
spasms, paralysis, and death, with lesions of gastro-intestinal and
uro-genital inflammation. In cattle and sheep they caused tym-
pany, anorexia, colic, hyperthermia, and constipation followed
by a bloody diarrhoea. Horses took 4, 8 and even 12 ozs. twice
daily for eight days without any ill effect (Sick).

Treatment. Evacuate the stomach, and give demulcents.

HEATH FAMILY.

The Ericaccze furnish a number of poisonous plants, dreaded
by the stockowner.

Andromeda polifolia (wild rosemary), found in swamps in
New England, contains a potent narcotic poison—andromedo-
toxin, and the leaves prove fatal to sheep.

Azalea Occidentalis of the Pacific coast contains a similar
toxic principle and is dreaded by sheep owners.

Kalmia Augustifolia (narrow-leafed laurel,) and Kalmia
Latifolia (broad-leaved laurel, lamb-kill) often prove fatal to
sheep and calves through the contained andromedotoxin.

Ledum Groenlandicum (Labrador tea), and L. Glandulo-
sum (California Labrador tea) are carefully avoided by flock-
masters for the same reason.

292 Veterinary Medicine.

Leucothoé Catesbza (branch ivy or calf-kill of the Alle-
gheny mountains) and L. Racemosa (swamp L. of the Atlantic
Seaboard) prove fatal to all kinds of stock that eat them.

Pieris Floribunda (Mountain fetter bush of Virginia and
Georgia) and P. Mariana (stagger-bush of the eastern states)
are destructive to sheep and calves.

Rhododendron Maxima (the great laurel of the Alleghanies
and common in ornamental grounds) and R. Californicum are
notoriously poisonous to stock.

DOGBANE FAMILY.

In Apocynacez must be named the Nerium Oleander (a
common house-plant in the north and a garden or wild plant in
the south and west), Thevetia and Apocynum Androsaemifol-
ium (spreading dogbane) as most deadly acrid poisons to all kinds
of stock. In my experience a horse cropping a few leaves from an
oleander died in a few hours with violent gastro-enteritis. - The
dogbane is less poisonous when dried in hay.

MILKWEED FAMILY.

Asclepias Syriaca (common milkweed of the Old and New
World) is a violent irritant poison for man and beast.

Asclepias Eriocarpa (California milkweed) has proved es-
pecially deadly to sheep in barren valleys where other vegetation
is scanty. Also when mixed with hay.

Asclepias Mexicana (narrow smooth-leaf milkweed of the
Pacific coast) has proved especially fatal to sheep, calves and
cows that ate it mixed with hay.

POTATO FAMILY.

Many members of the Solanacez are poisonous, but mainly
through their narcotic properties.

Datura Stramonium (thorn apple, Jimson weed) now com-
mon in the United States proves fatal to cattle eating the young
leaves mixed with hay.

Thistle Family. Convalariacee. Pink Family. 293

Hyoscyamus Niger (henbane) common in North Atlantic
States proves poisonous to stock eating the fresh plant, and above
all that which has been dried in hay.

Solanum Dulcamara (bittersweet ) Solanum Nigrum (black
nightshade) and Solanum Triflorum (spreading nightshade)
of the Great Plains prove fatal to cattle, sheep, goats and swine.

Tobacco may be eaten fresh, but more commonly when par-
tially dried, and may prove fatal. It may also poison when ap-
plied on extensive sores, or when given medicinally in large
doses to expel worms or allay nervous disorders.

Potato tops or green tubers are also dangerous, but may be
rendered more wholesome by boiling.

THE THISTLE FAMILY.

Various members of the Carduacez are common poisons of
our fields.

Helenium Autumnale (sneezewort, snéezeweed, staggerwort),
common in southern and eastern pastures, proves fatal to horses,
cattle and sheep which eat it in large quantity.

Helenium Tenuifolium (fine-leaved sneezeweed), common in
the South, proves fatal to solipeds and probably to a less extent
for cattle, yet giving a bitter flavor to the milk and meat when
eaten in small amount.

Senecio acts slowly causing hepatic cirrhosis.

CONVALARIACE.

Convalaria Majalis (the lily of the valley) Is very poisonous
to horses, cattle and other animals.

THE PINK FAMILY.

Various members of the Alsinacez are poisonous.

Agrostemma Githago (corn cockle) is claimed to destroy
thousands of dollars worth of stock yearly in Indiana. The seeds
mixed with grain and even ground up with it and made into

204 Veterinary Medicine.

bread, have been especially harmful to poultry and other animals
eating it.

Spring Cockle (vaccaria), in the north west, as in Europe,
is destructive by reason of a sapotoxin-like ingredient in the
seeds.

OTHER VEGETABLE IRRITANTS.

List of gastro-intestinal irritants. Common Symptoms. General treat-
ment: emesis, stomach pump, diluents, demulcents, laxatives, enemata,
anodynes, antiseptics, tannic acid. Prevention.

Among vegetables which produce more or less disturbance of
the digestion, or congestion of the digestive organs are named
the following: Acorns in horses (Morton) ; tares; bird’s tre-
foil (lotus corniculatus, Colin) ; vetches at ripening (Gerlach) ;
laburnum (cytissus) horse and ox (Cornevin); hybrid and
sweet trefoil (Pilz); officinal melilot (Carrey); the field
poppy, digitalis and sndpdragon, seeds often mixed with wheat
and rye (Cornevin) ; conium maculatum, cicuta virosa, yew
leaves, lolium temulentum, and other forms of ryegrass
when ripening; chickweed (stellaria) killed 60 horses in 200
(Semmer) ; privet; clematis, aconite, tobacco, male fern,
aloes, horsetail (equisetum) when full of silica; mercurialis
annua, wild radish, resinous plants, pimpernel; CEnanthe
Crocata (water dropwort); giant fennel, anemone, phyto-
lacca (poke root); rhus toxicodendron (poison ivy), radicans
and venenata (poison sumac) ; buckwheat in flower (Moisant) ;
St. John’s wort, various species of lathyrus, artichokes in ex-
cess, spurry seeds, galega, bryony, the fruit of melia azeda-
rach (in pigs) (Dreux) ; nux vomica, podophyllum.

It may be added that the plants credited with causing the
‘loco’ disease (Astragalus mollissimus, Hornii, and lenti-
ginosus, Patersonii, Bigeloria, the Aragalus Lambertii, and
Crotoloria sagittalis, the oxytropis Lambertii, mutiflorus
and deflexa) cause diarrhcea and sometimes ulceration of the
intestines.

The farina of mustard is sometimes mixed with linseed cake
and (developing the active principles of that agent) produces a
severe and even fatal gastro-enteritis in cattle and sheep. The
wild mustard of the fields, being allowed to grow with the flax,

Poisoning by Cantharides and Other Insects. 295

or rape, the seeds mingle when harvested and thus the cake comes
to contain an injurious quantity of the mustard.

Symptoms. ‘These will vary much according to the predomin-
ating action of the individual poison on other organs, but when
they irritate the gastro-intestinal mucosa they have this in com-
mon, that they impair appetite and rumination, produce colicy
pains (perhaps salivation and vomiting), and constipation or
diarrhoea of varying intensity.

Treatment. Apart from the individual treatment demanded by
the special symptoms of disorder of other organs, it may follow
the same general line for all: Unload the stomach by tepid water,
ipecacuan, with tickling of the soft palate, or by the stomach
pump or tube, and follow this by abundance of mucilaginous
drinks. In cases attended by constipation a laxative of Glauber
salts, or aloes may be demanded, or assiduous mucilaginous injec-
tions. With an excess of irritation anodynes may be indicated.
When there is tympany and fcetor of the discharges these must
be met by non-irritant antiseptics, such as naphthalin or salol.
For many of the vegetable poisons tannic acid proves advantageous,
being at once an antiferment, and fitted to unite with organic
alkaloids, rendering them less soluble and otherwise often chang-
ing their properties.

Prevention should be sought by removing all such poisonous
plants from pastures, or land used for raising fodder crops.

POISONING BY CANTHARIDES AND OTHER INSECTS.

Action on genito-urinary and alimentary tracts. Dysphagia, congestion,
retching, diarrhcea with mucus and blood, diuresis, enuresis, albuminuria,
retracted testicles, prostration. Lesions : urinary and gastro-intestinal con-
gestion, ecchymosis. Treatment: emesis with ipecacuan, demulcents,
avoidance of oils, alcohol and chloroform. Other vesicant beetles and larva.

Spanish flies have a primary physiological action on the genito-
urinary organs, but when introduced by the stomach they prove
direct and violent irritants to the gastro-intestinal mucous mem-
brane. ‘They cause redness of the buccal mucous membrane,
difficulty of swallowing, retching, emesis in vomiting animals,
diarrhoea with mucus and bloody feeces, diuresis or enuresis with

296 Veterinary Medicine.

albuminous urine, retraction of the testicles,‘ prostration, per-
spiration, paresis and death.

Lesions. Active gastro-intestinal congestion with ecchymosis,
marked congestion of the genito-urinary mucosa especially that
of the bladder.

_Treatment. Emesis with ipecacuan and tepid water, followed
by abundant mucilaginous or albuminous liquids. Flaxseed tea,
gum arabic, and white of egg are useful. Avoid oils, alcohol
and chloroform which dissolve the cantharides.

Among other insects which act as vesicants may be named the
cockroach (blatta orientalis) and the potato beetle (cantharis
vitatta), also the cantharis cinerea, cantharis marginata, cantharis
atrata, and cantharis nuttalli, The larve of various lepidoptera,
thus army worm, Cnethocampa primivora, Cnethocampa
processionea, liparis auriflua, lithosia crinola, and the larve
of the artica cassus ligniperda, and pieris brassica are
covered with stinging hairs charged with formic acid and perhaps
an enzyme, which are shed with the skinin passing into the state
of chrysalis, and getting mixed with fodders produce violent
stomatitis, hemorrhagic gastro-enteritis and nephritis.

POISONING BY FUNGI, BACTERIA AND THEIR
PRODUCTS IN FOOD.

Poisons in spoiled food. Moulds, rust, smut, bacteria, toxins. Action of
moulds on rabbits, on alimentary and nervous systems. Smuts, ergots and
their congeners. Tetanizing and paralyzing products. Duration of symp-
toms.

Food is usually spoiled by the growth of moulds, rust, smut,
bacteria and the toxins which they produce.

Kaufman has experimented with moulds on rabbits. He found
that aspergillus glaucus (green mould) grown on bread pro-
duces a fatal infection in the rabbit even in very minute doses
(7y milligramme) ; that it will attain this ina neutral or even
slightly acid medium as well as in an alkaline one; and that the
spores retain this pathogenic activity for six months at ordinary
temperatures. The aspergillus glaucus, penicillum glaucum, and
mucor mucedo affect the intestinal organs only, while ascophora

Cryptogamic Poisoning in Solipeds. 297

oidium aurantiacum affect the nervous system as well, The
smuts (ustilago) and ergots (claviceps purpurea) vary consider-
ably in their potency according to the conditions of their growth
and the stage of their development, yet experiment has shown a
special action on the vasomotor nerves leading to nervous dis-
orders, circulatory troubles, and trophic disease. In connection
with ustilago maidis (corn smut) there are usually found bac-
teria, such as bacillus maidis and bacillus mesentericus fuscus,
and the combined products of these and the ustilago have been
studied by Lombroso, Dupreand Erba. These observers isolated
a red oil with the tetanizing action of strychnia, and oleo-resinous
substances having bases which they named maisine and pellag-
rozeine, and which had a paralytic action on the nerve centres.
Pellizi and Tirelli cultivated the bacteria of damaged maize and
found that the sterilized cultures, introduced into rabbits hypo-
dermically or intravenously caused muscular jerking, exaggera-
tion of the reflexes, tetanic spasms and paralysis which lasted
for fifteen days after the injection. This is exactly in line with
the causation of contagious bacteridian diseases in which the
ptomaines and toxins are, as a rule, the immediate pathogenic
factors.

Butler, Nesom and others have shown that frequent, and
widely extended epizootics of staggers, in horses and mules, in
the Southern states, are caused by feeding spoiled western corn
which is sold as fit for stock only. "The losses are estimated at
tens to hundreds of thousands of dollars annually.

CRYPTOGAMIC POISONING IN SOLIPEDS.

Prominent symptoms, asthenia and vertigo. Vary with cryptogam,
merge into zymotic diseases. Causes: grain harvested damp and moulded,
bluish or greenish, hay greenish white, brown or black, clover reddish,
musty fodder and diuresis, indigestion, gastric intestinal and systemic
paresis, somnolence, delirium. Rusts, spring and summer, their evolution.
Bunt, smut, produce fever and paralysis, spasms, abortions and dry gan-
grene, buccal erosions ; evolution of ergot, honey dew on leguminous plants
causing skin disease, bacterial ferments, diplococcus, streptococcus from
foul water, causing enteritis. Symptoms: adynamic, dullness, blunted
sense, pendent head, ears, eyelids, congested, yellow, ecchymosed con-

298 Veterinary Medicine.

junctiva, fever, tympany, colic, constipation, dung small, round, coated
masses, vertigo, sometimes fatal diarrhoea, or colliquative diuresis; vertz-
ginous: fever, anorexia, yellow mucose tardy breathing, costiveness. colics,.
stupor, somnolence, giddiness, heavy steps, stumbling, delirium, push head
against wall, clinch jaws, grind teeth, make walking or trotting or plunging
motions, or pull on halter and fall, amaurosis, paralysis, coma. Remissions.
Death in one day or upward. Resumption of functions and recovery.
Diagnosis : from meningo-encephalitis. Lesions : gastro intestinal congestion,
infiltration, ecchymosis, fermenting ingesta, congestion of mesenteric glands,
liver, brain and meninges. Leucin and tyrosin in urine. Treatment : stomach
pump, antiferments, potassium iodide, purgatives, enemata ; for brain, bleed-
ing, sedatives, ice, suow, elevation, derivatives, prevent mechanical injury.

The most prominent features of cryptogamic poisoning in these
animals are asthenia and vertigo. In dealing with such poison-
ing, however, we must bear in mind that we have in hand, not
one particular disease but a group, differing among themselves
according to the cryptogam and its products which may be
present :—a group moreover which overlaps more or less the true
zymotic diseases.

Causes. Oats, barley and other grain or fodder which has been
put up damp, and especially ground feed, becomes speedily over-
grown and permeated with moulds, especially penicillium
glaucum, aspergillus flavus and glaucus, mucor racemosus,
and ascophora mucedo which give a bluish or greenish color
and heavy odor, rob it of its nutritive constituents and charge it
with toxic products. On mouldy hay it is common to find
aspergillus candidus, botrytis grisea, torula herbariorum,
and eurotium herbarium which form a greenish white or
brownish dust. The spoeria herbarium is characterized by
small black or brown spots with yellowish, brown or black spores,
The peronspora trifolium attacks growing clover (clover sick-
ness) and isaria fuciformis the fescue grasses. The latter has.
a red color and mucous consistency and is charged with produc-
ing fatal poisoning in cattle.

Mouldy or musty oats, or other grain or fodder have long
been notorious for producing diuresis in horses with excessive
elimination of phosphates, extreme emaciation, weakness and
death. In other seasons, and probably because of a difference
in the fungi or their products they have caused widespread en-
zootics of indigestion with paresis of stomach and bowels, and of

Cryptogamic Poisoning in Solipeds. 299

the systemic muscles. Paraplegia is a common manifestation,
suggesting lesions of the spinal cord, and in other cases there are
general paresis, somnolence and delirum suggesting cerebral
lesions, (Staggers).

Gillespie records an enzootic of gastro-intestinal indigestion
and tympany among the horses of a battery of artillery in Af-
ghanistan from eating mouldy grass. Frohner, Martin and Var-
nell have seen cases of poisoning by moulds without digestive,
urinary or febrile troubles.

Of rusts growing on grain crops there are two chief varieties ;
the spring rust (uredo rubigo vera) which commences as light
yellow patches on the leaves and stems, which change to black as
the fungus approaches maturity ; and the summer rust (uvedo
linearis) which grows toa larger size and assumes a browner
color. Each of these passes through an evolutionary cycle, the
small preliminary patches (uredo) passing into the mature fun-
gus (puccinia rubigo vera and puccinia graminis.) Then it
must pass through an alternate generation on another, family of
plants before it can again grow on the graminez.

Bunt produced by the /2/etia caries attacks the grasses and
small grains. The growing seed (wheat especially) 1s changed
into a black or olive colored powder, having a fishy odor. If the
stems are attacked the leaves become pale, withered and dry. It
can only be detected by carefully examining the individual seeds.

Other forms of smut are the ustilago carbo and ustilago
maidis the familiar black smuts of small grains and maize. These
develop by preference in the growing seeds, but also in the stem
and leaves. The ¢il/etia caries is as a rule more poisonous than
the wstilago the effects being mainly hyperthermia and paralysis.
There is, however, a tendency to spasmodic contractions, and
abortions, and dry gangrene will occur from smut. The author
has seen a large herd of cattle attacked with gangrenous sores
around the coronet, which were promptly stopped when the light,
smutty ears of corn were no longer given. In other cases the
hoof was in part separated from the quick and creaked when the
animal walked.

In connection with the gangrenous ergotism of cattle, the
author has found on the same farms and feed, horses ‘with ulcers
on the buccal mucosa and gastro-intestinal indigestion. Ergot

300 Veterinary Medicine.

affects the seeds in nearly all the small gramineze and is pro-
duced by the claviceps purpurea which first attacks the ovary of
the seed (sphacelia stage), then it invades the whole seed which
grows out from the glumes as a hard, dark or purple spur-like
process (evgot stage), then falling on the ground it grows upasa
minute stalk with rounded head containing spores.

Honey dew growing on leguminous plants is reputed to cause
skin disease in white horses and on the white spots of dark horses,
from which those not eating the diseased plants escaped.

Bacterial ferments have an equally bad reputation. Bastin
records the poisoning of five foals by fermented rye; Dieckerhoff
describes an acute gastro-enteritis with congestion and swelling of
liver, spleen and kidneys, as the result of microbes and their
products in the fodders. Galtier traced a pneumo-enteritis in the
horse to two cocci, a motile dzplococcus and non-motile streptococcus.
Both stained in aniline colors, and were bleached by iodine. They
grew in ordinary culture media above 50° F. but most freely at
98° F. ‘The animals were infected by drinking putrid water or
spoiled fodders in which the microbes were contained. The
change to boiled water in the former case led to their prompt dis-
appearance. Reynal, Cailleux and Foucher have also adduced
instances of severe enteritis in the horse from drinking putrid
water. ‘These animals showed active congestion of the intestinal
mucosa with abundant infiltration of the sub-mucosa.

Bouley found 14 cases in one stable, the owner of which had
marketed the good fodder and kept the spoiled for home use.
Barthelemy, Alasonniere, Lombroso and Hausmann, Clichy, Rey,
Gamgee and others give similar examples.

A large number of observations show the dangerous results on
the horse of mouldy bread, including colics, vertigo, profuse
sweating.

Symptoms. When Adynamia prevails there is great dullness
and depression, the senses are blunted, the head depressed rest-
ing on the manger, the eyes sunken, weeping and half covered
by the drooping upper lid, the conjunctiva is congested, some-
times yellow or marked by petechize. The mouth is hot the
lower lips pendent, the tongue furred, the abdomen somewhat
tympanitic, with slight colics, but with little rumbling or indica-
tion of peristalsis. There is a primary constipation, a few small,

Cryptogamic Poisoning in Solipeds. 301

hard pellets being passed with effort. the temperature may be
102" to 104°, breathing short, pulse small, weak; the walk
unsteady, the animal preferring to stand completely apathetic.
In some cases a profuse diarrhcea sets in and may prove fatal.

In the cases attended by diuresis, the weakness is extreme,
emaciation advancing rapidly, but the other symptoms of nervous
depression are less marked, the poisons being apparently elimi-
nated by the kidneys (see diuresis).

In the Vertiginous form the disease may set in with more or
less hyperthermia, anorexia, a dislike particularly of the spoiled
fodder, yellowness of the visible mucose, slow breathing, small
accelerated pulse, costiveness, tympany, colics more or less
intense, tenderness of the belly, and sooner or later marked ner-
vous disorder. This may be in the form of stupor, the head
resting in the manger, the senses are manifestly clouded, the
animal walks unsteadily, staggers, steps heavily, striking the
feet against obstacles, and stumbling. At the end of a variable
number of hours (2 to 6 or 8 after feeding) nervous excitability
and vertigo may supervene. He may push the head against the
wall, the jaws clenched, grinding the teeth, the eyes fixed, pupils
dilated, facial muscles contracted, respirations hurried, heart pal-
pitating and the skin perspiring. He may continue in this posi-
tion, moving his feet as if walking, or he may rear plunging his
feet into the manger or fall back over, and rising push anew
against any object he may come in contact with. Coulbaux
speaks of rabiform symptoms such as attempts to bite but any
such deliberate purpose is rare.

There may follow complete amaurosis, insensibility to pricking
of the skin, and even paralysis or coma. MHyperesthesia may
also be temporarily present.

Course. emissions and exacerbations usually alternate, the
duration of the former furnishing some criterion by which to
establish a favorable prognosis. Death may take place in 24
hours or it may be delayed for several days. Recovery is usually
heralded by the resumption of defecation and urination, and the
return of appetite. It is liable to be at first only partial, some of
the senses remaining dull, or a general stupor persisting.

Diagnosis. In all such forms of poisoning there is the history
of the ingestion of the toxic matters, and in any suspicious

302 Veterinary Medicine.

looking cases a careful examination of the food should be made.
From meningo-encephalitis the presence of the abdominal dis-
order will serve to identify and to incriminate the food.

Lesions. These vary much with the poison. There is always,
however, inflammation of the gastro-intestinal mucous membrane,
usually with ecchymosis, and infiltration of the sub-mucosa.
The contents of the bowels are imperfectly digested, the mesen-
teric glands congested and énlarged, the liver congested and
softened, and the brain and its meninges hyperzemic or infiltrated,
The leucine and tyrosine present in the urine during the acute
attack is said to disappear when improvement sets in (Pellagi,
Azzaroli).

Treatment. ‘The first object must be the removal or neutraliz-
ing of the poison. In some instances the stomach pump or tube
might be tried. Usually one must fall back on antiferments such
as naphthol, naphthalin, salol, salicylic acid, and aboveall iodide
of potassium. The last checks the growth of the fungi or bacteria
and favors elimination of the toxins. It may be given freely to
act on the kidneys. Creolin, 1144 drachm, repeated three times a
day has been found effective (Albrecht). In addition the action
of the bowels may be solicited by full doses of sulphate of soda
and abundance of water.

When the brain is implicated Cadeac recommends bleeding as
an eliminating as well as asedative measure. In any case use cold
water, snow or ice to the head, elevation of the head, and purga-
tives which may as a rule bedoubled, Potassium iodide or other
antiseptics should be pushed, and diuresis as well as a relaxed
condition of the bowels maintained. Counter irritants such as
mustard may be applied to the abdomen, and enemata used at
frequent intervals. It is important to fix the patient to a ring in
the center of a box stall or barn to keep him from injuring
himself.

CRYPTOGAMIC POISONING IN RUMINANTS.

Moulds and bacteria in brewer’s grains, or the marc of beet sugar or cider
factories derange digestion, or cause abortion. Spoiled potatoes cause en-
teritis, vertigo, palsy, in sheep, nephritis and cystitis. Mouldy bread
causes indigestion, urinary and nervous disorder. Mildew. Musty grain
and fodder asin the horse. Ergot causes winter and spring gangrene of
skin, feet, limbs, ears or tail, lethargy, palsy, spasms, delirium, abortion ;
variation in toxicity with stage and condition of growth, privation or liberal
supply of water, or succulent vegetables. Symptoms: varying, mouldy
bread causes digestive and urinary trouble, with marc or ensilage, develops
slowly, impaired appetite, salivation, tympany, colic, diarrhoea, debility,
‘paresis, spasms, delirium. Duration 5 hours to 2 weeks. Gangrenous er-
gotism, necrotic sore, slough hard, dry, leathery, black, living parts at de-
marcation line pink or purple, puffed up, tender, necrosis involves all soft
tissues and bone; nervous form; abortion form. Lesions: congestion of
stomach, bowels, mesenteric glands, brain and meninges, petechize. Diag-
nosis, from anthrax, from coccidian hemorrhagic dysentery, from foot and
mouth disease, from rinderpest. Prevention, stop or regulate the injurious
fodder, salt and pack the fresh grains or marc. Treatment: antiferments,
potassium iodide, saline purgatives, stimulants, oil of turpentine, injections,
derivatives.

Causes. The growth of moulds on or in brewer's grains,
which have been preserved without salting and close packing,
has at times rendered them dangerous poisons (Duvieusart, We-
henkel, Schiitz). the refuse or marc of beet sugar factories, or
of cider works may act in a similar manner. These products, at
first neutral or only slightly acid, undergo an acid fermentation,
with an abundant production of acetic, lactic or butyric acid
which adds materially to their action in deranging digestion.
‘These agents usually require a large amount to prove deleterious,
about 150 to 200 lbs. aday. Arloing found three active microbian
ferments in the pulp of the sugar factories, and four in that of
the distilleries. The marc of apples has even caused abortion
(Cornevin).

Spoiled Potatoes have caused adynamic enteritis, with ver-
tigo and paralysis (Zimmermann, Grabin, Hohne) and in sheep
‘symptoms of nephritis and cystitis as well (Kloss).

Mouldy Bread has been found to cause indigestion and cere-
‘bral disturbances in cows (Cagny) or nervous disorders without

393

304 Veterinary Medicine.

digestive, urinary or febrile trouble (Fréhner, Martin and Var-
nell).

Mildew on the leaves of a grapevine has also poisoned six cows.
(Bisseauge).

Musty grain and fodder has the same general action as on the
horse and produces paraplegia and other nervous disorders with
or without digestive troubles.

The isaria fucitormis has caused the death of cattle which ate
the grasses infested by it.

When we come to the ergots and smuts we find even more
evidence of poisoning than in the horse. ‘Toward the end of our
long winters in the Northern States we occasionally find wide-
spread gangrenous ergotism from eating infested hay, the
lesions varying from simple sores around the top of the hoofs, in
the inter-digital spaces or on the teats and mouth, to loosening of
part of the sole or wall, shedding of the entire hoof or sloughing
of the entire limb—just above the hoof, at the fetlock, or in the
metatarsal region. Portions of the tail or ears will similarly
slough. This appears to be mainly due to the lessening of the
calibre of the capillaries by contraction of their walls, under the
action of the ergotin and secalin, seconded by the cold of the
season. Cold is, however, by no means essential to its produc-
tion. The other most common form of ergotism is the action on
the nervous system. The contraction of the cerebral capillaries
and disturbance of the circulation lead in some cases to a condi-
tion of lethargy and apathy in which the animal fails to eat or
ruminate and gradually falls into marasmus, or paralysis may be
induced, or delirium and spasms. Then finally there is the
familiar form of abortion induced apparently by the contraction
of the involuntary muscles of the womb and of its capillary
vessels.

There is, however, a great difference of opinion as to the dele-
terious action of ergot. Various experiments with large doses of
ergot on pregnant animals have failed to produce any sign of
abortion. The agent, however, varies in its nature according to
the conditions under which it grew and the stage at which it was
collected, so that the failure to produce the expected result in a
given case can by no means be accepted as disproving its patho-
genic properties under other conditions.

Cryptogamic Poisoning in Ruminants. 305

The same remarks apply largely to the action of the smuts,
which are often eaten in large quantities with impunity, especially
if plenty of water or succulent vegetables are allowed, whereas
under other conditions as in winter, under the action of cold, with
the usual water supply frozen up, and no succulent food, it proves
very destructive.

Symptoms. These vary with the particular poison: With
mouldy bread the symptoms may come on promptly with indi-
gestion, tympany, constipation, marked irritation of the urinary
organs, and it may be nervous disorder. Sometimes, as noted
above, the narcotic action is shown with paresis or paralysis and
stupor without any manifest disorder on the part of the digestive
or urinary functions.

Most commonly with mouldy fodders, grains, marc, or ensi-
lage the results are tardily developed and only after long con-
tinued use of the spoiled food. There is then loss of appetite,
and rumination, drivelling of saliva, some tympany, and ab--
dominal pain shown by frequent movement of the hind limbs,
lying down and rising. The bowels may be costive at first, but
this early gives place to a fcetid diarrhoea, with weak rapid pulse
(100 per minute) palpitations and hurried breathing. The walk
becomes weak, unsteady, staggering or stumbling, and there may
appear marked paresis especially of the hind parts. When
nervous excitement sets in there may be twitching of the muscles
of the neck, shoulders or thigh; the eye rolls or becomes fixed
and the pupils are dilated ; the muscles of the face are contracted
and the jaws clinched, with grinding of the teeth. Bellowing or
pushing of the teeth and nose, the forehead or horns against the
wall or other obstacles, or the dashing violently against obstacles
is occasionally observed, and indicates in most cases an unfavor-
able termination.

The duration of the malady is uncertain. It may not be over
five or six hours in acute cerebral cases, and especially in sheep,
and again it may be prolonged for one or two weeks. Death
often takes place in convulsions.

In gangrenous ergotism a necrotic sore with more or less
surrounding swelling may be seen, and a line of demarcation
forms of a pink or purplish aspect along which the separation of

20

306 Veterinary Medicine.

the dead tissue takes place. The slough is usually of a dark red
or black color, the red globules having apparently migrated into
the tissues and piled up in the capillaries in the early stages of
stagnation. When the line of separation is higher, the line of de-
marcation completely encircles the limb, the inflammation and
swelling is very marked just above this line, the skin and soft
tissues beneath drying and withering up into a dark red leathery
mass, and this is gradually separated by the formation of a
granulating surface above. The process of separation takes place
much more slowly through the bony tissues, and not unfrequently
the soft tissues having become detached, the lower part of the
limb is separated at the first joint below the line of demarcation
and the bone from that line down to its free end remains asa
projecting necrosed stump. In the ear or tail the necrotic por-
tion withers up into a stiff rigid shrunken slough which becomes
detached sooner or later by mechanical violence.

In the nervous ergotism the symptoms are largely those of
the adynamia, paresis and convulsions already described.

In abortion from ergotism there are usually few premonitory
symptoms, and the occurrence is to be explained by the number
of victims in a herd eating ergot or smut.

Lesions. These vary greatly. Usually the congestion and
inflammation are most prominent in the abomasum and small in-
testine, complicated by ecchymosis and even extravasation which
may so thicken the mucosa as to block the intestine (Walley).
The mesenteric glands are usually gorged with blood and of a
deep red. The brain may be nearly normal or violently congested
and with its meninges covered with petechiz.

Diagnosis. From anthrax this affection is distinguished by the
absence of the specific large bacillus in the blood and of the
marked enlargement of the spleen, by the great prominence of
the nervous symptoms in many cases, and by the history of a
dietetic cause. :

From the coccidian hemorrhagic dysentery it is diagnosed by
the absence of the coccidia in the stools and the predominance of
the nervous systems.

From foot and mouth disease, the gangrenous ergotism is dis-
tinguished by the facts that the sores are in the nature of sloughs,
and not vesicles, and that some members of the herd are almost

Cryptogamic Poisoning in Ruminants. 307

certain to show sloughing of the limb at some distance above the
hoof. More important still is the fact that the daintily feeding
sheep and the pig kept in the same yards do not suffer from the
ergotism,

From rinderpest it is differentiated by the fact that the sores
on the mouth (when present) are not of the nature of epithelial
concretions, and they do not appear on the vulva, and more sig-
nificant still, there is no indication of the introduction of the
disease by contagion nor of its rapid progress from herd to herd.
The immunity of sheep from gangrenous ergotism is another
significant feature.

Prevention consists in putting a stop to the supply of the altered
food or, if it must be given, in giving it in small quantities only
with abundance of water or fresh succulent aliment. In the
case of grains or marcs the fermentation may be checked by
adding % per cent. of common salt and packing the material
firmly in a close box or silo.

In ergotism, succulent food, water ad libitum, stimulants, poultices, fo-
mentations or wet bandages, a warm building and pure air are all important.
Usually ergot and smut can be safely fed in relatively large amount with a
liberal ration of potatoes, turnips, beets, green food or ensilage.

Treatment does not differ materially from that advised for the’
horse. Antiferments including potassium iodide, and saline pur-
gatives stand at the head of the list. Stimulants may be de-
manded to rouse the torpid bowels and nervous system and un-
less contraindicated by gastro-intestinal inflammation oil of tur-
pentine offers itself as at once stimulant, antiseptic and eliminat-
ing. Injections and counter-irritants are of use. Then cold (ice,
snow, water) to the head, and the confinement of the patient so
that he cannot injure himself or others are not to be neglected.

CRYPTOGAMIC POISONING IN SWINE.

Spoiled foods. Toxic rye. Botulism. Brine poisoning. Flesh of over-
driven (leucomaines). Symptoms: from mouldy bread, brain disorder, gas-
tric, urinary, heematic; from brine, restlessness, convulsions, eructations,
vomiting, weakness, paresis. Lesions: congestion of stomach, bowels and
mesenteric glands ; with brine, heart and skin charged with black blood,
congestion of brain, kidneys and bladder. Petechiz. Treatment: empty
stomach, emetics, purgatives, potassium iodide, antiferments, sedatives, cold
to head, enemata, counterirritants. Prevention.

Causes. Spoiled foods of all kinds such as mouldy bread,
musty meal, spoiled grains of all kinds, or rotten potatoes, or
apples are common causes of poisoning. In specimens of toxic
rye Woronin found four fungi: fusarium roseum, gilberella
Sanbinetti, belminthosporium, and cladosporium herba-
rum. Prilleux and Delacroix have obtained a fifth, endoco-
nidum temulentum. Rye so affected produced nervous dis-
order in swine, dogs, birds and even in man. Pigs often die
from botulism, being fed flesh in a more or less advanced stage
of putrefaction. Old meat brine is also a source of toxin and
ptomaine poisoning since its toxic property increases with age
which is not the case with a mere solution of common salt. Yet
this is very deadly to the pig, a half pint often proving fatal.
Kuhnert records that the flesh of an overdriven horse {proved
fatal to the pigs that ate it.

Symptoms. From mouldy bread the pig becomes dull, stupid,
sluggish, stiff, stilty and staggering in his gait, and usually
costive. There are usually signs of colicy pains, inappetence,
frothy lips, champing of the jaws, yawning, retching and vomit-
ing. ‘The mucosz become yellow and the urine red and albu-
minous.

The symptoms caused by old brine are more violent. There
are dullness, prostration, and inclination to lie, but at short inter-
vals the animal gets up and wanders round, moving stiffly, is
seized by tremors and finally convulsions, in which he falls to
the ground, dashes his head from side to side, champs his teeth,
rolls his eyes and froths at the mouth. There are usually eruc-
tations and often vomiting which does not, however, give the

308

Cryptogamic Poisoning in Carnivora. 309

desired relief. The animal becomes rapidly weaker and though
unable to rise has frequent paroxysms of trembling and other
nervous symptoms.

Lesions. With mouldy bread the congestion of the gastric
and intestinal mucosa, and of the mesenteric glands are marked
features. With brine there is in addition the heart gorged with
black, tarry blood, the skin and subcutaneons connective tissue
shows a similar dark congestion, also the brain and its mem-
branes and the kidneys and bladder. Petechiz are abundant on
the serous membranes and other parts of the body.

Treatment. Evacuate the, stomach by tickling the fauces,
giving tepid drinks, or ipecacuan. Follow with purgative of sul-
phate of soda and diuretics especially potassium iodide. Potas-
sium bromide, sodium salicylate, or salol may be given to calm
nervous excitement and check fermentation. Degoix recommends
chloral hydrate, enemata, cold to the head, and counter-irritants
and in very prostrate conditions stimulants may be employed.

‘The most important measure, however, is the cutting off of the
supply of the poison and the administration of a wholesome diet.
Medicinal treatment is too often unsatisfactory and will seldom pay
for the trouble; prevention is the one ratlonal and economical
measure.

CRYPTOGAMIC POISONING IN CARNIVORA.

Botulism. Racial immunity. Acquired immunity. Gastric secretions,
protective. Bacteria in septic beef, old brine, stale fish, privy air. Symp-
toms: sudden onset, colic, nausea, retching, vomiting, septic vomit, fever,
tender abdomen, bloody, foetid, mucous diarrhcea, prostration, death in three
to twenty-four hours. Lesions: of gastro-enteritis, ingesta foetid, conges-
tions and petechiz of other organs. Treatment: emetic, laxative, diuretics,
potassium iodide, antiseptics, demulcents, stimulants.

Causes. What is called dotudism in man is not uncommon in
carnivora. Eating carcasses of animals that have died of disease,
of poisoning, etc., in a raw condition and too often in an ad-
vanced state of putrefaction, they are liable not only to infection
by the pathogenic or poisonous microbes, but also to direct

310 Veterinary Medicine.

poisoning by the ptomaines and toxins. ‘There are however cer-
tain protective conditions. Accustomed as this class of animals
is to the consumption of such food, they have by selective evolu-
tion acquired an insusceptibility to many such poisons which
would prove deadly to the herbivora. Again the mature dog or
cat has already been subjected to many of these poisons and hav-
ing survived them has acquired an immunity which renders it
comparatively safe for the future. The antiseptic power of the
gastric secretion of the dog may be easily shown, by letting him
bolt a moderate piece of putrid meat, and killing him ten or fif-
teen minutes later when the mass will be found in the stomach
without odor of decomposition. He succumbs to the poison
either when the quantity ingested is too large, or when the diges-
tion is from any cause deranged and the gastric secretion im-
paired. Anthrax flesh may produce pharyngeal or intestinal
anthrax in the dog. Inthe animal with temporarily impaired
immunity the more virulent septiceemias may prove infecting.
From putrid beef the following pathogenic bacteria have been
isolated: 1. Gartner and Basenau have independently isolated
bacillus bovis morbificans which forms clear colonies on the
surface of peptonized gelatine, and brownish ones beneath the
surface, and coagulates milk in 24 hours. ‘This is short with
rounded ends, very motile, non-liquefying, and capable of surviv-
ing the freezing temperature. Its toxins are not destroyed by
boiling. It causes enteritis, or subcutem debility, somnolence,
and stupor. ‘This bacillus was pathogenic to mice, rats, guinea-
pigs, rabbits, goats and calves but had little effect on dogs or
cats. 2. The bacillus of Poels which produces paraylsis. 3. The
bacillus of Gafky which performs very rapid gyratory move-
ments only, and is not found in the muscles.

Old Brine is as poisonous for the dog as for pigs. Six to nine
ounces proved fatal. (Reynal).

Stale Fish has been known to prove poisonous in the same
way.

Three dogs that were made to breathe the air over a foul privy
were seized with vomiting, fever and diarrhcea.

Symptoms. These usually develop six or more hours after a
feed. The earlier symptoms are those of digestive disorder.

Diarrhea, Scouring. 311

There is colic, nausea, retching, vomiting of septic or bilious
matter, ardent thirst, dry mouth, furred tongue, redness of the
buccal mucosa, and tenderness of the abdomen. Diarrhoea sets
in early and may become bloody, fcetid and dysenteric. There
is usually much prostration and debility so that apart from his
compulsory movements under the colics the animal remains most
of the time curled up. Fever is usually slight but the tempera-
ture may riseto 105° F. Death may take place in 3 hours, or
may be deferred 24 hours or longer.

Lesions. ‘There is usually gastro-enteritis, the mucosa being
congested, red, edematous, with petechize, and congestion and
swelling of Peyer’s patches, the solitary glands, the mesenteric
glands, the liver and kidneys. The contents of the bowel are
brownish red, and an effusion into the peritoneum is common.
The spleen is often engorged and enlarged. Congestions of the
lungs and brain are common.

Treatment. Evacuate the stomach by ipecacuan, etc., and the
bowels by a purgative. Next seek elimination of the toxins by
potassium iodide and other diuretics. Antiseptics (calomel, salol,
naphthalin) to counteract the further formation of toxins, and
demulcents by draught and enema are indicated. In cases of
great prostration, heart and nerve stimulants may be useful.

DIARRHG@A SCOURING.

Definition. Concomitant of other affections. Causes: Congestion, effu-
sion from small and large intestine, irritants in bowels, or blood, chill or
other shock acting as reflex, cold drink and violent exercise, aqueous food,
cooked, pulped ; irritants, feculent concretions, parasites, fermentation pro-
ducts, diseased teeth, jaws or salivary glands, drink after grain, gastric he-
patic or pancreative disease, spoiled food, purgative agents in food, fever
products, purgative waters, rains, dews, damp stalls. etc., fear, ‘‘ washy ”’
horses, nervous animals, root diet, cestrum, hepatic torpor, equine suscepti-
bility. Symptoms: with root diet, with much or little bile, slight cases do
not affect system, in severe cases, tympany, pawing, straining, foetor, in in-
fective diseases; complications, laminitis, enteritis, pneumonia. Treat-
ment : remove or expel cause, demulcents, laxatives, anodynes, antiseptics ;
chronic cases, iron, bitters, antiseptics, astringents, dietetics, rest.

Definition. A frequent discharge of fluid or semi-fluid evacua-

312 Veterinary Medicine.

tions from the bowels without excessive griping or painful
straining.

This isa common condition attending many diseases, rather
than a specific disease of itself yet it is such a prominent feature
of these various affections, and one so very characteristic that it
seems well to give it a special place, even at the risk of repeating
much of what must necessarily appear elsewhere.

The immediate cause of diarrhoea is a congestion of the intes-
tinal mucous membrane and a profuse secretion into the intestinal
canal. When such congestion occurs inthe small intestine alone,
it may be counter-balanced by increased absorption in the large,
so that the secretion must be excessive to produce liquid alvine
discharges. When on theother hand it occurs in the large intes-
tine or in both large and small, the product is likely to escape
in the liquid form.

In its turn the congestion of the intestinal mucosa may result
from irritants in the bowels, from the presence in the blood of
irritant agents which being secreted stimulate the intestinal glands
to excessive secretion, and from reflex nervous action, starting
from a distant point as in chilling or irritation of the skin or
other organ.

Among direct irritants of the intestinal mucosa may be named
a full drink of cold water especially if the horse is trotted or
galloped for twenty minutes immediately after ;—soft, juicy,
rapidly grown green food, to which the animal is unaccustomed,
as the first grasses of spring ;—cooked or pulped food or ensilage
in hard worked animals ;—many irritant and acid plants ;—accu-
mulations of hard feculent masses in the intestines ;—irritation
caused by intestinal worms especially the blood-suckers ;—the
presence in the intestines of undigested matters, and resulting
fermentations, the result of diseased teeth and jaws and imperfect
mastication, of disease of the salivary glands or ducts and imper-
fect insalivation, of a drink of water after a grain feed, washing
a part out of the stomach in an undigested condition, of disease
of the stomach, liver or pancreas interfering with their proper
functions ; unwholesome and fermenting food like spoiled grain,
or fodder, or decomposed potatoes, apples, turnips, pumpkins,
carrots, cabbages, etc.;—stagnant and putrid water ;—tumors,
ulcers, volvulus, invaginations, adhesions and other serious
lesions of the bowels may act in the same way.

Diarrhea, Scouring. 313

As examples of the secretion of irritant matters from the blood
may be mentioned almost all the different agents used as purga-
tives, and purgative agents accidently taken in, these being as
a rule absorbed and later secreted again on the intestinal surface,
increasing the secretions in their passage :—also the morbid pro-
ducts of fevers which irritate the intestinal mucosa and glands
as they are thrown out by them (rinderpest, lung plague,
Southern cattle fever) :—the purgative waters on certain ‘‘scour-
ing lands’’ actin a similar way. Under the head of reflex action
may be named the chills from exposure to cold rains, night dews,
damp stalls or beds, and damp, hot buildings, seasons and locali-
ties. Under the head of nervous causes must be included strong
emotions as excitement, fear, etc., which lead to increase of both
secretion and peristalsis. Some horses are very subject to this
and are known as ‘‘washy’’. ‘These have usually a slim abdo-
men and long loin, and scour whenever they are put to hard
work. Other nervous animals with good conformation, but
which fret under saddle or in harness will scour under specially
severe work or under excitement. This is especially common in
young colts while being ‘‘broken’’, and will occasionally show
in mares which are in heat. Cattle that have been on a specially
succulent diet (turnips, beets, ensilage, grass) are liable to scour
profusely if driven far or fast, and stock men seek to obviate this
by feeding some dry bran, meal, and above all fresh dry brewer’s
grains just before starting. Cows running at large when in heat
are very liable to scour. An exclusive diet of turnips or beets
will keep cattle in a chronic condition of mild diarrhea, though
not enough to interfere with rapid improvement in flesh. Chronic
diseases of the liver by obstructing the flow of blood through the
portal vein, cause intestinal congestion and predispose to
diarrheea. ;

Of the various domestic animals, horses are the most liable to
superpurgation, from an undue dose of aloes acting on the very
large colon and cecum. Hence the importance of using such an
agent carefully in the young, fat or debilitated especially, of the
avoidance of cold drinks or exercise to excess after the aloes has
been given, and of keeping from work during its operation or
immediately after.

314 _ Veterinary Medicine.

Symptoms. ‘These are of all degrees of severity from the fre-
quent pulpy evacuations of animals fed exclusively on roots,
(beets, turnips, potatoes), to the excessive and almost constant
discharge of a dark colored liquid mingled with more or less
mucus. ‘The discharge may be of a light color and feetid, indi-
cating deficiency of bile, or of a dark yellowish brown and odor-
less.

Slight diarrhoea does not affect the appetite nor general health,
nor check improvement in condition. In the more severe and
continued forms there is loud rumbling in the abdomen, loss of
appetite and condition, a rapid small pulse, accelerated breathing,
pallid mucous membranes, sunken glassy eye, and increasing de-
bility even to an unsteady gait. Distension of the abdomen with
pawing and other indications of abdominal pain may appear in
bad cases. In the milder cases due to simple irritation and con-.
gestion there is no tenesmus, no excess of mucus, no formation

-of bubbles or froth in the stools, as occurs in active intestinal’
fermentation and dysentery. In symptomatic cases on the other
hand there are superadded the marked symptoms of intestinal
inflammation, or fermentation, and the faeces become putrid and
offensive, which they do also in the different infectious diseases
(influenza, contagious pneumonia, rinderpest, lung plague, hog
cholera, swine plague, canine distemper, fowl cholera), when
the toxins and waste matters of the food and decomposing tissues
are being thrown off by the bowels.

Diarrhoea may be complicated with other diseases and especially
in the horse with laminitis.

In mild cases it tends to a spontaneous recovery, and is followed
by some slight costiveness, and if this should prove extreme
there may be some danger of complicating sequelz such as in-
digestion, enteritis, pneumonia or laminitis.

Treatment. The first consideration for the practitioner is to
discover if possible the immediate cause of the diarrhcea. If this
is found to reside in some infectious or other disease aside from
the bowel, the attention must be directed to that even more than
to the diarrhcea. If it depends on an overdose of some purgative
agent or of acrid purgative plants taken with the food, any further
laxative is to be avoided, and yet astringents and other agents
which tend to lock up the offending material in the alimentary

Diarrhea, Scouriug. 315

canal must be equally guarded against. An abundance of mucil-
aginous and demulcent liquids (mallow, flaxseed gruel, boiled
starch, etc.) may be given both by the mouth and anus, to sheathe
and protect the irritable mucous membrane and to dilute and
carry off the irritant contents. Moderate doses of opium may be
required to allay the violence of the spasms and peristalsis, but
this should not be pushed to the extent of locking up the irri-
tants. Sometimes antiseptics (naphthalin, salol) are useful to
check fermentation, and pepsin may be given to assist digestion.

In ordinary cases due to the presence of an irritant the first
object must be to relieve the bowels of this, and the second to
soothe the irritated mucous membrane. A laxative is usually all
that is required, but it must be a mild one so as not to add to
already existing irritation. Olive or castor oil are to be preferred
as a rule (horse and ox 1 pint; sheep and swine 4 ounces; dog %
ounce), alone or with a moderate dose of laudanum. Or rhubarb
or aloes may be substituted if desired. A dose of whisky or
brandy, or oil of turpentine will often do much to allay the secre-
tion and peristalsis. These should be followed by moderate doses
of flaxseed gruel, or solution of slippery elm or mallow, or simple
well boiled gruels.

If the discharge persists after the laxative has had time to
operate, these mucilaginous agents may be replaced by solutions
of boiled starch, or of gum arabic, and small doses of calmatives
such as laudanum (horse or ox 1 ounce, sheep or pig 2 drachms,
dog 20 drops), or prussic acid or cyanide of potassium (30 drops
of the acid or grains of the salt for horse or cow). Sub-carbonate
of- bismuth, chalk, and carminatives and antiseptics may also be
given. According to the indications the practitioner must combat
persistent intestinal fermentation, or a relaxed adynamic condi-
tion of the intestinal mucosa, or general weakness and exhaus-
tion, with such agents as seem best adapted to the individual
case.

Chronic cases will demand the exercise of much judgment.
After a gentle laxative, salts of iron (sulphate, chloride,) and
pure bitters may be given with antiseptics. Or vegetable astrin-
gents‘(catechu, kino) with freshly burned charcoal and essen-
tial oils (peppermint, cloves, cajeput) may be employed. In
some instances calomel and chalk (1:12 will serve a good

316 Veterinary Medicine.

end. In others silver nitrate, or arsenite of copper succeeds.
Quinine, nux vomica, pepsin, may be used to improve tone.
The diet is usually all important. Well boiled gruels, boiled
milk, arrowroot, pulped or scraped,raw flesh may be demanded
in different cases. The patient should be kept at perfect rest,
and all excitement avoided.

COLIC, ENTERALGIA, INTESTINAL SPASM.

Definition. Colicy pains from spasm, enteralgia, tympanitic indigestion,
overloading of bowels, impaction, calculi, concretions, sand, foreign bodies,
intestinal and arterial parasites, irritants, enteritis, catarrhal, bacteridian,
protozoan, chemicals, strangulation, adhesion, volvulus, invagination, her-
nia, trauma of stomach or intestines, peritonitis, pleuritis, metritis, ovaritis,
hepatitis, biliary calculus, nephritis, urinary calculus, neoplasms, lead pois-
oning. Causes of enteralgia or spasm, idiosyncrasy, nervousness, cold,
wet, high condition, debility, cold, rain, dew, perspiration, fatigue, indiges-
tion, rheumatism. Symptoms: horse—sudden attack, paws, kicks, anxious
look at flank, crouches, goes down, rolls, sits, rises, shakes himself, feeds,
repeats at intervals, rumbling, defecations. Complications. ) Diagnosis,
symptoms violent, transient, completely intermittent, no fever, no tender-
ness ; from acute indigestion by absence of faulty feed, loaded or tympanitic
abdomen, crepitation, continuous pain, and of careful decubitus ; from con-
stipation by complete intermissions and freer passages; from intestinal
worms by absence of fur on anus, of rubbed rump, and of parasites in stools ;
from verminous thrombosis by complete intermissious and absence of pros-
tration, cold sweats and of bloody stools; from enteritis and other inflam-.
mations by absence of fever ; from intestinal anthrax by the intermissions,
the absence of brownish mucosa, and perhaps of anthrax from the district ;
from hepatitis by absence of icterus, tender hypochondrium, and fever;
from kidney affections by lack of stiff, straddling gait, tender loins, stretch-
ing; from pleurisy by absence of catching breathing, tender intercostals,
and friction sound ; ruminants—similar symptoms except sitting up or roll-
ing ; swine—sudden starting with grunt or scream, vomiting, etc. ; Carni-
vora—frequent moving, yelps, snapping, straining, looking at flank. Treat-
ment: solipeds, morphia, subcutem, anodynes, laxative, friction, walking,
enemata, chloral hydrate; ruminants, walking, enemata, morphia, laxative;
swine, morphia, laxative, antispasmodics, injections, derivatives ; dog,—
purgative, injections, chloral hydrate, ether, olive oil.

The term colic is loosely applied to all abdominal pains from
whatever cause they may arise. It is thus allowed to embrace

Colic, Enteralgia, Intestinal Spasm. 317

all diseases of the abdomen. In its more restricted sense in
which it will here be considered it may be held to indicate ab-
dominal pain without inflammation or any structural lesion.

It may however be well to note the most common causes of
abdominal pain so that the distinction may be more definitely
reached by a process of exclusion.

1st. Simple spasmodic colic. 2d. Enteralgia or neural-
gia of the intestines. 3d. Colic from indigestion, a tym-
panitic, 4 from overloading with ingesta, ¢ from impaction
or constipation, d from calculi or concretions or from sand,
or gravel taken with the food or from foreign bodies swallowed,
e from worms in the intestines, f from worms in the mesen-
teric vessels (thrombo-embolic), ¢ from irritants taken with
the food or otherwise. 4th. Colics from structural lesions
of the intestines; @ from inflammation of intestine, 4 from
bacteridian inflammation of the bowels, c¢ from proto-
zoan inflammation, d from chemical or other irritants, ¢
from intestinal strangulations, / from adhesions, g from
volvulus, 4 from invagination, z from mesenteric omental
or phrenic hernia, 7 from strangulated inguinal, femoral
ventral or umbilical hernia, £ from wounds, ruptures or
perforations of stomach or intestines, / from peritonitis or
pleuritis, # from metritis or ovaritis, z from hepatitis or
biliary calculus, o from pancreatitis or pancreatic calculus,
p from nephritis, nephritic, uretral, cystic or urethral cal-
culus, g from neoplasms affecting any of the abdominal
organs. ; 5th. Colic due to lead poisoning.

Causes of enteralgia and spasmodic colic. Enteralgia may be
defined as a neuralgic pain of the bowel which may therefore bé
free from spasm or any other appreciable structural or functional
change. Its existence in the lower animal is necessarily some-
what problematical, as it can only be inferred from the analogy
of the animal with man, and of the enteron with the superficial
parts that are more frequently attacked with neuralgia, and also
from the absence of visible spasmodic contractions in the bowel
which has been the seat of intense pain, yet shows no inflamma-
tory lesion. But whether this is accepted or not, the occurrence
of spasm is undeniable and as both are functional nervous dis-
orders the same causative factors will apply to both.

318 Veterinary Medicine.

In some nervous animals, especially high-bred horses and dogs,
there is undoubtedly an idiosyncrasy which shows itself in a
special susceptibility of the nervous system. Insuch animals an
exposure to cold or wet, or the presence of a local irritant which
would have been without effect under other circumstances, lights
up the nervous disorder and produces an explosion, it may be as
spasm or it may be as nervous pain. Animals that are kept
under the best care, that are least accustomed to exposure and
neglect, that are highly fed, and maintained in high spirits and
are impatient of control are more susceptible than those that be-
come inured to change and exposure, yet are kept in moderately
good condition. On the other hand the subject which has be-
come debilitated by overwork, underfeeding, exhausting disease,
or the generation inthe system of some depressing poison is likely
to show a similar nervous susceptibility, so that at the two ex-
tremes of plethora and nervous susceptibility, on the one hand,
and anzemia and neurasthenia on the other, we find a correspond-
ing tendency to nervous disorder under comparatively slight
causes. Thus it happens that a drink of ice cold water, an ex-
posure to a cold blast or a drenching rain or a heavy night dew
may seem to be the one appreciable cause of the trouble. If the
animal has been perspiring and fatigued the attack is more likely
to occur. In other cases a slight indigestion unattended by im-
paction or tympany, or the ingestion of an irritant which on
another occasion, or in another animal would have been perfectly
harmless, will induce a violent nervous colic. In some instances
the attack is supposed to be of a rheumatic nature the causative
action of the cold giving color to the theory.

Symptoms. ‘The attack usually comes on suddenly especially
if it has followed on a drink of cold water or a cold exposure.

Solipeds. The horse leaves off feeding or whatever he may
have been engaged in, paws with his fore feet, moves uneasily
with his hind ones or kicks with them, one at a time against the
abdomen or out backward, he looks back at the abdomen with
pinched, drawn, anxious countenance, bright anxious eye, and
dilated nostrils, he moves uneasily from side to side of the stall or
box, crouches for a few seconds with semi-bent knees and hocks
and then throws himself down violently with a prolonged groan.
When down he may roll from side to side over the back, and

Colic, Enteralgia, Intestinal Spasm. 319

struggle in various ways, he may start to rise, sit for a moment
on his haunches, then go down and roll as before. Or he may
get up, shake himself and resume feeding as if entirely well.
Soon the spasms reappear, suddenly as at first, and after a time
subside as before. Thus the disease proceeds, each succeeding
paroxysm diminishing in violence until they permanently subside,
or increasing until the animal dies worn out with shock, suffering
and exhaustion. If the paroxysms are severe the skin is usually
bathed more or less in perspiration. Usually the peristalsis con-
tinues more or less, a rumbling is heard in the bowels and more
or less feeces are passed in small solid balls or semi-liquid.

The course of the disease is usually rapid and followed by re-
covery. When prolonged it may become complicated by volvulus,
invagination, indigestion or even enteritis.

Diagnosis. 'The characteristic symptoms are the suddenness
of the onset, the extreme suffering during the paroxysm, the
reckless manner in which the animal throws himself down, the
intermissions with complete absence of pain, the natural condi-
tion of the pulse and temperature in the intermissions, the com-
fort with which the patient shakes himself, and the absence of all
abdominal tenderness, manipulation and friction seeming to give
relief rather than discomfort.

In the colic of acute indigestion there is the previous exces-
sive or unwholesome meal, or the full drink after feeding ; there
is tympany, or a loaded state of the abdomen proving flat on per-
cussion, there may be crepitation on auscultation, there is contin-
uous pain with exacerbations (not complete intermissions), and
there is rather a careful mode of lying down.

In intestinal constipation or other obstruction, faeces may
be passed at first in small pellets coated with mucus or they may
be at first passed freely but in steadily lessening quantities until
they stop altogether, The pain is constant but worse at one
time than another and in case of external hernia the swelling will
be visible.

In helminthiasis there is the general unthriftiness, irregular
appetite, frizzled broken hair on the base of the tail, a fur of
dried mucus around the anus and the presence of parasites in
the droppings.

In verminous thrombosis, to the symptows just named there

320 Veterinary Medicine.

are added the reckless method of throwing himself down, hyper-
thermia, constancy of the pain, rapidly running down pulse, cold
sweats, and profound prostration. When blood is passed per
anum it is all the more significant.

In enteritis or peritonitis the hyperthermia and the con-
stancy of the pains are sufficiently pathognomonic.

In intestinal anthrax there are the dusky brownish yellow
mucose, the marked prostration, the hyperthermia and the con-
stancy of the suffering. There is also the fact that the region is
subject to anthrax, and bacilli may be present in the blood.

In acute hepatic disease there is hyperthermia, dusky or
icteric mucous membranes, great tenderness when percussion is
made over the short ribs, and sometimes Jameness of one shoulder
(usually the right).

In disease of the urinary or generative organs the stiff or
straddling gait, tender loins, and the frequent stretching as if to
urinate, are nearly pathognomonic.

In pleurisy the hyperthermia, the transient duration of the
colic, and the tenderness on manipulating the intercostal spaces
will usually differentiate.

Ruminants, Incattle, asin the horse, the symptoms of spas-
modic colic are restlessness, constant movement, looking round at
the flanks, wriggling of the tail, uneasy lifting of the hind feet,
kicking at the abdomen, and abruptly lying down and rising
again. The animal does not roll on the back nor sit on the
haunches. Feeces may be passed in small quantity or entirely
suppressed, and there may be a slight tympany of the paunch.

Swine. The animal is attacked abruptly, starts with a grunt
or scream, moves around uneasily, lies down, rolls, gets up, and
repeats the motions. Vomiting is not uncommon, and the belly
may be tense, tympanitic and even tender. The bowels may be
confined or relaxed.

Carnivora. The colicy dog is very restless, changing from
place to place, sitting on his haunches, lying down curled up,
starting up suddenly with a yelp, and repeating the restless move-
ments. He looks anxiously at his flank, sometimes bites at it,
and cries plaintively. The bowels are usually torpid, and defe-
cation effected with straining.

There are distinct intermissions, but these are cut short by a
new accession of pain.

Colic, Enteralgia, Intestinal Spasm. 321

The attack is usually transient and ends in recovery.

Treatment. Solipeds. For nervous colic the hypodermic in-
jection of sulphate of morphia (2 grs.) is very effective. This
will commonly bring relief in less than five minutes. Should
there be no effect at the end of this time it may be repeated with
advantage, but should a second dose fail, it is well to resort to
other measures. Eserin and barium chloride are contraindicated
as being liable to increase the spasm, and if there is no irritant to
expel there is no object in their exhibition. The old prescrip-
tions of laudanum and turpentine; laudanum and ether; sweet
spirits of nitre with belladonna, or hyoscyamus, and other stimu-
lants and narcotics are of little avail as they are not absorbed from
the horse’s stomach and cannot operate until they have reached
the duodenum. If givenat all, their action may often be hastend
by injecting them into the rectum.

When the morphia fails it is the safest treatment to give a
moderate dose of aloes or other laxative, in combination with
extract of hyoscyamus or chloral hydrate. This takes time to
pass into the duodenum, and be absorbed and secreted anew in
order to have its full effect, and therefore it may be necessary to
keep up a moderate action of the morphia asa palliative. In four
hours, however, at the latest, the aloes can be counted on to bring
permanent relief. This appears to come as soon as the active
principles have been absorbed, the nauseating effect operating at
once on the over-excited nerve centres. The action is more per-
fect still when a free secretion has been started from the intestinal
mucosa, and the circulation and inervation in the intestinal walls
are essentially changed. This measure which was long success-
fully practiced and advocated by the late Joseph Gamgee, is even
more perfectly adapted to the colics of indigestion and irritation,
of impaction and fermentation. There are of course cases of
complete obstruction in which it must fail, but it is probably the
most successful method for colicy affections in general.

In addition to the above, other methods of correcting the dis-
ordered inervation are available. Active friction of the abdomen
with straw wisps is often effective, also fomenting the abdomen
with hot water. Simply leading the animal around acts as a
nervous derivative, and may be employed to prevent his dashing
himself down so suddenly as to injure himself. Then copious

21

322 Veterinary Medicine.

injections of warm water soothe the rectum, solicit its peristalsis
and by sympathy affect the other intestines in the same way.
They may often be made more effective by the addition of anti-
spasmodics (extracts of belladonna or hyoscyamus or chloral
hydrate or extract Cannabis indica, 1 0z.).

In all cases a soft bed should be provided to secure the animaj
against injury in his sudden reckless movements.

Ruminants. Simple spasmodic colic is usually transient and
may be successfully treated by driving around, giving copious
warm water injections, and using morphia subcutem. Frictions
to the abdomen with straw wisps, or with oil of turpentine should
be tried. Should these fail there is a presumption of further
trouble and no time should be lost in giving a laxative (Glauber
salts 1 to 2 pounds, or castor oil 1 quart, with anti-spasmodics
and stimulants as for the horse.

Swine. The anti-spasmodic treatment may be tried on the
pig, but usually it is well to give a purgative at once in combina-
tion with the narcotic. (Castor oil 4 ounces, laudanum %
drachm, or jalap 2 drachms, and extract of hyoscyamus 20 grains
in electuary. Warm injections and embrocations to the abdomen
are desirable.

Dog. It is usually well to give a purgative at once (jalap 4
drachm) with ro to 20 drops laudanum according to size. Copious
injections of warm water and a warm bath may follow. Chloral
hydrate 20 to 60 grains, may be exhibited by the rectum ; also
ether 1 drachm, in olive oil.

CONSTIPATION FROM INTESTINAL ATONY.

Definition. Symptomatic. Causes: habit of retention in horse, dog and
cat, indigestible matters in colon, calculi, dry food, lack of water, fever, diu-
resis, diaphoresis, milking, bleeding, hepatic torpor, verminous thrombi,
old age, debility, nervous disease, matting of hairs, hamorrhoids, abdomi-
nal suffering. Lesions: dilatation and catarrh of bowel, disease of rectum.
Symptoms solipeds—small, dry, coated, infrequent stools, straining, inap-
petence, tympany, colic, stretching as if to urinate; dog, fruitless strain-
ing, or dry, earthy looking feces, coated, bloody, foetid, anus swollen, ten-
der, moist, palpitation, colic, vomiting, diarrhoea may fruitlessly occur,
male urinates like bitch, foul, foetid mouth; may last days or months;

Constipation from Intestinal Atony. 323

complications, sequelz. Treatment. solipeds—exercise, pasturage, cold
water before morning feed, regular regimen, bran, flaxseed, carrots, turnips,
ensilage, common salt, Glauber salts, nux, cold injection, glycerine, barium
chloride, purgative, enemata ; dog :—mechanical unloading of the rectum
and colon, injections, exercise, water, regular habits, laxative food, eserine,
oil, calomel, jalap, podophyllin, colocyuth, belladonna, nux vomica, ab-
dominal massage, electricity.

Definition. Constipation consists in dryness, hardness, and
undue retention of the faeces. It has of course many grades and
may lay claim to many different causes, so that it might, like its
antithesis diarrhoea, be held as merely a symptom of another dis-
ease. It has however such a definite character, that it is con-
venient to retain the name to designate those cases in which the
torpor or atony is the most prominent and dominating feature, while
other forms of obstruction will be treated under different heads.

Causes. Defecation is immediately due to the active peristaltic
movements of the rectum overcoming the resistance of the
sphincter. There is also the concurrent closure of the glottis
and contraction of the diaphragm and abdominal walls, and it is
usually the voluntary operation of these forces that rouses the
rectum to effective peristalsis. The excitability of the rectum
depends greatly on habit, hence the habitual retention of feeces,
gradually dulls that organ and renders it less and less disposed
to respond. In horses this is seen largely in connection with
abundant dry feeding and lack of exercise. In house dogs and
cats on the other hand, inculcated habits of cleanliness, compels
the suppression of the natural instinct, and the habitually over-
loaded bowel becomes less and less responsive. The retained ex-
crements meanwhile give up more and more of their liquids until
they become so dry, and incompressible as well as massive that
they can be expelled only by violent efforts. Inflammation of
the mucosa naturally follows the retention and this in its turn
adds to the weakness and torpor.

Acting in a similar way the partial obstruction, by accumula-
tions of bones and other undigested matters in the colon, and by
calculi, tends to continued accessions of new material and to
gradually increasing intestinal paresis. So with the other forms
of obstruction which will not be further referred to here.

In all animals dry feeding and a lack of water are potent causes
of inspissation of the ingesta and torpor of the bowels.

324 Veterinary Medicine.

All or nearly all febrile affections, leading as they do to sup-
pression of secretions, cause drying and tardy movement of the
contents of the bowels.

The excessive loss of liquid through other channels,—by
diuresis, by profuse perspirations, by excessive secretion of milk,
or by bleeding—has a similar tendency.

The suppression of the biliary secretion through liver disease,
or obstruction of the bilary duct, withholds from the intestine,
the most important of the stimuli to peristalsis, and tends to
constipation, unless the resulting irritation should cause ex-
cessive secretion. /

The derangement in the circulation in the intestinal walls caused
by verminous thrombi in the horse, acts in the same way, the
imperfectly nourished walls not only losing the normal power of
peristalsis, but sometimes contracting so as to cause a stricture.
Parasites encysted in the walls of the bowels, like catarrhal and
other inflammations of these parts tend to atony and tardy
peristalsis.

A weakness of the nervous system attendant on old age, or
debility, or chronic lead-poisoning often tells with force on the
alimentary canal, and the loss of nervous power through disease
of the great nerve centers (ganglionic system, brain, spinal cord)
impairs the vermicular motion. This is notoriously the case in
paraplegia, chronic hydrocephalus, and vertigo.

Finally among the causes of constipation must be noted the
matting of the hairs around the anus (in dogs), and painful affec-
tions of the anus, or the abdominal walls, which render efforts at
defecation painful and deter the animal from attempting them.

Lesions, ‘These are as varied as the diseases which give rise to
constipation, or result from it. Permanent dilatation or saccula-
tion of the intestine, and the structural changes attendant on in-
testinal catarrh are the most common local lesions. But proctitis,
hemorrhoids and ulcers of the anal follicles are met with in canine
patients, and ulcers of the colon in the seat of impaction are
common.

Symptoms. In Solipeds the faeces are passed, at long intervals,
in small quantity, usually only a very few balls at a time, firm,
dry, moulded smooth and black on the surface, often covered
with mucus, or with streaks of blood. ‘They are passed with

Constipation from Intestinal Atony. 325

unusual effort and straining, and even with groaning, and one or
more balls that may be exposed in the act are often drawn back
and retained by the inversion of the rectum and closure of the
sphincter. It is liable to be complicated by:impaired appetite,
tympanies, slight recurrent colics, and dryness, scurfiness and un-
thriftiness of the skin. Not unfrequently the pressure of the im-
pacted colon (pelvic flexure) irritates the bladder causing stretch-
ing as if to urinate, and the passage of urine often in small quan-
tity. There may be the symptoms of any one of the different
nervous affections that lead to impaired peristaltic action, or of
the local diseases which tend to obstruction of the bowels.

In dogs there are violent and painful efforts to defecate, which
may be fruitless, or may lead to the expulsion of small masses of
dry, earthy looking feeces, smoothly moulded on the surface,
coated with mucus, streaked it may be with blood and highly
offensive in odor. The anus may be puffy and swollen with muco-
purulent secretion from the anal glands, which soils the hair of
the hips and tail. If the abdomen is flaccid, manipulation with
both hands on opposite sides usually detects a solid mass repre-
senting the impacted rectum and colon, and extending from the
pelvis forward, often to the sternum. The same mass will be
reached by the oiled finger introduced into the rectum. Both
methods of exploration are painful and may call forth cries from
the patient. The abdomen is usually distended, largely from the
impacted feeces, in which case it gives a flat sound on percussion,
or from gaseous emanation, in which case it is intense, resilient
and resonant. Colicy pains are liable to appear, and vomiting at
first of food only, then more or less yellow and bilious, and finally
of distinctly feculent matters. For a time appetite may be re-
tained, but thisis gradually lost. "There may supervene diarrhea,
which in favorable cases may lead to expulsion of the impacted
mass, but in others it fails to completely dislodge it. The patient
is dull and spiritless, inclined to lie curled up in dark corners,
and when raised walks slowly and stiffly, with the tail carried
straight or slightly to one side. The male urinates like a bitch
without lifting the leg. The nose is dry, the tongue furred, the
teeth usually covered with tartar, and the breath foetid. There
is at first no hyperthermia, but some rise of temperature attends
on the advance of the disease, and the auto-poisoning by absorbed
products of the putrefaction of retained feeces.

326 Veterinary Medicine.

The disease may last a few days only or it may continue for
weeks or months. In the last case intestinal catarrh, ulceration,
and circumscribed necrosis are likely to supervene and the animal
may die of auto-intoxication, acute peritonitis or enteritis. Yet
the majority of cases in the dog reach a favorable termination, or
recover with remaining cicatrices, strictures or dilatations.

Treatment. In solipeds accustomed to an idle or pampered
life, plenty of daily exercise will often correct the torpor. Arun
at pasture will often effectually counteract the tendency. If the
patient must be kept in the stable a full drink of cold water every
morning before feeding willoften succeed. Regularity in feeding
and watering is of the utmost importance, and the addition of a
little wheat bran or flaxseed to the grain is often of material
advantage. Next may be added a moderate allowance of carrots,
turnips, or ensilage to furnish the needed succulence and organic
acids. Ifin addition medicinal measures are wanted, a small
handful of common salt, or of Glauber salts, in the morning
drink to be taken ten or fifteen minutes before the first feed, will
usually operate well. This may be continued for a length of
time if necessary, without the ill effects of purgatives given at
other times. It may be rendered slightly more effectual by the
addition of 10 grains nux vomica on each occasion, A morning
injection of a quart or two of cold water with one or two ounces
of glycerine may be tried. Another resort is 2 or 3 grains of
barium chloride in the morning drink or hypodermically repeated
daily for some time.

In the more severe cases with already existing impaction of
the colon, purgatives and copious injections will be demanded as
advised under that disease.

In dogs the first object is the unloading of the rectum and
colon and this usually demands direct mechanical intervention.
(See Intestinal Indigestion with Constipation.) In case of hyper-
trophied prostate this may be rendered somewhat difficult, yet
with a free use of oily, soapy or mucilaginous injections it can
usually be accomplished.

The further treatment is on the same line as for the soliped.
An abundance of exercise in the open air is a prime essential,
together with a free access to fresh water. House dogs must be
taken out for urination and defecation at regular times that are

Constipation in Birds. 327

not too far apart. The food must be of a laxative nature. At
first fresh whey or butter-milk only may be allowed, but as some
action of the bowels is obtained well salted beef tea, pulped or
scraped red muscle seasoned with salt, or milk treated in the same
way is permissible. If the bowels fail to respond when the dog
is taken out at the regular times an injection of cold water may
be given. Sulphate of eserine (4 gr.) may be given daily by the
mouth or hypodermically, or castor oil (% to 1 oz.) may be
administered at one dose to be followed by careful dietary and
hygienic measures. Or sweet oil, calomel and jalap, podophyllin,
or colocynth may be substituted. When the bowels have been
freely opened a daily morning dose of a drop of the fluid extract
of belladonna and %% gr. of nux vomica will often materially im-
prove the peristalsis. Active manipulation of the abdomen may
be employed, or, if available, a current of electricity through the
torpid bowels for 10 or 15 minutes daily.

CONSTIPATION IN BIRDS.

Causes : Matted feathers, impacted cloaca, arrest of eggs, debility, catarrh,
parasites, nervous disorder. Symptoms: swelling of anus, pendent abdo-
men, waddling gait, straining without effect. Treatment: remove obstruc-
tion by mechanical means, cut off matted feathers. egg matter may demand
laparotomy, castor oil, tincture of rhubarb, enemata, green food, ensilage,
roots, onions.

°

In birds torpid and obstructed bowels may come from the ef-
fects of a previous diarrhoea, which has led to the matting
together of the feathers over the anus at once obstructing defeca-
tion and rendering it painful. It may result in and be aggra-
vated by a slow accumulation of indigestible matters in the intes-
tine or cloaca (pebbles, feathers, etc.), and the arrest of eggs in
the oviduct, pressing upon and obstructing the bowel. Ina re-
cent case the author removed 18 ozs. of impacted egg matter
from the oviduct of a hen, which when divested of this load
weighed barely 2 lbs. Debility of the general system and par-
ticularly of the walls of the bowels, and its various causes (old
age, exhausting disease, intestinal catarrh, parasites, nervous

328 Veterinary Medicine.

diseases, etc.) retard defecation and favor impaction asin the
mammal.

The symptoms may be; hard dry droppings, matting of the
feathers over the anus with feculent matters, a firm swelling sur-
rounding the sphincter, a pendent condition of the abdomen which
when manipulated is felt to be firm and resistant, ruffling of the
feathers, drooping of the head, wings and tail, walking sluggishly
with legs half bent and a waddling gait, and ineffectual attempts
to defecate.

Treatment. As in dogs remove the obstructing mass by
mechanical means. Matted feathers may be clipped off, and
feculent accumulations may be dislodged by the aid of the finger,
or in small birds of a blunt prob. This may be favored by
manipulation through the abdominal walls, and the injection of
soapy or oily enemata. Accumulations of impacted egg matter
may be similarly removed, or, failing this, by an incision made
through the abdominal walls and oviduct. Asa purgative give
one or two teaspoonfuls castor oil according to the size of the
hen, or a few drops to a small cage bird. For the latter Fried-
berger and Fréhner advise a few drops of tincture of rhubarb in
the drinking water. Injections of warm or cold soapsuds or
water may be continued. as symptoms demand. Green food,
ensilage, roots, worms, snails and insects are indicated to correct
the tendency to costiveness and may be continued until the bowels
have acquired their proper tone. A moderate allowance of onions
is often of great value.

HAIR BALLS IN THE INTESTINES—HORSE.
EGAGROPILES.

Seat, colon, czecum ; hair of oat seed, clover leaf, vine tendrils, hair of
horse, nucleus, calcic admixture, straw, in horses on dry food, with depraved
appetite, or with skin disease. Symptoms: none, or torpid bowels, colics,
recurring, fermentations, tympany, obstruction, rupture, peritonitis, rectal
exploration. Lesions: impacted ball, with excess of liquid and gas in front,
rupture, ragged, bloody edges. Treatment: extraction, enemata, eserine,
barium chloride.

Hair balls, received the name of egagropiles because of their
discovery in the alimentary canal of the wild goat, but they are

Hair Balls in the Intestines—Horse. Egagropiles. 329

found in various forms in all the domestic animals. In horses
they occupy the caecum and colon and are most frequently com-
posed of the fine vegetable hairs that surround the grain of the
oat, or the leaf of clover, of the woody tendrils of vines, and of
the hairs of themselves and their fellows taken in at the period of
moulting. They sometimes contain a nuclens of leather or other
foreign body which has been swallowed but in many cases no such
object can be found, the hair having become rolled and felted by
the vermicular movements of the stomach and intestines. An
admixture of mucus assists materially in the felting, and calcareous
and magnesian salts may make up the greater part of the mass,
rendering it virtually a calculus. ‘They may further have a large
admixture of straw and vegetable fibres of larger size than oat or
clover hairs. They are most frequent in horses kept on dry food,
(sweepings of oat-meal mills) and at hard work, and which show
depraved appetite and lick each other. Omnibus horses suffer
more than army horses. Skin diseases, by encouraging licking,
contribute to their production.

Symptoms. In the great majority of cases hair balls do not
seriously incommode the horse. They do not attain a large size,
and being light do not drag injuriously on the intestine and
mesentery. They do, however, retard the movement of the in-
gesta, and when grown to a considerable size they may block the
intestine, more particularly the pelvic flexure, the floating colon
orrectum. Under such conditions they produce colics which may
be slight, transient, and recurrent, or severe and even fatal having
all the characteristics of complete obstruction from other causes.
Fermentations, tympanies, and straining without defecation are
common features. When the obstruction takes place in the pelvic
flexure, the floating colon or rectum, it may often be detected by
rectal exploration. When complete obstruction occurs all the
violent symptoms of that condition are present, and these may
pass into those of rupture (Peuch, Leblanc, Neyraud), and shock
or peritonitis. If the animal has passed hair balls even months
before, the colics may with considerable confidence be attributed
to other balls of the same kind.

