CORNELL UNIVERSITY THE Flower Veterinary Library FOUNDED BY ROSWELL P. FLOWER for the use of the N. Y. STATE VETERINARY COLLEGE 1897 RTT ETE 8 RA RGR 4 B.V.S, THIS BOOK BELONGS Departmenter Agricultura, STATE OF NEW YORK, THE PRINCIPLES AND PRACTICE OF VETERINARY MEDICINE THE PRINCIPLES AND PRACTICE OF VETERINARY MEDICINE BY WILLIAM WILLIAMS F.R.C.V.S., F.R.S.E., ETC. EX-PRESIDENT AND MEMBER OF COUNCIL OF THE ROYAL COLLEGE OF VETERINARY SURGEONS; PRINCIPAL AND PROFESSOR OF VETERINARY MEDICINE AND SURGERY AT THE NEW VETERINARY COLLEGE, EDINBURGH; EX-EXAMINER IN VETERINARY HYGIENE FOR B.SC. (AGRICULTURE), EDINBURGH UNIVERSITY; PROFESSOR OF VETERINARY SURGERY AND EXAMINER IN AGRICULTURE FOR THE HIGHLAND AND AGRICULTURAL SOCIETY OF SCOTLAND; FOREIGN CORRESPONDENT OF THE SOCIETE CENTRALE DE MEDECINE VETERINAIRE; AND AUTHOR OF “THE PRINCIPLES AND PRACTICE OF VETERINARY SURGERY” NINTH EDITION REVISED BY HIS SON W. OWEN WILLIAMS, F.R.C.V.S., F.R.S.E. PRESIDENT OF THE COUNCIL OF THE ROYAL COLLEGE OF VETERINARY SURGEONS, 1992-3-4 ; PROFESSOR OF VETERINARY MEDICINE AND SURGERY AT THE UNIVERSITY OF LIVERPOOL AND F. S. H. BALDREY Major LC.V.D., F.R.C.V.S., D.V.H. (Liv.) New YorKE WILLIAM R. JENKINS CO. PUBLISHERS 851-853 SIXTH AVENUE 1909 PREFACE TO THE NINTH EDITION. Tux rapid strides that have recently been made in veterinary medicine make it expedient, and indeed necessary, to issue a new edition of this work. Requests and applications from many quarters, both at home and abroad, and the sugges- tions of numerous friends have also had considerable influence upon my decision to reorganise the work, and reconstruct many of the chapters which have, since the issue of the 1897 edition, become out of date. In the present edition special attention has been given to the modern methods of sero-therapy and vaccine-therapy, and their applicability to veterinary medicine as revealed by the discoveries in the field of bacteriology. The distinction that has been drawn between bacteriology and protozoology is now a vital one, and is, indeed, all-important. By the former is meant the study of those diseases that are caused by schizo- mycetic or bacterial organisms ; the latter, which opens up an entirely new field of observation, is the study of animal parasites, such as trypanosomata, piroplasmata, and others of the same sort. Considerably more space than formerly has also been given in this edition to parasitology, which is becoming more and more intimately connected with medicine; by this I mean the study of those parasites other than bacteria and protozoa which infest the systems of domestic animals. I have found it necessary, under present-day conditions of specialisation, to ask for the co-operation of other investigators Vv vi PREFACE TO THE NINTH EDITION and I have been so fortunate as to obtain the valued help of, amongst others, Major Baldrey, who has aided me in recon- structing the chapters on infectious diseases and parasitology. My most sincere thanks are also due to Sir John MacFadyean, whom I have found myself quoting continually. So great is my obligation to him that, in despair of recording every point, I have instructed the friend who has framed my index to add the Latin words et passim (which may be freely trans- lated, ‘‘ on every other page’) to his name, as it has been added to Gamgee, Dick and Nocard. I must further acknowledge my great indebtedness to my colleagues in the University of Liverpool, and especially to Professor Ronald Ross, Dr. Breinl, Professor Sherrington, Mr. Newstead, Mr. Matheson, Mr. 8. E. Walker, Dr. Stephens, of the Tropical School, and many members of my profession. Finally, both Major Baldrey and myself most sincerely thank Mrs. Baldrey for her great assistance, and Mr. C. D. Campbell, of Edinburgh, for so carefully and skilfully compiling the index and tables of contents, in addition to much other help, as also my son, E. Owen Williams, for much assistance in revising proofs. I have, for the reasons stated above, every confidence in issuing this revised edition (the ninth) of my late father’s Veterinary Medicine to the veterinary profession and to all interested in the subject. I have the liveliest recollections of the kindly welcome which was accorded to the previous efforts of my father and myself, and I earnestly hope that the present volume may meet the same cordial reception. W. O. W. Toe University, LIVERPOOL, May, 1909, P.S.—I feel that a short postscript is necessary as a sort of obituary tribute to a distinguished French veterinary surgeon. PREFACE TO THE NINTH EDITION, vil I had the good fortune, when I was a student, to spend some months at the college at Alfort, near Paris, and there to come under the influence of M. Edouard Nocard, a veterinarian known over the whole civilised world by his writings on scientific subjects, and one who has influenced, directly and indirectly, the lives and careers of thousands of students. M. Nocard was present on May 11, 1903, at the Conference of Tropical Medicine held in Liverpool, and made a brilliant speech, in which, after praising the efforts made to advance the study of tropical diseases and tropical medicine, he pointed out that there was a distinct lacuna in the educational arrangements, and that was the institution of a school of veterinary medicine. M. Nocard’s speech will be found on page 15 of Vol. V. (new ser-es) of the Thomson, Yates and Johnston Laboratories Report, 1903, and is deserving of the most careful study. In a startling way he shows us how vitally important the study of the tropical diseases of animals is for us—a nation with great colonial dependencies—and narrates a particular instance which came under his own notice. I have no doubt that this speech gave the final impulse to Sir Rupert Boyce—whom M. Nocard frequently mentions in terms of admiration, and almost of affection—and led to the establishment, under his statesmanlike assistance, of the School of Veterinary Medicine in this University. It had always been my ambition to obtain University education for veterinary students, and Sir Rupert having his ambition, and I mine, running on parallel lines, a veterinary school was inaugurated in this University, as M. Nocard had so ardently desired. W. O. W. PREFACE TO THE EIGHTH EDITION. Since the last edition of this work appeared, in 1898, many important discoveries have been made in Pathological and Biological Science, more particularly in the departments that treat of the evolution, the physiological or pathological effects, and all the various phenomena associated with the develop- ment and life-history of the lower forms of life known as Bacilli, Bacteria, and Microbes. The Author has therefore been compelled to completely recast the Bacteriological portions of his work. In 1882 an attempt was made by certain parties to disparage and minimise the importance of a discovery which the Author claimed to have made—namely, the organism of the Tick. Since then the Author has continued assiduously his investiga- -tions, with the result that his former conclusions have been abundantly confirmed. For further information on this point, he refers the reader. to the chapter on what is popularly termed Louping-Ill, which he has ventured to term Ixodic Toxemia. This chapter, along with that on Texas Fever (termed by the Author Ixodic Anemia), which he had special opportunities of studying while in Jamaica in the summer of 1896, will, he trusts, be found interesting as being founded on the theory that certain saprophyte filaments, innocuous in themselves, may, when ingested with foods which they infest, become pathogenic or disease-inducing to the higher animals, when they have ix x PREFACE TO THE EIGHTH EDITION. passed through the blood of the lower forms of life, such as Ticks, and have been transmitted by these into the circulation of the higher animals. This view to some extent supports that of Buchner, who states that the ordinary Hay Bacillus—Bacillus subtilis—attains all the virulent properties of the Bacillus anthracis after it has been cultivated in animal media, meat- extract, blood, &c. Since this work has gone to press, the Author has received further corroboration of the seemingly anomalous occurrence of simple filaments as retrogressive stages in the development of an organism, apparently dependent upon a change in the nutrient medium—a fact previously noticed in the course of his “ Louping-Ill” investigations, 1882, which has led to a considerable amount of controversy. These so-called ‘ involution” stages, as exhibited by the Bacillus typhosus, will be found described and illustrated in a paper by Dr. Edward P. Carter in the Bulletin of the Johns Hopkins Hospital for June of this year. The thanks of the Author are specially due to his colleague, Dr. James Hunter, whose unwearied labours and whose acute judgment and profound learning have contributed greatly to the fulness and accuracy of many of the illustrations, in themselves unique, in the present work. W. W. New VETERINARY COLLEGE, EpinsurcH, September, 1897. CONTENTS. CHAPTER I. InrRopuctory ‘ é 3 é S “ II. PaTHoLoey . : III. THE Morsip a ee AND SIGNS oF Iv. Vv. VI. VII. VIII. IX. XL XII. XIII. XIV. XV. XVI. XVII. XVIII. XIX. XX. XXI, XXII. XXIII. XXIV. XXV. XXVI. XXVIII. . DisEASE—SEMIOLOGY 5 GENERAL SYMPTOMS OF DISEASE . 3 ATROPHY AND DEGENERATIONS OF TISSUE: ihissotire . ATROPHY AND DEGENERATIONS OF TissuzE: DEGENERA- TIONS CHANGES IN THE — j w i ‘ CHANGES IN THE Buioop: ANa&MiaA — Hypremia — OLIGEMIA CHANGES IN THE BLOOD: a eouniey . CHANGES IN THE BLoop: HypEnamia on ConcEesrion— Lipzmia, on Farry BLoop—SeErricaMia Moves or DEatTH . . CLASSIFICATION OF DISEASES ConTAGION AND ConTAGcious DISEASES THEORIES OF INFECTION . . ‘ ‘ IMMUNITY . : ‘ ‘ Conracious DIsEAsEs: Gare PLAGUE . Conracious DisEAsEs: PLEURO-PNEUMONIA Gonadidan Contacious Disrases: Eczema CoNYAGIOSA ContTaGious DisEASES: INFECTIOUS ABORTION , Contacious DiszasEs: VARIOLA Vaccina (Cow-Pox) . ContTacious DisEAsES: VaRrioLaA Ovina (SHEEP-Pox) . ContTacious DisEAsEs: RABIES ContTacious DISEASES: GLANDERS AND oe (mritien’ ContTaGious DisEAsEs: Epizootic LYMPHANGITIS Conracious DisEAsEs: CANINE DISTEMPER Contacious DISEASES: ANTIURAX a 4 Conracious DisrasEs: Hog . CHOLERA—SWINE fica —Pneumo-ENTERIrIS xi PAGES 4-23 24-26 27-47 48-52 53-65 66-76 77-83 84-89 90-108 109-121 122-124 125-138 189-142 143-146 147-169 170-198 199-205 206-212 213-222 223-233 234-249 250-271 272-275 276-283 284-320 321-331 Xli CHAPTER XXVIII. XXIX, XXX, XXXI. XXXII. XXXII. XXXIV. XXXV. XXXVI, XXXVIT. XXXVIII. XXXIX. XL. XLI. XLII. XLIIT. XLIV. XLV. XLVI. XLVII. XLVIII. XLIX. LI. LIT. LITI. LIV. LY. LVI. CONTENTS. Contacious DisEAsEs: SwWINE PLAGUE . . ° ConTacious DisEasEs: SwINE ERYSIPELAS < . Contagious DiszasEs: MALIGNANT (EDEMA Contagious DisEAsEs : SouTH AFRICAN HorsE- ee, ContTacious DIsEAsES: SPIRILLOSIS IN HorsE . ContTacious DISEASES: SPIROCHZTOSIS . Conracious DIsEAsEs : CoccroposIs i ‘ ContTacious DIsEASES: TUBERCULOSIS . ContTacious Disraszes: TreTanvs (Locksaw) Contagious DisEAsEs: HamorrHacic SEPTICHMIA (PASTEURELLOSIS) Contacious DISEASES : Croup F ‘ Enzootic and Epizootic DisEAsES: INFLUENZA— Er1zooTic CELLULITIS—EpiIzooTic PNEUMONIA Enzootic AND Epizooric Diszases: MALIGNANT CATARRHAL FEVER. oF OX ‘ ri ERUPTIVE OR PETECHIAL Fevers: Porura Hamor- RHAGICA—DIARRH EMIA—SCARLATINA . Szptic Boop DisEasEs Q ‘ Bioop DISEASES : Tievpinoseuraaté= Doom Sued —Nacana—MAu DE CaDERAS . z ‘ Bioop DisEAsEs: PrRopLAsmMosis — Ixop1c ‘Aenea (Texas FEVER) . ACTINOMYCOSIS ‘ : ‘ a é SporaDIc DisEASES: RHEUMATISM 5 ‘ “ Sporapic DisEases: Dretetic DisEAsEs Sporapic Diseases: Dizretic DIsrasEs: Daxkeres Insipipus — Potyuria — Hypruria — AZoTURIA — OXALURIA—ASTHMA—POISONING IN Various Forms Sporapic DisEasrs: Loca Diszases: Nervous SysTEM . SPORADIC DrsEAsES: LocaL DisEAsEs: CEPHALIC DISEASES . ‘ - 7 , SporaDIc Diseases: LocaL Deine ENCEPHALITIS— CrnreBro-MENINGITIS, ETC. . s Sporapic DisEases: Locan DiIsEasEsS: CEREBRAL APOPLEXY 3 ‘ SporApDIc DISEASES: fetes Disease chia FROM ConGESTION ‘ . * i . Sporapic Diszases: Locan DIsEAsEs: ADVENTITIOUS SUBSTANCES IN BRAIN ‘ . Sporapic Diszasres: Locan DiskAses: SprinaL Corp Sporapio Diszasrs: Locant Diszases: PARALYSIS — Lovupine-ILu 7 PAGES 332-334 335-339 340-341 342 343 844-345 346-347 348-384 385-392 393-398 399-404 405-438 439-440 441-455 456-470 471-494 495-541 542-543 544-549 550-553 554-611 612-616 617-621 622-630 631-633 634-646 647-651 652-656 657-700 CHAPTER LVI. LVIII. LIX. LX. LXI. LXII. LXIII. LXIV. LXV. LXVI. LXVII. LXVIII. LXIX. LXX. LXXI. LXXII. LXXIII. LXXIV. LXXV. LXXVI. LXXVII. LXXVIII. LXXIX. CONTENTS, Sporapic Disrases: Locat DIsEAsEs: RESPIRATORY ORGANS Sporapic Diszaszs: Locan Diseases: CATARRH AND LARYNGITIS @ Sronapic Diszases: Looat Diszases: BRONCHITIS Sporapic DisEases: Locan DuiszasEs: CHRONIC EMPHYSEMA OF Lungs ‘ é ‘ Sporapic Diszases: Loca DisEAsEs: CONGESTION OF Lunes—PuLMoNnARY APOPLEXY . ‘ Sporapic Disgases: Locan DiszAses: INFLAMMATION or Lunes i é ‘ " Sporadic DisEasEs: Locat Distasrs: PLEUVRISY— PLEURITIS 3 ‘ ‘ x8 Sporapic DiszasEs: Loca DisEases: HEART DISEASES Sporapic Diseases: LocaL DisEaszes: DISEASES OF DIAPHRAGM ‘ . ‘ ‘ Sporapvic DisEAsEs: LocaL Disnaszs: DISEASES OF DIGESTIVE ORGANS 5 F “ Sporapic Disrasges: Locan DisEasEs: DISEASES OF SromacH . : * x 4 5 . Srorapic DisEAsEs: Locan DiseasEs: DISEASES OF BowE1ts . ‘ 7 ‘ . ‘ Srorapic Diseases: Locan Disnases: DISEASES OF BowE.s : INFLAMMATORY—ENTERITIS. ‘ ‘ Sporapic DiszasEs: Locant Diskaszs: DISEASES OF BowELs : INTUSSUSCEPTION—VOLVULUS : Sporapic DisgasEes: Locan Diseases: DISEASES OF BowEts: INTESTINAL ConcreTions . ‘ % Sporapic DiszasEes: Locan DiskasEs: DISEASES OF BowELs: DiaRRH@A . ‘ : “ - Sporapic Diseases: Locan Disrases: DISEASES OF BowE ts : SUPERPURGATION a» . < . Sporapic Diseases: Locan DIsmasEs: DISEASES OF BowELs: DYSENTERY . * i Sporapic Diszaszes: Looat DrszasEs: DISEASES OF Bowers: Ascires oR Dropsy ofr ABDOMEN . Sporapic Diseases: LocaL Diseases: DISEASES OF THE LIVER ‘3 : ‘ ‘ : _ Sporapic Diseases: Locan DisEases: DIsEASES OF SPLEEN AND PANCREAS . ‘ : 3 2 Sporapic Diseases: Locan Diseases: DIsHASES OF THE KIDNEYS ; fi é Sporapic Disgaszs: Locan Diszases: DISEASES OF THE KipnNeys: NEPHRITIY z - . . xili PAGES 701-722 723-727 728-743 744-746 747-751 752-768 769-777 778-793 794-795 796-797 798-812 818-823 824-828 829-832 833-836 837-838 839-843 844-846 847-848 849-866 867-869 870-876 877-883 xiv CHAPTER LXXX. (LXXX1. LEXRIL LXXXIII. LXXXIV. LXXXY. LXXXVI. CONTENTS, Sporapic Diszases: Loca Diszases: CysTITIS, OR INFLAMMATION OF THE BLADDER Sporapic DisgasEs: Loca DisEases: HysTERIA Sporapic Diskases: Locat Distases: DISEASES OF PARTURITION 3 : ‘ ¥ Parasitic DisEAsEs: CLASSIFICATION OF PARASITES: NEMATODA, TREMATODA, CESTODA, ETC. Parasitic DISEASES: DISEASES CAUSED BY NEMATODA: Parasitic DisEasz oF Lunes—ParasiTic GAsTRIC CATARRH. : : : ‘ Parasitic DisEASES: DISEASES CAUSED BY TREMATODA : Rot 1n SHEEP ‘ i ‘ ‘ i: Parasitic DisEAsES: DISEASES CAUSED BY CESTODA: TABULAR ARRANGEMENT OF ENTOZOA. GENERAL INDEX SreciaAL INDEX . 3 a ‘ . 3 PAGES 884-886 887 888-893 894-935 936-957 958-963 964-972 973-979 979-986 LIST OF ILLUSTRATIONS. PLATES. NO. TO FACH PAGE I. Cattle Plague: Mouth and Palate of a Bullock, showing Ex- coriated Ulcers and Aphthous Deposit 156 II. Cattle Plague: Fourth Stomach, Pylorus, and Commienoemént of Duodenum of a Cow, showing Congestion and Aphthous Deposit . ; 5 é i : . 7 159 III. Cattle Plague: Small Intestine of a Cow, showing Aphthous Patches, Mucous Membrane intensely Congested, verging towards Gangrene 4 160 IV. Cattle Plague: Gall-Bladder of a Cow, atagdtii Apnthous Patches : 162 V. Cattle Plague: Heart is an Ox, devine Peeciael Spots 164 VI. Pleuro-Pneumonia Contagiosa 175 VII. Broncho-Pneumonia, or so-called American Gontagioas Platte: Pneumonia . Zi : . . 188 VIII. Bacteria of Broncho-Pneumonia . 189 IX. Foot and Mouth Disease: Excoriations on ‘Thviend 202 X. Glanders affecting Nostrils of a Horse 250 XI. Farcy Buds in Various Stages 262 XII. Swine Fever Q 321 XIII. Bacillus Luteus (Suis) 322 XIV. Tuberculosis of Outside of the ane (“ Groges ) 344 XV. Tubercular Pericarditis . ‘ 354 XVI. Spirocheta 356 XVII. Tuberculosis in Five-year-
  • some variations con- sistent with health. Thus the water varies in quantity accord- ing to the period since food has been eaten, the amount of bodily exercise, the state of the atmosphere, and all other events that affect the ingestion or the excretion of fluids. According to these conditions, it may vary from 700 to 800 parts in 1000. On the whole, however, a degree of uniformity is maintained, because nearly all those things which tend to lower the pro- portion of water in the blood, such as active exercise, or the addition of saline and other solid matter, excite thirst; while, on the other hand, the addition of an excess of water to the blood is quickly followed by its more copious excretion in sweat and urine. Dr. Zimmerman has shown that the quantity of water in the blood is increased during its abstraction from an artery or vein. In bleeding dogs he found that the last drawn portion contained 12 or 13 parts more of water in 1000 than that first drawn. This experiment goes to prove that the fiuid of the tissues must be rapidly absorbed during the operation. The water in the economy is required for many important pur- poses. (1.) The proper viscidity of the blood, and the degree of its adhesion to the blood-vessels, is due to the presence of water in proper proportion. (2.) It determines to a great extent the volume of the blood. (3.) Water is the general solvent of the other materials of the liquor sanguinis. (4.) The activity of absorption by the blood-vessels depends upon the due fluidity of the materials to be absorbed, for it is well known that no fluids quickly penetrate the vessels but such as are of lesser density than the blood. If the presence of water in excess continues beyond a short period, it is a certain symptom that the other constituents are defective in quantity, and that the condition termed anzmia is present. Deficiency of water in the blood is witnessed in super-purga- tion, diarrhoea, &c. The deficiency, however, is generally of a temporary character, for nature prompts the animal to over- come it by drinking freely. The water also becomes deficient when an animal sweats profusely from any cause, and when prevented from allaying his thirst for a considerable period, as when hunting or going long journeys. A great mistake a made 5% 68 PATHOLOGY. by those in charge of horses who have a belief that it is a bad thing to allow a horse to drink while out on a journey or in the hunting-field. Small and repeated drinks are always beneficial, and prevent much suffering. The albumen of the blood may vary, consistently with health, from 60 to 70 parts in 1000. Its amount, according to Andral and Gavarret, is notably increased in various diseases ; but this excess does not appear to be characteristic of any. In acute rheumatism an increase was found varying from 4 to 24; in pneumonia the highest increase was about 12; in pleurisy the extraordinary amount of 34 in excess was once observed ; and several other instances are mentioned of a lower degree. Excess of albumen in the blood is witnessed in the horse in a dis- ease which the late Mr. Haycock termed hysteria—(See Azotwria or Uremic Paralysis.) Very probably the albumen in this disease is not only excessive in quantity but deteriorated in quality. The albumen is defective in cases of piroplasmoses and trypanosomiases, in the “rot” in sheep, and in dropsies, whether dependent on organic disease of the heart, or on the presence of entozoa—distomata—in the liver. It is a remark- able fact, recorded by Andral, Gavarret, and Delafond, that in sheep affected with anemia, with deficiency of the red globules, but without dropsy or entozoa, there was no deficiency in the albumen. Dr. Williams concludes from this, that cachexia and anemia attended by dropsy owe this concomitant to a want of albumen in the blood; and he seems to be of opinion that a deficiency of the albumen, by destroying the due density of the blood, and allowing it to transude through the coats of the vessels, is a chief feature in the dropsical diathesis. The fibrin of the blood.—When fresh-drawn blood is left to itself, it very soon coagulates or becomes solid, and the sub- stance thus becoming spontaneously solid is the fibrin, which, when separated from the blood, is a tough, elastic, tolerably firm, whitish-grey looking material, insoluble in water. Under the microscope the fibrin appears as a fibrillated matter. It is stringy and elastic. The white globules are usually seen imbedded in the mass, but they do not appear to modify the character of healthy fibrin. This coagulation is due to the formation of fibrin, a material which does not exist in the blood circulating in healthy vessels, but is formed in the blood and lymph when removed from the body. At first CHANGES IN THE BLOOD. 69 the crassamentum or clot is soft, consisting of a few fibres on the surface. These soon extend throughout the mass, which becomes jelly-like. In the horse coagulation takes place but slowly, and the red corpuscles consequently sink; the upper surface, being thus deprived of their colour, assumes a straw- ' coloured appearance, and is called the buffy coat. Although the whole mass solidifies, the fibrin is only present in quantity of about 3 in 1000. MM. Andral and Gavarret record that in the domestic animals the fibrin diminishes before but increases after parturition. In the human female, however, it seems that the fibrin is decreased during the first six months of pregnancy—the average being 2'3 ; whilst in the last three months it is so increased as to average 4. Fibrin is more abundantly formed in arterial than in venous blood ; and it is mentioned by Schmidt that the blood of the portal vein contains only one-third of the ordinary amount of fibrin found in the blood of the jugular vein. An excess of the fibrin—hyperplasma or hyperinosis—exists in all true inflammations. In acute rheumatism it is generally very high; in some cases, according to MM. Andral and Gavarret, as high as 12 parts in the 1000. In some exhausting diseases, and even in ansmia, the fibrin is found occasionally increased in quantity. In rapid emaciation, more especially when accompanied by total loss of appetite, the quantity of fibrin is very materially increased. This is explained by the fact that fibrin results from the metamorphosis of the albumen of the blood and of the tissues. An increase of fibrin is found in meagre, half-starved horses, amounting to 7 or 8 above the healthy mean. In one case, where no food was given for four days, it was found increased from 5 to 9. As the fibrin is increased by all inflammatory diseases, such increase can also be artificially induced by the application of external irritants, such as blisters, setons, or the actual or potential cauteries. This fact is of great importance therapeutically, and it should be borne in mind that the application of the so-called counter-irritants in extensive inflammatory diseases, tends to increase a condition of the blood which is already present to an abnormal extent. Another very important circumstance connected with the increase of fibrin in the blood is pointed out by Andral, namely, that the effect of bleeding was not to diminish it. In M. Andral’s experiments the red globules became diminished in number by 70 PATHOLOGY. each abstraction of blood, whilst the fibrin often rose, some- times considerably. The following examples are very conclu- sive :— First Second Third Fourth Fifth Sixth Bleeding. Bleeding. Bleeding. Bleeding. Bleeding. Bleeding. Acute Rheumatism, 6:1 7:2 78 10-2 9:0 7-0 Pneumonia, . 71 82 9:0 10-0 _— —_ Peritonitis, . 38 4:7 61 — — —_— Pleurisy, . . 39 5°8 — — = —_ MM. Andral and Gavarret found that the fibrin production was increased in tubercular disease. In the crude state of the tubercles, the mean is about 4, when softening has commenced it is about 4:5, and when cavities have formed it is from 5 to 5°5, the red globules decreasing from the first. Deficiency of fibrin—hypoplasma, hypinosis, or defective coagulating power—is observed in various morbid states, in disease, and in conditions bordering upon it, and is indicated by imperfect coagulation of the blood when drawn. It is deficient in all conditions where the blood is imperfectly arterialized; and this isin accordance with the physiological law that arterial blood is more fibrinous than venous. Thus, in death from asphyxia, the blood often remains semi-fluid, of a dark, tarry appearance, and coagulates only after being exposed to the air and absorbing oxygen. Various poisons seem to have the power of preventing the coagulation of the blood. Among these are hydrocyanic acid, carbonic acid, sulphuretted and carburetted hydrogen, and ammonia. Andral states that if a concentrated solution of car- bonate of soda be injected into a vein, the animal presents the symptoms of blood disease, and that the blood is found fluid in the vessels. The same result may be produced by arsenious acid, digitalis, and oxalic acid. Other substances, although analogous to the carbonate of soda, seem to have no effect. Thus, the nitrate of potash does not always impede the coagulation of the blood; and Dr. Handfield Jones states that he has ob- served that liquor potasse, although given for several days, and until the animal’s health was interfered with, did not at all interfere with the coagulation of its blood; and he infers from these observations that it is not the alkalies, as such, nor the neutral salts, as such, which produce the effects usually ascribed to them upon the blood, but certain substances of CHANGES IN THE BLOOD. 71: particular qualities. In low fevers, influenzas of a typhoid character, particularly when animals so affected are stabled in ill-ventilated houses, the blood becomes remarkably fluid, and gravitates, even in cases that recover, to the depending parts of the body. Thus we find that’in the so-called purpura hemorrhagica the extremities and inferior portions of the abdo- men, breast, and face become the seats of extensive swellings, caused by an accumulation of a preternaturally fluid blood in the vessels, and even in the tissues, whilst the appearance of petechiz, vibices, and the occurrence of hemorrhages are due to the same cause. The partial suffocation to which animals are sometimes: exposed when confined in buildings accidentally or otherwise burnt, produce a remarkable degree of fluidity in the blood. I have often’ witnessed this in horses and cattle which had been early removed from burning buildings,—in fact, when they had not been exposed to any fire, but to the effects of the smoke of smouldering straw, wood; &c. At the time, the symptoms of distress have not always been noticeable, and little has been thought of the matter. In the course of time, varying from a few hours to three days, the animals have presented symptoms of great respiratory’ disturbance, with, hemorrhage from the vessels of the lungs, the blood presenting a dark olive appearance, and coagulating but very imperfectly, even when exposed to the influence of theair. In such cases, it is quite fair to presume that the coagulating powers of the blood have been destroyed by the action of the products of combustion con- tained in the smoke, and that it—the blood—gradually accumu- lates in the vessels of the lungs until they have become congested, even to rupture of their walls. In apoplexy of the spleen and in “ septicemia ” the same hypinotic condition of the blood is seen, and is probably the cause of the congestions and extravasations which characterise those diseases. Although it may justifiably be said that imperfect coagulation, as well as the abnormal fluidity of the blood, depends upon the absence of fibrin, modern research: has proved that fibrin, as such, does not exist in the blood, but is formed by the cumbination of two substances —or two modifications of the same substance—namely, globulin? and fibrinogen ; the former of which existing in the serum of the blood,.and in some tissues of. the body; whilst -the latter, so 1 Fibrino-plastic.—(ScHMIvT. ) 72 PATHOLOGY. far as it is known at present, exists only in the plasma of the blood, of the lymph, and of the chyle, and in fluids derived from them. “ Coagulation of the blood” (says Professor Huxley) “is an altogether physico-chemical process, dependent upon the pro- perties of certain of the constituents of the plasma, apart from the vitality of that fluid. This is proved by the fact that if blood-plasma be prevented from coagulating by cold and greatly diluted, a current of carbonic acid passed through st will throw down a white powdery substance. If the white substance be dissolved in a weak solution of common salt, or in an extremely weak solution of potash or soda, it after a while coagulates, and yields a clot of pure fibrin. It would be absurd to suppose that a substance which has been precipitated from its solution, and re-dissolved, still remains alive. “ There are reasons for believing that this white substance con- sists of two constituents of very similar composition, which exist separately in living blood, and the union of which is the cause of the act of coagulation. These reasons may be briefly stated thus:—The pericardium and other serous cavities in the body contain a clear fluid, which has exuded from the blood-vessels, and contains the elements of the blood without the blood cor- puscles. This fluid sometimes‘coagulates spontaneously, as the blood-plasma would do, but very often shows no disposition to spontaneous coagulation. When this is the case, it may never- theless be made to coagulate, and yield a true fibrinous clot, by adding to it a little serum of blood. “ Now, if serum of blood be largely diluted with water, and a current of carbonic acid gas passed through it, a white powdery substance will be thrown down; this, re-dissolved in a dilute saline, or extremely dilute alkaline solution, will, when added to the pericardial fluid, produce even as good a clot as that obtained with the original serum, “ This white substance is called globulin. It exists not only in serum, but also in smaller quantities in connective tissue, in the cornea, in the humours of the eye, and in some other fluids of the body. “It possesses the same general chemical properties as the albuminous substance which enters so largely into the red corpuscles, and hence at present bears the same name. But CHANGES IN THE BLOOD. 73 when treated with chemical re-agents, even with such as do not produce any appreciable effect on its chemical composition, it very speedily loses its peculiar power of causing serous fluids to coagulate. For instance, this power is destroyed by an excess of alkali, or by the presence of acids. “ Hence, though there is great reason to believe that the fibrino-plastic globulin (as it has been called) which exists in serum does really come from the red corpuscles, the globulin, which is obtained in large quantities from these bodies by the use of powerful re-agents, has no coagulating effect at all on pericardial or other serous fluids. “ Though globulin is so susceptible of change when in solution, it may be dried at a low temperature, and kept in the form of powder for many months without losing its coagulating power. “Thus globulin, added, under proper conditions, to serous effusion, is a coagulator of that effusion, giving rise to the development of fibrin in it.” The latest theories of coagulation slightly modify the above. Thus Schmidt says that the fibrin is formed by the coming together of two proteid substances which occur dissolved in the plasma, viz.—(1) fibrinogen, 1.., the substance which yields the chief mass of the fibrin; and (2) jibrino-plastic substance, or fibrino-plastin. The latter terms are now rarely used, having been replaced by either of the following—serum-globulin or paraglobulin. In order to determine the coagulation a ferment seems necessary, and this is supplied by (3) the fibrin ferment. Both fibrinogen and fibrino-plastin belong to the group of proteids called globulins. They are insoluble in pure water, but are soluble in dilute saline solutions (cummon salt, 1 per cent.), phosphates of the alkaline earths, and calcium sulphate. They are not distinguished from each other by any marked chemical characters, but differ in the following particulars : Fibrino-plastin or paraglobulin—serum-globulin—is only ap- preciably precipitated when a solution of sodium salt of at least 20 per cent. has been added, whereas fibrinogen is easily pre- cipitated by the solution of salt (sodium chloride), when it only reaches 16 per cent. Again, the very light granular precipitate of paraglobulin is more easily dissolved than that of fibrinogen, and its solution only begins to coagulate at 133° F., whereas that of fibrinogen 74 PATHOLOGY. readily coagulates at 105°F. The precipitate of paraglobulin forms a granular powder, whilst that of fibrinogen adheres to the sides of the vessel as a sticky deposit. The theory of Schmidt now seems to be superseded by that of Hammersten, and his researches have led him to conclude that fibrino-plastin is quite unnecessary for coagulation, and that the fibrin is formed from one body,—viz., fibrinogen, which is present in plasma when it has been acted upon by the fibrin ferment, which, however, has not as yet been obtained in the pure state. : Neither Hammersten nor Schmidt assert that this body is of the nature of a ferment, but they use the term for convenience. It is quite certain that fibrin may be formed, when no fibrino- plastin is present, by the addition of calcic sulphate or casein. prepared in a certain way; but as yet the views of specialists on this subject are by no means settled. Halliburton argues that the ferment supposed to be the determining agent in coagulation is really itself a proteid—in fact cell globulin; but as several experiments of others seem to show that the salt extract of fibrin can be very completely freed from all proteid matter without any loss of fermentive activity, this ferment can scarcely be a globulin. On the other hand, it might be assumed that the coagulative power is really due to the calcium sulphate (GREEN), which salt is well known to favour clotting even in very dilute solutions. But finally, as against this latter sup- position, remains the fact that in solutions of the fibrin ferment which have been most carefully freed from everything giving proteid reactions, and also carefully freed from saline matters by dialysis, the power of inducing coagulation only becomes lost: after heating to about 154°F., a condition that could by no means influence calcium sulphate, even if traces of it were present. Buchanan in 1831, Mantegazza in 1871, and Schmidt a year later, had all suspected that the white cells were the source of a ferment connected with coagulation. Among several recent methods of separating the ferment, perhaps the best is the prolonged action of strong aleohol— fifteen times the volume of the serum used—for two weeks or more. Subsequent filtering, drying and powdering the precipi- tate, and dissolving it in distilled water to twice the original volume of the serum, gives an extract with which coagulating experiments can be made. CHANGES IN THE BLOOD. 75 In addition to those above named, Halliburton and Rauschen- bach consider that plasma entirely free from white cells cannot be made to coagulate in the usual way, but information on the fibrin ferment is much less accurately determined than is the case with almost any other known inorganic ensyme. FERMENT CONTAINED IN THE SECRETIONS OF ANIMALS AND PLANTS. The following appears to be all that is really known :—(1.) Temperature is of much account, action stops after 1322° F. has been reached: 2. The amount of coagulative change is not affected by the quantity of the ferment, only the rate, as with all known ferments ; when the quantity is small the clotting is slow: (3.) The ferment is precipitated along with gelatinous matter found in its solutions; 4. It is most probably not used up, and a very small quantity indeed seems to be sufficient. It seems, however, to be the general opinion that the ferment is perhaps derived from the disintegration of the white corpuscles when blood is shed, or within the economy in certain conditions, such as septic fevers, diseases of the blood-vessels, foreign bodies introduced into them, pleuro-pneumonia contagiosa, the microbe of which seeming to determine coagulation of the blood within the vessels, and of the exudate in the surrounding structures of the lungs, z.e., parenchyma cells, alveoli, and bronchi; and it is also found that an injection of ichor into the blood causes the destruction of an enormous number of corpuscles, resulting in spontaneous coagulation within the circulation, after which the coagulability of the blood is diminished. From the foregoing we can understand how in metritis and other septic diseases where thrombi are abundantly formed, the blood itself may coagulate more feebly than natural. Whilst fibrin is absent in healthy blood, it must be admitted that the materials from which its factors are derived must be contained in their proper conditions and proportions. But it is equally evident that circulating blood contains no ferment so long as both the fluid and the walls of the vessels are in a normal condition. Coagulation of the blood varies iv different animals, and is 76 PATHOLOGY. modified by disease. The blood of the horse, for example, coagulates more slowly than the blood of other animals and of man; hence what is termed the buffy coat is observable in coagulated healthy horse’s blood, the buffy appearance on the top of the clot being ascribable generally to the fact that slow coagulation gives time to the blood globules, which are of higher specific gravity than the liquor sanguinis, to sink towards the bottom of the vessel before being incarcerated in the meshes of the coagulating fibrin. To prove this, fill two vials with the blood of a healthy horse, and to the blood in one add a small quantity of the chlorate of potash, and leave the other to coagu- late naturally. In the course of a very short time the blood to which the chlorate has been‘added will be found firmly coagu- lated, and with but a slight or without any buffy coat; whilst the blood to which no addition has been made remains fluid for a much longer time, the globules falling to the lower parts, leaving the upper portion of the clot a straw colour. During the first stage of coagulation, which is termed that of gelatinisation, the clot appears as a semi-solid mass. In the course of some time, however, it divides into serum and clot (crassamentum), the serum being pressed out by the fibrin. This shows’ that the fibrin possesses the power of contraction ; and to the presence or absence of this power the further changes in the clot are due. The clot may be defective in solidity— gelatinous—or it may present an excess not only of fibrin, but of contracting properties. The shrunk, contracted, or cupped appearance of the clot indicates increased contractility and a sthenic state of the system generally ; whereas the gelatinous clot is indicative of an aplastic condition of the blood and an asthenic state of the system. CHAPTER VIIL PATHOLOG Y—continued. CHANGES IN THE BLOOD—continued. ANEMIA, HYDR/EMIA, OLIGHMIA. Tues terms are applied to that condition of the system in which there is a deficiency and poverty of the blood, a state brought about by loss of blood (hemorrhage), profuse discharges of any of the natural fluids of the body, as those of diabetes, in which it seems as if the blood globules were melted down to supply the profuse discharge; insufficient food, deprivation of fresh air, exhausting diseases, and the action of some deleterious agents, as witnessed in horses kept in ill-ventilated stables, or suffering from the influence of the glanders poison. The symptoms of anzmia are paleness of the visible mucous membranes, with often an unhealthy or slate-coloured appearance of that of the nasal cavity. In some instances a coppery appear- ance is witnessed; this is undoubtedly due to an altered con- dition of the globules, and a disordered state of the powers by which they are formed ; the conjunctiva is pale, the mouth cool, and the tongue generally unnaturally soft. Young, growing animals, insufficiently fed and improperly cared for, exposed to the vicissitudes of the weather during the winter months, are reduced to an anemic condition, manifested by emaciation, debility, and often a depraved appetite. When thus reduced, great care is to be taken that such are not suddenly turned into rich pastures, for it seems that the process of the forma- tion and elaboration of the blood, and the organs concerned in it, are in such a state of disorder from long disuse, that the alimentary matters contained in luxuriant grass or nourishing food are transformed into an imperfect blood-plasma,—that is ta 17 78 PATHOLOGY. say, into blood abundant in quantity, but defective in quality, plasticity, and consistence, incapable of nourishing the tissues, and which ultimately becomes of itself diseased. From this cause—namely, the unwise and indiscriminate method in which young, rapidly growing, and imperfectly fed cattle are turned into rich pasturage in the spring, or put upon cake in the winter—gastric, blood, nervous, and other important diseases are caused, and the lives of valuable stock endangered. In horses I have repeatedly witnessed the anemic condition asso- ciated with such extreme debility of the muscular system as to simulate spinal paralysis, and in some cases paralysis, from the pressure of serous fluid on the spinal cord,’ has been actually present ; but in the horse, as in horned cattle, active signs of disease are not manifested until there has been a sudden change to a nourishing diet. Sheep fed on food con- taining an excess of moisture, and during long-continued wet weather, become anemic and dropsical. During the winter of 1872-3 this condition was exceedingly prevalent owing to the inferiority of the grasses, the moist condition of the turnips, and the humidity of the atmosphere; for in many instances no organic disease or parasitic invasion was present. The anemic condition is announced by abnormal sounds in various parts of the vascular system. These are called venous murmurs, and are ascribed to the thin, watery blood running with great rapidity in the ill-filled vessels, and are heard at the breast, at the base of the jugulars more particularly, and are, according to Dr. Williams, of the nature of ripples, ‘the natural inequalities of the surface over which the current of blood passes being sufficient to occasion, in its dilute and diminished condi- tion, vibrations and sonorous gushes, which would not occur in a fluid of greater density.”’ The nutrition of the various structures of the body being dependent upon a healthy condition of the circulating fluid, it naturally follows that emaciation and debility are the results of anemia. In none of the anemic states, unless it be in- tensified by an excessive discharge, as in diarrhea, is rapid emaciation so prominent a symptom as in that caused by the presence of Bacillus mallei,and in malarial affections. The pulse in anemia is feeble, thready, often jerky and irregular, and any sudden excitement produces a degree of pal- pitation of the heart, leading one to suppose that the organ is CHANGES IN THE BLOOD. 79 hypertrophied, so loud, sharp, and knocking is the character of its contraction. ‘The contractile power of the muscles is generally much im- paired, fatigue being soon induced; the bowels are often con- stipated,-the constipation being due to a want of tone in the muscular coat. Though the muscular system manifests great loss of power and tone, the nervous system seems to be exalted, excitement being induced by very trivial causes, but this seeming exaltation is in reality due to loss of strength and power. “The nervous system in the anemic condition may be likened to a spring which originally was of a certain strength, requiring a certain impressing, and reacting with a corresponding force, but having become much weakened, is bent by much less force, and reacts also with much less. Mobility and debility may be said briefly to be the chief characteristics of the nervous .actions in the anemiated.”—(Dr. HANDFIELD JONES.) The digestive powers are feeble and imperfect, and colicky pains are induced by trivial. causes ; tympanitis is frequent, and results from the defective power of the muscular coat of the alimentary canal. The secretion of the gastric juice is also impaired, and results from the gastric follicles being insufficiently supplied with nutritive materials. This constitutes a further cause for the continuance and aggravation of the anemic condi- tion, and acts as a bar to healthy digestion, though the food supply be liberal and good, for healthy chyle cannot be formed to renovate the blood if the primary digestion be impaired. Most probably the accession of disease, when nutritious food is supplied to half-starved animals, is due more particularly to this cause. Anasarcous swellings of the limbs is a common symptom of anzmia in the horse, but is rarely witnessed in horned cattle. In sheep, as already stated, dropsy of the cavities is frequently witnessed. Under the term “ spontaneous anasarca,” Mr. Brown of Melton-Mowbray has described the anemic condition, with dropsy of the cavities, in the horse. Mr. Brown says the disease attacks one and two year old colts, grazing during the winter season in wet, poor moorland, and is very prevalent in Lincoln- shire; the disorder being manifested by swelling of the legs, sheath, belly, and lips, and finally the eyelids, the breath and 80 PATHOLOGY. excretions exhaling a peculiar odour. The animal turns slug- gish and depressed, loathes its food, and seldom lies down; the respiration becoming accelerated and the pulse feeble. Loss of flesh, prostration of strength, short and difficult respiration, frequent and indistinct pulse, and finally diarrhoea, which, if once established, carries off the animal in despite of all remedies. The vost mortem examination reveals yellowness and flaccidity of the muscular system, effusion into the areolar tissue, thicken- ing of the pericardium and pleura, with effusion into their cavities, often so great as almost to cause collapse of the lungs and arrest of the heart’s action; effusion into the omentum, mesentery, and peritoneum.—(See Veterinarian, 1832.) The causes of anemia being generally apparent, I need scarcely state that they must be removed,as a primary step in its successful treatment; and for this purpose, it was, or is, the custom in Lincolnshire, to take up young colts for the month of August, and feed them during that time exclusively on dry provender. When anemia is due to the operation of a specific virus, as that of glanders, or when at any time its cause cannot be discovered, the employment of any mere remedial measures is of very doubtful utility. Again, the anemic condition, which can be ascribed to well-known and preventible causes, may have existed so long, or operated so strongly on a constitution perhaps natu- rally weak, as to act as a determining cause of some cachectic condition such as tuberculosis, or to disease of the osseous system; or may have so impaired the action of the heart—the fibres of which have become organically altered, degenerated—as to prove fatal, notwithstanding all rational treatment. The treatment cal- culated to overcome anemia consists in allowing nutritious diet, carefully selected, and of easy digestion: for horses—oats, beans, crushed linseed, the latter in small quantities, and good hay ; for cattle and sheep—an allowance of oilcake in addition to their ordinary fodder, which should be of good quality, and sufficient but not over-abundant in quantity ; in addition to which the salts of iron are to be given in small and repeated doses. If the digestion be weak and the appetite bad, the iron is to be withheld, the vegetable tonics and the mineral acids given. Should the appetite be depraved, or if there be an unnaturally acid condition of the juices of the stomach, manifested by a tendency on the part of the animal to lick the walls and grind its teeth, with sourness of the mouth and fcetor of the feces, the alkalies are to be com- CHANGES IN THE BLOOD, 81 bined with the vegetable bitters. For the ‘constipation, which is due to debility of the muscular walls, nux vomica is very useful, mashes being now and then allowed. To the food above prescribed, it may be necessary in aggravated cases to allow the animal to have a quantity of milk twice a day—say one gallon of skimmed milk night and morning, mixed with oatmeal or porridge ; this it will usually become very fond of in a day or two. The system of forcing food, by horning it, upon animals , is not to be recommended; for what an animal does not eat spontaneously is not digested, but disorders the digestive system, and destroys any little appetite that may possibly remain. Horses, during the spring and autumn, when casting their coats, suffer more or less from aneemia and debility, and are incapable of performing the same amount of work as at other seasons of the year. A little rest and gentle treatment at this period often prevent the accession of disease. Again, horses whose coats are very long, if kept in stables of even ordinary warmth, suffer from anemia, with anasarca, and even dropsy of the serous cavities, which will increase notwithstanding the most powerful tonics and the most nutritious food, until their heavy coats are removed by clipping. I have seen the lives of many valuable horses saved by timely clipping. In all aneemic cases the secretory organs—the kidneys, skin, &c,—are very apt to become torpid ; the urine is scantily secreted, the skin dry and harsh, the animal hide-bound, as‘it is termed. These complications must not be overlooked, or the blood will become loaded with effete materials. To stimulate the kidneys the spirits of nitrous ether may be given occasionally, and to excite the skin nothing is to be compared to good groom- ing, particularly damp wisping the whole surface of the body. Warmth, comfort, gentle exercise, and pure air all play an important part in the treatment, and should by no means be neglected. The changes and alterations in the several constituents of the anemic blood are briefly as follows:—(1.) The red corpuscles are remarkably diminished; they have been known in the ‘human being to sink extremely low in number ; they also con- tain less hematin, and are somewhat paler than those of healthy blood. (2.) The amount of white corpuscles is usually increased. (3.) The coagulability is often very low, showing a want of fibrin or of the fibrin ferment, but this is best seen in 6 82 PATHOLOGY. that form of anemia, occurring in malarial infection and piroe- plasmosis, when there is mechanical destruction of red blood cells. In some cases its quantity is notably increased, particu- larly if inflammation of any organ is present. The marked tendency to coagulation noticed in the exudate (pleural, peri- toneal, mucous, &c.) in inflammatory affections of these tissues, must not lead one to imagine that there is any increased ten- dency to this change in the blood itself. As Kitt points out, all exudations contain a great deal of the fibrin-forming element, and the ferment is supplied by the changes taking place in the proliferated cells of the affected surfaces. As a rule, in all acute inflammatory diseases the blood itself shows a decided disinclination to normal clotting, and this is equally noticeable in many chronic wasting diseases. (4.) The solids of the serum are not found much altered. (5.) The quantity of plasma in the blood in cases of anemia is seldom increased, but owing to the marked diminution in the number of red. corpuscles, there is an apparent increase, both macro- and microscopically. LEUKEMIA OR LEUCOCYTHEMIA Is a condition of the blood characterised by a large increase in the number of the white corpuscles, associated with a new formation of lymphatic tissue (lymphadenoma) in the lym- phatic glands, spleen, and other organs; but the association of leukemia with lymphadenoma is not constant. An increase of white corpuscles is also witnessed in some cases of farcy and glanders ; but the true nature of leukemia seems to depend more upon an inability of the normoblasts or nucleated red cells to form red blood corpuscles, than upon. any actual growth of lymphatic tissue. POLYEMIA, PLETHORA. The possibility of there being at any time an increased’ quantity of blood in the animal body—plethora—is denied by some observers. The condition, however, is recognised by veterinarians as one of not infrequent occurrence, more espe- - cially in young fast-thriving animals, when fed upon very highly ; CHANGES IN THE BLOOD. 83 nutritious food. The occurrence of a general plethoric con- dition is also recognised by Sir Thomas Watson, who says— “ Perhaps it may not be so obvious that the whole oes of blood throughout the body is sometimes in excess. Full living and a sedentary life are causes likely to occasion general plethora, and they do occasion it. The full diet, so long as the digestive powers are perfect, provides more chyle, con- ducts into the blood a larger quantity of its proper pabulum. ‘ Their entire vascular system is preternaturally dis- tended. If you open a vein you find that they [persons in a plethoric condition] bear a copious abstraction of blood without fainting, and are even refreshed by it; and the blood drawn separates into a large and firm mass of coagulum, with but little serum. Keeping tothe nomenclature we have already employed, we might say that there is here hypertrophy of the blood.” The treatment of these cases is sufficiently obvious—abstrac- tion of blood, purgatives, a restricted diet, and increased exercise. CHAPTER IX. PATHOLOGY—(continued).. CHANGES IN THE BLOOD—(continued). DEFECTIVE EXCRETION. Sik THoMas Watson, in his graphic language, says that “the animal fluids are—the blood, the fluids that enter the blood, and the fluids that proceed from the blood. “ The fluids that enter the blood are of two kinds— “1. Those by which it is renewed and enriched. “ 2. Those which enter it in order that they may be con- veyed out of the body.” A defective condition of the fluids which enter the blood to renew and enrich it —namely, the chyle—produces the condition already described—anzmia. A modified or altered condition of the chyle—that is to say, chyle imperfectly developed, contain- ing abnormal constituents, products of imperfect digestion or elaboration, or directly derived from the ingesta—is a frequent source of alteration in the blood and of disease. The fluids which enter the blood for the purpose of being conveyed out of it are the products of the metamorphosis of the chyle and tissue, accidental materials contained in the food, products of imperfect digestion, superabundant nutritive ele- ments unappropriated by the tissue cells, and undergoing degradation within the blood-vessels, or in organs such as the liver. For the removal of these effete materials the organs of excretion are provided. When the organs of excretion are dis- ordered or diseased, it follows that such produzts accumulate in the blood, contaminate and render it: unfit for the proper nourish- ment of the body. s CHANGES IN THE BLOOD. 85 The most remarkable and perhaps the most important change in the blood from defective excretion is that produced by arrested or deficient secretion of urine. In some experiments performed by MM. Prevost and Dumas, who removed the kidneys of dogs and cats, on the third day after the operation vomiting came on, with diarrhcea of a copious brown liquid containing ammonia, from transformation of the urea, eliminated from the intestinal mucous membrane; fever, with heat sometimes as high as 110°, sometimes as low as 92°; small and very frequent pulse, laboured breathing, and death, from the fifth to the ninth day. The post mortem appearances were, effusion of serum in the brain, much mucus in the bronchial tubes, bilious fluid and feeces in the intestines, an appearance of inflammation of the liver, great contraction of the urinary bladder, the blood more watery than usual, and containing urea; five ounces of blood of a dog yielding twenty grains of urea, and two ounces of cat’s blood ten grains. Defective secretion of urine, resulting from disease of the kidneys, induces symptoms very similar to the above, differing in degree and intensity according to the extent of the kidney disease. Thus, in acute nephritis, or in rapid degeneration of the kidneys, such an amount of urea and other effete urinary matters may collect in the blood as to cause convulsions, delirium, suffocative discharge of mucus from the bronchi, diarrhoea, and serous effusion into the cavities and areolar tissue. In subacute cases dropsy gradually ensues, the animal finally becoming cachectic. All these effects may be traced to excre- mentitious materials retained in the blood, especially urea, which if in great amount acts as a narcotic poison, in smaller, as an irritant, inducing inflammations in various membranes; in the horse, more especially in the membranes of the spinal cord, and the neurilemma of the great nerves given off from the lumbo- sacral plexus. TRANSFORMATION OF CHYLE AND OF THE TISSUES. The blood is kept in its normal or healthy condition by being supplied with new elements derivable from the chyle, and by having the products of the metamorphosis of the tissue and all 86 PATHOLOGY. its effete constituents removed by the various excretory organs. When any of these conditions are absent, or when, as sometimes happens, the waste of tissue is so rapid as to preclude the elimi- nation of all its products, a mal-condition of the blood-mass is induced, which may lead to grave local complications and diseases of important organs. Some chemists hold the opinion that urea more especially is derivable from waste of tissue only, and not from any change or metamorphosis in the chyle or blood. I shall, however, endea- vour to prove that an uremic condition of the blood may be caused by chyle imperfect in quality or excessive in quantity ; the imperfection of the quality being the result of disordered digestion, or of the ingestion of food unfitted for healthy chylifi- cation; and excessive in quantity from the animal being fed upon aliment too rich for its requirements. In order to under- stand this, however, the student must be made still further acquainted with the process of nutrition, and this may be divided into—(1.) The introduction into the stomach and ali- mentary canal of the food to be digested: (2.) The formation of the chyle and blood, and the changes which the latter undergoes in the lungs: (8.) The passage of nutritive plasma from the blood to be transformed into tissues: (4.) The metamorphosis and re-absorption of the tissues: (5.) The excretion of these effete materials from the body by the various excretory organs. I shall, however, confine myself, very briefly, first, to the digestion of the food, and the formation of the chyle; and second, to the changes and transformation of the chyle and blood in the vessels. All kinds of food are resolvable into carbon, hydrogen, oxygen, nitrogen, and mineral constituents; and food to maintain the animal body in a state of health must contain all these various substances in due and proper proportions, and in quantities depending upon its necessities and wants under the circum- stances in which it is placed, the amount of work it is compelled to perform, the amount of air it breathes, and upon various peculiarities affecting its powers of digestion, whether the animal be carnivorous, omnivorous, or herbivorous. It is immaterial to what natural order the animal may belong, the proximate chemical principles required for its nourishment are the nitrogenous—albuminous, non-nitrogenous—starch, gum, CHANGES IN THE BLOOD. 87 sugar, oil, and the mineral salts, more particularly the phosphate of lime and the chloride of sodium, with iron, potash, &c,; and it has been proved that all nutritive food must contain the three principles, and that the absence of any one of them induces starvation and death. It is also proved that the chemical con- stitution of plants and animals is nearly identical, and hence food derived from plants contains the substances of which the animal body is made, and by which it is nourished. Some animals are carnivorous, and must be maintained on flesh. In others life is supported by plants and grain. The digestive organs differ somewhat in these; but the digestion—that is to say, the ultimate end of the digestive process—is the same in all, namely, the formation of a whitish emulsion, the chyle, which is absorbed from the intestinal canal, and conveyed into the general circulation, there to be transmitted to all parts of the body, giving to each materials which it may at the time stand in need of for its development, growth, and vitality. In all animals water is also necessary, not only as a diluent, but as forming a component part of the blood and tissues. It must be understood that mere nitrogenous, non-nitrogenous, and saline materials of food will not serve the purposes of healthy nutrition; they must be blended and united to form the kind of food natural to each class of animal, and capable of being finally converted into albumen, fat, and salts, as all these exist in every tissue; the fibrous and muscular organs containing much albumen, the glands and areolar tissue fat, and the bones mineral matters. The quantity of food required is greatly influenced by the weather. If cold and condensed, the air contains more oxy- gen, which, rapidly uniting with the tissues for the purpose of maintaining the normal standard of animal heat, the body demands more nourishment to prevent emaciation. Again, work or severe bodily exercise causes waste of tissue, and at the same time, if not too severe, stimulates the appetite, and improves the powers of digestion. The demand for more food, the increased appetite, and the exalted digestive powers being necessary to the wellbeing of the animal, as compensating agents, by which more food is partaken of and digested, in order to make up the waste of tissue induced by the bodily exercise, a more or less even balance is thus kept up between the secondary digestion, 88 PATHOLOGY. or destructive process, and the primary igen ony ‘or caren process. It is very true that a heathy animal seit anaes its anpetite and be capable of partaking of food and digesting it.for a con- siderable time without exercise, and, under certain circumstances, which sometimes seem inexplicable, remain in health. Gene- rally, however, the excessive amount of nutriment is stored up amongst the fatty tissues in various organs; and the storage of fat may so far be looked upon as an act of excretion,-bearing out the proposition of Treviranus, that “each single part of.the. body, -in respect to its nutrition, stands to the whole body in the relation of an excreted substance ;” or, in other. words, every part and tissue of the body, by taking from the blood the peculiar substance of which it is made, or which it can accommodate and store for future use, acts as an excretory organ, inasmuch as it removes from the blood that which, if retained, would be’ in- ‘jurious to the rest of the body. eo In many cases, however, this act of sonommnpdation, as it may be termed, is insufficient ; and in animals fed upon rich food, par- ticularly nitrogenous food. the blood-mass becomes so impure, from the presence of effete materials, that the whole body is poisoned. For example—and this not at’ all uncommon—a horse is kept in the stable for some days, perhaps three or four days, and fed upon its usual liberal allowance of food, con- sisting of hay, corn, and water. When put to its work it usually commences its labour with the greatest spirit and ani- mation, every nerve and muscle being, as it were, in the highest state of functional perfection ; but before it has proceeded more than a few miles on the journey, very often before it has gone a mile, it suddenly staggers and falls paralysed. Sometimes it may be able to rise and walk slowly to its stable; sometimes it ‘never rises again. Shortly after the attack it is observed to pass large quantities of a dark coffee-coloured urine, so dark, indeed, as to lead many observers to suppose that it is blood. -Careful observations have, however, enabled me to determine that such urine contains no.blood, and little or no albumen; but that the darkness of its colour depends upon an excessive quantity of colouring matter, urea, and probably other pro- ducts of the degradation of the nutrient materials which had accumulated in the blood-mass during the period the animal was at rest. CHANGES IN THE BLOOD. 89 It has been maintained by some writers that urea is a product formed in the kidneys, and by others that it is an oxidized albuminous material, due to the degradation of muscular tissue, brought about by muscular exertion only, and merely excreted by the kidneys. Without a doubt urea is an oxidized or degenerated condition of albumen, but the occurrence of the immense quantity of it in conditions of the animal body opposed to that of tissue change, I think, disposes of the idea that urea is due only to metamor- phosis of tissue, and supports the theory that it is formed in the blood itself, or in the liver, as advocated by Meissner. The rules for the proper treatment of disease depending on blood loaded with effete materials are—1s¢. To clear the intestinal canal of the materials with which it may be loaded, and from which additional matter may be absorbed and conveyed to the blood: 2nd. To stimulate the powers of the excretory organs, kidneys, and skin: and8rd. To attend to the comfort of the patient, and particularly to supply it with abundance of water, which not only allays the thirst, but dilutes the blood and stimulates excretion. MELLITAMIA. The sugar in the blood is increased in certain diseased conditions—diabetes mellitus and in some cases of azoturia in the horse. It is then partly excreted by the kidneys. True diabetes mellitus is but rarely witnessed in horses, and perhaps never in cattle and sheep, but is not uncom- mon in dogs; and to replace the loss of sugar thus given there is an increased metabolism of the nitrogenous structures, and consequently the amount of urea is increased. There is loss of flesh, the glands atrophy, and the crystalline lens becomes opaque, and there being an increased amount of sugar in the humors of the eye, the water of the lens is extracted (Osmosis). CHAPTER X. PATHOLOG Y—continued. CHANGES IN THE BLOOD—continued. HYPERZEMIA OR CONGESTION. Tue liability of the blood to be variously altered and modified having been described in the preceding chapter, it now becomes necessary to enter into a consideration of certain changes which may occur in its circulation, arising from an alteration in the condition and properties of the blood-vessels, and causing an interference with its natural flow. By hyperemia is meant an excess of blood in the vessels of a part or organ of the body. It is of two kinds, namely, active or arterial, and mechanical or venous. Active hyperemia is an excess of blood in the arteries, with, most commonly, an increased rapidity of the flow, and arises from increased blood pressure and from diminished arterial resistance. Hyperemia from increased blood pressure occurs from inter- ruption of the main current of blood in any particular part, owing to which increased pressure is thrown upon the collateral esas: which thus become dilated, the amount of blocd in them being increased, and its flow accelerated. This kind of congestion is seen after the main current of a part has been obstructed from any cause, and is known as collateral hyperemia. Congestion of the vessels of one part from an obstruction to the flow of blood in another, is also well exemplified in con- gestion of the internal organs from contraction of the superficial capillaries, so often produced by exposure to cold. In some instances, the intropulsive operation of cold is so great that the internal capillaries become loaded with blood to such 90 Ethel eld ls] FC im CHANGES IN THE BLOOD. 91 an extent that their walls give way, and the blood is extravasated into the surrounding tissue. In this manner apoplexy of the lungs is brought about, and so great is the extravasation in some rare instances, that the blood has found its way into the bronchi and trachea, and has been finally expelled through the nostrils, The local constringing effect of cold is best witnessed upon the human body, more especially in persons of weak circulation, in whom, very often after washing or bathing in cold water, the fingers are quite bloodless, pale, and numb. If we reason upon this circumstance, and bring such reasoning to bear upon our own subject, can we wonder that exposure to external cold is followed by internal congestions. In many cases, however, nature provides a guard to the influ- ence of cold upon the skin, by furnishing animals with coats of hair or wool suitable for their several necessities, and it is only in animals which are caswally exposed to such cold that we witness its effect in causing internal congestions. Congestion from diminished resistance arises from atony of the wall of the vessels. This atony, loss of power, or relaxation of the vessels, is generally due to paralysis of their muscular walls, and most commonly occurs in vessels least provided with mus- cular fibres, that is, in the capillaries and veins of organs easily distended, and which are composed of much areolar tissue. This paralysis of the muscular walls may be due to an influence opera- ting upon the vaso-motor nerves, or to irritation of a sensory nerve. Pressure upon the great sympathetic nerve in the neck causes active congestion of the head and neck, and most probably the congestion of the brain, redness of the conjunctive, suffusion of tears, and other signs of fulness of the vessels of the facio-cranial region, with the coma and delirium which are sometimes asso- ciated with gastric or intestinal disease, are due to pressure upon the cardiac branches of the great sympathetic or ganglionic nerve. It is very true that some emotions are attended with hyperzemia ; and it may be said that the meningeal or cerebral congestion of parturient apoplexy is due to some sympathetic influence which the stomach has upon the brain. The question need not be discussed here, as it will again come under considera- tion; and let it suffice us for the present to know that dis- order of the stomach is capable of producing congestion of the brain. 92 PATHOLOGY. In hemipiegia, a disease rarely witnessed in the horse, but to which horned cattle are liable, congestion of the vessels of the paralysed side is a prominent symptom. ‘ Atony of the arterial walls may be due to degeneration of their muscular and internal coats. It is most commonly the cause of the various congestions seen in old animals. Mechanical congestion occurs chiefly in the veins, and is pro- duced by anything which interferes with the flow of the blood through them, such as obstruction of the vein leading from a part, arising from pressure upon its walls, or the pressure of a thrombus or clot within its canal. Thus congestion may be in- duced by the pressure of a tight bandage; and again, congestion of the portal vein is caused by cirrhosis or other disease of the liver, which causes pressure upon its venous branches. Disease of the valves of the heart produces fulness of both the pulmonary and systemic veins. When the incompetency is limited to the mitral valve, the congestion is mostly limited to the lungs, while insufficiency of the tricuspid causes congestion of the systemic veins. The character of congestion beginning in the veins is that the veins as well as the capillaries are distended, giving the part an arborescent appearance, which has a much more permanent character than congestion beginning at the arteries. Arterial congestion, especially that of an active type, very often disappears shortly after death by the post mortem contraction of the vessels. In addition to mechanical obstruction to the flow of blood, there are various and important causes of venous congestions, such as diminished cardiac power, gravitation, an altered con- dition of the blood, and defective secretions. 1. Diminished cardiac power—The contractile power of the heart becomes diminished in many diseases, and death may result, not so much from the original disease from which the animal has been suffering, as from congestion of some vital organ, more especially the lungs or the brain, arising from the inability of the heart to propel the blood through the vessels of such organ. The example most familiar to the veterinarian of this form of congestion is acute congestion of the lungs caused by ° over-exertion. Many instances of this occur in the hunting-field during severe runs; horses out of condition, and unfit for very © prolonged and severe galloping, falling down and rapidly sinking © CHANGES IN THE BLOOD. 93 from this cause. This form of congestion becomes aggravated by the blood remaining unchanged, for it is found that when the blood is not properly changed in the lungs, its passage through them is partially impeded, that it accumulates in them, in the right side of the heart, and in the veins generally. 2. Gravitation—The veins of the extremities and other de- pending parts of the bedy are congested from this cause. It indicates an atonic condition of the system generally, with diminished cardiac force; and is commonly associated with all the exhausting diseases of the horse, more especially if the animal is not exercised. Congestion from gravitation is also caused in many healthy horses by want of exercise. Indeed, a due amount of exercise, when in a condition to take it, seems to be of greater importance to the horse than to horned cattle. The cow or ox will remain in the stall for weeks, or even months, tied in one position and receiving no exercise, but the limbs never swell, and there are seldom any signs of venous con- gestions; not so with the great majority of horses. Now and then, however, a horse is met with whose limbs never swell from want of exercise, but as a rule horses when not exercised suffer from swellings of those depending parts of the body farthest removed from the centre of the circulation. Other horses habitually suffer from swelled legs, no matter how carefully and properly they are fed and worked. The debility produced by the process of “casting the coat” causes congestion of the vessels of the depending parts. A very remarkable example of the effects of gravitation in producing congestion used to be frequently witnessed in the days when bleeding was so commonly performed, and when inflammation of the jugular vein was more frequently met with than now. The loss of a jugular from the formation of a thrombus within it, and consequent obliteration of its canal, did not seem to interfere with the cervical circulation until the animal was turned out to grass; but immediately this was done, the animal’s head would commence to swell to a most alarming extent, proving that, although the collateral circulation was sufficient, so long as the horse was fed from the rack or manger, it was quite insufficient when the head was depressed whilst grazing. 8. Altered conditions of the blood.—Many congestive diseases, 94 PATHOLOGY. more especially those of horned cattle and sheep, are caused by an altered condition of the blood. How this determines a con- gestion of an organ or a system of organs it is difficult to understand; but such diseases as apoplexy of the spleen, quarter-ill, and other anthracoid diseases manifested by exten- sive congestions and extravasations, are all due primarily to blood alterations, the lesions of organs being secondary to and depending upon the blood disease. A thin watery state of the blood, as well as the presence of specific organisms, such as piroplasms and trypanosomes, have also in many cases a tendency to cause congestions of organs. 4. Defective secretion, either from an organ or a secretory sur- face, is a cause of congestion of such an organ or surface ; and it is found that the means which increase the secretion will often remove the congestion. It must, however, be borne in mind that diminished secretion is usually the result of the congestion, and that the means which have the power of exciting the secre- tion of such a part very often, in virtue of their irritating effects upon it, increase the congestion, or, what is perhaps of greater moment, transform a mere congested condition into that of in- flammation. Many writers seem to confound congestion with inflammation, and we continually see slight inflammations described as con- gestions. It appears to me that a distinction should be made between the two conditions, and that a congestion should be defined to be a fulness of the vessels of a part or parts arising from various causes, without the occurrence of any primary important perversion of the nutrition of that part; and that inflammation is a perverted condition of the nutritive function of a part, accompanied in the majority of cases by a congested condition of its vessels; such congestion, however, not being necessary to the inflammatory process, for it is found that inflammation involves the non-vascular as well as the vascular structures of the animal body. The results of mechanical congestion are transudation of serum, hemorrhage, thrombosis, and gangrene; and of active hyperemia, increased redness, elevation of temperature, and a sense of throbbing, succeeded, if the congestion continues, by enlargement of the small arteries and thickening of their walls; function heing in some cases exalted, more especially if the CHANGES IN THE BLOOD. 95 congestion be in a nervous centre, whilst in other instances function becomes diminished. Thus a long-continued con- gestion of a secretory organ arrests, or very considerably diminishes, the function of that organ. The congestion or fulness of the vessels is somewhat relieved by’ transudation of plasma into the tissues, or into cavities, constituting cedema, anasarca, and dropsical effusion. For this reason the limbs swell when their vessels are congested from debility or want of exercise; and the peritoneal cavity becomes filled with fluid, constituting ascites, when the portal veins are in any way obstructed. The transuded serum generally differs from that of the blood, in containing less of the solid blood constituents and more water; it has also a lower specific gravity. If exposed to the air it will sometimes coagulate, forming rather a gelatinous mass than a firm fibrinous clot. When the obstruction is very great the exudate is of a more coagulable nature, due to the presence of the fibrin ferment components, and the blood globules escape through the walls of the capillaries without rupture. This fact was discovered by Cohnheim, who, by applying a ligature to the femoral vein of the frog, observed, when the congestion of the vessels became very great, that the red corpuscles passed through the capillary walls, and in so doing assumed an hour-glass shape, or became constricted in their middle. This fact explains to some extent how, in some cases of purpura, transudation of blood takes place into the tissues without rupture of the vessels. Congestion from obstruction producing gangrene is seen in strangulated hernia, and in invagination of a portion of the intestines. Gangrene from obstruction is always of the moist kind, whereas that from arterial incompetency is of the dry kind. In the one the blood supply is scarcely or not at all interfered ‘with, but the return of that blood is arrested, stasis is produced, the blood thus imprisoned transudes into the tissues, and, rapidly ‘dying and decomposing, adds to the rapidity of the death and ‘decomposition of adjoining structures. In the other, or gangrene ‘from want of blood, the part turns pale and dry, shrinks, becomes “mummified, or crumbles into fragments. y The occurrence of thrombosis, or the formation of clots in the «congested vessels, results from the blood coagulating within ‘them during life, and may arise in congestion of any part, and 96, PATHOLOGY. from any of the causes already enumerated. When caused by direct pressure, the coagulation commences at the point where the obstructing cause comes into contact with the vessel, and extends as far as the collateral branches; when from debility, diminished cardiac power, or gravitation, the coagulation com- mences first behind the flaps of the valves, and appears to be owing to the force of the current being insufficient to completely open the valves. The blood thus allowed to lodge and stagnate coagulates and forms a thrombus or clot, which may finally obstruct the whole venous channel as far as the next large collateral branch. Treatment of congestion—The most important means for the removal of congestion are those which tend to remove its cause ; and if the causes already enumerated are borne in mind, the practitioner will at least have some guide to the proper line of treatment. When the congestion is due to the influence of cold upon the surface, clearly the first step is to restore the circulation of the skin by warmth, friction, and by the administration of remedies, such as the spirits of nitrous ether, which are known to promote diaphoresis. If the congestion be due to diminished cardiac power, or debility of the vessels—and this is often induced by want of exercise—the lost power and tone must be restored by good food, pure air, reoular and moderate exercise, and tonics. If the debility of the vessels be very great and obstinate, the effects of ergotine may be tried. This remedy acts by producing contraction of the blood-vessels; it may be very conveniently used hypodermically. The effects of bandaging, in supporting the weakened vessels of congested limbs, should not be lost sight of, nor its application neglected. In many instances a watery condition of the blood is associated with debility of the circulatory apparatus : in such cases tonic remedies combined with diuretics act most favourably. In severe internal congestions, where not only the organ chiefly affected is filled with blood, but the right side of the heart and the great veins also, the necessity of affording mechanical relief becomes a serious question, and very often an urgent necessity. It is very true that severe internal congestions, more especially those of the lungs and brain, are generally associated with greatly diminished cardiac power, feeble pulse, and nervous pro- stration; and if we were to admit what is so commonly mm- CHANGES IN THE BLOOD. 9? sisted upon, that the course of treatment is to be guided by the condition of the pulse, then the withdrawal of blood would be contra-indicated in every instance. But practitioners who have thought over the matter know full well that a moderate bleeding is followed by a diminished acceleration of the pulse, and improvement in its tone, and that many congestions are immediately relieved by such procedure. The explanation is not difficult. In cerebral congestions the diminished cardiac power and feebleness of the pulsations are caused by the pressure of the congested vessels upon the brain substance: in many instances this pressure is increased by the transudation of serum from such congested vessels. By diminishing the brain pressure by the abstraction of blood, the cause of the debility is at once removed. The heart is now able to beat fully and strongly, and thus a small, feeble, or even thready pulse is changed into a full, soft pulsation. The variety of opinions held as to the possibility of causing an alteration of the fluids within the cranium by bleeding or otherwise, need not be discussed at present. My own experience leads me to the con- clusion that a comatose condition produced by cerebral or cerebro-meningeal congestion is often removed, the pulse being at the same time improved in tone, by a moderate bleeding. Pulmonary congestion and the feebleness of the heart’s action— the “oppressed action ” as it has been termed—are aggravated by the right side of the heart and the great veins being choked with blood. In this instance, it is true, the withdrawal of blood does not relieve by removing the primary cause—that is, the congestion of the pulmonary capillaries—but, a most im- portant complication, it diminishes the supply of blood to the already overloaded heart, and through it to the already con- gested vessels. Bearing this in mind, the rapidity with which the withdrawal of a large stream of blood produces an impression will be understood ; indeed, it can most truly be stated that the relief afforded does not depend so much upon the quantity withdrawn, as upon the rapidity of the withdrawal. For example, six or eight quarts of blood might be abstracted in a small or trickling stream, and afford no relief, but, on the contrary, do much harm, by causing debility or exhaustion; but a smaller quantity, if withdrawn rapidly, may be followed by a marked remission of all the distressing symptoms. In the one case, the blood supply to 98 PATHOLOGY. the heart within a given time has scarcely been interfered with, while, in the other, the quantity returned by the veins has been most sensibly diminished, time has been afforded to the con- gested vessels to become to some degree emptied, and regain their lost tone, and for the circulation generally to be restored to its equilibrium. In these congestions the administration of diffus- ible stimulants after the bleeding will still further restore the lost power of the propulsive force and of the debilitated walls of the vessels ; and, in virtue of their exalting action, will diminish the internal congestion, by causing an increased circulation of the vessels of the skin and excretory organs. Local exudations, especially those seen in horses’ legs and such conditions as chilblains in human beings, are often the result of a loss in coagulability of the blood. It has been ascertained that the blood under normal conditions has a fixed time to coagulate when withdrawn from the body. If this time is exceeded, the blood is low in coagulability ; if it take less than the normal time, it has a high coagulability. These facts have latterly greatly assisted in the treatment of diseases. Wright has given a very happy metaphor in this respect. He illustrates it by showing that if a canvas hose- pipe has thick fluid gelatine passed through it, the force required to cause any exudation through the canvas must be very great. If, however, the gelatine be very fluid, the force required will be very much less. It is the same with the blood. If a horse’s blood is low in coagulability, that horse will suffer from cedematous legs, and its resultant evils, if the vessels are deprived of the help which they receive from the pressure exerted by muscles during exercise. If, however, the coagulability be normal, there is not this tendency. It is well, therefore, to ascertain the coagulability by taking a fixed quantity of blood in a pipette, and testing its time of clotting on a piece of blotting-paper, which should be in two minutes. Such drugs as lactate of calcium will accentuate clotting and ' citrate of soda will delay it. LIPAMIA, OR FATTY BLOOD. In February, 1882, I was consulted by a gentleman living in the West Highlands regarding a fatal disease which had appeared amongst his ewes. CHANGES IN THE BLOOD. 99 The history of the outbreak was very meagre, and was from the farm manager, who stated— “The appearance when first attacked, or rather when we notice them, is that they do not follow the flock, and, when walking, propping their legs as appearing to keep them from falling, which they often do, always going down head first. “Their droppings not at all natural, and mixed with a slimy mixture of blood. They live from three to four days after we detect them ill. “ Their food for the last three months, turnips carted out on grass land, with an allowance of half a pound of Indian corn and cotton cake mixed per day. “T may add that they were turned into the turnip fields to pick up broken and small turnips, but were only there about three weeks, during which time they had full turnips, and looked the very picture of health. “Mostly all the dead ewes when opened have shown a great deficiency of blood.” The proprietor in a short note informed me that “the only treatment that has been attempted is giving a dose of castor oil, and that some of those showing symptoms of disease improved since the giving of cotton cake was discontinued.” These letters were accompanied by the carcase of a sheep of the Shropshire Down breed in an advanced state of decom- position. On a post mortem examination being made the whole body was found to be loaded with fat ; that of the abdominal parietes being several inches in thickness; the sublumbar region had many pounds of fat in it, and here it was found that the interior of the fatty masses had undergone crystallisation ; well-formed crystals of stearine and margarine being found in the midst of a dry kind of débrvs. The structures of the liver and of the heart were not only thoroughly infiltrated with oil globules, but had undergone fatty degeneration to an advanced degree; the lungs were congested, and the large pulmonary vessels filled with thrombi; the cardiac ventricles were quite full of blood, showing that death had been induced by zsthenia and pulmonary congestion. Microscopically examined, the blood (which was pale in colour when seen with the naked eye) from the heart, pulmonary vessels, 7—2 100 PATHOLOGY. and from other parts, was found to be loaded with oil globules, as represented in the drawing, which was made on the spot. It will be seen that the oil globules vary in size, some being smaller, some much larger than the red blood corpuscles. It was unfortunately, however, impossible to prepare microscopic slides Fig. 94.—(a) Blood corpuscles altered in shape. (6) Oil globules, isolated and in groups, scattered about the field. of the blood and tissue owing to the advancing decomposition ; but notwithstanding this, the fat gave the usual reactions with perosmic acid and other staining materials. I am not aware that this disease has ever been observed by any veterinary writer, and it was only in 1874 that Professor Kussmaul first drew attention to it in the Deutsches Archiv fir Klinische, as causing a remarkable mode of death in diabetes mellitus of the human being; the fatal symptoms consisting in a peculiar kind of dyspncea, which after a time was accompanied by and ended in coma. In 1879, the late Professor Sanders, and D. J. Hamilton, M.B., Edinburgh, investigated two cases after death from diabetes, and found a condition of the blood similar to that described above. Death from lipemia has also been observed in cats which have suffered from exhaustive diseases, accompanied by great emaciation, but no cases have hitherto been recorded in which ‘this condition of the blood has accompanied obesity of the body generally. CHANGES IN THE BLOOD. 101 Fatty embolism of the pulmonary artery is a cause of death in some cases of compound fracture of the long bones in man, and is accounted for by the fact that the medulla of the osseous canal gains entrance into the ruptured blood-vessels, and is thus mixed up with the general circulation, becoming arrested in its passage through the pulmonary vessels, and there forming a block to the pulmonary circulation, which finally effectually stops the aération of the blood, and causes death by apneea, On comparing the fat condition of the body of this sheep to the emaciation of diabetic subjects, one cannot help being struck with the contrast between the two extremes. It is certainly difficult to answer the question, how is the fat produced in the blood of diabetic patients? But in this sheep the conclusion seems self-evident: that we had an animal which (along with others) had been fed up to such a point that it could no longer either assimilate, utilise, or excrete the highly nutritious matters contained in its food. The Shropshire Down breed of sheep are noted for their fattening properties, and in this case we had an example of an animal having been fed beyond the point of perfection. The winter of 1881-2 was a remarkably open one; grass was plentiful throughout the season, and, in addition to an abundance of grass, these sheep had a full allowance of turnips, besides corn and cotton cake. This rich food, the quantity of which, how- ever, does not strike one as being outrageously great, given in addition to the turnips and grass to animals whose fattening qualities is so well known, was evidently too much. After feeding upon it, the sheep would have little or no inclination to roam about; indeed, grass being abundant, there would be no necessity for them to travel far in search of food; fat was consequently so rapidly formed that all the tissues of the body became loaded with it, and finally the blood, where it caused an obstruction to the circulation, and thus induced death. SEPTICZMIA—-PROGRESSIVE GANGRENE. Definition.—A condition produced by the absorption or introduction of septic matter into the system, characterised by great prostration, metastatic lameness, colicky pains, with purging, the feces being fetid, foetor of the breath, and 102 PATHOLOGY. rapid emaciation in the horse. In horned cattle and sheep it is generally seen after parturition, and manifested by great prostration, collapse, fluttering pulse, expulsion of a coffee coloured fluid from the uterus, violent straining, purging, and great restlessness ; also known as braxy, affecting sheep in their first year (hoggs), and occurring in the late autumn and early winter months, especially when the weather is cold, and the grass covered with hoar frost. It is also very destructive to lambs, and to calves a few days old. These varying forms of septiceemia will be found described under various heads in the context of this work, as well as in the Principles and Practice of Veterinary Surgery. THE ARTIFICIAL INDUCTION OF SEPTIC@MIA has been the subject of various experiments—first of all by M. Davaine, and afterwards by M. Bouley, Director of the Alfort Veterinary School. The experiments were as follows :—Six watch-glasses were placed on a table. Into the first 100 drops of water were placed, and to these was added one drop of blood from a septicemic rabbit ; the whole was stirred so as to produce a solution of ;39. One drop of this was placed in the second glass containing 100 drops of water, and a dilution of yy5,3g produced. In the third glass, a drop from the second gave a dilution of 7,593,509. In the fourth glass a drop of third dilution added to the 100 drops of water produced a dilution of ~y5,530,500- In the fifth glass, similarly treated, there was a dilution of z9,509,300,000 3 and in the sixth a drop of the dilution gave a trillionth (z,500,300,000;000)" Matters being so disposed, four rabbits were inoculated respec- tively with the first, second, third, and fourth dilutions, a horse with the second, and a guinea-pig with the first. Next day all the rabbits were dead, the guinea-pig fell ill, but recovered, and the horse sustained no harm. M. Bouley communicated an account to the Académie de Medicine of numerous experiments he had made confirming the above, and stated that dogs can also be killed by the septicemic virus derived from the rabbit, and that such virus derived from the horse possesses much less virulence than that furnished by the rabbit. I have repeatedly experimented on birds and rabbits with the undiluted blood of pyszmic—septicemic (Vogel)—rabbits and birds, and have always induced death, either by a rapid CHANGES IN THE BLOOD, 1038 corruption of the whole blood-mass, from which the animals have died in a few hours, or, resisting the first effects of the morbid inoculated material, from pyzmia with abscesses in various internal organs. Selecting mice as being specially adapted for experiments on infective diseases, Koch has made some remarkable discoveries pointing to the conclusion that death may be induced by (a) a soluble poison, “ Sepsin ;” by (6) a true septicemia induced by the multiplication of the bacteria introduced by the inoculation ; and by (¢) a progressive destruction of tissue (gangrene), com- mencing at the point of inoculation and spreading rapidly to adjacent parts. Blood or meat infusion, which have putrefied for a short time, act more injuriously than when putrefaction has extended over a longer period, and five drops of such blood, if injected under the skin of the back of a mouse, kills it within a short time. There are marked symptoms of illness immediately after the injection. The mouse becomes restless, runs about constantly, but showing great weakness and uncertainty in all its move- ments; it refuses food, the respiration becomes irregular and slow, and death takes place in from four to eight houre. In such a case the greater part of the injected fluid is found in the subcutaneous cellular tissue of the back in much the same condition as before it was injected. It contains bacteria of the most diverse forms, irregularly mixed together, and as numerous as when examined before injection. No inflammation can be observed in the neighbourhood of the place of injection. The internal organs are also unaltered. If blood from the right auricle be introduced into another mouse, no effect is produced. Bacteria cannot be found in any of the internal organs, nor in the blood of the heart. ~ Koch therefore concludes that an infective disease has not been produced as the result of the inoculation, but that the death of the animal is due to a soluble poison—Sepsin—which has been shown by the researches of Bergmann, Panum, and others to exist in putrid blood. This supposition is confirmed by the fact that when less fluid is injected the symptoms of poisoning which follow are less marked, and are quite absent when one or at most two drops have been injected. After the use of such small quantities mice often, remain quite well, but 104 PATHOLOGY. a third of them, on an average, become ill after the lapse of about twenty-four hours. The less amount of septic fluid injected, the fewer mice become affected, but less than one drop is some- times sufficient; thus, of twelve inoculated with one-twentieth to one-tenth of a drop each, only one was successfully infected. The first symptoms of the success of the inoculation with this minute quantity is an increased secretion from the conjunctiva. The eyes appear dull, and a whitish mucus collects between the lids, and finally glues them together. At the same time lassitude sets in, the animal moves little and languidly; as a rule it sits quite still, with its back much bent and its extre- mities closely drawn up. It then ceases to eat; its respirations become slower; weakness gradually increases, and death comes on almost imperceptibly. Convulsions never precede it (they always do so in anthrax). After death the animal still remains in the sitting posture with its back strongly bent; whilst a mouse which dies from anthrax is always lying on its back or side, with its stiffened limbs fully extended. Thus, by the position of the body after death, a fatal result produced by the inoculation of putrefying blood is at once distinguished from that occasioned by inoculation with the material of anthrax. On post mortem examination there is found at the place of injection or inoculation slight oedema of the subcutaneous cel- lular tissue. This, however, is often absent, and the internal organs, with the exception of a considerable swelling of the spleen, appear quite unaltered. One-tenth of a drop of the fluid of the subcutaneous cedema, or of blood from the heart of such animal, inoculated into another mouse, is sufficient to cause exactly the same symptoms, and death in about fifty hours. From this second animal a third may be injected, and so on through as many successive animals as one pleases. Koch says that the certainty with which the infective material can be carried from one mouse to another is greater than in anthrax, as in the latter the material for inoculation must be taken from the spleen, because the blood of mice affected with anthrax often contains very few bacilli; but in septiceemia, pro- duced by putrefying blood, it is a matter of indifference from which organ the material for inoculation is taken, and even the smallest quantity will produce an effect with certainty. The blood of mice which became ill after intravenous angec- CHANGES IN THE BLOOD. 105 tion of one to ten drops of putrefying blood was found to contain, as a rule, different varieties of bacteria in small numbers, micrococci, and large and small bacilli. If, however, the animals died after inoculation with putrefying or septiceemic blood, small bacilli alone appeared. This result was invariable, and the bacilli were in large numbers. These bacilli are often attached to each other in septiceemic blood in pairs, either in straight lines or forming an obtuse angle. Chains of three or four bacilli also occur, but they are rare. They show at first sight a great resemblance to small needle-like crystals, but that they are undoubtedly vegetable bodies is evident, for when septiceemic blood is kept in an incu- bation apparatus, these grow in a manner similar to the bacilli of anthrax, not forming long threads like the latter, but dense masses, which consist of isolated bacilli sometimes containing spores. They are extremely difficult to see, and it is necessary to stain them. The relation of these bacilli to white corpuscles of the blood is peculiar. They penetrate into these and multiply in their interior, and it is often found that there is hardly a single white corpuscle in the interior of which bacilli cannot be seen. Disease induced by the inoculation of the blood of septicemic mice cannot so successfully be induced in so many different animals as with that of anthrax. Thus Koch failed to cause it by inoculating rabbits, and even field mice resisted the inoculations. Occurring along with the septicemic bacillus, Koch has found in mice, after the introduction of putrefying blood, a micrococcus in the neighbourhood of the place of injection. This organism is of rapid growth, and forms very regular chains. As a rule, when an animal dies of septicemia after about two days, none of the numerous forms of bacteria which were injected with the putrid blood can be discovered, except the septicemic bacilli, or it may be a few residual specimens growing with difficulty. It must therefore be supposed that none of the other bacteria injected at the same time find in the body of the living mouse a suitable soil, and that they therefore die more or less quickly. Koch’s attention was therefore arrested when he found in some cases, growing at and about the inoculated spot, micrococci in unusual abundance and of a constantly characteristic form. 106 PATHOLOGY. They were not present in the blood, and by inoculation with the blood the septiczemic bacilli alone were transmitted. In order to test whether they could be inoculated, it was necessary that the material should be taken from the place of injection. Inoculations carried out in this way were successful in pro- ducing both forms of disease, and the virulence of the serum from the subcutaneous cellular tissue containing these micro- cocci was just as marked as that of the septicemic blood. When the point of a knife which had been well cleaned was merely brought in contact with the subcutaneous tissue at a spot about one centimetre and a half from the place of injection or inoculation, and when with this knife another animal was immediately inoculated, the inoculation was successful on every occasion. Septiceemia was of course always produced at the same time, because the serum used contained also septicemic bacilli. The influence of these micrococci on animal tissues, and their mode of spreading, can be best traced on the ear of a mouse, and it is specially instructive to compare an ear on which only septicemic bacilli have been inoculated with one into which both the bacilli and the chain-like micrococci have been introduced. In the former the cellular tissue is full of red corpuscles and lymph cells, so that the bacilli can often be recognised only with great difficulty among the numerous cell nuclei. The other ear presents totally different appearances. Spreading from the place of inoculation, one can see extremely delicate and regular micrococcus chains, here pressed together so as to form thick masses, traceable almost to the base of the ear, all the tissues of the part occupied by them being remarkably altered. As far as the micrococci extend, neither red blood globules nor nuclei of lymph or of connective tissue cells can be seen. Even the extremely resistant cartilage cells, and the plasma cells so richly present in the mouse’s ear, and which are likewise characterised by great resisting power, are pale and scarcely recognisable. All the constituents of the tissue look as if they had been treated with caustic potash ; they are dead, they have become gangrenous. Under these circum- stances the bacteria develop all the more vigorously, and the micrococci penetrate in numbers into the damaged blood and lymphatic vessels, and here and there they fill them so com- CHANGES IN THE BLOOD, 107 pletely that the vessels appear as if injected. Among these the septiczemic bacilli, no longer obscured by nuclei, are seen very distinctly in small groups, which are at times very dense, and can be traced up to the root of the ear, and indeed be- yond it, having at the same time increased enormously in the blood, and ultimately causing the death of the animals. The micrococci, on the other hand, and the destructive process associated with them, have only extended during the same time (about fifty hours) as far as the vicinity of the root of the ear, where their limit is sharply defined. The appearances presented by the ear on a post mortem examination lead to the conclusion that the action of these micrococci in causing gangrene is somewhat as follows:—Introduced by inoculation into living animal tissues, they multiply, and as a part of their vegetative process they excrete soluble substances, which get into the surrounding tissues by diffusion. When greatly concentrated, as in the neighbourhood of the micrococci, this product of the organisms has such a deleterious action on the tissue cells that they perish and finally completely disappear. At a greater distance from the micrococci the poison becomes more diluted and acts less deleteriously, only producing inflammation and accumulation of leucocytes. Thus it happens that the micrococci are always found in the gangrenous tissue, and that in extending they are preceded by a wall of nuclei, which constantly melts down on the side directed towards them, while on the opposite side it is as constantly renewed by deposition of fresh leucocytes. These observations refer to inoculations with fluid containing both micrococci and bacteria, and it might have been supposed that the septicemic bacteria were necessary forerunners of the micrococci, and must to a certain extent prepare the way for them. Koch attempted by various means to separate them from each other, but for a long time with no avail. But chance led him to the proper method. A field mouse, which he had already © found out possessed an immunity from septicemia, was inocu- lated with bacteria and chain-like micrococci. The experiment was made in the expectation that neither parasite would develop. This expectation, however, was not fulfilled, for, though the rods, as usual, underwent no development, the 108 PATHOLOGY. micrococci increased and spread in exactly the same manner as had been the case with the domestic mouse. Beginning at the point of inoculation in the root of the tail, the gangrene spread onwards along the back, passing deeply among the dorsal muscles, and downward on both sides to the abdominal wall. The animal died three days after inoculation. The parts affected with the gangrene were partially denuded of epidermis and hair, and contained chain-like micrococci in extraordinary numbers. The same micrococci were also found on the surface of the abdominal organs, although there was no visible peritonitis. The blood and the interior of the organs were, on the other hand, quite free from them. From this animal other field mice, and from these again domestic mice in various successive series, were subsequently injected, and with always the like result—namely, that only chain-like micrococci, and in their train progressive gangrene, were obtained. The development of bacteria even in a suitable soil can be chacked by certain influences, physical, biological, and chemical, and of these none are more potent than temperature. No fully developed bacteria have as yet been found to survive after long exposure to 60° C. when in the moist state, and but few resist a temperature of 50 °C.=112° F. The spores of bacteria, however, can resist a much higher temperature than that which destroys the adult organism, and all agree that the boiling-point of water is the lowest which can be relied upon to destroy spores; but in the dried state they are much less readily destroyed, requiring three hours’ exposure to a temperature of 140° C.=284° F. Again, intense motion and sunlight checks bacterial life, but electricity seems to have no effect upon them. Of the chemical influences which destroy or retard bacterial life the most powerful is corrosive sublimate, its action being instantaneous even in a dilution of one part to five thousand. Next to the bichloride are placed bromine, iodine, and chlorine ; but carbolic acid is not so reliable, as nothing less than a three per cent. solution destroys spores, and requiring at least seven days, and a five per cent. solution requiring from twenty-four to forty- eight hours. When dissolved in oil, Koch says it is harmless both to spores and developed bacteria. When immersed in it in the dried state and dissolved in alcohol, it is also inert. CHAPTER XI. PATHOLOG Y—continued. MODES OF DEATH. FoLLOWING the example of Dr. Williams, Sir Thomas Watson, and other writers upon medicine, I purpose very briefly to con- sider the chief varieties of the modes of death. An inquiry into this subject, says Watson, “is not one of merely curious interest, but has a direct bearing upon the proper treatment of disease. It will teach us what we have to guard against, what we must strive to avert in different cases.” A continuance of “life is inseparably connected with the con- tinued circulation of the blood. So long as the circulation goes on, life, organic life at least, remains. When the blood no longer circulates, life is presently extinct; and our investigation of the different modes of dying resolves itself into an investiga- tion of the different ways in which the circulation of the blood may be brought permanently to a stand. “Observe the ample provision that is made in the construc- tion of the body for carrying on and maintaining this essential function. First, there is an extensive hydraulic apparatus distributed throughout the frame, consisting of the heart and other blood-vessels. Next, there is a large pneumatic machine, forming a considerable part of the whole body, com- posed of the lungs and the case in which they are lodged. Lastly, the power by which this machine is to be worked and regulated is vested in the nervous system. Each of these systems must continue in action, or the circulation will stop, and life will cease. The functions they respectively perform are consequently called vital functions ; and their main organs —the heart, the lungs, the brain—are denominated vital organs. 109 110 PATHOLOGY. The functions of any one of the three being arrested, the functions of the other two are also speedily extinguished.”’— (Wartson’s Principles and Practice of Physic.) Death, it is observed, occurs as follows :— 1. Death beginning at the heart—syncope. 2 os Be » lungs—apnea. Be. +45 +3 » brain—coma. 4. 4, +5 » blood—necremia. DEATH BEGINNING AT THE HEART. Death beginning at the heart may occur in two ways :— 1st. Suddenly, or by syncope; and 2nd. By gradual cessation of the heart’s action. Syncope may occur in two ways :— Ist. By the heart losing its irritability, so that it ceases to contract; and 2nd. By tonic spasm, in which it remains rigidly contracted. Death from tonic spasm of the heart is rare amongst the lower animals. I have, however, seen one instance, where a valuable horse died from this cause in con- sequence of a sudden fright. In both these cases death is instantaneous. In the first case, each chamber of the heart is found after death to be filled with its proper kind of blood, upon which it has been unable to contract. Sir Benjamin Brodie, in some experiments recorded in the Philosophical Transactions for 1811 and 1812, found that when death was occasioned by the upas antiar, that the heart was full after death, with purple blood in its right and scarlet blood in its left cavities. This proves that the heart has ceased to contract upon the contained blood. In the second case, the heart appears very small and hard, the ventricles, particularly the left, firmly contracted and containing no blood, and the heart substance very firm. This state of the heart was supposed to depend upon concentric hypertrophy, but its true nature was pointed out by Cruveilhier and Dr. G. Budd. Should any doubt remain as to its true nature, if the heart be kept for a few days, it will, if the condition be that of spasm, lose this tonicity, and may easily be restored to its regular dimension by a little manipulation. Both conditions of the heart—namely, loss of irritability and tonic spasm—may arise from similar causes. Shock, for example, may produce the one or the other MODES OF DEATH. 111 condition ; and wounds of the heart are sometimes followed by paralysis, sometimes by rigid contraction of that organ, In sudden death from drinking very cold water when the body is heated, the heart has been found contracted. In the slower modes of death beginning at the heart, it ig found that the same conditions exist after death. In death from hemorrhage—anemia—it is found that the heart is firmly contracted, if the animal be examined shortly afterwards; the circulation failing, not because the heart has lost its power of contraction, but because blood does not arrive in sufficient quantities in its cavities. That the heart does not lose its power of contraction in such cases is proved by the transfusion of blood from an animal into the veins of a human being or other animal apparently dead from hemorrhage, where it has been found that animation may thus be restored. “It is quite clear,” says Watson, “that this introduction of fresh blood could be of no avail in a case where the heart was unable to act upon the blood which had already reached it.” Approaching death from hemorrhage is manifested by great and rapidly increasing pallor of the mucous membranes, cold- ness of the mouth, surface of the body, and extremities, cold sweats, a dazed or dim appearance of the eyes, convulsive struggles—if the animal is down, at first strong but rapidly becoming feeble, if standing, the animal will balance its body upon the extremities; the pulse feeble, irregular—sometimes slow, sometimes fast—cold breath, convulsive breathing, dilata- tion of the pupils, and very often just before death the animal gives a loud scream or delirious neigh. In another form of gradual death beginning at the heart, it is found that the heart has gradually lost its power of con- tractility. This is the most common mode by which death occurs, and is the termination of many exhausting diseases, especially those which destroy the strength without directly interfering with the more vital functions, such as influenza, diarrhcea, diabetes, fevers, as well as inanition from want of food, or other causes which reduce the powers of the whole body. The two conditions of the heart found after death beginning at that organ may each be brought about in two ways:—lst. Suddenly, as in instantaneous death from shock or great violence ; and 2d. When death, although it may be said to occur suddenly, 112 PATHOLOGY. presents some symptoms of its approach, however brief those symptoms may be, as from hemorrhage, the operation of some poisons, as aconite, hydrocyanic acid, upas antiar, tobacco; from lightning, electricity, and various animal poisons, as snake-bites ; the operation of debilitating influences, as well as diseases which tend to weaken and paralyze muscular force, and to produce asthenia. In death from gradual asthenia the pulse becomes very feeble, frequent, and often irregular; the respirations feeble, sometimes sighing; the muscular debility extreme. Pallor of the membranes comes on gradually, or in some cases they may present an unhealthy reddened or brownish-red appearance from the blood remaining in the veins, the extremities become cold, and cedematous. In various wasting diseases, such as pleuro-pneumonia-bovina, diarrhea, polyuria, or any disease which more gradually exhausts the powers of life, death is caused by anemia and asthenia. The blood gradually diminishes in quantity and deteriorates in quality, therefore the supply to the substance of the heart becomes diminished, and in a condition unsuited to nourish the heart properly. The power of the heart, as well as of the muscles generally, is gradually lessened, and at length ceases altogether; and when death is so produced the heart is not contracted and empty asin death from anemia, nor so full and engorged as in death from asthenia. This form of death is called by Watson death by inanition, and its typical form is that occurring from starvation. DEATH BEGINNING AT THE LUNGS. By this it is meant that the function of breathing is the first to fail, improperly termed death from asphyxia—literally pulse- lessness—more correctly termed death by apncea, privation of breath, or suffocation. This form of death is caused by diseases of the lungs or bronchial tubes, pleurisy terminating in hydrothorax, where air is prevented from entering the lungs by the pressure of the pleu- ritic fluid, mucus, pus, or blood, filling the tubes and air cells; by laryngitis, spasm of the glottis, or when tumours press upon the larynx or trachea; by edema of the glottis ; diseases of the MODES OF DEATH. 113 heart affecting the quantity of blood in the lungs and great thoracic vessels; strangulation; drowning; pressure upon the diaphragm, forcing it forward and preventing admission of air into the lungs, as in severe tympanitis of the stomach and bowels, or from any circumstance which may paralyze the diaphragm—fraciure or dislocation of the upper cervical vertebrae, and pithing, for example—or obstruct the passage of air through the nostrils, larynx, trachea, or bronchial tubes. Sudden death from apncea is not often witnessed as the result of disease, but is generally brought about by accident or design, accidentally when the upper cervical vertebre are fractured or displaced; in cases of parturient apoplexy, when fluids gain entrance into the lungs, and from impaction of foreign bodies, or polypi in the larynx; and designedly, when an animal is pithed. Death is also thus produced by the entrance of air into the veins.