Lestons. Incase of death there are the usual lesions of gase-
ous indigestion, with or without enteritis, but with the accumu-
lation of a great quantity of liquid contents, above the ball,

330 Veterinary Medicine.

which is felt as a firm body impacted in the gut. In other cases
the distended bowel has given way and the liquid contents and
‘often the hair ball as well are found free in the abdominal cavity.
In such a case the edges of the laceration are covered with blood
clots and thickened with inflammatory exudation, and there is
more of less peritonitis.

Treatment. Relief may sometimes be obtained by the extrac-
tion of a hair ball lodged in the rectum or adjacent part of the
floating colon. In other cases abundant soapy or oily enemata,
and the employment of eserine or barium chloride subcutem are
indicated.

HAIR AND BRISTLE BALLS IN DOG AND PIG.

From licking in skin disease. Symptoms: of obstruction. Treatment :
manipulation, enemata, oil, antispasmodics, eserine, barium chloride, laparo-
tomy, diet in convalescence.

The hair balls of dogs come mainly from licking themselves
when affected with skin diseases or parasites. In pigs they are
mostly attributed to depraved appetite.

The hair balls of the dog are small, open in texture, and easily
disintegrated, having little mucus and no earthy salts in their
composition.

The bristle balls of pigs take the form of straight or curved
rods of firm consistency, but without earthy salts. The project-
ing ends of the bristles render them particularly irritating.

The symptoms are those of obstruction of the bowels, and the
treatment consists in efforts to dislodge them. If situated near
the anus they may sometimes be reached with the finger, or
copious oily injections may facilitate their passage. Manipula-
tions through the abdominal walls may be helpful in the dog.
Oleaginous laxatives and antispasmodics may be tried, or these
failing, eserine or barium chloride. Asa last resort laparotomy
may be performed, the ball abstracted and the intestine and ab-
dominal wall carefully sutured (Siedamgrotsky). Insucha case
the diet should be restricted for a week to beef soups, butter-
milk, and well boiled gruels, especially flaxseed.

INTESTINAL CALCULI. ENTEROLITHS. BEZOARS.

Earthy basis, nucleus, stratification, in caecum or colon, multiple, size,
number up to ro00. Composition, phosphates of lime, magnesia, and am-
monia, silica, mucus, ephithelium, organic matter. Ammonio-magnesian
tend to crystalline form, common phosphate of lime to smooth forms.
Concretions. Source in food. Ammonia from bacteridian fermentation, action
of colloids, varied nuclei, rapid growth. Lesions: catarrh, dilatation, ob-
struction, rupture, peritonitis. Symptoms: intermittent colics with ob-
struction. tyimpany, bowel distension, liquid and gaseous, before obstruction.
Diagnosis: by hand in rectum, hard obstruction with distension in front.
Treatment: purgative dangerous, but exceptionally successful, extraction,
oleaginous enemata, laparotomy.

Horse. Intestinal calculi have an earthy basis (ammonio-
magnesian phosphate, or oxalate of lime, and more or less silica)
glued together by mucus and having a central nucleus usually of
some foreign body, (a particle of sand, pebble, morsel of hair,
lead, cloth, nail, coin, blood clot, or inspissated mucus) around
which the earthy salts have been deposited layer after layer.
They are usually formed in the caecum or double colon and may
be multiplied and moulded upon each other, so that they become
discoid, angular or otherwise altered from the globular shape.
The worn, flattened surface in such cases shows concentric rings
representing the layers as deposited in succession.

The size of the masses may be from a pea or smaller, up to cal-
culi of six inches in diameter.

In number there may be a single calculus or there may be an
indefinite quantity. Zundel counted 4oo in a single colon, and
Gurlt 1,000.

Composition. They are usually composed of phosphate of lime
and of magnesia, of ammonio-magnesian phosphate, with a little
silica, mucus, epithelium, and organic matters from the ingesta.
Traces of sodium chloride, and iron oxide may also be present.

The phosphates of lime, magnesia, and of ammonia and mag-
nesia usually constitute the main part of the calculus. Fiirsten-
berg found specimens in which the ammonio-magnesian phosphate
amounted to 72 to 94 per cent.

331

332 Veterinary Medicine.

The calculi containing an excess of ammonio-magnesian phos-
phate tend to assume a crystalline or coralline form which causes
them to be specially irritating to the mucosa. When broken they
show a radiated structure from the centre to the circumference in
addition to the concentric rings. These are usually of a yellowish
brown or a gray color and have a specific gravity of 1694 to 1706.

Calculi in which the common phosphate of lime abounds are
likely to be smooth on the surface and on section show the con-
centric rings more distinctly and the radiating lines lessso. The
brownish calculi of this variety are much more compact, and
harder than the crystalline or mulberry caculi, and have a
higher specific gravity—(1823).

Bluish calculi with a smooth glistening surface and lower spe-
cific gravity—1681—, have been found of small size and in great
numbers in the colon (1000 in the colon, Gurlt).

In some calculi there is a large admixture of alimentary mat-
ters, and a low specific gravity (1605 to 1674). These were des-
ignated as pseudo calculi, by Furstenberg.

In still other cases a calculous looking mass, when broken into,
is found to be composed of a mass of dried alimentary matter
enclosed in a thin layer of lime salts. These have a low specific
gravity (1446 to 1566) and have been named concretions by Fiirs-
tenberg.

Causes. Asa large proportion of the calculus is phosphate of
lime or ammonio-magnesian phosphate, we must look for the
source of these in the food and then at the conditions which de-
termine their precipitation.

The percentage of ash and of phosphoric acid in the common
foods of horses may be seen in the following table :

Ash PO,in PO,in the

the Ash. entire food.
Per cent. Percent. Per cent.

Wheat bran_____ --_-----.----- 7.3 50 3.65
Wheat grain _________________- 3.0 46.38 1.3914
Oats grain ____.---____ --______ 2.50 26.5 0.6625
Barley grain _._.______________ 3.10 39.9 1.2276
Bean grain_________.___._-____ 3.10 31.6 0.9864
POas Praline 2 pee iad + 2.75 34.8 0.957
Tare grain __--_-___._--.---... 3.00 36.2 1.086
Indian corn grain_____________- 1.5

Rye grain____.___________-_-_. 1.6 39.9 1.0384

Intestinal Calculi.—Enteroliths,—Bezoars. 333

The source of the magnesia may be found to a large extent in
the grains represented in the following table: |

Ash Mg. in Ash.
Per cent. Per cent.
Oat grain. __-_- 2.50 7-3
Barley grain_______________._____ 3.10 8.5
Rye grain____. ____-_________.-_ 1.6 2.4
Wheat grain_______--_-__ ee 2.12 9.98
Wheat bran_____-- ee 7.3 11.2
BeaD 20s o2 oe eon el Rees 3.1 6.6
b 21 ape ee an a ee See eee 2.7 5.6

The amount of magnesia in each of these grains is amply
sufficient to furnish the material for the constant growth of a
calculus. Wheat bran is preéminent in the amount of its mag-
nesia and therefore wheat bran has been charged with predis-
posing to calculi. In the perisperm as a whole, Fiirstenberg
found 1 per cent. of phosphate of magnesia, and in coarse bran
not less than 2.5 per cent.

The ammonia which is essential to the precipitation of the
phosphate of magnesia in the form of the compound salt (am-
monio-magnesian) can be found wherever proteids are in process
of septic fermentation. The slightest failure to peptonize every
particle of such proteids, implies septic change and the evolution
of ammonia, which on coming in contact with magnesia phos-
phate instantly precipitates the insoluble salt.

This fully agrees with the doctrine of the formation of urinary
calculi through the agency of bacteria, since the ammonia is
essentially a fermentation or bacterial product.

It may also be noted that the experiments of Rainey and Ord
showed that in the presence of colloids (mucus, epithelium, pus,
blood) the earthy salts are precipitated as minute gobular bodies
which by further accretions become calculi. In the absence of
colloids the salts tend to precipitate in angular crystalline forms,
so that the mulberry and coralline calculi may possibly have been
precipitated in the absence of such bodies. From the solvent
quality of ammonia, however, the contents may easily pass from
a fermenting liquid containing colloids toa non-fermenting and
non-colloid mixture.

The presence of a solid body which may act as a nucleus is an
essential element, and the condition of the food or drink will often

334 Veterinary Medicine.

supply this. It has been noticed that army horses in the field,
feeding from the ground and taking in sand and pebbles, are un-
usually liable to intestinal calculus. Horses which lick earth in
connection with acidity of the stomach or other dyspepsia are
specially subject to it. Horses watered from shallow streams with
sandy bottoms, where they take in sand with the water, have been
similarly affected. Millers’ horses, in the days of old process
milling, suffered not alone because of the abundance of oat hairs
in the feed but also on account of the grit from the millstones.
Hay and other fodders that have lain on the ground and which
contain earth and sand furnish other sources of such nuclei.
Shingle nails and other small nails, pins, needles, coins, etc.,
which have mixed with the feed-are common causes of trouble,
and indeed any foreign body may become the centre and starting
point of a calculus.

Catarrhal affections and other lesions of the mucosa, which
furnish excess of mucus, beside pus, lymph and even blood as
nuclei, are invoked as starting points of the calculi, but however
true this may be in particular cases, irritation and catarrh appear
to be much more frequently the result than the cause of the
calculus.

Attempts have been made to estimate the time taken in the
formation of a calculus by allowing a ring for each feed and suc-
cessive deposit therefrom (Fiirstenberg, Colin). Thus a calculus
of 14 pounds with 720 layers, it was estimated could be formed in
one year at two feeds perday. More definite evidence was found
in the case of Pastore in which a coin with the mint mark of 1847
was found as the nucleus of a calculus the size of the fist in 1848.

Lesions. Formed in the most spacious parts of the colon and
cecum, calculi usually rest there for a length of time without
visible injury, and it is only when they are moved onward and
get arrested at a narrow part of the gut (pelvic flexure, floating
colon, rectum) that they cause appreciable trouble. Yet it is
claimed that by their weight they drag upon the yielding walls of
the bowel, causing dilatation and attenuation, weakening the
peristalsis and predisposing to rupture. The compression of the
vessels also tends to anzemia and atrophy. In the case of rough
crystalline calculi the mucosa is subjected to attrition, irritation,
and inflammation. ‘The more serious and urgent trouble is that

Intestinal Calcult.—Enteroliths. —Bezoars. 335

of obstruction of the narrower portions of the colon and rectum,
which may be absolute and persistent, leading to rupture and
death or a fatal inflammation on the one hand, or may end in
recovery on the other, in connection with a displacement onward
or backward of the calculus as the result of peristalsis or anti-
peristalsis.

Symptoms. ‘These are intermittent colics, each reaching a
climax and followed by a sudden recovery as the calculus is dis-
placed into a more spacious part of the colon. A significant
feature is the complete obstruction, feeces being passed for a short
time at first and then suddenly and absolutely stopped. Coinci-
dent with this are tympany, violent colics, straining, rolling, sit-
ting on the haunches, perspirations, anxious countenance, and
all the symptoms of obstruction.

Diagnosis is never quite certain unless the practitioner with
his oiled hand in the rectum can detect a hard stony mass obstruct-
ing the pelvic flexure of the double colon with a tense elastic dis-
tended bowel immediately in front of it, or a similar hard ob-
struction of the terminal part of the floating colon with a similar
distension in front of it. The pelvic flexure may usually be felt
below and to the right at the entrance to the pelvis, and the
floating colon above, under the right, or more commonly the left
kidney. Calculi in the more spacious parts of the double colon
or in the czecum are inaccessible to manipulation. The feed
(bran, ground feed) will be suggestive, as will the occupation of
the proprietor (miller, baker).

Treatment. ‘This is rather a hopeless undertaking. No effec-
tive solvent of the calculus can be given, and purgatives usually
increase the danger by increasing the peristalsis and dangerously
distending the bowel above the point of obstruction. It is true
that this is sometimes followed by a temporary recovery, the cal-
culus being loosened and falling back into the dilated portion of
the bowel. Less frequently the increase in the peristalsis forces
on a moderately sized calcuius to complete expulsion. It is a
desperate though sometimes successful resort. A more rational
course of treatment is the dilation of the bowel back of the ob-
struction by copious mucilaginous, soapy or oleaginous enemata.
Trasbot suggests CO, produced by injecting sodium bicarbonate
and tartaric acid. This may be seconded by the hypodermic in-

—

336 Veterinary Medicine.

jection of barium chloride or of atropia. When the calculus is
lodged in the floating colon or rectum it may be possible to reach
it with the hand and extract it at once. The last resort, is by
laparotomy for the removal of the calculus. One such successful
case is on record in which Filizet removed a calculus as large as
an infant’s head. In other cases the horses failed to survive.
Desperate as the resort may be it is not to be neglected in a case
of undoubted calculus, solidly impacted and of such a size that its
passage is impossible. A fatal result is imminent, and even if

the present attack should pass off it can only be looked on in the

light of an intermission, so that there is practically nothing to
lose in case the result should prove fatal. Anzesthesia and rigid
antiseptic measures should of course be adopted.

FOREIGN BODIES IN THE INTESTINES OF SOLIPEDS.

Sand, pebbles, earth, lime, nails, pins, needles, coins, shot, cloth, leather,
rubber, sponge, tooth, bone, wood, twine. Symptoms: as in intestinal in-
digestion or calculi, or sand or pebbles in feeces; peritonitis, phlegmon.
Lesions ; congestion, catarrh, ulceration, abscess, needles may travel to
other organs. Treatment: laxative, enemata, or as for calculi.

gu

All sorts of foreign bodies are taken in with food and water
and find their way to the intestines. Sand from drinking from
shallow streams with sandy bottoms, from browsing on sandy
pastures where the vegetation is easily torn up, or from feeding
grain from sandy earth will sometimes load the intestines to an
extraordinary extent so that such horses will pass sand for some
weeks after leaving the locality. Small stones and gravel are
taken in the same way, or from the habit of eating earth or
licking crumbling lime walls. Nails, pins, needles, coins, shot,
pieces of cloth, leather, caouchouc, sponge, and even a molar
tooth and a piece of a dorsal vertebra have been thus taken.
Recently the author saw asmall twig of hard wood transfixing
the pylorus and duodenum with fatal effect. In another case
were balls of binding twine which had been taken in with the
fodder on which it had been used.

Foreign Bodies in the Intestines of Ruminants. 337

The symptoms are usually those of intestinal indigestion or cal-
culi. In some cases, however, they are peculiar, thus there may
be a constant passage of sand, there may be indications of peri-
tonitis, or there may form a phlegmonous swelling of the abdom-
inal walls in the abscess of which the foreign body is found.

Lestons. Pechoux found 56 lbs. of a brownish earth in the
ceecum and colon. Congestion and ulceration of the intestines
are common, with occasionally abscess. All the lesions that
attend on or follow obstruction may be met with. Boullonsawa
remarkable case of the ingestion of needles in which these bodies
were found in the small intestine, liver, pancreas, diaphragm,
kidney and lung. ,

Treatment varies with the character of the bodies ingested,
sand and gravel may be passed on by a laxative diet and even by
the use of mild laxatives. Bernard gave 10 quarts of water and
4 0z. Glauber salts every hour for eight days, and the same
amount by enema. For the larger solid bodies which obstruct
the intestines the treatment is the same as for calculus. For
sharp pointed bodies causing abscess and fistulae, we must follow
the indications, ever aiming at the discovery of the whereabouts
of the offending object and its removal.

FOREIGN BODIES IN THE INTESTINES OF
RUMINANTS.

Foreign bodies are usually arrested in the rumen of cattle and
unless sharp, pointed or rough so as to cause mechanical trouble
or caustic so as to act chemically, rarely do much harm. The
most extraordinary objects that have found their way into the
intestine are snakes. Gherardi claims that he found in the in-
testines a snake of 25 inches long ; Jager found one of 21 inches
in length, in an advanced state of decomposition, in the rectum
of acalf. It is supposed that both had been taken-in with the
food. In each case there was obstruction of the intestine with
severe colicy symptoms.

22

FOREIGN BODIES IN THE INTESTINES OF
CARNIVORA.

Small bodies, especially playthings, feathers, hair, bristles, bones of prey.
Lesions: congestion, inflammation, hemorrhage, ulceration, perforation, in-
vagination. Symptoms: colic, vomiting, tucked up belly, straining, pal-
pitation, rabiform symptoms, cough, convulsions. Course: emaciation,
prostration ; death in five days or two weeks according to seat of obstruc-
tion. Treatment: Oleaginous injections, laparotomy.

Causes. 'The dog is especially liable to this form of trouble, in
consequence of his habit of carrying objects in his mouth and of
playing with different objects, especially the playthings of chil-
dren. Marbles, pebbles, spinning-tops, corks, coins, nuts, peach
stones, pieces of rubber, cloth of leather, bits of wood, sponge,
needles, pins, potato, bone, cord, hair, bristles, feathers, wire,
and a number of other objects. Some of them, like feathers,
hair, and bones are swallowed with food, and when that has been
digested, they are either vomited, or failing in this, are passed
on into the intestine. Lately the author made a post mortem of
a house dog with over 24 inches of the jejunum virtually blocked
with fragments knawed from a caouchouc ball and pieces of
twine.

Cats also swallow a variety of objects. Benjamin and Még-
nin record three cases of intestinal obstruction by the crystal
drops of shades.

Lesions. When the lumen of the intestine.is blocked with a
round solid body like a marble or peach stone there occur active
congestion, inflammation, blood stasis and hemorrhage, with, in
many cases, necrosis, ulceration and perforation. Similar lesions
occur from cord. In a recent case of impaction with gnawed
fragments of caouchouc and cord, the 24 inches of the bowel im-
plicated were the seat of extended patches of necrosis and of deep,
and even perforating ulcers on the lesser curvature of the intes-
tine, evidently caused by the tension of the stretched cord on the
shorter attached border of the gut. Cadeac says the lesions from
cord are always at the point of attachment of the mesentery,
whereas those coming from round or cubical solid bodies are
mainly on the greater curvature. Mathis found at the pylorus a

338

Foreign Bodies in the Intestines of Carnivora. 339

piece of net from which a cord extended through the small intes-
tine and ended in a ravelled mass near the ileo-czecal valve. The
dragging of the cord on the intestine often causes invagination
at one or several points.

Symptoms. ‘There may be slight colic, dullness, a disposition
to lie curled up in some secluded place, loss or caprice of appetite,
vomiting, tucked up abdomen, arching of the back, straining,
and unless the bowels are distended with gas, the obstruction can
usually be felt by the two hands applied on opposite sides of the
abdomen. The matters vomited are at first alimentary, then
bilious and in the advanced stages always feculent.

The French veterinarians assure us that rabiform symptoms
are very common as the result of obstruction of the intestines
with foreign bodies. The indications are signs of fury without
the barking which characterizes genuine rabies. The patient
becomes wicked, cross and excitable, sometimes dull and morose,
and snappish, his eyes glittering and his mouth frothy. He has
alternate paroxysms of fury and torpor, at one time flying at
and biting any living thing he meets, or tearing some object to
pieces, and at another hiding away in secluded and dark corners.
Massenat saw two dogs supposed to be affected by rabies, but
which recovered promptly after having vomited the foreign
bodies which they had swallowed. In a country where rabies is
so prevalent as in France, it would be interesting to see the re-
sults of inoculation with some of the most pronounced of these
rabiform cases.

Beside the rabiform symptoms cough and epileptic seizures
occasionally result from the foreign bodies.

Course. Termination. Unless relief is obtained by vomiting
or purging, appetite ceases altogether, emaciation advances
rapidly, the animal becomes dull and stupid, being evidently
poisoned by the absorbed toxins, and death may ensue in four or
five days if the obstruction is near the stomach, or in one or two
weeks if in the large intestines.

Treatment. ‘The general treatment advised for the horse is
applicable to the carnivora. Purgatives are always dangerous as
threatening the overdistention and rupture of the bowel above
the obstruction. Oleaginous and mucilaginous injections with
manipulations are more promising if the obstruction is in the
colon or rectum.

340 Veterinary Medicine.

In many cases laparotomy is the only hopeful resort. Félizet
and Degive have been quite successful in removing corks in this
way, and Frohner advises the operation to be performed under
opium narcosis, and with antiseptic precautions. Make an in-
cision of 134 inch near the umbilicus and parallel to the linea
alba, extract the blocked loop of intestine, ligature it in front of
the foreign body and behind it, incise, remove the offending mass
and carefully close by sutures, bringing the muscular and serous
coats in accurate opposition. Remove the ligatures, disinfect,
return the bowel into the abdomen, close the abdominal wound
with sutures and apply an antiseptic bandage.

If such cases are to be operated on it is important that it be
done early, before the occurrence of necrosis, ulceration, perfora-
tion, or general infection.

RUPTURE OF THE INTESTINE. SOLIPEDS.

Causes : overdistensions in front of obstructions, softening, friability, ne-
crosis, suppuration or ulceration, Duodenum from worms or perforation by
pointed bodies, exudate in verminous embolism, petechial fever. Jejunum
and ileum, by disease of walls, ulcers, abscesses, neoplasms, caustics in um-
bilical hernia, clamping of hernia. Caecum, falls, blows, kicks, blows of
horn, tusk, stump, calculi, abscesses, cauterizing of hernia. Colon, external
traumas, calculi, worms, verminous thrombosis, neoplasms, abscesses, over-
distensions, violent straining, arsenic. Symptoms: follow accident, signs
of obstruction, no rumbling, tympany, stiffness, great prostration, fever.
Death in short time.

Causes. Ruptures occur as we have already seen from over-
distensions of the bowel in front of some obstruction, by ingesta,
concretions, calculi, foreign bodies, etc., and this may take place
in the most healthy organs. In other cases, however, there has
been some pathological process at work rendering the intestinal
wall soft, friable, necrotic, suppurative or ulcerative, by which
its substance is attenuated or its consistency or cohesion reduced.

Duodenum,. Lacerations of the duodenum are often con-
nected with obstruction by tumors or the ravages of worms.
These latter are mostly the ascaris megalocephala, accumulated

Rupture of the Intestine.—Solipeds. 341

in mass, and sometimes engaged in pouches outside the walls of
the gut. In other cases, the walls of the intestine have been per-
forated by hard woody stalks of straw or hay (Mollereau) or of
still more woody plants as in a case observed by the author, and
in which the pylorus was perforated. Sometimes the exudate or
blood extravasation attending on petechial fever, or verminous
embolism will pave the way for the rupture. Perforations by
pieces of wire (Schmidt) or other metallic bodies are also ob-
served. Adhesive peritonitis has also rendered the walls friable
and predisposed to rupture.

Jejunum and Ileum. Lesions are most frequent toward the
termination of the ileum and resulting from obstructions of the
bowel or the weakening of the walls by disease, or both. Ulcera-
tions, abscess of the closed follicles opening into the peritoneum,
and neoplasms of various kinds are to be especially noted among
the causes. The impaction of the czecum, blocking the ileo-
czecal valve is also among the observed factors. Other instances
have been traced to deep cauterization of an umbilical hernia,
the enclosed loop of small intestine becoming inflamed and per-
forated. The author has observed one instance from clamping
of a hernia in which the contained intestine was adherent to the
hernial sac.

Czecum. From its position on the lower part of the abdo-
men and from its habitual plentitude with food or water, this
organ is especially exposed to direct mechanical injuries and
ruptures. A sudden fall, more especially if the umbilical region
strikes on a stone or other projecting solid body, kicks with
heavy boots or with the feet of other animals, blows with a cow’s
horn or a boar’s tusks, and violent contact with stumps, poles
and other objects may be the occasion of the rupture. These are
usually found near the base of the viscus. and across its longi-
tudinal direction.

Inflammations, connected with punctures, calculi, parasites,
etc., may render the walls so friable that they give way under
slight strain or injury. Abscesses have been found in the walls
of the viscus leading to perforation, and extension of infiamma-
tion from an umbilicus cauterized for hernia has determined ad-
hesion and perforation.

Colon. ‘The loaded colon is even more liable to mechanical

342 Veterinary Medicine.

injury than the cecum. Occupying as it does the more lateral
parts of the abdominal floor, it is even more exposed to kicks
and blows, and extending as it does back toward the inguinal
regions, it is especially in the way of blows of horns so often de-
livered in this region. From the solid nature of its contents the
presence of calculi, the presence of blood-sucking worms, and
its implication: in the congestions and extravasations of vermin-
ous thrombosis, this organ is especially liable to degenerations
and inflammations which render its walls particularly friable.
Neoplasms of various kinds, cancerous, tubercular, etc., have
been found on its walls as occasions of rupture. Abscesses of
strangles have ruptured into the viscus. Overdistensions in
front of an obstruction in the pelvic flexure, floating colon or
rectum are the most frequent causes of rupture. Again, cases
have been seen as the result of violent exertions, as during strain-
ing in dystokia. It has been a complication of phrenic hernia,
of volvulus of the double colon, and of ulceration caused by the
prolonged ingestion of arsenic. In severe impaction the necrosis
of the intestinal walls has proved a direct cause of laceration.
The seat of these ruptures may be at any point, bnt it is most
frequent in front of the pelvic flexure, or in the floating colon, or
directly in the seat of impaction.

Symptoms. ‘The attack comes on suddenly, perhaps in connec-
tion with some special accident or injury, and is manifested by
violent colicy pains which show no complete intermission. In
many respects the symptoms resemble those of complete obstruc-
tion of the bowel, there is a suspension of peristalsis, rumbling,
and defecation, a tendency to roll on the back and sit on the
haunches, an oblivion of his surroundings and pain on pressing
the abdomen. Usually the shock is marked in the dilated pupil,
the weak or imperceptible pulse, the short, rapid breathing, cold
ears, nose and limbs and the free perspirations. Tympany is
usually present as the result of fermentation. Signs of infective
peritonitis and auto-intoxication are shown in the extreme pros-
tration, unsteady gait, dullness and stupor, and general symp-
toms of collapse. The temperature, at first normal, may rise to
105” or 106° as inflammation set in, and may drop again prior to
death.

Termination is fatal either by shock or by the resulting peri-

Rupture of the Intestines in Ruminants. 343

tonitis and auto-intoxication. Exceptions may exist in case of
adhesion of the diseased intestine to the walls of the abdomen
and the formation of a fistula without implication of the peri-
toneum.

RUPTURE OF THE INTESTINES IN RUMINANTS.

From blows of horns, tusks, etc., from rectal abscess. Symptoms: colic,
resulting in septic peritonitis and sinking. Treatment.

Lesions of this kind usually come from blows with the horns
of others. ‘They may lead to artificial anus as in a case reported
by Rey, or the formation of a connecting sac as in that of Wal-
ley. Ina case seen by the author a large abscess formed above
the rectum, from injuries sustained in parturition. This ruptured
into the gut leaving an immense empty cavity in which the hand
could be moved about freely, but which gradually contracted so
that the cow made a good recovery.

André furnishes an extraordinary record of rupture of the
colon, blocked by a potato. It seems incredible that a potato
could have traversed the stomachs and intestine without diges-
tion.

The symptoms are those of violent colic suddenly appearing in
connection with some manifest cause of injury, and going on to
septic peritonitis and gradual sinking.

Treatment is manifestly useless excepting in the case of some
such fortunate condition asin the case of abscess of the rectum
in which the free use of injections and the antisepsis of the ab-
scess cavity proved successful.

LACERATION OF THE INTESTINE IN SWINE.

This is rare and appears to have been observed only in con-
nection with scrotal and ventral hernias, with adhesion. It may
lead to an artificial anus which in its turn may cicatrise and close,
or to the discharge of faeces into the peritoneal cavity with fatal
effect. If seen early enough, laparotomy with suture of the
bowel and careful antisepsis will be indicated.

LACERATION OF THE INTESTINE IN CARNIVORA.

Obstruction and overdistension, necrosis, ulceration, feculent impaction,
kicks, parasites, caustics, abscess, tubercle, cancer. Symptoms: peritoni-
tis following accident, vomiting, no defecation. Treatment : laparotomy.

‘The most common cause of intestinal rupture is obstruction by
foreign bodies, with overdistension of the bowel immediately in
front, or necrosis and ulceration of the portion of the bowel.
pressed upon. Feculent impaction acts in a similar way. Kicks
and other external injuries sustained on a full intestine will lead
to rupture. Perforation by parasites, by caustic agents swal-
lowed, by abscesses, and by tubercle or cancer is also to be met
with.

The symptoms are those of sudden peritonitis, with marked ab-
dominal tenderness, tucking up of the abdomen, bringing the
legs together under the body, vomiting, suspension of defecation
and peristalsis. Rabiform symptoms have been noted.

Treatment. As in swine there is every hope of success by
suture of the intestinal wound if done early. The same general
method may be followed as in closing the wound after extraction
of a foreign body. aes

ABSCESS OF THE BOWEL IN SOLIPEDS.

In strangles, from puncture, kicks, blows, foreign bodies in food, larva,
cysts, large or small, creamy or cheesy, open into bowel or peritoneum, 1n-
fective peritonitis Symptoms: rigor, ill health, unthrift, colics, tender ab-
domen, tympany, painful movements, lying, rising, turning, going down-
hill, rectal exploration, phlegmonous swelling, pus passed by anus. Treat-
ment : open when it points on abdominal wall, or when near rectum, anti-
septics, support strength, careful dieting, antipurulent agents.

This is most common as an irregular form of strangles, the ab-
scess forming in connection with the mesenteric glands or on the
walls of the intestine. Small abscesses may also implicate the
mucous glands or Peyer’s patches as a result of catarrhal enteritis.
Less frequently an abscess forms in the seat of the puncture of
the colon for tympany, or in connection with blows, kicks, punc-

344

Abscess of the Bowel in Solipeds. 345

tures with stable forks, nails and other pointed objects. Foreign
bodies entering with the food and the cysts of the larvee of the
sclerostomata will also give rise to suppuration.

These abscesses may attain a large size, especially in strangles,
and involve adhesions between the bowel and other viscera, or
the walls of the abdomen. Or they may be small like peas or
beans scattered along the coats of the intestine or between the folds
of the mesentery. They may be inspissated to the consistency
of thick cream or rich cheese, and they may rupture into the in-
testine, or through the abdominal walls into the peritoneum. In
the last case infective peritonitis sets in usually with fatal results.

Symptoms. These are generally obscure. There may have been
noticed a rigor, and there are always marked indications of ill
health, dullness, lack of spirit or appetite, dryness, and erection
of the hair, hide bound, insensibility of the loins to pinching,
colics after meals, tenderness of the abdomen, tympany, groan-
ing when lying down or rising, when turned around short, or
when walked down hill. Sometimes the abscess can be distinctly
felt by the hand in the rectum. When it implicates the abdomi-
nal walls there is usually a diffuse phlegmonous swelling, at first
soft and pasty, then firm and solid, and finally softening and
fluctuating in the center. Sometimes there is the evacuation of
pus by the anus or of the investing membrane of the abscess, and
this may be expected to herald recovery. In case of infective
peritonitis there are the usual symptoms of stiff movement, the
bringing of the feet together under the belly, abdominal tender-
ness, trembling, hyperthermia, cold ears and limbs, cold perspi-
rations, great dullness and prostration, small, weak or impercep-
tible pulse, hurried breathing and gradual sinking.

Treatment. ‘This is most favorable when the abscess ap-
proaches the surface so as to be punctured through the abdominal
walls. In other cases it is so situated that it can be punctured
with trochar and cannula through the rectum. In sucha case it
may be evacuated and injected with a nontoxic antiseptic, the
puncture and injection being repeated as wanted. In the inter-
nal and deeply seated abscesses we must seek to support the
general health, give pure air, easily digestible and nourishing
food, and agents that may be hoped to retard suppuration. Hy-
posulphite of soda in % oz. doses, or sulphide of calcium in
scruple doses, may be repeated two or three times a day.

ULCERATION OF THE INTESTINES.

Symptom or sequel of other disease, or from traumas, caustics, neoplasms,
peptic ulcers, verminous thrombosis, tubercle. Catarrhal erosion, peptic,
deep, round ulcer, calculi with irregular ulcers, cord ulcer at mesenteric
attachment, small, follicular, grouped ulcers, sloughing ulcers of infectious
diseases, circular projecting, button-like ulcers of hog cholera, microbes.
Symptoms: diarrhcea, black, or red, sloughs, fever, blood stained vomit,
manipulation. Treatment: for foreign body, poison, or infectious disease,
careful diet, antiseptics.

Ulceration of the intestines is commonly a symptom or sequel
of other intestinal disorder, such as intestinal catarrh, impaction,
calculus, foreign body, parasites, petechial fever, influenza,
glanders, rinderpest, Southern cattle fever, hog cholera, pneumo-
enteritis, rabies, canine distemper. Then there are ulcers,
caused by sharp-pointed bodies, by caustic agents ingested, and
by obstructive changes in neoplasms. Peptic ulcers may occur
in the duodenum asin the stomach. Finally local disturbances
of the circulation and especially such as attend on verminous
thrombosis, are at once predisposing and exciting causes of
ulceration. Tuberculosis and other neoplasms are additional
causes.

The ulcers may vary in different cases. In catarrh there is
usually superficial desquamation of the epithelium, and erosions
rather than deep ulcers. The peptic ulcer forms on the de-
pendent wall of the gut, where the gastric secretions settle, and
assumes a more or less perfectly circular outline (round ulcer).
Those due to calculus or impaction, may be irregular patches
mostly on the unattached side of the intestine and resulting from
necrosis of the parts most exposed to pressure. The ulcers re-
sulting from cords stretched along inside the bowel, are in the
form of longitudinal sores on the attached or mesenteric side of
the intestine, where the wall being shorter the cord continually
presses. Follicular ulcerations are usually small, deep excava-
tions, commonly arranged in groups. Ulcers connected with neo-
plasms have an irregular form determined by that of the morbid
growth. In infectious diseases the ulcers are round or irregular,
resulting from circumscribed sloughs. In most of the infectious

346

Ulceration of the Iniestines. 347

diseases the tendency appears to be to attack the intervals be-
tween the folds of the mucosa, probably because the bacteria of
ulceration find a safer lodgement in such places. In the hog
cholera ulcers the older ulcers tend to the circular form with
thick mass of necrotic tissue in the form of plates or scales im-
bedded in the bottom and projecting above the adjacent surface
of the mucosa. Asa rule the microbes which in the different
cases preside over the necrobiosis are found in the depth and
walls of the ulcers.

The symptoms are largely those of the diseases of which the
ulcers are a concomitant or result. There is usually diarrhcea,
which is generally black from extravasated blood, and may be
marked by fresher red bloody strize. Sloughs of variable size
are not at all uncommon in the feces. Hyperthermia is usually
more intense than in ordinary chronic enteritis, indicating the
action on the heat producing centres of the necrosing microbes
and their toxins. In pigs and dogs there may be vomiting of
dark blood stained material or of feculent matter. In the small
animal it may be possible to feel through the walls of the abdo-
men the thickening of the intestine at and around the seat of
any extensive ulcer.

Treatment. So far as this is not the treatment of the foreign
bodies, poisons, or specific fevers which cause the ulcers, it
consists mainly in careful dieting and the use of antiseptics such
as subcarbonate of bismuth, salol, salicylic acid, sodium salicylate
or napthol.

DILATATION OF THE INTESTINE.

Capacity adapted to ingesta, rich and nutritious food improves breeds,
excessive filling renders paretic, dilates ; obstructions, impactions, strangu-
lations, hernias, invaginations, twisting, tumors, compressions, calculi,
lowered innervation, impaired circulation, verminous aneurism, peritonitis,
persistent umbilical vesicle in horse and ox, hernia of mucous through
muscular coat, czecal dilatation, colic, rectal, with atresia ani, diseased end
of cord, retained feeces. Symptoms: colics after meals, abdominal and
rectal exploration, softer than impaction. Treatment : empty mechanically
or by laxatives, demulcents, kneading, stimulants, nux vomica, ergot, ba-
rium chloride, eserine, rich concentrated food, electricity, enemata, lax-
atives.

It is a physiological law that the intestine develops in ratio with
the demands made upon it, provided these demands are not too sud-
den and extreme. ‘Thus the domestic pig and rabbit have intes-
tines at once longer and more capacious than those of the wild
varieties. ‘[‘he same is trne of cattle and even of horses, heavy,
rich, feediug, generation after generation, increases the capacity
to take in and utilize more, and to attain toa larger size and earlier
maturity. In such a case the walls of the intestinal canal retain
their primary thickness and strength and the whole change is in
the direction of physiological improvement for economical ends.

When, however, the retention or habitual accumulation of food
in the alimeutary canal exceeds the self-adapting powers of its
walls a true pathological dilatation takes place, and attenuation
or thickening and paresis or actual paralysis of the walls ensues.

Whatever interferes with the normal active movement of the
ingesta predisposes to this. Thus partial obstructions of all
kinds, strictures, impactions, strangulations, hernias, invagina-
tions, twisting, tumors, compressions, calculi, contribute to the
overfilling of the bowel in front of them and to its more or less
speedy dilatation. Whatever weakens the muscular walls of the
bowels or the nerves presiding over these has a similar effect.
Thus pressure on the solar plexus or its branches from any cause,
or degeneration of the same, a tardy and imperfect circulation
resulting from verminous aneurism and thrombosis, and a cir-
cumscribed peritonitis extending from the serous to the muscular
coat of the bowel act in this way.

348

Dilatation of the Intestine. 349

The persistence of the canal of the umbilical vessel has been
repeatedly observed in solipeds, in the form of a pouch or dilata-
tion connected with the ileum three or four inches in front of the
ileoczecal valve. Rauscher records one of these of thirteen inches
long and having a capacity of seven quarts. These have been
noticed in cattle as well.

Another form of sacculation results from rupture of the muscu-
lar coat through which the mucous forms a hernial sac in the
peritoneal cavity. Ona small scale these sacs are not uncommon,
the size of a pea, a bean, or a marble, and very often containing
larval or mature worms. Degive records an enormous dilatation
of the horse’s czecuin, Peuch, one of the pelvic flexure of the
colon having a capacity of forty pounds, and Simonin one of the
floating colon. Dilatations of the rectum always take place in
the new born affected with atresia ani.

Dilatation of the rectum into a cloaca is found in the horse
and ox, often connected with disease or injury of the terminal
part of the spinal cord, and is very common in dogs and cats in
connection with the compulsory retention of the feeces when
indoors. Pigs also present instances of the kind.

The symptoms are in the main slight colics, with or without
tympany and recurring after each meal. In the small animals
the distended gut may often be recognized by palpation through
the abdominal walls, and in the larger animals by rectal explora-
tion. ‘The distended viscus has not the firmness nor hardness of
impaction or calculus and is mainly recognizable by its bulk and
form. When the distension is in the rectum it may be easily
reached and contents dislodged with the effect of giving complete
relief for the time being.

Treatment. ‘Treatment is necessarily mainly palliative and
consists in the removal of abnormal accumulations. From the
rectum this can be done with the hand, or in the smaller animals
with the finger. For abnormal dilatations more anterior, purga-
tives and mucilaginous injections are required, with kneading of
the bowels through the abdominal walls, or through the rectum
in the larger animals, and stimulation of the peristalsis by nux
vomica, ergot, barium chloride or eserine.

Having unloaded the dilated portion of any undue collection,
further accumulation should be guarded against by giving nutri-

350 Veterinary Medicine.

tious food in small compass, and of a laxative nature, by stimu-
lating peristalsis by nux vomica or other nerve stimulant and by
the daily application of electricity. Enemata and laxatives should
be employed when necessary. :

STRICTURE OF THE INTESTINE.

From healing of ulcers, inflammation or infiltration, neoplasms, ring like
or sacculated, in small intestine in horse preceded by a dilatation, au effect
of verminous trombosis; in cattle; in dog. Symptoms: Progressive, if in
duodenum can’t eat full meal, belches gas, has colics and tympany ; in
cattle tympany, unthrift ; in dog vomiting, tympany, colic, accumulations.
Treatment: Gradnal stretching by bougies if within reach.

Strictures of the intestine are in the main the result of ulcera-
tion of the intestinal walls which contract in healing, or inflam-
mation, and infiltration which leads to contraction in their
organization into tissue. Neoplasms of the walls (cancer,
myxoma, lipoma, polypus, melanosis, actinomycosis, tubercle)
are additional causes of constriction. If resulting from a lesion
which completely encircled the bowel there is an uniform con-
striction in the form of a circular ring. if on the other hand it
started from a longitudinal ulcer or lesion the bowel is shortened
on that side and puckered.

In solipeds strictures are most frequent in the small intestine,
orrectum. The pylorus is often affected. When on the small
intestine there is constantly a dilatation just in front of the ob-
struction. The constricted portion is usually short, but as seen
from outside of the gut may be duplicated a number of times.
Cadeac mentions seventeen such strictures in the same animal,
each preceded by a dilatation. The individual stricture may be
less than two inches in length and so narrow as just to allow the
passage of the index finger. The walls of many times their
natural thickness, are still further thickened by an external layer
of adipose tissue. It may be the seat of a small abscess, or of a
tumor. Internally the mucosa may show ulcerations.

The stricture or strictures in solipeds often depend on the dis-
turbance of the circulation which results from verminous throm-

Stricture of the Intestine. 351

bosis, the exudate into the intestinal walls, undergoing organiza-
tion, at once thickens and constricts the tube, and determines as
secondary result the dilatation in front of it.

Professor Mauri, of Toulouse, records the case of a horse with
a rectal stricture 4 inches from the anus, and a great dilatation
in front. The removal of the stricture secured normal defeca-
tion, (whereas before this the faeces had to be removed by hand)
and the colics entirely disappeared.

In cattle strictures have been found mainly at or near the
pylorus, less frequently in the rectum, and on one occasion
(Revel) in connection with a cancerous tumor, in the colon.

In the dog the pylorus is also the favorite seat of thickening
and stricture, yet it may occur in the small intestine, the rectum,
or the colon.

Symptoms. ‘These are gradually advancing, as the stricture
approaches more and more nearly to a complete stenosis. If the
stricture is in the pylorus or duodenum, the patient can not eat a
full feed of grain without discomfort. He stops, hangs back on
the halter, plants the fore feet in front, arches the neck, draw-
ing in the nose and eructating gas. If he cannot eructate he is
liable to show colics, tympany, and the general symptoms of
gaseous indigestion of the stomach.

In cattle there is tympany, partial loss of appetite, tardy
rumination, and loss of condition.

Dogs show vomiting as a prominent symptom. When the
stricture is in the rectum there is a gradual lessening of the
amount of faeces passed at a time and an accumulation of fecu-
lent masses in advance of the obstruction, recognizable by rectal ~
exploration. When in the terminal part of the small intestine or
in the colon, a gradual lessening of defecation with tympanies
and colics, culminating in complete obstruction, may afford a
suggestion of the trouble but no means of certain diagnosis.
In the smaller animals some additional indications may be had
from abdominal palpation.

Treatment is usually hopeless unless the stricture is in the
terminal portion of the rectum. In the latter case gradual dila-
tation by the passage of the hand, the finger, or of bougies
which are used larger and larger, as they can be forced through
with moderate pressure may secure a sufficient dilatation.

352 Veterinary Medicine.

Forced dilatation, or even careful incision at several different
points of the circumference of the stricture may give good
results in certain cases.

INTESTINAL INVAGINATION. INTUSSUSCEPTION
IN SOLIPEDS.

Definition, Seat: ileum into cecum, rectum threugh sphincter, duode-
num into stomach, floating small intestine into itself, caecum into colon.
Lesions: blocking, or tearing of mesentery, dark congestion, peritoneal ad-
hesions ; incarcerated gut, necroses, sloughing of invagination. Symptoms:
colics of obstruction, enteritis, and septic infection, eructation, emesis, ten-
esmus, signs of sepsis and collapse, death in seven hours or more, or recovery
by disinvagination or sloughing. Diagnosis: by rectal exploration or pass-
ing of slough. Treatment: oily laxatives, demulcents, enemata, mechani-
cal restoration of everted rectum, laparotomy.

Definition. The sliding of one portion of an intestine into a
more dilated one, as if a few inches of the leg of a stocking were
drawn within an adjoining portion which is continuous with it.

Seat. It is most commonly seen in the inversion of the small
intestine into itself or into the czecum, or next to this the pas-
sage of the rectum through the sphincter ani, to constitute
eversion of the rectum. It would appear to be possible at any
part of the intestinal canal in the horse, in which the bowels are
more free to move than they are in ruminants. Peuch records a
case of invagination of the duodenum into the stomach and
Cadeac gives a woodcut of such a case, which one would suppose
the fixed position of the duodenum would render impossible. It
is conceivable that the jejunum could be invaginated into the
duodenum, and that this should have continued until it extended
into the stomach, but it is difficult to see how the duodenum it-
self could have passed into the stomach without tearing itself
loose from its connections with the pancreas, liver and transverse
colon.

Schroeder, Serres and Lafosse describe cases in which the small
intestine was everted into the caecum and thence through the
colon and rectum until it protruded from the anus.

The invagination of the floating small intestine into itself is
common at any point, and extensive and even repeated. Marcout

Intestinal Invagination.—Intussusception in Solipeds 353

©

records a case in which 24 feet were invaginated, and Rey a case
of quadruple invagination at the same point.

The invagination of the caecum into the colon is frequent, the
blind end of the cecum falling into the body of the same organ,
and this continuing to increase until it passes on into the colon,
and even carries a portion of the small intestine with it. This
lesion is more rare in solipeds because the caecum has its blind end
lowest and gravitation opposes its invagination.

Resulting Lesions. In any case of invagination it must be
noted that it is not the intestine alone which slips into its fellow,
but it carries with it its attaching mesentery, which, dragging on
one side of the invaginated gut, shortens and puckers that and
turns its opening against the wall of the enclosing gut so as to
block it, while the opposite or free side passes on and tends to
form convolutions. If the outer and enveloping intestine is too
small to allow of this, the detaining mesentery of the invaginated

-mass must be torn or stretched unduly and its circulation and
innervation correspondingly impaired. When the invagination
occurs of one portion of the small intestine into another of nearly
equal size, the resulting mass is firm like a stuffed sausage, and
this enlargement and consolidation ends abruptly at the point of
visible entrance of the smaller contracted portion, into the larger
dilated one.

If recent, the invaginated mass is still easily disengaged from
the enveloping portion, though considerably congested and dark
in color in proportion to the duration of the lesion. When it has
been longer confined the incarcerated portion is the seat of
extreme congestion, and extravasation, and has a dark red or
black color. The exudation into its substance, which is especially
abundant in the mucosa and submucosa, produces a thickening
which may virtually close the lumen, and on the opposing peri-
toneal surfaces leads to adhesions which prevent the extraction
of the imprisoned mass. The interruption of the circulation and
the compression of the invaginated mass, leads soon to necrosis
and thus a specially offensive odor is produced, and if the animal
survives, the whole may besloughed off and passed with the feeces,
the ends of the intussuscepted portion and of that receiving it
meanwhile uniting and becoming continuous with each other.

Symptoms. ‘These are the violent colic of obstruction of the

23

354 Veterinary Medicine.

bowels, soon complicated by those of enteritis and finally of
septic infection.

The animal looks at his flank, paws, kicks with his hind feet,
lies down, rolls, sits on his haunches, waves the head from side
to side, and sometimes eructates or even vomits. Straining may
be violent, with the passage of a few mucus-covered balls only,
and rumbling may continue for a time if the small intestines
only are involved.

The partial subsidence of the acute pains, the presence of
tremors, dullness and stupor, the coldness of the ears and limbs,
the small, weak or imperceptible pulsations, the cold sweats,
dilated pupils, and loss of intelligence in the expression of the
eye and countenance may indicate gangrene, and bespeak an
early death which may take place in seven hours.

The subsidence of the acute symptoms with improvement in
the general appearance and partial recovery of appetite may
indicate a spontaneous reduction of the invagination, an issue
which may happily arrive in any case in the early stages, but
especially in those implicating the caecum and colon.

An absolutely certain diagnosis is rarely possible, unless the
lesion is a protrusion of the rectum, or unless as the disease ad-
vances the invaginated part is sloughed off and passed per anum:

Treatment. ‘The failure to make a certain diagnosis usually
stands iu the way of intelligent treatment. Oleaginous laxatives
and mucilaginous gruels are advised to keep the contents liquid,
and favor their passage through the narrowed lumen of the
invaginated bowel. In cases implicating the floating colon and
rectum abundant watery or mucilaginous injections may assist
in restoring a bowel which has not been too long displaced. In
case of eversion of the rectum, the hand should be inserted into
the protruding gut and carried on till it passes through the
sphincter ani. Then, by pushing it onward, the arm carries ina
portion of the invaginated gut and usually of the outer portion
next to the anus as well, and this should be assisted by the other
free hand, and even if necessary by those of am assistant, and
whatever is passed through the sphincter should be carefully
retained, while the arm is withdrawn for a second movement of
the same kind, and this should be repeated until the whole pro-
truding mass has been replaced.

Intestinal Invagination in Ruminants and Swine. 355

Invaginations situated more anteriorly and which can be cor-
rectly diagnosed by rectal exploration or otherwise, will some-
times warrant laparotomy, especially those of the caecum into the
colon, where adhesion of the peritoneal surfaces is less common
or longer delayed. The patient should be given chloroform or
ether, the abdominal walls should be washed and treated with
antiseptics, and the incision made back of the sternum and to one
side of the median line, and large enough to admit the exploring
hand. It has also been suggested to introduce the hand through
the inguinal ring, or behind the posterior border of the internal
oblique*muscle.

INTESTINAL INVAGINATION IN RUMINANTS AND
SWINE.

Double colon cannot be invaginated, floating small intestine, caecum and
floating colon can. Causes. Lesions. Symptoms: Acute, violent, persist-
ent colic, palpation of right flank causes gurgling, rectal exploration, pros-
tration, collapse. Duration one to five weeks. Treatment: Laxative, ene-
mata, injections of sodium bicarbonate and tartaric acid, laparotomy.

In these animals the double colon is rolled around itself between
the folds of the great mesentery the free border of which sup-
ports the small intestine. The arrangement is as if a piece of
rubber tubing were first doubled upon itself, and the end of the
loop were then turned inward and the remainder wound round it
asacentre. If this were then sewed between two pieces of cloth,
the stitches passing between the different windings of the tube at
all points, we would have an arrangement fairly representing that
of the double colon of ruminants, and, for our present purpose, of
swine as well. It must be evident that no portion of a tube
arranged in this way can slide into another. It would also appear
that the small intestine cannot become invaginated to any extent
into another portion or into the caeecum without extreme stretching
or laceration of the small portion of mesentery left between it and
the coils of the double colon above. The anatomical arrange-
ment is therefore opposed to the formation of invaginations in a
way that is not the case in the horse.

356 Veterinary Medicine.

Yet invaginations are by no means unknown in these genera.
The small intestine can be invaginated into itself or into the
cecum. ‘The ceecum, which floats loose at the right side of the
mesentery that envelopes the double colon, can be invaginated
into the colon, and the floating colon can be invaginated into the
double colon on the one hand and into the rectum and through
the anus on the other. Invagination into the rectum, for eight
inches, in a bull calf, of six days old, is reported by Cartwright
in the Veterinarian for 1829. Ina similar case of Youatt’s the
intussuscepted portion sloughed off and was discharged per anum.

The causes are like those acting in solipeds, and whigh give
rise to excessive and irregular peristalsis. A drink of ice cold
water, indigestions and colics of various kinds, diarrhcea, chills,
the irritation caused by poisons or parasites, and the paresis and
dilatation of portions of the intestine into which the more active
portions can easily pass. Almost any irritation or congestion may
cause intussusception, and young animals in which peristalsis is
most energetic are the most liable.

Lesions. The intussusception is usually found in the ileum and
to a less extent in other parts of the small intestine, or involving
the cecum and colon, or again the floating colon and rectum.
‘The successive conditions of congestion, exudation, adhesion, ob-
struction, necrosis, sloughing, and repair by union of the remain-
ing ends are the same as in the horse.

Symptoms. ‘There is acute, agonizing and dangerous colic in
an animal in which these troubles are usually comparatively slight
and transient. The animal looks at the right flank, paws or
stamps with fore feet as well as hind, lies down and rises often,
strains to pass manure but passes only mucus or a few small hard
masses, if anything. If pressnre is made on the right side of the
abdomen and the hand suddenly withdrawn there isa significant
gurgling and the corresponding hind foot is lifted or moved for-
ward or backward, appetite and rumination are lost, the pulse be-
comes rapid and weak, and the animal becomes prostrate, dull
and stupid, often remaining recumbent in spite of all efforts to
raise him. Rectal exploration may detect the firm tender mass in
the seat of the invagination. The disease may last from one
week to five, according as the obstruction is complete or partial.
The usual termination is a fatal one, though a certain number of
spontaneous recoveries are met with.

Intestinal Invagination in Dogs and Cats. 357

Treatment. By a happy accident the peristalsis or anti-peris-
talsis determined by a purgative will sometimes disengage the in-
tussuscepted bowel. Copious injections into the rectum may also
prove useful in case of intussusception of the floating colon or
rectum. Or the disengagement of carbon dioxide from the in-
jection of solutions of sodium bicarbonate and tartaric acid may
be tried. Laparotomy is however the most radical measure when
a certain diagnosis has been made and this is less dangerous in
the cow than in the horse in which peritonitis is so grave.
Under antiseptic precautions an incision is made in the right
flank and the invagination found and reduced. In case firm ad-
hesions have already taken place, and above all if the included
gut is apparently gangrenous, the latter may be exposed by
breaking down the connections at the side opposite to the attach-
ment of the mesentery, or where the lesions are least firm,
then cutting out and removing the incarcerated gut and carefully
closing the opening between the ends by suture. The use of a
sublimate or carbolic acid solution and careful suturing and ban-
daging of the external wound with carbolated cotton wool will
often give a successful issue.

INTESTINAL INVAGINATION IN DOGS AND CATS.

Anatomical conditions favor. Causes: as in other animals, common in
icterus, and surgical operations from deranged peristalsis. Lesions : most
common in small intestines, congestion, inflammation, necrosis, sloughing.
Symptoms: may be colic, but not always, dullness, anorexia, vomiting, con-
stipation, palpation, swelling firmer than from impacted twine. Treat-
ment: shot, castor oil and exercise on hind legs. Demulcents. Lapa-
rotomy.

The intestines of the carnivora are more open to invagination
than in other domestic animals for even the colon is free enough
throughout its course to allow of one part sliding into another.
The causes to which it is attributed are in kind the same as in
other domestic animals. The swallowing of ice cold water
in excess when heated, diarrhoea, superpurgation, intestinal
worms, the active peristalsis of early life, and jaundice have
been especially blamed. Reynal found intussusception twenty

358 Veterinary Medicine.

times in forty cases of icterus and Rancilla four times in five
cases. It has been frequently seen after severe surgical opera-
tions, and it is surmised that in both cases alike the deranged
peristalsis attendant on severe suffering was the cause of the
accident.

Seat and Lesions. The most common seat of invagination is
in the small intestines, and less so in the ceeum and colon, or
rectum. The lesions are as in the other animals, congestion,
infiltration, adhesion, necrosis, gangrene and sloughing.

Symptoms. ‘There may be colics as in the larger animals, but
in some instances there are simply prostration, dullness, inappe-
tence, vomiting, constipation, or the passage of a little liquid
and foetid excrement. Palpation of the abdomen detects a firm,
cylindroid and very tender swelling on the line of the softer intes-
tine which taken with the other symptoms is nearly pathognomo-
nic. If situated in the small intestine and disconnected from the
rectum and pelvis the diagnosis is more satisfactory. Impaction
is most commonly in the rectum and floating colon and can be
traced into the pelvis and even felt by the finger introduced into
the anus. It might be confounded with obstruction of the intes-
tine by the ingestion of twine, but the swelling is usually firmer
and the cylindroid outline more uniform in intussusception.

Treatment. ‘The measures recommended for the larger ani-
mals are applicable to the dog. Cadeac has had four recoveries
in seven cases after the use of leaden shot and castor oil. ‘Three
balls of No. 16 calibre are dipped in castor oil and given to the
dog. This is followed by % oz of castor oil slightly heated, and
walking or running exercise, or take the dog by his fore limbs
and walk him around on his hind. No drink is allowed for 24
hours, and a quart of decoction of flax seed on the day following.

Should these measures fail, laparotomy is available, yet it is
more promising in proportion as it is resorted to early, before
ulceration, or gangrene has set in. The manipulations are prac-
tically the same as in the ox and the outcome is even more
promising. The diet should be restricted to milk or mucilaginous
gruels for a week after the operation.

VOLVULUS (TWISTING) OF THE INTESTINE IN
SOLIPEDS.

Definition : rolling of a loop on its mesentric axis, bending in a vicious,
direction, rolling of one loop round another. Causes: laxity of mesentery
in hernia, relaxation or rupture of linea alba, pot belly in old breeding
mares, sudden movements in falls, leaps, draught, galop, slipping, mount-
ing, warm weather, casting, rolling, rising, sudden filling of a loop, heavy
feeding and fermentescible food, cold drinks, chills. Lesions, most in
double colon, next in jejunum, ceecum wrapped in small intestine, floating
colon, tympany and pallor of obstructed loops, later congestion, infiltration,
extravasation, adhesions, necrosis, sloughs, infective peritonitis. Symptoms:
sudden severe attack, violent, reckless colicy movements, pain constant with
exacerbations, fever, prostration, collapse. Diagnosis: only by rectal ex-
ploration and exceptionally. Treatment : by rectal manipulation, eserine,
castor oil, laparotomy.

Strictly speaking this lesion consists in the twisting of a loop of
intestine upon the mesenteric axis, so that the portion which is
drawn spirally over the mesentery of the other is more or less
completely obstructed. The term has, however, been applied as
well to the turning of a viscus at a sharp angle from its normal
direction so as to interfere more or less with the passage of its
contents and with its circulation. This has been especially seen
in a vicious direction given to the caecum, but also at times to the
double colon. ‘The simple twisting on the mesenteric axis is
common to the floating portion of the small intestines, the double
colon, floating colonand rectum. A third form of twisting which
is, however, rather a strangulation, consists in the rolling of one
loop of intestine round the loop of another, the mesentery of
which has become unduly long.

Causes. "The predisposing cause is a certain laxity or undue.
lengthening of the mesenteric attachment of the intestine. This is
sometimes formed in connection with the existence of hernia, into
which the bowel protrudes, or short of this relaxation or rupture
of the linea alba so that the whole of the intestinal mass hangs
down unduly, or finally in unthrifty pot-bellied animals and in
breeding mares in which the abdomen is unduly pendent.

Next comes the question of sudden movement as in falls, in
leaping, in violent exertions of draught, or galop, in sudden slip-

359

360 Veterinary Medicine.

ping upon wet or icy ground, and of stallions in mounting mares.
In the Omnibus Company’s (Paris) horses, Palat found 35 cases
in entire horses, 23 in mares, and 11 in geldings. “The stallions
in the stables were fewer than the mares and geldings put to-
gether, but it does not appear that the difference was sufficient to
make the above figures very significant. ‘These stallions it should
be added, are not used for breeding, so that the statistics have no
bearing on the effect of mounting.

Palat’s figures show a greater number of cases in summer than
in winter. ‘There were 58 cases from April to October and but 21
from November to March. It would seem as if the relaxation of
the system and mesentery in summer more than counter-balanced
the combined effect of slipping on ice and sudden chills.

A large proportion of the cases have been found in horses that
have died of colic, or which have been cast for operation, and the
recent character of the lesions has often shown that we must
look upon them as the result of the tumultuous peristalsis, and the
lying, rolling, sitting and other sudden and unwonted movements
performed. <A heavily loaded portion of bowel, occupying a posi-
tion slightly lower than a lighter portion or parallel to it, suddenly
moves by gravitation when their relative positions are altered as
in rolling, decubitus, or rising, and it thereby becomes twisted
upon itself. Or a portion of intestine filled with liquid or gaseous
contents is suddenly emptied by the passage of these onward into
another and the latter portion of intestine or some other lodged
alongside it, in moving to fill the place, rotates upon itself and
establishes a volvulus.

Hard worked horses which are subjected to stimulating feeding
, are much more frequently attacked than those which have light
work and feeding. Inthe same way newly harvested hay or oats,
spoiled or otherwise indigestible food have apparently been pro-
ductive causes. Cold drinks, and exposure to cold draughts
have been similarly charged. Indeed any cause of indigestion
and colic may be held to predispose to volvulus.

Lesion. Seat. Twisting of the small intestine is impossible
in the duodenum, and for the floating portion it is far more com-
mon in the ileum and terminal portion of the jejunum where the
mesentery is long than in the anterior jejunum where it is short.

The double colon from the sternal portion to the pelvic flexure

Voluulus (Twisting) of the Intestine in Solipeds. 361

being free from any restraint by omental or mesenteric bands is
especially liable to torsion. Palat found four cases of torsion of
the colon to one of the small intestine, and Schutze gives the
ratio as 56 of the first to 13 of the second.

The czecum has been frequently found twisted upon itself with
a portion of the small intestine rolled round it.

The floating colon like the small intestine is rolled around its
mesenteric axis, but cases are much more rare than in the case of
the small intestine.

In a recent and complete twisting with obstruction of the
bowel, the. loop of intestine is distended with gas the result of
fermentation of its contents, and its walls may be thin and pale.
Much more commonly and when the lesion is of longer standing
there is hyperzemia, and infiltration and thickening with in-
flammatory products, and blood extravasations. At the seat of
torsion the compressed intestine is congested, covered with pete-
chize, and its peritoneal surface with fibrinous exudate tending to
bind the parts together. Later there may be seen spots of necro-
sis and perforating sores and semi-detached sloughs, or the whole
mass of twisted bowel may be gangrenous. The patient usually
dies before this last stage has been reached. If the animal sur-
vives long enough the lesions of infective peritonitis are cons-
tantly present.

Symptoms. ‘The disease usually sets in suddenly with intense
severity. In exceptional cases there is an insidious onset, the
twist being at first but partial and gradually increasing and fora
time the contents pass on in a restricted but still physiological
manner. Colics at first slight become by degrees moreand more
intense until all the symptoms of obstruction and acute inflamma-
tion are developed.

More commonly symptoms of extreme gravity appear at once,
the patient stops, paws, kicks at his belly, tries to lie down, strains
to defecate or urinate, lies down, rolls, sits, gets up and moves
round uneasily trying to lie down again. He looks at the flank
with anxious eye and countenance and has all indications of the
most violent colic. Pain is constant, but worse at one time than
another, the pulse is from 50 to 90 and becomes weak and even
imperceptible as the case advances, and hyperthermia, at first
slight or absent, rises with the onset of inflammation. Finally

362 Veterinary Medicine.

great prostration, depression and stupor, sunken, glazed eye with
dilated pupil, and cold sweats and extremities bespeak collapse
or general infection.

Diagnosis is rarely certain. The sudden onset, extreme vio-
lence of the systems, and rapidly fatal progress are significant
and in exceptional cases rectal exploration will detect obstruction
in the rectum or floating colon, or atympanitic condition of the
pelvic flexure.

Treatmeut, A rational treatment is only possible in those rare
cases in which the diagnosis is certain. When the lesion can be
reached in the rectum or adjacent part of the floating colon, the
oiled hand may be made to drag on the interior of the viscus so
as to restore it to its normal position.

Cadeac has had recoveries from supposed volvulus by the use
of eserine hypodermically, and Trasbot by the use of castor oil
and it is just possible that active peristalsis, and plentitude of
the bowel running into the volvulus, may serve to unwind slight
cases. When the diagnosis is certain and the case as usual, in-
tractable, the resort of laparotomy and the attempt at untwisting
is fully warranted. The case is a fatal one if unrelieved.

VOLVULUS IN RUMINANTS.

This condition is almost unknown in ruminants, Reichert re-
cording a single case of volvulus of the ileum involving 8 inches
of the gut. The reason for the habitual immunity is to be found
in the arrangement of the small intestine at the end of a mesen-
tery which is strengthened and stiffened by the winding folds
of the colon until twisting is practically impossible. There re-
mains, therefore, only the floating colon and rectum at all ex-
posed to the lesion. The isolated case of Reichert only proves
the rule.

VOLVULUS IN DOGS.

Rare. Short mesentery hinders. Occurs with hernia. Symptoms: ob-
struction, prostration, colic, tense, painful abdomen, retching, anorexia,
exhaustion. Treatment: laparotomy.

The carnivora seem to be protected against volvulus by the
shortness of their mesentery, the comparative lightness of the in-
testinal contents, and the restricted area of the abdominal cavity.
Cadiot, Muller, and Friedberger and Frohner agree in ignoring
the subject as a canine disease, while Cadeac mentions only such
cases as are complicated by mesenteric hernia, the protruding
loop becoming twisted in the wound through which it has
protruded.

‘*The symptoms are those of invagination or intestinal obstruc-
tion ; sometimes the animal is dull, anxious, resting almost con-
stantly down on his belly, and this prostration dominates the
table of symptoms; sometimes, on the contrary, the subject
manifests signs of excitement and intestinal pain ; it trembles,
lies down, glances at its flanks ; sometimes it even lets itself fall
abruptly, straightens out stiffly its limbs and head, clenches its
jaws and rolls its eyes.’’

‘Tn all cases the belly is hard, drawn up, painful to pressure
or palpation ; but these means of exploration are insufficient to
feel the intestinal knot.’’

‘Constipation is persistent, obstinate, and efforts at vomiting
continuous. anorexia is incomplete, or the animal rejects the
solid and liquid aliments immediately after their ingestion.
Vomited matters, when they exist, become glairy, bilious toward
the end of the attack; but sometimes the animal becomes ex-
hausted in his fruitless efforts; one is rendered uncertain and
hesitates to confirm his diagnosis by laparotomy.”’’

The only treatment advised is by laparotomy.

363

INTESTINAL STRANGULATIONS BY ADVENTITIOUS
BANDS.

Result of circumscribed peritonitis. Extends from one part of abdominal
wall to another, around or between intestines, on omentum, or adhesion of
omentum to inguinal ring. In cattle tubercular products strangulate bowels.
Symptoms : the colic of obstruction, rectal exploration. Treatment: lapa-
rotomy, removal of constricting band.

Adventitious fibrous bands in the abdomen are the result of a
pre-existing peritonitis of a circumscribed area. The fibrinous
exudate thrown out on the parietal peritoneum is detached in its
median part but remains adherent at the ends, and when organized
into tense resistant white fibrous tissue remains as a trap to en-
tangle and strangulate the intestinal folds. In other cases they
form on or between intestines or other viscera which are for the
moment torpid and inactive, and contracting as they become
organized, they bind these together and hamper their move-
ments, and endanger the integrity of all movable viscera in the
vicinity. Again they form. on the omentum and threaten the
integrity of the bowels by strangulation. The omentum pro-
truding at castration becomes adherent to the inguinal ring and
forms a dangerous band.

In cattle the growth of peritoneal tubercle often binds the
small intestines together in an inextricable tangle leading to
considerable compression, and obstruction without a complete
stenosis.

Symptoms. ‘These vary with the organ constricted, but they
are usually those of a more or less perfect obstruction of some
portion of the intestine small or large, which has passed over or
under the constricting band and fails to return, ofter undergoing
a torsion which renders its imprisonment still more secure. The
author has found the double colon fatally constricted in this way,
and Leblanc furnishes a similar case. Cases are on record of the
binding of the duodenum to the right lobe of the liver by a strong
fibrous band, of the binding of the double colon to the right flank
and in another case to the floor of the abdomen, and of the ileum
to the meso-rectum and in another case to the left flank. These
give rise sooner or later to obstruction of these viscera, or, to in-

364

Pelvic Hernia in the Ox.—Gut Tie. 365

carceration of adjacent ones so that the animal dies of intestinal
obstruction with its attendant symptoms.

Treatment. If the true nature of the case can be made out by
rectal exploration the appropriate treatment is by laparotomy and
the removal of the constricting band.

PELVIC HERNIA IN THE OX. GUT TIE.

Cause : laceration of parietal peritoneum by tearing through the spermatic
artery, a loop of intestine is strangulated in the resulting pouch. Diagnosis:
patient is a steer castrated by the method named, rectal exploration con-
firms. Treatment: turn on back, jump froma height, trot down hill, dis-
lodge incarcerated mass by hand in rectum, pass cannula through rectum,
introduce probpointed bistoury and cut through the band, or laparotomy.
Second Form: adhesion of stump of spermatic cord to intestine, or ab-
dominal wall or formation of a pediculated tumor, and resulting strangula-
tion of intestine. Third Form: weight of testicles tears the peritoneum
from the abdominal wall forming pouch. Treatment: laparotomy.

Causes. This is a peculiar affection said to be connected with
a faulty mode of castration in calves. When the testicle has been
exposed, the spermatic cord is torn through by sheer force, or the
posterior portion having been cut across the anterior division is
dragged upon violently until torn apart. The gelders usually
estimate the quality of the operation by the length of the artery
which can be torn out. ‘The artery which is the most resistant
portion of the cord and the last to give way takes its origin from
‘the posterior aorta opposite the posterior mesenteric artery, ex-
tends outward by a curvilinear course just in front of the brim
of the pelvis, and when stretched violently it is straightened out
and carries with it the peritoneum, tearing it from the portion
immediately in front and forming a sac, or tearing it completely
apart from the abdominal wall in its median part and leaving it
attached above and below. Into this sac, or above this band,
which is just below the sacral transverse processes, a loop of in-
testine may pass, and becoming strangled there, produces all the
symptoms of intestinal obstruction.
Diagnosis is helped by the fact that the animal is a steer, and

366 Veterinary Medicine.

in a locality where the above-named mode of castration is in
vogue. It is completed by feeling the imprisoned intestine and
the constricting cord just under the right or left transverse pro-
cesses of the sacrum.

Treatment. ‘The gut will sometimes escape from the sac if the
animal is turned quickly on its back. Another method is to in-
voke the influence of gravitation by jumping the animal from a
high step down to a lower level, or by trotting him down a steep
incline. A still more effective method is to introduce the hand
into the rectum and press the palm upward and forward against
the soft mass of the imprisoned intestine. In this way the gase-
ous, liquid and solid contents are passed over into the portion of
the gut in front of the constriction, and by continuing the pro-
cess the intestine itself can usually be pressed out and the suffer-
ing relieved. It is further suggested to press the thumb or the
whole hand forward against the constricting band and tear it in
two. Acertain amount of to and fro movement is usually re-
quired and in exceptional cases the cord is so strong that the
measure has to be abandoned.

Another resort is to pass a cannula and trochar through the
adjacent part of the rectum, and withdrawing the trochar, to
pass a probpointed bistoury through the cannula, and beneath
the cord and cut it in two.

These measures failing an incision must be made im the right
flank, following the line of the fibres of the external oblique, and
the hand being introduced and passed round the posterior border
of the omentum the seat of the disease is found and the con-
stricting cord is cut with a probpointed bistoury or a bistouri
caché. The wound is then sutured, disinfected and covered with
antiseptic gauze or cotton and bandage. The sounds of peristal-
sis are resumed and in five or six hours defecation is restored.

2nd Form. Another alleged condition vouched for by
English and continental veterinarians depends on drawing down
the spermatic cord as far as possible, cutting it off and allowing
it to be retracted into the abdomen. Having been detached by
the traction from the abdominal wall it is alleged to float free,
sometimes establishing an adhesion to one of the intestines of
which it later limits the movements ; sometimes forming a con-
nection with the abdominal wall and forming a sling in which the

Diaphragmatocele—Diaphragmatic Hernia—Phrenic Hernia. 367

intestines may be snared, and sometimes swelling at its free end
to form a pedunculated tumor, and winding around a loop of
intestine so as to strangle it. For these conditions incision of the
abdominal wall and section of the offending cord are recom-
mended.

3rd Form. Lobbe tells us that the disease is common in
bulls as well as oxen in mountainous regions, being determined
by violent exertions, or by the struggle to rise, when the animal
has accidently fallen. In this alleged form there is the sugges-
tion of the heavy pendent testicles as factors in detaching the
cord with its vessels and nerves from the abnominal wall, so as
to form a loop or snare for the intestine.

DIAPHRAGMATOCELE. DIAPHRAGMATIC HERNIA.
PHRENIC HERNIA.

Definition. Susceptibility by genera, horse, dog, ox Enterocele, epi-
plocele, gastrocele, hepatocele. Congenital, arrest of development and of
closure of foramen or elsewhere, diaphragm absent. Traumatic, blows on
false ribs by pole, shaft, buffer, gate, bars, beams, kicks, blows with horns,
tusks, clubs, fractured rib perforating diaphragm, falls on projecting bodies,
muscular strains in draught, plunging, falling, slipping, casting, parturi-
tion ; trotting or galloping down hill, jumping to lower level, slipping to
knees, dystokia, colic, tympany. Symptoms: extreme dyspnoea and as-
phyxia; or difficult breathing slowly increasing, colics, dilated nostrils,
retracted angle of mouth, projecting eyeballs, shallow, rapid catching respi-
rations, gurgling in chest, drumlike percussion sounds, with perhaps flat
areas ; in slight cases, listlessness, colics, double lift of flank, tender inter-
costals ; in chronic cases, short wind on exertion, sluggishness, colics after
meals. Hernia through intercostal space. Lesions: unduly large foramen
sinistrum or dextrum, lacerations of all forms and sizes, edges ragged,
thickened, bloody, broken rib, inflated stomach causes shreddy tear ; post
mortem lacerations show no inflammatory products; chronic cases have
edges devoid of inflammation and often smooth, serosz usually perforated,
nature of hernial mass, omentum, intestine, colon, czecum, stomach, spleen,
liver, congestion of viscera involved. Prognosis: slight cases may survive,
to be fattened or to breed, but are useless for work. Treatment: quiet,
sedatives, antiferments, cathartic, concentrated food, lift by fore limbs,
incline stall backward and downward, laparotomy in cattle, dogs, and

swine.

As this lesion is shown by symptoms referable to internal or-

368 Veterinary Medicine.

gans only, and as it is considered irremediable by surgical
measures, it may be properly considered in the class of medical
affections.

Definition. A displacement of one or more of the abdominal
organs into the cavity of the thorax.

Frequency in different animals. It has been found most fre-
quently in the horse, and less so in the dog and ox. Severe
exertions conduce to it in horse and dog, while in the ruminant
the great bulk of the gastric cavities, covering the whole pos-
terior surface of the diaphragm, tends to prevent protrusion even
if a slight rupture has taken place. On the other hand, the
weight of the gastric cavities in the ox and the tension upon the
cesophagus, when the animals ride each other, sometimes cause
laceration of the foramen sinistrum and hernia of the reticulum.

flernial mass in different animals. In the horse the protruding
organ is most commonly the small intestine (enterocele), omen-
tum (epiplocele), colon, or less frequently the ceecum, stomach
(gastrocele), or liver (hepatocele.) In the ox the reticulum most
commonly protrudes, and after that the liver, abomasum, the
omentum or the small intestine. In the dog the mass is usually
formed by the stomach or liver, or less frequently by the small
intestine or omentum. ;

Causes and mode of formation. ‘The hernia is either congenital
or acquired after birth. Again, it may result from imperfect de-
velopment or from a trauma. Congenital cases usually depend
on an arrest of development, the foramen sinistrum fails to close
and the abdominal organ passes through by the side of the
cesophagus into the chest ; or the diaphragm is left imperfect at
some other point, and the two cavities, abdominal aud thoracic,
communicate. In some instances there is left not a distinct
opening but a mere relaxation of the parts and under traction, as,
for example, by the gullet, an orifice is torn and a hernia pro-
trudes. Such cases are very rare. Other lacerations may be
almost all referred to external injuries on the posterior ribs,
violent muscular exertions, sudden shocks in connection with
falls, or throwing for operations, and overdistension of the
abdominal viscera.

ist. External Violence. In the larger animals this may come
from blows on the last ribs, by poles or shafts of carriages, the

Diaphragmatocele—Diaphragmatic Hernia—Phrenic Hernia. 369

buffers of cars, the end of a gate and the gatepost, projecting ends
of bars or beams against which they run, kicks by horse or ox,
blows by the horns of cattle or tusks of boars. In the smaller
animals in addition to the above, blows with heavy clubs and
kicks with heavy boots. In all such cases there is usually a frac-
ture of one or more ribs, the sharp broken ends of which are
forced into the diaphragm, which they tear when they again
spring outward. The same occurs as the result of falls on hard
projecting bodies of any kind.

2nd. Muscular Strain. In heavy draught the fixing of the
glottis, ribs and diaphragm and the extreme contraction of the
abdominal muscles often lead to extraordinary tension of the mus-
cular septum by the mere violence of which, or when there is
superadded a sudden shock, (in plunging in harness, or displace-
ment of the feet or slipping and falling,) the diaphragm is torn,
usually in its tendinous portion, and the abdominal viscus pro-
trudes into the chest. If the diaphragm is momentarily relaxed
the lesion may take place in the peripheral muscular portion.
In still other cases the lesion is at one of the natural openings. ‘The
same accident occurs in animals thrown for operation, the
abdominal viscera being full, the hind limbs drawn forward so as
to further compress the belly, and the muscles being subjected to
violent contraction in the efforts to get loose. Violent straining
in dystokia is another cause which, however, usually partakes of
a sudden shock on the diaphragm when a violent pain sets in.