—(See Principles and Practice of Veterinary Surgery.) Death from apnea takes place most commonly from the supply of air being gradually cut off by morbid changes in the respira- tory organs, and is often accompanied by asthenia and coma; but generally the symptoms belonging to apncea are plainly predominant. In death, when the passage of air into the lungs is arrested suddenly and completely, it has been ob- served that the muscles of respiration exhibit strong and violent contractions; that the efforts to breathe are very great, struggling but ineffectual, and very distressing. This extreme listress, however, soon passes away, and is succeeded by vertigo, stupor, loss of consciousness, and convulsions, till at length all efforts cease, except a few irregular twitchings of the limbs; the muscles then relax, the sphincters yield, but even then the movements of the heart and the pulse continue for a short time after all signs of life are gone. The other signs of this method of death are congestion and lividity of the visible mucous membranes, a full, staring eye, protrusion of the nose, dilatation of the nostrils, and sometimes flapping of them. When it arises from inflammation or spasm of the muscles of the larynx, tumours, abscesses, or obstruction in the trachea, there will be a loud, roaring, inspiratory sound. In the slower forms of apnoea, from diseases of the lungs, air tubes, or hydrothorax, where the interruption is less complete, the efforts less violent, the congestion of the membranes less marked, there may he little 8 114 PATHOLOGY. perceptible protrusion of the nose ; indeed, in bronchitis, stupor is present to such a degree that the animal generally hangs its head. The functions of the body together gradually failing, the syinptoms of suffocation are less decided. The pathology of this mode of dying is now pretty well understood. Bichat made several experiments which went to prove that unaérated blood not only reached the left side of the heart, but was sent to all the arteries of the body. His experiments were as follows:—A ligature was applied to the trachea of a living animal; a small opening was then made in one of the carotid arteries. Presently the slender stream of blood which issued began to lose its arterial tint, and to assume the dark colour of venous blood; but, contrary to what had been previously supposed—namely, that the circulation would be immediately arrested in the lungs, the quiescence of the lungs, consequent upon the cessation of the alternate movements of the thorax, forming a mechanical impediment to the transit of blood through them (Haller), or that the unaérated blood passed through the lungs and entered the left auricle and ventricle, but went no farther (Dr. Godwin)—Bichat discovered that the blood continued to flow from the opened carotid, and that its afflux upon the brain was marked by convulsions and insensi- bility. This led him to believe that the blood underwent no obstruction in its passage through the lungs, but that, remaining unpurified and venous, it acted as a poison upon every part to which it was carried by the arteries—first upon the nervous system, and ultimately (passing through the coronary arteries) upon the muscular substance of the heart itself. “There are, however,” says Watson, “ two well-known facts upon which this theory is inexplicable—the comparative emptiness of the left chambers of the heart, and the restoration of the suspended functions by the timely performance of artificial respiration, The air could never reach and revivify or depurate the venous blood stagnating in the capillaries of the heart.” Sir James Kay Shuttleworth, in his work on Asphyxia, and later, Mr. Erichsen, in the Ldinburgh Medical and Surgical Journal, have endeavoured to prove that stagnation of the blood commences in the pulmonary capillaries, that the stagnation is due to its non-arterialization, and that the movements of the left side of the heart are brought to an end principally by the deficient supply of blood from the lungs. MODES OF DEATH. 115 Venous blood (say these observers), circulating through fhe arteries, has no directly poisonous operation, but is capable, though much less effectually than arterial blood, of supporting in some degree the irritability of the muscles; and it appears that the primary and main cause of the failure of the circulation seems to be the difficulty with which the non-arterialized blood passes through the capillaries of the lungs, and partly the imper- fect stimulus afforded by the venous blood to the walls of the heart, as well as its incapability to support the functions of the brain and nervous system. The appearance of engorgement of the pulmonary arteries and venous system generally, with dis- tension of the right side and comparative emptiness of the left side of the heart, seen after death, are more constantly visible in the slower forms of apnoea than after sudden suffocation ; for after sudden death blood seldom coagulates, and if the animal is not shortly examined, the engorgement is apt to disappear by gravitation. The conclusions of Sir James Kay Shuttleworth and of Mr. Erichsen, although correct enough, fall rather short of a full explanation ; for it has been ascertained by many observers that when an animal is strangled by a tight ligature on the trachea, and examined immediately after death, the lung tissue is always found void of blood, whilst the pulmonary artery, up to its smallest branches, the great veins and the heart, are greatly engorged. Dr. George Johnson, in explaining this, says that some opposing power is brought into play, more than equal to the propelling power of the heart, and that this opposition is due to the firm contraction of the muscular walls of the ultimate branches of the pulmonary artery. He calls this contraction the stop-cock action of the ultimate pulmonary arteries, Dr. Johnson proved by experiments of his own that this condition exists whether the ligature be applied after or before a full inspiration ; whether the lungs were at the time full or compara- tively empty of air. “These,” says Watson, “are the plain and unquestionable facts of the case. They show that some oppos- ing power must have been called into play more than equal to the propelling power of the right ventricle of the heart. Now, such a power—and it is the only conceivable one—actually exists at the very place where the venous current meets with its curb, and it consists in the firm contraction of those muscular g—2 116 PATHOLOGY. fibres of the minute arteries, the function cf which is to regulate the blood supply in accordance with the varying requirements of the part. This function again is determined by those un- sleeping sentinels the (vasa-motor) nerves. Were it allowable, for the sake of illustration, to impersonate the vital forces con- cerned in this marvellous adaptation, we might liken the process to the intelligent stopping of the traffic on an obstructed line of railway by a backward telegram.” In order to test the correctness of Dr. George Johnson’s experiments, I have repeatedly examined strangled dogs, and found that the heart will continue to beat for more than three minutes after the respiratory efforts have ceased, and that the lungs and great vessels are always as he has described them, namely, the lung substances pale and empty, the pulmonary artery and right side of the heart, with the cave, immensely engorged, and the pulmonary veins and left side of the heart containing a small quantity of venous blood. From these experi- ments it appears very conclusive that death by apnoea occurs in two ways, and that two distinct pathological conditions of the lungs are observable after death :—1st. When death is sudden, as from suffocation by strangulation, drowning, or any cause whereby the supply of air is suddenly cut off, the stop-cock action of the ultimate pulmonary arteries prevents the blood from flowing in its ordinary quantity to the pulmonary capil- laries, veins, and left side of heart, and that the lungs are pale when examined immediately after death: 2nd. When death more slowly occurs, the blood accumulates in all the vessels of the lungs, which after death appear engorged, congested, and black. This is the condition of the lungs seen when an animal is galloped to death, in pulmonary apoplexy, and congestion; and in death from some acute diseases, where towards the close of the disease the heart becomes too enfeebled to propel the blood through the intricacies of the pulmonary system, or when the blood itself becomes so altered as to be incapable of piepet arterialization. To prevent death by apncea, it is obvious that the respiratory function must be restored where it is defective, that all impedi- ments to the passage of pure air into the lungs must be removed. The subject of treatment will, however, be considered in another place, and I may merely state here that nothing has been found MODES OF DEATH. 117 so effective and so useful in balancing the circulation and in restoring the passage of blood through the lungs as the applica- tion of heat to the whole body, frictions, stimulating applications to the extremities, warm clothing, and bandages, in addition to abundance of pure air for the animal to breathe, and that blood- letting frequently affords apparent relief. DEATH BEGINNING AT THE BRAIN, Death by coma, or beginning at the brain, is much less com- monly witnessed in the lower animals than death by apncea or by asthenia. Such diseases, however, as parturient and idiopathic apoplexy, cerebral meningitis, and other allied affections, which act upon and destroy the functions of the brain, cause death in this way. Death by coma is also induced by certain narcotic poisons, such as opium, as well as by inordinate quantities of effete materials in the blood, more especially urea and carbonic acid ; by fractures of the cranial walls, the pressure of tumours, abscesses, serum or extravasated blood, and by coagula in the cerebral arteries, obstructing the flow of blood, and causing anemia of the cerebral mass. The symptoms of coma are stupor, insensibility, suspension of voluntary motion, which come on sometimes suddenly, as in apoplexy and injuries of the head, whilst in other cases they supervene gradually. The breathing becomes slow, irregular, stertorous; the instinctive motion of breathing still continues, but all voluntary attention to the act is lost. The feeling of the want of air is still sufficiently strong and powerful to excite, through the medium of the pneumo-gastric and branches of the fifth nerves, the reflex power of the medulla oblongata to sustain the involuntary movements of the thorax; but at length this fails also, the chest ceases to expand, the blood is no longer aérated, and thenceforward precisely the same internal changes occur as in death by apnoea.—(WArson.) Coma ultimately destroys life in the same way as apncea, with this difference, that in death by apnoea the aération of the blood and the functions of the lungs cease first—the circulation of the non-arterialized blood destroying the functions of the brain; whilst in coma the functions of the brain cease first, and in consequence of the loss of nervous power, the movements of 118 PATHOLOGY. the chest and the aération of the blood cease also. The post mortem appearances of death by coma and of that by apncea are the same, except, indeed, in those cases where the cause of the coma remains, when it will be present in addition to those of apnoea. Reasoning upon the conclusion that the circulation ceases consequent upon the cessation of the act of respiration, arising from suspension of the nervous power, Sir Benjamin Brodie was led to think that by continuing respiration artifi- cially in animals labouring under narcotic poisons, the circulation of the blood might be kept up until the effect of the poison upon the brain had passed off. The correctness of the supposition he soon verified by experiment. He inserted some woorara into a wound which he had made ina young cat: this after a short time entirely destroyed the respiratory movements, and the animal appeared to be dead, but the heart could still be felt beating. The lungs were then artificially inflated about forty times a minute. The heart continued to beat regularly. When artificial respiration had been kept up for forty minutes, the pupils of the cat’s eyes were observed to contract and dilate upon the increase and diminution of light, but the animal remained perfectly motionless and insensible. At the end of an hour and forty minutes there were slight involuntary contrac- tions of the muscles, and every now and then there was an effort to breathe. At the end of another hour the animal, for the first time, showed some signs of sensibility when roused, and made spontaneous efforts to breathe, twenty-two times in a minute. The artificial breathing was, therefore, now discontinued. It lay as in a state of profound sleep for forty minutes longer, when it suddenly awoke and began to walk about. It must be clearly understood that artificial respiration can be beneficial only where there is a suspension of the nervous functions, as in cases of poisoning, and not where there is destruction of them by disease, injury, or the long-continued action of poisons. Professor Sewell experimented upon the horse with the woorara poison, and found that by artificial respiration life could be maintained until the action of the poison had passed away, and that afterwards the animal regained consciousness and recovered from its effects. MODES OF DEATH. 119 DEATH BEGINNING WITH THE BLOOD. Necremia, or death beginning with the blood.—In rinderpest, splenic apoplexy, black-quarter or quarter-ill, braxy, purpura hemorrhagica, and scarlatina, death may be said to be due to the death and decomposition of the blood, the action of the heart ceasing because the blood is no longer capable of affording the necessary stimulus. At an early stage of these diseases, when they occur in their worst form, the blood exhibits changes in its composition, mani- fested by petechiz and vibices on the skin and mucous mem- branes, extravasations into the subcutaneous and muscular tissues, and by congestion of, and hemorrhages into, the internal organs. The blood is fluid, of a dark colour, and possesses pathogenic properties, as manifested in its deleterious operations on other animals and on man.—(See Malignant Pustule.) It decom- poses rapidly, and a putrid odour is exhaled from the surface of the body, and from the excretions. ‘The blood,” says Dr. Williams, “the natural source of life to the whole body, is itself dead, and spreads death instead of life. Almost simultaneously the heart loses its power ; the pulse becomes weak, frequent, and unsteady ; the vessels lose their tone, especially the capillaries of the most vascular organs, and congestions occur to a great amount; the brain becomes inactive, and stupor ensues; the medulla is torpid, and the powers of respiration and excretion are imperfect; voluntary motion is almost suspended; secretions fail ; molecular nutrition ceases; and, at a rate much more early than in other modes of death, molecular death follows close on somatic death—that is, structures die, and begin to run into decomposition as soon as the pulse has ceased; nay, a partial change of this kind may even precede the death of the whole body (Somatic Death—Dr. Prircuarp) ; and the foetid aphthous patches in the throat, the offensive colliquative diarrhea of persons in the last stage of various fatal diseases, parts running into gangrene, as in carbuncle, the sphacelous throat of malig- nant scarlatina, and the sloughy sores of the worst forms of typhus, and in the large intestines in dysentery, and the putrid odour exhaled even before death by the bodies of those 120 PATHOLOGY. who are the victims of similar pestilential diseases—are so many proofs of the early triumphs of déad over vital chemistry.”—Wiu1ams’ Principles of Medicine.) This mode of death is not recognised by some writers, but the truth of the above quotation will, I have no doubt, strike many who have witnessed the course and progress of the blood diseases of the domesticated animals; the extensive congestions and extravasations of black, tar-like blood, and its rapid decom- position in splenic apoplexy and quarter-ill; the gangrenous throat, and sphacelated patches of skin in purpura hemorrhagica and scarlatina; the putrid odour of the secretions and the aphthous patches of rinderpest, and the very general advent of an exhaustive diarrhcea in those cases which do not succumb to the shock of the disease; the peculiar odour exhaled, as well as the rapid decomposition of the whole body after death ;—indeed it may truly be said that decomposition of the blood has set in prior to death in many instances. The symptoms of the approach of death by necremia are generally as follows :—A dusky livid colour of the visible mucous membranes; slight exanthematous patches on the skin, pete- chial spots—in rinderpest these were thought to be small-pox pustules—or extensive extravasations and the production of a foetid gas subcutaneously ; oozing of a thin sanguineous fiuid from the nostrils or intestinal canal, or of blood in a semi-coagulated condition, extreme prostration of strength; the pulse accelerated, feeble, soft, sometimes presenting a double beat; twitchings of the limbs; dilatations of the pupils, the eye often fixed and staring, but sometimes with the lids closed; unequal and frequent respirations ; cold perspiration, and a gradual fall of the animal temperature. The horse will generally stand until the last, and will only fall from prostration ; it will then struggle in- effectually to rise. The cow and sheep, however, will lie down in the earlier stages of disease, and scarcely ever struggle to rise. The prognosis in all diseases which tend to terminate in necremia is seldom or never favourable, but it is generally con- sidered expedient to endeavour to avert the tendency to a fatal termination ; and there are certain considerations which may be useful guides to the practitioner to effect this end—namely, 1st. That such diseases tend to cause congestions of some organ or organs, as the lungs, spleen, stomach, and bowels, and conse- MODES OF DEATH. 121 quently means should be taken to prevent as much as possible the occurrence of such congestions by removal of the patient from the contamination of foul air or bad drainage, and the avoidance of gastric or intestinal irritants. 2d. That the blood to a varying extent loses its plasticity, and is apt to exude through the walls of the vessels into the looser and softer tissues, and there undergoing rapid decomposition, causes gan- grene of the tissue with which it is in contact, as in black- quarter, &c. Means must therefore be taken to overcome this condition of the blood-mass by the administration of the chlorate of potash, which has a remarkable effect in restoring both colour and plasticity to the altered blood by increasing its coagulability ; oil of turpentine, which is not only a most valuable antiseptic, but is also a styptic, and in virtue of its diuretic properties assists the kidneys in the removal of effete materials. Quinine, the mineral acids, and the salts of iron will be useful ata later stage, should convalescence be established. Ammonia and its salts are to be avoided, as they tend to decrease the blood’s coagulability. Eggs, milk, and, as some recommend, beef tea, may, however, be administered in the earlier stages of the maladies, and continued until there be a return of appetite. CHAPTER XII. PATHOLOG Y—continued. CLASSIFICATION OF DISEASES. A correct classification of diseases, at once simple and suggestive, is a subject of profound importance, essential to the existence of veterinary science, and necessary for its teaching; and were the veterinarians of Europe to assemble in a great congress, and there agree upon a system by which diseases might be named, defined, enumerated, and classified, they would indeed attain a great object. At the present time, however, the science of: nosology is very unsatisfactory as applied to the diseases of the. domesticated animals, and incomplete even in the science of human medicine. In a work of this kind it is necessary that I should refer to the efforts of physicians to arrive at a satisfactory system of nosology, and by reading books on medicine it will be found that diseases have been classified in different ways. In the system of Sauvages diseases were divided into ten classes—vitza, febres, phlegmasie, spasmi, anhelationes, debilitates, dolores, vesanic, flucus, cachexia. Linneus, Vogel, and Sagar’s classifications were also of this kind, and Cullen’s method was an unnatural simpli- fication of it, by which all diseases were arranged in four classes—pyrecice, newroses, cachexia, and locales. This system of classification is based upon the symptoms, and regards them as the essences of diseases; hence it is exceedingly unsatisfactory, and has been abandoned. Believing that nosology should be founded upon correct pathology, Pinel divided diseases into five kinds, namely, fevers, inflammations, hemorrhages, neuroses, and organic affections. This classification is necessarily imperfect from the state of pathological science in Pinel’s days, but it approaches very 122 CLASSIFICATION OF DISEASES. 123 nearly ‘the standard‘ of a pathological nosolog gy; was further developed by Bichat, and adopted by Dr. Craigie in 1836. ‘The results of modern investigations into disease prove that many ailments hitherto supposed t to be merely functional are in reality accompanied by organi¢ alteration of tissue; and it is not unreasonable to suppose that many of the so-called functional diseases will be found to depend upon an alteration of structure, and even where no organic change can be detected in cases where the existence oe disease cannot be doubted, we may attribute our failure to the imperfection of our means atid in- struments of investigation, or our modes of using them. Dr. Aitken, to whose works the reader is referred for further information, observes that “a perfectly philosophical or natural system of classification aims at having the details of its plan to agree in every respect with all the facts as they exist in nature, and to be, as it were, a ‘translation of the thoughts of the Creator into the language of man.’ To effect this end, arrange- ments, as they naturally exist, require ‘to be traced out, not devised. The tracks in which such a pursuit must be followed up, and in which our knowledge is as yet deficient, may be shortly indicated under the following heads, namely :— “(1.) The affinities or alliances of diseases with each other. (2.) The morbid anatomy of diseased parts. (3.) The com- munication, propagation, inoculation, generation, development, cause, and spontaneous natural termination of diseases. (4.) The connection of the phenomena recognised during life with the facts of morbid anatomy. (5.) The geographical distribution of diseases. (6.) The succession of diseases, as far as they can be traced through past ages; the peculiarities they have ex- hibited at different panied in the world’s history, or within comparatively recent cycles of years. “But the time has not yet come for a classification on a basis so comprehensive, simply because the material does not exist; and attempts to make so-called natural systems of arrangement must end in disappointment, on account of the uncertain and fluctuating data on which they must be based.” The arrangement of animal diseases, and their division into classes, groups, and orders, is a very difficult matter. They might certainly be arranged according to their pathology, to their causes, to the tissue or the systems of the animal body 124 PATHOLOGY. affected, or anatomically, according to the parts which they invade. The simplest plan, however, seems to me to be that adopted by Reynolds, namely, the division of diseases into two great groups. The first group includes those diseases in which the whole organism appears primarily and prominently deranged, and the second group those diseases in which special organs or systems of organs are in like manner affected. The first group is divided into two classes:—A, those in which the disease appears to be developed by causes operating from without; and B, those in which it depends upon change within the body. In the first class we have those diseases which are caused by atmospheric influences, contagion, and other external causes; and in the second, hereditary diseases, rheumatism, rickets, and other obscure bone diseases. The second group, or that in which special organs are diseased, is again subdivided into many classes, consisting of diseases of systems of organs, such as—A, diseases of the nervous system; B, diseases of the digestive system and its appendages; ©, diseases of the circulatory system ; D, diseases of the respiratory system; E, diseases of the urinary system; F, diseases of the reproductive system ; G, diseases of the locomotive system; and H, diseases of the cutaneous system. CHAPTER XIII. CONTAGION AND CONTAGIOUS DISEASES. THE origin of contagious diseases has been, and is yet to some extent, a matter of controversy. It is, however, generally accepted that they are caused by specific pathogenic micro- organisms, having the power of inducing specific morbid lesions when introduced into the animal body. Many writers assert that a contagious disease can only arise from the introduction of a specific microbe existing in the fluids and solids of a diseased animal into the body of another, and Koch laid down the following postulates, to which it was supposed there could be no exceptions; but further observa- tions have proved that there are many exceptions to his con- clusions, and an explanation is thus given to the belief in a spontaneous origin of a contagious disease. Koch’s postulates are as follows :— 1. The micro-organism must be found in the blood or diseased tissue of men or animals suffering from or dead of the disease. 2. These micro-organisms must be isolated from the blood, lymph, or tissues, and cultivated in suitable media outside the animal body. To obtain these cultivations pure they must be carried on through successive generations of the organisin. 8. A pure cultivation thus obtained must, when introduced into the body of a healthy animal, produce the disease in question. 4. Lastly, in the inoculated animal the same micro-organism must again be found. Although coming from such a high authority, these postulates must not be accepted in their entirety, for we have many microbic diseases where this form of origin cannot possibly have an 125 126 CONTAGION AND CONTAGIOUS DISEASES. existence. For example, septicemia originates from the acci- dental introduction into the circulation of surrounding external micro-organisms, naturally existing in the air, or within the body itself. Again, tetanus, now recognised as a microbic disease, is induced by an organism located in the ground. These examples might be multiplied, but will be referred to when dealing with microbic diseases specially. It may, however, be mentioned that these so-called non-pathogenic microbes are classified under the term saprogenic or putrefactive bacteria, and acknowledged that they play an important part in the economy of nature. The Koch postulates may be added to by including such diseases as rabies, rinderpest, South African horse-sick- ness, the poxes, &c., all of which are due to an organism, which is, however, too small to be seen with the present micro- scopes. We might also include those diseases which are due to an organism which has not yet been cultivated artificially, such as the Cryptococcus farcinosus of epizootic lymphangitis, and the protozoan organisms, such as trypanosomata and piroplasmata. Some of these multiply in dead organic matter, others pro- liferate accidentally within the body, their natural habitat being the external surroundings; but many of them can lead a double existence, saprophytes growing on dead organic matter, and parasites which lead their existence in a living host. Parasites which exist in and on living matter only are termed obligatory parasites ; those that lead a double existence facultative parasites ; and in addition to these ‘there is another class, called non-contagious facultative parasites, which live in their normal condition in the external media, and only inci- dentally develop within the living organism—which develop- ment is due to some loss of resistance on the part of the animal attacked. For instance, the Bacillus coli is a normal inhabitant of the intestine, but if an animal becomes low in resistance, due to the attacks of animal parasites (worms) or other cause, this organism may enter the liver and form an abscess, or set up an enteritis of the large intestine. The same may be said of the staphylococcus ; it is always present on the skin, but if an animal’s resistance be lowered it may gain a footing in the sub- cutaneous tissue and produce a pustulary eruption. These infections are undoubtedly microbic and also contagious, but CONTAGION AND CONTAGIOUS DISEASES, 127 it is very improbable that such infection would take place from animal to animal in the way that the more acute diseases, such as pleuro-pneumonia, &c., are conveyed. Other fatal infec- tions depend largely upon the aid they receive from other organisms, which also are alone practically harmless. For instance, tetanus, if injected in pure culture, would be very unlikely to cause harm, but if it be inoculated with a little garden mould and the many organisms of a saprophytic nature which that contains, the result would be fatal. The seat of inoculation has also a great deal to do with the production of the disease. The fatal Eastern Cholera, if injected subcu- taneously, does no harm; if, however, it be swallowed, the well-known fatal termination is often the result. Tn accordance with the above statement, pathogenic microbes are arranged under these heads— I. Obligatory parasites. II. Facultative parasites. Of the first it may be stated that their virulence is sometimes diminished, sometimes increased, but never wholly destroyed, whilst passing through the living organism, as in rabies, where the virulence of the yet undiscovered microbe is diminished whilst passing through the body of the monkey and increased in that of the rabbit. Some of them perish immediately on leaving their host, immediate transmission of the virus being essential, as in rabies, pleuro-pneumonia, and other diseases where inoculation or cohabitation is. necessary for the trans- mission of the disease. Obligatory parasites, more resistant, are preserved for vary- ing periods of time outside of the animal body, without, however, multiplying, and conveyed to healthy animals by various means, such as water, soil, clothing, &¢.—contact of a healthy with a diseased animal not being necessary. Facultative parasites are those which, as already stated, live and multiply not only in the bodies of animals, but also in external media,—dead organic matter, water, soil, and even food. Some of these lose their virulence whilst passing through the animal body, and the disease which they induce more or less quickly dies out. We can in this way account for the subsidence, or, as is sometimes the case, the total disappear- ance, of certain epizootics,—such as epizootic catarrhal fever, 128 CONTAGION AND CONTAGIOUS DISEASES. epizootic cellulitis, &c.—and for the sudden reappearance of these diseases. Whilst the majority of these parasites seem to have their virulence gradually attenuated whilst passing through the animal body, they still retain the power of trans- mitting their pathological effects, when conveyed by a diseased or newly recovered animal from one part of the country to another; hence it may be stated that a disease that has died out in one place owing to its virulence having been reduced in that place, or to the fact that the animals of that place have become immunised, may be virulent in another place, and be conveyed there by some animal which is resistant to the disease, but capable of carrying contagion, and giving it in a virulent form to others not having such resistant power, as was demon- strated by the introduction of smallpox in the West Indies. It often follows that after a severe and widely distributed outbreak of some epizootic the disease disappears for a long period of time; may it not be concluded from this fact that the germs have a resting stage, and that they are only called into activity by some telluric or atmospheric conditions, the nature of which has as yet escaped detection? Cognisable atmospheric changes have but little effect in calling the dormant virulence into activity, for we witness outbreaks of epizootic diseases in all kinds of weather. Long-continued wet or damp weather has sometimes an appreciable effect, but there are so many exceptions to this that it cannot be said to be a determining condition. It is already hinted that germs can be held in the air, in water, in the soil—particularly in the superficial layers—tfoods, stables, byres, sheep pens, vehicles, and utensils, as well as in the various secretions and excretions of animals suffering from their specific effects ; hence the importance of the destruction or disinfection of these carriers of contagion. CLASSIFICATION OF MICROBES. There are various systems of classification,—namely, of Muller, 1773, who established two genera—monas and vibrios—and grouped them with the Infusoria, but a scientific classification was not made until Ehrenberg in 1838 described four genera, namely :— CONTAGION AND CONTAGIOUS DISEASES, 129 I. Bacterium filamenti—straight, rigid. II. Vibrio- » —snake-like, flexible. TI. Spirillum » —Spiral, rigid. IV. Spirochete » —Spiral, flexible, Dugardin in 1841 united spirillum and spirochete, and classed them thus :— I. Bacterium filamenti—rigid, vacillating. II. Vibrio- » ——flexible, undulatory. NI. Spirillum » —Spiral, rotatory. And up to 1853 bacteria were considered as Infusoria; but Robin then pointed out their affinity to Leptothrix, and Davaine in 1859 demonstrated that they were vegetables and allied to the Alge, and his conclusions are now universally adopted. The classification of Cohn is now generally accepted, and he considers that the bacteria are a distinct group belonging to the Algee, and divisible into four tribes, including six genera. I. Spherobacteria—globules (Micrococcii). II. Microbacteria—short rods (Bacteria). If the length of a rod be less than twice its breadth, it is considered a bacterium, if longer, a bacillus. III. Desmobacteria—long rod (Bacillus and Vibrio). IV. Spirobacteria—spirals (Spirochzete and Spirillum). Cohn noted, notwithstanding the placing of them with the Alge, that the absence of chlorophyll connected the bacteria to fungi; and Negeli subsequently adopted this view, and termed them schizomycetes (cleft or fission fungi). We now recognise a group of parasites which has patho- genic members and belong to the group of animal parasites under the zoological family of Protozoa, many of which are pathogenic and cause such diseases as trypanosomiasis, cocci- diosis, piroplasmosis, &c. According to Dr. Stephens’s classification, the position of trypanosomes in the animal world is shown in the accompany- ing table, but this, says Professor Salvin-Moore, must not be accepted as fully proved, for, as yet, all known trypanosomes are parasitic, and their origin is unknown, and it is not possible to believe that parasitic protozoa have always been parasitic, 9 130 CONTAGION .AND CONTAGIOUS DISEASES. or could be so, and we feel sure that there is, or was, a non- parasitic form, or that they are different phases of some known non-parasitic Protozoa : Protozoa. ° Class. Sub-Class. Order. Genus. I. Rhizopoda ... Ameebina Entameba. Cercomonas. Herpetomonas (in| : : ig) peivs insects). II. Mastigophora | Flagellata | Protomastigina Trypanosoma. ; Trypanoplasma (in fish). Polymastigina | Trichomonas. _ Lambilia. III. Ciliata \ 1. Holotricha Opalina (in frogs). (Infusoria) f Balantidium Parameecium. Nyctotherus. Gregarina (in meal- vane Monocystis (in earth-worm). ( i ( | ( Coccidium 2, Coceidia | eee 2. Heterotricha IV. Sporozoa_ ... | Telosporidia | 1. Gregarinida rabbit, cattle, etc.). } Hemameba (malarial para- sites). Hemogregarina. ; Piroplasma, Nosema : silk- worms). i (in fish). Sarcocystis (in cattle). 3. Hemosporidia Neosporidia | Myxosporidia Sarcosporidia A word or two may now be said about the action of microbes: some of them excite fermentation, others putrefaction. The fermentative ones have the power of peptonising and liquefying culture media containing gelatine, and in many instances of producing a poisonous alkaloid—ptomaine—which causes toxic poisoning, a condition distinct from septic infection. The effect of septic poisoning depends upon the dose, a small dose produc- CONTAGION AND CONTAGIOUS DISEASES. 131 ing only mild and transient effects, whilst a large one may induce a fatal result; whereas in septic infection a small dose may in- duce severe disease and death, because the poison introduced is a living organism capable of propagation and numerical increase. The researches of Brierger have enabled him to isolate various ptomaines from dead bodies, putrid meat, fish, and cheese— cadaverin, putrescin, saprin, peptotovin, and many others, vary- ing in their toxic properties. Associated with or independent of the production of the poisonous alkaloids, a poisonous albumose is secreted in culture media, and in addition the following substances are evolved :—° (a.) Gases.—Carbonic acid, hydrogen, light carburetted hydro- gen, sulphuretted hydrogen, and ammonia. (b.) Nitrates, water, and sulphur. (c.) Volatile substances (trimethylamin, alcohol, formic acid, acetic acid, propionic acid, butyric acid. (d.) Fixed acids,—lactic, malic, succinic, oxalic, and tartaric. (e.) Taurin, leucin, alanin. (7) Tyrosin, phenol and kresol (aromatic bodies). (g.) Carbo-hydrates, albumoses, peptone, hydrolytic ferments. (h.) Colouring matters. When germs gain entrance into the animal economy, a kind of battle royal takes place between them and a defen- sive army of phagocytes, consisting mostly of white corpuscles, aided by the connective tissue corpuscles, the endothelial cells of the capillary vessels, soft epithelial and the cells of muscular fibres. These endeavour to arrest the invasion of the microbes by attempting to destroy them. When they fail in this the disease is developed, when successful in their efforts the disease is not developed; when the virulent germs are numerous and strong, they, in a susceptible subject, paralyse and overcome the phagocytes; but when the virus is attenu- ated, or when the subject is non-susceptible or immune, the leucocytes accumulate around the point of entrance, take up the germs into their substance and digest them; in fact, they kill and eat their enemies. Again, some germs are antagonistic to others, and it is now well known that the microbes of putrefaction are destructive to those of anthrax; but whilst anthracic blood and tissue are thus 9—2 132 CONTAGION AND CONTAGIOUS DISEASES. rendered impotent, it does not follow that they are rendered innocuous, for inoculations with such blood have proved that death may result, not from anthrax, but from septicemia ; and again, the ptomaines of pathogenic germs in many instances, when properly prepared, attenuated, and introduced by inocu- lation into the bodies of healthy animals, have the power of giving protection or immunity to such animals against the specific effects of the microbes themselves. A knowledge of this fact, first elaborated by Pasteur, has revolutionised modern medicine, and is likely to confer even greater blessings both upon man and the lower animals. No doubt, when the chemist and the botanist specialise more in discovering the special foods of the saprophytes and the various botanical groupings of these parasites, we shall, in a much better measure, be able to say exactly what processes are gone through by animals which are being immunised from one or other specific disease. I feel sure that this field is not nearly sufficiently exploited by the chemist. I am of opinion that the blood of each individual species of animal differs, and that each of these bloods contains, as identifiable chemical compounds, the various special pabula for the various organisms which give rise to specific disease, and I further think that when any one of these special pabula-enters into compound with saprophytes or with other specially prepared chemical compound, that pabulum loses its chemical identity and is so lost, so that if similar organisms enter the blood stream after that event they would be unable to find their special pabulum, and would consequently die without having had the opportunity of causing their own special disease. One of the most remarkable recent discoveries has been that of ‘‘opsonins,” and a very clear statement in regard to ‘opsonins”’ is contained in Dr. Geo. N. Ross’s address delivered recently in Birmingham, and in which Dr. Ross states the following, as taken from the British Medical Journal :— “In the early part of 1903 Wright and Douglas, of St. Mary’s Hospital, London, approached the problem of phago- cytosis from a totally different standpoint. They first separated the corpuscular from the fluid elements of the blood. That is to say, they obtained leucocytes suspended in a neutral CONTAGION AND CONTAGIOUS DISEASES. 133 medium instead of in the blood plasma, and the blood plasma (or blood serum) free from leucocytes or erythrocytes. They prepared an emulsion of staphylococci in normal salt solution, and found that if they brought together only the leucocytes and the staphylococci, practically no phagocytosis occurred, but that the addition of blood plasma (or blood serum) to the leucocytes and the staphylococci effected some change so that phagocytosis did occur. The obvious deduction was that the leucocyte by itself was impotent, and further that the blood plasma contained some substance which was essential to the attainment of phagocytosis. ‘Using ingenious methods of their own device, they in- vestigated the blood plasma in order to determine the char- acters of this phagocytic element, and the following are the most important of their conclusions : “1. The substance so essential to phagocytosis does not act upon the leucocytes (as a stimulant to the leucocytes, for example), but it combines with the micro-organisms and pre- pares them for phagocytosis: hence the name opsonin, from opsono, I cater for, I prepare victuals for. The conception of their mode of action is that the opsonins are carried in the lymph to the nest of microbes which are responsible for the morbid process ; that they chemically unite with the micro- organisms, and that then, and not until then, the leucocytes have the power of enveloping and destroying these micro- organisms. Thus it follows that the amount of phagocytosis which is observed is a measure of the quantity of opsonins present in any particular plasma, and does not represent the vital activity of the leucocytes. «9. The opsonins in a normal serum are almost completely destroyed by heating for ten minutes at 60° C. “3. The opsonins have been shown to be distinct from the bacteriolysins, the agglutinins, and the antitoxins. ‘“‘ Moreover, as shown by Bullock and Western, the opsonins have a high degree of specificity. For example, the blood of a person may contain half the normal quantity of opsonins necessary to combat a tuberculous infection, such as tuber- culous cystitis, and yet contain a normal amount of opsonins that have to do with an invasion of staphylococci, such as causes furunculosis. 134 CONTAGION AND CONTAGIOUS DISEASES. “* Teucocytes.—Wright and Douglas have shown by a striking experiment how invariable a factor the leucocyte really is. They obtained leucocytes both from an immunised patient and also from a normal individual. To a specimen of each of these they added some normal serum and also some staphylococci, and allowed phagocytosis to take place. They found that in the presence of normal serum the leucocytes of the immunised patient took up just as many staphylococci as the normal leucocytes in the presence of the same normal serum. They next took two portions of a suspension of normal leucocytes to which had been added some staphylococci, and mixed with one of these portions some serum from the immunised patient, and with the other some normal serum, and allowed phago- cytosis to take place. They then found that the leucocytes tu which had been added the serum from the immunised patient, took up about one-half as many staphylococci as did the leucocytes to which the normal serum had been added. .This affords striking testimony that the leucocyte is an indifferent or a constant factor in the phenomenon of phagocytosis. The amount of phagocytosis observed, therefore, represents the quality of opsonins present in the blood. So far as we can tell at present, plasma has nothing to do with the “ quality ” of the leucocytes. “« Bacterial Infections.—Certain generalisations have emerged from the investigation of numerous cases. “1. If the bacterial infection be strictly localised, the opsonic index of the blood, as concerns the particular microbe causing the infection, is below normal. For example, the blood of a patient who is suffering from furunculosis will probably show an opsonic index of about 0°6 to the infecting micro-organism—that is, to Staphylococcus pyogenes; or, again, the blood of a patient who is suffering from tuberculous glands in the neck will probably show an opsonic index of about 0°7 to the tubercle bacillus. In each case, the patient’s blood is compared with the blood of a normal man. “2. The second generalisation has to do with those infec- tions which are not strictly localised. In such cases the opsonic index will be found high at one time and low at another; that is, the opsonic index in systemic infections tends to fluctuate from high to low. This characteristic is CONTAGION AND CONTAGIOUS DISEASES. 135 well shown in cases of acute pulmonary tuberculosis. Dr. Ross has oftened observed one day an opsonic index 1°6 in such a case, and an index as low as 0°6 a few days later. “These two generalisations are of primary importance both as concerns the diagnosis and the treatment of bacterial in- fections. “‘ Treatment.—Briefly stated, the treatment of a bacterial in- fection, by Professor Wright’s methods, consists in increasing the antibacterial substances of the blood, by inoculating the patient with dead micro-organisms of the same species that has caused and is maintaining the morbid process. This is the general principle. “The first essential in the treatment of a given case is to learn the particular micro-organism which is responsible for the patient’s infection. In a case of furunculosis, for example, we know that the Staphylococcus pyogenes is almost certainly responsible, and so with certain other localised infections the organism is well known. When, however, we have to do with an empyema, or with a cystitis, we only know that one of several organisms is the chief offender. The particular organism is isolated by ordinary bactericlogical methods in pure culture and identified. The quantity of those opsonins present in the patient’s blood which have to do with combating this particular micro-organism is then estimated, and is, as a rule, found to be deficient.” -When “ opsoninism”’ is thoroughly understood, we shall have one of the most effectual, or the most effectual method of prophylaxis ever dreamt of. Many microbes that require a free supply of oxygen are called aérobic, whilst others seem to be destroyed or fail to grow -when oxygen is present; these are called anaérobic. Some, however, can live and grow with or without oxygen. Microbes are consequently divided into three groups by Liborius :— L Obligatory anaérobes, which flourish in the absence of free oxygen—eg., Bacillus butyricus, and of malignant cedema. Il. Facultative anaérobes.—These grow in free oxygen, but continue to live and multiply, but more feebly, in the absence of it—eg., Koch’s comma bacillus. III. Obligatory aérobes, which do not grow in the absence of oxygen—eg., Bacillus anthracis and Bacillus subtilis. 136 CONTAGION AND CONTAGIOUS DISEASES. Pleomorphism.—Lister in 1873 (Quarterly Journal of Micro- scopic Science) indicated that several micro-organisms in their life-cycle exhibit successively the forms of cocci, bacteria, bacilli, and streptothrix. This view is now generally adopted; and Lankester, also in 1878, observed a series of form-phases in the case of a peach-coloured bacterium, which led him to suppose that the natural species of these plants were within the proper limit protean, and that the existence of true species of bacteria must be characterised not by the simple form-features used by Cohn, but by the ensemble of their morphological and physio- logical properties, as exhibited in their life history (CROOKSHANK). Again, Chauvin has pointed out that the Bacillus pyogenicus, by modifying the basis on which it grows, may assume succes- sively the character of a coccus, a long thread, or a spirillum. This theory of pleomorphism is generally but not universally accepted. It is also stated by some observers that bacteria are not constant in their properties, and the experiments of Negeli, Davaine, Buchner, and Wernich seem to indicate that both the morphological and physiological characters of microbes are mutable, that changes in the nutrient medium may have effect on their form and size, on their mode of multiplication, and on their physiological and fermentative properties. Negeli says that a given bacillus does not invariably produce bacilli of the same structure, and does not always pass through the same developmental stages. A bacterium which under given conditions gives rise to a definite fermentation may lose this property when cultivated under other conditions, and Buchner states that the hay bacillus can be transformed into the Bacillus anthracis. He says if hay bacilli are injected into the blood of animals they do not give rise to anthrax. If, however, they are bred for several generations in meat extract, and then in the arterial blood of the rabbit, they acquire noxious properties, and give rise to anthrax in mice after two to nine days’ incubation; and conversely, if anthrax bacilli are properly cultivated, they can be transformed into bacilli whose properties are identical with those of hay bacilli. Without entering into the question: of the mutability both of form and physiological properties of micro-bacteria, rejected by many observers, it is satisfactory to know that the change in their power of virulence brought about CONTAGION AND CONTAGIOUS DISEASES, 137 by cultivation and attenuation, which has already done so much for the prevention and even cure of microbic diseases, will yet do more in assisting in the suppression of many others. Period of Incubation.—The period of latency, or that interven- ing between the reception of a disease-inducing microbe into the economy and the manifestation of the effect, varies very consider- ably. Some of the most virulent produce their deleterious effects in a very short time, while others have a prolonged period of in- cubation. For example, splenic fever and death may be induced in a few hours after inoculation, whilst the deleterious effects of the pleuro-pneumonia contagium, or that of rabies, may not be developed for weeks or even months after introduction into the body. Some contagious poisons again seem to affect one class of animals: thus pleuro-pneumonia is peculiar to horned cattle ; epizootic eczema originates in cattle and sheep, but is capable of transmission by direct contact to many other animals, and even to man; glanders affects the horse and ass, but is com- municable to man, dogs, sheep, goats, rabbits, and mice by inoculation; and rabies, originating in the dog, is capable of transmission to the majority of animals and to man by inocula- tion. These peculiarities in the action of morbid poisons are mysterious and unaccountable. We must, however, accept them as facts that investigation may some day throw light upon. Contagious diseases, whether induced by obligatory or by facultative parasites, may assume an enzootic, epizootic, or even panzootic character, the great feature of which is a tendency to spread rapidly, attacking large numbers of animals in a short space of time, destroying many and incapacitating a large majority. The term epizootic is derived from the Greek, Er, upon, and Saov, an animal. Diseases of this order are said to arise from enzootic influences—from Ev,in,and S@ov,an animal. Enzootic influences are those peculiar to certain districts, and result from conditions or agencies peculiar to a locality, which favour the development of various miasmatic diseases, such influences be- coming epizootic, or affecting the many, from causes as yet unknown. In this order of diseases may be included the catarrhal fever or influenza which prevails more or less at all times amongst the horses of large cities and certain localities. Such diseases may be said to dwell in certain localities, having, 138 CONTAGION AND CONTAGIOUS DISEASES. however, the tendency to spread rapidly. They are then said to be epizootic, or even panzootic. Research during the past decade has been so successful that there have been discovered the causal agent of very many diseases, some of which were believed to be miasmatic, and others, again, to be climatic. Our knowledge is now so far advanced that we are enabled to divide the causes of all of our known contagious and in- fectious diseases into three great classes, but this division still leaves us much more matter to be elucidated. The first class we shall refer to and deal with is that of “The Contagious and Infectious Diseases”’ due to, as yet. undemonstrable organisms, each of which has the power of producing a toxin which has specific action on one or more tissues and organs of the body. It is probable that when our powers of observation are more perfect, we shall be able to demonstrate the causal agent; but as yet neither can we see it, nor can we filter it out of tissues, fluid or otherwise, in which we are convinced it is present. Perhaps our hypothesis is wrong, and the causal agent of these diseases may be a diastase such as amygdalin or emulsin. The fact, however, remains that some vital reaction is necessary to produce the substances that cause such serious and fatal results as is seen in diseases which are caused by what are known as ultra-microscopic organisms. But whether that substance is a toxin or a ferment it is impossible to say until the causative organism producing it is demonstrated. CHAPTER XIV. THEORIES OF INFECTION. Tue method by which contagion or the organisms or virus of an infectious disease gain an entry to the animal’s body has given rise to much speculation. It is, however, of no doubt that animals are affected only when their susceptibility to any particular disease is increased—that is, when their natural resistance is lowered. The resistance of the body is due to the fully active condition of that body, and depends entirely upon a certain combination of the cellular and fluid tissues of the blood and organs being in a sufficiently virile state, so as to be able to prevent pathogenic organisms from producing any untoward effects, either by so uniting with them or their poisonous products as to render them inert, or to actually kill and digest these organisms, and so prevent them producing any poisonous properties. Various theories have been intro- duced to show how this infection or the resistance to it is effected. They are known as the Cellular Theory, whose chief exponent is Metchnikoff; the Humoral Theory advanced by Ehrlich ; and latterly a combination of the two has been demonstrated by Wright, and is known as the Opsonic Theory. Ehrlich explains the humoral theory by an ingenious method, showing that in the body there exist molecules of matter which may be acted upon in a deleterious manner by toxins or the bacteria which produce them. These cells are, however, protected by substances which they throw off. The molecule has what are known as receptors, which are ordinarily the recipients of food-stuffs, but which may attract the receptive properties in the. toxin or bacterial poison. These receptors may only join with such receptive properties as will 139 140 THEORIES OF INFECTION. combine with them whether they be the poisonous properties of disease or the natural food-stuffs. If such a union takes place to excess, in the case of disease, then an animal becomes infected. In an animal that has some resistance, this union will stimulate the molecules of matter to the production of fresh receptors, and then in such quantities that they become cast off and free. In this free state they will still unite with the receptive or haptophore group of the toxin, but, being free, the harmful effect of this toxin is unable to operate, as itis unable to affect the original animal cell which produced the receptor, It is therefore due to the excessive production of receptors that immunity is established, and their excess receptors are the antitoxins. If by artificial means this immunity is strengthened, the animal’s blood may furnish a fluid which, upon injection into another unimmunised animal, will provide that animal also with a temporary immunity, which, upon the excretion of all the fluid injected, will pass away. The theory, when applied to the actual invasion of the blood by bacteria, is somewhat more extended, but the same principle applies. The invading organism possesses a haptophore group which combines with the receptor of the animal cell, and so allows the toxophore, or poisonous property of the organism, to attack and destroy that animal cell. If, however, receptors or side chains are cast off in excess the action is nullified. In this case the receptors are known as the amboceptor or immune body, which has two groups—the cytophile group, by which it joins on to the bacterium, and the complementophile group, by which it joins the alexin, or ferment, and allows of this substance, which is normally present in all animals, to destroy the offending bacterium. The alexin is a normal ferment in the body, but is unable to act unless the bacterium be joined to it by the action of the amboceptor, or immune body. The cellular theory demonstrated by many experiments of Metchnikoff explains immunity in a much simpler manner. The leucocytes or phagocytes are the chief factors in the pre- vention or elimination of infection. If an animal’s resistance is high, if is necessary that its leucocytes should be imme- THEORIES OF INFECTION. 141 diately ready to attack and destroy by ingestion and digestion the offending bacteria; if they are unable to do so, then the animal becomes infected with disease. If the body juices have any bactericidal effect upon the invaders, Metchnikoff thinks that this effect is produced by the action of a product of the leucocytes. The term negative chemiotaxis is applied when the phagocytes show a dis- inclination or inability to attack the bacteria, and a contrary condition is known as a positive chemiotazis. The Opsonic Theory.—Wright has demonstrated another theory by which immunity or infection is accomplished. This is a combination ot the above two theories. The phagocytes are the main factors, but they are unable to perform their duties of ingestion and subsequent digestion unless the bacteria have been acted upon by a substance which Wright has called opsonin. It is a normal product of the blood, but may be more or less in quantity ; if there is a sufficiency, the bacteria are so acted upon and prepared that their ingestion by the phagocyte becomes a simple matter; if they are not sufficient, then the phagocytes cannot act, and a severe invasion of the organism by the bacteria results (see p. 184). The above is only a very short sketch of the immense subject of immunity, and further reference should be made to the works dealing with this subject alone. In each of the above theories it is conceded that the immunisation from a disease is the result of the formation of a specific immune body. Ehrlich thinks that each disease requires the formation in the body of an amboceptor which is specific for only one disease, and if this be not present and the animal still remain immune, the immunity is due to that animal not possessing suitable receptors for that particular disease. In the cellular theory it is conceded that this is what Metchnikoff calls a fixatewr, which corresponds to the ambo- ceptor, or immune body, and this also acts specifically to one disease only. In the opsonic theory each particular disease requires the development of a specific opsonin for that disease. It will thus be seen that the animal organism, according to the above 142 THEORIES OF INFECTION. theories, must, like a chemical factory, be prepared to furnish numerous immune bodies whose function it is to prepare harmful organisms for the fermentative or phagocytic action which is necessary for their destruction. It must be understood that the above are all theories, although it is possible to demonstrate by the aid of the micro- scope both the cellular and opsonic theories. The humoral theory can only be demonstrated by deduction. It is very possible that both are correct; and it is a combination of the two that prevents us all suffering from bacterial invasion and extinction. CHAPTER XV: IMMUNITY. Immunity may be divided into active and passive, the former being the result of the immune body in the blood having its origin in the animal itself—i.c., the animal produces it. It is the sequence to recovery from a specific disease, or the intro- duction of a vaccine. The vaccine is a substance formed of the organisms themselves, and introduced in a weakened or harmless form incapable of producing the disease, but retaining the power of stimulating the animal economy to the production of antibacterial bodies. A passive immunity is the sequence of the introduction into the system of immune bodies, and which only remain until in the ordinary course they are eliminated by the excretory organs. The animal is incapable of producing fresh immune bodies itself. This immunity may be accomplished by the injection of an immune serum, and is necessarily only temporary. It has been found that there are substances connected with the subject of immunity which are demonstrable in the blood serum. The composition of these substances is problematical, but their action upon bacteria is specific. Agglutinins.—It has been noticed that the serum of animals suffering from, or having recovered from, an infectious microbial disease, is capable of affecting the organisms producing that disease in a marked manner. If a mixture of a serum of a typhoid patient be mixed with a young broth culture of typhoid bacilli, these bacilli may be observed under the microscope to gradually collect together into clumps, and lose their mobility. A control is made by preparing the organisms without any serum, but in a solution of normal 143 144 IMMUNITY. salt, and no clumping will be observed. This phenomenon is known as agglutination. The same result may be obtained in many diseases, but it is not so marked as in what is known as ‘“‘Widal’s reaction” in typhoid, and by which a certain diagnosis of the disease may be made. The reaction may also be observed by the action of normal serum when it is undiluted, but its specificity is demonstrated when this serum is capable of producing the result if greatly diluted, and the reaction follows in a comparatively short time. For instance, serum from a typhoid patient diluted in sterile normal salt solution up to some hundreds of times will still cause agglutination in half an hour, but this would not be so in a person whose resistance had not been raised by the stimulation of the presence of the organisms. Agglutination is therefore an indication that the animal may possess some resistance to the specific infection. The phenomenon may be observed macroscopically in ordinary blood pipettes, and this is probably a better method than the microscopic one. . Precipitins are substances like the above, and cause a very similar reaction, which is observed in blood pipettes or tubes, by mixing the organisms with a given dilution of serum and testing the time taken for the organisms to be collected at the bottom of the tube. A sedimentation due to gravitation will always show the sediment of bacteria with a concave meniscus, but if by the action of the precipitins, the sediment will have a flat upper surface. This method is used largely in the differentiation of varieties of meat and blood. If an animal is injected repeatedly with the blood or muscle of an animal of a different species, its serum will acquire the power of acting upon the blood or muscle juice of that other animal and producing from it a precipitate, by which a definite diagnosis can be made as to the source from which the meat or blood was obtained. It is essential in the application of any of the above tests that a control be made by mixing with the bacteria or fluid to be tested a solution of sterile normal saline, and observing that the agglutination or precipitation only occurs in the tube containing the specific serum, and not in the saline tube. Aggressins are a product of bacteria, and obtained from i IMMUNITY. 145 inflammatory exudates in the body of an animal. Their action appears to be to paralyse the cellular elements of the blood and to so prevent phagocytosis. They are, as it were, the antipathy of opsonins. . Bacteriolysins.—Pfeiffer inoculated cholera vibrios into the peritoneal cavity of a rabbit immunised against cholera; he then at intervals withdrew the fluid from the cavity, and observed the action of the exudate upon the organisms. He found that they lost their motility, became broken up into coccoid forms, and finally disappeared. This is known as Pfeiffer’s phenomenon, and is a bacteriolytic action. The substances causing it are bacteriolysins, and may be demon- strated in a variety of microbic diseases in the serum of animals immunised against specific organisms. These substances are destroyed by a temperature of 55° C., but their activity may be reintroduced by the addition of normal serum from an unimmunised animal, which shows that the heating does not destroy the specific ferment, but only the alexine or complement which is present in all normal blood, and necessary for the union of the amboceptor or immune body to the specific organism so causing the latter’s disintegration. Hemolysins.—It has already been mentioned that if an animal of one species be injected with the blood corpuscles of an animal of another species, the injecjed animal will acquire the power in its serum of dissolving the red blood corpuscles of the animal with whose biood it has been inoculated. The substance producing this soluble action is known as hemo- lysin. Cytolysis—This—a similar action—is not confined to red cells, but may be demonstrated in the same way with other animal cells, such as spermatozoa. For instance, if the spermatozoa of a horse be injected into the blood of a rabbit, the rabbit’s serum will have the property of immobilising the spermatozoa in vitro, and finally dissolve them, and the same may be accomplished with leucocytes, &c. The rule as to the application of heat is the same in all these substances—such as agglutinins, precipitins, &e.—as already explained in con- nection with bacteriolysins. It must be understood that in all such demonstrations it is necessary to hold control experi- 10 146 IMMUNITY. ments—i.¢., a tube containing non-immunised serum together with specific substance to be tested, must be treated in the same way as the one containing the immunised serum. In the case of hemolysins, the corpuscles in the control tube will simply sink to the bottom, but those in the. tube containing immunised serum will become dissolved, and a generalised red staining of the fluid will result. CHAPTER XVI. CONTAGIOUS DISEASES. CATTLE PLAGUE. Synonyms.— Rinderpest (G.); Typhus bovum contagiosus! (L.); Fiévre pestilentielle du gros bétail (F.). Definition. A specific, malignant, and contagious fever. It is indigenous to the Asiatic steppes of Russia, also Hindostan, Persia, China, Burmah, Cochin-China, Thibet, Ceylon, &c., never occurring in this country but as the result of direct or indirect communication between imported cattle (which have been exposed to the contagium) and those of our own shores. It is the scourge of South Africa and of India, but is unknown in America and Australia. The disease has a period of incubation of three days, at the end of which time its local manifestations are developed. It runs a definite course, and usually terminates fatally ; but where recovery takes place the animal is rendered unsusceptible to another attack. It is essentially a disease of the bovine family (the ox, auroch, and zebu), but it may be communicated to the sheep, goat, deer, camel, giraffe, antelope, gazelle, and even the peccary. It is said that an accidental inoculation of the human skin with the juices of an animal which had died of rinderpest has caused the formation of a pustule similar to that of variola vaccina.—(See Appendix to the Third Report of the Commis- sioners appointed to inquire into the origin, nature, &c., of the Cattle Plague, page 79.) 1The word contagiosus was introduced into medicine by Vegetius, and is now recognised as a generic term. et 10—2 148 CONTAGIOUS DISEASES, PATHOLOGY AND SYMPTOMS. The specific contagium absorbed into the blood gives rise tc primary fever. This fever, as indicated by a rise in the temperature, precedes all other symptoms, and occurs in a period ranging from thirty-six to forty-eight hours after an animal has been inoculated. The elevation of temperature varies to some extent. As an average of the normal tempera- ture of the healthy ox during different periods of the day, 101° may be accepted. During rumination it may be as high as 103°, and may then fall to 100°, or even lower. Taking 101° as the standard average, it has been found that the tem- perature. rises in seventy-two hours to 103° or 104°, this elevation of temperature occurring when the animal appears to be otherwise perfectly well. From this we learn that the true period of incubation—latency—is very short indeed, and that, although there are no symptoms visible to the ordinary observer, the disease has actual existence. Two days after the perceptible rise of temperature has begun, an eruption on, and a peculiar appearance and condition of the mucous membrane of the mouth is seen, having some resem- blance at first sight to the appearance of that found in the foot- and-mouth disease. In some rare instances, however, this characteristic symptom has been absent. I have seen it in every case of the plague but one which has fallen under my own observation, and usually veterinary surgeons have been able to diagnose the disease by its presence. Almost simultaneously with this appearance of the mouth, the mucous membrane of the vagina of the cow becomes peculiarly altered. One or other of these signs is rarely absent; so that when they are taken in connection with the elevation of the temperature, the diagnosis of the disease can be made with certainty. On the day following the eruption in the mouth, or about seventy-two hours after the first elevation of temperature, the animal may be observed to be a little ill, to have less appetite than usual, and to ruminate irregularly. Even at this time, however, the pulse may be unaltered. On the following day, the fourth from the first rise of temperature, the animal, for the first time, shows marked symptoms of illness; and this period, which may be one hundred and ten hours after the real CATTLE PLAGUE. 149 commencement, is usually considered by superficial observers as the beginning of the disease. The seriousness of the oversight is obvious, on account of the great importance of the earliest possible separation, isolation, or more particularly the slaughter of the diseased animal, and of all cattle with which it may have been in contact. After the fourth day is over, the constitution is thoroughly invaded. Then ensue the urgent symptoms—the drooping head, hanging ears, distressed look, rigors and twitchings of the super- ficial muscles, failing pulse, oppressed breathing, foetid breath, and the discharge from the eyes, nose, and mouth. During the sixth day there occurs a great diminution of the contractile force of the heart and voluntary muscles, the pulse becomes feeble and thready, the respiratory movements are modified, and the animal sometimes shows such weakness in the limbs that it has been thought that some special affection of the spinal nerves must exist. The temperature now rapidly falls, and signs of a great diminution in the normal chemical changes in the body present themselves. : Death usually occurs on the seventh day from the first per- ceptible elevation of temperature. Although this is given as the typical course of the disease, there are great deviations from it, as some animals live a longer, many a much shorter time, and the severity and sequence of the symptoms vary considerably. Rinderpest is caused by an organism of the ultra-visible group. This organism cannot be filtered with undiluted blood ; but if the fluidity of the blood be increased by the addition of citrate of soda and normal salt solution, it will pass through a Chamberland filter and the filtrate be as virulent as the blood itself. The virulence is demonstrable before any actual clinical symptoms are noticed, and later all the tissues, fluids, exudates, and excretions of the body are virulent, except the bile, which, as Koch showed, may be used as an immunising agent. The morbid poison is also contained in the discharges from the mouth, eyes, intestinal canal, &c., of an animal ill from the cattle plague, and that, in a small quantity of the mucus from the nose, eyes, or mouth, when placed in the blood of a healthy animal, increases so fast, that in less than forty-eight hours, 150 CONTAGIOUS DISEASES. perhaps in a shorter time, the whole mass of blood, weighing many pounds, is infected, and a very small particle of that blood contains enough poison to give the disease to another animal. This at once accounts for the rapid spread of the cattle plague. It has not been determined to what length of time the blood and textures retain the power of propagating the disease. Professor Jessen of Dorpat, however, says that the mucous discharges, carefully protected, occasionally retain their power of causing the disease by inoculation for no less than eleven months. The virus, which is both volatile and fixed, can be diffused and the disease communicated by the air for a distance of about fifty yards; but beyond this distance it remains in- operative. It is also conveyed by flies, which, after resting on a sick animal, or its offal, fly about and alight on healthy animals ; and by the offal of animals dead of the disease ; by hay, bedding, dung, vessels, men, dogs, conveyances ; in fact, by any material contaminated by a diseased animal. The contagium is destroyed by dry air, by a temperature of about 140° F., by chlorine, carbolic acid, &c., and, it is stated, by putrefaction. It is difficult to keep infected blood for any time, and in order to convey blood for experimental purposes, it is necessary that it should be kept in ice, and even then its virulence may not last more than four to five days. It is therefore the more astonishing how it is kept for so long in a natural state. If, however, the infection could be traced, it would be found that it had been carried, owing to carelessness from a more or less recent infection, either by men or insects contaminated with infected material. The fever, as shown by the elevation of the temperature, begins when the poison has infected the whole mass of blood, or within from about forty to sixty hours after its first entrance into the system. Coincident with the elevation of temperature, the chemical changes in the body are augmented, and, according to Dr. Marcet, one of the products of degradation of tissue—the urea—is largely increased. Soon afterwards the blood is other- wise altered, the amount of fibrin largely increased, the amount of water lessened, and the physical condition of the albumen CATTLE PLAGUE, 151 altered ; and, according to Dr. Beale, the proportion of soluble substances is also largely increased.! About the third or fourth day local congestions are to be seen on the skin and visible mucous membranes, varying in intensity and in size. Stagnation takes place in the small capillaries of many parts of the body, the blood in which becomes coagulated. A great increase of granular matter is found to occur both within and without the vessels of the congested parts. The 1)2/3)4/5}6)7] 8) 9) lol | 12) 13 | 14] 16) 16 | 17 | 18) 19 | 20 EME E EIMEIME E ‘simultan- Rinderpest 75cc | of Inoc, = Ss § wy e awe Temperature : Large M I Eosinophil os sseereereesreee Total Leucocytosis———— = Small 00. eaweeenna - Polynuclear Neytrophils——- Transitional -------------- Fic, 9p. capillaries become greatly enlarged, and the spaces between them lessened or obliterated. At the same time considerable 1 The following abstract from a Report by Captain Baldrey in 1906 on i is of great interest : sr seh to te blood in rinderpest observations, a study of the charts (Figs.9B and 9c) will give a clear idea of the rapid changes which take place in the leucocytic elements. There is a very marked leucocytosis, which may be divided into two periods, the primary and the secondary. The extraordinary feature of this primary leucocytosis is its suddenness. Twenty-four hours after inoculation with rinderpest virus there is an immediate rise to as much as three times the normal, the maximum may not be obtained until the second or third day after inoculation, or concurrent with the first rise of _temperature. There is then a fall which is not quite so sudden, and attaining its minimum about the fourth or fifth day—i.e., twenty-four to forty-eight hours after the access of 152 CONTAGIOUS DISEASES. nutritive alterations take place in the mucous membrane and skin, leading to very rapid and imperfect growth of many of the cellular elements, and followed by rapid disintegration and detachment in the form of discharges. As that portion of the OF 7 2 3 q 6 6 7 8 9 fo) 12) 13 TiME M M E\M E|M EIM EIME E|M E|M E|M EIM EIM E E Temperature (Fahrenheit) Leucocytosis in Thousands 3 (8 ey very foul and of Inoculat Disappeared. 2 3 = ® 0 Temperature —_—_—_—_——_—_—_—_ Small Mononuclear ---+- Total Leucocytosis —1—1—1—1—1—1— Transitional - Polynuclear Neutrophil! ——————— Eosinophil Large Mononuclear —-—-—-—-—-—-— Fic. 9c, mucous membrane which is most essential for digestion ig most affected, the appetite soon fails, rumination ceases, and the fever. The highest rise recorded was 32,000, and this occurred in a variety of cases on the second, third, and fourth day. The lowest was 18,000. The secondary augmentation is more gradual than the initial, and attains its maximum on the seventh day after inoculation—i ¢., the third to fourth day of the fever. This ascent was never so pronounced in an ordinary case of rinderpest as the first rise. The highest recorded was 26,000, and the lowest 17,000. If the animal lives, there will then bea fall, and the secondary minimum will be lower than the initial, reaching, I found, as low as 7,500 per cubic millimetre.’ CATTLE PLAGUE. 153 large accumulations of undigested food are met with in the first stomach. In many cases the villi of the small intestines are so destroyed, that even if food were taken it would scarcely be absorbed in sufficient quantity to maintain life, and hence the rapid exhaustion, failure of the heart’s action, depression of the animal heat, and general sinking of the powers. In some cases, when the process is more superficial, the mem- brane rapidly recovers its healthy condition ; and it is curious to find that one affected part may be healing while another is just beginning to suffer. When, as sometimes happens, the mucous membrane most affected by the congestion is that of the bronchi, the phenomena are not less severe; indeed, the disease is sometimes even more rapidly fatal. A slight cough is soon followed by accelerated breathing, which rapidly increases; and, according to Drs. Sanderson and Bristowe, the difficulty in breathing becomes so great, that some of the pulmonary vesicles are broken, and emphysema, not only of the lungs, but of the subcutaneous tissues of the neck and back, is thus induced. I cannot, how- ever, endorse this, being of opinion that both the pulmonary and subcutaneous emphyseme are due to the formation of gases in the areole of the connective tissue. With reference to the true nature of the cattle plague, and its identity with or resemblance to various human maladies, many theories have been advanced by writers upon the disease. Some have considered it to be the precise counterpart of typhoid or enteric fever, and this view has been held by the German pathologists for a considerable period, and was undoubtedly the view held by most veterinary surgeons who had the oppor- tunity of witnessing it in this country. Dr. Murchison, however, successfully combats this view, and very lucidly points out its error. He says: “ Human enteric fever is characterised by definite and easily recognised anatomical lesions; and for my own part I have been unable to discover any analogy whatever with them in those of rinderpest. The alterations in Peyer’s patches in the latter disease are clearly the result of the general inflammation of the mucous membrane, and tend to obliterate the glands, instead of rendering them more prominent. Their resemblance to the lesions of enteric fever is much less than that of the condition of the corresponding glands in cases of cholera, small- 154 CONTAGIOUS DISEASES, pox, scarlatina, pyzemia, and other blood diseases. It is probable that the diminution in the size of Peyer’s patches in rinderpest, as compared with the glands in a healthy ox, may be due in part to the length of time that has elapsed since digestion has been arrested, as it is well known that these glands are larger and more developed during the digestive process than during fasting. But, whatever be the cause, nothing can be greater than the contrast between the appearance of these glands on the tenth day of rinderpest and on the corresponding day of human enteric fever. In the former case the glands have almost, if not entirely, disappeared ; in the latter they are enormously prominent, owing to abnormal deposit in and around the glandules.” Dr. Mur- chison quotes the writings of several observers, who agree that the intestinal glands are not enlarged; on the contrary, that they are usually diminished in size, often covered over with a layer of discoloured and softened mucous membrane.” “Peyer's glands,” says Professor Simonds, in his Report on the Cattle Plague, published in the Royal Agricultural Society's Journal, 1857, “are not invariably diseased; but like other follicular openings of the digestive canal, they are often covered with layers of lymph, beneath which ulceration is occasionally ob- served, but more frequently the surface is healthy, although tinged with blood.” After further comparing cattle plague with typhus, influenza, dysentery, erysipelas, scarlatina, and variola, Dr. Murchison concludes that cattle plague has no resemblance to typhoid fever, typhus, scarlatina, erysipelas, influenza, or dysentery, but that it resembles small-pox. The promulgation of this theory during the prevalence of the plague in 1866 led to the belief that vaccination would prove a preventive, and immediately cattle all over the country were vaccinated, very much to the benefit of the vaccinators but not of the cattle, for it proved a total failure; except, indeed, that it confirmed the view that rinderpest was not variola, but a disease having some resemblance to cholera, scarlatina, and to diphtheria, at the same time having characteristics of its own which separate it from all other diseases, and prove it to be an incurable and highly contagious malady, very properly denomi- nated “the cattle plague.” Mr. John Gamgee, in his work on the Cattle Plague, very CATTLE PLAGUE, 155 successfully controverts the conclusions of Dr. Murchison, and if the reader is desirous of further information he may consult that work with great advantage. In addition to the general symptoms of cattle plague which are embraced in the foregoing observations, the more particularly visible signs are worthy of notice; and these are shivering, muscular twitchings, restlessness, often a husky cough, yawning, sometimes great dulness, with drooping of the ears, sometimes excitement approaching to delirium, appetite at first capricious, but soon becoming entirely lost, suspension of rumination, and secretion of milk arrested. The latter symptom was one of great significance amongst cattle owners during the prevalence of the plague, the arrestation being much more sudden and complete than in any other disease. Theshiverings and muscular twitchings are not always observable in the earlier stages of the disease, but often seem to usher in the second stage, when the symptoms pre- sent a more aggravated character. The animal now incessantly grinds its teeth, arches the back, and draws its legs together, moans, and otherwise shows signs of much uneasiness. The eyes, mouth, and nose are at first dry, hot, and red; the legs and ears are generally cold. At first the bowels are constipated, but this condition is succeeded by violent purging, and the dry con- dition of the mouth, nose, and eyes is followed by a discharge of a glairy watery character, soon assuming an opaque or turbid nature, which is very typical of the disease. The respiratory movements are generally but not always accelerated; the in- spiratory movement is quickened, whilst the expiratory is rather prolonged, and accompanied by a low moan. The colour of the visible mucous membranes becomes pecu- liarly altered. In some cases they present a characteristic salmon-red colour over their whole extent, with deep crimson-red patches interspersed here and there. Dr. Sanderson, in his Report to the Commissioners, and Pro- fessor Gamgee, in his book on the Cattle Plague, quote the observations of Jessen and other Continental veterinarians. Jessen says—< The appearances observed by me on the mucous membrane of the mouth, both in the natural and inoculated disease, are as follows:—‘In some cases, small round nodules, seldom larger than a millet seed, are observed, which are still covered with epithelium, through which a yellowish or yellowish- 156 CONTAGIOUS DISEASES. grey material can be distinguished. A few hours later (some- times not till twenty-four hours) the epithelium gives way, and the contents become visible; hence results a superficial lesion, which, after the removal of the material lying upon it, is scarcely recognisable; it heals in a few days, leaving no cicatrix. In other cases these nodules become confluent, and then give rise to an excavated ulcer of considerable extent, with irregular margins, which, however, usually heals quickly, leaving no cicatrix. In another form of the affection the epithelium is raised in the form of small vesicles, which contain either a clear or slightly turbid fluid, and leave behind shallow, round excavations, with smooth edges.’” Dr. Brauell of Dorpat, who has made very extensive observa- tions on the anatomy and microscopy of the disease, says that the buccal mucous membrane is usually reddened in patches of greater or less extent; these patches being in some places merely deprived of epithelium, in others covered with layers, varying in size from that of a lentil to that of a fourpenny piece. These layers are of a yellow or greyish colour, and of irregular form ; they project from one to two lines above the surface of the reddened mucous membrane, and are so soft that they can be readily stripped off with the tip of the finger.2 The mucous membrane beneath is more or less reddened by congestion of the capillaries and hemorrhage, and in some cases broken down in its texture; usually, however, it is entire. Similar alterations are found at the margins of the lips and nose. In addition to these changes, roundish depressions about as large as a hemp seed, their bases covered with a yellowish material, were observed in the mucous membrane of the lips, and sometimes along with them greyish nodules, which might on superficial examination be easily mistaken for vesicles or pustules. On pressing these, a yellowish, semi-fluid mass could be squeezed out, leaving behind one of the depressions or pits above described. These were the appearances seen in animals suffering from the disease naturally contracted. Those seen in inoculated animals did not materially differ. On the third or fourth day after inoculation there was redness of the gum around the incisor teeth, and, more rarely, injection of the mucous membrane of the lower lip. At these spots the membrane was covered with a yellowish-white material, which could easily be stripped off, 1 See Plate I. PLATE I. CATTLE PLAGUE. MOUTH AND PALATE OF A BULLOCK, SHOWING EXCORIATED ULCERS AND APHTHOUS DEPOSIT, To face page 156. CATTLE PLAGUE. 157 leaving small roundish pits. About the same period of the disease, nodules similar to those above described were observed on the lower lip. “As the disease advances the animal becomes exceedingly restless, lying down and rising again, and otherwise denoting abdominal and colicky pains. Whilst lying down, the head is generally turned upon the upper flank. The voluntary muscles are, in most cases, affected with clonic spasm, and constant twitchings of them occur, more particularly about the neck, shoulders, and hind quarters. Diarrhoea sets in, and the animal becomes in some cases very thirsty ; in others, there is loathing both of food and drink. The intestinal discharges, at first black, become of a pale greenish-brown colour, and are very fcetid; and as these are voided they cause much straining (tenesmus) by irri- tating the rectum. The urine is rather scanty, dark coloured, and sometimes albuminous.” The pulse now becomes much accelerated and very feeble—as high as 120 to 140 per minute; the surface of the body deathly cold; the general weakness increases rapidly, the animal standing with difficulty, and lying most of the time; the cough is weak and soft; the sub- cutaneous areolar tissue becomes, but not invariably, emphy- sematus; the buccal membrane and gums are covered with masses of bran-like epithelial scales; the angles of the mouth ulcerated ; the vagina of the cow and the preputial orifice of the male present a dark, deep redness. The animal is drowsy and unconscious; the breathing is performed with a spasmodic jerk ; the ale of the nostrils spasmodically open and shut; and as death approaches, the mucous membranes acquire a leaden hue; whilst dark coloured spots of erosion and ecchymosis stud their surfaces. Tympanites sets in, and the discharges from the bowels are involuntarily excreted, whilst muscular twitchings denote the approach of death. Some cases of cattle plague recover, and in these cases it is observed that the skin over the neck, withers, &c. becomes covered with a yellowish sebaceous secretion, but there are no’ vesicles or pustules. In some of the fatal cases it is said that there is an eruption: the disease in this respect must, however, differ in different localities. I have seen recovery take place where subcutaneous em-. physema was present over the greater part of the body. 158 CONTAGIOUS DISEASES, Now and then a relapse takes place after signs of improvement have become established, and in some instances animals appa- rently quite convalescent commence to purge, and to sink from intestinal and other complications. Mr. Gamgee says that the disease is periodical in its manifes- tations: “Improvement in the morning ; exacerbations at night; a distinct subdivision of an attack into stages, and from the date of the crisis either sudden aggravation or gradual abatement of alarming symptoms.” This periodicity may exist to some ex- tent; it is, however, so slight as to escape ordinary observation. Indeed, in many instances I have observed that the symptoms were quite as bad in the morning as.in the evening. The mortality in Great Britain is always very great. Amongst Russian cattle mild cases of the disease are not of uncommon occurrence, the animals passing through the disease presenting but slight symptoms of it. But even in Russia from 80 to 90 per cent. is reckoned the usual mortality, and under the most favourable circumstances 58 and 56 per cent. have been witnessed. Although the disease is so highly contagious, it is found that some cattle resist its influence, remaining healthy whilst sur- rounded with the plague; but it is also no less remarkable that an animal thus exposed to the contagium will, whilst resisting the malady itself, convey the disease to other cattle, the morbid material being lodged about its body. The post mortem appearances of cattle plague vary in different stages. In the first stage there is congestion of the mucous membranes of the mouth, larynx, pharynx, and particularly of the fourth stomach near its pyloric end, the small intestines are marked with streaks and patches of red, and the follicles are uniformly reddened. The surface of the mucous membrane is covered with a viscid, tenacious, and bloody secretion; is denuded of its epithelium, whilst the submucous tissue is charged with a turbid semi-fluid exudate. The condition of the first two stomachs calls for no special remarks. Sometimes the rumen presents patches of congestion on its mucous surface, approaching in tint the colour of port wine, and in a very small number of cases sloughing of the membrane has been observed. The condition of the third stomach has been supposed to give Geo Waters PLATE It CATTLE PLAGUE. FOURTH STOMACH, PYLORUS, AND COMMENCEMENT OF DUODENUW OF A COW, SHOWING CONGESTION AND APHTHOUS DEPOSIT. (By permission of J. H. B. Hatten, M.R.C.V.S., F.R.C.S.E., F.R.S.E.) «Sons, Lith, Edinb To face pag CATTLE PLAGUE. 159 origin to the disease ; hence the Germans have called it Ldser- duirre—impaction of the third stomach. The late Professor Dick for a long time held out that the disease was neither more nor less than this impaction of the omasum, that it was consequently a non-contagious disease, and that if by the timely administra- tion of purgatives the stomach could be unloaded, the animal would be restored to a healthy condition. And Dr. Bristowe, in his report to the Commissioners, says, “The contents of the omasum are almost invariably preternaturally dry and caked, and as they are at the same time moulded accurately to the highly papillary surface of the folds of this stomach, it is probably due to the concurrence of these two conditions that the epithelial covering of the folds (when, as often occurs, its normal attach- ments are loosened) becomes so frequently in this disease removed with the food.” Now, I am of opinion that the majority of observers have fallen into some degree of error as to the abnormal state of the contents of this viscus; and have concluded that, because the food is found dry and moulded to the leaves, the condition is unnatural, whereas in reality (as may be confirmed any day by calling at a slaughter-house where healthy cattle are slaughtered) the condition of the contents of the omasum is almost invariably firm, the viscus having the appearance of being impacted. In some instances the leaves of the omasum are quite healthy; sometimes they are slightly reddened, the vessels which radiate from their attached border being more or less injected, and sloughing may occur in patches. The fourth or true digestive stomach—the abomasum.—The contents of this stomach are nearly always fluid, and sometimes mixed with blood, and the specific lesions of the disease are intensely marked in this organ. Its mucous membrane? is not only intensely red and covered with adhesive mucus, but is studded with numerous superficial erosions, like those which are so common in the ordinary catarrhal inflammation of the human stomach.—(Murcuison.) The mucous membrane is easily re- moved from the submucous tissues, and the gastric glands are filled with granular epithelium and with blood. “In addition to the general redness,” says Dr. Murchison, “ which is most. intense in the pyloric region, the mucous membrane at this part often presents circular or irregular patches of a claret colour, 1 See Plate II, 160 CONTAGIOUS DISEASES. varying in size from a mere speck to a crown piece. This appearance is due to the extreme vascular injection of the parts in question, and sometimes to actual ecchymosis. The colour may be uniform over the patch; but at other times it is limited to its circumference, forming a coloured rim, with a central greyish-yellow portion. Occasionally these patches may be seen surrounded by a distinct fissure, and in rare cases the membrane corresponding to the patch separates as a slough, which may be found more or less extensively adherent. On separation of the sloughs, deep, excavated ulcers, penetrating the mucous mem- brane, and even the entire muscular coat, may remain.” With regard to the mucous membrane of the small intestines, it is generally more or less inflamed throughout. Sometimes, however, it has been found almost free from disease. When it exists, however, the inflammation is most intense at the iliocecal opening, and about the middle of the cecum. The serous surface of the bowels is of a bluish aspect, dotted with spots of ecchymosis, and softened. The discolorations vary much in colour, some spots being scarlet or rose-red, whilst others are of the deepest purple. True ulceration of the bowels is rare, though the mucous membrane is easily removed, and croupous exudates are now and then found in the canal.? The large intestines, according to Professor Simonds (see Report on the Cattle Plague, Journal of Royal Agricultural Society, 1857), show marks of the disease even to a greater extent than the small ones. The observations of Professor Simonds were made on the Continent: in this country, the large intestines rarely mani- fested such signs of inflammation as the small. As already stated, Dr. Murchison has very carefully compared the lesions of the intestinal glands with those occurring in the typhoid fever of man, and has arrived at the conclusion that there is no resemblance. In the healthy ox the glands of Peyer are very often found enlarged and hardened, and when these enlarged glands have been discovered in cattle dead of the plague, micro- scopic examinations have determined that their contents were chiefly composed of granular masses with cholesterine; products more indicative of a chronic than of an acute alteration. The lining membrane of the respiratory track invariably pre- sents signs of congestion, and is covered in patches with a soft membranous (croupous) exudation. In the majority of cases 1 See Plate IIL. as asee wa as aaa CATTLE PLAGUE. SMALL INTESTINE OF A COW, SHOWING APHTHOUS PATCHES. MUCOUS MEMBRANE INTENSELY CONGESTED, VERGING TOWARDS GANGRENE. (By permission of J. H. B. Haren, M.R.C.V.S., F.R.C.S.E., F.R.S.E.) To face page 160. CATTLE PLAGUE. 161 the rim of the glottis is considerably swollen, and the tonsils much enlarged. Emphysema of the lungs is very commonly met with, and is a condition which causes great distress to the animal prior to its death. The remarks of Dr. Sanderson upon this point are very interesting. He says, “ During the first stages of the disease respiration is performed in a perfectly natural manner, but about the fifth day irregularities begin to be observable. From time to time the rhythmical movements of the chest are interrupted, and expiration is accompanied by an audible moan. On the sixth day (that is, in fatal cases, the day before death) the breathing usually assumes a character which 1s so remarkable that if once observed it cannot be forgotten. The chest dilates suddenly, but apparently with considerable effort, in consequence of, as I believe, the unnatural permanent vxpansion of the lungs due to obstructed expiration. This inspiratory movement is immediately followed by closure of the glottis, the expiratory muscles being at the same time thrown into violent action, much in the same way as they are in the act of rumination. The closure of the glottis is always attended with a sound (such as might be produced by the sudden closure of a soft leather valve) so loud that it can be heard at a con- siderable distance. This sound coincides with the resisted expulsive effort, which is often so strong as to throw the whole body of the animal into oscillation. The chink of the glottis is continuously closed for one and a half to two and a half seconds, the chest remaining expanded and motionless. At the end of this period the air shut up in the thoracic cavity is expelled with a peculiar grunting noise, which is quite as characteristic as the valvular sound already described. It is immediately followed by a renewed inspiratory effort.” Dr. Sanderson says that this peculiarity of movement is the cause of the interlobular emphysema. He says,“ The pause, instead of occurring between each expiration and the succeeding inspiration—that is, when the breathing apparatus is in a state of relaxation—occurs when the chest is expanded, or, more accurately speaking, in the middle of the expiratory act; for, inasmuch as the expulsion of air from the chest commences immediately after the chest is filled, a considerable quantity escapes before the glottis has had time to close. At the moment that closure takes place the air con- fined in the chest is strongly compressed by the action of the 11 162 CONTAGIOUS DISEASES. expiratory muscles, and in this way gives rise to the interlobular emphysema, which is so commonly observed in cattle plague.” I feel compelled to differ from Dr. Sanderson on this point; my own observations leading me to the conclusion that the emphysematous condition of the lungs is due to the generation of gases in the interlobular lung tissue, and that the peculi- arity of the breathing results from, and is not the cause of, the emphysema. The other organs of the body do not present many post mortem signs which may be called peculiar to the disease. The heart is often covered, both externally and internally, with petechial spots—(See Plate V.) The liver is sometimes pale, sometimes dark; the gall bladder is usually full of bile, and sometimes covered with aphthous patches.—(See Plate IV.) The spleen is usually healthy, a circumstance of great interest, says Professor Gamgee, when taken in connection with the condition of this organ in the typhus and typhoid fevers of man. The lining membrane of the vagina and uterus, like the mucous membranes of other parts of the body, are deeply tinged with various degrees of redness and purple, and their epithelium is in a softened and semi-detached condition. The skins of animals suffering from cattle plague present a variety of appearances, such as crusts, eruptions, pustules, and elevations. In inoculated animals dermic alterations are said to be pretty constant, but, as already indicated, they were absent in those cases which fell under my notice whilst the disease was raging in Yorkshire. They were, however, carefully looked for in every post mortem examination which I made. Dr. Sanderson says that “they may be described generally as con- sisting in the first place of incrustation of material exuded in a soft or semi-solid state from the glandular follicles of the skin; and, secondly, of pathological changes in the superficial structures of the skin, which, without taking anything for granted as to their nature, may be designated by the term eruption. Subcut- aneous emphysema was not infrequent as an ante as well as a post mortem condition. PLATE 1¥; CATTLE PLAGUE. GALL BLADDER OF A COW, SHOWING APHTHOUS PATCHES. (By permission of J. H. B. Harren, M.R.C.V.S., F.R.C.S.E., F.R.S.E.) terston&Sons,Lith Erin To face page 162. CATTLE PLAGUE. 163 TREATMENT OF THE CATTLE PLAGUE, In South Africa, where the late Mr. Duncan Hutcheon, Chief Veterinary Surgeon and Director of Agriculture to the Government of Cape Colony, successfully fought rinderpest and other contagious diseases in animals, there were tried several methods of preventive and curative inoculation. These were as follows :— “First. The inoculation of healthy stock with virulent blood in increasing doses, after an injection with virulent bile, with the object of increasing the immunity, but this was found to be unsuccessful. “Second. The inoculation of infected herds with serum obtained from diseased animals. “ Third. The inoculation of in-contact animals with bile from infected animals. “ Fourth. The inoculation of healthy stock with glycerinated bile.” The following abstract, from an article written by Mr. Duncan Hutcheon in the Cape Colony Agricultural Journal, is most instructive and valuable :— “‘Glycerinated bile can with perfect safety be injected into healthy susceptible cattle in doses sufficiently large to give complete immunity against the danger of a second large dose -of fresh pure bile communicating the disease. Considering, therefore, that rinderpest has practically died out in the Colony, no farmer with a clean herd would willingly run the risk of introducing the disease amongst his cattle, if he could get them protected without the necessity of doing so. I have no hesitation, therefore, in reply to the question, What method of inoculation should be adopted in the case of clean herds which are in danger? to recommend that they be at once inoculated with a large dose of glycerinated bile (from 20 to 80 ¢.c.) corresponding to the size of the animals, and follow this inoculation in from eight to twelve days with an injection of a large dose (10 to 20 ¢.c.) of strong pure bile. If this is properly carried out, such inoculated animals would have a lengthened immunity conferred upon shem sufficient for all practical purposes. “With respect to the doctors Krause’s recommendation to 11—2 164 CONTAGIOUS DISEASES. follow these two bile inoculations with an injection of virulent biood—there is no part of South Africa in which an injection of virulent blood after bile inoculation has been so largely prac- tised as in Cape Colony, and our experience is that one dose of virulent blood injected on the tenth day after bile inoculation does not strengthen or extend the immunity conferred by the bile, if such bile possessed strong immunising properties, and the blood inoculation that followed produced no fever reaction. If, on the other hand, the bile was weak in immunising properties, the mortality that followed the virulent blood inoculation was very high, in many cases 75 per cent. and even more. “In controverting our expressed opinion on this point the doctors Krause make a very important qualifying remark. They say: ‘It isan established fact that once an animal is rendered immune, and gradually infectious materials are conveyed to its blood, the greater the increase of the immunity will be.’ Quite so: we never disputed that inoculation with virulent blood in gradually increasing doses, injected at short intervals after bile, will increase the immunity conferred by the bile. We empha- sised this fact (vide my annual report for 1897, p. 25). The point that we disputed and still maintain is that one dose of virulent blood injected into an animal ten days after that animal was inoculated with Koch’s bile, when the latter con- fers an immunity which resists the action of the dose of viru- lent blood so completely that no reaction follows, then the immunity of that animal is not perceptibly strengthened by such an inoculation with virulent blood. I do not think that anyone who reads the account of our experiment at Taaibosch- fontein in the Herbert district in 1897 can entertain any doubt on that point (vide my annual report for 1897, p. 14). “ But apart from its utility or otherwise, there are very few farmers in the Cape Colony who would now favour the blood inoculation after bile in healthy herds owing (a) to the danger of introducing active rinderpest amongst them, and (b) the danger of introducing other diseases, such as red-water, by the blood inoculation. “These are also the chief reasons why the serum and bload method of inoculation should not be applied to healthy herds, in the majority of the cattle districts of the Colony—at least, PLATE V. CATTLE PLAGUE. HEART OF OX, SHOWING PETECHIAL SPOTS. (From a Model in Museum of New Veterinary College.) 008 Sons, Lith, Edinb To face page r6a. CATTLE PLAGUE. 165 not unless the disease should again assume an epizootic form, which we sincerely hope it may not. But independent of the undesirability of introducing the disease into clean herds now that it has become sporadic in its character, it will be im- possible to obtain any strong serum after our present limited supply is exhausted, as there will be no suitable animals avail- able for its immediate production. As Dr. Turner remarks, ‘such highly fortified animals as would produce strong im- munising serum could not be prepared in less than three months. Hence bile must of necessity be used for the inocu- lation of herds in fresh outbreaks of an isolated and sporadic character.’ I would therefore strongly recommend that in every outbreak of the disease that occurs, every drop of suit- able bile obtained from the animals which die should be mixed with glycerine in proper proportions, 2 parts of bile to 1 of glycerine, so that it may be preserved and made available for the inoculation of infected herds, and also for the first inoculation of clean herds which may be considered in danger. Pure bile for the second inoculation of clean herds can always be obtained when the disease appears in any locality, which should be the only reason for inoculating clean herds in the immediate vicinity. The method of inoculation which I would recommend in future sporadic outbreaks of the disease is. briefly, as follows :— “« Infected Herds.—These should be inoculated at once with either serum or glycerinated bile. Every animal which in- dicates infection by a rise of temperature should receive a large dose’ of not less than 100 c.c. of serum, or 30 c.c. of glycerinated bile; the latter should by preference be injected into the jugular vein, so as to secure its immediate action. Then from eight to twelve days after, all the animals in the herd which give no indication of being infected with the disease or fever should receive an injection of pure bile; not less than 10 ¢.c., and for large animals 20 c.c. This will confer a lasting immunity sufficient for all practical purposes. “ Clean Herds.—When it is decided to inoculate a clean herd which is in danger of becoming infected through its proximity to diseased cattle, I would recommend that the animals composing the herd should be inoculated first with 20 cc. of glycerinated bile, and to follow this inoculation in 166 CONTAGIOUS DISEASES, from eight to twelve days with an injection of from 10 to 20 ¢.c. of pure bile. This will confer a strong and lasting immunity on the animals in the herd, and will be free from risk arising from the inoculation or of introducing the disease. DIRECTIONS FOR PREPARING THE BILE. ‘The bile should be taken from an affected animal imme- diately after death, or from one which is killed in the last stage of collapse. ‘Biles of all shades of colour—except those which are red from the presence of blood—may be used, so long as they are clear and free from a putrid smell. Thin light yellow biles should algo be rejected. ‘All the galls extracted at one time should be mixed together, after standing separately for twelve to eighteen hours, so as to render them uniform in strength and im- munising properties. Pure bile should be used on the second day after being drawn, unless it is kept in an ice-chest, when it may be kept sweet much longer. But if pure bile is used as a second inoculation only as above directed, it is not desirable to keep it longer than twenty-four hours. “Glycerinated bile is made by adding 1 part of glycerine to 2 parts of bile, stirring the mixture well; then mix all the biles taken at one time, and allow them to stand for eight days. But if there is urgency, the glycerinated bile may be used forty-eight hours after it is mixed. “Cleanliness and all antiseptic precautions formerly published, and with which the public are familiar, must be carried out in extracting the bile and inoculating the cattle.” In countries—such as the plains of India, the steppes of Russia, and Eastern Asia—where the disease is enzootic and has been for thousands of years, cattle have acquired some natural resistance, and the percentage of deaths is not so great as was experienced in England and in South Africa. It is, however, even then as high as 60 per cent., although in many outbreaks only 33 per cent. of animals attacked die; the remainder recover naturally without any treatment. If treat- ment be attempted, it can only be on general hygienic CATTLE PLAGUE, 167 principles with nourishing diet and attention to symptoms. It is, however, advisable to endeavour to stamp out the disease by slaughter and isolation, rather than to treat, on account of its extremely infectious nature and very rapid spread. Prophylaxy.—Many attempts have been made to give animals immunity, but it was not until Koch suggested the bile inoculation that any satisfactory results were obtained. This observer found that bile from animals which had died of typical rinderpest was itself incapable of reproducing the disease, but conferred an immunity. It acted, in fact, as a vaccine, the antiseptic properties of the bile destroying the virulence of the disease, but the resultant products having sufficient properties left to stimulate the production of anti- bacterial bodies in the blood of the animal inoculated. The method, however, was somewhat impractical, as it necessitated the using of so many diseased animals, and the bile was not really satisfactory unless obtained on the sixth day of the disease. Various expedients were resorted to in the prepara- tion of this bile in order that it could be kept. The com- monest of these was to glycerinate the bile in a similar way to the preparation of vaccine virus. The amount necessary to give immunity was about 10 c.c., and the animal was not immune until about fifteen days afterwards, in which it again resembled the protective vaccines as employed in anthrax, etc. The immunity thus given lasted for some months and could be described as an active immunity. Subsequent experiments showed that a preventive serum could be obtained by im- munising animals, bleeding them, and using their blood serum as a prophylactic. The method is to immunise animals with bile and then to increase this immunity by the sub- cutaneous inoculation of large doses of virulent blood. In a very short time an animal will stand 18,000 c.c. of such blood. Ten days after such a dose the animal is bled from the jugular and will yield about 2,000 c.c. of blood. The loss will occasion only transient inconvenience, and the operation may be repeated at intervals of a week for three or four times, when it is again necessary to inoculate with viru- lent blood. This blood is defibrinated and then centrifuged, the supernatant fluid is mixed with 0°5 per cent. of lysol to 168 CONTAGIOUS DISEASES. insure its keeping aseptic, and it is then ready for use. The doses necessary for the immunisation of cattle vary from 5 to 20 «.c. Animals vary in the strength of serum they will produce, but it is usual to pool the result of a number of bleedings and to standardise the bulk by testing it on animals. The greatest care is necessary in all these operations to obviate contamina- tion. By the inoculation of this serum alone, a temporary passive immunity only is given, which will last for some ten to twenty days. This is long enough to tide an animal over an outbreak in a herd, but something more is required. It has, therefore, been necessary to inoculate animals with viru- lent blood and protective serum at the same time. The two are not mixed, as this would nullify the action of both; they are therefore inoculated on different sides of the body. A mild attack of the disease is induced, from which the animal usually recovers, and as a result it is given an active or permanent immunity which will last for a year or more. The dose of virulent blood is immaterial, as it has been found that 0:1 c.c. will as surely induce the disease in susceptible animals as will 1 ¢.c.; the usual dose of virulent blood is 0°5 c.c. The losses from this method are not great—i.e., they should be less than 5 per cent.—and the results obtained quite justify the risk. By the serwm-alone method, it is obvious that repeated inoculations are necessary, which, in the case of large herds, is both laborious and expensive, although the results may be very satisfactory. RINDERPEST IN SHEEP. It was at one time affirmed that cattle only were subject to the plague, “‘ the cattle tribe being alone its victims.” —(SiMonpDs’ Report to Agricultural Society, 1857.) Experience has, however, proved that sheep, though less susceptible, are still capable of being affected with the plague. The symptoms are the same as in the ox, and anyone familiar with the disease in the latter animal will at once be able to recognise it in the sheep. The incubative stage is more variable than in cattle; the disease induced by inocula- CATTLE PLAGUE. 169 tion appears in from five to eight days; naturally caused by cohabitation or contact, in from five to twenty days. Sheep kept in fields with cattle suffering from the plague remain a long time unaffected with the disease, many escaping it alto- gether ; but if kept in closed sheds they are almost certain to become affected in a very short time.—(Professors VaRNELL and PritcHarD, Report to Commissioners, 1866.) CHAPTER XVII. CONTAGIOUS DISEASE S—conitinued. PLEURO-PNEUMONIA CONTAGIOSA. Definition.—An infectious febrile disease, peculiar to cattle and goats, supposed to have originated in Central and been conveyed to all parts of Continental Europe, to Britain, Africa, America, Australia, India, and New Zealand. It is due to a contagium, which gains access to the system by the lungs, and which after an incubative period of from two to three weeks to as many months, induces complications in the form of extensive exudations within the substance of the lungs, and upon the surfaces of the pleura, finally resulting in con- solidation of some portions of the lungs, occlusion of the tubes, embolism of the vessels, and generally adhesion of the pleural surfaces. In some cases there is extensive and rapid destruc- tion of lung tissue, with death from suffocation; but most commonly the disease is of a lingering character, symptoms of great prostration manifesting themselves, with blood poison- ing from absorption of the degraded pulmonary exudates, and death from marasmus and apnoea. Synonyms.—Lung disease, pleura, new disease, new delight (Yorkshire), pulmonary murrain, epizootic pleuro-pneumonia, &e.; called by the Germans lungen seuche and peri-pneumonia exudativa contagiosa; by the French maladie de poitrine du gros bétail and péripnewmonie contagieuse. PATHOLOGY AND SYMPTOMS. There is much variety in the manifestations of the disease. in some instances, more especially during its first outbreak in a 170 PLEURO-PNEUMONIA. 171 district, it runs a rapid course, destroying life in the course of a few days, the lungs after death presenting the appearance of a congestive inflammatory change, with embolism and hemorrhagic infarction. In other cases—and these are the most numerous— the onset, course, and termination of the disease occupy a period of from two to eight weeks, or even longer, the animal becoming much emaciated, and finally succumbing to an exhausting diarrhoea ; imperfect aération of its blood; hydrothorax ; the de- pressing influence of degenerated animal matters absorbed into the blood, and anemia. Premonitory symptoms of the Disease—As in cattle plague, the commencement of the disease is often not observable. Thus attention is only called in many instances to an animal for the first time appearing unwell, but in which an examination brings to light the fact that changes of structure have taken place, to such an extent as to convince the observer that disease has been gradually increasing for a lengthened period. The thermometer is not even a true guide by which we are able to discover the end of the incubative and the beginning of the active stage, as later investigations have proved that extensive pulmonary changes may exist without elevation of temperature, and that the fever is probably concomitant with the invasion of the pleural surfaces. For example, the introduction of the disease into Australia from this country proves that the first manifestation of illness is not at all to be depended upon as a guide to its true commencement; for the carriers of the contagion—bulls for breeding purposes—were three months on the voyage, the disease only breaking out after they were landed; but it is of great importance that thermometric observations should be made during the prevalence of pleuro- pneumonia, in order that owners of stock might be warned in time, and that measures be taken to isolate or otherwise dispose of all animals in which the temperature is found to be rising. In a suspected herd, all animals showing a temperature above 102° should be carefully watched. If the heat rises above this, there can be little doubt that disease is at work, When the disease is established the temperature may rise to 105°, 106°, and rarely to 107° F. In 134 cases, 61 of which were recorded by Mr. Elphick, V.S, Newcastle, and the remainder by myself, only in 8 did the temperature reach 107°. 172 CONTAGIOUS DISEASES. The palpable or obvious symptoms are slight rigors or shiver- ings, the hair merely standing the wrong way, loss of appetite to some extent, secretion of milk diminished ; in some cases the animal “knuckles over” at one hind fetlock, usually the right one; an occasional cough is heard, which is dry and hard in character, not the painful cough of pleurisy, as one would suppose, nor the moist hoarse cough of inflammation of the bronchial mucous membrane ; rumination becomes irregular, and although there is some loss of appetite, the animal seems fuller than its fellows, which are healthy and eating vigorously. The bowels are rather constipated, and the urine is scanty and high coloured. The pulse of cattle, as I have already stated, is not, more especially with regard to its number, a good guide to the practi- tioner in this or many other diseases; however, as it advances, the pulse becomes accelerated and of a feeble character—sometimes a large soft pulse, other times a small wiry one. These insidious symptoms may continue for several days, the most careful examination of the chest denoting nothing unusual except a tenderness upon pressure applied to the intercostal spaces of one or both sides, and pressure upon the back causing the animal to wince and perhaps give a slight groan. Some cases in an infected herd will at this stage begin to give obvious signs of recovery, and in a few days seem well again, the morbid material having evidently been expelled from the body without causing any extensive pulmonary change. In all cases, however, some amount of irritation and alteration of the lung tissue has been induced, as a cough remains for some time longer. These cases, however, are a source of great mischief, as they become the media through which the virus continues to be conveyed to the cattle with which they are herded, for a considerable period after their apparent recovery. Should recovery not take place, the signs of general disturbance gradually, sometimes rapidly, increase; the cough becomes more persistent, the mucous mem- branes, except that of the nose, are generally pale, the respiratory movements increased in frequency, more abdominal and shallow ; when the animal stands, the elbows are turned out, the nose extended, back arched, and the hind limbs drawn under the body and knuckling over at the fetlocks; when recumbent, the animal throws the weight of its body upon the sternum, and, PLEURO-PNEUMONIA. 173 owing to the anatomical conformation of this bone and its articulation with the true ribs, the chest is thus expanded. The breathing becomes painful, and is often accompanied by @ moan or grunt, emitted during each expiration, and the nostrils are dilated ; but even these signs are not constant, many animals with extensively consolidated lungs being but slightly distressed in the breathing when left quiet; but accelerated respirations are easily induced by percussion applied to the sides, or by compelling the animal to move. A discharge sometimes issues from the eyes and nose, which is at first colourless, but often becomes purulent and yellowish, but is seldom profuse. The extremities, as well as the horns and ears, vary much in tem- perature. Sometimes all are cold; often, however, one ear and one horn may be cold whilst the others are hot, and so on with the extremities. The surface of the body becomes harsh and dry; the skin appearing tightly bound to the subcutaneous structures, and there is rapid loss of flesh. Constipation of the bowels continues in many instances for a long period ; in others it is suc- ceeded at an early stage by a diarrhcea, which, if not too persistent, seems to have a salutary effect ; but ifit assume the colliquative character, the animal dies in from two to three weeks from the first visible manifestation of the symptoms. The physical signs upon percussion are tenderness and some amount of dulness, the dulness increasing in proportion to the exudation and consolidation. If at the outset of the disease it can be determined that both lungs are inflamed, the prognosis in all cases is unfavourable; but if, on the contrary, it can be demonstrated that but one lung is affected (the right lung, according to my experience, being more prone to suffer, but showing a greater tendency to recovery), there are some hopes that the case may recover, for very frequently the morbid action is confined to the side primarily attacked. Auscultation will detect friction and other sounds, which indi- cate that the disease is not confined to the pleural surfaces; thus we have crepitations, both large and small, indicative of inflammation of the lung connective tissue, with rhonchus and sibilus, denoting bronchial disease. It is scldom, indeed, but that some sound or other is detectable in all parts, except the lower portions, of the chest ; the consolidation of the lung, extensive though it may be, being insufficient to mask or hide the abnormal sounds emitted by the lung tissue, pleura, or bronchial tubes. 174 CONTAGIOUS DISEASES. When the disease is confined to one lung, the respiratory murmur in the healthy lung is louder than natural, owing to its having to admit more air than when both are ina state of health. This must not be confounded with a diseased condition ; and in order not to make a mistake, percussion must be applied,—the healthy side will be resonant, the diseased one dull. I have seen some cases where the diseased and consolidated lung has enlarged to such an extent as to push the .ribs immediately covering it outwards to some extent, the animal appearing rounder and larger on that side in consequence; and some of these cases have afterwards thriven and become fit for the butcher. Now and then it is found that some portion of the lung becomes gangrenous, and is coughed up; these cases are, how- ever, very rare. When gangrene occurs, the discharge from the nose is sanious and foetid, and a fcetid diarrhoea soon carries off the suffering beast. Abscesses in the lungs are an occasional consequence. An animal apparently recovers from the disease ; but after a time begins to lose flesh, and sinks from exhaustion, the post mortem revealing caseous tumours or a large abscess or abscesses in the lungs. In some instances of very extensive consolidation, the sounds detectable by auscultation and those emitted by percussion are very trivial. In such it is found that the alteration of structures is most extensive in the central portion of the lungs. One symptom is very diagnostic of this condition—namely, much coughing when the animal attempts to swallow; this is caused by the exudate pressing upon the cesophagus within the chest, and retarding the action of deglu- tition. When the exudate presses upon the large blood-vessels, there may be turgescence of the jugulars and the venous pulse. POST MORTEM APPEARANCES, On opening the chest of an animal which has been slaugh- tered early in the disease, the visible changes are dulness of the affected pleural surfaces; the substance of the lungs, parti- cularly of the large lobes, is red, congested, and more or less consolidated; the redness and congestion being often in patches, each patch being generally surrounded by whitish bands of thickened interlobular tissue, giving them a marbled appearance. 350g arvf of ‘VSOIDVINOD VINOWNANd-OUNATd “panayg pauay1y paqzagiy 41099y ‘assy ADjngop Lagu pr04q¥ PIO uoizsog pasygny hasF PIO IA ALV Id PLEURO-PNEUMONIA. 175 In other instances the redness is diffused over a more or less extensive surface, and is due to staining of the interlobular bands by extravasated blood, one or several affected lobules forming one patch, whilst the lung tissue for some distance may be more or less healthy, until another patch of more or less consolidated tissue is arrived at. The groups of consoli- dated lobules vary much in colour, some showing the varying tints of recent inflammation—blood brown, or dark brown redness; whilst others present signs that the exudation is not only consolidated, but is undergoing a change of colour. We have thus the red and a yellowish grey hepatization, the red denoting the early, the other the more advanced stages of the inflammation; but the true grey hepatization is seldom or never seen now-a-days, as cattle are slaughtered before the exudate has undergone this change. In some animals from an affected herd it has been noticed that the first change is a dilatation of the blood-vessels, and the lung assumes a scarlet colour. There is no exudation into the interlobular connective tissue, but the lung is increased in weight, and sinks farther in water than healthy lung. The true grey hepatization seems to indicate a drying up of the inflammatory products, the formation of new connective tissue in the lung, and the disappearance of the alveolar spaces ; but the apparent grey or marbling hepatization seen in the early stages of pleuro is due to a distended state of the interlobular lymph vessels surrounding the infarction in the lobule. The peculiarities in the character of the inflammation of pleuro-pneumonia are its tendency to invade small groups of lobules, more especially those composing the large lobes, or even a single lobule, and to spread not only by diffusion, but also by the invasion of non-contiguous lobules. In this respect it simulates to some extent the pulmonary inflammation in- duced by the glanders poison, and is characteristic of a local change depending upon a cause existent in the blood ; and we may conclude that the true nature of the inflammation differs from that of an ordinary one; that it is secondary to a general infected condition ; that the exudates do not tend to become highly organised, but rather to become gangrenous, or | iH 176 CONTAGIOUS DISEASES. degrade into lower forms of matter—i.e., caseous or calcareous— and rarely to change to cicatricial tissue, and to remain latent in the part for an indefinite period; and that it may commence primarily in the parenchyma of the lungs, and that finally the tubular portion and vessels of the lungs become obliterated, not only by the pressure of exudates external to them, but by histo- logical elements and clots within them. In consequence of these changes, the diseased lung becomes very heavy, sometimes attaining the weight of twenty, thirty, or even fifty pounds, sinks in water, is resistant, solid, non-crepitant, and on section presents the marbled appearance already mentioned. In those rapid cases of death which occur after the first introduction of the disease into a locality, the changes in the lung tissue are those of an acute character; there is great red- ness or blackness of the parenchyma—hemorrhagic infarction —which is at same time loaded with much serosity, and is very friable, soft, and easily broken by the finger; but in the ex- amples which most frequently fall under the pathologist’s notice the cadaveric lesions are—Isf. Extensive deposits of yellowish, friable layers of false membrane upon the surface of the pleura and upon the pericardium. These false membranes exist upon one or both sides, as the case may be. Portions of the lungs are found adherent to the sides and to the diaphragm, but in many cases the bands of lymph are of a friable nature, the adhesions very imperfect, and the opposing surfaces easily separated, while there is, in old-standing cases, generally much fluid in the cavity of the thorax, in which flakes of fibrin are seen floating. The effused fluid is of a yellowish colour, con- tains much albumen, and if exposed to the atmosphere will often coagulate into a gelatinous clot. There is much variety in the quantity of the fluid. In some cases the pleural cavity and pericardium will contain several gallons, whilst in others the quantity may only measure a few ounces. The pulmonary pleura, in addition to the bands of lymph, which form the adhesions already alluded to, is invested by a firm layer of lymph, which may be stripped off, leaving the lung rough, mottled, and having papille-like eminences upon its surface. These bands of lymph, as well as the flakes found floating in the serum, are composed of fibrin. When examined PLEURO-PNEUMONIA. 177 microscopically, cellular elements, partaking of the nature of pus cells and white blood globules, are seen imbedded in the fibrin, which is sometimes granular, but often filamentous. The turbidity of the serum is caused by these globules and some amount of fatty matter. The tissue connecting the pleura to the thoracic walls is but slightly involved, and when removed after slaughter, the under- lying structures seem healthy, but a careful examination of the part will show the ribs to be bare, stripped of their pleural covering, and to have an unnaturally clean whitish appearance, and the intercostal flesh, in advanced cases, unhealthy, moist, or even dropsical. The pericardium is also covered with flakes of lymph, and greatly thickened by exudative materiais. It has been considered that the primary seat of the disease is situated in the pleura; that the inflammation is of a rapidly spreading character, causing the formation of what have been termed by Rokitansky “the croupy exudates,” both upon the surface of the serous membrane and in the substance of the lungs. As a rule the inflammation in pleuro-pneumonia con- tagiosa is more pronounced in the parenchyma than upon the pleural surface; but this is liable to exceptions, for in’ some cases the pleural disease is more marked than the parenchy- matous. Some writers think that the disease may begin in the bronchi and air cells, and that the irritation extends from the tubes and cells into the parenchyma and pleura. Their con- clusions are based upon the fact that inflammatory products are generally found, in the advanced stages of the disease, in the air vesicles, blood-vessels, and bronchi, as well as in the other portions of the inflamed part. Dr. Yeo, in an elaborate report published in the Veterinary Journal and other periodicals, concludes that the disease origi- nates in the bronchial tubes, and that the surrounding tissne is in a state of chronic inflammation for a lengthened period before any symptoms are manifested. He says—‘“I am con- vinced that the lung disease usually exists for months without being suspected, and invariably the beast is first thought to be sick only when the affection has spread to the pleura, and caused intense inflammation of that membrane with its accom- panying well-marked symptoms.” 12 178 CONTAGIOUS DISEASES. These very confident conclusions of Dr. Yeo, if allowed to go unchallenged, are calculated to lead to much misapprehension, and even to actions at law. They prove to me that he has had but little or no opportunity of studying the disease in the living animal, and that he bases his conclusions upon what he has observed in the laboratory. Now, if pleuro-pneumonia were a species of bronchitis, or, as he puts it, if the virus acted primarily on the bronchial mucous membrane, one would naturally conclude that the bronchial walls would in the earliest stages show evidence of disease; but such is not the case, and only occasionally do we meet with congestive patches along their course in those parts of the lungs already involved in the disease. As the disease advances, however, the bronchi, as shown by Dr. Yeo in the woodcut, Fics. 10 and11.—Transverse section of Broncho-vascular System, contrasting the healthy with the diseased state. A. State of advanced disease. A. Artery, partially occluded by a thrombus. B. Bronchus, contracted and plugged. V. Vein. C. Common broncho-vascular sheath, thickened by exudation. I. Interlobular tissue. P. Lobular parenchyma. B. A corresponding broncho-vascular system in health.!—(YEo.) 1 The cut was kindly sent me by Dr. Fleming. become occluded, their walls invaded by the inflammation, and they, as well as the blood-vessels, alveoli, and air cells, are filled with a solid exudate, differing, however, from that of bronchitis, where the occluding material is composed of more or less fluid catarrhal products; and one most important condition is absent, namely, the blood-vessels of the inflamed lobules are not occluded by coagula as in pleuro-pneumonia contagiosa. In some instances, rarely met with since early slaughter has been made compulsory, the bronchial tubes of a non-invaded PLEURO-PNEUMONIA. 179 lung territory are found occluded, and the lung tissue sur- rounding them collapsed by the gravitation or entrance into them of the degraded, softened products of the pneumonia, which, having escaped from the seat of formation, have been forced by the inspiratory act into the healthy tubes. Here we certainly find the bronchi filled with diseased products, and the pleural surface presenting little or no signs of disease ; but an examination of the pneumonic products will at once prove that they consist of degraded fibrinous exudates, and that the parenchymatous disease is antecedent to the occlusion of the bronchi. In the second place, Dr. Yeo concludes that, in the common run of cases where pleurisy is associated with exten- sive disease of the lung, the latter gives the impression that it is of much older standing than the pleural affection. He says, “The pleurisy is commonly acute; while in the lung we usually have evidence of such chronic change as would require a very long time for their development.” If Dr. Yeo had had clinical experience amongst cattle he would have seen that these conclusions are quite opposed to facts. Many instances have occurred in my experience where animals, apparently healthy, which had been slaughtered in consequence of having been in contact with others affected with pleuro, have presented, post mortem, round patches of consolida- tion in one or more parts of their lungs, always associated with pleural exudation, and sometimes even adhesion of the opposing pleural surfaces; indeed, in some instances the most pronounced evidences of the presence of the disease have been patches of pleural exudation with but little or no corresponding invasion of the lung parenchyma. Then, as to the chronicity of pleuro-pneumonia, the state- ments of Dr. Yeo are against all clinical facts, and consequently must not go unchallenged. A reference to the accompanying woodcut (fig. 12),and a short history of the case from which it was obtained, will illustrate this point. The large dark patches reveal the condition of dark red consolidation, and the smaller ones the commencement of that, process, which is evidently that of hemorrhage into the alveoli; the dark patches are surrounded by cedema of the tissue contiguous to the points of extreme congestion ; the interstitial tracts are much distended, and if 12—2 180 CONTAGIOUS DISEASES. carefully cut, a quantity of straw-coloured lymph, only found Fic, 12,—(a) Pleural surface presenting a smooth opaque appearance, (0) Subpleural exudation. (c) Red consolidation, (d) Thickened inter- lobular tissue. (¢, ¢) Hemorrhagic spots, due to extravasation into alveoli. in recently invaded lung territory, flows from the cut surface. This may be collected and used for inoculation purposes. Ata peore tee mae oe \‘I1G, 18.—(a,a) Exudation in air vesicles, composed of a fibrinous net- work, with leucocytes lying in it. (0, L) The same caseating, (c) Air vesicle filled with leucocytes only. (480 diam.) In the centre is seen a blood-vessel filled with a fibrinous plug, and around it numerous leucocytes in the substance of the wall of air vesicle. later stage this is more gelatinous in consistence. The pleural PLEURO-PNEUMONIA. 181 surface is much thickened, the exudate being both within and upon the serous membrane. Microscopically examined, as shown in fig. 18 the diseased products have every appearance of being of recent origin, the secondary or degenerative changes (8, b) which occur very early in pleuro where the blood supply is cut off by plugging of the blood-vessels, having only commenced. The history of the animal from which the specimen was obtained was clearly traced. It had been brought from a healthy herd six weeks prior to slaughter, throve and milked well up to the two days prior to slaughter, when it presented slight signs of illness, became rapidly worse, and when examined clear evidence was obtained that both lungs were gravely invaded. I may state that, along with four others, all of which succumbed, the animal had been brought into a byre where the disease had previously prevailed, but which had been declared free under the Act of 1868. Taking into consideration the clinical fact, which has forced itself upon me upon many occasions, that it generally takes from a month to six weeks for the disease to develop in a healthy animal introduced into an infected byre, and the condition of the diseased products in the above case, one cannot help concluding that pleuro-pneumonia is often a very acute disease, and that it may rapidly involve large tracts of lung tissue. In other instances, however, the invasion is confined to small areas; the disease may then assume a mild type, and the animal recover; whilst in others the disease becomes chronic, the animal dying, not so much from destruction of lung struc- ture, but from a mal-condition of the whole system, arising from absorption of the degraded products of the inflammation. The cause of pleuro-pneumonia, in this country at least, is undoubtedly contagion and infection, and these only. My ex- perience of the disease enables me to state that no mismanage- ment with regard to feeding, housing, or the general treatment of stock, will induce an outbreak of pleuro-pneumonia con- tagiosa. PREVENTION OF PLEURO-PNEUMONIA. When the disease breaks out in a herd, the affected animals are to be isolated, or, if ‘‘in condition,” slaughtered for beef, experience having proved that such beef is good and wholesome if the animal is killed early in the disease. If the animal be 182 cCoNTAGIOUS D.SEASES, out of condition, slaughter and burial are the safest, and, in the end, the most economical ; indeed, it may be distinctly laid down that the slaughter of the whole herd for human food is the cheapest in the end, the hides, hoofs, &c. being carefully kept from coming in contact with any healthy cattle. Some recom- mend the destruction of hides, hoofs, &c. I think this a wasteful destruction of property, and fail to see how the disease can be propagated by them; unless, indeed, they are actually brought into contact with healthy cattle—not a very likely occurrence. Disinfection —All sheds, cow-houses, or other premises which have contained cattle affected by the lung disease should be thoroughly cleansed and disinfected. The best and cheapest way of doing this is—1st. To burn sulphur in the buildings; Qnd. To whitewash the walls, stalls, roofs, and every nook and crevice within the building with lime-wash containing carbolic acid (crude), in the proportion of one pint to each bucketful of whitewash. ; Inoculation of pleuro-pneumonia products was attempted by Dieterichs with no satisfactory results. The experiments were repeated by Vix, who obtained results in the form of pneumonia, which was due in all probability to pyzmia. Nothing conclusive, however, was obtained until Dr. Willens of Hasselt, Belgium, instituted a series of experiments, the result of which led him to arrive at the following conclusions :— “1. Pleuro-pneumonia is not contagious by inoculation of the blood or other matters taken from diseased animals and placed on healthy ones. “2. That the blood and the serous and frothy liquid squeezed from the lungs of a diseased animal in the first stage of pleuro- pneumonia are the most suitable matters for inoculation. ‘“©3. The inoculation of the virus takes from ten days to a month before it manifests itself by symptoms. «4, The matter employed for the inoculation has, in general, no effect upon an animal previously inoculated or having had the disease. “5. The inoculated animal braves the epizootic influences with impunity, and fattens better and more rapidly than those in the same atmosphere with it that have not been inoculated. “6. The inoculation should be performed with prudence and circumspection, upon lean animals in preference; and towards PLEURO-PNEUMONIA. 183 ‘the tenth day after the operation a saline purge may be given, and repeated if necessary. “7. By inoculating pleuro-pneumonia a new disease is pro- duced ; the affection of the lungs, with all its peculiar characters, is localised in some part on the exterior, but whether it occasions apparent morbid manifestations or not, the inoculated animal is preserved from pleuro-pneumonia. “8. The virus is of a specific nature; it does not always act as a virus. The bovine race alone is affected by its ino- culation, since other animals of different races, inoculated in the same manner, and with the same liquid, experience no ill effects.” Method of inoculation —tThe virus is to be selected from the interlobular tissue of a lung in the first stage of a mild attack. The lung will then be found distended with a yellow semi-fluid exudate. All parts of the lung which present any appearance of dark red colour, and are consolidated, or which have the appear- ance of being gangrenous, should at all times be avoided. The selected portion of lung, after having been cut along the lymph spaces to allow the fluid to ooze out, is to be placed whilst warm in a strainer, over a clean stoneware or glass bowl, covered over by flannel or cloths, to keep in the warmth and to prevent dust, &c. gaining access. Ina short time a quantity of clear yellow fluid will be obtained, which, if not required for immediate use, is to be enclosed in glass tubes, about four inches long, three- eighths of an inch in diameter, and, when filled, hermetically closed by a blow-pipe flame. The tip of the tail is the spot which should be selected for inoculation, and a single drop of the virus is sufficient. It is better to inoculate on the upper than on the lower surface of the tip of the tail, removing the hair, and then slightly scarifying the skin, the scarification being quite superficial. The point of the tail is selected in preference to any other part, because it can be easily amputated if gangrene occur. _ In the most favourable instances, a slight heat and swelling occurs round the inoculated spot in a period varying from a week to two months ; generally, however, the eruption manifests itself from the ninth to the sixteenth day, accompanied by slight rigors, loss of appetite, and slightly diminished secretion of milk. When. 184 CONTAGIOUS DISEASES. the operation has been properly performed, and the virus care- fully selected, the effects are generally as above described ; but when the virus is putrid or badly selected, or, as sometimes happens, some peculiarity exists in the inoculated animal, the primary swelling is excessive, the tip of the tail becomes gan- grenous, the animal suffers from a high state of fever ; secondary deposits occur at the root of the tail, around the anus, and in the abdominal glands, and death occurs in a few days after the inoculation. The conclusions arrived at by the Belgian Commission with regard to inoculation are as follows :— “1, The inoculation of the liquid extracted from the lungs of an animal affected with pleuro-pneumonia does not transmit to healthy animals of the same species the same disease—at all events so far as its seat is concerned. “2. The appreciable phenomena which follow the inoculation are those of local inflammation, which is circumscribed and slight on a certain number of the animals inoculated; extensive and diffuse, with general reaction proportioned to the local disease, and complicated by gangrenous accidents, on another number of the inoculated animals, so that even death may result. “3. The inoculation of the liquid from the lungs of an animal affected with pleuro-pneumonia exerts a preservative influence, and invests the economy of the larger number of animals sub- jected to its influence with an immunity which protects them from the contagion of this malady during a period which has yet to be determined.”—(GAMGEE.) The losses sustained during the experiments of the Commis- sion amounted to 11:11 per cent.; the number of animals on which the operation was benignant was 61:11 per cent.; the pro- portion in which there was gangrene and loss of a portion of the tail was 27-77 per cent. ; in twenty-one subjects the inflammation was very severe, and complicated by gangrenous phenomena, causing the death of six; and lastly, the recoveries amounted to 88°88 per cent. Following the method of Willens, Professor John Gamgee introduced preventive inoculation into Edinburgh about 1857, but the casualties were very numerous, many animals dying from blood-poisoning induced by the operation; in fact the , PLEURO-PNEUMONIA. 185 operation was condemned as being worse than the disease. In London it was condemned by Professor Simonds and others, and to the present time it finds no favour there. Dr. Burdon Sanderson and other experimentalists recommend the injection of the lymph into the venous system by means of a small syringe, selecting the superficial aural vein for that purpose. This method of inoculating, while inducing no local results, is said to be quite as effective as that of inoculation of the tip of the tail. Further investigations on the cultivation of virus, as recom- mended by Pasteur with those of anthrax and fowl cholera, may reveal the fact that an attenuated virus is quite as effective as that removed from the pneumonic lung, and that successful inoculation by direct injection into a vein may be performed without inducing any local ill effects. Intravenous injection has also been investigated by Professors Thiernesse and Degive, who, having found that inoculation with the lymph of pleuro-pneumonia in the cellular tissue of the dewlap generally caused death, performed a series of experi- ments, and concluded— 1st. That the injection of pleuro-pneumonic virus into the veins is not at all dangerous, if care is taken that not a single drop of this liquid falls into the cellular tissue. 2d. That this infusion, possesses the same properties as caudal inoculations,—that is to say, that it invests the animal body with a real immunity. Professors Thiernesse and Degive inject the virus into the jugular, and recommend certain precautions to prevent all con- tact between the virulent fluid and the cellular tissue. I, however, the steel cannula be plunged into a vein, and then the syringe adapted carefully, and care taken that all the fluid is injected into the vein before withdrawing, first the syringe, then the cannula, there will be little or no danger of this occurring. These various methods of preventive inoculation have been within the past twenty years much improved upon. Firstly, the collection of the lymph is made with much care. A lung, a portion of which has only an exudate of lymph into its interlobular tissue, but which has little or no 186 CONTAGIOUS DISEASES. hepatization, is selected ; an incision is carefully made through the pleura into one of these spaces; the trabecule# are then broken down with a blunt spatula, to enlarge the cavity; the lymph, as it accumulates therein, is carefully removed by means of a porcelain spoon and placed in an aseptic wide- mouthed bottle. The lymph thus collected is allowed to stand for at least twenty-four hours, during which time it diminishes in viru- lence, and does not cause such a strong reaction when inocu- lated into the tail. Such lymph causes marked lesions in the tail, and a certain amount of systemic disturbance within six days under ordinary conditions amongst cows in byres, but takes two or three days longer in cold weather and in stock out at pasture. Tf the lymph be introduced into the under or upper surface of the tip of the tail, at the expiry of about six days, the hairs will stand on end, and the part become swollen. This swelling is very typical, has the appearance of brawn, and glistens like jelly. The wound caused by the inoculation should heal by first intention in a successful inoculation. Should it not do so, but commence to suppurate, the operation is usually unsuc- cessful. So long as the swelling remains local, and only the last 6 or 8 inches of the tail are qffected, things may be considered to be favourable, and no interference is necessary ; but if the swelling should commence to extend up the tail and become diffuse, then it will be necessary to amputate the tail above the swelling, taking great care that all invaded tissue is removed. The virus causes thrombosis of the vessels, and if the incision of amputation be through infected tissue, there will be no spurting of arterial blood. By the Contagious Diseases (Animals) Act, 1878, it is enacted that all cattle suffering from pleuro-pneumonia are to be immediately slaughtered; and by the Pleuro-Pneumonia Slaughter Order of 1888, all cattle being or having been in the same field, shed, or other place, or in the same herd, or otherwise in contact with cattle affected with pleuro-pneu- monia, are to be slaughtered within ten days after the fact of their having been so in contact has been ascertained, or within PLEURO-PNEUMONIA, 187 such further period as the Privy Council may in any case direct. All cattle which have been certified by an inspector of the Privy Council to.have been in any way exposed to the infection of pleuro-pneumonia are also to be slaughtered within such period as the Privy Council may direct. THE PATHOGENIC MICROBE OF PLEURO-PNEUMONIA, At the meeting of the National Veterinary Medical Associa- tion held in Edinburgh in 1886, I stated that pleuro-pneumonia was due to an organism. This announcement was received with derision by certain members present. At that time, after several years’ work, I had found two organisms, a bacillus and a micrococcus, and was of opinion that the micrococcus was the pathogenic microbe. The question has been since studied by various Continental observers. Lustig found that there are generally four organisms in the exudates of pleuro. These four, however, may be classified into two groups, as seen under the microscope :—1st. A bacillus which rapidly liquefies gelatine in cultivation tubes: 2nd. Micrococci, which are proved by cultivation to be of three kinds—(a.) a micrococcus whose colonies are white, like boiled white of egg; (b.) a micrococcus the cultivations from which assume a golden yellow colour; and (c¢.) a micrococcus whose cultures on gelatine resemble drops of wax. These four organisms were studied by Lustig in 1885, and by Cornil and Babes in 1886, but the results which the latter obtained were not very precise ; and they concluded that their work, and that of all investigators who had preceded them, would have to be repeated. Arloing and others have also found four different organisms: —Ist. A bacillus called by Arloing Pnewmobacillus liquefactens bovis; 2nd. Three micrococci—(a.) a non-liquefying coccus whose colonies resemble drops of wax—Pneumococcus gutta- cerei ; (b.) a micrococcus the white colonies of which spread in a thin layer, and as this grows older it becomes wrinkled and folded— Pneumococcus lichenoides ; and (¢.) a micrococcus whose colonies, elongated or round, assume a beautiful orange tint— Pneumococcus flavescens. Arloing is now of opinion that the Pneumonia bacillus liquefaciens is the pathogenic microbe of pleuro-pneumonia; for, by means of subcutaneous inocula- tions of cattle with pure cultivations of the microbes, it was 188 CONTAGIOUS DISEASES, found that the bacillus produced the greatest effect, and when injected in larger doses pulmonary effects were induced closely resembling those of pleuro-pneumonia. Arloing has repeated his experiments, and says—‘ I have reproduced in the bovine with pure cultures of the pneumobacillus taken between the second and tenth generations the typical alterations produced under the skin or in the chest by the virus of the peripneu- monia contagiosa. I then emphatically say—(jirst) that the virulent agent of contagious peripneumonia is an ordinary microbe; (second) that this microbe is the prewmobacillus liquefaciens bovis.’—(Compte Rendus @ Académie des Sciences.) Nocard has shown that all the above observations are wrong. The casual organism is what has been described as an ultra-microscopic one, as if is too small to be seen defi- nitely with the strongest lenses. Nocard demonstrated its presence by obtaining pure cultures in bouillon contained in celluloidin sacs and placed in the peritoneal cavity of rabbit. By this means a growth was obtained in the broth which rendered it cloudy, and it was found capable of reproducing the disease and being again recovered from the lungs of in- fected cattle. The organism would not grow on ordinary media in the incubator, and, being so small, its morphology could not be made out. This organism may be taken con- clusively as the causa causans of the disease, and pleuro- pneumonia contagiosa can now hardly be placed among that class of contagious diseases which is described as being due to organisms of the ultra-microscopic variety. BRONCHO OR CATARRHAL PNEUMONIA, CORN-STALK DISEASE, TRANSIT PNEUMONIA. Pleuro-pneumonia has been confounded with another disease —broncho-pneumonia, called by American veterinarians the “corn-stalk disease,” and transit pneumonia by the Cana- dians, described by Billings as interstitial pneumonia, follow- ing a septicemia induced by eating decomposing corn-stalks (Indian corn-stalks)—by the veterinary officers of the Board of Agriculture and others, and I feel warranted in relating the history of that disease as seen in this country. Karly in 1879 pleuro-pneumonia was reputed to have been found amongst American cattle landed at Liverpool, and the 2, INTERNAL ASPECT OF No. 1. Bronchial Tubes filled with catarrhal products. Lung tissue engorged. 1, EXTERNAL ASPECT, showing red parts, collapse of lobules, and at lighter portions some degree of emphysema of the pervious lobules. BRONCHO-PNEUMONIA, OR SO-CALLED AMERICAN CONTAGIOUS PLEURO-PNEUMONIA. OT ee a, ee = a ee Se ene Oe ee ee eee ey! 691 afvg 270f OF “usodap remnuesZ 2q3 Aq pasaa09 AyTeorndo Jou SI JI SJaqYA yeuLIoU aq 0} UaDS S]feo We pus wNIpqUdT “yisoda) aWOS WIM poyenyur poe yno pouedo saoqe jo sien one P *Nsodap 1epIuns YIM poyTy Jassaa-poojg 7 *saqoeleyo JepnuEIZ pa relN]]20 -uou & j0 usodap snouriqy 94] YIM pally s][ao ate aY3 Jo IOP 7 ‘Tewiou wntayqiids —wsodep snounqy woy se1j seduejsuT SUIOS UT s]jeo IW v (oof X ‘VSOIDV.LNOO VINONWOENd-OUnNe Id ‘OUIULAD-OLI YUJI paulvszs) Mee eas mea Tees “your ue jo ©9998 _i3pim aSe1ay ‘VINONN3Nd-OHONOYS 40 VidaLlova TIIA H2LV Id *HONeUIMIE YUL JeINWSIEII OF SNP Seduvyd SMOYS SNssIy SATIOITUOD 3YI ‘Suny BY} Ul JIVYAMAS|A OST INQ ‘TYDUEAq 9t} utpunosms Ayperedsy *yjno pauedo uvyy pasuspuod JayIeEF eaoge jo sjem snoiqig 2 “ztsodap ou—aitjue SurUTy S3t ITM Jassea-poolg 7 *S]]99 Are 3y3 jo yeteaes ZurAdnov0 umntyayrdes payesajtjoid pur pays josessew 9 7 *peyeurendsap ssa] 10 aro s[jao yetayyide sey? YI “GIsodep wor e015 seo My 9 F “2502 501U0D VIMOMNINY-OLNG T aq 07 aInyNDUsy jo preog jo s1s0qj() Aq paieys pue ‘zogr 39q039Q ‘3jiq ‘se1opury ye pally ‘xO UeIpeued woy Bun] worg (008 X ‘angen Q-0421q YIIM pauIvIS) ‘VINON NH Nd-OHONOUS PLEURO-PNEUMONIA. 189 shippers there, in order to satisfy themselves of the correctness of the diagnosis of the veterinary advisers of the Privy Council, and who now hold the same position on the Board of Agricul- ture, requested Professors M‘Call, Walley, and myself to visit Liverpool and examine the cattle, and watch the post-mortem results ; and here commenced the dispute, as, after having seen a few diseased lungs, I maintained that the malady was not pleuro-pneumonia, but a catarrhal or broncho-pneumonia, com- bined in a few cases with pleurisy, but in others the pleurisy was absent. Professors M‘Call and Walley agreed with the advisers of the Privy Council, and I found myself in a magnificent minority. During the spring and summer of that year several condemned lungs were sent to me from Liverpool, and after further investigation I found no reason to change my opinion. The matter remained in abeyance so far as the profession was concerned until April 1891. It is very true we now and then heard that pleuro had been detected amongst American cattle landed in this country, but we had no means of verifying or contradicting these reports; but some two years or so ago the American Government sent inspectors to the various ports where American cattle are landed, for the purpose of investiga- ting and reporting upon the cattle slaughtered ; and, wonderful to relate, we heard ‘no more of American pleuro, except one notable report from Dundee, until a lung of an ox was found at Deptford in April 1891, and said by Professors Brown and Duguid and Mr. Cope, and confirmed by Professors Walley and M‘Fadyean, to have plewro-pnewmonia contagiosa, and in further support of the correctness of the diagnosis Mr. Chaplin, the Minister of Agriculture, said it was pleuro, for he had seen the lungs. But Dr. Wray, the American veterinary inspector at Deptford, disputed this opinion, and on 18th April brought a portion of the lungs to me. I, along with my son, examined this portion of lung, and we both came to the conclusion that it was not pleuro-pneumonia. I was again in the minority, and nothing more would have been heard of the matter, at least so far as I am concerned, had not a remarkable coincidence occurred in Paris during the winter of last year, when it appears that MM. Redon, Godbille, and Blier, well-known veterinarians and sanitary inspectors at La Villete— the Parisian cattle market—where thousands of American cattle 190 CONTAGIOUS DISEASES, were exposed for sale. On three several occasions these veteri- narians affirmed that some of the animals were affected with an unusual disease of the respiratory organs. In November, 1890, in a lot of more than 400 cattle direct from Illinois and Indiana, one died, and two were very ill, the symptoms leading to the sus- picion that they were affected with contagious pleuro-pneumonia, “The sick animals were killed, and the lungs examined by Godbille, who found no pleurisy, but such a suspicious appear- ance that, considering the importance of the matter, the two Photo-Micrograph by W. Forgan. Fic. 14.—Pure Pneumonia as seen in Pleuro-Pneumonia. u. Healthy epithelium of bronchus. b. Fibrinous plug. ce. Air vesicles containing croupous—fibrinous—exudate. sets of lungs were sent to Alfort, to be submitted to M. Nocard, one of the most illustrious of veterinarians and pathologists, and he reported that at the first glance a section of the hepatised tissue presented the appearance of a recent lesion of pleuro- pneumonia contagiosa. The tissue was dense, compact, friable, the colour varied from bright red and deep brown to almost black, whilst the lobules were isolated from one another by thick septa, infiltrated with a considerable quantity of yellow limpid fluid, etc.” —See Veterinary Journal, October, 1891, PLEURO-PNEUMONIA. 191 These appearances were startling, and if the investigator had been a less eminent man than he is, he might have made his conclusions from these naked eye appearances, and said it was contagious pleuro; but there were great international and commercial considerations in question, as well as the scientific bearing of the subject; and Nocard did what our own Government officials ought to have done, if not in 1879, at least in 1891. He made further investigations, and arrived at the iC 2 Photo-Micrograph by W. Forgan. Fic. 15.—Broncho-Pneumonia as seen in ‘‘ Corn-Stalk ” Disease, from American ox slaughtered at Deptford, 14th April, 1891, and referred to in text. a. Bronchial walls, epithelium desquamating and shed. b. Catarrhal products in tubes and vesicles. «. Increased fibrous tissue—fibrosis. conclusion that he had other than pleuro to deal with. He found, in the first place, that the infiltration of the connective tissue was less abundant, the serum less albuminous ; that the tissue of the lobule in the thickened girdle of connective tissue had not the uniformity of tint and consistence that characterise pleuro-pneumonia lesion ; that it was hafder, more manifestly ‘hepatised in the centre than at its periphery—the invasion being from the bronchial, and not from the perilobular tissue. “In pleuro” 192 CONTAGIOUS DISEASES. it is the opposite, notwithstanding what Drs. Yeo and Wood- head have stated, and which statements have been partly accepted by Professor M‘Fadyean. There was another important differential sign. Pressure caused a notable quantity of thick, viscid, light yellow pus— analogous to that observed in certain forms of verminous broncho-pneumonia—to issue from the bronchioles (this con- dition was very manifest in the Liverpool cattle in 1879); but a microscopic examination of this fluid and of the lung-pulp did not lead to the detection of ova, embryos, or worms of any kind. The bronchial mucous membrane was inflamed, thickened, corrugated, and more or less denuded of its epithelium, while the submucous connective tissue was infiltrated with yellow serum, and considerably thickened in places; but the blood- vessels contained no thrombi. This muco-pus from the bronchioles was found to contain an abundance of short, oval, mobile bacteria, which appeared to be the only microbes present. The organisms were also found, as if in a state of pure culture, in the hepatised tissue, and more especially in the limpid serosity that distended the perilobular lymphatic sac. This single character alone sufficed to affirm that the lesion was not of a pleuro-pneumonic kind; for it is well known that the lung serum in that disease is very poor in figured elements, and that when it is collected pure from the infiltrated septa it does not usually contain any microbes. In this instance the microbe, which existed in great numbers, belonged to the large class of ovoid bacteria of which the rounded poles fix aniline colouring matters more strongly than the centres. It is well known, as pointed out by Nocard, that the fowl cholera, the duck cholera, the septicemia of rabbits and ferrets, the game plague, the swine plague, &c., all have analogous microbes,and which can only be distinguished from each other by the collective biological characters, and more especially by the effects of their inoculation on different kinds of animals. Experimental inoculations were now made by M. Nocard, when he found that mice, rabbits, guinea-pigs, and pigeons, when inoculated subcutaneously with two or three drops of the serum or the culture,succumbed in less than forty-eight hours, without cedema at the point of inoculation, with intense con- « gestion of all the viscera, but without any definite localisation. PLEURO-PNEUMONIA. 193 Sheep and calves inoculated subcutaneously, or in the trachea, with a cubic centimetre of culture, of serosity, or of virulent pus, did not die; they suffered, however, from intense fever, and remained prostrate, without appetite, for some days, but soon regained their normal condition. Intra-pulmonary inoculation was more effective, as a calf of eight months and a ram of two years, inoculated in the right lung with five drops of peritoneal pus from a guinea-pig, died in less than forty-eight hours with fibrinous pleurisy and exuda- tive broncho-pneumonia, analogous to that observed in American cattle, the lesions being very rich in bacteria. Nocard concludes that the disease does not resemble any known in France, and considers it is a malady special to American cattle, and is inclined to think that it is the affection known in the Western States as the “corn-stalk disease,” described by Gamgee, and more recently by Billings, of whose observations there is an account by Bowhill in the Veterinary Journal for February 1892. And the question arose as to whether the importation of this microbic broncho-pneumonia would prove a source of danger to France. M. Nocard was able, however, from his close observa- tion of facts, and the experimental study of the conditions of contagion, to state that the malady had only very feeble con- tagious properties. In three very large importations in which the disease was detected, notwithstanding the considerable number of animals in each, and their long and close contact with each other, the affection did not spread, and the cases remained isolated ones. From all these facts, his opinion was there was no urgent danger, or any necessity for special measures. Dr. Fleming, in a leader upon M. Nocard’s observations (see Veterinary Journal, October 1891), says :—“ The question that now arises on this side of the Channel is one of some moment, not only from an economical, but also from a pathological point of view. Many cargoes of American cattle have been con- demned because it was found that one or two in each lot were affected with what was supposed to be the specific lung plague. United States veterinary surgeons have strenuously denied the existence of that malady among cattle, and Professor Williams on two occasions, when the matter has been referred to him, has concluded that lung plague was not present, but the lesions were those of catarrhal or broncho pneumonia ; and now Nocard finds 13 194 CONTAGIOUS DISEASES, what we are almost forced to conclude is the same disorder, exa+ mines and experiments with it, as a scientist of his position and responsibility should do, and—mirabile dictu—arrives at the same conclusions as Williams, and even designs it by the same name.” Notwithstanding this, the North of England Veterinary Medical Association passed a formal resolution— That the best methods of recognising pleuro were by the naked eye and hands, and that when these methods failed, little reliable assistance could be obtained from the examination of micro- scopic sections; that is to say, as far as determining it to be absolutely a case of pleuro-pneumonia was concerned.”— (Veterinary Record, 17th December). At a meeting in Liverpool on 16th December 1891 a descrip- tion was given by M‘Fadyean of the post mortem appearance of pleuro, and a careful perusal of that description will at once con- vince any impartial reader that he labours very hard to prove the catarrhal origin of that disease. In one passage it was stated by M‘Fadyean that— The alveolar contents are by no means always fibrinous in character. In many lobules the change is distinctly a catarrhal one, air vesicles being filled with round nucleated cells, apparently the progeny of the swollen and proliferating epithelium. This change may affect the lobular bronchi also. Sometimes the catarrhal proliferation is associated with a peculiar transformation of the alveolar epithelium, that having become distinctly columnar in character. The fact that catarrhal changes are common in contagious pleuro-pneumonia has been strongly insisted on by several writers upon the subject, notably by Dr. Gerald Yeo and Dr. Woodhead.”—( Veterinary Periodicals.) With regard to the conclusions of Yeo, I have already demon- strated their fallacy ; and with reference to those of Woodhead, published in the Journal of Comparative Pathology, &c., 1888, I wish to draw attention to a review of that article by M. Dela- forge, sanitary veterinary surgeon for the Department of the Seine—Recueil de Méd. Vétérinaire for 15th May 1889, page 324, He says:—“In an analysis of ‘Studies on the Pathological Anatomy of Pleuro-Pneumonia, by Sims Woodhead, which appeared in the Recueil for 15th March, I read as follows: ‘ The pathological process consists in an irritation of the mucous mem- brane of the smaller bronchi, followed by shedding of the epi- PLEURO-PNEUMONIA. 195 thelium of the pulmonary vesicles and a catarrhal proliferation of their elements. The virus then penetrates from these vesicles and the smaller bronchi into the neighbouring lymphatics (peri- bronchial lymphatics), but not into those of the bronchi,” &e. From this it appears that this author's opinion is that the initial start of the malady is in the bronchioles, and from these to the lymphatics or lymphatic spaces—the perilobular networks. This idea is radically false. Sims Woodhead mistakes the epiphenomena for the primordial phenomena—such as clinical observation shows very distinct. Every practitioner who cares to take the trouble to inform himself otherwise than through his imagination will readily perceive that at the periphery of the hepatised mass there are almost constantly met with, in an extent of 5, 10, 15, and 20 centimetres, connective tissue bands, with their ramifications distended by the exudate of pleuro- pneumonia, without any alteration, any change even in colour, in the pulmonary lobules, which are surrounded by these advanced-guard projections. When two such projections run parallel at a short distance from each other, we can clearly see, from their point of emergence from the hepatisation, the gradu- ated effects of the compression they exercise on the imprisoned strip of lung. The congestion and density of the lobules is then marked in decreasing proportion from the base to the terminal divergence of the two infiltrated bands (or spaces); while, on the contrary, the lobules outside them and touching them remain absolutely healthy. The clinical facts, which are very common, I repeat, prove distinctly that the evolution of con- tagious pleuro-pneumonia takes place from the connective tissue septa (interlobular spaces) towards the pulmonary vesicles, and not—as Sims Woodhead asserts—from the bronchioles towards these septa. The obstruction of the vesicles, the catarrhal and ephithelial transformations, the blood stasis, the pulmonary hepatisation, in a word, are evidently not the initial essence here, but rather physical corollary or epiphenomena. It is in this course, by this order in succession of the PJeuro-pneumonia lesions, that in a first case, for instance, the practitioner can most certainly affirm the contagious nature of the malady ; for whatever may be said and written to the contrary, there is observed in the bovine species a non-specific pneumonia and pleurisy, which may or may not be coincident, and a a 196 CONTAGIOUS DISEASES. tions in which are physically similar to those of contagious pleuro-pneumonia. I have had cases, the circumstances attend- ing the origin of which, as well as the consecutive circumstances, left no doubt in my mind with regard to this. And apart from inoculation, which is not always practicable, I did not know until then of anything that had been published that informs us how we can differentiate between what is specific and what is not. Nevertheless, this means is, if not always constant, at least so in the majority of cases. To find it, it is only necessary to make an attentive and minute examination of all the periphery of the diseased parts; if only for a few centimetres, we find an interlobular exudation advancing into the soft rosy tissue, we may be certain that we have before us the contagious pleuro-pneumonia. It is less with the view of rectifying the above error than of establishing this indication that I request the insertion of this short note.” Further, in order to prove the catarrhal theory; M‘Fadyean says that the piece of lung brought to me by Dr. Wray might have had broncho as well as pleuro-pneumonia. I do not deny the possi- bility of the two conditions being sometimes—but, as a matter of fact, very rarely—co-existent ; but it is a remarkable thing that the very many specimens of American and Canadian lungs that I have seen since the commencement of 1879 should all have been catarrhal, and the many hundreds of pleuroed ones that I have seen in this country should have the catarrhal conditions absent, and since then I have received a portion of another lung from Dr. Wray, in which the lesions are identical with those found in the 1891 lung. Portions of this lung were sent to. M. Nocard, who kindly examined them, and I now append his opinion :— ** ALvortT, 29th December 1891. “My Duar Cottzacus—You will excuse my not having replied sooner, but I did not wish to limit myself only to an examination of the sections you sent me; for I was desirous of thoroughly studying the piece of lung you also forwarded. This study I have now made comparatively, with pieces I myself collected at the commencement of this year or end of 1890 from American cattle, the history of which I brought before the Société Centrale Vétérinaire in July lasi, under the title of ‘ Infectious Broncho-Pneumonia.’ “T have made a great number of sections of your specimens and of my own, and have treated them by the same methods of PLEURO-PNEUMONIA, 197 staining, which I have varied as much as possible. I have examined them with much care, and I believe I am now in a position to con- clude :—1. The lesion which you have submitted to me is certainly not that of pleuro-pneumonia ; 2. It is a bacteridian broncho-pneu- monia, which, in all probability, is of the same nature as that I have already described. On the latter point I am not so positive as on the first, for although the distribution is very analogous, and the microbes have the same form and the same dimensions, and react in the same way to the different staining methods, you know as well as I do that we cannot, on these alone, affirm the identity of two microbes. In order to do this we must cultivate your bacteria, and then study them comparatively with mine, to see how they behave in the different culture media, and observe their pathogenic action on various animals. By doing this I shall doubtless be able to affirm or deny that we are dealing with one and the same organism. However this may be, I again repeat that it appears probable to me that you and I have studied one and the same disease. E. Nocarp.” A statement having been made that the microbe found was an ordinary putrefactive one, I wrote to Dr. Wray, and I append his reply, with the simple observation that when the lung arrived in Edinburgh it was free from putrefaction :— ‘* No. 39 BELVEDERE Roap, Uprer Norwoop, Lonpon, 8.E., 8th January 1892. sew. Witirams, F.R.C.V.8., &c., Principal, New Veterinary College, Edinburgh, Scotland. “ My Dear Proressor—In reply to yours of the 6th instant, the section of lung that I showed you on 18th April 1891 was taken from the lungs of a bullock that was slaughtered at Deptford on the afternoon of 14th April 1891. The lungs from the said bullock were sent to the Royal Veterinary College the same afternoon. ‘The next morning, 15th April, I inspected the lungs in company with Professor Duguid, and Doctors Coghill and Shaw, the section I took you being cut off immediately after the inspection, Professor Duguid cut- ting off an adjoining section at the same time. The section I had was placed in a tin box, and there kept until I arrived home the same evening, was then taken out of the box and wrapped in a linen cloth saturated with a solution of bichloride of mercury [1 to 1500], and placed on ice, where it remained until 10 p.m. of the 16th, when it was taken out of the cloth, re-saturated with the solution, then packed in a clean box, having been removed from the box twice previous to your seeing it on the morning of the 18th. I took the utmost care 198 CONTAGIOUS DISEASES. to get the section to you in as fresh a state as possible. When you saw the section I remember distinctly that it was quite fresh and free from any signs of putrefaction. If I can be of any assistance to you in this case, please command me. With many happy returns of the past holiday season to you and yours.—Very respectfully, “WwW. H. Wray.” Now, in conclusion, I have simply to say that the American disease is not pleuro, but that it agrees in every respect with what Gamgee, Billings, and Nocard have described as broncho- pneumonia, and that it is identical—but the specimens show a more chronically diseased condition—with what I discovered in both States and Canadian cattle landed in Liverpool in 1879. CHAPTER XVIIL CONTAGIOUS DISEASES—continued. ECZEMA CONTAGIOSA. Synonyms.—Eczema epizootica; epizootic aphtha; aphthous fever ; foot-and-mouth disease; murrain; epidemic. Definition.— A highly contagious and infectious febrile disease, associated with a vesicular eruption in the mouth, between the pedal digits, and around the coronets. In some cases the mouth only is affected, in others the feet may be the seat of the erup- tion, the membrane of the mouth remaining free. In milch cows it sometimes happens that a vesicular eruption occurs on the mammary gland, and within the lactiferous ducts: when such occurs, the milk, contaminated by the vesicular discharge, is rendered unfit for use, either as food for the human being or for the lower animals, as it is said to induce a vesicular eruption in the mouth, larynx, pharynx, and intestinal canal. PATHOLOGY AND SYMPTOMS. Unlike rinderpest and pleuro-pneumonia, which are almost confined to the ruminantia, contagious eczema affects cattle, sheep, pigs, dogs, poultry, and even human beings are subject to the influence of its virus. It is amongst horned cattle that we find the ravages of this disease to be most extensive, they seemingly being most susceptible to the influence of the con- tagious poison; sheep and goats, however, suffer very severely, and dogs, pigs, and poultry often die from it. After a period of incubation, varying from twenty-four hours to three or four days, the invasion and progress of the disease are characterised by an elevation of temperature of from two to four 199 200 CONTAGIOUS DISEASES, degrees; by the formation of vesicles, varying in size from that of a sixpence to that of half-a-crown, on the tongue, inside the lips, roof of the mouth, and sometimes on the udder; whilst smaller blisters make their appearance between the digits, and around the coronets and heels, and there is a discharge from the eyes and nose. The animal presents signs of uneasiness in the mouth, by constant movement of the lips, champing of the teeth, a flow of saliva from the mouth, and difficulty in masti- cating its food; the affection of the feet being indicated by some degree of lameness in the foot or feet affected. In a short time the epithelial and cutaneous structures enclosing the vesicles are separated and thrown off in more or less rounded patches leaving raw surfaces (see Plate VI., p. 182), which are, however, speedily re-covered by epithelium. In some instances there is an entire separation of the hoofs from the feet. The symptoms are undoubtedly due to the presence of a conta- gious micrococcus in the animal economy, and are manifestations of the elimination or excretion of a virus, which evidently has some special affinity to the mucous and cutaneous structures of the several parts of the body which it invades. Eliminated by the feet and by the mouth, pastures very soon become impregnated with it, and hence we find that, owing to the great facility by which it is thus spread over a wide district of country, it appears to be the most infectious of maladies. Beyond question the virus of eczema is conveyed from field to field, from parish to parish, from county to county, by small game, vermin, and dogs; and looking to this fact, we can account for the sometimes mysterious outbreak of the disease in places and districts into which no fresh cattle have been admitted. This frequently un- accountable appearance of the foot-and-mouth disease has led to the belief that it is of spontaneous origin; some believing that, although originating spontaneously, it is propagated by contagion; others that it originates in all cases independently of contagion, and that it is due to climatic or atmospheric causes, exposure, and the debilitating effects of long journeys by land or sea. It is very true that increased susceptibility to the disease is in- duced by any debilitating cause, but neither age, condition, management, climate, temperature, nor any common cause of disease seems to exert any modifying influence. No extremity of privation, nor the continued action of ordinary causes, is ECZEMA CONTAGIOSA. 203 capable of inducing it; and one reason for the indifference which has been shown in respect to its ravages is to be found in the belief in its spontaneous origin, an idea which arises out of the observations of its frequently unaccountable appearance in iso- lated places—(Professor BRown on Mouth and Foot Complaint.) It was at one time believed that an animal which had once suffered from eczema contagiosa was guarded against another attack. This, however, is a fallacy; and it is now generally believed that an animal is only once attacked during a season. As a general rule this may be said to be the case, and consequently a herd which has gone through the disease early in the season— let that be the spring or autumn, the periods when, in conse- quence of the increased movements of cattle from place to place, the disease is most rife—is considered more valuable to the purchaser, and worth more money in the market. This rule is, however, liable to many exceptions, and it is by no means impossible for the same animal to suffer from two, three, or even four attacks during a period of a few months. Milk from cows affected with foot-and-mouth disease acts energetically upon young animals to which it is given warm. Calves occasionally die quite suddenly after sucking cows affected with the malady; and fatal effects have followed the administration of the milk to young pigs. Not only is the disease communicable from cattle to sheep, goats, and pigs, but it is also to children, and even grown-up people, as well as to numbers of other kinds of animals. It is now established that the causal agent in foot-and- mouth disease is an ultra-microscopic organism. The exudate from the buccal or pedal vesicles may be filtered through a fine porcelain filter, so that the filtrate is free from all visible organisms; and yet this filtrate will produce the disease. This eliminates the possibility that any of the visible cocci or bacteria are in any way the causal organisms, and their presence there is only accidental, as would be natural in any skin-lesion. This disease then comes under the same classi- fication as pleuro-pneumonia, rabies, South African herse- sickness, etc. The virulent filtrate obtained does not yield any growth upon cultivation in any known media, and we can only surmise that the organism, although existent, is invisible. Cows, when suffering from the worst form of disease, lose 202 CONTAGIOUS DISEASES. nearly all their milk; but when the attack is mild in character, the decrease will not be more than one-third of the usual yield. The average loss in a large dairy while the disease is going through the sheds will vary from one-third to two-thirds, according to the number of severe cases. As all the milk obtained is mixed, the worst milk will be to some extent modified by the addition of that which is less highly charged with morbid elements, and the whole is further diluted by the addition of water,.which, judging from some specimens obtained from an establishment where the disease was known to exist among the cows, is sometimes added to the extent of 40 per cent. Boiling the milk has been recommended for the purpose of preventing or lessening its injurious action. In ordinary cases of eczema the symptoms are not very severe, and provided the feet are not seriously implicated, the animals recover in about a week from the first manifestation of the febrile symptoms. In many instances, particularly if the weather be cold and the cattle exposed, a hoarse tracheal cough is present, with much discharge from the trachea and bronchial tubes, whilst in aggravated cases the mucous mem- brane of the intestinal canal is very seriously involved, and when vesicles appear at the anus, it is fair to presume that vesication exists along the whole alimentary track; and post- mortem examinations of such reveal the presence of much inflammation of the intestinal mucous membrane, patches of denudation here and there, more especially in the fourth stomach, giving the disease very much of the characteristic appearance found in cattle plague, to which disease it is to some extent allied. It is when the feet are much affected that the loss to the stock-owner becomes great, for not only does the animal lose condition from the disease, but also from inability to roam about its pasture in search of food. Such cases should at once be comfortably housed, provided with proper aliment, and have the feet properly treated. In sheep, goats, and pigs the feet are the principal parts affected, the vesicles occurring between the digits and around the coronets. During the summer of 1872 eczema contagiosa assumed a very malignant character, especially in some herds of Iceland PLATE IX. FOOT AND MOUTH DISEASE. . EXCORIATIONS ON TONGUE. (From a Model in Museum of New Veterinary College.) on&Sons,Lith, Edin To face page . ECZEMA CONTAGIOSA. _ 208 cattle brought to Leith and Edinburgh, the ordinary symptoms being complicated with swelling of the legs and other parts of the body, the swelling when opened discharging a very fetid fluid. In all there was great prostration of strength, and many cases terminated fatally. The loss from foot-and-mouth disease to the dairyman, from the diminished secretion of milk, and to the owner of cattle nearly fit for the butcher, is very great. I do not think £4 a head too high an average; but when it is confined to lean or store cattle, provided the attack is mild, the loss of condition is quite ephemeral, and can scarcely be accounted a loss at all, for such animals appear to make flesh much faster after than prior to an attack of the disease. In India, where foot-and-mouth disease is common, it is as a rule a comparatively harmless affection, and working bullocks often continue to work without any apparent diffi- culty. If, however, these animals are severely tried, as happens upon a campaign amongst draught animals, the affec- tion is liable to assume a severe or even dangerous type, and sequele such as extensive gangrene of the foot may super- vene. If an outbreak of a contagious disease such as rinder- pest should affect such animals, the death-rate will assume alarming proportions. In that country, amongst the cattle of the plains, rinderpest is usually fatal to about 33 per cent. of the animals, but if foot-and-mouth disease be present the death-rate will be 90 to 100 per cent. As sequele to eczema contagiosa, the following alterations of structure have been observed—namely, swelling of the joints, open joints, with sloughing of interdigital substance, gangrene of a whole foot, marasmus, and disease of the bones. TREATMENT OF ECZEMA CONTAGIOSA. Mild cases require little medical treatment, foot-and-mouth disease being one of that kind which, running through a definite course, terminates in recovery. Whilst the mouth is very sore, all that the animal requires is a plentiful supply of cold water; if the fever be high, the water may contain an ounce of nitrate of potash dissolved in each bucketful. As a rule, however, even this is unnecessary. The food should 204, CONTAGIOUS DISEASES. be soft and easy of mastication—bran mashes, pulped roots, or grass. The feet must be looked to, and if suppuration be detected, with separation of some parts of the horn, the detached horn is to be removed, and the exposed sensitive surfaces dressed with a mild astringent, such as a solution of acetate of lead, containing a small modicum of carbolic acid. What I usually prescribe is an ounce of the concentrated solution of pure carbolic acid—one part acid to sixteen hot water—to twelve of the white lotion. Pledgets of tow dipped in this lotion are to be bound to the foot by a bandage. This simple expedient, so generally neglected, will often prevent a lameness of many weeks’ or even months’ duration; for sup- puration, once established to any great extent in the sensitive structures of the foot, causes violent pain, increases the inflam- mation, and induces the process of sloughing. Some writers recommend a variety of remedies both to the mouth and feet. My experience leads me to the conclusion that, except care- fully washing the feet, the less medical interference the better. Now and then cases will be marked by extreme prostration of strength, entire loss of appetite, inability to stand from weakness as well as from the lameness; such ought to be more actively treated, and stimulants, such as whisky, brandy, or spirits of nitrous ether, administered internally, and the feet washed repeatedly with cold water, and kept cool with wet cloths fastened around them. In all instances, bleeding, purging, and other depleting measures are most injurious. The bowels, perhaps constipated at first, become loose as the disease advances; but this condition is not to be interfered with, for the diarrhea may be looked upon as one result of the vis medicatrix nature, by which the morbid material is expelled from the system. Eixtensive sloughing of the struc- tures of the feet is best treated by more powerful antiseptics— solutions of chloride of zinc, or strong solutions of carbolic acid, say one part of crude acid to six or eight of oil. Sheep lose flesh very rapidly whilst suffering from foot-and- mouth disease. They suffer more in the feet than cattle, and consequently require more careful vigilance. It is a good plan to cause the affected flock to walk through a shallow trough, containing the above-named weak astringent and antiseptic solution, once or twice a day. And finally both cattle and ECZEMA CONTAGIOSA. 205 sheep ought to be washed before they are allowed to be driven on a public road or exposed in a market, if they have recently recovered from this disease. It may be difficult to do this with large herds of young cattle, and its compulsion would be considered a hardship, but of two evils it is incomparably the lesser. Pigs are frequently affected by receiving the milk from cows suffering from the affections, and have very well-marked lesions around the coronets. In these animals the disease is of a comparatively mild form, and they soon recover under ordinary treatment. Children contract the disease by drinking infected milk, and suffer from sore throat, aphtha or thrush, and often an eruption of vesicles between the fingers. CHAPTER XIX. CONTAGIOUS DISEASE S—continued. INFECTIOUS ABORTION. ABORTION in cows is offen seen as an epizootic, both in this and other countries, and its pathology has been profoundly studied in France and Switzerland, more particularly by Nocard, and its clinical aspect by Strebel, Galtier, de Poncius, and Org; by Lavat, who has witnessed it in sheep; by Biot, who considers it is an infectious inflammation of the serous _lining of the uterus; and by Herr G. Sand, Copenhagen, and Professor Bang. In this country, M‘Fadyean, Woodhead, and Aitken endeavoured to throw light upon its pathology. Their experiments were repetitions of those of Nocard, and lead tc no fresh conclusions; but a very valuable paper was read upon the subject by Mr. Harry Olver, F.R.C.V.S., Tamworth, at the meeting of the National Veterinary Association at Bir- mingham, 1895. Mr. Olver, who seems to have had great practical experience, rightly describes the disease under two heads—namely, non- contagious and contagious abortion—and states that abortion occurs at from the third to the seventh or eighth month. He also states that sporadic abortion is due to many causes, such as cold, wet, fright, injuries, food, water (when drunk icy cold); but he traverses the opinion of C. Stephenson and others, that stagnant water contaminated by sewage has any appreciable effect,1 though since then it has been fully proved that in-calf cows which drink water contaminated with sewage are likely to suffer from its ill-effects and to abort. Contagious abortion rarely occurs in the mare, ewe, or goat, and still more rarely as an epizootic in this country, but 2 See Transactions of National Vetcrinary Association, 1895. 208 INFECTIOUS ABORTION, 207 cases are recorded of undoubted outbreaks in America, France, Australia, &e. The disease occurs at all periods of gestation after the third month, and in the same animal at a later stage in each succeeding pregnancy, until at length the foetus is carried its full term, if the mother has not become sterile. The calf is generally dead at birth, but in some instances it is born alive ; it is, however, generally in bad health, emits a peculiar lowing, and after the third day is attacked with diarrhea, which rapidly terminates fatally. It is true that there is often great excitement amongst the cows in a byre during and after abortion by one of them, and that there is also often a peculiar odour emitted by both mother and offspring. It has been attributed to ergotism, mouldy food, cold, contusions, unwholesome drinks, &c. All these may be predisposing causes, but it is now fairly demon- strated by Nocard and Bang that the virus exists in the dis- charge from the mother, and in the uterine fluids, and that by the introduction of these fluids from an aborted cow into the vagina of healthy ones abortion will be induced in from nine to twenty days.—(Braver.) Lehnert thus produced it in twelve to twenty days, and Trincherra obtained a purulent vaginal catarrh and abortion in from nine to nineteen days. Inoculation matter obtained by scraping the surface of the chorion of an aborted cow produced a like result. The trans- mission from cow to cow is most probably by immediate con- tact of the material with the genitals of cows in the same byre, the discharges being conveyed by the groop or drain which is immediately behind the cows in all byres. It can easily be understood how the virus thus conveyed contaminates the tails and hind extremities of the cows when recumbent, and how easily natural inoculation is thus effected by the movements of the tainted tails, more especially if the drain leads from the aborted to the healthy ones. Noecard states that abortion takes its origin in diverse germs met with in the uterus of aborted cows, but which are never found in healthy ones. These germs are also present in the amniotic fluid in the alimentary canal of aborted calves, as well as in the medulla oblongata of those which during life give utterance to the peculiar lowing sound already referred to. 208 CONTAGIOUS DISEASES. Nocard states—“The autopsy of diseased animals does not reveal any alteration of the thoracic or abdominal viscera, with the exception of the uterus. The peritoneal serous membrane is normal, incision of the uterus reveals the presence between the mucous membrane and the chorion of a fibrinous muco- purulent matter, which is more or less abundant and often acid, in which the microscope shows epithelial cells, leucocytes, a large number of isolated micrococci, which are generated or associated in short chains of three, four, or five sections, and a few short bacilli, which are isolated or associated in pairs; in the cotyledonous liquid the bacilli are predominant; in the product obtained by scraping the uterine mucous membrane both micro-organisms exist in almost equal numbers. The amniotic fluid also contains them. In the aborted fcetus the intestinal mucous membrane is the seat of abundant epithelial desquamation; its tissue seems infiltrated with various microbes, which also exist in abundance in the contents of the intestines. These micro-organisms, which are contained in the digestive tube, give an explanation of the diarrhoea by which the calves which have been aborted in an advanced state of gestation are affected in two or three days after birth. Micrococci identical with those found in the amniotic fluid are also found in the medulla oblongata in those calves which continually bellow during the days preceding death.” Nocard arrives at the fol- lowing conclusions :— 1. In aborted cows, even in primipara, there exists in the uterus, between the mucous and the foetal membranes, especially in the cotyledonous crypts, several micro-organisms which can- not be found in newly calved cows, which belong to a locality where abortion does not exist. 2. These micro-organisms do not seem to exercise any noxious action upon the uterine mucous membranes of the mother, either during the period of gestation, which must be interrupted suddenly, or even after abortion. 3. Repeated abortion in the same subject can easily be explained, if we admit the pathological influence of the microbe, by the persistency of the latter in the uterine cavity till the time when it is able to exercise its action on a new foetus or on its envelopes. INFECTIOUS ABORTION. 209 4. Also cases of sterility which are consecutive to abortion can be explained by the acid reaction of the uterine mucus, in which the microbes thrive, the spermatozoa not being able to preserve their vital properties except in alkaline elements. 5. Epizootic abortion seems indeed to be a microbic disease of the fcetus and its envelopes, but one which does not affect the mother.—(ReEvszEt, 1889.) This form of abortion, while prevalent in certain districts, is unknown in others, but it may be conveyed from one district to another by the introduction of cattle from an infected area. Upon this point a mass of evidence is adduced by Bang; Royal Veterinary College, Copenhagen, who hints at the conclusion that abortion, independently of its isolated sporadic occurrence in widely separated districts, occurs in an epizootic or enzootic but non-contagious form from accidental causes, such as musty food, bad or cold water, insanitary surroundings, stall feeding, and in-and-in breeding. In addition to the evidence ag to its spread by the intro- duction of affected cows, proof is brought forward establishing the fact that the disease is also introduced by using bulls from an infected herd, and instances are recorded where bulls have been known to suffer from severe preputial inflammation after having served diseased cows. It is also stated that the vaginal mucous membrane is reddened, permeated throughout with cord- like swellings, and showing numerous small reddish-yellow or reddish-brown nodules. There are also small eruptions about the root of the tail, anus, and vulva. These symptoms, how- ever, are not common, but there is often a chronic purulent discharge from the vulva. As already stated, a first abortion occurs earlier than later ones, often at the third or fourth month, whilst the period. is gradually extended in later ones, and the explanation seems to be that the microbes gradually lose their virulence, until finally the animal has immunity. This fact is very important, and contradicts the generally adopted method of eradicating the disease, namely, that of disposing of aborted cattle and replacing them with fresh ones, which in their turn become affected and maintain the continuance of the disease in a herd ; whereas, if aborted cattle are kept, only those proving sterile being disposed 1 See Infectious Abortion, by Jno. A. W. Dollar,— Veterinarian. June 1893. 210 CONTAGIOUS DISEASES. of, they become immune, and the disease dies out in from two to four years, as it gradually loses its virulence, appears at a later period of gestation, and attacks fewer animals, The best and cheapest method of disinfection is to thoroughly cleanse the byres by washing and scrubbing, and then brush them over witha hot 1 per cent. solution of chloride of lime. Everything should be thoroughly cleansed twice a year, the stalls, walls, and floors once a week, and the drains daily rinsed with the chloride of lime solution. Animals showing signs of abortion should be at once isolated and provided with separate attendants. When the fcetal membranes are retained more than twelve hours they should, as far as possible, be removed by hand, and, together with the dead fcetus, destroyed by fire or buried in quicklime. The uterus should be washed out with 1 per cent. creoline, or 5 per cent. lysol solution, and this should be con- tinued weekly or oftener as along as vaginal discharges continue (usually two or three months after calving), and the cows not put to bull until their entire discontinuance. This both pre- vents the spread of the disease, and allows the majority of the animals to become pregnant. In the apparently healthy cows and heifers the vagina should be carefully washed out before they are allowed to enter the cow-shed, and afterwards the vulva, tail, and surrounding parts washed daily with the same solution, and the sheaths of infected bulls should be similarly washed out. Or Nocard’s recommendations may be substituted. They are as follows :— (1.) The floors, &c. are scraped, thoroughly cleansed, and sprinkled with a solution of sulphate of copper. (2.) Each week from the date of conception the vaginze should be thoroughly injected by means of a large syringe with the following tepid solution :— Distilled water, ; : . Twenty quarts. 36 per cent. alcohol and Siyedvine aa. 3 ounces, Ziii. Bichloride mercury, 24 drams, ; : Zii.ss. The vulva, anus, and surrounding parts of all the pregnant cows should be carefully sponged with the same solution. After removal of the foetal membranes of an aborted cow, the INFECTIOUS ABORTION. 211 uterus should be irrigated, by means of a long tube introduced to the bottom of its cavity, with eight or ten quarts of the solution (tepid), but containing only half of the sublimate. Aborted foetuses and foetal membranes should be destroyed by fire or boiling water. In the cow abortion generally takes place from the third to the seventh month; in the mare from the fourth to the ninth; and the act will be indicated by redness of the vaginal mucous membrane, on which pimply eruptions are often seen ; there is a discharge from the vulva of a reddish fluid, and a diminished Fic. 16.—Bang’s Organism and Spores of Contagious Abortion. secretion of milk, which becomes thick, simulating colostrum. These signs may continue for three days, when the foetus is easily expelled, leaving no other symptom than an increased vaginal discharge. The internal administration of half-ounce doses of crude carbolic acid, given three times a week in a bran mash for about a fortnight, and then discontinued for a fortnight, and again recommenced for a fortnight, and so on until parturi- tion occurs, will enable an infected animal to carry its calf the full period and at the same time be cured of the disease. The recent researches of Bang have thrown a great deal 14—2 212 CONTAGIOUS DISEASES. of light upon this subject. He has clearly demonstrated that the disease is due to a specific organism. The means of con- tagion are usually by the bull, and this is accomplished by the peculiar characteristic of the organism. The effects upon the contaminated bull or cow are practically nil either locally or systematically, and it is this fact that constitutes the greatest danger in its dissemination, as there may be no physical signs that a bull is infected, and yet this animal may be the means of contaminating every cow that he serves. The effects upon the cow are also nil until she conceives, and and even then, beyond causing abortion at variable periods, generally at the third or seventh month, there may be no systemic disturbance. It is seen, therefore, that the organism may lie dormant upon the penis of the bull or in the vagina or uterus of a cow for an unlimited period, and in the latter eventually cause abortion. It is said that cows tend to become immune; there is less chance of abortion the second time; and after the third time the animal will be altogether immune. PROPHYLAXIS. The means of prevention are to cease using any suspected bulls; cows that have already aborted should not be taken to a clean bull, and, if feasible, fattened and sold to the butcher. Thorough disinfection and cleanliness are essential. Attempts have been made to provide a protective vaccine, and the matter is still being investigated. The results, however, have so far not been very successful, and it would seem that, at any rate in England, it is hardly a necessary method. The organism is difficult to grow, and it is doubtful if vaccination will have the desired effect. The medium used in the preparation of the vaccine is serum broth. CHAPTER XX. CONTAGIOUS DISEASES—continuea. VARIOLA VACCINA (COW-POX). Synonyms.— Vaccine (F.); Kuhpocken (G.) Definition —A contagious, febrile, and eruptive disease, known in most parts of the globe, resulting from the presence of a specific fixed virus, which is reproduced and multiplied in the animal body during the course of the malady. Aftera period of latency of from six to nine days, the contagium causes the development of an eruption on the surface of the mammary gland, which eruption passes through the stages of pimple, vesicle, pustule, and scab. The disease runs a definite and mild course, and destroys the susceptibility of the affected animal to another attack; but in hot countries it sometimes assumes a diffuse and severe character. PATHOLOGY AND SYMPTOMS. Cow-pox has been described by high medical’ authorities as a malignant disease which destroyed cattle almost as extensively as small-pox did the human race. This view of the malignancy of cow-pox is evidently the result of a pathological error, which led observers to confuse the cow-pox with cattle plague. Jenner believed in the identity of cow-pox and small-pox, and that both had a common origin in the “ grease” of the horse. Jenner did not, however, perform any inoculations of cattle with the lymph of human small-pox. The first successful experiment of inoculating the cow with human small-pox was performed at the Berlin Veterinary College in 1801; the efforts previous to that period having been unsatisfactory. In 1807 Gassner of 213 214 CONTAGIOUS DISEASES. Giinsburgh inoculated eleven cows with small-pox matter, the result of which was the production upon one of them of vesicles having all the character of vaccine vesicles, and from which a stock of genuine lymph was obtained. In 1830 Dr. Sonderland of Barmen infected cows with the disease by enveloping them in blankets taken from the bed of a patient who had died of small- pox. Various other experiments have been made to this end by Mr. Ceely of Aylesbury, Mr. Badcock of Brighton, and by Mr. Macpherson in India. Mr. Ceely, in the tenth volume of the Transactions of the Provincial Medical and Surgical Association, gives a most interesting history of the communication of the disease to cattle from man without inoculation. “At the village of Oakley, about sixteen miles from the town of Aylesbury, small-pox had been epidemic from June to October 1840. Two cottages,in which three persons resided during their illness, were situated on each side of a long narrow meadow, comprising scarcely two acres of pasture land. One of these three patients, though thickly covered with pustules of small-pox, was not confined to her bed after the full development of the eruption, but frequently crossed the meadow to visit the other patients, a woman and a child, the former of whom was in great danger from the confluent malignant form of the disease, and died. According to custom she was buried the same evening; but the intercourse between the cottages across the meadow was still. continued. On the day following the death, the wearing apparel of the deceased, the bed-clothes and bedding of both patients, were exposed for purification on the hedges bounding the meadow, the chaff of the child’s bed was thrown into the ditch, and the flock of the deceased woman’s bed was strewed about the grass over the meadow, where it was exposed and turned every night and for several hours during the day. This purification of the clothes continued for eleven days. At that time eight milch cows and two young heifers were turned into the meadow to graze. They entered it every morning for this purpose, and were driven from it every afternoon. Whenever the cows quitted the meadow the infected articles were again exposed on the hedges, and the flock of the bed was spread out on the grass and repeatedly turned. These things remained till the morning, when the cows were readmitted, and the con- taminated articles were supposed to be withdrawn, It appears, VARIOLA VACCINA, 215 however, that the removal of the infected articles was not always accomplished so punctually as had been enjoined, so that, on one occasion at least, the cows were seen in the midst of them, and licking up the flock of the bed which lay on the grass. These cows were in perfect health when first put out to graze in this meadow; but in twelve or fourteen days five (out of the eight) milch cows appeared to have heat and tenderness of the teats. The teats became swollen, and small, hard pimples could be distinctly felt upon them as if imbedded in the skin. These pimples daily increased in magnitude and tenderness, and in a week or ten days rose into blisters—vesicles—passing into brown or blackish scabs. When the teats were in this condition and very tender, constitutional symptoms of il health became developed. Sudden loss of milk, drivelling of saliva from the mouth, frequent inflation and retraction of the cheeks, staring of the coat, tucking up of the flanks, sticking up of the back,” and rapid loss of flesh, were the appearances observed. By the middle of the third week the pustules were mature, “and the srusts and loose cuticle began to be detached.” One interesting fact was brought out in the course of this outbreak, namely, that heifers may be affected with variola as well as milking cows, an occurrence which up to this period was supposed to be impossible. The reason for this is obvious, heifers before calving, bulls, and oxen not being subjected to the same chances of accidental inoculation as milking cows. The interesting papers on this subject by Mr. Ceely, pub- lished in the eighth and tenth volumes of the Transactions of the Provincial Medical and Surgical Association, and the Reports of the Vaccination Section of the British Medical Association, contain many important facts bearing upon the identity of variola vaccina and human small-pox, and are well worth the careful study of every veterinary surgeon. But whilst these experiments seem so clearly to prove the identity of the variola of man with that of the cow, those of Chauveau point to an opposite conclusion. He performed numerous inoculations with small-pox lymph on the cow, which induced papular pustules, having no analogy with those of cow-pox. The lymph from those pustules implanted on man produced small-pox and not cow-pox; and it is stated in the Boston Medical Jowrnal for 1860 that during that year Martin inoculated some variolous 216 CONTAGIOUS DISEASES. matter, taken from a pock upon the body of a man who had died of small-pox, into a cow’s udder, and subsequently vacci- nated some fifty persons with the matter derived from the cow. Most of those so inoculated were attacked, not with vaccina but with variola (small-pox), and three died. It is difficult to reconcile such a wide difference in the results of experiments seemingly carefully performed, but I am not prepared to admit that the experiments of Chauveau and those of Martin have satisfactorily proved that those of others were wrong. In 1836 Dr. Basil Thiele of Kasan, in South Russia, inoculated some cows on the udder with the virus of human small-pox, the result being the production of vesicles bearing all the characteristics of the true vaccine vesicle. The lymph so produced from the variolation of the cows continued to retain the specific properties of variola vaccina throughout seventy-five successive trans- missions to the human body; and it is not stated that it had lost its specificity after so many transmissions. In the face of such conclusive evidence, I think we are justified in concluding that in the experiments made by Chauveau, the virus, granting that it was properly selected, had not under- gone that alteration during its transmission through the bodies of the inoculated animals which modifies and mitigates its virulence under ordinary circumstances, and that the virus selected by Martin from a fatal case of small-pox was not proper for an experiment where human life was at stake. Many experiments might be quoted (Ceely, Thiele, and others) to prove that great uncertainty and difficulty often attend the attempts to transfer the virus of variola from one animal tu another; that when variolous disease affects the lower animals in a malignant form, it is capable of producing by inoculation a disease of similar severity in man, and that marked improvement sometimes takes place in the energy and in the quality of the virus by subsequent removes or inocu- lations in animals of the same kind, after the variolous virus had been successfully implanted in one of them; it seems to become less acrid, less virulent, and to acquire increased specific activity; capable of inducing more pronounced and_ perfect development of vesicles, with milder and less dangerous general symptoms. Variola vaccina has been transmitted back to the cow from VARIOLA VACCINA. 217 man (retro-vaccination). By this process good human lymph loses some of its activity, for, according to Mr. Ceely, the pheno- mena in man, after vaccination with this retransmitted lymph, appears later, smaller vesicles are produced, but ultimately, after successive reinoculations on man, it regains its activity. The disease vulgarly termed “grease” in the horse, believed by Jenner to be the origin of variola, has nothing to do with small-pox or cow-pox ; but it is placed beyond a doubt that the horse is subject to a true equine pox, and that it is transmissible to the cow by inoculation and cohabitation. It is stated that the equine pox occurs as an epizootic when small-pox is epidemic. When small-pox was raging in Edinburgh in 1872, I saw one case of what I considered genuine equine pox. The animal (a mare) presented signs of fever, had a slight cough, loss of appetite, with costive bowels for eight or ten days before any skin disease was observed. She was treated for a common cold, with fever: but at the end of the time mentioned small pimples were ob- served on various parts of her body, more particularly about the shoulders and back. At first these pimples were very numerous, small, and pointed ; the great majority of them, however, withered, and a small scab fell off, leaving the skin bare of hair. About a dozen on each side of the shoulders and upon the back increased in size, became vesicular, and afterwards pustular. These erup- tions had very much of the character of those seen in cow-pox, namely, pimples increasing in size from a point to that of a horse- bean, becoming vesicles in three or four days, and then pustules, depressed in their centres. In about ten days, or eighteen after the first manifestation of illness, dark, thick, solid scals formed on the sites of the pustules. These scabs did not all fall off until fully a month had elapsed, and the hair was not completely restored in two months afterwards, when I lost sight of her. Jenner, Saccho, and others, have used equine lymph for the purpose of vaccination, and human small-pox has been transmitted through the horse to the cow, and so to the child in the form of cow-pox. It has not been determined whether the small-pox poison originated in man, the cow, or the horse; whether man had the disease communicated to him from the lower animals, or whether horses and cows had it from man. The origin will most probably for ever remain a mystery, and we must be content with the 218 CONTAGIOUS DISEASES. knowledge that, through the keen penetration of Jenner, the disease directly communicated by vaccination from the lower to the higher animal has proved a blessing to millions of the human race. There are many forms of eruption in the udder of the cow, which are sometimes confounded with those of variola; but those of variola have certain characteristics which distinguish them from all other, or so-called spurious, forms of the disease. The local symptoms of the true variola are heat, swelling, and tenderness of the teats for three or four days, followed by irregular pimply hardness of the skin, more particularly about the base of the teats. The pimples may sometimes be felt in five days after communication; they assume a red hue when about the size of a pea, are very painful and hard, gradually increase in size, and in other three or four days attain that of a horse-bean, assuming a circular form on the udder, and an oblong on the teats. They rise in the centre, become more or less pointed (acuminated), containing at first a clear, and ultimately a turbid fluid. If the vesicles are broken, troublesome sores supervene, the discharge from which will communicate the disease to the milker, if he is not already protected by previous vaccination. The vesicles, if not broken, become depressed in their centres, and have an indurated margin, around the circum- ference of which the skin denotes active inflammation by a circle of redness, acquiring their maximum size about the tenth day, and are then pustular; and as the pustules dry, dark brown or black solid scabs or crusts form upon the surfaces. Some of these scabs may be seen semi-detached, others entirely so, ex- posing a raw surface, with a slight central slough. Vesicles, pustules, and scabs may be witnessed on the same teat at one and the same time, indicating the formation of new crops of vesicles at different periods. The crusts, if left undisturbed, gradually become thicker, darker, and more compact until about the fourteenth day, and spontaneously separate about the end of three weeks, leaving shallow, smooth, oval, or circular pits of a pale rose colour, with some traces of surrounding induration. The depression in the pocks is accounted for in various ways. Dr. Petzholdt thinks it is caused by the ducts of the cutaneous glands, which are ruptured as the pustules fill with pus and maturate, but which, in the early period of the eruption, bind VARIOLA VACCINA, 219 down the cuticle to the cutaneous glands, thus producing the pit or umbilicus. Dr. Gustav. Simon differs from the above opinion, and says that “ variolous pustules are not always constituted alike. In many cases, where a central depression clearly existed, the epi- dermis was entirely raised from the subjacent cutis; and only at the spot corresponding with the umbilicus were both mem- branes united by a thin, whitish cord, which, as the microscope evidently showed, was a hair sac. The presence of a hair sac is not, however, essential to the production of an umbilicus, and a remarkable peculiarity, first noticed by Rayer, characterises the variolous vesicle in those parts of the body where neither hair sacs nor sebaceous follicles exist. Rayer found, on removing the epidermic cap of the vesicle, and wiping off the fluid collected beneath, that a little elevation existed in the centre of the denuded corium, whilst the circumference was visibly depressed below the level of the neighbouring healthy cutis. These eleva- tions were found by Dr. Simon, who examined them micro- scopically, to consist of a file of papille of normal or nearly normal size and condition, while the depressed margin is paved with papille bent down or flattened. The explanation is simple. At the centre of the vesicle an organic connection (from some yet unexplained cause) exists between the cutis and cuticle, and at this point no fluid is effused; but around this centre, exudation of fluid occurs without impediment, and tends to force the cutis and cuticle asunder.”—(British and Foreign Medico-Chirurgical Review, vol. iii.) About the ninth day of the vaccine disease a purely vesicular eruption makes its appearance upon the udder. Within twenty- four hours the vesicles contain a pellucid serous fluid. On the following day the fluid becomes turbid, the cuticle collapses or bursts, and a thin, brittle, flimsy crust forms, and speedily falls off. Successive crops continue to form and dessicate for three or four weeks. It is difficult to trace the origin of an outbreak of variola vaccina in a herd of cattle. Outbreaks of it seem to follow similar inexplicable paths to those which characterise other con- tagious diseases. Cases spring up now and then which appear to be solitary, and cannot be traced to a cause. At other times it seems to be epizootic, and prevails at several farms at the same 220 CONTAGIOUS DISEASES, time. Unlike, however, the other contagious diseases of horned cattle, and unlike variola ovina, it is a disease which seldom or never proves fatal in this country. In some instances, the constitutional disturbance is rather severe, the mucous mem- branes being particularly prone to participate; the mouth becomes sore, and there is drivelling of saliva. In hot climates the symptoms are succeeded by abdominal pains, profuse diarrhoea, rapid wasting of flesh, and sometimes death; but in temperate climes the general symptoms are slight diminution in the secretion of milk, with but little or no loss of appetite. The organism or actual cause of cow-pox is another of those which must be classed among the ultra-microscopic. Various observers have described the cause as being a coccus, but in all cases this has been demonstrated as an accidental contamination, as is in most diseases with a cutaneous lesion, such as scarlet fever, measles, &c. Cocci, diplococci, and even streptococci are constant inhabitants of the skin, and if any lesion occur, they will naturally be found easily, yet although not the actual cause of the disease, they will cause complications and even grave sequele from the pustular condition they set up and the danger there is of absorption, resulting probably in septicemia. By filtering the vesicular exudate, these contaminating organisms may be eliminated, but still the filtrate is infective, showing that it contains materies morbi which are infinitely smaller than coccoid bacteria—in fact, so small as to be in- visible with the highest powers of the microscope yet invented. What this material is we are as yet ignorant. Pfeiffer and others have endeavoured to demonstrate that the causal agent is a protozoan organism; but even these are too large to pass through a porcelain filter, so that if the organism is a proto- zoan it must have an intermediary stage or a sporulating form which is infinitely small. The disease must, therefore, be placed with foot-and-mouth disease, &c., as one of those due to an ultra-microscopic organism. When once the disease breaks out in a dairy, it is apt to spread to the whole herd, unless precautions be taken against its diffusion, by segregation of all affected animals and the employment of separate attendants, particular care being at VARIOLA VACCINA, 221 all times taken that the milker of an affected cow shall not touch a healthy one. The milk should be drawn off with the teat syphon, and, if the mammary gland becomes much in- flamed, fomentations may be necessary, with other treatment recommended for ‘‘mammitis” (see Principles and Practice of Veterinary Surgery) ; but in all ordinary cases of the disease non-interference is to be strictly observed. The protective vaccination of human beings by using cow- pox lymph has, now that its benefits have received almost universal acceptance, been placed upon sound commercial productive lines, and this is accomplished in specially fitted laboratories, with a proper staff, whose duty it is to provide pure vaccine lymph obtained from healthy calves. The old method of vaccinating from child to child was objectionable and dangerous, from the risk of infection by other diseases. It is almost impossible to obtain lymph from a calf that is not contaminated with various pathogenic and non-pathogenic organisms unless elaborate precautions are taken. It is there- fore better that good lymph should be prepared and issued from central laboratories. The power of glycerine to kill ordinary staphylococci, and not to in any way reduce the activity of vaccine lymph, has been taken advantage of in this preparation, and the modus operandi of lymph-produc- tion is as follows: Healthy calves of from four to seven months old are selected. It is well to test them with tuber- culin, and to keep them under observation for some weeks prior to using them. Such a calf is secured on a clean table in an operating-room ; its abdomen is shaved and thoroughly washed with hot water and soap, and then douched with sterile distilled water; no antiseptics are used, but if the above operation be properly performed, the abdominal surface will be sterile. Calf-lymph is then inoculated by scarifying the skin in longitudinal lines all over the shaved surface, taking care not to draw blood, as this would have a bacteri- cidal effect upon the virus. The virus is well rubbed into the scarification with a sterile horn spatula, the calf released, and a sterile cloth bound loosely round the vaccinated surface. Five days after the operation the virus will have “taken,” and be ready for removal. It is scraped off with a blunt sterile spoon quickly and cleanly, again taking care not to 222 CONTAGIOUS DISEASES, remove any blood. The vaccine so obtained is mixed with glycerine and water, equal parts of each, and one part of vaccine to four parts of the mixture. The emulsion so produced is then thoroughly pounded in a special grinding apparatus, and is then ready for use. It is as well to allow a month before use, as the glycerine will ensure the destruc- tion of extraneous organisms in that time. It is understood that every stage in the operation is conducted with absolutely sterile materials. The vaccine for issue is put up in small capillary tubes, each containing some six to eight doses. The calves recover from the effects in a few weeks, but should be destroyed, and a post mortem made to see if they are free from all infection. By this means, if any calf be found diseased, the lymph should be discarded. There is now no doubt that small-pox and cow-pox are one and the same, and that the former is modified in its passage through the latter, so rendering it a useful vaccine. This fact is taken advantage of to obtain a more active calf-lymph for protective vaccination. A successful lymph may also be obtained in the same way from horse-pox. CHAPTER XXL CONTAGIOUS DISEASES—continued. VARIOLA OVINA (SHEEP-POX). Synonyms.—Claveau or Clavelée (F.); Schafpocken, Schaf- pochenseuche, and Schafblattern (G.) Definition—A contagious and infectious eruptive disease, analogous to small-pox and cow-pox; runs a definite course, and occurs but once, as a rule, in the same animal. It is divided into two forms :—1st. A malignant, virulent, or confluent form ; and 2d. A benign or discrete form. The malignant form never produces vesicles ; the sheep lose their eyes; their wool falls off, the skin cracks in a zig-zag manner, and the nostrils become filled with a fcetid discharge. In the benign form, genuine vesicles appear, which, after the scabs fall, leave pits in the skin, on which the wool never grows again. According to Pro- fessor Simonds the disease is not communicable to the cow or to children. Saccho, however, states that ovinaiion is protective against small-pox. HISTORY. Sheep-pox is said by Mr. Fleming to have appeared as an epizootic in England about a.D. 1277, but that it was well known in Britain more than two hundred years previous to 1275, and was called the Rot. The term variola had, however, been made use of in 569 (Animal Plagues, 1875). But in more modern times sheep-pox was unknown in this country until 1847, when it broke out on a farm at Datchett, near Windsor, where it was introduced by fifty-six merino sheep, brought to this country in the ship “ Trident,” from Tonning, in Denmark. Professor Simonds, in his treatise on Variola Ovina, says of 223 224 CONTAGIOUS DISEASES. these sheep— When disembarked they appeared to be in health, and were sold by the salesman to whom, with other sheep, they were consigned. We have not succeeded in tracing the subse- quent distribution of each separate lot of this cargo, but we are assured that many of the animals continue well. It is, therefore, evident that in this particular instance the malady was imported from Denmark; but this unfortunately did not prove to be a solitary case of its introduction. “Within a day or two of the arrival of the ‘Trident,’ the ‘Mountaineer’ and the ‘ Princess Royal’ came into port, each vessel having on board a number of merino sheep brought from Hamburg. . . . . Some of these sheep—507 brought by the ‘ Princess Royal "—were sold to butchers ; others to farmers, as ‘stock sheep.’ The latter were bought in several quantities on 26th July by Mr. B. Weall, of Woodhall, Pinner ; Mr. Good- child of Kingsbury; Mr. Pittman of the same place; and Mr. Choke of Barking. These purchased by the two last-named gentlemen are said to have continued in health ever since. Mr.. Goodchild’s sheep, however, showed symptoms of the disease very shortly after arriving at his farm, their illness being attri- buted to his having had them dipped or washed, for its true nature was not suspected. That portion of the cargo of the ‘Princess Royal’ which was purchased by Mr. Weall consisted of 80 merinos; and on the same day he bought 166 other sheep of the merino breed that had arrived by the ‘ Mountaineer.’ These two lots were placed together, and subsequently, being sent to Pinner, were equally divided between Mr. Weall and his brother. In each moiety the disease showed itself, being first observed among the 80 sheep about ten days after their pur- chase, and from them it rapidly extended to others. Out of those belonging to Mr. B. Weall, 20 died in the acute stage of the malady, 27 more were sacrificed, and the residue was dis- posed of at a low price.” ; “We examined Mr. B. Weall’s flock on the 7th of September, and found two of the sheep in the earliest stage of the malady, but most of them were recovering.”—(Simonps on Variola Ovina.) The outbreak of 1847 committed great ravages in Middlesex, Surrey, Norfolk, Cambridgeshire, Suffolk, and Hampshire, and continued during 1847, 1848, 1849, and 1850; the losses from VARIOLA OVINA. 225 it were also severe in 1852, and more so in 1853, at which time the practice of slaughtering sheep in or near London put an end to the disease until 1862, when it broke out at Allington, in Wiltshire. This outbreak was supposed to be of spontaneous origin, as it could not be distinctly traced to foreign sheep. Mr. Gamgee visited the district at the time, and made many observations, from which he came to the conclusion that “the district turns out to be one not unfrequently visited by con- tagious disorders. . . . The district is traversed in all directions by driftways, so that drovers can pasture their sheep on the downs for days, and go from Bristol to London with the pay- ment of a single toll. There are some notorious dealers who have no farm or down on which to keep their flocks. They pick up odd animals at a low price here and there, and drive over the downs, where they sleep, and move gently backwards and for- wards on the ‘pretext of travelling, but in reality getting food for their flocks. Many instances have occurred of the spread of contagious disorders, such as scab, the foot-and-mouth disease, foot-rot, &c., from these infected flocks passing over the downs along the Wans Dyke.” The disease is not readily transmissible to other animals, but it appears that goats, pigs, hares, rabbits, and dogs are amenable to it. These observations of Mr. Gamgee, along with the fact that sheep-pox is one of these diseases which never occur spontane- ously in this country, are to my mind quite sufficient to account for the Wiltshire outbreak. The early history of sheep-pox on the Continent of Europe, in some parts of which it is very prevalent, is very confused ; it is certain, however, that it was introduced into Western Europe by diseased animals brought across the Russian frontier into Poland, Hungary, Prussia, Pomerania, &c. Rammazini states that the malignant affection amongst cattle and sheep which prevailed in 1514, 1599, and 1691 was small-pox. From his description it is very probable that the disease of 1691, which chiefly attacked sheep, was in reality variola ovina, inasmuch as it was characterised by pustules similar in form, colour, and in the manner in which they went off. When they had died off after the suppuration, they left a black scar, like that which remains after the small-pox. Professor Simonds instituted various experiments which prove 15 226 CONTAGIOUS DISEASES, that variola ovina is inoculable, contagious, and infectious, and that its incubative stage varies from seven to thirteen days when communicated by inoculation, and from nine to twelve days in natural cases. Like the poison of cattle plague, that of sheep-pox is both volatile and fixed, existing in’ the blood, the tissues, secretions, and emanations, and may be carried from place to place in the clothes of attendants, in fodder, wool, skins, and particularly by dogs. Mr. Chas. Percivall informed Mr. Gamgee that he had seen a dog (Mr. Stephen Neate’s) suffering from symptoms of disease identical with those of variola ovina, and there could be no doubt but that the dog contracted the disease from affected sheep (Domestic Animals); and it is pretty well demonstrated that a healthy fiock is not secure from the disease at the distance of a quarter of a mile from affected sheep. Upon this head Continental writers are very clear, and they point out the danger of driving a healthy flock on the same road which shortly before has been travelled over by a diseased one. Chauveau has shown that the virus is a hundred times more infective, that the matter contains in an equal quantity thirty times the number of corpuscles, and is more active than that of vaccina. He has also shown that if vaccine matter be diluted with fifty times its weight of water, it propagates itself when inoculated with great uncertainty, while ovine matter may be diluted 1500 times before its virulence is appreciably affected. The virus retains its vitality, when protected from the air, for a very considerable period, but is destroyed by the influence of air, heavy dews or rain, sunlight, a temperature of 122°F. frost, and disinfectants, such as chlorine, permanganate of potash, and ozone, as well as by putrefaction, and if the wounds he suppurat- ing, the matter from them will not infect. PATHOLOGY AND SYMPTOMS! As already stated, the period of incubation varies from about the seventh to the thirteenth day, during which time there are no symptoms observable to a non-professional person. Like all specific fevers, however, there is an increase in the tempera- ture of the animal body for some time prior to the outward 1 The remarks made concerning the etiology of small-pox apply equally to sheep-pox. It is one of those eontagious diseases due to an organism of the ultra-visible variety. Sheep-pox would appear to be as malignant a form amongst ovines as small-pox is to man VARIOLA OVINA. 227 manifestation of the disease. In thirty-six to forty-eight hours after the first manifestation of the disease, the temperature rises to 105°, or even as high as 107° or 108°, but in the benign form it diminishes at the commencement of the eruption. In the malignant it is slower and later in diminishing, more irregular, and increases when suppuration occurs, becoming normal at the period of desiccation. A careful observance of the tempera- ture is of great importance, in order that affected sheep may be removed from the flock before any of the ordinary signs of the malady can be detected, and before the disease becomes infectious. By carefully watching and examining their flocks, some farmers have been able to arrest the spread of the malady, and the course they have adopted has been that of segregating the diseased ones when the slightest rash made its appearance upon them. Mr. Charles Fielder of Sparsholt, near Winchester, says—“I em- ployed two men to turn every sheep I had on my farm, and minutely inspect every one of them; and if they saw the slightest appearance of any rash, or a single pustule showed itself between the inside of the shoulder and the breast, where the skin of the sheep generally looks white and clean, and where it was sure to show itself first, [ had it immediately taken away, putting the whole of the diseased together in one large field in the middle of my farm, at a distance from any road, as a pro- tection to my neighbours. I followed the same course every morning, by having all my sheep turned and closely inspected, not looking to the trouble and expense, as I felt in my own mind that it was the only remedy I had to stop the infection; as I calculated, if I could only find out those sheep which had taken the disease and were breeding it, before it became infectious to others, 1 should be able to arrest its progress. Fortunately I was right in my calculations, for they daily decreased in num- bers, although they still kept faltering for a fortnight or three weeks from the time I began turning them (particularly in one flock where the Spanish sheep had been), before it, as I hoped, ceased altogether, as I have not found a diseased one for some time past.”—(From the Farmers’ Magazine, vol. xvi, page 524, quoted by Professor Stmonps.) If separating the diseased from the healthy sheep after the first symptoms of the malady are discernible by an ordinary observer has so far been sufficient to arrest its spread, it can easily be understood that removal prior to the appearance of the rash will yet prove more satisfactory. 15—2 228 CONTAGIOUS DISEASES. Symptoms.—The first appreciable signs of the disease, after the termination of the incubative stage, are recognisable “ by the existence of papule or nodules deeply imbedded in the dermis, having a florid red aspect. These show a preference for some parts of the integument, and are usually to be first detected on the inner side of the arms and thighs, and on the cheeks and lips, where the animal has a hairy and not a woolly covering. Other portions of the body are often simultaneously attacked, as the prepuce, labia, anus, and under surface of the tail—parts which are perfectly nude.”