3rd. Sudden Shocks on the diaphragm, and pressure by
the abdominal organs. In the horse especially the weight of
the abdominal viscera is very great and the floor of the abdomen
inclines downward and forward so that the whole mass presses
with great force against the concave diaphragm. In cattle the
great weight of the stomach and liver is especially important and
in dog and pig of the liver mainly. In trotting or galoping down
hill or jumping from a higher to a lower level, or in slipping back
on the fore feet so that the horse falls on the knees or shoulders,
this pressure is suddenly greatly enhanced and the tense diaphragm
may give way in its tendinous portion or the relaxed organ
through its muscular tissue. A similar danger attends on the
violent straining which attends on difficult cases of parturition,
and even in cases of overloaded stomach and tympany and

24

370 Veterinary Medicine.

especially when the tortured animal throws itself suddenly and
recklessly on the ground. In cattle and sheep this is usually the
result of tympany of the rumen, and in solipeds of stomach and
intestines.

Rupture by simple overloading or overdistention is, however, a
rare occurrence, and many cases attributed to this are in reality
instances of post-mortem lesions, to be identified by the seat of
the laceration in the muscular portion, and by the absence of
blood clots, exudate, thickening or other sign of inflammation on
the torn border.

Symptoms. ‘These bear a direct relation to the size of the
laceration and the mass of abdominal organs that protrude into
the chest. :

In very grave, recent cases, with a great phrenic rupture and a
most extensive protrusion of abdominal organs into the chest,
there may be simply the indications of extreme dyspncea, nostrils
and chest widely and persistently distended, nasal mucosa darkly
congested, countenance pinched, eyes protruding and fixed, pupils
dilated, breathing rapid, shallow and oppressed, and in a few
minutes the animal staggers and falls in the death agony.

In cases which are less rapidly fatal, the patient lasting for hours
or even days, there occurs, after the accident, deep, difficult and
oppressed breathing, but not so violent as to threaten instant suf-
focation, or more commonly, these symptoms increase slowly as
more and more of the hernial mass protrudes through the narrow
opening into the chest. This form is usually seen only in animals
of a specially quiet disposition, and which have not been subjected
to active exertion or excitement after the accident and the hernia
has increased by slow degrees only. ‘The patient becomes listless,
or very restless, paws, looks at his flanks, shifts from one hind
foot to the other or even kicks at the abdomen, lies down care-
fully, rolls, sits on his haunches (though no more than in other
forms of colic), and manifests the anxious, pinched, colic-
countenance. The advance of the pain is constant but slow, and
usually it is not characterized by that intensity which drives the
animal to throw himself down recklessly and to roll and kick with
violence. There is also usually an absence of the weak running
down pulse of hemorrhagic congestion (thrombosis) and of the
pallor of the surface mucose which usually attends on the

Diaphragmatocele— Diaphragmatic Hernia—Phrenic Hernia. 371

extensive blood extravasations of that disease. An exception
may be made in those cases in which the hernial mass is strangu-
lated, as these may closely resemble spasmodic colic or heemor-
rhagic congestion.

The respiration furnishes more distinctive symptoms. The
breathing which may be hurried and almost panting in colic and
acute congestion, is changed in this lesion to a condition of ex-
treme oppression, the nostrils remain widely dilated in expiration
as well as inspiration, the angle of the mouth is retracted so as
to show the teeth and gums, all the facial muscles stand out, the
eyes are protruding and fixed, with dilated pupils, the head is
held extended on the neck, and the ribs are not allowed to fallin
freely, as after ordinary inspiration, but like the nostrils they
remain permanently drawn out. The efforts at inspiration are
violent though shallow and marked by lifting of the flanks.
There are usually one of two nervous catches in each expiration
and sometimes in inspiration as well. This is partly due to the
impotence of the deeply lacerated diaphragm as an organ of
respiration, but also to the pressure of the displaced and over-
distended abdominal organs on the lungs, and to the profound
nervous shock. ‘The whole work has been suddenly thrown on
the costal muscles, and the depressed nervous system proves
unequal to sustaining them in the unwonted toil.

Still clearer indications may be obtained from auscultation and
percussion. These are gurgling, rumbling and clucking, or a
coarse mucous rale which seem abnormally close to the ear, and a
drum-like resonance, much greater than that of emphysematous
lung and enormously in excess of what is given out by the sound
lung tissue. These may be heard at points where only pulmonary
murmurs naturally occur or where abdominal sounds, if heard at
all, are distant in health. There may also be areas of abnormal
flatness on percussion by reason of the protrusion of a solid
viscus like the liver or spleen or one with solid contents. These
symptoms are only clear when there is a large intrusion of
abdominal organs into the thorax, and they increase rapidly until
asphyxia supervenes. ‘

In cases which do not immediately threaten life the extent of the
phrenic laceration is usually small and the orifice may be blecked
by a bulky organ like the rumen, double colon, stomach or liver,

372 Veterinary Medicine.

so that any protrusion takes place only in a limited amount and
the function of the diaphragm can still be carried on to a reason-
able extent. In these cases there may be no very marked symp-
tom at the outset, though the animal is dull, listless and without
appetite, or, if he eats or drinks, it is liable to be followed by
slight colics and a double action of the flank in expiration as in
pulmonary emphysema (heaves). Pressure or percussion in the
posterior intercostal spaces is painful. Cough when roused by
pinching the larynx is broken and abortive. These symptoms
are not distinctive however, and unless there is a protrusion of a
loop of small intestine, to give gurgling and drnm-like sounds
the diagnosis of the case is liable to fail. The fact of a recent
injury may however assist in the recognition of the lesion.

The chronic cases are even more difficult to recognize as there
is no record of recent injury and no fever. There may be short
wind, the animal breathing hurriedly on slight exertion, and
showing a double lift of the flank in expiration (Girard). In
place, however, of the tympanitic bowels and frequent passage
of flatus which characterize heaves, there is a tendency to colic,
especially after meals, and in a certain number of cases there are
all the symptoms of fatal’strangulation, due to the coutraction of
the diaphragmatic wound. When the hernia is made by a loop
of intestine there are the characteristic symptoms of thoracic
gurgling and drum-like resonance,

Cases are on record in which the intestine protrudes through
one of the last intercostal spaces or between the ends of the
broken rib as a hernia and diagnosis becomes easy by ausculta-
tion, palpation and percussion. But in a large proportion of
cases the lesion escapes recognition and is only found on post
mortem examination.

Lesions. ‘The lacerated orifice in the diaphragm varies much
as regards situation, extent, form and the nature of its border.
In congenital cases due to an imperfect closure of the natural
openings there may be simply a round or ovoid opening, too
spacious to be filled by the gullet, vena cava or aorta as the case
may be, and capable in thedifferent cases, of containing an organ
of any size from the omentum to the liver or stomach. Its mar-
gins mav be perfectly smooth and even, without any thickening,
irregularity, fringe, clot or exudate. In traumatic cases on the

Diaphragmatocele—Diaprag matic Hlernia—Phrenic Hernia. 373

other hand the orifice may be of almost any form, size or situa-
tion. It may be round, elliptical, triangular, or irregular in
many ways. It may be so small as to admit nothing more than
a small fold of the omentum, or it may be large enough to open
the two cavities, thoracic and abdominal into one common space,
and to practically abolish the function of the diaphragm. If
the lesion is a recent one the torn margin is irregularly indented
or fimbriated and marked by small black blood clots, and some-
what later by exudate and irregular thickening or swelling.
When due to a broken rib, the existence of the fracture is patent
and the laceration extends along two lines often radiating from
point of perforation by the rib. When the laceration has resulted
from tympany of the stomach or intestines or from other over-
distension of the abdominal organs, the general and comparatively
equable pressure has determined the independent laceration of
numerous tendinous or muscular bundles all over the diaphragm,
so that the divided ends stand out at intervals each bearing its
little clot of dark blood, but without actual perforation. The
actual orifice in such cases is confined to one point where the
tension has been greater or the resistance less. Post mortem la-
cerations, from tympany or other cause, are easily distinguished
from those occurring during life, in that the edges of the wound
are pale and bloodless, without clot or exudate.

When the hernia is chronic there is an absence of exposed
fringes, and of indications of inflammation, the margins of the
orifice being in some cases smooth, even and fibrous, and in
others irregularly notched or indented with nodular, fibroid swell-
ings of various sizes at intervals. In such cases the orifice is
always relatively small and the hernial mass inconsiderable.

As a rule the peritoneum and pleura, being firmly adherent to
the diaphragm, are involved in the laceration so that the hernial
mass is not retained in a special sac, but simply protrudes into the
pleural cavity, after the manner of an eventration. In excep-
tional cases they become detached from the muscle, and becoming
distended, envelope the hernial mass in a distinct sac.

In hernia with a very small orifice the omentum alone may
pass through, even the small intestine proving too large for ad-
mission. In such cases it is usual to find the band of omentum
adherent to the callus formed by the repair of a fractured rib.

374 Veterinary Medicine.

When the orifice is somewhat larger a portion of small intestine
or of the double colon or czecum may be engaged, while with a
still larger opening the stomach, spleen, or liver may form the
hernia. In cattle the reticulum is most likely to be the hernial
mass, as noted in an article below. In rare cases the small in-
testine, omentum or liver protrude (Youatt, Lafosse). The
protruding organ is liable to be constricted and strangulated
sooner or later by increase in its bulk in connection with its ver-
micular movements, the accumulation of its contents or the ex-
trication of gas in its lumen, or by the gradual contraction of the
orifices in process of healing. Then there may be dark red venous
congestions, blood extravasation and effusion, friability and even
rupture of the intestinal walls, and adhesions to the wound or
the lungs. Once started this congestion and extravasation may.
extend backward into the abdominal cavity involving a great
part of the contiguous intestinal canal.

Prognosis. ‘The worst cases are promptly fatal, while others
destroy life in one or two days and such are always to be recog-
nized by the extreme dyspncea which appears soon after the ac-
cident. The slight cases with small orifice and little protrusion
may merge into the chronic form, and the animal may even be
fit for work, notwithstanding existing dyspnoea, which closely
resembles that of chronic emphysema (heaves), but is not bene-
fited by the same treatment. In the ruminants even considerable
lacerations and protrusions may not be incompatible with fatten-
ing provided the animal is kept from all causes of excitement or
over-exertion.

Treatment. Surgical treatment has not proved successful.
Expectant and medicinal treatment are the only available resorts
and then only in the slighter cases. Quiet and the absence of all
excitement is the first consideration, to allow of an arrest of any
increase of the hernia and the establishing of a healing process in
the torn margins. Bouley strongly advises bleeding to allay ab-
dominal pain. Chloral hydrate (1 ounce for the larger animals)
will often meet the same end, with the additional advantage that
it counteracts fermentation and tympany. The unloading of
stomach and bowels by a cathartic, and the use of flaxseed meal
or other concentrated food of a laxative nature are indicated.
Small animals may be lifted by their fore limbs, and the abdomen

Diaphragmatic Hernia of the Reticulum. 375

may be meanwhile manipulated to favor the return of the hernial
mass by gravitation. Large animals should be placed in a stall
having an inclination downward and backward for the same
reason. When it can be ascertained that the hernia consists of a
loop of small intestine only, it is permissible, especially in cattle,
carnivora and omnivora, to make an incision in the flank and with
the disinfected hand to attempt the reduction of the hernia and
the placing of a bulky viscus, like the rumen, stomach or liver
in the way of its return. In case of violent abdominal pain
Bouley advises active counter-irritation over the abdomen, but as
strangulation is usually present in such cases, this measure may
be held to be inferior in value to gravitation, anodynes, antisep-
tics, unloading of the gastro-intestinal organs and absolute rest
or surgical interference.

DIAPHRAGMATIC HERNIA OF THE RETICULUM.

Anatomical reasons. Gullet, weight of stomach, riding, dystokia. Symp-
toms. Tendency to chronicity. Treatment.

In ruminants this is the most common phrenic hernia of a hollow
abdominal viscus. On the right side the gastric and intestinal
organs are separated from the diaphragm by the flat mass of the
liver. A laceration in this region must therefore be extensive to
allow of the protrusion of any abdominal organ into the chest.
The left half of the diaphragm, however, comes in direct contact
with the reticulum and any opening large enough to admit of
this viscus is likely to entail hernia of the second stomach. ‘The
lesion is further favored by the fact that the gullet passes through
this part of the diaphragm and is connected with the stomachs in
the furrow between the first and second stomachs. In case,
therefore, that the gullet is violently dragged upon by the weight
of the contents of the overloaded or tympanitic paunch, or
when the animal rises on its hind limbs, in riding its fellow, the
foramen sinistrum is liable to be enlarged by laceration, and the
second stomach most naturally protrudes through the opening.
The strain thrown on the diaphragm in violent abdominal con-
traction, as in difficult parturition, is mainly expended on this

376 Veterinary Medicine.

left half, and the laceration takes place around the cesophagus,
or as in cases reported by Schurinck and Siedamgrotzky through
the aponeurotic portion. The protrusion may be composed of
the second stomach alone, or together with portion of the paunch
as observed by Schmidt in a goat, or of the third and fourth
stomachs as in a case in a bull reported by Baraillé. The edges
of the orifice may show, in recent cases, the fringed or irregular
jagged outline with blood clots and thickening, or in chronic
cases the pale, fibrous, smooth, even outline already described
under diaphragmatic hernia.

The symptoms are like those of other forms of phrenic hernia,
in ratio with its extent. The tendency to survival, and chron-
icity is greater than in the monogastric animals, 1st because
the entrance of the smaller viscera is barred by the great gastric
masses applied against the wound, and 2nd by the quiet un-
eventful life of the ox and the absence of active work and violent
excitement.

Treatment will not differ from that of other forms of phrenic
hernia.

HERNIA THROUGH THE MESENTERY, OMENTUM
OR OTHER FOLD OF PERITONEUM.

Definition. Causes: Concussions in horse especially, anatomical condi-
tions in cattle, pediculated tumors, dystokia, hernia of small intestine in
horse, ox, broad ligament, pelvic hernia. Lesions : Congestion, hemorrhage
of hernial viscus, adhesions, softening, thickening, strangulation. Symp-
toms : Intestinal obstruction, rectal exploration. Treatment: Laparotomy.

Definition. ‘This consists in a protrusion through an opening,
congenital or acquired, in the double fold of peritoneum (mesen-
tery) which passes off from the abdominal wall to support a
viscus, or that which passes from organ to organ (omentum).

Causes. ‘The lacerations of mesentery or omentum are at-
tributed to sudden concussions of various kinds (falls, blows,
leaps, violent efforts), and have been especially found in horses
in which the bulk and weight of the contents of the digestive
organs furnish a special predisposition. In ruminants in which
the contents of the abdomen are equally bulky and heavy the

Flernia Through the Mesentery, Omentum, etc. 377

lesion is rarely seen, probably because the great bulk of the
ingesta lies in the first three stomachs, and because the large in-
testines are folded up in the mesentery which supports the small,
thereby strengthening this means of support and restricting the
freedom of movement on the part of the intestines themselves.
In carnivora the limited bulk of the intestines and their contents,
and the relative shortness of the mesenteric folds largely obviate
the predisposition.

Pediculated tumors of mesentery or omentum may drag on the
delicate membrane so as to cause laceration, and circumscribed
peritonitis, by producing softening and friability, may act as a
causative factor. Violent straining in defecation or parturition is
another cause of laceration.

In solipeds the loosely suspended and eminently mobile small
intestine is the viscus which most commonly forms a hernia
through such adventitious openings, either through the great
mesentery, the great omentum, the gastro-splenic omentum, the
mesentery of the umbilical vein (falciform ligament of the liver),
or the gastro-hepatic omentum. Cases are on record, however,
in which the floating colon, the double colon and even the caecum
formed herniz through the peritoneal lacerations.

In cattle the most common lesion is the hernia of a knuckle of
intestine through a laceration in the mesentery, but, the rupture
has also occurred in the great omentum and exceptionally in the
broad ligament of the uterus which is very extensive in these
animals. Pelvic hernia or gut tie as usually described is depen-
dent on a laceration of the mesentery of the spermatic artery.

Lesions. ’The fold of intestine which makes the hernia is liable
to become strangled, and sometimes twisted in the opening, so
that the circulation of blood and ingesta is interrupted, congestions
and hemorrhages set in, and necrosis and general infection follow.
Oftentimes a fibrinous exudate is thrown out, binding together
the intestinal convolutions, and attaching them to the margins of
the mesenteric or omental opening. Similarly the lips of the
Jacerated wound in the mesentery become covered with blood
clots, or congested, or infiltrated, and sometimes the seat of ex-
tensive extravasations. The inflamed membrane may soften, be-
come friable and tear more extensively, or if the patient survive,
the exudation becomes organized, thickening and strengthening

378 Veterinary Medicine.

the margins of the wound and causing them to contract so as to
strangle the inclosed loop of intestine.

Symptoms. ‘The indications are those of intestinal obstruction,
to which accordingly the reader is referred. The only possible
indication of the exact nature of the lesion is to be obtained by
rectal exploration. Herniz through the meso-colon or broad
uterine ligament may be reached in this way, and possibly
diagnosed.

Treatment. T,aparotomy alone gives any hope of success, and
this will only be warranted when a certain diagnosis has been
reached.

HERNIA THROUGH THE FORAMEN OF WINSLOW IN
THE HORSE.

Anatomical considerations, small size and elevated position of foramen,
length and freedom of mesentery of jejunum ; spare diet, draught, strain-
ing, rolling, colic. Symptoms: of intestinal obstruction only, lesion found
at necropsy.

The foramen of Winslow is a comparatively small opening
between the lesser curvature of the stomach and the liver, and
between the gullet and its cardiac ligament on the left side and
the gastro-hepatic omentum on the left. With its elevated and
anterior position in the abdomen it would seem to be little ex-
posed to this kind of accident, yet a number of recorded instances
in the horse, show that it is certainly not immune. ‘The great
mobility of the jejunum, owing to the extra length of its mesen-
tery is believed to be the essential predisposing cause. A spare
diet, or one which is in small bulk, allows the comparatively
empty gut to pass more readily through the small opening.
Severe efforts in draught and straining in defecation and parturi-
tion are also invoked as means of pressing the jejunum through
the orifice. So with the concussions attendant on falls and the
unwonted positions taken in decubitus and rolling on the back in
wantonness or colic.

Symptoms of this lesion are essentially those of intestinal ob-
struction, with usually a rapid and fatal course. An accurate
diagnosts is impossible during life.

Other Forms of Hernia.—Paralysis of the Rectum. 379
OTHER FORMS OF HERNIA.

The other forms of hernia (umbilical, inguinal, scrotal, femo-
ral, ventral, vaginal, ischiatic), are essentially surgical and need
not be further referred to here, than to guard the reader against
overlooking them as factors in producing intestinal and omental
strangulation and colic. They are all to be recognized by the
presence of a local swelling, which may often be obliterated by
returning its contents into the abdominal cavity, which sensibly
enlarges when the animal is made to cough, and which, if made
up of intestine, is subject to gaseous distention, and gurgles
when manipulated and returned. A violent colic occurring in a
male animal should never be considered as certainly diagnosti-
cated until the scrotal and inguinal region have been carefully
examined for hernia.

PARALYSIS OF THE RECTUM.

In solipeds, ruminants, swine, carnivora. Injuries to loins and croup.
Palsy of tail and sphincters. Nerve centres in end of cord. Fractures and
dislocations of the pelvis. Hzaemoglobinuria. Advanced gestation. Scle-
rosis. Ovariotomy by vagina. Impaction of rectum. Neoplasms. Throm-
bosis of internal iliac artery. Ptomaines and toxins in fevers. Symptoms:
tardy defecation, impaction, over distension, feeces firm, dry, roller like,
liquid oozing, excoriation, foul tail and thighs, bulging of anus, inconti-
nence of urine. Paresis and wasting of quarter. Treatment: remove cause,
for sprains and fractures sling, treat myelitis, debility, poisoning, unload
rectum often, oily or soapy enemata, strychnuia, eserine, ergot, barium chlo-
ride, derivations.

This is much more common in the horse than in ruminants,
swine or carnivora, mainly because the soliped is more exposed
to traumatic injuries of the loins, croup, and pelvic bones. It is
noticeable that in the majority of cases the paralysis of the rec-
tum is connected with palsy of the tail, anus, and sphincter
vescicee. ‘This comes from the anatomical fact that the centres
presiding over the motions of these different parts are situated
close to each other in the terminal portion of the spinal cord, and
any lesion of that part by traumatism or disease is likely to affect
all of these parts alike.

380 Veterinary Medicine.

The condition has been especially noticed in fractures or severe
sprains of the loins causing pressure on the spinal cord. In
some cases injury to the nerves supplied by this part of the cord,
leads to an extension of inflammation to the nerve centres, thus
paralysis of the rectum has followed on fracture of the ischium,
dislocation of the sacro-iliac joint, or even of the first bone of the
coccyx. Again, congestions and effusions on the terminal part
of the cord, which occur in certain cases of heemoglobinuria and
in old hard-worked horses is a cause of these local paralyses.
Advanced gestation appears at times to produce the disease
through pressure on the nerves, though it has also been noticed
in non-breeding animals, and is doubtless traceable to sclerosis or
other degenerations of the cord. It sometimes follows vaginal
ovariotomy.

Sometimes the condition is traceable to local lesions as over dis-
tension of the rectum in horse or dog or in rectitis, but the re-
sult in such cases is usually partial, a paresis rather than a paral-
ysis. The same may at times result from the growth of the
neoplasms, and from the debility of old age. In other cases
thrombosis of the aorta or internal iliac artery, implicates the
heemorrhoidal vessels and paresis occurs as a result of the limited
blood supply.

It may further result from the action of toxins and ptomaines
on the spinal cord as when it supervenes in the course of debili-
tating fevers. This usually shows itself first as paresis of the
sphincter ani, and later implicates the rectum as well.

Symptoms. Inthe slighter forms defecation is retarded, the
faeces accumulate and over-distend the organ, adding to the
paresis; they escape only under violent straining and apparently
by the peristaltic contractions of the anterior portion of the rec-
tum ; the ejected matters are discharged usually in the form of
a cylindroid mass ; and they are dry, and firmly compressed. In
some cases the irritation caused by the impaction leads to a free
secretion, which escapes through the widely open anus and runs
down the thighs, leading to excoriation of the skin.

In the more severe cases the accumulation is more complete,
the expulsion still more difficult, and as the tail is often impli-
cated, it lies flacid between the thighs, and issmeared with the dis-
charges. The peristalsis in front and the forcible compression by

Paralysis of the Rectum. 381

the abdominal muscles may be entirely inadequate to effect defeca-
tion so that the faeces have to be removed by the hand. The
pressure on the bladder often leads to incontinence of urine, if
the paralysis of the vesical sphincter has not already brought
this about.

The trouble is not unfrequently associated with paresis and
wasting of the muscles of the quarter.

Treatment. ‘The first consideration is the removal of the cause.
If fracture of the loins or pelvic bones, or severe sprain of the
lumbar region, slings are usually requisite to obviate renewed
injury in lying down and rising. Simple inflammation of the
cord or its membranes may be met by laxatives, blisters and per-
haps bromides. In the old and debilitated, tonics, rich food, open
air, and sunshine, with locally, blisters or stimulating embroca-
tions, will be demanded. In case of poisoning by ptomaines or
toxins the disease which produces them must be attended to, and
elimination favored as far as compatible with existing weakness.
In all cases the rectum must be frequently unloaded with the
hand or soapy injections, and its walls may be stimulated by
giving of nux vomica, or by the hypodermic use of eserine,
ergotin or barium chloride. Blisters or stimulating embroca-
tions may be applied over the croup or between the thighs, or
mustard or tobacco may be added to the injectious.

NEOPLASMS. TUMORS OF THE INTESTINE IN
SOLIPEDS.

Lipoma: sessile or polypoid, pediculated, strangulation, stenosis, size.
Sarcoma: on bowel or peritoneum. Fibroma: flat or pediculated, obstruc-
tion, stenosis, degeneration, fatty, calcic. Myoma: hypertrophy of muscu-
lar coat, degeneration, stenosis. Myxoma: small translucent, oval, intes-
tine, mesentery. Carcinoma: extension from urocyst in horse, intestine,
lymph glands, spleen, stomach, liver, mesentery, omentum. Epithelioma:
colon, stomach. Cystoma: may contain sand or sclerostomata. Lympha-
denoma: rectum, colon. Undetermined neoplasms. Causes: foreign bod-
ies, microbes, constitutional, hereditary. Symptoms: tardy defecation, ob-
struction ; in malignant, pallor, angemia, emaciation ; peritonitis, ascites ;
foetid irregular stools, bloody, sloughs, rectal exploration. ‘Treatment : sur-
gical removal where possible, recovery by sloughiug, laparotomy, useless in
multiple or malignant tumors.

Tumors of the intestine are very varied in kind (lipoma, sar-
coma, fibroma, myoma, myxoma, carcinoma, epithelioma.
cystoma), and are found on all portions of the canal.

Lipoma or fatty tumor is most frequent in connection with
the small intestine or rectum, and on the mucosa it may assume
a pediculated or polypoid form and may more or less perfectly block
the intestine. When situated under the peritoneal surface it is
usually sessile and flattened apart from the mesentery, but if
growing from the latter or at its connection with the bowel it
tends to become pediculated, sometimes hanging at the end of a
very long cord which may roll around a loop of intestine and
strangle it. Similarly the sessile masses, as they increase press
inward so as to diminish the calibre of the bowel and finally close
it. They are often found no larger than a coat button, while in
other cases they grow to enormous size (25 lbs. Vogt, 42 lbs.
Semmer). Semmer’s case bound the ceecum and colon to the
abdominal wall. The structure is essentially fatty tissue, though
in some cases the fibrous stroma is more dense than in others.

Sarcoma. Small round cell tumors have been repeatedly found
in connection with the intestine or mesentery. Baranski found
one over 4 inches in length in the wall of the large intestine pro-
ducing a serious constriction. Lucet found one of 18 lbs. weight
and Moquet one of 7 lbs. attached to the omentum. They are

382

Neoplasms.— Tumors of the Intestine in Solipeds. 383

found to follow in certain cases the irritation and exudation of
peritonitis.

Fibroma. Pediculated fibrous tumors have been found in the
rectum of the horse and when large may threaten obstruction.
They are usually of a loose fibrous texture, soft and elastic, and
are often situated between the mucous and muscular coats.
Quite frequently they are already in process of fatty or calcareous
degeneration at particular points, the debris tending to fall into
the intestine and be discharged with the feeces.

Myoma in the form of hypertrophy of the muscular coat of
the bowel, the muscular fibres being increased in number and the
wall further thickened by an intermixture of fibrous tissue, with
areas of fatty degeneration. This may be confined to one side of
the bowel and assume a spherical form, but it tends to contract
the lumen until it is little more than half an inch in diameter.
Mollereau records one case of myoma of the double colon which
measured nearly a foot in diameter.

Myxoma. ‘These are small, pale, translucent, round or oval
neoplasms having a sparse network of fusiform cells and fibres,
filled in the main with small round mucus corpuscles. They are
not frequent in man and appear to be less so in the lower animals,
but Friedberger and Mollereau have recorded two cases of
myxoma in the intestines of the horse, and Chasseraud one case
connected with the mesentery. In one case a mare passed such a
tumor three inches long and nearly an inch in thickness. Chas-
sereaud’s case caused torsion of the floating colon.

Carcinoma. Cadeac says it is not rare to see cancer spread
from the urinary bladder to all the abdominal organs in the horse.
Conté describes a case in the duodenum, Marty one on the pelvic
flexture of the colon. Latour on the ileo-czecal valve, Mario on
the floor of the rectum, and Casper in the lymphatic glands of
the spleen, stomach, liver, mesentery and omentum, the last
showing a mass of 28 lbs.

Epithelioma. When in a growing neoplasm, epithelial ceils
are arranged not only on the surface, but also in the form of
cylinders extending into the substance of the tissues the growth
is looked upon as epithelioma. Morot records a growth of this
kind on the horse’s colon, and which had grown to enormous
dimensions. RO6ll also mentions it as occurring on the gastric
and intestinal mucous membrane.

384 Veterinary Medicine.

Cystoma. As seen in the horse these have usually been
determined by the presence of foreign bodies. Redieux describes
a cyst of the small intestine which enclosed 30 lbs. of sand.
Charlot speaks of a cyst placed between the stomach and sternal
arch of the double colon, furnished with a smooth serous lining.
Vernant and the author have found on the walls of the caecum
and.double colon small cysts, each communicating with the interior
of the intestine by a narrow opening. Beside muco-purulent
matter, these have often in our experience contained the scler-
ostomata or their larvee.

Lymphadenoma. Wuth describes a case of obstrnction of
the rectum by an adenoid tumor as large as the closed fist, which
induced a fatal hemorrhage. It was connected with the terminal
part of the floating colon. Jobelot records another case.

Tumors of uncertain kinds. A large number of tumors
are described in veterinary literature, the true nature of which
has not been made out. If these could be successfully differen-
tiated they would add to the above list materially, and other
forms not referred to above.

Causes. "The causes of these neoplasms are not always trace-
able. In the case of some an occasion may be found in the
presence of an irritant, like worms, sand, gravel, oat seed, etc.,
found in their interior, in others like the carcinomata we may
accept the presence of the protozoon of that disease, and in still
others there is an unknown cause, perhaps constitutional or her-
editary which predisposes to the new growth. This last cause was
probably operative in producing the fatty neoplasm in the rectum
of Pritchard’s fat Hereford heifer, seeing that her grandsire also
died from a similar lesion.

Symptoms, These usually culminate in the classic symptoms
of obstruction of the bowels, but there is sometimes a train of
significant symptoms leading up to this climax. Thus in the
malignant tumors in particular, though in some other forms as
well, there is anzemia, pallor or yellowness of the mucosz, weak-
ness and emaciation. In other cases there are symptoms of
peritonitis and ascites. In others there is obstinate constipation
or diarrhoea, the excretions having a peculiar foetid odor, often
suggesting the decomposition of animal matter. They may be
mixed with fresh blood, or sloughs from the surface of a tumor,

Tumors of the Intestine in Cattle. 385

or the whole tumor may be passed at once. Rectal exploration
may be intercepted by a rigid stricture, by a tumor blocking the
lumen, or a mass may be felt projecting in from one side. Aside
from these the situation, form and size of the tumor can some-
times be felt through the flaccid walls of the rectum. In other
cases the blocked and distended bowels may be felt, without the
identification of a tumor as the cause.

Treatment. For tumors situated in the rectum, the removal
by surgical measures (torsion, ecraseur, etc.) is indicated. If
the tumor is. simple a permanent cure may be hoped for; if
malignant it is likely to recur. Tumors situated more anteriorly
are usually desperate cases. Yet a certain number of pediculated
tumors are detached spontaneously and discharged. In the ab-
sence of this, and when a tumor can be certainly diagnosed,
there remains a resort to laparotomy, which in the horse is too
often unsuccessful. If the tumor can be made out to be malig-
nant and multiple it is useless to resort to removal.

TUMORS OF INTESTINE IN CATTLE.

Sarcoma: usually near lymph glands. Lipoma: mucosa, serosa, pedicu-
lated, strangulation, obstruction. Fibroma: floating colon. Carcinoma:
generalized cancer, colon. Cystoma: reticulum, omasum, abomasum. Un-
determined tumors. Symptoms: discovery by rectal examination, in case
of debility or digestive disturbance. Treatment: removal through rec-
tum or by laparotomy, spontaneous sloughing. Hyperplasia of intestinal
mucosa.

Sarcoma. Multiple sarcomata have been found in nearly all
parts of the abdominal cavity, but above all in or near the lymph
glands. They are from a small size up to masses of 60 lbs.
(Revel).

Lipoma. Fatty tumors are found attached to the mucosa,
and peritoneum, but above all as masses with long elastic ped-
icles which are liable to wind round and obstruct the intestines.
Tannehauer records a case of fatal obstruction of the small in-
testine from a lipoma of the mucosa, and Pritchard two cases of
fatal obstruction of the rectum by a fatty neoplasm occupying its
walls.

25

386 Veterinary Medicine.

Fibroma. Furianetto furnishes an interesting case of a
fibrous tumor connected with the mucosa of the floating colon, on
which it had dragged so as to cause a fatal invagination.

Carcinoma. Mauri relates a case of multiple cancer involv-
ing not only the intestines but also the lymph glands, the heart,
the brain, the muscles, etc. Landis also records the case of a
cancerous tumor of six inches in circumference attached to the
floating colon of a calf.

Cystoma. ‘Tumors of this kind have not been found to any
extent in the intestines of cattle. Reboul describes a large cyst
weighing 20 lbs., attached to the reticulum, omasum and aboma-
sum and containing a pultaceous fcetid debris. There was at-
tendant congestion of the colon.

Tumors of Uncertain Kind have been recorded by other
observers.

Symptoms. As in the soliped the one diagnostic symptom is
the discovery of the neoplasm and its effects by rectal examina-
tion, in those cases in which the tumor is within reach. Apart
from this there are the general symptoms of ill-health, anzemia,
pallor of the mucosa and emaciation in malignant cases, and
recurrent colics, tympanies, impaired rumination and appetite,
with dark colored liquid or bloody feces, or complete suspension
of defecation. In Pritchard’s cases one animal was in the highest
possible condition, having been in preparation for the Smithfield
(London) fat stock show.

Treatment, Jf the tumor has been diagnosed with certainty,
it may be removed by surgical means from its seat in the rectum,
or even from other parts if not multiple or malignant. Laparot-
omy is better borne in cattle than in horse.

Hyperplasia on the Intestinal Mucosa in Cattle. Ina
Jersey heifer presented at the clinic of the New Vork State Vet-
erinary College a hyperplasia of the mucosa of the duodenum,
which blocked the lumen, was removed and the bowel resected.
On examination the mass was found to be the result of productive
inflammation, and undergoing necrosis and separation.

TUMORS OF THE INTESTINES IN DOGS.

Sarcoma: lymph glands. Epithelioma, intestine. Adenoma, rectum.
Undetermined tumors. Diagnosis by abdominal palpation or rectal explo-
ration. Removal by rectum or laparotomy. Chickens: Sarcoma. Epithe-
lioma.

Cadeac records the frequent existence of sarcoma of the lymph
glands, and epithelioma of the intestines and Friedberger an
adenoma close to the rectum. Born describes a tumor of uncer-
tain kind, and with a number of smaller adjacent rounded masses.

The diagnosis is usually easier than in the larger animals, the
flaccid walls of the abdomen facilitating a satisfactory manipula-
tion.

In the case of isolated and non-malignant growths, laparotomy
should be resorted to without hesitation. Even resection of the
intestine may be resorted to for the removal of a neoplasm the
ends being reunited by sutures or by Murphy’s button.

TUMORS OF THE INTESTINES IN BIRDS.

In chickens it is no uncommon thing to find sarcomata, and
other tumors of less determinate structure in connection with
the intestine. Pommay and Bizzard record a case of cylindroid
epithelioma in an ostrich, almost completely blocking the
intestine.

The treatment in birds may be very heroic, the tendency to
infection by -pyogenic and other common bacteria of wounds
being reduced to a minimum.

387

STRANGULATION OF THE INTESTINE BY THE
OVARIAN LIGAMENT IN SOLIPEDS.

Pediculated ovary in mare. Strangulation. Diagnosis by rectal explora-
tion. Castration.

In most healthy animals the ovary is light and its situation in
the anterior border of the broad ligament is so firm that it is im-
possible for it to enwrap and constrict the intestines. In the
mare, however, the healthy ovary may be almost as large as
the closed fist, and when further enlarged by cystic or other
degeneration, it drags upon and enters the ligament until that
may form a long pedicle which can easily be wound round the
floating colon or small intestine.

Diagnosis of this trouble can often be satisfactorily made by
rectal exploration, and treatment will consist in the removal of
the offending body by castration through an incision made in
the anterior part of the roof of the vagina close behind the os
uteri.

PERITONITIS.

Acute: Chronic; general; local; idiopathic ; traumatic; surgical; acci-
dental; perforation ; strangulation; cachexia; microbian almost always;
aseptic foreign bodies escape into bowel: Castration ; gastric or intestinal
rupture or ulcer, enteritis, obstructions, cold storms, draughts, chills, all
lower resisting power of tissue; generalization through peritoneal serum.
Non-infective peritonitis from chemical irritants. Paves the way for mi-
crobes of ingesta. Rheumatic peritonitis, tuberculous, actinomycotic, mi-
crobes differ.

All inflammations of the peritoneum go under this general
name. Atthe same time clinical and pathological distinctions
have been made with the view of distinguishing more precisely
different classes of cases. Thus it is ascribed as acute and
chronic, general and local, idiopathic and traumatic, surgical,
accidental, or by perforation, by strangulation and by cachexia.

The advance of bacteriology has greatly simplified our views
of the disease, as microbes are found to be at work in practically
all cases. If we could exclude microbes from this membrane.

388

Perttonitis. 389

peritonitis would be practically abolished, portions of aseptic
powdered glass, sponge or gauze can be left in the abdominal
cavity with comparative impunity, the tendency being, as shown
in the dog, to coat themselves with a fibrinous exudate, and to
make their way into the intestines through which they escape
(Sternberg, Jalaguier and Manclaire). Hence it is that periton-
itis is to a very large extent the result of a traumatism (castra-
tion, penetrating wound of the abdomen, contused wound of the
abdomen), or of a rupture or ulceration of the stomach or intes-
tine, through which the microbes make their way into the
peritoneal cavity. In enteritis, congestions, strangulations, in-
tussusceptions and obstructions of the bowels, the cause is the
same, the microbes making their way with greater ease through
the coats of the bowels in which the circulation and nutrition are
impaired and the power of resistance diminished. Finally the
occurrence of the disease as a consequence of exposure to cold or
wet, of exposure in a cold rain or snow storm, of standing in a
draught when perspiring, or plunging into cold water when
heated and fatigued, or drinking ice cold water when in a similar
condition, may in most cases be explained on the same grounds.
The germs in this case had already gained access to the blood,
but were helpless to accomplish much harm, until by chilling, the
resisting power of the system was lowered and an occasion
furnished for their successfully colonizing the peritoneum.
Parallel cases are found in the frog which is immune from anthrax
until it is heated, and in the chicken which is immune from
anthrax until chilled. Reduce the vitality of the system and the
germ which was already present, and up till now harmless, takes.
occasion to colonize more or less destructively.

This view also furnishes an explanation of the tendency of
local peritonitis to become generalized. In the scanty liquid
which bedews the surface of the abdominal organs, the microbes
grow, multiply and spread ; by the constant peristaltic movements
of the bowels and their rolling upon each other this extension is
largely favored; and the tendency to generalization will be in
ratio with the potency of the invading germ, and the general or
local weakening of the invaded tissues. With a limited infection
wound in an otherwise healthy peritoneum and system, and in-
yvasion by a pus coccus only, the infection may not succeed in

390 Veterinary Medicine.

extending from its primary centre, but with a debilitated system,
an extended enteritis, or when the invasion is made by septic
germs it is likely to become speedily and fatally generalized.

Pernice has shown, however, that peritonitis may occur inde-
pendently of infection. The injection into the cavity of concen-
trated mineral acids, acetic acid, phenol, nitrate of silver and
other powerful antiseptics determine inflammation by their purely
irritant action. By weakening the tissues of the bowels these in
their turn pave the way for the escape of the microbes from the
contents, and to the occurrence of a secondary infective inflamma-
tion.

Cases occur as a manifestation of rheumatism, tuberculosis,
actinomycosis and other affections which will be treated at greater
length under these respective heads.

The microbes would seem to vary greatly. Soula attributes
infection of castration wounds mainly to the bacillus of malignant
cedema which is 3 to 3.5 long and 1 to 1.1 broad often bearing
a refrangent spore at one end (is sporeless in the peritoneal cult-
ures), and growing out into chains in artificial cultures. They
are anzerobic, liquefying, motile, easily stained by aniline colors,
but bleached by iodine.

In other forms of peritonitis the bacillus coli commune is found
and probably comes from the intestinal contents where it is
present in all our domestic animals.

In man Frankel found the bacillus coli communis 9 times,
streptococcus pyogenes 7 times, bacillus lactis aerogenes 2 times,
micrococcus pneumoniz croupose 1 time, staphylococcus pyo-
genes aureus 1 time. Flexner found the proteus vulgaris.

ACUTE PERITONITIS IN SOLIPEDS.

Susceptibility to pyogenic bacteria, infection simple or complex. Trau-
matic injuries ; accidental, omphalitis, operations, strangulation, wounds
in rectum or vagina, coition, hernia, castration of mare, or horse, infected
from second to sixth day, later granulation protects, ruptured stomach, per-
forating ulcer, perforation of parturient womb, ruptured abscess, microbes
in circulation, debility. Symptoms: trauma with spreading swelling, cede-
ma, tenderness, stiffness, arched back, tucked up abdomen, fever, prostra-
tion, colics, careful decubitus and rising, tense tender belly, ridge along
flank, breathing short, inspirations catching, straddles, steps short, costive
or later diarrhoea, enuresis, abdomen fluctuates, death in one to eight days.
With ruptured stomach or intestine prostration extreme, collapse, vomiting.
Resolution. Ascites. Diagnosis: trauma, gastric or intestinal lesion, fol-
lowed by specific symptoms. Lesions: trauma, rupture and escape of in-
gesta, congestion, ecchymoses, false membranes, adhesions, liquid effusion,
bloody, pink, or straw colored, albuminous, fibrinous, granules, cells, salts,
bacteria, pus, foetor, bowels tympanitic, later fibrous bands, strangulations,
degenerations. Prevention : fatal in solipeds, avoid abdominal congestions,
inflammations, traumas, infections, accumulation of serum, blood, etc.,
also debility, ill health, chill. Treatment: old methods, by anodynes and
checking peristalsis. Modern method : antiseptics, iodoform, carbolic acid,
mercuric chloride, irrigation with boiled water, drainage ; internally, saline
laxatives, eliminates from bowels, blood, peritoneum, favoring, phagocyto-
sis, and innervation, antiseptics, sodium salicylate, chloral hydrate, morphia,
enemata, hot fomentations, or ice, in suppuration drainage and washing with
normal salt solution at body temperature, derivatives, laparotomy, puncture
in tympany.

Causes. Solipeds are especially subject to peritonitis in its
acute and dangerous forms largely because this class of animals
is preéminently obnoxions to the attacks of pyogenic bacteria.
The disease may however be dependent on a great variety of
different organisms, and these may cause different forms through
invasion by one specific microbe or by a complex invasion. It is
convenient to note the different channels of invasion.

a. Traumatic Injuries. Wounds are not uncommon from
pricks with forks, pickets, broken rails, prongs of stump fences,
poles or shafts of wagons, nails, barbed wire, horns of cattle,
tusks of boar, and other sharp or pointed objects, which carry
infecting germs, or in any case make an entrance for those found
in the dust of the stable, on the horses skin, comb, brush, rubber

391

392 Veterinary Medicine.

or clothing. Inflammation of the umbilicus and resulting ab-
scess may prove an entrance way for the germs either by rupture
into the peritoneum or by causing adhesions between two loops
of intestines from which the microbes escape through the
weakened tissues. Wounds made in operations on hernias may
have a similar ending and as Dieckerhoff has pointed out the
onset of the peritonitis may be delayed for one or two weeks
while the abscess is maturing or the walls of the bowels are being
traversed by the microbes. Strangulated hernias and those in
which the intestine is congested are especially subject to such
peritonitis, as the germs may enter by the external wound and
through the intestinal wallas well. The author has seen artificial
anus formed through inclusion in the clamps of an adherent loop
of small intestine, and at sucha point peritonitis is liable to start.

Wounds of the rectum or vagina are sometimes the starting
point of the inflammation. The penis of a stallion entering and
lacerating the rectum of a mare, or the large penis of an ardent
male rupturing the roof of the vagina are occasional causes. The
latter may occur without fatal consequences, yet the author has
seen a generalized and rapidly fatal attack follow such an injury
when the mare had at once thereafter made a journey of nine
miles in a cold rainstorm. ‘The horse was a Percheron with very
large penis and the mare would weigh about 900 lbs. The cas-
tration of mares, even through the vagina may be followed by
peritonitis from sepsis of the instruments, hands or arms.

The castration of the horse is more liable to be followed by this
infection. Too often no attempt at asepsis is made, implicit trust
being placed in the defensive power of the tissues. In other cases
even a very careful local antisepsis fails, the germ being already
present in the circulation and the extensive wound and resulting
local congestion and debility are seized upon as an opportunity
for colonization and growth. This infection usually takes place
from the second to the sixth day while the inguinal canal and
vaginal sheath are still open to the cavity of the abdomen. Later
when these have closed by adhesion, and when protective granu-
lation has formed, the implication of the peritoneum is rare.

6. Rupture of the Stomach or Intestine. This comes as
already shown from gaseous distension, overloading, sudden
shock or concussion, obstruction by dried ingesta, calculi, foreign

~

Acute Peritonitis in Solipeds. 393

bodies, parasites, etc., and by abuse of too powerful purgatives
in cases of obstruction. The resulting infection is very abundant
and varied, and the microbes accustomed to an anzorbic existence
intheintestines, multiply with extreme rapidity in the peritoneum
and prove rapidly fatal. Beside the bacillus coli commune, there
are usually staphylococcus and streptococcus pyogenes and not
unfrequently the baccillus of malignant cedema.

c. Perforating ulcer. Though having a separate point of
origin, the effect of this is precisely the same as in rupture, the
same bacteria escaping and the nature of the infection being
identical. Inasmuch, however, as the perforation is usually
small at first and the escape of contents very limited the symp-
toms advance more slowly and reach their acme later.

d. Perforation of the Parturient Womb. This usually de-
pends on a case of dystokia in which the organ is torn by a foot
of the foetus or by some ill-directed instrument. The infection
has usually been carried in on the hands or instruments, or intro-
duced as dust by an aspiratory movement in the intervals of labor
pains. The healthy womb is usually sterile as regards microbes,
yet Lignieres claims that he has found staphylococcus pyogenes
albus and aureus and in contagious abortion the specific bacillus
of this affection can always be found. In woman peritonitis fol-
lowing rupture of the womb usually shows streptococcus pyogenes.

e. Rupture of Abscess into the Peritoneum. As an
abscess is nearly always the product of pus microbes it follows
thatits rupture into the abdominal cavity will determine infection.
If the abscess contains some special infective germ like that of
strangles or glanders the resulting inflammation partakes of its
nature.

jf Penetration of Microbes through the Circulation.
Healthy blood is free from germs, yet it is not uncommon to find
a few circulating in the blood in given conditions. Debility,
toxin and ptomaine poisoning and other conditions render it
possible for bacteria to successfully invade the circulating blood,
hence, many infective diseases are at first local, and later on be-
come generalized. Under these circumstances any cause of de-
bility operating especially on the peritoneum opens the door to
their infection. Under such debilitating causes all those already
referred to as chills must be recognized, together with kicks,
blows, local congestions and other injuries.

394 Veterinary Medicine.

Symptoms. “The existence of a penetrating wound or sore of
the abdomen, a kick, an open abscess, or a recent exposure to
severe cold when heated and fatigued, or finally some serious
affection of the abdominal organs will give definiteness to some
of the symptoms which follow. There may have been noticed a
rigor, or trembling of the muscles may still continue. There is
swelling around the external wound, which in case of castration
is usually cedematous and more or less tense, affecting the entire
sheath and extending forward on the abdomen. In any such
case there is tenderness to pressure around the margin of the
wound, for a distance that constantly increases. The animal
moves stiffly and the back is more or less arched. ‘The tempera-
ture is raised two or three degrees and may go on till it has
reached 107. ‘The patient becomes dull and listless, with droop-
ing head and ears, sunken, lustreless, pale eye, more or less
fixed, lips drawn up firmly and muscles of the face contracted
and prominent. He stands with back arched, loins insensible to
pinching, and legs drawn somewhat toward each other under the
belly. There are indications of colic, pawing, looking toward
the flanks, and shifting of the hind feet without the violent kick-
ing motion of spasmodic colic or intestinal congestion. When
he lies down it is comparatively slowly and carefully and he is
more inclined to lie on the side with hind legs, or at least the
one on the affected side extended backward. The rolling on the
back and the sudden jerking movement of the hind limbs, seen
in spasmodic colic are rarely noticed. There are exceptions to
this rule when violent spasms or acute congestion is present as
well as in some cases following castration and with strangulated
cord.

The abdominal walls are always tense from muscular contrac-
tion, and often also from tympany, in which case there is marked
drumlike resonance on percussion. An elevated ridge like that
seen in pleurisy extends from the outer angle of the ilium to the
lower end of the last rib. The breathing is hurried and carried
on mainly by the ribs, the diaphragm being kept as fixed as pos-
sible. The inspirations are short and catching as in pleurisy, the
expirations a little more prolonged. In standing the hind legs
are held apart, and in moving the animal straddles and moves
them stiffly avoiding advancing them far forward. Constipation

; Acute Peritonitis in Solipeds. 395

is the rule the rectum containing a number of small, round, dry
balls, yet after a day or two diarrhcea may set in. Urine is us-
ually suppressed, or passed in small amount and of a high color.
The pulse is usually small, hard, and at times thready, the skin
perspires more or less generally, prostration and dullness set in
and death may occur within 24 hours or more commonly in 4 to
8 days. After the 1st day there may be fluctuation of the ab-
domen from liquid effusion.

In case of infection from perforated or ruptured stomach or
intestine the symptoms are more severe from the first, and the
issue is more rapidly fatal. With marked trembling, there occur
extreme weakness and prostration, dull, sunken eyes, flaccid
facial muscles, cold perspiration, chilly ears and limbs, entire
cessation of defecation, small, weak accelerated pulse, breathing
rapid, broken in inspiration or expiration, and more or less
tympany. Yet the tenderness of the abdomen is less marked,
and the animal may move with somewhat less stiffness, and gets
up and down with less apparent suffering. The temperature is less
elevated than in the external traumatism, and the whole aspect is
that of collapse and sinking. These cases may die from shock or
tympany in a few hours, or they may survive 24 or even as long as
48 hours but rarely longer. In case of rupture of the stomach
there may be the usual feature of eructation or vomiting. Res-
olution may occur but non-fatal cases are liable to become chronic
with ascites.

Diagnosis. Apart from traumatism, the evidence of some
previous intestinal or gastric lesion, or abscess, succeeded by
continuous dull colicy pains, the arching of the back and drawing
together of the limbs, the tender abdomen, the careful decubitus
and lying on the side, the tympany, obstinate constipation, and
pale conjunctiva, the pleuritic ridge and breathing without the
friction sounds or intercostal tenderness of pleurisy, the high
temperature, the weak rapid pulse and rapidly advancing weak-
ness, prostration and collapse furnish a combination which is
very characteristic.

Lesions.- In rapidly fatal cases there may appear to be little
more than general peritoneal congestion and ecchymosis. In
such cases, however, there is usually a mixture of the ingesta
with the intestinal convolutions and omentum.

396 Veterinary Medicine.

In cases that have survived twelve hours, false membranes are
found in the form of fine filamentous shreds on the surface of
the congested serosa, which has become dull, opaque, and thick-
ened. In twenty-four to thirty hours these have increased in
thickness and solidity, binding together the convolutions of the
intestines or floating free as shreds or membranous layers in the
exuded liquid. At first yellowish white, these become gray,
red, and finally white as they become organized into fibrous
tissue. They may cover any of the abdominal organs and bind
these together more or less firmly.

The liquid effusion collecting at the lower part of the abdomen,
may be blood red, serosanguinolent, or straw colored, and contains
a considerable amount of albumen, fibrine, granules and cells as
well as the bacteria. It may attain to as much as 25 or 30 quarts.
When purulent or septic the liquid is comparatively limited in
amount and is usually connected with a ruptured abscess or
external wound or intestinal perforation. The presence of ali-
mentary matters, the foetid odor, and gaseous emanations are
marked features in this last condition.

The intestines are usually distended with gas, and have thin
walls infiltrated, pale and thickened, and often bound to other
convolutions or to adjacent organs by false membranes. ‘The
liver and spleen are pallid, and their capsules swollen, thick and
opaque, with more or less membranous exudate.

In case the patient survives, the effusion and neoplasm are
slowly absorbed, but the false membranes only imperfectly, and
they may be found later as organized bands attaching the intes-
tines or other organs to adjacent parts, and limiting their motions
or constricting and strangling them. Hence there is left a pre-
disposition to relapse or to other disease of the abdomen. Roll
has noticed degeneration and softening of the false membranes,
which extended to the wall of the bowel beneath and led to per-
foration.

Prevention. In solipeds especially this affection is so fatal
that every precaution should be adopted to prevent its occurrence.
In this class of animal the tendency to suppuration in wounds
and inflammations of all kinds greatly exceeds what we see in
other animals. A wound that in man will heal kindly by first
intention will almost certainly suppurate in the horse, and an

Acute Peritonitis in Solipeds. 397

abdominal wound which in man, ruminant or pachyderm might
be viewed with confidence, must be treated as a very serious
matter in the horse. But though thus differing in degree, all ab-
dominal wounds must be considered as serious lesions. ‘the
peritoneal sac is, like other serous sacs, a dependency of the
great lymphatic system of vessels, and the liquid present in it in
health is, like the lymph, the most favorable culture medium of
the body for microbian life, the greater the amount of such peri-
toneal fluid (as in inflammatory or other exudate) the more
favorable it becomes to its growth and diffusion, and finally the
enclosed intestine is teeming with micro-organisms, which, though
held in check by the healthy mucosa, are ready when any con-
gestion, inflammation or other morbid process gives occasion, to
traverse these thin walls and start their deadly career in the
peritoneum.

In every animal, therefore, but in solipeds above all, every pre-
caution should be taken against the infliction of accidental wounds
of the abdominal walls. and to remedy any serious derangement
of the digestive organs. Above all, operations that involve the
peritoneal cavity should be made only under careful surgical
precautions. The introduction of pyogenic, septic or potentially
septic material from hands, head, beard, floating dust, unboiled
water, or surgical appliance of any kind, is a direct bid for a
fatal peritonitis. Next to this the greatest care must be exercised.
to prevent unnecessary injury to the peritoneum or any abdomi-
nal organ, which would in any way impair its vital properties
and resisting power. Again, to leave blood or exudate of any
kind in the wounded peritoneum is a direct bid for the propaga-
tion of micro-organisms. These should be removed by means of
aseptic agents. Finally, in case of enteric disease and abdominal
wounds the patient should be guarded against chill, which would
lower the vital and resisting powers and lay the system open to
microbian invasion.

Treatment. The therapeutics of peritonitis furnishes a striking
example of the transforming influence of bacteriological discovery.
Systematic medical and veterinary works enjoin the time-honored
method of treatment by opium to check intestinal peristalsis and
the painful friction of inflamed surfaces on each other, and to
keep the organs quiescent until nature shall have time to subdue

398 Veterinary Medicine.

the inflammation. The still older treatment by calomel and
opium has essentially the same foundation. To the bacteriologist
the latter has the recommendation of being to some extent antisep-
tic and of tending to secure depletion from the intestinal mucosa.
Another cardinal principle of the old practitioner was to hail the
liquid exudate as tending to separate the inflamed and painful
surfaces, and as allowing them to move past each other. without
aggravating the suffering andinflammation. In short, the prac-
titioner of the past had an especial dread of mechanical injury,
and treated all other measures as secondary to this though by no
means unessential.

Bacteriological considerations direct attention rather to the vital
properties of the causative bacteria and seek to check the disease
by checking this its most effective cause.

In simple local peritonitis, as in the infection following castra-
tion, the washing out of the infected wound with boiled water
and application of an antiseptic (dilute solution of iodine (1:3),
iodoform, iodoform or carbolic acid gauze), and the free use of
carbolic acid solution (1:50) to the skin is of great value. If
the sheath or inguinal region is swollen to any extent punctur-
ing it at intervals with a lancet to the depth of half an inch so
as to drain it speedily and thus reduce the swelling and culture
fluid, and to restore the vitality of the parts, and the frequent
bathing with the carbolic acid lotion, will usually succeed in
bringing about a healthy action.

The question of medical treatment comes forward mainly in
cases that have invaded the abdominal peritoneum, and which are
not already completely generalized, nor the result of extensive
escape of gastric nor intestinal contents. In such forms and
above all in the early stages of surgical cases sulphate of soda
given to the extent of causing free purgation has been found to
be incomparably more effective than the opium treatment. ‘The
explanation of its action may rest in part (1) on the expulsion
from the bowel of a large proportion of the dangerous microbes
which are simply waiting for that opportunity to pass into the
peritoneum, which will be furnished by the inflammation of the
intestinal walls; (2). On the elimination from the blood and
system of much of the deleterious ptomaines and toxins which have
already been absorbed from the inflamed surface and the presence
of which robs the tissues of their vitality and resisting power ;

Acute Peritonitis in Solipeds. 399

(3). On the active depletion from the intestinal mucosa, and
(through the common capillary plexus) ‘from the congested peri-
toneal coat, counteracting alike the effusion into the peritoneum
which forms the culture fluid for the invading bacteria, and the
infiltration of the serous and subserous tissues which beside
tearing apart the tissue elements, and robbing their leucocytes of
their power of phagocytosis, furnishes within the invaded tissue
itself the most favorable of culture media ; and (4) on preserving
a better tone of the nervous system, and, locally, of the tissues,
the cells of which can struggle more successfully against the small
body of invading bacteria advancing slowly along the surface of
the peritoneum, than with the countless myriads produced in and
washed everywhere by the abundant liquid exudate.

Along with the soda sulphate may be given antiseptics, like
sodium salicylate, or chloral hydrate. The latter serves to miti-
gate the pain without checking the secretion or peristalsis.

When the suffering is very acute, opium may still be resorted
to, but preferably subcutem, in the form of morphia sulphate so
as to lock up the poisons as little as possible.

Enemata are in order to facilitate the operation of the bowels,
and may be made laxative and antiseptic. The danger of tym-
panitis speaks forcibly for a judicious use of antiferments, both
by the mouth and anus.

Hot fomentations have long been in use but require persistent
applications and this is often difficult to secure. Recently cold
applications to the abdomen in the form of ice or snow, or in the
absence of these of cold water applied on a light rug, kept against
the abdominal walls by elastic circingles, have been found of
great service. ‘This can be persistently applied, as all that is re-
quisite is to keep the rug constantly wet.

When pus forms in the peritoneum or when extensive effusion
has taken place, it should certainly be evacuated, as it is but a
centre for the development of the deadly bacteria. It can be
drawn off through the already existing traumatic orifice, or, if
necessary, a new opening can be made by cannula and trochar, or
by direct incision under suitable antiseptic precautions. The
opening having been made, and the liquid having escaped, the
peritoneum may be profitably washed out with a normal salt solu-
tion which has been recently boiled and which is used at near the

body temperature (80° to 90°).

400 Veterinary Medicine.

Blisters are sometimes of use in the advanced stages of the
disease, in stimulating resolution and reabsorption, but hot or
’ cold applications are preferable in the early acute stages.

Laparotomy in cases due to rupture of stomach or bowel, or of
extensive perforation, has not been attempted in solipeds, and it
could hardly be expected to succeed, yet in such cases, which are
otherwise inevitably fatal, any measure giving even a remote
hope of success is allowable.

When tympany sets in it may be met by using a fine cannula
and trochar, and as soon as the gas has escaped, antiseptics like
chloral hydrate, salicylate of soda, salicylic acid, or glycerine,
can be injected into the fermenting mass by attaching a caouchouc
tube and funnel to the cannula.

CHRONIC PERITONITIS IN SOLIPEDS.

Secondary : after acute, or with disease of liver, spleen, kidney, rheuma-
tism, melanosis, lymphadenoma, epithelioma, carcinoma, or sarcoma. Gas-
tric ulcer, infected punctures. Symptoms: poor health, tender abdomen,
irregular bowels, slight colic, tense, fluctuating belly, pallid mucose, dropsy
of sheath, limbs, etc., slight fever. Treatment: remove primary disease :
saline laxatives, diuretics, drainage, antiseptic irrigation (boric acid, etc.),
abdominal bandage, tonics, derivatives.

Causes. Chronic peritonitis‘ is always a secondary disease,
succeeding the acute, or dependent on some other affection of the
abdominal organs, as chronic congestion of the liver, or spleen,
Bright’s disease, rheumatism, melanosis, lymphadenona, epithe-
lioma, carcinoma, or sarcoma. ‘Tuberculosis and actinomycosis,
so common in cattle, are rare in solipeds. Chronic ulcers of
stomach or bowels and injuries and infections from punctures are
exceptional causes.

Symptoms. ‘The manifestations of the disease are indefinite,
the acute form may have subsided so that the patient is supposed.
to have completely recovered, a moderate appetite and a certain
capacity for work may be present, yet he is easily fatigued, there
is some tenderness of the abdomen to pressure, some irregularity
of the bowels—constipation and diarrhcea alternating — and

Chronic Peritonitis in Solipeds. 401

occasional slight colics. Some weeks later may be noticed
abdominal tension and tympany, with perhaps fluctuation in the
lower parts, increasing pallor of the mucosz, and cedematous
swelling of the sheath, mammz, abdominal walls or hind limbs.
To detect fluctuation it is sometimes necessary to introduce one
hand into the rectum. When present hyperthermia is slight, but’
assists in diagnosis from ascites.

Treatment should be directed to the primary disease. As that
is too often irremediable the peritonitis will resist all other treat-
ment.

In cases that supervene on the acute form,:paracentesis, saline
laxatives and diuretics with antiseptics, tonics, and counterirri-
tants will sometimes succeed. Asin the acute form of the disease
the removal of the effusion is the removal of the culture fluid, and
may be followed by irrigation of the peritoneum with a normal
salt solution, or with an antiseptic solution (boric acid or potassium
permanganate, 1:20 warm water; Aluminum acetate, 1:2000.
Sulphate of soda given to keep up a moderately laxative action,
tends to counteract the contraction of the intestine by false mem-
branes, and operates with diuretics in reducing the tendency to
exudation or in causing its reabsorption. After removal of the
liquid, support by a close (or elastic) abdominal bandage is often
of value in preventing further effusion. As tonics, gentian, nux
vomica and the iron salts may be profitably employed, and as
antiseptics salicylate of soda and iodide of potassium. As counter-
irritants mustard and cantharides may be named.

26

PERITONITIS IN RUMINANTS.

Causes : infection, chill, blows, wounds, debility, ill-health. Chauveau’s
experiment with castration, dystokia, abdominal congestion and inflamma-
tion, bile or urine in absence of sepsis, gastric or intestinal ulcer or perfora-
tion, foreign bodies, abscesses, surgical wounds. Spoilt marc of beet sugar
factories. Symptoms: fever, stiffness, dragging hind limbs, knuckling,
arched back, shifting feet, moving tail, tense belly, pendent, fluctuating
below, friction sounds, diarrhoea, later constipation, weakness, emaciation,
death fourth to twentieth day. Recovery, often partial. After dystokia
putrid vaginal discharge, and nervous depression, resembling parturition
fever. Infection in ewes through shepherd’s hands, cedematous swellings
of vulva, perineum and abdomen. Lesions: as in solipeds, with abundant
false membranes, foetid pus, metritis, with putrid contents of womb. Treat-
ment: saline laxatives, diuretics, demulcents, enemata, morphia, antisep-
tics, cold to abdomen. After dystokia, antiseptic irrigation of womb, ele-
vation of head, with ice, strychnia. acetanilid. Tubercular peritonitis.

Causes. As in solipeds infection of the peritoneum and the in-
crease of susceptibility by exposure to cold, blows, wounds, poor
feeding or stabling, disease and other causes of ill health, operate
together in inducing peritonitis.

The effect of debility or predisposition of the tissues is well
shown in Chauveau’s experiments with dzstournage, in rams.
Healthy rams subjected to bistournage showed no infection, and
rams subjected to intravenous injection of pus microbes without
bistournage showed no infection, whereas if the rams were first
subjected to injection of pus microbes, and then to distournage,
peritonitis set in. In the same way chills occurring after dys-
tokia, when the womb is charged with microbes and more or less
congested, may determine peritonitis, and congestions, impac-
tions, tympanies, and other injuries of the gastro-intestinal
viscera cooperate with cold to the same end. Rupture of the gall
or urinary bladder does not usually cause prompt peritonitis, yet
it irritates the serosa and lays it open to infection if the germs
should reach it through the circulation. Otherwise the animal
suffers only from uremia or biliary poisoning and may survive
one or two weeks. Ruptures of stomach or intestine, or ulcera-
tion or the perforation of their walls by hard, pointed or other
metallic bodies are causes of peritonitis. The rupture of abscesses

402

Peritonttis in Ruminants. 403

into the peritoneum and the escape of germs from the womb in
case of rupture of the womb in difficult parturition, or in metritis,
are additional causes. Surgical wounds as in castration of the |
male or female, and punctures and incisions of the rumen are oc-
casional causes, but there is by no means the tendency to exten-
sion of such peritonitis that we see in solipeds. The self-protec-
tive power of the tissues is incomparably greater in the ruminant.

Nocard, Butel and others have recorded a gastro-entero-peri-
tonitis of septic nature, occurring in cattle and above all in sheep,
fed on the fermented refuse of beet sugar factories, which had
been kept in silos through the winter, On the third and fourth
days of this feeding many were attacked.

Symptoms. Beside the general systemic disorder and a very
variable amount of hyperthermia (102° to 107°), there are the
special indications of abdominal inflammation, stiff movement
and dragging of the hind limbs, or if standing the back is arched,
the head drooping and the legs drawn together and slightly bent,
with uneasy shifting of the hind feet, and lateral movements of
the tail. The walls of the abdomen are usually tense, often
bulging laterally below, though fallen in beneath the lumbar
transverse processes (pot-bellied); they are tender to pressure,
and may be drum like to percussion above, while flat, dull, and
fluctuating below. The tenderness is slightest below, where
liquid effusion has settled, but is quite marked in the upper and
resonant parts, where pressure will cause wincing and trembling.
In this upper part on the left side may be heard friction sounds
after the fourth or sixth day. ‘This is especially observable in
tuberculous peritonitis over the parts covered by tubercular
growths. There may be at first diarrhoea which usually soon
gives place to constipation, and weakness and emaciation advances
rapidly, and death may take place from the fourth to eighth day,
or may be deferred for some weeks.

In favorable cases the acute symptoms subside, the liquid
effusion is absorbed, appetite and rumination are in great part
restored, and a partial recovery is made. It is, however, very
liable to merge into the chronic form, and inevitably so in tuber-
culous cases.

In cases following on difficult parturition there are redness of
the vaginal mucosa, with muco-purulent or putrid discharges,

404 Veterinary Medicine.

and swelling of the lower part of the abdomen, with liquid
effusion and fluctuation, and tenderness of the right flank. The
further symptoms are largely nervous, approximating somewhat
to those of parturition fever. Temperature may rise to 104° or
°106°, blindness, stupor, incodrdination of muscular movement,
staggering gait, if down she may lie on the side or sternum
unable to rise, has frequent afterpains, tympany, sour eructations,
and grinding of the teeth. The case may culminate in loss of
vision, in stupor and coma, or improvement may set in and goon
to a rapid recovery. This isa more common affection in ewes
than in cows and is very destructive, the infection being carried
by the hands of shepherd. The most fatal cases are those in
which the infection becomes generalized, and cedematous swellings
appear round the vulva, between the thighs and beneath the
abdomen.

In traumatic cases the external wounds can usually be found
with active inflammatiou and surrounding tumefaction.

Lesions. ‘The peritoneum, as in solipeds, shows the symptoms
of congestion, exudation of a fine fibrinous network or shreds, of
thicker and more extended false membranes in patches, of
effusions more or less sanguineous, of formation of pus, usually
fcetid, or the presence of decomposing ingesta which has escaped
through a lesion of stomach or bowels. The peritoneal and sub-
serous tissue are infiltrated with liquid, and the other gastric and
intestinal organs are more or less tympanitic, and the mucosa of
the latter is thickened, ecchymosed, or eroded, with black, foetid
bloodstained contents. In parturient cases, the uterine mucosa
is congested, reddened and softened, the cotyledons swollen, per-
haps gangrenous, and the membranes, if still present, float ina
dark, putrid offensive liquid.

Treatment. As inthe horse, morphia has been used to relieve
pain and check peristalsis. The addition of saline laxatives, and
diuretics, will assist in elimination and depletion, and in the re-
moval of intestinal bacteria which become a source of danger. A
laxative dose should be followed by frequent drinks of pure water
or mucilaginous liquids, and sulphate of soda may also be given
freely in enema. As diuretics, saltpeter, or digitalis may be re-
sorted to. Antiferments (salicylate of soda, bisulphite of soda)
should not be forgotten nor cold applications to the abdomen.

Peritonitis in Carnivora. 405

When effusion or suppuration has taken place evacuation by
puncture may be followed by antiseptic irrigation.

If with septic metritis, antiseptic injections of the vagina and
womb are the first consideration. With boiled water at a tepid
heat the womb should be thoroughly washed out, followed by a
solution of mercuric chloride (1:2000), or permanganate of potash
(1:1000), or boric acid (1:25) until the liquid returns clear and
odorless. This may be repeated several times a day. The symp-
toms of brain congestion, may be met by tying, or packing up the
patient with straw so that the head will be somewhat elevated, and
bags of ice or snow, or simple cold water may be kept applied to
the upper part of the head and neck. When there is no great
nervous excitement the nervous functions may be roused by nux
vomica in enema, or strychnia subcutem. If on the other hand
the temperature runs very high acetanilid may be tried with cau-
tion, or resort may be had to wet compresses.

In case of perforation or rupture, if the animal cannot be at
once sacrificed for beef or mutton before inflammation has set in,
the only hope lies in laparotomy, followed by the cleansing, dis-
infection and suturing of the wound.

In tubercular peritonitis which constitutes a very large propor-
tion of bovine cases, treatment is undesirable, and the animal is
unfit for consumption.

PERITONITIS IN CARNIVORA.

Causes: gastro-intestinal inflammations, metritis, trauma to walls of ab-
domen, pyaemia, septicaemia, tuberculosis, cancer, tumors, parasites. Symp-
toms: dullness, hiding away, movements tardy, painful, arched back, re-
tracted abdomen, tense and tender, drags hind limbs, vomits, yawns, bloats,
hopeless look, snappish, death in 2 to 8 days. Treatment: anodynes, saline
laxatives by mouth and rectum, damp compress, warm bath, antiseptics,
diuretics, in effusion, puncture, antiseptic irrigation, laparotomy.

Causes. Allinflammatory and other serious affections of the
stomach and bowels may be associated with peritonitis. Metritis
and injuries to the womb, and all injuries to the walls of the
abdomen (kicks, blows, penetrating and castration wounds), may
have a similar complication. Pyzemia and septiceemia may also

406 Veterinary Medicine.

have localization in the peritoneum. It must be borne in mind,
however, that purulent and septic infection are less likely to
occur in the dog than in cattle, the leucocytes of the dog having
much more resisting power. On the other hand the dog, and,
still more so, the cat has a fair measure of susceptibility to tuber-
culosis, cancer and various forms of tumors, which show a strong
tendency to localization in the abdomen. Parasites also pene-
trate and irritate the peritoneum.

Symptoms. ‘The animal becomes dull, retiring, and inclined
to lie in a quiet place, though his suffering may lead to frequent
change of bed, he moves slowly, painfully, with arched back, re-
tracted abdomen, and drooping head, and dragging his hind
limbs stiffly. The abdomen is tense and firm, hot and very ten-
der, drawing forth whines and yelps when it is handled. There
are hyperthermia (104°), small, weak, accelerated pulse, hur-
ried, catching breathing, vomiting, yawning, tympany and
constipation. ‘The face has a hopeless, stupid look and the eyes
are sunken and at times glazed. Some patients become ill
natured and snappish. The animal gradually sinks into a con-
dition of prostration and finally of collapse and dies in two to
eight days.

Treatment does not differ materially from that given for larger
animals. {j Pain may be moderated by belladonna, hyoscyamus,
chloral, or even opium, wirile the sulphate of soda is employed
by both mouth and rectum. The abdomen may be enveloped in
a damp compress, or a warm bath may be given. Diuretics will
be in order and above all antiferments, the latter by enema as
well. Distension of the abdomen with fluid may be relieved by
puncture, followed by antiseptic irrigation. If there is good
ground to suspect a gastric or intestinal lesion or tumors, lapa-
rotomy is a much more hopeful resort than in the larger animals.

PERITONITIS IN BIRDS.

From caponizing, accidental traumas, ruptured oviduct, perforations of
bowels by foreign bodies or worms, pyogenic susceptibility slight. Symp-
toms: inappetence, drooping head, wings, tail, erect plumage, stiffness,
straining, tense, tender, pendent belly. Treatment : unload cloaca, punct-
ure and irrigate abdomen, laxatives. Prophylaxis, by laxative food, expul-
sion of worms, antisepsis in operations, unloading cloaca, etc.

Causes. Birds contract peritonitis from caponizing, and other
penetrating wounds of the abdomen, from rupture of the ovi-
duct impacted with egg matter, from perforations of the in-
testines by foreign bodies, and from perforations by worms.

The danger from ordinary pyogenic germs is, however, at its
minimum, since birds stand at the opposite extreme from the
horse, and their wounds rarely suppurate.

Symptoms. The bird loses appetite, droops head, wings and
tail, ruffles its feathers, walks stiffly and heavily, and expels
feeces with much effort and even with cries. When caught the
abdomen is found to be full, tense and pendent and very tender
to the touch. There is more or less hyperthermia (108° and
upward), and the subject becomes more and more dull, stupid
and feeble until death.

Treatment. In certain cases relief may be had by the unload-
ing of the cloaca, or the evacuation of peritoneal fluid, followed
by antiseptic, irrigation of the cavity. Laxatives may also be
resorted to. The most important measures are, however,
prophylactic, and run in the direction of careful manipulation
and antisepsis in caponizing, the unloading of impacted cloaca,
before it has developed serious disease, the maintenance of a’
suitably laxative diet, aud the prevention and treatment of
worms. In case of tumors causing chronic peritonitis, laparo-
tomy can be resorted to with great confidence.

407

ASCITES IN SOLIPEDS.

Causes: follows peritonitis, obstruction of portal vein, tumors, hepatic
diseases, pressure on posterior cava, dilated right,heart, heaves, ovarian dis-
ease, nephritis or kidney degeneration, hydrocemia. Symptoms: slow ad-
vance, pot-bellied, with fluctuation, hollow above, dropsy in limbs, sheath
and under belly, percussion sound flat below, weakness, debility, no fever.
Diagnosis : Absence of fever, and of fibrine, cells and granules in effusion.
Lesions: those of primary disease, amount and composition of effusion.
Treatment: treat primary disease glandular swelling or actinomysosis,
iodide of potassium, remove diseased ovary or tumor, draw off fluid, com-
press abdomen, saline laxatives, diuretics, iodides, pilocarpin, electricity,
bitters.

Causes. Ascites may be a remnant of a pre-existing chronic
peritonitis, or it may occur from any obstruction of the portal
vein, such as compression by organized false membranes, throm-
bus, in the vessel, or pressure by lympadenoma in the portal fissure,
melanosis, sarcoma and other tumors. It results from cirrhosis
and other diseases of the liver which retard its circulation, from
pressure on the posterior vena cava, from insufficiency of the
right aurictlo-ventricular valves, from dilatation of the right
heart, and from heaves or other obstruction in the pulmonic cir-
culation. Other causes are cystic or other disease of the ovary,
diseases of the kidney and hydrozmia, the latter two tending to
general cedema as well as ascites.

Symptoms. 'The disease comes on slowly and insidiously and
at first it usually passes unnoticed. When more fully developed
the abdomen is distended but somewhat pendent (pot-bellied),
fluctuating below, with falling in beneath the lumbar transverse
processes. Later the whole abdomen may be full rounded
smooth and tense, and the hind limbs cedematous to above the
fetlocks or hocks. ‘There may be cedema of the sheath or lower
wall of the abdomen. Fluctuation “can still be felt as a shock
when an assistant makes sudden concussion with the fist on the
opposite side from that on which the hand is pressed. This may
be felt even more distinctly by the hand introduced into the rectum.
Percussion gives a flatsound below and more or less resonant
above. The pulse is small, weak, and accelerated, heart-beats irri-

408

Ascites in Solipeds. 409

table (sometimes palpitating), and respiration labored and with
lifting of the flank. From first to last there is no hyperthermia.

If the cause is irremediable the issue is necessarily fatal sooner
or later.

Diagnosis from peritonitis depends largely on the absence of
hyperthermia, and of abdominal tenderness, and on the nature of
the ascitic fluid which is incoagulable, and comparatively desti-
tute of leucocytes cells and granules.

Lesions. The quantity of effused liquid is often enormous
(50 qts. Reynal, 80 qts. Woodger, 150 qts. Friedberger and
Frohner). It is very watery and poor in salts and albuminoids,
of a density near 1012, neutral or slightly alkaline, does not
coagulate spontaneously, and is not associated with false mem-
branes. The peritoneum shows no congestion, but is pale, and,
like the abdominal walls, infiltrated. Tumors, cysts and venous
obstructions referred to under causes may be found.

Treatment. When ascites depends on actinomycosis or glandu-
lar enlargement a course of iodide of potassium may remove the
cause. In other cases an operation may remove the offending
tumor or ovary. ‘Too often, however, the cause is beyond
remedy and palliative treatment only is available. The most
urgent indication is the removal of the accumulated fluid, and
paracentesis under proper antiseptic precautions is the readiest
means to this end. Compression by a tight bandage is necessary
to prevent the sensation of vacuity and tendency to fainting which
come from the removal of the fluid and to counteract the disposi-
tion to the instant effusion of more. Even with the compress it is
judicious not to draw off all of the fluid at once in bad cases, but
to make two or three operations and allow the patient to become
accustomed to the change in the intervals. These may be
repeated as circumstances demand. Saline purgatives, or diuret-
ics (saltpetre 1 0z., digitalis 25 grs., squill 3 ozs., iodide of
potassium 2 drs.), are useful, and pilocarpin is the most efficient
agent of this kind, but also dangerous by reason of the extreme
depletion which it causes. Electricity has been employed with
alleged advantage, also poultices of digitalis applied over the
loins.

Cholagogues are also recommended especially in cases of liver
disease. Bitters may prove useful.