—(SIMONDS.) In some cases there will be a diffused redness of the skin, in patches of various sizes, prior to the formation of the papule. Professor Simonds says that in inoculated cases this is so well marked that it constitutes a disease of the skin, analogous to roseola variolosa of the human subject, and establishes another similarity between these maladies. During the papular stage the skin has a flea-bitten appearance, the eruption being at first in the form of small red points; these gradually enlarge, often uniting one with another. Professor Simonds considers that three days may be regarded as the period of papulation, and that it is generally longer in confluent than in the distinct form of the disease. The disappearance of the papulated eruption, the disease afterwards lying dormant in the system for three weeks and then breaking out, as described by Hutrel d’Arboval, was not witnessed by Professor Simonds. Concomitant with the appearance of the rash, febrile symptoms are manifested, the animal becomes dull, with blood-shot eyes, is thirsty in all cases where the eruption is extensive, and the papule confluent. Where the eruption is distinct the febrile symptoms are much milder. Continental writers state that the outward signs of fever precede the eruption: the experience of Professor Simonds and others in this country does not confirm this, for in all cases seen by Professor Simonds the eruption preceded the constitutional disorder. “The red papule gradually enlarge in size, then become ele- vated and transparent in their centres. The papula is now a vesicle containing a liquid at first transparent and then turbid. Many of the vesicles are very small, and if punctured yield no fluid. The duration of the vesicular stage differs to some degree, and it has been observed that many of the papule disappear without vesicles being produced. The ovine vesicle is flat on its VARIOLA OVINA, 229 surface; and in this particular it forms a contrast both with the vaccine vesicle df the cow and the variolous of man. The serosity of the vesicles, first clear, becomes milky, turbid, less serous, and straw coloured, and ultimately by drying hardens Into a crust, and is cast off with the epidermis.”—(SIMonDs.) Both Professor Simonds and Mr. Ceely are of opinion that the term pustule should not be applied to the eruption, except, as Mr. Simonds says, in the latter stages of extreme and protracted cases, where pus is in reality formed, and is succeeded by the ulcerative process. “The period of desquamation or desiccation depends on the extent of the original eruption, and also on its being distinct or confluent. It is likewise governed by the amount of inflamma- tory action which existed in the dermis, and is always protracted when suppuration has taken place.”—(SIMoNDS.) The vesicles, scab, and crusts are liable to be injured in various ways, but more particularly by the sheep scratching themselves, and this interferes materially with the process of healing, and causes considerable irregularity in the duration of the malady. “Tn natural cases, even when mild,” says Professor Simonds, “and when no cause retards their completion, a month, reckon- ing from the period at which the animal was first exposed to the contagion, usually passes before it is restored to health. “ The following summary of the gradations of the malady may be accepted as sufficiently accurate for practical purposes :—The first ten or eleven days are those of incubation ; the twelfth and “hirteenth of invasion; the fourteenth, fifteenth, and sixteenth of papulation ; the seventeenth, eighteenth, and nineteenth of vesication; the twentieth, twenty-first, and twenty-second of suppuration; and the twenty-third to twenty-eighth of desiccation and separation of the crusts.”—(Stmonps on Variola Ovina.) The same authority says that the constitutional symptoms, especially those which indicate the greatest danger, “are dejec- tion, the head being held low; the infected animals separate from their fellows; mostly lie down in a corner of the field; the ears are pendent; the breathing quick and short; the eyelids are swollen, and tears trickle down the face; the conjunctiva varies in shade from a bright scarlet to a modenared ; a mucous discharge flows from the nostrils, and increases in viscosity as the disease advances, often becoming sanguineous in the latter stages ; yellowish spots may likewise be seen scattered 230 CONTAGIOUS DISEASES. here and there on the pituitary membrane; the pulse early gives evidence of febrile excitement; at first it is quickened and somewhat increased in force, numbering about ninety- five beats in a minute; later on it becomes tremulous and indistinct, even over the region of the heart; rumination is suspended, and all food refused; but the patients show a great disposition to take water, and also to lick earth, which, mingling with the mucus of the nose, assists in clogging the nasal open- ings, and renders the respiration more difficult. The alvine evacuations are but little changed in the majority of cases; in some, however, diarrhcea succeeds to a torpid condition of the bowels, and hastens the fatal termination; the temperature of the body is unequal, the feet and ears being generally cold, while the skin elsewhere is hot. “These symptoms, more or less modified, are present from the commencement of the eruption, and seldom abate until the papular stage gives place to the vesicular, when the animals usually experience a relief. In all natural cases, the constitutional disturbance is great, and makes the probable termination of the attack doubtful, which is also rendered more uncertain when the confluent form of variola prevails; for the type of the disease, as elsewhere stated, governs to a considerable extent the amount of the fatality. “Not only is the prognosis unfavourable in confluent variola, but it is equally so if the fever continues unabated, which is certain to be associated with an augmentation of the patient’s sufferings. The breathing now becomes rapid and painful; the inspirations frequently, but more often the expirations, are accompanied with a moan ; frothy saliva is discharged from the mouth ; the exhalations are fcetid ; the wool separates from the skin on the application of the slightest force; ulcerations of the conjunctival membrane occasionally result ; and sometimes the internal structures of the eye give evidence of disorganisa- tion ; the animal shrinks from the touch; the pulse gets more and more indistinct; great prostration of all the vital powers succeeds, and death closes the painful scene.” The percentage of mortality arising from variola ovina varies considerably ; very often half the sheep which are attacked suc- cumb to the disease, and it is not unusual for nearly the whole ‘flock to be swept away. Mr. Gamgee states that in one out- break ‘‘ the losses on 3811 sheep were 221 before inoculation VARIOLA OVINA. 231 had been practised, and the loss since has amounted to 537, or a total of 758 on 3811, viz., very nearly 20 (19°89)? per cent., whereas in 1310 not inoculated the loss amounted to 21 sheep, or 1°6 per cent.” It is evident that Mr. Gamgee intends the reader to under- stand that the small mortality in the 1310 was due to the precaution of separating the diseased from the healthy animals during the earlier stage of the malady. POST MORTEM APPEARANCES. The post mortem appearances of small-pox are as follows :— Body swollen, and exhaling a fcetid odour; the eyes and nose closed with dry discharges ; the mucous membranes of the mouth, nose, pharynx, cesophagus, larynx, bronchi, and rumen are covered with light copper-coloured vari or nodules, and occasionally small ulcers are seen on the epiglottis and other parts of the larynx. The lymphatic glands in various parts of the body are enlarged, and marked with red spots. The subcutaneous tissues are engorged with blood, and covered with solid red nodules, whilst purulent formations exist beneath the confluent papule. The areolar tissue of the face and extremities is often filled with effusion, and the skin itself is in some parts red, in others of a blackish hue, and the wool, if not already detached during life by the animal scratching itself, easily comes off. PREVENTION AND TREATMENT. The prevention of the disease in this country depends upon the exclusion of animals from infected countries. The incuba- tive stage being of such a duration, affected animals may easily pass the examination of the most careful inspector, no signs of illness being manifested during this stage. If, however, variola should appear in a flock, the best way of dealing with it is that recommended by Mr. Fielder(see page 214), namely, the separation of all diseased sheep during the earliest stage of the disease ; and pastures, roads, and other places frequented by the diseased animals should be avoided until heavy rains have destroyed the contagium. 1 In Mr. Gamgee’s book it says very nearly 10 (19°89) per cent. ; the figure 10 is evidently a mistake. 232 CONTAGIOUS DISEASES. Inoculation or ovination is recommended by very high autho- rities. In this country, however, the experiment has not proved at all satisfactory. French veterinarians speak highly of ovina- tion: thus, at the Alfort Veterinary School the mortality was only at the rate of 1 in 400 after ovination. Professor Simonds says our experiments are too limited to suggest correct conclusions, and they have shown a result so different, that, were we to found an opinion on the merits of ovination on them alone, it would not be in favour of the practice. The deaths have been at the rate of 20 per cent. Professor Gamgee condemns ovination entirely, Undoubtedly inoculation serves to increase the centres from which the contagium may extend in every direction, whereas segre- gation or slaughter at once diminishes the cause of the propagation of the disease, as well as the centres from whence it might spread. Variola ovina, being a disease that runs a definite course, is not beneficially influenced by the action of medicines; on the con- trary, the forcible introduction of drugs, or even of gruels, and other so-called nourishments, into the animal’s stomach when it is incapable of digesting them, is calculated to do much harm. If the diarrhoea be excessive, chalk is to be mixed with the water which the sheep may drink; or if there be much fever, but no diarrhoea, chlorate or nitrate of potash may be ordered in the same vehicle. It is essential, however, that the sheep be kept clean, have their nostrils sponged or syringed to prevent suffocation, have clean beds to lie upon, be well sheltered and kept warm, have plenty of fresh air, and, if they eat at all, be supplied with easily digested food. On the Continent variola occurs among goats, pigs, dogs, and fowls. Mr. Gamgee describes a form of chicken-pox in cattle, occur- ring on the Continent under the term varicella bowm—(See GAMGEE'S Our Domestic Animals in Health and Disease, p. 256.) VARIOLA EQUINA, OR HORSE-POX (Also called grease, constitutional grease, Soy’s discase, and sore heels), is described by Dr. Fleming in his Sanitary Science and Police as an eruptive vesico-pustular malady, generally diffused in the different parts of the world inhabited by the horse. With the exception of the case mentioned at p. 193, I have never witnessed anything approaching to variola in the horse. VARIOLA EQUINA. 233 tt appears, however, that the eruption, preceded by a very slight, almost imperceptible, degree of fever, may appear on the skin at different parts, or over the whole body, on the nasal and buccal mucous membranes, and occasionally on the conjunctive. The nasal eruption not only involves the Schneiderian membrane, but the nostrils and lips, and is apt to become confluent on the lips and the inferior parts of the limbs. The contagium of the variola is transmissible from horse to horse, to the cow and to mankind, by contact and inoculation but not by infection. Variola equina appears to be a very mild and benignant disease ; and as Dr. Fleming’s work contains a full description, the reader is referred to it, as well as for descriptions of the goat-pox (variola caprina), porcine pox (variola suilla’, variola canina, and the variola of fowls. Professor M‘EKachran, of the Moutreal Veterinary College, reports in the Veterinary Journal, August, 1877, an outbreak of equine variola in Montreal in February and March of that year. Variola equina has been confounded with grease, but there is not sufficient evidence to show that the two conditions have any relationship. Grease may be excited by variola, but the former is a comparatively common affection, and the latter is very rare, at least in England. Some prominence has recently been given to variola in horses in India by Pease and Baldrey, on account of its having been compared with dourine. The variolous eruption is mild, and often affects the genital organs of entire horses and breeding mares, and this eruption in its pustular stage has given rise to the fear of a dourine infection. Its evanescent character and mildness, and the absence of any trypanosomes, however, render it not difficult in differential diagnosis. Horse-pox in a somewhat acute form occasionally occurs in an epizootic form amongst horses, and attacks the nostrils and lips often without affecting either the coronet or the genitals. In the pustular stage, ulceration may supervene and spread into the mucous membrane of the nose. In this case it has happened that glanders has been suspected; but again, the rapidity with which the lesions heal, and the absence of any other glanders lesions, will render diagnosis easy, even without the use of mallein. -_— CHAPTER XXII CONTAGIOUS DISEASES—continued. RABIES. Definition—A disease originating in the canine, and, less frequently, in the feline race. During the progress of the malady a specific virus is developed in the saliva of the affected animal, which, being implanted through a wound, bruise, or thin epidermis without wound or abrasion, conveys the disease to other animals and to man. After an indefinite period of latency, it causes pain and stiffness in the bitten part, excite- ment, feverishness, inability to swallow liquids, a tendency to bite, great prostration, and death. The poison is only recognised by its morbid effects in the animal economy. ° HISTORY, Rabies (Rabio, to rave), or, as it is sometimes erroneously called, so far as the lower animals are concerned, hydrophobia, is a disease which has been known from very early times. Dr. George Fleming, in his work on Rabies and Hydrophobia, says—“Tts great antiquity is undoubted. Plutarch asserts that, according to Athenodorus, it was first observed in mankind in the days of the Asclepiade, the descendants of the god of medicine, Aisculapius, by his sons Podalirius and Machaon, who spread through Greece and Asia Minor, as an order of priests, prophets, and physicians, preserving the results of the medical experience acquired in the temples as a hereditary sect. They were the earliest physicians known to us, and it is not unlikely 234 RABIES. 235 that they may have been the first to observe the madness of dogs transmitted to man.” Dr. Bardsley, in his Memoir on Hydrophobia (Cyclopedia of Practical Medicine, vol. ii.) says— “We have already said that the disease was well known to Homer, and applied by him, with his usual critical exactness of similitude, to the indiscriminate havoc with which Hector sweeps through the battlefield of his enemies.” Hippocrates alludes to hydrophobia in the faintest manner; but Democritus, who was contemporary with Hippocrates, according to Czlius Aurelianus, wrote upon the nature and treatment of the disease. Aristotle, in his De Historia Animalium says that the disease is communicable to all ani- mals put man. Many other ancient and modern writers have described the fearful malady: amongst the latter may be mentioned Van Swieten, Sauvages, Cullen, Mead, Bardsley, Youatt, &e. In 1271 wolves became affected with rabies in Franconia, and, contrary to their usual habits, they spared the herds and flocks and attacked human beings: upwards of thirty men fell victims to these attacks. In 1590 canine madness prevailed in Spain—(BLaINE.) In 1590 epizootic rabies prevailed amongst the wolves in the province of Monthelliard. The further history of rabies may be obtained from Dr. Fleming’s excellent treatise, to which the reader is referred. Like other epizootic and contagious diseases, its prevalence is liable to many fluctuations, at: times prevailing to a great extent, whilst for long periods the disease is almost unheard of. During the earlier portion of the present century rabies was very pre- valent both in this country and on the continent of Europe, not only in dogs, but in foxes as well. Since then there has been an abatement in the frequency of the disease; but even up to the present, outbreaks are not very rare. In 1869 I witnessed the disease in a pack of hounds in the north: the nature of the disease was detected after one man had been bitten, and he fortunately resisted the action of the poison, although he took no precaution against its effects. The disease has again been prevalent in 1876-7-8 in the southern and lowland counties of England. By the stringent rules enforced by the Board of Agriculture, rabies has now been stamped out in England, Scotland, and 236 CONTAGIOUS DISEASES. Wales. Occasional cases are found in Ireland, but it is there rapidly on the decrease. Rabies is a disease which owes its prevalence to the fact that it is spread only by actual inocula- tion, and this can only be accomplished by animals addicted to biting. In Britain the dog is essential, and it therefore is a comparatively easy matter to suppress the disease. If there were no dogs, wolves, jackals, or other similar carnivora, it is very probable that there would be no rabies. Britain, on account of its insular position, can be easily protected against the disease. The Board of Agriculture prevents the importation of it by a strict quarantine of six months on all imported dogs; and stamped out the disease in Britain by stringent muzzling regulations applying to dogs, and immediate slaughter or isolation of all suspects or strays. These con- ditions are not easily accomplished in foreign countries, where carnivora, such as wolves, jackals, &c., exist in a wild state, and spread the disease to one another, and also to other animals and man. CAUSES. Opinions have been divided as to the spontaneity or other- wise of the origin of rabies. Some maintained that even in the dog and allied quadrupeds the malady never originated except by inoculation; whilst others held that it originated spontaneously in the dog, even in this country. After discussing the opinions of Blaine, Youatt, and Maynell, who affirm it owes its origin to a wound from a rabid creature, Fleming says: ‘“ There are few nowadays who are not convinced that it will occasionally appear in a spontaneous manner, and without any certain assignable cause. No doubt the transmis- sion of the disease by inoculation furnishes by far the largest number of cases, and many of these, from the obscure manner in which the inoculation has been effected, appear to be due to other causes than that of a traumatic character; but, notwith- standing, the disease must have a commencement.” However, he changed his opinion, and affirmed that it originates from contagion only. In this view of the origin of the malady, facts and circumstances compel me to agree with Dr. Fleming; at the same time I am fully aware that the opinions of many observers are opposed to it. Professor Dick was of opinion RABIES. 937 that rabies always originated spontaneously—from atmospheric causes—a species of catarrh, which, by extension from the nasal mucuous membrane, through the cribriform plates of the ethmoid bone, involved the meninges of the brain, and produced the phrenzy, delirium, and the other train of nervous symptoms which characterise the disease. He also held the opinion that it was never caused by inoculation from the bite of a mad dog; in fact that it was a non-contagious disease.— (Veterinary Papers by Professor Dick.) This opinion of Pro- fessor Dick is still believed by a few, but fortunately very few, and the sooner it is dispelled the better, for nothing is more calculated to do mischief than the promulgation of what has been proved to be so erroneous. Rabies, once generated in the dog or cat, is transmissible by inoculation to every warm- blooded creature. The idea that hot weather is productive of rabies is also now dispelled. The following report, arranged by Professor St. Cyr, of the Lyons Veterinary School, is very instructive, showing that rabies is even more prevalent in the temperate months than in those of extreme heat and cold :— Rabid. | Suspected. | Became ed a acta) ,_ [Total Rabid. January, . a 12 2 0 14 12 February, 2 14 4 1 18 15 March, . F 6 11 0 17 6 April, . . 14 20 1 34 15 May, . . 12 14 1 26 13 June, . é 6 14 1 20 7 July, 2 8 2 10 4 August, . 7 3 2 10 9 September, . 1 3 0 4 1 October, . _ 3 id 0 4 3 November, . 0 0 0 0 0 December, 1 1 1 2 2 78 81 9 159 87 Sometimes the annual statistics show a predominance of cases in the summer months. But according to M. Bouley’s observations there is no great difference in the seasons with regard to the disease. An analysis by M. Bouley of reports 238 CONTAGIOUS DISEASES. for the six years 1863-1868 gives—for the spring months, March, April, and May, eighty-nine cases; for the summer months, June, July, and August, seventy-four cases; for autumn, September, October, and November, sixty-four cases ; and for the winter months, December, January, and February, seventy-five cases. It was at one time maintained that rabies never became developed in the bitch, and it is now advocated that it is far less frequent in females than males. Professor Coleman stated in evidence in 1830 that on the occasion of rabies entering kennels, the mad dogs bit dogs but spared the bitches. This opinion of Coleman is still believed in, more particularly by medical writers. But there can be no doubt that bitches are as susceptible to the contagion by inoculation as dogs. This is well exemplified in what occurred a few years ago to a bitch pack of foxhounds belonging to Mr. Standish, South Shoreham, Southampton. The pack was nearly exterminated by rabies, through the disease having been introduced to the kennels by a hound which had strayed away for several days, and on its return was discovered to have been bitten. — Veterinarian, vol. xliv. I think the reason for the supposition that fewer cases of rabies are seen in bitches than in dogs, is to be found in what seems to have escaped medical observers, namely, that there are fewer of them in the world. Indeed, the same explanation can be given on this point as on what appeared so strange to some during the prevalence of the cattle plague, that fewer bulls than cows were attacked by that malady. There no longer exists the slightest doubt that rabies can originate in any other way than from a previous case. Spon- taneous origin is impossible, and in some of the cases in which no previous bite or method of infection could be traced, it is from lack of an exact history that the idea of spontaneity has arisen. The materies morbi of the disease are found in all the body fluids, and especially in the saliva, which becomes in- fective as soon as any symptoms appear. What the actual infection is we do not know. It is, however, an extremely small organism, or one capable of extremely small phases in the course of its development, as virulent saliva when RABIES, 939 filtered through a fine porcelain filter is still infective. Many observers have advanced arguments as to the actual con- tagion, but none are’so far satisfactory, and it is only safe to say that the disease is one due to an ultra-microscopic organism. The theory of its protozoan origin has been advanced, and it has been found in the spinal cords of affected animals, and in the cerebellum, fons of Ammon, and origin of the seventh nerve bodies, which are called Negri bodies. These are small ovoid cellular bodies, varying in size from 10 to 25 » long and 1 to 5, broad. They are dark, covered with dots of a darker shade; they stain with some difficulty, but are easily seen in very thin sections of the medulla with a high power. They are too large to pass through a filter, and, therefore, cannot be the form in which the organism causes the disease; and if they are the cause, they must have some other period in their life-cycle in which they are smaller. These bodies are also found in the medulla of very old dogs, so that it seems prob- able that constant existence in connection with rabies is accidental, and that they are the products of some nerve disintegration. No other specific cause has been ascribed, and until the Negri bodies have received further attention it is not possible to accept them as such, although their constant presence has rendered diagnosis practically certain if they are found. This is a very considerable advantage, as formerly until a rabbit died it was impossible to give a positive diag- nosis. By section and examination of the cord, this can now be given in a few hours. PATHOLOGY AND SYMPTOMS. The following circumstances in the pathology of rabies are worthy of notice, namely—First, That the period of latency after inoculation is very indefinite, and that it varies in different animals; Second, That inoculation does not always produce the disease, one-fourth of the inoculated animals generally escaping ; and Third, That, notwithstanding the strongest evidence as to the microbic nature of the disease, the morphological character of the microbe is as yet undeter- 240 CONTAGIOUS DISEASES. mined. Cocci observed in the spinal cord of rabid dogs have been described by Babes (Les Bacteries, 1886), cultures from which were said by Babes to communicate the disease. Babes also describes a short bacillus. And again it is said that very fine bacteria have been isolated from the brain, cultures from which gave the disease. Researches are being still carried out which will in time doubtless deter- mine the nature of the microbe. Virulence is said to be destroyed in thirty hours at a temperature —20°, and in moist heat at 100°C. in halfan hour, and desiccation in the air diminishes and even destroys the virulence in a few days. This fact has enabled Pasteur to modify his method of preparing his vaccine, which at first was transmitted from the dog to the monkey, in which animal the virulence became enfeebled after each transmission, until it became too attenuated to convey the disease, and was used as a preventive vaccine. Now, however, Pasteur inoculates a rabbit, in which the period of incubation is always short, through a trepan in the skull, having discovered that after successive inoculations from one rabbit to another virulence becomes intensified, and the period of incubation shortened, until it is reduced to six days. The virus then has attained its highest degree of virulence, and is called “virus fixe.” The spinal cord of a rabbit, having had this intensified rabies, having been suspended in a jar at a tem- perature of 73° F. in an atmosphere kept dry by the presence of potash, gradually loses its virulence. The opinion that rabies could not be transmitted after an animal had been dead twenty- four hours, or after rigor mortis had been completely established, has been found to be erroneous; for it is now placed beyond doubt that virulence may be retained for a considerable time, provided putrefaction be prevented. The activity of the virus is also destroyed by various disinfectants, as such 1-1000 corrosive sublimate solution, 5 per cent. solution permanganate of potash, 50 per cent. alcohol ; but 15 per cent. alcohol is said to preserve it for several days, and large doses are rendered innocuous by being rendered acid, alkaline, or putrefactive. The virus of rabies is contained in its most concentrated form in the saliva of the rabid animal; but it by no means follows that other parts of the diseased animal are free from its presence; indeed, direct experiments have determined that the virus is present in RaBIEs, 941 the blood, flesh, and other parts of therabid animal. The virus of the rabid skunk, wolf, and hysna appears to be more virulent and prompt than that of the dog. It was at one time believed that the virus of rabies was in: nocuous when the bite was inflicted by any of the herbivora. Observation on accidental cases had led to this belief, and direct experiments seem to confirm its correctness. Girard, Vatel, Huzard, Dupuy, Lafosse, and others failed to transmit the disease from the herbivora to the dog. Professor Coleman, Sir Astley Cooper, and others in this country believed that the disease was not communicated except by animals which “naturally employed their teeth as weapons of offence.” Dr. Fleming mentions several instances where rabies was com- municated by inoculation with virus obtained from cows, sheep, and even domestic fowls, and argues ‘‘that the facility with which the disease can be transmitted by different species depends, besides the activity or degree of virulency of the infecting principle, upon the organisation, habits, or rather nature of the disease. Flesh-eating or carnivorous animals, as is well known, generally attack other creatures with their teeth, which are well adapted for wounding and tearing ; consequently they are the most successful in inoculating with the poison.” The virus, having been introduced into the system, generally lies dormant for a very indefinite period of time, the shortest period in the dog being about seven days, and the longest 155 days, but in rare exceptions even longer than this; in man, from three days to nine months, and even ten years in rare instances (such cases, if inquired into, will show a subsequent inoculation) ; in the horse, from fifteen days to three months, and even fifteen months; in the sheep, from fourteen days up to three months; and in the pig, from a few days—eight or nine—to as many weeks, or even months. The wound in- flicted by the rabid animal generally heals rapidly. In 1862 M. Renault published the results of some experiments which had been conducted with the view of determining the period of incubation in the dog. Out of 131 dogs bitten by mad dogs, or inoculated with their saliva, 63 remained well at the end of four months; the disease being developed in the other 68 after intervals varying from 5 to 120 days. Thus— 16 943 CONTAGIOUS DISEASES. In 25 dogs the disease set in between the 5th and 30th day. In 31, 30th and 60th day. In 7 ,, i o 60th and 90th day. In 5 ,, i 3 90th and 120th day. Symptoms in the Dog.— There are no premonitory signs in the lower animals, at least none that can be detected—such as pain in the seat of the bite, melancholy and irritability, febrile dis- turbance, and stiffness about the neck and head. The dog, when the period of latency is passed, becomes restless, dull, watchful, withdraws from its companions, choosing solitude, shunning the light ; hiding in corners, or below chairs or other furniture ; being fidgety, lying down, then jumping up again in an excited, unnatural manner; it has a tendency to rove about, and if possible to escape from its room or kennel, and wander about the country. At first, the dog’s power of recognising people about it does not seem lost; indeed there are moments when the usual faculties of the dog, its affection and liveliness, seem greater than usual. Along with these symptoms there is a desire to lick anything cold, to rest the nose on a cold object, and to pick up stones, bits of wood, straw, &c. At this stage the ten- dency to bite is not observed, but as the disease advances the movements of the animal become unsteady; the eyes follow objects in a peculiar staring manner; sometimes the dog will stare at some imaginary object, then rush forward, and bite at anything that may chance to be in his way, or even at the air, as if he were catching flies; cushions, straw, and other objects by which dogs are ordinarily surrounded, are tossed about; the animal scratches the ground, snuffles as if on the scent; the appetite is lost, but the thirst is considerable, and the act of drinking is performed without much dificulty during the early stages of the disease. At a later stage, however, swallowing—, deglutition—is performed with difficulty, or is not performed at all, owing to the spasmodic constriction of the throat; but even then the animal has no dread of water, does not shrink at the sight of fluids, but, on the contrary, will plunge its muzzle deeply into it, and endeavour to drink with great avidity. The coat is staring, the skin tight on the ribs, and the belly tucked up. The dog occasionally vomits, the ejected matter being tinged with blood; there is a brownish coating on the tongue; the nose and RABIES, 243 mouth are foul and offensive, and there is generally a flow of saliva from the mouth. A symptom is mentioned in connection with the disease in the human being, which is of doubtful presence in the lower animals, namely, the formation during the early period of the disease of lysses or eruption on each side of the tongue. If any eruption does occur, its presence is seldom detected. The mad dog, or indeed a rabid animal of any kind, brought into the presence of one of the canine species, exhibits great excitement, exasperation, and fury, with a desire to attack and destroy what seems the object ofits hatred. “‘ The horse assaults it with its teeth and hoofs; the bull, cow, and ram with their horns ; even the timid sheep, when rabid, becomes the assail- ant.”’—(Bouney.) The females of the canine species do not always lose their maternal affection ; on the contrary, the young are attended to with great affection. In the course of a day or two: after the first manifestation of the above symptoms, the characteristic signs become more marked; the desire to bite is greatly exaggerated; the pupils are dilated; the conjunctive red and injected; the eyes alternately widely opened with fury, and then closed in a dull but fierce manner. The fore- head. becomes wrinkled, and the looks of the animal are terrifying and repulsive; the presence of a living object ex- cites the rage of the sufferer, causing it to spring at and endeavour to bite it. Any shining object will bring on a paroxysm of rage and excitement, and water, if the light shines upon it, will do the same; but if placed in a dark place, or where light does not shine, the dog will endeavour to drink with avidity. Intermitting with the excitement are periods of great -prostration, the exhausted animal lying down in the quietest spot it can find, insensible to all surrounding objects. All at once, however, it springs up, and becomes greatly agitated ; the excitement, rage, and agitation being always much greater when the animal is surrounded by noises and objects; when away from these things, in a quiet place, the fits of rage are not so great, indeed sometimes scarcely observed. The bark of the rabid dog is unnatural; it is husky, spasmodic, and more of the nature of a howl. In some cases, the nervous symptoms are those characterising paralysis of the jaws, with inability to close the mouth; the lower jaw is dropped, the 16—2 244 CONTAGIOUS DISEASES. cavity of the mouth and its contents exposed, the tongue dry, and the buccal membrane ofa brownish hue. This is the ‘‘ dumb madness,” thus called because the animal is unable to bark or howl. Rabid dogs have a strange tendency to eat filth; they have been known to eat portions of dead dogs, and to swallow hair, coals, earth, excreta of all kinds, and these remaining in the stomach present a characteristic post mortem appearance. A mad dog, when loose, will travel an immense distance in a short time, generally rushing at everything that comes it its way, but preferring to attack other creatures than man, and finally endeavouring to return home, as if prompted by some instinct. The pulse is said not to be accélerated, nor are the respira- tory movements much increased, except during the paroxysms ; the bowels are constipated, and the urine is high-coloured ; the gait is unsteady, the tail droops, the head is depressed, the nose protruded ; the fits of rage become shorter, those of depres- sion longer; scent, sight, and hearing are much impaired; in- sensibility to pain, which is generally present from the earliest stages, is more and more manifest ; and finally paralysis, parti- cularly of the hind limbs, supervenes, and if not destroyed, the dog dies, an emaciated, repulsive object, the desire to bite remaining to the last. In the dumb form, the ability to bite is lost, as well as the power to lap fluids. The exposed and protruded tongue is covered with a stringy, tenacious saliva; the desire to drink is even more intense than in the furious form, and attempts to lap and swallow become painful to witness. Squinting of one or both eyes has been observed ; there is also abdominal pains in some instances, and an inflamed condition of the nasal cavities, larynx, and bronchial tubes. There is no tendency to harm and bite surrounding objects, and the dog dies from coma, exhaus- tion, and suffocation. Both forms of the disease terminate in death in from four to eight days. It is, however, reported that some chronic cases of rabies exist for an indefinite period. With regard to the dread of water—hydrophobia—which has been looked upon by some as the diagnostic symptom of the disease, I may repeat that it is absent in the dog. The desire for water is always excessive; there is inability to swallow fluids, owing to the paralysed state of the pharyngeal muscles, hence a dog will plunge his nose deepiy into water, lap it with avidity, but owing to the thirst being still unallayed, he will] RABIES. (245 become greatly agitated, and is thus often thrown into a state of fury or of involuntary spasms. Causes and Symptoms in the Horse.—Rabies in the horse occurs from the bite or contact of the saliva of a dog or cat, generally from that of the dog. The disease is manifested in a variety of ways. In some cases it commences by great apparent distress, with sudden perspirations over the body ; unruliness, the horse stamping and pawing violently, finally becoming frantic, and destroying everything within its reach. In other cases, along with restlessness, there is manifested a desire to bite the seat of injury. In one case that came under my notice, where the horse had been bitten on the breast, three months before any symptoms of rabies were visible, the animal during the paroxysms continually bit the cicatrix, until at last the whole sternal region was denuded of its skin; there was also intolerance to light, great nervous- ness, the animal being easily startled, with fixity of the eyes, staring at some imaginary object, the pupil being the while dilated, and the ears moved backwards and forwards, as in a blind horse, when it hears some strange sounds. At one time, during the day and night upon which it was ill, it) seemed to present some signs similar to those of laminitis, shifting its weight from one foot to another, and swinging its body back- wards. At the same time we noticed convulsive twitchings of the superficial muscles, difficulty in swallowing, spasm of the throat, a hoarse cough, acceleration of the breathing, a quickened pulse, and a flow of saliva from the mouth. After a while it became very furious, fought violently, destroying everything within its reach. Gradually signs of paralysis of the posterior extremities became apparent, and at last it was unable to rise. It would, however, make violent efforts to do so, and during a rapid spring or jump one thigh was fractured. The efforts to rise were not discontinued even after this accident, and so violent did it become, and so strenuous were its efforts to get at some- thing, that the other thigh was broken. It still continued to sit upon its haunches, and to fight with its fore feet, all the while tearing at its breast with its teeth. Seeing that both tibie were fractured, the owner consented to what had long before been urged upon him—to have the horse shot. In the stallion and mare it is stated that the sexual desire is 246 CONTAGIOUS DISEASES. augmented; that the stallion has frequent erections, and neighs in a harsh tone, and the mare stands with her hind legs apart, showing signs of cestrum. The remissions and paroxysms are less apparent in the horse than in the dog. In the latter, the animal seems for a time to be almost free from the disease, but in the horse the absence of anxiety, restlessness, and exhaustion is of much shorter duration, and the fits of violence more violent and prolonged, so much go, that it soon becomes prostrated, and dies in frightful convulsions upon the second, third, or fourth day. Hydrophobia in man is generally characterised by a sensation of intense pain in the seat of the wound, the cicatrix becoming red and irritable, the pain shooting from the extremities (if the wound be situated upon them) to the trunk. It seems most probable that this sense of pain is felt in some instances by the horse, and is manifested by the persistent efforts to bite the seat of the wound, particularly, as in the case described, if it be within reach of the teeth. The symptoms of rabies in tle cow, sheep, goat, &c., are very similar to those in the horse; in all there is “loss or depravity of the appetite, prostration, great restlessness, in- creased excitability, muscular tremblings, a flow of saliva from the mouth, excitation of the sexual desire, especially in the bull, difficulty in swallowing, and manifestations of hallucinations as well as disagreeable sensations in the seat of the wound.”-— (FLEMING.) And succeeding to these signs are those of great violence, paralysis of the hind extremities, emaciation, and finally coma and death. Medical treatment, after rabies has established itself, is of no avail. , PREVENTIVE TREATMENT. - Complete excision of the bitten surface, as soon as possible after the infliction of the injury, is the best that can be adopted. If the wound be superficial, the free application of the caustic potash (Potassa fusa) or of the nitrate of silver is sufficient ; but if deep or much lacerated, the parts are to be carefully excised before the caustic is applied. Where this has been done in man seven out of ten escape, whilst if no such means are used RABIES, 247 eight out of ten die-—(Bonninerr.) It is very difficult in the lower animals, covered as they are with hair, to know whether the part bitten be confined to any particular region of the body, no matter how carefully the skin may be searched. _ It is there- fore advisable to have the bitten animal shaved as quickly as possible, in order that all scratches be brought into view, and that they may be dressed with the caustic. In dogs pre- ventive treatment should not be resorted to, but the bitten animal ought at once to be destroyed. It is very true that all dogs inoculated with the rabies poison do not become mad; the risk of their becoming so is, however, so great, and the mischief they might inflict is so grave and important in its nature, that the chance of their doing such mischief should never be allowed. Whilst the above precautions are considered necessary, it cannot be said that they are always effective in preventing the disease in bitten persons or animals. Pasteur, however, a8 is well known, had carried out his system of vac- cination by attenuated virus to almost a universally successful conclusion, and he anticipated that, although the time was still distant when canine madness would be extinguished by vaccina- tion, he hoped, pending that consummation, that he would be able to avert the consequences of a bite from a mad dog. He said—* Thanks to the duration of incubation after a bite, I have every reason to believe that patients can be rendered insuscep- tible before the mortal malady has had time to declare itself.” M. Pasteur’s anticipations were put to the test by a Commis- sion appointed by the Minister of Public Instruction, consisting of MM. Bouley, President; Paul Bert, Bécland, Vulpian, Tisserand, Director of Agriculture, and Professor Villemin. Forty dogs were submitted to the bites of rabid dogs. Twenty of these healthy dogs had been previously inoculated with attenuated virus, whilst the other twenty were not inoculated ; the rabies showed itself exclusively among the non-inoculated dogs. M. Pasteur was requested by the Commission to perform his proof experiments in a more expeditious and certain manner than by only submitting healthy dogs to the bites of rabid ones. He having found, first, that if nervous matter from the bulb of the brain of a rabid animal be inserted on the brain—by trephining—of a healthy dog; second, that when the virus was injected into the veins ; and third, that when the dogs were 248 CONTAGIOUS DISEASES. repeatedly bitten about the head by rabid ones, a rapid and fatal rabies occurred within twenty days—therefore proceeded to carry out a series of experiments on protected and non-protected dogs, with the result that none of the protected animals had, up to 10th July, 1884, shown any signs of the disease, whilst twelve of the unprotected ones, including two which were repeatedly bitten about the head, had succumbed to the disease. The dogs still remaining healthy were to be watched by veterinary surgeons for a year, to see whether the inoculations hold good permanently or only temporarily. These experi- ments proved entirely successful, and, acting upon this con- clusion, Pasteur continued to apply preventive inoculation to man, and with remarkable success. PATHOLOGICAL ANATOMY, From the symptoms observed during life, the conclusion naturally suggests itself that the brain and its membranes are the seat of organic lesions. Indeed, the specific action of the poison ‘appears to be exercised, particularly in the first instance, upon the medulla oblongata and the par vagum, the branches of which seem to lose their natural properties; hence the difficulty in swallowing, the depraved appetite, alteration of the voice—or its entire loss in the dumb form—as well as the convulsions of the respiratory muscles, are all due to derangement of this nerve; and as the nervous system of the animal becomes more and more deranged, complete paralysis of the respiratory muscles occurs, and the animal dies from asphyxia. The principal post mortem appearances are cedema or con- gestion, sometimes in patches, of the brain and spinal cord, particularly at the base and pleaus choroides, effusion into the arachnoideal space, cerebral ventricles, and the cerebro-spinal substance, and softening of the membranes. On the lower surface of the medulla oblongata, at the origin of the seventh, eighth, and ninth pair of nerves, the membranes are generally highly injected, thickened, softened, and matted together. The liver, kidneys, spleen, and the muscular system are congested. The bladder is empty, and its mucous membrane covered with petechize. The lungs ere greatly engorged with blood. The blood in the vessels is but imperfectly coagu- RABIES. 249 lated, often black and tarry, sometimes bright and red, in appearance. The mucous membranes of the pharynx, ceso- phagus, stomach, and bowels are either greatly congested, with extravasation of blood on their surface, or diffusely inflamed. Patches of extravasation are particularly met with on the gastric mucous membrane, and account for the hemorrhagic vomiting which is sometimes witnessed during the illness. The contents of the stomach are generally of a peculiar nature, consisting of hay, straw, stones—in fact, of a collection of ,the most incongruous materials, which, owing to depraved appetite, the animal has picked up during life. This appearance is of great value, as it proves most conclusively that the dog has died rabid. The tongue is often wounded by the teeth; its papille con- gested; and the salivary glands enlarged and vascular. In «dumb madness ” the congestions, more particularly those of the upper part of the respiratory and digestive tracks, are developed to a greater extent than in the other form of the disease. DIAGNOSIS OF RABIES. “Tn a case of suspected rabies in a dog, the animal should not be killed immediately, but should be kept under observa- tion for three or four weeks and then killed. ‘Moderately thin smears on slides are made from (a) the cortex in the region of the fissure of Rolando (the crucial sulcus in the dog), (b) the hippocampus major, (c) the cerebellum. They are dried in the air, fixed for five minutes in methyl alcohol, and then stained in weak Giemsa (1 drop stain, 1 c.c. distilled water, with 1 drop of 1 per cent. potassium carbonate solution to every 10 c.c. of the dilute stain) for three hours. The stained films are then washed in running tap-water for one to three minutes, dried with filter-paper, and examined for the Negri bodies. “Or the moist films may be fixed in methyl alcohol, and, without drying, stained for one minute in a mixture of 10 cc. distilled water, 3 drops of a saturated alcoholic solution of basic fuchsin, and 2 c.c. of Loffler’s methylene blue. Hosin-methy- lene blue mixtures may also be used. “The cytoplasm of the bodies stains orange, pink, red, or magenta, the central nuclei are granular and appear bluish or purplish.” —Hew ert : Manual of Bacteriology (J. and A, Churchill). CHAPTER XXIII. CONTAGIOUS DISEASE S—continued. GLANDERS AND FARCY (EQUINA). Dejinition.—A malignant, contagious, and fatal disease, due to the introduction into the animal economy of a virus (said by Dr. Strick of Berlin to consist of an organism —the Bacillus mallei—about the same size as that of tuber- culosis), which, infecting the whole system, shows specific effects more especially upon the Schneiderian mucous mem- brane, the lungs, and upon the lymphatic glands and ducts. Glanders, and its variety farcy, are capable of transmission to man, in whom the virus seems to increase in malignancy, ass, mule, sheep, goats, dogs, the feline species, and even to mice and rabbits. Cattle, pigs, and fowls resist the action of the contagium, even when inoculated. HISTORY, Glanders was described by Aristotle) by Vegetius,? and other early writers, under the terms morbus humidus, cy- moira, capitis morbus, &c.; and its variety farcy, as morbus farcimosus, vermis equi, vermis volaticus, farcina equi, &c. Glanders is a disease of all climates. The contagious nature of glanders was for a long time a disputed point; it is, however, now determined beyond question that its propaga- tion is by contagion and infection only. -Glanders may occur under at least four forms, namely, acute glanders, chronic glanders, acute farey, called by some bud farcy, and chronic or button farcy. 1 Aristotle, De Hist. Anim., lib. viii. c. xxv. 2 Vegetii, Renati Artis Veterin., lib. i. c. vii. 250 PLATE xX. 1 Lead-coloured \ Mucous Membrane. Confluent Ulcers. Ulcers. GLANDERS AFFECTING NOSTRILS OF HORSE. Warerston s Sang, Lath, Edn To face page 250. GLANDERS AND FARCY. 251 CAUSES. It is now believed that equina originates from contagion only. Many debilitating influences act as predisposing causes, such as old age, bad food, overwork, exhausting diseases, and general bad management; specific miasmatie or animal poisons, such as those generated in localities when large numbers of horses are congregated together, in camps, ‘barracks, large cab or other establishments, even when the stables are well ventilated, lighted, drained, and the animals well attended to in every way, but more particularly where the stables are ill-ventilated, badly drained, dark, and foul. Horses, when crowded on board ship, are very liable to this affection, and the Arabs in transporting their horses from -Arabia to India always choose that part of the year when the passage is shortest, lest the accidents incident to a long voyage might oblige the hatches to be closed, and want of ventilation facilitate the spread of glanders. I have also observed that glanders is developed in new stables, where the walls are not thoroughly dry—where in fact, in common language, they are said ‘‘to sweat’; and, finally, glanders occurs as a sequence to exhausting diseases, more especially if the animal be old, or of a bad constitution. These causes, and a generally vitiated condition of the animal system, may be said to predispose glanders—(1.) By causing the introduc- tion into the blood of vitiated or decomposing material generated in the external surroundings of the animal ; (2.) By inducing the formation of degenerated material within the animal system; (3.) By preventing the excretion of the de- graded constituents normally generated within it by natural tissue changes, or excessively formed within it by various dis- ordered functions, or introduced into it from without. - 'Phe most common forerunner of glanders, more particularly of that form of it known as farcy, is the disease commonly called diabetes insipidus or polyuria. It cannot be said that in diabetes there is any obstruction to the excretion of degraded tissue ; indeed, the reverse is the case, excretion of urine being enor- mously increased. If we look deeper into the matter we shall, however, see that the polyuria is associated with rapid tissue changes, rapid emaciation of the body being a most prominent 252 CONTAGIOUS DISKASES. symptom, with debility arising from degradation of tissue, and from the presence of the degraded materials within the cir- culatory fluid. So apparent is this condition, that it has been truly said that diabetes, when arising from no cognizable cause, is often indicative of a general breaking-up of the con- stitution. Although glanders and farcy are one and the same disease, differently manifested, farcy is apparently more frequently de- veloped spontaneously than gianders. This circumstance, and the possibility of recovery from mild attacks of farcy, has led some to conclude that they are two separate disease; but direct experiment has proved that the virus is identical in both forms of the disease. The discharge from the nose of a glandered horse, when introduced into the systems of other horses, may in one produce glanders and in another farcy, whilst the pus from a farey ulcer may produce in the inoculated animal glanders, farcy, or both; and the common termination of farcy, if a horse affected by it be allowed to live a sufficient length of time, is glanders, and of glanders farcy. Such an animal is described as being “ both glandered and farcied.” CONTAGION. Glanders, and its variety farcy, are highly contagious and infectious, and when once introduced into a stable are almost certain to spread amongst the horses there located. As already stated, the contagium is found to be an aérobic bacillus discovered by Loeffler and Schiitz, 1882, called the Bacillus mallei. These organisms are seen in the form of minute rods yztyq long, aud from ggdgq tO zodey of an inch broad ; they are rather thicker than the tubercle bacillus, and retain the methylene blue stain. They are found in the nodules in the lungs, liver, Schneiderian membrane, and other involved structures, and are free or within the cells of the part. They are non-motile, straight, or slightly curved, with rounded ends, and sometimes appearing as diplo-bacilli. They stain readily with aniline dyes, but do not retain their colour with Gram’s method. The best stain is that of Schtitz: potash solution, 1 in 10,000, and concentrated aleo- holic methylene blue, equal parts. Wash the section in a GLANDERS AND FARCY, 253 watch-glass full of water, containing four drops acetic acid. Transfer for five minutes to 50 per cent. solution of alcohol, fifteen minutes to absolute alcohol, clarify in clove oil, and mount in Canada balsam. By careful staining, the glanders rods may show what is known as mitachromatic staining ; that is, comparatively clear spaces may be seen, as is always the case in staining tubercle bacilli with carbol fuchsin, by Zieh] Neilsen’s method. It is unknown what these spaces are, but it is probably some fatty Fic. 17,—Glanders Bacilli. substances that resist the action of the stain, as they are decidedly not spores. The specific poison can be introduced into the system either by the skin or mucous membranes. By inserting the virus under the skin with the point of a lancet, by rubbing the greasy heel of a horse, and by inoculating the mucous mem- brane of the nose, the disease has been produced. With regard to the transmission of the contagium of glanders otherwise than by actual contact, opinion seems to be divided, some writers maintaining (and the experiments brought to bear upon their conclusions are formidable) that it is impossible to communicate it in any one of its forms by compelling healthy 254 CONTAGIOUS DISEASES. animals to inhale the expired air of those suffering from the disease, whilst others maintain that it is both contagious and infectious. The first opinion, if acted upon in every day prac- tice, would, I opine, lead to disastrous results, and should not be- entertained ; for even if we were to grant that the virus is con- tained in the discharges from the ulcers, numerous experiments have proved that pus and other organised cells float in the atmosphere; the specific virus contained in these cells may thus be easily conveyed from one animal to another. Again, it. must not be forgotten that in some instances glanders may exist without any external manifestations, 7.c., without discharge from the nose, nor from farcy ulcers, but even in this form it is capable of propagation. Farcied matter, made into balls, and introduced into the stomach of a horse, has caused glanders ; and whichever way the virus has been introduced, once absorbed, it infects the whole blood, as has been proved by the experiment of the late Professor Coleman, who says—‘I have produced the disease by first removing the healthy blood from an ass until the animal was nearly exhausted, and then transferring from a glandered horse blood from the carotid artery into the jugular vein of the ass. The disease in the ass was rapid and violent in degree; and from this animal, by inoculation, I produced both glanders and farcy.” Professor Coleman also experimented on asses with virus obtained from man. He directed two asses to be inoculated with matter taken from the arm of a man labouring under the malady, which resulted from a puncture received in dissecting a glandered horse, and both asses died of glanders. These experiments have been repeated, and similar results obtained by Girard, Hering, and Leblanc. It must not be concluded from these facts that glanders is a septicemia. It is conceivable that, when an animal is infected, the lesions set up will tend to break down, and thus the organisms being liberated may gain entrance to the blood-stream. They will then be carried by this fluid until they obtain a resting-place, where they will locate and set up fresh lesions. It is in this way that most probably a miliary condition is set up in the lungs, spleen, &c., as is seen also in tuberculosis. Period of Incubation.—Like all mor bid poisons, that of glan- GLANDERS AND FARCY, 255 ders has its period of latency, which is, however, generally short. In the ass, the submaxillary glands become swollen and tender the second or third day after inoculation, and a discharge from the nostril occurs from the third to the sixth day. In some instances the incubation is much longer—from one to three or even six weeks; one case is mentioned in the Procés-verbal de V Ecole de Lyons where the disease did not appear till the end of the third month after inoculation. The matter in this instance was obtained from a farcy ulcer, and the disease appeared at the precise point of the inoculating puncture. . ACUTE GLANDERS. Symptoms.—The disease, preceded by increased temperature of the body, appears suddenly, ushered in by rigors, some- times of a most persistent character. In one case which fell under my notice the rigors continued without intermission for: three days and nights, at the end of which time a sanguineous. discharge issued from both nostrils, the Schneiderian mucous: membrane became violently inflamed and deeply ulcerated. More commonly, however, the rigors are not so persistent, but they are always more or less observable; the temperature is: sometimes as high as 106° or even 109° F., the breathing is: accelerated, the pulse feeble, rapid, and even dicrotonous, the: heart’s action palpitating and accompanied by metallic tinkling, the appetite fails, the pituitary membrane, at first of a dark copper colour, with patches of ecchymosis of a dark red hue, becomes purple, and the patches are rapidly converted into pit-- like, ragged-edged ulcers, from which issues a copious sanious discharge. The submaxillary lymphatic glands enlarge. . Other lymphatic glands inflame, enlarge, suppurate, burst, and expose raw, unhealthy-looking sores, from which issues a more or less ichorous and irritating purulent material. The eyes are weak, and a discharge issues from them ; the nostrils are often swollen. The breathing is hurried, irregular, and impeded by the swelling of the nostrils, and by the glutinous discharge drying around them; abscesses speedily form along the course of the lymphatics of the face. The urine is pale, watery, and increased in quantity. Acute glanders is rapidly fatal, and the post mortem. exami-. 256 CONTAGIOUS DISEASES. nation reveals the following lesions:—The mucous membrane lining the nasal passage and facial sinuses is violently inflamed, and covered with a numerous crop of pustules and ulcers, from which a purulent or sanious fluid is freely discharged. In many instances, and where the disease has been very rapid, the inflam- mation is diffused over the whole surface of the mucous mem- brane, which then presents one uniform purple or purplish-black hue, its structure being exceedingly soft and friable from degene- ration, and it is easily detached from the bones. Now and then it will be found that the nasal bones, the septwm nast, the turbinated and ethmoidal bones, are in a state of necrosis, their surfaces bathed with a purulent discharge, and wholly separated from the mucous membrane. The intermaxillary glands are congested and surrounded by a yellowish exudate, and the lym- phatic ducts leading from them are thickened and congested. The lungs in almost every case of glanders, acute and chronic, are more or less inflamed. Now and then the inflammation is diffuse, embracing perhaps the whole of one ora part of both lungs, whilst in others it is limited to some of the lobes, and presenting the appearance of a series of tumours and patches of congestion of different sizes, and in varying stages of development, scattered throughout the lung tissue. Many of these inflamed spots will be found to contain pus; hence they have been termed tubercles, and the nature of the disease has,. from this supposition, been laid down as tubercular; and so close is the relationship between tubercle and glanders, that the editor of the British and Foreign Medico-Chirurgical Review says —“Tt is in glanders that Villemin thinks he has found the closest marks of analogy with tubercle, not only in its anatomy, but also in its symptoms and causation. He seems to have been’ conducted from the study of glanders direct to the inoculation of tubercle. The characteristic lesion of glanders is a small nodule, which is strewn either in the mucous membrané of the nasal passages, or in the lungs, or, more rarely, in the liver and spleen. At first a greyish-white, firm granulation, composed of cells and nuclei apparently developed by hyperplasia of connective tissue, it soon tends to soften centrally and form ulcers on the mucous membrane, cavities in the lungs. Like miliary tubercle, it occurs isolated or in clusters. Together with this little granulation, streaks and bands of fibrous tissue, as well patches of cheesy GLANDERS AND FARCY. 257 infiltration, are not infrequently met with in the lungs of glan- dered horses. It is interesting, too, that the same doubts have been raised concerning the real nature of these ‘infiltrations’ in glanders as in tubercle. They are regarded by Villemin as one form of glanders, just as in man they are one form of tubercle. As to which is the part primarily affected in glanders—the nasal membrane or the lungs—there is some difference of opinion ; Virchow maintaining that the deposits in the lungs are always secondary and by metastasis from the nasal membrane; Phillippe and Bouley being convinced by repeated post mortem examina- tions that the primary lesions are always in the viscera, more particularly the lungs, and that the formations in the nasal membrane are invariably secondary. If, say they, a horse has the ‘jetage’ (discharge from the nose), it is already thoroughly glandered. It really matters very little which part of the body is first affected. In either case the analogy with a tubercular outbreak remains as strong as can be. The intestinal ulceration of tuberculosis—in which we see the counterpart of the nasal ulceration in glanders—is more often secondary to the pul- monary disease, but occasionally shows itself before any evidence of mischief can be detected in the lungs. Again, glandular enlargement of a severe and persistent kind constitutes an im- portant part of glanders, as it does of tubercle. The mode of invasion is likewise identical in the two diseases; now acute, foudroyant, destroying life in a few days as by an overwhelming blood poison ; now chronic, so as to last for years. Further, in the chronic form, the same recurrence of acute attacks compli- cating and adding to the chronic mischief is observed in glanders as in tuberculosis. To read a description of chronic glanders is, mutatis mutandis, to read an account of chronic phthisis. It is, therefore, not surprising that Dupuy goes so far as to say that glanders is a tubercular disease in the horse. In speaking of the supposed causes of tubercle, we purpose presently to follow out still further this remarkable thread of resemblance; but for the present it will suffice to say that glanders is transmissible by inoculation, and contagious from horse to horse, and that it is also unmistakeably cominunicable from horse to man. Can we hesitate to believe, says Villemin, that the parallel between tubercle and glanders must hear find its completion 2? To con- clude, glanders and tubercle are so closely akin that they must 17 258 CONTAGIOUS DISEASES. be looked upon as nearly related species of the same genus.” — (Brarrawaite’s Retrospect of Medicine, vol. lviii.) Whilst admitting the close resemblance between glanders and tuberculosis, and of the similarity of the microbes found in both diseases, we cannot admit their identity, for the broad fact remains that inoculation with glanders produces glanders nodules, whilst inoculation with tubercle is followed by the development of tubercular tubercles. The essential difference histologically between the glanders nodule and a tubercle of tuberculosis is, that in the former it is always distinctly hemorrhagic, in the latter this is not so. The former tends but slowly to caseation, and seldom to calcification; in tubercle this is the normal and rapid sequence. The form of pneumonia seen in glanders is very characteristic, the inflamed part resembling an infiltration, with thrombi in the blood-vessels—gangrenous, emphysematous—of a greenish- -black colour, and rapidly decomposing after death. The line of termi- nation or demarcation between the healthy and inflamed lung tissue is often abrupt and very distinct. The tracheal and bronchial mucous membrane is more or less highly inflamed; in some instances covered with petechial spots or deeply ulcerated, and thickly covered with an unhealthy discharge, which exhales a gangrenous odour. The changes which occur in the lymphatic glands in glan- ders are characteristic. The glands, irritated by the specific poison, become congested and enlarged; their cellular elements proliferate more or less rapidly, and are mixed with a citron- coloured exudate, which invades the surrounding connective tissue. In a few days the glands become dense and hard to the touch, more or less lumpy on their surface, and those in the submaxillary space fixed to the jaw by the now inflamed and indurated vessels which enter their deeper seated parts. CHRONIC GLANDERS. Symptoms—In some instances the disease presents itself in such a mild form that the general health is scarcely affected. There will be a discharge from one or both nostrils, generally from one nostril, and that very often the near (left) one. The submaxillary GLANDERS AND FARCY. 259 lymphatic glands are swollen and hard; the hardness and swelling are of a remitting nature, very often varying in size in a short period. For example, a horse may be left at night with scarcely any discoverable swelling, and found in the morning with a hard knot under the jaw, which is both easily seen and felt. The swelling may continue for several days, afterwards slowly disappear, and then reappear as rapidly as before. This condition may exist before any discharge issues from the nose, and a horse so affected is elegantly said to be “‘jugged.” Ifthe nostril of such a horse be examined, it will be found to be paler in colour than natural, or perhaps tawny, coppery, and some- times of a dull leaden hue. The discharge of glanders presents a starchy or glue-like appearance, adheres to the nostrils, where it dries and accumulates, causing the nasal opening of the affected side to appear smaller or more contracted than in health. These appearances, in addition to a weak or debilitated condi- tion of the eye of the affected side, may be all the symptoms present in a case of chronic glanders; indeed in some instances there may be nothing but the discharge from the nostril to lead the practitioner to suspect anything wrong with the animal, and the diagnosis is consequently very difficult, more particularly if the case is a solitary one; but where glanders is found to exist in a stud of horses, any suspicious symptom becomes significant. I have said nothing about the glanders-ulcer, because in many instances of chronic glanders the ulcer is undiscoverable ; indeed in some rare cases ulcers are never found either before or after death. For this reason Percivall limited the term chronic to that form in which no ulcers could be detected. He says, how- ever, that they are always present in the frontal sinuses. Before describing the more common form of glanders—namely, that in which ulceration is a characteristic sign, and called by Percivall “subacute glanders ”—I shall call the reader’s attention to what may be termed a spurious form of glanders; that is to say, a form of glanders where there is neither discharge from the nose, ulceration of the Schneiderian membrane, nor enlargement of the submaxillary glands; but in which all these may become apparent if the animal live long enough. This form may be appropriately termed pulmonary glanders, and the symptoms are as follows:—The animal is languid, unthrifty, loses flesh, sweats on the slightest exertion; the visible mucous membranes are 17—2 260 CONTAGIOUS DISEASES. pale; diarrhcea is easily induced, and there are occasional attacks of diabetes. There is a dry, dull, soft cough; the appetite is very capricious ; the hair is easily removed from the mane and tail; the legs are sometimes very fine, sometimes more or less cedematous. The affected animal may remain in this unsatis- factory condition for several weeks, or even months, and may die from marasmus and debility without any other symptoms becoming apparent, or all the signs of glanders and farcy may very rapidly develop themselves, and carry it off in a few days. Jf a case of this kind occur in the horse first attacked in a stud, or if in a horse where no others are kept, it is now possible to arrive at a satisfactory conclusion as to the nature of the malady by inoculating the animal with mallein, here- after referred to. The post mortem examination of a horse which has presented these symptoms prior to death will reveal the lungs studded with nodules, varying in size from a pin’s head to a pigeon’s: egg, or even larger. Some of these nodules will be found to consist of an organised exudate—lymphoma—of a pearly grey’ appearance, and rather hard; others will contain pus enclosed in sacs—vomice ; whilst others will be found in a degenerated’ condition, and presenting the appearance of rotten cheese, the degraded material consisting either of inspissated pus or a caseous metamorphosis of the exudate, in which the bacilli may be discovered by microscopical examination. In many instances the trachea is found studded with ulcers, and some of the deep- seated lymphatic glands will be found enlarged, or in a sup- purating condition. One remarkable pathological change which Ihave seldom failed to observe either in this or any but.the most acute forin of glanders, the splenic veins are filled with thrombi; the larger branches in particular being generally obli- terated by hardened fibrinous coagula. Glanders, as most commonly met with in this country, pre- sents the following signs :—The horse is generally more or less off its feed, has a tendency to shiver on the slightest cold; its coat is rough and unhealthy, “has lost the bloom of health ;” it may or may not cough; the appetite is capricious; and perspiration is induced by slight exertion. There is a dis- charge of a starchy or gluey material from one or both nostrils;- the discharge is often tinged with blood. In some instances GLANDERS AND FARCY. 261 recurrent hemorrhage from the nostril is a premonitory sign of glanders. The mucous membranes are pale and unhealthy, and that covering the nasal chamber, from which the discharge issues, is studded over with deep, pit-like ulcers. The ulcers are characteristic, being excavated, as if cut with a punch, but after a time they become ragged at their edges, irregular, en- larged in all directions, and confluent. The spaces between Fie. 18,—Mallein reaction, showing swelling in neck. the ulcers are covered with hard, yellowish pimples, which soon ulcerate. The eye of the affected side is weak, and looks smaller than its fellow, and an unhealthy discharge often issues from it over the face. The submaxillary lymphatics of the same side enlarge and form a tumour—sometimes single, sometimes lobulated—which is more or less firmly adherent to the surrounding tissues. This tumour seldom suppurates ; occasionally, however, I have seen it developed into an abscess, 262 CONTAGIOUS DISEASES. which, after having discharged a little unhealthy pus, has healed slowly, the tumour, however, continuing as large, or even larger, than before the suppuration. If the animal is allowed to live, these symptoms remit, and some of the ulcers may cicatrise, but they finally increase in intensity, and upon the application of any slight cause of dis- order become rapidly developed into those of acute glanders. If the horse is well taken care of, it may do moderate work for a long time whilst affected with chronic glanders. In the course of time, however, symptoms of farcy appear ; it then becomes a loathsome object. and if not destroyed, acute glanders sets in and carries it off in a very short time.! Chronic glanders is more frequently seen than the acute form in the horsé,.but in the ass and mule the latter is more frequently met with. In acute glanders the period of incubation is very short—from three to seven days; whilst in the chronic form the period is very uncertain, extending from a few days to several months before actual clinical symptoms become apparent. It is. practically certain, however, that the incubation period does not extend beyond twenty-eight days. The administra- tion of mallein will always with certainty give a reaction if there be any disease present, although there may be nothing appreciable to an ordinary clinical examination. ACUTE FARCY. This form of the disease occurs either as the result of direct inoculation with the discharge of glanders or farcy ; from in- ‘fection through the medium of the air; as a sequel to some exhausting disease, particularly diabetes; from old age and other debilitating influences. Symptoms.—The primary signs are those of fever, elevation of the animal heat to 106° or even to 108° F., rigors, loss of appetite, and swelling of the extremities. The swellings of acute farcy, commonly confined to the ex- tremities, manifest themselves by engorgement of a whole limb, resembling the swellings of acute lymphangitis or cedema, but ' For the differential symptoms of glanders and other diseases accompanied by a nasal discharge, see Principles and Practice of Veterinary Surgery, page 493. PLATE. XI, FARCY BUDS IN VARIOUS STAGES.: Waterstons Sane,Lith, Edin To face page 262, GLANDERS AND FARCY. 263 presenting an uneven surface, increasing and decreasing sud- denly, and attended with painand lameness. When the engorge- ment of the areolar tissue diminishes, enlarged lymphatic glands and vessels will then be detected, forming buds and cords. The swellings, which are due to inflammation of the ducts and valves, point and burst, giving exit to a thin, purulent, yellowish material, which generally soon dries, and forms a yellow crust on the surface of the ulcer. These buds are generally found in groups, and away from the articulations. In some instances farcy manifests itself by, first, the formation of a single painful swelling, which runs on to suppuration, on the flexor tendons of a limb, below the hock or knee, and from which enlarged lymphatic vessels may after a time be traced. Other swellings form on various parts of the affected limb, with intervening enlarged lymphatic vessels, which ultimately burst and present ragged-edged, confluent, unhealthy-looking sores that discharge copiously. In other instances, farcy is preceded by symptoms of rheuma- tism in some part of the body. Sometimes the muscles of the neck become acutely painful, and very often, but not always, swollen. The pain and swelling may disappear as suddenly as they came, and appear in some other part of the body, and this may occur repeatedly before any diagnostic signs of farcy mani- fest themselves; or the seat of pain may be the muscles of the chest, simulating pleurodynia or pleurisy, the animal groaning if made to move sharply or suddenly, and with a catch in his breathing diagnostic of thoracic pain. Again, one limb may suddenly become swollen and painful, causing much lameness. The tumefaction, heat, and lameness may recede, and attack the other limb; and such attacks may appear repeatedly and for several months, the animal’s general health during the remissions being scarcely affected; but at leneth the disease assumes a more marked character, and unmistakeable symptoms of farcy appear, or glanders results, unprececed by any true signs of farcy. In other instances, extreme lameness may appear in a limb without any traceable cause, and continue for days, or even weeks, without inducing any observable local change; generally, however, farcinous engorgement succeeds, and relieves excessive pain, and as a rule extreme pain is not of long duration. But it may be safely stated that equina is manifested in such a variety of ways as sometimes to mislead the most experienced. 264 CONTAGIOUS DISEASES. CHRONIC FARCY. In chronic farcy the local symptoms generally precede any apparent febrile disturbance; but if the thermometer be em- ployed for the examination of all horses in a stud where glanders exists, some elevation of the temperature of the body may be apparent in the infected prior to the development of any local symptoms. These local symptoms consist of circumscribed inflammatory swellings, running in the direction of the principal vessels, which suppurate and burst, without much accompanying engorge- ment of the surrounding areolar tissue. The circumscribed elevations or buds are connected together by corded lymphatic vessels, and wherever a valve is situated in a lymphatic duct, there a swelling will usually appear, and a bud will form. The buds are ranged in groups about the inner and outer aspects of the thigh, fore arm, flank, neck, and head. From the circumstance that the enlarged cords and buds run in the same direction as the veins, the old farriers concluded that farcy was a disease of the veins; dissections, however, soon dispelled this delusion, and the reason why the disease accom- panies the vessels is explained by the fact that the lymphatics and blood-vessels run in company. In some instances farcy is found confined to the cervical lym- phatics. An examination of the neck along the course of the jugular vein will enable the veterinarian to detect the lymphatic duct swollen, hard, and presenting irregular knots along its course. Suppuration seldom occurs, but the animal sooner or later presents signs of glanders or of farcy in some other part of the body. Chronic farcy differs from the acute only in intensity and duration, and is the only form of equina which is at all amen- able to treatment. The Contagious Diseases (Animals) Act, provides, however, for the destruction of glandered and farcied horses. I think that the provisions of the Act should be strictly carried out, and compensation paid from the imperial exchequer, as the disease, in whatever form it appears, has hitherto remained incurable, and is always a source of danger both to human and GLANDERS AND FARCY. 265 animal life. It is stated, however, that cures have been effected by fourteen injections in forty days of mallein from a cat in- oculated with glanders. Decroix and Bougome, two Algerian veterinary surgeons, are stated by Semner to have cured farcy by cauterisation and extirpation of the farcy buds—an exploded practice found to be useless in this country long ago. Brusaco, of Turin, and his pupils are stated to have cured 50 per cent. of glandered horses with carbolic acid, iodine, sublimate and sulphate of iron; whilst others claimed to have cured horses with tracheal injections of iodine and iodide of potassium; and in France they are satisfied with the curative effects of creosote in oil injected hypodermically. Semner again mentions that ox blood serum is useful in the cure of glanders. Pilarios states that he cured eight cases in this stage of the disease by repeated® weak injections of mallein. Glanders in man has been cured by frequent injections of mallein. Semner, however, prefers ox serum to mallein, and says that it has a more marked effect in destroying the viru- lence of the bacilli than mallein. Like Professor Macqueen, from whose observations (Central Veterinary Medical Society) I am now quoting—*To prevent misunderstanding, I ought to say that a glandered horse is said to be cured when it ceases to react to mallein. So much for the curability of glanders.’”— (Veterinary Record, April 20th, 1895). I entirely disapprove of the practice of working animals whilst affected with this malady, and would recommend the strictest surveillance by properly qualified inspectors. THE ANTISEPTIC PREVENTIVE TREATMENT OF EQUINA. When glanders appears in a stable of horses, in addition to the removal of all affected animals, and the inoculation with the mal- lein test of all in contact, it is most essential to attend carefully to the ventilation, drainage, food and water, and to the clean- sing and disinfection of the stables, fittings, harness, and other appurtenances, the removal of contaminated wood-work, the painting of all fixtures, lime-washing, or even scraping and then lime-washing—the wash to contain a pint of crude carbolic acid to every bucketful—and to the prevention of overcrowding, exhaustive work, and all debilitating influences. It has been found serviceable to administer for several weeks to all horses in \ 266 CONTAGIOUS DISEASES. the same stud, with every meal, two ounces of the hyposulphite of soda, or two drachms of the chlorate of potash. American practitioners laud the hyposulphite in farey, and say that the sores require no treatment except cleanliness. McFadyean says: ‘ Thorough disinfection of infected articles or premises is not difficult. The vitality of the bacillus is not great, being destroyed in a short time by exposure to sunlight, and by such substances as carbolic acid and corrosive sublimate. The bacillus retains its vitality in ordinary clear water for some ten or fifteen days, and silk threads, which had been saturated with pure cultures and then dried, were found infective as long after as eighty days. In ordinary positions, such as are afforded in stables, the bacillus has to contend with other organisms which impair its vitality. The old notions of the necessity for destroying old infected buildings to get rid of infection are entirely wrong. The cases in which glanders has broken out in horses that were put into old stables which had been badly infected months or years previously are explained by the simple fact that some of the animals suffered from latent glanders when placed in the stable.” Tue Mauuzin Tust.—Following the example of Koch, the discoverer of tuberculin, Helman of St. Petersburg success- fully obtained the now recognised test for occult glandcrs, namely, ‘‘ mallein,”’ which is a glycerine extract of cultures of the Bacillus mallet. This extract is sterilised by heat, and attenuated to ten times its weight with a two per cent. solution of carbolic acid. Thirty minims of this solution injected into a glandered horse causes an elevation of tem- perature of 2° to 8° in about nine to fifteen hours. There is also depression and increased rapidity of the pulse.—(See Preparation of Tuberculin.) As a rule, within a few minutes after the injection there is a swelling at the seat of operation, and this swelling may remain in a healthy animal for the matter of twenty-four hours and then disappear, which must not be confounded with the “ swelling of reaction.” This latter swelling develops slowly, and is doughy to feel and flat to look at. It shows no sign of “pointing.” Within twenty-four hours it may measure 6 in. long by 6 in. broad by 1 to 2 in. thick, and will go on increasing in length and STOMATITIS PUSTULOSA CONTAGIOSA. 267 width, but not in thickness, for even another twenty-four hours, and then measure 10 in. long by 10 in. broad (see Fig. 18, p- 261). After two or three days from inoculation, this swelling, which is extremely painful all the time, will gradually subside. In healthy animals there is no elevation of temperature or other febrile symptom, nor is there any swelling other than that simply due to the irritation of the injection, and which disappears in the course of twenty hours, or even less. It must be borne in mind that both mules and horses which are recovering from or have recently recovered from some of the forms of influenza and other bacterial diseases, may show a typical glanders reaction if injected with mallein. : This, therefore, much discounts the value of mallein, and in these cases it will be necessary to resort to the agglutina- tion test; though this is uncertain, for Foulerton has shown that the sera of diphtheria and typhoid also produce agglutina- tion of the bacilli of glanders. STOMATITIS PUSTULOSA CONTAGIOSA OF THE HORSE, The Veterinary Journal for November 1878 contains a report on this disease by Professors Eggeling and Ellenberger of the Berlin Veterinary College, translated from the Archiv fiir Wissenschaftliche und Pratishe Thierbeilkunde by G. A. B. I am indebted to Dr. Fleming for the woodcuts illustrating the eruptions characteristic of the disease. They state that during the summer of 1876 several cases of a contagious disease appeared in and outside the clinic of the Berlin Veterinary College, presenting phenomena similar to those of variola, and chiefly affecting the mucous membrane ' and external integument. Some cases outside the clinic had been declared by the inspecting veterinary surgeons to be suffering, or suspected of suffering, from glanders. Most of the patients were from four to five years old, in good condition, and showing but slight indications of general illness ; having on the whole a lively appearance, smooth and glossy coats, and eating bran mashes with good appetites ; but whilst eating hay, large quantities of saliva flowed from the angles of the mouth. 268 CONTAGIOUS DISEASES. Some of the horses stood with depressed and stretched-out heads; the temperature of the skin was warmer than natural, although the ears and extremities were cold. The pulse was 60 per minute, and full; the respirations normal. Even those showing the worst symptoms ate their food eagerly, but evinced pain during prehension, masti- cated slowly, swallowed with difficulty, and saliva was secreted in abundance, and a fine chloro- phyl green discharge flowed from the nasal cavities; when water was taken large quantities of it was returned through the nose. The Schneiderian membrane was of a red rose colour; both the submaxillary glands were en- larged to about the size of a hen’s egg—hard and knotty— but unattached to the submaxil- lary bone or integument. The oral mucous membrane became intensely hot, red, and covered by a tenacious secretion. On Fie.19.—Uiceration of dental sur- passing the hand over it, small eee firm nodules, varying in size from a millet to a lentil seed, could be felt. These nodules rapidly increased in number.and size, extending to the cheeks, tip of tongue, frenum lingue, inferior surface of tongue and upper lip, and in one or two days later their summits presented a white appearance, or the epithelium was removed, and a small ulcerated surface was apparent, and in four or five days the ulcerations were numerous, the dental surface (see Fig.19) of the lips, the tip of the tongue (see Fig.20), ' Fie, 20,—Uleeration : ; ; j of tip of tongue. frenum, and inferior surface of it, being specially affected. About the sixth or eighth day the ulcerations began to heal. Four horses condemned as glandered, presented, in addition to the above phenomena, ulceration of the external integument, namely, on the upper lip, cheeks, and anterior extremities. STOMATITIS PUSTULOSA CONTAGIOSA. 269 The ulcerations of the skin in two of these cases were more numerous than in others observed before or since, and the prescapular glands were swollen in one case. In one case the nodules appeared between the external nares and Schneiderian membrane; in another, on the skin of the breast and fore extremities; in fact, on those parts on which saliva is most likely to be thrown, several nodules about the size of a pea, and two ulcers about the size of a threepenny piece were seen. On no other parts of the body could nodules or ulcers be found. | ( Fic. 21.— Ulceration of skin of lips and cheeks, The disease runs a rapid course, the small nodules on the mucous membranes soon becoming prominent, presenting a smooth, round, and sharply defined surface, with a yellowish- white summit, or the epithelium becomes removed, and they are transformed into round or slightly angular ulcers, varying in size from a threepenny piece to a shilling—they, in their turn, becoming encrusted, somewhat resembling pus scabs. Micro- scopically examined, they were seen to consist of pus corpuscles and epithelial cells, with red blood corpuscles. Fungi and micrococei were also present. The ulcers on the legs were generally larger than those on the mucosa. 270 CONTAGIOUS DISEASES, The healing process commenced in the ulcers about the sixth or eighth days, and all the cases under treatment resulted in the animals getting quite clear of the disease in from twelve to fourteen days. Experiments as to the transmissibility of the disease by in- oculation and infection were made on sixteen horses, two cattle, four sheep, one goat, three swine, two dogs, one rabbit, and five men, with varying results. Four men and a number of horses took the disease by natural contagion, independently of experimental inoculation. Below are given a few extracts from the diary kept during the course of the experiments. 22d May.—A seven months’ old foal was successfully inocu- lated on the dental surface of the lip, the left ear, and the internal surface of the left fore leg; the resulting eruption was extensive and confluent, and the disease protracted, not having completely ceased until the twenty-first day. 30th May.—A healthy foal was placed with the above one, and another was inoculated on the vaginal mucous membrane. The inoculated one gave a negative result, but in the healthy foal the result was positive, the disease running its course, and terminating in eleven days. 31st May.—Another horse was placed with the last-mentioned foal. On the 2d of June nodules were formed, the disease terminating on the 12th. Others were inoculated with similar results, and the four foals which passed through all the stages of the disease before were again inoculated, but did not become infected a second time. One showed three small nodules, which disappeared without ulcerating in a few days. . 24th May.—A calf was inoculated on the vulva. No symp- toms appeared, and it was again inoculated on the 30th, after which the disease fully established itself, terminating in eight days. Others were inoculated with similar results. 23d May.—Sheep were inoculated with negative results. In pigs the result was also negative. In dogs, nodules appeared, but no ulceration. Rabbits were nos affected. 29th May.—Mr. Hausel (student) inoculated himself. There was redness and unpleasant itching and swelling of the part, the formation of a pustule,over which a yellow-brownish crust formed, which fell off in fourteen days, leaving a deep cicatrix. Other four gentlemen inoculated themselves without infection. STOMATITIS PUSTULOSA CONTAGIOSA. 271 A groom was infected, the disease running the course above described, he becoming quite convalescent in twelve days. In contrasting this disease with that of glanders, the authors say—lIn a superficial examination the malady might be easily mistaken for that of glanders. In favour of this diagnosis we had its contagious character, the feebleness of the discharge from the nostrils, the swelling of the submaxillary and pre- scapular glands, accompanied with the formation of ulcers in the external integument and Schneiderian membrane (the last in one instance only). Close examination and observation, however, brought to light important differences between this disease and glanders. The most striking deviation was the appearance of the ulcer itself, which presented quite a different character to that of glanders. In these instances the ulcers were round, with sharply defined borders, varying in size from a threepenny piece to a shilling, the edges neither being serrated nor swollen as they are in glanders. The ulcerations were isolated, and independent of the course of the lymphatics. For instance, those on the lips and cheeks were irregularly distri- buted, and covered with a brownish-white scab projecting somewhat above the surrounding skin. When this was removed a white granular ulcerated surface presented itself. The ulcers were generally superficial, and rarely attained any depth, hardly ever reaching the subcutis. After the sixth day they readily healed. The disease lasted in individual cases from twelve to fourteen days, and ran through a whole stable in about three weeks. The disease in question differs then from glanders, more particularly in the character and distribution of the ulcers ; also in the absence of lymphatic inflammation ; in the quickness with which the ulcers healed; in the non-appearance of ulcers in the Schneiderian membrane ; further, in the rapid course of the disease, its short incubative period, and the quickness with which it spread from one animal to another. The virus seems to lose its virulence after passing through the system of several animals. From the scarcity of horses the experimentalists had to use cattle, when by degrees the lymph lost its infectious properties, until it finally ceased altogether. This characteristic separates the disease from variola, which it otherwise closely resembles. CHAPTER XXIV. CONTAGIOUS DISEASES—continued. EPIZOOTIC LYMPHANGITIS. Eprzootrc lymphangitis is a contagious disease affecting equines and bovines, and is due to a specific organism known as the Saccharomycosis farciminosis of Rivolta, an oval-shaped body resembling a melon-seed, and having a well-defined contour and a refractile double outline, and measures 8 to 4» in diameter. Its favourite habitat is the subcutaneous lymphatic system, and the disease much resembles chronic farcy. Cultivation has up to the present not succeeded in any artificial media. It is difficult to stain except by the Claudius method, and when it is stained it loses its characteristic double contour. If possible, a diagnosis should be made from fresh pus examined wet under a cover-glass. It is, however, possible to dry the pus on a slide as a smear, and when an opportunity occurs place a moist cover-glass over it, and examine. A magnification of 800 diameters is sufficient to see the organism distinctly, but 1,000 renders the diagnosis more certain. HISTORY. It is only of recent years that this disease has attracted much attention. It caused a great deal of loss in India, to which country it probably gained access with some Italian mules. It subsequently caused considerable trouble in South Africa, from which country it was imported to England. It is indigenous along the Mediterranean Littoral, particularly in Italy. 272 EPIZOOTIC LYMPHANGITIS. iti go) o a a a Ry 5 QQ 2 3 “Sh ES 3 a 6 & a 3 2 2 3 ° 3 N BS a 7 nN a 3 g & 274 CONTAGIOUS DISEASES. SYMPTOMS. The onset of the disease is usually most insidious, and in this lies its greatest danger. It usually commences with what a stable-keeper would think was a girth or saddle gall, and its original mode of entry is usually at an abrasion occasioned by this means—i.c., either by the saddle, collar, traces, bridle, or crupper. It is not until after it has been noticed that the wound shows no tendency to heal, or that the adjacent’ lymphatics are seen to be “corded,” that suspicion arises, Fra, 23.—The saccharomycosis farciminosns of epizootic lymphangitis, unless the disease is known to be prevalent at the time. The lack of a tendency to heal in a wound is always then suspicious; the subsequent cording of the lymphatics, and their nodulated appearance, will render it still more so. The symptoms then develop and the adjacent tissues become swollen; the nodes in the lymphatics get larger; in palpa- tion they are soft, and appear to contain pus, and eventually burst. Jf a leg is affected, the limb will swell and show symptoms of subacute lymphangitis, with possibly enlarged glands. No time should be lost in making a microscopical examination, and, if possible, it is advisable to incise an un- opened lymphatic bud and abstract some fresh pus from EPIZOOTIC LYMPHANGITIS. 275 near the walls of the abscess. The only conclusive positive symptom is the finding of the cryptococcus. The general systemic disturbance is slight. In very acute cases there will be dejection, unthriftiness, remittent fever, and its concomitant symptoms, and somewhat rapid falling off in condition. In chronic cases there may be very little evidence except the actual lymphangitis. Even in acute cases death may not occur for weeks or even months, and in the chronic form it may go on for years. The disease is not necessarily fatal, but the chances of complete recovery are remote. Many cases in which the lesions have healed and the animal apparently recovered have been known to break out afresh after some months. TREATMENT, If a case be treated in the very early stages by absolute extirpation of all diseased areas, there are hopes of preventing any recurrence ; but even then it is doubtful, and it is now con- sidered advisable to stamp out by slaughter and by thorough disinfection of all harness, litter, &c. If treatment be at- tempted, rigid isolation must be adopted and insisted upon for at least a year after all symptoms have disappeared. The incubation period is extremely uncertain, and it may not evince itself for many months. Its extremely contagious nature and insidious advance would then suggest stamping out as the most efficacious and cheapest method of treatment. The disease is now scheduled by the Board of Agriculture (vide Regulations). 18—2 CHAPTER XXV. CONTAGIOUS DISEASE S—continued. CANINE DISTEMPER. Definition.—A febrile disease, due’ to the operation of a morbid poison, as the result of contagion and infection, and known in almost all parts of the world. The specific microbe has not been discovered, but it is known that the disease is transmissible by contagion aud infection, and that, therefore, the virus is both volatile and fixed. It is most readily con- veyed by the air. The virulence of the contagium contained in the discharges, the blood, &c., is diminished if kept in a dry state for a time, but congelation and desiccation seem to exert no power over it. It is therefore one of those diseases which now make a considerable list—i.e., one of those due to an ultra-visible organism. Cause.—It_ is by many observers now conceded that dis- temper is due to an organism of the Pasteurella type, and this may be accepted. The work of Phisalix and Ligniére have demonstrated this organism as the cause, and have made both a curative serum and a protective vaccine which have given good results. It has already been pointed out in con- nection with contagious pneumonia of the horse that the peculiarity of Pasteurella’s generally is that in the later stages of the diseases which they induce their presence may not be demonstrated either by microscopical examination or cultural tests. It does not follow, however, that they were not the initial cause ; but having practically finished their work, they die off, and become replaced by other saprophytic organisms. This may be the case in distemper, as we know that in the later stages bipolar organisms in the lesions are as a rule in 276 CANINE DISTEMPER. 277 the minority. The effects of the vaccines of Phisalix and Ligniére, however, tend to show that the specific cause is undoubtedlya Pasteurella. These serums and vaccines must, to be efficacious, have a polyvalency; that is, they must be made from races of the organism obtained from a variety of sources, aS an organism that is pathogenic in one locality may not be so in another, and vice versa. To obtain a true polyvalency, each variety of organism must be cultivated separately, and the products not “ pooled” until the vaccines are ready. PATHOLOGY. The virus primarily induces a febrile condition of the system, and specifically affects the mucous membranes of the nose and eyes. In some cases the poison destroys by shock, the animal dying, in a few hours, from collapse, without any true signs of distemper being developed. In other cases the action of the poison is concentrated upon the nervous system, causing epi- leptic fits, spasms of various muscles, and finally coma and death. Again, the liver seems to be the organ chiefly affected, and in other instances the intestinal canal or the bronchial mucous membrane is the seat of the local effects of the virus. Secondarily, the spinal cord or some of the spinal nerves become diseased, and, consequently, distemper often terminates in para- lysis of the posterior extremities, or in chorea; the clonic spasm characteristic of chorea being generally more observable in the muscles of the neck and fore extremities. In consequence of the variety of forms which the malady assumes, it has been described as five different diseases, namely—(1.) The catarrhal ; (2.) The respiratory or bronchial; (3.) The bilious; (4.) The intestinal; and (5.) Thenervous. These are merely varieties of one and the same disease, and exemplify in a most remarkable manner the method in which the same virus or poison may act upon more parts or organs than one, as is the case with various medicinal and other agents. The spasmodic condition of the body—the chorea—and the paralysis also illustrate how a morbid poison, after exhausting its powers upon one or more organs, may, after a space of time, affect other organs of the same body. 278 CONTAGIOUS DISEASES. Distemper, like all contagious and infectious diseases, has an uncertain but short period of latency. It, as a rule, affects the system only once; hence it is most prevalent in young dogs, and sometimes prevails as an epizootic. Some writers have compared distemper to the typhoid fever of man. I have carefully dissected numerous fatal cases of distemper, and looked particularly for the specific lesion of typhoid, namely, congestion and tumefaction of Peyer’s glands, but have failed to detect any growth in the gland cells of the intestines. In the intestinal form of the disease a generally congested condition, with even ulceration of the mucous mem- brane, may be witnessed, but these ulcerations are very different to those observed in typhoid fever. Again, intestinal lesions are the specific distinctions of typhoid, whereas in distemper inflammation of the mucous membrane of the bowels is only seen in that form in which the virus seems to exert its influence on that part of the animal body, and it is only in a minority of instances that this effect is witnessed. I can compare distemper to no human disease except measles, and the points of analogy are very great. In both diseases catarrhal symptoms are manifested; they are infectious diseases ; they generally occur but once in a lifetime; they chiefly affect the young; in almost all cases of distemper there is some cutaneous eruption or rash, and desquamation of the cuticle; catarrhal ophthalmia, bronchial and pulmonary inflam- mation, and dysentery, are complications of both diseases, and, finally, convulsions sometimes occur both at the commence- ment and during the progress of measles and of distemper. Iam not aware, however, that measles is succeeded by either paralysis or chorea; nor do I mean it to be understood that distemper is communicable to man. SYMPTOMS. The primary symptomsare those of fever, associated with those of catarrh. The dog shivers, is dull, restless, with dry nose and injected eye. The appetite is partially lost; there is thirst and rapid loss of flesh and condition; the urine is high coloured and scanty ; the bowels are generally irregular, sometimes con- stipated, sometimes looser than natural; the feces are dark CANINE DISTEMPER. 279 coloured and fetid. In the course of a few days the catarrhal symptoms, which at first may have been limited to frequent sneezing, with a slight discharge from the nose and eyes, are fully confirmed. The nasal discharge is now more or less pro- fuse; the eyes are weak, occasionally inflamed, and discharge tears and mucus. Very often the eyelids will be gummed together, and the animal thus rendered temporarily blind. Cough is present, at first dry and husky, afterwards moist. The breathing is sometimes much quickened, and the cough dry and painful, showing that the lung tissue and pleura are affected : the pulse may range from 120 to 150 beats per minute, and the temperature is elevated. In other cases the respiratory move- ments are but little affected, except when the bronchial tubes are filled with mucus, which is coughed up, and the breathing becomes much relieved. As the disease advances, debility rapidly increases, the dog being often at the end of the first week scarcely able to stand; the appetite becomes more and more impaired, and the digestive powers much debilitated. Food now partaken of or forced upon the animal is quickly ejected by vomiting, or passes through the intestinal canal in a foetid, ill-digested condition. At the end of about a fortnight these symptoms may abate in intensity, and the dog slowly regain its strength. Very commonly, however, complications occur which tend towards a fatal termination. The complica- tions are as follows :— 1st. Pnewmonia.—The breathing becomes laboured, rapid, and panting; the prostration of strength is very great; the dog is unconscious of surrounding objects; the pulse is frequent, feeble, and intermitting, and the feet, nose, and ears are icy cold. If the ear be applied to the chest the crepitating sounds of pneumonia will be detected. 2d. Jaundice—This occurs from the presence of a blood poison, interfering with the normal metamorphosis of bile, from congestion of the liver, or most commonly from catarrhal inflam- mation of the mucous membrane of the biliary ducts; the swollen mucous membrane mechanically blocking up the tubes, and thus impeding the flow of bile—(See Liver Diseases.) 3d. Intestinal complications.—Vomiting and purging are prominent symptoms, Sometimes there is true dysentery, the feeces being tinged with blood ; tympanites and abdominal pain. 280 CONTAGIOUS DISEASES. 4th. Epileptic fits —Spasmodic convulsions of varying inten- sity, coma and paralysis, more or less complete, occur as primary symptoms. These are to be separated from those signs of nervous alterations which occur as secondary affections in dis- temper. In the first case the brain and nervous symptoms are concomitant with or shortly succeed the attack; whilst in the latter, chorea, paralysis, or complete coma appear after the febrile condition has more or less abated, and when the dog seems in a fair way to recover. Conjunctivitis is not at all an uncommon complication, and ulceration of the cornea, perhaps unpreceded by any inflammatory signs, may occur from mal-nutrition. In other cases cellulitis or an erysipelatous inflammation of the extremities occurs, the inflammation sometimes suppurating in various parts: the suppuration, being of a diffuse or in- filtrating character, causes much pain and rapid exhaustion. In most instances some cutaneous eruptions are seen on the inner surfaces of the thighs and other parts, where the hair is thin and downy; the eruptions at first resemble flea-bites, but may become vesicular or even pustular; the skin is harsh, and much epithelium is thrown off, causing the hair to be filled with scales of scurf. There are various conditions of the body which predispose the disease to attack the dog in the various ways above enumerated. The presence of worms in the intestinal canal may excite the intestinal form; previous high feeding and obesity the bilious ; and the eccentric irritation of the nervous system caused by teething, worms, &c. predispose the dog to the nervous form. Distemper originates undoubtedly from contagion as well as from atmospheric infection, and usually rages as an epizootic. The majority of dogs in some districts suffer from the disease, whilst in other parts of the country it is scarcely ever heard of, unless brought there by a dog already diseased, and no class of dog is exempt. During the author’s residence in Australia the disease was imported from Europe, and scarcely a dog in the colony of Victoria was unattacked. Nor were the wild dogs allowed to escape ; hundreds of these were to be seen lying dead in the bush in various parts. It is also stated that it attacks the cat, wolf, hyena, prairie dog, and monkey. The contagium or virus, probably a microbe which may yet be CANINE DISTEMPER, 281 attenuated and applied for the purpose of protective inoculation, will taint a kennel for a long time after the disease has dis- appeared ; and it is always unsafe to introduce fresh dogs into such a kennel, if it cannot be proved they have passed through the disease, unless the walls, drains, fittings, &c. are thoroughly cleansed and disinfected. TREATMENT. In the treatment of distemper it must always be remembered that the disease runs a certain but indefinite course, and that all the symptoms are but the result of the operation of a morbid material existing in the blood. If these facts be borne in mind, the practitioner is not likely to resort to those dangerous and exhausting remedies so generally recommended by writers on canine diseases. The administration of calomel, jalap, aloes, tartar emetic, digitalis, with the application of blisters or setons, is calculated at all times to do harm. , In the earlier stages, if the bowels are at all irregular, a small dose of castor oil is to be prescribed. The dose must vary in strength according to the size and age of the dog; from a tea- spoonful for a small dog or young puppy, to an ounce for a well- grown dog. This will remove any ill-digested or indigestible material from the intestinal canal. After the laxative has operated, I have found from two to six grain doses of the hyposulphite of soda useful, modifying the symptoms most materially, and converting what has threat- ened to be a serious case into a mild attack. Care must always be taken not to administer any medicine in such large doses as to disorder the stomach in any way, or to cause vomiting, as it is of essential importance to keep up the animal strength by proper food, spontaneously partaken of. If there be much prostra- tion of strength, a tea-spoonful of good sherry, or one drachm of spirits of nitrous ether, may be administered three or four times a day, in addition to the hyposulphite, with very great advantage, This simple treatment, in addition to warmth, fresh air, a clean bed, and clothing for thin-haired dogs, with a plentiful supply of fresh cold water (or milk and water if the dog will take it) for the animal to drink, sponging of the nose and eyes not being forgotten, will often be successful. The food must be restricted in quantity, and of an easily digested nature. In 282 CONTAGIOUS DISEASES, my own practice I find porridge and milk to be the best, pro- vided the dog will take it; but if it be a pet dog, and used to pampering, it must have what food it will eat, and what it has been used to, in modified quantities. It may be laid down as a rule that the digestion of what the dog is fondest of will be more easily performed, provided that it is not allowed to eat too much. After the disease has continued for six or seven days, small doses—from one grain to three—of quinine may be administered, care being taken to discontinue it if it seem to disagree with the dog. If there be much irritation of the stomach and vomiting, hydrocyanic acid, from two to four drops, Scheele’s strength, will have a calmative effect on the gastric organs and allay the vomiting. Purging, if not excessive, should not be violently checked, but should the dog seem to lose strength from this cause, chalk may be first tried, and afterwards tincture of opium, from ten to twenty drops, three times a day. The pulmonary complications are best relieved by the appli- cation of hot flannels to the sides, or hot fomentations may be substituted in smooth-haired dogs. In rough-haired ones, the hair saturated with the wet is a long time in drying, and the animal is apt to take cold. Nitrate of potash may be dissolved in the dog’s drinking water, or given in solution in from six to twenty grain doses, as a febrifuge and diuretic; and the chloral hydrate may be given at night, particularly if the dog is sleep- less. The nervous symptoms may depend upon reflex irrita- tion. If from teething, the gums are to be lanced. If from the presence of worms, and this is a common cause, and tape-worm the parasite generally met with, from one scruple to one drachm of areca-nut is to be administered. If the appetite is entirely lost, advantage must be taken of the thirst, and beef tea or milk allowed the dog to drink. If it will not drink spontaneously, nourishment must be forced upon it, in small quantities and oft repeated. A raw egg beaten up with a glass of sherry, care- fully administered, will be of great service; in other cases, brandy and beef tea. I am, however, opposed, unless the pro- stration of strength threatens to prove rapidly fatal, to the forcing of large doses of stimulants, as they often cause much mischief, careful nursing and good attendance being much more beneficial than any mere medicinal-remedy. CANINE DISTEMPER. 283 I have very little to say upon the treatment of the secondary nervous complications. They are due to a variety of pathological changes. Paralysis sometimes results from obliteration or plugging of the spinal veins, which are found enlarged and pressing upon the cord: I have found this in several dissections of dogs which had died or had been destroyed whilst suffering from paralysis— from atrophy of the cord, the nervous matter of which being in some instances replaced by a semi-fiuid deposit, and from con- gestion and disintegration of its substance. Some cases of paralysis after distemper, if kept long enough and well fed, will recover. Asarule, however, the loss of power remains, and the dog has ultimately to be destroyed. I have tried strychnia and other nervine tonics, but cannot say that they do much good. Iodide of potassium—given on the assump- tion that the paralysis resulted from the pressure of an exudate on the cord—has been tried also by me, but with no very suc- cessful results. - Blisters to the spine, setons, and even the application of the actual cautery, have also been tried in such cases. Such treatment inflicts much pain on the poor patient, but does not remove the disease or prolong life. If the eyes are tender or inflamed, they are to be bathed with a solution of boracic acid ; and, in order to relieve any pruritus and prevent scratching, a five per cent. solution of cocaine should be applied every few hours. Irritants, such as the nitrate of silver and sulphate of copper, should be avoided. Calomel, blown into the eye, may be tried in chronic opacity. Within the past few years it was thought that immunity might be conferred in dogs by the injection of a series of virus vaccines of various degrees of virulence, and the method is known as Phisalix’s vaccination. Unfortunately, however, McFadyean, Gray, and others have found that it is useless as regards dogs in Great Britain. (For full details of this form of vaccination, see ‘‘ Blood-serum Therapy,” by Jowett ; Bailliére, Tindall and Cox, London.) CHAPTER XXVI. CONTAGIOUS DISEASE S—continued. ANTHRAX. AntHRrax; charbon; gloss-anthrax; apoplexia splenetica; car- bunculo contagiosa, &c. (L.); charbon ; chancre 4 la langue; mal de sang; sang de rate; typhomié; fiévre putride, &c.(F.); miltz- brand; miltzbrand-fieber ; petechial typhus; pestfieber (G.); carbone; febbre carbonculara, &c. (I.); apoplexy of the spleen ; malignant sore throat; known in India as Loodiana disease, and in South Africa as horse sickness ; in sheep as splenic apoplexy; in America as splenic fever, Texan fever, trembles, &c. The term charbon is applied by the French veterinarians for the reason that the regions of the body where the disease is localized are coloured black. Anthrax (a burning coal) is now adopted by most writers as a generic term, and applied to what is otherwise known as splenic fever; but it throws no light on the nature of the disease, as others, septic and putrefactive in their nature, present a similar appearance of the blood. Definition.—The disease is a true septicemia, and consists in a special and primitive alteration in the blood, in which an organism termed the Bacillus anthracis is rapidly developed and propagated, and is more special to the herbivora and birds. Inoculation with the blood or tissue of animals which have died from it induces some one or other form of the disease,—in man, asa rule, malignant pustule. For this reason anthrax is looked upon and described as a truly contagious disease. Anthrax appears at all seasons, but principally in the spring or during summer and autumn. It occurs either as a sporadic, enzootic, or epizootic disease, attacking animals of any age—the fat, vigorous, plethoric, as well as the lean, feeble, and languid, 284 ANTHRAX, 285 It is a remarkable fact that wounds, simple in themselves, in cattle subjected to the influence causing charbon, although not suffering from it, often become mortal. HISTORY. Anthrax has a very ancient history, and was known in Asia Minor at the period of the siege of Troy; but, leaving ancient history aside, it may be useful to mention that the seventeenth and eighteenth centuries were remarkable for the devastations committed by various epizootic outbreaks of anthrax. In 1617 it was prevalent and of such a fatal nature in the neighbourhood of Naples, that over 60,000 persons perished through partaking of the flesh of animals which had died of the disease. In 1731 it declared itself in several provinces of France, notably in Auvergne, Bourbonnais, and in Languedoc, where it was studied by Sauvages, and described by him under the term glosso- anthrax.—(Nosologia Methodica, vol. ii. page 360.) 1757, 1763, 1775, 1779, 1780, and 1800.—These years were signalized by a charbonous malady which extended nearly all over France, and affected all the domesticated animals. The disease was studied by Bourgelat, Chabert, Berdin, Huyard, Desplas, Detil, Gordine, Gilbert, and a great number of veteri- narians. From 1800 to 1846 many outbreaks of charbonous disease were observed, generally in the hottest months. They were studied by Demoussy, Sansol, Pradal, D’Arboval, Mathieu, and others. During more recent periods, outbreaks have been studied by Roche-Lubin in Avignon; by M. Rey on the heights of the Alps; and in Eure et Loire by the Medical Society of the department ; and by MM. Renault and Delafond, who were sent by the French Government, the one to Allier and Niévre, and the other to Somme, to report on the disease. Within recent years the disease has been profoundly studied by Pasteur, Chauveau, and Koch, and others in France and Germany. In this country, however, little has been done for its elucidation ; and though less frequent here than on the Continent, it is, how- ever, quite as fatal in its character. ETIOLOGY. The influences which predispose to the development of anthrax are arranged by French veterinary writers under four 4 286 CONTAGIOUS DISEASES. principal heads, comprising respectively the influences of temperature ; water spread over the surface of the earth, as in morasses and stagnant ditches ; forage tainted with decomposing animal and vegetable matters; and contagion. Influence of temperatwre—The hygrometric and thermometric conditions of the atmosphere, which always exercise a marked action on the organism, disposing it under certain circumstances to anthrax, are stated by several authors to be those charac- terised by humid and persistent fogs, coldness, and humidity; a tempestuous atmosphere; alternations of burning heats and stormy rains, It rages as an enzootic on the borders of rivers, and in low lands which have been inundated. In the months of July and August, signalized by excessive heat, charbon has been frequent. The years 1712, 1731, 1775, 1779, 1780, 1823, 1824, 1825, 1846, have furnished memorable examples. Under the influence of excessive and prolonged heat, the rivers, ponds, brooks, &c. were dried up, the soil opened in crevasses, and the disease was developed to an enormous extent. In France it is stated that a very warm summer is never seen without charbonous diseases being prevalent; and it is concluded that a high temperature, especially if preceded by a damp or moist atmosphere, is very favourable to the development of charbon. Influence of ponds, morasses, and stagnant waters—The history of the malady demonstrates that morasses are favourable to its development, as it is observed that it is frequent in countries where they occupy a large surface. It is also frequent in countries exposed to inundations, and where water stagnates on the surface of the soil; and where animals are made to stand in mosses and stagnant waters, the malady commits great ravages. This fact is remarkable, not only in France, but in other countries, particularly in the Mississippi valley in America, and in Africa and India. Observers who have closely watched these affections in this country, where it seldom appears in the horse, almost unani- mously conclude that in cattle and sheep they are due to dietetic errors; more particularly to sudden and violent changes in diet, whether that change be from a poor to a highly nutritious, more particularly a nitrogenous diet; from dry and good food to watery unripe provender ; to damaged food of any kind; the ANTHRAX. 287 influence of undrained lands; defective ventilation and drainage of stables; to food and water contaminated with the morbid products of animals which have died of anthrax. In one re- markable outbreak which came immediately under my notice, the disease appeared amongst sucking calves of the pure shett- horn breed, and which had never partaken of other food than what they obtained by sucking, the dams remaining healthy. Anthrax is also disseminated through the agency of flies; and Bollinger, who has observed that the disease is often most prevalent when flies are in the greatest abundance, has induced it in rabbits by inoculating them with flies caught on the car- cases of animals dead from anthrax. The flies, however, resist the influence of the virus, although bacteria are found in them. Pasteur’s assertion that the spores of anthrax are brought to the surface of the ground by earth-worms—contested by Koch—is now confirmed by Bollinger, who has found that five per cent. of the worms coming from an infected pasture-ground contained the spores of anthrax. The theory as to spores being conveyed by earth-worms is open to serious doubt. The bacillus of anthrax is strictly aérobic, and will only sporulate at a temperature of about 30° C. (86° F.). If an animal affected with anthrax is buried without opening the carcase, all the organisms are exposed to anaérobic conditions, and therefore cannot grow or sporulate. Previous to death no sporulation will take place in the body. It would seem, then, that no spores are buried, and as the temperature of the soil is never as high as 98°6° F., in England at any rate, the possibility of such means of contagion ‘is very remote. Contagion must therefore be by the careless disposition of diseased carcases, thus blood or contaminated material is exposed to aérobic conditions, sporulates, and so infects the soil. These spores remain alive indefinitely under ordinary conditions until an opportunity is afforded them of infecting an animal. The earth-worm theory is a possibility, but rather an improbable one. It will be seen, therefore, that if an infected dead animal is buried without the skin having been broken, or without in any way giving the infected tissues aérobic conditions, then all danger is exempted, and neither lime nor other disinfectant is necessary. As a safeguard, however, dis- infectants or fire are invariably used. 288 CONTAGIOUS DISEASES. Dogs, cats, white mice, and Algerian sheep are said to have an immunity from the disease.—(CRooKSHANE.) In opposition to the view of the spontaneous origin of anthrax, we have the observations of many eminent pathologists—and this view is now universally accepted—who maintain that the malady is due to the propagation of a now well-known aérobic organism, the Bacillus anthracis, the history of which is as follows: These organisms were first observed by Brauell, and afterwards by Delafond and Gruby, in the blood of animals which had died of anthrax, as peculiar staff-shaped bodies, which Delafond designated bétonnets, and which were believed to be products of putrefaction, and that anthrax was a septicemia or putrefaction of the blood. These bétonnets were afterwards observed* in 1850 by MM. Davaine and Rayer, and some time later Koch studied them, and found the aqueous humour of the ox’s eye to be papirontarly suitable for their nutrition. With a drop of the AW alilt aqueous humour he mixed the smallest speck of a liquid containing the rods, placed it under the microscope, warmed it suitably, and watched the subsequent action. During the first two hours hardly any change was noticeable, but at the end of that period the rods began to lengthen, and the action was so rapid that at the end of three or four hours they had attained from twenty to thirty times their original length, and at the end of a few additional hours had formed filaments in many cases a hundred times the length of the original rods; and further, it was seen that within the transparent rods little dots appeared; these became more and more distinct until the whole organism was studded with minute ovoid bodies like peas within their shell. After a time the integument fell to pieces, the place of each rod being taken by a long row of seeds or spores. Koch concluded that these spores, as dis. tinguished from the rods, constituted the contagium of the disease in its most deadly and persistent form. By inoculating animals with the fresh blood of an animal suffering from splenic fever, he found that they invariably died within twenty to thirty hours after inoculation. By drying the infectious blood containing the rod-like organisms, Fig. 24, —Troneparent rods. 4 ANTHRAX. 989 in which, however, the spores were not developed, he found the contagion to be fugitive, maintaining its power of infection for five weeks at the furthest. He then dried the blood containing the fully developed spores, and exposed it to a variety of conditions. He permitted the dried blood to assume the form of dust, wetted this dust, allowed it to dry again, placed it for an indefinite period in the midst of putrefying matter, and subjected it to other tests. After keeping this spore-charged blood, which had been treated in this fashion for four years, he inoculated a number of mice with it, and found its action as fatal as that of blood fresh drawn from the veins of an animal suffering from splenic fever, each spore in the millions con- Fie. 25.—Spore-bearing filaments. tained in the diseased blood being sufficient to produce the disease. The bacilli are not always found in the blood of living animals suffering from the disease; indeed, they generally appear a few hours before death, which never takes place in less than twenty hours, and then only singly and in very small numbers. Their number, however, varies with the animal inoculated ; in the guinea-pig they are numerous, sometimes exceeding the blood corpuscles; in the rabbif much smaller, and in the mouse often absent altogether. If the disease has been induced by inoculation, they are present, though in variable numbers, in the inoculation carbuncle. Though the rods are not always found in the blood, the spores are said to be invariably present, and some assert that it is their product that destroys life. The bacilli rods are straight or somewhat irregularly outlined, measuring from zs295 tO ssd00 Of an inch in breadth, but they 19 290 CONTAGIOUS DISEASES. vary in length very considerably, those in the spleen being longer; the shortest rods being in length generally about twice the diameter of a human red corpuscle, the longer ones two or three times the length of the shorter*; but when carefully examined, the latter will be seen in a process of division into two or more segments. They are broad at each end, truncated, and slightly concave, and when united the concave ends enclose a lenticular space; they are non-motile, and their ends are not rounded, but terminate sharply. The bacillus of anthrax is easily stained by any of the aniline stains. The stain preferred, however, is old solution Fie 27.—Anthrax bacillus and blood corpuscles. of ethyl blue, because with it there is a peculiar reaction which is not noticed when other organisms are stained with this dye. McFadyean and a German pathologist simultaneously ob- served that when using this stain in anthrax blood-smears the stain split up, the bacilli were stained blue, and the fluid around them stained pink. In carefully prepared specimens this is so marked that the smear seems stained more pink than blue if held up to the light. Another important fact to be remembered is that anthrax bacilli have well-marked capsules which are unstainable, and ANTHRAX. 291 ina typical specimen we should see with methylene aniline blue a blue clean-cut rod surrounded by a clear space, and this again surrounded by pink. According to the observations of Koch, it appears that, what- ever be the species of animal inoculated with anthrax blood, and no matter how many successive inoculations may be made, the bdactllt multiply solely by fission, but only so long as the animal is alive; when dead a minute portion of its blood, placed in aqueous humor, and kept at a temperature of 35° to 37° C. (95° to 983° F.), the rods, as already stated, lengthen out very considerably. This process of lengthening of the rods into filaments is apparently effected by the temperature. In five hours a rod at a temperature of 32° C. (89°6° F.) may have increased so as to be from eighty to one hundred times its original length, and in twenty-four hours the filament may be full of spores. If the temperature, however, be kept about 28° C. (82°5° F.), the spores may not appear till the thirty-sixth or fortieth hour. When the spores have once appeared, all the other changes go on at ordinary temperatures from 12° C. (53°6° F.) to 18° C. (644° F.), but not nearly so rapidly, even when the preparation is kept in the sun for a few hours daily, as when artificial heat is applied. On the other hand, a high temperature, 37° to 40° C. (98°6° to 104° F.), at once checks all developmental changes. The filaments differ in cultivated specimens very much in their arrangements. Sometimes they form a network—indeed a mycelium—made up of numerous, nearly parallel, unbranched threads, crossing each other at different levels; the threads are sometimes straight, but have generally a wavy outline. This condition may obtain throughout the whole preparation, but generally at some parts the filaments are extremely irregular and much convoluted. Pasteur stated that the spores of bacilli remained toxic after boiling ; and after being subjected to a pressure of twelve atmo- spheres of oxygen, Dr. Burdon Sanderson and Dr. Cossar Ewart tested the accuracy of this statement, and found that mice inoculated with the boiled and compressed solutions remained quite well. The experiments of Bert, however, support to some extent 19—2 292 CONTAGIOUS DISEASES. the conclusions of Pasteur. In a series of experiments Bert submitted anthrax blood to the action of considerably com- pressed oxygen, and found the bacilli had disappeared, killed by the oxygen, and yet the blood retained its virulence, for it killed rabbits, guinea-pigs, and dogs inoculated with it; and in another series of experiments Bert took anthrax blood contain- ing bacilli, and added drop by drop of absolute alcohol to it, until a precipitate was formed, and which was dried in vacuum. This dried powder was injected under the skin, and it killed a rabbit, a guinea-pig, and even a dog. If this alcoholized precipitate be dissolved in water and filtered, the filtrate is still virulent. If alcohol is again added to it, it forms a flocculent matter, which is deposited at the bottom of the vessel. Collected on a filter and dried, this precipitate is still toxic. It would therefore appear that the active or virulent element of anthrax resists absolute alcohol, and that it resists oxygen, and that it is precipitated by alcohol and soluble in water. It behaves itself something like diastase, except that, whatever may be its nature, it can reproduce itself to an indefinite extent ; while it is asserted by some authorities that diastase cannot reproduce itself. Putting aside the conclusions of Colin—that the bacilli are simple transformation of the blood-corpuscles— we are left between two sets of conclusions. Those of Koch and others point to splenic fever being due toa minute organism possessing wonderful powers of: resistance and reproduction; Bert’s to something independent of the presence or absence of animal or vegetable organisms—a ptomaine—which resist the action of compressed oxygen and absolute alcohol, and which would, he asserts, kill everything possessing life: this something he is of opinion is a substance analogous to diastase. Blodd containing bacilli, if dried in very thin layers, by being exposed to the air in a shady place, was found by Koch to lose its virulence and its power of developing elongated fibres after twelve to thirty hours. Thicker layers retained their powers for two or three weeks; and some still thicker for four or five weeks. After a longer time they were never capable of pro- ducing the disease. Koch also found that if the bacilli were deprived of air they soon died. ANTHRAX, 293 When rubbed up with the blood or aqueous or vitreous humor of an ox, and placed in a well-closed glass vessel, there quickly ensued an odour of putrefaction ; the bacilli disappeared after twenty-four hours without the fibres enlarging, and lost their infective power. That their death was due to the absence of oxygen was shown by placing a drop of blood infected by the bacilli under the microscope. Examined by the micro-spectro- scope it gave the bands of oxy-hemoglobulin ; the fibres in this drop increased four or five times in length in three hours, but after that time the oxygen was clearly used up, as the presence of the absorption band of reduced hemoglobulin proved. From this moment the growth of the bacillar fibres ceased, although true putrefaction had not set in. When the spores and bacilli are separated from the blood by filtration, the blood is said to be rendered innocuous; and when pregnant animals become affected, or have been inoculated, the blood of the foetus does not become diseased, and. other creatures can be inoculated with it and suffer no harm, the intervening membranes acting the part of a filter. The bacilli also disappear in liquids in the presence of carbonic acid, and the blood soon loses its specific property. This proves that, to live and grow, the bacilli require to absorb oxygen and give out carbonic acid; hence they are what M. Pasteur terms “aérobic.” If the fluid which contains them begins to putrefy they are destroyed, not only by being deprived of oxygen, but by being brought into contact with other organisms, such as the microbes of putrefaction, in the presence of which, and of all other low forms of organisms, they either do not develop at all, or develop with great difficulty. The organisms of putrefaction are not aérobic, and cease to move when brought in contact with, oxygen; disappear, being trans- formed into refracting corpuscles, which in a suitable soil become motile, and multiply with extreme rapidity in a putrefying fluid. If an animal be inoculated with it when in this condition, it does not die of anthrax, but of septicemia, the symptoms of which, when produced in guinea-pigs with the blood of a horse which bad been dead of charbon twenty-four hours, and which contained the bacteria of putrefaction as well as some bacilli, and with the blood of a cow which had been dead forty-eight hours, and which contained a preponderating quantity of motile 294 CONTAGIOUS DISEASES. organisms, were violent inflammation of all the muscles of the abdomen and limbs, and here and there, especially on the ears, bulle formed containing gas. The blood was diffluent, and on examining these animals immediately after death, M. Pasteur found that the muscles were filled with active vibrios of putre- faction, and in the peritoneal cavity they had undergone extra- ordinary development; one drop of this serosity taken from an animal still. living affected another animal profoundly, while a drop of blood from the heart had no effect. The spores are very tenacious of life, resisting many germicides. The rods are destroyed by dry heat at a temperature of 212° F., whilst the spores require to be exposed for three hours to a dry temperature of 283° F. before they are killed. Some writers assert that the spores resist the action of boiling water, but Hamilton says that they are killed after a few minutes’ boiling: the rods, however, perish in a moist atmosphere at a temperature of about 140° F. Putrefaction and the action of carbonic acid gas, whilst destructive to the non-sporulated rods, have no effect upon the spores themselves; both spores and rods are, however, killed in ten minutes by corrosive sublimate—1 per 1000 solution— within twenty-four hours by a two per cent. solution of chlorine, bromine or iodine, and strong sunlight; but they seem to resist five per cent. solution after twenty days’ exposure, twelve days phenic acid five per cent., and nineteen days ten per cent. solution of lysol. Iodoform seems to have no influence either on the spores or rods. Whilst the rods are destroyed by putrefaction, it is otherwise with the spores, which have a much greater degree of resistance, and it is due to this retention of virulence by the spores that anthrax continues in buildings, grass lands, dried fodder, and water. Grass and hay grown upon land where anthrax carcases have been buried months before have conveyed the disease, and the same may be stated of water, particularly spring water obtained from wells situated at a considerable distance, but below the graves of such animals. - Again, dilution of the fluid containing the bacilli with a moderate amount of water has no effect on its virulence, but a large quantity destroys it, and traces of carbolic acid prevent the development of the bacilli. It has been stated that the bacilli destroy life—(1.) By acting ANTHRAX, 295 as asphyxiants, depriving the blood of its oxygen; and (2.) By mechanically obstructing the blood-vessels. Against both these theories must be placed the fact that they are very few in number, indeed often absent altogether in the blood during life. Anthrax is not transmitted by infection from one animal to another, for animals kept in the closest proximity to diseased ones, and placed under the most favourable conditions for infec- tion through the air, do not become diseased. Mice and rabbits seem capable of eating food containing bacilli with impunity, and flies can gorge themselves with the infected blood and suffer no harm ; but horses, cattle, pigs, dogs, cats, guinea-pigs and ferrets succumb after partaking of food and water contaminated with the virus. It is now generally admitted that animals are infected by spores contained in the food, which gain entrance into the circu- lation either through abrasions in the mucous membranes of the digestive track, or, as some assert, by the pulmonary mucous membrane ; but this is doubtful. My own experience leads me to conclude that undecorticated cotton cake is the most fertile source of the disease of all the artificial foods, and it seems to acquire virulence after being kept for some time, particularly if neglected and allowed to become heated and mouldy. When freshly made, it seems to have no effect, and I have known several instances where cattle have eaten the same cake for weeks or even months before becoming affected, then all at once they have died off. I am of opinion that the spores—few in number—have been present in the cake from the first, and that they multiplied in the cake, which, as is well known, is imperfectly dried; thus, after repeated reproductions of the organisms, the cake has become sufficiently charged to induce the disease in its partakers. The decorticated cotton cake is differently prepared, being highly dried and submitted to great pressure ; thus heating and fermentation are prevented, and any increase of the organisms rendered impossible. . When soil is contaminated with the blood or discharges of animals dead of anthrax, it is found that spore formation goes on actively in many moist and warm media, and it is stated that these spores may be conveyed by floods to surrounding pastures, It is also supposed that the organism may grow as a saprophyte 296 CONTAGIOUS DISEASES. on dead vegetable matter. Whether this be true or not, the vitality of the organism must be very tenacious, as it is well known that certain pastures are always dangerous to cattle, but more particularly after rain preceded by warm dry weather. It is most remarkable that preventive inoculation has not succeeded in this country, although so successful on the Conti- nent. Is it the fault of the operators, or what? A reference to experiments of Dr. Burdon Sanderson and Mr. Duguid (see below) ought to convince any one that the operation should be further tested, and that the Government should encourage all experiments calculated to increase the general welfare, instead of throwing obstacles in the way. The local effects of inoculation of the skin with anthrax blood is as follows:—In twenty-four hours there is redness of the spot, with heat, swelling of the skin and subcutaneous tissue, extending from a third of an inch to an inch in depth. The swelling increases in forty-eight hours to perhaps two inches, and on the third day, if the animal survive, to several inches; the heat and redness being most intense at the in- oculated spot. The process extends in the connective tissue, particularly along the track of the lymphatics. In superficial inoculations bacilli can be seen in every instance in twenty- four hours, at a distance only of about one-fourth of an inch, but their after extension is not proportionate to’ the extent of the tumefaction, nor does the serum found in the swelling con- tain many of them until after forty-eight hours, when great quantities will be found in it; when the virus is injected into the subcutaneous tissue death may occur without bacilli being found at the point of injection. INOCULATION FOR THE PREVENTION OF ANTHRAX, In 1878 it was discovered by Dr. Burdon Sanderson and Mr. Duguid that cattle might be inoculated with splenic fever from a guinea-pig, and though such inoculation caused the development of serious symptoms, the animals did not die; and in continuing these experiments it was found that cattle once so inoculated re. sisted the results of further inoculation,—that in fact they could be thus rendered insusceptible to future attacks of splenic fever. Dr. Greenfield, in making a series of experiments with the view ANTHRAX, 297 of obtaining a suitable virus for inoculation, found that the virus modified by transmission through the guinea-pig, and, cultivated under particular conditions, gradually lost its activity, and at last became practically inert; and it occurred to him that, by making use of this fact, a virus might be obtained so far modified as to be sufficient to ensure protection and yet not endanger the life of an animal inoculated with it, and this he found could be done with success. The priority of this discovery is therefore claimed for England, but the merit of working out its details is undoubtedly due to Pasteur. VARIETIES OF ANTHRAX. The more recent investigators are disposed to confine the term anthrax to that form of disease characterised by black tumour, associated with the presence in the economy of the Bacillus anthracis ; but as the term merely indicates a symptom —namely, a black tumour, the charbon (coal-like) of the French —-I intend to include under it all those diseases in which it is an expression or a symptom, contenting myself by pointing out in which of them the bacilli have been discovered, and which are proved to be contagious. Chabert designates anthrax or charbonous diseases as foul affections of different natures, and external tumours terminating in mortification of the tissues, and divides them into three kinds, namely :— 1st. Charbonous or Anthrax Fever.—In this form there are no external manifestations, and it is rapidly fatal; the post mortem appearances being engorgement and congestion of the spleen, liver, mesentery, intestinal mucous membrane, the sublumbar tissues, lungs, and heart. In some cases death is preceded by roughness of the coat, dry, hot skin, excessive sensibility over the dorso-lumbar region, choking cough, glairy discharge from the nostrils, and a quick, strong pulse. Sometimes the animal may live long enough for level tumours to form under the skin ; but very often the patients succumb without presenting the least symptom of the malady, or in a few hours after the first appear- ance of illness. ANTHRAX IN THE HORSE. Anthrax in the horse rarely occurs in this country, but is 298 CONTAGIOUS DISEASES. prevalent in India, where it attacks the elephant as well as other animals. Symptoms.—The animal may appear dull, walking with a heavy, feeble step, then falls prostrate in a state of somnolence; if it be standing, the head hangs down, resting on the manger or other solid body. It sometimes stands back in the stall, resting the body on the side, and finally becomes restive, stamps with the feet, looks to the sides and flanks, and shows other signs of colic, and the temperature is much elevated. If the disease comes on whilst the animal is at work, added to the above symptoms there is extreme lassitude, great weak- ness of the lumbar muscles and posterior extremities, with stag- gering gait. The skin has lost its suppleness, is hot, and slightly crepitates on the back, over the kidneys, and sides; the coat is rough and bristly in some parts; and there are partial or general tremblings of the muscles, and flow of saliva from the mouth. There are sweats, alternating from hot to cold. At the base of the ears, and behind the elbows, the veins become augmented in volume. Above all, the lymphatic ganglia of the groin are swollen; and if the horse be entire, the testicles move rapidly up and down. Great excitement now sets in, the animal is irritable and timorous, and afterwards becomes uncon- scious of all around. The conjunctive are yellow or reddish- yellow ; and sometimes petechial spots are present on the visible mucous membranes. The pulse is small and thready ; the beatings of the heart are, however, strong, and are accompanied by a metallic tinkle. The respiration is often irregular, and often associated with roaring. These symptoms may insensibly disappear, or may be suc- ceeded by a critical eruption. At other times, even after the animal has seemed to rally, ageravation of the symptoms takes place. The animal grinds its teeth, has violent colic, rolls about, carrying its head to its flanks; the muscles of the head and neck are agitated by convulsive movements; the eyes are haggard and wandering; the mucous membrane injected, and of a brown or red tinge; the heart beats with extreme violence, very irregularly, and accompanied by a strong metallic sound; the pulse is trembling or double, and very small; the respira- tions tumultuous and agitated; the nostrils dilated, and clots of yellow (almost sulphur coloured) serosity and blood escape ANTHRAX. 299 by the nose; the mouth is filled with a mucous foam, the tongue is tumefied, and of a deep bluish-red colour (GLoss- ANTHRAX); tears, sometimes tinged with blood, flow from the sunken and haggard eyes. The belly is sensitive when pressed upon, tympanitic, and the excremental matters are often liquid and mixed with blood clots; the rectum is often everted, appearing as a tumour, folded and livid; the tem- perature of the skin is lowered; the countenance is particularly anxious, the face shrunken. The muscular force now becomes exhausted ; the animal falls to the ground; convulsions come on, more particularly of the neck and extremities; and finally it succumbs, after a few moments of calmness, which, suc- ceeding a paroxysm, always precedes death. The disease may terminate in from six to forty-eight hours after the manifestation of the first symptoms. The ordinary time is from twelve to twenty-four hours, unless external eruption eliminates the morbid material from the body. In the spring of the year 1884 a remarkable outbreak of charbonous fever, presenting the salient symptoms of Loodiana disease, occurred in a large stud of cart-horses under the care of Messrs. Leather, veterinary surgeons, Liverpool, and which had been, for some time previously, fed on an Indian pea (Piswm sativum), called in Liverpool Indian mutters. Mutur is the Hindustani word for the common pea (Piswm sativum), but that brought to Liverpool is different from the ordinary pea of this country, and resembles a lentil more than a pea. It is imported into Glasgow from India in large quantities, I believe, mostly as ballast, and has, I am told, not only been given to horses, but ground and mixed with various cakes for cattle, and with many fatal consequences. However, in the outbreak at Liverpool, it appears that horses commenced to die very suddenly some time after the owners had commenced to use the mutters, and for several weeks after they had discontinued to use them they still died. The symp- toms were roaring, hemorrhage from the nose, great prostration, swelling of the throat, succeeded in many cases by sudden death. Other horses, however, lived a considerable period; but none recovered in which roaring had become pronounced. I saw them in March, and found two dead on my arrival—one having only been dead a few hours; and from the blood of which I obtained the bacilli shown in the drawing. 300 CONTAGIOUS DISEASES. On examining the food everything was found to be of the best and cleanest quality; but the Indian mutters were very dirty, dusty, and mixed with the excrement of rats; and from this dust bacilli identical with those found in the blood were cultivated; but in no instance did I succeed in obtaining bacilli from the interior of the grain. From this it may be inferred that the microbes were in the dirt surrounding the grain, but not in the mutters themselves, and that by proper washing and cleaning they might be a safe diet. x 400. e Blood corpuscles. | Bacilli of various lengths, but about s5$55 inches in diameter. These bacilli seem to differ from those of splenic fever, being rather smaller in diameter, and, so far as my observations go, multiply by fission only, not developing spores. This, however, requires confirmation. This, however, requires further investigation, as animals have died on the Continent presenting similar symptoms to those at Liverpool after being fed on the legumen Lathyrus sativus, a bitter legumen ; but whether from a vegetable poison contained in the legume or from bacillary growths has not yet been determined.! In animals which have white skins, or where an eruption 1 Further experiences of the effects of Jathyrus poisoning have led me to con- clude that the hemorrhagic engorgement of the throat and the epistaxis were accidental complications due to the tainted state of the food in these particular cases seen at Liverpool. The effects of feeding with /athyrus are now well known, and will be referred to in the chapters dealing with Dietetic Diseases. ANTHRAX. 301 takes place in parts of the body void of hair or wool, red, brown, violet, or mulberry spots of bloody effusion are seen. These spots are independent of tumours and extravasations, and some- times exist on the surface. of the tumours. They are most commonly seen in the pig and sheep. Ecchymoses are seen on the visible mucous membranes. When the fever progresses slowly these spots unite by con- fluence, and surround, notably in the pig and sheep, the whole body. Some of them become crepitous and emphysematous ; others take the form of tumours, passing rapidly to the state of gangrene. In addition to these eruptions, there is often a sore- ness and swelling of the throat, infiltration of the upper end of the trachea, and a discharge of a lymph-like material from the nostrils, constituting what is termed gloss-anthrax, common in the pig which was fed upon anthrax flesh. It is also seen in the ox as well as the horse. Charbonous tumours are generally of a black-brown colour. The phlyctene are filled with a brown liquid, which is very irritating ; it sweats on the surface as drops of cold serosity. The tumours have little tendency to suppuration, and speedily become gangrenous. If these symptoms are added to those furnished by the mucous membranes, no difficulty need be felt in diagnosing charbonous tumours, phlegmonous and gangrenous. Terminations—When the tumours resist mortification, they terminate by delitescence, by suppuration, and by metastasis. 1st. Delitescence—The morbid products are effused, and con- stitute tumours, which are reabsorbed and expelled by the excretory organs. Examples of this kind of termination have been observed by veterinarians in Africa. 2d. Suppuration—When the tumours progress in a slow manner, indurating gradually, suppuration may be brought about by therapeutic and surgical means. Resolution is slowly induced, and it is not without pain that the necessary suppuration can be provoked. The animals remain poor and unthrifty, and often in the horse glanders and farcy conclude this morbid state. 3d. Metastasis—The amelioration of the symptoms which succeed the development of tumours is not often lasting. The products are reabsorbed and carried anew into the circulation. This unhappy crisis is announced by the reappearance of all the symptoms proper to charbonous fever ; their succession is 80 rapid that death may take place in from eight to ten hours. 302 CONTAGIOUS DISEASES. SYMPTOMS OF ANTHRAX FEVER IN HORNED CATTLE, APOPLECTIC ANTHRAX, SPLENIC APOPLEXY, SPLENIC FEVER. The symptoms in the ox are very analogous to those in the horse. The ox suddenly goes off its feed; rumination is sus- pended ; there are rigors and tremblings ; partial sweats bedew the body, which is alternately hot and cold ; the temperature rapidly rises, until in many cases if may become as high ag 108° F. in the course of a few hours. After the onset of the disease this symptom should be looked upon as of much value in differentiating this disease from most other diseases. The dorso-lumbar region is excessively tender to pressure, and when it is the seat of the tumour, very acute pain is thus caused ; the gait becomes staggering, and the animal rapidly exhausted. A recumbent posture is almost constantly main- tained ; the animal will now and then attempt to rise, but will rarely succeed in doing so. When standing, the back is arched, the legs stiff and rigid, but the standing posture is not long maintained. The animal looks towards its flank, falls into convulsions, and expels, without much effort, soft and bloody matter by the anus. The heart beats with violence against the thoracic walls; the pulse is small, rapid, irregular inter- mittent, and sometimes double ; the conjunctive red, injected, and reflect a blackish-red tint; the respiration is panting and plaintive ; there is tympanites of the abdomen ; the tongue is bluish-red, and the mouth filled with mucus; blood escapes from the nose; the eyes are sunk in their orbits, and tears flow over the cheeks. The areolar tissue of the back and sides becomes crepitous to the touch, and the animal dies during a convulsive exacerbation, or during the succeeding calmness. In some animals the excitement is so great that it is dangerous to go near them. The rapidity with which the symptoms succeed each other is variable, death taking place in the space of from a few minutes to even three days. In cattle above two years old, particularly milch cows, the local lesions are often confined to great congestion of the spleen, and to a lesser extent of the liver and mucous membrane of the intestinal canal. In other, but rarer, instances, the engorge- ments may be in the lungs, and should the animal survive for some days, decomposition of the extravasated blood is estab- ANTHRAX. 303 lished, as expressed by footor of the breath, the decomposed extravasated blood being absorbed into the circulation, causing death by septicemia. I have also seen this condition in a sucking calf. In true splenic apoplexy the spleen is often much enlarged, broken down in structure, and its capsule distended with a mass of tar-like blood. If one end of the organ be elevated, it will be seen that the blood will gravitate into the most dependent part, showing that the splenic tissue is disintegrated, and that the blood is more or less fluid. Death from splenic fever is very sudden ; in many instances an animal seen a few hours before apparently in good health is found dead, death having apparently occurred without a struggle. If, however, the disease is not so rapid in its course, it may be noticed that there are various alternations in the symptoms; in some instances an animal will be unwell for several days, suffering from a remittent fever ; one day very ill, with rapid, feeble pulse, hurried and painful breathing, red and injected eyes, hot mouth, irregularity of the bowels, and redness of the urine. After continuing for some hours these symptoms may subside, and the animal commence to eat and ruminate. The febrile symptoms, however, often return, and in the end the sufferer too often succumbs. In another form of anthrax without external tumours, the most prominent signs, in addition to the general disturbance, are severe colic and the passage from the bowels of quantities of dark coloured blood; and the disease is then denominated enteric or abdominal charbon, the post mortem characteristics being congestion of the intestinal mucous membrane, more particularly of the small intestines, which are covered with petechial spots, with incipient ulceration in their centres, extravasation of dark coloured blood into the canal, and very often extravasations into the sub-lumbar areolar tissue; the fatty mass surrounding the kidneys being loaded with extra- vasated blood, in a disintegrated, broken-down, tarry, semi-fluid condition, or covered with petechiz. SYMPTOMS IN SHEEP, In this country anthrax in sheep assumes the enteric form, but on the Continent of Europe splenic apoplexy seems to be the form by which they are usually attacked. 304 CONTAGIOUS DISEASES. . Braxy in sheep—an anthracoid disease—is a form of septicemia, simulating anthrax in its post mortem appearance. See Septic Diseases. The other form of charbonous fever in the sheep, not com- monly met with in this country, but which seems common on the Continent, is splenic apoplexy, the symptoms of which are similar to those witnessed in the ox. Indeed it may be men-~ tioned that the malady in all its forms may be accompanied by splenic congestion. ESSENTIAL CHARBON, OR THAT ARISING FROM INOCULATION— MALIGNANT PUSTULE (PUSTULA MALIGNA) IN MAN. Definition —Implanted on some uncovered part, the organism produces in the first instance a redness like the bite of a gnat, and afterwards a minute vesicle. A peculiar form of gangrenous - inflammation is excited, which rapidly spreads from the point first affected to the neighbouring tissues. Hardening and blackening of the part is so extreme, and death of the tissue is so entire, that the part cracks when cut with a knife. No pain attends the incisions ; crops of secondary vesicles form round an erysipelatous-like areola, chains of lymphatics become inflamed, the breath fcetid, and death follows, amid all the indications of septic poisoning—(Dr. Wm. Bupp.) Such is the disease in man, and its identity with charbon has been satisfactorily proved by the fact that, when contracted by man, it has been communicated by inoculation to the lower animals. Malignant pustule in man is concurrent with charbon in cattle, &c., and is a result of direct inoculation. Other cases occur in which the exact vehicle of the poison cannot be identi- fied, but these cases have all this significant peculiarity, that the disease is always seated on some part of the person which is habitually uncovered.—( AITKEN.) Propagation.—The disease may be communicated to man in the following ways :—By direct inoculation, as in the case of butchers and others employed to skin the carcases of animals which have died of charbon, the poison finding access by means of the skin or hands or arms of the operators; by means of the skin or hair of animals dead of charbon; and there are many ex- amples related by Dr. Budd which clearly prove that the virus, when once in a dried state, may retain its virulence for an inde- ANTHRAX. 305 finite period of time. Trousseau relates that in two factories for working up horse-hair imported from Buenos Ayres, and in which only six or eight hands were employed, twenty persons died in the course of ten years from malignant pustule. The disease may be communicated by eating the flesh of animals killed while affected with it, as also by using the milk and butter of affected cows. ANTHRAX IN THE PIG. The observations of Klein having proved that the very fatal disease amongst pigs known as anthracoid erysipelas, the blue sickness, pig typhoid, &c., differs in many particulars from anthrax; the varieties witnessed in the pig are reduced to anthrax fever, gloss-anthrax, and anthrax with tumour. Anthrax fever is as rapidly fatal in the pig as in other animals, destroying life in a very short time, with but slight manifestation of sick- ness, killing by shock. In milder cases, however, there is loss of appetite, sudden prostration, sullen appearance, hanging ears, painful and haggard expression, vomition of a coffee-coloured fluid, continual convulsions, paralysis of the extremities, rapid alternations in the heat of the body, highly injected mucous membranes, and generally terminating in death. Gloss-Anthrax—Malignant sore throat—Anthracoid angina— ‘This form of anthrax is most commonly seen in the pig when it has fed on the flesh of other animals which have died of the malady. It is rapidly fatal, the throat swelling enormously ; the pharynx, larynx, tongue, &c. becoming enormously swollen and gangrenous; an exhaustive diarrhea, with great tenesmus and discharge of blood, often appearing prior to death. I have known of several instances in which pigs have died in great numbers after having eaten of the flesh and offal of cattle which had died of quarter-ill and splenic apoplexy; and Mr. Borthwick, V.S. Kirkliston, has told me an instance which occurred in 1872, in which twenty-five pigs died in two days after having eaten the flesh of a bullock which had died of splenic apoplexy. ANTHRAX 1N POULTRY. Charbonous fever is announced in poultry by the following symptoms :—No appetite; feathers ruffled; walk difficult and staggering; foetid diarrhoea ; great prostration ; dragging of the 20 306 CONTAGIOUS DISEASES. wings ; turgescence or blackness of the conjunctive ; excessive sensibility of the extremities. The fowls squat, and do not look for a perch; the bill and comb become black; tumours, or red spots, which soon become black and gangrenous, form on the palms of the digits, and the animal dies in convulsions, PATHOLOGICAL ANATOMY OF ANTHRAX. Post mortem examinations disclose very manifest lesions, which explain the rapidity with which putrefaction has taken place’ in the tissues. (1.) Eaterior—A short time after death the whole body is tumefied and disfigured from excessive formation of gas in the areolar tissue. The abdomen is considerably swollen from gas in the gastro-intestinal organs, and blood-clots escape from the nose and mouth; the rectum is reversed, and looks like a black tumour, from the centre of which gas and tainted liquids escape. On different parts of the body, notably on the skin deprived of hair, red or mulberry spots, sometimes interspersed with yellow ones, are found. After being opened, the body emits a very foetid odour. (2.) Skin, cellular tissue.—In incising the skin crepitation is heard, which results from the disengagement of gas accumu- lated in the subcutaneous areole; black and liquid blood escapes from the parts cut with the knife. The skin on the tumours and engorgements is found semi- detached, and its internal surface presents spots of infiltration corresponding to those seen externally, and the tainted skins are at these spots without consistence, and depreciated in value. The areolar tissue is the seat of blood and sero-albuminous infiltrations of yellow, red, or black colour, which extend into the interstices of muscles and to deep-seated organs. (3.) Muscular tisswe.— Yellow infiltrations on the surface, and to a less degree in the bed of the muscles, in the form of lines which put the fibrille in relief. The muscular system generally is impregnated with black blood, which communicates this colour to the whole frame. The normal adhesions of the muscles to the bones, tendons, and aponeuroses are so relaxed that one may detach them without much effort. PATHOLOGICAL ANATOMY OF ANTHRAX. 307 In the thickness of the muscular substance black spots are found from the escapement of blood. These morbid alterations are most marked in tumours and charbonous engorgements, con- stituting masses of serosity of a citron colour, which raise the skin, infiltrate the subcutaneous areolar tissue, and penetrate deeply into the organs of the bady. Infected gas is disengaged from the surface of the divided tissues; here and there portions of the tissues are decomposed. It is a remarkable and important peculiarity that in these vast engorgements no trace of inflammation can be found, no plastic material, no injections, no vascular arborizations, which characterise the inflammatory process. M. Delafond has recognised the following microscopic par- ticulars :— (1.) That where tumours are situated the tissue is penetrated by blood globules deprived in part of their colouring matter. (2.) That the red colour of the tissue is due to the escape of the hematin from the red globules. (3.) That the serosity of the infiltrations is fibrino-albuminous. (4.) That this serosity is associated with a great number of very little globules, abnormally indented on their surfaces. (5.) That the areolar plates, in which this serosity is deposited, are slightly opaque from coagulation of fibrin. The morbid lesions of the solids are evidently a consequence of the primitive alteration of the blood. The large vessels—the aorte, vene cava, vena porta, the cavities of the heart—are filled with fluid blood reflecting a strong dark violet tint, presenting no signs of coagulation. The walls of the vessels and of the heart possess a red colour, which resists washing, showing that the colouring matter has penetrated the tissues. These alterations explain the formation of black spots, of effusions, of bloody extravasations, and of serous citron infiltra- tions on the surface and in the depths of the organs. At the same time the deficiency of fibrin renders the fluid incoagulable both during life and after death. The heart is flaccid, soft, and covered with bluish spots. The blood in both sides of the heart is black, liquid, and more abundant in the right than in the left side of that organ. When exposed to the atmosphere it retains its black colour, or is but very slightly reddened. Some deny hat it changes colour at all. that it changes colour sig 3808 CONTAGIOUS DISEASES. The pericardium is covered with ecchymosed spots. The peri- cardial fluid reflects a red tinge, more or less marked, according to the time which has elapsed between death and the autopsy. (4.) Lymphatic system.—The ganglia of the cervical region, of the thoracic cavity, of the dorso-lumbar and inguinal regions, are always diseased. They are much increased in volume, ecchy- mosed, yellow or red, soft, impregnated with a great quantity of serosity, and a citron-coloured infiltration, and are easily pulpified by pressure between the fingers. These characters are found in a degree more or less marked in the lymphatic ganglia of all the organs; on minute dis- sections being made, cords and little nodules are seen of a yellow colour, and of various forms and sizes, and the lymphatic vessels, especially those that have the tumours, are much distended. (5.) Digestive apparatus.-—-The peritoneum, epiploon, and mesenteries are irregularly covered by ecchymosed spots. The peritoneal cavity contains serosity of a deep colour, mixed with blood-clots. The large veins which follow the convolutions of the intestines have a bluish aspect, and are distended with very black blood. In the mesentery, and above all in the sub- lumbar region, charbonous tumours of various dimensions are found. They are very common in horses which have died of charbonous disease without external eruption. The tumours are formed by a mass of very black blood of a syrupy ahd gelatinous consistence, and by an infiltration of serosity of a yellow colour. They are situated in the fatty masses that surround the kidneys, the pancreas, the posterior vena cava, the sublumbar ganglia, and between the folds of the mesentery, immediately above the convolutions of the intestines. The intestines present exteriorly a red colour, more or less marked, following the extravasation and escape of blood. The lesions found in the interior of the canal vary from a simple red discoloration to a dark congested state of the mucous membrane. When washed, the villi are seen congested and augmented in volume. In other cases blood is extravasated and fills the intestinal conduit, mixing with the alimentary matters. It rapidly decomposes, and emits a bad smell. Under the mucous membrane a yellow infiltration is found, extending into the sub-peritoneal areolar tissue. Peyer's patches do not PATHOLOGICAL ANATOMY OF ANTHRAX. 3 _ present any characteristic alterations. In some cases t mucous membrane surrounding them has been seen to ulcerated ; and in animals of the bovine species the glands Brunner have been seen to be augmented in volume. (6.) Spleen.—This organ is the seat-of very remarkable lesio and in virtue of the general constancy of their character, tk may be considered as the most conclusive expression of the « istence of charbon. Its volume is often double, triple, quadruple; it is larger, longer, and thicker, and its exter surface has a livid blue or black colour. The enlargement sometimes uniform, sometimes irregular, and is formed by mass of blood distending the splenic capsule, which occasiona becomes ruptured, giving exit to thick, black blood. When cut, black incoagulable blood escapes from the incisi On pressing and washing the tissues, the putrid matter removed, and the fibres left are of a reddish-black colour. (7.) Lwer—Augmented in volume, with the appearance having been boiled. Its tissue is friable, easily cut, and fr the cut surfaces great quantities of black blood escape. (8.) Respiratory organs—Some amount of serosity in © chest, of a muddy and slightly red colour. The costal and p monary pleure are covered with black spots. In the subser: areolar tissue there is a yellow citron infiltration. which is c tinued into the interlobular areolar tissue. Gas is developed in the subcutaneous areolar tissue, and brown and black sp are seen throughout the lung tissue and on the respirat< mucous membrane. (9.) Nervous system.—The meninges of the brain and spi cord are covered with black spots. The venous sinuses | filled with a very liquid blood, and in places yellow infiltratic are observed. ‘The cerebral substance is ecchymosed, and cl of blood are seen on its surface. The ganglia of the great sympathetic nerve are large, r soft, and infiltrated. (10.) Urinary apparatus.—Like the liver, the kidneys : augmented in volume. They are of a brownish colour, eas broken down, and the blood with which they are filled escaj when they are squeezed. A consideration of the lesions found post mortem leads us one conclusion—namely, that the alterations seen in the sol 310 CONTAGIOUS DISEASES. are due to a profound modification which has been established in the physical and chemical characters of the blood. In the horse more particularly, the jelly-like yellow and sero- hemorrhagic infiltrations are encountered nearly everywhere in the body where there is loose connective tissue, chiefly in the retro-pharyngeal and laryngeal tissues, along the course of the great blood-vessels of the neck, in the mediastinum, peritoneum, and about the kidneys. The corresponding lymphatic glands, especially the mesenteric, show sero-hemorrhagic infiltrations, are considerably enlarged, and here and there in a state of incipient gangrene. The intestinal lesions in the horse are for the most part not so diffusely spread; but still upon the mucous membrane, which is in a catarrhal state, cedematous, and sprinkled with ecchymoser, there are found well pronounced carbuncles, which are the seat of more or less superficial sloughs. The intestinal contents are likewise often bloody and thinly fluid. The large glands, liver, and kidneys as a rule are swollen, the parenchyma cloudy, succulent, and full of blood. In the blood, besides the presence of. bacteria, the white corpuscles are found to be in considerable number. The red corpuscles for the most part are of lessened consistence, and manifest a ten- dency to cohere in little heaps. On microscopic examination of the carbuncles in the intestines, as well as elsewhere, and of the jelly-like hwmorrhagic effusion into the connective tissue, there are found in the capillaries, which are considerably diluted, besides a massing of white blood corpuscles (cellular cedema), numerous bacteria, and a finely granular mass, consisting partly of metamorphosed blood detritus, and partly bacterial germs. The thickness of the blood is due to its being deprived of water by the dropsical, jelly-like, and cedematous effusions. The dark colour is caused by carbonic acid poisoning.—({BOLLINGER. ) TREATMENT, When the symptoms of the disease, in any of its forms, are fully developed, but little good can be effected by medical or surgical interference. Some few cases may, however, be amen- able to treatment. The blood is fluid, dark, imperfectly coagulated, containing the constituents which unite to form fibrin in a diminished quantity, TREATMENT OF ANTHRAX. 311 or in an altered or modified condition. How, then, is the viscidity of the blood to be restored? Direct experiments upon the blood removed from the body, and the treatment of hemorrhagic diseases, have very satisfactorily shown that the chlorate of potash has a peculiar effect in this direction, and it is upon this substance that dependence must be placed. For young stock the following draught is to be administered :— B. Pot. chlor. iii. Aquee, Oi. M. and give three times a day. For a full-grown animal an additional drachm may be given with safety ; but if given in large doses intestinal irritation is apt to be induced. On account of its well-known antiseptic properties, carbolic may prove very useful in the treatment of anthrax ; indeed, I understand that Principal Veterinary Surgeon Collins has pre- scribed its internal administration with marked effect in India. It may. be given largely diluted, two or three times a day, in doses proportionate to the species and size of the animal under treatment. M. Decroix, P.V.S., French Army, recommends the borate of soda, 100 grammes daily, dissolved in water, and given as a draught to the horse. Purgatives generally do harm, and for the reason that there is some congestion of the intestinal mucous membrane. During the course of treatment of charbon it is important that special regimen be used. The animal should be well nourished. Food easily digested and of good quality should begiven. Tonic medicines, as preparations of iron, gentian, and decoctions of aromatic plants, may be used at the time of convalescence. The prevention of charbonous fever is a matter of great importance. Some writers affirm that it is more commonly met with since the introduction of artificial manures, and that it is due to the presence of the nitrites conveyed from the soil to the blood in the water, herbage, turnips, &c. I think that this view is not established, as the malady is met with where artificial manures are not at all used. If it were solely due to the nitrites or to any of the salts contained in artificial manures, its existence would have been unknown prior to the introduction of such manures. It is a fact, however, that when animals are poisoned with the nitrites, such as the nitrite of amyl, that the blood 812 CONTAGIOUS DISEASES. assumes a chocolate colour (Dr. A. Gamgee) ; and it is also a fact that certain diseases are more prevalent on rich than on poor soils. Preventive Treatment.—It is supposed by many veterinarians of experience that the introduction of setons is a very effectual preventive of charbon, and their operation is explained by the fact that in inflammations, artificially produced or otherwise, the coagulating properties of the blood are increased, as well as the power of phagocytosis. The quantity of fibrin dis- coverable after the blood is removed from the body’ is appreciably increased. The safest and quickest method of creating an artificial inflammation is by inserting a seton in the breast—the seton to be deeply inserted, and in order to increase its irritating properties it should be dressed with blistering ointment. If the disease has appeared amongst a herd before the veterinarian’s attention is directed to any method of prevention, in addition to setons, the chlorate of potash is to be given, mixed with the animal’s food or water for several days, the diet in the meantime being restricted, and all circumstances likely to promote the malady fully inquired into and removed. Tt is alyo essential, not only as a means of prevention, but after the actual occurrence of the malady, that the excretory organs be kept performing their proper functions, and for this end gentle aperients and diuretizs should be employed. I have already pointed out the danger of administering drastic cathar- tics, but there is no reason why the bowels should not be gently opened by laxatives, such as linseed or castor oil. If during the course of the malady it is thought necessary to employ stimulants to rouse the flagging animal energies, the prepara- tions of ammonia are to be avoided, as they cause the blood to lose its coagulating properties, both within and without the body ; and, as already stated, an excess of ammonia already existing in the blood, alcoholic stimulants are to be given in preference. Acting upon this conclusion, I at one time administered acid preparations, and with some success, but a larger experience has taught me that the chlorate of potash is superior to all other medicines. The flesh of animals which have died or have been killed whilst suffering from the disease should not be used as food, TREATMENT OF ANTHRAX. 8138 as it is apt to cause death, and the milk of affected cows has proved fatal to man. Seeing that the curative treatment of anthrax in the lower animals is futile, and in fact attended with danger not only to the attendants, but also in facilitating the spread of the disease, it is recommended that affected animals should be immediately destroyed and extreme measures taken in the matter of pre- vention by adopting segregation and disinfection. The pre- ventive treatment is now supplemented by the administration of both sera and vaccines. The advantage of the former is that their effects are demonstrable immediately, but are not lasting—i.e., they do not endure for more than about ten days, whereas by vaccination, although attended by a certain amount of risk, the immunity conferred is for a period of ten to fourteen months. Preventive serum is obtained by immunising animals and increasing their immunising power by the repeated sub- cutaneous and ever-increasing doses of virulent culture. Blood from such animals is withdrawn, serum obtained by defibrination and centrifugalisation or by sedimentation, under strictly aseptic precautions, and then mixed with 25 per cent. lysol. This serum in proportionate doses may be used either a8 a preventive or a curative. Vaccines are obtained from the pure cultures of the organism. Pasteur found that the inoculation of bacilli whose capabilities of sporulation had been destroyed did not cause death, but gave an active immunity which was more or less permanent. In order to obtain a culture of organisms in- capable of sporing, the organisms must be grown at a high temperature; and to render the vaccination more complete two inoculations are made, the one with strong, and the other with weak, vaccine. The weak vaccine is made by growing an anthrax culture at 42°5° C. for twenty-four days; a fixed quantity of this will kill mice, but not rabbits or guinea-pigs, Ten days after the administration of this weak vaccine a dose of the strong is given. This is obtained by growing cultures of anthrax at 42°5° C. for twelve to fourteen days. A fixed quantity of this will kill mice and guinea-pigs, but not rabbits, and is used to strengthen the cattle’s immunity and render that protection more complete and lasting. The objection to 314 CONTAGIOUS DISEASES. this method is, so it is said, that one is spreading the disease or is liable to raise infection by its use, as one never can tell if a culture, so prevented from sporulating, may not recover that power. There is also in the course of its administration a certain percentage of deaths, although small. In the use of vaccines it is always advisable to use killed cultures, and thus to obviate such dangers, but it has been found that a killed culture has not such advantageous powers as a weakened one. A combination of serum and vaccine has been advocated, as the serum gives immediate immunity and the vaccine the subsequent permanent protection ; moreover, the one opera- tion is sufficient, as the serum will so give the temporary pro- tection that it is possible to administer the stronger vaccine at once. The two are inoculated separately and at different sides of the body, as in rinderpest. Here, again, the danger of in- fecting clean areas is evident, although it may be said that when such operations are necessary the disease already exists, and that the remote chance of spreading a fresh infection is not worth consideration, and would not matter anyhow. In the Argentine and other places benefit is said to be obtained by the use of the two vaccines, but for the reasons given the method has not found favour in England. QUARTER-ILL, BLACK-LEG, OR CHABERT’S DISEASE. Quarter-ill, black-leg, strike, symptomatic anthrax, quarter- evil, sarcophysema hemostaticum bovis, infectious emphysema, are a few of the numerous names applied to a specific disease affecting cattle and sheep, and occasionally horses and pigs, and due to the presence of an organism, the Bacillus Chawvei, also called the Bacillus sarco-physematos bovis. Quarter-ill was, until recently, supposed to be an external manifestation of splenic fever (anthrax), that in young cattle anthrax was always thus developed, whereas in older ones the disease was located in the spleen. This disease is fortunately not nearly so common in Scotland as it ig in England, France, and other countries on the Continent; but owing to better drainage of the land it is less common than formerly, even in England. It occurs much more frequently in young than in old animals, QUARTER-ILL. 315 as is well illustrated by the following record by M. Hess of 989 cases :— 374 cases in animals aged between 6 and 12 months, 439 3 1 and 2 years, 83 ‘s fs 2and3 65 7 5 gand4 ,, 10 % 5 4and5_,, 18 3 5 Sand6 ,, Not only is it less frequent in old animals, but it is also less fatal to them. Animals affected under two years old almost invariably die, but animals over that age frequently recover: so much is this so, that many affirm all animals over three years of age to be free from danger of contracting this disease. But this conclusion, however, must not be implicitly believed in, as the following statements by Hess show there is even danger though the animals are beyond the stated age. Out of 36,000 animals, from six to twelve months old, 350 died of the disease ; of 13,000 animals, from one to three years old, 500 died; and of 135,000, from three to six years of age, 120 died ; giving us the following percentages of total mortality— Between 6 and 12 months, -972 per cent. died. 5 land 3 years, 3°845 ,, 4 ey 3and6 ,, 08, ‘ The disease is never, or hardly ever, seen in calves under six months old, unless they are fed on a diet which is not an exclusively milk one. Quarter-ill, like many other diseases, has periods at which it is rife in the country, and other periods when it seems to be dormant. It is most frequently seen when animals are changed from one pasturage to another, or from one condition of living to another, more particularly when the change is from poor feeding to rich pasturage. The disease is also most prevalent in low- lying pastures, and when there is rain and humid heat, though it may occur on any lands and in all kinds of weather. Symptoms.—The symptoms of the disease are usually mostly as follows, but occasionally the initiatory ones do not: indicate it very clearly, and may readily be taken for those of some other affection, and perhaps one which may be cured by treat- ment, and so consequently ‘is apt sometimes to mislead even 316 CONTAGIOUS DISEASES. the expert :—Loss of appetite, dulness, listlessness, cessation of rumination, harshness and staring of the coat, elevation of tem- perature, rigors and local tremblings, coldness of the extremities, then lameness or stiffness when moved, arching of the back, and on examination of the skin a tumour is found forming under it in some part of the body. It may be on the head, neck, shoulders, dewlap, loins, genital organs, or mammary gland, but by far most frequently in either the shoulder or the loins. M. Hess has observed that the tumour forms more often on the right side of the animal than on the left, but he can give no reasons why this should be so. The tumour is found in regions which abound in muscular tissue, and where the connective tissue is loose, and seldom in the region of joints and tendons, and where the tissues are firm. These tumours are ill-defined, and have no limiting membrane. Externally they may not appear of great size, but when care- fully examined they are found to extend deeply into the sub- jacent tissues. At first hot and painful to the touch, they rapidly become cold, insensitive, and dead in their centres, and when then handled are found to crepitate or crackle, due to the presence of evolved gases under the skin ; their peripheries extend and penetrate into the surrounding parts until they attain enormous dimensions. If incised, they discharge a dark-coloured and fcetid, acid fluid, succeeded by a flow of frothy, citron-coloured serosity. As the disease progresses, the tumour or tumours enlarge, gases are evolved beneath the tissues, the animal evinces great distress, the breathing becomes greatly hurried, the tempera- ture rises to a great height, the pulse beats at 120 to 130 per minute, feebly and intermittently; the expression of the face becomes haggard, tympanites (hoven) ensues, faeces are passed involuntarily, the animal falls, becomes unable to rise, is attacked by fits, and either dies during one of these, or immediately after its cessation. In the last stages the temperature falls below the normal, and decompusition sets in even before death. There are, however, cases which do not exhibit the ordinary symptoms to commence with. In some the disease begins as colic, or some digestive derangement; and in others there may be lameness and stiffness, but no appearance of a tumour QUARTER-ILL. 317 anywhere. On post mortem examination, the animal is found to be enormously swollen, due to the evolution of gases into the stomachs, intestines, and in the tissues under the skin. Bloody froth is seen issuing from the mouth, nostrils and anus. On cutting into the carcase, gases of a sour odour escape, and are often accompanied by spurts of dark blood or yellow serosity. The tumours are found to be black in their centres, and the muscles in their immediate neighbourhood to have the same colour. The farther we proceed from the centre of the tumour the lighter the colour becomes, tili, instead of being black, it is black and yellow streaked, then pinkish, and then sur- rounded by a citron-coloured portion. In some cases the tumour is found in the muscles under the shoulder—in others in the diaphragm and in many varied situations, but these are rare compared to those found in the loins and withers. Disposal of carcase.—It is the practice in some parts of England to slaughter cattle affected with the disease, to prepare them for human food by carefully removing the discoloured portions, and sending the rest of the carcase to market. We are opposed to this, and consider that this disease should be dealt with by the authorities, under the ‘‘ Anthrax Order of the Contagious Diseases (Animals) Act.” Quarter-ill is not capable of infecting man, and if the diseased parts be removed there would, in all probability, be no danger in consuming the flesh ; nevertheless, the rapidity with which putrefaction sets in in such cases renders it extremely undesirable that such meat should be exposed in the public markets, and it is recommended that animals which have died from the disease should be destroyed. The blood of an animal affected coagulates readily, and hence is quite different from that of anthrax (splenic fever). Cause of the Disease.—The cause of this disease is an an- aérobic germ, which when in connective tissue and outside blood-vessels propagates itself with wonderful activity, and in so doing causes destruction of the tissues in its neigh- bourhood, the formation of the tumours, and an excessive evolution of gases of a very fcetid odour, and ultimately death. 318 CONTAGIOUS DISEASES. This germ is smaller than the true Anthrax bacillus, measures from s7s9 tO ¢s'sy Inch in length, and from sods to gsizy inch in breadth. It is found in the tumour, and the exuded fluids contained in and about it, in large numbers, is scarce in the blood itself; it varies in shape,—cylindrical when the contents are homogeneous, club-shaped wher sporu- lated, but when the spore is central the bacillus becomes spindle-shaped, and often contains a clear spot or spore at one end (known as racquet form), sometimes one at each end (known as spectacle form). It is motile, its movement being from side to side. Many of the rods contain spores, and have an irregular swollen appearance. If iodine solution be added, the germs stain a violet colour. They also stain with fuchsin, more particularly the spores contained in them, with careful technique—vide bacteriology works. They grow rapidly on glycerine agar and other cultivation fluids, lique- fying gelatine, and evolving much gas, having an unpleasant sour odour. The virulence in culture is easily lost and difficult to regain. Tt is, in fact, difficult to cultivate under the strictest anaérobic conditions, in a pure condition. Virulence is regained by inoculating guinea-pigs, and taking some of the resulting exudate and inoculating others, and so on, until it is lethal. As the disease affects muscular tissue, it is best obtained by inoculating directly into muscle, and by making a post mortem immediately after death; then the muscle is carefully excised and dried. The virulence is by this means unimpaired; and if the procedure be carefully carried out, a piece of such muscle may be kept for years and retain its virulence. Protective Inoculation.—It has recently been demonstrated that when the germs are introduced directly into the blood- stream, and not into the connective tissues, immunity to the disease is caused. To obtain the germs for protective inoculation the following is the method recommended by Messrs. Arloing, Cornevin and Thomas, and others, and found to be extremely successful : From an animal just dead of the disease, take the blackest portion of the tumour, cut up into small pieces, mix with distilled water, then triturate in a mortar, squeeze through cloth, and filter through several folds of muslin which has QUARTER-ILL. 319 been previously wetted with water, and of this fluid inject from five to ten drops into the jugular vein by means of a hypodermic syringe, taking the very greatest care that none of it escapes into the wound. If the operation be care- fully performed, the animal will have immunity conferred upon it. In many, for two or three days, there is dulness and dis- inclination to feed, but this soon passes off, leaving no ill- effects. But if the virus escapes into the wound, or if the animal has any bruises upon it, there we may expect to see the tumour of quarter-ill appearing, and death resulting. Others, again, instead of using the virus direct, inoculate a guinea-pig subcutaneously, and cause the formation of a tumour containing germs, which are thus modified in their power, and after mixing with water, triturating, and passing through muslin, use it. Others, again, have used the desiccated virus prepared by drying in air portions of the diseased tissues. Cornevin, Arloing and Thomas’s method of using the viru- lent tissue mixed with water and filtered as above stated, is the best, if it were not attended with such danger which renders it too impracticable. The method now in use is by two vaccinations, which are prepared as follows: Strips of muscle characteristically affected, and uncontaminated, are dried in an oven at a temperature of from 32° to 37° C. When quite dried, it is powdered and mixed into a paste with distilled water. This is smeared on plates, and these placed in a thermostat for a first vaceine. These should remain in for six or seven hours, at a temperature of 103° C. For a second vaccine other plates are placed in a thermostat, and kept there for six or seven hours, at 90° to 95° C. The dried material must be carefully removed from the plates and measured. The dose of each vaccine is 1 centigramme, and the second vaccine given seven days after the first one. The vaccines may be mixed with water and given hypodermically, and near the extremity of the tail. Immunity is obtained in about a week after the second vaccine, and lasts a year. Many other methods of preventing this disease have been in use from ancient times, and seemingly with success; setoning, 320 CONTAGIOUS DISEASES, for instance, when performed on young animals not affected with the disease, but having been in contact with affected animals, almost invariably is said to protect the animal, for the time being at least. We think that the setoning itself does not protect, but that the dietetic and hygienic alterations which accompany it materially tend to stop its progress, and the credit is thus given to the wrong agent. "1eE advg aovf of, ‘NNOAYD GALVYEYSAOINQ—asAsa4 ANIMS yoogay jonuup ainynisdp fo nwaang ‘Y'S'Q Wot DIP A MNT suey 2 tore tary 06g) TIX ULV Id CHAPTER XXVILI. CONTAGIOUS DISEASE S—continued. HOG CHOLERA—SWINE FEVER—PNEUMO-ENTERITIS. Tue term swine fever is applied in this country to a con- tagious and infectious disease of a very fatal nature. The pathology of infectious swine diseases has been profoundly studied on the Continent of Europe and in America, and it has been found that the pneumo-enteritis of Klein, typhoid fever of Budd, hog cholera, blue sickness, measles, erysipelas, and intestinal fever are terms incorrectly applied to what was supposed to be one disease, but which has now been dis- covered to include three separate, although similar, patho- logical conditions; and the researches of Schutz, Loffler, Eggeling, Salmon, and others have brought to light that under these terms there are in reality three diseases, namely —A. Swine plague, also called rouget de pore, angina, pete- chial fever, &c., characterised by septic gastro-enteritis, hemorrhagic nephritis, with congestion of the spleen, inflam- mation of the heart, liver, and voluntary muscles, induced by a. very suaall immobile bacillus, stainable by Gram and Weigert’s preparations. B. Contagious or infectious pneumonia, pleuro- pneumonia, having a tendency to pulmonary gangrene and caseous products, and arising from an ovoid bacterium of the bipolar staining, Gram negative, Pasteurella type. C. Hog cholera, diphtheria, pneumo-enteritis, swine fever, &c., charac- terised by an inflammation and ulceration of the glands, large intestines, enlargement of the mesenteric glands. The ulcera- tions of the glands of the large intestines are situated in the cecum, immediately posterior to the ileo-cecal valve, distin- guished from swine plague by its slower development, its tendency to involve the pulmonary organs, and by differences in the specific microbes, which are motile, ovoid bacteria, aérobic and facultatively anaérobic, unstainable by Gram’s 321 21 322 CONTAGIOUS DISEASES. method, and but slightly coloured by Weigert’s process. This is the disease usually found in Britain. Recent observations have brought to light the fact that infective material, when filtered through a porcelain filter, is still infective, though no organisms can be discerned microscopically. If this be so, it will place swine fever amongst the already long list of diseases due to an ultra-microscopic organism, and show that the organism at present considered the cause is only an accidental contamination. Further investigation is necessary. Definition.—Swine fever may be defined to be a highly con- tagious and infectious disease, having a period of incubation, after inoculation, of about five days, at the end of which period there is elevation of temperature to 104° to 106°, succeeded by signs of general ill-health, and generally a rash on the skin. When propagated by cohabitation, it appears, according to experiments performed by Dr. Lutton in America, that the disease took about thirteen days to manifest itself in healthy pigs amongst which diseased ones had been introduced. The disease is very common in Great Britain, Ireland, America, and various parts of the world. It prevails as an epizootic, and is the most fatal malady to which swine are liable; but pigs differ in their susceptibility to it. Causes.—Like cattle plague, pleuro-pneumonia, &c., swine fever appears to arise from contagion and infection only; no amount of bad management, filth, want of drainage, nor decomposing food being sufficient of themselves to induce it. The microbe is a small ovoid motile bacterium, both aérobic and anaérobic, measuring zsto0 tO zeta in length, and zstoo Of an inch in breadth. Klein, however, states that it is due to a small bacillus which in cultures assumes a long, leptothrix-like filament, which develops spores which become free after the disintegration of the filamentous matrix ; Detmer discovered a bacillus which he called Bacillus suis, and said it was the specific agent. The disease is transmissible by inoculation to the mouse and pigeon, and, according to Law (Cornell University), to the sheep and rat. PATHOLOGY AND SYMPTOMS. The symptoms are loss of appetite, general prostration, small and frequent pulse, hanging ears, sullen appearance, painful and haggard expression, watery eyes, conjunctive red and spotted, PLATE XIII Ulcer-like Growth in Nutrient Jelly. BACILLUS LUTEUS (SUIS). serstona Sons Lith Edin : To face page 322. SWINE FEVER. 323 dirty secretion about the eyelids, generally preceded by a red blush and red spots on the ears, the abdomen, and internal aspects of the extremities. The reddened spots are at first hot and painful to the touch, but afterwards become cold, humid, and insensible even to the pricking of a pin. As the disease advances, tremblings and convulsions are manifested, the animal grinds its teeth, the flexor muscles of the limbs contract, and the animal stands upon its toes. These symptoms are succeeded by paralysis of the posterior extremities, or of the whole body, involuntary defecation and passage of high-coloured and even bloody urine. The bowels are generally torpid at first; but the fecal matters may be soft, and mixed with very black, foetid blood, and thick, tenacious mucus. Diarrhoea, however, often sets in; the defecations are then profuse and exhaustive; the breathing becomes catchy and convulsive, a painful cough is present; the convulsions become more aggravated, and may continue to the end, or the animal becomes comatose, till death closes the scene. In some cases the first observable symptoms remain stationary for a period varying from twenty-four to forty-eight hours; then the surface of the body becomes burning hot, and very sensitive to the touch, notably at the sides and abdominal walls. If touched, the animal cries with pain, and to these signs are added tremblings, convulsions, grinding of the teeth, and tetanic contraction of the muscles; succeeded by rapid diminution of temperature. The conjunctive become brown; the eyes bleared; the tongue dirty, thick, and bluish; and the animal, extended on its litter, incapable of any regulated move- ments, succumbs in from twenty-four to forty-eight hours. These symptoms are liable to various modifications, depending upon the intensity of the fever and the various localizations of the poison. In some cases, the virus seems to expend itself upon the serous membranes, inducing peritonitis or pleurisy; sometimes upon the mucous membrane, as expressed by bronchitis or broncho-pneumonic congestion and hemorrhage, enteric con- gestion and ulceration, sometimes even to perforation or rupture of the bowel. In many cases the animal is amaurotic, wanders to and fro, falls down, rolls and kicks, and seems to be in pain. Now and then it will rise from its bed and give a piercing cry, the whole body being involuntarily convulsed. 21—2 324 CONTAGIOUS DISEASES. The condition of the blood. differs in a marked degree from that of anthrax, being fibrinous, red in colour, and as a rule contains neither bacilli nor the contagium of the disease. The experiments of Klein point to the conclusion that—* 1st. The fresh blood of diseased animals does not, as a rule, contain the virus, as it fails to produce the disease when introduced into a healthy animal. “ Four animals were inoculated (at different times) with the fresh blood of diseased animals. They remained healthy. When subsequently inoculated with virus-containing matter, they be- came smitten with the disease. “ In a fifth instance, however, fresh blood did produce infection, [And this same blood proved active after having been kept sealed up in a capillary tube for several weeks.] This blood was obtained from a very severe case with copious peritoneal exudation; in which were found peculiar, abnormally large, coarsely granular cells; the same cells were also present in the blood; so that it appears probable that the blood became charged, by absorption during life, with matter from the peri- toneal exudation. This latter always contains the virus in an active state. « 2, Experiments showing that fluid as well as solid lymph of the diseased peritoneum contains the virus in a very active state. “ Six successful inoculations with fluid peritoneal exudation. “ There is no difference of activity to be noticed between fresh exudation and one that had been kept sealed up in a capillary tube for several weeks. “ Solid lymph obtained from the peritoneal cavity of diseased animals, having been dried at a temperature of about 38° C., proves very active. — “ 3, Experiments showing that parts of the diseased lung, ulcerated intestine, and also diseased spleen, contains the virus in an active state. Diseased parts of lung or intestine that were dried at a temperature of about 38° C., retain their virulence unaltered. “Tn all cases of pneumo-enteritis, the trachea as well as the bronchi have frothy blood-containing mucous matter, possessed of infectious properties. It must be therefore supposed that the breath of a diseased animal is charged with the poison. On SWINE FEVER. 325 account of the diseased state of the intestine, also the dung is to be regarded as infectious. “4. Experiments showing that infection is produced by co- habitation with a diseased animal, or by keeping healthy animals in a place whence a diseased animal had been removed. “5. Several experiments were made to sec whether feeding healthy animals on matter obtained from the diseased organs (intestinal ulcers especially) produces the disease. The experi- ment was always attended with success, if a lesion-abrasion existed in the mucous membrane of the mouth or pharynx ; this was usually the case when the matter had to be introduced into the mouth while the animal was being held by assistants. “ There were, however, two cases which appear to prove that the disease cannot be produced by simple feeding. “This was unfortunately at a time when te was not as yet acquainted with the fact that in many animals the disease is of so mild a form that it can hardly be recognised in the living animal. I have not made any post mortem examination of those two animals. “ But since then I have made two other experiments, in which the virus was brought directly into the stomach, by means of an india-rubber tube introduced per fauces and cesophagus. In both these instances the animals became diseased, and their intestines were most conspicuously affected. “ From the last three series of experiments, we may conclude that the principal way in which contagion of pneumo-enteritis is carried out, is through the instrumentality of the air and the food. “6, This series comprises experiments to prove that the virus can be cultivated artificially—ze., outside the body of an animal ; in the case of splenic fever it has been successfully done by Dr. Koch. “ The experiments are seven in number :—(a.) Two refer to cultivations commenced with fluid peritoneal exudation; (0.) In the five others the virus had been obtained by cultivation of dried lymph from the peritoneum of an animal suffering from the disease. “(a.) The cultivation of the virus for the first two cases was carried out thus :— “ Fluid peritoneal exudation of a diseased animal had been 326 CONTAGIOUS DISEASES. collected and sealed up on November 6th, in a capillary glass tube. On the following day there was present a small clot due to coagulation. A minute speck of this clot was removed with the point of a clean needle, and with it was inoculated a drop of fresh aqueous humour of ahealthy rabbit. This drop had been placed on a thin covering-glass, which, after the inoculation, was inverted over a small “ cell,” made by fixing a glass ring on an ordinary glass slide. The covering-glass was fastened on the glass ring by means of a thin layer of pure olive oil. The preparation was then kept in the incubator for twenty-four hours at a temperature of 32° to 33° C. After this time it was used to inoculate a new drop of aqueous humour ina similar manner to the one just described. We will call this the second generation. “ This new specimen was placed in the incubator, and kept there at a temperature of 32° to 33° C. for another twenty-four hours. In the same manner a third generation was started, by inoculating a fresh drop of aqueous humour. After having been kept in the incubator for several days, it was used to inoculate two animals at different times. Both animals became infected with the disease. “(6.) The other five experiments were carried out with virus cultivated from solid lymph of the peritoneum of a diseased animal. The lymph had been dried at 38° C. (see series 2). A small particle of dried lymph is crushed into fine powder. With a granule of this, a drop of fresh aqueous humour is inoculated in the same manner as above described,—first generation. “ After having been kept in the incubator for two or three days at a temperature of 32° to 33° C., it is used to inoculate a second generation, care being taken to use a trace only of the fluid part, and not to come in direct contact with the original granule, which may be still discerned in the preparation. “The specimen representing the second generation is kept in the incubator for a day or two. It is then used to inoculate a fresh preparation,—third generation. And, finally, this is used for establishing a fourth generation. -After having been kept in the incubator, a part of it is used for inoculating ¢wo animals, the inoculation being carried out at different times. “Both these animals became affected with the disease. Another portion of this fourth generation was used to start a SWINE FEVER. 327 fifth generation, then a sixth, a seventh, and an eighth genera- tion. With this three animals were inoculated at different times, All three animals became diseased in due time. “ In order to correctly interpret the results of this last (sixth) series of experiments, it is important to mention that inoculation with dried lymph, diluted far less than would correspond to the third generation in the last-named experiments, is followed by a negative result.” MORBID ANATOMY. In the majority of animals, the skin about the perineum, groin, belly, and neck is swollen, and of a diffuse red or bluish- red colour, and the ear lobes and the skin of the nose also red and swollen, whilst in some instances there are gangrenous patches of the superficial cutaneous structures. In many in- stances, however, this redness of the skin may be entirely absent, even after death ; but the longer the animal lives, the superficial structures become, as a rule, the more swollen, and the dependent parts of the ears become deep red, puffy masses, from the surface of which the epidermis peels off. The blood-vessels of the skin are more or less filled with blood or plugged with fibrin,"and around the vessels lymphoid cells are discoverable ; the sudoriparous glands are greatly distended, and often filled with blood charged with large coarsely granular cells containing large clear vesicular nuclei. The connective tissue of the corium contains fibrinous exudations and a yellow serosity. The small intestines almost invariably, and the stomach more rarely, are congested and covered with spots of ecchymosis, both upon their mucous and peritoneal surfaces. The large intes- tines have always the most characteristic appearances. There are isolated or confluent, generally roundish, ulcerations at and around the ileo-czcal valve, the rest of the mucous membrane being congested and studded with spots of ecchymosis. Klein says the whole large intestine down to the rectum contains ulcers ; in the cecum they are confluent, and measure several inches; extending transversely as well as longitudinally ; while the whole remaining mucous membrane of the large intestine is much thickened, and in some parts the mucous tissue con- tains large accumulations of blood. The ulcers are of various 328° CONTAGIOUS DISEASES. aspects. The following forms may be seen—very minute, well defined, prominent yellowish-whitish specks of the size of a millet or hemp seed; then somewhat larger, more flattened, | prominent, circular or oval, yellowish patches (with which in one case the whole mucous membrane of the cecum seemed quite covered) of the size of a hemp seed, up to about one- eighth of an inch in diameter; next, flat, circular, or slightly oblong patches, situated on the crust of a fold of the mucous membrane, in size from one-eighth to one inch in diameter, generally black or grey (from bile pigment), except a very con- spicuous, and, I may almost say, characteristic prominent rim, which is yellow. The ulcer generally shows a pale central or eccentric disc, around which the rest of the ulcer is arranged as concentric rings. Between these flat ulcers with concentric layers, and those uniform, yellowish-white, prominent patches and nodules, there are all interme- diary forms. This is easily under- stood, if it is borne in mind that as the latter increase in size, the central part is transformed into that black or greyish mass. Besides these, there are very oft@n formed on the surface of the mucosa minute whitish specks, just perceptible by the unaided eye. In one single instance have I seen ulcerations of the lower part of ileum. This case had exceedingly numerous ulcerations of the large intestines. The two ulcers of the ileum were. quite different from the ulcers gene- rally found in the large intestine, for they were oblong, deep pits, sur- rounded by a thick, prominent wall of swollen mucous membrane, very Fre. 29.—Portion of cecum of Much the same as ulcers of human pera acy em alaial at Liver- typhoid. But under any circum- a. Tlec-caecal opening. stahces the microscope reveals a b, b, ». Ulcers in various stages. marvellous difference between the two diseases; for in the pig these patches, whether nodules or ulcers, have absolutely nothing whatever to do with lymphatic SWINE FEVER. 329 follicles, whereas in human typhoid there is found in the first stage round, or generally oblong, prominent papule or patches of swollen lymph follicles, surrounded by swollen mucous mem- brane, after which stage the greater part of the swollen lym- phatic patches dies, and is finally discharged as a slough leaving behind a pit-like excavation bordered by a well-defined fringe of mucous membrane, which is neither thickened nor indurated. Next in importance to the intestinal lesions are those dis- covered in the lymphatic glands, which are congested, generally swollen, of a dark red colour, or infiltrated with blood, black, soft, and pulpy ; those in connection with the intestinal canal are not only swollen, but infiltrated with a greyish-white opaque- looking matter. The condition of the glands is sometimes very slight to the naked eye, there being merely swelling, and an apparent con- gestion ; but even here the microscope reveals bursting of blood- vessels in the cortical tissue, and hemorrhage into the lymphatic follicles and sinuses of that part, amounting in severe cases to total destruction of the adenoid tissue by blood. In severe cases the medullary sinuses, and partly also the medullary lymphatic cylinders, become filled with extravasated blood. In so far as this condition is similar to what is found in anthrax. “ This state of the lymphatic system is very characteristic, and, com- bined with the disease of the intestine, is of paramount impor- tance to the diagnosis.” —(KLEIN.) Respiratory organs—In a large number of casés, the tongue, mouth, fauces, and pharynx are ulcerated, and sometimes gan- grenous ; the lymphatic vessels filled with micrococci; the lungs are generally congested in patches, with distinct mapping out of the lobes and lobules by cedema of the interlobular tissue, succeeded by hepatisation, at first red, subsequently opaque, or white specks or patches appear in the red substance, which, as they increase in size, become confluent. This is due to the fact that the bronchial tubes become gradually filled with a white, brittle, cheesy mass, progressing gradually from the finest ramifications on to the larger branches of the lobules and lobes. Finally the whole lobule is transformed into a discoloured, dry, hard, friable mass. The pleura of the corresponding parts is of course inflamed, being in some cases exceedingly thick, and 330 CONTAGIOUS DISEASES. covered with false membranes. In severer cases, the greater part of one lung and portions of the other may be thus changed, and on the external surface there may exist smaller or greater ulcer- ations. Except in very slight cases, there is generally a certain amount of pleural exudation; and in severer cases the pleura contains a considerable quantity of a thick, offensive, yellowish or discoloured exudation. In some severer cases the pericardium is also inflamed, containing a large quantity of exudation, and its walls being much thickened by false membranes. The same is also the case with the peritoneum, this being in some cases hypereemic in parts, or even covered with solid lymph and pus. The spleen and liver are, in severe cases, dark in colour, en- larged, and the kidneys are sometimes changed, being hyperemic and covered with petechie, particularly in the pyramids and underneath the capsule, which is easily stripped off—(KLEIN.) In the Privy Council Order dated 17th December 1878, which is termed also the “ Typhoid Fever of Swine Order, 1878,” it is laid down that typhoid fever of swine, otherwise called soldier disease or red disease, shall be deemed to be a disease (under the Contagious Diseases Animals Act, 1878) for the purposes of slaughter and compensation, notice of disease, Orders of Council, power of police, and power of entry; and, also (under the Animals Order, 1878), for the purposes of movement and exposure, movement of dung, burial or destruction of carcases, and general provisions, as also for cleansing and disinfection ; but this order has been very imperfectly carried out. Preventive inoculations have not been tested in this country, but Billings (Nebraska) claims that he has successfully induced immunity by inoculations with attenuated cultures, and Cornil and Chauternesse are said to have succeeded (Freidberger and Fréhner) in attenuating the virus by subjecting the cultures to air and heat 93° F. At the end of ninety days the virus no longer kills, but gives immunity to the rabbit. and guinea-pig. This attenuation is transmissible to a series of cultures, and with these the following experiments were made. Four pigs were successively inoculated subcutaneously at eight days’ interval, with a dose of two cubic centimetres of bouillon cul- tures, which were ninety, seventy-four, fifty-four, and eight days old, and finally with virulent virus. During the days following the inoculations the animals showed only a slight SWINE FEVER. 331 illness. Two months after the beginning of the experiments they received in their food one litre of virulent culture in bouillon. Two pigs which were not inoculated were subjected to the same treatment. Within ten days these latter died with characteristic intestinal lesions. The inoculated animals did not show any important morbid phenomenon for two months ; after this lapse two died. The autopsy showed intestinal lesions, which were much developed, and had a chronic course, and very slight pul- monary lesions. Both of the other inoculated animals resisted. These first experiments showed that the pig acquires immunity with more difficulty than the subjects of other species. CHAPTER XXVIII. CONTAGIOUS DISHASES—continued. SWINE PLAGUE. Swine PLAGUE, rouget de pore, angina, petechial or spotted fever, red disease, erysipelas, &c., is common on the Continent of Europe, and is, according to Continental writers, a specific septi- cemia due to a fine bacillus resembling that of Koch’s mouse septicemia. If inoculated in the mouse, the animal invariably dies; it is also often fatal in the rabbit, guinea-pig, birds, and the pig, but, according to Kitt, the field-mouse possesses im- munity, as in septicemia, to the action of the microbe, and he has also observed that its virulence is attenuated by once pass- ing through the rabbit, and that after six days pigs may be inoculated with blood exudate collected at the point of inocula- tion, and thus obtain immunity. The microbe exists externally in different media, in damp earth, in water, and in plains and valleys with slow flowing streams. Cornevin states that the horse, ox and sheep, and guinea-pig are immune to its action, as already stated; it is a very fine cylindrical bacillus, measuring from zstoy tO retoo in length by gzhgy in breadth; it is found in the blood, particularly in the capillaries in contact with their intima, in the white corpuscles, spleen, liver, kid- neys, lymphatic glands, the bone marrow, exudates, feeces, and urine; is non-motile, anaérobic, but grows in contact with air, and in a temperature as low as 45° F. According to Kitt, it resists putrefaction. Schottelius says that it develops spores ; but this is denied by Cornevin and Kitt, who base their objec- tions on the non-virulence of dried virus. This microbe, in reality the discovery of Loffler and Schutz, although ascribed to Pasteur and Thuillier, is destroyed by slow desiccation in from fifty to eighty hours; by water at a tempera- 332 SWINE PLAGUE, 833 ture about 83° F. in twenty minutes, and in two minutes at that of 168° F. Cold of about 20° F. kills it in about a fortnight, and salted meat within a month. It is, however, stated that it resists the action of saturated solutions of boracie acid, benzine, chloride of zinc, &c., but is killed by chloride of lime, quicklime, &c. Symptoms.—After a period of incubation of about three days, the disease is manifested by intense fever, constipation, red or purple patches upon the skin, particularly of the abdomen, lower parts of chest, ears, inner aspect of the thighs, &. There is often grinding of the teeth, muscular twitchings, vomiting, great weakness, paralysis of the hind quarters, The conjunctiva are dark red or reddish-brown in colour, and the patches on the skin become confluent, change from a clear red to dark red, and finally a bluish colour. The constipation is succeeded by diarrhoea, the feeces being often bloody and containing much mucus, and finally the breathing becomes much accelerated, the surface of the body bluish in colour. Death may occur in twenty-four hours or on the third or fourth day, but is seldom prolonged to over more than a week, and the percentage of deaths is from 50 to 85 per cent., or even higher. A cure has been attempted by the administration of emetics and calomel, but more attention is now paid to the arrest of the disease by segregation, disinfection, destruction of the carcases,and finally preventive inoculation has seemingly been of great value in some instances, whilst in others the benefits have been doubt- ful, and further researches will have to be made before its adoption can become universal. The post mortem lesions indicate a more general septic condition ; there is congestion of the spleen, liver, kidneys, and endocardium, with hemorrhage into these organs and into the muscular structures. The spleen externally, however, is tense and resistent from distension of its capsule, but is soft internally and of a reddish-blue colour, and generally un- associated with hemorrhagic infarctions or extravasations. There is an intense congestion of the mucous membrane of the stomach and bowels, which is sometimes of a uniform dark red colour, swollen, covered with superficial hemorrhagic and diphtheritic patches; sometimes it has a marbled appearance. The solitary glands and Peyer's patches are swollen, often covered with bloody mucus, surrounded by a red zone and very often ulcerated, as in the typhoid of man. 334 CONTAGIOUS DISEASES. INFECTIOUS PNEUMONIA OF SWINE is manifested by accelerated breathing, pulmonary gangrene, and caseous tumours, induced by an ovoid non-motile bacterium similar to that of the septicemia of the rabbit and the bacillus of chicken cholera, measuring about zo3pq of an inch in length and about s2y, in breadth, proving fatal, when inoculated, to the pig in from twenty-four to forty-eight hours. It induces an inflammatory oedema at the point of puncture, and proving fatal in sixty hours in a pig which had been given immunity against swine plague by inoculation. According to Schutz, the contagium is very subtle and induces the disease by inhalation by the skin and digestive apparatus, is rapidly fatal, and is marked by redness, tumefaction of the skin in the regions of the neck and legs; with cough, difficulty of breathing, intense fever, and great depression. The post mortem appearances are those of pneumonia, with several reddish grey hepatised spots, having yellowish necrosed spots in their centres of the size of a grain of sand, and associ- ated with pleuritis and fibrinous pericarditis. The bronchial glands are enlarged, the liver, kidneys, spleen, and heart are softened and degenerate, but the lymphatics of the intestine are not usually altered ; and in some chronic cases of the lungs, lymphatic glands, tonsils, bones and tendons, caseous tumours, resembling those of tuberculosis—but not containing the tubercle bacillus—are discovered. The disease can be inoculated into the rabbit, mouse, guinea- pig, fowls, and pigeons, but large doses are required to induce fatal results in the three latter. It is mostly transmitted from one pig to another by inhalation. poe ast CHAPTER XXIX. CONTAGIOUS DISEASE S—continued. SWINE ERYSIPELAS. Mvc# confusion has taken place, owing to the somewhat similar external lesions that are seen in Swine Fever and in Swine Erysipelas, and also of many other porcine diseases. It is a well-known fact that pigs, much like infants, if they become sick of almost any disease, are sure to have a skin eruption of some description; hence the difficulty or impos- sibility of diagnosing disease by the skin lesion alone. Eggeling distinguishes four forms of swine erysipelas : 1. Sporadic erysipelas of the head, due to infection of wounds. 2. Urticaria, due to dietetic error. 3. Epizootic erysipelas, an acute exanthematous disease similar to scarlet fever in man, and involving both skin and mucous membranes. 4. Contagious pneumonia of the pig, a most serious and prevalent form, involving skin, lungs, stomach, and bowels particularly (see p. 334). Loffler states there are only two forms—namely, swine erysipelas and contagious pneumonia. The disease is due to a very fine rod-shaped, non-motile bacillus found in the blood, the organs, and the excretions of affected animals, and in Great Britain usually runs a chronic course, and is specially marked by the post mortem lesion of verrucose endocarditis. During life there may be no symptoms, or, if any, they are vague and often overlooked. In some countries, however, the disease assumes a virulent form, and causes great mortality ; and in these countries resort ig had to protective inoculation. 333 336 CONTAGIOUS DISEASES. In the acute form the symptoms and post mortem appear- ances are well described in Captain Hayes's translation of Freidberger and Frohner’s ‘ Veterinary Pathology”? (Hurst and Blackett), and are as follows: ‘* Symptoms.—After a period of incubation of at least three days, the disease usually begins suddenly and violently. The animal refuses its food; sometimes vomits or makes efforts to vomit; has a very high temperature (up to 48° C.); manifests severe nervous disturbance; is very weak, torpid, sleepy, and indifferent to its surroundings, and tries to hide itself under its bedding. - The hind-quarters become weak ‘and paralyzed. Muscular spasms and grinding of the teeth are sometimes observed. At first there is constipation; the mucous mem- brane of the eyelids is of a dark red or brown-red colour, and the eyelids are sometimes swollen. Usually, a couple of days after the first manifestations of the symptoms, or even from the very commencement of the attack, spots appear on the thin parts of the skin, such as the region of the navel, lower surface of the chest, perineum, inner surface of the thighs, ears, and throat. These Spot which at first are bright red and about the size of a man’s hand, become, later on, dark red or purple, and soon unite into large, irregularly shaped patches. Asa rule, they are neither painful to the touch nor prominent, but sometimes show a slight inflammatory swelling. The skin of the red spots, especially of the ears, may suffer from an eruption of vesicles, and may even slough. This spotted redness of the skin may be very slight in severe cases, or may appear only immediately before, or even after death. At other times it may be entirely absent, or may become spread over the entire body. Diarrhcea also sets in, and the feces become thin, mucilaginous, and sanious in a few instances. Towards the end, respiration becomes greatly accelerated, general cyanosis (edema of the lungs) supervenes, and death takes place, usually on the third or fourth day of the attack, with increased general weakness and considerable fall of temperature (down to 87° C. or less). When the disease is very severe, the animal may die in twenty-four hours. Some- times the disease takes a week or longer to run its course. ‘Endocarditis of erysipelas has been carefully studied by Bang. It often begins acutely with the ordinary symptoms of SWINE ERYSIPELAS. 337 erysipelas, and is followed by a latent period, during which the animal apparently recovers ; but subsequently becomes affected with a well-marked, visible, cardiac affection, which generally lasts for a week or two. In a few cases the pigs die from apoplexy. The symptoms are: loss of appetite, depression, persistent lying down, shortness of breath, slight cough, and redness of the skin, in varying intensity and extent; although not to such a high degree as in acute erysipelas. After this, we find palpitation of the heart, greatly accelerated action of the organ, and sometimes endocardial murmurs. The tem- perature is often increased and the animal dies with symptoms of cardiac paralysis. Ina few cases we may observe paralysis of the hind-quarters. On post mortem examination the left heart is usually found to be affected ; the right, less frequently.. “* Prognosis.—The ordinary kind of epizootic erysipelas has @ mortality of from 50 to 85 per cent. Lydtin states that the losses from it in Baden were between 50 and 75 per cent. “ Anatomical Changes.—In post mortem examinations of cases of the ordinary form of epizootic erysipelas, we find signs of septicemia without any well-marked morbid conditions of separate organs.. This septicemia is a general infection which produces hemorrhagic and diphtheritic gastro-enteritis, considerable swelling of the lymphatic system, hemorrhagic or parenchymatous nephritis, acute swelling of the spleen, parenchymatous hepatitis, and myositis. “1. The hemorrhagic gastro-enteritis consists at first of excessive inflammation of the mucous membrane of the stomach in the region of the fundus. The mucous membrane shows a dark red discoloration, which is partly diffuse, partly in spots; suffers from cloudy swelling; often has eminences on its surface; is covered with a viscid layer of mucus; and may even have superficial scabs. The glands of the mucous membrane are inflamed (gastritis glandularis). The intestinal mucous membrane is swollen, especially on the top of the folds, narrow parts of the small intestine, and in the neigh- bourhood of Peyer’s patches ; is covered with reddish mucus ; infiltrated with hemorrhages; and sometimes shows super- ficial scabs. Less frequently, circumscribed parts of the mucous membrane of the cecum and of the anterior part of the colon suffer from a diphtheritic affection. 22 338 CONTAGIOUS DISEASES. “9. The solitary follicles and Peyer’s patches present, throughout, medullary swellings in the form of prominent raised patches of the size of a grain of millet to that of a lentil. Sometimes they are infiltrated with hemorrhages, and surrounded by a red ring. We very frequently notice ulcera- tion and cicatrisation of the solitary and agminated follicles. The mesenteric glands become more swollen than the other glands of the body, are of a dark red colour, and show softening. The surface of their section is dun-coloured, with interspersed dark red spots, and the paraglandular tissue is hyperemic and infiltrated with hemorrhages. “3. The hemorrhagic nephritis is distinguished by enlarge- ment of the kidneys, and by the kidneys assuming a grey-red colour. The medullary layer is generally of a very dark red, and the cortical layer is infiltrated with blood points, and widened out. In slight cases we find only a parenchymatous inflammation (cloudy swelling) of the kidneys. Frequently catarrhal nephritis occurs as a complication. “4, Acute swelling of the spleen arises in consequence of an acute, severe hyperemia, with great increase of the cellular constituents of the spleen (new formation of splenic cells), in which case the spleen is enlarged, but not softened as in anthrax. It is, on the contrary, tense to the touch, as the capsule is considerably stretched. The pulp on the surface of a section is purple, moderately soft, and free from hemorrhages. “5. The parenchymatous hepatitis consists of a cloudy swelling and enlargement of the liver, in which the surface of sections has a greyish-brown colour, soft, flaccid, watery, shiny, are sometimes infiltrated with hemorrhages, and look as if they had been boiled. The myocardium shows similar spotted changes and subendocardial hemorrhages. “In the abdominal cavity, thoracic cavity, and pericardium we sometimes find small quantities of an orange-coloured clear fluid, which may be mixed with flaky coagula, and punctiform hemorrhages under the serous membranes, especially on the auricles. We rarely meet with severe hemorrhages in the brain, or in the dorsal and lumbar portions of the spinal cord. The congested parts of the skin are somewhat discoloured after death. The lungs remain un- SWINE ERYSIPELAS. 339 changed, or at most exhibit a post mortem cedema. By micro- scopical examination, the bacilli are found everywhere in the body, especially in the spleen and kidneys, but to a less extent in the blood.” In our experience the patches on the skin are frequently diamond-shaped, and contain the specific organisms. In some cases large patches of the skin slough off, and leave large ulcerating surfaces. Mr. Blackhurst, of Preston, has seen numbers of people associated with such diseased pigs affected with erysipelas of the face. There are three recognised methods of preventive inocula- tion : 1. Lorenz’s Serum Method.—The simultaneous injection of immune serum and virus at different parts of the body. 2. Leclainche’s Method.—Inoculation with a serum virus mixture, followed in twelve days by the injection of a pure culture of the organism without any serum. 8. Pastew’s Method.—Inoculation with two vaccines at different degrees of virulence. This is done by passing the virus through rabbits, whereby it gradually loses its virulence, until it no longer kills swine. This attenuation of virulence is maintained if the virus be grown in bouillon. Pasteur uses two vaccines, an extremely weak one, and followed up in ten days by a stronger. The procedure is to inject inside the thigh of young pigs 0-1 c.c., and immunity is thus obtained in a fortnight and maintained for a year. w2—2 CHAPTER XXX. CONTAGIOUS DISEASE S—continued. MALIGNANT GDEMA. Tas disease affects all classes of animals, and is due to the inoculation of a wound, however slight, with the organism known as the bacillus of edema of Koch (Vitrio septicus of Pasteur). These organisms are found almost everywhere in the soil— in dust, in feces, &ec., &e. They are particularly harmful when they obtain a footing in the connective tissue, and especially so when that tissue is in a condition of irritation or inflammation. They are anaérobic and motile, and are destroyed by oxygen; but their spores resist ordinary disinfectants. When the bacilli gain entrance to a wound, and when there is little or no blood and no oxygen, they grow and multiply by division, and by their action cause the evolution of several gases—namely, sulphuretted and carburetted hydrogen, hydrogen, and carbonic acid—which gases accumulate under the skin, and give rise to emphysema. Invasion of the wound by the bacilli results in a febrile condition, a gradual loss of sensibility, and ultimately coma. The swelling extends rapidly, and the affected parts become of a bluish colour, a leaden hue prevails, and finally the part becomes cold and gangrenous. Should the wound which becomes infected be in the neigh- bourhood of the throat, the swelling will so much interfere with respiration as to cause suffocation. The disease is frequently seen in lambs after castration and tail-cutting, and terminates fatally in a gangrene of the abdominal muscles or of the hind-quarters. 340 MALIGNANT CEDEMA. 341 The bacillus of cedema is frequently found in the blood of dead animals, and has been mistaken for the Bacillus anthracis. The treatment for the disease is to freely incise the swelling, so as to admit oxygen, and to irrigate the part with antiseptics. When the throat is swollen, it may be necessary, in addition to the above treatment, to perform tracheotomy. Post mortem reveals, in addition to the local swelling, which, when cut into, is found to contain large quantities of orange- coloured frothy exudate, an exudation of serum into the substance of the lungs, and very often an inflamed condition of the bowels. ° The spleen is found to be normal. CHAPTER XXXI. CONTAGIOUS DISEASE S—continued. SOUTH AFRICAN HORSE-SICKNESS. Turis is one of the most fatal of diseases affecting the horse in South Africa, and is said by Duncan Hutcheon to be due to the inoculation of an ultra-microscopic organism, through the agency of a nocturnal insect, and the disease can be transmitted to other horses by injection of the blood of diseased animals. The period of incubation is said to be about eight days, but no special indications of illness may be noticed until an hour or two before death, and in many cases a horse is found dead which had seemingly been in good health a few hours before. The symptoms that have been recognised are great depres- sion, elevation of temperature, hurried respiration, a well- marked swelling of the pits or hollows above the eyes, and the visible mucous membranes become of a dark red hue. On auscultation of the lower part of the trachea and the larger bronchial tubes, a bubbling sound is heard, due to effusion. This effusion is great, and as the inspired air mixes with it, it is discharged from the nostrils as a copious yellow froth, and in a very short time the effusion into the tubes and vesicles is so great that the animal dies of suffocation. On post mortem examination one finds great effusion into the lung substance, the bronchi and vesicles, the pericardium, and the pleural cavity. Effusions are also seen subcutaneously in the lower cervical region. The blood is black, but coagulates quickly. The line of procedure is purely defensive, and is to keep the animals in a stable, if possible, or in a kraal, and seemingly this prevents infection, 342 CHAPTER XXXIL CONTAGIOUS DISEASE S—continued. SPIRRILOSIS IN THE HORSE. Tuts disease is due to the presence of spirilla in the blood, and is characterised by general depression, emaciation, and cedematous swellings of the upper eyelids (like horse-sick- ness), of the neck, and of the dependent parts of the body. The disease seems to run a rapid course; the emaciation is great, accompanied by much debility and loss of appetite, terminating in death. An examination of blood-smears usually shows the presence of spirilla. On post mortem examination the swellings are found to consist of a yellow gelatinous exudate, and the kidneys to be pale and enormously enlarged (as described by R. T. Sturdy, M.R.C.V.S., they may weigh 56 ounces each even in a pony), and the bladder to be filled with pale urine. The muscular tissue is noticed to be in a seeming parboiled condition, and the rigor mortis is very slight. The most noticeable appearance is the great emaciation, Mr. Sturdy’s case wasting from a well-conditioned pony to a mere bag of bones in five days. 348 CHAPTER XXXIII. CONTAGIOUS DISEASE S—continued. SPIROCHATOSIS. Tus is a specific blood disease, due to the presence of small, thin, and very active parasites, which have the appear- ance of young and thin eels, writhing and wriggling with great rapidity. They have also been found by Jowett in the discharges from cases of ‘‘ grease” and “ canker ” in the horse. The parasite was first demonstrated by Obermeier in the blood of a patient suffering from relapsing fever. These parasites have since been demonstrated in horses, cattle, sheep, pigs, and birds, and are known as— S. Duttoni: The cause of tick fever in cattle in Africa; also supposed by some to be the cause of red or black water in cattle. S. Theileri: A similar parasite to the above, and described by Theiler as occurring in African cattle in 1902. . ovina: In sheep. . suis: In pigs. . anserina: In geese. . gallinarum : In birds. . Obermeirei: In man. The first demonstrated. . pallida: In syphilis of man. . of Jowett: In “ grease” and canker of the horse. S. suis gives rise to progressive anemia in pigs, and has a period of incubation of about fourteen days; is characterised at first by the appearance of certain cutaneous lesions— namely, firstly, a desquamation of the epidermis, in small, circular patches; then an extravasation of blood, which dries up, leaving a brown scab; and later on the scab drops off, 344 RAHRRRAHRNB Sons,Luth, Edin PLA TUBERCULOSIS OF OU XIV. )F LUNG. (“GRAPES.”) BACILLUS TUBERCULOSIS. Stained by Ehrlich’s method from specimen in College Laboratory. X 2000. To face page 344. SPIROCH ATOSIS. 