ASCITES IN RUMINANTS.

Causes: as in horse, tuberculosis, in sheep distomatosis, chills when
heated and fatigued. Symptoms: pot-belly, fluctuating on percussion, gives
flat sound, debility, pallid mucosz, sunken eyes, superficial dropsies on
belly, in limbs, and under jaw, in distomatosis, great emaciation, weakness,
paperskin, ova of distoma in feeces. Diagnosis: from ruptured bladder by
passage of urine, and perhaps by sex, and absence of urinous odor in liquid,
from hydrometra by fluctuation over whole belly. Lesions: those of soli-
peds, also tubercles or enlarged gall ducts with distomata. Treatment: as
for solipeds. Tuberculosis demands separation or destruction, distomatosis,
prevention.

Causes. ‘These are in the main those which operate in the
horse and need not be repeated. In cattle, however, the affection
is to a large extent the result of abdominal tuberculosis, while in
sheep it is a constant result of advanced distomatosis. Gellé says
it is common in working oxen, which are turned out, hot and
perspiring, to pass the night in cold and wet.

Symptoms. ‘The belly is enlarged and pendent, bulging out
back of the ribs, with fluctuation and dullness on percussion.
The animal is in very low condition, the mucosz pale or yellow-
ish white, the eyes dull and sunken, panting and palpitations
may be roused on the least exertion, and swellings often appear
along the lower aspect of the body and between the branches of
the lower jaw. In distomatosis it is common to find dropsy of
the chest, pallor and attenuation of the skin, complete absence
of the subcutaneous fat (paperskin), and great emaciation and
weakness. Ova of the distoma can be found in the feces. (See
distomatosis). By turning the sheep on its back or setting it up
on its croup the percussion dullness will be made to shift, always
to the dependent part of the abdomen.

Diagnosis, From rupture of the bladder it is distinguished,
by its occurrence in females as well as males, by the absence of
fever, and of the complete suppression of urine and emptiness
and tenderness of the bladder which characterize the latter.
Liquid drawn from the abdomen has no urinous odor. From
hydro-metra, pyometra, and hydramnios it is distinguished by
the fact that the water accumulates in the lower part of the

410

Ascites in Carnivora. 411

abdomen, and is not confined to the womb. On rectal explora-
tion the outline of the empty womb is made out.

Lesions. Besides the lesicns described for solipeds, one finds
in cattle, tuberculosis of the liver, spleen, and lymph glands, and
extensive clusters of tubercles on the peritoneum. In sheep the
white branching lines on the back of the liver may indicate the
distention of gall ducts infested by distomata.

Treatment does not differ from that recommended for solipeds.
in tuberculous cases, sanitary considerations demand the destruc-
tion of the animal and disinfection of the carcass. In distomato-
sis treatment must be preventive, as the distomata are difficult
to reach with vermifuges.

ASCITES IN CARNIVORA.

Causes: obstructed flow of blood iu hepatic, portal or renal veins, or in
vena cava, renal heart, liver or splenic diseases, pulmonary congestion,
asthma, tuberculosis. Symptoms: pot-belly, hollow above, drooping back
and loins, flat percussion sound and fluctuation, change of position changes
area of flatness, anzemia, debility, scanty urine, diarrhoea, no fever. Diag-
nosis : absence of fever, general fluctuation changing its seat by turning the
patient, not confined to a given organ like the bladder or womb. Lesions :
quantity and composition of liquid, lesions of primary diseases. Treatment :
Correct if possible the primary disease, evacuate the liquid, compress on ab-
domen, iodine solution for irrigation, saline purgatives, diuretics, pilocar-
pine, bitters, iron, sunshine.

Causes. Ascites is generally the result of some obstruction to
the return of blood from some abdominal organ, but may also
come from renal disease, or hydrozemia in which general dropsy
is likely to occur. The dog is specially subject to heart disease,
and disease of the right heart (tricuspid insufficiency, dilatation,
hydro-pericarditis, fatty degeneration, etc.) throws the blood
back on the whole venous system and the extensive and dilatable
portal veins are especially liable to suffer. Diseases of the liver
so common in pampered house dogs, still more directly block
the portal circulation and induce ascites. Tumors in the liver or
spleen or in the lymph glands of the porta act in this way, also
cirrhosis, tuberculosis, cancer, hepatic congestion, and degenera-
tion. Constrictions of the vena portee by false membranes the

412 Veterinary Medicine.

result of former peritonitis must also be recognized. As more
distant causes, must be named obstruction to the pulmonary cir-
culation, as in congestion, asthma, tuberculosis and diseases of
the left heart. Seventy-eight cases were traced as follows: to
diseases of the heart and pericardium, 10; to tuberculosis, 8;
to pleurisy, 4; to malignant tumors of the liver and lung, 2; to
hepatic disease without heart lesion, 3; to cancer of the liver, 1;
(Cadiot).

Symptoms. Enlargement of the belly is marked and peculiar,
the liquid accumulationg below, pushing outward the lower ends
of the ribs and making the lower part of the abdomen baggy,
while the upper part, under the lumbar transverse processes, is
flattened or hollow. The back and loins droop, forming a con-
cavity superiorly, so that the belly may almost drag on the
ground. On palpation this pendant abdominal sac gives the
sensation of a mobile fluid without the usual firm outlines of the
intestinal masses, and when percussed it gives out a flat, dull
sound and produces a fluctuation or shock at the opposite side of
the abdomen. In the upper part of the abdomen over the hollow
flank more or less resonance is found. If the animal is made to
stand on his hind limbs the saccular dilatation and flatness on
percussion are in the region adjoining the pelvis; if held up by
its hind limbs they are transferred to the epigastric and hypo-
chondriac regions and the respiration is seriously interfered with ;
if turned upon his back, the resonance is obtained on the linea
alba, and at each side, while the percussion dullness is next to
the vertebrae. The clearness of the fluctuation is in ratio with
the amount of liquid present.

As in other animals, there are anzemia, pale mucosze, poor con-

dition, thin, dry, unhealthy skin, weak pulse, irritable heart
and interference with respiration proportionate to the amount of
liquid. The urineis scanty, and there may be diarrhea.
_ Diagnosis, From advanced or chronic peritonitis it is dis-
tinguished by the history or evidence of diseased liver, heart, or
kidney, the absence of hyperthermia or abdominal tenderness,
and the absence in the ascitic fluid, extracted with a hypodermic
needle of blood globules, or leucocytes in numbers, of false
membranes, of excess of salts, or of a tendeucy to coagulate
firmly.

Ascttes in Carnivora. 413

From over-distended bladder it is diagnosed by its slow, and
gradual development, and the change of fluctuation to the most
dependent part no matter what position is given to the patient,

- whereas the tense bladder can be felt through the abdominal walls,
extending forward from the pelvis under all circumstances.

From ruptured bladder there is the same distinguishing feature
of slow development, the absence of symptoms of urzemic poi-
soning, of tenderness of the bladder, and of suppression of urine,
and also of the urinous odor in the ascitic liquid obtained with
the hypodermic needle.

From advanced gestation the differentiation is found in the gen-
eral diffusion of the swelling and fluctuation, which is not con-
fined as in gestation to the mobile uterine horns, with a series of
enlargements each containing a solid nodular foetus.

From hydrometra and pyometra there are the same pathogno-
monic differential features of the general diffusion of the swell-
ing among the intestines, and its accumulationin one fluctuat-
ing mass at the most dependent part of the abdomen.

Tympany of the bowels causes uniform drum-like resonance,
and the swelling does not sag and fluctuate in the lower part of
the abdomen.

Abdominal obesity in old dogs gives the rounded swollen ab-
domen, but there is an entire absence of the pendulous and fluc-
tuating features, and when punctured with-the hypodermic
needle it furnishes no fluid.

From tuberculosis it is distinguished by the absence of nasal
discharge, or of tubercle bacilli in such discharge, or in the
ascitic fluid, and the latter inoculated on guinea pigs or rabbits,
does not cause tuberculosis. The tuberculin test may also be
resorted to.

Lesions. The liquid exudate has been found to amount to 30
or 40 quarts in large dogs (Hordt). It is often clear and trans-
lucent, of amber tint, though in some cases it is slightly opaque,
or reddish yellow. It may remain fluid after extraction or again
it may form a loose jelly. It may be red in case of soft tumors
or other neoplasms. ‘The liquid is very watery but may contain
a considerable amount of fatty globules or granules, and a few
epithelial cells and leucocytes. The peritoneum is pale or in
advanced cases dull white from fatty degeneration of the epithe-
lium.

414 Veterinary Medicine.

Treatment. ‘The first consideration is the removal of the
cause. If this is a mere vicious action of the peritoneum, or the
presence of a thrombus, or of operable tumor, or even of curable
disease of the liver or kidneys, success may be hoped for, while
in dilatation of the heart, insufficiency of the cardiac valves, ir-
remediable disease of the lungs, liver or kidney, or malignant or
inoperable tumor no such result can be hoped for.

Apart from the removal of the cause the first indication is to
evacuate the liquid and this may be done with a large hypodermic
needle or small cannula and trochar inserted by preference on or
near the linea alba while the animal is in a standing position.
Skin and instrument should be rendered thoroughly aseptic, and
a bandage should be wrapped round the abdomen and gradually
tightened as the liquid escapes. This to a large extent obviates
the tendency to faint, or to cerebral anzeemia which has caused
sudden death in a number of cases. It also to some extent
counteracts the sudden effusion of blood in the abdomen, which
is at times determined by the vacuity. °

Injection of a solution of iodine (tincture of iodine 1 pt., iodide
of potassium 1 pt., boiled water 20 pts.) has been employed
sometimes with success, but in other cases it has roused a fatal
inflammation. It is best adapted to a simple morbid relaxed
state of the peritoneum.

‘Saline purgatives (sulphate of soda or magnesia) are especially
useful in complicated cases and should be pushed in continuous
action, as far as the strength of the animal will warrant. By
depletion from the portal system they oppose the tendency to
mechanical transudation, while by rendering the portal blood
more dense they strongly solicit endosmosis from the adjacent
peritoneum.

Diuretics have been used extensively and with benefit. They
may prove injurious in a kidney that is already the seat of irri-
tation and yet after all be the least of two evils. In some cases
instead, the resulting dilution of a dense and irritating urine is
directly soothing to the tender kidney. Saltpeter (10 to 15 grs.),
acetate of soda (15 to 30 grs.), squills (1 to 2 scr.), may be re-
peated so as to keep up a free action. Pilocarpine (subcutem)
(zt to gy grain daily), has removed the ascitic fluid in 14 days
(Zahn), but its action is always to be dreaded in a weak system,
or with a diseased heart or lungs.

Diseases of the Liver. 415

A supporting bandage on the abdomen is always useful as
counteracting the tendency to vacuity and further transudation.

A course of bitters and iron, and a supporting diet, and out
door life (sunshine) are important elements in treatment.

DISEASES OF THE LIVER.

In veterinary and medical works the diseases of the liver have
been accorded a minor place, ill in keeping with the great
physiological importance of the organ. If the function of the
liver were circumscribed by the mere secretion of bile there would
be some excuse for the apparent neglect, as the gland is so deeply
situated and so much enveloped in surrounding organs that
physical exploration is difficult and somewhat unsatisfactory, and
the one symptom of jaundice was long relied on as indicating
hepatic disorder.

Taking into account all the varied functions of the liver we
realize the wide-reaching nature of its physiological influence and
the extensive and varied effect of its disorders. We can also
deduce, with greater or lesser certainty, the existence of hepatic
disorders from the morbid conditions of the blood or of organs,
the functions of which are inter-dependent with those of the
liver. Tro elucidate the subject it is well to trace some of the
most prominent functions of the liver ; the following considera-,
tions are submitted.

SANGUIFICATION IN THE LIVER.

Glycogenic function. Glycogen derived through’ glucose and laevulose
from starch, glycerine, milk and cane sugars. Less from proteids. Pep-
tones asa source. Its use in cell growth and heat production, in white blood
cells, in contracting muscle, becoming lactic acid. Excess dissolves red
globules, setting free hemoglobin. Ammonia carbonate and asparagin in-
creases it. Arsenic, phosphorus or antimony arrests glycogenesis. Liver
increases leucocytes, and reduces size of red globules. Reduction of pro-
teids. Fibrine formers reduced, urea formed ; liver inactivity means less
of soluble urea, and more of le-s soluble and more dangerous products.
Urea increases with hepatic circulation. Hepatic disorder and suppression
of urine dangerous. Red globules probably destroyed. Bile: Amount,
uses, oil solvent, helps endosmosis, deodorant, stimulates glycogenesis, ex-
cretory. Source of bile pigments, tests. Bile acids, dissolve blood globules,
antiseptic, tests. Bile increased by ; bile absorbed from bowel, olive oil, salol,
salicylates, benzoic acid and benzoates, turpentine, terpene, terpinol, euony-
mus, alkalies, arsenic, ether. Agents lessening biliary secretion, starva-
tion, excess of fat, alkaline iodides, atropia, strychnia, hepatic diseases, sep-
tic duodenal fermentation. Arrest in liver of copper, iron, iodides, bro-
mides, nicotine, quinine, morphia, curare, toxic bile products, ptomaines,
toxins. Reduces toxicity of peptones, casein, ammonia salts, indol, phenol.

The liver is the goal to which most of the products of gastric
and intestinal digestion are carried by the portal vein. In the
hepatic cells large quantities of glycogen, 6(C,H,,O,) + H,O,
are stored up after each meal. This is believed to be derived
largely from the transformation of glucose, (C,H,,O,) and laevu-
lose’ (C,H,,0,) which have been produced from starch in the
alimentary canal and conveyed by the portal vein to the liver.
By the liberal use of starch, glycerine, or the sugars of milk,
fruit or cane, (but not mannite, or glycol, or inosite) the glyco-
gen is very greatly increased (to 12 per cent. in the fowl), but it
is diminished on a purely albuminous diet. Yet it can be pro-
duced from albuminous food, as it is always increased in the dog
after a meal of flesh, and is largely present in the livers of car-
nivorous animals that have been fed for a month on flesh only
(Landois). The peptones are therefore decomposed in the liver
with the production of glycogen and such waste products as
leucin and tyrosin, whlch are finally resolved into urea. A
purely fatty diet diminishes it enormously and duriug prolonged

416

Sanguification in the Liver. 417

abstinence it practically disappears. It passes, not into the bile,
but into the hepatic veins, and ‘the general circulation, where it
serves in its decomposition to generate heat, and probably to
hasten cell growth. In the vegetable and animal world, in the
germinating seed, and in cartilage, muscle and epidermis of the
foetus and in the amnios, glycogen and glucose are found in
abundance. The liver, too, the great center for the production
of glycogen, is relatively much larger in the young and growing
animal, and also in the adult animal which has great power of
assimilation.

Glycogen is always present in the white blood globules so long
as they maintain their vitality and amceboid movements, but
when they die, it is replaced by sugar (Hoppe-Seyler). The
red blood globules give up a ferment which rapidly transforms
glycogen into sugar.

Glycogen and sugar are evidently of use in muscular contrac-
tion as they are always diminished in the vessels of contracting
muscles (Sanderson), being converted into lactic acid (Bernard).

Forced muscular movements soon expel glycogen from the
dog’s liver, passing it into the blood, and there the excess of
glycogen dissolves the red blood globules. If glycogen is in-
jected into the blood, acrodextrin and hamaglobin appear in the
urine (Landois).

Ammonia carbonate and asparagin, or glycin, with a carb-
hydrate diet produced in rabbits a considerable increase of gly-
cogen (Rohmann).

Poisoning by arsenic, phosphorous or antimony destroys the
glycogenic function of the liver, which then fails to respond even
to diabetic puncture of the medulla.

‘There are important changes effected in the blood globules in
passing through the liver. The Jeucocytes are increased, the
hepatic veins containing 5 or even Io times as many as the portal
vein (Bernard, Lehmann, McDonald). Their ratio to the red
globules is in the portal vein 1:524 and in the hepatic veins 1:136
(Hirt). The ved globules undergo marked changes, having, in
the hepatic veins, a smaller size, sharper outlines, less flattening
in the disc, a habit of massing together irregularly in place of
adhering in rouleaux, and they dissolve less readily in water.

27

REDUCTION OF ALBUMINOIDS.

A large proportion of the fibrine formers are changed in pass-
ing through the liver (Lehmann, Bernard), in man as much as
2,690 grammes daily (Brown Sequard), a fact which goes to
account for the increase of fibrine in inflammation when the liver
is inactive. The change consists mainly in deoxidation and
reduction into simpler compounds which can be more readily
dissolved and eliminated. Arrest of the liver functions in fever
is therefore liable to throw into the blood, products that are little
soluble and often poisonous. The end product is largely urea,
and this Cyon always found in excess in the hepatic veins of dogs
(in the portal veins 0.08 grammes, and in the hepatic veins 0.14
too.17 grammes). Inman hepatic disorder is at once marked by
the lessening or disappearance of urea from the urine, and the
increase of the less oxidized uric acid (Parkes). In acute atrophy
of the liver, urea disappears from the urine, being replaced by the
less oxidized leucin and tyrosin (Frerichs, Murchison). In birds
urea is replaced by uric acid and this is always found in the liver.

The increase of urea and allied products bears a direct relation
to the activity of the hepatic circulation. Stimulation of the
liver by electric current sent through the abdominal walls largely
increased the secretion of urea (Sigrist, Stolnikow, Schroder and
Salomon). Murchison, Perrin and Bruardel had a great increase
of urea by stimulating the circulation in the liver. Certain
agents ingested are transformed into urea, among which may be
named glycocolle, brucin, asparagine, sarcine, alaunine, and
ammonia muriate.

Any degeneration of the hepatic cells which impairs or arrests
their functions lessens the production of urea. In fevers there-
fore and in hepatic degenerations the extent of the functional or
structural derangement may be to a large extent gauged by the
diminution of urea. A simple hyperemia, without as yet any
serious impairment of structure or function, may be attended by
a marked increase of urea, whereas any destruction of the liver
cells, or any serious modification which interferes with the normal
function, brings about a decided decrease. A hepatic disorder

418

Secretion of Bile. 419

accompanied by suppression of urine is always a grave disorder.
On the contrary a free secretion of urine during liver disease is a
favorable symptom.

There is reason to believe that red blood globules are destroyed
in the healthy liver, producing bilirubin and urea (Landois). In
diseased states this becomes excessive, and the resulting coloring
matter is often modified, giving the strong tints, seen in the
urine in fever and certain hepatic disorders.

SECRETION OF BILE.

The secretion of bile is but a small part of the function of the
liver, and that is by no means a purely eliminating process.
Man secretes in twenty-four hours about 10 parts per 1000 of
body weight, the dog 14 to 15, the cat 15 to 20, the sheep 25, the
rabbit 130, the Guinea-pig 170, the goose 12 (Cadeac), the horse
12 (Colin). But the amount varies largely ; Scott found that a
dog yielded 21, and K6lliker that another yielded 36 per 1000 of
the body weight.

Only about one-fourth of the biliary acids (Bischoff, Voigt),
and one-eighth of the sulphur (Bidder and Schmidt) of the bile
can be found in the faeces. Most of the bile is re-absorbed from
the intestine and secreted anew, so that, in the course of twenty-
four hours, the material secreted serves the same purpose again
and again. During this repetition of secretion and absorption, it
becomes little by little metamorphosed into other products whlch
are eliminated by the lungs and kidneys (Parkes, Murchison).

The functions of the bile so far as known are :

a. The solution of alimentary matters, and especially of fat, in
the intestine, and the hastening of endosmosis, of fats and pep-
tones :

4. The stimulation of peristalsis in the bowel ;

c. Antisepsis and deodorization of the contents of the bowels ;

d. The determination of the formation of glycogen ;

e. The excretion of bile-coloring matter, bile acids and choles-
terine.

420 Veterinary Medicine.

In regard to the glycogenic action it may be said that in cats,
the bile ducts of which have been tied, no glycogen was formed,
even when the diabetic puncture of the brain was made (Legg).
Clinical observation seems to throw some doubt on the formation
of bile coloring matter apart from the liver. In diseased liver
with suspended secretion of bile (waxy and fatty degeneration,
cancer, cirrhosis) the bile pigment was found in neither blood nor
urine (Frerichs, Murchison, Haspell, Budd). Even after extir-
pation of the liver in frogs, neither biliary acid nor pigment
could be found in the blood (Miller, Lehmann, Moleschott).
These results must, however, be qualified by the observations of
Hammersten who found bilirubin asa normal constituent of blood
serum in the horse, and by Virchow’s discovery that heematoidin
(now held to be identical with bilirubin) is constantly found in
old blood extravasations into the tissues.

The origin of the bile coloring matters may be traced in part to
destruction of red globules in the liver. Quincke has shown that
in the hepatic capillaries in post-embryonic life the leucocytes
englobe and destroy the old and worn out red blood corpuscles
which thus become a source of bile coloring matter. Such
destruction is specially likely to occur in badly maintained condi-
tions of the blood, and in hepatitis or other liver disease in which
the white cells accumulate in the hepatic capillaries, and when
the blood current is retarded. Hence the liability to jaundice in
such conditions. The formation of new red blood corpuscles has
been observed in the protoplasmic cells of the liver in the embryo
but this has not been established for post-embryonic life (Neu-
mann, Lowitt. :

The two common coloring matters of the bile are bilirubin
which colors the yellow, bile of man, omnivora, and carnivora
and biliverdin which tints the dark green bile of herbivora.
Bilirubin (C,,H,,N,O,) forms, transparent fox red clinorhombic
prisms. It is insoluble in water but soluble in chloroform, and
may thus be separated from the biliverdin which is insoluble in
chloroform. United as a second basic acid with alkalies it is
soluble in water. It is easily obtained from the red gall-stones
of man or ox, and is chemically identical with hzematoidin.
Biliverdin (C,,H,,N,O,) isan oxidized derivative of bilirubin and
is insoluble in chloroform, slightly soluble in ether and freely

Secretion of Bile. 421

soluble in water. In addition to its presence in bile it has been
found in the placenta of the bitch. The test for bile coloring
matter is made by placing a drop of the suspected liquid on a
white porcelain plate and adding a drop of impure, brown, nitric
acid (nitric and nitrous acids). If bile is present there is pro-
duced a beautiful play of colors passing from the green of biliver-
din, through blue, violet, red, and ending in yellow.

With regard to the formation of bile pigments in morbid con-
ditions it may be noted, that agents which dissolve the red blood
globules (such as bile-acids or water), when injected into the
veins determine the appearance of bile pigment in the urine
(Frerichs, Kuhne). When we consider that an animal (dog)
secretes = of its body weight daily of bile, and that nearly all of
this is re-absorbed from the intestines, we can realize this is an
important source of bile and urinary pigments.

Of the bile acids, taurocholic is the most abundant in the
bile of man, birds, and of many mammals and amphibians, while
glycocholic acid is the more plentiful in the ox and pig. It is
absent in sucklings. The taurocholic acid has been found to
prove most destructive to red blood corpuscles, and in strong
solution is distinctly antiseptic, checking the development of
bacteria, of the alcoholic and lactic fermentations and of the
tryptic and diastatic action of pancreatic juice.

These are conjugate acids, formed by the union of cholic
acid with taurin and glycin respectively, and they are found
almost exclusively, in combination with soda and bile. They
are found in the liver and do not accumulate in the blood when
the liver has been removed. They increase under an albuminous
diet.

The test for bile acid, is to take the suspected liquid from
which all albumen has been precipitated, add a few drops of
solution of cane sugar. shake into a froth, and pour sulphuric
acid, drop by drop, down the side of the test tube. A reddish
purple color appears in the froth, and shows two absorption
bands at Eand F. Any albumen left in the liquid will give the
same color, but only one absorption band.

The secretion of bile is more abundant on animal than on
vegetable food, and on albuminous than fatty. It ceases during
hunger, but is increased by ingestion of water. Its solids are

422 Veterinary Medicine.

most abundant one hour after feeding. It increases under a co-
pious and rapid blood supply, but is arrested by diminished blood
flow, even under increased pressure (in ligature of the vena
cava in front of the diaphragm). Vigorous exertion, drawing
off blood to the muscles of the trunk, diminishes the secretion of
bile, while transfusion of blood, up to a given grade of blood-
pressure increases it. Nervous conditions, which cause contrac-
tion of the portal vessels, increase the secretion by forcing more
blood through the liver. Such are strichnia or other stimulation
of the valve of Vieussens, of the inferior cervical ganglion, of the
hepatic or splanchnic nerves, or of the spinal cord. Fever causes
its arrest.

The secretion of bile is further stimulated by the following :

a. The ingestion of bile into the stomach and abdomen. This
being absorbed and carried to the liver greatly increases the
biliary secretion. It is not necessary that the bile shall be a pro-
duct of the same genus of animal, the bile of the ox is an active
stimulant of the liver of the dog.

6. Of medicinal agents the following increase and liquefy the
bile : olive oil in large doses, phosphate of soda, salol, and sali-
cylate of soda.

c. The following not only increase the bile, but through their
purgative operation, expel it from the bowels: calomel, mercuric
chloride, colocynth, aloes, jalap, rhubarb, podophyllin, and cold
rectal injections. These accordingly lessen the secretion later,
by removing the stimulus of the absorbed bile.

d. The following are comparatively mild biliary stimulants :
benzoic acid, benzoate of soda, oil of turpentine, terpine, terpinol,
and euonymus, and still less active are alkaline bicarbonates,
bromides, sulphates and chlorides, arsenic and ether.

Secretion of bile is lessened by: starvation, a too fatty
dietary, alkaline iodides, atropia, strychina, hepatic degenera-
tions, (fatty, cirrhosis), catarrh of the bile ducts, diseases of the
liver, gall duct, or duodenum which interfere with the discharge
of bile, the antisepsis of the bowels, or the reabsorption of bile.
This work virtually moves in a vicious circle, as the action of
septic ferments in the duodenum hinders the reabsorption of bile
and of the food products which go to the production of bile, and
in its turn the withholding of bile from the intestine removes the

The Liver as a Destination and Destroyer of Poisons. 423

normal antiseptic (the bile acids) and favors septic fermentation
and the inhibition of duodenal digestion and absorption.
Another factor is found in the ptomaines and toxins absorbed
from the alimentary canal and arrested in the liver. These de-
bilitate the liver cells, impair the liver functions and lay the gland
open to bacteridian infection. The bile in such a case is trans-
formed into a pale or yellow, viscid liquid, with more or less dark
colored granular debris, and this provesa favorable culture ground
for bacteria especially the golden staphylococcus and the bacterium
coli commune. With septic condition of the liver the usual result
of ligature of the bile duct is a peri—and intra-lobular sclerosis
and the formation of minute biliary abscesses. In the absence
of sepsis, ligature of the biliary duct, produces—not abscess but—
necrobiosis, preceded by interlobular connective tissue hyperpla-
sia, and granular or fatty degeneration of the hepatic cells.
(Charcot, Legg, Lahousse, Dupre).

THE LIVER AS A DESTINATION AND DESTROYER
OF POISONS.

The liver in the mature animal, being the one destination of
the blood carried in the portal vein, necessarily becomes the
recipient of all medicinal and poisonous agents absorbed by the
capillaries and venous radicals of the stomach and intestines.
This organ retains and lays up for a time the heavier metals, such
as the salts of copper and iron, the iodides and bromides, the
vegetable alkaloids such as nicotine, quinine, morphia, and curare,
the toxic elements of the bile, the ptomainesand toxins produced
by gastric and intestinal fermentations, indol, phenol, etc. Some
agents it transforms, as peptones (which it renders non-poison-
ous), casein, the carbonate of ammonia and its salts with vegeta-
ble acids, also indol and phenol, which it combines with sulphuric
acid as indyxol and phenyl sulphate, thus rendering them much
less toxic. ‘The destructions or new combinations established in
the cases of the ptomaines and toxins may explain why such
agents are usually much less poisonous when taken by the stomach

424 Veterinary Medicine.

than when generated in tissues or blood, or when injected hypo-
dermically. Another interesting fact in connection with the
ingestion of these bacteridian products (ptomaines and albumoses)
is that, when the liver functions are normal as evidenced by the
production of glycogen, the toxins are largely destroyed, and
they fail to produce poisoning, whereas with a functionally de-
ranged liver and no production of glycogen, they retain their
potency, almost as if injected subcutem.

FUNCTIONAL DISORDERS OF THE LIVER.

MELLITURIA, GLYCOSURIA, DIABETES MELLITUS, SACCHARINE
URINE.

Source of glucose in food. Glycogen: Its use: Enlarged liver means
more glycogen. Glycosuric centre in medulla. Other glycosuric nerve
centres. Reflex action, action of drugs and poisons, phlorizin. Disease of
lungs or pancreas. Removal of pancreas in dogs. Removal of thyroid.
Diseased, liver, fatty, fibroid, hypertrophy, congestion. Extreme fatty
change arrests glycogensis. In solipeds: three cases with liver bypertro-
phy ; one case with adenitis; six cases with emaciation; two cases with
hemoglobinuria. Symptoms: Emaciation, debility, langor, fatigue, breath-
lessness, hollow flanks, unthrifty skin, ardent thirst, polyuria, urine saccha-
rine, of high density. Diagnosis by analysis of urine, sweet taste, Fehling’s
test, Trommer’s test, fermentation test, Prognosis: Grave, diet being car-
bonaceous, when functional resulting from curable disease is hopeful.
Treatment : In poisoning cases, antidotes and eliminants, in curable disor-
ders treat these, in more inveterate cholagogues, antiseptics, codeine, opium,
croton, chloral, strychnia, phosphoric acid, iodoform, ergot, skim milk or
buttermilk, good hygiene, open air, shelter, carminatives, bitters, mineral
acids, treat complications.

Grape sugar (glucose, C,H,,O,) is undoubtedly formed in the
stomach and intestines by the action of saliva and pancreatic
juice on starch (C,H,,O,), and glucose and lzvulose (C,H,,0,)
are also derived from the transformation of cane sugar (C,,H,,O,,).
These sugars are absorbed, transformed into glycogen in the liver
and passed into the circulation, where they serve to maintain
animal heat through their decomposition into carbonic acid and
water. They further assist in nutrition and growth, and if their

Functional Disorders of the Liver. 425

metamorphosis is imperfect they pass out of the system in the
urine, producing a temporary glycosuria. As shown above gly-
cogen is produced in the liver cells, and stored up there, in great-
est abundance during digestion of starchy and saccharine food,
but it is also formed in animals kept on a purely albuminous diet.
(flesh), and in the foetal calf and unhatched chick to which
neither starch nor sugar has been furnished as food. It is pro-
duced during the decomposition of albuminoids, along with the
other end products, leucin, tyrosin and urea. None of these last
three is found in the portal vein nor bile ducts, but all four are
found in the liver cells, and in the hepatic veins.

In health a physiological balance is maintained by the oxida-
tion of the glucose, mainly in the lungs, so that in the blood of
the pulmonary veins no sugar is found. There is an exception
to: this observable after a full meal, rich in starch and sugar,
which produces such an excess of glycogen that a portion is car-
ried to the kidneys and expelled by them causing temporary
glycosuria.

A small amount of glycogen is also produced habitually by the
white blood cells and stored up in them, but this is insufficient to
determine its appreciable elimination by the kidneys.

In cases of persistent glycosuria the fault may be held to con-
sist in one of three functional derangements :

ist. The failure of the liver to transform the alimentary sugar
into glycogen.

or 2d. The excessive production of glycogen in the liver.

or 3d. The arrest of the destructive oxidation of sugar in the
lungs and tissues.

In a diabetic patient who died suddenly of apoplexy Bernard
found that the liver was enlarged, comparing with the average as
25:14 while the contained sugar bore the ratio of 37.5:22. This
enlargement coming from malaria or other poison, such as
alcohol, ether (Harley), arsenic, quinia (Aitken), ammonia,
chloroform, or phosphoric acid (Murchison), is an established
condition of glycosuria. A rich and abundant food (starchy and
saccharine especially), or an unusually active hepatic circulation
acts in the same way. i

Bernard as early as 1849 showed that the glycogenic function
of the liver was greatly increased and glycosuria determined by

426 Veterinary Medicine.

pricking the floor of the fourth ventricle in the median line just
in front of the calamus scriptorius and near the root of the vagus
nerve, or a few millimeters in front of this.

It follows that irritation of this part of the medulla however
produced, whether from local disease, or by reflex action from
some distant organ in a state of irritation, may serve as the start-
ing point of diabetes in particular instances. That the cause may
be a reflex stimulus is shown by the suspension of the glycogenic
function after section of the vagus nerves, and its reappearance
when the central end of the cut vagus is galvanized, or, the floor
of the fourth ventricle is irritated, the direct or efferent excitation
being transmitted through the sympathetic nerve (Bernard).
I can cite a case of glycosuria in a man supervening on a severe
blow on the head from a falling ledger. Brain injuries which
suspend animal functions, but not the nutritive ones, such as
apoplexy, concussion of the brain or curare poisoning are liable
to induce diabetes.

Traumatic injuries to other parts of the nervous system induce
glycosuria. ‘Thus traumatism of the optic thalami ; of the cere-
bral lobes or peduncles ; of the pons ; of the cerebellum or of its
middle or posterior peduncles ; transverse section of the medulla
or of the spinal cord opposite the second dorsal vertebra ; trauma-
tism of the superior or inferior cervical ganglion or the first
thoracic (Eckhard); of the sympathetic twig which accompanies
the vertebral artery (Pavy); of the brachial plexus; of the solar
plexus (Munck, Klebs); or of the sciatic nerve (Schiff).

The explanation of these facts may be sought in a reflex action
established by the conveyances of irritation to the true glycogenic
centres in the brain and the transference of the efferent nervous
impulse through the sympathetic nerve to the liver.. It will be
borne in mind that in the case of section of the vagus nerve
electric stimulation of its detached peripheral part has no glyco-
genic effect on the liver, while galvanizing the central portion
determines glycosuria.

In the case of glycosuria through stimulation of the sympa-
thetic nerve or its ganglia the action may be concluded to be
direct. Strangely enough, irritation of the sympathetic between
the tenth and twelfth ribs or the splanchnic nerves fails to produce
glycosuria, though the hepatic branches of the sympathetic pass
through them.

!

Functional Disorders of the Liver. 427

In ordinary cases of reflex glycosuria it may be assumed that
the existence of irritation at the peripheral ends of the vagus
and of some other nerves, leads to an apparent glycogenic influ-
ence passing through these to the brain, and of the distribution
of the efferent impulse through the upper portion of the spinal
cord, as far as the fourth dorsal vertebra in the rabbit (Cyon,
Aladoff, Schiff), and through the sympathetic nerve to the liver.
This may account for the appearance of the disorder as a sequel
of disease in any part to which the vagus in particular is dis-
tributed, and notably in the lungs. A number of poisons
(malarial, alcoholic, ether, carbon monoxide, amyl nitrate,
curare, or the nitro-propionic acid, methyl delphinin, morphia,
chloral hydrate, arsenic, quinia, ammonia, chloroform, phosphoric
acid, and phlorizin) produce glycosuria.

The intravenous injection of dilute saline solutions, or frequent
blood letting materially increases the sugar, probably by causing
solution of the red globules. Phlorizin is the most potent of all
these agents. Whether given hypodermically or by the stomach
it causes in three hours a marked production of glucose which
continues to be eliminated for a period of thirty-six hours. The
urine may become charged with glucose to the extent of from 6
to 13 per cent., and without any rise in the body temperature.
This artificial glycosuria may be kept up indefinitely by the con-
tinued administration of phlorizin, and even in the fasting animal,
or one on an exclusively albuminous diet, as well as in those on
an aliment ‘rich in saccharine or hydro-carbonaceous matter. In
the frog it produces diabetes even after the extirpation of the
liver showing that it stimulates other sources of sugar production
beside the hepatic or that it inhibits the transformation of sugar
derived from the alimentary canal and other sources.

Another suggestive source of mellituria is disease of the lungs,
or any condition which interferes with the due eration of the
blood and oxidation of the alimentary or hepatic sugar. But it
cannot be assumed that the réle is altogether or mainly chemical.
The thoracic organs being supplied by branches of the vagus and
sympathetic nerves there is the obvious suggestion of a reflex
action through the diabetic centers in the brain. The frequent
complication of diabetes with lung diseases (inflammatory ,jtuber-
cular, syphilitic, and otherwise) is abundantly proved, whether it

428 Veterinary Medicine.

is to be explained on the above hypothesis or through other un-
known changes in the blood.

Diabetes has been repeatedly found in connection with disease
of the pancreas, and the complete extirpation of the pancreas in
dogs gives rise to glycosuria (Mering and Minkowski, Thiroloix,
Lancereaux, Lepine). If asmall portion of the pancreas remains,
glycosuria does not supervene. It has been suggested that the
pancreas has a double function, and beside its secretion, produces
a glycolytic ferment which passing into the portal blood deter-
mines the formation of glycogen in the liver. Arrest of the pan-
creatic secretions does not cause glycosuria, so it has been sug-
gested that the glycogenic enzym is a product of the connective
tissue cells of the pancreas. Functional as well as structural
disease of the pancreas can be conceived of as inhibiting the pro-
duction of this ferment and the consequent elaboration of gly-
cogen: Chauveau and Kauffmann deduce from their observations
that the action is a reflex one established through the glycogenic
centres in the medulla. Pancreatic glycosuria is especially fatal
(Harley ).

Finally, extirpation of the thyroid body in dogs has been fol-
lowed by glycosuria (Falkenberg). This suggests a systematic
examination of the urine in all cases of goitre, with extensive
glandular changes.

Apart from experimental cases diabetes in the lower animals
has been observed to be nearly always associated with diseased
liver. Fatty degeneration has been the most frequent lesion, but
cirrhosis, hypertrophy and congestion were present in other cases.
In a number of cases as the fatty degeneration reached an extreme
degree, the sugar disappeared from the urine, the hepatic cells
being no longer functionally active, and death speedily followed.
The same has been observed in the fatty degeneration attendant
on poisoning by arsenic or phosphorus.

GLYCOSURIA IN SOLIPEDS.

Heiss records two cases of this disease in heavy Belgian horses
ten and eleven years old, the urine of which showed a percentage
of 3.75 of grape sugar, and which died in two months in a state
of marasmus. ‘The liver was enlarged and of a clay yellow color.
Dieckerhoff reports one fatal case in which there were also yellow
discoloration, congestion and hypertrophy of the liver. No lesion
could be found in the pancreas or nervous system. Perosino
records a case in a horse suffering from contagious adenitis,
which may be supposed to have been connected with the action
of the toxins or the imperfectly oxidized albuminoids on the
nerve centres or liver. Delprato relates six cases in the same
stable in overworked, half starved and emaciated horses. Rueff
and Mouquet each contributes a case occurring in paraplegia
attendant on hemoglobinuria and in which the amounts of
sugar were respectively 5.85 and 1.01 per cent. ‘These latter
cases are manifestly complicated ones in which the reflex irrita-
tion (or inhibition of glycogenesis) is transmitted from the dis-
eased or poisoned brain to the already disordered liver.

Symptoms. ‘There is a profound interference with nutrition,
a rapid loss of flesh and weight, of spirit and energy and an ex-
treme muscular weakness in spite of at times excessive appetite.
The subject is fatigued and breathless under the slightest exertion,
the flanks are retracted and hollow, and the hair dry, rigid and
lifeless. Appetite is poor and fastidious, but an intense and con-
suming thirst is usually present, the animal drinking deeply at
every opportunity, and passing urine with corresponding fre-
quency and abundance. The urine is clear, yellow, neutral and
saccharine, the sugar varying from 1 to 12 per cent. (3.6 on an
average). Notwithstanding the amount passed (55 litres per
day, Cadeac) the density usually exceeds the normal (1052 and
upward), normal being 1040 to 1050. There may or may not be
hyperthermia, and in exceptional cases appetite has been retained
to the last. Cataract and corneal ulceration are sometimes ob-
served as in man.

Diagnosis. Presumption may arise from the above mentioned

429

430 Veterinary Medicine.

symptoms, and especially the bulimia, the polydipsia, the
polyuria, the rapidly advancing emaciation, weakness, and pros-
tration and the occular troubles, but conclusive evidence is only
found in the presence of glucose permanently in the urine.

Tests for Sugar in the Urine. For one who can go through
it the touching of the tip of the tongue with a drop of the sus-
pected urine will give a prompt and reliable test.

Fehling’s cupric test is the next best for simplicity and avail-
ability. Dissolve 34.639 grammes (14 oz.) pure cupric sulphate
in 200 cubic centimeters of distilled water : 173 grammes (6 ozs.)
of pure neutral sodia-potassic tartrate and 80 grammes of potas-
sium hydrate in 500 cubic centimetres of distilled water. Add
the copper solution slowly to the potassium one and dilute the
clear mixture to one litre. One cubic centimeter of this fluid
will be decolorized by 0.905 gramme of sugar ; or 200 grains will
be decolorized by 1 grain of sugar.

Trommer’s test is even simpler for a mere qualitative test.
Pour the suspected urine, freed from albumen, into a test-tube
and add a solution of caustic potassa or soda until distinctly
alkaline. Should this throw down earthy phosphates or carbon-
ates filter these out. Then add drop by drop a solution of pure
cupric sulphate in distilled water (3.5 : 100) so long as it throws
down a yellowish red precipitate of oxide of copper. When the
supernatent liquid remains clear and assumes a distinctly bluish
tint, the sugar has all been precipitated. The amount of precipi-
tate is a criterion of the quantity of sugar, which may be other-
wise estimated by the amount of copper salt used.

The fermentation test is made by adding a teaspoonful of liquid
yeast to four ounces of the suspected urine, stopping the flask
lightly and placing it in a temperature of 60° to 80° F. for 12 to
24 hours when the sugar will have been converted into alcohol
and dioxide of carbon. ‘The loss of weight will indicate the
amount of sugar, as also will the lowering of the specific gravity.
If before testing the urine was 1060, and after 1035, it contained
15 grains of sugar to the fluid ounce.

Prognosis. ‘This is always rendered more grave in the horse
than in man, because of the impossibility of putting him ona
purely albuminous diet. The great tendency is to a rapidly fatal
issue, especially in cases of irremediable structural lesions in the
brain and liver. Where the disorder is largely functional, as in

Glycosuria in Solipeds. 431

connection with heemoglobinuria or as the result of poisons in-
gested the prospect of recovery is often good.

Treatment. In cases due to poisoning the use of antidotes and
eliminating agents will be effectual, and in transient and curable
diseases like pulmonary disorder, heemoglobinuria and paralysis
the appropriate treatment will restore. In the more inveterate or
constitutional cases all treatment is liable to prove ineffectual.
At the outset some apparent amelioration may be obtained from
salicylic acid, salicylate of soda, bicarbonate, acetate, citrate,
sulphate or chloride of soda, nitro-muriatic acid and other
cholagogues. Blisters to the perichondrium may also be em-
ployed. Later, when degeneration of the liver has reached an
extreme point, these will be of no avail. Cadeac recommends
acetanilid, antipyrin, and benzo-naphthol largely on their anti-
septic merits, and Jong claims a recovery in a horse under daily
doses of 12 grains of codeine. Opium has long been employed
in man with partially good results, and croton-chloral, strychnia,
phosphoric acid, iodoform and ergot are recommended in differ-
ent cases.

One of the most beneficial agents is skim milk or buttermilk as
an exclusive diet, and this may be to a large extent adopted for
the horse. Under its use the sugar may entirely disappear, and
though rheumatoid pains in the joints may be brought on,
these usually subside on withdrawing the source of lactic acid.
They may further be met by the use of salicylates. The greatest
care should be taken of the general health, an open air life, with
protection against colds and storms, and a healthy condition of
bowels, kidneys and skin being particularly important.

The impaired digestion and assimilation usually demand car-
minativas, stomachics, bitters, and mineral acids, particularly the
nitro-muriatic. With the same intent a fair amount of exercise
short of absolute fatigue should be secured. But each case will
require a special study and treatment consonant to its special at-
tendant lesions, its causative functional disorders, and its stage.
One case may demand attention to bacteridian poisoning, one to
a better regimen and diet, one to liver disease, and one to disease
of the brain, etc. After this treatment specially directed to the
abnormal function or structure, would come the more specific
treatment for mellituria which would be more or less applicable
to the general glycolytic disorder.

-

GLYCOSURIA IN CATTLE.

Accompaniment of parturition fever and apoplexy. Essential glycosuria.
Dense saccharine urine, passed often, congested mucose, emaciation. Le-
sions uncertain. In parturition fever and apoplexy the congested medulla
is the reasonable starting point. Toxic glycosuria. Treatment: addressed
to the primary disease or poison ; otherwise treat as in the horse.

In cattle this has been observed as a symptomatic affection in
connection with parturition fever or apoplexy (Nocard, St. Cyr,
Violet). One case of essential mellituria has been recorded by
Darbas. .

Symptoms. In the last mentioned case in a work ox, the ani-
mal, when at work, would stop every five or ten minutes to
urinate, passing a small quantity of amber colored urine of a high
density and containing a large amount of glucose. The con-
junctiva was pink, the animal considerably emaciated, and rest
and generous feeding brought about no improvement, so that
the subject was finally sent to the butcher to anticipate a natural
death.

The lesions in this case are altogether hypothetical. The red
eyes might imply congestion of the encephalon (medulla), but
the redness might be caused by active disease in the liver, pan-
creas or kidney. The failure to notice jaundice does not indi-
cate a healthy liver, as some of the most fatal diseases of that
organ are unattended by icterus. The frequent emission of
urine in small amounts would imply irritation in kidneys or blad-
der, from which the glycogenic stimulus may have started. In
the absence of any more definite evidence of disease in other or-
gans, it is, however, more probable that the fundamental disorder
resided in the liver, the great glycogenic factor of the body.

In parturition fever, the presumption isin favor of considering
the congested medulla as the starting point of the disease, yet in
view of the manifest paralysis of stomach and bowels, it is not
improbable that the vascular congestion and paralysis of the
chylo-poietic viscera constituted the initial step in the morbid
process, while the glycogenesis was the result of a reflex opera-
tion on the liver.

432

Glycosuria in the Dog. 433

Toxic mellituria would occur in cattle under the same condi-
tions as in the horse.

Treatment is only hopeful in the sympathetic and toxic forms.
These must be treated according to the nature of the primary
disease or the poison. To these the general principles of treat-
ment as recommended for the horse should be superadded. For
essential diabetes an exclusively milk diet and any one of the
agents that have given good results in man or horse can be tried,
but with an animal in fair condition it will be better as a rule to
turn him over to the butcher.

GLYCOSURIA IN THE DOG.

More common than in horses and cattle. Causes: pampered in diet,
sweets, liver, disease of pituitary body, or mostly of the liver. Removal of
pancreas, Brain and nervous lesions and reflex action. Symptoms: pam-
pered asthmatic subject, with dysuria and lameness, dense saccharine urine,
bulimia, loss of weight, corneal ulcers, cataracts, palsy, coma. Duration:
4 to 8 months, sugar may disappear with complete liver degeneration. Diag-
nosis: by pampered condition, asthma, thirst, diuresis, later by loss of
weight, troubles of vision, saccharine urine. Lesions: usually hypertro-
phied, fatty or caseated liver, thickened capsule, disease of thyroid, heart
andeye. Treatment: skim or butter milk as sole diet, restricted diet of
lean meat clear of fat, warmth, dryness, pure air, sunshine, gentle exercise
only, cholagogues, sodium sulphate, or chloride, or carbonate, or salicylate,
salol, nitro-muriatic acid, antithermics, ergot, codeine, bitters, mineral
acids, derivatives.

Among domestic animals the dog has furnished the greatest
number of cases, yet even in this animal the disease appears to be
far from common.

Causes. ‘The relative frequency of diabetes in the dog is prob-
ably dependent on his life in human dwellings and on gourman-
dizing on dishes prepared for man. Friedberger and Frohner
have produced the disease artificially by feeding a great quantity
of sugar and W. Williams has met the disease in dogs fed exclu-
sively and generously on liver. Thiernesse records one case
complicated by atrophy and steatosis of the pituitary body, but
in all other instances the appreciable lesions were confined to the

28

434 Veterinary Medicine.

liver. In one case, reported by St. Cyr, the liver was hyper-
trophied, yellow, mottled, marked by irregular elevations of con-
gested and hypertrophied hepatic tissue, and showing extensive
degeneration—mucous, caseous and fatty. Thiernesse found the
liver of a yellowish white color, and the seat of fatty degenera-
tion implicating the hepatic cells. Franzenberg in one case
found fatty degeneration of the liver, and Frohner and Schindelki,
in four cases, met with extensive hepatic disease. The macro-
scopic lesions of the disease in dogs asin horses appear to be
mainly hepatic.

On the other hand the complete removal of the pancreas in the
dog by Mering, Minkowski, Thiroloix, Lancereaux and others
was invariably followed by mellituria, so that even in the absence
of clinical examples, we must recognize pancreatic lesions and
functional disorders as possible primary causative factors in gly-
cosuria. In the light of experimental medicine we must similarly
recognize brain and nervous lesions and reflex actions as possible
causes, even if as yet unsupported by clinical facts observed in
the dog.

Symptoms. ‘The disease usually appears in an old, fat, pam-
pered dog, affected with dyspnoea or asthma, with dysuria and
lameness. The urine is high colored, viscid, and of a high
density (1055 to 1060, the normal canine urine being about
1020), and charged with glucose. The subject may have an
enormous appetite but fails to gain in weight, and after a time
loses flesh and becomes badly emaciated. The pulse is small
and frequent, and the temperature which at the outset may
reach 102”, falls to the normal as the end approaches. Watering
eyes, corneal ulcers, and cataracts as well a hemiplegia and dia-
betic coma may precede death. The amount of sugar has been
found to vary in different cases from 3.2 to 12 per cent. of the
urine.

Course. Duration, 'The dog may live from four to eight
months and, as in the horse, sugar may finally entirely disappear
from the urine, in connection with the progressive degeneration
of the liver. If the patient is unable to take exercise, the case
reaches a more speedily fatal issue.

Diagnosis is deduced from the bulimia, pampered condition,
breathlessness, thirst, and diuresis, the subsequent loss of condi-

Obesity and Emaciation. 435

tion, ocular troubles, and dropsy or coma, the whole being con-
firmed by the dense, high colored viscous, saccharine urine.

Lestons. As already noticed the most constant lesion is hyper-
trophy of the liver, which is swollen unevenly, has thickened
borders, is yellow or red, very friable and often fatty, or caseated.
The capsule of Glisson is thickened and fibrous. Hyperthropy
and fatty degeneration of the thyroid have been found in differ-
ent cases, and in one instance insufficiency of the mitral valve
with systemic venous congestion. Ocular troubles are constant.

Treatment. Put the patient on an exclusive diet of skim or
buttermilk, or if this is impossible it may be conjoined with lean
meat—raw or cooked—keep warm and dry, but give plenty of
open air and sunshine. Avoid fatigue and over exertion. Re-
stricted diet is of great importance. During the siege of Paris
the short rations led to the disappearance of glycosuria from
many human patients.

Among medicinal agents, cholagogues come first, sulphate of
soda with chloride of sodium, bicarbonate of soda, salicylate of
soda, salol, nitromuriatic acid, may be named. For the febrile
condition, antipyrine, acetanilid, or phenacetin may be employed,
and iodoform, ergot or codeine may be tried when other measures
fail. Bitter tonics and mineral acids may be beneficial, and lastly,
blisters to the region of the liver may prove of service.

OBESITY AND EMACIATION.

Sugar essential to growth. Ratio of liver to active increase in weight.
Obesity and fatty degeneration. Small inactive liver and stunted growth,
or loss of weight. Biliary fistula, death in 12 months. Influence of pan-
creas. Nitrogenous food for obesity, outdoor life, exercise, cholagogues,
salines. Saccharine and starchy food for emaciation, hepatic, and pancreatic
stimulants. Mild laxatives and cholagogues, pure air, green, succulent food,
pure water, bitters, tonics, moderate exercise.

There is reason to believe that both of these occur as results of
hepatic disorder. The generation of sugar in connection with
rapid cell growth in germinating seeds and growing plants, and
also in rapidly growing animal tissues as in the body of the foetus

436 Veterinary Medicine.

and foetal membranes, and finally in the inflammatory products of
pneumonia and in leucocytes, seems to imply that it is essential
to such cell growth (Murchison). In keeping with this is the
fact that the liver is of relatively much greater size in the foetus
and in the young and rapidly growing animal, and also in meat
producing animals which have been selected and bred through
many generations for early maturity and rapid fattening. The
enormous development of adipose tissue and of lipomata in such
animals is essentially abnormal, though it is a deviation from the
natural that is esteemed as evidence of excellence, and a neces-
sary condition of success in the meat producing industry. While
other conditions are necessary to the production of such obesity,
such as abundance of rest, slow, shallow breathing, a genial cli-
mate, and a generous hydro-carbonaceous food, yet all of these
would prove ineffective without a large liver, working under
high pressure in producing a large output of sugar. ‘The mere
obesity in the meat producing animal is not considered as disease
and it is only when the tendency to fat production culminates in
an adipose degeneration of the muscles and other tissues that
actual disease is conceded.

Emaciation in certain cases is traceable to the opposite condi-
tion. A small or inactive liver with a diminished production of
sugar and fat will ensure loss of weight, which is still further ag-
gravated by decreased secretion of bile and insufficient absorp-
tion of peptones. Experimentally this condition has been re-
peatedly brought about by making a biliary fistula, and cutting
off all bile from the intestine. Death preceded by extreme ema-
ciation ensues in 12 months (Murchison). This being. the case
with the escape of all the bile secreted, a slower but no less cer-
tain emaciation must follow on a structural or functional disorder
.of the liver which is attended with a greatly lessened production
of bile. This, indeed, is the condition met with in advanced
glycosuria, when the liver is the seat of general fatty degenera-
tion.

From the experiment of the removal of the pancreas we may
infer that diseases of this organ which pervert or destroy its nor-
mal functions, will check glycogenesis in the liver by withhold-
ing the supposed pancreatic ferment, and by so doing will con-
duce to emaciation and marasmus.

Obesity and Emaciation. 437

So far as obesity and emaciation are dependent on diet they
may be checked by subjecting the patient to the dietary which
will favor a more healthy liver function. For excessive obesity a
strictly nitrogenous food in restricted amount will tend to lessen
the glycolytic action of the liver and secure the formation of
muscle rather than fat. An outdoor life, and an active though
not exhaustive use of the muscles will greatly favor this result.
For the carnivora or omnivora a diet of lean meat or skim milk
might be employed, while for the herbivora, wheat bran, cotton
seed hulls, beans, peas, vetches, or cotton seed would measure-
ably meet the demand. Cholagogues and saline laxatives, by
eliminating from the liver and intestine, will contribute to the
same end.

If emaczation depends on a deficiency of sugar, that may be
freely fed along with richly amylaceous food, and the liver may
be stimulated to increased glycogenesis by stimulants such as
chloroform, ammonia, or ether, and by a moderate use of carbon-
ate of soda or other alkalies. Ether has in additiona stimulating
effect on the pancreas and will tend to increase that ferment which
stimulates the liver to its glycogenic work. Mild laxatives and
cholagogues will second this, such as small doses of podophyllin,
taraxacum, nitro-muriatic acid, chloride or bromide of ammonium,
plenty of pure air, abundance of green or aqueous food, and
plenty of pure drinking water. Finally, moderate exercise, by
increasing the aspiratory action of the chest and thereby ac-
celerating the hepatic circulation is a material stimulant of the
glycolytic function. Bitter and other tonics are contributions
to the same object and should not be neglected,

SECONDARY OR REMOTE RESULTS OF LIVER
DISEASE.

In gout: Arrest of oxidation of proteids into urea. Deposits of biurate
of lime on joints, and other disorders. Urinary calculi containing urates,
cystine, zanthine, etc., also from imperfect oxidation of albuminoids. Ox-
alic acid represents a similar arrest. Kidney degenerations from irritating
urates and oxalates. Fatty kidney from excessive glycogenesis. Digestive
disorders from excess or deficiency of bile or torpid liver. Nervous disor-
ders, dullness, lameness, vertigo, spasms, irritability from hepatic inactivity
and resulting poisons. Sore throat and bronchitis from hepatic derange-
ment. Skin eruptions in tardy or imperfect action of the liver. Treat-
ment: Abundant water, succulent vegetables, ensilage, fresh grains, bal-
anced ration, in carnivora and omnivora oat meal, buttermilk, clear meat
juice, avoid sweets, gravies, spiced animal food. Dangers for pampered
horses, dogs, and old improved meat producing animals. Open air exer-
cise. Laxatives with alkalies, salines, mercurous and mercuric chloride,
pilocarpin, chlorides, iodides, bromides, nitro-muriatic acid. ipecacuan,
euonymus, bitters.

Among the many secondary results of hepatic disorder, and
which are habitually described as affections of other organs a few
may be mentioned as indicating the wide range of influence
exercised by the liver in disease as well as in health.

Gout as it appears in fowls and omnivora is directly due to the
arrest of the transformation of the albuminoids into urea. Cir-
culating in the system in the form of the less perfectly oxidized
and less soluble uric acid, it determines deposits of biurate of lime
around the joints, with local inflammations and disorders of
circulation and innervation, and altered spirit, temper, etc.

Urinary calculi in the same animals, are composed largely of
urate of lime, cystine, xanthine and other nitrogenous products
representing various stages of oxidation short of the final transi-
tion into urea and ammonia. Recognizitig the active réle which
the urinary bacteria fill in this respect we must still acknowledge
the great importance, as causative agents, of an excess in the
urine of these comparatively insoluble products.

The oxalic acid found in certain calculi points in the same
direction, as this acid, both in the body and in the laboratory,
is found to result from the oxidation of uric acid (Wobhler,
Schenck, Hutchinson).

438

Secondary or Remote Results of Liver Disease. 439

Degenerations of the Kidneys are to be largely traced to the
same hepatic source. The uric acid diathesis, and the oxalic
acid diathesis, both the result of imperfect liver function, are
among the most frequent causes of irritation of the kidneys, by
which channel they are eliminated from the body. Hence acute
and chronic nephritis, as well as nephritic calculi result from
morbid conditions which have their starting point in the imper-
fect function of the liver. Again, fatty degeneration of the kid-
ney is very liable to result from derangement of the glycogenic
function of the liver, the tendency to the formation of fat and the
constant irritation caused by the passage of the sugar contributing
to the tissue degradation. In such cases albuminuria is a not
unconimon accompaniment.

Derangements of the Digestive Organs may be said to be a
necessary result of hepatic disorder. Excessive secretion of bile
stimulates peristalsis and may induce diarrhoea, while diminished
secretion tends to constipation, light colored, foetid stools, intes-

‘tinal fermentations and poisoning by the irritant products. A
torpid hepatic circulation means congestion of the whole portal
system, indigestions, colics, chronic muco-enteritis, intestinal
hemorrhages, hemorrhoids, etc.

Derangements of the Nervous System. In this connection may
be named the lameness of the right shoulder which accompanies
certain disorders of the liver, the extreme dullness and depression
that attends on others, the sluggish pulse that appears in certain
types, the unsteadiness of gait (giddiness) in others, the muscular
cramps, and irritability in still others. These appear to be due
in some instances to the nervous sympathy of one part with an-
other, while at other times they as manifestly depend on the cir-
culation in the blood of partially oxidized and other morbid pro-
ducts of hepatic disorder which prove direct poisons to the nervous
system.

Derangements of the circulation, like extreme rapidity, or
slowness of the pulse, irregularities in rhythm and intermissions,
may be charged more directly on the nervous affection, though
primarily determined by hepatic disorder.

On the part of the Respiratory Organs, affections of a chronic
type, like sore throat and bronchitis may often be traced to
hepatic torpor or disorder.

440 Veterinary Medicine.

Skin Diseases are notoriously liable to come from inactive or
disordered liver, the irritant products circulating in the skin or
sweating out through it, giving rise to more or less irritation.
The result may be a simple pruritus, an urticaria, an eruption of
papules, vesicles or even pustules. Inany such cases it is proper
to look for other indications of liver disease,—pale color and
offensive odor of the feeces, muco-enteritis, indigestion, icterus or
yellow patches on the mucous membranes, tenderness on percus-
sion over the asternal ribs, muscular neuralgia, nervous disorder,
the passage of bile, haemoglobin, albumen, sugar or other ab-
normal elements in the urine, etc.

TREATMENT OF SECONDARY AND FUNCTIONAL
DISEASES OF THE LIVER.

Diet. Many hepatic disorders, and especially those that are
exclusively or mainly functional may be corrected by diet alone.
Prominent among dietary influences is the abundant supply of
water. The succulent grasses of spring and early summer con-
stitute the ideal diet, hastening and increasing elimination, and
lessening the density of the bile, even to the extent of dissolving .
biliary calculi and concretions. Upon dry winter feeding such
calculi are common, especially in ruminants, whereas after a
month or two at pasture they are extremely rare. In winter the
same good may be arrived at by the use of ensilage, brewer’s
grains, roots, fruits, or even scalded hay or bran. The two
extremes of highly albuminous and highly carbonaceous or
saccharine food are to be avoided or used only in limited
amounts. In the one class are clover, alfalfa, sainfoin, vetches,
cow-pea, lespedeza, especially in the form of hay, beans, peas,
cotton-seed, gluten-meal, rape and linseed cake. In the other
are wheat, buckwheat, Indian corn, sorghum, sweet-corn and
cornstalks. Some agents like beets which are rich in saccharine
matter may be actually beneficial by reason of their laxative and
cholagogue action. In the carnivora the food should be largely
of simple mush of oatmeal, wheat seconds, or barley meal, skim-

Secondary and Functional Diseases of the Liver. 441°

milk or buttermilk. If it is needful to tempt the appetite in a flesh-
fed animal this should not be done by rich, fat gravies, highly
spiced animal food, or rich saccharine puddings, but rather by
the addition of a little pure juice of lean meat, or some well
skimmed beef tea.

It is as important to regulate the quantity as the quality of the
food as the heavy feeder will over-charge the liver as much by an
excess of otherwise wholesome food, as will the ordinary animal
by the indigestible and unwholesome articles. As a rule the
improved breeds of meat producing animals, have acquired such
facility in fat production that much of the surplus is largely and
profitably disposed of in this way, and in their short lives little
obvious evil comes of the over-feeding, but in cases in which
this outlet proves insufficient, as in horses and dogs that are
highly fed on stimulating or saccharine diet, and which are kept
for the natural term of their lives, with little exercise, the evil
tends to'reach a point of danger. Nursing mothers and dairy
cows find a measure of safety in the free flow of milk and the
yield of butter, but breeding cows that have been improved till
they have no longer a capacity for milking, but must have their
calves raised on the milk of other and milking strains are cor-
respondingly liable to suffer.

Exercise in the Open Air. As enforced idleness, on a full diet
and in a warm and moist environment is a main cause of hepatic
disorder, so abundant exercise in the open air and especially ina
cool season is beneficial in a marked degree. Beside the bracing
effect on the digestive organs and the improvement of the general
tone of the system, the action of the muscles in hastening the cir-
culation greatly favors the removal and elimination of waste
matters. Still more advantageous is the increased activity of the
respiration and the aspiratory power of the chest in at once un-
loading the portal system and the liver by hastening the progress
of the hepatic blood into the vena cava and right heart, and in
furnishing an abundant supply of oxygen for the disintegration of
the albuminoids and amylaceous products. Such exercise must
of course be adapted to the condition of the animal and its power
of sustaining muscular work, but judiciously employed, it is one
of the most effective agencies in correcting and improving hepatic.
disorder or hepatic torpor. Idle horses, the victims of obstinate

442 Veterinary Medicine.

habits of constipation, muco-enteric irritation, indigestion,
nervous, urinary or cutaneous disorders will often be greatly
benefited or entirely restored by systematic exercise. This is one
of the great advantages of a run at pasture, as the subject secures
at once the laxative cholagogue diet, an abundant supply of
oxygen, a better tone of the muscular and general system, and a
more perfect disintegration of albuminoids. Sea air with its
abundance of ozone is especially advantageous.

In the carnivora while we cannot send them to grass, much can
be done in the way of systematic exercise, and in the case of city
dogs a change to the country, where they can live out of doors
and will be tempted to constant exercise and play, will go far to
correct a faulty liver.

Laxatives. Cholagogues. When a free action of bowels and
liver cannot be secured by succulent food and exercise, we can
fall back on medicinal laxatives. These are advantageous in
various ways. Some laxatives like podophyllin, aloes, colocynth,
rhubarb, senna, jalap, and taraxacum act directly on the liver in
increasing the secretion of bile. These may be used for a length
of time in small doses'and in combination with the alkalies.
Other aperients act directly on the bowel carrying away the ex-
cess of bile, the albuminoids and saccharine matter that would
otherwise be absorbed, and by a secretion from the portal veins,
abstracting nitrogenous and saccharine elements which would
otherwise overtax the liver to transform them. Thus, indirectly
these also act as cholagogues by withholding the excess of ma-
terial on which it has to operate, and by rousing its functions
sympathetically with those of the bowels. Thus, sulphates of
magnesia and soda, and tartrates and citrates of the same bases,
given inthe morning fasting, dissolved in a large quantity of warm
water and conjoined with sodium chloride, ammonium chloride,
sodium carbonate or other alkaline salts, or with one or more of
the vegetable cholagogues above mentioned, may be continued for
a length of time until the normal functions have been re-estab-
lished, and will maintain themselves irrespective of this stimulus.

Calomel (and even mercuric chloride in small doses), though it
is not experimentally proved to be a direct cholagogue, is one of
the very best correctives of impaired hepatic function. It expels
the bile from the duodenum and bowels generally, thereby pre-

Secondary and Functional Diseases of the Liver. 443

venting its reabsorption; it proves antiseptic to the ingesta; it
eliminates much of the peptone, saccharine and fatty matter from
the intestines and portal system thus relieving the liver material-
ly; and it is supposed further to modify the other liver functions
by a direct action on the hepatic cells, and by reducing the co-
hesion of fibrine, and promoting the disintegration of albumen.
Certain it is that calomel gives most substantial relief in many
torpid and other disorders of the liver and as it is not in itself an
active liver stimulant but has rather a soothing action on that gland
it can be safely resorted to in states of hepatic irritation in which
the more direct cholagogues would prove more or less hurtful.

In some forms of hepatic disorder where a speedy and abundant
secretion is demanded, pilocarpin may be employed, with great
caution so as not to reduce the strength unduly by the attendant
diaphoresis, diuresis, salivation or diarrhcea.

Alkalies have long been recognized as of great clinical value
in hepatic disorders. Though carbonate of soda decreases the
secretion of bile, (Nasse, Rohrig), yet the alkalies generally
appear to promote oxidation, and to hasten the disintegration of
albumen and the albuminoids. They increase the disintegration of
sulphur compounds, materially adding to the sulphates and
urea in the urine. They further tend to increase the hippuric
acid, carbonate of soda (2 drs.) even determining the abundant
excretion of this acid in man (Nasse). It may be concluded
that the acknowledged value of alkalies in these diseases, is
largely due to their hastening of the metabolic processes in al-
buminoids. Small doses of sodium carbonate further stimulate
the gastric secretion and may thus benefit by rendering the pro-
cess of digestion more complete and satisfactory.

Chlorine, Iodine, Bromine and their Salts. These halogens
are of great value in many hepatic disorders. The universal
craving for sodium chloride indicates the need of its elements in
the animal body, and whether this is mainly the supply of chlor-
ine for the hydrochloric acid of the gastric juice, or to fulfill its
uses in favoring the oxidation and disintegration of the nitrogen-
ous matters in the blood and tissues, or for other more or less
obscure uses, it is well to recognize and act upon the indication.
The various mineral waters which are held in high esteem in liver
affections contain a large proportion of sodium chloride. As a

444 Veterinary Medicine.

medicinal agent ammonium chloride maintains an equally high
position. Large doses thrice a day, so as to induce diaphoresis
and diuresis greatly relieve hepatic congestions. This agent
determines a great increase in the urea eliminated so that it is
even more effective in the same direction, than sodium chloride.
Free chlorine is also effective in hepatic torpor and congestion,
and to this in part may be attributed the great value of nitro-
muriatic acid.

Bromide and iodide of potassium have been found to be effec-
tive in reducing hepatic enlargement and thus in conducing to
a more healthy activity of the liver.

Lpecacuanha, Euonymus, etc. ‘These agents are more or less
hepatic stimulants and may be found beneficial as combined with
the laxative or alkaline agents in securing a better functional
activity in cases of torpor or deranged function.

Tonics, Bitters. ‘Tonics are often useful when the health has
been undermined by long continued hepatic disorder. The iron
tonics are as a rule contra-indicated as tending to check secretion
of bile, unless they can be given with alkalies. Iron sulphate or
chloride, combined with sodium or potassium carbonate so as to
establish a mutual decomposition will obviate this objection.
The vegetable bitters (gentian, cascarilla, calumba, salicin, ser-
pentaria, aloes, nux vomica) combined with alkalies are often of
great value. Quinia, like opium, checks secretion and is to be
avoided or used with judgment and in combination with chola-
gogues.

HAMOGLOBINAMIA. AZOTAMIA. AZOTURIA. HA-
MOGLOBINURIA. TOXASMIA FROM IMPERFECT
HEPATIC FUNCTION.

Definition. Theories, of hysteria, urzemia. spinal myelitis, myelo-renal
congestion, rheumatic lumbago, myosito-myelo-nephritis, rheumatic chill
with destruction of muscle albuminoids. Yet it occurs in our semi-tropical
midsummer with a temperature of 80 or 90, in spring and autumn, and rarely
even in the cold, damp stable in midwinter in the absence of exercise.
Constant conditions: One or more days absolute rest, following steady
work, a strongly nitrogenous ration, continued during the rest, sudden act-
ive exertion, accelerated breathing and unloading of peptones and proteids
from portal vein and liver into the general circulation. Sanguineous albu-
minuria from excess of albuminous food, free ingestion of water, suppressed
milk secretion, forced marches. Transfusion of blood. Excess of albumen
dangerous, excess of red globules not dangerous. The blood concentration
of diuresis or diaphoresis is not dangerous. Continuous muscle decomposi-
tion from work bars the disease. Stable miasm untenable. Potson may be
drawn suddenly from the enormous mass of blood in the liver, spleen and
portal system. The absence of icterus antagonizes the bile theory. Ben-
zoic acid, unaltered peptones, and glycogen are examples of elements de-
structive to blood. Normal destruction of red globules in liver, spleen and
bone marrow. Sudden access of resulting hzemoglobin to the blood. Other
products of disintegrated globules. Poisons from food, and antitoxic action
of liver in presence of glycogen. Carbon dioxide favors solution of red glob
ules. Theoriesof hamoglobinzmiain man. Microbes. Lesions: Blood black,
diffluent, irridescent, has no avidity for oxygen, with excess of urea and ex-
tractives, serum of clot red, globules small, pale, distorted, not sticky ; ex-
travasations ; liver, enlarged, congested, blood gorged ; spleen congested,
swollen : Lumbar or gluteal muscles pale, infiltrated with loss of striation ;
bone marrow congested, hemorrhagic: kidneys congested infarcted ; urine
dark brown or red, with excess of urea and hemoglobin. End of spinal
cord has congestion or infiltration. Symptoms: History of high condition,
constant work, high feeding, a day’s rest, then exercise and attack. To
fall life, follows flagging, droops, moves one or both hind limbs stiffly,
knuckles, drags toes, crouches, trembles, perspires, breathes rapidly, is ten-
der on back, loins, croup or thigh, muscles firm, paretic, and drops unable
to rise. Urine retained, brown, red or black, sometimes glairy, later may
have casts. Appetite may return. In mild cases, stiffness, lameness, with
or without visible muscular lesions or tremors. Urine glairy, dense, with
excess of urea and nitrogenous products. Recover under careful feeding
and exercise, and relapse under original causes. Progress: May recover
under rest. In bad cases accelerated breathing and recumbency forbid rest
and recovery. Recovery in a few hours or after a week. Urinary casts

445

446 Veterinary Medicine.

with renal epithelium, imply nephritis and grave conditions. In persistent
paresis, muscles waste. Modes of death. Mortality 20 per cent. Diag-
nosis, by history of onset, etc. Prevention: When highly fed and hard-
worked, give daily exercise ; with comparative rest, reduce, ration and give
laxative or diuretic. Plenty of water. Treatment: Rest, sling, diffusible
stimulants, bleeding, bromides, water ad libitum, fomentations, unload liver
and portal vein, purgative, eserine, barium chloride, enemata, diuretics, for
remaining paresis, derivatives, strychina, diet, laxative, non-stimulating,
restore to work gradually, antiseptic, potassium iodide.

Definition. An acute auto-poisoning occurring in plethoric
horse on being subjected to active exertion after a period of idle-
ness, and manifested by great nervous excitement and prostra-
tion, paresis commencing with the hind limbs and the passage of
heemoglobin in the urine.

Nature and Causes. ‘The most varied conclusions as to the
nature of this disease have been put forward by different authors.
In England, Haycock called it hysteria, mistakenly supposing
that it was confined to mares, and Williams attributed it to
urzemic poisoning, conveniently ignoring the fact that the sudden
manifestation of the most extreme symptomsin an animal which
just before was in the highest apparent health and spirits contra-
dicted the conclusion. In France (Trasbot) and Southern Europe
(Csokor) it has been looked on as a spinal myelitis, a conclusion
based on the disturbed innervation of the posterior extremities in
the great majority of cases, but which is not always sustained by
the pathological anatomy of the cord. In Germany veterinarians
have viewed the disease from widely different standpoints.
Haubner calls it myelo-renal-congestion (Niéren-Riickenmarks):
Weinmann, a rheumatic lumbago ; Dieckerhoff defines it as an
acute general disease of horses, manifested by a severe parenchy-
matous inflammation of the skeleton muscles, with a bloody in-
filtration of the bone marrow, especially of the femur, and with
acute nephritis and hemoglobinuria. He attributesthe attack to
exposure to cold. If this were the real cause the attack would
be far more common in very cold weather when the horse is sud-
denly exposed to cold drafts between open doors and windows,
than when he is harnessed and driven so as to generate and
diffuse animal heat. Yet attacks inthe stable are virtually un-
known, and in almost every instance the onset occurs during a
short drive. Friedberger and Frohner say that the epithet rheu-

Hemoglobinemia.—Azotemia, Etc. 447

matismal may be correctly applied to almost all cases that we meet
in practice. They quote Goring as having produced the disease
experimentally by exposure to cold, and go on to explain that
rest in the stable before the attack causes the extreme sensitive-
ness to cold that is generated by a warm environment. The im-
plication of the lumbar, pelvic and femoral muscles they explain
by the stimulation of the nutritive metamorphosis by the action
of cold on the sensitive nerves of the skin. The effect of this
cutaneous irritation is exaggerated by the heat of the stable to
which they have been previously subjected. The products of
the destruction of the albuminoids of the muscles, pass into the
blood as hemoglobin, and produce the ulterior phenomena. The
muscles of the hind quarters especially suffer because of their
greater exposure and because they are subjected to the hardest
work in propelling the animal machine. In this connection they
quote the experiments of Lassar and Nassaroff in which sudden
exposure to cold determines parenchymatous degeneration of
muscles ; also the cases of paroxysmal or winter haemoglobi-
nuria in certain susceptible men whenever they are exposed to
an extremely low temperature.

There are serious objections to the acceptance of this as the
essential cause, among which the following may be named:

tst. The disease is not confined to the cold season but occurs
also at midsummer when the out-door temperature is even higher
than it is in the stable.

2d. In our Northern States it appears to be more common in
spring and autumn or early winter, when the extreme colds have
either already passed, or have not yet set in, but when the abrupt
changes of weather (rain-storms, etc.) are liable to shut up the
animal indoors for a day or more at a time.

3d. The popular names quoted with approval by these authors
—Monday disease, Easter disease, Whitsuntide disease—indicate
the prevalence in Europe also, of the malady in the milder, or
more temperate seasons rather than during the prevalence of ex-
treme cold.

4th. The fact that the disease rarely or never occurs in the
stable, no matter how cold the season, how open the wooden
walls or floor, nor how strong the draft between doors, or win-
dows, shows that the theory of cold as the sole or main cause
must be discarded.

448 Veterinary Medicine.

It is not necessary to ignore the action of cold as a concurrent
factor in certain cases, or as a stimulant to reflex vaso-motor
paresis, to muscular metamorphosis and the increase of hemo-
globin in the blood. It is only necessary that this should be
held as subordinate and non-essential to the final result. Several
other factors that are accorded a subordinate place by these
writers, are so constant and so manifestly essential that they
must be allotted a much more important position in the list of
causes.

A period of rest is a constant precursor of an attack. The
more extended the inquiry the more certain we become that a
short rest is a prerequisite to equine haemoglobinemia. The
horse that is kept at daily steady work may be said to be prac-
tically exempt. Even the non-professional observer recognizes
the fact and names the disease after the weekly or yearly holiday
or rest day which was the occasion of it. To him it is the Mon-
day morning disease, the disease of the day following Thanks-
giving, Christmas, New Year, or Fourth of July. It is the dis-
ease of wet weather, of heavy snowfalls, of the blizzard, or of
the owner’s absence from home, of any time that entails one or
two days of absolute inactivity in the stall.

But again the affection does not appear in the horse that is
absolutely idle for a length of time. It is the short period of
rest in an interval of otherwise continuous work that deter-
mines it. In short the subject must be in good muscular condi-
tion and with a hearty, vigorous appetite and good digestion.
The short unwonted rest interrupts the disposal of the rich
products of a vigorous digestion, and tends to overload the portal
veins, the liver, the blood and tissues with an excess of proteids.
The condition of the animal is so far one of plethora.