345 and leaves a permanent cicatrix, rather like a pock mark, and in white pigs, intensely white, and glistening like pearl. The spirochete were always found in the primary lesion, but never in the blood, and they are not found on or in the skins of healthy pigs. The disease is highly contagious, and frequently terminates in death from anemia, even though the acute skin lesions have disappeared. (Sydney Dodd, M.R.C.Y.S., is the first to demonstrate this disease.) CHAPTER XXXIV: CONTAGIOUS DISEASE S—continued. COCCIODOSIS. Coccip1a are protozoa, which assume the form of ovoid cysts, varying in length from 18 to 25 », and in width are about 13 ». They possess a hyaline envelope whose existence is proved by its double contour and yellowish, granular, highly refractile contents. This granular material does not always occupy the whole of the cavity. Ata certain stage of development it collects towards the centre, forming a nucleus, and leaving clear spaces at the poles of the cells. Ata later stage this nucleus divides into four portions, which afterwards separate. These protozoa live in wet, marshy places, but are destroyed by drying in the open air (Degoix), and are the cause of fatal diseases in cattle, hares, rabbits, and fowls. In cattle the disease is often called bloody flux, hemor- rhagic enteritis, and dysentery. After infection, it takes about six weeks to two months before the coccidia have become sufficiently numerous to cause disease. It affects cattle of about eighteen months to two years of age, and usually breaks out in midsummer. The first symptom is a serous, foetid, dark greenish diarrhea, this fluid being voided without any straining or pain. Within a few days, however, the animal is seen to stand with arched back, to show signs of abdominal pain, and to grind its teeth. The character of the ejectais much altered. Itisnow mucous, sanguinolent, and often contains blood-clots. This causes considerable pain, tenesmus, and violent straining. The fluid is expelled in large quantities. 346 COCCIODOSIS, 347 Signs of fever appear; the temperature rises; the animal ceases to feed and to ruminate; great thirst is exhibited; rapid emaciation takes place; the animal becomes very weak and hardly able to stand. Then a change occurs in the course of a few days—a week to ten days. Hither the animal is so weakened that it dies, or if any appetite had been present during the acute stage, the symptoms gradually disappear, and recovery takes place. In some cases, particularly in animals in good condition, after the initial stage is passed, a bloody flux has set in, the animal has violent convulsions, lies on its side, head stretched out, legs stiff and straight, eyes retracted, and sometimes there is opisthotonos. The convulsions occur time after time, and terminate in death. Treatment consists of the administration of alkaline, muci- laginous drinks, and of weak solution of creolin or salol, accompanied by easily digested and rich foods, followed by a course of vegetable tonics (Degoix). As the disease is contracted by the animals pasturing on infected lands, all those not affected should be removed, and preventive treatment adopted. All ejecta from infected animals should be sprayed or dressed with a 3 per cent. solution of sulphuric acid. Post mortem examination reveals the fact that the large intestines have been the seat of the disease. They are found to be almost entirely empty, the mucous membrane to be cedematous, reddish-brown in colour, and covered with mucus, sometimes having the appearance of grey, diphtheritic patches, and which on removal leave a whitish ulcer, and it is principally in these patches that the coccidia are found. Coccidia are found here in greatest number, though they are seen almost as numerously in the epithelial cells of the follicles, and as often they are found in masses at the bottom of the much-dilated blind ends of the follicles, and contained with the epithelial cells, which have undergone considerable hypertrophy. CHAPTER XXXV. CONTAGIOUS DISEASES—continued. TUBERCULOSIS. Definition.—An infectious, infective, and inoculable disease induced by the action, particularly upon the hereditarily pre- disposed, of a bacillus discovered by Koch in 1882, and termed the Bacillus tuberculosis, affecting many kinds of animals, and in consequence called by Lydttin the “ universal panzootic.” Tuberculosis is most commonly seen in man, monkeys, and horned cattle, less frequently in the pig, horse, dog, and cat, and birds; amongst the latter, however, it sometimes assumes an epizootic form, attacking poultry, pigeons, pea and guinea fowls, turkeys; even small birds not being proof against its ravages. The smaller ruminants, sheep and goat, are very rarely attacked with tuberculosis ; they may resist subcutaneous inoculation, but they are not proof against its intravenous inocu- lation. The direct introduction of the bacilli into the blood, and the repeated ingestion of tuberculous growths, induces the disease even in them. It is also found in the camel, giraffe, antelope, llama, gazelle, zebra, &c., and it is now well known that the disease is transmissible from man to animals, and from animals to man. ‘The tubercular nodules vary in appearance, some being grey, like pearls, hence the term “ pearl disease ” in England, “ perl- sucht ” in Germany; some being yellow, and some calcareous, these varying appearances indicating the age of the growths. They are non-vascular, and vary much in size, some being even smaller than a millet seed (miliary tubercle), very numerous, and invading one or many organs. Some larger ones are hard, greyish-red, pedunculated, or having broad bases, arranged in clusters of various sizes, covering the lungs, thoracic walls, surface of diaphragm, the peritoneum, &c.; or they are found in the form of great fluctuating masses filled with yellow pus, which is thick, grumous, full of calcareous grains, resembling mortar, or of an 348 TUBERCULOSIS. 349 opaque yellowish matter infiltrating the tissues. These vary- ing appearances gave rise to the opinion amongst Virchow and his followers that they were lesions of different diseases; and Villemin, who first discovered the inoculability of tuberculosis in 1865, vainly tried to prove their identity by inoculations, but it remained for Koch to prove that they were all due to tubercular bacilli. Examined microscopically, the nodules present giant cells with branched processes and large epithelioid cells, which are round or oval in shape, and outside a zone of lymphoid cells. The cells are surrounded by a more or less complete fibrous stroma. These tubercles are sometimes scattered throughout the sub- stance of the organs, having the form of distinctly rounded nodules, rather gelatinous in structure, and a pearly grey trans- parent appearance. In other cases it will be found that beneath the pleurz, both visceral and parietal, there are large yellow nodules, which give off numerous radiating branches. These are called “ grapes,” from the supposed similarity to that fruit, and between them are seen some red lines in which degeneration has not advanced to any extent. Each yellow patch is seen under a low power to consist of a number of follicles, each being de- generated—caseated—in its centre, embracing the alveoli and their contents. There are no blood-vessels in the centre, but some vessels are seen with difficulty some distance from it, where the alveolar walls are slightly thickened. In order to differentiate the giant cells from those of an epithelial type and from the fibrous capsule, stain with picro-carmine, when the giant cells will present the yellow picric acid colour, and the others will be stained carmine; for the recognition of the bacilli other methods must be resorted to. There is a difficulty in finding the bacilli in caseous tubercles, particularly in cattle, but they can often be demonstrated in material taken from the periphery of the nodule. If cavities containing pus are formed, such as are not uncommon in tuber- culous horses, the bacilli can be detected very readily by the following process :— A drop of water is placed on a perfectly clean cover-glass. Remove a small portion of the pus or caseating matter with the point of a needle, then rub it with a drop of water already placed on the cover-glass. The cover-glass is then dried in 350 CONTAGIOUS DISEASES. the air and fixed over a spirit lamp or Bunsen burner until the albumen is coagulated. A few drops of filtered carbol- fuchsin solution is put on the cover-glass, and held by a pair of forceps over the flame until steam rises for five minutes. Wash in water, and decolorise by 25 per cent. sulphuric acid solution, and then wash in water. Counter-stain with aqueous solution of methyl blue, then wash with water, dry over a flame, and mount in Canada balsam. The bacilli will present a bright red colour on a pale blue ground, and occur singly, in pairs, or aggregated in rosettes. The bacilli vary in number in different lesions, and have no relation to the magnitude of the growths. Thus in a large nodule very few bacilli will be found after the most careful examination, whilst a smaller one may contain a large number. When the giant cells are numerous the bacilli are gene- rally few in number, many of them having doubtless been ingested by the giant cells. They are easily detected in the ex- pectorations of human consumptives, and in the thick purulent yellow discharge which is sometimes ejected from the mouths of cattle after long and violent fits of coughing, This material coughed into the mangers and upon partitions and walls of the cow-shed is, when dry, diffused through the air inspired by the healthy cattle, and thus becomes one of the great causes of the spread of the disease. The transmissibility by inhalation, as well as that by inges- tion and inoculation, has been proved experimentally. The animals experimented upon were compelled for several hours daily, to breathe, in a chamber, air in which were fine particles of phthisical expectoration, mixed with water, from persons with cavities in their lungs, and rendered into fine particles by a steam atomiser. Dogs alone were used, as they rarely suffer from tubercle. Eleven animals were experimented upon, and all were killed in a period varying from twenty-five to forty-five days, and, with one doubtful exception, presented well-developed miliary tubercles in both lungs ;".and in most of them tubercles were also found, but to a smaller extent, in the kidneys, and to a still smaller extent in the liver and spleen. Microscopical examination demonstrated the presence of the bacilli. These experiments were conducted by Dr. Tappeinier of Meran, and a preliminary account of them led Dr. Max Schottelius to make similar ones, not only with the sputum of TUBERCULOSIS. 351 Fic. 30.—Tubercle bacillus. a, Giant cell invaded by bacilli. b. Minute germs. Fic. 31.—Tubercular nodule. a. Caseated centre of nodule. b. Giant cells. c. Reticulum of nodule with epithelium-like cells. d. Leucocytes, red cells, &e. c. Portions of adjacent alveoli. 352 CONTAGIOUS DISEASES. phthisical individuals, but also with that of persons suffering from simple bronchitis, and with pulverised cheese, brain, and cinnabar. The result was that miliary tubercles were found in the lung in all cases, and in equal quantity with both phthisical and bronchial sputum. Cheese produced a smaller quantity, pulverised brain still less, and the cinnabar least of all, merely a few whitish tubercles with pigmented centres, with an interstitial deposit of the substance, which had caused no inflammatory reaction; though the tubercles produced by non-specific matter closely resembled those of tuberculosis, they contained no bacilli, hence they cannot be classified as those of true tuberculosis. Tuberculosis is described under three divisions, namely,—I1s¢, Tuberculosis of the organs ; 2d, of the serous membranes ; and 3d, of the lymphatic glands; but generally these forms co-exist in the same subject, constituting the so-called “ diffuse tuberculosis.” According to Nocard, it is shown that 40 per cent. of tuberculous animals are affected in both lungs and pleura, 20 to 25 per cent. in lungs alone, 15 to 20 per cent. in pleura and peritoneum, the remainder comprising either generalised lesions of all the organs, or lesions localised in the glands, the genital organs, mamme, tongue, osseous tissue, &c., and that the lymphatic glands proceeding from the organs attacked are always more or less severely affected ; and he makes this impor- tant statement, that in many cases when the animal is slaugh- tered quite at the commencement of the disease tuberculous nodules are only found in the bronchial or mediastinal glands ; and the pulmonary lesion which has served as the entrance gate for the contagion eludes the most careful research, or is only represented by a minute focus of disease much less important than the glandular alterations which it has preceded and caused. Bollinger thinks it possible, or rather probable, that intestinal tuberculosis, consecutive to pulmonary phthisis, may be pro- duced by the discharges (sputa) being swallowed and passing into the intestines, mesenteric glands, and liver, without there being generalisation through the blood-stream. It has now been definitely proved by McFadyean and others that ingestion is a common means of entry for the organism, and that the infection of the lung is secondary to the intestinal infection. The path of contagion may be by the lymphatics, or be carried by leucocytes through the blood. TUBERCULOSIS. 353 This has been one of the arduous duties of His Majesty King Edward’s Royal Commission, and by its demonstration it has been enabled to show the communicability of bovine tubercle to man. It has been proved that human tubercle, when fed to bovines, will reproduce the disease, but its virulence is somewhat modified. The cultural characteristics of the two are very similar, but the human, after its passage through the bovine, becomes seemingly identical, thus demonstrating that the two are of the same species, but varying slightly under the different conditions. The disease tabes mesenterica is therefore undoubtedly produced in children, in numerous cases, by the feeding with tuberculous cow’s milk. This is a direct intestinal infection, and not through the medium of the lungs. The bacillus has a natural power of selection, and prefers thelungas a seat of growth; but no matter in what way infection is obtained, there.is a probability of early pulmonary infection. Symptoms in Cattle Tuberculosis is generally slow in de- veloping, and its symptoms are often very obscure, whilst in a few instances its manifestation may be very rapid. In the latter case signs of ill-health appear, excited, perhaps, by par- turition, a slight cold, indigestion with recurrent tympanites, or some other, perhaps trivial, cause ; the illness continuing longer than usual, and the animal, being fat, is slaughtered to prevent loss, and the post mortem reveals the presence of tubercular tumours in various parts of the economy. In this case some of the tumours will be found in a softened, semi-fluid condition, the contents of which being absorbed, induce the continuance or aggravation of the otherwise trivial illness. Generalised tuberculosis only occurs when the blood-stream has become in- fected by the entrance of the bacilli. Nocard says :-—‘“It often happens that apparently healthy animals slaughtered for human consumption are found to have several organs invaded by the disease, yet in such condition it cannot be said that the disease is generalised: these are successive localisations, and it is main- tained that general tuberculosis only occurs when all the glands in the chain are destroyed, the lymph carries the bacilli into the thoracic duct, whence they are poured into the anterior cava, or, again, when a tubercular focus penetrates a vein of a certain size and pours into it the virulent material which it contains. Tuber- culosis then assumes the character of a general disease, aa all 354 CONTAGIOUS DISEASES. the vascular tissues are virulent, and the tissues which are favourable to the growth of the bacilli, notably the liver and spleen and the marrow of the bones, become the seat of a number of specific granulations all of the same size and age, which constitute what is known in human medicine as granular or acute miliary tuberculosis.” Miliary tubercle in the spleen is said by Ostertag to be the surest sign of general tuberculosis. Although the animal may be fairly fat, the flesh usually is pale, watery, pitting under pressure, and prone to rapid decomposition. In deep milkers, and in some highly bred cattle, the cachexia may seem to precede and accompany the tuberculosis, and gene- rally the earliest signs are those of unthriftiness, and deteriora- tion in the quality of the milk, which becomes thin and watery, although for some time it may keep up in quantity. If the cow be in calf, abortion is apt to occur; if not pregnant, the condition called nymphomania is frequently present. The appetite is capricious; the mucous membranes pale; a cough of a dull character exists ; the skin looks dull, the hair dirty ; the animal does not lick itself, and, in the white parts, the skin is often observed to be yellow. Emaciation now proceeds more or less rapidly ; the cough becomes troublesome, but there is seldom any expectoration or discharge from the lungs. The digestive organs are weak, the rumen prone to tympanites, and diarrhea’ sets in, which soon renders the animal a mere bag of bones. Auscultation and percussion may find the lungs and contents of the thorax diseased or otherwise. There is generally some degree of pain and tenderness evinced by the animal when the sides are sharply struck or pressed upon, and very often a friction (pleural) sound is heard, and pressure upon the loins will cause the animal to cringe, groan, or otherwise evince pain. As the disease advances the cough becomes more trouble- some,—-paroxysmal ; louder than that of pleuro-pneumonia, and occasionally bronchial discharges may issue from the mouth after a severe fit of coughing. As already stated, in this yellow, grumous, and viscid material the bacilli may be detected by microscopic examination. It, however, most frequently happens that the severest fit of coughing brings about no discharge, the material being swallowed. This also occurs in pulmonary glanders in the horse, in which abscesses may be found on post mortem examination filled with pus, freely communicating with ns, Lib Edina PL The Heart and Lungs wer TUBERCUI XV. Tubercular growth in the wo pericardial sac. External wall of heart. » and together weighed 56 lbs, RICARDITIS. To face page 354. TUBERCULOSIS. 355 the bronchi, from which during life no discharge has reached the nostrils, having been swallowed, as may be observed by watching the animal. It can be seen by standing at the left side, that the act of swallowing is performed, and the course of the material followed by the eye during its course from the pharynx into the chest. The animal rapidly becomes more or less hidebound, the hair dull, the expression dejected, the eyes watery and sunken, and the lids often covered with a scaly material, whilst a foetid discharge may issue from the nostrils. The respira- tions, as the disease advances, become greatly accelerated, short and jerky, each expiration being often associated with a moaning or grunting sound ; the prostration is extreme, and the animal soon succumbs. On percussing the walls of the chest the animal evinces some signs of pain, and a cough is often excited; there is decreased resonance and often signs of lung consolidations and of pleural change, whilst auscultation may reveal increased tubular sounds with diminished or absence of the vesicular murmurs, and often signs of consolidation. There may also be pronounced bronchial rales when the discharges have invaded the bronchi, and friction sounds when the pleural surfaces are roughened by the sub-pleural nodules and adhesions of the pleural surfaces. Some authors state that the external lymphatic glands are frequently enlarged: so far as my experience goes this is excep- tional, and of no great diagnostic value. The temperature varies considerably in individual cases ; in some very pronounced ones there is no great elevation, whilst in others this is extreme,— 107° or higher during the exacerbations, falling several degrees during the remissions, and these exacerbations and remissions are not infrequently met with in the pulmonary form. As already stated, the calf is rarely tuberculous, and from the observations made at the abattoirs at Berlin and Copenhagen it was found that at Berlin the percentage of tuberculous animals was 15°1 for oxen and cows, 1°55 for swine, 0°11 for calves, and 0°004 for sheep. At Copenhagen the percentage was 17°7 for oxen and cows, 15:3 for swine, 0°2 for calves, and only 0:0003 for sheep. From its rarity in calves some writers have argued that tuberculosis is not congenital. This conclusion, however, is against evidence, for cases are ee where 356 CONTAGIOUS DISEASES. undoubtedly the calf has given evidence of the disease at or shortly after birth, where the lungs and various serous mem- branes—1.e., pleura and peritoneum—were covered with caseous and calcareous tumours, which must have been developed in utero. In two instances which came before me the arachnoid was covered with tubercles in an early stage of development, the calves dying from meningitis in an acute form. Infection of the foetus results from the penetration of the bacilli through the foetal membranes, or from their presence in the semen of the male or ovum of the female at the time of coition. We can understand this when we recognise that the ovaries of the female and the testes of the male are occasionally the seats of tuberculosis. The liver, spleen, heart, mesenteric glands, and peritoneum may be invaded with many clustess of tubercles similar to those shown in figs. 15 and 16, whilst not infrequently the ovaries and uterus are involved, causing continuous sexual excitement,— nymphomania,—and sometimes discharge from the vagina, with non-impregnation after repeated serving; but should pregnancy occur, the animals generally abort, and according to Roloff this abortion is often the first sign of the infection of a herd. Tubercle is also found invading the meninges of the brain and spinal cord, giving rise to fits of convulsions; to ptyalism and dysphagia and tympany when located in the pharyngeal glands; to purulent discharge when involving the penis of the male, uterus or vagina of the female; and colic, with alternating constipation and diarrhoea, and flatulency after food, particularly if the liver be involved. The pericardium may be considerably affected without apparent symptoms, but after a time signs of cardiac irregularities become more and more apparent (see Heart Diseases), and sometimes the ex- ternal lymphatic glands are enlarged; whilst in other cases an animal apparently quite healthy manifests symptoms of lameness from no assignable cause, and this lameness is generally irremovable, resisting all treatment, and after death the bones or joints present the usual characteristics of tubercular disease. ; Tuberculosis, when affecting the mammary gland, is very frequently secondary to its development in other organs, but is supposed to be occasionally primary. Bang, Copenhagen, PLATE XVI. Fra, 4. Kia. 6. . Fic. 5. Fig. 3. Tie. 3, Fic. 12. SprrocHazta DuTroni FRoM Monkeys anp Rats. x 4,500. Fics. 1 to 12: From peripheral circulation of infected monkeys and rats. Fic. 13: From monkey’s liver. Fics. 14 to 16: As found in the spleen. From the Report by Dr. Anton Breinl, Director of the Runcorn Research Labora- tories of the Liverpool School of Tropical Medicine, and published in the Annals of that School, vol. i., No. 3. To face p. 344. TUBERCULOSIS. 857 describes the condition as a diffuse, painless, hard swelling, involving one or more quarters of the gland, but generally the posterior ones. It frequently is secondary to an ordinary mammitis, and after the acute symptoms have subsided the quarter slowly but continuously increases in size. It differs from an ordinary inflammation of the mammary gland— mammitis or mastitis—in which the milk is curdled at com- mencement; but in the tubercular form the milk is at first normal, but after a time it becomes watery, contains clots, and sometimes bacilli. Bacilli are found with great difficulty; and Bollinger states that in fifty-five per cent. of examined cows where the milk was virulent the bacilli could only be found once in twenty cases. There is therefore great danger to human life when the milk of tuberculous cows is made use of as food. No doubt innumer- able cases of consumption are thus induced in the human being, particularly that form of tubercular disease tabes mesen- terica, So common in young children. It must be particularly borne in mind by the veterinarian that, as a conservator of public health, he should at all times discountenance the consumption of the unboiled milk of tuber- culous cattle not only by human beings, but by the lower animals, for it has been abundantly proved that the milk of a tuberculous cow will, unless boiled, be dangerous to life; and when we reflect upon the fact that it is so largely consumed, particularly by infants and young children, we can at least imagine the appalling consequences it may give rise to without being boiled. The danger to human life from the ingestion of the milk of a tuberculous cow is greatly increased if its mammary gland be in a condition of inflammation, the seat of an abscess, or in a state of induration, as—in addition to the deficient nutritive value of all milk from tuberculous cows, which is blue in colour, thin in consistency, and in some cases contains cyanides —it will in such an instance be tainted with bacilli, and be a direct means of infecting the human being, particularly young and delicate infants. The boiling of milk and the thorough cooking of meat destroys with certainty the bacilli, and all suspected milk should be so treated. Let the veterinary surgeon, when called upon to give his opinion, consider the 358 CONTAGIOUS DISEASES. sacredness of his position, and—even if he chance to offend a client—do his duty towards his fellow-beings. The majority of the veterinary profession are in favour of preventing the flesh of all tuberculous cattle—no matter what its condition and appearance may be—being used as human food; but I cannot support the wholesale condemnation of such flesh; and, whilst maintaining that such flesh, when properly dressed, and all tubercular growths with adherent flesh have been carefully removed, is fit for food, I must explain that if it present any appearance of being watery, pale, or otherwise unhealthy, I should not hesitate in at once expressing my conviction that it should not be used as food for man. The following abstracts from the Report of the Royal Commission, appointed to inquire into the administrative proceeding for controlling danger to man through the use as food of the meat and milk of tuberculous animals (Part I., 1898), will be found of much interest and value : There is a total absence of uniformity in the special qualifications required of the persons employed as meat inspectors by the sanitary authorities in different places, as may be seen by a Return presented to the House of Commons in 1896, showing the previous vocations of those acting in that capacity. In Battersea, for instance, four plumbers and three carpenters discharge the office of meat inspector; in Hackney the duties have been committed to two plumbers, one carpenter, one com- positor, one bricklayer, one florist, one builder, one surveyor, and one stonemason. In Portsmouth a solitary butcher has received as colleagues three school teachers, one medical dispenser, one carpenter, and one tram-conductor. In Manchester the public slaughter-houses are under supervision of a veterinary surgeon; in Glasgow inspection is carried out by the police, assisted by three butchers, and in Liverpool the staff of inspectors have been “ butchers by trade and training.” We may add that in the Edinburgh public slaughter-house we witnessed meat inspection carried on more nearly on the enlightened system of the best Continental abattoirs than it was our fortune to see in any other part of the United Kingdom. Here there are six meat inspectors, of whom four are veterinary surgeons, one has been a butcher, and one a cattle salesman. We were very favourably impressed with the organisation, though the standard by which the meat of tuberculous carcases was judged appeared to us unnecessarily severe. In many districts meat inspection is made part of the duty of ordinary sanitary inspectors, without any special training. A number of witnesses expressed the opinion that veterinary inspectors Se mee pe oo id Tubercular asses (Grapes)- Fic. 32.—Tuberculosis bovis. 859 360 CONTAGIOUS DISEASES. alone should be employed. On this question we are satisfied that some pathological training is the proper basis upon which to build the knowledge required by a meat inspector, and that, wherever practicable, veterinary surgeons, thus educated, should be employed as meat in- spectors. In large towns, where a staff of inspectors is maintained, we do not think it necessary that all of these should be veterinary surgeons, but all meat inspectors should pass an examination and receive a qualify- ing certificate from a central authority before appointment. As to the amount and distribution of tubercular disease which justifies the seizure and condemnation of « carcase as unfit for human food, the widest discrepancy prevails in opinion and practice. Chaos is the only word to express the absence of system in the inspection and seizure of tuberculous meat, and it has, in our opinion, become necessary that regu- lations should be formulated for the guidance of those who are concerned in dealing with this subject. Entertaining, as we do, the strongest opinion in favour of public over private slaughter-houses, we cannot but recognise in the present arbitrary system of seizure the surest discouragement to the use of public ones. Butchers will seek relief from inspection which they consider unduly strict by using private slaughter-houses, where inspection is either more lenient, or, as in most cases, wanting altogether. Very strong representations were laid before us on the part of butchers and meat traders, and also on behalf of the agriculturists who supply the butchers, as to the effect of this want of uniformity upon their business. It is obvious, we think, that these complaints are well founded. Pro- ducers and traders are making no unreasonable demand when they ask that a recognised standard should be observed, and that meat which, after effective inspection, is pronounced fit for sale in one market, should not be liable to seizure in another because the inspecting authority happens to differ in opinion as to the extent of tuberculosis which may be dangerous. Of the dead meat imported in vast quantities, the greater part is not inspected till it reaches a public meat market, without the offal and internal organs ; and that which is consigned to private establishments generally escapes inspection altogether. In order to remedy this inequality, and the risk arising from it, we are of opinion that arrangements should be insisted on whereby each animal slaughtered at the port of landing shall be inspected, together with its own offal; and further, that ‘stripping’ the pleura of a carcase should be taken as evidence of unsoundness, and be followed by seizure. We feel that we should be exceeding the limits of our reference were we to dwell on the manifest disadvantage which the home producer suffers in having to submit his carcases to a more stringent and extensive inspec- tion than the foreigner is exposed to. But this much is clear from the evidence: first, that tuberculosis exists among imported cattle and carcases ; second, that if the rigidity of inspection to which British meat is subjected in some places be justified by the existence of danger there- from to the consumer, similar danger from imported meat is not provided against under the present unequal system. * Matterof Tubercular Growth (Grapes) Fic. 83.—Tuberculosis bovis. 361 362 CONTAGIOUS DISEASES. We have been favourably impressed with the value of the peculiar institution known in Germany as the Freibank, and alluded to in the last paragraph. It is a department of the slaughter-house where meat of carcases affected by disease, but not to such an extent as to render it unfit for food, is exposed for sale. It is sold at about half the market rate, in portions not exceeding 10 pounds to each customer, either having been sterilized by exposure to steam for half an hour at a temperature of 100° C., or, where the quality of the meat is considered to warrant it, in a raw state. No butchers, meat salesmen, or restaurant keepers are allowed to purchase at the Freibank ; but many poor people, who would otherwise have to go without meat altogether, are able to buy cheap and not unwholesome meat at a very low rate, and the demand is usually found to exceed the supply. Under an efficient system of inspection, we regard the Freibank as the most desirable adjunct to a public slaughter- house, and one that would protect the poor from the unwholesome supplies at present obtained in some of our large towns from the lowest class of butchers. We are, therefore, of opinion that when, under the certificate of a veterinary surgeon, the sale of milk from a given cow is prohibited, the local authority should slaughter the same, and if, on post mortem ex- amination, it appears that the cow was not so affected, the local authority should pay compensation to the extent of the full value of the cow immediately before slaughter. If, on the other hand, the animal be found to have been so suffering, the carcase should be sold by the authority, and the owner thereof should receive the proceeds of the sale. QuaLiFicaTions oF Mrat InsPEcToRS. We recommend that in future no person be permitted to act as a meat inspector until he has passed a qualifying examination before such authority as may be prescribed by the Local Government Board (or Board of Agriculture), on the following subjects : (a.) The law of meat inspection, and such by-laws, regulations, &c., as may be in force at the time he presents himself for examina- tion. (b.) The names and situations of the organs of the body. (c.) Signs of health and disease in animals destined for food, both when alive and after slaughter. (d.) The appearance and character of fresh meat, organs, fat, and blood, and the conditions rendering them, or preparations from them, fit or unfit for human food, TUBERCULOSIS IN ANIMALS INTENDED FoR Foon. We recommend that the Local Government Board be empowered to issue instructions from time to time for the guidance of meat inspectors, prescribing the degree of tubercular disease which, in the opinion of the Board, should cause a carcase, or part thereof, to be seized. Pending the issue of such instructions, we are of opinion that the eo cee it TUBERCULOSIS. 363 following principles should be observed in the inspection of tuberculous carcases of cattle :— (a.) When there is miliary tuberculosis of both) lungs - - 6 - (6.) When tuberculous lesions are present on the pleura and peritoneum (c.) When tuberculous lesions are present in the muscular system, or in the lymphatic glands embedded in or between the muscles - : (d.) When tuberculous lesions exist in any part of an emaciated carcase -J The entire carcase and all the organs may be seized. (a.) When the lesions are confined to the lungs and the thoracic lymphatic glands (b.) When the lesions are confined to the liver - (c.) When the lesions are confined to the aa geal lymphatic glands (d.) When the lesions are confined to any com- bination of the foregoing, but are col- lectively small in extent - - The carcase, if otherwise healthy, shall not be con- demned, but every part of it containing tuberculous lesions shall be seized. In view of the greater tendency to generalisation of tuberculosis in the pig, we consider that the presence of tubercular deposit in any degree should involve seizure of the whole carcase and of the organs. In respect of foreign dead meat, seizure shall ensue in every case where the pleura has been “ stripped.” MILK. DISEASES IN THE UDDERS oF Cows. * We recommend that notification of every disease in the udder shall be made compulsory, under penalty, on the owners of all cows, whether in private dairies or those of which the milk is offered for sale. We recommend that for the purpose of excluding from their districts the milk of cows affected with tuberculosis of the udder, or exhibiting clinical symptoms of the disease, local authorities should be given powers somewhat similar to those of sections 24 to 27 of the Glasgow Police (Amendment) Act, with power to slaughter such cows, subject to com- pensation under the conditions named in the Report. We also recommend that powers shall be given to local authorities to take samples and make analyses from time to time of the milk produced or sold in their districts, and that milk vendors shall be required to supply sufficient information as to the sources from which their milk is derived. At ports where milk and milk products are received from foreign countries, any costs that may be thus incurred in their examination shall be borne by the importers. 364 CONTAGIOUS DISEASES. ELIMINATION OF Boving TUBERCULOSIS. We recommend that funds be placed at the disposal of the Board of Agriculture in England and Scotland, an of the Veterinary Department of the Privy Council in Ireland, for the preparation of commercial tuber- culin, and that stock-owners be encouraged to test their animals by the offer of a gratuitous supply of tuberculin and the gratuitous services of a veterinary surgeon on certain conditions. These conditions shall be— (a.) That the test be applied by a veterinary surgeon. (b.) That tuberculin be supplied only to such owners as will under- take to isolate reacting animals from healthy ones. (c.) That the stock to be tested shall be kept under satisfactory sanitary conditions, and more especially that sufficient air space, ventilation, and light be provided in the buildings occupied by the animals. TUBERCULOSIS OF THE HORSE, The horse is seldom affected with tuberculosis, and it is only seen in isolated cases, never attacking many animals in the same stable. An inquiry into the life-history of tuberculous horses has enabled the author to discover that in several instances, where the history could be traced (the animals being still in the hands of the breeders),they had, when foals, been fed on cow’s milk either after they had been taken from the mothers, or where the mare had been a bad mother or had died. In these cases the spleen and mesenteric glands were the seats of the lesions, which to a lesser extent involved the liver and bronchial glands. As in cattle, the symptoms in the horse are generally very obscure, except in one particular, namely, that it is always associated with a more or less rapid emaciation. If the pul- monary organs are involved, there may be a cough, hurried respirations, particularly if excited by exercise or any other cause, and abnormal sounds may be heard in the chest on auscultation. If the contents of the abdomen are the seat of the disease, there may be frequent attacks of colic, with con- stipation or diarrhcea. Nocard has observed a very pronounced diabetes insipidus and irregular variations of temperature, but polyuria is not at all a constant symptom in my experience. "ggg *a aonf Oy ‘(ASVO S.NVNDGOH ‘Yy{) G10 SXVEA AAIY AUOH V NI sisotnouTaAy, TAX GLV1d TUBERCULOSIS. 365 There is a third form in which this disease affects the horse, and that is what might be called the vertebral form. The premonitory symptoms are gradual emaciation, more or less polyuria, general unthriftiness, and a great desire to lie down continuously, and seemingly to doze. After a time the animal stands in a stiff position, almost as if he had tetanus; and if an attempt be made to turn him, he either turns all of a piece or may fall down. If one tries to put him back, he does it with great difficulty, or may fall in the effort. Later on the stiffness is most marked in the cervical region, and the prominences of these vertebre can be easily seen standing out from the wasted muscles (vide photo-lithograph). In the great majority of cases in the horse they are isolated ones; but Mr. W. R. Davis, M.R.C.V.8., of Enfield, has placed on record an outbreak of four cases in three years in the same stud. The tuberculin test may be applied to-the horse as well as to cattle, and the appended table will give the reader a good idea as to the efficacy of the test when applied to a suspected tubercular horse : Temperature prior to and at time of injection 101°5 . nine hours after injection - 105-4 i twelve hours after injection - - 105-2 5 fifteen hours after injection, - - 104-4 fe twenty-two hours after injection 103-5 In this case there was a considerable amount of swelling round the seat of inoculation, which remained for eighteen hours (Mr. Hodgman’s case). In the majority of cases observed by the author the spleen and mesenteric glands were the seat of the lesions; the liver, lungs, and bronchial glands being less frequently involved. In some instances the spleen has been enormously enlarged, and studded throughout its substance with grey translucent, yellow-cheesy tumours ; whilst in the liver, lungs, and kidneys similar growths are seen, but are caseous in their centres if truly tubercular. Those tumours found in these organs and consisting of white, round, firm succulent tissue, invading the glomeruli of Malpighi and free from bacilli, are not to be con- sidered tubercular; they are those of lympho-sarcoma, having 366 CONTAGIOUS DISEASES. some degree of organisation ; whereas tubercle is incapable of a higher organisation than the grey nodule, is prone to rapid decay, retrogressive changes commencing in the centre of the nodule, and, the caseous material being the product of the death of the cell elements, the surrounding growth is simply the hyperplasia of the normal tissue, due.to the invasion of the bacilli; in fact, an effort to erect a barrier to the further inroad of the attacking bacilli. TUBERCULOSIS OF THE PIG is much less frequently met with than in horned cattle, the average, according to statistics, varying from 1°34 to 1°64 per cent. in Saxony, a little more than 10 per cent. in Amsterdam, 04 at Rouen, ‘02 in the Duchy of Baden. In some districts it is never seen, and in Scotland it is so rare that at one time I was inclined to think the pig was immune. I have, how- ever, observed it, and reported the results of the tuberculin test to the Royal College of Veterinary Surgeons; and in which, one of the most prominent symptoms—not mentioned by authors—was an eruption of small tubercular nodules in the dermoid structures, invading the whole surface of the body. Causes.—The ingestion of tubercular growths, or of tuber- cular milk. A tuberculous mother has, within my own know- ledge, transmitted the disease to her offspring, and in some red Tamworth pigs of my own this was remarkably exempli- fied. A pregnant sow was sent to me from a celebrated breeder. In course of time she produced a litter, of which the majority did well, but shortly after the young pigs were weaned the sow became rapidly emaciated and was slaughtered ; on post mortem she was found to have tuberculosis in an ad- vanced stage, involving most of the organs. One boar and one sow of. this litter were kept, and after the sow became pregnant the boar was sold and not heard of again; the sow, a very large fine one, gave birth to eight or nine pigs, and shortly afterwards commenced to lose condition very rapidly. An erythematous eruption appeared on the skin, and under the red spots hard nodules soon began to form; the young pigs throve for a short time, when some .began to fall off rapidly and died tuberculous; the remaining ap- parently healthy ones were tested with tuberculin, and all TUBERCULOSIS. 367 reacted, and some time afterwards verified the value of the test, presenting signs of the eruption upon and nodules within the skin ; rapid emaciation followed, and generalised tuber- culosis was found in all. No cough was observed in these cases; the appetite remained fairly good for a time; it then became capricious, and signs of indigestion became apparent, with constipation or diarrhcea. Pallor of mucous membranes, of the tongue, oral cavity, and conjunctiva, as well as of the nose, was a prominent symptom in all the cases; the skin, in addition to the eruption, became very dirty, and the animals soon became miserable objects, with sunken eyes and pendent bellies. The tuberculin test is the most reliable means of diagnosis, for in the absence of obvious symptoms of tuberculosis its detection becomes otherwise a matter of some difficulty. The characteristic lesion in the pig is the enlarged sub- maxillary gland, which may be felt between the branching of the lower jaw, and is invariably affected, so that diagnosis in a slaughter-house is rendered easy. On account of the extreme tendency to generalisation of this disease in pigs, it is in- sisted that the whole carcase should be deemed unfit for human consumption. Tuberculosis is seldom seen in the sheep or goat, but under certain conditions these animals are found not to be immune. Experimentally the disease has been transmitted, particularly by intravenous injection, which sets up an acute, generalised, miliary tuberculosis of a rapidly fatal type, and it is thought that prolonged cohabitation with tuberculous cattle gives the disease to both the sheep and the goat, although they, as a rule, resist subcutaneous and intra-ocular inoculation. The post mortem examination of these animals reveals invasion of the lungs, bronchial, mesenteric, and other glands, spleen, &c., and when there is a discharge from the nose the bacilli can be found in abundance. Care must be taken that actinomycosis, which is not a rare disease in the goat, be not mistaken for tuberculosis. TUBERCULOSIS OF THE DOG. The dog is much more frequently affected with tuberculosis than is generally believed; one authority found over 4 per 368 CONTAGIOUS DISEASES, cent. out of 7,000 dogs on post mortem examination. It may assume either the acute or the chronic form. A case recently occurred in my practice. The dog had been: ill for three or four weeks, and was brought to the College. It died three days after admission. On post mortem ex- amination nearly every organ was found to be affected with tubercular neoplasms. They appeared in great numbers on the surface of the pleura, peritoneum, and diaphragm. In the peritoneal covering of the bladder, in the substance of the kidney, and in the liver they showed as minute pearly points, while in the lung their confluence had formed nodes and excavations of various sizes. The heart was studded with nodules, a large one being placed on one of the cusps of the mitral valve. On the base of the heart, and bordered by the pulmonary artery, was an elongated tubercular abscess con- taining a couple of tablespoonfuls of pus. The spleen was apparently unaffected. The brain and testes were unfortu- nately not examined. In other cases, however, we have a form much resembling human phthisis, which is characterised by chronic pneumonia and pleurisy, or a chronic asthma and bronchitis. In all cases there is great emaciation and in many there is ascites. Cats are more frequently affected than dogs; indeed, it is little suspected what a common cause of death consumption is in these animals. The disease in them also often appears as a generalised tuberculosis; sometimes, however, the ab- dominal viscera and membranes are affected to the exclusion of other parts. Then chains of tumefied glands can be seen along the course of the large intestines, and one or several large tubercular glands in the mesentery. They are extremely hard—cartilaginous, in fact. In the liver, kidney, and spleen the tubercle follicles are as a rule quite small, and appear in sections as a round-celled infiltration, containing, especially in the liver, where they affect the portal space for the most part, beautiful examples of giant cells with their brightly shining zone of nuclei. When in this animal the lung is affected, the formation of vomice is quite common.! 4 T am strongly of opinion that the presence of dogs, cats and birds in rooms used as living-rooms by people is fraught with much danger, and should not be permitted.—W. O. W. TUBERCULOSIS, 369 Tuberculosis of Birds (Avian Tuberculosis).—It is maintained by some and contradicted by other writers that the tuberculosis of birds differ in some essentials from that of mammals. Thus Rivolta, Strauss, Mafucii, and other experimentalists have failed to transmit the disease from mammals to birds, whilst Cadiot, Albert, Nocard, and others state that the inoculation is occasionally successful, and that the disease can be trans- mitted from one to another ; and Nocard says: “It is true that the lesions observed in the guinea-pig as the result of the inoculation of avian tuberculosis are widely different, namely, large, red, and soft spleen, absence generally of tubercular nodules in the lungs and liver, but the latter as well as the spleen are crowded with tubercular follicles rich in bacilli, and a few transmissions from guinea-pig to guinea-pig are all that is necessary to enable these lesions to reproduce the type so well described by Villemin.” Lastly, the same writer says: “It must be remembered that the tubercle bacillus so resistant to-all causes of destruction may, however, experience profound modifications by means of suc- cessive passages through the organs of divers species of animals. But if the modifications which it undergoes as the result of numerous transmissions through birds are profound enough to make the bacillus of avian tuberculosis a peculiar variety of the bacillus of Koch, they are not enough, in my opinion, to make these bacilli two distinct species.” The avian bacillus is longer than that of mammals, grows more rapidly and more readily on cultivation media, appearing as thick, moist, luxuriant spots, which preserve their vitality longer than those from man. They grow ata higher tempera- ture—109° F.—whilst those of the mammal cease to grow at 104° F. ‘To prevent the spread of avian tuberculosis it will be necessary to kill all the birds in the infected yard ; the diseased ones being cremated or buried deeply in the ground, their bodies surrounded by a layer of some antiseptic, the healthy birds of course being disposed of for food as quickly as possible. All the wood-work of the hen-houses should be destroyed, the walls scraped and whitewashed, the wash to contain carbolic acid, the excrement removed and burnt with the wood-work, and on no account should birds from an infected run be sold except for slaughter. 24 370 CONTAGIOUS DISEASES. TREATMENT OF BOVINE TUBERCULOSIS. If the disease has passed beyond the very earliest stage, it is a waste of time and money to treat animals suffering from tubercular consumption. It is far better to slaughter and make the best of them; and in all cases it is better to make the animals fit for the butcher by ceasing to milk them, giving fattening food such as oil-cake and good hay, avoiding grasses and roots, as they tend to produce indigestion, diarrhea, and an acid condition of the digestive apparatus, and by ad- ministering cod-liver oil in such quantities as the animal may digest and assimilate—say, from six ounces to half a pint daily ; if purgation is not induced, the latter quantity. The oil is best given mixed with lime-water, and small doses of oil of turpentine may also be added with advantage, particularly if there be a tendency to indigestion, tympanites, or diarrhoea. The following curative or preventive agents have been recommended: iodine (Williams), mercuric chloride (Her- roun), eucalyptus oil (M. Ball), salicylic acid (Griffiths), creasote (various), inhalation of turpentine, hydrofluoric acid, &c. (various); but so far these have proved uncertain. Paraffin has also been recommended, but the results do not warrant the continuance of any medicinal treatment. In 1901 Von Behring published his method of immunising cattle against the disease. Some years previously he had inoculated a guinea-pig with sputum from a human subject, and had continued the cultivation. These bacilli so obtained were dried in vacuo, and to them was added a few drops of glycerine, and the two were well rubbed together in a special mortar. This mixture was then gradually emulsified by the slow addition of normal salt solution, and 1°5 parts of sodium carbonate in each 1,000 parts; thus every 2 c.c. contained 4 milligrams of the dried bacilli. To afford immunity, two intravenous injections are neces- sary, the first to contain 4 milligrams of dried bacilli, and at the expiry of twelve weeks the second injection, consisting of 20 milligrams. The immunity lasts for about a year. Quite recently Von Behring has produced a new preparation named “ tuberculase,” which is said to be more certain in its action. TUBERCULOSIS. ° 371 STRUMOUS ABSCESSES, In the Provisional Nomenclature of Diseases adopted by the Royal College of Physicians, London, tubercular diseases are considered under two heads, namely—(1.) Scrofula with tubercle, sometimes a concomitant of internal tuberculosis ; and (2.) Scrofula without tubercle. This latter condition is witnessed in the sheep, in which the true tubercular nodule is rarely developed. This ruminant, however, is prone to suffer from strumous scrofulous abscesses in the submaxillary, facial, and parotidean regions, sometimes commencing in the con- nective tissue about the jaws, neck, and face, and involving the lymphatic glands (strumous adenitis), and known as ‘“‘cruels” by Scots farmers. These abscesses often appear, without any premonitory signs of ill health, as hard swellings, which sooner or later suppurate imperfectly, or burrow deeply in all directions ; at first they are not painful, but often become very much so, and may multiply rapidly, appearing between the jaws, on the neck, about the eyes, lips, and nostrils, and occasionally upon other parts of the body, causing swelling, preventing the sheep from feeding, and rendering the breathing difficult, and snoring. In some instances swelling of the face and discharge from the nose are observed previous to the development of the tumours. Young animals, particularly young fast-growing tups, if exposed to cold, are especially subject to this disease, but older animals of both sexes, as well as lambs, are not exempt. If these abscesses are opened, the quantity of pus contained within them, not always commensurate with their size, is generally thick, and flows tardily, but afterwards becomes thin, and more or less ichorous; it is surrounded by a thick sac of low fibrous material, like the walls of an old ulcer, and sinuses are often found running from the cysts into the sur- rounding structures. Microscopically examined, the pus is found to consist of ordinary pus cells, rather shrivelled in appearance, but showing little or no tendency to caseation, and the tubercular bacilli are absent, but the pus may be loaded with the cocci of suppuration. In many instances the tumours undergo little or no change for two or three years, the sheep seemingly suffering no inconvenience; but in other cases the 24—2 372 CONTAGIOUS DISEASES. animal loses flesh rapidly, the wool falls off in patches, symptoms of fever manifest themselves, a cough 18 now and then heard, and the sufferer dies from exhaustion, anemia, and sometimes dropsy. The flesh in this advanced stage is pale and watery, but if an animal be slaughtered in the earlier stages it is fairly good. The post mortem appearances are often quite local, merely collections of pus in the various thick-walled abscesses observ- able before death ; the pus will, however, be found to have burrowed from the abscesses in various directions into the surrounding tissues. Now and then some degree of ulceration of the nasal mucous membrane may be detected, and abscesses found in the lungs, but these two latter conditions are by no means constant. Strumous abscesses in sheep, or the conditions which lead to their formation, do not seem to be hereditary, as the stock of many tups affected remain quite free from the disease, provided they are not exposed to that cause—namely, cold— which induces it in the progeny of those which have never been affected. Treatment—The cause or causes being removed, it will be necessary to open the abscesses as soon as pus can be detected in them, a matter of some difficulty, as their walls are very firm and unyielding; however, if by firm pressure with one hand, and manipulation of the tumour with the other, the pus can be felt fluctuating slightly, the operator need not hesitate, but make a bold incision, press out the semi-fluid matter, and dress the wound with some digestive, such as turpentine liniment. The parts are to be kept clean, dressed antiseptically daily; the wounds prevented from closing too quickly, and the animal fed liberally. A small quantity of sulphate of iron in the food often assists the recovery. A varying degree of swelling may exist for a time after the wounds have healed. Abscesses about the throat in cattle are often supposed to be tubercular, when in reality they are due to the actinomyces. —(See Actinomycosis.) PREPARATION OF TUBERCULIN. For diagnostic purposes this preparation of the products of the development of the bacillus in culture media has proved of TUBERCULOSIS. 373 incalculable value, experiments having been made by scientists in almost all parts of the world, and with the almost invariable result of inducing a reaction in diseased animals only, healthy ones, or those free from tuberculosis, remaining unaffected. In France a strong tuberculin is prepared as follows, but it must be diluted prior to use: A pure culture of tubercle bacillus is inoculated into broth containing five per cent. of glycerine, and this is kept at a temperature of about 98° F. in an incubator for six weeks. The broth, now teeming with bacilli and rich in their products, is sterilised by heating to 230° F. in the steam steriliser. This kills the bacilli, while their products remain unaltered. It is now evaporated until one-tenth only of the original volume remains, and is filtered. In England it is now made by growing the organisms for twenty-eight days, or until a thick uniform scum covers the whole surface of the broth at a temperature of 38° C.—i.e., 108° F. There is some difficulty in getting a culture on the surface, by which means only a good toxin can be obtained ; but this is accomplished after some time and several efforts. The growth is then sterilised and filtered. The filtrate is used as tuberculin without any further condensation. The preparation of mallein is accomplished in practically the same way. It may be noted that in both tubercle and glanders the best medium in which to keep stock cultures is potato. The action of mallein and tuberculin is not properly under- stood, but the reason of its affecting animals suffering from the specific diseases of which these products are the toxins is that the excess of such products being inoculated into a system already charged with similar substances causes a local and general reaction which could not take place in a normally healthy animal, whose system would be capable of dispersing it without showing any constitutional trouble. We know that an animal suffering from either chronic glanders or tubercle has periods of illness and comparative freedom from any symptoms. When such an animal’s temperature sud- denly rises, it is possibly due to the liberation of an excessive amount of toxin from organisms growing freely in some en- capsuled lesion. The inflammatory envelope becomes patent, and allows of the flooding out of toxin, and probably also of 3874 CONTAGIOUS DISEASES. the microbes themselves, into a circulation that is already charged with as much of the bacterial products as it can stand without showing a reaction. The inoculation of mallein or tuberculin will create an analogous condition, and so explains the phenomenon. The extracellular products known as mallein are undoubtedly a toxin, but it is very improbable that they are altogether the same as those that are produced in the animal body. In accordance with Wright’s theory of opsonins, the explanation is that the fluid of the blood con- tains a subnormal amount of the specific opsonin required for the proper preparation of the tubercle or glanders organisms, so that they are continually getting ahead of the phagocytic power of the leucocytes to cope with them, and it is at such periods, when the bacteria have become so over- abundant, with a consequent increase in toxin formation, that acute symptoms supervene. This flooding of the system, as it were, with bacteria and their products acts as a stimulant to the production of opsonin, and so defeats itself. An arti- ficial stimulation may be accomplished in the same way by the administration of bacteria in the form of vaccine, by the inoculation of which, intra-, and possibly some extra-, cellular toxins are introduced. By the proper administration of such substances, an animal’s opsonin content may be so increased as to induce a cure of the disease. The application of a tight bandage (Bevis bandage) to a local lesion of tubercle will induce a stagnation of the lymphoid fluid, which will become bathed in the bacterial products. On removal of the bandage, the excess fluid will be reabsorbed into the circulation, and act as would a vaccine. In this is constituted the danger of surgical interference in the treatment of microbial local lesions. The cutting of surrounding vessels and tissues facilitates the inoculation into the system of bacteria, and their products convey a generalised infection which, but for that interference, would have remained encapsuled in the fibrous or inflammatory zone which the irritation of the organisms has established. It will be seen from this short explanation how that the separated inoculation of tuberculin will so stimulate the pro- tective powers of the blood that the reaction will be quicker and more easily respond to the stimulus the oftener it is ‘ TUBERCULOSIS. 375 applied, and that each time this reaction, being more in the nature of a response to a healthy stimulus, will be more evanescent in character, simply because the animal economy is in @ more efficient state of meeting it. It must not be concluded from the above that mallein and tuberculin are the same as a vaccine—i.e., actual bacteria. They are only the extracellular products of these bacteria, and are useless to stimulate the production of antibacterial bodies. They can only stimulate those conceptions of Ehrlich which are capable of dealing with toxins as apart from bacteria (vide chapter on Ehrlich’s theory). METHOD OF INOCULATION AND EFFECT OF TUBERCULIN. Upon the discovery of tuberculosis in a herd, all animals in contact should be examined, the temperature of the animals to be operated upon should be taken and carefully noted for a day or two before the inoculations are made. The seat of operation should be the lower parts of the neck or behind the elbow. The part is to be well washed with a five per cent. solution of carbolic acid and the syringe disinfected with the same solution, Taking up a fold of the skin, the needle is pushed into the loose subcutaneous tissue, which in these positions is abundant, and about 40 minims of the tuberculin injected. The tem- perature is to be taken ten, twelve, fifteen, eighteen, and twenty-one hours after the injection. The following are con- clusions arrived at after very extensive trials, and published in the “ Annales of the Pasteur Institute ” :— 1. Tuberculin has a specific action on tuberculous bovine - animals, which is expressed by a considerable rise in temperature. 2. The injection of a strong dose gives rise in tuberculous animals to an elevation of temperature of between 2 to 5 degrees Fahrenheit. 3. The same dose injected into non-tuberculous animals does not ordinarily produce any appreciable febrile reaction. 4. The febrile reaction appears most frequently between twelve and fifteen hours after the injection, sometimes at the ninth hour, very rarely after eighteen hours: it 376 CONTAGIOUS DISEASES. always lasts several hours. It has been found that after one, two, or more injections of tuberculin that the reaction takes place more quickly and is more evanescent, so that all traces may have passed off in a few hours. This has been taken advantage of by | unscrupulous dealers, and it is therefore necessary to commence taking the temperature at once, and con- tinue to do so up to the eighteenth hour if necessary. 5. The duration and the intensity of the reaction are not related to the number and the gravity of the lesions; it seems even that the reaction may be more decisive in the case where, the lesion being very limited, the animal has conserved the appearances of health. 6. In the subjects gravely affected by tubercle, and especially in those which are fevered, the reaction may be little marked or absolutely wanting. 7. It is prudent to take the temperature of animals morn- ing and evening for several days before the injection, because it may happen that from trifling and temporary affections — congestion and the like—there may be fluctuations of temperature productive of serious error. For these animals it is necessary to put off the injec- tion. 8. In certain tuberculous animals, not fevered, the reaction consecutive to the injection of tuberculin does not reach more than 1°4°; still, as experience shows that in perfectly healthy animals the temperature may undergo variations of 1°4° or more, only reactions above 2°4° should be allowed to have any real diagnostic value. All animals in which the injection is followed by a rise of 14° to 24° should be considered as suspect, and ought to undergo a new injection after the lapse of about a month. Professor Dr. A. Eber, Leipzig, on tuberculin testing, Bays: (a) For young cattle up to six months of age: In those whose temperature does not exceed 104° F., any rise about 104° F. is to be regarded as a reaction, provided the difference before and after injection be not less than 0°9 F. TUBERCULOSIS. 377 (b) Cattle above six months : (1) No animal whose temperature is above 103-1° F. to be tested. (2) Rises of temperature to 103°1°F. to be regarded as non-guspicious. (3) Every animal whose temperature before inocula- tion is below 108°1°F., and rises above 104° F., be regarded as suspicious. (4) Rises between 108:1° F. and 104° F. to be accounted as reaction, provided the difference before and after amounts to at least 1°8° F. (5) Similar rises, but not up to 1°8° F., to be regarded as doubtful, and to be especially considered. In true reaction there is a special temperature curve—up, pause, and fall. (6) In ordinary testing all should be regarded as suspicious whose temperature rises above 103°1° F., providing the rise is at least 0°9° F. Crookshanks and Herroun have separated a ptomaine and an albumose from the crude glycerine extract of cultures, which, when ejected hypodermically into tubercular guinea-pigs, induces a rise of temperature, and its effect on tubercular glands in the cases associated with rise of temperature was to render them well defined, indurated, and painful. Other ex- periments have been made to determine the action of the amide group of organic substances upon the economy in health and in tuberculosis. In a report by Professor Samuel G. Dixon, M.D., and W. L. Zuill, M.D.D.V.S., Academy of N: atural Science, Philadelphia, it is stated that, in endeavouring to discover the true nature of the active principle of tuberculin, a crystalline substance was produced that at once suggested the amide group,—allantoin, glycocin, tyrosin, kreatin and kreatinin, taurin, cystin, &c. They determined to make use of kreatin, which was at hand, and injected a small quantity into tuber- culous and healthy small animals, and afterwards by Zuill into cattle, with results resembling those obtained by tuber- culin. Zuill states that the action of kreatin upon tuber- cular tissue is intensely energetic, causing its rapid necrosis, giving it the appearance of having undergone a cystic de- 378 CONTAGIOUS DISEASES. generation. Experiments with taurin also caused elevation of temperature. Mr. George N. Kinnell, M.R.C.V.S., Pittsfield, Mass., re- ports (1895) that more definite results are obtained by using smaller doses of tuberculin. He says: ‘‘ By a smaller dose I mean two-thirds of a minim; a large dose, the ordinary one from three to five minims—of Libbertz’s Tuberculinum Kochii. The small doses will not cause reaction in the earlier stages, or where the disease is but slightly advanced, but will do so in advanced cases where a large dose has failed to cause eleva- tion of temperature.” We strongly desire to impress upon the reader that neither tuberculin nor mallein is of any particular value, and cannot be relied upon when injected into animals suffering either with or recovering from other diseases, more especially those of the Pasteurella order. At the International Congress on Tuberculosis, held in Philadelphia this year (1908), Dr. Melvin (Chief of the United States Bureau of Animal Industry) considered the economic aspects of tuberculosis in food-producing animals. Statistics of the United States Federal Meat Inspection for the year ending June 30, 1908, concerned 53,973,337 animals, or more than one-half of all those slaughtered for food in the country. They showed the following percentages of tuberculosis: Adult eattle, 0°961; caives, 0°026; hogs, 2°049; sheep and goats, 0. The proportion of tuberculosis was probably higher in animals slaughtered without inspection. Reports of tuberculin tests made in the fifteen years from 1893 to 1908 with tuberculin, prepared by the Bureau of Animal Industry, show that of 400,000 cattle tested—mostly dairy cattle—there were 37,000 reactions, or 9°25 per cent. From these two classes of statistics the author concluded that on an average about 10 per cent. of the milch cows, 1 per cent. of other cattle, and 2 per cent. of the hogs in the United States were affected with tuberculosis, the average percentage for all cattle being estimated at 3°5. The accuracy of the tuberculin test had been confirmed in a remarkable manner by post mortem examination. Out of 23,869 reacting cattle slaughtered, lesions of tuberculosis were found in 23,585, a percentage of 98°81. The loss on animals in which tuberculosis was found TUBERCULOSIS. 379 in the Federal Meat Inspection was estimated at $2,382,433 annually, and if the same data were applied to animals slaughtered without Federal Inspection the loss would amount to $4,354,855. The stock of animals was also depreciated in value because of tuberculosis. Assuming that living tuber- culous milch cows were annually depreciated to the extent of one-tenth of what the loss would be if they were slaughtered, other cattle one-third and hogs one-half, the total annual depreciation amounted to $8,046,219. The annual loss in decrease in milk-production was estimated at $1,150,000, and there was also some loss from impairment of breeding qualities. Taking all these items into account, the aggregate annual loss from tuberculosis among farm animals in the United States was estimated at not less than $14,000,000. Dr. E. C. Schroeder, of the Department of Agriculture, Washington, read a paper on his investigations, showing that about 40 per cent. of cattle, apparently healthy, and known to be tuberculous only because they had reacted with tuber- culin, intermittently passed tubercle bacilli with their feeces. When a number of such cattle were kept under continued observation, the percentage that expelled tubercle bacilli per rectum was found to be double in about eighteen months ; and both the frequency with which bacilli occurred and the number found in individual animals also showed an increase. Among twelve cows, bacilli in the faces were at first found in five, but before the end of two years the number had risen to ten. The proof that the acid-fast bacilli demonstrated by microscopic examination actually were tubercle bacilli was established by (1) producing fatal generalised tuberculosis in guinea-pigs inoculated with the feces; (2) causing fatal generalised tuberculosis in hogs by feeding them with the feces; and (3) causing fatal generalised tuberculosis in guinea-pigs by inoculating them with milk soiled with small quantities of such feces, and with butter made from such soiled milk. Pure cultures of tubercle bacilli, isolated from the infected guinea-pigs, caused fatal tuberculosis in cattle on subcutaneous inoculation. Dr. Schroeder further observed that with rare exceptions commercial milk could be shown on examination to be contaminated with cows’ feces, and he concluded that, considering the wide prevalence of tuber- 380 CONTAGIOUS DISEASES. culosis among cattle, the presence of fecal material in milk was frequently associated with the presence of virulent tubercle bacilli. Cream and butter were also exposed to this danger. Dr. Hermann M. Biggs, General Medical Officer, New York, described what had been done in New York City with a view to the control of tuberculosis. Following an extensive campaign of education, the Board of Health in 1894 classed pulmonary tuberculosis as an infectious disease, and required all hos- pitals and public institutions to report all cases under their charge. Private physicians were asked to do the same, and the Board of Health established a diagnosis Jaboratory, where sputum was examined for them free of charge, the only stipu- lation being that the physician should furnish the name and address of the patient. In the course of time it became recog- nised by the public that the Board of Health was interfering neither with the work of the private physicians nor with the right of the individual, so that in 1897 the Board was able to adopt a regulation requiring even private physicians to report their tuberculosis cases to the health authorities. At the present time the basis of the tuberculosis campaign in New York City consisted in the compulsory notification and regis- tration of all cases of the disease. The reported cases fall into two large groups: (1) Those reported by private phy- sicians as being under their care, and (2) those reported as not being under such supervision. If the consumptive was regularly under the care of a private physician, no further action was taken by the Board. If, however, he were not, or if he were receiving charitable medical advice, then all objection to the visitation and the supervision of the case by the Health Department was removed, and, in fact, the Depart- ment was required to intervene. In this latter class of case the health authorities did their most effective work. The con- sumptives were visited in their homes by trained nurses or by physicians. If country air would benefit the patient, the Department of Health offered to take him to its country sanatorium at Otisville or to refer him to the State sanatorium at Raybrook. If the patient was able to be about, and could not leave the city, he was offered free medical care at a city tuberculosis dispensary ; if he were bedridden, and in a decent home, he might receive medical care at the hands of the TUBERCULOSIS. 381 Board’s physicians, assisted by trained nurses; if he needed hospital care, he was sent to a special hospital; and, finally, if the consumptive was filthy in his habits, and so situated that he was a menace to those about him, the Board could forcibly remove him to its special tuberculosis hospital on North Brother Island. Owing to the multifarious nationalities populating New York, the anti-tuberculosis campaign had been far from easy. Millions of circulars in a score of lan- guages had been supplied and distributed by the Health Department, and had instructed the people as to the nature of consumption and how to avoid contracting it. Lectures had been given in the public parks and schools. Exhibitions, showing the right and wrong way to live, had been held in various parts of the city, and had been found to be even more effective than words. ‘‘ Don’t spit” notices had been placed in all the public conveyances, railway-stations, &c, and flagrant offenders had been arrested and fined. The result of the campaign had been that the death-rate from tubercu- losis had dropped from 4°42 per 1,000 in 1886 to 2°41 per 1,000 in 1907. Professor Calmette stated that after numerous experiments he had prepared for therapeutic use a particularly active and relatively pure tuberculin called Tuberculin CL, which could be introduced intravenously into the body of a healthy animal in large doses, without producing any elevation of tempera- ture. In this respect it possessed an advantage over all other tuberculins. As much as 50 centigrams could be injected at a single dose into the jugular vein of a healthy bovine without producing any reaction; if, however, the same injection, in the same dosage, were repeated three times, at intervals of six to ten days, the animal, in from five to twelve hours after the third injection, reacted by a rise of 1'8° C. to 2°50° C., just as though it were tuberculous. A further consequence of such repeated inoculations was that the animal acquired a high degree of resistance to artificial tuberculous infections. The intravenous injection of a dose of virulent bovine bacilli, sufficient to produce without fail an acute and fatal miliary tuberculosis in control animals in from four to six weeks, merely produced in an animal prepared by previous injections of tuberculin a chronic and slowly progressing tuberculosis. 382 CONTAGIOUS DISEASES. The author’s tuberculin was prepared by centrifuging in vacuo, at a low temperature, entire cultures of the bovine bacillus. The product was then filtered, in order to separate the bodies of the bacilli, precipitated three times with alcohol and ether, redissolved in water, and dialysed until all the precipitants and salts had been completely eliminated. The colloid sub- stances which remained on the dialyser were then precipitated once more with alcohol and ether, and dried in vacuo. When the activity of this tuberculin was tested by direct inoculation into the brain of a healthy guinea-pig, it was. found that 00008 milligram sufficed to kill the animal, whereas almost ten times as much of Koch’s old tuberculin was required to produce the same result. The greater activity of the new preparation was attributable to the avoidance of heat during its manufacture and to the absence of all chemical treatment except precipitation with alcohol and ether. Professor Cal- mette stated that his Tuberculin CL was very well borne by tuberculous patients, and, whilst not curing tuberculosis any more than any other tuberculin, it evidently delayed the progress of the disease, and endowed the organism with resistance to the infection. It was recommended to begin with a very small dose—one-thousandth of a milligram—and to increase it gradually by fractions to one to three thou- sandths, hundredths, and tenths of a milligram, administer- ing the injections at intervals of ten to twelve days. At the same time, an effort should be made to obtain a constant increase of the opsonic index over the index of the previous inoculation, or at least to maintain it at the same level. SUGGESTIONS FOR SUPPRESSION OF TUBERCULOSIS. 1st. For dealing with Non-Breeding Cattle—When tubercu- losis ig suspected in an animal, it and all in-contact cattle should be subjected to the tuberculin test, and that all in which the reaction followed, if in good condition, be slaughtered, and the beef, if found fit after careful examination by a duly qualified veterinary inspector, be sold for human consumption. That the animal be valued prior to slaughter, and that the difference between the value of a milch cow as beef be made up by the Government as in pleuro-pneumonia, or perhaps divided between Government and owner. TUBERCULOSIS. 383 slaughtered and their carcases at once destroyed, no compensa- tion being given, and that neglect to report such cases to the proper authority be considered an indictable offence. That all animals in which the tuberculin reaction indicated that they were affected, but apparently showing no signs of ill-health, if not fit for slaughter, should be prepared for the butcher and slaughtered when fit, being in the meantime removed and isolated from those in which no reaction had taken place. That the healthy stock be again tested and the same rules applied. 2d. For dealing with Breeding Stock—In dealing with breed- ing stock, I can do no better than quote from Nocard, who says: “All those engaged in agriculture, in breeding, rearing, feeding, or fattening, ought to carry out each for himself the prophylaxis of the disease. Each of them is directly interested in it. The methodical use of tuberculin, by denouncing the sick animals at the outset of the disease, permits one to isolate them, and to protect the sound animals from all danger of contamination. As the young animals mostly escape the infection, breeding would not be seriously interfered with, and the vacant spaces would be filled in a few years. Of course, a farm once made healthy ought to be protected from re-infection. To effect this it would be sufficient to introduce into it no new animals without having them previously tested with tuberculin. Professor Bang of Copenhagen has a similar scheme, and has, according to his last report, carried it to a successful issue. He proceeds as follows :— The whole herd is tested with tuberculin, and thus divided into a healthy and a tuberculous section, which are separated from one another, and have separate attendants. The healthy section is tested every six months with tuberculin, and any animals which react are at once removed to the tuberculous section. Those animals of the tuberculous section which are obviously affected are got rid of ; but those which are apparently healthy are kept and used for breeding purposes as long as may be convenient, and as they will generally be fattened for slaughter before the disease is far advanced, the total condem- nation of their carcases as butchers’ meat will not, as a rule, be necessary. The calves of the tubercular section are removed to. 384 CONTAGIOUS DISEASES. the healthy section immediately after birth, and are fed for the first day on colostrum, which has been heated to 65° C.— 149° Fahr.—and subsequently on boiled milk, this boiled milk being from tuberculous cows. At first these calves were kept in separate boxes, and only added to the sound section when they had successfully under- gone the tuberculin test, but he now thinks that they may with safety be removed to the sound section immediately after birth, and wait till the time of the general half-yearly testing with tuberculin. In carrying out the above, I think the Government might safely devote an annual sum of money to assist cattle-owners in suppressing so great and increasing an evil as tuberculosis ; and, being of opinion that the schemes are tangible and reason- able, I would now suggest that tuberculosis be included in the statutory schedule of infectious diseases, and that compensation be paid to the owners of cattle affected with tuberculosis when such cattle are slauglitered in the public interest. The eradication of tuberculosis is a question of absorbing interest, but difficult of practical realisation. There should certainly be more endeavour made to limit the progress of the disease amongst cattle, and undoubtedly the first attempt should be made with milch cows. The amount of disease that it is possible to disseminate in milk is incalculable. The present indiscriminate regulations, which are applicable in some places and not in others, are useless from a general practical view. It would appear that nothing can be accom- plished until the State will compensate farmers for the loss that would be occasioned by compulsory slaughter, as is done in the United States, and this method should be adopted. The initial cost would be heavy, but it would not be a heavy recurrent one, and the benefits would be enormous. By the use of tuberculin, diagnosis may be made quickly, and in the early stages, when by slaughter the greater part of the meat would be good. This, in combination with the increasing number of phthisical homes and retreats for consumptives, would in a few years cause a great diminution in the ravages of this scourge. Even with the paltry measures now adopted in some towns in dairy inspection, great improvements are acknowledged, but it is unfair to ask the farmer to do even as much as he is doing without compensation. CHAPTER XXXVI. CONTAGIOUS DISEASE S—continued. TETANUS (LOCKJAW). Tetanus is usually described as a powerful and painful spasm of the voluntary muscles, which is long-continued and uncon- trollable. The spasm of the muscles is that of rigid contrac- tion, and from its constancy and non-intermitting character it has been termed tonic. It is due to the presence of the bacilli of tetanus in a wound (see fig. 34, p. 888). Of all the domestic animals, the horse is most liable to tetanus. It is but rarely seen in the ox or dog. Tetanus may result from a very trivial injury, although it is most likely to do so after a severe laceration or puncture, more especially when nerves are injured. Wounds of the feet and joints, although giving rise to a high degree of irritative fever, seldom favourably harbour the tetanus bacilli, and in my experience wounds in the region of the quarters, thighs, and fore-arm, more especially if the great nerves of those parts are injured, are those most liable to encourage its growth. The operations which are most commonly succeeded by tetanus are docking, castration, the insertion of setons, and in one instance which fell under my notice a moderate blister to a fore-leg was a precursor of tetanus. Tetanus is rarely seen in certain districts. Mr. Cartwright, of Whitchurch, informed me that he had never seen a case of tetanus in his district, although he practised there for forty- five years; and during the ten years I practised in Bradford I saw but two cases. In other districts of the country tetanus is exceedingly prevalent. Tetanus is occasionally seen as an enzootic disease, simul- 3885 25 886 CONTAGIOUS DISEASES. taneously attacking several animals in the same district. During the summer of 1858 I witnessed ten cases in a fort- night. Some writers on veterinary surgery state that tetanus is more apt to prevail in cold than in hot weather. My experience is contrary to this, and that it is mostly during warm weather that the disease prevails to any extent, although isolated cases of it occur at all times of the year. There are several varieties of symptoms of the disease, and the word tetanus is made use of to denote it generally. Asa generic term, it comprehends all the varieties, but when not used in this sense it implies that the disease involves all classes of muscles equally. When the muscles of mastication are alone involved, it is called trismus. When it chiefly affects the superior cervical and dorsal muscles, causing the head to be elevated and the spine curved downwards, it is called opisthotonos. When the muscles of one side are affected, it is called tetanus lateralis or plewrosthotonos ; and in other cases— rare even in the human being—the inferior muscles are chiefly affected, the chin drawn towards the breast, the spine curved backwards, the disease is named emprosthotonos. In the lower animals, trismus, with opisthotonos, is generally met with. I have seen a modified form of tetanus lateralis, but the other form—namely, emprosthotonos—is, I think, unknown in either horse or ox. Tetanus, whatever be the variety, may be acute, subacute, or even chronic. The acute is that which is most common, and most fatal; it has a tendency to involve the whole frame, and to destroy life by arresting the respiratory movements. Amongst the uncommon variety of causes of wounds which may permit of the entrance of the bacilli of tetanus, in addi- tion to external wounds, I have observed worms in the stomach and intestinal canal, collections of sand in the large intestines, and uterine irritation after abortion. Tetanus follows injuries, whether inflicted surgically or otherwise, in an indefinite but limited period of time; but usually the occurrence of the spasm is not observed until the wound is nearly or quite healed. Neglect in the treatment of, the presence of a foreign body in, or the application of irritating medicaments to, a wound, is apt to favour tetanus. The Symptoms of Tetanus.—In the earliest stage there will TETANUS, 387 be a stiffness of the muscles near the seat of the injury; if a limb is wounded, the animal will move it with diffienlty ; the stiffmess spreads over the whole body; the animal will begin to champ his jaws and grind his teeth, the power of opening the mouth gradually diminishing, until the jaws become firmly locked. There is often a flow of saliva from the mouth and a collection of froth upon the lips. The breathing now becomes accelerated, the nostrils dilated, the nose protruded, the membrana nictitantes pushed more or less over the eyes, which are withdrawn within their sockets, best observed when the patient’s head is elevated or he becomes excited. If the animal be suddenly disturbed, the superficial muscles will be seen to twitch or tremble; the eyeballs, convulsively with- drawn within the orbits, causing the patient to show the white of the eye at every convulsive retraction ; the tail is suddenly elevated, and is maintained in that position by an irregular clonic spasmodic action of the levator muscles so long as the excitement continues. At first the pulse is not much affected, and in all but the most severe attacks it continues undisturbed for two or three days. It has a hard, incompressible character, however, and as the disease advances it becomes accelerated, harder, and more incompressible. When the spasm becomes general, the position of the various parts of the body is regulated by the action of the more powerful muscles. The limbs are extended, flexion of them is performed with difficulty, and the patient stands with outstretched limbs, and there is a hyperesthetic condition of the skin. The course of the levator humert can be easily traced, and the contraction of this, and other muscles which act upon the superior part of the cervical region, cause the neck to assume the appearance of what is termed “ewe neck.” The peristaltic motion of the bowels is stopped; the urinary bladder firmly contracted; a dry, husky cough comes on when the animal attempts to swallow, and the act of deglutition is performed with a difficulty which increases from day to day. The muscles of the abdomen are rigid; the belly looks small and hard; the intercostals act imperfectly; and when the diaphragm becomes involved, the breathing is per- formed with very great difficulty. Although the spasm of tetanus is of the tonic or persistent 25—2 388 CONTAGIOUS. DISEASES. kind, there are exacerbations of a clonic intermittent char- acter; and the whole course of the disease is marked by paroxysms of great severity if the animal be subjected to meddling attendance, strong light, or rustling noises. In a modified light, and when the animal is kept quiet, the spasms are usually diminished and the exacerbations much milder. For many years it was suspected by many English veteri- narians that tetanus was both a contagious and infectious disease. The contagiousness of tetanus has now been con- clusively proved, the disease having been transmitted by inoculation, even with tetanin (without bacilli) obtained from the spinal cord of tetanic subjects. Fic. 34.—Bacilli of tetanus. x 3500. The contagiousness of the disease is due to a micro-organism —the Bacillus tetani—described by Nicolayer, 1884, and by Rosenbach, which gives rise to the formation of a toxin termed Tetanin. This organism is longer but narrower than that of anthrax, having one enlarged spore-bearing end. Nocard has demonstrated that dried blood and pus scraped from instruments employed in castrating horses, all of which had died from tetanus, caused the disease when inoculated into rabbits. The Bacillus tetant is also found in garden mould, and it is possible to explain the non-existence or rarity of the disease in some districts, and its prevalence in others, upon the assumption that the organism common to the soil gains entrance to the animal economy. TETANUS. 389 Bearing these conclusions in mind, the practitioner will not fail to see the probable and beneficial effects of germicide treatment, both locally and generally. Weak sublimate dress- ings to the wound, tincture of iodine, iodide of potassium, carbolates, salicylates, and biborates internally. In post mortem examinations of tetanus I have invariably found the nerves leading from the injured parts to present some signs of inflammation; the newrilemma more vascular than natural, the vessels of the spinal cord engorged, and the sub-arachnoid space to contain some effusion. Treatment of Tetanus.—Suppose the disease to be caused by docking or neurotomy, the first question to be considered is whether a portion of the stump of the tail or the end of the nerve should be removed or not. The nervous irritation is due to the nervous fibrille of the part being irritated by the tetanin from the bacilli which are in the immediate neigh- bourhood, so that further amputation of the tail or excision of the nerve will afford relief. The wounds, or the seats of them, if healed, are in all cases to be fomented, and after being thoroughly cleansed, should be saturated with weak tincture of iodine twice daily. Should tetanus occur soon after an injury is inflicted, the wound should be examined, and any lacerated or partially divided nerve, foreign body, or dead tissue removed. There are some cases of tetanus so acute from their com- mencement that it is quite hopeless to expect any but a fatal termination; and in every case where all the symptoms are firmly established before the fourth day of attack, death may be expected. But in cases where the symptoms are slowly developed, some movement of the jaws still remaining, the exacerbations not very severe—more especially if the animal possess a calm quiet temper, and lives over the ninth day—a recovery may be expected. The wound having been properly attended to, the next thing to be done is to place the animal loosely in slings; this ought to be done early, and before the nervous excitability becomes too great. If the patient is comfortably slung, he will get used to the slings before the malady has attained its height. I recommend the slings, because many horses which are in a fair way of recovery lie or fall down when the muscles begin 390 CONTAGIOUS DISEASES. to relax, and, when down, struggle and fight to such an extent that they seldom recover from the excitement and renewed severity of the disease thus brought on. The surroundings of the patient are of the utmost importance; the stable must be darkened; should contain no other horses; be situated in a quiet spot, removed from noises, and the door must have a lock, a key of which is to be kept by one individual (the veterinary surgeon, if possible), who is to visit the patient at most twice a day. and great care must be taken that the animal is not tormented by flies. As a rule, the desire for food continues for several days; the thirst is considerable, and large quantities of nutritious fluids will be drunk with avidity. Quietude having been secured, nourishment is to be given by allowing the patient milk and thick gruel to drink; along with these, eggs may be mixed with advantage. A little hay or grass placed in the rack will often keep the animal quiet, although the attempts to swallow sometimes cause a paroxysm. The medicinal agents that have been used in the treatment of tetanus are numerous—purgatives, opium, tobacco, Calabar bean, woorara, prussic acid, calomel, chloroform, belladonna, hyoscyamus, cannabis indica, arsenic, chloral-hydrate, &c., &e. Ihave treated tetanus in various ways, and am satisfied that administration of a dose of aloes, if it can be given with- out exciting the horse, followed by belladonna—which is only to be given when the patient shows symptoms of great excite- ment—is the best method of treatment. The Calabar bean, given in doses of two to four ounces of the tincture, has a most wonderful effect upon the spasms, the pulse, and the breathing; but this effect is very transient, and is succeeded by a return of the spasms with great severity. The seat of the wound is from time to time to be smeared with the extract of belladonna; and when the belladonna is administered internally, it should be either dissolved in the animal’s mash or drink, or else placed between his teeth, allowance being made for the probable waste. The prussic acid treatment, so highly recommended by the late Mr. Lawson of Manchester, has with me proved to have no special superiority; and doubtless the success of Mr. TETANUS, 391 Lawson in the treatment of tetanus was due more to the tact and skill of the man than to any virtue contained in the remedy. The reviser of this work is greatly in favour of the internal administration of iodide of potassium and the external appli- cation of weak tincture of iodine twice daily, along the course of the nerves of the injured limb, and also to the wound itself. Anti-tetanin at one time was considered of considerable value in the treatment of the disease, but it has not proved successful ; although as a preventive of the disease, if injected in doses of 10 to 20 e.c. for the horse, within a day or so of an accident, or at the time of a surgical operation, it is of the utmost value, and should always be made use of by veterinary surgeons whenever they perform operations or have wounded patients. During an experience abroad, acting as Veterinary Adviser to the British Remount Commission, some tens of thousands of horses, cobs, and mules (all of which came long distances by train) were received by me for shipment across the seas. Many on arrival were found to have severe punctured wounds, either from gathered nails, or running into stakes, or by the prods of the nigger’s driving-pole, often with,a nail in the end of it. I had every injured animal injected with anti-tetanin, and had not one single case of tetanus, though the disease was rampant in that country, which was very swampy, and the local practitioners could always show me a case or two. Working in the knowledge that the toxin of tetanus com- bines specially with nerve-matter—in fact, seems to have an affinity for it—Fiebiger takes the fresh brain of a lamb, emulsifies it with physiological salt solution, and injects about 16 ounces of it below the skin. This seems to be a good curative agent in many cases of tetanus, and is certainly well worth trying, as anti-tetanin seems of little or no value once the disease is established. Those cases of tetanus which terminate favourably take usually about six weeks before the spasmodic contractions entirely subside. As soon as they can eat good food, they are to have it liberally. Corn, roots, and hay in the winter, 392 CONTAGIOUS DISEASES. corn and grass in the summer, and a few doses of tonic medicine, such as the sulphate of iron, will materially assist convalescence. In the fatal cases of tetanus, the breath very frequently becomes foetid prior to death, and if the mouth be examined, a quantity of slate-coloured epithelium will be found on the inner surfaces of the lips, gums, and tongue. ; if CHAPTER XXXVILI. CONTAGIOUS DISEASE S—continued. HEMORRHAGIC SEPTICAIMIA (OR PASTEUREL- LOSIS). Accorpine to some authorities, this hemorrhagic septicemia is a most inclusive term, and is applied to a variety of diseases due to Pasteurella—namely, deer disease, buffalo disease, gloss anthrax, swine plague, fowl cholera, fowl diphtheria, contagious pneumonia of the horse, Irish white scour in calves, influenza in horses, distemper in dogs, Stuttgart’s disease in dogs, septic pleuro-pneumonia of calves, cornstalk disease of cattle, and Newmarket fever. In all of these diseases the causal agent is a cocco-bacillus, non-motile, polymorphous, both aérobic and anaérobic, and which does not form spores nor does it stain by Gram’s method. These cocco-bacilli, or Pasteurella, appear to be everywhere—in water, soil, food, in the respiratory and digestive tracts of all animals, and seem as if lying in wait for an opportunity to gain access to the animal economy and give rise to disease. In cattle we frequently see three forms of the disease : 1. The exanthematic form, which is characterised by its rapidity of onset and course and its fatal termination. The animal ceases to feed or ruminate, the temperature may rise as high as 108° to 109° F., the breathing becomes hurried and laboured, and there is frequently a bloody discharge from the nostrils and bowels, large swellings of a tense nature appear at the throat, in the dewlap, the fetlocks, and behind the shoulders. In many cases there is so much swelling round the throat that the tongue becomes purple and swollen and protrudes 393 394 CONTAGIOUS DISEASE. from the mouth, and there is interference both with deglu- tition and respiration, and the animals rapidly succumb. 2. The lung form, in which there are exanthematic lesions with a croupous pneumonia and a pleurisy, the exudate into the chest cavity being very large in quantity. 3. The intestinal form, in which there are gastritis and enteritis, and in these cases there are usually the skin and subcutaneous tissue exudates. On post mortem examination, the most marked lesions are exudations of serum into subcutaneous tissues and around the various lymphatic glands, and a general dissemination of minute hemorrhages or petechie throughout the subserous and submucous membranes. Microscopic examination reveals the presence of the organism, and subcutaneous injection of infected fluid into horses, cattle, pigs, or rabbits, causes death, with similar symptoms, in about twenty-four to forty-eight hours. The disease is often enzootic, and is found on marshy, low- lying pastures and in badly-drained and ill-ventilated stables. Preventive measures to be adopted are: Remove the animals from unhealthy surroundings, administer hypo- sulphite of soda night and morning, and build up the strength with good foods and tonics. , If necessary, the unaffected animals may be protected by injecting what is known as Ligniére’s polyvalent vaccine. This vaccine consists of a mixture of the cultures of the various Pasteurelle, and is used in two strengths—firstly, an injection of a weak vaccine; and, secondly, a stronger vaccine in the couree of about twelve or fifteen days. This protection is only expected to last about a year. It is to be noted, in many cases of disease and death, occurring in live stock, particularly in cattle, due to the drinking of water contaminated with decomposing animal and vegetable matter, that the actual cause of death is due to a Pasteurella invasion. The animal’s system becomes so depressed and vitiated that it can no longer resist the entrance of the Pasteurella, and thus we have various forms of hawmor- rhagic septicemia, some even resembling rinderpest, others akin to anthrax, and others, again, exhibiting a septic con- dition of the womb. %. HAMORRHAGIC SEPTICEMIA, 395 Bowhill, a well-known veterinary pathologist and a most careful observer, says in his 1906 Report to the Department of Agriculture, Cape of Good Hope : “T am now in a position to present for your further consideration and information experimental proof in support of my previous contentions regarding the rdle played by organisms of the Pasteurella and allied group of bacteria in some of the prevailing diseases in the Eastern Coastal Dis- tricts. From the various animals I have been able to isolate typical cultures of the organisms belonging to the Pasteurella and allied species, and in most instances have been able to produce a similar disease with cultures obtained from the original species. The disease amongst the cattle, especially the acute cases, have in many instances been mistaken for anthrax. The organisms isolated from the various animals are morphologically indistinguishable one from the other, but this does not prove that they are one and the same. They are, however, individually capable of causing a specific disease under natural conditions in animals specially predisposed to their action. Nevertheless, some of the organisms under consideration have produced death, associated with specific lesions, in more than one species of these animals, when experimentally inoculated. It has been inferred that these organisms have probably a common origin, but that some of them are one and the same has not yet been definitely proved. The results included in this report tend to prove the existence of a very close relationship between the organisms associated with Pasteurella diseases in cattle and sheep. According to Ligniére, many of the organisms of the Pas- teurella group possess the important faculty of causing ephemeral infections ‘so mild that the disease often passes unobserved. Although no symptoms become apparent, the toxins produced facilitate a secondary, multiple, or varied (sometimes) terminal infection by organisms present in either the alimentary or respiratory tracts.’ Ligniére’s observations have enabled the exact nature of many diseases to be deter- mined which were heretofore imperfectly understood. 6 PASTEURELLOSIS OF ADULT CATTLE. “The prevalence of this form of Pasteurella infection in _ the coast-lying districts is a very serious matter, as the out- 396 CONTAGIOUS DISEASES. breaks are becoming more frequent. It has recently been reported on farms where it was previously unknown. There is also evidence that the non-burial or burning of the carcases of animals dead from this malady harbours infection as well as being the means of the disease being spread to neighbour- ing farms by natives, wild dogs, jackals, &. Another source of infection is by means of water contaminated with the dung and urine of infected animals. In the introductory portion of this report it is stated that organisms similar to those described by Ligniére as belonging to the Pasteurella group were isolated from the lesions found in cattle dead of this infection. There is also another very important point to be considered in connection with the cultures obtained, and that is the symbiosis or association of other organisms with those of the Pasteurella group observed. ‘This, no doubt, plays a very important réle in the course of this disease, and an undoubted active part in many virulent and rapidly fatal cases. I have repeatedly found the Bacillus coli, Proteus vulgaris, also Staphylococci and Streptococci associated with the Pasteurella organisms. In many instances, it was only after carefully plating the growths that I was able to obtain pure Pasteurella cultures, the pleomorphic characters of these bacteria causing a lot of extra plating. It must be noted that animals of the same species exhibit a varied susceptibility to the same organism under similar conditions; this is increased by bad or insufficient food or exposure, which all tend to lower animal vitality. In many instances. the disease appears in an acute form; at other times it runs a chronic lingering course; while in others it remains apparently latent, and when the natural resistance of the system is lowered by de- bilitating natural causes or inoculations with other organisms, vaccines, &c., the dormant Pasteurella organisms suddenly acquire an active réle, resulting in a terminal infection. It is in cases of this nature that a mixed growth develops when cultures are instituted. It is also in such cases that the true nature of the Pasteurella infection is often overlooked, and the animal’s death assigned to some other cause. Sanarelli, when he was experimenting with Bacillus typhi abdominalis of man, found that his inoculation experiments with the experimental animals were rendered much more effectual HEMORRHAGIC SEPTICAMIA, 897 when the animals were first inoculated with products of the — of Proteus vulgaris, Bacillus prodigiosus, and Bacillus coli. “T maintain that a similar condition exists amongst animals acquiring Pasteurella infections on this coast. If the intestinal canal be healthy and free from abrasions, ulcers, &c., and there is no abnormal acquirement of the Bacillus coli or other organisms by contaminated drinking- water, &c., there will be consequently no favourable ground for the multiplication of the Pasteurella organisms. The localisation of the lesions, the ‘low adynamic fever, the foul odour of the ejections, and the terminal complications in many of the chronic cases of Pasteurella bovis bear a striking resemblance to paratyphoid in man. In the attenuated form, when the lesions are more or less limited in their extent, it appears probable that in the chronic cases the prolongation of the fatal issue, and consequent continuous production of toxin, accounts for the great anemia present in both cattle and sheep Pasteurelloses; also the microbic changes in the various organs, especially the liver and the abdominal lymph- glands, as well as the derangement of the nervous system, whereby the disease is often erroneously described as Lam- ziekte, a bone disease stated to be due to the want of phos- phates. It is a noteworthy fact that bones taken from typical cases were found on analysis to be normal in the chemical constituents specially described as wanting in Lamziekte. It has lately been shown that the reaction of bone-marrow to septic infection is avery delicate one. There is very early a congestion of the vessels, and increase of the leucoblastic elements, and a disappearance of the fat cells. Carnegie Dixon, in an Edinburgh University thesis (stated as not yet published), shows that the congestion appeared in two to three hours after infection, and leucoblastic transformation is well marked in twenty-four to forty-eight hours. “This will no doubt explain why the congested state of the bones in many of these cases has led to a misunderstand- ing of the true nature of the disease. .In the lymph-glands examined, necrosis of the lymphatic or adenoid tissue and hemorrhage into the medullary spaces were observed, the organism evidently causing a bacterial infarction of the 398 CONTAGIOUS DISEASES. vessels of the cortex and medulla. This agglomeration or _clumping of the organisms no doubt enables them to increase and elaborate toxins. The above changes account for the many involution forms observed in smears prepared from these organs, as well as the difficulty of obtaining cultures in many chronic cases, a difficulty not anticipated when the prepared smears were found on microscopical examination to be teeming with bacteria. In 1904 I described three forms of this bovine infection as prevalent in the coastal area, and since then I have not found any reason to alter the opinion I expressed at that time. The form associated with a swelling of the throat is very fatal. An cedema of the neck, head, and tongue develops in a few hours, associated with great diffi- culty in breathing, frothing at the mouth, the animal being totally unable to swallow, and, owing to pressure on the larynx, the breathing 1s very noisy. The visible mucous membranes are cyanotic, and the tongue, being very much swollen, hangs out. Death occurs sometimes in a few hours, and sometimes the animal dies from suffocation about the third or fourth day. Diarrhea is often present, and at other times the dung is dark coloured, hard, and covered with large pieces of bloody mucus, the odour being most offensive. There is another form that has been of very frequent occur- rence this year. It is associated with extensive thoracic lesions, the chest being full of exudate and also the pericardial sac, the lungs being hyperemic and cdematous, the same being well-marked in the interlobular septa of the lung.” CHAPTER XXXVIIL CONTAGIOUS DISEASE S—continued. CROUP. Youne cattle, varying from a few weeks to a few months old, are subject, when kept on low, damp pastures, more especially in meadows near rivers, and during the fall of the year, to a form of inflammation of the throat, characterised by the formation of a fibrinous exudate or false membrane of a greyish-white colour, sometimes brown or yellow, extending over the larynx, trachea, and sometimes fauces, or the bronchial mucous membrane. Croup differs from ordinary catarrhal laryngitis in a most remarkable manner. In laryngitis there is an increased formation of mucus, which is discharged as quickly as it is formed. In croup, an exudative process attends the inflam- mation in the larynx and trachea, which induces the formation of false membranes, varying in thickness and consistency, some of which being several lines in thickness and very opaque, whilst others are so thin that the mucous membrane is easily seen through them. Some are so firm in consistence that they can be detached for a considerable length without tearing, whilst others are almost diffluent. In colour they vary from a dirty greyish-white to a yellow or yellowish- brown. If an animal be examined post mortem, after the disease has existed for four or five days, the windpipe and larynx will be lined for a considerable distance, in some places partially only; in other parts the entire circumference will be embraced by the false membrane, forming a complete hollow tube or cylinder. The cause of the disease is the necrosis bacillus, a long, slender, thread-like organism, which is Gram negative, and so difficult to stain in tissue. 399 400 CONTAGIOUS DISEASES. Symptoms.—These generally commence with a hoarse cough, discharge of frothy saliva from the mouth, and of mucus from the nose; the animal is unthrifty, has some difficulty in swallowing; sometimes swellings appear in the parotid and submaxillary regions, succeeded by difficulty in breathing, the inspiratory act being accompanied by a crowing noise, and by spasm of the laryngeal muscles, causing violent paroxysms. In other cases the spasmodic affection of the larynx and difficult breathing may occur without any premonitory warn- ing. The pulse, hard and quick at the commencement, becomes feeble and indistinct as the disease advances, the fits of coughing more and more troublesome and violent; paroxysms constantly occur, particularly if the animal be subjected to any sudden excitement. In the course of two or three days flakes of the grey non-yascular and unorganised false membrane are coughed up; the expectoration becomes more profuse; being loosened and detached by a fluid poured from the mucous follicles, until finally separated and cast out; and if the case progresses favourably the false membrane is not again formed, the suppurative process terminating the inflammatory action. If the stethoscope be applied to the larynx and trachea, a peculiar trembling may be detected in places where false membrane exists. Treatment—When the symptoms are very alarming, the breathing difficult, and the noise loud, tracheotomy should be immediately performed; indeed, it is essential that air be ad- mitted early in every severe case, for should the operation be delayed, the blood becomes so overloaded with carbonic acid and effete materials, that the animal succumbs to a condition of blood poisoning. The head is to be steamed for several hours consecutively, and the hot water used for that purpose may contain carbolic acid or iodine. Nitrate of silver in solution may be directly applied to the diseased mucous membrane, as directed in a former page. The solution commonly in use contains half a drachm to the ounce of distilled water. The medicinal treatment will greatly depend upon the con- dition of the animal, but little good need be expected from any very heroic remedies. In the early stages the nitrate or chlorate DIPHTHERIA, 401 of potash are to be given in small doses, or the hyposulphite of soda in the animal’s drinking water. If there be much prostration, spirits of nitrous ether, with camphor, may be prescribed, and in all cases a gentle oleaginous purge may be ordered if the bowels are costive. It must not be forgotten that the patient must be kept in a warm, dry shed, and have the body clothed if the weather be cold. The croup of fowls must not be confused with this croup of calves, as it is usually parasitic and due to the thread-worm, Syngamus (vide Parasites). DIPHTHERIA. Diphtheria may be described as a specific blood disease, associated with sore throat of great severity, attended with extreme prostration, and characterised by exudation of false membrane upon and pulpification of the mucous membrane of the throat and sometimes that of the nose. In the Veterinary Journal for August, 1875, Mr. W. Robertson, Kelso, reports some facts in connection with the occurrence of diphtheria in dogs and horses, and places on record the causes, spread, and subsidences in two particular outbreaks—one amongst horses, the other amongst dogs. Mr. Robertson restricts the term ‘‘ diphtheria” to ‘ that specific sore throat ordinarily regarded as contagious, accom- panied with much systemic disturbance, and tending to laryngeal croup.” The difference between a croupous and diphtheritic membrane is that in the former the false mem- brane may be stripped off, leaving, under favourable conditions, a healthy granulous surface; in the latter this membrane is adherent and will not strip off, but tends to increase in thickness and plasticity. The disease diphtheria does not exist in the lower animals, except possibly in the cat; but there are conditions in which there is the formation of a diphtheritic membrane, although it is unassociated with Léffler’s bacillus of diphtheria. In both the outbreaks the fatality was great, all the horses— five in number—dying; in the case of the dogs, there were three or four recoveries from between thirty and forty seizures. Asseen in the horses the seizure was in every instance sudden; the animals—farm horses in good working condition, of different 26 402 CONTAGIOUS DISEASES. ages--apparently in the enjoyment of the fullest amount of health and vigour one day, were on the following found unac- countably ill; two, indeed, were only noticed unwell in the evening, having worked all day, and fed with their usual zest, both in the morning and at mid-day. Attention was first directed to the animals from their inability or disinclination to drink when offered water; some pushed their noses into the trough or pail, and seemed attempting to swallow, but at once desisted, or the water returned by the nose. The breathing was at the same time noticed to be rather faster than natural, and the nose slightly pushed forward; occasional muscular tremors at this time showed themselves, and the animals were rather restless or uneasy. There was little or no cough, and when it did exist, it seemed merely to result from, attempts made to swallow. The glands of the throat were slightly swollen from the first, but certainly did not increase much during the period the animals lived. The temperature rose rapidly, and continued high until shortly before death ; while the pulse was accelerated about one-half, but was considerably less*in volume and force. In one case there were well-marked symptoms of abdominal pain from the outset of the disease, with no abdominal organic lesion observable after death to account for these. In this instance there was also very noisy breathing; this, however, was accounted for at the post mortem examination, which showed more extensive involvement of the larynx and trachea than any of the others. None of these animals lived over the fifth day, and two of them died within forty-eight hours. I have never witnessed a disease similar to that described by Mr. Robertson in the horse; but during. the winter 18'78-9 I had the opportunity of seeing several dogs, the property of various owners, that had this fatal form of sore throat, and which pre- sented signs very nearly approaching those of diphtheria as described by physicians. The symptoms were those of great prostration and languor; flow of tears from the eyes; a very sunken and pinched ap- pearance of the face; the power of swallowing completely lost; inability to close the mouth, which in all cases was persistently open, the muscles of mastication, as well as those of deglutition, having lost their function either from paralysis or inflammation. Indeed, the first symptom observed was a dropping of the lower DIPHTHERIA, 403 jaw, and on this account it was supposed by the owners the disease was dumb madness; a more or less copious discharge of a viscid ropy saliva from the mouth, dirty yellowish-red tongue, the neck stretched and rigid, the glands slightly swollen, cedematous, and painful to the touch. Diarrhoea was present in all, and the posterior extremities were paralyzed. The mucous membrane of the mouth and fauces was of a dark red colour, swollen, tense, and glistening from extraneous infil- tration, but no ulcers were observable. Three of the dogs died in from twenty-four to forty hours after they were first observed, but the fourth, a staghound, lived for four days, the symptoms in it having been much more gradually developed. In none of the dogs were convulsions or coma present; they all remained conscious to the last, evi- dently dying from diarrhoea and exhaustion. No history could be obtained with any of the dogs. One was a lady’s pet dog, and was daintily fed; another was a brewer's yard dog, always on the chain; so it was impossible, in these two cases at least, that the disease could have been induced by any tainted—infected—food, even if diphtheria had prevailed amongst the inhabitants of Edinburgh. Such, however, was not the case, diphtheria being entirely absent at that time. _ The disease did not seem contagious or infectious, there being several dogs at the College at the time; some of these, owned by students, being confined in the boxes in which the diseased ones had died for the purpose of testing its contagiousness. One dog was inoculated, the results being negative. Mr. Robertson traces the outbreaks which he witnessed to unsatisfactory sanitary conditions of the stable and kennels. These being drained and better ventilated the disease disappeared. Post mortem appearances——The post mortem appearances in four different cases examined at the College in 1879 were pretty much alike. A frothy mucus escaped from the nose and mouth, and the joints remained quite flaccid for three or four days. On cutting through the skin, the larger veins were found to be engorged with extremely black fluid blood ; and on pricking an artery, blood of the same colour and consistency exuded from it. The mucous membrane of the mouth, and all other mucous cavities, was very much congested, and covered by a frothy mucus; that of the fauces and tonsilar cavities being extremely 26—2 404, CONTAGIOUS DISEASES, so in two cases, having commenced to undergo granular degener- ation; in a third, a false membrane had formed over the glottis. All the cavities of the heart were filled with black fluid blood, and only here was there any appearance of its coagulating, and the pericardial sac contained a quantity of fluid. The surface of the lungs looked unnaturally red, with here and there small dark spots; and on cutting into its tissue, the same dark fiuid blood exuded from it. The stomachs, as in rabies, in two cases were filled with straw, stones, and other rubbish; but in the other two no such materials were found there. The kidneys were also engorged with black blood. Some interesting experiments are published in the Veterinary Journal for August 1875 as to the transmissibility of diphtheria, which the reader may profitably consult. Treatment.—The treatment indicated by the symptoms is that calculated to destroy a virus, and for this purpose antiseptics, such as carbolic acid, might be worthy of trial. If the power of swallowing be completely lost, subcutaneous injections might be iried, and the throat repeatedly dressed with it or a solution of permanganate of potash. Experimental inoculations with the diphtheric products of man have hitherto failed to induce the disease in animals, but it has been discovered that the serum of horses inoculated with diph- theric products furnishes an antitoxin which not only gives immunity, but has a powerful curative action when the disease is actually established in the human being; if applied in the early stages, the mortality is reduced as much as two-thirds. CHAPTER XXXIX. ENZOOTIC AND EPIZOOTIC DISEASES. INFLUENZA. Unver this term is included three diseases, which every now und then prevail as epizootics in this and other countries, and which have been indiscriminately. denominated fever of the horse, epizootic of the horse, nervous fever, putrid fever, infectious pneumonia, typhus, &c. Falke, however, has reduced these to two conditions recog- nised under the term injluenza—namely, the red disease, for which he has reserved the term influenza, and the other form he has named typhus. Whilst giving due credit to Falke for endeavouring to abolish the mystification concerning influenza, I feel constrained to state that under the term I can recognise three different morbid conditions, namely—(1) LE pizootic catarrhal fever; (2) Epizootic cellulitis or pink-eye; and (8), Epizootic pnewmonia, all being due to sapremic organisms generally existent in large horse establishments, and liable to cause epizootic outbreaks under certain alterations of external surroundings, which seem to determine either the receptivity of animals subjected to their action, or a transformation of the vital properties of the microbes. For example, the disease may have been absent in a stable for a period of time, or until fresh animals are introduced. Then there is an outbreak of the malady amongst the freshly-introduced animals, and from which it spreads indefinitely amongst those which have had immediate or mediate contact. Here I think we have an example of the action of a non-contagious facultative parasite becoming transformed during its passage through the animal body into a contagious parasitic microbe, and which at first is thus increased in virulence, and after a period of time the 405 406 ENZOOTIC AND EPIZOOTIC DISEASES. intensity of this virulence seems to become exhausted, and the microbe again is transformed to its original nature, often to remain dormant until some cause is brought into operation by which its morbific effects are again reproduced. 1s¢.—PANZOOTIC CATARRHAL FEVER OR INFLUENZA. An epizootic febrile disease attended with great prostration of strength, and with early inflammation of the nasal, laryngeal, and sometimes bronchial mucous membrane, complicated with irritability of the digestive mucous membrane. Occasionally the disease implicates the substance of the lungs, pleura, liver, the fibrous structures of the articulations, thecee of muscles and tendons, and the connective tissue of various parts of the body. Synonyms.—Distemper ; epidemic catarrh ; epizootic catarrhal fever; (F.) courbature, morfondure ; (L.) febris catarrhalis, de- fluxio catarrhalis, &c. The disease was first called influenza in Italy in the seventeenth century, because it was attributed to the influence of the stars. Panzootic catarrhal fever or influenza has a very early history, but to trace this would be beyond the purpose of this work. In 1299 it appeared in Seville, and is referred to by the veteri- narians Martin Arrendondo and Fernando Calvo, who derived their information from Laurentius Rusius. It killed more than ene thousand horses and seemed to be incurable. “In 1648 an epizootic broke out amongst the horses of the French army in Germany,and is described by Solleysell. It began by fever, great prostration, and tears running from the eyes, and - there was an abundant discharge of a greenish colour from the nostrils.”—(FLEMING.) In 1688 influenza was prevalent over the whole of Europe, affecting both men and horses. In 1699 Europe and America suffered from the disease, and again in 1732 it pre- vailed in both hemispheres. In 1767 it once more appeared in both hemispheres, and it is recorded that both horses and dogs were liable to its attacks. In 1776, after a very severe winter and warm summer, with an earthquake in Wales, influenza spread over Europe, attacking horses and dogs first, and human beings after. Poultry died in great numbers of an epizootic with defluxion from the eyes. This epizootic was observed in Edinburgh in December, and in England at the commencement of January INFLUENZA. 407 1788. Influenza was very severe in New York, and caused great mortality amongst the horses of Maryland. During the present century the disease has raged with varying degrees of virulence in 1849-50, 1863-4; and the last outbreaks we have to record are— Influenza in Britain in 187i-72.—This outbreak was mostly confined to the English metropolis ; it was of a severe but not fatal type; in 1891-92 it was general all over Great Britain. The American Horse Disease, 1872-73.—This disease broke out in Toronto, Canada, on October Ist, 1872. In nine days it had attacked nearly all the horses in the city, and carriages could not be had for any price. On October 18th it had reached Mont- real, and was prevalent throughout Canada. On 14th October it had reached Buffalo ; 17th, Rochester ; 22d, Boston, New York, Brooklyn, and Jersey City ; 27th, Philadelphia ; 28th, Washing- ton. It made its appearance in Nova Scotia on October 13th. Mr. James Law warmly advocates the contagious origin of this epizootic. Mr. Greene, M.R.C.V.S., St. John’s, N.B., records the following important fact :—*I was always under the impres- sion that influenza was both contagious and infectious till the late outbreak ; since then I have altered my views with regard to the contagion and infection of that disease. One among several facts which I could mention will bear me out in this question. “During the month of July 1872 a horse had been put to grass on Partridge Island, in the Bay of Fundy. This island is three miles distant from this city. No other horse had been near the island from the date of his landing up to the time of the outbreak in St. John’s, N.B., and on the 15th or 16th of October, which was only two or three days after the first case was reported in this city, the horse on the island was affected with the most violent form of the epizootic. “Would not the morbific matter have become diluted to such an extent (after travelling three miles) as to be inert ?”— (Veterinarian, April 1873.) ETIOLOGY. The microbe cause of influenza is not determined. The disease may occur spontanecusly in various places, but its first source of origin cannot be indicated. It does not depend upon any known condition of the atmosphere, nor upon soil, seasons, or temperature. It prevails on every soil and geological for- 408 ENZOOTIC AND EPIZOOTIC DISEASES, mation, sometimes more so in low-lying districts than on the hills. It may appear at all times of the year; perhaps it is more commonly seen in autumn, winter, and spring than in summer. Very often, however, its worst form is seen during the hot summer months. Influenza has often appeared in foggy weather, but outbreaks have occurred without such a coincidence, and consequently no weight can be attached to this circumstance. Its spread is not influenced by the wind ; sometimes it moves against it. “The outbreak of 1766 and the American one of 1872 suc- ceeded to two very similar climatic conditions. The winters had been exceedingly severe and the summers unusually hot, and earthquakes had been frequent.’—(Law.) Similar climatic conditions have, however, not been followed by an outbreak of influenza; and as in the case of fogs, mildews, &e., the coincidence can only be looked upon as accidental. Sudden changes of temperature appear to assist the develop- ment of the influenza poison, and exposure to cold predisposes the animal to the disease, but neither of these causes is suffi- cient of itself to produce it. Ozone in undue quantity in the atmosphere has been supposed to be a cause of influenza. This is, however, highly improbable, as ozone, although an irritant to the mucous membrance of the nose when applied in large quantities, has no effect on the nervous system like the influenza poison. Influenza, like contagious pneumonia, is due to an organism of the Pasteurella variety, in all probability identical or nearly related to that organism. The diseases said to be due to these organisms are now very considerable, and it is somewhat remarkable in what different ways very similar organisms manifest themselves. We have perhaps accepted the Pas- teurella too freely, but evidence is sufficient to show that these organisms, so prevalent and widespread in nature, are a never-ending source of trouble, and at all times have the power of acting in an actively pathogenic manner. Until further evidence is forthcoming we must accept the Pas- teurella as the causative organism of influenza (see Hemor- hagic Septicemia). Predisposing causes.—Animals crowded together in damp, ill-ventilated, and otherwise unhealthy situations, are generally INFLUENZA. 409 the first to suffer from influenza. In them it commits its greatest havoc. Young horses are more predisposed than those of maturer years; still, the old suffer severely, and are often carried away. Sex has no influence. Neglect of every de- scription, as well as bad food and over-work, by debilitating, render animals subject to severe and early attacks of disease. But no amount of care will exempt them from it, as it appears in the stable of the nobleman as well as that of the poorest carter. The latter, however, experiences it in its greatest intensity, and at a much earlier period than the former. PATHOLOGY. The morbific agent absorbed into the blood gives rise to febrile disturbance and depression of the nervous centres. The period of latency, between the reception of the poison and the first manifestation of symptoms, is short but uncertain. To the febrile symptoms succeed those of the specific effect of the poison upon the mucous membrane of the nose, eyes, throat, and respiratory tract, as well as the intestinal mucous membrane and its ramifi- cations in the biliary tubes. In some cases, the genito-urinal mucous membrane may participate in the inflammation, and in the majority there is more or less sympathetic or actual irritation of ail the mucous membranes of the animal body. In the majority of instances the fever precedes the catarrhal symptoms ; the rigors, increased frequency of pulse, and eleva- tion of temperature to 103° or 104° Fahrenheit, being observable prior to the appearance of any localization of the disorder. In other instances the irritation of the mucous membrane has been the first appreciable sign. In uncomplicated cases the fever begins to abate in from three to five days, leaving the animal weak and prostrate. It cannot be said that the fever terminates in a critical dis- charge, as in the human being. All that can be observed is that, coincident with the abatement of the fever, the secretions of the body become natural or slightly increased ; the critical sweat, diuresis, or diarrhoea so generally observed in the human being, are usually absent in the horse. Complications—The catarrhal form is the one to be regarded as the simple or uncomplicated; to this is added, in some in- stances, pulmonic, gastro-enteric, hepatic, and rheumatic com- 410 ENZOOTIC AND EPIZOOTIC DISEASES. plications, peri- or endo-carditis, the formation of thrombi, and nervous symptoms, as convulsive fits and coma. Symptoms of the catarrhal form.—Actual rigor may or may not precede the other symptoms; very possibly the rigor is not observed. There is a dry, staring coat, the legs, ears, and nose are cold, with redness and dryness of the Schneiderian membrane, and an elevation of temperature to 103-4-5-7° F. or higher. There is sneezing, a hacking cough, and shortly a defluxion, from one or both nostrils, of at first a thin, more or less acrid mucus. The eyes are heavy, conjunctive injected and sometimes yellow, and tears flow over the face. The symptoms increase in inten- sity for two or even three days. The discharge from the nose becomes flaky and more profuse. In some cases the conjunctiva of one or both eyes is actually inflamed, as marked by opacity and imperfect vision or actual blindness, and there is partial or entire loss of appetite. The cough now becomes deep, sonorous, painful, and paroxysmal, convulsing the whole body, occasioning impatience, stamping of the feet, and great distress. The tem- perature of the surface of the body and extremities is very variable, sometimes high, sometimes low, or one leg hot, three legs cold, and vice versa. The pulse is feeble and easily compressed, numbering generally from sixty to eighty beats per minute. The mouth is hot and clammy, and the desire for water is intensified. ‘The head is generally depressed. The animal is made to move with difficulty, and when compelled, he does so in an unsteady manner, swaying from side to side as if partially paralyzed. This muscular debility is much increased where there is great soreness of the throat and inability to swallow food or drink. Soreness of the throat is indicated by “ quidding of the food” (that is to say, the food is chewed and ejected from the mouth), or by its return through the nostrils. In the latter case an attempt to swallow excites a violent fit of coughing, and the food imprisoned behind the velum pendulum palati is forced into the nasal chambers. It there tinges the mucus discharges with its own colour; and when the horse is fed on grass the nasal discharge is thus turned green—a cause of great fear to some people, who at once conclude that the green discharge indicates something mysterious. The conditions of the secretions.—In the earlier stages the fzces INFLUENZA. 411 are dry, hard, pellety, and often covered with mucus ; the urine high-coloured and scanty, sometimes tinged with bile, some- times opaque, and sometimes of the consistence and appearance of linseed oil, containing albumen, or loaded with urea and hippuric acid. In a period of time varying from three to five days the symp- toms begin to abate in intensity. The discharge from the nose becomes thick, yellow, and profuse; the cough looser, moist, and not so paroxysmal; the pulse gradually falls in number and improves in tone; the action of the heart is less jerky; the appetite improves; the throat can now be handled without causing the animal to cough. Any swelling of the throat which might have been present gradually subsides, and strength is generally restored in from twelve to fifteen days. The leading character of the disease consists of an inflamma- tion of the naso-pharyngeal mucous membrane; it also gives to the secretory organs a tendency to participate in the disease. Thus it is not at all uncommon for the submaxillary and parotid glands to become inflamed, swollen, and even to suppurate. When the critical stage has passed, the debility is generally very extreme, and the loss of flesh most marked. Indeed, it is a common observation that a horse in which the fever has abated and convalescence commenced, “ looks as if the flesh has melted off his bones.” Owing to the debility of the circulation, dropsical swellings appear on the belly, legs, and chest. These, however, are not to be regarded in any way as serious, for as the animal regains its strength they will rapidly disappear. In many instances, more especially in those which have been neglected or maltreated in the earlier stages, bronchitis is apt to supervene, and its accession is indicated by the cough be- coming more paroxysmal,and the difficulty of breathing (dyspnoea) at first quite disproportionate to the other physical signs; the flanks heave, and the nostrils are widely dilated; in many instances the horse is said to fight for breath. The pulse, at first perhaps no quicker than the respiratory movements, which may be as frequent as 60 or 70 per minute, becomes very rapid—-90, 100, or more beats per minute. The auscultatory sounds are, roughness of the inspiratory murmur, best heard at the lower part of the trachea, and im- 412 ENZOOTIC AND EPIZOOTIC DISEASES. mediately behind the scapula, or the sibilant rale heard over the greater part of the chest. The first indicates bronchitis, involving the larger bronchi, the second inflammation of the smaller tubes. The visible mucous membranes become livid, dark purple, or leaden in colour, the animal is semi-torpid from the action of non-oxidized blood on the brain and medulla oblongata. The discharge from the nose differs from that seen in the uncom- plicated form, being scanty, and sometimes streaked with blood, whilst in other cases dark-coloured blood, extravasated from the engorged bronchial blood-vessels, will issue from the nostrils. The pulse now falters, cold sweats appear on the body, and the animal sinks on the sixth, seventh, or eighth day. The bronchitis or broncho-pneumonia of influenza is distin- guished from other chest affections by the greater difficulty of breathing, by the respiratory movements being relatively more disturbed than the action of the heart, by the lividity of the mucous membranes, and by the semi-comatose condition of the affected animal. The pneumonia of influenza is characterised by a soft, dull cough, by rapidity of the pulse, great coldness of the extremities and surface of the body, by crepitation on auscultation and dulness on percussion of the lower parts of the chest, the post mortem revealing desquamation and proliferation of the bronchial epithelium, the presence of catarrhal products in the tubes and vesicles, and by effusion of serosity, mostly confined to the lower portions of the lungs. In consequence of the asthenic nature of the inflammation there is a tendency to gangrene and disintegration of the lung tissue. This termination—a rare one it must be admitted—is expressed by foetor of the breath, sweats over the body, a faltering and excessively feeble pulse, rapid emaciation, looseness of the hair of the mane and tail, rapid sinking, and death. Panzootic catarrhal fever is not very frequently complicated with pleuritis, although, during some seasons, the latter disease rages as an epizootic. Abdominal or enteric complications.—In all catarrhal affections there is great irritability of the gastro-enteric mucous membrane, hence all teachers of experience warn their students to be care- ful in administering purgatives. Succeeding to the naso-laryn- INFLUENZA, 413 geal symptoms, those of abdominal pain will become manifest, the animal frequently looking at its flanks, alternately lying down and rising, kicking at its belly, and frequently passing small quantities of hardened feeces, thickly coated and mixed with mucus. There is great debility, and some degree of torpor or somnolence; in some instances the sphincter ani is relaxed, and the anus constantly open, the animal straining incessantly, and exposing the intestinal mucous membrane of a deep red colour. The conjunctive are yellow; the tongue is coated, dry, and shrunk; the animal is thirsty, and the urine is high- coloured and scanty. Great care must be taken in properly diagnosing this condition, for, if treated as ordinary colic, the result is almost sure to be fatal. Towards the termination of influenza rhewmatic complications often appear; in some instances pain and stiffness in the joints appear early in the catarrhal form. Generally, however, rheu- matism manifests itself towards the termination of the other symptoms. The animal becomes at first restless and uneasy, lifting its feet alternately from the ground; the joints emit a crackling sound when moved, then swell, after which the pain subsides. In other instances the rheumatic inflammation appears in some particular muscle, or more frequently tendon, especially the great flexors of the feet. The swelling and inflammation are generally situated immediately below the knee or hock, in- volving the flexors—perforans and perforatus. The swelling is very great, hot, painful, hard, and causing severe lameness, which sometimes remains for a long time after the animal has regained its health in other respects. Few horses suffer from more than one attack during one season; many cases relapse, but one attack in no degree protects against another at some future period. Prognosis.—If properly treated influenza is rarely fatal; the old, bad constitutioned, and over-worked horses only succumbing. TREATMENT. The practitioner is always to bear in mind that influenza is a disease which runs a definite course, and that it is inno way cut short by any interference. The treatment must consequently be directed to relieve any distressing symptom, to allay irritability, and to support the strength. 414 ENZOOTIC AND EPIZOOTIC DISEASES. Comfortable clothing to the body and extremities ; food, con- sisting of warm mashes of bran, boiled oats, linseed, or barley, and an abundance of good cold water for the animal to drink, aré always to be recommended. It is good practice to see that the water is so placed that the animal can get at it at its pleasure, for in many instances, if it is not thirsty, it will wash its mouth and cool its tongue, and feel grateful for the relief thus afforded. Inhalations of warm water vapour, continued for an hour at a time, afford much relief, frequently mature the nasal discharges, and relieve the cough. The throat may be fomented with hot water and stimulated with an embrocation consist- ing of ammonia and oil, or at once blistered with the cantharides ointment. Mustard applications are very commonly used. I must confess that I never use mustard, for it causes very much distress, without securing any marked abatement of the disease. If there be much prostration, doses of spirits of nitrous ether, or of the carbonate of ammonia, may be given in cold water two or three times a day; if the debility is not marked, nitrate of potash or sod. hyposulphite in the enteric form, dissolved in the animal’s drink or mixed with its mash. Purgatives are always to be avoided, and any constipation which may be present in the earlier stages of the disease is best relieved by enemas of warm water. Should diarrhea spontaneously occur, it must not be checked, at least if not excessive. Any irregularity of the bowels should be overcome more by food than by medicines. If costive, a laxative diet is to be given; if the reverse, it may be advisable to give dry food. If the appetite does not return in the course of the third or fourth day, milk should be substituted for water, and if the animal likes it, it should be allowed to drink of it abundantly— say three or four gallons per day. Skimmed milk suits better than unskimmed, as the latter is apt to induce some degree of diarrhea. If at any time the milk disagree, and it will some- times do so, it must be discontinued and gruel substituted. Neither milk nor gruel should be forced upon the animal by horning or bottling it down its throat in spite of its mute and often determined resistance; and itis a point worthy of remem- brance that food thus forced is only calculated to disorder the digestive organs, and destroy all chance of a return of appetite. In the human being, dog, &c. food thus forced would be INFLUENZA. 415 vomited, the stomach would at once be able to express its re- bellion, but, in the horse, vomition rarely occurs; and who knows what unpleasantness or even pain is inflicted by thus dis- ordering the already delicate digestion, by the common, but to my mind barbarous, practice of forcing sundry quarts of gruel, beer, &c., upon its unwilling stomach. Finally, never give the patient carrots, turnips, potatoes, or hard and raw food, till convalescence is well-established; if such should be done, there is every probability of a fatal termination from enteritis. In mild attacks of influenza but little medical treatment is necessary ; pure air, comfortable loose box, without draughis, well-drained and well-ventilated, with careful nursing and careful daily medical inspection, and the saline medicine above recommended, are all that is necessary. When con- valescence has commenced, the restoration is materially assisted by a few doses of, first, vecetable, and, secondly, mineral tonics, good food, carefully regulated exercise, and careful grooming. If any cough remain, it may bo necessary to apply a blister to the throat, and to administer such remedies as belladonna extract and camphor ; and shouid the swelling of the limbs continue, the kidneys are to be stimu- lated by diuretics. In some rare instances the local inflammation of the larynx is very great, and the tumefaction of the mucous membrane, vocal chords, &c., interferes with the act of respiration. When this occurs the horse’s nose is ‘‘ poked out,” that is to say, the face is elevated, and the respiratory passages placed as nearly in a straight line as possible ; the eyes become prominent, the in- spiratory movement is performed with great difficulty, and accompanied by a loud, roaring sound. No time should be lost in giving relief to an animal in this state, and if fomentations and steaming fail to give relief, tracheotomy must be per- formed.—(See Principles and Practice of Veterinary Surgery, page 46.) Influenza is also occasionally complicated with disorder of the liver, in which case the mucous membranes are more or less tinged with yellow; the bowels are constipated, or irregularly relaxed and torpid, the faeces are of a dirty clay colour, and feetid ; the urine is high-coloured; the appetite is almost lost; and in some instances there are convulsive fits and comatose periods, which 416 ENZOOTIC AND EPIZOOTIC, cause much alarm. Professor Dick was of opmicn that these cerebral symptoms were due to the extension of the nasal inflam- mation to the meninges of the brain, through the cribriform plates of the ethmoid. They are, however, due to the presence of biliary matters and products of degeneration of tissue in the blood, and are to be overcome by elimination through the natural channels. Some practitioners have termed this “ bilious fever,” but there is no necessity for any distinguishing term, as it is due to tumefaction of the lining membrane of the bile ducts prevent- ing the free flow from the liver into the duodenum of bile, which, accumulating in the liver, is absorbed into the circulation, giving the visible mucous membranes the characteristic yellow, jaundiced tinge. I have never found it necessary to administer any liver stimu- lant in this complication. All that is necessary is to keep the bowels regular by a mild aperient, such as a pint of linseed oil, and allow the animal such food as it will partake of which is of an easily digested and aperient nature. One condition which often prevails in this form requires modification, as it is apt to cause some degree of suffering, namely, an acid state of the stomach. The acidity of the stomach is manifested by grinding of the teeth, licking the walls, placing the tongue on cold objects, with drivelling of a clear saliva from the mouth. The bicarbonate of soda is very useful, giving speedy relief from this annoying symptom. The medicine is to be given two or three times a day, either dissolved in the drinking water, or as a draught out of a bottle. If there be abdominal complications, the colicky pains are to be relieved by fomentations to the belly, and small doses of opium, the bowels being regulated by oil. But even here no very decided and heroic steps are to be taken to relieve symp- toms, it being always kept in view that they are the result of a cause which will not expend itself until a certain period, and that mere remedies, although perhaps affording relief at the time, are generally debilitating in their effects, and often tend to cause a fatal termination. The sequele of influenza are, hydrops pericardii, hydro- thorax, ulceration of the larynx, roaring, and sometimes glanders and farcy. INFLUENZA. 417 MORBID ANATOMY. Uncomplicated influenza seldom proves fatal, except in the very old or otherwise debilitated animal; the most prominent lesions being great congestion of the mucous membrane of the respiratory track, extending even into the minute bronchi, some of which are filled with a muco-purulent discharge; the pulmonary lobules being consequently Collapsed. The blood is dark, and is said to contain micrococci. The majority of fatal terminations are caused by the gravity of some local complication, such as pneumonia, bronchitis, and enteritis. Fic. 35.—Congestive patch on mucous membrane of stomach, (Specimen sent by Mr. T. Taylor, V.S., Manchester.) In Manchester it has been found that many dead animals present a dark patch of congestion, with incipient ulceration on the mucous membrane of the stomach, as shown above. Qd.—EPIZQUTIC CELLULITIS, OR PINK-EYE. The term “‘pink-eye” seems to be an importation from America—from one of the inconstant symptoms of the disease being redness of one or both eyes, and swelling of the eyelids. Some suppose that it is a new disease, and that it first appeared in America in 1872, the actual seat of its outbreak, being Toronto, Canada, where it appeared on October Ist, 1872 ; in nine days it had attacked nearly all the horses in the city, 27 : 418 ENZOOTIC AND EPIZOOTIC DISEASES, and carriages could not be had at any price. On 18th October it had reached Montreal, and was prevalent throughout Canada. On October 14th it had reached Buffalo; 17th, Rochester ; 22d, Boston, New York, Brooklyn, and Jersey City ; 27th, Phila- delphia; 28th, Washington; and had been witnessed in Nova Scotia as early as October 13th. It is characterised by great and sudden prostration of strength, elevation of temperature and other signs of fever, with pain in and swelling of the extremities; generally redness of the conjunctive, swelling of the eyelids; and sometimes cranalgia ; often colicky pains ; congestion of the lungs, and in some rare instances an involvement of the brain and its membranes, expressed by phrenzy or coma. The rate of mortality differs very widely,—from 1 to 35 per cent. In fatal cases death is due to congestion and gangrene of the lungs, ante mortem clots in the heart and great vessels, enteritis, and extreme prostration of the system generally. CAUSES.—ETIOLOGY. Some writers maintain that it arises from contagion only, but there are many facts against this exclusive view. 1st. Its sudden and simultaneous occurrence in various parts of a district or city. For example, a place may be entirely free from the disease one day, and upon the next outbreaks will occur in many and widely separated spots in that place. 2d. Its occurrence in isolated places where contact with diseased animals is out of the question ; for example, the first appearance of the disease in 1880 was at a farm in the Lothians at least one mile and a half from a railway station, and during the spring, when all the horses were kept at home ploughing. Ina few days it was in Edinburgh and in many centres ; but whilst I am con- vinced that it occurs as a malarial disease, I am equally convinced that it is highly contagious and infectious, and can be conveyed from diseased to healthy animals with great facility. Diéckerhoff says it may be readily communicated to healthy horses by the intravenous or subcutaneous injection of warin blood taken from a diseased animal ; and Mr. Archibald Robinson, F.R.C.V.S., Greenock, says that it can be transmitted by the stallion which has had the disease months before to the mare by the act of coition. EPIZOOTIC CELLULITIS, OR PINK-EYE. 419 A purely infectious disease like the pleuro-pneumonia of the ox follows the great lines of commerce, and can be traced from place to place with a certain degree of exactitude, but a miasmatic disease, which may afterwards become infectious or contagious, cannot be followed from place to place. I am therefore forced to the conclusion that, like Roman and typhoid fevers in man, this disease, arising as it does from the entrance of a microbe into the animal system, is not due so much to that germ itself, but to certain properties which it has obtained from perhaps unknown conditions of the air; that the germ itself is constant in the surroundings of animals and under ordinary conditions quite innocuous, but let those conditions be altered, the properties of the germ become virulent and infectious. Now it appears that the infcetious properties of this germ are generally developed during or immediately after a long continuance of wet weather. Several outbreaks within my memory have been so ushered, but this is not universal, as some writers state that it occurs in all weathers and in all climates. This might be more correctly said of the catarrhal form than of the other. The microbes, which I have invariably discovered, as shown in the photo-micrographs, have a great tendency to arrange themselves in pairs. (See fig. 36.) They average about szgo5 of an inch in size,’grow freely in gelatine and agar-agar, and are easily stained, with the aniline dyes. These organisms correspond to the description already given of a Pasteurella which is now considered as the causative organism, and is probably the same as that which causes influenza, being altered in its acute pathological effects by some altered conditions of environment. The symptoms are as follows :—Some degree of lassitude ; more or less failure of the appetite ; the animal is inclined to be sluggish; his movements are clumsily performed, and he is inclined to “‘ trip” with his toes; the eyes are heavy, eyelids partly closed, in many cases some increased redness and some swelling of eyelids, with a discharge of tears over the face, and sometimes opacity of the cornea, and fibrinous clots in the aqueous humour of the eye. If examined at this stage, the temperature may be from 102° to 104°, or even 105°; the pulse from 60 to 70 per minute; 27—2 420 ENZOOTIC AND EPIZOOTIC DISEASES. respirations not particularly hurried ; and if the horse bestopped from all work at this period the severity of the disease may increase, but very slightly, and recovery may be expected in the course of a week or nine days; but if the animal be kept at work, or, even if not working, in a badly ventilated or other- wise improper stable, the symptoms rapidly increase in severity, the temperature rises to 106°, 107°, or even as high as 108°, the respirations hurried, the pulse increased in frequency to 80 or even 110 beats per minute, is small and sometimes almost too indistinct to be felt by the most practised touch; the animal becomes excessively lame, sometimes immoveably so; or he is Fic. 36.—Microbes of pink-eye, showing bipolar staining. continually resting or pointing one foot and then the other, as if suffering agony in feet or limbs. In a short period of time the limbs begin to swell, more particularly about the lowor joints, i.¢., the hocks and knees downwards, and as the swellings become pronounced the pain disappears. As already stated, there is usually a cough and some degree of rouzhness of the throat and bronchial tubes, but in the last outbreak in Edinburgh these were conspicuous by their absence. In some instances intestinal pain, expressed by restlessness, looking round at the flanks, scraping with the feet, and even EPIZOOTIC CELLULITIS, OR PINK-EYE, 421 rolling about, is present shortly after the first manifestation of ilness ; and in others—and these are the really dangerously fatal ones—well-marked signs of inflammation of the bowels ure observable at an early stage, with intermittent action of the heart and total loss of appetite, or even extreme abhorrence of food, and occasionally of water. The bowels are at first normal or slightly constipated ; the feeces covered with mucus (hence the terms typhus-mucosa and muco-enteritis), and their colour frequently indicates an absence of biliary secretion or the presence of altered bile; the rectum Fig. 37.—Microbes in groups. is often irritable, and the passage of feces causes some degree of pain; on the third or fourth day the feces become pul- tuceous and often of a brown colour, and later on diarrhea may occur. In other cases, including from the third to the sixth day of the disease, serious pneumonic symptoms are observed : there is an extensive exudation into the lung tissue—in fact, what is observable as taking place in the extremities, viz., exudation and swelling, is occurring in the lungs, causing the respiratory movements to become greatly accelerated, but if gangrene does not set in, indicated by fcetor of the breath or discharge of 422 ENZOOTIC AND EPIZOOTIC DISEASES. dark-coloured blood from the nostrils, recovery may still be hoped for. In other instances, even during convalescence, the pulse, hitherto moderately strong, and all other symptoms passing away, becomes rapidly feeble, and the animal suddenly dies, and on making a post mortem examination, firm clots or thrombi have been found in the heart, lungs, and blood-vessels, which have stopped the circulation and caused death. This termination has to be very carefully guarded against, as it may occur in the most promising cases. It is brought about as follows :—The disease is one which particularly attacks areolar tissue; and inflammation of this tissue, like that of the more firmly fibrous, causes the development of coagulating properties in the blood, and when—added to this coagulative tendency— the heart loses its tone, the blood coagulates in its cavities and blocks the circulation. In other instances horses have died weeks or even months after they have passed through the disease, and ost mortem examinations have revealed plugging of the vessels of some important organ. Another rare complication is witnessed by symptoms of irritation of the brain and its membranes, with effusion into the ventricles and sub-arachnoid space. As this complication mani- fests itself there will be at first delirium, the eyes staring, the pupils dilated, perhaps complete blindness, with unconscious restlessness, tendency to elevate the head, followed by paralysis commencing in the hind limbs and extending to the whole muscular system, with total blindness, unconsciousness, stertorous breathing, inability to swallow, and loss of voluntary movements : these conditions indicate a rapidly approaching fatal termina- tion. To recapitulate, the symptoms may be briefly stated to be as follows :— Swelling of eyelids, often with diffuse redness of the con- junctive; congestion of the superficial vessels of the eyes, cloudiness of the cornea, and collection of yellowish fibrinous matter or blood-clots in the anterior chambers of the eyes. Sensitiveness to light, eyelids more or less closed, and discharge of tears; but in milder cases the eye symptoms may not be very distinct. Pulse from 50 or 60 in mild to 100 or even 120 in severe cases. EPIZOOTIC CELLULITIS, OR PINK-EYE. 423 Temperature from 103° or 104° in mild to 106°, 107°, or even 108° in severe cases. 108° was observed in one case only in the College practice, and ended in recovery. During con- valescence the temperature rapidly falls, and in many cases to below the normal—to 99°, and rises to normal—about 101°. Gait awkward and slow, loss of tone in the muscles, par- ticularly those of limbs, ears, and lips, and sometimes marked weakness in the hind quarters, and sometimes very great lame- ness. The respirations from 15 to 20 in mild to 30 or 40 in grave cases ; these, however, are subject to modifications, as in some horses treated at the College we observed the respiration even slower than natural at first, and increasing in frequency during convalescence. In some fatal cases the breath is fcetid for some time before death, and respirations very rapid. Mucous membrane of the mouth of a venous red colour; tongue dry ; feeces at first dry, but on third or fourth day brown and poultice-like in consistence ; later on, diarrhcea in some cases. Limbs slightly or considerably swollen; urine diminished, and sometimes albuminous, and in some cases of a chocolate colour, and containing broken-down blood-corpuscles. POST MORTEM APPEARANCES, Heart.— Congested ; sometimes covered with mulberry coloured spots—petechiz. Clots of blood in auricles, ventricles, and larger blood-vessels. Blood.—Dark-coloured and viscid; white corpuscles increased in numbers, and many of the red ones broken down. Lungs.—Generally congested; infiltrated with fluid, or filled with blood extravasation, which has undergone decomposition prior to death, and given rise to fcetor of the breath. Liver — Kidneys—Generally congested. Kidneys some- times black. Connective Tisswe, particularly of the limbs, contains much fluid or semi-coagulated exudate. Muscular System.—Generally pale and flaccid. The Brain and its Membranes congested, and the cranial cavities containing a superabundant quantity of fluid in those cases where frenzy or coma have appeared during life. a. 424 ENZOOTIC AND EPIZOOTIC DISEASES. Digestive System.—Mucous membrane of stomach sometimes congested ; bowels inflamed, and occasionally covered with petechial spots; contents generally fluid. MORTALITY. This seems to have varied during the 1890-91 outbreak in a most remarkable manner. Some practitioners who have replied to a circular issued by me, record a loss of only 1 to 2 per cent., whilst others return from 5 to 9; and it is reported that some have lost even a greater number. Our loss at the College was under 1 per cent.,and at Piershill Barracks, out of a total of 59 treated by Mr. Phillips upon the principles of this College, there were no deaths. TREATMENT. The first and most important essential in the treatment of the disease is absolute rest as soon as the slightest indication of illness has been observed. The animal, if possible, should be placed in a cool, well- ventilated, but not cold, loose box, warmly but not too heavily clothed with sheet and hood; and when bandages do not cause irritation the legs should be bandaged. The diet should consist of bran mashes, and a moderate quantity of hay for the first few days, except where a horse has been used to and is fond of a linseed mash. In such a case one pound of well-boiled linseed should be mixed with the mash every night until the bowels are loosened, when, if there be any signs of diarrhcea, it should be discontinued, and dry corn given. The mashes should be continued until the fever has subsided, and then gradually changed to the horse’s ordinary diet. Cold water should be placed within the animal’s reach, so that he can satisfy his, often inordinate, thirst night and day, and if greatly prostyate, the patient should be placed in slings. Medicinally, salines and other remedies recommended for the catarrhal form may be administered in accordance with the phase of the disease. If pain be prominent, the bromide of potassium has proved useful. EPIZOOTIC PNEUMONIA, 425 3d.—EPIZOOTIC PNEUMONIA, OR PLEURO-PNEUMONIA OF THE HORSE—LOBAR-PNEUMONIA. Definition.—A croupous inflammation of the pleura and sub- stance of the lungs, preceded and accompanied by a low typhoid or adynamic form of fever, which lasts from seven to fourteen days. It generally occurs but once in a season, but one attack does not render an animal exempt from a second or third. It is now considered an infectious disease, due to a micro-organism, which is asserted by some writers to be the Diplococcus pneu- monia of Frankel, identical with that found in the saliva of certain persons, and which produces septicemia in the rabbit. Others state that it is a streptococcus. Galtier and Violet describe two organisms—a streptococcus and diplococcus— whilst Cadéac states there is only one micrococcus, often grouped in pairs, sometimes in chains. The microbes of Galtier and Violet do not stain with Gram, whilst all the others do. They are all facultative anaérobes. The cause is undoubtedly a bipolar staining organism of the Pasteurella group which was at one time thought to be a diplococcus; but it is not, and has no relationship to the diplococcus of pneumonia of man. Some controversy on this subject has taken place on account of the frequency of strepto- cocci in old cases of epizootic pneumonia, but this has already been explained in connection with Pasteurella infections. The original organisms, having disappeared, have given way for the appearance of others, whose presence is an accidental con- tamination. The pneumonia following on strangles, and due to the streptococci of Schultz, is an entirely different disease. It has been said that all pleurisies of the horse are due to strep- tococcus infection, and this may be so; but it does not follow, any more than that all pleurisies of man are due to tubercular infection. Such statements are too wide. The epizootic pneumonia of the horse, which is rarely ac- companied by a pleurisy, is most probably a complication of concurrent disease with influenza, and due to the same organism. For the last few years this form of epizootic has prevailed to a very great extent both in the north and south of Britain, Erroneously called “influenza,” it has seemingly and for some 426 ENZOOTIC AND EPIZOOTIC DISEASES. time taken the place of that affection, from which it differs very materially. The true uncomplicated influenza is a disease of the mucous structures: this affects the serous covering and sub- stance of the lungs. In 1861-2, also in 1891 and 1894, this form of epizootic disease became very prevalent in the north of England, where it raged for many months, committing great havoc amongst horses of all kinds, but particularly amongst those most exposed to the vicissi- tudes of the climate. It has prevailed more or less ever since, both in town and country, more particularly amongst young horses and those removed from pastures into stables. The know- ledge that nearly every newly purchased horse is liable to suffer from this or some other form of epizootic disease, deters many persons from keeping horses, and hence we find that many whose business requires that horses should be employed, prefer to let out their work to contractors and carriers. This repugnance to purchase and keep horses by men in business has also been in- creased by the great mortality which has generally resulted from this epizootic. SEMIOLOGY. The primary symptoms are very often more or less obscure. The animal is dull, dejected, off its food, performs ordinary labour with difficulty ; lassitude, perspiration, and fatigue are easily induced. Examined carefully, the pulse will number from sixty up to eighty per minute—during some seasons eighty has been the common number—and the animal temperature will vary from 104° to 106°. Sometimes there is a cough from the commencement; very often, however, there is no cough during the first three or four days. The extremities and ears are alter- nately hot and cold; the appetite is almost entirely lost; the alvine and urinary secretions are defective ; the visible mucous membrane injected, and frequently of a rusty tinge; in some eases there is a rash in the mouth, a rusty or straw-coloured discharge from the nostrils. The animal does not lie down, Auscultation does not reveal much at first; in fact, for three or four days the animal may be said to be suffering from fever without local complications, but at the end of that period a hard, dry, painful cough is now and then heard; the thoracic walls are fixed; the breathing is abdominal; the elbows are EPIZOOTIC PNEUMONIA. 427 turned out, and a line or hollow extends from the ensiform car- tilage of the sternum to the anterior spine of the ileum, which denotes that the ribs are fixed, owing to pain within the chest. If the horse is now made to move suddenly, it emits a grunt or groan; in some instances it groans at each expiration, and if slightly rapped in the chest with the knuckles it will do so with pain; the breathing is catching and short, and auscultation will detect a friction sound.—(See Pleurisy.) Very commonly the right side only is affected, in some cases the left, and in rare instances both sides. In the course of the next ensuing two days, the sounds ol the chest indicate pleurisy, pleuro-pneumonia, or a complica- tion of these with pericarditis. Froin the commencement of the manifestation of chest disease, the breathing becomes somewhat hurried, the pulse assuming a hardness of character which it did not possess at first; the number of its beats are not further increased ; on the contrary, rapidity of the pulse may decrease as the exudation on the pleural surfaces advances, and it is not at all uncommon for one to witness an increased rapidity of the respiratory movements, gradual condensation of lung tissue, some effusion into the thoracic cavity, and a diminution in the number of the pulsations. If pericardiac complications are present the pulse is marked by a peculiar indistinctiveness and irregularity; the cardiac beat is generally loud and short; the impulse, however, is weak, and the arterial pulsations indistinct. In some instances the whole body becomes stiff and sore, and the horse is disinclined to move, but stands with its nose extended forwards, nostrils dilated, and fore legs apart, pre- senting an appearance of distress, which is heightened by frequent looks at its sides, and by attempts to lie down, as if suffering from colicky pains. In such instances the respiratory movements are short, shallow, and much accelerated, numbering fifty, sixty, or even eighty or more per minute, whereas in the majority of cases they do not number more than thirty per minute, when auscultation may detect considerable exudation into the lung tissue. An examination of the respiratory apparatus by percussion and auscultation—the only satisfactory method of diagnosing chest diseases—will enable the practitioner to detect the various changes as they occur. 428 ENZOOTIC AND EPIZOOTIC DISEASES. 1. For the first two or three days after attack both percussion and auscultation often give negative results; at the termination of that period percussion over the seat of the pleural inflam- mation will cause the animal to groan. Auscultation will detect a dry friction sound if the pleura be affected; absence of true respiratory murmur, and the presence of crepitations, large or small, if the lung-substance be involved; a combination of friction sound, and crepitations, if both pleura and lung tissue, and a “ to-and-fro” rasping friction sound, with more or less palpitation, if the pericardium be involved. These signs indicate—1s¢. That the natural pleural secretion is arrested, and that the dry pleural surfaces rubbing on each other cause the friction sound ; 2d. That engorgement of the lung tissue has taken place; and 3d. That the pericardial secretion is arrested, causing the “to-and-fro” sound at the heart. 2. In the course of from one to two days the above abnormal sounds disappear. Auscultation now reveals that in the part affected there is no sound at all, or that a tubular or hollow sound is heard. The absence of sound indicates either that the lung tissue has become impervious to air, or that a considerable effusion of serum has occurred into the thoracic cavity. If the former, the absence of sound becomes apparent by degrees only; that is to say, the respiratory sounds become gradually feeble as the consolidated part is approached, showing that at the border of the hepatized tissue the inflammatory process is less advanced. There may be crepitations or tubal sounds, but when the absence of sound is due to effusion of serum (hydrothorax) the sounds terminate abruptly at a certain distance from the floor of the thorax, the respiratory sounds being louder than natural above the line of termination, and in some instances the presence of fluid in the chest will be indicated by a “ dripping sound,” as of drops of water falling into a well. The tubal sounds indicate a less degree of consolidation ; that air finds ingress into some of the bronchial tubes, but not into the more minute ones and air cells. This condition may exist for three or more days, and then the crepitations reappear, showing that the exudate is breaking up and becoming gradually removed by absorption; the dull im- pervious part at the floor of the cavity becoming daily shallower, and the normal sounds slowly returning. EPIZOOTIC PNEUMONIA, 429 Poreussion during the stages of consolidation and effusion produces a dull sound over the diseased part, and increased resonance over the healthy parts of the chest. In all the unaffected portions of the lungs the respiratory murmur is increased. The “ to-and-fro” cardiac friction sound also disappears, owing to effusion into the pericardial sac, and reappears as the exudate is removed by absorption. Very often after convalescence has been established the cough becomes more frequent; it, however, loses its painful hacking character, being now louder and stronger. In some instances, more especially if the exudate has been very abundant, a mal- condition of the system is induced by the abundance of effete materials in the circulation, removed by absorption from the transformed exudates. This has been compared by Professor Gamgee to the hectic fever of the human being. There is much emaciation, imperfect digestion, capriciousness of the appetite; the hair is easily removed from the mane and tail; irregularity in the surface temperature; and continuance of the increased temperature of the body, as indicated by the thermo- meter. If this condition of the system be not successfully combated, the respirations again become accelerated and the ribs fixed; there is flapping of the nostrils, which are greatly dis- tended ; the animal again discontinues to lie down. Anasarcous swellings may appear on the chest, abdomen, and the legs, denoting the presence of hydrothorax, to which the animal may eventually succumb in the course of an indefinite period—some- times in two or three days only, sometimes in as many weeks— or symptoms of farcy or glanders may appear. POST MORTEM APPEARANCES, Tn very acute cases, the appearances revealed by a post mortem examination are, intense redness of the pleural surfaccs of one or both sides of the chest; the engorgement of the vessels embracing the visceral and parietal surfaces, and some degree of effusion and exudation of lymph. In some instances, the lungs show but little disease, whilst in others patches of inflam- mation are found throughout their substance. The pericardium and endocardium are generally more or less injected, and the death of the animal at this early stage generally results more 430 ENZOOTIC AND EPIZOOTIC DISEASES. from the cardiac complication than the pleural disease. It is but seldom that a case terminates so rapidly, unless the animal be kept at work after it has fallen ill. ‘The general symptoms of septicemia, together with the hemorrhages and heart symptoms, all tend to show that the disease is due to an organism of the Pasteurella variety. If the horse live for two or three days after the pleural symptoms have become manifested, along with the injection of the vessels, an abundant quantity of serum will be effused into the pleural sac, floating in which, and loosely adherent to the pleural surfaces, bands of lymph will be found. These bands of lymph are loose and watery, and the serum is turbid or flocculent. If the horse has lain for some hours after death, and the post mortem is carefully performed, the effusion is clear at its upper and turbid at its lower part. If the inflammatory process has been less rapid, the lymph is of a more consistent appearance, and forms over the inflamed parts flocculi of various sizes, or a distinct lining varying in thickness, and of a honey-combed appearance ; but the lymph in the epizootic form does not possess the firmness, plasticity, and tendency to organization which is characteristic of that of the sporadic form of the disease. These bands of lymph are some- times of very rapid formation, and they may even show some trace of organization in forty-eight hours after attack. This fact is of considerable importance legally, as it is often found that if a horse dies in a week or two after purchase, an attempt is made to compel the seller to refund the purchase-money on the ground that the animal was diseased prior to the date of sale. Old bands of lymph, and such as indicate previous disease, are firm, organized, of a glistening appearance, and unite the oppos- ing surfaces more or less firmly together. New bands of lymph, on the contrary, are soft, watery, and the parts which they may attach together are easily separated. In some instances, extravasations of blood give the lymph a red colour. This must not be mistaken for vascularity, as the latter would denote organization and age. Examined microscopically, the lymph exhibits the presence of numerous inflammatory corpuscles, oil globules, and ill- developed fibres. The exudate into the lung tissue is also wanting in plasticity, EPIZOOTIC PNEUMONIA, 431 the lung cuts up soft and moist, a whitish fluid oozing from the cut surfaces. In some cases, where the vital powers have been very low, or where they have become weakened by injudicious treatment, an abundant, turbid, fcetid fluid has been thrown out, partaking much of the character of unhealthy pus; or abscesses form in the lungs, and in rare instances gangrene of the lungs has occurred. The pulmonary complication is generally found at the inferior portions of the lung, and in many instances the exudate indi- cates that the process is wanting in the true character of plastic inflammation. TREATMENT. From the foregoing observations, it will be understood that the local complications of this disease are preceded by fever, the pleural and pulmonary inflammation appearing after a few days have elapsed. The fever is of a typhoid or adynamic character, and the severity of the chest affection is generally in accordance with that of the premonitory fever. The fever, slight perhaps at first, is very often intensified by the suffering animal being kept at its ordinary work for some time after the appetite has ‘failed. This inattention on the part of those in charge of horses is often a cause of great loss, inducing a fatal termination where recovery might reasonably have been expected. The febrile state and the local inflammation are increased by all debilitating influences, such as bad food, previous disease, natural delicacy of constitution, by the abstraction of blood, and very commonly by the administration of purgatives. Many horses are destroyed by the administration of aloes, a dose of which is often given when the horse is seen to be “ off his feed.” Superpurgation may not be induced, but the chest inflammation is much increased, and the animal often succumbs. There is another practice in vogue, more particularly amongst horse-dealers, namely, that of giving a purgative (aloetic) ball to nearly every fresh horse they buy, and this is done without taking the health of the animal at the time into consideration at all, I am convinced that this is a most reprehensible practice, 432 ENZOOTIC AND EPIZOOTIC DISEASES. leading to grave pulmonary diseases and to death, more especially if an epizootic is prevalent. The pathology of chest inflammation leads us to the conclu- sion that when once established it runs through certain stages, namely, congestion of the vessels, the outpouring of an effusion, and the formation of an exudate. The congestion, effusion, and exudation are determined by the intensity of the preceding fever. If the fever is slight, the local disease will be slight also; if, on the contrary, the fever is severe, the local inflam- mation will be proportionately grave. During some seasons the disease trom its commencement is severe, and then the weakly succumb. But at other times this is not the case, and very few deaths result from the disease; but its character is always rendered more serious by irrational treatment. The duration of the fever cannot be cut short by any treatment, and attempts to do this are very often the cause of numerous deaths. Its severity, however, is amenable to modification by— (1.) Complete rest whenever the slightest sign of illness is discoverable. (2.) By housing the animal in a warm, dry, light, well-venti- lated loose box. (3.) By taking special precautions that no draught of cold wind blows upon it ; for it must be remembered that cold, more especi- ally cold wind, is the common cause of the disease, and that removal of the cause is the first step in the treatment of all diseases ; and, again, that the severity of many affections is dependent on the “dose” of the cause. When this is heavy or long continued, the results will also be heavy and severe. (4.) By clothing the animal and bandaging the legs, in fact by keeping up the equilibrium of the circulation; for if the vessels cf the skin are prevented, by the operation of cold—acting upon and constringing them—from receiving a due supply of blood, internal congestions and inflammations are aggravated and often determined. In addition to these rules, the practitioner must remember that the disease, once established, is the effect of a cause which nas been in operation for some time past; that the effects, what- ever they may be, are the natural physiological responses of the animal body to the action of such cause or causes; and that all attempts to remove such effects or conditions by other than those EPIZOOTIC PNEUMONIA. 433 processes which nature herself attempts, and generally accom- plishes, can only result in disappointment and loss. How, then, does the animal body rid itself of disease and its results? Briefly, in the one before us, the inflammation is the result of an irritant, acting for a certain time upon a certain tissue or organ. If the dose of the irritant is strong, the resulting inflammation will be strong also, and nothing will subdue that inflammation so long as the cause retains its strength and is allowed to operate. This inflammation is characterised by congestion, effusion, and exudation. When the cause is re- moved, or when its strength is exhausted, the congestion slowly disappears, and the products of the inflammation, namely (1.) the effusion, is gradually taken up into the circulation and removed from the body by the excretory organs; and (2.) the exudation or lymph, degenerated into a turbid fluid material —the pathological milk of Virchow—is removed in the same manner as the serous effusion, or is replaced by a fibrous struc- ture, which binds the surface of the opposing parts together, and constitutes adhesion. When this adhesion is completed, the new structure becomes a part of the living body. Seeing, then, that the various changes are natural results of the operation of a cause, the practitioner must be careful to avoid doing anything that is calculated to irritate or debilitate the animal body. At the same time he must be careful to keep the excretory organs in a natural condition, maintain the strength by appropriate diet, and allay morbid irritability by the ad- ministration and application of suitable remedies. In the first place, the practitioner is to avoid irritating and debilitating his patient. In order to accomplish this, three methods of treatment now pursued by many practitioners must be abandoned, namely, bleeding, purging, and counter-irritation. Bleeding and purging, separately or conjointly, lower the animal powers, which are already too low, and prevent the physiological changes from taking place which are essential to the final removal of the disease. If they do not kill in a very short period of time, they cause an alteration in the inflam- matory process, whereby large quantities of an aplastic material are formed, which, by blocking up the lung tissue, or filling the cavity of the chest, cause death by suffocation; and by their debilitating influence generally render the vital powers less able to resist even a mild attack of disease. 98 434 ENZOOTIC AND EPIZOOTIC DISEASES. Counter-irritatton.—This is the favourite method of treatment at the present time, and it is accomplished, or thought to be accomplished, by the application of mustard, cantharides, or other irritants to the skin of the sides and breast. It is applied on the principle that no two inflammations can exist in the body at the same time; that an artificial inflammation of the skin, excited by the irritant, removes or destroys that which is going on within the chest. Others say that it rouses the capillary circu- lation, removes congestion, &c. For many years I followed this method of treatment, and so plausible were the arguments in its favour, that I could scarcely bring myself to believe that it could do harm, although I saw that many horses died even when a blister had acted. I was at last induced to abandon it altogether, and the result has been most satisfactory. Irritation of the sides and breast is injurious in all instances of chest disease in the horse, except in a condition presently to be described, and for the following reasons :— 1st. It cannot and does not remove the internal inflammation. Many post mortem examinations have convinced me of this. During the summer of 1873 I had a good opportunity of demon- strating this fact to my students. A horse newly bought by a dealer died from pleurisy, and its value was in dispute between buyer and seller. On viewing the carcase, both myself and students were struck with the violence of the inflammation of the skin upon the sides, induced by the repeated applications of irritants. Some of the students, having been pupils of gentle- men who advocated the “ counter-irritation”’ theory, were under the firm belief that no internal inflammation could exist where the external was so very marked. The result, however, proved the fallacy of the hypothesis, for the pleura was intensely inflamed. Still further, the editor has induced an acute pleurisy in healthy horses by applying strong blisters to one side of the chest. The internal inflammation being an effect, until it can be proved that an external irritant can remove the cause which has produced such effect, it is quite as reasonable to suppose that a blister on the palm will remove or prevent the effects of another on the back of the hand, as it is to think that a blister on the outside of the chest, no matter how soon EPIZOOTIC PNEUMONIA. 435 applied, can remove an irritant, or prevent it from affecting the internal structures. 2d. Another argument which tells against blisters is the fact that their advocates differ as to the stage at which they ought to be applied. One party says they cannot be applied too soon, in order to counteract the internal inflammation, | ‘by drawing the morbid action and the blood to the surface whilst another says that external irritants do harm whilst there is any fever present, and that they should always be applied after the pulse has fallen and when convalescence has commenced, in order to stimulate the removal of the products of the inflammation. I, however, fail to see the necessity of doing this ; for the removal of the exudates is a physiological process, best accomplished when uninterfered with, and counter-irritation at this period can only retard the recovery, or, by again setting up the febrile condition, bring about a fatal termination. There is, however, a very rare exception to these objections to external stimulants during the second stage of the disease, occurring in that condition where the horse neither gets better nor worse for several days—* hangs fire,” as it is commonly termed. In such instances a weak solution of mustard, by gently stimulating the skin, will often induce the beginning of convalescence, and act as a stimulant to the whole body. Inno other condition are counter-irritants beneficial, and in this, care must be taken not to apply them too strong nor for too long a time. The sides should be quickly rubbed over with about two or three ounces of mustard mixed in a quart of warm water, and the parte covered over with paper or linen. If one application does no good, it is not advisable to apply another; but if the horse seems to improve for a time and then relapse, a second or even third application may be admissible. 3d. The application of blisters causes pain and increases the fever. If applied to the sides they impede the respiratory move- ments by the pain they cause, and thus add to the distress and suffering of the animal. The cantharidine absorbed into the system causes irritation of the urinary organs, sometimes con- gestion of the kidneys, interferes with their excretory functions, and by the pain and disturbance thus induced adds materially to the febrile condition, and often causes the animal’s death. 28—2 436 ENZOOTIC AND EPIZOOTIC DISEASES. Horses that recover from the disease naturally do so much more rapidly than those which have been blistered, and which are often a long time in overcoming the effects of the blister; with raw sides, they remain for weeks in their stables unfit for work. Sometimes, more especially if the blisters have been oft repeated, the animal becomes much emaciated, is unthrifty, the blistered skin will slough, and when it finally recovers the blemish remains for life. Finally, animals which die from the disease do so much easier than those which have been severely blistered. Indeed, the agony of death from disease bears no comparison to that from treatment. Having now pretty strongly condemned what I consider to be wrong in principle and disastrous in practice, J must proceed to describe the treatment which has proved successful. During the premonitory fever, in addition to housing, clothing, &c., already described, the animal is to be allowed an abundant supply of cold water to drink, warm or cold bran mashes, which- ever it likes best, to eat, a boiled linseed mash every night, roots, such as carrots, turnips, or potatoes, with a handful or two of the best and sweetest of hay, or grass if in season. If the alterna- tions of the temperature of the skin be very marked, two or three doses of spirits of nitrous ether are to be daily adminis- tered in warm water; and to excite the action of the kidneys, which is often in abeyance, the ether is to be supplemented by half-ounce doses of the nitrate of potash. Even when the fever is high and the symptoms acute my experience leads me to conclude that it is unwise to use depressants, such as aconite, antipyrine, &c. If the bowels are costive, clysters of warm water are tc be administered, and in rare instances, where the bowels are extraordinarily torpid, a dose of linseed oil. In the majority of cases, however, laxative food will effect all that is necessary, and it is better to avoid even the oil, except where the constipation continues, or where it causes uneasiness. The chest is to be carefully examined at least once a day, and when convenient the animal temperature registered, as well as the pulse and number of respirations. If at the onset of the pleural inflammation there be pain and distress, manifested by the horse looking to its sides and grunt- ing, or attempting to lie down, opium or morphia subcutaneously administered is to be given to alleviate the pain, and in order to EPIZOOTIC PNEUMONIA, 437 prevent its constipating effects, from eight to twelve ounces of oil are to be given. One or two doses will be sufficient, for when the dry condition of the first stage of the inflammation has passed away, pain generally disappears. If the symptoms are those of irritation rather than pain, bromide of potassium may be given in preference to the opium; and at any time during the progress of the disease, if irritability is much in- creased, the bromide will prove serviceable. In addition to the opium, warm, soothing—not hot, scalding—fomentations to the sides give great relief. These warm fomentations are to be applied for at least an hour two or three times a day in every severe case; and in all instances, whenever the breathing becomes catching or accelerated, they must be applied until relief is given. In many cases their effect in allaying pain and soothing the animal is most marked, the patient often giving a “ sich of relief” in a few minutes. The best method of applying them is either to wrap the horse’s body in a thick blanket or horse sheet, and pour warm water upon it, placing a tub so as to catch the water as it falls from the sheet, or to wring cloths out of warm water and apply them to the sides. The latter method is the cleaner, as there is less water lost on the bedding, &c.; but in the former the skin is not exposed during the fomentation, and is to be preferred. When the fomentation is concluded, the wet sheets are to be covered, with a waterproof covering, or, if removed, the skin lightly rubbed with weak ammonia liniment, say one ounce of liquid ammonia to sixteen of oil, for the purpose of preventing the sensation of cold which is apt to follow warm applications. The inhalation of oxygen, three or four times a day, has an extremely beneficial effect in many cases, and is in constant use in many practices, Mr. Faulkner of Manchester, the editor, and others, having great faith in its value. As the local inflammation progresses the nitrate of potash is to be slightly increased. From one to two ounces may be given in the twenty-four hours, and it always acts best dis- solved in the drinking water, as the horse can then sip it at its leisure. It lowers the animal heat, cleans the mouth, has some effect on the exudation, and stimulates the kidneys. When the diuresis becomes increased, the nitrate must be discontinued, and if the horse is progressing favourably, but idl 438 ENZOOTIC AND EPIZOOTIC DISEASES, little more is needed. In the course of a few days, if the appetite is not good, vegetable, and afterwards mineral, tonics are to be given. In many cases where the kidneys act very languidly a few doses of colchicum will prove of great service. I think the colchicum seeds are the best, made into a tincture, and given in doses containing one to two drachms, for two or three days, or until diuresis is induced. The colchicum, in virtue of its action in causing the elimination of the solid ingredients of the urine, removes from the economy much. effete material, products of the metamorphosis of the inflam- matory exudates. Some veterinarians are very fond of giving the carbonate of ammonia as a stimulant in all typhoid diseases. If the kidneys are acting freely it is a very useful stimulant; but if the secretion of urine is diminished, its administration only tends to load the system with ammonia—when it is already over-burdened with the products of tissue changes, all tending to be resolved to ammonia, carbonic acid, and water; but if administered in conjunction with the vegetable tonics in the later stages, it tends to stimulate the appetite and restore strength. It should always be given in a ball, as solutions tend to irritate the mouth, and prevent the horse from eating. lf the appetite is very much impaired, the horse must have an abundant allowance of milk to drink instead of water. Some horses are very fond of milk, and almost all will partake of it after tasting it a few times. If the debility is excessive, eggs beaten up with the milk will prove of great service. They supply those constituents which are required by the wasted tissues. If milk is refused, the animal must have gruel, linseed tea, or hay tea, if it will take them spontaneously, but nothing must be forced upon it. Of the termination of pleuro-pneumonia in hydrothorax I have only to say that since I have abandoned the heroic and counter-irritating treatment, hydrothorax has been almost un- known to me. Other terminations, such as rheumatism, roaring, thick wind, &e., will be described under their proper heads. CHAPTER XL. ENZOOTIC AND EPIZOOTIC DISEASES—continued. MALIGNANT CATARRHAL FEVER OF THE OX. A MALIGNANT form of catarrhal fever, sometimes, but erro- neously, called glanders of the ox tribe, due to the operation of a morbid poison, which expends its specific effects upon the mucous membrane lining the sinuses of the head and nasal chambers; manifested by rigors, dulness, and debility, suc- ceeded by the mucous membranes becoming of a bluish-red colour, the eyes closed, the eyelids swollen, and flowing of tears over the cheeks. There is a painful and frequent cough; the pulse is feeble; bowels costive at first, but diarrhcea soon succeeds. In the course of a few hours after the onset of the disease, a profuse discharge issues from the nostrils, mouth, and eyes; the sinuses of the face and head become filled with purulent matter, and in some instances the horns drop off. The connection between the bone of the horn (flints) and the sinuses of the head is very intimate, for the bony process, the horn core, which springs from the crest of the frontal bone is hollow, and this hollow is continuous with the frontal sinus. This hollow or sinus in the horn-process is very vascular, and its blood-vessels anastomose with those upon its periostal sur- face. Any influence, then, which causes inflammatory action in the sinuses, easily induces the same processes in those structures which are so intimately connected ; and such we find it to be the case in malignant catarrhal fever,—inflammation is excited in the sinuses of the flint, which extends to the surface of the bones, and the consequent suppuration detaches the horny coverings. The symptoms of this affection are not dissimilar to thos¢ 439 440 ENZOOTIC AND EPIZOOTIC DISEASES, of cattle plague. The discharge from the nostrils is more profuse than in the plague, purulent or sanguino-purulent, and the horns fall off. There may be appearances on the mouth and in the viable mucous membranes very similar to those of rinderpest; and in some instances lameness and sloughing of the hoofs may lead one to suppose that it is an aggravated form of con- tagious eczema. TREATMENT. Removal to warm, sheltered sheds ; enemas, to relieve consti- pation ; stimulants, such as the carbonate or acetate of ammonia and the spirits of nitrous ether, with hot water vapour to the nostrils, constitute the treatment of the earlier stages. If the animal survive, these remedies may be succeeded by tonics, mineral acids, and good food. The disease is very fatal, and causes death in from three to seven days. If the animal live over the latter period convalescence may be expected. Violent remedies, such as strong doses of salts, bleeding, calomel, &c., always hasten the fatal termination. If aperients are imperatively called for, oil or treacle are preferable to the more drastic agents. CHAPTER XLI. ERUPTIVE OR PETECHIAL FEVERS, USUALLY ASSOCIATED WITH EPIZOOTICS, ALTHOUGH THEY DO NOT THEMSELVES USUALLY ASSUME EPIZOOTIC CHAR- ACTERS. L—PURPURA HAIMORRHAGICA, DIARRHAMIA, Tuts disease was arranged in the first edition of this work in the same group as the charbonous affections, which in several characteristics it simulates; but the life history of the morbid processes, the causes, the non-contagiousness, and the absence of organisms in the blood in this disease separate it from anthrax. Fault has been found with the term “ purpura hemorrhagica,” and Delafond has named the disease “ diastasheemia.” I think the term is more objectionable than purpura, as it merely implies a standing apart or a separation of blood; and were I to venture upon a new term, I would suggest “diarrhemia”—Gr. d/a, through; “pew, I flow; afua, blood; or a disease characterised by break- ing up of the blood, and ecchymosis. Definition —An eruptive non-contagious fever of an inter- mittent type, usually, but not uniformly, occurring as a sequel to another disease. Pathology and symptoms——The primary manifestations are often uncertain. In some instances the earliest symptom may be the expression of pain in one or more limbs, with but slight swellings, which, however, become more pronounced in a very short time. In other instances, the approach of the disease is shown by the appearance of a few petechial spots in the nostrils 441 442 ERUPTIVE OR PETECHIAL FEVERS. or papulz on the skin, whilst in other cases the malady is fully manifested in a very short period. Similar to its analogue anthrax, purpura is a disease in which the blood is gravely altered, associated with extravasations, effusion of red coloured serum, preceded and accompanied by constitutional disturbance, languor, debility, sudden elevation of temperature to 104°-106° F,, or even higher, the alternations of temperature being very great. The alternations in the following table are from the clinical report of a case which died at the College :-— Date. Hour. Pulse. | Temper- Date. Hour. Pulse, | Temper- ature, ature. 1879, 1879, May 23. | 9°20 a.m. | 78 | 104:2° ||June 1. | 6 P.M. 66 | 102:2° 2 ” 6 P.M. 84 106°4° ” 2. 9 a.M. 60 102°1° » «24, 9 A.M. 84 102°3° ” »” 6 P.M. 66 102° » os | OPM. 72 102°4° » & | 9AM. 60 | 102° » 25. | 9am, 60 | 102°3° || ,, 4 | 6pm. 66 | 101°4° ” ” 6 P.M. _ 66 102°2° i 4. | 9AM. 66 101°2° » 26>) 9 aM. 60 102°1° i xy 6 P.M. 72 103°8° oo 6 P.M. 66 104°1° 7 5. | 9AM, 72 102° » 27. | 9AM. 75 103°1° » oo | ORM. 78 104° » oo | OPM. 8g | 102:3° » 6 | 9am 78 | 104° » 28. |! 9am 68 102° » 9 | ORM 88 105° i as | 6 Bea 78 103 °2° » %@ | 9AM. 96 105‘1° » 29% | 9am, 68 | 102:2° || ,, ,, | 6pm. 110 | 106° » » | 6PM 72 | 102°3° » 8 | 9AM. 110 | 105-4° » 80. | 9am. go | 104° >>: | : 10°80 aa. | 108 | 105-4° » 9 | OPM. 86 | 1038°4° isos | 108 | 106° w ol. tO AM, 75 102°3° 93) 39 3 P.M. 86 105°3° » + | ORM 66 103°1° » 9, | 42M 72 104°4° June 1. | 9 A.M. 60 102° » 9 | 4°80 BM. Death. On the last day there was a copious discharge from nostrils and mouth. Horse kept on its legs till the last, and dropped down dead without a struggle. The capillaries of the skin and mucous membranes are espe- cially implicated in the congestions, and at all times there is a tendency to gangrene and decomposition of the extravasate, the products of which, being absorbed into the circulation, give rise to septicemia and death. In some instances, thrombi form in the vessels of the parts more extensively and persistently swollen, and induce sudden death by embolism in the vessels of some vital organ, or a more protracted one by pyzemia. PURPURA HAMORRHAGICA. 443 In other instances, effusion poured out into the lungs is con- verted into a fibrinous exudate, which tends rather to a retrograde metamorphosis than to organisation, forming a caseous or semi- caseous mass, and interfering most materially not only with the integrity of the organ, but with the general health of the horse. The more particular symptoms are petechial spots, of a dull mulberry or purple hue, on the visible mucous membranes. There is very often hemorrhage from the mucous surfaces, the discharged blood being dark in colour and often fcetid in odour. Extravasations also occur in the substance of several viscera, more particularly the lungs, spleen, and liver. The limbs, lips, and other depending parts of the body swell, the swelling aris- ing from extravasation of blood into the areolar tissue, and from the transudation of serum, and feebly coagulable lymph. The swellings are characteristic: they are generally uniform, extend- ing perhaps the whole length of a limb, and terminating superiorly very abruptly, as if a cord had been drawn around the part. They are painful, hot, hard, and in those portions where the skin is barely covered with hair, as the lips, nostrils, and inside of the thighs, shining; and if uncoloured, petechial spots are seen upon its surface, but where it is dark-coloured no spots are discernible. Vesicles of about the size of a pea are present upon the lower parts of the limbs, around the hock and fet- lock joints; these burst and discharge an amber-coloured acrid serosity that scalds and excoriates the surface of the skin over which it flows. Oracks and fissures appear at the flexures of the limbs, from which an unhealthy amber or purple coloured discharge issues. Swellings appear about the sheath, abdomen, and breast; these, in the earlier stages often disappear from one part of the body and reappear in another. In many instance the face, lips, nostrils, and eyelids become fearfully swollen; the swelling being tense, uniform, and end- ing abruptly about the forehead. This swelling of the head is apt to cause a fatal termination by interfering with the respiratory function; the swollen nostrils diminishing the calibre of the nares, great dyspnea is thus induced. By interfering with the movements of the tongue and jaws it also prevents the animal from feeding, and thus becomes an additional cause of debility. The skin over the swollen parts has a great tendency to slough, leaving large open and unhealthy looking sores, which 444 ERUPTIVE OR PETECHIAL FEVERS. discharge an unhealthy, foetid sanies. The pulse is feeble, often fluttering, dicrotonous—double, and there is great prostration of the vital powers. The bowels are at first generally con- stipated, but purgation is easily excited. Sometimes the feces are mixed with blood, and abdominal pains are often present. In some instances there is soreness of the throat ; but in purpura it is an accidental complication, and absent in the majority of cases. There is very often a hoarse or hollow cough, and a discharge of coffee-coloured fluid from the air passages. The petechial spots on the nose frequently slough, and leave a raw surface, from which issues an abundance of dark-coloured sanies, causing a snuffling sound in the nasal passages; and in some instances the tongue has been found swollen, with large, dark- coloured vesicles on its surface, containing much fcetid material. Some cases will commence to improve under proper treat- ment on the third or fourth day. Others take a much longer period, the fever being of a remittent character, and at all times the animal is liable to exacerbations from very trivial causes. It is with difficulty that the animal can be made to move, owing to the stiff and painful condition of the limbs; it will often stand rooted to one spot for hours or even days together. The urine is generally high, often dark-coloured, and emits a strong odour of ammonia; it contains much solid matter, and if kept in a vessel very soon undergoes decomposition. In many instances the enteric complications are very grave and important, and in every case there is a danger of sudden extravasation into the intestinal mucous membrane and alimen- tary canal, the extravasations being so excessive as to cause rapid death from internal hemorrhage. Causes.—In the great majority of instances purpura occurs as a sequel to some debilitating disease, more particularly catarrhal fever, and its origin can in most instances be traced to bad ventila- tion or drainage. When an animal suffering from catarrhal fever is kept in a well-ventilated, well-drained stable, and otherwise properly cared for, purpura is scarcely ever seen ; but if such an animal is housed in a badly drained, ill-lighted, and defectively ventilated stable, in fact, when it is compelled to inhale the products of decomposing urine, feces, and of its own breath for several days together, the blood becomes so empoisoned with effete products that it loses its integrity, accumulates in the PURPURA HAMORRHAGICA, 445 capillaries and smaller veins of loose structures, more particu- larly in the depending parts of the body, constituting those swellings which are so characteristic of purpura, and when withdrawn from the body it is only feebly coagulable. Again, I have witnessed the occurrence of the disease in horses apparently recovered from influenza and strangles, placed to work or taken to exercise while still debilitated. In rarer instances purpura may appear as a primary disease, traceable to defective drainage, ventilation, or bad food. I have witnessed a few instances where death has occurred in the horse without the usual external manifestations ; but where the post mortem examination revealed many of the characteristics of this blood disease, sometimes the animals have suffered from enteritis, sometimes they have sunk without manifesting any pain, have refused food, hung down their heads, the surface of the body being cold, they have become pulseless, and.died in a few hours. In one instance the animal suffered from several convulsive fits for three days, and died in one of them, the post mortem revealing darkness and fluidity of the blood, petechial spots on several internal organs, more particularly on the cerebro-spinal meninges. In this, as well as in the other cases, a careful examination of the tongue prior to death enabled me to detect the nature of the disease. This organ had a peculiar mulberry, purple, or claret colour, and that was the only symptom of blood alteration that could be detected, the Schneiderian membrane and conjunctive being merely injected. It may safely be concluded that the causes of purpura are of a septic nature, and are due to the absorption of products of decomposition extrinsic to the body; to the severity and rapidity of tissue change within the body, either owing to a previous disease or debilitating circumstances, and to their accumulation when naturally generated, owing to impairment of the excretory organs. The acute symptoms are generally of a remittent type, and when the practitioner is consoling himself with the belief that the animal is improving, it often happens that at the next visit the symptoms have become much aggravated, and the patient is rapidly carried off, dying perhaps on the second, third, or fourth day. In many imstances again the acute 446 ERUPTIVE OR PETECHIAL FEVERS. symptoms subside, and the animal begins to feed, but rapidly becomes emaciated, with great muscular debility, and inability to rise after lying down; these symptoms being accompanied by, or independent of, extensive sloughings of the swollen parts. When sloughing takes place, the skin and subcutaneous tissues assume a dry, leathery appearance, and separate tardily from the subjacent living structures; the discharge from the nose may continue, and the animal may die from repeated exacerbations, exhaustion, pyemia, glanders or farcy, or from gangrene of the lungs, on the third, fourth, or even sixth week after attack. In some cases abscesses may be detected in various parts of the body, in the glands; or the lungs, liver, kidneys, &c., may be infiltrated with purulent accumulations. In purpura, then, there is no doubt that the chief tissue of the body affected is the blood, the poison being a toxin which is absorbed. The inner lining of the blood-vessels is composed of a layer of cells whose vitality is derived from the blood passing through them, and any irritation of the blood will at once be felt by this layer of endothelium ; the capillaries, being composed of this layer only, will neces- sarily be the quickest to suffer disintegration, and so we find that effusion of a serous fluid and ecchymoses are amongst the first clinical symptoms of the disease. The post mortem appearances of those which have died during the early and acute stages of the disease are as follows :— Darkness and fluidity of the blood ; the subcutaneous tissues of the swollen parts filled with dark red or cinnamon coloured, feebly coagulable exudate. Dark spots will be found on the thece of muscles, and in the muscular structures of various parts of the body. They do not penetrate deeply into the muscular tissues, but the stain gradually decreases as the muscle is cut into, and some trace of it may be found to extend perhaps an inch into the thicker muscles. The various serous membranes—the pleura, endocardium, pericardium, and cerebral meninges—will be covered with petechial spots, the mucous membranes stained black or blackish-green. This colour will not be uniform, but interspersed with petechial spots, and in some instances the membranes will be covered with a thick layer of imperfectly coagulated blood ;} and, again, cinna- 1 T havea beautiful drawing, given me by Mr. C. Stephenson, Neweastle, of a brain and spinal cord of a horse which died comatose from purpura, showing the arachnoidean cavity, cerebral and spinal, filled with extravasation. PURPURA HAMORRHAGICA. 447 mon-coloured, gelatinous coagula will be found on the heart, along with a serous effusion, filling the pericardial sac. The dark spots become black on exposure to the air. The blood has a violet tint, and is variously altered on exposure; in some instances it reddens, in others, like the spots, it becomes darker. Kept in a vial closely corked, it will retain its fluidity for a very long period. (Healthy blood, to which ammonia has been added, can scarcely be distinguished from the blood of purpura.) The mesenteric and other glands are generally congested, friable, and enlarged; the liver, spleen, and kidneys are vari- ously altered,— sometimes merely congested, sometimes enlarged, softened, and containing a large quantity of dark-coloured fluid blood; the lungs dark, enlarged, pigmented, and more or less decomposed; the bronchi and trachea filled with dark-coloured extravasation. Treatment.—It is useless attempting to treat this disease with- out first removing the animal from all offensive smells, bad drains, and bad ventilation. Pure air, light, warmth, and comfort are the first essentials. Secondly, it must be borne in mind that the great danger of a suddenly fatal termination is from extravasa- tion into some internal organ, or even into the subcutaneous tissues. Some cases may die from the empoisoned condition of the blood, without the occurrence of any extravasation or even congestion, but these are rare compared with the first named. For the purpose of overcoming this tendency to extravasation, styptics, such as turpentine or ergot of rye, or astringents, as the tincture of the terchloride of iron, are sometimes successfully employed. If these are given in combination with an oleaginous purgative, any astringent effect which they might otherwise exercise on the alimentary canal is prevented. It must, however, be remembered that extravasations depend more upon the con- dition of the blood than upon the blood-vessels, and remedies which are calculated, either by their antiseptic or oxidizing pro- perties, to alter the abnormally fluid condition of the blood, are better calculated to attain the object than those which merely act upon an effect of the disease. For this reason, the chlorate of potash has been prescribed, and with marked results. Whether this salt acts as a direct antidote to the septic poison or not, is a matter which I cannot explain. Itis a fact that blood,when drawn 448 ERUPTIVE AND PETECHIAL FEVERS. from an animal suffering from purpura, or from one in a state of health, has its coagulating properties much increased when a small quantity of this salt is added to it. J have kept blood thus treated in a firmly coagulated condition for more than a year. Thecoagulation is so rapid and so firm that scarcely any serum is pressed out; and, what is most remarkable, there is but little contraction of the clot. The action of chlorate of potash is to increase the coagula- bility of the blood, and so to a great extent limit the tendency to exudation. Its antiseptic property may also be efficacious, but that is of very little account as compared with its first action, which, by so assisting the blood, gives the animal organism time to make an attempt at elimination before it is too late. Calcium lactate might with advantage be tried, it being said to be the most useful drug. Acting upon my experience as to the effect of the chlorate in promoting coagulation, and at a time when physiologists believed that fibrin was a natural constituent of the blood, I commenced to treat purpura with the chlorate, for the purpose, as I then supposed, of increasing the fibrin in the blood, and thus prevent the occurrence of congestions and extravasations. The result was most satisfactory; the swellings rapidly diminished, and restoration to health ensued in the great majority of instances. One ounce in the twenty-four hours is quite sufficient after the first dose, which may be from one-half ounce to an ounce, given at once. If more than this be given, intestinal irritation is apt to be produced, and the disease thus complicated. In addi- tion to the administration of the chlorate, it is necessary that the excretory organs perform their functions, in order that the morbid material and the products of tissue changes be eli- minated from the system; for this purpose oleaginous aperients are to be administered. The latest method of treating purpura is by the intratracheal injection of a solution of iodine, and to the success of which I can bear testimony from actual experience ; in fact, the effect has been most remarkable, improvement taking place very quickly in cases which threatened to terminate fatally. I do not recommend those strong doses used by some practi- tioners. The solution I use is made as follows:—Iodine 4 vrains, iodide of potash 8 grains, water 1 ounce. I have not found it necessary to use a larger quantity than this in the twenty-fow PURPURA HAMORRHAGICA, 449 hours ; the whole may be injected at once, or it may be divided into two injections daily. Beyond this, I think medical interference is uncalled for; and it may be stated here that much advantage is derived from non-interference, both in this and many other ailments of the lower animals. The convalescence is very often prolonged, great prostration remaining for a long time. The animal must therefore have a liberal supply of good food—oats, beans, hay, &c—and be care- fully groomed and tended. The mineral tonics may be adminis- tered, and daily aud carefully regulated exercise given. External treatment.—If the head be much swollen, and there be a difficulty in breathing from tumefaction of the nostrils, con- tinuous cold sponging must be ordered. The sponge may be dipped in cold water or in some weak astringent solution— vinegar and water, or the terchloride of iron tincture, largely diluted ; if the cold sponging fails to reduce the swelling, warm may be substituted, particularly if the weather be very cold, but beyond doing this to the head, I am of opinion that all other interference does much mischief. The swellings are but the result of the condition of the blood, and when the latter is restored to its normal standard the swell- ings will disappear. Indeed, an abatement of the swelling in one part of the body is often succeeded by tumefaction in some other, and perhaps more important structure or organ. The swellings are generally metastatic, and when they are confined to those parts of the body where they cannot endanger life, it is far better to leave them alone. Puncturing the swellings is usually recommended and gene- rally practised. In very severe cases of purpura admission of air into the degraded tissues causes deep and sometimes intractable sloughings. Punctures are, therefore, inadmissible. If there is dyspnea from swelling of the throat or nostrils, tracheotomy must be performed, and it ought always to be done early, as it is essential that the horse be enabled to breathe freely ; in fact, it must not be forgotten that oxygen in abun- dance is required by the vitiated blood. The incision into the trachea should be antiseptically treated; as there is a great tendency to gangrene of the exposed structures; entrance of the gangrenous products into the bronchi, indueing septic pneumonia, thrombi in blood-vessels, pulmonary gangrene, and death. 29 \ 450 ERUPTIVE OR PETECHIAL FEVERS. IL—SCARLATINA—-SCARLET FEVER. A febrile disease, characterised by an eruption on the skin, petechial spots on the nose or under surface of the lips, soreness of the throat, and sometimes suppuration in various parts of the body, particularly in the submaxillary space. Unlike the scarlatina which attacks the human being, it is a non-contagious disease, generally attacking but one or two horses in a large stud, amongst which some form of epizootic disease is at the time prevalent. Dr. Copland, in his Medical Dictionary, article “Skin,” says— « First, That scarlatina was originally a disease of the horse, and that it formerly occurred, and has recently occurred, epidemically or as an epizootic among horses. Secondly, That it was com- municated in comparatively modern times from horses to man. Thirdly, That it may be, and has been, communicated also to the dog.” If this be true, scarlatina of the present time must be very different from what it nas been in the past. I have seen numbers of horses suffering from it, but in no case did it ex- hibit any tendency to spread by contagion or infection; and I am of opinion that it is impossible to transmit it from the horse to any other animal. Scarlatina is divided by medical writers into—(1.) Scarlatina simplex; (2.) Scarlatina anginosa; (8.) Scarlatina maligna ; and (4.) Scarlatina latens. Of these the two first are observed in the horse, what is called the malignant form being identical with purpura; it is quite possible, however, for any of the forms to degenerate into purpura. Scarlatina is usually associated with epizootic catarrh, and occurs in animals that have been for some days suffering from that disease; and the production of such an alteration in the blood as induces the scarlatina is due to defective ventilation or drainage of the stable in which the animal has been kept, or to over-crowding, by which the air becomes loaded with decomposing animal matters. Sometimes a weak constitution will convert a catarrh into scarlatina, and the severity of an epizootic disease may alter the blood, and give origin to scarlatina. SCARLATINA. 451 Like chilblains, nettle-rash, and other affections where local swellings are the chief symptom, it is probable that this so- called scarlet fever is due to an excessive loss of coagulability of the blood. This is a common complication in chronic infectious diseases of animals, and people subjects of debility. In scarlatina the degree may be worse and more alarming, but the pathology would seem to be somewhat similar, in a minor degree, to purpura. It has been undeniably demonstrated that there is absolutely no connection between human scarlet fever or scarlatina, and this affection in the domestic animals. Semiology.—1. Scarlatina simplex.—On the third, fourth, or even as late as the sixth day after the commencement of epizootic catarrh, the animal is seen to be covered with blotches, upon the face, neck, body, and extremities. The blotches elevate the hair, but in many places there is scarcely any elevation of the skin, for if the hand be passed lightly over the apparent swellings, the skin is felt but little altered. In other parts of the body, particularly upon the inner aspect of the thighs, actual elevations of the skin in the form of rounded pimples can be both seen and felt. The nasal membrane will be covered with scarlet spots of variable size, and there will be a discharge from the nostril of at first a thin serous mucus, which afterwards becomes yellow or yellowish brown. The limbs are generally swollen, and the animal stiff in conse- quence. In some instances, no eruption is present, and the only evidence of scarlatina is found in the Schneiderian membrane, and perhaps the membrane of one nostril only will be covered with minute scarlet spots that escape the observa- tion of all but the practitioner. Soreness of the throat is almost a constant symptom, and if it has preceded the rash, it will in all probability be more or less increased ; but it by no means follows that soreness of the throat will appear concomitant with the rash. In a few days the rash and scarlet spots begin to disappear, and on the rash declining, some desquamation of the cuticle takes place, the skin being scurfy, and the coat dirty for some time afterwards. 2. Scarlatina anginosa.—The symptoms at’first may be those of the simple form, which, instead of disappearing, may continue to increase in severity. The limbs rapidly swell, the swellings 29—2 452 ERUPTIVE OR PETECHIAL FEVERS, appearing in lumps or masses, large, hot, painful, and numerous. These swellings may also appear on the body and face; they are inconstant in their seat, aften disappearing from one place and appearing at another, whilst the intervening spaces may be covered by a rash similar to that of urticaria, and by blotches not elevated to the touch. The skin covering the blotches will often be found moist, and an amber-coloured serosity will ooze from it. The petechial spots on the membrane of the nose in- crease in size, and become more intense in colour, assuming a tinge of purple, more especially at their centres; in other cases they coalesce, forming one large block, which covers the whole nasal chamber. The soreness of the throat now becomes very great, and is accompanied by a loud moist cough, and at each cough large quantities of a yellowish-red mucus are discharged through the nose and mouth. There is difficulty in swallowing, and in some cases in breathing, the inspiratory act being accompanied by a roaring noise, and by a snufiling nasalsound. The submaxillary lymphatic glands become enlarged, tender, and inflamed, and suppuration occurs after the other symptoms have begun to disappear. In favourable cases the soreness of the throat will recede with the eruption about the fourth or fifth day, whilst in others it will remain for some days after the disappearance of the rash. In all cases that recover, however, both the exanthem and angina will have disappeared by the ninth or tenth day, leaving the animal weak, emaciated, with swollen limbs, and in a more or less unthrifty condition for some time longer. The fever is usually proportioned to the severity of the sore throat, and very often, but not always, to the rash. In slight attacks, the fever, rash, and angina are of a mild character; but in the severer forms they are proportionately grave. The pulse, which is always of a weak or feeble character, varies from 60 or 70 in the mild, to 90 or even 100 in the severe forms; the respiratory movements are accelerated, and very rapid when congestion of the lungs is present; the urine is scanty, and of a thick yellow or brownish colour, smelling strongly of hippuric acid, and quickly becoming ammoniacal; the bowels are constipated, but diarrhoea is easily induced. Mr. Haycock describes the malignant form. I am of opinion SCARLATINA. 453 however, that what he thus describes is purpura, or a combi- nation of purpura and scarlatina. For a number of years I was of opinion that purpura and scarlatina were one and the same disease, but I have had occasion to alter this opinion, as typical cases of both diseases are not uncommon in Edinburgh. The distinguishing differ- ences between the two diseases are to be found in the character of—Ilst. The petechie, which, in scarlatina, are composed of minute dots, forming a blotch by coalescence; the spots may be as large as in purpura, but each is composed of several smaller ones; they are scarlet in pure scarlatina, of a dark purple in purpura. 2d, The sore throat. This is never absent in scar- latina, and but rarely present, unless it is a symptom of previous disease, in purpura. 3d. The swellings. In scarlatina, these are at first in the form of lumps or masses, whereas in purpura they present an even surface, occupying the face, or a whole limb or limbs, and terminate abruptly above, as if a cord had been drawn tightly around the part. 4th. Scarlatina is often associated with swelling and perhaps suppuration of the glands, whilst in purpura this is not present; and finally, the latter disease is characterised by a tendency to sloughing in various parts of the body, and occasionally by gangrene of some extreme parts of the organism, such as the ears, which will present a shrivelled and blanched appearance, become dry, and slough, leaving a raw, unhealthy surface. The animal temperature may not distinguish the one disease from the other. If scarlatina be severe, the thermometer may register 103°, or even higher; in purpura this would indicate a mild attack. Scarlatina is sometimes followed by inflammation of the joints, which is supposed to be rheumatic in character, and by suppuration in various parts of the body; but I am not aware that it is succeeded by renal dropsy, or associated with albu- minuria, as in the human being. There is generally more or less cedema of the limbs, breast, and abdomen, but these are not necessarily due to any renal complication, as they are common sequel to most debilitating diseases in the horse. Treatment.—In the milder forms of the disease it is sufficient to keep the animal in a warm, well-ventilated, light, loose box, to feed it on laxative food, and give small and repeated doses of the nitrate of potash, hyposulphite of soda, or chlorate of potash, 454 ERUPTIVE OR PETECHIAL FEVERS. in the food or water. The body must be clothed according to the weather, and the general comfort of the animal attended to. In the graver forms, the animal must be carefully watched, more especially with regard to its breathing, for in some cases the glottis and other structures of the throat rapidly swell, the larynx becomes constricted, and the animal may die from suffo- cation. Whenever this is threatened, tracheotomy must be performed ; and in all cases where the breathing is difficult, and accompanied by a loud roaring noise, this operation is to be resorted to, in order that the animal may obtain pure air to oxidize its already impure blood. The throat is to be repeatedly bathed with hot water and enveloped in warm poultices, and the animal made to inhale the steam of hot water. The mouth is to be frequently washed out with salt and water, and if the coryza is excessive some of it may be applied to the nose. If the face and nares are swollen, they must be frequently bathed with cold water, and afterwards dressed with some astringent lotion, such as a solution of the tincture of terchloride of iron. If the bowels are very torpid, a gentle laxative may be administered, such as one pint of linseed oil, but active purgation must on no account be induced; the nitrate of potash may be given freely in the food or water, and abundance allowed of the latter, which must be cold and fresh. If signs of purpura supervene, the chlorate of potash must be substituted for the nitrate. If much depression is present, draughts of spirits of nitrous ether may be given, provided deglutition is not difficult; but if the act of swallowing causes pain and cough, nothing should be forced upon the animal, or suffocation may ensue. Indeed, where the throat is very sore, even the oil must be withheld, and the bowels relieved by enemas, or by the sulphate of magnesia dissolved in the horse’s water. If he will drink this, it has a very good effect, but many horses will not drink at all if salts are dissolved in their water. After the first few days milk, or milk with eggs, is to be allowed in abundance, in order to support the animal strength. When the secretions are restored to their natural condition, and the soreness of the throat a little abated, a small ball containing carbonate of ammonia—the ball being well oiled—may be given two or three times a day with great benefit, and later on the mineral tonics, with bark or quinine. If soreness of the throat SCARLATINA. 455 and cough remain after the subsidence of the rash and fever, ulceration is to be suspected, and this can occasionally be detected by an examination with the oral speculum.—(See Principles and Practice of Veterinary Surgery, page 515.) It may be combated by a blister to the throat, or by direct appli- cation of the nitrate of silver solution to the part by means of a sponge tied to a piece of cane. When suppuration has occurred, the abscess is to be opened, as the abscesses of scarlatina eter become languid, and do not burst readily.1 Whenever the fever abates, and other signs of venpaisseeas appear, food of the most nutritious quality must be allowed in moderate—not over-abundant—quantity. Exercise should not be enforced until all febrile sions have disappeared, and the animal has to some extent regained its strength; even then much exercise is to be strictly forbidden. I have seen the most severe and rapidly fatal purpura caused by exercising the animal too soon and too severely. I have said nothing about the treatment of the external swell- ings of the limbs. I am of opinion they should not be interfered with, as they are but expressions of a condition of the blood which does not endanger the life of the animal, and will dis- appear spontaneously. The post mortem appearances are similar to those of pur- pura, with the addition of inflammation and swelling of the throat. 1 The frequency of abscesses in scarlatina points to the conclusion that one or more of the cocci of suppuration is present—most probably the Staphylococcus pyogenes albus. As has already been pointed out, staphylococci are always present in the skin, and if any circumstances arise which will debilitate the animal, and so lower its resistance to bacterial invasion, there is every possi- bility of these staphylococci setting up local lesions upon, or in, the epithelium. CHAPTER XLII. SEPTIC BLOOD DISEASKS. Distasss due to ordinarily non-contagious facultative parasites, but which become infective by inoculation in suitable soils. The most deadly microbes are Vibrio septicus of Pasteur, the pyogenic bacteria, especially the streptococci, and some are sufficiently virulent to poison the most healthy; but generally the animal body whilst in a state of health is not affected by their presence, unless, indeed, they are very numerous. Septic diseases are induced in two ways :—/irst, by the entrance of the microbes themselves into the general circula- tion (septicenvia), in which case the symptoms and results are not proportionate to the dose,—i.e., fatal results may follow a very small dose; and second, by the entrance of microbic products—toxins only (toxemia)—in which case the symptoms are proportionate to the dose,—i.e, if large, the results may be immediately fatal; if small, it is soon excreted, and, having no reproductive powers, the effects soon pass off. These microbes in their normal condition exist in external media, and only induce disease under circumstances which have rendered the animal body susceptible to the morbific effects of themselves or their ptomaines. For example, the body whilst in a state of health can generally resist the bacteria, unless very numerous; but when an organ or tissue injured—as in a wound —or diseased is exposed to the influence of such germs, they or their products overcome the resistance of the injured or diseased structures, penetrate the blood-stream, and give rise to grave disturbances, and even death. In proof of this I may refer to the experiments of Burdon Sanderson, who found that putrefac- tive fluids injected into the healthy peritoneal cavity of guinea- pigs produced no ill effects, but when the peritoneum had been irritated by an injection of some irritant, such as mustard and water, the virus penetrated the irritated membrane, inducing a general septicaemia, with rapidly fatal results. 