Another feature that bears this out is that the attack comes
only in the animal that is heavily fed on a strongly nitrogenous
ration. It is not the disease of the horse kept on straw, or
hay, or which receives a limited amount only of grain. It does
not occur in the animal which has its grain suspended or materi-
ally reduced during the one or two days of idleness. It does
not select the horse that has had a laxative either in the form of
food or medicine. This last may increase the sensitiveness to
cold, but it certainly lessens the tendency to heemoglobinzemia.
The most rational explanation appears to be that it affords this

Hemoglobinemia.—Azotemia, Ete. 449

protection by interfering with the thoroughness of digestion and
absorption, by securing elimination from the portal veins and
liver, and by reducing the amount of albuminoids in the blood.

A blood abnormally rich in albuminoids, as it is in the tran-
sient plethora induced by a: short period of rest, in the well-
conditioned working horse, without any restriction of his diet,
may therefore be set down as one of the most important factors
in producing hemoglobinemia. Nor is this without approxi-
mate examples in human pathology. VonBamberger has shown
that ‘‘ hematogenous albuminuria’’ will occur in healthy indi-
viduals when there is an excess of albumen in the blood-plasma,
as after a too free use of albuminous food, or after suppression
of the milk secretion (Landois). A similar result comes from
increase of blood pressure, as after drinking freely, or when,
under emotion or violent exertion, the heart’s action is increased
in force and the blood is thrown with greater impetus into the
large renal arteries. Senator has found albuminous urine to
attend and follow, for several days, upon forced marches made by
young recruits. Here the muscular work is added to the in-
creased blood tension superinduced by the more active contrac-
tions of the heart.

In this connection it is interesting to trace the changes in the
blood after transfusion. The dilatability of the capillaries
enables the system to accomodate itself to a very great increase
in the volume of blood. An increase of 83 per cent. may be borne
without serious results, but above this limit there is increasing
risk and an increase of 150 per cent. entails immediate danger to
life. In the restoration of the blood to its normal condition, the
secretion of water sets in promptly leaving an excess of albumin-
oids and blood globules. The next change is in the albuminoids
which in two days are almost entirely transformed into urea.
‘This leaves the blood abnormally rich in globules (Panum, Lesser,
Worm-Miiller), the red globules break up much more slowly and
may still be in excess after the lapse of a month (Tscherjew).

In this light, temporary plethora cannot of itself be accepted as
the main or essential cause of the disease. It must be admitted
to be a more constant and important factor than the mere ex-
posure to cold, but of itself it is inadequate to the production of
hzemoglobinemia. In the absence of exertion the general

29

450 Veterinary Medicine.

plethora fails to produce the specific disease ; again, after trans-
fusion a plethora of albumen lasts for one or two days, but hzemo-
globinzemia sets in only in the first few minutes after the animal
starts out from the stable, (never after an hour or two at work):
once more, excess of globules may last for a month, but with
steady work there is no danger of this disease, after the first mile
or two has been traversed, on the first day of the resumption of
labor.

A similar plethora of albuminoids and globules may be induced
in a plethoric animal by a profuse diarrhoea, diuresis or perspira-
tion, the blood having been robbed of its watery constituents,
and concentrated especially as regards its globules and albu-
minoids, but heemoglobinzemia never occurs as the result of such
an artificial concentration. On the contrary a free secretion by
the bowels or kidneys is of the greatest value in cutting short its
progress after it has set in.

The doctrine of poisoning by heemoglobin produced by exces-
sive work and disintegration of the muscles is equally insufficient
to account for an attack. Excess of muscular work and of
muscle-decomposition-products, would not reach its maximum
within the first few minutes after the animal has started from the
stable, but, other things being equal, would increase with the
‘continuance of work and the accumulation in the blood of a con-
stantly increasing amount of these products. The sharp line of
restriction by which the attack is limited to the initial period of
work, while it is never seen after hard work continued for hours
in succession, rules out this from the list of essential causes. It
may be that the products of muscular decomposition aggravate
the attack, but to set them down as the cause of the attack is to
beg the whole question and to contradict the truth that continu-
ous and severe muscular work with its consequent increase of
waste products is a direct bar to the development of the disease.
It should be noted in this connection that the increase in the
waste of nitrogenous bodies, as shown by the increase of urea, is
dependent far more on the amount of nitrogenous matters ingested
than on the muscle work or decomposition. In eleven hours just
before ascending the Faulhorn, Fick passed 21.686 grs. of urea
per hour ; in eight hours ascending the hill, 12.43 grs. per hour ;
and in six hours after the ascent he passed 13.39 grs. per hour.

Hemoglobinemia—Azotemia, Etc. 451

A general survey of the field shows that it is not the simple
increase of any normal waste product in the blood which de-
termines hzemoglobinzemia, and on the other hand the sudden-
ness and severity of the attack bears all the marks of a profound
poisoning. The nature of the poison has not yet been definitely
ascertained, yet one or two hypothesis may be hazarded, as
furnishing a working theory, in anticipation of the actual
demonstration which may be expected in the early future.

The action of a stable miasm as claimed by some writers is con-
tradicted by the fact that the disease does not develop so long as
the animal is left to inhale that mzasm, and on leaving the stable,
the life and vigor are usually remarkable.

The morbific agent must be sought in some source from which
it can be supplied with great rapidity under the stimulus of a
short but active exertion. The chylopoietic viscera furnish such
asource. ‘The healthy liver contains one-fourth of the entire mass
of the blood. ‘The torpid congested liver of the vigorous high con-
ditioned horse, after a short period of idleness, on full, rich feed-
ing, must hold much more than this normal ratio. The spleen,
the natural store-house or safety-valve of the portal veins, is also
gorged with this liquid in the high fed, idle animal. This organ
which is always turgescent after meals, is especially so in the
over-fed horse, which for twenty-four hours has been denied the
opportunity of working off by exercise, the superfluous products
of an active digestion and absorption. Then the whole of the por-
tal veins and the capillaries in which they originate are surcharged
with rich blood which cannot make its way with the necessary
dispatch through the inactive liver.

In this condition there isincomparably more than a quarter of
the entire mass of blood, enriched to the highest degree in pro-
teids, ready to be discharged through the liver and hepatic veins
into the general circulation. Under the action of the hurried
breathing and circulation, caused by the sudden and active exer-
tion, this whole mass of rich blood is speedily unloaded on the
right heart, the lungs and the systemic circulation. One can
hardly conceive of a more effective method of inducing a sudden
plethora, with an excess of both globules and albuminoids.

The presence of actual poisons in such blood is not so easily
certified.

452 Veterinary Medicine.

The absorption of dz/e elements and especially of taurocholic
acid, which is a solvent of the red blood globules, and would set
free their globulin might account for the characteristic condition
of the blood. The powerful aspiratory action of the chest,
would speedily empty the whole of the liver blood vessels, and
lessening their tension below that of the biliary radicals would
determine an active absorption of bile or of the more diffusible
of the bile elements. A manifest objection to this view is the
absence of an icteric tint in the mucous membranes of the affected
animals. ‘The visible mucosze are of a brownish red hue, such as
might come from hemoglobin dissolved in the blood serum,
rather than the yellow tint which might be expected from bile
pigment. The theory of poisoning by bile acids therefore, would
require an explanation of concurrent suppression or decomposi-
tion of the bile pigments.

Other sources, however, offer solvents for hemoglobin, benzoic
acid, which is derived from a cellulose in the fodders, and forms
the source of hippuric acid, dissolves red globules (Landois).
In the over-fed horse with active digestion, but inactive body and
liver, this must accummulate in the liver, spleen and portal sys-
tem, and when suddenly drawn into the blood without: time for
oxidation in the liver it will contribute to the condition of hamo-
globinzemia.

Peptones, being very diffusible, are very rapidly absorbed, but
they are not found, in healthy conditions, in the portal vein
(Neumeister). These are manifestly transformed into albumen
in the intestinal mucosa (Salvioli), or taken up by the very
numerous leucocytes and transformed or carried elsewhere (Hoff-
meister). But peptones injected into the blood of the dog render
it incoagulable, and in large quantity are fatal (Landois). An
excess of glycogen dissolves the red globules, and the conditions
of heavy feeding and torpid liver, are calculated to produce this
in great excess and to store it in the liver cells.

Under the extra vigorous aspiratory force of the chest, these
highly diffusible agents, present in great excess, are likely to be
drawn on through the mucosa, into the portal vein, liver and cava,
without an opportunity for complete transformation by leucocytes
or liver cells. These would tend to rob the blood globules of
their normal physiological vigor, would unfit them for maintain-

Hemoglobinemia.—Azotemia, Etc. 453

ing the healthy functions of lungs, kidneys, brain or muscle, and
would unfit the globules for successful resistance to solvents and
other inimical influences.

Again it isan important function of the liver, spleen and red
bone marrow to disintegrate worn out or abnormal red globules.
These are taken up by the white blood corpuscles of the hepatic
capillaries, by the cells of the spleen and the bone marrow and
are stored up chiefly in the capillaries of the liver, in the spleen,
and in the marrow of bone. ‘They are transformed, partly into
colored and partly into colorless proteids, and are either deposited
in the granular form, or are dissolved (Landois). Quinckesays:
‘That the normal red blood globules and other particles sus-
pended in the blood stream are not taken up in this way, may be
due to their being smooth and polished. As the corpuscles grow
older and become more rigid, they, as it were, are caught by the
amoeboid cells. As cells containing blood corpuscles are very
rarely found in the general circulation, one may assume that the
occurrence of these cells within the spleen, liver and marrow of
bone, is favored by the slowness of the circulation in these
organs.’’ From this chain of normal processes of blood disinte-
gration, we may reasonably infer, a greatly exaggerated work of
blood destruction when, in connection with anincreased density
of the plasma, and the presence in the portal blood of poisonous
products of digestion, the red globules have been altered in
density, in outline and in vitality, so that they become ready
victims of the amceboid cells of blood and tissues. Then the
stagnant condition of this altered blood in the compulsorily idle
animal favors the greatest excess of this destruction and the
storing upof an increased quantity of hemoglobin and other
products, to be poured suddenly into the general circulation as
soon as the movement of the blood is quickened by exercise.

This destruction of the red blood globules by disintegration
contributes to the formation of numerous decomposition-products,
like succinic, formic, acetic, butric and lactic acids, inosit, leucin,
xanthin, hypoxanthin, and uric acid, some of which are strongly
toxic. ‘The tendency will be to lower the vitality of the red
globules and thus to render them the easier victims of the leu-
cocytes and of the liver, spleen and marrow cells. Even the freed
hzemoglobin appears to exert a solvent action on the red blood

454 Veterinary Medicine.

globules. These are, of course, most concentrated and effective
in the seat of their production, yet when drawn suddenly in large
amount, into the general circulation, by the vigorous aspiratory
action of the chest, they may prove seriously detrimental to the
blood at large.

Again a variety of toxic matters are introduced into the system
in the food and others are developed from the food in the stomach
and intestine. Brieger found in the gastric peptones a potent
alkaloid having the effect of urari, and which in excess would
determine muscular paralysis. The alkaloidal and other poisons
produced by fermentations in the intestines have to be safely dis-
posed of. The ptomaines, if not too abundant, are arrested or
even decomposed in the liver which thus stands as a guardian, at
the outlet of the portal system, to protect the body at large. But
this anti-toxic function of the liver is only exercised in the
presence of glycogen (Rogers, Landois), and forced muscular
movement soon removes all glycogen from the liver of the dog
(Landois). Again glycogenesis in the liver is now believed to be
dependent on a ferment produced by the pancreas. If therefore,
the sudden active exercise and the aspiratory action of the chest
freed the liver of its glycogen, and hurried the alkaloidal and
other poisons through its capillaries too rapidly to allow of the
protective action of the liver cells, or if the pancreas as well as
the liver had become torpid and had failed to produce the requisite
amount of glycogen-ferment for the liver, the poisoning of the
blood and system at large would be imminent.

Not to mention the other toxic products which come from im-
perfect metamorphosis in the liver, it may be noted that a venous
condition of the blood or an excess of carbon dioxide contributes
greatly to the solubility of the red blood globules. It also tends
greatly to modify the fibrinogenous elements. Thus the blood
of a suffocated animal fails to coagulate or coagulates loosely,
and the blood of the portal vein of a suffocated horse is strongly
toxic (Sanson). Now the conditions attendant, on the onset of
equine hemoglobinzemia are snch as to give free scope to both of
these inimical influences. The great mass of blood in the portal
vein, spleen and liver is venous blood strongly charged with car-
bon dioxide, and by the sudden, active exertion this is forced
rapidly through the liver and lungs without time for full zeration,

Hemoglobinemia,—Azotemia, Ete. 455

so that the whole mass of the circulating blood is speedily re-
duced below par, and laid specially open to the action of blood
solvents. By the same action the systemic blood is charged
with poisons, direct from the food, and fermenting ingesta, and
from the overworked spleen and liver whose functions are pro-
foundly impaired, and later from other important organs, the
healthy functional activity of which can no longer be maintained
by the deteriorated blood supplied to them.

Heemoglobinzemia in dogs has been produced experimentally
by the injection of water into the veins the mere dilution of the
plasma dissolving out the coloring matter from the red globules
(Hayem); also by the inhalation of arseniureted hydrogen
(Naunyn and Stadelman) ; by the ingestion of toluylendiamine,
or phosphorus (Afanassiew, Stadelman); by snake venom,
septicemia, influenza, contagious pneumonia, petechial fever,
anthrax, etc. These cannot be looked on as causes of the acute
heemoglobinzemia in the horse, but they serve as illustrations of
changes in the plasma, and poisons in the blood determining the
escape of hzeemoglobin from the cells.

Ralfe recognizes two forms of hamoglobinzemia in man :

1st. That in which the haemoglobin is simply dissolved out of
the blood globules, the solution taking place chiefly in parts ex-
posed to cold.

2d. A more severe form in which the dissolution is general and
probably attended by some destruction of red globules in the
liver, spleen and even in the kidneys. The general opinion ap-
pears to be that the attacks are due to some nervous disturbance,
which causes vaso-motor disorder and it is supposed that there is
an exaggerated sensibility of the reflex nervous system. It has
been suggested that peripheral irritation causes irritation of the
vaso-motor centre, and in turn this causes local asphyxia in the
part stimulated, under which conditions the red globules part
with their haemoglobin (Roberts).

Murri holds that the disease depends on an increased irrita-
bility of the vaso-motor reflex centre, and the formation, owing
to the disorder of the blood forming organs, of corpuscles unable
to withstand exposure to cold or carbon dioxide.

While it is not assumed to point out the actual poisons of
hzemoglobinzemia in the horse the above suggestions may offer

456 Veterinary Medicine.

valuable hints as to the lines of inquiry that may be followed
with the best hope of reaching definite results.

Since the publication of the rst edition Lignieres has advanced
the doctrine of microbian origin. A Percheron, after two days
of idleness, went to work at 10 P. M., was attacked at 1 A. M.,
and died at 3 A. M. Culture inoculations made from his blood,
spleen, liver, kidney, bone marrow, myelon, and subarachnoid
fluid from the loins to the bulb proved sterile, while that from
the subarachnoid fluid on a level with the bulb yielded a rich
growth of streptococcus that appeared to the naked eye as small
granules. It proved zrobic and anezerobic, stained in Gram’s
(1) solution, coagulated milk acidifying it, showed small round
grayish-white colonies on peptonized gelatine, without liquefying
it, failed to grow on potato, but grew well in serum and bouillon.

Two or three drops proved fatal to mice, producing, when
thrown into the peritoneum, a highly acute parenchymatous
nephritis with bloody urine. Very few microbes were found in
the kidney. There was loss of control of the hind limbs and ex-
treme nervous irritability.

Intravenous injection of 300 cc. of the culture in a powerful
stallion produced hyperthemia, 102° F. on the second day, 104°
on the third, 105° on the fourth, paraplegia on the sixth, and
death on the seventh.

A second horse which received 150 cc. was sick for several
days, without paraplegia, then appeared to recover; but three
weeks later he became paraplegia, with albuminous urine and died
next day. :

In neither of the horses was the urine sanguineous.

The Guineapig succumbed to intraperitoneal inoculation and
the rabbit to intravenous. Carnivora, swine, ruminants and
birds proved immune. :

It is to be noted that the two inoculated failed to show hzemo-
globinuria which characterizes all violent and fatal cases that
occur casually. The streptococcus is therefore probably an acci-
dental complication of this case and not the specific cause of the
familiar heemoglobinemia. It may have been a predisposing
cause in Lignieres’ Percheron, debilitating the nervous system
and rendering it specially susceptible to the real cause, so that
the case proved rapidly fatal.

Hemoglobinemia.—Azotemia, Etc. 457

The microbian doctrine of causation is virtually disproved by
the absence of all evidence of contagion, and by the encreased
susceptibility left after a first attack. It is a common experi-
ence that one horse only out of a stable falls a victim, and
though he may have later attacks, under the usual conditions of
high feeding and condition, interrupted by a short period of
idleness, and followed by a resumption of work, yet there is no
evidence of an encreasing tendency to the disease on the part of
the other horses as would happen with a contagious microbian
affection. The remaining debility of the nerve centers after a
first attack, or even the continued presence of a streptococcus and
its toxins, might easily encrease the susceptibility to a second
attack, without requiring us to subscribe to the apparently un-
tenable position, that this is the essential cause of the disease.

Lesions. ‘These are especially found in the blood, liver, spleen,
muscles, bone-marrow and kidneys. The spinal cord and nerve
trunks are occasionally affected.

The dlood is charged with carbon dioxide and is black, tarry,
comparatively incoagulable remaining in the. veins and showing
an irridescent reflection. It does not absorb oxygen readily
though exposed to the air, and thus bears a strong general
resemblance to the blood of anthrax. It contains an abnormal
proportion of urea and allied extractive matters which greatly
increase its density, and interfere with the healthy exercise of
the different cell organisms and fnnctions. These are not due to
excessive muscular activity as stated by Friedberger and Frohner,
but are derived mainly from the abundant products of digestion.
When the shed blood coagulates it forms a soft clot without buff
and the expressed serum is reddish from the presence of haemo-
globin, and of hematoidin crystals. The uncoagulated blood
drawn over a sheet of white paper stains it deeply by reason of
the same coloring matters in solution. The red corpuscles may
be paler than natural, some even entirely colorless, and they are
often notched or broken up in various irregular forms. They
have lost the natural tendency of the shed equine blood to stick
together, to collect in rouleaux and precipitate to the bottom of
the vessel, so that no buffy coat is formed, should the blood
coagulate. The white corpuscles are relatively increased. Finally
the coloring matters contained in the plasma are imbibed by

458 Veterinary Medicine.

the different tissues and give a brown or reddish tinge to such as
are naturally white. Limited blood extravasations are not un-
common especially in the more vascular organs like the muscles,
liver, spleen and kidneys.

The diver is more or less congested and enlarged, friable, yellow,
or mottled yellow and red and exudes black blood freely when
incised. The bile is thick, viscid and dark green, as in cases of
experimental intravenous injection of hemoglobin,

The spleen is also swollen and congested with blood, and the
pulp is very high colored from the excess of hemoglobin and
other products of blood destruction. The muscles of the croup
are usually the seat of visible lesions. ‘There may be pallor,
cedema and swelling, but not unfrequently there are blood ex-
travasations varying in size from a pin’s head upward and giving
a dark red aspect to the affected tissues. Under the microscope
the affected fibres are seen to have lost their transverse striation
and to have assumed a more or less granular or hyaline appear-
ance. Next to the gluteal muscles, these changes are frequently
found, in the muscles of the thigh (especially the rectus femoris,
and triceps extensor cruris), and in those of the loins (psoas,
ilio-spinalis, and longissimus dorsi). Exceptionally the pectoral
muscles are involved or even the abdominal muscles. A con-
siderable straw-colored cedema may be found in the inter-
muscular connective tissue.

The ved bone marrow primarily of the large bones of the limbs
(femur, tibia, humerus, radius,) and less frequently of other
bones, even of the vertebrze, is often the seat of intense vascular
congestion and even of hemorrhage. The medullary matter is of a
deep red or black color, and there is an abnormal accumulation of
red globules in various conditions of growth and destruction (red
nucleated corpuscles, fragments of corpuscles, colored granules).
Dieckerhoff considers the condition one of osteomyelitis, but it
seems to be rather a sudden, extraordinary exaggeration of the
processes of blood metamorphosis. Neumann found that when
the blood regeneration process is very active even the yellow
marrow may be changed into red, and this throughout all the
bones of the extremities.

The kidneys are usually the seat of congestion, and black spots
of infarction, when the disease has lasted for twenty-four hours.

, flemoglobinemia.—Azotemia, Etc. 459

In rapidly fatal cases they may appear normal. There may be
enlargement of the kidneys with softening and granular degen-
eration of the renal epithelium in cases that survive for some
days.

The dladder contains dark brown or red glairy urine of a high
density and loaded with urea, hemoglobin, etc.

The terminal portion of the spinal cord and the lumbo-sacral
plexus, or some of its branches, are sometimes blood stained, or
the seat of an exudate or surrounded by one.

Symptoms. In the regular type of hemoglobinzmia in the
horse the history of the attack is highly significant. The subject
is in good working condition, he may be fat, or lean, but in either
case the muscles are firm and well developed, diet has been
liberal, embracing a large proportion of albuminoids, work has
been constant up to within a day or two preceding the attack,
when the animal has been left absolutely idle in the stall without
any reduction of feed. Then finally it has been suddenly sub-
jected to active exertion which demands vigorous muscular move-
ment, and above all activity of the respiratory muscles and the
heart. ‘his exertion usually consists in riding under the saddle
or going in harness, but may attend on casting in the stall,
lounging in a ring, or in a playful run when suddenly set at
liberty. 7

Severe Cases. The attack comes on early in the course of
such exercise. The patient may not have gone more than one
hundred yards from the stable or he may have traveled for half
an hour or an hour, but the disease rarely shows itself after a
longer period of work.

The horse which left the stable full of life and spirit, suddenly
flags and hangs on the bit, the ears or head may drop, and one
or more limbs usually the hind ones, are moved stiffly and awk-
wardly, or even stagger. He knuckles over at the fetlocks,
drags the toes on the ground, flexes the joints imperfectly, the
muscles appearing to be rigid and uncontrollable, or he crouches,
the joints remaining semi-flexed the animal in vain attempting to
extend them. The patient trembles violently, sweats profusely,
breathes deeply and rapidly and assumes a pinched, anxious,
agonized expression of countenance. The heart beats tumultu-
ously, the pulse (in 84 per cent. Friedberger and Frohner) is

460 Veterinary Medicine.

accelerated to a variable degree, and the temperature is still nor-
mal (in 80 per cent. Friedberger and Frohner), or rarely exceeds
101.5° F. There is often tenderness on percussion and some-
times even on manipulation over the loins, short ribs, and the
croup, and pinching of the loins may cause wincing. The
affected muscle or muscles (lumbar, gluteal, crural) are usually
firm, hard and tender, they may be the seat of spasm or of
cedema and paresis. These parts may, however, have their
sensitiveness lessened and even punctures or electric currents may
have little effect on them.

Soon the increasing muscular weakness is incompatible with
the maintenance of the standing position, the bending of the
limbs and crouching become extreme, the animal makes vain
efforts to control the muscles and extend the joints, and help-
lessly drops to the ground. When down he moves his legs con-
vulsively, but is unable to codrdinate the muscular movements
and all efforts to rise are unavailing.

The spasms and paresis may attack other parts of the body
such as the pectoral region, the shoulders and even the abdomen,
but the earliest and most persistent disorder is usually in the
divisons of the lumbo-sacral plexus affecting the supra or snb-
lumbar muscles, the gluteals, the patellar (triceps), the adductors
and the abductors. The caudal muscles are exceptionally in-
volved. Ina series of ten cases Bouley noticed that the left hind
limb was always the first paralyzed (evidently a simple coinci-
dence).

Urine may be passed freely or the bladder may be paretic so
that it must be emptied with a catheter. In severe cases the
urine is of a high density and of a dirty brownish gray, red or
almost black color. It contains no blood clots, nor blood
globules, but granular hemoglobin, tyrosin and other waste
products contribute to produce the reddish color. In some in-
stances there is an abundant metalbumen which renders the liquid
glairy, causing it to fall in fine threads or films. Urea is usually
present in great excess. Hippuric and even uric acid are usually
present but not in-excess. When the disease has advanced to
nephritis the albuminuria is complicated by the presence of casts
of the uriniferous tubes, renal epithelium, white and even red
blood globules.

Hemoglobinemia,—Azotemia, Etc. 461

During the violence of the attack there is no disposition nor
leisure to eat, but when the more violent symptoms abate appetite
is usually manifested. There may be more or less paresis of both
bowels and bladder, so that neither feeces nor urine is passed,
yet in other cases both are discharged spontaneously.

The senses are preserved, excepting in the case of the affected
muscles and the integument which covers them. ‘There may,
however, be more or less dullness and stupor in certain cases from
poisoning of the cerebral centres by the poisons circulating in the
blood.

Mild Cases. In the mildest cases there is stiffness and lame-
ness in one, or less frequently in both hind limbs, coming on
when put to work after a period of idleness, and not associated
with any appreciable lesion of the limb in question. There may
or may not be hardness and swelling of the gluteal or other
muscles of the quarter or loins. This has the appearance of
rigidity or spasm but may be primarily due to cedema or exuda-
tion into the substance of the muscle. In some instances the
muscles of the breast, shoulder, or forearm are the seat of the
trouble. Muscular trembling and perspiration may be present
and if the urine is examined, it is often found to be glairy, or
charged with urea, and allied nitrogenous products. These cases
are not benefited by local applications, but they recover (tempo-
rarily ) under rest and above all under active eliminating treatment.
Under gentle and progressive exercise too they improve and get
well. They recur, however, with great readiness under a rich
nitrogenous diet and a temporary rest followed by sudden exer-
tion.

Between the mildest and gravest cases there are infinite grada-
tions of severity, one-third to one-half of the worst cases usually
terminating fatally, whereas the mildest are always amenable to
treatment.

Progress. ‘The course of the disease depends on the severity of
the attack but also, in no small degree, on the good judgment of
the driver. Cases that develop with great suddenness, and ap-
parently with extreme severity may subside spontaneously if the
animal is placed in a condition of absolute rest. If, however, we
can secure rest of the muscles of progression only, while the
breathing remains rapid and labored, improvement is unlikely, as

462 Veterinary Medicine.

the system continues to receive large accessions of the toxic pro-
ducts. When the patient isdown and unable to rise, the enforced
rest may be beneficial, but too commonly, the greater effort with
which breathing is carried on in the recumbent position, and the
frequent ineffectual struggles of the limbs prevent the requisite
muscular quietude.

In some cases, and especially in the mildest, recovery may
seem to have been effected in a few hours, and in others it will
be seen in twenty-four or forty-eight hours, while in still others
the paresis and helplessness may continue for a week and yet be
followed by recovery. In these cases appetite may be retained
in greater or less degree, but the intestinal peristalsis is usually
weak and imperfect, the faeces small in quantity and dry, and
the bladder atonic so that the urine may have to be drawn off
with the catheter. It usually retains the deep red color, or im-
provement may be heralded by a change to a dirty grayish hue.
If, however, it shows an excess of albumen, cylindroid casts en-
tangling renal epithelium and white or red globules it will indi-
cate the access of diffuse nephritis and a prolonged or even a
fatal illness.

When control of the limbs is not restored at the end of a week,
the paretic muscles usually undergo marked and rapid wasting,
which may last for months or years. This is especially common
in the case of the patellar muscles (muscle of the fascia lata, tri-
ceps extensor cruris) in which the atrophy may become so ex-
treme that the skin covering the inner and outer sides of the
thigh may be brought virtually in contact in front of the femur.
This entails an almost complete inability to sustain the body on
the hind limbs. When atrophy is less extreme, there is only a
weakness, stiffness, or swaying or staggering on the hind limbs
in progression.

In fatal cases death may occur early in connection with the
violent struggles, the excited breathing, pulmonary hypostasis
and congestion, a cyanotic hue of the visible mucous membranes
and a gradual increase of stupor. Though delayed for several
days, there is a continuation of the muscular struggles, and the
labored breathing ; the red or glairy character of the urine per-
sists or is exaggerated ; the nervous irritability increases, with
muscular trembling ; and cyanosis, or stupor increases until death.

Hemoglobinemia. Azotemia, Etc. 463

The mortality has been high in the severe forms of the disease,
the deaths ranging from 20 per cent. upward.

After a first attack there is a strong predisposition to a second
under similar exciting conditions.

Diagnosis. ‘The peculiar symptoms of this disease and the
circumstances attending its onset, are usually sufficient to dis-
tinguish it iromall others. There may be danger of confounding
certain cases with thrombosis of the posterior aorta, or of the
iliac arteries or their branches, but the absence, in such cases, of
the special history of the attack and of the morbid state of the
urine, and the absence of pulsation in the arteries distal to the
thrombosis will serve to prevent confusion. Spinal myelitis will
be distinguished by the gradual nature of the onset, by the ab-
sence of the conditions attending on the attack of hemoglo-
binzemia, and usually by the absence of hemoglobin, urea and
other nitrogenous products in excess in the urine.

Prevention. ‘The hard-worked or systematically exercised horse,
which is at the same time heavily fed must not be left in a state
of absolute restin his stall for twenty-four hours. A fair amount
of exercise must be given on every day in the week, and at the
same time, the food should be restricted in ratio with the restriction
of exercise. Turning for an hour or two daily into a yard may be
asufficient precaution. When from any cause, rest is imperative,
the diet must be materially reduced and given in part in a laxa-
tive form (bran, roots), or a slight laxative (Glauber salts) or
diuretic (saltpeter) may be added. Cleanliness and a free ven-
tilation of the stable, are also of value in obviating at once anto-
intoxication and the admission of poison through the lungs. In
the same way a free allowance of drinking water is beneficial as
favoring a general elimination from the various emunctories, and
a dilution of the plethoric blood.

These precautionary measures are especially important in the
case of horses which have passed through a first attack and which
are in consequence strongly predisposed to a second. Horses
fed liberally on highly nitrogenous food (oats, beans, peas, cot-
ton-seed meal), will also require specially careful oversight when
at rest for a day or two only,

Treatment. 'The first and perhaps the most important con-
sideration is absolute rest. If the subject is stopped instantly on

464 Veterinary Medicine.

the appearance of the first symptoms, the disease may be often
aborted. It is better to avoid the exercise of walking to a stable
until such time as the severity of the attack has somewhat
moderated and then to move the subject only in the slowest and
quietest possible way. If the patient is already down and unable
to rise, he may be carried to the nearest stable in an ambulance
or on a stone-boat, and there helped to his feet and supported in
slings. ‘Though he may be unable to continue in the standing
position without the sling, yet if he can use his limbs at all for
support, and is prevented from lying down, the breathing will be
rendered so much more free and quiet, that it may greatly lessen
the transfer of the poisonous elements into the general circulation
and materially contribute to recovery. If, however, he cannot
stand on his limbs at all, but must settle in the slings, the com-
pression of the chest will so excite the breathing that it will
induce dyspncea, pulmonary congestion and a rapidly fatal result.
In such a case a good bed must be provided and the patient made
as comfortable as possible in the recumbent position.

In some cases in the earliest stages a full dose of sweet spirits
of nitre or even half a pint of whiskey has seemed to assist in
aborting the disease though the urine was already of a deep red
color. It probably acted by supporting the already oppressed
heart, and securing a prompt elimination by the kidneys.

Friedberger and Frohner strongly recommend bleeding in all
cases of dyspnoea and excited heart action, and considering the
plethoric condition of the animal it would equally commend
itself in other cases as well. This is the most prompt sedative
of the nervous and vascular excitement, and the most speedy
and certain means of removing much of the poisons accumula-
ted in the blood, and of diluting what remains by reason of the
absorption of liquids from every available source. This will more
than counterbalance any temporary increase of poisons drawn
from the portal system to fill up the vacuum in the systemic veins
caused by the emission of blood. When the thick tarry condi-
tion of the blood seriously hinders a speedy abstraction both
jugulars may be opened at once.

In some cases of great nervous excitement bromides may be
useful in moderating circulatory and respiratory movement,
but on the whole the advantage is greater from an immediate
resort to eliminating agents.

Hemoglobinemia.—Azotemia, Etc. 465

One of the most effective agents is water. If the patient is
thirsty he should have all he will drink, and if not, it may even
be given from a bottle, or thrown into the rectum. A still more
effective resort would be to'introduce water intravenously in the
form of a normal saline solution, or even to pass it into the
trachea through a small cannula or large hypodermic needle.
This serves to dilute the over dense blood, to stimulate the kid-
neys and other emunctories to active secretion, and to retain in
solution the hemoglobin, urea and other products which would
otherwise cause greater irritation. This would be especially ap-
plicable after the blood-tension had been diminished by phle-
botomy.

Warm fomentations to the loins or croup are not without their
influence. They tend to soothe the irritated parts and to solicit
the action.of the kidneys more particularly. The old resort of a
fresh sheep skin, with the fleshy side in, may be used as a sub-

stitute.

Perhaps the most important indication is to secure depletion
from the overloaded portal system and liver. Where nothing
better offers, a pint or quart of castor oil, or a pound of Glauber
salts, or a half drachm of podophyllin and four drachms of aloes
may be given. If available 1 to 1% grains of eserine, or 7
grains of barium chloride may be given hypodermically or intra-
venously in distilled water or that which has been raised to the
boiling point. This may be supplemented by frequent injec-
tions of hot soap suds or even of laxative saline solutions. If the
bowels can be roused to free secretion the removal of toxic
matters from the portal blood and the delay in the progress of
similar matters through the liver will go far toward securing a
favorable result. When free purgation has been secured recov-
ery can usually be counted on.

The action on the bowels must be followed up by diuretics to
eliminate the offensive matters from the general system. Colchi-
cum has been recommended because of its action in increasing
the solids of the urine, and this may be combined with saltpeter
or other diuretic, or the latter may be used alone and repeated
twice a day. If, however, the patient can, by the free use of
common salt or otherwise, be induced to drink freely of water,
the elimination through the kidneys will be sufficiently secured.

30

466 Veterinary Medicine.

The muscular weakness and paralysis that remain after the
acute symptoms have subsided must be met by stimulating lini-
ments and even blisters to the loins or affected muscles, by the
internal use of strychnia (2 grs. twice daily) until the jerking of
the muscles indicates that its physiological action has been
secured, and by an electric current daily for ten minutes at a
time through the affected nerves and muscles. Animals that
have been helpless for weeks have, in our hands, recovered under
such treatment, and even cases of several month’s standing, with
the most extensive atrophy of the triceps, and in which the ani-
mal could barely stand, have made a satisfactory recovery.

Any remaining nephritis must be treated according to its
indications.

During recovery and in the convalescent animal the diet should
be laxative and non-stimulating. Bran mashes, turnips, beets,
carrots, green fodder, ensilage and scalded hay. may be allowed.
Oats, corn, beans, peas, vetches, etc., must be carefully avoided.
If the food fails to maintain the bowels in a gently relaxed con-
dition one, two or more ounces of sulphate of soda may be added
daily.

In the mild cases a good dose of purgative medicine succeeded

. _ by a course of diuretics will serve a good purpose.

In all cases alike work must be resumed very gradually. At
: first the animal may be walked a few hundred yards, and the
pace or load and duration of exercise may be increased day by day
until full work can be safely endured. In an animal that has
once suffered the same gradual inuring to labor should be
followed, after any short period of rest on a fairly good ration.
The microbian theory of causation led to the treatment by
large doses of potassium iodide. W. A. McClanahan gave this
in % oz. doses, and in three severe cases complete relief was
obtained in from 15 to 20minutes. An early and complete con-
valescence followed. In the hands of J. H. Kelly of New Haven,
Conn., and T. S. Childs of Saratoga, N. Y. it proved for a time
invariably successful. The agent was given at once ina ¥% oz.
dose, and followed by 1 to 2 drs. every hour or second hour accord-
ing to the size of the animal and the severity of thecase. It has
proved less constantly successful in other hands perhaps because
of the severity of the case, and the atony and inactivity of the

Jaundice, Icterus, the Yellows. 467

stomach in which the agent lay without being absorbed. In-
travenous injection might successfully meet such a case. The
well known action of potassium iodide as a mild antiseptic, as a
chemical antidote of the toxins of certain cryptogams, as a nervous
sedative, and as an eliminating agent, would help to explain its
curative actions.

A still later resort to large doses of sodium bicarbonate in this
disease equally suggests the value of elimination, and of a
markedly alkaline treatment.

JAUNDICE, ICTERUS, THE YELLOWS.

Symptoms. Causes: Mechanical obstruction of bile duct, gall-stones,
hydatids, distomata, extraneous bodies, inflammation, stricture, oblitera-
tion, absence, ulceration, spasm, tumor, enlarged lymph glands, gastric
tumors, pancreatic, kidney or omental tumor, aneurism, fecal accumula-
tion, pregnancy, ovarian tumor: Without mechanical obstruction, ptomaines
and toxins, animal venoms, mineral poisons, hepatic atrophy, fear, other
emotions, cerebral concussion, imperfect oxidation, excess of bile, hepatic
inflammation, constipation and reabsorption of bile, experimental jaundice,
balance of tension in gall-ducts and blood vessels, duodenitis, compression
of aorta, heematodin and bilirubin, destruction of blood globules by hydro-
zemia, taurocholate of soda, chloroform, ether, freezing, heat, electricity,
alkalies, nitrites. Haemoglobin: Its solubility in horse. Bile acids and
blood pigment. Summary of causes. Gravity of icterus. Symptoms: Col-
oration, yellow, orange, brown, of tissues of secretions: Tests, staining white
paper, Gmelin’s test, nitric and sulphuric acids, rainbow hues: Pettenko-
fer’s test for bile acids, syrup and sulphuric acid, dark violet : Stranburg’s
test syrupy paper and sulphuric acid, dark violet ; clay colored fcetid stools ;
gravity.

The terms icterus and jaundice are applied to a yellowness of
the mucosz, urine, skin and tissues caused by the presence in
them of the coloring matters of bile. The condition is a symp-
tom of many different affections rather than a disease fer se, yet
the phenomenon is so characteristic that it has been hitherto
accorded a special place and article in systematic works.

Jaundice is either associated with mechanical obstruction of the
bile duct or ducts, or it is zxdependent of such obstruction. ‘The
following enumeration of its causes slightly modified from Mur-
chison, is equally applicable to the lower animals as to man :

468 Veterinary Medicine.

A. Jaundice From Mechanical Obstruction of the Bile
Duct.

L. Obstruction by foreign bodies within the duct :
1. Gall stones and inspissated bile.
2. Hydatids and. distomata.
3. Foreign bodies from the intestines.

LI, Obstruction by inflammatory tumefaction of the duodenum
or of the lining membrane of the bile duct with exudation into tts
interior.

IIf, Obstruction by stricture or obliteration of the duct.

1. Congenital deficiency of the duct.
2. Stricture from perihepatitis.
3. Closure of the orifice of the duct in consequence of ulcer
of the duodenum.
4. Stricture from cicatrization of ulcers in the bile duct.
5. Spasmodic stricture.
IV. Obstruction by tumors closing the orifice of the duct or grow-
ing in tts interior.
V. Obstruction by pressure on the duct from within, by :
. Tumors projecting from the liver itself.
. Enlarged glands in the fissure of the liver.
. Tumor of the stomach.
. Tumor of the pancreas.
. Tumor of the kidney.
. Post peritoneal or omental tumor.
. An abdominal aneurism,
. Accumulation of feeces in the bowels.
. A pregnant uterus.
. Ovarian and uterine tumors.

Oo ON DAMN PWD HH

4
e}

B. Jaundice Independent of Mechanical Obstruction of
the Bile Ducts.

L. Poisons in the blood interfering with the normal metamor-
phosts of bile.
1. The poisons of the various specific fevers( Anthrax, Texas
fever, Hog-cholera, Swineplague, Petechial fever,
Pyzmia, Septiceemia, etc. ).
2. Animal poisons: snake poison.

Jaundice, Icterus, the Yellows. 469

3. Mineral poisons : phosphorus, mercury, copper, antimony,
etc.
4. Chloroform, ether, etc.
5. Acute atrophy of the liver.
II. Impaired or deranged innervation interfering with the
normal metamorphosis of bile. .
1. Severe mental emotions: fright, anxiety, etc.
2. Concussion of the brain.
III. Deficient oxygenation of blood interfering with the nor-
mal metamorphosis of bile.
IV. Excessive secretion of bile, more of which is absorbed
than can undergo the normal metamorphosis.
Congestion of the liver : a. Mechanical, 4. Active, c. Passive.
V. Undue absorption of bile into the blood from habitual or
protracted constipation.

Mechanical obstruction, by tying the bile ducts in a dog,
caused in two hours yellow coloration of the contents of the
hepatic lymphatics and thoracic duct, and also of the blood in the
hepatic veins (Saunders). That this jaundice is due to reab-
sorption and not to suppressed secretion of bile, already present
in the blood, may be fairly inferred, from the complete absence of
icterus, where, from general disease of the liver, the secretion of
bile has been entirely suspended, and in which the gall ducts and
bladder contain only a little gray mucus (Haspell, Frerichs,
Budd, Murchison), also from the fact that after complete extirpa-
tion of the liver in frogs not a trace of biliary acids nor pigment
can be detected in the blood, urine, or muscular tissue (Miller,
Runde, Lehmann, Moleschott). Bile acids and bile pigment are
formed in the liver by disintegration of blood globules, and when
present in excess in the blood it is by virtue of reabsorption.

This absorption will take place under the slightest favoring
influence. ‘The obstructions in the bile duct, above referred to,
cause the tension in these ducts to exceed that of the blood in
the capillaries of the liver and at once osmosis of bile into the
blood vessels sets in. This may occur from so slight a cause as
the congestion and swelling of the duodenal mucosa around the
opening of the bile duct. Again, reabsorption of bile may be de-
termined by a lessening of the normal fullness and tension of the

470 Veterinary Medicine.

hepatic capillaries as when the aorta is mechanically compressed
by abscess, neoplasm, ingesta, or otherwise, just behind the dia-
phragm (Heidenham, Brunton). The cause is the same in both
cases, namely, the want or balance between the fullness and
tension of the bile ducts, and the hepatic blood vessels. There is
increased fullness of the hepatic biliary ducts, or decreased
plentitude of the hepatic capillaries and lymphatics.

It must be added, however, that the coloring matter of the bile
is apparently produced, in the liver, from that of the blood, and
that the pigment (hematoidin), found in old extravasations of
blood, is probably identical with bilirubin, and that any agent
or condition which causes liberation of the coloring matter of the
red blood globules, will cause a staining of the tissues, like that
of jaundice. The following agents are known to have this
effect on the blood globules : water, in hydrozemic states of the
blood (Hermann) ; taurocholate of soda from absorption of bile
(Frerichs, Kiihne, Feltz, Ritter): chloroform (Chaumont) ;
ether (Burdon-Sanderson) ; freezing (Rollet) ; a high tempera-
ture+60° C. (Schultze) ; frictional aud induction currents of
electricity (Burdon-Sanderson) ; the alkalies (ammonia, potass
and soda) and nitrites when present in excess.

The injection of hemoglobin into the veins of dogs has been
followed by the appearance of bile pigment in the urine, but
Naumyn, Wolff, Legg and Brunton failed to obtain the same
result in rabbits.

It is noticeable that the heemoglobin of horses’ blood is very
soluble at all temperatures and that of dogs very slightly so
(Burdon-Sanderson). ‘This may serve to explain the great. pre-
valence among solipeds of diseases, associated with dusky brown
or yellow discoloration of the mucosze, with petechiz, and with
the passage of blood pigments in the urine. It may further ex-
plain the usually benignant conrse of jaundice in the horse and
its extreme gravity in the dog.

There is further reason to believe that the bile acids, when in
excess, may be transformed into bile pigment in certain conditions
of the blood, as occurs under the action of sulphuric acid out of
the body (Stcedler, Meukomen, Folwarcyny, Rohrig). Moreover,
in the healthy state, the greater part of the bile secreted, includ-
ing acids and pigment, is re-absorbed from the intestinal canal,

Jaundice, Icterus, the Yellows. 471

but is oxidized and decomposed in the blood so that it cannot be
detected, in blood or urine. But let the transformation be inter-
rupted, as in certain diseases of the lungs, with imperfect oxida-
tion, and the bile circulates in the blood, stains tissues and urine,
and in short causes jaundice.

‘To sum up: it may be said that icterus is probably never due
to simple inactivity of the liver: it may, however, be caused by
excessive secretion of bile which is re-absorbed from obstructed
bile ducts or bowels :—it may result from imperfect transforma-
tion, in the blood, of the bile which is normally re-absorbed from
the intestine: or it may possibly be caused by the formation of
pigments in the blood from the abnormal transformation of bile
acids, or by solution of the hemoglobin of the blood corpuscles.

The gravity of jaundice varies as much as its causes. It is
well known that the system may be saturated with bile, and the
tissues and urine deeply stained without much constitutional
disorder. The pigment alone is not an active poison. But there
may be much attendant suffering from obstructed biliary ducts or
bowels, from diseases of the lungs, or from disintegration of the
blood globules and imperfect nutrition, or there may be profound
nervous prostration and disorder from ureemia, or from the pres-
ence in the blood of an excess of effete and partially oxidized
albuminoids (See Azoteemia). According to our present knowl-
edge, constitutional disorder, prostration and suffering in cases of
jaundice, are mainly due to the presence in the circulation of these
albuminoids, and of taurocholic acid which latter has a most
destructive effect on the blood corpuscles.

The symptoms, therefore, are not characteristic apart from the
yellow coloration of the tissues and urine and the chemical
reactions of the bile acids and bile pigments furnished by the
latter.

The coloration of the tissues may be a simple tinge of yellow
especially noticeable in the eye (conjunctiva), or it may amount
to the darkest shades of orange and brown. It may or may
not be complicated by the presence of spots or patches of blood-
staining (ecchymosis) on the visible mucous membranes but
especially in cases complicated by poisoning with taurocholic acid
or effete nitrogenous products.

The urine may be similarly colored in all shades of yellow or

472 Veterinary Medicine.

orange brown, and may leave a correspondingly deep stain on
white paper.

The est for bile pigments (Gmelin’s) is simple and beautiful.
Pour a little nitric acid into a test tube held obliquely and then
add a few drops of sulphuric acid, and finally a little urine, so
slowly, that it will remain on the surface. Soon at the point of
junction appear in succession the various colors of the rainbow :
yellow, green, blue, violet, red and lastly a dirty yellow. It is
open to this objection that the characteristic play of colors may
be produced by alcohol in the absence of bile pigments. Indican
also will produce the green and yellow with blue between but
never the violet nor red, nor all in their regular order.

A second mode of applying this test is by spreading a few drops
of the urine on a white plate and letting fall a drop of nitric acid
in the centre. The play of colors is very characteristic.

The fest for bile acids (Pettenkofer’s) is to place a portion of
the urine in a test tube, and after adding a drop of syrup, to add
cautiously, drop by drop, two-thirds of the amount of sulphuric
acid. Shake the mixture and set aside for some minutes. If
sufficient heat is not produced by the mixing of the acid and
urine warm slightly. The mixture becomes of a dark violet
color which is destroyed by a temperature a little above 140° Fah.

A convenient application of this test (Stranburg) is to add a
little cane sugar to the urine, dip a piece of filtering paper in the
mixture, dry it thoroughly, pour a drop of sulphuric acid on the
paper and allow it to run partially off. Ina quarter of a minute
a beautiful violet color is produced, best seen by holding up the
paper to the light and looking through it (Brunton).

In cases due to obstruction of the bile ducts the dung is desti-
tute of bile, whitish, often clayey and foetid, while in cases due
to reabsorption without obstruction the feeces have their natural
color and odor.

It is needless to enumerate all the concomitant symptoms of
jaundice which will be better noticed under the different disorders
which determine it, for a list of which see the causes,

The gravity of the affection will.depend on the dangerous
nature of these concurrent diseases, and the destructive changes
in the liver and blood rather than on the depth of color in the
textures,

CATARRHAL ICTERUS (JAUNDICE) OF SOLIPEDS.

Causes: infection from duodenum through biliary duct. Suppression of
bile favors. Musty, heated, mow-burnt fodder, over feeding, irregular feed-
ing, or watering, over work, worms, fatigue, damp stables, duodenal con-
gestion, gall-stones, concretions, pancreatic tumor, ascaris in bile ducts, dis-
toma, infection through portal vein, toxins. Symptoms: of duodenal ca-
tarrh, icterus, yellow, viscous, odorous urine, dullness, weakness, somno-
lence, tardy pulse and breathing, costiveness, or diarrhcea, pale, foetid stools.
Duration : two to three weeks or longer. Lesions : duodenitis, distended
biliary and pancreatic ducts, calculi, enlarged softened liver and kidneys.
Diagnosis : icteric symptoms in absence of fever. Prognosis: usually favor-
able. Treatment: laxative diet, pasture, soiling, ensilage, roots, fruits,
water freely, exercise, antisepsis, elimination, laxatives, cholagogues, diure-
tics, calomel, salines, nitro-muriatic acid, podophyllin, castor oil, aloes, tar-
tar emetic, bitters, sodium bicarbonate.

Causes. ‘This may be said to be an extension of infection
from the duodenum through the bile ducts. The microbes of
the intestinal canal become acclimatized by living in the bile-
charged contents of the duodenum until they acquired the power
of survival and multiplication in the biliary ducts themselves.
The well-known antiseptic qualities of the bile, constitute a
powerful barrier to this, yet the power of adaptation on the part
of certain germs is greater than the defensive action of the bile.
The attack is however mostly in connection with indigestion or
muco-enteritis, and a more or less perfect suspension of biliary
secretion, so that this defensive action is reduced to its minimum
and the germs can ascend the bile ducts in the mucous secretion
as a culture medium, and by interference with the resumption of
a free hepatic secretion, they succeed in safely colonizing them-
selves in the mucosa and hepatic parenchyma. Whatever, there-
fore, interferes with the integrity of the duodenal functions di-
rectly contributes to the extension of infection from bowel to
liver. Old, heated, musty, cryptogamic, dusty fodder, grains
that have been badly harvested in wet seasons, feed that has been
damp and fermented, overloading of the stomach, irregular feed-
ing and watering, giving drink after a feed of grain, under-
feeding, overwork, worms, excessive fatigue, damp, dark stables,

473

474 Veterinary Medicine.

etc., tend to induce indigestions and to lay the bile ducts open to
infection. Blocking of the bile duct and stasis oi its contents
may bea sufficient cause. The swollen mucosa around the orifice
of the duct not only blocks the passage but favors the formation
of a mucous plug as recorded by Benjamin of an equine patient.
Wolff found obstructions of the duodenum in the horse by a mass
of ingesta, and blocking of the gall duct, with jaundice.

Gall stones and concretions are very direct causes of biliary ob-
struction and jaundice. Though less common in horses than
cattle, these are not unknown in idle, pampered animals when on
dry winter feeding.

Tumors of the pancreas or adjacent organs pressing on the gall
duct are recognized as causes of equine icterus, (Megnin, Nocard),

With any obstruction to the bile a disturbance of balance of
pressure between the bile ducts and the hepatic veins is brought
about by respiratory movements. On the one hand the aspira-
tory power of the chest empties the hepatic veins, lessening blood
pressure, and in expiration the contraction of diaphragm and
abdominal muscles compresses the gall ducts increasing their
tension and favoring absorption of bile. :

The entrance into the bile duct of the ascaris megalocephala is
at once acause of obstruction and of the transference of duodenal
microbes, and the presence of trematodes (fasciola hepatica, or
distoma lauceolatum) will also favor obstruction. Other para-
sites, like the echinococcus or actinomycosis, may press on the
bilary ducts and determine jaundice.

Another mode of infection is by way of the portal vein, the
microbes entering from the intestine and becoming arrested and
colonized in the liver (Dieckerhoff).

Whether from the presence of the microbes or from the absorp-
tion of ptomaines and toxins from the intestines, the radical
biliary ducts become inflamed, swollen, and even blocked, and
the hepatic cells degenerated or even completely devitalized, so
that they fail to take an aniline stain. In such cases the remain-
“ing sound hepatic cells go on producing bile, but as this cannot
any longer escape through the partially obstructed interlobular
biliary radicles, it is largely absorbed and produces icterus.
Cadeac mentions a case of this kind in a mare in which the toxic
matters had not only led to hepatic disease, but also to structural
changes in the eliminating organ (the kidney).

Catarrhal Icterus (Jaundice) of Solipeds. 475

Symptons. Inthe horse the disease is mostly attendant on
subacute duodenitis, and even when this is associated with in-
fective catarrh of the biliary passages the kidneys remain mostly
sound and active, and eliminate alike the bile pigments and the
more toxic matters so that the disease is not often grave. Beside
the essential feature of yellow mucosz, and urine, the latter
viscous and smelling strongly, there is profound depression, slug-
gishness, weakness and somnolence. Imperfect muscular control
and even slight paresis may be present. ‘Tardy pulse and breath-
ing are at times noticeable. At others these, like the tempera-
ture, are normal. The mouth is hot and dry. The urine may
be slightly albuminous. The bowels incline to constiveness from
lack of their customary stimulus, yet this in turn may give rise to
diarrhcea. In either case, as the disease advances, the defeca-
tions lose the healthy yellowish brown color, becoming pale and
foetid.

Duration. ‘The attack may last one, two or three weeks, and
generally endsin recovery. With irremediable structural lesions,
it is of course permanent and even fatal.

Lesions. ‘The most common feature is duodenitis with thicken-
ing around the orifice of the common bile and pancreatic duct.
The biliary ducts may be distended and their contents more than
usually viscid and glairy from the presence of pus. Their mucosa
may show ramified redness, or concretions as casts or calculi.
The liver is enlarged, soft and friable giving way readily under
the pressure of thefinger. Enlargement of the kidneys is usually
present, the cortical substance having a brownish red and the
medullary portion a yellowish pink hue.

Diagnosis. ‘The absence of hyperthermia in jaundice, serves
to distinguish it fromthe acute febrile affections (pneumonia,
influenza, contagious pneumonia, petechial fever, etc.,) which
are marked by yellowness of the mucosz and skin.

Prognosis. ‘The merely functional forms of icterus in solipeds
usually end in recovery.

Treatment, 'The first consideration is a laxative diet. A run
at pasture will usually meet every indication. Fresh cut grass,
ensilage, turnips, carrots, potatoes, beet, apples, or other succu-
lent diet may be given as substitute. Bran mashes and hay cut
and moistened may be allowed in the absence of the above.

476 Veterinary Medicine.

Abundance of water and especially cool water will stimulate
bowels, liver and kidneys, favor the elimination of the bile by
contraction of the biliary ducts, and hasten the expulsion of the
poisons through the kidneys. Regular exercise an hour after
meals stimulates both bowels and liver to action.

Medicinal treatment is largely directed to antisepsis of the
bowels and the arrest of the production of injurious toxins;
elimination from the bowels and incidental depletion from the
portal vein and liver ; antisepsis and stimulation of the liver;
and stimulation of the urinary secretion.

The preparations of mercury fill several of these indications.
Calomel 2 drs., or blue mass 1% dr., is not only a soothing laxative
and antiseptic, but seems to operate as a calmative and antiseptic
to the liver as well. It may be continued in 5 to 10 grain doses
two or three times a day, according to the size of the animal and
the condition of the bowels, and associated with % dr. belladonna
extract to each dose together with a bitter (quassia, gentian, nux
vomica). Or 4 or 5 ozs. sulphate of soda may be given three
times a day, with 2 drs. salicylate of soda as an antiseptic. Or,
to increase the hepatic action, nitro-muriatic acid largely diluted
may be given in sixty drop doses thrice a day in the drinking
water. ‘These are especially valuable for their antiseptic action,
cutting off at once the source of nervous irritation from the at-
tendant indigestions, and duodenal congestion, and arresting the
flow of the irritant toxins and other products through the portal
system. Podophyllin, castor oil, aloes, rhubarb, often act well
by depletion from the portal vein, and expulsion of indigestible
and irritant matters from the intestines, but there is more danger
of resulting swelling of the duodenal mucosa than with the
mercurials or aqua-regia. Goubaux recommends 2% drs. of
tartar emetic.

Siedamgrotzky has had good results from an electric current
sent through the region of the liver, but in the horse this is rarely
demanded.

A course of bitters, with bicarbonate of soda in small doses,
may be demanded to reestablish the healthy tone of the stomach
and intestines, and a run at pasture, or at least an open air life,
exercise, and a laxative diet with abundance of good water
should be secured. Any undue costiveness should be counter-
acted at once by a saline laxative.

CATARRHAL ICTERUS (JAUNDICE) IN DOGS.

Pampered artificial life of dogs as predisposition. Eating carrion. Chills
especially when heated and exhausted. Infection from bowels. Obstruc-
tion of gall duct by inflammation, calculi, neoplasms. Catarrhal exudate
as a protector of microbes. Toxins from intestines, food or water. Youth,
lack of acclimation, mental shock, blocking of bowel, blood effusion in
gall bladder, incubation. Symptoms: signs of gastro-enteritis, prostration
with invasion of the liver and especially of the kidney. Icteric urine with-
out jaundiced mucosa. Gravity of icterus with suppression of urine. Hyp-
ochondriac tenderness, arched back, dullness, irregular bowels, excited cir-
culation and breathing, preliminary fever tends to subside, tympany, colic,
trembling. Death in one or two days or more. Lesions: congestion, de-
generation, ecchymosis, ulceration of gastro-duodenal mucosa, extending
into liver ducts and acini, bile inspissated, liver enlarged, yellowish brown,
softened, fatty, shrunken, distorted hepatic cells. Kidneys congested, ec-
chymosed, cortical part with necrotic foci; lymph glands congested. Diag-
nosis : by icterus of tissues and urine tests. Prognosis: grave in acute cases,
more hopeful in. tardy ones. Treatment: antiseptics, cholagogues, salol,
salicylates, alkalies, carbonates, tartrates, iodides, laxatives, cold enemata,
aloes, electricity, water freely, pilocarpin, strychnia, aqua-regia, digitalis,
bitters, muriatic acid, convalescent diet.

Causes. ‘The dog is much more subjected to jaundice than the
horse, and the affection is liable to be much more severe, than
insolipeds. He leads a more artificial life, especially in cities,
where the lack of open air exercise, and of the facility for attend-
ing to nature’s wants, together with an excessive, varied, stimu-
lating diet predisposes him to constipation, indigestion, and
disorders of the stomach, bowels and liver. In other cases the
devouring of decomposing food and foul water proves a cause of
direct microbian infection, and of poisoning by ptomaines and
toxins generated out of the body. Exposure manifestly has
something to do with the prevalence of canine icterus, which is
more common in spring and especially in autumn than at other
seasons. In hunting dogs, out of condition, the suddenly in-
duced over-exertion and fatigue, and the succeeding chill in cold
air or water, become accessory factors.

It appears to be most commonly the result of the transference
of germs from the intestine, either by way of the bile ducts, or
with the blood through the portal vein. The first form is usually

477

478 Veterinary Medicine.

the sequel of muco-enteritis affecting the duodenum, with swell-
ing of the walls of the common bile and pancreatic duct at its
orifice, or from obstruction by gall-stones, concretions, impacted
bowels or neoplasms. With the arrest of the biliary flow the in-
testinal ferments gain an entrance into the common duct and the
sac of Vater, finding protection from the antiseptic bile in the re-
sulting catarrhal exudate, and in this way they reach the gall-blad-
der, the biliary radicles and the acini. With the entrance of bac-
teria or toxins by the portal vein on the other hand, there is first a
troubled condition of the acini and hepatic cells, an over-secretion
of thick bile, and blocking of the passages so that little is passed
into the intestine, the greater part being absorbed into the hepatic
veins. Fermentation microbes in the stomach and intestines, the
germs of suppuration and septicaemia, and saprophytic germs
from outside the body are held to be causative oficterus. Cadzec
lays much stress on the putrefactive germs in water, and traces
different attacks to marshes and foul ponds.

As in other infecting diseases, early age has a predisposing in-
fluence. The older subject has presumably been already exposed
to the microbe and acquired some measure of immunity. Ani-
mals coming new to the locality and poison, are equally suscepti-
ble with the young. Trasbot found that 14 out of 17 dogs thus
attacked were between three and eighteen months.

Leblanc and Trasbot claim mental shock as a cause of icterus
in the dog. The disappointment and weariness caused by the
master’s absence, the excitement of a fiercely contested fight, and
brutal punishment are adduced as cases in point. Abuse of
emetics and purgatives, in connection with a preexisting hepatic
or duodenal disorder or as a supposed prophylactic of canine dis-
temper has induced jaundice.

Obstruction of the small intestine has proved a factor, partly
by the reflex irritation through the splanchnic nerves, and partly
through obstruction to the common bile and pancreatic duct.

Walley records a case of obstruction of the cystic duct by
extravasation of blood in the gall bladder.

Icterus not infrequently supervenes during canine distemper in
which the early gastric and duodenal irritation becomes an occa-
sion of the extension of the catarrhal infection to the common
bile duct. Even apart from this, Trasbot has seen the majority

Catarrhal Icterus ( Jaundice) in Dogs. 479

of cases ushered in by a gastro-duodenitis. In this connection
it is interesting to quote the remark of Pfuhl that 26 out of 27
persons using the foul baths of a given establishment contracted
icterus, while the soldiers bathing in another branch of the Elbe
entirely escaped.

The fact that icterus usually sets in several days after such an
exposure, whether in man or dog, indicates a period of incuba-
tion, and thereby sustains the theory of infection.

Symptoms. In the majority of cases, gastro-enteritis consti-
tutes the first step of this affection and the early symptoms are
characteristic of that disease. Frequent vomiting, at first of
food, and later of a glairy fluid which may be discolored by bile,
redness of the tongue, especially along its margins, bloodshot,
watery eyes, lying down with the nose on the right side of the
abdomen, or standing with the abdomen tucked up and the back
arched, halting movements of the limbs, wincing if manipulation
is made of the spine or the epigastrium, elevated temperature,
accelerated pulse and breathing, anorexia and perhaps purging,
mark the onset. So long as the liver is unaffected prostration is
not a marked feature.

Even when the liver is invaded, a fair measure of life and activity
may often be retained so long as the kidneys remained sound and
active. The bile pigments and salts, and the toxins generated
by the invading microbes are alike eliminated in large part in the
urine, and the profound poisoning and prostration of the nervous
system are in a measure prevented. In many cases therefore the
urine is strongly jaundiced without much or any discoloration of
the mucosz and in such cases the prospects are usually good for
an early and complete recovery. It must not, however, be in-
ferred that such a happy issue will always follow, as the pigments
are by no means as toxic as are other hepatic products and fatal
results may ensue with very slight jaundice of the tissues.

As a rule, however, the jaundice of the tissues (eyes, nose,
mouth, white portions of the skin) is to be accepted as a grave
manifestation, indicating either an excessive production and ab-
sorption of bile, or a suppressed secretion through the kidneys,
or both. Then the poisoning by biliary salts and bacterial toxins
is shown in profound dullness, prostration, muscular weakuess,
indisposition to rise, moving stiffly and only when dragged by

480 Veterinary Medicine.

the collar, the limbs trembling and the back arched. ‘The tender
back is arched, the right hypochrondrium sensitive, the expression
dull, stupid and listless, and constipation or a foetid diarrhoea is
liable to set in. ‘The heart beats may be strong and irregular,
the breathing is easily disturbed and hurried. The temperature
at first 104° to 107° may descend to the normal as the system be-
comes charged with the toxic products, and does not usually ex-
ceed 99.5° after two or three days of jaundice of the tissues.

The icterus is shown in the eye or mouth, or on any white
portion of the skin, and in the urine it will be detected by the
eye or by the tests above given.

In the worst cases the urine is very scanty and of a deep yel-
lowish brown color, prostration is extreme, tympany, colic, obsti-
nate constipation or bloody dirrahcea may set in, the breathing hur-
ried or not, is trembling, the pulse small, and the temperature at
first high may descend to 95° or even much lower before death.

The course of the disease varies according to its gravity. If
there is complete retention of bile, and abundant production of
toxins, the animal dies in one or two days in a state of collapse.
If there is general progressive degeneration and destruction of
the hepatic tissue without at first absolute suppression of the dis-
charge of bile into the duodenum, the patient may last till the
fourth or fifth day, or later.

Lesions. There are usually congestion, tumefaction, friability,
ecchymosis and even ulceration of the gastric and duodenal mu-
cosa. The organs are empty, but show a reddish brown exudate
of a glairy consistency, and containing red blood globules and
pus corpuscles. The same inflammatory lesions are to be traced
into the common bile duct, the cystic duct and bladder, the
biliary ducts, and the acini. The mouth of the common duct is
usually blocked with a plug of tenacious mucus, the gall bladder
having been unable to expel this and the inspissated bile into the
intestine. The liver is slightly enlarged, yellowish, with patches
of brownish yellow more or less deep, and the acini contain an
abundance of oily globules, and yellowish brown granules. ‘The
acini have no clear line of delimitation, and the contained hepatic
cells are shrunken and distorted, standing apart from each other
in a dropsical or watery medium.

The kidneys are congested and ecchymosed ; the cortical sub-

Catarrhal Icterus (Jaundice) in Dogs. 481

tance brown, friable, and with numerous areas of necrosis of a
bluish white color, and even abscesses. The medullary substance
is yellow and the uriniferous tubes contain an abundance of yel-
lowish brown granules.

The lungs have a yellowish red color, with patches of ecchy-
mosis.

The lymph glands generally are congested and many of them
gorged with blood, of a dark red color, and lacking in consistency
and cohesion.

Diagnosis. ‘The characteristic icterus is lacking in the early
stages, and active treatment gives good hope of success. When
indigestion, persistent vomiting and tenderness of the epigastrium,
and right hypochondrium, are associated with diarrhcea, it is
highly important to examine the urine for even slight traces of
bile. When the jaundice is due to impaction of a biliary calcu-
lus, the symptoms may increase slowly, and yet reach a sudden
climax with acute colicy pains and tenderness of the right hypo-
chondrium.

Prognosis. In acute rapidly developing cases a fatal issue is
to be expected. In those which develop more slowly, recovery
may be hoped for if early treatment is instituted.

Treatment. Cases due to biliary calculus must be treated for
that lesion.

In purely infective icterus attempts must be made to arrest the
intestinal and hepatic fermentation. As intestinal antiseptics,
napthhol, benzo-naphthol, naphthaline, 5 grains four to six times
a day. As hepatic antiseptics, salol 5 grains, salicylate of soda
8 grains, or calomel 1 grain four times a day. The salol and
salicylate tend to increase biliary secretion and to render it more
fluid. The same end is attained by alkalies (carbonates of po-
tassa, or soda or lithia, bitartrate of soda, iodide of potassium).
These are further valuable in hastening the elimination of toxic
matters by the kidneys. The expulsion of bile, and of intestinal
microbes and toxins may be sought by laxative doses of Glauber
salts, or by cold enemas of the same. Verheyen recommends
aloes in laxative doses for six days. Siedamgrotzky had good
results from induction currents of electricity, sent through the
region of the liver twice a day for ten minutes on each occasion.

31

482 Veterinary Medicine.

To assist in elimination abundance of pure water or of watery
fluids may be used. The most effective eliminating agent is
pilocarpin in + gr. dose hypodermically, repeated daily. In
weak conditions frequent small doses of strychnia, ether, aqua
regia, or digitalis may prove valuable.

In case of improvement a course of bitters is usually demanded,
and these may be combined with hydrochloric acid or small doses
of sodium bicarbonate.

Throughout the disease, gruels, beef tea, buttermilk, whey or
any simple nutritive aliment which the animal relishes may be
given, but both then and during convalescence fatty matters and
indigestible materials should be carefully withheld.

JAUNDICE IN CATTLE AND SHEEP.

Usually with gall stones or concretions, or distomata. In sheep from de-
composing vegetation. Symptoms: anemia, emaciation, pallor, icteric mu-
cosze. Digestive disorder and bilious stools suggest worms. Treatment :
as in horse, or vermifuge.

Though less common than in the dog icterus in ruminants
occurs, but most commonly in connection with gall stones and
concretions, or with trematodes in the gall ducts. These forms
will be noticed under these respective headings. Verheyen de-
scribes an icterus of sheep which occurs enzootically in damp low
undrained localities, and is attributed by shepherds to the con-
sumption of dead and fermenting leaves. The symptoms are
those of anaemia, emaciation, and increasing weakness, with a
pallor and more or less dull yellow of the conjunctiva, and, later,
of the other mucosz. ‘The loss of appetite, indigestion, yellow
liquid feeces, suggest the possible presence of parasites as a cause,
and the prescribed treatment by common salt juniper berries and
tonics strengthens the suspicion. Other forms must be treated
according to cause on the lines laid down above.

JAUNDICE OF THE NEW-BORN. ICTERUS NOU-
VEAUX NES.

In mules ; less frequently in horses and cattle. Bacteridian. Predispo-
sition from alleged miscegennation. Offspring of lymphatic mares. Spoiled
fodders, foul buildings, exposure, infection by umbilicus. From gastro-
enteritis, diarrhoea, dysentery. Congenital. Symptoms: refuses the teat,
scours, red urine, palpitation, colics, perspirations, inflammations, or ab-
scesses, of navel, arthritis, other internal disorders. Death from exhaustion
orin convulsions. Or symptoms subside and passin 15 days. Diagnosis:
prostration, palpitation, icterus, and bloody urine with omphalitis. Strep-
tococci. Prognosis: with hematuria nine-tenths fatal. Lesions : icterus,
heart soft, flabby, lungs congested, general ecchymosis, blood black, clot
diffluent, liver congested, enlarged, spleen, swollen, softened with spots of
brownish yellow, meconium blood-stained, kidneys swollen, congested,
points of infarction or necrosis, urine bloody, navel lesions. Treatment:
for congenital cases improve hygiene for dams: for offspring, antiseptics
to navel, shelter, warm box; aloes to dam, or oil to colt, antiseptics inter-
nally, demulcents, stimulants, derivatives, opium, water, alkalies.

This has been observed in cattle (Kitt), and in horses (Levrier,
Bernadin, Lhomme) but above all in mules (Villa-Roya, Carrére,
Levriere, Bernadin, Lhomme, Hartmann, Dieckerhoff).

The affection is a bacteridian disease, in which there is a great
destruction of red globules, and liberation of hematin, with
hematuria and yellow coloration of the tissues.

Causes, Carrére attributes much to a supposed congenital weak-
ness induced by the unnatural generation of ass with mare.
Cadec noticed that the offspring of certain mares and horses re-
mained sound, while the progeny of the same animals, and asses
suffered largely from icterus. Levriere found it especially in the
mules born of mares having a lymphatic temperament or suffering
from canker, grease or chronic lymphangiectasis. Bernadin and
Lhomme attribute much to bad hygiene, and especially to poor or
spoiled fodders. Lhomme, Lafosse and Trasbot find accessory
causes in cold and wet weather. Retention of the meconium is
another cause. Dieckerhoff, Hartmann, Cadzec and Bournay
trace the disease to bacterial infection as the essential cause.
Many cases originate in septic infection and inflammation of the
navel and umbilical veins. Others commence with mucous gastro-
enteritis, attended by diarrhoea or dysentery.. In other cases the

483

484 Veterinary Medicine.

germs appear to have reached the liver through the circulation as
the animal is already affected at birth.

Symptoms. When not congenital, symptoms are usually seen
in the first few days of life, usually before the fifth day.

In congenital cases the new born animal is unable to stand at
all or for longer than a very short time, it lies listlessly and makes
no attempt to suck even when held up to the teat. There is ac-
celeration of pulse and respiration, the heart beats are tnmultuous,
the mouth is dry, the mucosz of a straw yellow, the bowels are
costive, and the urine, whether discharged in life, or found in the
bladder after death, is bloody.

When attacked later, the animal becomes dull, weak, and
stupid, refuses the teat, and has the bowels relaxed. The
mucosz become pale yellow, the breathing accelerated, the heart
beats violent, and the pulse rapid, smalland weak. ‘The urine is
passed slowly and with effort and has a red hue more or less deep
according to the severity of the attack. Colics are not uncom-
mon, causing uneasy shifting of the limbs and tail, cries, frequent
lying down and rising, and partial or general perspiration. Com-
plications on the part of the navel and umbilical veins are to be
looked for, in open sores, swellings, abscess, phlebitis, and in
arthritis and secondary abscesses in different organs. Death may
occur quietly, as from exhaustion, while in other cases it is
preceded by convulsions.

In case of recovery, there is an improvement of the general
symptoms, the heart and respirations become moderate, appetite
is restored, the little animal sucking the teat, there are abundant,
yellow, semi-solid defecations, the strength increases day by day
and convalescence may be fully established by the twelfth to the
fifteenth day.

Diagnosis. This is mainly based on the extreme weakness
and prostration, the violent heart action, the jaundiced hue
of the mucous membranes, and the bloody urine. Confirmation
may be sought in the presence of streptococci in the fresh urine,
kidneys, liver and blood, and in the artificial cultures made from
them. The presence of omphalitis is further significant.

Prognosis. Bernardin says that if hematuria is present nine
out of ten cases are fatal, while in the absence of this feature
nine-tenths recover,

Jaundice of the New-Boru. 485

Lesions. The jaundiced appearance of the conjunctiva and
other tissues is constant. The heart is pale, soft and flaccid,
with petechial patches of a deep red extending into the muscular
substance ; the lungs are congested with similar patches of blood-
staining ; the blood in the heart and larger vessels is dark, and
fluid or only loosely clotted. The liver is congested to twice or
thrice its normal size (1olbs. in place of 3 or 4 lbs.); the spleen
is enlarged, softened, and shows spots of brownish yellow. ‘The
small intestine contains a yellowish or dark red meconium, and
it may contain effusions of dark blood, while its mucosa is in-
flamed, thickened, easily lacerated, and pigmented, or marked
by petechiz. The large intestines and especially the rectum are
packed with hard dry balls.

The kidneys are enlarged, often to double their volume, and
deeply congested, with infarcts, and patches of necrosis, of a
pale brownish yellow hue. The urine in the bladder is deeply
stained with blood coloring matter.

Treatment. For congenital cases it is manifest that treatment
must be preventive and applied to the dam, before parturition.
An open air life, moderate exercise, sound, easily digestible and
nourishing food; grooming; in the stable, cleanliness, dryness
and good ventilation ; good water, are essential.

For the offspring, antiseptics (tannin, mercuric chloride
lotion, tincture of iodine, copperas, calomel, iodoform), applied
to the navel, and protection against cold winds and rains, and
damp lairs. For mules and other young animals born in severe,
winter weather a dry, warm, foaling box is desirable, and the
little animal should be rubbed dry and covered with a warm
woolen blanket. When the temperature approaches zero or the
barn is cold, the smaller animals, as soon as they are dropped,
should be placed under a box with a jar of hot water wrapped in
woolen coverings, or with hot bricks similarly wrapped, and
should only be let out for food when they are completely dried,
or when the weather is moderated.

Therapeutic treatment may be commenced by a dose of aloes
given to the dam, or of olive or castor oil or manna given to the
offspring. As a substitute sulphate of soda may be used.
Antiseptics like salicylate of soda, salol, or the sulphites may be
added. To act asa demulcent on the alimentary and urinary

486 Veterinary Medicine.

tracts, well boiled flaxseed tea is usually recommended. Weak-
ness may be met by warm strong coffee, salicin, quinia, or other
bitters, and more stimulating agents like eamphor, angelica,
assafoetida, or even oil of turpentine may be added. Diarrhcea
may be checked by linseed tea, mustard plasters, or in obstinate
cases, by opium. Elimination should be sought by administering
abundance of pure water or watery demulcents, and even by the
use of alkalies like bicarbonates of soda of potash. A moderately
free action of the bowels must be constantly maintained.

Antiseptic treatment of the navel and umbilical veins must not
be overlooked.

LUPINOSIS, ACUTE TOXAIMIC ICTERUS, ACUTE
YELLOW ATROPHY OF THE LIVER.

Attacks sheep, goat, ox, horse, stag: and, experimentally, dog. Causes:
consumption of lupins, at a given stage of ripeness, from a given part of a
field, or from centre of a stack. Lupinotoxine, conicine, methyl conicine,
lupinine. Cryptogamic or bacterial poison. Weak subjects, sheep and
even ewes and lambs, suffer most. Symptoms: Acute form: anorexia,
fever, excited pulse and breathing, stupor, or hyperzesthesia, vertigo, swell-
ings on head. Poisonous lupins are first rejected. Bloody nasal froth. In
two or three days icterus. Urine may be bloody. Feces at first hard,
coated, bloody, later dark brown and often liquid. Emaciation. Death in
one to five days. Chronic form, gastro-enteritis, emaciation, anamia. Nasal
catarrh, Facial swellings and sores. Lesions: hepatitis, nephritis, muco-
enteritis, enlarged spleen, icterus, blood extravasations ; hepatic tissue, in-
filtrated, cloudy, granular, fatty, later cirrhosis. Kidneys contain casts:
Spleen tumid, blood gorged. Prognosis: grave; acute cases die, chronic
may recover. Prevention : feed no lupins, avoid dangerous fields, wash off
poison from lupins with a soda solution. Ensilage with acid producing
fodder in alternate layers. Treatment: avoid alkalies, give acids, purga-
tive, castor oil; water. In horse, causes anorexia, anzesthesia, dullness, stu-
por, colic, constipation, urinary irritation, fever, slight jaundice, vertigo,
orange nasal discharge, sores on tongue and face, and lower part of limbs.
Diagnosis. Prognosis hopeful. Treatmentasin sheep. Icterus from other
fodders.

This affection has been noticed especially in sheep, but also in
the goat, horse, ox and stag as the result of eating lupins. ‘The
dog has contracted the disease under experiment. It has been

Lupinosis, Acute Toxemic Icterus. 487

studied especially in Northern Germany where the lupin is largely
cultivated as a fodder crop. ‘The yellow lupin (Lupinus Luteus)
is mainly to blame for the disease, but the Lupinus Albus and
Augustifolius are also spoken of as factors.

The disease caused by altered seeds and straw of the lupin is
mainly characterized by jaundice, fatty degeneration of the
hepatic cells and hypertrophy of the connective tissue of the
liver causing acute atrophy of the organ.

Causes. ‘The essential cause of the disease appears to be the
consumption of lupins. But all lupins are not equally poisonons.
Those taken from one portion of a field are harmless, while those
from another are toxic. In stacks builtin the field and weathered
the upper and outer portions are often harmless while the interior
remains poisonous. It would seem as if the poison were washed
off by the rain, or deprived of its potency by the action of the
air. It successfully resists dry heat, for three hours at boiling
temperature, but is rendered harmless by steam acting under the
pressure of two atmospheres for the same length of time. A
poisonous principle (lupino-toxine) has been obtained from the
toxic lupins but it is not quite certain that this is the sole toxic
ingredient. This agent is extracted from the powdered seeds by
macerating them for two hours in a soda solution (in which it is
very soluble) at 102° F., and purified by treating the solution suc-
cessively with acetic acid, lead acetate, hyposulphuric acid and
alcohol. ‘This agent produces the symptoms of lupinosis in the
acute or chronic form according to the doses of the agent ad-
ministered. Eichhorn and Baumstarch have isolated from lupins
an alkaloid analogous to comicine : Stener found an alkaloid which
he believed to be methylconicine : Baumert attributed the activity
to another alkaloid /upinine. It is not definitely known whether
the poisoning is usually effected by a simple poison or by a com-
binatiou of several. Nor is it certain whether the toxic matter
is a normal product of lupins grown on particular soils and under
given conditions and harvested at a particular stage of growth, or
if it is the product of a cryptogamic or bacterial growth. Some
leguminous seeds are poisonous at a given stage of ripening but
there is as yet no proof of lupinosis being confined to any particu-
lar stage. The common moulds often grow on lupins without
rendering them poisonous, but it does not follow that some less

488 Veterinary Medicine.

familiar cryptogam is equally harmless under all circumstances.
The soda extract of the poisonous lupins was deadly though it
contained no cryptogams, but it is not shown that it was free from
soluble chemical products (toxins) of the cryptogams. The same
remark applies with equal force to the bacteria which have been
invoked as the cause of the poisons. Though not themselves
present in a given deadly extract of the lupins this does not ex-
clude from such extract the toxic products of bacterial growth.
It is claimed that Arnold has produced lupinosis with lupins that
had been first robbed of their alkaloids. But the absence of alka-
loids does not prove the absence of nonbasic (neutral) poisons,
of vegetable, cryptogamic or bacterial origin.

That certain lupins contain a deadly poison is certified, but the
precise source of the poison remains to be demonstrated.

In estimating causes we must take into account the lessened
power of resistance of animals lacking in constitutional strength
and vigor. Thus sheep suffer far more severely than horses,
oxen, or even goats. Ewes and lambs perish in greater numbers
than rams, hoggets and wethers.

Symptoms in sheep. In the acute form the disease appears
suddenly, as manifested by anorexia, hyperthermia, rapid and
oppressed breathing, accelerated pulse, stupor, vertigo, and not
unfrequently swellings of lips, ears or face. Inappetence may be
first manifested by the rejection of poisonous lupins, while sound
ones and especially other food are still eaten, but soon all are re-
fused alike. Temperature, which may reach 104° to 106° F. ou
the next day after feeding on the poison, may rise and fall day
by day, and finally fall materially as a herald of death. Respiration
rises to 100 per minute and becomes labored or panting, with, in
some cases, a bloody froth in the nostrils. The pulse rising to
130 and upwards keeps pace with the hyperthermia and general
excitement. Vertigo is shown in the staggering gait when
moved, and by a tendency to steady by resting the head on the
trough, rack, fence or ground. The recumbent position is often
preferred, the head being extended on the ground, and the animal
remaining oblivious to all efforts to raise him—even to blows.
Sometimes there is stupor, and at others hypereesthesia, or indi-
cations of fear, There is grinding of the teeth, and sometimes
trismus (Schiitz, Kotelman).

Lupinosis, Acute Toxemic Icterus. 489

In two or three days jaundice is shown, more especially in the
conjunctiva and the urine. ‘The latter, however, is not unfre-
quently colored with blood, and contains albumen, bile acids,
and renal epithelium and casts. It is passed frequently in small
quantity, so that its condition is easily ascertained.

The feeces are at first scanty and hard with a coating of yel-
lowish mucus, and it may be streaks of blood. Later they are
uniformly stained of a dark brown, and diarrhcea may alternate
with the constipation. Emaciation advances with rapid strides.

Death may occur as early as one day after the attack but is
usually deferred to the fourth or fifth.

A steady amelioration of all the symptoms may be welcomed
as a precursor of recovery.

In the chronic form jaundice may be entirely absent, and a
subacute gastro-enteritis may be attended by emaciation and
anemia. Roloff has frequently found the implication of the
other mucosz especially those of the nose and eyes which become
catarrhal, and Zurn notes the implication of the skin of the face
with exudations, swellings and the formation of sores and scabs
on the eyelids, lips, ears, etc.

Lesions in Sheep. The prominent lesions are parenchymatous
inflammation of the liver and kidneys, muco-enteritis, enlarge-
ment of the spleen, and icterus, with more or less blood extrava-
sation.

The liver is the seat of acute hepatitis. It is usually swollen
and abnormally friable, with a yellowish color often as deep as
citron. The parts recently attacked exhibit albuminoid infiltra-
tion and cloudy swelling, the older lesions show fatty or granular
degeneration. These changes exist especially in the hepatic
cells, and fatty metamorphosis bears a direct relation to the
obesity of the sheep. If the patient has survived the first few
days, the liquefied products are absorbed, there is a relative in-
crease of the interstitial connective tissue and the volume of the
organ is materially decreased (acute yellow atrophy of the liver,
Schiitz). In chronic cases, the hypertrophy of the interstitial
connective tissue is the most prominent feature, constituting a
distinct cirrhoses (fibroid induration) and the atrophy becomes
very pronounced while the surface is very irregular and uneven.
The gall bladder is distended, and its mucosa congested.

490 Veterinary Medicine.

Jaundice, which may be little marked apart from the conjunc-
tiva, is usually shown in the subcutaneous connective tissue, the
skin of the abdomen, the omentum and mesentery, but according
to Cadeac is never shown in cartilage, bone nor tendon.

The kidneys show parenchymatous inflammation, congestion,
swelling which gives a hardness of touch through the resisting
fibrous envelope, and often a pervading shade of yellow. The
epithelium of the uriniferous tubes is cloudy, turbid and granu-
lar and the tubes themselves contain cylindroid casts. The
bladder is catarrhal and has been too irritable to contain urine.

The spleen is tumid, soft, reddish gray, and on section shows
excess of blood, pulp, and here and there marbling by fibrinous
exudate.

The heart is pale, granular, friable, with a tinge of yellow and
with a slight citron colored effusion in the pericardium. ‘The
cardiac blood is dark and thick but coagulates and brightens in
color on exposure to the air.

There is usually some cedema of the lung, larnyx and pia
mater.

There are catarrhal lesions of the abomasum and entire intes-
tinal canal with granular degeneration of the epithelium and
spots and patches of aborescent congestion and hemorrhage.
The icteric tint is usually distinct.

Prognosis is always grave. Acute cases are almost always
fatal. Chronic cases due to eating lupins in which the poison is
relatively weak, or a very restricted amount of the more poisonous
lupins, may recover. This mortality is very serious in the affected
districts 5.8 per cent. of all the sheep of some districts in Pommer-
ania perishing yearly from this affection and entailing the loss of
almost the same number of lambs (Von Below-Seleske).

Prevention. Radical prevention can be secured by the exclu-
sion of lupins from the ration. Where this is undesirable the
fields that produce poisonous lupins can be ascertained and devoted
to the production of other crops: When a crop of lupins has
already been produced on a dangerous field the poison may be
extracted from the fodder or subjected to the action of an anti-
dote. Fortunately the poison is concentrated on the surface of
the lupin and is easily washed off.

Damman advises to leave the cut forage exposed to the rain so

Lupinosis, Acute Toxemitc Icterus. 491

that the poison may be washed off. A more prompt and effective
plan would be to put the fodder under a stream of water from a
hose, and it could be fed while still fresh and unaltered. Fried-
berger and Frohner directs that the forage be steeped for forty-
eight hours in a soda solution (1:100) to dissolve off the offen-
sive matter, after which it may be washed and safely fed.

Glasser would put the lupins in a silo, in alternate layers with
some material which rapidly undergoes acid fermentation
(brewers grains, maize, pulped roots). The acid renders the
poison insoluble and is directly antidotal. To develope this acid
it is important to put the materials into the silo before they have
become too far matured.

The destruction of the poison by steaming the fodder under a
pressure of two atmospheres, as recommended by Kuhn and Ro-
loff requires a too elaborate apparatus for ordinary use.

Therapeutic treatment. ‘The first desideratum is to render in-
soluble any poison which has already entered the alimentary
canal. Alkalies, as solvents and distributers of the poison must
be carefully avoided and acids (acetic, nitric, hydrochloric, sul-
phuric) freely used. These may be mixed with the drinking
water or given from a bottle. If appetite is still retained, they
may be mixed with the food, or acid aliment (sour ensilage, old
grains, or fermented swill) may be supplied.

The next resort isa purgative to eliminate the poison from
the alimentary canal. But the cathartics usually given to the
ruminants are dangerous. Sulphate of soda undergoing decom-
position, furnishes an alkaline solvent for the poison. Castor oi
is therefore to be preferred.

An abundance of water will favor the action of both bowels
and kidneys and hasten the elimination of the poison which may
have been already absorbed into the system.

European writers recommend the use of the flesh as human
food, unless the animal has reached the last stage of the disease.

Symptoms of Lupinosis in the Horse. There is always the
history of the presence of lupins in the oats, or of lupin straw as
a food or litter. ‘Though less fatal than in sheep the disease sets
in with great severity, the symptoms referring especially to
gastro-enteritis, and disorders of innervation. There is com-
plete anorexia, impaired sensibility, dullness and stupor, the

492 Veterinary Medicine.

head resting on the manger or drooping with the nose near the
ground. ‘There is grinding of the teeth, colicy symptoms, and
constipation, the faeces being passed as a few small, hard balls cov-
ered with mucus and foetid. Urine is passed frequently in smal!
amount and albuminous. ‘There is more or less hyperthermia
(rising at times to 102° to 103°), the respiration is hurried (36 to
40 per minute) and pulse is rapid (60 per minute). Jaundice is
usually present but less prominent than in sheep. When moved
the animal sways unsteadily or staggers. Butzert notices, in
addition to the above, a thick orange colored discharge from
the nose, and the formation of sores and scabs (mummification)
of the lingual mucous membrane, of the lips, of the skin, of the
face, and of the pastern, and swelling of the lower parts of the
limbs.

Diagnosis. ‘The development of disease with the above symp-
toms, in the inmates of a single stable, or in horses having a
common ration, in which the lupines are found, will make diag-
nosis easy and reasonably certain.

Prognosis is hopeful or confident. The disease is not fatal in
the horse.

Treatment should follow the same lines as in sheep.

Allied or identical diseases. Friedberger and Fréhner quote a
number of outbreaks of hepatic inflammation or disorder with
icterus in the absence of lupins, but on rations that were other-
wise faulty. Haubner describesa ‘‘ malignant icterus’’ in sheep
fed on malted potatoes ; Sander records a ‘‘ hepatic typhus’’ in
the horse when fed on inundated pastures ; Reinemann and Jan-
sen speak of a similar affection in animals fed on the straw of
peas, beans, and vetches. (See cirrhosis from Senecio).

CONGESTION OF THE LIVER.

Physiologically after a meal is hypereemic, and may increase one-third.
Rich feed and temporary idleness may cause morbid congestion. Other
Causes are: ptomaines and toxins in spoiled food, hepatic irritants, damp,
hot, tropical climates, warm, damp, buildings, overfeeding, dilated right
heart, insufficiency of tricuspid valve, pulmonary emphysema or congestion.
Absence of valve between the right heart and hepatic veins, slow hepatic
circulation, dilatability of hepatic vascular system, compression of lung by
false membranes, cedema, hepatization, infarction, hydrothorax. In horse:
special causes: spoiled fodders, carminatives, volatile oils, work in hot sun,
vaso-dilatation in heat and atony, falls, kicks, goring, blows; passive forms
from obstacles to the circulation. Lesions: Hepatic enlargement to 20 or
30 pounds, and dark red color, darker spots of extravasation, hepatic vein
congestion in centre, and portal vein congestion in periphery of acinus, soft-
ening, granular, fatty, nuclei disappear from hepatic cells, nutmeg liver,
cirrhosis, Symptoms: general febrile symptoms, great prostration, drowsi-
ness, slight colics, arched loins, trembling or jerking, lies on right side,
percussion on last ribs painful, slight icterus and increased urination and
urea. In passive cases, less icterus and kidney trouble ; tends to intestinal
catarrh and ascites. Prevention: good hygiene, moderate laxative ration,
cool air, exercise. Treatment: green or laxative foods, salines, derivatives,
water at will, always before morning feed. In dog: overfeeding, indolence :
pulmonary and circulatory troubles. Lesions: nutmeg liver, degeneration,
cirrhosis. Symptoms: pampered idleness, obesity, pulmonary or cardiac
disease, intestinal catarrh, piles, ascites, slight icterus, percussion tenderness
of right hypochondrium, lying on right side, increase of percussion flatness.
Treatment: saline purgatives or laxatives, antiseptics, restricted laxative
diet, open air exercise, derivatives, etc.

Physiologically the liver undergoes hyperzemia in connection
with an abundant meal and active digestion. Within the limits
of health it may increase one-third in bulk and weight. When
this hyperzemia attends on temporary idleness and rich feeding it
may overstep the limits of health and become pathological.
Other causes of pathological congestion are, tainted food rich in
ptomaines and toxins, food injured by cryptogams, and food that
contains principles irritating to the liver. It is especially common
in swampy regions in tropical or semi-tropical latitudes, and where
the warm air is surcharged with moisture. Hot, close, damp
stables, with over-feeding and lack of exercise in the pampered
horse or dog, or under the forcing system of feeding for exhibi-

493

494 Veterinary Medicine.

tion, or forthe butcher, actsin a similar manner. Dilatation of
the right heart, or imperfection of the tricuspid valve is a direct
cause of mechanical congestion and emphysema, congestion or
other obstruction in the lungs has a similar effect. In short the
absence of valves between the right heart and the hepatic veins
determines a passive congestion of the liver whenever there is
any serious hindrance to the passage of blood through the right
heart and lungs. The tardy circulation through the liver (5 mm.
per second) also predisposes to congestion. The great develop-
ment of the circulatory system in the liver, and its dilatability
predisposes it to such congestions in a pre-eminent degree. For
the same reason the liver suffers in the horse that is attacked with
pulmonary congestion, whether as the result of over-work or of
heat congestion. It will also suffer from compression of the
lungs by false membranes or hydrothorax, or obstruction, by
cedema, hepatization or infarction. The toxic matters produced
in infectious diseases, and especially those affecting the intestinal
canal and its connections, are arrested in the liver and contribute
to hyperzemia.

CONGESTION OF THE LIVER IN THE HORSE.

Causes. Beside the general causes above mentioned, may be
specially named, musty, decomposed, and irritant fodders: those
which like green legumes, are easily fermented ; and those which
contain stimulating volatile oils or carminative principles. ‘They
are also especially exposed to such causes as severe and prolonged
work under a hot sun, the nervous atony which causes vaso-dila-
tation in a hot climate, and such traumatisms as come from falls,
kicks, goring, and blows by shafts, poles and clubs. ‘These
especially induce active congestion. The passive forms come
mainly from obstruction in the lungs, or heart (dilatation, right
valvular insufficiency, pericarditis, hydropericardium, myo-
carditis, fatty degeneration, endocarditis), or in the posterior
vena cava.

Lesions. ‘The congested liver is enlarged and deeply colored
with blood. The weight of twenty to thirty pounds is often at-

Congestion of the Liver in the Horse. 495

tained. While the color is of deep red throughout, there are
spots of a still darker hue indicating the seat of subcapsular or
deeper seated hemorrhages. The color varies according as the
congestion is passive or active. In the former the coloration is
deeper in the centre of the acinus (nutmeg liver) indicating con-
gestion of the hepatic veins, while in the latter the periphery of
the acinus may be most deeply stained implying congestion of the
portal vein. The consistency of the organ is diminished, and the
more acute the attack the greater the friability. In such cases there
is a parboiled appearance indicating granularand commencing
fatty degeneration. Under the microscope the relative distension of
the intralobular, and interlobular veins and the hepatic capillaries
becomes more distinctly marked and the presence of pigment and
fatty granules and the lack of protoplasm and nuclei in the hepatic
cells indicate their progressive changes. When the peripheral
cells are pale from fatty granules the contrast between the light
margin and dark centre of the acinus, makes the mottled or nut-
meg aspect of the liver much more pronounced.

In old standing cases of passive congestion the liver may be the
seat of fibroid degeneration, extending from the capsule inward
in bands or trabecule, and giving to the organ a firm resistant
character (sclerosis, cirrhosis).

Symptoms. The symptoms are general and suggestive rather
than pathognomonic. ‘There are dullness, prostration, unsteady
walk, pendent head, with occasional jerking, semiclosed eyes,
redness of the conjunctiva, slight colicy pains, arching of the
loins, muscular tremblings and decubitus on the left side rather
than the right. The more definite symptoms are tenderness on
percussion with the closed fist over the last ribs (the liver)
especially on the right side, increase of the area of hepatic per-
cussion dullness (which may be rendered valueless by a loaded
colon), the presence of a slight icterus in the conjunctiva and
urine, and an increase of the urine secreted and an excess of the
contained urea.

In passive cases however the obstruction to the escape of blood
from the liver prevents.the development of icteric symptoms, of
urzemia and of polyuria. In all such cases however there follows
a general congestion of the portal system and if it persists for
any length of time gastro-intestinal congestion and catarrh and
even ascites may develop.

496 Veterinary Medicine.

In all cases alike the history of the attack will help towards a
satisfactory diagnosis.

Prevention. A rational hygiene embracing daily work or
exercise, moderate laxative diet, green food in its season, and
pure cool air are important precautions.

Treatment. A moderate supply of green or laxative food, the
withholding for the time of grain, and especially of maize, wheat
or buckwheat, saline laxatives daily, and a stimulating embroca-
tion or blister to the tender hypochondrium are the most import-
ant measures. Exercise in a box stall, or still better in a yard or
paddock in the intervals between more systematic work forms an
important adjunct to medicine. Asa laxative sulphate of soda
is to be preferred at first in a full cathartic dose and later in a
daily amount sufficient to relax the bowels. Given in a bucket
of water every morning before the first meal a very small dose
will be effective.

CONGESTION OF THE LIVER IN THE DOG.

Active congestion is very rare excepting in over-fed and in-
dolent family pets. Passive congestion induced by diseases of
the lungs and heart is however far from uncommon.

Lesions. ‘True to their origin these usually appear as the
spotted nutmeg liver with the deep congestion in the centre of
the acini. For the same reason the fibroid degenerations shown
in chronic cases, show the firm fibroid neoplasm chiefly around
the hepatic veins. Granular, fatty and pigmentary degeneration
of the cells are found as in the solipeds.

Symptoms. These are as obscure as in the horse. ‘Mhere is
always a history of a sluggish, gormandizing life, and in the
early stages, a manifestation of embonpoint which suggests a
torpid liver. Further suggestions may also be obtained from
coexisting diseases of the lungs, or heart, from gastro-intestinal
catarrh, from piles, or ascites. Then thereis at times a slight
icterus of the conjunctiva and urine. Finally tenderness on per-
cussion on the right hypochondrium, decubitus on the left side,
and an increased area of dullness on percussion may afford useful
hints for diagnosis.

Flepatic Hemorrhage or Rupture. 497

Treatment. In the rare cases due to infection from the intes-
tine, an active saline purgative, followed by antiseptics (salol,
naphthalin, naphthol, etc.,) daily will be of value. It is also
desirable to keep up the action of the bowels by morning doses of
salines. In cases consequent on chest disease attention must be
given to such primary trouble. In all cases a restricted laxative
diet, and graduated but increasing exercise in the open air are
demanded.

HEPATIC HA MORRHAGE OR RUPTURE.

Causes : Mechanical injuries, falls, blows, kicks, degenerations, amyloid,
fatty, granular, congestion, neoplasms, glanders, tuberculous, myomatous,
microbian infection. In the horse, disease of liver, heart, lungs, hepatic
artery, portal vein degenerations following over-feeding, idleness, foreign
bodies, arsenic, phosphorus, parasites, violent movements in colic, running,
draught, leaping. In the dog, pampering and traumatism. In cattle forced
feeding, emaciation, microbian infection. In birds, tubercle, taeniasis, mi-
crobian infection. Lesions: extravasation, intracapsular, or through capsule
into the peritoneal cavity. The extravasation bulges of a deep black, cover-
ing a dark softened, pulpy, hepatic tissue, with light colored fatty tissue
around. Clots may be stratified from successive bleedings. Liver usually
enlarged. Symptomis: onset sudden, or preceded by stiffness, soreness and
other signs of hepatic trouble. Extensive rupture, entails weakness, un-
steady gait, perspiration, pallor of mucosz, small weak rapid pulse, palpita-
tions, dilated pupils, rolling eyes, amaurosis, tremors, convulsion in case of
survival, coldness, cedemas. Death in five hours to five days. Risk of
relapse in recovering cases. Treatment: rather hopeless, rest, laxative,
ergot, ferric chloride, tannic acid, witch hazel, cold water, snow or ice to
right side. In meat-producing animals fatten.

Causes. Hemorrhage and rupture of the liver are closely cor-
related to each other, the accumulation of extravasated blood in
the parenchyma in the one case leading to over distension of the
capsule, and the laceration of this capsule and of the adjacent
substance of the liver occurring in the other as a mere extension
of the first. They usually occur as the direct result of mechani-
cal injury (falls, blows, kicks) acting on a liver already softened
and friable through disease. ‘These predisposing degenerations
may be amyloid (Caparini, Johne, Rabe), fatty (Julien, Gowing,
Adam, Siedamgrotzky), granular softening, hepatitis or conges-

32

498 Veterinary Medicine.

tion (Zundel), glander neoplasms (Mathis), tubercles, angiomata
(Trasbot), microbian infection (Stubbe), tumors (Briickmiiller).

In the horse predisposing conditions may be found in diseases
of the liver, heart or lungs, in embolism of the hepatic artery
(Wright), in obstruction of the portal vein (Pierre), in infarction
of the liver, in degeneration with softening, in sarcomatous,
melanotic, glanderous or cancerous deposits in its substance, in
degenerations consequent on over feeding, idleness, congestions,
on the penetration of husks of grains into the liver substance, on
arsenical or phosphorus poisoning. The presence of flukes,
echinococci and other parasites may also cause congestion and
softening. To the immediate or traumatic causes above named
may be added the violent movements attendant on a severe attack
of colic, and violent exertions in running, draught, leaping, etc.
(Friend).

In the dog we must recognize all the pampering conditions
which predispose to congestion and degeneration, together with
the more direct operation of kicks, blows, falls, fights, over exer-
tion, etc.

In cattle a forcing regimen is especially predisposing, and yet
the loss of vigor resulting from a diametrically opposite treatment,
must be accepted as an occasional cause. Stubbe found in emaci-
ated cows miliary hemorrhagic infarcts of a dark red color which
gradually extended to an inch or more in diameter. These he
traced to microbian infection coming by way of the chronic intes-
tinal lesions which are common in old cows. ‘The final result of
such infarctions was loss of hepatic substance and the formation
of cicatricial tissue with a marked depression on the surface of the
organ.

In birds fatal hepatic hemorrhages occur in connection with

‘local tubercle (Cadiot), teeniasis of the liver, or microbian infec-
tion.

Lesions. 'The hemorrhage may take place into the substance
of the liver only, or the capsule may be lacerated so that the
blood escapes into the peritoneal cavity in considerable quantity.

In the Horse it usually occurs in the right or middle lobe, rarely
in the left. There may be one or more hemorrhagic effusions
varying in size from a cherry to a duck’s egg, or evenan infants’
head (Lorge.). This projects from the surface of the organ and

ffepatic Hemorrhage or Rupture. 499

its deep black contrasts strongly with the white of the adjacent
capsule. When laid open the hepatic tissue is seen to be softened
and pulpy, and its dark color forms a striking contrast with any
surrounding fatty liver. Any form of degeneration may be
revealed on microscopic or chemical examination. Not unfre-
quently small clots of blood form under the capsule raising it in
the form of little sacs. Such clots are usually stratified indi-
cating a succession of small hemorrhages.

When the capsule is torn, the lesion may extend from one sur-
face of the organ to the other, and the edges, smooth, uneven or
fringed, are united together by a blood clot.

In case of hemorrhagic infarcts the lesion usually has a dis-
tinctly conical outline corresponding to the vascular distribution.
These are especially characteristic of cases supervening on heart
disease.

The volume of the liver is usually increased and the weight
may reach 30 lbs, (Schmeltz), 34 lbs., (Lorge), or even 66 lbs.,
(Trasbot).

In other domestic animals analogous lesions are found modified
largely according to the size of the subject.

Symptoms. ‘These may develop instantaneously without any
marked premonitory indication. In other cases tenderness on
percussion over the liver, stiffness or groaning under sudden
movements or turning, arching of the back, hanging of the head,
slowness in rising, costiveness, slight transient colics, and even
icterus may have been detected on close observation. ‘The symp-
toms of actual rupture are essentially those of internal hemor-
rhage. The animal becomes weak, or unsteady upon its limbs,
perspires, arches the back, and shows a marked pallor of the
visible mucosze. ‘The pulse is small, thready, weak and acceler-
ated, and the heart beats are violent or palpitating. The percussion
dullness over the liver is extended (Weber), the loins become
insensible to pinching, and there may be some distension of the
abdomen. Dilatation of the pupils, retraction or rolling of the
eyes, amaurosis, tremors of the muscles of the neck, lying down,
or falling, and general convulsions may precede death. This
may occur in a few hours or it may be delayed if the lesions are
restricted. In case of survival, coldness and cedema of the ex-
tremities and sheath have been observed. ‘The lesser hemor-

500 Veterinary Medicine.

rhages may terminate in recovery if there is no attendant incur-
able disease. In anthrax, glanders, cancer, tuberculosis, septi-
czemia, etc., a favorable issue is not to be looked for.

Duration. Termination. In severe cases a fatal issue may be
expected in from five hours to five days. In the milder cases
which make a temporary recovery there is great danger of a
second hemorrhage from the new vessels in the tissue undergoing
organization or from the adjacent degenerate liver tissue. The
course of the affection may be altered by such complications as
arthritis (Dieckerhoff), pneumonia, pulmonary thrombosis
(Leblanc), enteritis or peritonitis (Cadeac).

Treatment is usually of no avail. Rest, and the administra-
tion of laxatives and hzemostatics, have been especially recom-
mended. Of the latter, ergot by the mouth or ergotin subcutem,
tends to contraction of the bloodvessels and to check the flow.
Ferric chloride is also used, though apt to interfere with hepatic
function. Tannic acid, hamamelis, and other astringents may
be used instead. Cold water, snow or ice applied to the right
hypochondrium may act as a check to the hemorrhage. Unless
in purely traumatic cases in an otherwise healthy liver, a recovery
is at best temporary, and the already degenerate liver is liable to
relapse at any moment. In horses and dogs, therefore, recovery
is by no means an unmixed good. Meat producing animals that
recover should be prepared for the butcher.

HEPATITIS.

Forms of hepatitis: Parenchymatous hepatitis. Definition . Degenera-
tion of hepatic cells, Relation to enteritis and nephritis. In horse—causes :
as in congestion, pampering, spoiled fodder, malt, inundated meadows, chill,
over feeding, bot, moist climate. haemoglobinzemia, infection. In cattle—
causes : forcing ration, hot weather, overwork, infection. In dog—causes :
infection from alimentary canal. Lesions: Enlarged, softened liver, round
edges, a week later yellow atrophy, granular on section, bloodless. Acini
with indefinite margins, cells granular, nuclei lost. In dog centres of soft-
ening. Symptoms: in horse—attack sudden, rigor, fever, dullness, pros-
tration, yellowish red mucosz, unsteady gait, slight colic, anorexia, urine

Parenchymatous Hepatitis. 501

decreased, glairy, brownish red, groaning in defecation, excited circulation
and breathing, increased icterus by third day, foetid, colorless, diarrhoea.
Diagnosis: Coincidence of fever, prostration, icterus, painful defecation,
foetid diarrhcea, light color of stools, tenderness and flatness on percussing
hepatic area. From influenza by absence of watering eyes and contagion.
Prognosis in horse: Very grave unless urine is free. Treatment in horse:
Portal depletion, calomel, ipecacuan, salines, diuretics, fomentation of loins,
antiseptics, derivatives, mineral acids, bitters. Careful laxative diet in con-
valescence. Symptoms in cattle: Slower onset, anorexia, dullness, depres-
sion, drivelling saliva, grinding teeth, icterus, constipation, later foetid
diarrhoea, pale colored stools, recumbency, groans on rising, arching back,
tender right hypochondrium, fever. Prognosis grave. Death in five to six
days. Treatment asin horse: Only saline laxatives. Symptoms in dog:
Muscular tremors, staring coat, hyperthermia, icterus, foetid breath, ventral
decubitus, extreme prostration, anorexia, tender right hypochondrium, di-
minished urine. Death in two or three days. Treatment in dog: Calomel
and jalap, diuretics, laxatives, derivatives, germicides, in convalescence,
mineral acids, bitters, careful diet.

The different forms of inflammation of the liver are distin-
guished according as they affect, especially the hepatic cells and
tissue of the acini (parenchymatous), as they result in suppura-
tion (suppurative, catarrhal, abscess), as they cause necrobiosis
in nodular masses (infectious or necrotic), as they lead to fibroid
thickening under the peritoneum and proper capsule (perihepa-
titis) ; or as they cause general fibroid induration of the organ
by increase of its connective tissue (cirrhosis).

PARENCHYMATOUS HEPATITIS, ACUTE YELLOW
ATROPHY OF THE LIVER.

‘The characteristic morbid lesion in this disease is the degenera-
tion of the liver cells, loss of their protoplasm and nuclei and of
their normal functions. It may be circumscribed to limited
areas, or may affect the liver, generally. As the hepatic functions,
are so intimately related to those of the bowels and kidney, the
affection is usually accompanied by inflammations of these organs
aswell. |

Causes in horses. ‘The same general causes which produce

502 Veterinary Medicine.

congestion, may also determine the further morbid stage of
inflammation. Cadeac mentions a case which developed in a horse
kept alone and idle in the stable. He makes no mention of con-
dition, food, cleanliness nor ventilation. Hanbner and Franzen-
have traced it to a diet of malt or of hay harvested from inundated
meadows. Zundel records a case following exposure to extreme
cold. More commonly the disease is secondary to the overtaxing
of the liver, by heavy feeding in warm moist climates, or in
hemoglobinzemia, or to the arrest of the microroganisms of the
food, or of infectious diseases. __

Causes in cattle. These suffer rarely, but from essentially the
same conditions. It has followed aphthous fever (Eletti), and
arisen under a forcing ration, in hot weather (Callot, Cruzel), or
under overwork (Cruzel).

Causes in dogs. Most cases result from infection by way of
the stomach and intestines, or by the transfer to the liver of the
ptomaines and toxins of such infections. It is thus related in
its origin to catarrhal jaundice and hyperzemia.

Lesions. Jn the earliest stage with albuminoid exudation into
its substance the liver may be greatly enlarged, its sharp edges
rounded, and its consistency softened. After a week’s illness
atrophy may have set in and the organ appears shrunken and of
ocherous yellow. In the early stages there may be sanguineous
engorgement, the cut surface may bleed freely, and small extra-
vasations may show throughout the liver substance, later the
clay-yellow hue, the granular aspect and the absence of blood on
the cut surface are characteristic. The margins of the adjacent
acini are indefinite or lost, and under the microscope the hepatic
cells are charged with granules (albuminoid, fatty and pig-
mentary), while the nuclei are no longer demonstrable.

In cattle the liver may be double the normal size and at first
of a deep purple red, which may change later to the earthy
yellow.

In dogs the liver is tumid and yellow, and marked by small
pea-like centres of softening. There is marked softening and
the microscope reveals the characteristic degeneration of the
hepatic cells.

Symptoms in the Horse. These resemble those of congestion
rendered more intense and therefore somewhat less obscure. ‘The

Parenchymatous Hepatitis. 503

attack is usually sudden, there may be rigor followed by hyper-
thermia, dullness, pendent head, drooping eyelids, injected con-
junctiva with a yellowish tinge, unsteady gait and slight indica-
tions of colic. There is anorexia, partial suppression of urine,
and what is passed is thick, glairy and brownish red, feces are
passed with pain, and groaning, probably from compression of
the liver, the heart beats violently, while the pulse is small,
breathing accelerated and perspiration abundant. ‘The tempera-
ture rises (Io1” to 106°) and remains high throughout unless
lowered through biliary intoxication. Percussion over the liver
and especially on the right side shows increased area of dullness
and marked tenderness. On the second or third day the icterus
usually increases, and a slight foetid diarrhoea may set in with
marked foétor of the pale or colorless discharges. "The jaundice
is not, however, a criterion of the danger, as it may become: less
marked or entirely disappear because of the extensive degenera-
tion of the hepatic cells and the arrest of the formation of bile.

Diagnosis in the horse. ‘The disease is recognized by the coin-
cidence of fever, with great depression, icterus, painful defeca-
tion, constipation followed by a fcetid diarrhcea with lack of
color in the stools and by increased area of dullness and tender-
ness in the region of the liver and especially on the right side. -
From influenza which it resembles in many respects, it is dis-
tinguished by the absence of watery discharge from the eyes,
and by the entire absence of all indication of contagion. The
cases occur one at a time.

Prognosis in the horse. The disease is exceedingly fatal.
When the kidneys remain active, the poisons are eliminated and
there may be hope of recovery, but when urine is suppressed an
early death by poisoning is to be expected.

Treatment in the horse. A most important indication is to
secure depletion from the portal system. Calomel 1 dr., aloes
4 drs., ipecacuan 1 dr. may be given in bolus, and followed by
small daily doses of sulphate and nitrate of soda with bitters,
with or without the ipecacuan. Action on the kidneys is essen-
tial to secure elimination of the poisons which threaten a fatal
poisoning if retained. To favor the same action fomentations
may be applied to the loins. The frequent presence of patho-
genic microdrganisms either in the bowels or liver suggests the

504 Veterinary Medicine.

use of germicides (salol, salicylic acid, salicylate of soda, naph-
thalin, naphthol, beta-naphthol, etc.) as in catarrhal jaundice.
Sinapisms or blisters applied to the right side of the chest and
over the short ribs may be useful, and after the subsidence of
the more violent symptoms, dilute mineral acids and especially
nitro-muriatic acid may be resorted to in combination with
diuretics and bitters.

When appetite returns, succulent, laxative, non-stimulating food
in small quantity should be given. Wheat bran mashes, carrots,
turnips, potatoes, apples, fresh grass, ensilage may be adduced as
examples. Throughout the disease the ingestion of an abund-
ance of pure water should be encouraged.

Symptoms in the ox. ‘These may appear more tardily than in
the horse, loss of appetite, staring coat, dullness, pendent head
and ears, unsteady movements, rigors, drivelling of saliva from
the mouth and grinding the teeth are usually noted. To these
are added the more diagnostic symptoms of slight (or severe)
jaundice, constipation followed by a fcetid light colored diarrhcea,
a strong disposition to remain recumbent, marked suffering attend-
ant on rising, arching of the back when up, and tenderness on
percussion over the right. hypochondrium. The temperature
gradually rises, though more slowly than in the horse, and may
again descend under a profound poisoning.

Course. ‘The disease reaches its acme in four to six days, and
generally has a fatal issue.

Treatment, is on the same lines as for the horse only as a
purgative, sulphate of soda may advantageously replace the aloes.

Symptoms in the dog. ‘The symptoms are those of congestion
in an exaggerated form. ‘There are muscular tremors, erection
of the hair, followed by rising temperature upto 105° or 106°, an
icteric hue of the mucoseze, the pulse is accelerated, strong, irreg-
ular, respiration rapid, panting, fcetid breath, ventral decubitus,
and prostration extreme. Appetite is completely lost, the bowels
become relaxed, the stools feetid, the right hypochondrium pain-
ful on pressure or percussion, and the urine greatly reduced and
icteric, or suppressed. ‘This feature of urinary suppression, de-
termines a rapid poisoning and death in two or three days.

Treatment must follow the same lines as in other animals, a
purgative of calomel and jalap, followed by diuretics, laxatives,

Suppurative Hepatitzs. 505

derivatives, and above all germicides. Incase of survival mineral
acids, aqua regia, bitters, and a carefully regulated diet will be
in order.

SUPPURATIVE HEPATITIS. HEPATIC ABSCESS.

Causes in herse: Pyzemia, omphalitis, thrombosis, infection, biliary cal-
culi, concretions or parasites, foreign bodies, hot, damp climates, strangles,
brustseuche, glanders, endocarditis. Lesions in horse: from parasites and
mechanical irritants, pea-like or hazel-nut; embolic abscess, pin head to
hen’s egg; infection from strangles, foreign bodies, etc., may be of large
size, and burst into adjacent organs, the peritoneum or externally. Symp-
toms in horse ; of pre-existent malady, remitting fever, successive chills, in-
termittent icterus, hypochondriac tenderness. Spontaneous recovery, aspi-
ration, opening, antiseptics locally and generally. Lesions in ruminants :
secondary multiple abscesses, bean-like or (with foreign body) very large ;
may extend into adjacent parts. Symptoms in cattle: fever, chills, jaun-
dice, tympany, diarrhoea, dysentery, wasting, tender right hypochondrium.
Treatment: asin horse. Causesin dog: foreign bodies, tumors, infections,
blows, traumas. Lesions: traumatic abscesses. single, large, infectious ab-
scesses multiple, small. Former fcetid. Symptoms in dog: hepatic con-
gestion or colic, then chills, prostration, irritability, tenderness of right hyp-
ochondrium, nausea, vomiting. Treatment in dog: antiseptic aspiration,
laparotomy.

Causes in the Horse. Hepatic abscess arises from a great
many primary morbid conditions. As a secondary abscess it is
seen in the different forms of pyzemia and especially in suppura-
tive omphalitis in young animals. It may start in thrombosis
determined by clots or septic matters carried from a distance
through the portal vein or hepatic artery, in biliary calculi or
concretions, in parasites introduced from the duodenum, in barbs
or husks of the cereals that have penetrated through the biliary
ducts, or in bacteria or their toxins which have been carried from
the bowels, spleen or pancreas. The government veterinarians
have found it a comparatively common lesion in the hot damp
climate of Hindoostan, and asimilar frequency has been noticed
in west Africa. Among general affections it is liable to occur in
strangles, contagious pneumonia, glanders, endocarditis of the
left heart and phlebitis with the formation of thrombi in the

506 Veterinary Medicine.

lungs. In the two last named disorders, the affection takes place
by the simple transference of detached clots to the liver blocking
its arteries or capillaries. Or it may be that micro-organisms are
transferred in thesame way. With modern views of suppuration
the presence of the pyogenic organisms must be conceded.

Lesions in the horse. Cadeac distinguishes the different types
of hepatic abscess as: rst biliary abscess in which suppuration
commences in the interior of the biliary ducts and usually from
parasites or mechanical irritants introduced or from calculi or
concretions formed within them: these rare abscesses contain
biliary salts, pigments, and epithelium and acquire the size of a
pea or hazel-nut: 2d Metastatic abscesses which start in the ar-
terial, portal, or capillary vessels, by the arrest of infecting clots,
which determine a further clotting, the obstruction of the vessel,
the accumulation of leucocytes and the formation of abscess of the
size of a pin head or larger up to a hen’s egg, surrounded by a
hemorrhagic infarct softening in the centre: these are numer-
ously disseminated through the liver : 3d Mechanical abscess due
to the penetration of foreign bodies or parasites: 4th Infection as
in strangles. These may attain a large size, cause adhesion to ad-
jacent organs, and rupture into the chest, the colon, stomach or
peritoneum. The pus may even escape externally through the
right hypochondrium.

Symptoms in the horse. ‘These are always obscure and vary
much with the source of the malady. If there has been a pre-
existing hepatic malady the symptoms of that will be in evidence;
if an omphalitis its existence may still be recognizable ; if pul-
monary or cardiac disease, that may be detected ; if parasites, evi-
dence of their existence may perchance be found ; if gall stone,
a previous violent hepatic colic with icterus may have occurred;
and if intestinal septic disorder, there may be the testimony of in-
testinal troubles. The more diagnostic symptoms are a fever of
a remittent type, one or several violent shivering fits, a marked
jaundice which like the fever shows exacerbations, and a similar
irregularity of the condition of the urine which may be succes-
sively of a dark brown, a deep yellow, and a transparent amber
color. Tenderness and grunting on precussion of the right
hypochondrium would be an additional aid in diagnosis.

Treatment. Death has been hitherto considered as the in-

Suppurative Hepatitis. 507

evitable result, yet recoveries may ensue after rupture into the
colon or through the abdominal walls. If the seat of the abscess
can be ascertained its evacuation through an aspirator and the
subsequent injection of an antiseptic would be appropriate.
The ‘concurrent use of antisuppurants like hyposulphite of soda,
or sulphide of calcium would also be in order.

Causes in Cattle. Hepatic abscess is much more frequent in
cattle, and is commonly a result of perforation by sharp pointed
bodies (needles, pins, nails, wires, etc.) from the reticulum and
rumen, or of parasites, or biliary calculi. Other cases are
occasioned by the presence of tubercles, actinomycosis, or
omphalitis.

Lesions in Cattle and Sheep. Secondary abscesses are usually
multiple and disseminated through the organ, though Cadeac
says they are more common in the left half. They vary in size
from a bean to a pigeon’s egg, project often from the surface, and
contain a viscid, creamy, yellowish or greenish pus. Abscesses
dependent on foreign bodies often attain a great size, so as to
contain a pint or quart of pus (Landel). They may make their
way through the diaphragm, rumen, or abdominal wall leaving a
thick cicatrix in the liver, or they may become slowly absorbed
and dry up into a putty-like or cretaceous mass. Brusaferro
found hepatic abscesses in lambs twenty to thirty days old—
probably of omphalic origin.

Symptoms in Cattle are usually very obscure. Fever, shiver-
ing fits, jaundice, indigestion, diarrhcea or dysentery, emacia-
tion, colics, tender right hypochondrium, and peritonitis may all
be in evidence but the diagnosis is little better than a guess.

Treatment when possible at all would be on the same lines as
for the horse.

Causes in the dog. According to Cadeac these are mostly
foreign bodies (needles, pins, etc.) which have been swallowed,
tumors of the liver or adjacent organs, phlebitis and thrombosis
of the portal vein, pyzemia, septicaemia, and external injuries
(kicks, blows, contusions, falls, etc.)

Lesions in the dog. As in the other animals traumatic abscess
is usually solitary and large, secondary abscess multiple and small.
The pus developed around a foreign body is reddish, greenish and
foetid, that of the metastatic abscess is usually whitish or yellowish
and with a sweet odor.:

508 Veterinary Medicine.

Symptoms in the dog are those of hepatic congestion, or violent
gall stone colic, followed by severe rigor, great depression, or
irritability, and tenderness over the right hypochondrium.
Nausea and vomiting is a marked symptom though not a diag-
nostic one.

Treatment. Tf the flaccid abdominal walls will allow of the
locating of the abscess it should be treated by aspiration and
antiseptic injections. It would even be admissible to perform
laparotomy, stitch the wall of the abscess to the external wound,
and empty it under due antiseptic precautions.

INFECTED HEPATITIS. NODULAR NECROBIOSIS OF
THE LIVER.

In ox, sheep, pig, dog, horse. Necrotic areas projecting on surface of
liver. Causes: bacteria, toxins, from bowels, womb, navel. Lesions: In
cattle, dirty gray nodules in brownish red liver, nodules firm, granular, ne-
crotic, elements do not stain, later leucocytes and fibro-plastic growth in
periphery. In lambs the nodules are white, common to the lungs and
pleura, pathogenic to rabbit. In pigs, nutmeg liver, cells without nuclei,
fatty, granular, pathogenic to rabbits, guinea pigs, rats and young pigs,
In dog, nutmeg liver, with violet areas, and white spots, one-half line, hav-
ing granular, fatty cells without nuclei. Symptoms: fever, constant lying,
tarry faeces, icterus, tender right hypochondrium, and those of the primary
disease. Treatment: antisepsis of primary seat, and bowels, elimination
by kidneys, general antisepsis, stimulants, etc Case usually hopeless. Pre-
vention.

This has been observed particularly in cattle, but also in sheep,
pig, dog and horse. It is characterized by the formation of cir-
cumscribed areas of gangrene, becoming hard, dry, yellowish
and usually slightly projecting beyond the adjacent surface. Its
infected character is shown by the presence in the lesion and
adjacent parts of the hepatic tissue of an abundance of bacteria,
which, from the varied description, appear to differ in different
cases. ‘The cause may however be safely stated as one of the
bacteria of gangrene. It is alleged with some show of reason,
that the lesion may be determined by the action of toxins and

Infected Hepatitis. 509

ptomaines produced by bacteria in the alimentary canal and carried
to the liver with the portal blood, (Cadeac). The bacteria them-
selves commonly come from the same source, (Stubbe), but also
from the uterus (Berndt), the mammz (LeBlanc), and above all
from the supputating or septic umbilicus. McFadyean in
five cases found a long slender bacillus, Hamilton in a single
case in a horse found cocci, Rivolta in an infectious hepatitis in
sheep found dactertum subtilis agnorum, and Semmer found the
same condition in young pigs from micrococci introduced through
the diseased umbilicus.

Lestons. In cattle the liver has a general brownish red, or
greenish white color, and shows projecting, hard nodules of a
dirty gray color more or less tinged with yellowish brown. ‘The ©
margins of these hard nodules are very sharply defined, and on
section show a homogeneous granular surface, devoid of areas of
softening or of connective tissue, and formed of the hepatic par-
enchyma in a state of necrobiosis. The granules and nuclear
elements do not stain like those of healthy liver. As the
disease advances the periphery of the nodule may be invaded by
leucocytes and become the seat of a fibro-plastic hypertrophy
(McFadyean) with the ultimate formation of cicatricial tissue
(Stubbe).

In Jamés Rivolta found the necrosed nodules standing out as
white patches under the capsule of the liver, but similar lesions
were met within the lungs and pleurz, an observation which
has been confirmed by Hanbold. ‘The affection was conveyed by
inoculation to the rabbit.

In pigs Semmer found nutmeg liver, deep red or grayish yel-
low, hypertrophied, the hepatic cells swollen and divested of nuclei
but containing fatty and pigmentary granules. It was inoculable
on rabbits, guinea pigs, white rats and on young pigs.

In the dog Courmont and Doyon found congested liver (portal
congestion) with projecting patches of a deep violet color and
sharply defined borders, and one to two lines in diameter, also
salient white spots with distinct outlines. In the white spots the
hepatic cells had lost their nuclei and were charged with fatty
granules.

Symptoms. These are indications of hepatic disease. In
parturient cows, Berndt noted fever (102° to 104°), anorexia,

510 Veterinary Medicine.

stiffness, cough, labored breathing, intense thirst, constant de-
cubitus, and constipation followed by lowering temperature,
tarry feeces and icterus. The region of the liver was very
sensitive to pressure ori percussion. In the other animals the
symptoms appear to be largely over-shadowed by those of the
primary disease, but the same general indications of jaundice,
hepatic tenderness and digestive disorder are superadded.

Treatment when it can be intelligently adopted, consists largely
in evacuation and antisepsis of the seat of primary infection, and
of the prima vie, and in maintaining elimination by the kidneys.
In this way, as in congestion and hepatitis, the concentration of
the poison is as far as possible counteracted, and an opportunity
may sometimes be furnished for the recuperation of the liver
cells. Asa rule, however, the case is hopeless, and thus pre-
ventive measures, by cleanliness, disinfection and antisepsis of
the ascertained sources of the infection are indicated.

PERIHEPATITIS.

Inflammation of capsule of liver (external and Glisson’s). Causes: Trau-
mas, infective diseases, phlebitis of the portal vein, chill, distomatosis.
Lesions: Peritonitis and inflammation of the capsule in patches, yellowish
gray exudate, fibroid thickening or pus. Adhesions to adjacent objects.
Thickening of trabeculae. Symptoms: tardy respiration and circulation,
tender hypochondrium, colics, diarrhoea, painful defecation, moan with ex-
Piration. Slight cases recover. Sequel: compression of portal vein or
bile duct, gastric catarrh, piles, etc. Treatment: Salines, alkaline diuretics,
mineral tonics, bitters.

This is inflammation of the external capsule of the liver and
Glisson’s capsule. It may arise from direct mechanical injury,
or by extension of inflammation from adjacent structures, such
as the peritoneum. It may also complicate contagious pneumonia
in the horse, tuberculosis in the ox, pneumoenteritis in pigs, and
also phlebitis of the vena portee (Cadeac, Morot). It may follow
a chill, or distomatosis. :

Lesions. ‘These are essentially peritonitis circumscribed by the
liver, and extending to the proper capsule, and its vaginal invest-

Perihepatitis. 511

ments of the hepatic vessels. It is usually limited to certain spots
which become the seats of a yellowish gray exudation, with a
tendency to fibroid development and thickening, but sometimes
degenerating into pus. The deposits on the outer side of the he-
patic peritoneum may develop false membranes and fibrous adhe-
sions to surrounding objects, the diaphragm, omentum, stomach
or intestine. The deposits under the peritoneum lead to similar
fibrous development with hypertrophy or thickening of the cap-
sule, the trabeculz extending thence into the liver and the vagi-
nal sheaths of the vessels. Such areas of thickening are revealed
as depressed spots or patches of a white color, and showing a firm
fibrous, pearly appearance when incised. Such lesions are not
uncommon in the livers of horses, cattle and swine. In the pig
they may have a violet, or brownish red color, but with spots of
other colors—grayish or brownish (Kitt).

Symptoms. Dopheide, who has studied the disease in cows
and to a less extent in horses, found a reduction in pulsations (26
per minute) and respirations (6 per minute) in connection with a
mild peritonitis, intestinal catarrh, colicy pains and diarrhcea.
The conjunctiva is pale, the pulse compressible, the respirations
unequal and accompanied by a moan, and the appetite impaired
or lost.

If confined to mere spots on the liver, a restoration to appar-
ently vigorous health may take place, but if extensive it may lead
to compression and obstruction of the portal vein or bile duct, or
to compression and atrophy of the liver, with corresponding
symptoms.

Treatment. As in other congestions of the liver, the use of
salines to deplete the portal system, and of alkaline diuretics are
especially indicated, to be followed by bitters and mineral acids.
Sinapisms and other counter irritants to the region of the liver are
of great service. If not complicated with abscess, or microbian
infection, cases of this kind will often do well.

CIRRHOSIS OF THE LIVER. FIBROID DEGENE-
RATION. :

Definition Increase of connective tissue, decrease of gland parenchyma.
Causes : in man, alcoholism; in animals, chronic heart disease, chronic re-
current peri-hepatitis, biliary obstruction, toxins. In horse, age, emphyse-
ma, unwholesome fodders, vegetable alkaloids, infection. Symptoms: pros-
tration, hebetude, impaired appetite, colics, constipation, later diarrhcea,
unthriftiness, emaciation, dropsy, icterus, ascites, intestinal catarrh, tender
hypochondrium, early fatigue. Lesions: increase of connective tissue, com-
pression and absorption of parenchymatous tissue, greatest around portal
vessels, thickening of fibrous stroma between capillaries of acini, shrunken,
granular, pigmented liver cells. Treatment: salines, Glauber salts, diure-
tics, sodium carbonate, or iodide, or salicylate, derivatives, mineral acids,
bitters, open air, laxative food, pure water. In cattle: obstruction to circu-
lation or the flow of bile; advances from the vessels, causes absorption,
caseated foci, adhesions, enlarged liver. Symptoms: jaundice, yellow, red,
albuminous urine, chronic indigestion, tends to fatal though slow advance,
Treatment: green food, open air life, saline laxatives, alkalies. In dog:
common following heart disease, parasites, bacteria. Lesions: Congested
brownish red liver, fibroid increase from Glisson’s capsule, compression of
acini, their elevation above surface, fatty and pigmentary degeneration of
hepatic cells, increasing sclerosis. Symptoms: as in parenchymatous he-
patitis with slower advance, in time tender loins, brownish or reddish urine,
ascites, intestinal catarrh, it may be icterus. Treatment: Correct cardiac
troubles, digitalis, strophanthus, and intestinal, careful diet, mineral acids,
bitters, pure water, saline laxatives, antiseptics, alkaline diuretics. Potassi-
um iodide. Derivatives. Draw off liquid. Laxative non-stimulating diet.

.

Definition. An interstitial inflammation of the liver charac-
terized by a great increase of the connective tissue and compres-
sion, atrophy and degeneration of the glandular elements.

The same final result may undoubtedly originate in various
different primary morbid processes.

In man cirrhosis is looked upon as almost always the result of
abuse of alcohol. In animals this cannot be the case, apart
from a few kept in connection with breweries or distilleries.

In heart disease a long continued mechanical congestion of the
liver causes compression and degeneration of the secreting cells
in the centre of the acini (around the intralobular veins), while
the peripheral portions undergo cell proliferation and increase of
connective tissue.

512

Cirrhosis in the Florse. 513

In chronic or recurrent perihepatitis, a whole lobe may be
compressed by the hyperplasia of the investing connective tissue,
and the hepatic cells are degenerated and absorbed.

Overdistension of the biliary ducts from obstruction to the flow
of bile (gall stone, catarrhal inflammation, constipation), leads to
proliferation and hyperplasia in the walls of the biliary radicals
throughout the entire liver.

The presence in the liver of toxic agents, ingested, or gene-
rated from microbian fermentation in the intestinal canal or liver
is another recognized cause of connective tissue hyperplasia.

CIRRHOSIS IN THE HORSE.

Cirrhosis of venous origin has been observed mainly in old
horses, while hypertrophic cirrhosis from biliary obstruction oc-
curs rather in the young (Cadeac). Brtickmuller records a case
of the first kind in a horse with extreme pulmonary emphysema.
Walley gives a bad condition of fodders as the main cause, vir-
tually implying, in many cases, infective catarrh and obstruction
of the biliary ducts.

A form of the disease prevails at Schweinsberg in Hesse, and
has been variously attributed to spoiled fodders (Nicklas), to
vegetable alkaloids and other poisons in the food (Friedberger
and Frohner), to clover, to telluric poisons (Redner), to infec-
tion (Meminger), and to heredity (Neidhart). It is a sug-
gestive fact that it is confined to the valleys of the Ohm, Glon,
and Zusam where the land is peaty and swampy and subject to in-
undations, while it is unknown on the dry table lands (Fried-
berger and Frohner). This strongly suggests intoxication with
microbes or their deleterious products. The gastric catarrh that
frequently attends the disease may point in the same direction.

Symptoms. These are too often general rather than diag-
nostic. Dullness, prostration, hebetude, yawning, hot, sticky
mouth, lost, irregular or depraved appetite, colics, constipation
or diarrhoea, dry, harsh coat, emaciation, weakness, cedema of
the limbs, vertigo and drowsiness may be among the symptoms.

33

514 Veterinary Medicine.

More characteristic are icterus, abdominal distension from ascites
or congestion of the liver, yellow or high colored urine, intestinal
catarrh, indigestion, and tenderness in the region of the liver.
The mucose are usually pale at first and not always icteric later,
On exertion the horse shows early fatigue, tumultuous heart
beats and oppressed breathing.

The Schweinsberg disease often lasts for months, with alter-
nate improvements and exacerbations, but almost invariably ends
in death, and sometimes completely depopulates a stable.

Lesions. These consist primarily in the great increase of the
connective tissue and the relative decrease of the hepatic tissue.
This is usually mostly around the divisions of the portal vein
and the periphery of the acini, but also in the end around
the hepatic veins as well. When it has formed around the bili-
ary canals there is a great increase of the liver (often doubled)
and its edges have become rounded. Within the acini the increase
of the fibrous stroma is seen between the radiating capillaries, and
the hepatic cells are contracted, granular, pigmented, and com-
paratively destitute of protoplasm around the still persistent nu-
cleus.

Treatment. Glauber salts to clear the bowels of offensive mat-
ter, and deplete from liver and portal vein, bicarbonate of soda or
iodide of potassium to eliminate the poisons through the kidneys
and to lessen the induration, and finally salicylate of soda as a
liver stimulant and intestinal antiseptic are suggestive of the line
of treatment that may bepursued. The saline laxatives and diu-
retics, and antiseptics may be changed for others according to
special indications, and bitters and mineral acids may be resorted
to. Counterirritants to the right hypochondrium should not be
neglected in case of local tenderness. In the otherwise fatal
Schweinsberg disease, Imminger, Kiinke and Stenert had a
remarkable success from the free use of potassium iodide, which
suggests a cryptogamic origin, as this agent is so valuable in
polyuria which results from musty fodder. In all cases, gentle
exercise in the open air and a moderate ration of laxative food
(green) are of great value. Above all the old suspected diet
should be carefully avoided, also any impure water supply.

CIRRHOSIS IN CATTLE.

This has been recorded by different observers and usually as
the result of some obstacle to the circulation, or of catarrh and
obstruction of the biliary passages. Morot saw it in young
calves, which showed greatly enlarged liver (in one case 24 lbs.)
and kidneys, the former containing numerous cysts and marked
sclerous thickening around the vessels. This advancing thicken-
ing of the connective tissue, causes increasing firmness of the
liver and absorption, distortion and diminution of the lobules.
Albrecht describes a chronic interstitial hepatitis with caseated
centres (non-tuberculous) many of them an inch in diameter.
The liver is brown or grayish with whiter callosities which ex-
tend into its substance and make points of attachment to the
diaphragm or other adjacent organ. ‘The contrast between the
fibrous layers and the hepatic tissue has been likened to a
checker board (Héhmann). The enlarged liver may weigh 30
lbs. ; in one remarkable case it weighed 300 lbs. (Adam). The
bile is of a light color and mixed with mucus.

Symptoms. The symptoms are indefinite; a gradually in-
creasing jaundice, the passage of yellowish red urine becoming
more and more red and albuminous, and finally coagulating on
the walls of the urethra or on the litter, chronic indigestion,
salivation (Schaffer), weakness, breathlessness and more or less
fever may give indications of the disorder. Hohmann failed to
find tenderness of the right hypochrondrium. The disease is
liable to go on to a fatal issue, so that it is often sought to pre-
pare the animal for the butcher.

Treatment will follow the same line as in the horse, Green
food, pasturage, open air life, saline laxatives, and alkalies with
a free use of potassium iodide to check the sclerosis will be indi-
cated.

»

515

CIRRHOSIS IN CATTLE, SHEEP AND HORSES FED
ON SENECIO JACOBGA. PICTOU DISEASE.

Definition. A fatal, usually chronic cirrhosis of cattle, sheep
and horses, met with in the counties of Pictou and Antigonish,
Nova Scotia, in New Zealand, and elsewhere in ratio with the
extension of Senecio Jacobcea in the pastures and meadows.

History in Nova Scotia. Thedisease was unknown until the
arrival from Scotland in 1853 of a ship, the ballast from which,
containing the seeds of the Senecio, was spread in the vicinity
of the wharf, and seeded the locality with this injurious weed. So
manifestly parallel, ran the extension of the plant and the dis-
ease, that Mr. Gordon, Street Commissioner, imposed a fine on
any one who allowed the Senecio to grow on his lands, but es-
caping this jurisdiction it slowly extended and in 50 years has
gradually invaded the two maritime counties of Pictou and Anti-
gonish, while respecting the remainder of Nova Scotia though
on the same geological formation, in the same climate, and much
of it under the same rather backward agricultural system. ‘‘ Not
one case has occurred beyond the weed area, and it does not ap-
pear in the territory where the weed is found only in the high-
ways.’ (Pethick.) It may be added that on farms that had
been formerly deadly, the thorough eradication of the Senecio,
by pulling them in the fields, and even the picking of the plant
from the hay to be used for winter feeding, has put a stop to the
disease. (Pethick).

History in New Zealand. This is less circumstantial than
that of Nova Scotia. Early reports, about 1883, refer to a cir-
cumscribed area of Senecio and cirrhosis on one farm only, in
Winton district, Southland. From this it seemed to extend
slowly along the railroad line to Lumsden on the one hand, toward
Invercargill on the other, toward Fortrose on another, and along
the Dunedin line to Gore and Mataura on still another. (Pater-
son). Some districts becqgme invaded by the Senecio and disease
through the hay broughtfto feed horses kept in connection with
saw mills, in other cases it was spread by pasturing cattle in
place of sheep. The sheep cropped the Senecio when young and
prevented it from running to seed : the cattle let it grow and seed

516

Cirrhosis in Cattle, Sheep and Horses fed on Senecto. 517

until it was so abundant that they could not bite grass without
taking ragwort. (Paterson). The mortality ceased in two
months after the cattle were removed from pastures infested with
ragwort. (Gilruth).

In the North Island it was first noticed in 1901, in the southern
portion of Auckland District, on a 4000 acre pasture, about 1500
to 2000 feet above the sea, in a large herd of breeding cows turned
out there. Senecio Jacobcea was very abundant over the whole
pasture and in places almost monopolized the soil. The Senecio
was not a new arrival, and its effects were only shown when sus-
ceptible animals (cattle) were first placed on the range. Not
only the sick cattle showed the lesions of hepatic cirrhosis, but
cattle killed in apparent health showed the same morbid condi-
tion, though not advanced to the extent of producing antemortem
symptoms. (Gilruth).

Here and elsewhere in the North Island, Senecio appeared to
have been introduced with the grass seeds when the land was
seeded for pasture, and thus gradually extended.

Experiments with Senecio Jacobea. The following ex-
periments were carried out under the direction of J. A Gilruth,
Principal Veterinary Officer, New Zealand :

ist. March 29th to April 17th, two calves were fed Senecio
which they ate greedily in the green state. They died April
27th and 29th respectively with highly cirrhotic livers.

2d. Two cows and one horse fed carefully-dried Senecio for
three months. All kept in good health. One cow sacrificed
showed a healthy liver.

3d. A steer, cow, yellow bullock and horse were placed on pas-
ture abounding in Senecio. The steer died in three months with
cirrhotic liver. The cow died in 4 months with cirrhotic liver.
The horse died in 5 months with hepatic cirrhosis. The yellow
bullock remained healthy and when killed showed the liver
sound. ‘The stomach contents gave no evidence that he had
eaten Senecio.

4th. A gelding was fed, twice daily, 1 lb. of Senecio flowering
tops and branches carefully dried and cut in chaff. On the 28th
day he was dull and losing flesh, so the dose of Senecio was re-
duced to % lb. twice daily. In three weeks more he was lan-
guid, dull, yawning and more emaciated. Senecio reduced to ¥/

518 Veterinary Medicine.

lb. twice daily. In 35 days more he showed marked symptoms
of the cirrhosis:—drowsy, eyes amaurotic, conjunctiva red,
mouth clammy, feeces scanty and hard, mastication slow, fre-
quent yawning, swayed and staggered in walking, and in lying
rested his muzzle constantly on the ground. ‘Two days later he
was very much worse, temperature 96.6°, pulse 86, respiration
40, stood with head resting in the manger and pressing against
the wall, body swayed with sudden jerks to recover balance, urine
abundant, dark colored, viscous, foetid, no feeces, eyes half closed,
led out he swayed, walked in a circle, dragged the hind limbs
and knuckled over at the fetlock. He died next morning. Liver
cirrhotic, but no yellowness of the tissues.

Senecio Poisoning in Other Countries. Gilruth quotes the
old herbalist name of Senecio Jacobcea as staggerwort, which
suggests a recognition of its pathogenic effects on the liver in
the distant past ; also epizdotics of stomach staggers in the dry
years 1800 and 1819, ‘‘ which were supposed to arise from the
animals eating ragwort or staggerwort.’’ He further quotes Wal-
ley on-a common ‘“‘ interstitial inflammation of the liver in cat-
tle ;’’ McFadyean ‘‘ two cases of biliary cirrhosis in the horse ;’”’
and Williams, Dixon’s ‘‘ three cases of biliary cirrhosis in horses
on the same farm,’’ but without suspicion that they were con-
nected with Senecio Jacobcea. It can only ‘be said that the plant
is well known in England, and might well be eaten in dry sea-
sons or when pastures were bare.

In Germany the Schweinsberger disease referred to above
(page 513), offers a close parallel, occurring as it does in partic-
ular valleys only, pursuing a chronic progression, and proving
generally fatalin the end. (See Cirrhosis in the horse).

In America the hepatic cirrhosis of S. Dakota is significant.
This is known as the Bottom Land Disease, suggesting a toxic
vegetable origin, but is vulgarly ascribed to Rattlebox ( Crotolaria
Sagitalis.) This may be the essential cause, but it is not im-
probable that the Senecio has also been scattered widely on the
bottoms, the seat of frequent inundations. ‘he disease, in its
symptoms and progress agrees with the Senecio poisoning : there
is its circumscribed prevalence, its chronic character, its steadily
advancing progress, the digestive disorders, the icteric urine and
mucose, the encreasing dullness, languor, weakness and emaci-

Cirrhosts in Cattle, Sheep and Horses fed on Senecio. 519

ation, the acute stage which precedes death, the fatal termina-
tion and the cirrhotic liver.

Another suggestive enzdotic affection is the /ctero-Hematuria
of sheep in Roumania, Italy and Montana. This has been
ranked with Texas fever, by reason of an organism found in
the red globules, but neither in Europe nor America has any
intermediate bearer (tick) been identified, and the introduction
of the disease at a definite date, and its gradual extension in the
Silver Bow, and Deer Lodge Valleys in Montana would be en-
tirely in keeping with the toxic action of some vegetable product.
Moreover it has two yearly periods of extension, in spring and
autumn, the #vs¢ when the sheep are driven to the alkaline bogs
to obtain sustenance till the grasses have started on the general
range, and the second when the higher ranges are dried up and
the sheep must again fall back on the bogs for support. Again,
like a dietetic disease it shows itself in all grades, fat sheep ap-
pearing in the packing-house with yellow carcase ; others show
loss of condition and icterus without acute symptoms ; and still
others mope about apart, showing anorexia, arched back, stiff-
ness in the hind limbs, icterus, fever and bloody urine. Unriless
therefore the alleged piroplasma of zctero-hematuria can be
traced through an intermediate, invertebrate host as can that of
Texas fever or the plasmodium of malaria or yellow fever, it
would seem the part of wisdom to institute an enquiry as to the
possible presence and operation of Senecio or other toxic plant
spreading in the area in which the disease has developed. It is
noteworthy that Professor Adami found, in the liver cells and
mesenteric glands of the affected Pictou cattle, diplococcoid bodies
in abundance, so that these latter cattle are in no way behind
those of Roumania, Italy and Montana in the evidence of a
microorganism. But in none of the affected countries (Rou-
mania, Italy, Nova Scotia, Montana or New Zealand) have
inoculations produced the disease (as it does in Texas fever),
and, wherever it has been attempted, (Nova Scotia, New Zea-
land) the disease has been clearly traced to the Senecio Jacobcea.

Gilruth suggests the staggers of horses in Va. (Horsbrough,
B. A. I. Third Report), and the hepatic cirrhosis of cattle in
S. Africa (Hutcheon) as inviting fields of enquiry in this same
connection.

520 Veterinary Medicine.

The Senecio Jacobeva is doubtless largely prevalent in different
regions, and, wherever animals die with symptoms suggestive of
its toxic action, this weed should be carefully looked for as well
as the attendant conditions which might drive the stock to eat
it :—early spring before the grasses have come up ;—dry, or ad-
vanced seasons, or overstocking when pastures are bare ;—the
intimate mingling of the prevalent Senecio with the grass ;—the
abundant admixture of the flowering tops and upper branches
and leaves with the hay.

Senecio Jacobcea.—Order Composite. Tribe Senecionidee.
(St. James’s Weed, Golden Weed, Yellow tops, Ragweed, Rag-
wort, Canker weed, Staggerwort, Stinking Willie). Perennial,
erect, glabrous, glabrate or rarely cottony, stems 1 to 6 feet high
(occasionally more), furrowed, leafy. Lower leaves petioled
2-6 in. long: upper leaves sessile, clasping, pinnatifid or irregu-
larly 2 pinnatifid, divaricated, lobed or toothed. Heads % in.
in diameter, numerous, forming a dense or rarely spreading
corymb; involucre hemispherical; bracts oblong, acuminate,
outer few, small, subulate. Rays spreading golden yellow.
Achenes of the ray angled glabrous; achenes of the disc sub-
terete, hairy.

Another species S. Canzcida, indigenous to Pueblo, Mexico, is
very poisonous and is used for killing dogs.

Symptoms in Cattle. The conditions of life give important in-
dications. The pastures or hay fed to the animals contain the
ragweed intimately mixed with the wholesome fodder. The
disease is known to occur more or less frequently in stock on
such pastures or hay. ‘The victims, are asarule, those that
have been on such land for at least one year, the first cases usu-
ally occurring about the end of the first year on the ground, and
the numbers encreasing, the longer they stay on the particular
aliment. Hence newly purchased cattle and young calves mostly
escape, while yearlings, two year olds and mature cattle raised
on the farm furnish the majority of the cases (Johnson). ‘The
season of the year is to be noted: the cows are especially tempted
to eat the Senecio in early spring when the pastures are still
bare, in dry summers or autumns when the grass has been eaten
down and the less attractive ragwort is left, or when refreshing
rains have brought up a new growth of grass so intimately mixed

Cirrhosts in Cattle, Sheep and Horses fed on Senecio. 521

with the weed that the two must be cropped together. While
acute cases may occur from an overdose of Senecio, yet the
disease is essentially chronic and progressive, and what appear
to be sudden and fatal attacks are but instances of recrudescence
under the action of a large toxic dose on a liver already degener-
ated and incapable of healthy function.

Among the first observed symptoms are dullness, sluggishness,
and apathy, so that the animal fails to promptly follow the herd
and may be found lying apart. At this date and even from the
start the skin exhales a peculiar offensive odor rendered more
manifest by actively rubbing it with the palm or between the
fingers. The same odor is present in the milk, and intensified
by rubbing it between the hands (Paterson). ‘The milk shrinks
and has a peculiar acrid flavor, rendering it absolutely useless for
buttermaking. The calf often declines to suck though the dam
bellows for it. The function of the bowels is imperfect, the
early tendency being to torpor and constipation, yet relaxation
and diarrhoea, usually supervene. The head and ears drop, the
eyes lack lustre, the coat stares, and progressive, often rapid,
emaciation sets in. Temperature and breathing are usually
normal and pulse variable (about 68). Appetite may be vora-
cious, or absent. Icterus may be present though not always
strongly marked.

As emaciation advances, the diarrhcea becomes more marked,
the feeces black, and the belly pendent (pot belly), with some
drooping of the loins and hollowness of the flank, and fluctua-
tion in the lower part from ascites and this may encrease to
tension. Muscular weakness is marked especially in the hind
quarters, by swaying or distinct staggering. The urine like the
mucose may become yellow or brownish. With the acute
disease of the liver or extensive ascites, pulse and breathing are
encreased, and temperature may be raised two or three degrees,
but only when sepsis has supervened (Johnson).

In advanced cases there may be nervous disorder, the patient
even making helpless efforts to rush the visitor, or there is com-
plete apathy and prostration, trembling of the hind limbs, and
utter indifference to loud bawling in the ears, switching with a
cane, or even twisting of the tail (Paterson).

Feeding cattle and cows kept for breeding only show less pro-

522 Veterinary Medicine.

fuse diarrhoea, and more limited ascites, but with greater nervous
disorder and delirium and such cases are likely to end fatally in
from two to five days from the onset of the severe attack. Cows
in full milk on the other hand may survive such violent access
for ten days or a fortnight, the elimination of the poison in the
milk perhaps tending to relieve the system in a measure.

An excessive dose of the poison may doubtless produce a sud-
den, acute and fatal attack, but in the usual run of casual cases,
and as strikingly shown in the experimental ones, the progressive,
chronic cirrhosis of the liver has been steadily paving the way
for the final fatal intoxication.

Lesions in cattle. Jf the disease has ended fatally the most
striking feature of the carcass is the yellow discoloration of the
normally white tissues. There is usually marked emaciation yet
the abdomen is distended by an accumulation ofa clear yellowish
liquid. A semigelatinous exudate often distends the spaces of
the adipose connective tissues, replacing the fat, in various parts
of the body, as subcutaneously beneath the chest and abdomen,
in the omentum, mesentery and sublumbar region, and in the
submucosa of the abomasum. The liver presents the most marked
changes. In the early stages it is congested and the gall ducts
and bladder replete with a thick, dark colored bile which is also
found in the intestines. In old standing, fatal cases the liver is
small, shrunken, with rounded margins, a dull, mottled slaty
blue color, and a very firm consistency “‘like tough India-rub-
ber.’’ Dark blue pitted areas are frequent. The capsule adheres
to the gland with great tenacity, and when torn off with the for-
ceps leaves a very irregular surface, while portions of the liver
substance remains adherent to the detached capsule. When cut
the hepatic substance feels tough, resistant, leathery, almost
gritty, and under the microscope the fibrous framework is found
to be greatly increased and thickened, at the expense of the acini
which have degenerated and undergone absorption. Johnson
has seen ulcers of the mucosa of the abomasum, and sometimes
petechiz are scattered through the lungs, pleurz, pericardium,
peritoneum and nervous system in connection with the general
intoxication.

Symptoms in sheep. Sheep eat the young ragwort more readily
than cattle and seem to enjoy a comparative immunity from its

Cirrhosis in Cattle, Sheep and Horses fed on Senecio. 523

ill effects. Yet in the New Zealand experiments on the lands that
had proved so destructive to cattle, it was found that after a year
of intermittent pasturage, six weeks at a time, they began to die
with all symptoms and lesions of Senecio poisoning and, very soon
after, 5 per cent. of a flock of 2000 head had perished. The mor-
tality was greatly lessened though not altogether stopped when
the flock had been removed two months from the Senecio pasture.

The affected sheep became dull, with indifference to food,
drowsiness, remaining apart from the flock, and thick, red urine
(even like black coffee). In the later, violent stages of the dis-
ease there was slight hyperthermia (106° F.), hurried breathing,
grunting with expiration, tenderness along the back, coma and
yellowness of the skin and mucose, and diarrhcea.

In the Montana zctero-hematuria there are the same symptoms
together with the following : aimless wandering, sagging of the
loins, frequent, painful urination, urine very dark, feeces in large
solid masses covered with mucus (rarely diarrhoea, ), in protract-
ed cases dropsical effusions on the sides of the head and neck,
the sheep maintains a recumbent or crouching position and in-
variably dies. E

Lesions in sheep. ‘The early lesions are mainly those of icterus.
In New Zealand many sheep from a Senecio pasture, though
shipped and killed in fine condition and apparent health, fur-
nished the familiar yellow carcass, and numbers shipped in
apparent health perished on the way, the animal proving unequal
to the excitement of travel. The same is true of sheep from the
pathogenic Montana pastures.

‘The liver in some sudden New Zealand attacks was pronounced
congested, with thick, dark, tarry bile, but in others, more ad-
vanced or chronic, it proved smaller, firmer, cirrhotic, mottled,
and at points grayish. Microscopic examination showed exten-
sive fibroid degeneration essentially interlobular. In many the
liver felt hard, tough, and almost gritty under the knife, and the
surface showed pitting with abnormal adherence of the capsule.
In general the liver is somewhat less fibroid than in the ox, there
is a much greater abundance of new connective tissue cells, sug-
gestive of more rapid growth, and fatty degeneration of the he-
patic and even of the connective tissue is more common. Hem-
orrhagic areas are frequent and excessive congestion of the kid-

524 Veterinary Medicine.

neys characterizes the worst cases. There was serous effusion,
and a dropsical condition of the intestinal walls and abdominal
lymph glands. The kidneys were often greatly congested and
the urine had a blackish-red color.

In the Montana disease, the following additional points are
noted : The majority of the victims were ewes, recently lambed ;
the carcases showed marked emaciation, and the blood count was
reduced from 13,000,000 to 9,000,000, or in extreme cases 1,000, -
ooo red globules percmm. ‘The white cells were increased from
7,000 to 28,000 per cmm.

Symptoms in horses. ‘There is a weak, uncertain, staggering
gait, a disposition to stamp with the hind feet, dullness, drowsi-
ness, muscular twitching, of the hind limbs especially, amaurosis,
icteric mucosz, clammy mouth, depraved appetite, a disposition
to eat leaves, stable-soiled straw, weeds, etc., torpid bowels, rest-
ing the head on the manger, resting the quarter on the partition
of the stall, delirium shown by quiet movement in one direction
regardless of obstacles, or violent plunging into the manger or
elsewhere, and falling followed by spasms, unconsciousness or
coma and death. ‘The very dark color of the urine is.a promi-
nent symptom. At first, appetite may persist, and be gratified to
the dangerous overloading of the stomach and indigestion. The
intestinal paresis is shown in the need of double doses of purga-
tives to move the bowels. In other cases he takes a mouthful
and then doses off with the unchewed morsel in the mouth.

Lesions in the horse agree in the main with those of cattle. The
liver is cirrhotic to a marked degree, the capsule thickened and
firmly bound down by bands passing into the interlobular tissue,
which in its turn is thickened so as to compress the acini and
cause degeneration and disappearance of the hepatic cells. On
section it proved firm, resistant, almost gritty, and showed dark
spots and mottling. There was less disposition to effusion than
in ox or sheep, though a little liquid might be present in peri-
cardium or peritoneum. The kidneys showed marked conges-
tion, and the urine was dark, thick and viscous.

Treatment. Gilruth found that when the disease is in its in-
cipiency it may be treated like other forms of stomach staggers.
Keep the patient in doors, feed wholesome food, give purgatives
in double doses (horse, aloes 1% to 2 0z.; ox, Epsom or Glauber

Cirrhosis in Cattle, Sheep and Horses fed on Senecio. 525

salts, 114 to 2 lbs.; sheep, 4 to 6 oz.), and daily doses of stry-
chnia subcutem, or nux vomica by the mouth. Diuretics should
be added to assist in elimination of the toxic principles, and above
all potassium iodide daily. But this can only be looked on as a
palliative resort. When the liver is already the seat of pro-
nounced cirrhosis, no restoration to the healthy condition can be
hoped for ; the animal may be preserved until fattened, or until
one or more of her valuable progeny shall have been secured, but
to hope for a prolonged and healthy life is unreasonable.

Unlike a contagious plague however the sick, or surviving
animal is not a source of danger to others, except so far as it may
carry the seeds of the Senecio in its alimentary canal to be
scattered on new ground. After the expulsion of the seeds from
stomach and bowels the patient may be left in the herd or flock,
and allowed to occupy uncontaminated pastures.

Prevention. ‘The question of the eradication of the Senecio
Jacobcea, or the arrest of its further spread is the really import-
antone. ‘The danger of extension lies in the great abundance of
the seeds, formed in the many composite heads and the facility
of their extension. In this the ‘plant resembles its allies the
thistle and the ox-eye daisy. Yet in soils under yearly culture
the plant is usually exterminated, or restricted within the nar-
rowest limits. Itis in waste or non-arable lands, woods, rocky
hills, bogs, swamps and the like, that the plant secures its per-
manent hold, and from which it extends into adjacent arable
areas. In Nova Scotia it spread along the highways, and in New
Zealand, at first in lands adjoining the bush. On highways the
seeds are carried on the hoofs of animals and the wheels of
vehicles. Again the watershed comes in as a fruitful channel
of diffusion. In Nova Scotia, herds have been saved by picking
the Senecio from the hay before it is fed, and farms rendered
wholesome by pulling up and destroying all ragwort}found in the
fields, fences or roads. A penalty for allowing the plant to grow
on farms or adjacent highways would be a rational and economical
measure. In case of wild land, unfit for cultivation, the same
measure would apply, and where this is not practicable, stock
once put on such contaminated land should be confined to it until
ready for slaughter: they should not be moved elsewhere to
carry and distribute the seeds. When bogs and swamps can be

526 Veterinary Medicine.

reclaimed by drainage, this should be done even at public expense ;
otherwise stock must be fenced out from them. Sources of the
watershed, that are infested by the plant should be cleared of it,
or the land through which the water flows, must be cultivated.
Fodders harvested from infested lands, must be consumed on
them, and not carried elsewhere to spread the disease. Above
all no seeds of grasses or other plants grown on infested lands
should be offered for sale, for use outside such areas.

In New Zealand where the wide infested ranges are the des-
pair of the sanitarian, attempts have been made to reduce the
losses by overstocking the land with sheep in early spring and at
intervals thereafter, that the young fresh stems of Senecio may
be eaten down close and the formation of seed prevented ; also
by pasturing such infested lands by two flocks of sheep alter-
nately, each being allowed to occupy the ground for six weeks at
a time, and then turned for the same length of time into a whole-
some pasture. But it is found that in either case, after a year
the sheep have cirrhosis and begin to suffer and die, and, it may
be added, the frequent shifting from the infested to the sound
pastures, is the means of carrying the seeds to the latter and thus
extending the area of the disease. T'o obviate this the sound
pastures should be cultivated in the following year to destroy the
young plants as they grow from the seeds.

This is a matter of immense importance to the future live stock
industry, and will warrant rigid government control for the eradi-
cation of the pest, but not the common resort of maintaining an
expensive sanitary (?) staff engaged in work that can never put
an end to the evil.

CIRRHOSIS IN THE DOG.

In the dog, cirrhosis is much more common than in the larger
animals, in connection with idle pampered habits, the frequency
of diseased heart and consequent disturbance of the circulation,
and the presence of parasites in the liver or biliary ducts. Bac-
teria intoxication and infection are also common.

Lesions. ‘The liver is at first tumefied, with hard consistency
and rounded edges, and a deep brownish red color, but this is

Cirrhosis in the Dog. 527

modified by the grayish fibroid hyperplasia which is especially
abundant in and around the vaginal sheaths of the capsule of
Glisson. In cases arising from diseased right heart or lungs the
induration is rather concentrated around the hepatic veins. The
contraction and shrinking of the fibroid hyperplasia as the disease
advances, causes the projection of the hepatic tissue in minute
rounded elevations which give a peculiar uneven appearance to
the surface of the organ. The fibroid growth gives a remarkable
hardness to the liver which resists even the edge of a knife. The
hepatic cells are the seat of fatty and pigmentary degeneration,
Inflammation and tumefaction of the kidneys, and ascites are
common features of the malady.

Symptoms. ‘The general symptoms are as in parenchymatous
hepatitis with a more tardy development. There are impaired or
irregular appetite, dullness, sluggishness, in an obese animal
short-windedness or palpitations on slight exertion, symptoms of
disease of the heart, lungs or digestive organs, a spasmodic cough,
constipation followed by relaxation of the bowels, nausea and
vomiting.. As the disease advances tenderness of the loins, the
passage of brownish or reddish, albuminous urine; the formation
of ascites and of gastro-intestinal catarrh may be noticed. Icterus
may be entirely absent, but, with a flaccid abdomen, enlarged
liver and spleen may be detected by palpation.

Treatment, 'The indications are to first combat the causes.
Irregularities in the heart’s action may be met by digitalis or
strophanthus ; gastro-intestinal catarrh by a carefully regulated
diet, with mineral acids and bitters; portal congestion by a free
use of water and other diluents and by saline laxatives ; intestinal
fermentations by antiferments (salol, naphthol), and toxic matters
in the blood by alkaline diuretics. For the liver hyperplasia,
potassium iodide may be freely used. Blisters to the right side
will occasionally prove useful. The ascitic fluid must be drawn
off when it accumulates. A diet of milk, bread and milk, butter-
milk and mush, or one in which albuminoid elements are in mini-
mum amount and the action of which is laxative is to be preferred.
Out door exercise is desirable.

CHRONIC ATROPHY OF THE LIVER.

Chronic Atrophy: In old horses: In right and spigelian lobes ; others
show hypertrophy. In ruminants, omnivora and carnivora : in areas com-
pressed by tumors or parasites. Perihepatitis. Sclerosis. Remedy causes
if possible. Fatty Degeneration : Oil globules in liver cells, pathological
when they destroy the protoplasm. In ducks and geese, on forced feeding.
Causes: poisoning by phosphorus, arsenic, antimony, lead, phenol, iodo-
form, alcohol ; excess of fat in food, spoiled fodders, colchicum autumnale,
yellow lupins, bacteria, hemorrhages, inflammations, tumors, parasites ; im-
proved meat producing breeds, old animals, hot stables. Lesions: liver en-
larged, pale, yellow, bloodless, knife in cutting is smeared with fat, oily
stain on paper, liver cells enlarged, protoplasm replaced by fat or oil; may
be circumscribed. Symptoms: obesity, overfed in fats and starches, of fat-
tening breed, kept in confinement, in hot, moist environment, if fed certain
poisons, with costiveness and indigestion, no endurance, short winded,
slight icterus, scanty urine, little urea, later, emaciation, palpation of en-
larged liver. Treatment: send to butcher, pampered horses, cows from
swill stable, a run at grass, with shade trees, a poor pasture, salines, chola-
gogues, mineral acids, bitters, iron with alkalies, currying, massage, douches.

Acute yellow atrophy has been referred to under parenchy-
matous hepatitis but a chronic atrophy is also met with in all
domestic animals.

In old horses it affects, by preference the right and spigelian
lobes, the portal circulation of which is less direct because of the
veins of supply leaving the parent trunk at right angles (Leblanc),
and because these lobes are more exposed to compression by solid
accumulations in the double colon (Kitt). In such cases a com-
pensatory hypertrophy of the left and middle lobes is often
observed.

In ruminants the lesion is often circumscribed to the areas that
have undergone compression by tumors or parasites (echinococ-
cus, actinomycosis), and there may be compensatory increase
elsewhere in the organ.

In swine, dogs and cats the same conditions are operative. In
all alike perihepatitis may be a causative factor, and sclerosis
(cirrhosis), with contraction of the fibrous hyperplasia may also
operate.

Symptoms are very obscure and treatment unsatisfactory unless
the active causes can be recognized and arrested.

528

HEPATIC STEATOSIS. FATTY LIVER. FATTY
DEGENERATION.

The presence of oil globules in the liver cells is normal and
physiological, the liver acting to a certain extent as a storehouse
for fat. This is always a marked feature, in healthy animals on
high rations, and taking little or no work, but so long as the
protoplasm and nuclei of the cells retain the normal characters
and functions the conditionis not a morbid one. It may, however,
become excessive, with great enlargement of the liver, and with
the substitution of fatty granules for the protoplasm of the cells
as in ducks and geese subjected to forced feeding, and the con-
dition becomes a distinctly pathological one.

In true fatty degeneration the protoplasm of the hepatic cells
is destroyed and replaced by fatty granules, the resulting condi-
tion being a permanent destruction of the cell for physiological
uses.

Causes. ‘The liver cells undergo fatty degeneration under the
action of certain poisons like phosphorus, arsenic, antimony,
lead, phenol, iodoform and alcohol. According to Neyraud
oxide of antimony is given daily to fattening geese to hasten the
development of fatty liver.

An excess of fatty elements in the food leads to the same re-
sult as shown first by Majendie in dogs, in which not only did
the liver undergo this degeneration but the sebaceous glands of
the skin secreted an excess of volatile fatty acids.

The cryptogams and their products on musty fodders determine
a gastro-enteritis in herbivora, accompanied by fatty degeneration
of the liver.

Colchicum Autumnale, and poisonous yellow lupin both deter-
mine this degeneration.

The products of a number of pathogenic bacteria have a simi-
lar effect. This has been noticed in the cat with bacillus pyocy-
aneus (Charrin), and in other animals with the cholera spirillum,
pyemic and septiczemic infection, contagious pneumonia of the
horse, strangles, and ulcerative endocarditis. It has been long
noticed to be a complication of pulmonary tuberculosis, the result

34 529

530 Veterinary Medicine.

in this as in other affections of the lungs having been attributed
to lessened oxidation in the tissues. It occurs also in heemorr-
hages, ruptures and inflammations of the liver and in passive con-
gestions of the organ, the impairment of the normal functions (in
the altered conditions of nutrition, or under the influence of poi-
sons,) proving an important factor in the process. The same
remark may apply to the fatty degeneration which complicates
most other liver diseases, cirrhosis, catarrh of the bile ducts, dis-
tomatosis, echinococcus, carcinoma, and epithelioma.

Certain other factors must be taken into account. The inheri-
ted disposition to the production of fat which characterizes the
improved breeds of butcher animals, and particular individuals of
all breeds, mature age which predisposes to the deposit of fat in
internal organs, old age which lessens the vitality of the cells,
and hot, damp climates or stables, all operate more or less in
determining the fatty change.

Lesions, In fatty degeneration the liver is enlarged, pale,
bloodless, yellowish, its cut surface exudes an oily fluid which
smears the knife, and it is so light that it floats on water. If
scraped and the material drawn across a sheet of paper it forms a
transparent oily stain. Under the microscope the liver cells are
seen to be enlarged and to have their protoplasm and nuclei re-
placed by fat or oil, If due to obstruction in the heart or lungs
the degeneration is greatest toward the centre of the acinus, if
due to an infectious disease it is usually greatest towards its periph-
ery. In infectious diseases too the liver is not pale yellow, but
usually of adeep brownish or yellowish red. The degeneration
may be local or general. McFadyean found a circumscribed
lesion in an ox’s liver, of a bright ochreous color, and the cells
completely transformed into fat cells, while the rest of the liver
was sound. In the dog fatty areas, up to an inch in diameter,
are not uncommon. The swollen cells pressing on the adjacent
vessels, account for the bloodless condition, and favor the degen-
erative process.

Neyrand records a fatty liver of 28 tbs. weight from the horse,
and Kitt one of 10 tbs. from the pig.

Symptoms. Vike as in most chronic liver diseases the indica-
tions are uncertain. The conditions may, however, suggest fatty
degeneration ; if the patient is very obese; if it has had an

flepatic Steatosts. 531

abundant food, rich in hydrocarbons and carbhydrates, and little
exercise ; if it has received in food or water continuous doses of
phosphorus, arsenic or antimony ; if it has lived in a hot moist
climate or stable ; if there has been a tendency to costiveness and
indigestion ; if the patient is weak, easily fatigued and short-
winded ; if there is a slightly yellowish red tinge of the conjunc-
tiva and if the urine is scanty and contains little urea. If the
disease is more advanced and the animal emaciated, it may be
possible in the smaller animals at least to manipulate the liver to
make out its increase, its smooth surface, and its absence of ten-
derness.

Treatment, When met with in meat producing animals the
best resort is to turn these over to the butcher. When in an
animal which is mainly valuable for breeding purposes, or in
horses or carnivora, something may be done to check the
progress of the malady, and maintain at least the present con-
dition. The value of this will of course depend on how far the
disease has already progressed. Cows that have spent a winter
in a hot swill stable are of little use afterward for breeding or
dairy uses and advanced cases of fatty degeneration in the horse
or dog hold out little hope of a satisfactory issue. For cases in
the earlier stages, nothing can be better than a run at grass,
where there is opportunity for shelter from the noonday sun.
If the pasture is short and the animal has to exercise to se-
cure a living, so much the better. If kept indoors the patient
should have a clean, roomy airy box stall, with a moderate allow-
ance of easily digested food, and laxatives and cholagogues daily
such as Glauber salts, aloes, calomel, podophyllin or cream of
tartar. Mineral acids, especially nitro-muriatic acid, and bitters
may also be given. ‘The preparations of iron are sometimes
useful in maintaining the tone of the digestive organs and
counteracting anzemia but they must be conjoined with diuretic
doses of bicarbonate of soda.

There is great advantage in stimulating the skin, and active
brushing, currying, hand-rubbing, and even cold douches may
be resorted to.

AMYLOID DEGENERATION OF THE LIVER.

Degeneration of basement substance of connective tissue, swollen, trans-
parent, homogenous, colored mahogany brown by iodide. In wasting dis-
eases, tubercle, cancer, malaria, dysentery, leukezemia, suppuration, ulcera-
tion, pleurisy, pericarditis, peritonitis, chronic catarrh, broncho pneumonia,
orchitis, biliary calculi, nephritis. Chronic. Lesions: Affected part swol-
len. sinks in water, bloodless, clear, smooth, homogeneous, yellowish or
reddish gray, under compound solution of iodine becomes mahogany brown,
uuder sulphuric acid, dark violet. Extends from vessel walls to adjacent
connective tissue. Symptoms: Of wasting diseases, but not diagnostic.
Treatment: Unsatisfactory, directed to causative disease.

This is a condition in which the basement substance of the
connective tissue, and especially of the walls of the vessels, be-
comes swollen and composed of a transparent, homogeneous sub-
stance, albuminous in character, and which stains of a deep
mahogany brown on the application of a solution of iodine.
The degeneration is usually associated with severe wasting dis-
eases, in the human being with tuberculosis, syphilis, malignant
tumors, malarial infection, dysentery, leukaemia, and chronic
suppuration or ulceration, especially of the bones.

In the lower animals (horse, dog, ox, sheep, rabbit, poultry)
it has been seen to attend or follow on similar cachectic condi-
tions. In the horse it has been seen in connection with the
effusions of pleurisy, pericarditis and peritonitis (Rabe), in
chronic bronchial catarrh (Fischkin), in chronic broncho-pneu-
monia, and dilated right heart (Trasbot), in orchitis, phlebitis
and cachectic states (Caparini), and in calculous obstruction of
the biliary duct (Burgoin). In cattle it hasaccompanied chronic
nephritis (Briickmtiller), tuberculosis, leukeemia, etc. In lambs
kept in confined stables, though well fed on oats (Werner). In
long standing suppurations and in animals fed on distillery swill
it has been observed.

It may last for months or years, and predispose to other dis-
orders, functional and structural. It does not, however, interrupt
secretion as bile continues to be formed.

Lesions. ‘The affected part of the liver is enlarged, the entire
organ in the horse may amount to 32 lbs. It is smooth and even,
though thick and rounded at its inferior border, yet occasionally

532

Amyloid Degeneration of the Liver. 533

on the posterior aspect there may be hyperplasia and a rough
irregular surface. The diseased liver is heavy and sinks in water,
unlike the fatty liver. In the horse it is soft and friable or even
pasty whereas in man it is firm and resistant. The cut surface is
bloodless, smooth, clear, homogeneous and grayish, yellowish or
reddish gray. When treated with a solution of iodine and potas-
sium iodide it changes to a deep mahogany brown ; if dilute sul-
phuric acid is then used it changes to a deep violet, almost black
color. If the iodine solution is brushed over the smooth cut sur-
face the mahogany color of the amyloid stands out in marked con-
trast with the bright yellow of the healthy hepatic tissue. The
amyloid commences in the walls of the smallest arteries, in the
media and intermediary layers of the intima, and thickens the
walls so as to obstruct their lumen more or less completely and
render the part comparatively exsanguine. It may extend tothe
conncctive tissue of the organ, but it is not certain that the hepatic
cells are involved in the process. The cells are, however, pressed
upon by the diseased vessels and stroma and undergo consequent
fatty degeneration. The amyloid may be confined to but a small
part of the liver or to its smaller bloodvessels or it may extend to
the whole. In fowls it is always in multiple centres (Leisering).
It may be found in other important organs, kidneys, spleen,
lymphatic glands, intestinal mucosa, etc.

Symptoms are not diagnostic. If with an old standing, ex-
hausting disease, paresis, weakness, emaciation and unfitness for
work, there is loss of appetite, dryness of the mouth, congestion
of the rectal mucosa, yellowish, whitish, or dark tarry feeces, and
a slightly brownish or yellowish tinge of the visible mucous mem-
branes (Rexante) it may be suspected. In fowls Leisering
noticed, weakness, lameness ruffling of the feathers and attacks
of vertigo. Icterus, ascites and tenderness over the region of the
liver may all be absent. In the absence of ascites, tympany, or
an excess of fat in the smaller animals, manipulation may detect
the considerable enlargement of the liver, and the characteristic
smoothness, of its surface. In other cases some indication may,
at times, be had from the increased area of dullness or percussion.

Treatment. Is essentially unsatisfactory even if a correct diag-
nosis can be made. ‘The most hopeful course would be to correct
the debilitating disease in which the amyloid seems to have orig-

534 Veterinary Medicine.

inated. Diseased bones, ulcers, chronic suppurations, and ca-
tarrhs may be done away with, and at least any further advance
of the degeneration arrested. Open air exercise and a green or
otherwise laxative diet would beindicated. ‘Theamyloid inlambs
fed on oats was corrected by a change of diet (Werner). As
medication the alteratives, potassium iodide and potassium ar-
seniate have been mainly restored to. Bittersand iron may also be
of use to build up the strength. The latter should be given with
potassium bicarbonate.

BLACK PIGMENTATION OF THE HEPATIC CELLS.
BROWN ATROPHY.

In horse. With melanoma and atrophy, or without, pigment granules
fill hepatic cells, liver becomes brown or black. In calves. In sheep.
Apart from melanosis, the real cause unknown.

The accumulation of granules of black pigment in the hepatic
cells has been noticed in old and worn out horses (Louis Blanc,
Cadeac, Brickmtller), in calves (Degive, Cadeac), and in
sheep (Siedamgrotzky, Barrier). In horses it has been found in
connection with atrophy, orin other cases, with melanotic tumors
in other parts. In atrophic cases the liver is small, puckered,
brown and dull, with a leathery appearance on section, and with
the hepatic cells charged with pigment granules so that each
acinus has a stellate appearance from the radiating lines of cells.
This constitutes brown atrophy.

The second form which may be called melanotic liver, is not
associated with atrophy, but is characterized by the crowding of
the hepatic cells with black pigment granules, which fill up the
protoplasm and crowd the still pale nucleus toone side. The
affected portions become of a deep black.

In calves the [pigmentation may be confined to the superficial
portion of the liver (Degive). ,

In sheep pigmentation may be in the peripheral cells only of
the acinus (Cadeac) but is about equally distributed on the sur-
face, and throughout the interior of the liver, and may extend to
the stroma of the gland. (Siedamgrotzky).

Dilatation of the Gall-Bladder. 535

Apart from the general causes of melanosis, benignant or
malignant, no definite reason for this pigmentation has been
assigned. The development of melanzmia and tissue pigmenta-
tion in man from malarious microdganisms suggests that other
germs and their products may have a similar effect in the lower
animals but nothing certain is known as to the true cause.

Apart from melanosis, it is not known that this pigmentation
of the hepatic cells is of any essential pathological importance.
It is important however for the veterinarian to be acquainted with
the condition, that he may intelligently deal with such lesions
whether seen in ordinary post mortem examinations, or in the
course of meat inspection.

DILATATION OF THE GALL BLADDER ,AND BILE
DUCTS.

Causes: obstruction of common bile duct, distoma, round worms,
teenize, gall stones, encrustrations, inflammations, tumors, cicatrices, hy-
datids. Congenital absence. Ducts stand out on liver. Symptoms of
colic, icterus, bile poisoning, marasmus. Treat the causative conditions.

This may occur in all our domestic animals except solipeds in
which latter there is no gall bladder.

Causes. Any serious obstruction to the-discharge of the bile
into the duodenum may cause it. The presence of trematodes,
nematodes, or even tenize in the ducts, gall stones, incrusta-
tions, occlusion of the ducts by inflammatory swelling, tumors of
the liver or adjacent parts, echinococcus, cysticercus, or cica-
trices may be cited. Cadeac mentions a case of congenital
atresia of the bile duct in the calf. Vigney records a case in the
cow in which the greatly dilated gall bladder formed a hernial
mass in the epigastric region which was, however, easily reduced
by manipulation.

In all such cases the distended bile ducts stand out as white
branching lines on the back of the liver converging toward the
portal fissure. The walls of the ducts may be attenuated or
thickened and it is alleged calcified. They are usually lined by
a deposit of cretaceous consistency precipitated from the retained

536 Veterinary Medicine.

bile. ‘The contents of the distended ducts and bladder are vari-
able. They may have the color (yellow, green) and consistency
of bile; they may be thick, dense and albuminous ; they may be
thin and serous from inflammatory or dropsical exudation ; they
may be granular, or purulent.

Though there is no gall bladder, in the soliped, a similar con-
dition of the biliary ducts may be produced in the same way.

According to the degree of obstruction there may be more or
less acute symptoms of biliary colic, icterus, marasmus, poisoning
by bile acids, etc.

Treatment must be directed toward the removal of the special
cause of dilatation.

DOUBLE GALL-BLADDER.

Asa congenital formation the gall bladder is sometimes divided
into two at its fundus, and in other cases the division extends
throughout, forming two complete sacs. This has been found in
the sheep, cat, ox (Gurlt, Goubaux) and pig (Goubaux). Such
a redundancy does not interfere with normal functions.

CHOLELITHIASIS. BILIARY CALCULI. GALL STONES.

In ruminants, omnivora, and carnivora, less often in horse, 1 to 1000, or
more, biliary sand \o marble or more, casts; nucleus, bile pigment, blood
mucus, etc., with concentric layers of cholesterine, pigment, salts and lime.
Causes: idleness, overfeeding, dry feeding, thickening of bile, colloids,
bacteria, wintering in stable. Colloids induce globular deposits. Parasites.
Inflamed biliary epithelium secretes excess of cholesterine and lime. Age.
Acid bile, constipation. Diseased liver. Lack of bile salts. In solipeds :
all sizes and numbers, green, brown, yellow or white. Liver disease.
Symptoms : colic with depression, prostration, yellow or red urine, icterus,
sudden recovery. Treatment : sulphate of soda, olive oil, antispasmodics,
warm drinks, fomentations, salicylate of soda, chloroform, pasture, or suc-
culent food, and open air exercise. In cattle: musk odor; calculi dark
green, yellowish green, whitish or orange, dry red, all sizes and numbers.
Causes : dry winter feeding, etc. Lesions: dilated bilary ducts and blad-

Cholelithiasis.— Biliary Calculi.—Gall Stones. 537

der, catarrh, thickening, rupture, septic peritonitis. Symptoms : relapsing
colic, with icterus, prostration, and tender right hypochondrium, in stalled
animal on dry feeding. Suggestive: not pathognomonic. Treatment : as
in horse: succulent spring pasturage. In sheep: rare, musky odor ;. con-
cretions and casts common in distomatosis. Hypertrophied ducts. Symp-
toms of distomatosis. Treatment : for distomatosis and calculi. In swine:
rare: circular. In carnivora: round, dark grecn, pin’s head to hazel nut.
Symptoms: colics, constipation, emesis, icterus, tender right hypochon-
drium, concurrent catarrh of bowels, heart disease, dyspnoea, sudden relief.
Mode of relief. Treatment : olive oil, bile, sodium sulphate, or salicylate,’
antispasmodics, alkalies, enemata, fomentations. Laxative food, exercise,
open air.

Gall stones are most frequent in animals having a gall bladder.
Some medical writers say they are formed in the gall bladder
only, but the soliped which has no gall bladder has in particular
instances furnished hundreds of gall stones. Yet the ox, dog,
sheep and pig are the common victims of biliary calculi among
our domestic animals. In these the calculi appear to be mostly
deposited from the stagnant bile in the gall bladder, yet concre-
tions on the biliary ducts and hollow casts inside the ducts are
by no means uncommon.

A gall stone may be single, or they may be multiple up to
hundreds or even thousands, and when very numerous they are
individually small, perhaps no larger than a pin’s head. They
may, however, attain the size of a marble or more, and by mutual
pressure and wear they assume various polygonal forms. Ifthey
lie apart in the gall ducts or bladder they are regularly rounded.
They are sometimes mulberry shaped as if conglomerate. In
other cases the solid masses are so small as to have secured them
the name of biliary sand. Casts and incrustations in the ducts
are necessarily made up of smaller globular masses.

On section a calculus shows a nucleus, composed of bile pig-
ment, blood, mucus, with the debris of parasites or bacteria.
Around this nucleus, the calculus is deposited in concentric layers,
of a hard material consisting largely of cholesterine, but contain-
ing also bile coloring matter, bile salts, and lime, in short all the
constituents of bile.

Causes. Various conditions contribute to the precipitation of
biliary solids in the form of calculi or encrustations. The most
prominent causes are : lack of exercise, over-feeding, dry feed-

538 Veterinary Medicine.

ing, concentration of the bile, the presence of colloids and bac-
teria infection.

Idleness is especially operative in cattle, which are quite subject
to biliary calculi and concretions, when shut up in the stall on
abundant, dry feeding for a long winter. They are not noticed
in stalled animals, that are fed watery or succulent rations, such
as green fodder, distiller’s or brewer’s swill, ensilage, brewer’s
grains, mashes, roots, potatoes, apples, pumpkins, and in case a
tendency to their formation is developed on the dry feeding of
winter, the concretions may be re-dissolved and entirely removed
by the succulent spring grass. A similar influence is noticed in
the human family, as the female sex living mostly indoors, and -
males pursuing sedentary occupations furnish the greatest number
of gall stones.

Concentration of bile results in part from muscular inactivity
and hepatic torpor, but also from over-feeding which loads the
portal blood and indirectly the bile with an excess of solids, and
from dry feeding which lessening the secretion of water leaves
the bile more dense and predisposed to precipitate its solids. The
density of the liquid, however, developed from «a rich and dry
ration and a prolonged inactivity, may continue for a length of
time, without the occurrence of actual precipitation. It usually
requires some additional factor to make this predisposition a
direct cause.

Presence of Colloids. This may be found in the presence
of solid or semi-solid particles. Just as the introduction of a
thread into a concentrated solution of sugar or salt will induce
an instant crystallization‘on a filament so the presence of solid
bodies determines a similar condensation in solid form of the
solids of the bile. But this tendency is increased materially if
the solid body is itself of a colloid or non-crystallizable material.
Rainey and Ord have shown experimentally that colloid bodies
like mucus, albumen, pus, blood, epithelial cells, not only de-
termine the precipitation of crystallizable salts from a strong
solution, but that they cause the precipitate to assume the form of
globular or spherical particles, which by gradual accretions on
their surfaces tend to grow into calculi. They found that salts
which are deposited by mere chemical reaction, without the in-
tervention of colloids, appear in the form of sharply defined

Cholelithiasis.—Biliary Calculi.—Gall Stones. 539

angular crystals. The very fact that a precipitate assumes a
spherical form suggests the presence of colloids as an active factor
in the precipitation. Heat appears to intensify this action, though
probably the normal body temperature operates mainly through
the more active proliferation of bacteria.

Bacteridian infection. In connection with the action of colloids

it has been observed that when such bodies are in a condition of
fermentation they are much more potent as precipitants than if in-
active and sterile. But as all fermentations are the work of
nlicroodrganisms we are at once brought to the conclusion that
bacterial infection is one of the most potent causes of calculous
formations. The invading microbes operate upon the dissolved
solids, causing changes in their condition which reduce their
solubility, and thus determine the separation of calculi and con-
cretions in a manner allied to the precipitation of nitrates in the
soils. ‘
But the same microbes operate in producing the colloids which
cooperate so effectively in the formation of calculi. The catarrh-
al biliary ducts, or bladder shed their epithelium, and transude
white and red globules, and form pus and an excess of mucus, all
tending to the separation of the biliary solids or forming nuclei:
on which these solids may condense. ‘The calculi and concretions
tend in their turn to maintain and advance the inflammation.

The access of the microbes to the biliary duct or bladder may
be effected through the blood of the portal vein or hepatic artery,
or in the new-born, through the umbilical vein from an infected
navel. As other modes of access may be named, a gradual ad-
vance from the duodenum through the common bile duct, or
more speedily on or in the bodies of parasites (ascaris, strongylus,
stephanurus, tenia, echinococcus, distoma; fasciola, ‘coccidia),
etc.

Changes in the chemical composition of the bile have been invoked
as a cause of gall-stones, and Naunyn has found that the inflamed
biliary epithelium secretes an excess of cholesterine and salts of
lime. ‘Thomas has also observed a great increase of cholesterine
in connection with a catarrhal angiocholitis in the dog.

Among other alleged causes of biliary calculi are advanced age
(Rigot, Hering), actdity of the bile (Zundel), constipation, and
any organic disease of the liver and bile ducts which interferes with
excretion of bile.

540 Veterinary Medicine.

Age is supposed to act by inactivity, lessened secretion,
hepatic torpor, and the greater presumption of liver disease,
acidity by the precipitation of cholesterine and the dissolving of
lime present in the tissues, and constipation throngh hepatic
inactivity, obstruction of the flow of bile, and the tendency to
infection through intestinal fermentations.

It may be added that any diminution of glycocholate or tauro-
cholate of soda or potash, decreases the solubility of cholesterine
and bile acids and favors their precipitation.

GALL STONES IN SOLIPEDS.

Characters. ‘The biliary calculi of solipeds are of all sizes and
shapes. When numerous they are mostly the size of a pin’s head
(Lucet). Birnbaum found in one animal 4oo like peas.
Dieckerhoff has repeatedly found four or five of the size of a
hazelnut. Verheyen found one as large as an apple and says one
exists at the Berlin Veterinary College which weighs several
pounds. Rigot found go in the biliary ducts of an old horse,
and Zundel records the death of a stallion of twenty-six years
from multiple gall stones.

The calculi may be little larger than grains of coarse sand.
When larger and solitary they are mostly globular or mulberry
shaped ; if many are together they have become polygonal by
friction. In other cases notably with distomata they form hollow
tubular incrustations on the bile ducts, and contain a thick
grumous bile. They are usually of a green color, but may be
yellowish brown, yellow, or whitish. When cut across they
present a nucleus enclosed in successive layers, each successive
one often differing from the last in color. Their specific gravity
is low, some will even float in water when taken from the ducts,
and all float when dried. Their composition is variable but
chiefly cholesterine, bile acids, resin and pigments, an albuminoid
matter, with lime salts, etc. The nucleus may be the remains
of a dead parasite, epithelial cells, blood, pus, mucus, etc. ‘The
outer layers are usually the hardest.

Gall Stones in Solipeds. 541

There may be attendant hypertrophy of the liver, cirrhosis,
amyloid and other degenerations, catarrh of the biliary ducts, and
distension or (according to Birnbaum) rupture of the portal vein.

Symptoms. ‘There are no reliable diagnostic symptoms apart
from the colics which accompany the obstruction of a bile duct by
a passing calculus. These in the main resemble the colic of
ordinary indigestion, but they may be complicated by unusual
depression and nervous prostration. There may be drooping of
the head, ears and eyelids, watery eyes, resting the head on the
manger or pushing it against the wall. The urine is liable to be
red or reddish (Jobelot), and if it or the mucosz show a yellow-
ish tinge it is strongly suggestive. There may be constipation or
diarrhcea. The colics are severe and may last for several days
(Seaman, Lucet, Burgoin) without fever and recover abruptly
when the stone passes into the duodenum. ‘They recur, however,
with the impaction of another stone, and this intermittent feature
with the marked prostration, and the access of slight jaundice
with each colic furnishes the best means of diagnosis.

Treatment. During the access of colic give a full dose (1 to 2
lbs.) sulphate of soda in warm water along with some active anti-
spasmodic (belladonna, lobelia, chloroform, ether),- and foment
the loins and hypochondriac regions. Olive oil in large doses
(1 to 2 quarts) has been found effective. Salicylate of soda in
full doses is beneficial in stimulating the biliary secretion, diluting
the bile, and securing some measure of antisepsis in both bowels
and liver.

In the intervals between the colics, sodium salicylate, sodium or
potassium carbonate, or olive oil in continuous doses may assist
in disintegrating the calculi or passing them on. Chloroform
tends to break them up by dissolving the cholesterin. But any
such treatment must be accompanied by the abundant ingestion of
water, and this is often best secured by a run ina rich green
pasture. In the absence of pasturage, succulent fruits, and roots,
ensilage, mashes, and gruels may be advantageously substituted,
and conjoined with systematic exercise in the open air.

GALL STONES IN CATTLE.

Characters. The biliary calculi of cattle are characterized by
a faint odor of musk, which becomes stronger on the addition of
potassa and the consequent disengagement of ammonia.

They are distinguished according to their color as dark green,
yellowish green, and orange, brownish or white. There are also
the sedimentary deposits (biliary sand).

The dark green calculi are the most frequent, and being found
in the gall bladder and larger bile ducts, they attain a larger size
than the others. ‘Those in the gall bladder may be pear-shaped,
and those in the ducts, round, ovoid or cylindroid. They are
often rough and uneven on the surface with deep cracks and
holes penetrating deeply into their substance and often filled
with cholesterin. The pigments may change to a blood red
when dried. ‘The consistency of these calculi varies, some being
hard, resistant and heavy, while others are soft and friable. All
are composed of concentric layers around a central nucleus as in
those of the horse. ‘hey vary in weight up to seven ounces in
exceptional cases. They contain cholesterin, fat, resin, pig-
ments, and lime and magnesia salts.

The yellowish green calculi are usually spherical unless moulded
‘into polygonal shapes by mutual contact. In the last case they
have flattened surfaces. These have a firm consistency and are
composed of successive layers of nearly equal color and density
surrounding the central nucleus. They are on an average
smaller than the dark green variety but individual calculi have
been found of three ounces.

The whitish or orange calculi are usually in the form of hollow
casts of the bile ducts having a dull white color externally and a
yellowish brown internally. They are usually thin, fragile and
crystalline and contain relatively more earthy salts than the two
first named varieties. From this cause also they have a higher
specific gravity. One specimen weighed 8 ounces.

The dchary sand or pulp, is made up of granules of a yellowish,
dark green or black color, forming with the bile a pultaceous
mass but drying into a consistent mass. It may be firmly adher-

542

Gall Stones in Cattle. 543

ent to the mucosa of the gall bladder and require to be scraped
off. These granules may be looked on as the first step in the
formation of calculi or encrustations.

The causes of biliary calculi in cattle are mainly close confine-
ment, dry feeding, abundant rations, the presence of trematodes
in the bile ducts and finally microbian infection.

Lesions vary. With obstruction of the common bile duct or
cystic duct, there are usually dilatation of the bile ducts with
fibrous thickening of their walls so that they stand out as white
branching lines on the back of the liver. In extreme cases the
common duct may acquire the calibre of the small intestine. The.
gall bladder may participate in this thickening (Chassaing) or
may even rupture (Proger, Shaw).

In connection with obstruction microbian infection extends
upward into the liver, and in rupture of the bladder an acute,
diffuse septic peritonitis follows (Chassaing). This only follows
on infective inflammation of the gall bladder. Aseptic bile causes
little or no irritation.

Symptoms. As in the horse, general symptoms of ill health or
hepatic disorder are not pathognomonic. The presence of inter- ,
mittent attacks of constipation, and colic, with icterus, tympanies
and violent efforts at expulsion are the diagnostic symptoms of
an acute attack. Pulsation and respiration are accelerated, and
the urine dense, high colored, oily and slightly yellow. Reboul
has noticed that symptoms are aggravated on exposure to cold ;
there are great prostration and dullness, frequent moaning and
marked indications of tenderness when the right hypochrondium
is percussed. Charlot has observed that the only symptoms may
be persistent jaundice with scanty, high colored urine, containing
some sediment.

Treatment is essentially the sameas in the horse. Vanswieten
and Verheyen draw special attention to the fact that whereas bili-
ary calculi are very common in cattle during winter, they are
rarely found in animals that have been for even a short period
on the spring grass. Spring pasture is therefore the best thera-
peutic agent. During paroxysms of colic, Glauber salts, or olive
oil, antispasmodics and fomentations over the liver are to be
tried. In the intervals salicylate of soda, sodium and potassium
carbonate, olive oil, chloroform, and ether may be used. Abun-
dance of water and aqueous rations are essential.

GALL STONES IN SHEEP.

Calculi are very rare. One described by Morton had a brown-
ish yellow color on its surface, and a white color spotted with
green internally ; it had a bitter taste, colored saliva yellow, and
melted when heated, diffusing the odor of musk. It weighed
twelve grains and contained 70 per cent. of cholesterin, calcic
phosphate and carbonate and the usual biliary elements.

But if spherical calculi are rare, concretions and casts of the
bile ducts are common, especially in distomatosis. These are of
a yellowish, reddish, greenish or blackish brown, and form gran-
ular plates, or veritable cylindroid casts often firmly adherent to
the mucous membrane of the duct.

In such cases the walls of the incrusted ducts are hypertrophied
and stand out on the back of the liver as white bands diverging
from the portal fissure.

Apart from the usual symptoms of distomatosis no special indi-
cations have been observed.

Treatment is primarily that of distomatosis, to which the gen-
eral measures advised for calculi may be added.

GALL STONES IN SWINE.

Characters. 'The calculi are spherical, of a dull red when dried,
rough or on their opposed surfaces flat, clear and glistening,
where they have become polished by friction. They are found
as a fine sand or as calculi the largest of which have been 75
grains, and of a high density (1303 to 1484). Briickmiiller
found that they contained carbonate of lime and biliary mucus.
Verheyen found biliary resin, mucus, pigment and a little fat.
They are not rare in fat hogs in America. No diagnostic symp-
toms have been observed.

544

GALL STONES IN DOG AND CAT.

These are more or less spherical, dark brownish green, and
usually found in the gall bladder or larger bile ducts. They may
vary in size from a pea toa hazel nut. Their chemical analysis
is wanting.

Symptoms. ‘There may be evidence of biliary obstruction and
if this occurs intermittently and is associated with colic, it becomes
somewhat characteristic. Constipation, emesis, icterus, and some-
times tenderness of the right hypochondrium would indicate the
source of the colic. A pre-existing and concurrent catarrh of
the bowels corroborates these indications.

Cadeac explains that the obstructing calculus is called on to
resist the impulse of the bile forced upon it by the spasmodic
contraction of the bile ducts, which distends the bile duct imme-
diately back of the stone to perhaps ten times its normal size.
Then under a suspension of the spasm or even an auntiperistaltic
contraction of the duct, the calculus is forced back into the dilated
portion or even into the gall-bladder, and the attack is relieved.
Under repeated irritations of this kind the inflammation of the
bile ducts extends into the liver and determines cirrhosis. The
irritation further through the sympathetic produces a reflex con-
striction of the pulmonary capillaries, with the natural results of
increasing tension of the pulmonary artery and right heart, and
dilatation and degeneration of the walls of the latter even in the
best nourished animals. Thus dyspnoea and modified heart
sounds (murmurs) may be symptoms of biliary calculi.

Treatment. Three or four ounces of olive oil were found to
greatly increase the quantity and fluidity of the bile in from
thirty to forty-five minutes. Bile, sulphate of soda and salicylate
of soda are excellent cholagogues, and the latter at the same time
anantiseptic. Anti-spasmodics are especially indicated to relieve
the colics, but they must be used in relatively smaller doses thanin
the herbivora. Potassic and sodic carbonates or tartrates (Vichy)
may be used as enemas if they cannot be administered by the
mouth. Fomentations may be resorted to. The food must be
laxative and aqueous, and exercise must be imposed as far as the
animal can bear it.

35 545

FOREIGN BODIES IN THE LIVER.

In horse: spikes of leguminose, barley awns. Symptoms: of internal
hemorrhage, pallor, weakness, vertigo, death ; jaundice, prostration, stupor,
weakness, crossing of fore limbs, tender right hypochondrium. In caéile:
bodies passing fromrumen. In swine,sand. In dog, sharp bodies from
stomach. Treatment: laparotomy.

Foreign bodies are rare in the liver in our domestic animals.
Forse. St. Cyr has found the spikes of leguminosz and Megnin
the beards of barley. St. Cyr believed that he traced the passage
followed by the stalk through the walls of the duodenum, and
portal vein where it divided to be distributed through the
liver. _At the point of supposed entrance the walls of the
vena portee were thickened and its lumen filled with clots. The
further course of the portal vein and its branches showed similar
thickening and clots, and on the branch leading to the right lobe
was a large abscess containing 4 decilitres of pus. Clots ex-
tended into the splenic, omental and mesenteric veins, and be-
tween the folds of the mesentery of the small intestine were a
number of minute ruptures and blood extravasations.

Megnin found traces of the passage of the barley beards
through the gastric walls and into the substance of the liver close
to the portal fissure. Around the centre where the barbs were
implanted there was an irregular heemorrhagic extravasation in the
liver, and in the abdominal cavity an effusion of 8 or 10 quarts
of blood.

Symptoms. In such a case the only definite symptoms are
those of internal hemorrhage, pallor of the mucous membranes,
gradually increasing weakness, vertigo, unsteady gait, and an
early death. In more protracted cases slight jaundice, dullness,
prostration, stupor, drooping of head, ears and eyelids, resting it
on the manger or walls, muscular weakness, crossing of the front
limbs, and it may be tenderness on percussion on the right side
of the chest posteriorly. It resembles the coma or immobility of
the horse but the patient backs more easily.

Cattle. In ruminants sharp-pointed bodies passing from the
rumen will occasionally penetrate the liver, and give rise to
symptoms of hepatic disorder. Augenheister found in a cow

546

Tumors of the Liver. 547

dilatation of the larger bile ducts, which contained about 10 quarts
of sand, that had apparently entered from the duodenum by
the common bile duct which had an orifice an inch in diameter.

Fig, The gall ducts of a pig’s liver, in the Veterinary College
of Berlin contains a large amount of sand (Gurlt).

Dog. The liver is exceptionally perforated by sharp-pointed
bodies coming fromthe stomach. Cadeac and Blanc report three
cases of needle in the liver. Blanc’s case had been killed be-
cause of old age; one of Cadeac’s showed symptoms resembling
rabies.

Treatment of these cases would be very hopeless as nothing
short of laparotomy and the removal of the foreign body would
promise success.

TUMORS OF THE LIVER. NEW GROWTH.

Largely secondary, from stomach, intestine, lymph glands, spleen, pan-
creas ; the hepatic tumor may be disproportiouately large. In horse : sarcoma
rapidly growing soft, succulent, slow-growing, fibrous, tough, stroma with
round or spindle shaped cells and nuclei. Symptoms : emaciation, icterus,
enlarged liver, rounded tumors on rectal examination. Melanoma, in old
gray ot white horses, with similar formations elsewhere ; not always malig-
nant. Lymphadenoma. Angioma. Carcinoma. Epithelioma, lesions,
nodular masses, white or grayish on section, and having firm stroma with
alveoli filled with varied cells with refrangent, deeply staining, large, multiple
nuclei, cancerous cachexia and variable hepatic disorder. In ca¢t/e : sarcoma,
adenoma, angioma, cystoma, carcinoma, epithelioma. In sheep: adenoma,
carcinoma. In dog : lipoma, sarcoma, encephaloid, carcinoma, epithelioma.
Wasting and emaciation, yellowish pallor, temporal atrophy, ascites, liver
enlargement, tender right hypochondrium, dyspepsia, symptoms of primary
deposits elsewhere. :

The great quantity of blood which passes through the liver
lays it open, in a very decided way, to the implantation of germs
and biological morbid products. Hence tumors of the liver are
largely secondary, the primary ones being found mostly in the
stomach, intestine, abdominal lymph glands, spleen and pancreas.
The primary neoplasm is often comparatively small, while the
hepatic one supplied with a great excess of blood may be by far
the most striking morbid lesion. The hepatic tumors are mostly
of the nature of angioma, sarcoma, melanoma, adenoma, lipoma,
cystoma, carcinoma, and epithelioma.

NEOPLASMS IN HORSES LIVER.

Sarcoma. ‘This is usually a secondary formation from the
primary tumors in the spleen and peritoneum, and it occurs as
multiple masses throughout the substance of the gland. The
liver is greatly increased in size, extending far beyond the last
rib on the right side, and weighing when removed as high as 70
tbs. (Mason), or even 88 tbs. (Cadeac), in extreme cases.

The whole surface of the liver may show bulging, rounded
. masses, and the morbid growth may have involved the capsule
and caused adhesion to the back of the diaphragm (Bachstadt).
The cut surface of the neoplasm is smooth, elastic, yellowish and
circular or oval in outline. It may have a variable consistency—
friable or tough, according to the activity of growth and the
relative abundance of cells and stroma. The portal glands are
hypertrophied and thrombosis of the portal vein is not uncommon.

Microscopic examination of the dark red scrapings shows nu-
merous blood globules, intermixed with the round or spindle
shaped cells and nuclei of the tumor. Sections of the tumor
show these cells surrounded by a comparatively sparse fibrillated
stroma. The round cells may vary from .005 to .o5 m.m. They
contain one or more rather large nuclei and a number of refran-
gent nucleoli. The nuclei are often set free by the bursting of
the cells in the scrapings. They become much more clearly de-
fined when treated with a weak solution of acetic acid. Small
grayish areas in the mass of the tumor represent the original
structure of the liver, the cells of which have become swollen and
fatty.

A liquid effusion more or less deeply tinged with red is usually
found in the abdominal cavity.

Symptoms are those of a wasting disease, with some icterus,
sometimes digestive disorder, and a marked enlargement of the
liver. The last feature can be easily diagnosed by palpation and
percussion. If an examination through the rectum detects the
enlargement and irregular rounded swellings of the surface of the
liver or spleen, or the existence of rounded tumors in the mesen-
tery or sub-lumbar region, this will be corroborative. ‘The pre-
cise nature of the neoplasms can only be ascertained after death.

548 .

Neoplasms in Horses Liver. 549

Melanoma. Melanosis of the liver is comparatively frequent,
especially in gray horses, and above all when they are aging and
passing from dark gray to white. In many cases a more certain
diagnosis can be made than in sarcoma for the reason that primary
melanotic neoplasms are especially likely to occur on or near the
naturally dark portions of the skin, as beneath the tail, around
the anus or vulva, in the perineum, sheath, eyelids, axilla, etc.
The extent of the disease is likely to be striking, the liver, next
to the spleen, being the greatest internal centre for melanosis.
The whole organ may be infiltrated so that in the end its outer
surface is completely hidden by melanotic deposit. The surface
deposits tend to project in more or less rounded, smooth masses
of varying size according to the age of the deposit and the
rapidity of itsgrowth. Individual deposits may vary in size from
a pea to a mass of 40 or 50 lbs. They are moderately firm, and
resistant, and maintain a globular or ovoid outline. The color of
the melanotic deposits is a deep black with a violet or bluish tint.
If the pigmentary deposit is in its early stage it may be of a dark
gray. ‘The deposits are firmer than the intervening liver tissue
and rarely soften or suppurate.

Melanosis in the horse is not always the malignant disease that
it shows itself to be in man, and extensive deposits may take place
externally and considerable formations in the liver and other in-
ternal organs without serious impairment of the general health.
It is only in very advanced conditions of melanosis of the liver
that appreciable hepatic disorder is observed. If, however, there
is marked enlargement of the liver, in a white or gray horse,
which shows melanotic tumors on the surface, hepatic melanosis
may be inferred.

Lymphadenoma, Adenoid Tumor. TLjienaux describes cases of
this kind in which the liver was mottled by white points which
presented the microscopical character of adenoid tissue, cells en-
closing a follicle and a rich investing network of capillaries.

Angioma. ‘These are rare in the horse’s liver, but have been
described by Blanc and Trasbot as multiple, spongy tumors on
the anterior of the middle lobe, and to a less extent in the right
and left, of a blackish brown color, soft and flucuating. The
largest mass was the size of an apple, and on section they were
found to be composed of vascular or erectile tissue. The tendency

550 Veterinary Medicine.

is to rupture and extensive extravasation of blood (30 to 40 lbs. }
into the peritoneum. *

Carcinoma, Epithelioma. ‘These forms of malignant disease
are not uncommon in the liver as secondary deposits, the primary
lesions being found in the spleen, stomach, intestine, or pancreas,
or, more distant still, in the lungs. The grafting or colonization
of the cancer in the liver depends on the transmission of its ele-
ments through the vena porte in the one case, and through the
pulmonary veins, the left heart and hepatic artery in the other.

Lesions. The liver may be greatly enlarged, weighing twenty-
seven pounds (Benjamin) to forty-three pounds (Chauveau),
hard, firm, and studded with firm nodules of varying sizes.
These stand out from the surface, giving an irregular nodular
appearance, and are scattered through its snbstance where, on
section, they appear as gray or white fibrous, resistant, spheroidal
masses shading off toa reddish tinge in their outer layers.
Microscopically these consist of a more or less abundant fibrous
stroma, enclosing, communicating alveoli filled with cells of
various shapes and sizes, with large nuclei (often multiple) which
stain deeply in pigments. ‘The relative amount of fibrous stroma
and cells determines the consistency of the mass, and whether it
approximates to the hard cancer or the soft. In the horse’s liver
they are usually hard, and, on scraping off the cut surface, yield
only a limited quantity of cancer juice. In the epithelial form,
which embraces nearly all that have originated from primary
malignant growth in the walls of the intestine, the epithelioid
cells, flattened, cubical, polyhedral, etc., are arranged in spheroi-
dal masses or cylindrical extensions, which infiltrate the tissues
more or less. These seem in some cases to commence in the
radical bile ducts (Martin), and in others in the minor coats of
the larger biliary ducts.

As the disease advances a brownish liquid effusion is found in
the abdomen, and nodular masses formed on the surface of the
peritoneum.

Symptoms. As in other tumors of the liver these are obscure.
As the disease advances there may be cedema of the legs and
sheath, indications of ascites, stiff movements, icterus, occasional
colics, tympanies, and diarrhcea. Nervous symptoms may also
appear, such as dullness, stupor, coma, vertigo and spasms.
Emaciation goes on rapidly and death soon supervenes.

TUMORS OF THE LIVER IN CATTLE.

Sarcoma, Round or spindle shaped celled sarcomata have
been described by Sodero and Cadeac, leading in one case to per-
foration of the vena portee and death by hemorrhage into the
peritoneum.

Adenoma. Martin records a case of a hepatic tumor formed
of adenoid tissue which had extended into the vena porte, and
microscopicaliy presented a cylindroid character. In the ad-
vanced stages it caused some jaundice, digestive disorder, obsti-
nate constipation, progressive and extreme emaciation, and weak-
ness which kept the animal constantly in a recumbent position.

Angioma, ‘These are rarely seen in the young but are com-
paratively common in old cows as they are in aged men. They
form masses of a dark red color and very variable size, and have
a limiting sac of connective tissue or merge into the adjacent
hepatic structure. Microscopically they consist of a series of
irregular lacunee filled with liquid blood, blood- clots, or leuco-
cytes, and communicating with small blood vessels in the walls
and partitions. They are believed to be formed by dilatation of
the liver capillaries with subsequent thickening of their distended
walls, and atrophy of the nearest liver cells. Cases of the kind
have been recorded by Kitt, Martin, McFadyean, Saake, Van
der Sluys, Korevaar and others. Though often seen in abat-
toirs, they seem to have little effect upon the general health, and
no special symptoms have been noted as indicating their exist-
ence.

Congenital Cysts. ‘These are found on the anterior surface or
lower border of the liver in young calves. They have no con-
nection with the blood vessels, or biliary canals, contain no
head of larval tzenia, and do not constantly show the presence of
any particular bacterium. These walls are thin and their con-
tents alkaline, with sometimes slight blood extravasations, or a
yellowish deposit in which cocci have been found. Unless con-
nected with cirrhosis or other serious disease of the hepatic
tissue, their presence seems to have no pathological significance.

Carcinoma. ‘This has been recorded in the liver of cattle by

551

552 Veterinary Medicine.

Gurlt, Briickmiiller, Kitt and others. From the walls of the
gall bladder it grows in pyriform masses, and on the surface and
in the interior of the liver, it may appear as hard, cancerous
masses of all sizes.

Epithelioma. ‘This has been described by Kitt, Martin, Blanc,
Leblanc, Morot, Cadeac, and Besnoit. It appears in masses
varying in size from a millet seed up, bulging from the surface of
the organ or deeply hidden in its substance, and stained yellow or
green with bile. The liver is usually enlarged, amounting to
even 34 pounds (Cadeac). The formation commencing in the
acini invades all surrounding parts causing compression and
atrophy of the liver cells, and the formation of nests of epithelioid
cells often with multiple nuclei and nucleoli. Cirrhosis is not un-
common, and fatty and othér degenerations. Microbic invasion
and necrobiosis are also common.

NEOPLASMS IN THE SHEEP’S LIVER.

Adenoma has been met with by McFadyean, Johne, Kitt and
Bollinger. They hung as pediculated tumors from the surface of
the liver, and were in part wedged into its substance displacing
the hepatic tissue and vessels. In general they consisted of a
dense fibrous stroma with cylindroid and biliary cells in great
abundance, sometimes arranged in tubular form. Specimens
described by Kitt and Bollinger attained to the size of a man’s
head and were stained of a deep green color.

Carcinoma. Casper reports a case of hepatic cancer in the
sheep secondary to cancer of the mesentery.

NEOPLASMS IN THE DOG’S LIVER.

Lipoma. ‘Trasbot describes two fatty tumors in the liver of a
bitch, one of them as large as an infant’s head. It hada yellow-
ish white color, and had taken the place of the proper hepatic
tissue.

Malignant Tumors. ‘These are rather common. Sarcomatous
masses with round and fusiform cells in a fibrous stroma ; ez-
cephaloid with a delicate stroma and large alveoli filled with cells,
and having a soft brainlike consistency ; carcinoma with dense
and thick fibrous stroma and nests of cells in comparatively
small numbers; and efzthelioma with flattened, cylindroid or
- other epithelial cells in masses often affecting a tubular aggre-
gation, are seen in different cases. Sometimes apparently primary,
they can more commonly be traced to pre-existing centres of the
same formation on the course of the portal vein or elsewhere.

Symptoms. A gradual wasting and emaciation with a yellow-
ish pallor of the mucous membranes are characteristic. Trasbot
gives the excessive atrophy of the temporal and masseter muscles
as pathognomonic. Ascites is a usual complication. Enlargement
of the liver, as shown by percussion of the right hypochondrium,
and, in case of flaccid abdomen, by manipulation, and attendant
signs of tenderness are corroborative. Variability or loss of
appetite, and vomiting is not uncommon, and in case of primary
or secondary deposits in other organs in the abdomen, thorax or
elsewhere, the symptoms resulting from functional derangement
of such organ may be found. ‘Treatment is hopeless.

553

CALCAREOUS NODULES AND DEGENERATIONS OF
THE LIVER.

Calcified roundish nodules, in groups, under capsule. Mostly in solipeds.
Theories of origin: parasites, microbes, emboli, omphalitis, intestinal, dis-
ease, biliary obstructions. Calcification of liver with large abdominal aneu-
risms. Cszoker’s case, Diagnosis and specific treatment impossible.

In the domestic animal in general the liver may become the
seat of imperfectly spherical nodules of a white, yellow or brown-
ish white color, varying in size from a millet seed to a pea or hazel
nut, and of a gritty consistency and feeling, from the deposition of
earthy salts. "These may be seen in groups under the proper cap-
sule, the adjacent hepatic tissue being healthy, or atrophied,
sclerosed or pigmented. These lesions have been found most
abundantly in solipeds.

Pathogenesis. 'The most varied doctrines have been advanced
as to the origin of these lesions. They have been attributed to
the previous presence in the liver of linguatula, echinococcus,
coenurus, oxyurus, distoma, and other parasites (Cadeac, Masan-
ti, Olt, Ostertag, Gripp, Leuckart, Ratz), to glanders, to micro-
bian attacks (Dieckerhoff), to minute embolic infarcts in ompha-
litis in the foal, or intestinal disease in the adult (Kitt), and
to obstructions by*® the eggs of distomata in the biliary ducts
(Galli-Vallerio). It is not improbable that the lesion may be
due to any one of these in a specific case, and this may be ascer-
tained by the existence of certain definite features and conditions.
Linguatula, echinococcus and ccenurus can only be suspected in
districts where these prevail, and a careful examination of the
central mass of the nodule should reveal the presence of the inde-
structible hooklets, as certified for given cases by Olt, Ostertag,
and Gripp. Incase of nematoid worms or distomata, the eggs
may possibly be found as in the cases of Villach and Ratz, or the
embryos (Mazanti). Or there may be traces of channels formerly
hollowed out by the worms in the vicinity of the nodules, as seen
by Leuckart. Coincident tumors of the intestinal mucosa from
larval nematodes, or aneurism or emboli in the anterior mesente-
ric artery would corroborate this conclusion. If distoma has

554

Calcareous Nodules and Degenerations of the Liver. 555

started the lesions, the distension of the gall ducts and the thick-
ening of their walls would be likely to indicate their former pres-
ence. Glander nodules might be suspected from the absence of a
distinct rounded or oval outline, from the lack of a distinct, clear
line of demarcation .between the nodule and the adjacent liver
tissue, and by the manifestation in the periphery of the nodule
and around it of free cell proliferation, showing the mode of pro-
gression by the invasion of new tissue. “If still active, the bacilli
should be discoverable in stained scrapings or sections. ‘There
should also be distinct indications of the lesions of glanders in the
lymph glands of the portal fissure, of the mediastinum, of the
submaxillary region and of other parts.

Heiss records an interesting case of general calcification of the
horse’s liver, with large aneurism of the abdominal aorta, mesen-
teric and renal arteries. The liver was thirty-two pounds,
puckered on the surface and showed calcic degeneration of the
walls of the vessels and hepatic tissue, to such an extent that
when the organ was dried it did not add materially to its hard-
ness. Microscopically the diseased centres indicated minute blood
clots (thrombi), with fibrinous developement and cretifaction.
The lesions in this case were attributed to multiple emboli in
connection with the aneurism. It might suggest further, micro-
bian infection of both the aneurismal and hepatic vessels. In
another case of extensive cretifaction of the horse’s liver reported
by Cszoker, calcified masses tended to assume rounded forms
like tubercle, and had a clear glistening surface.

‘These lesions are mainly interesting in a pathological sense, and
unless they are very extensive do not give rise to appreciable
symptoms.

Treatment could only be prophylatic and directed to the
removal of the special conditions, in which the calcification
originated in a given locality.

ACTINOMYCOSIS. OF THE LIVER.

Ou damp infested soil, in cattle and swine. Round tumors, hard sur-
face, soft centre, fibrous sac, clubshaped cells in tufts. Symptoms of liver
disorder. Coincident external actinomycosis. Treatment : potassium
iodide.

In damp soils where actinomyces are present in the soil and
vegetation, it is not uncommon to find the characteristic growths
in the liver of cattle and swine. Rasmussen saw twenty-two cases
of hepatic actinomycosis in one year (1890) and in a number of
cases he has found the liver, spleen, peritoneum and intestine
simultaneously affected. Jensen who has also recorded hepatic
cases, found tumors extending from the liver to the diaphragm.
He describes them as rounded masses, of different sizes, enclosed
in a fibrous envelope of variable thickness, hard and resistant at
the surface and somewhat softened toward the centre. Micro-
scopic examination detects the club-shaped cells arranged in tufts
and radiating from a common centre.

Symptoms are only the general indications of hepatic disease
differing according to the size, and position of the morbid product
and its interference with normal functions. When, however,
superficial actinomycosis is found these symptoms may be fairly
attributed to the existence of similar products in the liver.

Treatment consists in the administration of potassium iodide in
full doses, daily for a week, followed by a laxative, and then,
after an interval of two days, repeat the treatment for a second
week, and so for a third, fourth and fifth until the microbe has
been destroyed.

556

PARASITES OF THE LIVER.

Lying as it does in the channel of the blood charged with the
products of absorption from the intestine, the liver is especially
liable to parasites. Among protozoa are: Monocercomonas he-
patica (pigeon), saccharomyces guttulatus (rabbit), eimeria falci-
formis (rabbit), coccidium oviforme (rabbit, pig, dog). Among
the lower cryptogams are actinomyces (ox, pig). Of the tape-
worm family are: Cysticercus tenuicollis (ruminants, pig), c.
pisiformis (rabbit), c. cellulosa (dog, pig), echinococcus veteri-
norum (animals, man), teenia fimbriata (sheep, deer), and an un-
determined ccenurus (cat). Of trematodes are: Distoma hepatica
Cherbivora, man), distoma lanceolatum (herbivora, man), disto-
ma giganteum, or Americanum (cattle), d. truncatum, d. con-
junctum, d. campanulatum (dog), amphistoma explanatum (ox).
Of nematodes are: Stephanurus dentatus, ascaris suis, oesopha-
gostoma dentatum (pig), sclerostoma equinum, ascaris megalo-
cephala (horse), ascaris bovis (ox), oesophagostoma columbiana.
(in ruminants), filaria hepatica, enstrongylus gigas, ascaris
marginata (dog), ollulanus tricuspis, ascaris mystax (cat). (See
Parasites, Vol. V).

DISEASES OF THE PANCREAS.

Obscure. Shown only by digestion or hepatic disorder. Excess of fatin
stools suggests suppression of secretion. Intestinal fermentations. Su:-
pension of glycogenesis and consequent emaciation, stunting or poisoning.
Pancreatic calculus and icterus.

Diseases of the pancreas are even more obscure than those of
the liver. Situated on the course of the duodenum, beneath the
lumbar vertebrze and their right transverse processes, and sep-
arated from the lateral walls and floor of the abdomen by the
great mass of the intestines, it is not open to manipulation or sat-
isfactory percussion, and its secretions being used up in the func-
tion of digestion, so that they cannot be perceived and tested ex-
ternally like the secretions of the kidneys. Beside the general

557

558 Veterinary Medicine.

constitutional disorder therefore, we must look rather to the de-
rangements of the digestive functions, to the abnormal condition
of the faeces, and to the alterations in subordinate functions like
the glycogenic action of the liver, for indications of an unhealthy
state of the pancreas. ‘The suppression of the pancreatic secre-
tion has long been associated with the occurrence of fat in the
stools, yet this may result from the lack of bile which has im-
portant functions to fulfill in emulsionizing fat, and in securing
its endosmosis. On the other hand the lack of pancreatic juice
may hinder the complete digestion of the albuminoids, and favor
their fermentation and the occurrence of tympanies, congestions,
abnormal secretions, etc., which may be easily attributed to an-
other origin. Then again the dependence of the liver on the
pancreas for its stimulus to glycogenesis, would suggest a series
of disturbances from the abundance of the unused food principles,
from the hindrance to nutrition and growth, and perhaps from
the toxic action of the hepatic products. Once more, through
the common excretory duct, infection of the pancreas may extend
to and involve the liver, and blocking of the common duct by
pancreatic parasites, or calculi, may stop the flow of bile and
cause jaundice or other icteric disorder. And yet, it is rarely the
case that pancreatic disorder is successfully diagnosed, and it is
too often only at the post mortem examination that the actual
lesions are revealed.

CATARRHAL PANCREATITIS.

Probable causation by parasites, calculi, irritants, microbes. Lesions:
mucosa reddened, thickened, ducts dilated, epithelium fatty, granular, des-
quamating, pus, connective tissue indurated. Interdependence of pancre-
atitis and hepatitis in horse, sheep and goat. Liver lesions. Symptoms:
loss of vigor, eudurance, appetite and condition. Icterus, costiveness,
foetid, fatty stools, percussion tenderness—right side. Treatment: anti-
thermics, eliminants, antiseptics, derivatives, alkalies, salicylates, ether.

Causes. We know little of the causes of this affection, but it
may be inferred that parasites, calculi and other irritants, will
produce in this as in other mucosze a mucopurulent inflammation.
Then again the presence of pus suggests the codperation of pus

Catarrhal Pancreatitis. 559

microbes as in the infective catarrhal icterus. The blocking of
the common gall and pancreatic duct, by gall stones or biliary
products, will entail arrest of the discharge of pancreatic juice,
and a consequent pancreatitis, just as blocking with pancreatic
products will cause hepatitis and icterus.

Lesions. ‘The mucosa of the pancreatic ducts is reddened,
congested and thickened and their lumen blocked by a white,
granular matter, containing pus globules, fibrine filaments, and
granular, ciliated epithelium. The blocked ducts become di-
lated, and their walls thickened, the epithelium is desquamated
to a greater or less extent, and the raw exposed surface may pre-
sent ulcers or granulations. The pancreatic cells undergo fatty
degeneration and the connective tissue becomes steadily indurated
(sclerosis). These lesions were especially noted by Megnin and
Nocard in a case of pancreatitis in the horse.

In the horse, sheep and goat, which have a common outlet for
the bile and pancreatic juice, the blocking of the latter and the
arrest of the bile almost of necessity causes hepatitis, and infec-
tion in the one gland is directly transferred to the other so that
pancreatitis and hepatitis are mutually causative of each other.
In the ox, pig, dog and cat, in which the bile and pancreatic
juice are poured into the duodenum through separate ducts and
orifices, this mutual pathogenic action is not so certain.

When the liver is implicated, there is catarrh and dilatation of
the bile ducts, fatty degeneration commencing in the centre of
the acini, pigmentation appearing at their periphery, and sclerosis
of the organ follows.

Symptoms. In Nocard’s equine case there was progressive
loss of spirit, energy, and endurance; appetite was poor and
eating listless; after two weeks jaundice set in, the visible
mucosze and skin showing a yellow tinge, and the scanty urine
becoming brownish yellow ; the bowels become costive the feeces*
being formed of small hard discolored balls, but no excess of
fatty matter isrecorded. Emaciation advanced rapidly, the most
marked wasting being in the muscles of the back, loins and croup.
Death ensued at the end of two months from the commencement
of the illness. In man sudden, violent colic, with nausea,
tympany and collapse are prominent symptoms.

Diagnosis is more satisfactory when with digestive disorder,

560 Veterinary Medicine.

tardily developing icterus, and rapid emaciation, there is an ex-
cess of fat in the ill-smelling feeces, Pain on percussion of the
right hypochondrium would be an additional feature.

Treatment can rarely be adopted because of the uncertainty of
the diagnosis. It would proceed on general principles, antither-
mics, eliminants, antiseptics, and counterritants being resorted
to as the conditions seem to demand. Alkaline laxatives and
diuretics, salicylates of soda or potash, and guarded doses of sul-
phuric ether to solicit the action of the pancreas, might be re-
sorted to. ‘The disorder of the liver would require attention
along the lines indicated under catarrh of that organ.

INTERSTITIAL PANCREATITIS. °

Causes: paresis, marasmus, septic infection, blood diseases. Lesions -
connective tissue in excess—pancreas and liver; catarrhal complications ;
calcic points ; congestion and petechiz in septic infection. Areas of fat
necrosis in the pancreas and abdominal adipose tissue. Stearates of lime.
Calcic foci in animals. Symptoms: obscure. Treatment.

This is especially liable to accompany paretic and wasting
diseases, septic infection, and diseases of the blood. Radionow
examined the pancreas in animals that had suffered from chronic
paralysis, gastro-intestinal catarrh, hepatic catarrh, chronic
anemia and marasmus, and found fatty degeneration of the epi-
thelium, with atrophy and pigmentary degeneration of the
glandular epithelium. The fibrous tissue of the gland was in
excess in the pancreas and in the liver (sclerosis), and mucous
cysts were found.

Siedamgrotzky found a chronic interstitial pancreatitis con-
nected with alopecia, cedema and leucocythemia. The pancreas
was indurated, fibrous, resisting the edge of the knife and
sprinkled with gritty particles. Much of the granular tissue
had been destroyed, and the ducts were filled with a dense,
grayish, grumous mucus.

Kirilow and Stalnikow have found interstitial pancreatitis
marked by congestion and ecchymosis, with intervening anemic

N

Pancreatic Abscess, Suppurative Pancreatitis. 561

areas, in animals injected with septic matter. There was in-
creased secretion in the early stages.

A marked feature of pancreatitis in man is the occurrence in
the interlobular tissue of the gland, the omentum. mesentery and
abdominal fatty tissue generally, of circumscribed areas of fat
necrosis, each varying in size from a pin’s head upward even toa
hen’s egg. On section these show a soft tallowy consistency and
Langerhans has shown that they are composed of lime and fatty
acids in combination. When lime isin excess they become gritty.
According to Osler they may be dependent on some other primary
affection (Bright’s disease). The partially calcified concretions
found in the pancreatic ducts, and the yellowish white, grity
areas, which represent the degenerate lobules in animals (Seidam-
grotzky) are suggestive of a similar morbid condition of the
pancreas or it may be of some distant organ. Of late yearsa
number of cases have been recorded in man and a very high
mortality noted.

The symptoms in the lower animals are very obscure, and an
accurate diagnosis is looked upon as almost impossible. They
are essentially the same as given above under catarrhal pan-
creatitis.

Treatment too has the same narrow limitations.

PANCREATIC ABSCESS, SUPPURATIVE PAN-
CREATITIS.

A complication of strangles or purulent infection. Symptoms: Colics,
chill, tender right hypochondrium, emaciation, fatty stools. Treatment:
Constitutional.

Reimers has reported several cases of pancreatic abscess, as a
phase of irregular strangles (rhinoadenitis). In one case multiple
abscesses with an aggregate capacity of 214 quarts were found,
and some of the pus had escaped by rupture into the peritoneum
and produced infective inflammation. Theabscesses had destroyed
the greater portion of the gland, only a few isolated lobules
being left.

36

562 Veterinary Medicine.

Galland found an abscess as big as a walnut in the pancreas of
a horse which had multiple tumors in the abdomen.

Symptoms. Colics occur from the local phlegmon, and it may
be from its pressure on the duodneum so as to obstruct it, and
this appearing in the course of strangles would indicate a forming
abdominal abscess. Staring coat or shivering may coincide.
Tenderness of the abdominal walls has been noticed by Reimers,
together with a partial loss of appetite and a characteristically
rapid emaciation. Fatty stools, if present, would be almost the
only pathognomonic symptom. ,

Prognosis is that the abscess will open into the abdomen, and
cause fatal infective peritonitis. It is only as an exceptional oc-
currence that its rupture into the duodenum or colon can be
hoped for, yet in such a case recovery is possible.

Treatment. Little can be done. It would be well to treat the
constitutional symptoms, and await results.

FOREIGN BODIES IN THE PANCREAS.

Briickmuller has noticed needles and other sharp objects in the
pancreas of the dog, determining abscess and the formation of a
thick, greenish pus in the adjacent glandular follicles. Goubaux
once found a fragment of straw in the pancreatic duct of the
horse. Such conditions are not likely to be diagnosed, but if
this could be done laparotomy might be permissible in the dog
for the removal of the foreign body.

PANCREATIC CALCULI.

Mostly in cattle from over-feeding, dry feeding, inactivity. Small. Mul-
tiple. Round, angular, lobulated. Nucleus. Composition, Dilated ducts.
Atrophied or sclerosed glandular tissue. Prevention: succulent food,
water at will, open air life, correction of local catarrh.

Pancreatic like biliary calculi have been found especially in
cattle. They appear to be predisposed by their stimulating,
forcing feeding, by their quiet life apart from all causes of excite-
ment and especially by the combined effect of dry feeding and
prolonged confinement in the stall through the long winter.

The calculi are usually small but numerous, Jungers having
found 36 weighing 38 grammes. Bar has found a mass with an
aggregate weight of 23 grammes.

‘The form of the calculus varies ; many are angular from mutual
attrition in the large ducts; others from the smaller ducts are
rounded ; those from the glandular follicles may be even lobulated,
in keeping with the divisions of the cavity. The color is white
and each shows a distinct central nucleus of epithelial, mucus, or
other origin. Their specific gravity is 2.397 (Fiirstenberg), and
their composition 92 per cent. calcium carbonate, 4 per cent.
magnesia, and traces of calcium phosphate (Gurlt).

‘The pancreatic ducts are as a rule greatly dilated and thickened
(in man they form enormous cysts, Senn, Osler), and the glandu-
lar tissue is atrophied, indurated (sclerosed), and of a brownish’
yellow color.

Treatment in such cases would be unsatisfactory. By way of
prevention succulent food, abundance of pure water, and the cor-
rection of any infective catarrhal affection of the duodenum, or of
the bile or pancreatic ducts would be specially indicated. Free
exercise in the open air would be desirable.

563

PANCREATIC NEOPLASMS. ‘TUMORS.

Often malignant, and secondary. Melanoma in white horse. Carcinoma
in mare and dog. Epithelioma. Debility, icterus, abdominal swelling,
emaciation. Treatment: laparotomy, or potassium iodide.

Tumors of the pancreas are quite frequently malignant, and
show a preference for the head of the organ. They may be pri-
mary but are more frequently secondary.

In gray horses melanotic tumors are found, in connection with
similar formations externally, and especially as age advances.
Briickmiiller found them of varying size, from a pea to a hazel
nut, scattered through the pancreas and adjacent tissues.

Gamgee records a carcinoma of the pancreas of a mare.

Carcinoma is more frequent in this organ in dogs, the neo-
plasm having an irregular form, an imperfect line of delimitation
from surrounding parts and a hard fibrous stroma enclosing
caseous centers, undergoing fatty degeneration.

Nocard reports an epithelial tumor of the head of the pancreas
in a bitch. The animal which had been ill for six weeks was
debilitated, emaciated, and icteric, with a marked abdominal
swelling, It died two weeks later, and necropsy revealed a
whitish sublumbar tumor the size of a large apple, with irreg-
ular rounded projections. ‘This pressed on the posterior vena
cava, surrounded the vena porte and gall duct and completely
-closed the latter. Microscopic examination showed it to be an
epithelioma. The liver was undergoing cirrhosis.

Treatment, usually hopeless, would be by laparotomy. If acti-
nomycosis were present give potassium iodide.

564

DISEASES OF THE SPLEEN.

No guidance through palpation or secretion. Leukemia: Lymphade-
mona. Spleen a favorite culture ground for microbes. Congestions, en-
gorgements, ruptures. Safety valve to portal system andliver. Rhythmic
splenic contractions under reflex action.

The spleen even more than the pancreas isso deeply seated
and so surrounded by other organs, that its diseases are not
readily appreciable by physical examination, while the absence
of any special secretion excludes the possibility of diagnostic de-
ductions through this channel. Even the relation of the con-
dition of the organ to the number of the leucocytes and red
globules fail to afford trustworthy indications of disease, since
leucocytes originate in other tissues as well as the spleen, and the
destruction of red globules may take place elsewhere. Yet an
excess of eosinophile leucocytes in the blood suggests hypertro-
phy or disease of the spleen, and an excess of leucocytes in
general is somewhat less suggestive of disease of this organ
(see Leucocythemia). If adenoma is further shown, in en-
largement of lymphatic glands elsewhere there is the stronger
reason to infer disease of the spleen.

The physiological relation of the spleen to the blood especially
predisposes it to diseases in which the blood is involved, The
termination of splenic capillaries, in the pulp cavities, so that the
blood is poured into these spaces and delayed there, opens the
way, not only for the increase of the leucocytes, and the disinte-
gration of red globules, but for the multiplication of microdrgan-
isms which may be present in the blood, and for a poisoning
(Jocal and general) with their toxins. Hence we explain the
congestions, sanguineous engorgements and ruptures of the spleen
in certain microbian diseases (anthrax, Southern cattle fever,
septiceemia, etc. )

We should further bear in mind that the spleen is in a sense a
safety valve for the blood of the portal vein, when supplied in ex-
cess during digestion. In this way it protects the liver against
sudden and dangerous engorgements, but it is itself subjected to
extreme alternations of vascular plenitude and relative deficiency.

565

566 Veterinary Medicine.

This may be held to take place largely under the influence of the
varying force of the blood pressure in the portal vein, but accord-
ing to the observations of Roy on dogs and cats, it is also power-
fully influenced by muscular and nervous action. He found
rhythmic contractions of the organ due to the muscles contained in
the capsule and trabecule, repeating themselves sixty times per
hour, and which might be compared to tardy pulsations. He fur-
ther found that electric stimulation of the central end of a cut sen-
sory nerve, of the medulla oblongata, or of the peripheral ends of
both splanchnics and both vagi caused a rapid contraction of the
spleen. The spleen may thus be looked on not only as a tempo-
rary store house for the rich and abundant blood of the portal
system of veins during active digestion, but also as a pulsating
organ acting under the control of nerve centres in the medulla.
That the various ascertained normal functions of this viscus may
be vicariously performed by others, as shown in animals from
which it has been completely extirpated, does not contradict the
occurrence of actual disease in the organ, nor the baleful influ-
ence of certain of its diseases on the system at large.

ANAMIA OF THE SPLEEN.

General anzmia, debility, wasting diseases, starvation, hemorrhage,
stimulus to formation of red globules, asphyxia, electricity, cold, quinine,
eucalyptus, ergot. Symptoms : lack of eosinophile leucocytes in the blood
of a debilitated subject may lead to suspicion. Treatment : tonic, light,
sunshine, pure air, exercise, nutritive food, iron, bitters.

In cases of general anzemia the spleen is liable to be small,
shrunken, wrinkled, and when cut the surface is drier and lighter
colored than in the normal condition. This condition may be
seen after old standing debilitating diseases, but is common in
animals that have been reduced by starvation, just as the opposite
condition of hyperzemia and enlargement comes of abundance of
rich food and an active digestion. It may shrink temporarily as
the result of profuse hemorrhage, but Bizzozero and Salvioli
found that several days after such loss of blood it became en-

LfTyperemia—Congestion of the Spleen. 567

larged and its parenchyma contained many red nucleated hzema-
toblasts. The result of hemorrhage is therefore to stimulate
the organ to enlargement and to the resumption of its embryonic
function of producing red blood globules. Contraction of the
spleen further occurs under asphyxia, the deoxidized blood being
supposed to operate through the medulla oblongata. As already
noted the spleen shrinks under stimulation of the central end
of a sensory nerve (vagus, sciatic). An induced current of
electricity applied to the skin over the spleen causes marked
contraction (Botkin). Cold, quinine, eucalyptus, ergot and
other agents also induce contraction. In the normal condition
there is an inverse ratio between the bulk of the spleen and the
liver, the enlargement of the one entailing a diminution of the
other, but in certain diseased states, such as anthrax, ague, etc.,
both are liable to enlargement at the same time.

Symptoms of splenic anzemia are wanting, through a lack of
eosinphyle leucocytes, in the blood of a starved or otherwise de-
bilitated animal, may lead to suspicion of the condition.

The treatment of such a case would be addressed rather to the
general debility which induced the splenic contraction than to the -
contraction itself. Light, sunshine, pure air, exercise, grooming,
nourishing food and the avoidance of all debilitating morbid condi-
tions would indicate the principles of therapeutic management.

f

HYPEREMIA—CONGESTION OF THE SPLEEN.

Four hours after full meal in splenic diastole. In-well fed, high condi-
tioned. From obstruction of splenic or portal vein or vena cava, heart,
liver, or pulmonary disease, inhibition from encephalon acting through
splanchnics or vagi, microbes, ptomaines, toxins, paresis, albuminoid diet.
Spleen may be seven times its normal weight. Lesions: simple blood en-
gorgement : proliferation of pulp cells : increased friability ; rupture ; dark
color; hyperplasia of trabeculee—hypertrophy. Symptoms: none ; or colic ;
palpation in ruminants; tenderness. Treatment: directed against the
causative disease ; quinine, cinchonine, eucalyptus, ergot, cold douche,
electricity, puncture,

Considerable hyperemia of this organ takes place physiogi-

568 Veterinary Medicine.

cally in connection with active digestion in the first four or five
hours after an abundant meal, and especially at intervals of a
minute, during what may be called the diastole of the viscus.
The supply of blood is also much greater in the well fed animal,
than in the emaciated and impoverished one.

Pathological hyperemias of a passive kind may occur as the re-
sult of obstructions in the veius leading from the spleen, such as
the splenic veins, the posterior vena cava, or that part of the
portal vein comprised between its junction with the splenic and
the liver. Diseases of the right heart or its valves, of the lungs
(emphysema), or of the liver which hinder the onward flow of
blood and increase the blood tension in the vena cava or portal
vein have a similar action. Perhaps we should include inhibition
of the nerves (splanchnic, vagi) and nerve centres (medulla ob-
longata, cerebral cortex) which preside over the contraction of
the splenic vascular walls, and of the capsular and trabecular
wouscles. There is reason to believe that the ptomaines and
toxins of several microbian diseases, operate through these
centres, while other such microbes and toxins operate directly on
the spleen itself.

Active congestions of the spleen are most commonly associated
with microbian diseases and may be attributed partly as above
stated to the action of the toxic products on the contraction nerve
centres, and on the splenic vessels and parenchyma, but also in
no small degree on the active proliferation of the germs them-
selves in the splenic pulp, and of the splenic cells. Among the
most notable instances of this kind are, zz man, malarious, yel-
low and typhoid fevers, and, zz anzmals, anthrax, and Southern
cattle fever. In most febrile diseases, however, there is a ten-
dency in this direttion, which may be fairly attributed to the
paresis of the organ and the delay of the blood in its pulp chan- -
nels and spaces with the consequent local increase of microbes
and toxins, The microdrganisms can usually be found abun-
dantly in such cases, in the liquid of the pulp, and in the inte-
rior of the leucocytes and other cells that go to make up its solid
constituents.

It has been long recognized by veterinarians that acute con-
gestion often arises in connection with a sudden transition from a
poor or insufficient diet to an abundant and nutritious one and

Hyperemia—Congestion of the Spleen. 569

especially to one that is rich in albuminoids (beans, peas, vetches,
lucerne, sanfoin, clover, trefoil, in the fresh or preserved con-
dition). If these are not in themselves the direct causes of acute
and fatal engorgements of the spleen, they at least contribute in no
small degree to the over-distension of the pulp spaces, the paresis
of the organ and its successful invasion by pathogenic microbes.

The acute congestion attendant on specific microbian infection
may be estimated by the increase in weight of the spleen. In
the Southern Cattle fever this organ, which isnormally 1.45 1b.,
is habitually 2 to 5 lbs., and may reach 8 or 10 lbs, and in anthrax
an equal increase may be noted.

Lesions. In such cases the organ may appear as if there were
a simple blood engorgement, and this is largely the case in the
early stages, but with the persistence of the disease there occurs
an active proliferation of the splenic cells and especially those of
the pulp. With the hyperzemia the consistency of the organ is
diminished, and still more so with the cell hyperplasia, so much
so that in extreme cases rupture may ensue. The color is always
darker (purple or blue), but this is only in part due to the abund-
ance of blood and in part to the thinness of the splenic capsule.
If the condition persists a hyperplasia of the capsule and trabe-
culz ensues, and the condition becomes essentially one of
hypertrophy.

Symptoms. Inthe slighter congestions there are no appreci-
able symptoms. In the more severe there may be more or less
violent colic, but this is usually marked to some extent by the
profound depression attendant on the specific fever which is the
cause of the congestion. Palpation of the spleen is impossible in
the horse. In ruminants it may sometimes be felt along the
upper border of the rumen just behind the last rib on the left

‘side. It is soft and yielding retaining the indentation of the
finger. If manipulation produces signs of pain it is all the more
significant.

Treatment. Asa rule this is the treatment of the fever which
determines the hypereemia. Apart from this, laxatives, quinia
other alkaloids of cinchona bark, eucalyptus,a current of cold water
directed to the region of the spleen, or induction currents of elec-
tricity to the same region are also decided stimulants to contrac-
tion. Ergot has been used with alleged advantage. In cattle
acupuncture of the spleen has been put in practice in anthrax.

CHRONIC CONGESTION OF THE SPLEEN. HYPER-
TROPHY.

Hypertrophy from chronic congestion, over feeding, hepatic cirrhosis.
In horse: from ‘mechanical obstruction in heart, lungs, posterior cava,
splenic veins, angioma, from glanders or tubercle in lungs, chronic splenic
congestion, disease of splenic plexus. Lesions: increase enormous ; mainly
of pulp, or largely of fibrous framework. Special neoplasms. Symptoms :
excess of leucocytes in blood, eosinophile cells, weakness, anzemia, emacia-
tion, bleeding from mucosz, stretching, right hypochondriac tenderness,
stiff gait, ascites, colic, disorder of the bowels, rectal exploration. Treat-
ment: is that of primary disease; not encouraging ; quinia, eucalyptus,
saline laxatives, open air, sunshine, electricity. In cattle is habitually en-
larged in Texas fever area. In lymphadenoma increase mainly of fibrous
framework and Paccinian bodies, and of adjacent lymph glands. Symp-
toms: leukemia, employ palpation, percussion, rectal exploration. Treat-
-ment asin the horse. In swine. from high feeding, leukemia, lymphade-
noma, tuberculosis, neoplasms, liver, heart and lung disease. Lesions:
great increase of Paccinian bodies, fibrous capsule and trabeculae. In dog -
from traumas, leukemia and lymphadenoma. Enlarged Paccinian bodies
and adjacent lymph glands. Symptoms: leukemia, many eosinophile
cells, abdominal enlargement, palpation, icterus. Treatment ; as for large
animals.

A continuation of passive congestion from the causes enumeér-
ated above, leads to permanent increase of the fibrous reticulum
and connective tissue and increase of the splenic pulp. Even the
stimulus of a rich and abundant alimentation increases the size
of the whole organ, the amount of pulp and the number and de-
velopment of the Paccinian bodies. Apart from disease the
spleens of well fed cattle or horses are always decidedly heavier
than those of the starved or debilitated. Of mechanical causes
the most potent is cirrhosis of the liver or some other obstacle to
the free passage of blood through that organ. The most com-
mon causes are, however, the continuous operation of those
specific poisons which determine the acute hypereemias. —

57°

SPLENIC HYPERTROPHY IN HORSES.

Causes. It occurs as the result of mechanical obstruction of
the posterior vena cava as noticed by Varnell, from obstruction
in the splenic artery or veins by Ellenberger and Schiitz, as the
result of an angioma by Martin, as the result of the morbid hy-
perplasias in specific diseases—glanders, tuberculosis—taking
place in the spleen or lungs and thus directly or indirectly caus-
ing chronic congestion of the spleen (Morot, Leisering, Nocard,
Varnell) and again as the result of innervation, in disease of the
splenic plexus of nerves (Varnell).

Lesions. The increase in size may be enormous (42 lbs.
(Bouret and Druille), 92 lbs, (Cunningham), and over 100 lbs.
(Girard).) The consistency is varied. There may be such a re-
dundancy of blood and splenic pulp that the capsule is distended
to its utmost or even ruptured (Peuch). In other eases the
splenic veins have given way and the blood has poured out into
the abdomen with fatal result (Crafts, Cunningham, Reis). In
other cases the spleen is enlarged, unevenly swollen and indu-
rated by the formation of angioma (Jacob), lymphadenoma,
glander or tuberculous nodules. In still others the capsule and
fibrous framework are greatly thickened and the substance of
the organ has assumed the consistency of the hepatized lung
(Rodet).

Symptoms.’ These are suggestive rather than diagnostic.
Most prominent is the condition of the blood with excess of
leucocytes and especially of the eosinophile cells. Weakness,
emaciation, feebleness of pulse, bloodlessness, bleeding from the
nose or other natural passages, are attendant symptoms. In
cases of extreme hypertrophy distention of the abdomen is
marked and even the enlarged spleen may be made out by palpa-
tion, there may be special tenderness and dullness on percussion.
Even partial sweats over the region of the spleen (Cadeac), and
stretching with the fore feet far in advance (Welsby) have been
noted as symptoms. Insuch conditions the animal walks stiffly,
groans in turning, or when suddenly started and is with difficulty
urged beyond a walk. ‘There may be ascites, signs of colic, or
irregularity of the bowels. Rectal exploration may reveal the
hypertrophy.

571

572 Veterinary Medicine.

Treatmentis usually the treatment of the primary disease. In
glanders, tuberculosis, lymphadenoma, or leucocythemia there is
little to hopefor. Nor is there much in hepatic cirrhosis, obstruc-
tion of the vena cava or valvular disease of the heart. In simple
hypertrophy we may resort to quinia or other bitters, eucalyptus,
saline laxatives, exercise in the open air and sunshine, and local
currents of electricity.

SPLENIC HYPERTROPHY IN RUMINANTS.

A moderate hypertrophy is the rule in the case of cattle which
have passed through the Southern cattle fever, but have con-
tinued to live within the area of its prevalence. Gamgee’s ob-
servations in 1868 were very conclusive on this point. In over 1,000
western cattle the average weight of the spleen was 1.45 hh.,
in 441 Cherokee (Indian Territory) cattle the average was
2.34 tbs., and in 262 Texas cattle the average was 2.66 ibs.
All these animals were killed for beef, in what was considered to
be perfect health. The difference relative to the weight of the
entire animal is even greater than is indicated above, for at that
date even more than at present, the Texas steer was a small and
thin animal in comparison with the portly western bullock.

In lymphadenoma the organ may weigh 24 tb. (Tannenhauser);
in simple hypertrophy it has been found to weigh 37 tbs. (Koch).
There was usually a marked increase in the size and number of
the Paccinian bodies, and hyperplasia of the fibrous reticulum,
while the pulp might be deficient and the cut surface rather dry.
The adjacent lymph glands are usually enlarged.

Symptoms. Unless in the case of excessive increase, no symp-
tom is usually observable, apart from leucocythsemia. With
enormous hypertrophy the enlarged organ may be recognized by
palpation, percussion, and perhaps rectal exploration.

Treatment is unsatisfactory apart from the control and arrest
of the primary diseases. For simple hypertrophy, bitters, laxa-
tives and electricity may be tried.

SPLENIC HYPERTROPHY IN SWINE.

Causes. ‘This disease appears to be rather frequent in pigs, in
connection with high feeding, and more particularly with leuco-
cythemia and lymphadenoma. It is further a complication of
tuberculosis and of neoplasms located in the spleen, and of he-
patic, cardiac and pulmonary disorder.

Lesions. In leucocythemia there is general enlargement of
the spleen, and especially of the Paccinian bodies which may
attain the size of a pea (Leisering, Fiirstenberg, Bollinger, Sie-
damgrotzky, Roll, Ellinger). The total weight of the organ
may attain to 5 lbs. (Mathieu), or 13 lbs. (Goubaux). Ina
remarkable case recorded by Zell, the organ measured 30 inches
in its longest circumference and 20 inches inits shortest. It had
an enormous thickening of the capsule and trabecule which en-
closed softened contents in a state of fatty degeneration.

Symptoms are wanting, as most of the observed cases were only
discovered after the animal had been killed for pork.

SPLENIC HYPERTROPHY IN THE DOG.

This condition has been less frequently seen in dogs, the recog-
nizable causes having been traumatism (Notz), and leucocy-
theemia (Zahn, Forestier, La Forgue, Nocard). Lymphadenoma
is another complication (Nocard, Leblanc, Siedamgrotzky,
Brtickmiiller}. The spleen has been found to weigh 2 lbs.,
(Bollinger, Siedamgrotzky). Asin other animals the enlarge-
ment of the Paccinian bodies has been a marked feature. In
other cases the splenic lymph glands are enlarged.

The symptoms are obscure as in other animals. Yet the pres-
ence of white cell blood, with a predominance of eosinophile cells,
enlargement of the abdomen, and the detection of a large solid
body in the left hypochondrium which proves tender to the touch
may prove more satisfactory than in other animals. In certain

573

574 Veterinary Medicine.

cases it has obstructed the biliary duct by pressure and entailed
hepatic disorder and jaundice.
The treatment would not differ from that of the larger animals.
Siedamgrotzky has also observed splenic hypertrophy in the
cat in connection with leucocythzemia.

SPLENITIS. PERISPLENITIS.

Causes : extension from adjacent inflammations, penetrating bodies, con-
tusions, lacerations, infections, over exertion, cold, damp, over feeding.
Symptoms : those of primary disease, visible traumas, chill, fever, swelling,
flatness of percussion sound, absence of crepitation, anorexia, vomiting,
constipation, diarrhoea. Prognosis usually good. Treatment : castor oil,
enemata, cold douche, electricity, phlebotomy, in infective cases quinine,
salol, salicylates, iodides.

No accurate border line can be drawn between splenic hyper-
zemia and hypertrophy on the one hand and inflammation of the
spleen on the other. It is, however, not difficult to assign to in-
flammatory action all cases that tend to suppuration and abscess.
Also in perisplenitis with adhesions to adjacent parts like the
liver, stomach, intestine, kidney or abdominal wall inflammation
cannot be doubted.

Causes. Extension from the disease of adjacent parts—peri-
hepatitis, perinephritis, peritonitis, enteritis—is a distinctly
appreciable cause, as are also penetration of the spleen by foreign
bodies, contusions, lacerations and infections of the organ.
Cruzel, who claims an extensive acquaintance with the disease in
working oxen, attributes many cases to violent exertions, over-
driving, cold and damp weather, and an overstimulating alimen-
tation. As inflammation may supervene on hyperemia and
hypertrophy we must accept the various causes of these condi-
tions as factors in producing inflammation.

Symptoms. Most observations of inflammation of the spleen
and its results have been made only post-mortem, so that we must
allow that the simple forms occur and undergo resolution without
obvious symptoms. In the perisplenitis supervening on another
disease also in infective cases there will be the antecedent symp-

Hemorrhagic Infarction of the Spleen. 575

toms of such primary diseases. In those resulting from trau-
matic injury, bruises, swellings or wounds, cutaneous or subcuta-
neous, there will often be suggestive features. In the more purely
idiopathic cases symptoms are only shown when the lesions are
extensive and acute. In oxen, Cruzel has noted the initial chill,
followed by disturbance of the respiration, more or less hyper-
thermia, and a swelling of the left flank and hypochondrium in
the absence of tympany of the rumen. ‘The nature of this swell-
ing is the most characteristic feature, as it gives a flat instead of
a drumlike sound on percussion, and does not bulge outward and
downward over the whole left side of the abdomen, pit on pres-
sure, nor crepitate uniformly all over from fermentation, as in
overloading of the stomach.

If abscess should form, chills and high febrile reaction are
marked symptoms. In vomiting animals, anorexia, nausea,
vomiting, constipation, and even diarrhoea may appear.

Prognosis. Unless in extreme cases and those due to trauma-
tism or infection, the result of splenitis is usually favorable.

Treatment would consist in depletion from the portal system
and spleen by rectal injections, and laxatives which like castor
oil, will operate without extensive absorption. Cold water or
ice is applied to the left flank and induction currents of electricity
may also be resorted to. General blood letting is strongly
advised by Cruzel, and Friedberger and Froéhner. -In infective
cases quinia, salicylates, salol, and the sulphites, or iodides would
be indicated.

HAMORRHACIC INFARCTION OF THE SPLEEN.

In congestive conditions. Absence of free capillary anastomosis and con-
traction, absence of valves in splenic veins. Embolism of splenic artery.
Clots in pulp spaces. Wedge shaped infarcts, first black, later yellow, later
caseated, or cicatrized. Abscess. Prognosis good in non-infective forms.
Treatment as for hyperzemia, or infection, or both.

This condition appears in hyperzemia, hypertrophy, splenitis,
and splenic infection and largely because the structure
and circulation in the organ conduce to such trouble. The

576 Veterinary Medicine.

splenic arteries terminate in open vascular spaces filled with
splenic pulp and where all trace of a freely anastomosing capillary
network is lost. The splenic veins in the same manner originate
from the open vascular spaces. There is, therefore, an absence
of the free communication of capillary network, which virtually
acts as a safety valve in other vascular tissues, and the vascular
cavities connected with each terminal artery are independent of
those belonging to another, and find no way of ready relief when
they become over distended, or when there occurs obstruction
(thrombosis) of their afferent or efferent vessels. From blocking
of arteries or veins there is at once produced a wedge-shaped area
of stagnation which cannot be relieved through any colateral cir-
culation. Again the splenic veins, being destitute of valves,
offer no obstacle to the reflux of blood into such vascular spaces
whenever the further access of blood has been arrested by the
blocking of the artery. The blocking may occur in the afferent
artery through embolism by clots carried from the lungs or left
heart, or formed within the vessel by the colonization of microbes
on its walls. Even more likely is the formation of coagula in
the vascular spaces themselves as the result of the introduction of
pus, or septiczemic microbes, which are long detained and have
ample time for multiplication in these cavities. In either case
the result is obstruction to the sanguineous current, the filtering
of blood backward from the veins and the engorgement of the
cavity with blood. The plugs consist of fibrinous matter enclos-
ing colonies of micrococci, and the result is not only black
infarction of the spleen, but a subsequent general infection of the
system at large.

The wedgeshaped infarcts are usually situated at the surface
of the organ, the base turned outward and forming a dark pro-
jection on the surface, and the apex turned inward. ‘The aggre-
gation of two or three in one group may considerably alter the
outline. If recent they are of a dark red color. Later from ab-
sorption of the coloring matter and fatty degeneration of the
mass they assume a pale yellow hue and the swelling flattens or
disappears. Later still through complete fatty degeneration they
may be transformed into caseated masses, or through organiza-
tion into fibrous tissue they may form thick white cicatrices. If
pus cocci are present suppuration and abscess may be the out-
come.

Abscess of the Spleen. 577

The simpler forms recover like cases of simple hyperzemia
while the severe infecting forms may become the point of de-
parture for the formation of multiple abscesses in other organs,
and of more or less fatal general infections.

These conditions can only be discovered post mortem, and any
symptoms directing attention to the spleen could only suggest
such treatment as would be indicated in hyperemia. Any puru-
lent or septic disease which might coexist would of course serve
to indicate a germicide line of treatment.

‘ ABSCESS OF THE SPLEEN.

In Solipeds : in infectious diseases, pyeemia, embolism. Symptoms: of
primary disease or ill health. Involving other organs. In caééle: foreign
bodies from reticulum, distomata, embolism, microbes. Enlargement : in-
volving other organs: seen in left hypochondrium, fever, albuminuria.
Treatment. aspiration, antiseptic injections, internal antiseptics.

Soliped. Abscess of the spleen in this animal is unusual and
has only been discovered post mortem. It has been found as the
result of the local colonization of pyogenic microbes, in connec-
tion with strangles, contagious pneumonia and other infectious
diseases and can then often be traced to an infected embolus in
the splenic blood vessels. The peculiar vascular structure of the
spleen is very conducive to abscess as it is to infarction, as has
been already noticed and hence this complication of a pre-
existing infection in another part is a natural pathological
sequence. Symptoms are rather the general ones of a rigor fol-
lowed by hyperthermia than any diagnostic ones of splenic dis-
ease. Bouges found a splenic abscess in a cachectic, melanic
mule but no definite splenic system was observed even on rectal
examination. Nottel found an abscess as large as an infant’s
head, in the base of the spleen, closely adherent by its sac to the
left kidney and containing a floating mass of splenic tissue as
large as the closed fist. Rutherford found a neoplasm connecting
the great curvature of the stomach, to the diaphragm, and
hollowed out into a series of pus cavities. Fetzner and Cadeac

37

578 Veterinary Medicine.

report cases of extensive abscesses in the head of the spleen and
intimately connected to both stomach and diaphragm. Hahn
found abscesses in connection with the penetration of the spleen by
foreign bodies. In other cases the substance of the spleen was
studded with abscesses varying in size from a pea upward and
containing necrotic tissue or adjoining such dead tissue.

Ruminants. In cattle the penetration of the spleen by sharp
pointed bodies coming from the reticulum appears to be the most
common cause of abscess. Other cases depend on the penetration
of distomata carrying the pyogenic microbes, and still others are
due, as in the horse, to local infection, with embolism. External
traumatisms are unusual causes. There is usually considerable
enlargement of the spleen as a whole, rounded swellings indicat-
ing the seat of the abscess, and adhesions to surrounding parts,
such as the rumen, the left kidney or the diaphragm. When the
abscess is chronic, there is emaciation, unusual flatness on percus-
sion of the left hypochrondrium, and, at times, of the flank, swell-
ing and tenderness of the flank, above all, according to Immin-
ger, a persistent elevation of temperature (104° to 106° F.),
which is not lowered by antithermics, and albuminuria. In cattle
. it is sometimes possible to diagnose the disease, and if the abscess
can be definitely located, aspiration and antiseptic injections into
the sac would be indicated, conjoined with calcium sulphide, or
sodium sulphite internally. .

FOREIGN BODIES IN THE SPLEEN.

In horse: body from intestine. In ruminants bodies from reticulum.
Laparotomy.

One such case in the Horse is reported by Hahn. A mare had
loss of appetite, slight colics, frequent efforts to urinate, dullness,
prostration, profuse perspirations, and tremors of the muscular
walls of the abdomen. Rectal examination detected a staff-shaped
body extended from behind forward in the direction of the
stomach. The mare survived twenty days, when it was carried
off by a more violent access of colic. At the necropsy, the

Rupture of the Spleen. 579

spleen was found to measure 28 inches by 8 ; its base was adher-
ent to a loop of intestine, and presented a large cavity filled with
a grayish brown fcetid liquid, and a piece of oak measuring 17
inches by ¥% inch.

Ruminants. In cattle and especially in those that are stabled,.
needles, pins, nails, wires and other sharp-pointed bodies, that
have been swallowed with the food, and have become entangled
in the reticulated walls of the second stomach, have been found
to penetrate the spleen and determine local abscess and fistule.
The offending body in such cases is found in the interior of the
abscess or in its walls. If such cases can be diagnosed the super-
ficial position of the spleen would seem to warrant surgical
interference for the removal of the foreign body.

RUPTURE OF THE SPLEEN.

Solipeds: Causes: Blows, kicks, goring, leukaemia, compression of splenic
or gastric veins, anthrax infection. Lesions: Blood may escape into per-
itoneum or remain confined under serosa. Splenic degeneration or pulpy
condition. Fractured ribs, ecchymosis, surface swellings. Spontaneous
arrest. Symptoms: Ofinterual hemorrhage. Vomiting. Trembling.
Vertigo. Coma. Treatment: Rest, quiet, locally ice, snow, cold, internally
jron chloride, matico, astringents, anodynes. Caftle: Blows, crowding,
leukzemia, youth, anthrax, Texas fever, microbes. Symptoms: Persistent
lying down, advancing bloodlessness, surface coldness, stiffness, local
tenderness, fluctuation. Treatment as in horse.

Horse. 'This is not a frequent lesion in solipeds, yet the num-
ber of cicatrices of the spleen which are found post-mortem in
old horses would indicate a considerable number of slight and
non-fatal cases. “[he'most common cause appears to be external
violence and especially kicks or blows with horns on the left
hypochondriac region. Horses running at large in pastures, or
in yards, or standing side by side in short stalls or tied with too
long halters are the usual victims. Cadeac refers to cases reported
by Tausch, Millot, Berndt, Humbert and Pont, and one case
occurring in a three year old colt came under the notice of
the author. ‘The subject stood in a stall to the right of an irrita-

580 Veterinary Medicine.

ble mare, and though the kick left no noticeable skin lesion the
colt died in three hours with symptoms of internal hemorrhage.
At the necropsy a laceration of the spleen of about five inches long
was disclosed, and a large quantity of blood had accumulated in
the peritoneum.

Brandis mentions a case consequent on a violent fall on the left
hypochondrium,

In other cases pre-existing disease of the spleen or its blood-
vessels have proved active factors. In the friable degenerated
spleen of leucocythemia multiple small lacerations have been
found (Peuch, Laulanie) ; in engorgement of the spleen conse-
quent on thrombosis of the splenic vein (Wiart) ; in chronic indi-
gestion with habitually loaded stomach compressing the gastric
and hepatic arteries and determining a reflux of blood through
the celiac axis into the spleen (Mongin).

Finally, though less frequently than in the ox, the engorge-
ment of the spleen with blood in cases of anthrax may be a cause
of rupture.

Lesions. The rupture may be on any part of the spleen and
it may be complete or incomplete; in the latter event the
capsule may have ruptured while the more elastic peritoneal
covering has remained intact enclosing a coagulum of variable
size bulging above the level of the spleen. When the peritoneal
coat has given way, its laceration is usually smaller than that in
the spleen and its proper envelope. Any degeneration of the
spleen will affect the appearance of the lesion. In one case
caused by external violence the adjacent portions of the spleen
were reduced to a soft pulp. In such a case thereis a slow but
continuous flow of blood in a small stream which may, however,
prove fatal (Humbert and Pont).

Again in cases caused by external violence there may be
fractures of the ribs, ecchymosis, local swellings or even wounds
of the skin, but all these may be absent. ‘The blood effused into
the peritoneum is usually clotted. If the effusion has taken place
slowly it is more or less coagulated around the edges of the wound
or even in its depth and in this way the hemorrhage may be
arrested. When the peritoneum is still intact the pressure of the
clot beneath it has served to arrest the flow. In such cases the
clot may be in part liquefied and absorbed and in part organized

Rupture of the Spleen. 581

into fibrous tissue, constituting the cicatrices of the spleen found
in old horses..

Symptoms appear to have been varied. Colicy pains are gener-
ally noted, Tausch has observed vomiting, Millot vertigo, and
Wiart coma and trembling. In the author’s case the animal was
found down, unable to rise, almost unconscious, pulseless, with
great pallor of the visible mucous membranes, dilated pupils, and
cold extremities. A diagnosis was made of internal hemorrhage,
but its actual seat was only revealed post mortem.

Treatment, The early mortality usually forbids treatment.
When opportunity is furnished keep the animal absolutely still
and quiet, apply snow, ice or other refrigerant to the left hypo-
chondrium, give internally tincture of muriate of iron, matico, or
other astringent, and relieve any severe suffering by anodynes
(hyoscyamus, belladonna, opium). External wounds may be
treated antiseptically.

Cattle. The cazses of laceration and hemorrhage of the spleen
are similar to those acting in the horse. Blows with the horns on
the left side, crowding through a doorway or gateway, and direct
blows of other kinds are charged with its pathogenesis. The
friability which attends on leucocythzemia has been noted asa
predisposing cause. Calves by reason of their small size and the
relative bulk of the spleen are especially liable to rupture by
kicks from animals or men.

Much more commonly than in solipeds, rupture of the spleen
occurs as a complication of specific microbian diseases like anthrax
and Southern cattle fever.

Symptoms. The mature animal assumes the recumbent posi-
tion, refusing to rise, and dies in a few hours. In calves, life
may be prolonged for a few hours longer, and there have been
noticed, anorexia, watering of the eyes, accelerated pulse and
respiration, arrest of intestinal peristalsis, cold ears, rigid limbs,
and moderately full belly (Notz). ‘There should also be tender-
mess on manipulation or percussion of the left hypochondrium,
and until coagulation occurs, fluctuation in the lower part of the
abdomen, with pallid mucous membranes and other signs of pro-
fuse internal hemorrhage.

Treatment is useless in the majority of cases. In the slighter
forms it would be the same as in the horse.

TUMORS OF THE SPLEEN.

Secondary. Delay of blood favors. Sarcoma. horse, cattle, dog. Car-
cinoma: horse, dog. Melanoma: common and large in gray and white
horses, rupture, external melanosis, Angioma- horse, ox. Lymphadeno-
ma: horse, ox, external adenoma.

The different tumors of the spleen are usually secondary. The
intimate structure of the organ, the peculiarity of the circulation
through the pulp cavities, and the delay of the blood in the pulp
spaces, predispose it in a very especial manner to the growth of
neoplasms, the germs or bioplasts of which are carried in the
blood.

Sarcoma. In the horse sarcomata have been found in the
spleen secondary to similar tumors in the other parts of the ab-
dominal and thoracic cavities. They may attain to any size,
from a pea to the closed fist and, in exceptional cases, of a mass
which practically fills and distends the abdominal cavity.

In the cow an encephaloid sarcoma in the spleen, weighed nine
pounds and was associated with similar formations in the lymph
glands generally of the abdomen and chest.

In the dog also sarcomata are common in the spleen.

Carcinoma, ‘These are found in the forse in connection with
similar primary tumors, as in the case of the sarcomata. ‘They
are at times extremely vascular and soft, and at other times they
are hard and fibrous (scirrhus).

In the dog secondary cancer of the spleen is comparatively
common.

Melanoma. Black pigment tumors are especially common in
gray and white horses. Their common seat is on the black,
hairless portions of the skin (anus, vulva, perineum, tail, sheath,
mamma, eyelids, lips, etc. ), and secondarily in the lymph glands
and spleen. In the latter they may grow to an extreme size,
Wehenkel having mentioned one specimen of 60 pounds. Its.
surface is marked by uneven, rounded black-swellings, the entire
organ, indeed, seeming to be a conglomerate of these masses.
The intimate structure is that of a sarcoma, so abundantly
charged with black pigment granules that these appear to make
up the greater part of the mass.

582

Amyioid Degeneration of the Spleen. 583

Rupture of these neoplasms with the escape into the abdomen
of blood highly charged with the melanic matter is not uncom-
mon.

The symptoms of the splenic deposits are not.usually recog-
nizable, but indications of chronic abdominal disease in connetion
with external melanotic formations may well lead to a reasonable
suspicion.

Angioma. Ina horse’s spleen weighing 30 lbs., there were
numerous soft nodules of a deep cherry color. These were
cavernous masses with connective tissue walls and the meshes
filled with blood.

Similar vascular cavernous tumors have been found in the cow.

Lympadenoma has been found in the spleen of horses and catttle
in connection with the same disease of the lymph glands.

Like the other splenic tumors this is obscure and usually only
found afterdeath. The existence of adenoid swellings elsewhere
conjoined with excess of white globules and indications of abdomi-
nal pain would be suggestive of splenic disease.

AMYLOID DEGENERATION OF THE SPLEEN.

Amyloid: horse; with exhausting diseases. Waxy secretion staining
mahogony brown with iodine. Gangrene: Swine. Tubercle and glander
nodules.

This has been occasionally detected in the spleen of the horse.
It is usually connected with longstanding suppuration especi-
ally of bones, with advanced tuberculosis or other exhaustiag
disease. ‘he organ is usually greatly enlarged and the affected
parts are firm, resistant and swollen. On section it has not the
soft friable or pulpy appearance of the spleen, but an uniform
waxy looking, consistency, grayish or sometimes stained with
blood. On the application of a solution of iodine and iodide of
potassium the healthy splenic tissue is colored yellow, while the
amyloid portion becomes of a deep mahogany brown.

GANGRENE OF THE SPLEEN IN SWINE.

Hertzen records the case of a pig in which the spleen had _ be-
come gangrenous and lay free in a surrounding fibrous capsule.

TUBERCLES AND GLANDERS NODULES OF THE
SPLEEN.

Tubercles in the spleen are common in cattle, swine, guinea-
pigs, rabbits and cats, in the last largely as the result of inges-
tion of tuberculous meat. In the larger mammals individual
tubercles are usually of the size of a walnut and upward, while
in the smaller they show as miliary deposits. The products are
often caseated or calcified.

Glander nodules are found in the spleen of the horse and other
solipeds and as the result of inoculation in that of rabbits and
guinea-pigs. In solipeds they may be of considerable size
whereas in the inoculated rodents they are usually small and
numerous—like millet seed or pins’ heads.

PARASITES OF THE SPLEEN.

Parasites are less common in the spleen than might be expected
yet the encysted parasites of the liver and pancreas, are also to be
found in the spleen. Thus echznococcus is found in the spleen of
cattle, and headless hydatids in that of the horse; Cysticercus
tenuicollis in the spleen of sheep ; cysticercus cellulosa in that of
pigs; distomata, and pentastoma denticulata in the spleen of
cattle ; coccidia in the spleen of rabbits; and actinomyces in
that of horses and cattle.

In addition to these the spleen is a general rendezvous for the
different pathogenic organisms that can survive in the blood
stream, such as the bacilli of tubercle, glanders, septiceemia,
anthrax, black quarter, swine plague and hog cholera, and for
the cocci of suppuration, strangles, contagious pneumonia, etc.
(See Parasites and Contagious Diseases).

584

INDEX.

ABOMASUM, catarrhal inflammation
of, 170.

Abomasum, indigestion in, in suck-
lings, 136.

Abomasum, indigestion of, 134. |

Abortion from ergotism, 306.

Abscess in gullet, 93.

Abscess in pancreas, 561.

Abscess of bowel, 344.

Abscess of spleen, 577.

Abscess, supra-pharyngeal, 58.

Acetic acid and gastro-enteritis, 270.

Aconite poisoning, 294.

Acorn poisoning, 294.

Actinomycosis of lips, 7.

Actinomycosis of liver, 556.

Actinomycosis of omasum, 133.

Actinomycosis of pharynx, 85.

Actinomycosis of rumen, 123.

Adenoma of liver, 551, 552.

Adenosarcoma of stomach, 195.

Adynamia from cryptogams, 300.

Agrostemma poisoning, 293.

Albumen reduced in liver, 418.

Alkaline caustics, causing gastro-en-
teritis, 268.

Aloes poisoning, 294.

Ammonia carbonate in gastro enteri.
tis, 269.

Ammonia in gastro-enteritis, 268.

Amphistoma conicum, 122.

Amyloid degeneration of liver, 532.

Amyloid of the spleen, 583.

Anemia of spleen, 566.

Andromeda poisoning, 291.

Anemone, poisoning by, 296.

Angioma of liver, 547, 549.

Angioma of the spleen, 583.

Aqua ammonia, 268.

Army worm, poisoning by, 296.

Arsenical poisoning, 273, 275.

Arsenic, tests for, 275.

Artichokes, poisoning by, 294.

Arytenectomy, results of, 92.

Ascites in carnivora, 411.

Ascites in ruminants, 410.

Ascites in solipeds, 408.

Asclepias poisoning, 291.

Aspergillus poisoning, 296.

Asthenia from cryptogams, 300, 305.

,

Astragalus, poisoning by, 294.
Atrophy of the liver, 534.
Azalea poisoning, 291.
Azedarach, poisoning by, 294.
Azotemia, 445.

Azoturia, 445.

BACILLUS coli communis, 259.
Bacillus diphtherize columbarum, 67.
Bacillus gallinorum, 258

Bacillus of duck cholera, 259.
Bacillus of Shiga, 246.

Bacteria in gall-stones, 539.
Bacteria, poisoning by, 296, 300, 301.
Barbs, 13.

Barium poisoning, 283.

Bezoars, 331.

Bichromate of potash poisoning, 284.
Bile acids, 421.

Bile acids, test for, 421.

Bile, functions of, 419

Bile pigments, 421.

Bile pigments, test for, 472.

Bile secretion, inhibitors, 422.

Bile, secretion of, 419.

Bile secretion, stimuli of, 422.
Biliary calculi, 536.

Bilirubin, 421.

Biliverdin, 421.

Birds, constipation in, 327.

Birds, intestinal indigestion in, 213.
Bittersweet poisoning, 293.

Black pigmentation of the liver, 534.
Bloating, 96.

Bloating in solipeds, 154.

Botulism, 309.

Bowels, obstruction of in birds, 213.
Box leaves poisoning, 288.

Branch ivy, poisoning by, 292.
Brine poisoning, 272, 310.

Bristle balls in stomach, 191.
Bristle balls, Pig, 116, 191, 330.
Bromine poisoning, 280.

Bromism, 280.

Bryony, poisoning by, 294.

Buccal inflammation, 8.
Buckwheat, poisoning by, 294.
Buxus sempervirens poisoning, 288.

CALCAREOUS nodules in liver, 554.

586

Calculi, biliary, 536.

Calculi, colloids as causes, 538.

Calculi, coralline, 332.

Calculi, diagnosis of, 335.

Calculi, fermentation as cause, 333.

Calculi, intestinal, 331.

Calculi, intestinal, sources, 331.

Calculi, in tonsils, 48.

Calculi, pancreatic, 563.

Calculi, pseudo, 332.

Calculi, rate of growth of, 334.

Calculi, treatment of, 335.

Calculus, salivary, 40.

Calfkill, 292.

Calves, infective gastro-enteritis in,
138, 150.

Cancroid of lips, 6.

Cantharides, poisoning by, 295.

Carbolic acid poisoning, 285.

Carcinoma in pancreas, 564.

Carcinoma of intestine, 383, 386.

Carcinoma of liver, 550, 552, 553-

Carcinoma of spleen, 582.

Carnivora, cryptogamic poisoning in,
309.

Ge oil seeds poisoning, 286.

Catarrhal enteritis, chronic, in cattle,

243.

Catarrhal enteritis, chronic, in soli-
peds, 238.

Catarrhal enteritis in birds, 258.

Catarrhal enteritis in cattle, 239.

Catarrhal enteritis in dogs, 254.

Catarrhal enteritis in sheep and goat,
250.

Catarrhal enteritis in solipeds, 232.

Catarrhal enteritis in swine, 251.

Caustic acids and gastro-enteritis, 270.

Caustic alkalies in gastro-enteritis,
268.

Caustic potash poisoning, 269.

Caustic soda poisoning, 269.

Cheeks, inflammation of, 19.

Cheilitis, 5.

Chickweed poisoning, 294.

Chloride of barium poisoning, 283.

Chloride of zinc poisoning, 281.

Cholera of birds, 258.

Choking, injuries in, 86.

Cholelithiasis, 536.

Chromium poisoning, 284.

Cicuta Balanderi poisoning, 290.

Cicuta maculata poisoning, 290.

Cicuta vagans poisoning, 290.

Cicuta virosa poisoning, 290.

Cirrhosis in the dog, 526.

Cirrhosis of the liver, 512.

Cirrhosis of the liver from senecio, 516.

Index.

Cirrhosis of the liver in sheep, 519.

Cirrhosis of the liver in solipeds,’513.

Cirrhosis of the liver in cattle, 515,
516.

Claviceps purpurca, 300.

Cleft palate, 49.

Clematis poisoning, 294.

Cloth in stomach, 192:

Clover-hair balls in stomach, 191.

Coccidian enteritis in birds, 267.

Coccidian enteritis in cattle, 262.

Coccidian enteritis in dogs, 265.

Coccidian enteritis in rabbits, 266.

Coccidiosis, intestinal, 258, 265, 266,
267.

Coccidiosis of the gullet, 93.

Coccidium bigeminum var. canis, 265.

Coccidium oviforme, 263, 266.

Coccidium perforans, 263, 265, 256.

Coccidium tenellum, 267.

Cockle poisoning, 293, 294.

Cockroach, poisoning by, 296.

Colchicum poisoning, 290.

Colic, 316.

Colic, crapulous, 317.

Colic cystic, 317.

Colic from bacterial invasion, 317.

Colic from calculi, 317.

Colic from hernia, 317.

Colic from impaction, 317.

Colic from indigestion, 317. -

Colic from inflammation, 317.

Colic from irritants, 317.

Colic from peritonitis, 317.

Colic from protozoa, 317.

Colic from strangulations, 317.

Colic, hepatic, 317.

Colic in solipeds from verminous em-
bolism, 214, 317.

Colic, lead, 317.

Colic, nephritic, 317.

Colic, pancreatic, 317.

Colic, tympanitic, 197, 317.

Colic, uterine, 317.

Colic, verminous, 214, 317.

Colloids in gall stones, 538.

Colon bacillus, 259.

Colon, impaction of, 201.

Colon, impaction of, in ruminants,
207.

Colon, impaction of, in swine, 208.

Common salt, poisoning by, 271.

Concretions in intestines, 332.

Congestion of the liver, 493.

Congestion of the spleen, 567, 570.

Conium poisoning, 290, 294.

Constipation from atony, 322.

Constipation in birds, 327.

Index.

Constipation in dog, 209.

Convalaria poisoning, 293, 294.

Copperas poisoning, 283.

Copper poisoning, 280.

Corrosive sublimate poisoning, 278.

Cotton balls in stomach, 191.

Creosote poisoning, 286,

Crop, impaction of, 94.

Croton seeds poisoning, 287.

Croupous enteritis in birds, 230.

Croupous enteritis in cattle, 227.

Croupous enteritis in dogs, 229.

Croupous enteritis in sheep, 228.

Croupous enteritis in solipeds, 225.

Croupous pharyngitis, 60.

Crowfoot poisoning, 289.

Cryptogamic poisoning in carnivora,
309.

Cryptogamic poisoning in ruminants,
303.

Cryptogamic p isoning in solipeds,
300.

Cryptogamic poisoning in swine, 308.

Cryptogams, poisoning by, 2096.

Cystoma of intestine, 384, 386.

DAFFODIL poisoning, 288.

Darnel poisoning, 294.

Datura poisoning, 292.

Death camas poisoning, by, 290.

Delirium from cryptogams, 301, 305.

Depraved appetite. 76.

Diabetes mellitus, 424.

Diarrheea, 311.

Diaphragmatic hernia, 367.

Diaphragmatocele, 367, 375.

Digestive disorders in fever, 3.

Digestive organs, area and capacity, I.

Digestive organs, food in relation to
diseases of, 2.

Digestive organs, general considera-
tions, I.

Digestive organs, importance of dis-
eases of, T.

Digestive organs of carnivora, herbi-

' yora and omnivora, T.

Digestive organs, rumination in rela-
tion to diseases of, 2.

Digestive organs, structural diseases
of, 5.

Digitalis poisoning, 294.

Dilation of intestine, 348.

Dilatation of stomach, 184.

Diphtheria in calves, 24. ;

Diphtheria in chickens and pigeons,
67.

Diphtheritic enteritis in chickens, 230.

Dogbane poisoning, 292.

587

Dog, chronic gastritis in, 177.
Dog, gastric indigestion in, 162.
Dog, torsion of stomach in, 188.
Dry murrain, 124.

Dysentery Amcebic, 246.
Dysentery bacillar, 246.
Dysentery, catarrhal, 245.
Dysentery, diphtheritic, 246.
Dysentery in cats and dogs, 246.
Dysentery in cattle, 244.

EGAGROPILES, 116, 328.
Emaciation, 435.
Embolism, verminous, 214, 317.
Enteralgia, 316.
Enteritis, adynamic, 303.
Enteritis, bacterial, 309.
Enteritis, catarrhal, in birds, 258.
Enteritis, catarrhal, in cattle, 239.
Enteritis, catarrhal, in dogs, 254.
Enteritis, catarrhal, in sheep and
goat, 250.
Enteritis, catarrhal, in solipeds, 232.
Enteritis, catarrhal, in swine, 251.
Enteritis, chronic catarrhal, in cattle,
243.
Enteritis, chronic catarrhal, in soli-
peds, 238.
Eoteritis, coccidian, in birds, 267.
Enteritis, coccidian, in cattle, 262.
Enteritis, coccidian, in dogs, 265.
Enteritis, coccidian, in rabbits, 266.
Enteritis, croupous, in birds, 230.
Enteritis, croupous, in cattle, 227.
Enteritis, croupous, in dogs, 229.
Enteritis, croupous, in sheep, 228.
Enteritis, croupous, in solipeds, 225.
Enteritis from tuberculin, 256.
Enteroliths, 331.
Epithelioma in pancreas, 564.
Epithelioma of intestine, 383, 387.
Epithelioma of lips, 6
Epithelioma of liver, 550, 552.
Epithelioma of the stomach, 195.
Equisetum poisoning, 294.
Ergot as a cause of stomatitis, 9.
Ergot, poisoning by, 297, 304.
Ergotism in cattle, 299, 304, 306.
Euphorbia poisoning, 287.
Exhausted soils, 78.

Farry degéneration of the liver, 529.
Fauces, injuries to, 48.

Feathers in stomach, 192.

Fermented marc, stomatitis from, 27.
Fermentescible foods, 96.

Fetterbush poisoning, 292.

Fibroma in gullet, 93.

588

Fibroma of intestine, 383, 386.
Fibrous bands causing strangulation,

304.
Fistula, salivary, 4o. ae
Foals, infective gastro-enteritis in,
138.
Food in infective gastro-enteritis, 141.
Food in relation to digestive disorder,

2.

Food, unwholesome, 3.

Foramen of Winslow, hernia through,
378.

Foreign bodies in food, 3.

Foreign bodies in intestines, 336, 337,
338.

Foreign bodies in liver, 546.

Foreign bodies in pancreas, 542.

Foreign bodies in spleen, 578.

Fourth stomach, catarrhal inflamma-
tion of, 170. .

Fourth stomach, indigestion in, 134.

Fowl cholera, 258.

Functional liver diseases, treatment
of, 424.

Fungi as a cause of stomatitis, 9.

Fungi, poisoning by, 296, 297.

Fungi, varying pathogenesis of, 9.

GALEGA, poisoning by, 294.

Gall-bladder, dilatation of, 535.

Gall bladder, double, 536.

Gall-ducts, dilatation of, 535.

Gall-stones, 536.

Gall-stones in cattle, 542.

Gall-stones in dog and cat, 545.

Gall-stones in sheep, 544.

Gall-stones in solipeds, 544.

Gall stones in swine, 544.

Gangrenous ergotism, 299, 304.

Gases evolved from different foods,
100.

Gastric catarrh in solipeds, chronic,
174.

Gastric dilatation, 184.

Gastric indigestion in carnivora, 162.

Gastric indigestion in solipeds, 154.

Gastric indigestion in swine, 163.

Gastric ulcer, 179.

Gastric ulcer, perforating, 183.

Gastritis, acute catarrhal, in horse,
164. °

Gastritis, catarrhal, in swine, 172.

Gastritis in cattle, 170.

Gastritis in dogs, chronic, 177.

Gastritis in ruminants, chronic, 175.

Gastritis, toxic, in solipeds, 168.

Gastritis, phlegmonous, in horse, 166.

Index.

Gastro-enteritis from aqua-ammonia,
268.

Gastro-enteritis from caustic acids,
270.

Gastro-enteritis from caustic alkalies
and alkaline salts, 268.

Gastro-enteritis, hemorrhagic, in
dogs, 256

Gastro-enteritis, infective, in suck-
lings, 138.

Gastro-enteritis from navel infection,
150.

Gastro-enteritis, microbes in, 144, 151.

Gums, inflammation of, 20.

Giant-fennel, poisoning by, 294.

Gingivitis, 20.

Githagism, 293.

Glander nodules in spleen, 584.

Glisson’s capsule, inflammation of,
510.

Glossitis, 20.

Glossoplegia, 37.

Glycogenesis, 416.

Glycogenic center in medulla, 425.

Glycosuria, 424.

Glycosuria in cattle, 432.

Glycosuria in dogs, 433.

Glycosuria in solipeds, 429.

Glycosuria, reflex, 426.

Glycosuria, tests for, 430.

Glycosuria, toxic, 427.

Glycosuria, pancreatic, 428.

Glycosuria, pathological, 425.

Glycosuria, physiological, 424.

Gnathitis, 19.

Gout, 438.

Gongylonema in gullet, 93.

Grass staggers, 124.

Green potatoes, poisoning by, 292.

Gregarina avium intestinalis, 267.

Growth, sugar in relation to, 436.

Gullet, inflammation of, 86.

Gullet, spasm of, go.

Gut-tie in ox, 365.

HAMOGLOBINEMIA, 445.

Heemoglobinuria, 445. .

Hemorrhagic gastro-enteritis in dogs,
256.

Hair and bristle balls, dog and pig,

330
Hair balls in intestines, 328, 330.
Hair balls in intestines, horse, 328,
Hair balls in stomach, ror.
Hard palate, congestion of, 19.
Hare lip, 49.
Harvest bug on lips, 7.
Heath family, poisoning, 291.

Index.

Helenium poisoning, 293.

Hellebore poisoning, 290.

Helleborus niger poisoning, 290.

Hepatic abscess, 505.

ere cirrhosis in N. S., and N. Z.
516.

Hepatic cirrhosis from Senecio, 516.

Hepatic congestion, 493

Hepatic congestion in dog, 496.

Hepatic congestion in solipeds, 494.

Hepatic hemorrhage, 497.

Hepatic inflammation, 500,

Hepatic steatosis, 529.

Hepatitis, 500.

Hepatitis, infective, 508.

Hepatitis, parenchymatous, 501.

Hepatitis, suppurative, 505.

Hernia, 365, 379.

Hernia, mesenteric, 377.

Hernia of reticulum, 375.

Hernia, omental, 375.

Hernia, pelvic, 365.

Hernia, phrenic, 367.

Hernia through foramen of Winslow,
378.

Honey dew, poisoning by, 300.

Horse chestnut, poisoning by, 288.

Horsetail poisoning, 294.

Hydrochloric acid and gastro enteri-
tis, 270.

Hyoscyamus poisoning, 293.

IcTERUS, 467.

Icterus, from lupin poison, 486.

Icterus nouveau nés, 483.

Impacted cloaca, 213, 327.

Impacted rumen, 108.

Impaction of colon in solipeds, 2or.

Impaction of colon in ruminants, 207.

Impaction of large intestine, soliped,
201.

Impaction of omasum, 123.

Indigestion, acute gastric in solipeds,
154.

Indigestion, gastric, in carnivora, 162.

Indigestion, gastric, in swine, 163.

Indigestion in abomasum, 135.

Indigestion in fourth stomach in suck-
lings, 136.

Indigestion, ingluvial, 94.

Indigestion, intestinal, 197.

Indigestion, intestinal in birds, 213.

Indigestion, intestinalin solipeds, 201.-

Indigestion, with impaction, in dog,
209.

Indigestion, tympanitic, of rumen, 96.

Ingluvial indigestion, 94.

Intestinal atony, 322.

589

Intestinal calculi, 331.

Intestinal congestion, from verminous
embolism, 214. :

Intestinal congestion in solipeds, 224.

Intestinal indigestion in birds, 213.

Intestinal indigestion with impaction,
201.

Intestinal invagination, 352.

Intestinal obstruction in birds, 213.

Intestinal obstruction in dog, 209.

Intestinal pain, 316.

Intestinal strangulations, 364.

Intestinal tympany, 197.

Intestine, abscess of, 340.

Intestine, dilation of, 348.

Intestine, hyperplasia of, 386.

Intestine, rupture of, 340.

Intestines, foreign bodies in, 336.

Intestines, hair balls in, 328.

Intestines, strangulation of, by ova-
rian ligament, 388.

Intestine, stricture of, 350.

Intestiné, tumors of, 382.

Intestine, ulceration of, 346.

Intestine, volvulus of, 359, 362, 363.

Intussusception, 352, 355, 357-

Invagination of bowel, 352.

Iodine poisoning, 280,

Todism, 280.

Iron, poisoning by, 283.

JAUNDICE, 467.

Jaundice, catarrhal, 473, 477, 482.

Jaundice, catarrhal, in dogs, 477.

Jaundice from ferments in fodder, 486,

Jaundice from lupins, 486.

Jaundice from obstruction, 468, 469.

Jaundice from poisons, 468.

Jaundice in cattle, 482.

Jaundice in new born, 483.

Jaundice without bile obstruction,
468.

Juniperus sabina, poisoning, 291.

KaLMia poisoning, 291.
Kidney, degeneration of, 438.

LABRADOR tea poisoning, 291.

Laburnum poisoning, 294..

Laceration of intestine, 340, 343, 344.

Lambs, infective gastro-enteritis in,
138.

Lampas, 19.

Lathyrus, poisoning by, 294.

Laurel poisoning by, 291.

Leather in stomach, 192.

Ledum poisoning, 291.

Leucomoé poisoning, 292.

’

1

"590

Lily of the valley poisoning, 293.
Lips, actinomycosis of, 7.

Lips, epithelioma of, 6.

Lips, indurated, 5.

Lips, inflammation of, 5.

Lips, polypi on, 6.

Lips, treatment of inflammation of, 5
Lips, trombidiosis of, 7.

Lips, warts on, 6.

Lips, wounds of, 5.

Lipoma of intestine, 382, 385.
Lipoma of liver, 553.

Lipoma of stomach, 195.

Liver, abscess, 505.

Liver, actinomycosis of, 556.

Liver, acute yellow atrophy of, 501.
Liver, action on proteids, 418.
Liver, amyloid, 532.

Liver, brown atrophy of, 534.

Liver and circulatory disorders, 439.
ee and gastro intestinal disease,

439.
Liver and kidney disease, 439.
Liver and nervous disease, 439.
Liver and respiratory disorders, 439.
Liver and skin diseases, 440.
Liver, as a destroyer of toxins, 423.
Liver, calcareous nodules in, 554.
Liver, chronic atrophy of, 528.
Liver, congestion in dog, 496.
Liver, congestion in horse, 494.
Liver, congestion of, 493.
Liver, cirrhosis of, 512.

Liver disease, secondary results of,

438.
Liver, diseases of, 415.
Liver, effect on leucocytes, 417.
Liver, effect on red globules, 417.
Liver, fatty degeneration, 529.
Liver, fibroid degeneration, 512.
Liver, foreign bodies in, 546.
Liver, functional diseases, treatment,
440.
Liver, functional disorders, 424.

Liver, infective inflammation of, 508.

Liver, inflammation of, 500.
Liver, metabolism in, 416, 418
Liver, parasites of, 557.
Liver, pigmentation of, 534.
Liver, rupture of, 497.

Liver, sanguification in, 416.
Liver, steatosis of, 529.

Liver, tumors in, 547.

Liver, tumors in cattle, 551.
Liver, tumors in sheep, 552.
Liver, tumors in dog, 553.
Liver, yellow atrophy of, 501.
“Toco”? weeds, poisoning by, 294.

Index.

Lupinosis, 486

Lupinosis in solipeds, 486.
Lymphadenoma of intestine, 384.
Lymphadenoma of liver, 549.
Lymphadenoma of the spleen, 583.

Maizz, poisoning by damaged, 299.

Male fern poisoning, 294.

Marsh’s test for arsenic, 275.

Maxillitis, 44.

May apple, poisoning by, 294.

Meadow saffron poisoning, 290.

Melanoma of gullet, 93.

Melanoma of liver, 549.

Melanoma of spleen, 582.

Melanosis in pancreas, 564.

Melia azedarach, poisoning by, 294.

Melilot poisoning, 294.

Mellitur'a, 424.

Mercurialis annua poisoning, 294.

Mercurialism, 32.

Mercurial poisoning, 278

Mercurial] stomatitis, 32.

Mercury, test for, 279.

Mesenteric hernia, 377

Metabolism in liver, 416, 418.

Meteorism, gastric, 154.

Meteorism of the intestines, 197.

Meteorism of rumen, 96.

Microbes in gastro enteritis, 144.

Mi'dew poisoning, 304.

Milk in infective gastro-enteritis of
sucklings, 141.

Milk of women, and animals, 143.

Milkweed poisoning, 292.

Marc, stomatitis from, 27.

Monocercomonas gallinze, 7

Moulds, poisoning by, 296, 298.

Mouldy bread, poisoning by, 303.

Mouth, diseases of, 4.

Mouth, functional disorders, 4.

Mouth, general inflammation of, 8.

Mouth, injuries to, 4.

Muguet, 27, 36.

Muriatic acid and gastro enteritis,
270.

Mustard, poisoning bv, 294.

Musty grain, poisoning by, 290, 304.

Myoma of intestine, 383.

Myxoma of intestine, 383.

NARCISSUS poisoning, 288.
Nails in stomach, 192.
Necrobiosis of liver, 508.
Needles in stomach, 192.
Neoplasms of intestine, 382.
Nervous ergotism, 300, 306.
Neuralgic colic, 316.

Index.

Nightshade poisoning, 293.

Nitrate of soda poisoning, 272.
Nitric acid and gastro-enteritis, 270.
Nocard on umbilical infection, 150.
Nux vomica, poisoning by, 294.

OaT HAIR BALLS in stomach, Igr.

Obesity, 435.

CGinanthe crocata, poisoning by, 294.

Csophagean tumors, 93.

(sophagismus, go.

Césophagitis, 86.

Esophagus, paralysis of, 92.

CEsophagus, spasm of, go.

Omasum, impaction of, 123.

Omasnm, inflammation of, 131.

Omasum, tumors of, 133.

Omental hernia, 376.

Osteomalacia, 78.

Ovarian ligament, strangulation of
intestine by, 388.

Oxalic acid and gastro-enteritis, 270.

Oxalic acid diathesis, 438.

Oxytropis, poisoning by, 294.

PALATITIS, 19.

Pancreas, diseases of, 557.

Pancreas, foreign bodies in, 562.

Pancreatic abscess, 561.

Pancreatic calculi, 563.

Pancreatic tumors, 564.

Pancreatitis, catarrhal, 558.

Pancreatitis, interstitial, 560.

Pancreatitis, suppurative, 561.

Paper ball in stomach, 192.

Papilloma of gullet, 93.

Papilloma of omasum, 133.

Papilloma of stomach, 195.

Paralysis of gullet, 92.

Paralysis of rectum, 379.

Paralysis of the pharynx, 83.

Paralysis of tongue, 37.

Parasites of liver, 557.

Parasites of ruwen and reticulum,
122.

Parasites of spleen, 584.

Paris green poisoning, 273.

Parotid gland, inflammation of, 41.

Parotitis, 41.

Pecking feathers, 76.

Pelvic hernia in ox, 365.

Perforating ulcer of stomach, 183.

Perihepatitis, 510.

Perisplenitis, 574.

Peritonitis, 388.

Peritonitis, chronic, 400.

Peritonitis, general causes, 388, 391.

Peritonitis in birds, 407.

Peritonitis in carnivora, 405.

591

Peritonitis, infection of, 388, 391.

Peritonitis in ruminants, 402.

Peritonitis in solipeds, 391.

Peritonitis, traumatic, 391.

Pharyngeal abscess, 58.

Pharyngitis, catarrhal, 49.

Pharyngitis, chronic, 73.

Pharyngitis, microbes in, 50, 56.

Pharyngitis, phlegmonous, 54.

Pharyngitis, pseudo-membranous, 60.

Pharyngitis, pseudo-membranous, in
birds, 67.

Pharyngitis, pseudo-membranous,
cattle, 63.

Pharyngitis, pseudo-membranous,
dogs, 66.

Pharyngitis, pseudo-membranous, in
sheep, 64.

Pharyngitis, pseudo-membranous,
solipeds, 61.

Pharynx, paralysis of, 83.

Pharnyx, tumors of. 84.

Phenol poisoning, 285.

Phlegmonous gastritis in horse, 166.

Phosphatic calculi in stomach, I92.

Phosphorus poisoning, 276.

Phrenic hernia, 367, 375.

Phytolacca, p isoning by, 294.

Pica, 76.

Pictou disease, 516.

Pieris poisoning, 292, 296.

Pimpernel poisoning, 294.

Pins in stomach, 192.

Pip in birds, 18.

Plants, paralyzing element in, 95.

Playthings in stomach, 192.

Podophyllum, poisoning by, 286.

Poisoning by acetic acid, 270.

Poisoning by aconite, 289, 294.

Poisoning by acorns, 294.

Poisoning by actea, 289.

Poisoning by agrostemma, 293.

Poisoning by aloes, 294.

Poisoning by American water hem-
lock, 290.

Poisoning by ammonia, 268.

in

in

in

_| Poisoning by anemone, 294.

Poisoning by andromeda, 291.
Poisoning by antimony, 277.
Poisoning by army worm, 296.
Poisoning by arsenic, 273, 275.
Poisoning by artichokes, 294.
Poisoning by aragalus, 294.
Poisoning by asclepias, 292.
Poisoning by astragalus, 294.
Poisoning by azalea, 291.
Poisoning by azedarach, 294.
Poisoning by bacteria, 296.

592

Poisoning by barium, 283.
Poisoning by birds’ trefoil, 294.
Poisoning by bittersweet, 293.
Poisoning by bluestone, 276,
Poisoning by box leaves, 288.
Poisoning by branch ivy, 292.
Poisoning by brine, 272.
Poisoning by bromine, 280.
Poisoning by bryony, 294.
Poisoning by buckwheat, 294.
Poisoning by bunt, 299.
Poisoning by calfkill, 292.
Poisoning by cantharides, 295.
Poisoning by carbolic acid, 285.
Poisoning by castor seeds, 286.
Poisoning by chick weed, 294.
Poisoning by chromium, 284.
Poisoning by cicuta balanderi,290 .
Poisoning by cicuta maculata, 290.
Poisoning by cicuta vagans, 290,
Poisoning by cicuta virosa, 290, 294.
Poisoning by clematis, 294
Poisoning by cockroach, 296.
Poisoning by colchicum autumnale,
290.
Poisoning by conium maculatum, 290,
294.
Poisoning by convalaria, 293, 294.
Poisoning by copper, 280.
Poisoning by coccle, 293.
Poisoning by creosote, 286.
Poisoning by crotalaria, 294.
Poisoning by croton seeds or oi], 287.
Poisoning by cryptogams, 297, 303,
308, 309.
Poisoning by daffodils, 288.
Poisoning by datura, 292.
Poisoning by death camas, 290.
Poisoning by delphinium, 289, 294.
Poisoning by digitalis, 294.
Poisoning by dogbane, 292.
Poisoning by ergot, 297.
Poisoning hy euphorbia, 287.
Poisoning by fetter bush, 292.
Poisoning by fungi, 296, 303.
Poisoning by galega, 294.
Poisoning by giant fennel, 294.
Poisoning by githago, 293.
Poisoning by heath family, 291.
Poisoning by helenium, 293.
Poisoning by horse-chestnut, 288.
Poisoning by honey dew, 300.
Poisoning by horsetail, 294.
Poisoning by hyoscyamus, 293.
Poisoning by iodine, 280.
Poisoning by iron, 283,
Poisoning by kalmia, 291.
Poisoning by laburnum, 294.

Index.

Poisoning by lathyrus, 294.
Poisoning by laurel, 291.
Poisoning by ledum, 291.
Poisoning by leucothoe, 292.
Poisoning by lily of the valley, 293,
294.
Poisoning by lolium temulentum, 294.
Poisoning by male fern, 294.
Poisoning by melilot, 294.
Poisoning by mercurialis annua, 294.
Poisoning by milkweed, 292.
Poisoning by mineral acids, 266.
Poisoning by moulds, 296, 298.
Poisoning by muriatic acid, 270.
Poisoning by mustard, 294.
Poisoning by nightshade, 293.
Poisoning by nitrate of soda, 272.
Poisoning by nitric acid, 270.
Poisoning by nux vomica, 294.
Poisoning by cenanthe crocata, 294.
Poisoning by oxalic acid, 270.
Poisoning by oxytropis, 294.
Poisoning by Paris green, 273.
Poisoning by phosphorus, 276.
Poisoning by phytolacca, 294.
Poisoning by pieris, 292, 296.
Poisoning by pimpernel, 294.
Poisoning by podophyllum, 294. ss
Poisoning by poppy, 294.
Poisoning by potash, 269.
Poisoning by potato beetle, 296.
Poisoning by potato tops, 292.
Poisoning by privet, 294.
Poisoning by ragwort, 293.
Poisoning by ranunculus, 289.
Poisoning by resinous plants, 294.
Poisoning by rhododendron, 292.
Poisoning by rhus toxicodendron,
294.
Poisoning by rusts, 298.
Poisoning by ryegrass, 294.
Poisoning by salts of mercury, 278.
Poisoning by saltpeter, 272.
Poisoning by savin, 291.
Poisoning by senecio, 293.
Poisoning by silver, 282.
Poisoning by smut, 297.
Poisoning by snapdragon, 289, 294.
Poisoning by soda, 269.
Poisoning by sodium chloride, 271.
Poisoning by solanum, 292.
Poisoning by spoiled potatoes, 293,
303.
Poisoning by spoiled maize, 297.
Poisoning by spring coccle, 294.
Poisoning by spurge laurel, 287.
Poisoning by spurge nettle, 288.
Poisoning by spurry seeds, 294.

Index.

Poisoning by St. John’s wort, 294.

Poisoning by staff vine 288.

Poisoning by stagger bush, 292.

Piosoning by stale fish, 310.

Poisoning by strychnia, 294.

Poisoning by sulphur, 279.

Poisoning by sulphuric acid, 270.

Poisoning by tares, 294.

Poisoning by tartar emetic, 277.

Poisoning by thorn apple, 292.

Poisoning by tobacco, 293, 294.

Poisoning by toxins in food and water,
296.

Poisoning by trefoil, 294.

Poisoning by vaccaria, 294.

Poisoning by vetches, 294.

Poisoning by veratrum viride, 290.

Poisoning by white vitriol, 287.

Poisoning by wild radish, 294.

Poisoning by wild rosemary, 291.

Poisoning by yew, 294.

Poisoning by zinc, 287.

Poisoning, chronic, by arsenic, 275.

Poke root, poisoning by, 294.

Polypi on lips, 6.

Poppy poisoning, 294.

Postpharyngeal abscess, 58.

Potash and gastro-enteritis, 268.

Potato beetle, poisoning by, 296.

Potato tops, poisoning by, 292.

Privet poisoning, 294.

Pseudomembranous enteritis in birds,
230.

Pseudomembranous enteritis in cat-
tle, 227.

Pseudomembranous enteritis in dogs,
22

Dey ienemibeawoud enteritisi in sheep,
228.

Pseudomembranous enteritis in soli-
peds, 225.

Pseudomembranous pharyngitis in
cattle, 62. .

Pseudomembranous pharyngitis
dogs, 66.

Pseudomembranous pharyngitis
pigeons and chickens, 67.

Pseudomembranous pharyngitis
sheep, 64.

Psendomembranous pharyngitis
solipeds, 61,

Pseudomembranous pharyngitis in
swine, 65.

Ptomaines and toxines of brine, 272.

Ptyalism, 39.

in
in
in

in

Racwort poisoning by, 516.
Rape cake, stomatitis from, 27.

593

Rank vegetation as a cause of stoma-
titis, 9.

Ranunculus poisoning, 288.

Rectum, paral ysis of, 379.

Red dysentery i in cattle, 262.

Resinous plants, poisoning by, 294.

Rhododendron, poisoning by, 292.

Ricinus communis poisoning, 286.

Reticulum, hernia of, 375.

Reticulum, tumors of, 122.

Retropharyngeal abscess, 58.

Rumen, actinomycosis of, 123.

Rumen, balls of vegetable fibre in,
116,

Rumen, foreign bodies in, 118.

Rumen, gaseous fermentation in, 96.

Rumen, hair balls in, 116.

Rumen, impacted, 108.

Rumen, inflammation of, 144.

Rumen, overloaded, 108.

Rumen, parasites of, 122.

Rumen, puncture of, 104.

Rumen, tumors of, 122.

Rumenotomy, 113.

Ruminitis, 114.

Ruminants, chronic gastric catarrh
in, 175.

Ruminants, cryptogamic poisoning
in, 303.

Ruminants, impaction of colon in,
207.

Rupture of intestine, 340, 343, 344.

Rupture of stomach, solipeds, 186.

Ryegrass poisoning, 294.

SACCHARINE diabetis, 424.
Sacculated bowel, 348.
Saliva, excessive secretion, 39.

‘Saliva, suppression of, 38.

Salivary calculus, 4o.

Salivary ducts, dilation of, 4o,
Salivary fistula, 4o.

Salivary glands, diseases of, 28.
Salivary glands, surgical lesions, 46.
Salivation, 5, 39.

Salivation, mercurial, 32.

Saltpeter poisoning, 272.

Sand and gravel in stomach, 192.
Sarcoma in liver, 548, 551.

Sarcoma of intestine, 382, 385, 387.
Sarcoma of omasum, 133.

Sarcoma of spleen, 582.

Sarcoma of stomach, 195.

Savin poisoning, 291.

Schweinsberg disease, 513, 514.
Sclerostoma equinum, 214. y
Scouring, 311.

Senecio Jacoboea, poisoning by, 516.

594

Sequestrum in spleen, 584.

Silver salts, poisoning by, 282.

Smut, poisoning by, 297.

Snapdragon poisoning, 289, 294.

Soda in gastro enteritis, 269.

Sodium chloride, poisoning by, 271.

Soft palate, injuries to, 48.

Solonacee poisoning, 292.

Solipeds, acute catarrhal gastritis in,
164.

Solipeds, chronic gastric catarrh in,
Solipeds, cryptogamic poisoning in,
Salineds, phlegmonous gastritis in,
Solipede, toxic gastritis in, 168.

Spanish flies, poisoning by, 295.

Spasm, intestinal, 316.

Spasmodic colic, 316.

Spirillum Metehnikowi, 260.

Spiroptera in gullet, 93.

Spleen, abscess of, 577.

Spleen, amyloid degeneration of; 583.

Spleen, anzemia of, 566.

Spleen, chronic congestion of, 567,
570.

Spleen, diseases of, 565.

Spleen, foreign bodies in, 578.

Spleen, gangrene of, in swine, 584.

Spleen, glander nodules in, 584.

Spleen, hy perzemia of, 567.

Spleen, infarction of, 575.

Spleen, parasites of, 584.

Spleen, rupture of, 579.

Spleen, tubercles in, 584.

Spleen, tumors of, 582.

Splenic hemorrhagic infarction, 555.

Splenic hypertrophy, 570, 571, 572,

573.
Splenic hypertrophy in dogs, 573.
Splenic hypertrophy in ruminants,
572. ;
Splenic hypertrophy in solipeds, 571.
Splenic hypertrophy in swine, 573.
Splenitis, 574.
Spurge laurel poisoning, 287.
Spurry seeds, poisoning by, 294.
Staff vine, poisoning by, 288.
Stagger bush poisoning, 292.
Staggers, 124, 300.
Stale fish, poisoning by, 310.
St. Johnswort, poisoning by, 294.
Stomach, bristle balls in, 116, gr.
Stomach, dilatation of, 184.
Stomach, feather concretions in, 116,
192.
Stomach, foreign hodies in, 191.

Index.

Stomach, hair balls in, 19r.

Stomach, perforating ulcer of, 183.

Stomach, puncture of, 160.

Stomach, rupture of, solipeds, 186.

Stomach staggers, 124.

Stomach, torsion of, in dog, 188.

Stomach, tumors of, 195.

Stomach, tympany of, 154

Stomach, ulceration of, 179.

Stomatitis, aphthous, 21.

Stomatitis, catarrbal in birds, 18.

Stomatitis, follicular, 21.

Stomatitis from buccal fermentation,
10.

Stomatitis from caustics, 35.

Stomatitis from fermented marc, 27.

Stomatitis from rape cake, 27.

Stomatitis, gangrenous, 22.

Stomatitis, general catarrhal, 8.

Stomatitis, general catarrhal in cattle,
13.

Stomatitis, general catarrhal in dog,
15.

Stomatitis, catarrhal in sheep, 15.

Stomatitis, general catarrhal in soli-
peds, o.

Stomatitis, general catarrhal in swine,
I

Ws
‘Stomatitis, local, I9.

Stomatitis, mercurial, 32.
Stomatitis, mycotic in birds, 36.
Stomatitis, mycotic in calves, 36.
Stomatitis, mycotic in foals, 36.
Stomatitis, mycotic in young, 36.
Stomatitis, sympathetic, 10.
Stomatitis, ulcerative, in calves, 24.
Stomatitis, ulcerative, in carnivora,
30.
Stomatitis,
kids, 27.
Stomatitis,

ulcerative, in lambs and

ulcerative, in solipeds, 23.

Stomatitis, ulcerative, in swine, 29.

Stoma itis, ulcerous, 22.

Strangulation of intestine by ovarian
ligament, 388.

Strangulation, intestinal, 364.

Stricture of intestine, 350.

Strongylus armatus, 214.

Strychnia, poisoning by, 294.

Stump sucking, 76.

Submazxillary adenitis, 44.

Sugar in urine, tests for, 430.

Sulphuric acid and gastro enteritis,
270.

Sulphur poisoning, 279.

Swine, catarrhal gastritis in, 172.

Swine, gastric indigestion in, 163.

Swine, impaction of colon, 208.

Index.

TARTAR emetic poisoning, 277.

Third stomach, impaction in fever,
124.

Third stomach, impaction of, 124.

Third stomach, tumors of, 133.

Thrush of the mouth, 36.

Tobacco poisoning, 293, 294.

Tongue, inflammation of, 20.

Tongue, paralysis of, 37.

Tonsilitis, 46.

Tonsils, calculi in, 48.

Torsion of stomach in dog, 188.

Toxemia from imperfect hepatic
function, 445.

Toxic gastritis in solipeds, 168.

Toxic rye, 308.

Toxin and ptomaine poisoning, 296.

Toxin, liver as a destroyer of, 423.

Tracheotomy, 57.

Trefoil poisoning, 294.

Trichosoma contortum, 95.

Trombidiosis of nose and lips, 7.

Tuberculin as cause of enteritis, 256.

Tubercle in spleen, 584.

Tubercles in gullet, 93.

Tumors in liver, 547.

Tumors in liver of solipeds, 548.

Tumors of gullet, 93.

Tumors of intestine, 382.

Tumors of omasum, 133.

Tumors in pancreas, 564.

Tumors of pharynx, 84.

Tumors of rumen and reticulum, 122.

Tumors of the stomach, 195.

Twisting of intestine, 359.

Tympanitic colic, 197, 317, 319.

Tympanitic stomach in solipeds, 154.

595

Tympany, chronic, of rumen, 106.
Tympany of rumen, 96.
Tympany of the intestines, 197.

ULCERATION, gastric, 179.
Ulceration of intestine, follicular, 346.
Ulceration of intestine, peptic, 346.
Ulcer of intestine, 346.

Ulcerous stomatitis, 22.

Urinary calculi, 438.

VACCARIA poisoning, 294.

Veratrum poisoning, 290.

Verminous embolism in solipeds, 214.
Verminous thrombosis, 219, 350.
Vertigo from cryptogamis, 297, 301.
Volvulus of bowel, 359.

Warts of lips, 6.
Water dropwort, poisoning by, 294.

‘Water hemlock poisoning, 290.

Washing powders, poisoning by, 252.
White scour, 138, 150.

Wild radish poisoning, 294.

Wild rosemary poisoning, 291.

Wire in stomach, 192.

Wood in stomach, 192.

Wool balls in stomach, rg1.

Wool eating, 76. :

Worms, intestinal, 312.

XEROSTOMIA, 38.

YELLOWS, the, 467.
Yew poisoning, 294.

ZINC poisoning, 281.

ns
4

+ ey me NIT