456 SEPTIC BLOOD DISEASES, 457 Putrefaction is a form of fermentation, and as the yeast plant in alcoholic fermentation splits up the elements of the sugar into those of alcohol by a process of digestion, so the various putrefactive microbes consume the constituents of materials in which they are lodged, multiply rapidly when their food is abundant and suitable, alter its chemical combinations, the pro- ducts of such change being excreted, with or without fcetor, in the form of various chemical combinations, S.H. and N.H. and other organic bases, designated ptomaines, some of which are injurious and some actually preservative. The writer’s experience leads him to conclude that when the putrefactive materials are of vegetable origin, the products, subjected to sunlight and a plentiful supply of air, as in ponds, are generally innocuous, so far as the domesticated animals are concerned; but when they are of animal origin—cadaveric alkaloids, human ordure, decomposing animal fivids or solids, blood, milk, &c. contami- nating drinking water, the results are often disastrous. Many of my readers have repeatedly seen cattle standing in ponds during the hot summer weather for hours, polluting the water with their excreta, drinking freely of it, although in appearance it may resemble a green coloured gruel or porridge more than water. Yet they take no harm, indeed seem to thrive on it. If such water be examined microscopically it will be found to be swarming with bacteria of various kinds. But if such water contain the products of the decomposition of animal fluids or solids, even when sunlight and air are plentiful, there will be a repulsive odour, and unless forced, animals will not drink it; but when compelled for want of other supplies, the consequences are very prejudicial, the animals become emaci- ated, unthrifty, hidebound, often have diarrhea, with irritation of the respiratory mucous membrane, causing the animal to cough, and if the water be not changed death may result. The post mortem will reveal a general anemic condition, with broncho- pneumonia, and perhaps some degree of congestion of the gastro-intestinal mucous membrane ; as a rule, however, the lung lesions are in chronic cases more pronounced than those in the digestive tract. In some instances, and when the source of contamination is abundant, the animals may rapidly succumb to gastro-enteritis, with colliquative and foetid diarrhcea, great prostration of strength, high fever—106-7° F. or more—and other 458 SEPTIC BLOOD DISEASES. signs of putrid intoxication, arising from the absorption of the microbes or of the cadaveric ptomaine. These observations only apply to the putrefaction of vegetable materials when occurring in ponds or ditches exposed to air and sunlicht, for if the same materials are retained in leaky liquid manure tanks, and thus contaminate pump wells or other source of the supply of drinking waters, their effects are quite as disastrous as those emanating from animal sources. It is difficult to explain this fact, unless it be admitted that the algee and other vegetations of low origin, which grow abundantly in ponds exposed to sunshine and air, either destroy the septic microbes or produce an anti-ptomaine, which overcomes the virulence by breaking down the toxic materials into simpler forms—ammonia, &c. We cannot have a general septicemia without the actual presence of the microbes in the circulation, and the pathogenic causative organisms are existent in the blood. As a rule, however, the blood does not seem to be a suitable medium for their development and growth; they soon disappear from it, are destroyed by the oxygen, or are arrested in the capillaries of the liver, spleen, kidneys, &c., and are there quickly destroyed; their virulence is thus overcome, and the disease is not transmitted from one animal to another. In many cases, however, the germs remain external to the tissues, and act solely through their products, which gain entrance into the circulation and produce their virulent effects —toxic poisoning. In many instances microbes or their products gain entrance into the body from without—traumatic septicemia, septic metritis, &c.; but there are other instances where they are formed within the body itself, and microbes, always existent in the intestines, may give rise to systemic and local dis- turbances of a grave or even fatal nature. The intestinal mucous membrane—always in contact with decomposing materials—has the power, whilst in health, of excluding them from entrance into the circulation ; but when that membrane is irritated in any way and by any cause, it not infrequently loses that power of exclusion, and the ptomaines, indol, skatol, gaseous products, &c., instead of being eliminated, are absorbed into the blood, inducing high fever, local inflam- mation, diarrhea or dysentery, and even death. SEPTIC BLOOD DISEASES. 459 I think the above in a great measure explains why inflam- mation of the feet is such a frequent concomitant of bowel affections, even a slight irritation of the mucosa being suffi- cient to induce it, such as that arising from an ordinary pur- gative administered whilst the animal is in perfect health; absorption of gaseous products, as in flatulent colic; of putrefactive products in septic metritis; and in broncho- pneumonia, when the catarrhal products have been retained in the bronchii, and there undergone putrefaction. A form of poisoning arising from absorption of organisms or their products from the intestine has been named ster- coremia or intestinal septicemia, and is said to supervene upon a number of conditions, such as insufficiency of gastric juice to neutralise the majority of the germs wlich pass through the stomach, &c. In order to make this subject more easily comprehended, I have ventured upon the following arrangement:—(A) Toxemia, where the products only are absorbed; and (B) septicemia, where the microbes themselves, as well as their products, gain entrance into the circulation, and there increase and multiply. Under the first head may be included— I. Traumatic Fever.—The mildest form of septicemia. Causes.—Tissue necrosis, as in subcutaneous wounds, or in any effusion of blood, fibrin, or serum which undergoes but slight change from the mildly pathogenic staphylococci that are always present in the skin, and easily gain access through crevices in that tissue. They, in fact, find a favourable home in the skin and its appendages, but develop no lesions unless an injury takes place. Then normally the leucocytes are very quickly able to cope with them, and the inflammation they engender soon subsides. Symptoms.—Sudden elevation of temperature—two to four degrees—as soon as shock has passed off; no other consti- tutional disturbance, the temperature falling in a few days, according to the extent of the absorption. If disturbance occurs, it is certain that some complication has arisen. Il. Malignant wdema (Koch), gangrenous septicemia (Pas- teur), is caused by the small sporogenous cedema bacilli called ‘ibrio septicus by Pasteur, which exist in large numbers, par- ticularly in the upper layers of soil, and infection is easily hi 460 SEPTIC BLOOD DISEASES, produced by subcutaneous connective tissue inoculation, but not by intravenous injection, or when applied to superficial scratches on the skin; the microbes, being anaérobic, are killed by the oxygen, and granulating wounds form an in- superable barrier. Chauveau says that a first infection confers immunity. Some observers state that whilst the guinea-pig, goat, sheep, dog, horse, fowls, pigeons are susceptible to malignant cedema inoculation, cattle are absolutely refractory ; but Kitt states that he has induced the disease in calves as well as in the other animals specified above; and further, that these bacilli are probably the cause of several diseases in cattle, such as septic parturition fever, surgical tumefactions, progressive inflammation of connective tissue, &c. In the cedema of the septic centre the bacillus is found in the form of a rod with a spore at one end, or devoid of the spore, in which case itis of a slightly greater length ; in serous membranes it reaches a considerable length, and becomes segmented into non-sporulated sections, and only invades the circulating blood towards the end of the disease or after death. They are little affected by antiseptics, but are killed by boiling for fifteen minutes and by a dry temperature of about 250° F., and Cornevin states that by continuing the action of heat and antiseptics he has obtained a vaccine which confers a safe immunity on animals, and particularly the dog, against septi- cemia by them. The bacillus is a rod measuring 4 » in length by 1 » in breadth, with or without a terminal spore, but, as already stated, it may be much longer in serosities; it is motile, having very active flexuous movements, quickly arrested by contact with oxygen, and slowly loses its virulence through the influences of putrefaction (two months, thus differing from the bacilli of Chauveau, upon which putrefaction has no effect). Chauveau and Arloing state that corrosive sublimate 1 to 500 does not kill it, and a three per cent. carbolic solution has no effect unless assisted by heat. Sulphurous acid, however, seems to have a rather powerful effect upon it. It is preserved when dried even at 100° F. Symptoms. — Experimental inoculations in the connective tissues, particularly when protected from air, are followed by SEPTIC BLOOD DISEASES. 461 an cedematous, doughy, sensitive, and crepitant swelling, ex- tending in all directions, and there is intense reaction. The connective, adipose, and muscular tissues in the neighbourhood become the seat of gelatinous infiltration containing a large quantity of very fcetid gases, and a reddish-yellow liquid teeming with the characteristic vibriones, absent in the blood during life, and only found in small numbers after death. The central part of the swelling soon loses its sensibility, and becomes moist, clammy, and cold—gangrenous; the circumferences of the swelling, however, are hot, tense, and extremely sensitive, the vibriones having evidently abandoned the centre, as only putrefactive germs can now be found therein, and invaded the surrounding tissues, where they continue to live at the expense of its vitality, and so on in a regular invasion until a general infection results, manifested by pulmonary cedema and con- gestion of the intestinal mucous membranes, the bacilli being found abundantly in the serous discharges, and but sparsely in the blood. The disease may follow surgical operations, par- ticularly castration, when performed with unclean instruments. III. Stercoremia—Intestinal Toxeemia.—Absorption of bac- terial products from any tissue or a mucous membrane, whether abraded or not—(a.) when the products are those of pyogenic bacteria, or (0.) those of ordinary putrefaction, eg., Proteus B. coli conumunis. Symptoms.—These vary in proportion to the dose. (a.) The temperature rises several degrees, and remains so till absorption ceases, from the products becoming arrested in the course of natural drainage, such as free suppuration, free incisions, and irrigation, when arising from a wound. Constitutional dis- turbance well-marked. (b.) When the dose is large, rapid collapse may follow. (c.) Surgical shock is usually a septicemia, in which death oceurs in one to two days after severe symptoms, especially those seen after abdominal operations, castration, &c., owing doubtless to the enormous rapidity with which the peritoneum absorbs the bacteria and their products. IV. Hectic.—A chronic form of sapremia seen typically in long-continued ‘‘ mixed infections,” in chronic tuberculosis, where there is a constant absorption of small quantities of virus. 462 SEPTIC BLOOD DISEASES. Symptoms. — Irregular, with a tendency to periodicity of elevations and remissions, progressive emaciation, loss of appetite, and death from exhaustion. PARTURIENT FEVER. There are two distinct causes of post-parturient sapremia and septicemia— 1. Retention of the fatal membranes, or “* first cleansing.” 2. Retention of the lochial discharge, or ‘‘ second cleansing.” In health, after a female is delivered of young, there is a continuance of labour pains, known as after-pains, and as a result of these efforts the uterus contracts, and at the sama time any portion of foetal membranes which did not accom- pany the foetus are expelled. In most of the domesticated animals retention of these membranes for many hours results in grave lesions. The membranes, portions of which may protrude from the vulva, become infected with various organisms. These grow rapidly, and penetrate to the portions of membranes in the womb. The amount of toxin excreted by them is enormous, and if it be absorbed it gives rise to septic intoxication. In many cases the organisms themselves gain entrance to the wall of the uterus, and then there is a septic metritis, followed by a septic metro-peritonitis. The mare seems far more susceptible to this affection than any other of the domesticated animals; the cow less so than the rest. Retention of the membranes in the mare for a few hours may result not only in a septic metritis, but also in a septic laminitis and pneumonia, whereas in the cow retention may have been for days, and yet the animal feeds and milks, and has none but local symptoms. It is obvious from the above remarks that after a mare has foaled the membranes should be at once removed, and that in the cow one may with comparative safety leave matters to nature for a day or two. When an animal becomes affected, the first symptom is usually a more or less difficulty in standing, a swinging of the hind quarters, and a tendency to fall; the appetite fails, PARTURIENT FEVER. 463 the secretion of milk is suspended, respirations are hurried, pulse quickened, and temperature elevated. There are often strainings and expulsion of small quantities of dark coloured discharge of a most fetid odour. On further examination, the lips of the vulva may be puckered, the vagina hot and red, and considerable pain evinced if the os uteri be touched. If the surgeon passes his hand and arm right into the womb, he finds it distended, and containing considerable quantities of fluid and portions of foetal membranes. If an examination be made per rectum, the uterus can be felt as distended and with hardened walls. It is not until impending death that signs of delirium appear; and though there may be a paralysis of the hind quarters, there is never that comatose condition and complete loss of volition as seen in parturient apoplexy. With regard to treatment, if possible remove the patient to a clean loose box, and have a good bed of straw put down; then, after having smeared the band and arm with carbolised oil or vaseline, remove all remaining portions of foetal mem- branes which have remained in the womb. This must be succeeded by tepid injections of antiseptic solution, to be repeated twice or three times daily. As a matter of self-protection, it is advisable to thoroughly irrigate the womb prior to the removal of the membranes. The patient must be kept warm, and if necessary back- raked, and the urine withdrawn by means of a catheter. The medicinal treatment should be of an antiseptic char- acter—hyposulphite of soda, quinine, turpentine and oil, and such-like medicines. Saline purgatives and absorbents are contra-indicated. The strength should be maintained with eggs, linseed, and other mashes, and easily-digested nourish- ing foods. Post mortem appearances indicate a general septicemia, with enlarged, hardened, and inflamed uterus, containing quantities of foetid material. When the disease is due to the retention of the lochia, we have the history that the first cleansing, or fetal membranes, had been successfully cast or removed; further, that it is several days since parturition; and, finally, on examination through the vaginal canal, we find the os uteri closed, and 464 SEPTIC BLOOD DISEASES. so retaining the lochia, which had become infected prior to the closure. The cause of the two affections is the same—namely, de- composition and septic infection of the contents of the womb— and the line of treatment is the same in both. In the latter form it may be necessary to use considerable pressure with the fingers to open the os uteri. BRAXY, Septicemia Gangrenosa.—Braxy.—Striking of Blood, éce.— This is a well-known disease of sheep, particularly of young one-year-old sheep—hoggs—prevailing during the autumn and winter months, and is known in Scotland under two different terms—namely, ‘dry braxy” and “ wet braxy,” the latter form being characterised by more or less effusion of a reddish- coloured serosity into the peritoneal cavity. This latter con- dition is to be looked upon as an endeavour to excrete the morbid material from the circulation, and may be compared to the compensatory pleurisy and hydrothorax witnessed in septic broncho-pneumonia subsequent to parturition, or as a result of the ingestion of food containing ptomaines of animal origin. The Symptoms.—Untortunately in the majority of cases a sheep left quite well at night is found dead in the morning, and the shepherd judges of the nature of the disease by the swollen and discoloured appearance of the carcase. But if seen some time prior to the fatal result the first symptom seems to be manifested by a short step, then the animal stands apart from its companions with the head depressed and back arched. Tym- panites rapidly follows, the stomach becoming enormously swollen and distended with gases, and is resonant on percussion The other signs are those of colicky pains, lying down and rising alternately, or standing apart with the head and ears hanging down, the eyes dull, and the back arched; prostration and swelling of the belly rapidly increase, the sheep then goes down, and, although struggling, is unable to rise, when death closes the scene. The post mortem appearances are analogous to those seen in cattle, namely, a great tendency to rapid decomposition of the BRAXY, 465 blood and tissues; the blood-vessels are full of dark semi-tuid blood; bloody froth issues from the nose, mouth, and some- times anus; the flesh has a dark red appearance ; petechial spots are visible upon the serous membranes and in the subcutaneous tissues ; the abomasum and duodenum are highly congested, and covered with large dark-coloured spots of ecchymosis; the ali- mentary matters are mixed with blood, and the mucous mem- brane generally infiltrated in its substance, and coated on its surface with a layer of semi-coagulated, dark-coloured blood. The peritoneal cavity is generally filled with serum, and the bowels distended with fcetid gas. The pathology of braxy has yet to be determined, but it seems to be one of the forms of mycotic gastro-enteritis arising from the ingestion of grasses in a semi-putrefactive condition, as it is only commonly seen after the grasses have been more or less destroyed by frost, and is most common in frosty rimy weather, or when a hoar frost has covered the ground. When grasses in this half-frozen and withered state are eaten, the stomach, debilitated by the coldness or low temperature of its contents, is to some extent paralysed, and consequently disabled from per- forming its function. As its contents become warm, fermentation rapidly takes place, ptomaines and noxious gases are freely evolved, which, gaining entrance into the circulation, set up a fatal septic or putrid intoxication. In order to prevent this fermentation, I would suggest that, where it is possible, the sheep should be fed on hay in the early mornings, in order to moderate the keenness of the appetite, and thus ensure a slower and more perfect mastication ; and also, by elevating the tem- perature of the cold food, prevent lowering the temperature and vitality and function of the digestive organs. When sheep are folded on turnips, “sickness” might be prevented if this were done. Treatment.—Unfortunately there is seldom any opportunity of testing the efficacy of any remedy, but should there be an opportunity, the hyposulphite of soda might be administered, say in half-ounce doses, dissolved in half a pint of water, for a well- grown hogg or sheep. This remedy counteracts putrefaction, and has a slightly aperient effect on the bowels. Carbolic acid or. any of the other disinfectants are also serviceable, and to pre- vent death from suffocation the rumen should be punctured, and the gases allowed to escape. 30 466 SEPTIC BLOOD DISEASES, The flesh of sheep which have died, or been slaughtered whilst on the point of death, is generally salted and dried— made into mutton ham—and eaten with impunity in many parts of Scotland, and it can be truly said that it is at least equal, if not superior, to venison, and any one who is fond of high game would thoroughly enjoy a nicely brandered cut of it. Septicemia and pyemia in young animals are known under the terms pyemic omphalitis, navel-ill, pyeemic arthritis, joint- ill, erysipelatous disease, also called black spaud in Scotland. Omphalitis and arthritis will be found described in my Veterinary Surgery. Even a more marked form of malignant cedema or gan- grenous septicemia prevails and is known in Scotland by the term black spaud,a gangrenous form of disease seen in lambs under a week old, and characterised by the skin and subcutaneous tissues surrounding and extending from the umbilicus, becoming slightly swollen and assuming a dark purple colour. The discoloration and swelling are sometimes in large patches, covering the lower parts of the abdomen, breast, and sides, but more frequently they consist of one large diifuse patch, embracing the regions mentioned, and extending to one or both shoulders, hence the term black spaud (shoulder). This disease sometimes commits great havoc, the author having known as many as ten score lambs being carried away at one sheep farm in a few days. Etwology and Pathology.—lIf during the first few days of the lamb’s life, or before the umbilicus has completely closed, and a hard eschar formed, the umbilical cord be brought into contact with decomposing materials, both the germs and the products of the septic process may gain entrance into the umbilical canal, and there, acting upon its contents, set up the putrefactive process, which, extending into the surrounding tissues, induces locally congestion and thrombosis of the blood-vessels, characterised by diffuse mulberry coloured patches, with or without suppuration of the cord, and generally great and increasing prostration, and a rapidly fatal collapse, death occurring in a few hours after attack. On many farms the sheep slaughtered for food are skinned in the lambing sheds, the blood and offal allowed to remain on the ground, the skins thrown across the beams of the roof to dry; and the skins of others which have died of disease or accident BRAXY. 467 are also brought there, and allowed to remain there, very often until the next clipping season. From the foregoing observations it is evident that infection of the umbilical cord by the products of putrid decompositions which cover the floor of lambing grounds, particularly lambing sheds, is the starting-point of the infection. Can it be wondered that lambs dropped in such an atmo- sphere fail to escape the contamination ? Careful observers, whilst agreeing that permanent lambing sheds, contaminated as they necessarily must be by decompos- ing materials, are the great cause of both black spaud and joint-ill, state that both of these forms of septicemia are more prevalent during cold east winds; and they reason as follows :—I1st. That during cold weather the ewe does not cleanse 60 freely and quickly—indeed in some instances, owing to the debility induced by the cold, expulsion of the fetal membranes does not occur; that the retained membranes putrefy, giving rise to fcetid discharges and emanations: 2d. That in order to receive warmth the lamb clings more closely to the mother, and is consequently more exposed to become infected by the septic matters. Many who have experienced losses from this disease have now dispensed with permanent lambing sheds, and lamb their ewes in an open but well shel- tered spot, or in temporary removeable sheds. Treatment.— The disease is not amenable to medical or surgical treatment, therefore its prevention should be carefully studied. All lambing sheds should be abolished ; but if this is impos- sible, they should be thoroughly cleaned, lime-washed, and dis- infected before the commencement of the season, all skins and decomposing materials being first removed. The bedding should be dry, frequently removed and replaced ; all blood, foetal membranes, &c. swept away at the end of each day, and before putrefaction has commenced, or else the place will soon become tainted. If the disease has made its appearance, the ewes should be lambed somewhere else. Ifin the absence of sheds the lambing take place in the open air, the ground should be clean and protected from cold, particularly east winds, as these are acknowledged to predispose to the disease, and some anti- septic dressing, such as carbolised oil, or sublimate solution, applied to the umbilicus—(See Joint-IU, Veterinary Surgery.) 30—2 468 SEPTIC BLOOD DISEASES. Septic diseases may become contagious amongst animals under certain conditions, as in metritis of the ewe. Here the initial or spontaneous attack spreads amongst lambing ewes, but has no effect upon the males and barren females. SEPTIC PNEUMONIA OF CALVES AND LAMBS. This disease has prevailed to a considerable extent in various parts of England, Scotland, and Ireland during the last few years, committing great havoc amongst calves a few weeks or months old, killing them very quickly. Poels, who has studied this disease, states that it is due to the presence of a facultative bacterium which is found in the soil of certain farms, and the disease is thus rendered persistent on such infected lands. It is an ovoid bacterium with rounded ends, with a clear centre, measuring from go'9 9 tO yedou Of an inch in length, and gy$55 in breadth, staining with aniline colours, but not by Gram’s or Weigert’s. The same, or a similar bacterium, is found in the broncho-pneumonia of American cattle. The same microbe is said to be found in the diarrhea of calves—* white scour”— and calves fed with small doses of bouillon cultures, about 1}. drachms, become diseased, and die in one to two days. The same germ is found in the contents of the intestines of healthy calves, but destitute of pathogenic properties, and it is supposed by Jensen that it only becomes virulent under certain abnormal conditions, perhaps attributable to the diet, and that this virulence becomes increased by subsequent passage from calf to calf. The symptoms are those of pneumonia, with or without diarrhea. There is a cough, with discharge from the nostrils, and the catar- thal products contain the microbes, which are thus spread around with the expectoration and feces. Anyhow, it is admitted that the disease is transmitted from one animal to another, and Poels says that he has found the microbes in all the organs; and he is supported by Jensen, who has found them in the blood, spleen, liver, lungs, kidneys, heart, and in the mucous membrane of the intestinal canal. The disease is occasionally very fatal amongst sheep, par- ticularly lambs and others under one year old (hoggs), and SEPTIC PNEUMONIA. 469 Galtier states that it is identical with pneumo-enteritis of the pig, and that he has transmitted it from the pig to the sheep, guinea-pig, rabbit, and from these latter he has retransmitted to the pigand sheep. He has also transmitted it to the dog, goat, calf, donkey, and poultry, and toa goat in an advanced state of pregnancy, inducing abortion. The foetus when examined was found to have in the thoracic and abdominal cavities a sero- sanguineous exudate, containing the microbes, and reproducing the disease by inoculation. Since Nocard found that ‘‘ white scour” in Ireland was caused by a Pasteurella (bipolar organism), much more atten- tion has been devoted to these parasites. It is not now by all observers accepted, that white scour, joint-ill, and lamb-sick- ness, are invariably due to these organisms ; in fact, from the recent researches of Jensen, it would seem that organisms of the colon type are largely responsible, and Baldrey found only coli in an Indian outbreak. Jensen has made a polyvalent vaccine from colon organisms which he has found to be of exceeding benefit in preventing this complaint, and this again would point to the colon bacillus being the main factor. On the other hand, Ligniéres in South America, and Bowhill in South Africa, think that the Pasteurella is the cause of joint- ill and Lamzickte, or lamb-sickness ; and Ligniéres has made a polyvalent protective vaccine and a polyvalent curative serum from these bipolar organisms, which have also given good results in the Argentine. It would seem, then, that both organisms may play a part, and either may produce very similar symptoms. It has already been pointed out that a Pasteurella may induce an acute disease, but it may be impos- sible to detect the organism microscopically or culturally as in the case of contagious pneumonia. If a colon vaccine will induce immunity, then the disease in such an instance is certainly not a Pasteurellosis, and vice versd. The question as to cause, then, remains in some doubt. The post mortem appearances are those of intense pulmonary congestion, with or without pleurisy. In some cases a gelatinous exudate is found on the pleural surfaces, whilst in others they have simply presented a more or less deeply congested appear- ance. On cutting into the lung structure, minute yellowish- white spots are to be seen, and if the lung be pressed, a muco- 470 SEPTIC BLOOD DISEASES. purulent discharge will be seen to issue from the inflamed bronchi, and if this discharge be examined microscopically it will be seen to contain the microbes more or less abundantly. The pericardium, heart, liver, kidneys, and digestive tract will also often be found more or less inflamed. Treatment.—Assuming that the usually harmless microbe becomes virulent under abnormal conditions of the body of its host, and in order to limit the spread of the disease, separation of the sick from the healthy should at once be resorted to, and the surroundings cleansed and disinfected. Medicinally but little can be done beyond endeavouring to destroy the virulence of the microbe by the administration of carbolic acid, hyposulphite of soda, or remedies having a similar effect, as the condition of the animal might justify. 1.—SecrioN oF Liver or Mouse INFECTED with Tryp PARASITES IN A BrLoop-Vrsspr 2.--TRYPANOSOMA Equinum IN BLoop BEFORE TREATMENT OF THE PATIENT WITH ATOXxYL AND Trypan Rep. From ‘Trypanosomes, Trypanosomiasis, and Sleeping Sickness : Pathology and Treatment, by Wolferstan Thomas and Anton Breinl, in Memoir XVI., Liverpool School of Tropical Medicine. PLATE XVIII. ANOSOMIASIS, SHOWING THE ° Pe Sin ae hh aes “o) é a) ) sf ae Sees { | 990 { ees / 0 Seo / } aoe aS fe feo Lr ( ae 3.—TryPanosoma EqQuinum AFTER TREAT MENT, To face p. 471. CHAPTER XLIII BLOOD DISEASES. TRYPANOSOMIASIS. TRYPANOSOMIASIS (3 the term applied to a numerous class of specific diseases, due to the presence of hematozoa of the genus trypanosomes in the blood of the affected animal. Trypanosomes are morphologically recognised as being somewhat fish-shaped, each having a flagellum on the anterior end. They are endowed with life, and are of the animal and not of the vegetable world, and are classed as protozoa. If a trypanosome be stained by Romanowsky’s method, we find the body to be coloured blue; in the anterior end we see a red-stained nucleus, and at the posterior end a much smaller red-stained body, sometimes called the nucleolus, but better known as the centrosome. From this centrosome a thin red thread extends along the outer margin of the body right forward to the anterior end, where it becomes continuous with the flagellum. Trypanosomes multiply by longitudinal fission; first the centrosome, then the nucleus divides, and then a new flagellum appears ; it often happens that these young trypano- somes remain slightly attached to the parent, and thus give rise to the roseate appearance. Koch divides trypanosomes into two great groups, and this grouping is based on three important peculiarities—the mor- phology of the parasite, its virulence, and its relation to its host. The first group only exists in one species of animal; their virulence is constant but slight, and the group comprises the trypanosome of rats and the Trypanosoma Theilert. ‘'he second group, which includes all the other forms of 471 Fic. 38. 1, Resting stage of the trypanosome ; 2, stage showing formation of the new flagellum and division of the nucleus ; 3, trypanosome showing details of the division of the intranuclear centrosome and the nuclear substance ; 4 and 5, trypanosomes showing later stages of the same process ; 6 and 7, trypanosomes showing still later stages in the division of the nucleus and the characters of the intranuclear centrosomes; 8, trypanosome wherein the nucleus has divided into four con- stituents, although there is only one flagellum. 472, t TRYPANOSOMIASIS. 473 trypanosomes, exhibits great variations both in form and in virulence, and is not confined to one species of animal, but may affect horses, dogs, rats, &c., and what is of considerable interest, individual species may morphologically differ in different animals. Not only do they vary morphologically in different animals, but particular trypanosomes vary in virulence in animals of the same species. It is further shown that trypanosomes which have great virulence in some animals, have very little when inoculated into other animals, or gradually become modified in their virulence if passed through a series of animals of the same species. Thus, by inoculating dogs with trypanosomes of compara- tively small virulence, and reinoculating from dog to dog in series, we find that the virulence increases in each stage. Again, trypanosomes which are very virulent to oxen if introduced directly, are much reduced in virulence if first passed through rats and dogs. Many animals harbour trypanosomes which are seemingly harmless, but which if passed into other animals will give rise to virulent disease. The trypanosomes which are of most interest to veterinary surgeons are the causes of the following diseases, which will be discussed separately : Mal de caderas, Trypanosoma equinum (has no centrosome ?) ; surra, Trypanosoma Evansii; tsetse-fly disease (nagana), Tiry- panosoma Brucei ; dourine, Trypanosoma equiperdum. It may be well to state that at the present time the leading authorities are agreed that mal de caderas, swrra and nagana have many symptoms in common, but there are these differences : 1. Animals immunised from nagana may contract mal de caderas, but not surra. 2. In mal de caderas, hemoalbuminuria is almost a con- stant symptom, but it is an extremely uncommon one in nagana. 3. In mal de caderas paralysis is a most marked symptom, but it is rarely seen in nagana. Appended is the genealogical table showing the origin of the trypanosomes. BLOOD DISEASES. 474 *qs0.104UI oTueSonyed vB SulABY esOyy E78 SOTBIL UT poqyurad ore yey} solrurey oT, =a 490L “DIDDY *81804P10900 -soumosowwd ha T, | | “pusy) dong “dD IT “eyaurse[doued dry, “pypuosoundhs J, | | | ‘pypwusnidoug ‘sUlosesomey “quar ‘wpruosoundhsy, “eprmouloosty { | | | | “pozojphoowm “pypr9900 “BUIstyseud [Og ‘DpiUnwUozod | | | | | | *SPlULIOseLy “py dLowmorpr9o0y “eyepoSepg-ossQ “eyBleSe_A- OUI, 0701060) | | | , | | “VILOSNJUT *eII0JONG ‘pozoLodg -pLoydobysvyy “epodozigy | | | | | | | ‘pLoydouiy “DULOLPOWSD] | | [ | M0%0}0LT ‘VOZOLOUd 40 NOILVOIAISSV'TIO *“LYVHO : salogag :SQNGH + ATINVT :aaCTO :ssv19-aag : SSVI : WOGDNIY-20g : WOGANIS, MALADIE DU COIT. 475 MALADIE DU COiT. The name maladie du coit gives no further idea of the disease than that it results from the act of copulation. Other and various denominations, however, have been offered as express- ing more definitely the character of this affection, some having been founded on its supposed analogy with the syphilis of the human being, and others upon the predominance of certain symptoms which have most particularly struck the observers. Among these designations are the following :—Syphilis du cheval (syphilis of the horse); vérole ; typhus vénérien ; mala- die pustuleuse et chancreuse maligne (frambesia morbus pustu- losus) (Erdley); épizootic chancreuse (Hering) ; maladie véné- rienne du cheral; contagious eczema; paralytic disease of the horse; epizootic paralysis ; epizootic paraplegia (Signol) ; dourine, &e. DOURINE (MALADIE DU COiT—HORSE SYPHILIS). Due to the Trypanosoma equiperdum. These parasites are found not only in the blood, but also in other fluids of the body, and also in the discharges from ulcers. The Trypanosoma equiperdum is smaller than that of surra, being about 18 to 26 uw in length and 2 to 24 w in width (Baldrey). Infection is conveyed from animal to animal of the equine species, usually during the act of coitus (inoculation from an infected sponge or infected litter is improbable, if not impossible, as the protozoan parasites would be too weakened or even killed by such treatment) and, it is said, not by any other natural means; thus differing from other known forms of trypanosomatic disease, which are conveyed from animal to animal by means of flies. The disease may be induced in the ass, rabbit, rat, and mouse. The ox is said to be immune, but may have borne the parasite without showing any clinical symptoms. The period of incubation is about seven to fifteen days after infection from coitus ; it is less if artificially induced. After the period of incubation, the first symptom noticed 476 BLOOD DISEASES. is, in the male—urethral irritation and a discharge—and in the female a discharge from the vulva. Nocard divides the progress of the disease into three stages : Primary, in which there is urethral or vaginal irritation, with ulceration and discharge, and frequent attempts to urinate. The mucous membranes of the genital organs become reddened and swollen; and owing to this irritation the horse has frequent erections, and the mare shows signs of cestrum at short intervals. As the disease progresses the stallion has phymosis and paraphymosis, and oedema of the dependent parts of the body—wmore particularly the testicles and scrotum. Often the ulceration may extend to the sheath and the scrotum, but yields to ordinary treatment, only, unfortunately, to break out again. During this, the primary stage, there is little or no fever, and the appetite remains good; in fact, in many cases the appetite is voracious, though all the food taken is, as they say, ‘‘put into a bad skin,” and the animal pines. Secondary, four to six weeks, in which there are marked skin lesions—notably, an exanthematous condition of the skir and the appearance of ‘‘ plaques,’’ which look much as if odd shillings and half-crowns had been slipped under the skin. These patches come and go in a very indefinite manner. They exude a sticky substance, and sometimes become cedematous and then persist. This condition is always accompanied by progressive anemia and by involvement of the various lymphatic glands—more particularly those of the groin, which may suppurate at this stage. Owing to debility and neurotic affection in its initial stage the animal rests a great deal, is most apathetic, and has difficulty in rising, and when on its feet its power of progression is uncertain, and wobbly if trotted. Stallions and mares from the commencement of the disease are usually sterile, but if a mare becomes pregnant she is almost certain to abort. Tertiary stage, characterised by grave changes in the nerve centres, and terminating in paraplegia or partial paralysis, often of one leg only. In this stage of the disease the patient is very emaciated, MALADIE DU COIT. 477 there is more or less fever, the appetite is capricious, the mucous membranes now assume a pale pink colour, the urine is irritant and thick, the power of co-ordination is greatly interfered with, and it is with the greatest difficulty that the animal manages to even support itself, far less progress. Indolent abscesses appear in the scrotum and sheath, and, if it be possible, the animal gets still more shadowy and dies. During the whole course of this disease, which may extend over a period of eighteen months, or even more, it should be noted that it is an intermittent disease, having exacerbations as each new crop of parasites is born; but there is little elevation of temperature at this period, and there is not that marked subnormal temperature after the exacerbation as is seen in other trypanosomatic diseases. The disease might be confounded with farcy, but the mallein test would determine that. Again, the disease, being transmitted by coitus, is only seen in stallions and covered mares; it never occurs, naturally, in geldings or virgin fillies. Pease finds that a ready means of differentiating between surra and dourine is to inoculate a pariah dog with some blood from the patient. If it be dourine, the dog remains healthy ; if surra, the dog becomes ill from surra. GENERAL SYMPTOMS, As these are the same in both sexes, it would be useless to consider them separately. A more or less abundant discharge of a muco-purulent matter from the nostrils, and of tears from the eyes, saffi- ciently indicate that there is a general affection of the mucous membranes, of which those visible are highly injected. The lymphatic ganglia, not on'y in the vicinity, but also those in the submaxillary space, are engorged. The appetite is generally good, and the food thoroughly digested ; nevertheless, the animal gradually falls off in con- dition, and, to use a common expression, becomes hide-bound, with a dry and staring coat; the perspiration gives off an offensive odour. 478 BLOOD DISEASES. General weakness soon manifests itself by the weight of the hind quarters being thrown alternately and incessantly from one posterior extremity to the other. When the animal is caused to walk, the gait is very uncer- tain, and the sudden flexion of the joints is sometimes so great as to cause it to fall. There is a considerable tumefaction around the larger joints, and especially around that of the. haunch. This tumefaction is very painful, and causes the animal while at rest to lift its leg with a sudden jerk, after the manner in which a horse with stringhalt behaves when caused to move suddenly, but it places it more carefully on the ground again than does the latter. When both limbs are affected, this movement is manifested alternately. These symptoms of lameness are sometimes intermittent, disappear- ing for a week or two, and then reappearing with a greater intensity. After some time the appetite becomes exceedingly capricious, but is never entirely lost, the animal continuing in many cases to eat till within an hour of its death. One or both hind extremities now become paralysed, causing the sufferer to fall upon its litter, and the entire muscular system becomes atrophied, but more especially the hind quarters and legs. The mucous membrane of the nose becomes of a yellow and the buccal membrane of a leaden colour; and there may be slight constipation. Unless pneumonia or other complications of the respiratory organs set in, the respiration remains natural. M. Rodloff has often observed horses suffering from this disease become broken-winded. In the mare, one or other half of the mammary gland sometimes becomes the seat of an inflammation, which usually terminates in suppuration. Post mortem reveals great emaciation, no fat, blood pale and small in quantity; yellow, gelatinous exudation beneath the skin, and in dependent parts of the body; enlarged spleen; bones fragile (from removal of salts); bone marrow of a brownish hue ; articular cartilages often eroded. The cord in the lumbar region is reddened and softened, and the superior columns degenerated. MALADIE DU Coit, 479 Treatment.—Castrate the stallions and segregate all mares. In a country like Britain we should undoubtedly destroy all affected and suspected animals. As a matter of fact, once an animal contracts the disease there is little or no hope of curing it, and it is always a source of danger to other animals, so the above course is much the best for all concerned. CONTAGION, The contagious properties of the disease have been denied by some, but the experiments of M. Lafosse are sufficient to convince the most incredulous. In 1852 that gentleman took fifteen healthy mares from a regiment stationed at Toulouse (where the disease had never been seen, and where it has never since reappeared), and presented them to affected stallions which had been brought for the purpose from the Dépots de Tarbes, where the disease was then raging. Five of these mares became affected to a slight degree, the disease disappearing spontaneously. Five others became seriously affected, one of which only recovered ; thus showing that five only entirely resisted, while four succumbed to the disease. Other experiments could be related, but I think the above is quite sufficient to show that its transmission during the act of copulation is undeniable. Tt is, however, just to observe that numerous experiments by inoculation were conducted without result, before the con- tagion was denied. M. Hering, notwithstanding, succeeded in one instance in producing the disease by rubbing the mucous membrane of the vagina with the virulent matter. It is worthy of remark that stallions offer more resistance to the contagion than mares.—(M. Reynat.) The actual cause, as already stated, is the Trypanosoma equiperdum. The organism is never found in great numbers. In the early stages it may be seen if a very careful examina- tion be made in the discharge from the local lesions, but more certainly by harpooning the testicle and obtaining some of the seminal fluid. It is invariably found in the plaques in the second stage, and in the third stage has been seen in the spinal fluid. The presence of one organism is sufficient for 480 BLOOD DISEASES. diagnosis, and this may entail the examination of many preparations. It is not so active or so large as the surra parasite, and is no more present at periods of fever than at any other time. It is rarely, or never, found in a droplet of blood taken from the general circulation except when done so from a plaque. Contagion is entirely by coitus, and not through the medium of any fly. In this it differs from all other trypanosomata. POST MORTEM APPEARANCES, The post mortem appearances with regard to the genital organs do not coincide in different subjects. The lesions of the external organs and of the mucous membrane are, how- ever, constant. On cutting through the skin it will be noticed that in- variably there is a layer of thick yellowish gelatinous exu- date, which drips continuously a yellowish fluid. This is observed over the whole of the subcutaneous tissue, but par- ticularly of the abdomen. The sheath, when cut into, presents the appearance of a hard, homogeneous, yellow tissue, but on a closer examina- tion the fibres of the areolar tissue may be distinguished, and between them the serosity which gives the appearance indi- cated. The penis is partly protruded from the sheath, and slightly infiltrated towards its free extremity. On its external surface, though very rarely, small whitish elevations, formed by the infiltration of a small quantity of serum under the epithelium, have been observed. Small dried coagula of blood, which give the ecchymosed appearance mentioned in the symptoms, have also been encountered; but the mucous membrane offers no other alterations than a slight protrusion, a thickening, and a yellowness in colour. The mucous membrane of the vesicule seminales is said by some to offer a red or violet appearance, containing a yellowish thick matter of a purulent aspect; by others, the vesicule seminales, as well as Cowper’s and the prostate glands, are said to be in a normal condition. The testicles may either be healthy, atrophied, or hypertro-. MALADIE DU Coit. 481 phied. When hypertrophied, a yellowish serosity is found in their interior. In the mare the mucous membrane of the uterus and vagina is thickened, ecchymosed, and of a reddish-brown colour. In the uterus a muco-purulent, yellowish-white, or a chocolate-coloured fluid, analogous to that which flows from the vagina during the course of the disease, is found in greater or less quantity. It is said to have been so abundant in some cases as to have given the patient the appearance of being pretty far advanced in gestation. The kidneys may be either in the normal condition or they may be hypertrophied. Their pelves contain a substance resembling the white of an egg, which has been found to be abundantin albumen. M. Lafosse has found them to contain, in exceptional cases, a substance similar in appearance and consistence to honey. The mucous membrane of the ureters and bladder of both sexes present a similar aspect to that of the womb in the female. The muscles are friable, as are also the boues, especially the femur and ribs, of which the spongy tissue is generally impreg- nated with a dark-coloured blood, or with a yellow gelatinous matter. The coxo-femoral and pubio-femoral ligaments are red, thickened, softened, and sometimes ruptured. The synovia of the articulations is abundant, muddy, and presents the colour of blood. : The cartilages are yellow and soft, and have sometimes disappeared from the articular surfaces. The fatty matter has everywhere disappeared. The subglossal, sublumbar, and mesenteric ganglia, as also those in the vicinity of the urino-genital organs, are consider- ably enlarged, and of a yellow or reddish-brown colour. They are sometimes found to contain purulent matter. The French authors describe no other lesions in the cranial cavity than the superabundance of the subarachnoidean fluid, while the German authors affirm that the brain is in a degenerated state. They, however, agree that in some cases the spinal cord is softened, particularly in the lumbar region. It may, how- ever, be remarked that when the disease terminates in para- plegia, if this condition of the cord be not found, it is at least slightly congested. ss 4S2 BLOOD DISEASES, Occasionally the volume of the sacro-lumbar plexus and sciatic nerves is augmented by a serous infiltration. The digestive organs are healthy; in some instances, how- ever, the liver and spleen are enlarged and softened. The lungs are healthy (unless the disease has become com- plicated by pulmonary affections), but the mucous membrane of the bronchial tubes and larynx is slightly affected. The sinuses of the head often contain a yellowish, oily matter, and the Schneiderian membrane is of a leaden colour, with red spots scattered over its surface. The muscular tissue of the heart, like the rest of the muscles, is soft, friable, and of a pale yellow colour. The blood is very much altered ; it is fluid, deficient in fibrin, and, according to M. Lafosse, who has made microscopical examinations of it, the coloured corpuscles present a deformed appearance, TREATMENT. Antiphlogistics (including bleeding), emollients, tonics, stimulants, alteratives, &c., have all been employed in this disease, but with so little success, that until the appearance (in 1865) of M. Trelut’s memoir it was believed incurable. M. Trelut, after a careful study of the disorders produced in the organism by the maladie du coit, adopted an entirely different treatmeit, the efficacy of which is beyond a doubt. Being struck by the fact that the blood of animals suffering from the disease was deficient in one of its most important elements, viz., the fibrin, he thought that if this constituent were renewed in the vital fluid the disease might be overcome. He accordingly procured the necessary fibrin by stirring the blood of cattle when warm, thus separating the fibrin from the other constituents. The fibrin obtained in this manner was dried in an iron pot, in which a little butter had been melted to prevent carbonization; it was then divided into small particles and administered in the morning, fasting, in doses of sixty grammes (5xv.), either as an electuary, or added to half a quart of gruelasadrench. To stimulate digestion twenty or thirty grammes (4v. or Zviiss.) of turpentine were ad- ministered every second morning with the drench. From 3i. to Ziiss. of iron, reduced by hydrogen, alternated with from MALADIE DU COIT. 483 fifteen to thirty grains of the white oxide of arsenic, were also given, and food of the most substantial kind was allowed. As the patients under the charge of M. Trelut increased, he found that a sufficient quantity of fibrin could not be obtained in the manner described. He then substituted for the pure fibrin of the blood of cattle cooked horse flesh, very finely divided, and administered in the water which had served to cook it. When the bouillon was finished, the flesh was mixed with honey and given as an electuary. Were it not important to utilise the soup, says M. Trelut, the flesh could always be given most conveniently in the latter manner. The flesh was administered in doses of from 100 to 150 grammes. When paralysis set in, cantharidine liniments, followed by mustard poultices, were applied to the abdomen; and as soon as an abundant effusion had been established, the pointed firing-iron was applied, penetrating as deeply as possible, in order to fix the engorgement. After the establishment of this engorgement the paralysis became gradually ameliorated, and in twenty-four hours, the animal, which was helplessly stretched upon its litter, was able to regain its feet without assistance. The internal treatment requires to be continued at least forty-five and at most 145 days, and on an average from two to three months. By this treatment M. Trelut was successful in sixteen cases (in.which the patients were seriously affected) out of seventeen. The seventeenth was a mare which aborted, and the lesions of metro-peritonitis found at the autopsy would have been sufficient to account for her death.—(Memoire sur la Maladie dite du Coit, par M. Trenut, Recueil de Médecine Vétérinaire, Janvier, 1865.) Local treatment.—In stallions, during the first stage, or that in which the disease is confined to the genital organs, it was stated that good results had been obtained from castration. In the mare, mucilaginous injections, followed, later on, by mild antiseptics, astringents, and still later, if necessary, by the sulphate of copper, sulphate of zinc, or nitrate of silver, &c., have been recommended. Castration is beneficial in the early stage, and probably acts by removing all the organisms, as they would appear to 81—2 48 4 BLOOD DISEASES. be located in this region for a considerable time ; it is useless after the disease has become generalised. No satisfactory medicinal treatment has yet been discovered, although it is quite certain that cases do recover without any treatment. It is probable that the alternate administration of arsenic and mercury, as it is now being applied in the treatment of sleeping sickness and nagana, and was first suggested by Lingard fifteen years ago, might have beneficial results. The theory of giving the two alternately is that the arsenic acts upon the organisms when they are motile in the blood-stream, but does not kill them; they simply become encysted. The mercury will then attack them and cause their speedy disso- lution. COITAL EXANTHEMA OF HORNED CATTLE. It is stated in Friedberger and Frohner’s works on pathology and therapeutics of the domestic animals that this disease is more frequent in cattle than in horses simply on account of their greater number. It is very contagious, as all the cows of a village may be infected by one bull, and it is said that it is communicated by friction of diseased against healthy cows, and by continual wagging of the tail. In oxen Numann has observed the eruption around the anus and sheath. Armbruster states that the contagion is conveyed by wooden drains—when animals lie down, their genitals coming in contact with these drains —when these are contaminated by diseased discharges. Schneiper says that the disease may affect the same subject several times at short intervals. The symptoms are similar to those observed in the mare There is intense pruritus, vaginitis with redness and tumefac- tion, muco-albuminous secretion; membrane covered with dark red spots, vesicles, and pustules of various sizes, which rapidly ulcerate, the discharge from which contaminates the perineal region and tail, drying up, forming crusts; micturition is difficult, and manipulation causes much pain. The appetite, secretion of milk, and other signs of general disturbance are frequently present. The duration of the disease seems to vary from eight to fifteen days, and more rarely from three to four SURRA. 485 weeks. Some cows abort. In the bull there is much tume- faction of the genitals, the penis studded with pimples, and there is a discharge of a yellowish purulent material from the urethra ; phymosis is frequent; erection causes the ulcers to bleed; there is more or less constipation and loss of appetite. Local antiseptic and astringent treatment is recommended. AN AMIA—SURRA. A fatal form of anemia has been observed on the Continent of Europe, in India, and Burmah. Some observers state that it is due to a fine bacillus in the blood, and that it is infectious ; whilst Evans, Burke, Steel, and Lingard, who have studied it in India, where it is well-known under the name of Sura, have discovered that it is due to the presence of hamatozoa—the Trypanosoma (see Chart)—in the blood of the affected animals —horses, mules, camels, elephants, donkeys. The hematozoa are also found in rats and bandicoots, and in honour of its discoverer, Evans, it is now called Trypanosoma Evanst. Evans, when he first discovered the parasite, thought it was a spirillum, but further examination convinced him that it belonged to the animal kingdom, presenting when fresh and active an apparently round body, tapering in front to form a neck, and terminating in a blunt head, and posteriorly a tapering tail, extending from which is a long slender lash. He also states that at the head end there appeared in one or two cases a circlet of pseudopods, and as the body slowly died in serum it gave the appearance of flattening out. After watch- ing carefully all the forms and movements of the parasite, he concluded that on each side of the body there existed two pin- like papill, one near the neck and the other close to where the tail began; but he only observed them in a very few instances, and supposed they were of the nature of pseudopods. The parasite is very active in its movements, with an undu- latory eel-like motion, moving generally with head foremost, put occasionally in the direction of the tail lash, when, as Captain Appleton, A.V.D., describes it, tugging at and worry- ing a red corpuscle: they thus attack and disintegrate the red corpuscles, 486 BLOOD DISEASES, Sometimes two will unite and swim off as one body. Evans thought that they joined heads and tails; others thought that they fastened with their tails in opposite directions. The disease is not contagious or infectious in the ordinary sense, but can be communicated by subcutaneous inoculation, and by the introduction of blood containing the parasites into the stomachs of healthy animals. Steel differed from Evans as to the exact classification of the parasite, maintaining that it resembled the spirillum of relapsing fever in man. Notwithstanding this error, it must be admitted that he did good work when the disease broke out in British Burmah in 1885, confirming its communicability by inoculation of blood containing the parasites to the dog, horse, mule, &c., that the disease was relapsing in its nature, that the parasite appeared as the temperature rose, and disappeared during the non-febrile periods; and he concluded as follows :—* That relapsing fever of mules is invariably a fatal disorder, charac- terised by the periodical occurrence of attacks of high fever, during which a special organism closely resembling the spirillum of relapsing fever in man is found in the blood. This organism is one-sixth of the size of a blood corpuscle in width, and three to six times in length, &c. All observers conclude that the parasites are not always present in the blood of the diseased animal, but come and go in successive broods.” Seeing that Evans and Steel differed in opinion as to the exact classification of the surra organism, Evans referred the matter to the late Dr. Timothy Lewis, who concluded that it resembled, but was not exactly like, that which he had dis- covered in the blood of rats, now called. Trypanosoma Lewist. The matter was further referred to Crookshank.—(“ Journal of Royal Microscopical Society,” part 6.—“ Flagellated Protozoa in the blood of diseased and apparently healthy animals.”) He says, page 916 :—“ In the face of these conflicting opinions, Dr. Evans was good enough to place in my hands for investigation some preparations of the organism in the blood as well as material from the lungs and intestines of a camel that had succumbed to the clisease. “On examining a stained preparation with a power of 200 diameters, a number of the parasites could be distinguished in the field of the microscope, and with a 1/12 and 1/18 O.L. (oil SURRA, 487 immersion) the individual characters were clearly brought out. These were quite sufficient at once to dispel the idea of its being a spirillum. It was obvious that it was a more highly organised micro-parasite, presenting very peculiar and distinctive structural appearances. “ The first glance at the parasites recalled the appearance of nematode hematozoa, as if, indeed, they might be embryonic Filarice ; but when I had carefully studied several specimens, and had further undergone the searching examination entailed by the accurate focussing necessary to obtain a number of sharply defined photo-micrographs, I came to the following conclusions : “The somewhat tapering central’ portion or body of the parasite is continuous at one end with the whip-like lash, and at the other end terminates in an acutely pointed stiff filament or spine-like process. Here and there, possibly from injury or want of development, the spine-like process appears to be blunted or absent. By carefully focussing on the upper edge of the central portion, I discovered the existence, much more markedly in some of the parasites than in others, of a longitudinal membrane, with either straight or undulating margin. The membrane is attached along the body, arising from the base of the rigid filament, and becomes directly continuous at the opposite end with the flagellum. Insome cases the edge only is deeply stained, giving the appearance of a thread continuous with the flagellum, so that one might be easily led to overlook the membrane, and imagine that the flagellum arose from the opposite end of the body, at the base of the spine-like process. “ Close to the base of the spine-like process, a clear unstained spot is in many parasites easily distinguished, and at the opposite end there is in some the appearance of the deeply stained protoplasmic contents having contracted within the faintly stained membranous investment. Where the longitu- dinal membrane has a wavy outline the undulations are much more marked in some cases than in others. Here and there the wavy outline appears first on the one side of the central portion and then on the other, but there never is any wavy outline on both sides of the same part of the body ; and this was explained by careful examination, which showed that in dying the some- what ribbon-like parasite had become doubled on itself. The discovery of this undulating membrane at once suggested to my 488 BLOOD DISEASES. mind an explanation of the lateral pseudopodia described by Evans. “Tf we imagine that we are looking down upon the parasite, with the edge of the membrane towards us, one can conceive that the rapid undulations, first on one side and then on the other, might give an image upon the retina which could be construed as due to protrusion of lateral pseudopodia, “T may add that I could not discover in the stained prepara- tions any trace of the circlet of pseudopods, and I think the undulating membrane may account for this appearance also.” Fic. 39.—Monads in Rat’s Blood. a, A monad in free motion among the cells, b, Another, attached to a red corpuscle, c. Angular form. d. Encysted form. e. The same seen edgeways. f and g. Normal red blood corpuscles, h, Crenated red blood corpuscle. i. White blood corpuscle, SURRA, 489 Owing to the somewhat curved and twisted shape of the parasite, and the curling of the flagellum, in the stained pre- parations it was difficult to make exact measurements, but I was able to ascertain that the average width, according to whether the membrane was visible or not, varied from 1 to 2 w, and the length of the body from 20 to 80». The flagel- lum was about the same length as the body. Similar, if not identical, parasites are found in the blood of rats, bandicoots, mudfish, and carp, apparently inducing no inconvenience to their hosts. There is no longer any doubt that the Trypanosoma Evansi is the causal agent in surra. This protozoan is of the family Flagellata, measures from 25 to 30 » long, andisfrom1to5 broad. The flagellum, a continuation of the undulatory membrane, is atthe anterior end. It usually moves in this direction, but may proceed backwards. There is an ovoid granular macro-nucleus about the centre of the body, and a small circular micro-nucleus or centrosome, com- posed of chromatin at the posterior extremity, from which the flagellating membrane arises ; this membrane is also composed of chromatin. Multiplication occurs by longitudinal division, usually commencing at the centrosome. It is extremely probable that there is an intermediary stage occurring in some other host, in the same way that the malarial parasite of man has an intermediary stage in the mosquito. At present our knowledge as to the habitat of these organisms during the apyrexial stage of the disease is very incomplete, although encysted forms have been observed in the spleen. This subject is at present engaging the atten- tion of many scientists. In the case of nagana, the means by which the disease is conveyed is by a biting fly, named the Glossina morsitans. The method of contagion is purely mechanical—i.c., a fly bites an infected animal, and some organisms collect with the indrawn blood in the proboscis of the fly. This dipterous insect, by then biting another healthy animal, will infect it with living trypanosomes. In the case of surra, a fly has not been absolutely demonstrated as the carrier, but there is considerable evidence to show that a fly of the family Tabanide is the agent that transmits the disease from infected to healthy animals. The question as to the method by which the disease is 490 BLOOD DISEASES. carried over from one fly season to another is a difficult one; but it would appear from investigations made by Pease and others that cattle may be infected with the disease although they show no pathogenic symptoms. These animals are bitten by the Tabanus, indiscriminately with horses, and may serve as a medium for promulgating the infection. The whole subject, however, requires further experimental research. The ques- tion of rats conveying infection is not now taken into con- sideration, the parasite usually found in these animals being the Trypanosoma Lewisi, which has nothing to do with surra, though the parasites are much alike. Rats may acquire surra, but probably only be experimental inoculation. Corn, grain, and food generally may also be eliminated, and we may now accept that surra is entirely a fly-borne disease. Tha rat, owing to its habits of life, being very urlik:'y to suffer from the attacks of Tabanide. . It was discovered by Lingard that one attack did not render an animal immune to a second, and the following experiment is interesting as bearing on this point: Twelve months after an Australian horse had been cured of surra by the adminis- tration of arsenic, iodide of arsenic, and mercury, this horse was inoculated with a minute drop of surra blood—a mere trace of soiled blood being smeared over a scratch on the muzzle—in order to ascertain whether any immunity had been given by the previous attack. The latent period of the second attack occupied seven days. The progress of the disease was marked as usual by paroxysms of fever and inter- missions, the former occupying a much more prolonged period (twenty-two days) and the latter being shorter than usual (only two days). Death took place on the fifty-third day of the disease, clearly proving that one attack of surra is unable to protect against a second attack.—(Lingard, Report on Surra to the Inspector- General, Civil Veterinary Department, Simla, 1895.) Symptoms of Surra.—Outbreaks of this disease occur in India and Burmah chiefly after the rainy season. The more prominent symptoms observed at first are a capricious appetite, dulness, and slight fever, which after a few days’ rest frequently pass off without medical treatment. When a relapse occurs, which is almost invariable, there is an increase of fever, the mucous NAGANA OR TSETSE-FLY DISEASE. 491 membranes are yellow in colour, and petechiz become apparent, also local or general urticaria. There is generally some cedema of the limbs, also beneath the belly, chest, and sheath. The urine becomes much altered, viscid, of a dark yellow or orange- green colour, frequently containing albumen and blood. The animal becomes emaciated, and great thirst is invariably present. There are occasionally catarrhal symptoms. The lungs may be more or less congested, and breath foetid. There are periods of remission, marked by improved health, which is merely transitory, as repeated attacks of increasing intensity finally end the animal’s life. This disease, according to the condition and age of the animal attacked, may last from a few days to several months before death occurs. It is very fatal. The disease, until quite recently, has not been amenable to any line of medical treatment. Professor Lingard, however, has been experimenting with the arsenic treatment, with some amount of success in patients possessed of vigorous constitutions. NAGANA OR TSETSE-FLY DISEASE. Due to the injection into the circulation of horses, cattle, dogs, goats, donkeys, and wild animals of trypanosomes (Trypanosoma Brucei), in one of their stages of development, by the tsetse-fly. Symptoms in the Horse. The period of incubation is from fifteen to twenty days. After this period of incubation, during which the hematozoa multiply to an enormous extent, we notice that the patient is dull, his coat stares, and there is a watery discharge from his eyes and nose. Shortly afterwards swellings appear beneath the abdomen and in the sheath; then the hind-legs become swollen—these swellings are remarkable in the fact that they come and go; during this period he rapidly loses condition and becomes weaker and weaker each day, even though the appetite is maintained till death supervenes. The mucous membranes at first are pale, the cornea be- 492 BLOOD DISEASES. comes cloudy, and he may become totally blind, and the dis- charge from the eyes continues to increase. In the later stages the conjunctival mucous membrane is covered with dark purple petechiz and patches. During the progress of the disease the temperature is very variable, somewhat as follows on consecutive days — 98°, 103°5°, 100°, 106°, 102°, 105°, 100°, 107°, 100°, 102° F., and so on for about six or seven weeks, the afternoon temperature being as a rule higher than that of the morning, the patient by now being nothing but a bag of bones—so thin in his quarters that his anus falls inwards and his thighs are quite apart—his coat is ragged, dirty, scurfy, and the hair has fallen off in many places, and there are dropsical swellings at the dependent parts of the body. He becomes too weak to stand, and ultimately dies of exhaustion. If during the course of the disease an examination of the blood be made, the trypanosomes can be easily seen, varying in number on different days, some days great in number—and on such days temperature is high—other days vice versa. Blood examination also reveals that the number of red blood corpuscles is greatly diminished. Whilst in America in 1900 I saw a considerable number of such cases in Texan ponies, but had no opportunity of proving it by microscopic examina- tion of the blood. MAL DE CADERAS. This is a specific blood disease due to the presence of try- panosomes, named the Trypanosoma equinwm, which is stated by Vosges to be transmitted from animal to animal by a fly belonging to the species Musca brava. The disease is specially seen in Central America, and is called mal de caderas, or disease of the hind-quarters, on account of one of its most marked symptoms. Asses and mules are not so susceptible as the horse. Guinea-pigs are even less susceptible, but rats and mice die of the disease very quickly. Dogs die in two or three months. Sheep and goats contract the disease, but may live for months, and then they quickly become emaciated and die. MAL DE CADERAS. 493 Birds die of it in two or three weeks. Cattle appear to be immune from this disease. There has been considerable confusion amongst observers as to the differentiation between dourine, surra and mal de caderas, but it is now generally agreed that they are three distinct diseases, in so far as the causal agents are concerned, though at the same time many of the symptoms are common to each of the three. In experimental cases, Vosges says, if 5 to 20 c.c. of blood from an affected horse be injected into a healthy horse, a fever develops in four or five days, and increases in severity hourly until the following morning, the temperature going up to as high as 40° C. to 41° C., or about 104° F. to 106° F., and then © during the day falling to normal or almost so, and reaching its minimum on the second day of the fever. The temperature again commences to rise, and gradually rises for four or five days until it attains its maximum, about 105° F. This periodic rise and fall may recur four, five or even more times, with intermissions of three days to a week. During all this the pulse and respiration remain normal, and the appetite is only slightly diminished, and that occurs in the evenings. The thirst, however, is increased. Sometimes the feces are streaked with blood. Hemo-albuminuria is observed and remains constant. The coat retains its healthy gloss and is cast at the proper time of the year. In the second stage, which gradually replaces the first, the intermittency of the fever disappears, the temperature does not so markedly rise and fall, but fluctuates round about 101° F. to 104° F. The heart becomes weak, the animal droops, loses condition rapidly, and is always thirsty. The coat stares, edematous swellings appear in the hind-legs, and later, in other dependent parts of the body. The skin becomes anssthetic, and flies on it seem to cause no irritation or annoy- ance. The urine is abundant and always contains blood. The animal staggers when moved, and seems partially paralysed behind, and may fall, and after some struggling will die. Some may remain standing until the last moment and then drop dead, without any pain or suffering. 494 BLOOD DISEASES. Towards the end, the morning temperature may be as low as 84° C. or 98°2° F., and in the evening rise to 39° C. or 102° F. The disease runs a course of from fourteen days to four months, and is only seen in swampy districts. If horses be stabled at night, they do not become affected, and if the disease break out in a large number of horses they should at once be removed to a high and dry locality. Post Mortem Appearances. Cidematous swellings in various parts of the body; coat harsh and staring, body much emaciated, hide difficult to remove, muscles dry, as seen in cholera patients; pleural cavity contains large quantity of clear or almost clear yellow serosity ; pericardium filled with similar fluid; heart pale and flabby. The abdominal cavity contains a large quantity of fluid similar to that in the thorax. The liver is enlarged, so are the kidneys. The spleen is enormously enlarged, the enlargement being in proportion to the duration of the disease, and the various lymphatic glands are all swollen. The blood-cownt shows an enormous decrease in the number of red blood corpuscles from 10,000,000 down to 3,000,000, or even 800,000; at the same time there is an increase in the number of white blood corpuscles. The parasites appear in the blood in five days after inocula- tion; they increase in number as the temperature of the patient rises, but suddenly disappear when that temperature is up to 40° C. or 104° F. In about three or four days they again appear and increase in number as before, and disappear when temperature is again 104° F, When they are most numerous, they may be in the propor- tion of 1 in 10 to 1 in 4 of the blood corpuscles. The blood loses its infectivity in from twenty-four hours to two days after death. So far all medicinal treatment has been unsuccessful. CHAPTER XLIV. BLOOD DISEASE S—continued. PIROPLASMOSIS. PrropLasmosis (P. bigeminum) is a disease due to the presence of piroplasmata in the blood, and more particularly in the red blood corpuscles, where these parasites exert a malignant influence, and cause a breaking down of the corpuscles. These parasites are introduced into the economy by ticks of various species, and give rise to the following well-recognised forms of disease: Texas Fever, Jamaican Fever, Malignant Jaundice in the dog, Biliary Fever in the horse, African East Coast Fever, Red Water, and Black Water. TEXAS FEVER (IXODIC ANAEMIA). Later studies of this disease have brouglit to light that it assumes two forms: an acute fatal type, as seen in America in the hot summer months, and a mild, rather prolonged, usually non-fatal form, recognised by an examination of the blood, which must reveal the micro-parasite in the red cor- puscles and plasma. This form is seen in the autumn when the heat of summer has passed away, also during October and November, and, rarely, in the first week of December. It is stated that the difference between the acute and mild type is accounted for by the fact that during a stage of its life—the small stage—the Texas fever parasite circulates in the blood in a condition differing from that observed in acute cases ; that in the latter it rapidly destroys the blood corpuscles, giving rise to hemoglobinuria—red water—whereas in the mild form the destruction of the corpuscles is much more prolonged, and not. associated with hemoglobin in the urine. 495 496 BLOOD DISEASES. It has also been observed that in certain cases when an animal has recovered from the acute attack, and the number of red corpuscles has nearly reached the normal number, they again diminish, and many of them contain the parasite in its small stage. The reason for the recurrence of this disease is not clearly defined—whether these second attacks are merely re- lapses or reinfections. As already stated, the symptoms of the mild form are indefinite, and may be confused with a variety of mild diseases, but the acute form is manifested suddenly in the hot summer months, and simultaneously in all animals of a herd which have been exposed to the same infection together. The fever, characterised by a temperature of from 105° to 108° F., precedes outward symptoms for several days, the animals apparently quite well. The pulse and respiration then become accelerated, and the urine is now observed to have the appear- ance of blood, varying in colour,—reddish, claret, or blackish red water (hemoglobinuria) in the most acutely fatal cases. Out of forty-six fatal cases (Bureau of Animal Industry, Washington, 1893), hemoglobin was found in the urine in the bladder of thirty-three after death. It is uncertain whether this condition of the urine is present in all cases of the acute form, the opinion of the reporters to the American Bureau being that it “ depends upon the rapidity with which the red corpuscles are infected and destroyed. A slow destruction may allow other organs to excrete the débris and thus forestal the discharge of hemoglobin in the urine.” But if free from hemoglobin, the urine at the height of the fever is found to contain a small quantity of albu- men, to have a specific gravity of 1030-40, may be strongiy alkaline and effervescent when treated with acids; but as the disease advances its specific gravity will fall to 1010-12, its re- action becoming neutral or slightly acid. It sometimes con- tains small numbers of red corpuscles, which may be derived from small hemorrhages in the pelves of the kidneys, regularly observed post morten. The bowels are, as a rule, constipated during the high fever, but as the fever subsides the fseces become softer and tinged with bile. After a few days’ illness the debility becomes very great, and whilst the animal is standing, trembling of the hind quarters and limbs are prominent features in many-cases: the blood is then found to have become very thin, pale, and watery, TEXAS FEVER (IXODIC ANAEMIA), 497 due to the destruction of the red corpuscles. In the earlier stages, if freshly drawn blood be allowed to stand, the serum will be found to present a very dark red colour, indicating the presence of much colouring matter in solution. Later on, this colour may not be present, but thinness of the blood, owing to destruction of the red corpuscles, seems to be the “ most essential character of Texas fever.” The duration of the disease varies, proving fatal or disappear- ing in a few days. Recovery, however, is associated with great debility ; degenerations may occur in organs, and frequently there are relapses. Some animals never regain their health ; in others, recovery takes place after weeks or months. High temperature rarely lasts longer than eight to ten days; it is then followed by a period of normal or subnormal temperature, the falling of the temperature marking the cessation of the destruction of the corpuscles, and the disappearance of the para- site from the blood. The mortality varies greatly. A mid- summer outbreak, when acute in its nature, is the most fatal, and from this time there may be all gradations towards the mild, non-fatal form of the disease. Etiology.—Several observers have reported the discovery of various forms of bacteria in this disease. In 1883 Salmon described a diplococcus obtained from spleen cultures. Detmers found bacilli and micrococci in the liver, but none in the blood ; and in 1888 Billings claimed the discovery of what he terms the “true germ,” an ovoid bacterium, staining at the ends, similar to that of swine plague. All these contentions, however, have now been apparently terminated by the discovery of a parasite in the blood corpuscles, conveyed from Southern to Northern cattle by cattle ticks (Boophilus bovis). At the experi- mental station of the Bureau, near Washington, it was found by experiments in 1889 that the disease can be produced by ticks artificially hatched in the laboratory. The parasites thus conveyed are found in certain proportions of the red corpuscles in the form of rounded or somewhat ovoid or pyriform bodies, isolated or in pairs, in the acute form of the disease, whilst in the mild form it appears that from 5 to 50 per cent. of red corpuscles are found to contain coccus-like bodies, sometimes on the border, and outside the corpuscles; they are from s7ioo tO sooo Of an inch in diameter, scr ae 498 BLOOD DISEASES. into two; they, as well as the larger pyriform bodies seen in the acute form, stain with aqueous solutions of aniline dyes, and with hemotoxylin. Both the large and small forms aro considered to be different stages of the same parasitic protozoa (Pyosoma bigeminum, Dr. Theobald Smith). The smaller ones are found in cattle exposed to the disease late in the season, or during a second attack or relapse after passing through an acute attack, and in milder cases during or previous to the season (hot) of the acute disease. With the better acquaintance of these intra-corpuscular parasites, improved staining methods have been acquired. The way now adopted is that first recommended by Romanow- sky, or a modification of his method. It is based on the principle that methylene blue as a basic dye will stain the protoplasm of protozoans, and eosin will stain the chromatin of the nucleus, the flagellum, and centrosome. The methylene blue and eosin are prepared by special methods, and used asa mixture or separately in definite proportions. By this means very beautiful specimens are obtained. The blood-film is first fixed in alcohol after rapidly drying in the air. The mixed stain is then applied for a definite time, and the reaction will be to stain the red corpuscles pink, and the parasite within them a blue, and within the parasite will be seen a small red mass of chromatin. Post Mortem Appearances.—Congestion of the vessels and occasional patches of extravasation in the subcutaneous tissues, blood sometimes thin and watery, lungs normal or discoloured by congestive patches, heart congested ; petechial spots on peri- and endocardium, spleen congested, its capsule streaked from distension of its vessels. The weight of the organ varies, according to the stage of the disease in which the animal dies, the more rapid the fatal termination the larger the spleen. Generally it is from two to four times its natural weight, distended, firm to the touch, its capsule attenuated, the pulp dark brown, glistening, and homogeneous. The markings of the Malpighian bodies and of the trabecule have disappeared. The liver is gravely altered, enlarged, sometimes of a dark colour from blood congestion, or light coloured from extreme bile engorgement ; gall bladder full of thick grumous bile; when Fic. 40.—Various phases in the development of Piroplasma of the dog. (From article by Drs. Anton Brein] and Edward Hindle, in the Annals of Tropicat Medicine and Parasitology, University of Liverpool, July 1st, 1908.) land 2, Early forms of parasite ; 8, single budding; 4, double budding ; 5, pear-shaped form ; 6, signet-ring form ; 7, free small flagellate parasite ; 8, amceboid form with long pseudopodium ; 9, formation of flagellum ; 10, extrusion of chromatin from the nucleus; 11, extrusion of two masses of chromatin ; 12, development of large bi-flagellate forms with characteristic nuclei. 499 32—9 500 BLOOD DISEASES. incised the cut surface presents a uniformly brownish-yellow colour, or else a mottled appearance, also seen on the surface. There is occlusion of the biliary canaliculi and ducts, and a more or less extensive fatty degeneration of the liver cells, and a tendency to necrosis of the inner zone of the lobules. The kidneys vary in colour according to the severity and stage of the disease when death occurs. In the early stages, when the bladder contains port-wine coloured urine, they are enlarged and of a uniform dark brownish-red colour, and the vessels are uni- formly distended with red corpuscles. The secreting structures are not seemingly altered. In cases which die after the acute stage and fever have passed away, they are paler than normal, and quite flabby, having pigmentary deposits in the convoluted tubules, and their epithelium so loaded with a reddish-yellow pigment that they are easily traceable in their windings by their colour. In those cases where the capillaries are filled with red corpuscles, the microbes are usually found in all the corpuscles. Extravasations of blood are found in the pelves, and in most cases the bladder is found to contain urine mixed with hemo- globin, whilst ecchymosed spots are seen on the inner surface of the mucosa. The digestive apparatus, with the exception of the abomasum, which is frequently congested, generally presents no definite alterations. The pyloric portion of the abomasum is found to contain deep ragged excavations with hemorrhagic bases. The constancy of these ulcers, probably the result of vascular occlusion, is considered by Moreau Morris to be a more certain indication of Texas fever than any other lesions com- monly present. The intestinal lesions are congestions and pigmentation, with an increased flow of bile. Prevention and Treatment.—lIf the disease is suspected, the herd should be examined thoroughly for ticks, and the animals’ temperature taken. The combination of ticks and fever, or the presence of the former, in a locality where they do not naturally exist, may be considered a sure sign of the imminence of Texas fever. If the ticks are found, they should be carefully removed and the cattle at once transferred to uninfected grounds. The examination for ticks should be done repeatedly, and all ticks destroyed. These measures may not prevent all attacks, nor TEXAS FEVER (1XODIC ANEMIA), 601 cut short the disease after it has once shown itself, but the reporters are satisfied that fewer animals will succumb. A single infection is sufficient to cause severe and prolonged disease, as shown by the experimental injection of blood; but the mortality seems to be lower than in natural exposures, where the infection is intensified with every additional tick. No special line of medical treatment has as yet been tried. Quinine and its preparations are proposed as possibly valuable, and methylene blue, recommended for malaria, is referred to as worthy of trial. Inoculation with the blood of Southern cattle, apparently healthy, and with that of diseased Northern cattle, transinits the disease, and if this is done after the hot summer weather has passed, the induced disease may be of a mild character; but it appears that immunity is not assured, as it is reported by Dr. Dinwiddie that of vaccinated and non vaccinated cattle sent to Texas 662 per cent. of the vaccinated and 882 of the non- vaccinated died. Had there been a well-marked immunity conferred by inoculation, it would have heen possible to have improved the method of procedure; and perhaps carefully prepared blood serum, freed from the organism, might have been of value. One remarkable instance is mentioned in the report, namely, that the Texas fever parasite was found in the blood of a North Carolina animal three years after it had left the permanent infected territory. Similar diseases, manifested by coloured urine, are reported to prevail in the marshy regions of Roumania. These were investigated by Babes in 1888, and disseminated largely by draught oxen: in the Cape of Good Hope also conveyed from place to place by yoke oxen. By keeping communication with the territory north of the colony, these cattle, like those of the Southern States, seem not to infect others directly, but they infect ground over which they have passed. It also prevails in Australia, and is due to the same cause, ticks being numerous in that country. Infected pastures, have been found to be harmless to sheep, and it is thought that other domesticated animals may graze unharmed in such pasture. The discovery that the disease is conveyed by ticks explains. 502 BLOOD DISEASES. ‘what has hitherto been very mysterious, namely, that Northern cattle become affected by the disease when pastured on lands previously grazed by Southern cattle apparently in perfect health. This fact leads to the conclusion that Southern cattle, recovered, perhaps, from previous attacks, have acquired im- munity, though covered with ticks. Although it is clearly demonstrated that Southern cattle are dangerous when they bear the cattle tick, and that this tick conveys the micro-parasite from Southern to healthy Northern cattle; but transmission from Northern cattle is very rare. Northern cattle have ticks on them, but only those which survive the disease, or die after a prolonged attack, ripen the ticks on their bodies. Those which die of an acute attack in a short time after infection have only inmature ticks on them. If the fever has occurred early enough in the season to permit a second generation of ticks to appear before the cold weather arrives, another outbreak during the same season may occur. Usually the first outbreak occurs in August, and the second, to be looked for late in September or early in October, is so mild as to pass unobserved. If, however, the first outbreak occur in July, the second may appear in September, and perhaps be of greater virulence. When the disease is induced by inoculation, experiments have. proved that it has no contagious properties,—in fact, that it is not transmitted by cohabitation, but by the intermediation of the cattle tick. But, as already stated, it seems to be concluded that preventive inoculation has so far been a failure, for the effect produced in the body of an animal by the destruction of the red corpuscles equal in amount to all those circulating in the body at any given time should make much more impression than any method of inoculation is likely to do. Not being, so far as at present known, a ptomaine-producing organism, like bacilli, &c,, this is as might be expected. Yet such an attack not only does not always prevent a second attack, but may not pre- vent death during a second attack. Aside from the difficulties attending the production of immunity, under any circumstances the difficulties of preparing a “ vaccine” according to the method hitherto practised are at present insurmountable. The micro- organism cannot be cultivated. The infection of Northern cattle might be prevented by careful destruction of the ticks upon TEXAS FEVER (IXODIC ANAEMIA). 503 Southern cattle before their removal to Northern territories, or by prohibiting their migration during hot weather. These suggestions are not, however, made by the reporters, but they attach great importance to the protection of animals taken south into permanently infected pastures. They state that it is probable that if calves be taken they may, without treatment of any kind, survive the infection upon southern pastures, and become gradually insusceptible. But in case of animals more than twelve to eighteen months old the first attack might be fatal ; and, perhaps, the simplest way of dealing with older cattle is to endeavour to induce immunity by exposing them to infection at some specified time in autumn. In the latitude of Washing- ton it was found that the most convenient time is the middle of September. In more northerly latitudes the exposure should be correspondingly earlier. Cattle exposed in this way invariably take the fever, but the mortality is very small, Such animals may die of a second attack during the succeeding summer, but a mild exposure during the following autumn may furnish a sufficient protection. Anotner method of inducing the disease is the injection of blood from infected cattle, which generally induces—if practised after the hot summer weather—mild attacks of the disease. The blood of apparently healthy Southern cattle will serve the same purpose. Exposure to ticks during the cool autumn months is also recommended, being simpler, requiring no operation, the ticks being easily procurable from the permanently infected Southern territory. In concluding their observations upon these methods of protection, the reporters say that their statements concerning the possible uses of mild infections as a means of subsequent protection must be regarded as mere suggestions, which may or may not prove of practical utility on a large scale. In Australia it has been established that blood inoculations from affected animals to non-infected will induce an immunity, but this must be done before such animals are placed upon pastures infested with ticks infected with Texas fever. The inoculation induces an attack of fever which is, however, of short duration and rarely fatal. After recovery the animal is immune, and may be moved with a comparative degree of 504 BLOOD DISEASES. safety to infected areas. It is reasonable to suppose that the dose of infection by the inoculation of a slight quantity of infected blood is very small; moreover, the infective material is less virulent than when inoculated directly from the ticks, as well as being so much less than from the bites of numerous ticks. Recovery from this mild attack induces immunity, but it does not follow that the parasites disappear entirely from the bovine’s blood, as they may be found for months, or even years, after, and such blood will be capable of infecting ticks, or other animals by inoculation. This explains the danger of allowing apparently healthy animals from infected areas on to healthy clean pastures; even though such animals be quite free from ticks, they may be capable of infecting healthy ticks in the fresh pastures. It is for this reason that every precaution should be taken to eradicate ticks, and this can only be done by systematic dipping or spraying. With- out ticks there could be no reproduction of piroplasma, and, without this intermediate host, the disease must in course of time die out. Appended is a report by Mr. C. P. Lounsbury, Govern- ment entomologist, taken from the Cape Colony Agricultural Journal : Tick destruction has become a stock-farming problem of considerable importance in South Africa. Lverywhere in the country ticks are more or less of a pest, and in many sections they are a veritable plague. The south-eastern and eastern seaboard is the most afflicted part of the Cape Colony, but stock often suffer severely in southern and south-western districts, and even in portions of the Karroo. Year by year the evil has been increasing, in some places slowly, in others rapidly. A prominent Willowmore farmer recently told the writer that ticks were no trouble at all in his locality five years ago, whilst now the Bont Leg species is so injurious to his stock that he fears he will be driven out of sheep-farming by it. Various remedies are employed in the Colony to destroy ticks, but most are used in a more or less haphazard manner, with little attempt at system or thoroughness. Jam told that many natives practise greasing their cattle, and that at some kraals hogs are reared chiefly to furnish fat for the purpose. TEXAS FEVER (IXODIC AN4MIA). 505 Tick-clipping with scissors, leaving the parasites to dry out on the skin or to drop off as may chance to follow, is a common resort along the coast. One old pioneer of the East London district writes that he pays his native herdsmen to collect female Bont ticks from his cattle, giving them 3d. for each fill of a half-pound jam-tin. In this way he obtained between two and three bushels of ticks last year. A great many farmers now spray or hand-dress with one or another of the numerous carbolic and arsenical sheep-dips at a heavy expense for materials and labour, and unfortunately, through ignorance of the habits of the ticks, most of these men grossly overestimate the value of their applications. Incidental Evils from Ticks—There are many distinct kinds of ticks on stock in the Colony, and aside from the direct injury the various kinds do in draining off the blood of their hosts, some sorts transmit disease. The common blue tick is no doubt the usual if not the sole agent in the spread of redwater; the Bont tick spreads heart-water; and the dog tick spreads malignant jaundice, or what is more commonly though wrongly called distemper. Probably other diseases are similarly disseminated, and not only diseases but putrefac- tive organisms, that give rise to open sores that seriously affect the health of stock. One small tick, a species of Ixodes, is considered by many observant farmers to be responsible for a form of paralysis in sheep common in several eastern districts; and much lameness in stock, both large and small, is directly due to deep-biting ticks like the Bont Leg and the Bont. Of all the various ticks probably none is so pernicious in its effects as the Bont tick (Amblyomma hebreum), and it is against this species that most attempts at tick destruction in Cape Colony have been specially directed. This tick is very abundant along the Fish River Rand in the northern part of the Albany district. It was here that the first really systematic and intelligently directed efforts at tick destruction in South Africa, of which I am aware, were begun. The man who instituted this work was the Hon. Arthur Douglass, M.L.A., and the remedy he adopted and still faithfully follows ‘is paraffin oil spraying. _For many years ticks had been getting steadily worse on ° 506 BLOOD DISEASES. Heatherton Towers, Mr. Douglass’s property, and along in 1896 he concluded that he must manage to suppress the pest or soon cease cattle-farming. The various dressings that were and are still more or less used by others were tested, and one by one discarded as inefficient. A dipping-vat was con- is Fic. 41.—Spraying horses (Douglass’s race), structed and some dipping tests made, but various circum- stances led to the abandonment of dipping in favour of spraying. His efforts to find a successful wash were finally rewarded by his demonstration that paraffin oil, the ordinary illuminating oil found in every household, answered the requirements. Other colonial farmers had used paraffin * ne TEXAS FEVER (IXODIC ANEMIA). 507 against ticks, but when put on with a sponge or cloth, as was usual, it was less effectual against ticks, and burned the skin of the animals. In America, too, paraffin had for several years been employed as a cattle spray, but Mr. Douglass did not know of this, and the fact should not detract from the Fic, 42,—Spraying cattle (Douglass’s race), credit given to him. His delight at the discovery was unbounded, and with characteristic enthusiasm he issued an invitation early in 1898 to all and sundry interested to visit his farm on an appointed day to witness a practical exposition of tick-killing by the newly-found agent. The value of the demonstration was not wholly the bringing forward of oil as a 508 BLOOD DISEASES. spraying material, for of almost equal importance was the exhibition of how a wash could be economically and quickly applied by having the cattle being treated enclosed ina narrow passage between two fences. A large number of farmers attended the demonstration, and by them and the newspaper reporters a knowledge of the remedy was quickly disseminated throughout the surrounding country. Many farmers have begun to follow his example, but not nearly the number that should do so or that would have done so had it not been for the troublous times through which the Colony has but just emerged. Now we may expect a more general crusade against ticks, and hence it is a most fitting time for the review of this oil remedy. The first requisite when many cattle are to be sprayed is the passage in which to enclose them. This is called the ‘‘race.” Two races are shown in our illustrations, the one at Heatherton Towers, and the one at Cottesbrook, Adelaide, Mr. L. J. Roberts’s farm. . The Douglass race is a passage 23 feet long and 2 feet wide, between wires. It accommodates three adult cattle at a time. The posts for the sides are set about 6 feet apart and are bedded in cement. They are strung with eight horizontal size No. 6 wires stayed with three ties of doubled No. 8 wire between each two posts. The top wire is 5 feet from the ground. The floor is made 9 inches to 1 foot thick, and is finished with cement mixed with good sand in the propor- tion of one to three. It is depressed along the middle, and slopes towards one end, where it drains into a cemented hole at the side. To enable the men to better spray the under side of the animals, a trench about 2 feet wide and nearly as deep extends along each side close to the fence; therein the men crouch who handle the spraying nozzles. » 12. Temperature 103° F. Results negative, » 16. Sheep No. 3 inoculated, ] P.M. Temperature 103° F. » 17. Temperature 103° F. », 18. Temperature 102‘4° F, », 19. Temperature 102°6° F. », 20. Temperature 102° F. Results negative. » 16. Sheep No. 4 inoculated with tick cultivation in egg albumen, 1 P.u Temperature 103°4° F, » 17. Temperature 103° F. », 18. Temperature 103° F. », 19. Temperature 103:2° F. », 20. Temperature 104° F. Results negative. — : »» 20. Tup No. 5 inoculated, 4 30 p.m, Temperature 103° F. », 21. Temperature 105° F, », 22. Temperature 103° F, : », 28. Temperature 103° F. >, 24. Temperature 103°6° F. ; », 25. Temperature 103° F. Results negative. >, 29. Sheep No. 6 inoculated in vein. Temperature 104° F. », 30. Temperature 104° F. July 1. Temperature 103°8° F. Results negative. June 29. Sheep No. 1 reinoculated in back (subcutaneously). Temperature 103° F. >, 80. Temperature 103:8° F. July 1. Temperature 103° F. Results negative. The attempt to induce the disease by placing the ticks upon healthy sheep, and by inoculations with the organism cultivated from ticks, having proved unsatisfactory, and the season being too far advanced for further experiments, I determined to adopt another line of procedure during the season 1895. I may here state that all the experiments with living ticks had hitherto given negative results: ticks, except small ones and those which had not yet become adherent to the sheep, could not be induced to cling to a fresh host; no matter how many fairly or fully grown ticks were placed on a sheep, they would disappear in a few hours. I then determined to send sheep during the following year to tick-infested districts ; to muzzle these sheep in order to prevent them from grazing; to feed and water them indoors with food sent from the College; and to allow them to remain in the infested district until infested with the ticks, then have them returned to the College for examination and further study. « April 21, 1896.—We visited Mr. Hamilton, Leithen Hall, and an adjoining farm, occupied and owned by Mr. Carruthers. 686 SPORADIC DISEASES. He removed there from the south of Scotland (the Hawick district) about fifty years ago, and placed a large number of sheep from that part on his new farm. The mortality was very great, quite 30 per cent. He reduced this percentage by limit- ing the introduction of fresh sheep, and devoting his energies towards the increase and retention of sheep home bred. The loss was thus reduced to 10 per cent; and when he became the owner of the land he limed and drained to such an extent that at this date a case of louping-ill is very rare. He is a firm believer in ‘no ticks, no louping-ill.’ He frequently witnessed in the old days bullocks affected with the disease. He still washes his sheep with Bigges’ Dip in solution, and lays down the rule to be good to the land, and louping-ill will disappear wherever it has been seen. “ At four a.m. on the morning of the 22d April we accom- panied the shepherd to the hill, and found some 600 ewes and their lambs all in good health. About thirty six hours pre- viously the shepherd had found a hogg dead that for two days previously showed very pronounced symptoms of louping-ill. He had, after skinning it, preserved the carcase for our exami- nation in a cavern on the hill. We found it to be cool and quite fresh, with the head cut off. This we regretted, but he stated that a large quantity of fluid had escaped from the cranial cavity on section. At nine AM. we (having had the carcase and head carried to the farm-house) made an examina- tion of all the internal organs, also of the brain and spinal cord. The jelly-like exudate was present in great abundance, particu- larly in the lumbar portion of the spinal canal; the spinal cord was inflamed in patches along its whole length, but the jelly- like exudate was confined to the lumbar region. “The test sheep having arrived—they having been driven from the station with a mouth-piece on each, which effectually prevented them from feeding—the muzzles being removed, they were fed with oats and hay and watered, also rested for a few hours. The mouth-pieces were then re-applied, and about one o'clock they were turned on to a field where ticks were known to exist. About ten a.M. the following day they were returned to the outhouse to be fed and watered, A few minute ticks were seen about the inner parts of the fore legs. At one P.M. they were again turned out with their mouths securely covered. Every day until Tuesday, the 28th, when the sheep were re- LOUPING-ILL, 687 turned to the College, this system was carried out. One of the ticked sheep died on 10th May and another on 12th.”} On May 13 ten sheep, out of eleven obtained from Mr. Skir- ving, were sent from Edinburgh to Leithen Hall, as I supposed the ticks would now be more numerous. They safely arrived, were muzzled in the usual way, and remained there until the 21st, when they returned apparently healthy. The student, Mr. Morgan Williams, who accompanied these sheep, wrote to me as follows :—“ The sheep were all muzzled, and examined for seven days, but owing to the early season this year very few ticks were found on the farms, neither were there any sheep affected with louping-ill during the above period. Out of the ten sheep two only were found with ticks on, and, as far as could be seen, there were only three ticks on each. Nothing abnormal was detected on these from the time they came under my charge until they were brought back to the College. Mr. Hamilton informed me that fewer of their sheep were infested this season with ticks, and consequently fewer were affected with louping-ill; that they were all dipped this season, as recommended by Professor Williams. He also in- formed me that a top-dressing of salt, 10 cwt. to the acre, gratuitously supplied by Mr. Thompson, V.S., Aspatria, was applied to one park, which had been previously badly infested with ticks; but since the application of the salt the sheep cannot be kept away from the dressed park. But Mr. Hamilton could not inform me whether this dressing had made any difference as regards the ticks, because, as above stated, the sheep were dipped, and they did not find any on the sheep after the application (dip), irrespective of the part of the farm the sheep were grazed on.” On their return to the College, 21st May, these ten sheep were carefully examined, but no ticks could be found upon any of them. They were carefully watched, and their temperatures taken daily until 27th May, when four, including the one re- tained at the College, were inoculated with cultivation material from the spinal canal of the ticked sheep which had died on the 12th. The cultivation material was filled with the well- developed organism. One of these sheep died on May 29, having presented very acute symptoms, which we supposed were due to some septic blood-poisoning; but on making a post-mortem examination, the condition of the spinal cord and 1 Report by Mr. R. Moir, M.R.C.V.S., who kindly took charge of the sheep. 688 SPORADIC DISEASES, brain left no doubt in our minds as to the true nature of the disease. Although there was no jelly-like exudate in the spinal canal, the cord itself was inflamed in patches, and the organism could be detected microscopically and cultivated in the usual way. On 1st June a second inoculated sheep died, and on 5th June another died. Thus three out of four inoculated on 27th May died. ‘The fourth remained healthy. On May 5 I visited Mr. James R. W. Wallace’s farm of Auchenbrack, near Thornhill, and there met Professor Wallace, who takes a keen interest in this question. We found several sheep and lambs affected—some dying, some recovering, and some dead; but Mr. Wallace thought the mortality had not been as great as usual. The symptoms during life and the post-mortem conditions revealed were undoubtedly those of louping-ill. No experiments beyond tube cultivations were made, but it was arranged—Mr. Wallace generously offering to perform the experiment free of expense—to buy about a score of sheep and place them muzzled on that part of the farm where trembling and ticks committed the greatest’ havoc. The sheep, nineteen blackfaced hoggs, were bought on May 13, and fourteen of them were muzzled and turned out during the day, and described by Mr. Wallace as follows: “13th May.—Will turn out fourteen of the ewe hoggs on the hill on which there is trembling, with the muzzles on, and take them in again in the morning, and driving them to the fields free from trembling to feed during the day. 26¢4 May.—The sheep have been a week on, and I only see one tick each on three of them. The season being so early, I think the time is now past, as fewer of my own sheep have been affected this year; but I will go on with the hoggs this week, and then turn them on sound land free of trembling for a while, till we see if anything turns up.” On 1st June one of the ewe hoggs died, and was sent to the College, where a post-mortem examination was made, but no trace of louping-ill could be detected. On 6th July Mr. Wallace wrote again as follows: “The blackfaced ewe hoggs I had muzzled and put to the hill to test for trembling have all done well since they were turned out. It was rather late for this early season, so a better result might be got another year. There were not so many ticks and less trembling with me this season than usual, but some places were worse. I did not think the hogg that died, died of trembling, but I thought it better to send you the carcase, as it was one of the lot.” LOUPING-ILL. 689 Fic. 65.—Filamentous stage of the organism in spinal canal of sheep dead from louping-ill, May, 1896. » 500. Fic. 66.—Filaments breaking up into spores. Cultivation from blood of sheep inoculated with material shown in Fig. 65. 1500. 44 690 SPORADIC DISEASES. Fic. 67.—Cultivation from tick, tenth day. 500. Fic. 68.—Portion of Fig. 67 under a higher power. x 1500. LOUPING-ILL. 691 Fic. 69.—Jelly from spinal canal of Twiglees lamb, 1882. x 500. Fic. 70.—Cultivation from cardiac blood of sheep which died after being inoculated, June 5, 1896. x 1500. 44—92 692 SPORADIC DISEASES. Fic. 71.—Cultivation from spinal canal of ticked sheep, which died at College, ay 10,1896. x 1500, > thy eg Fic, 72.—Cultivation of spinal fluid from sheep,dead from louping-ill, 1896. x 500. LOUPING-ILL. 693 SEE ie Fic. 73.—Portion of Fig. 74 under a higher power. x 1500. Fic. 74.—Cultivation from cardiac blood, Auchenbrack lamb (agar-agar ten days), May, 1896. x 500. 694 SPORADIC DISEASES. ‘ By comparing the photo-micrographs with the microscopic drawings, both by Dr. Hunter, published in my article on Louping-Ill in 1882,) it will be observed that the similarity, if not identity, is maintained throughout. From the long and exhaustive investigation (in which I have been assisted by my son, W. O. Williams, and Dr. James Hunter, and to whom my thanks are due) of this disease, I am now more convinced than ever that the organism or organisms are most probably developed in one stage as minute moulds on old grasses—in this condition, innocuous to the higher animal, until it has passed through the tick; that in the body of the tick it attains properties which are virulent when subsequently communicated to the sheep by the tick. It will be observed that in the louping-ill organism there are met with, during its complete life history, those involving series of transitions assumed by G. Zopf and other bacteriolo- gists to be more or less presented during the development of many micro-organisms. Leaving it, as most have done, to be decided whether or not the forms seen in such cases as the present are the exact counterparts of saprophytes, typical micrococci, bacteria, or bacilli, there is no doubt that such variations are seen during the growth of the louping-ill organism. But further, when it has been found that the inoculation of healthy animals by certain of these forms has led to the appear- ance of the others in great constancy under varied conditions, the identity of a series of forms can no longer be disputed. It must, however, be confessed that as yet the true relationship and significance of the individual forms have not been so fully made out as could be wished from a purely biological point of view; but the pathogenic action peculiar to the organism has, by all the usual modes of research, been placed beyond cavil. This is not to be wondered at, when it is remembered that several well-known micro-organisms have stages in their development that are by no means fully understood. Appar- ently the simple unsegmented saprophytic filaments are generally met with in the spinal myxcedema of the affected animal, while the higher forms of spore filaments, fully seg- mented and free rods, closely resembling the typical bacillus, were seen, so far as the present observations go, mostly in culti- 1 See Transactions of the Highland and Agricultural Society. LOUPING-ILL. 695 vations outside the animal body. They, however, presented themselves with great constancy in cultivations of the spinal fluid and myxcedema—jelly-like material—under every possible variation, produced by change of media, place, and manner - ol experimenting. It must therefore be surmised that they are either various stages in the life history of the same organism, or that, as in some other diseases, multiple organisms are present. As an organism certainly more nearly allied to the moulds than to any pathogenic type previously described, it is interesting as being, so far as I am aware, the first known instance of what appears to be a mould, in one stage at least, proving capable of producing pathogenic effects upon the higher animals, and it is also interesting to note that this pathogenic property is pro- bably acquired after passage though the body of the tick, a state of matters now found to exist in other diseases. When this disease was first investigated by me, the influence of the tick in inducing the so-called Texas fever, and other similar sources of inoculation, had not been investigated; but now it is proved beyond all doubt that the tick disease, as well as other diseases communicated by insects, is now known in various parts of the world. One remarkable circumstance might, in conclusion, be added, viz., that whilst in this country the tick is but seldom injurious to other animals than sheep, in other parts of the world its pathogenic effects are mostly confined to horned cattle, although it attacks human beings, sheep, horses, mules, &c. In 1901 the President of the Board of Agriculture appointed a Depart- mental Committee to report as to the etiology, pathology, and morbid anatomy of the diseases of sheep, known as louping-ill and braxy. Professor Hamilton, of Aberdeen University (who had gained some knowledge of these diseases when on the Committee or Commission appointed by the Highland and Agricultural Society, the chief of which was Principal Williams of the New Veterinary College), was appointed chair- man, and in the findings of the Committee of 1901, published in 1906, Professor Hamilton takes the sole responsibility for the conduct of the research and for the bacteriological part of it, and herewith are appended certain portions of these reports. There seems to have been hopeless confusion to commence with, and the editor feels quite unable to accept the conclusions arrived at. 696 SPORADIC DISEASES. SECTION I. LOUPING-ILL (CHOREA PARALYTICA OVIS).} Recognition of the Disease—The symptoms at first appeared to be somewhat anomalous, and this rendered their study all the more perplex- ing, for while some of the animals exhibited distinct nervous spasms of the limbs and neck, or it might be almost complete rigidity, followed by more or less complete paralysis of motion, others again seemed to be in a dazed condition throughout, and speedily collapsed. * * * * * * We were confronted with the problem, therefore, of whether we had to deal with a single disease or whether this train of phenomena roughly comprised under the term ‘“louping-ill”’ was of a two-fold nature. Had we to deal with two diseases running side by side, say, “ louping-ill” proper and so-called ‘‘ black-quarter ”’? or were the symptoms due to the same agent modified in some peculiar manner ? * * * * * * It must be remembered and emphasised, that the sheep is subject to many other diseases, especially in the spring months, which may readily be mistaken for the disease in question, such as puerperal septicemia or pyemia, malignant cedema, sturdy, a form of anemia known as “blood- rot’’ sometimes very prevalent in the early spring months, and, in lambs, spinal abscess with meningitis followed or not by pyemia, _ ¥ * * * * * It has been the practice of others before us, as it was with ourselves during this season of 1902, to slaughter most of the animals under observa- tion when the disease was in the acute stage of its course. The reason for this is self-evident, for while the disease is at its height it might be supposed that there would be afforded the very best opportunity of detecting any lesions produced by it, and of securing the liquids and tissues in a perfectly fresh condition. As a matter of fact, however, if this method be practised, any clue to the cause of this disease will be almost certainly lost. Everything probably will be found in what seems to be an almost perfect state of health, without the slightest indication of where to look for the hidden cause of the disease. We learned by experience to renounce this method of procedure, to allow the animal to die a natural death, and to make the examination immediately afterwards. It was by so doing that the first indication of the pathology of the disease was obtained. * * * = # * When we slaughtered the sheep at the height of the disease, the peritoneal liquid had invariably the clear limpid character of that in health, whereas, did the animal perish in the natural course of the disease, 1 So named by Williams in 1881. LOUPING-ILL. 697 it very often was turbid; but sometimes, even under these circumstances, it was quite unaltered, or appeared to be so. * * * * * * Microscopic examination of the clear liquid usually failed to discover anything abnormal within it. A few lymph-corpuscles such as may be met with in health seemed to be the only particular matter which it con- tained. The most persistent examination of it, stained or unstained, failed to reveal the presence of any micro-parasite. The turbid variety of the liquid however, was always swarming with a bacillus. This bacillus was of great size (see Part II., p. 28), and in a large number of instances had developed a spore, also of large size, in its interior, while liberated spores were abundant in the surroundings, Where this turbid liquid existed, the abdominal walls and, indeed, the carcase generally underwent rapid putrefaction. The abdomen became distended with gas, and the ° odour, which was that of putrefaction, was very much in evidence. Those carcases, on the contrary, which possessed clear peritoneal liquid did not putrefy so rapidly, and the odour was less striking. * * * * * * End of First Season at Kielder.—The season being over, we left the Kielder district this summer (1902), after nearly two months’ sojourn, with certainly a knowledge of the symptoms and morbid anatomy of the disease, of the negative character of the blood as a medium of contagion, of the difficulty of reproducing louping-ill by inoculation, and under the impression that we had to deal with two diseases, the one louping-ill proper the other so-called “ black-quarter.” * * * * * * Then, further, we had administered the contents of the stomach and intestine to normal sheep and had failed to confer the disease upon them; we had injected the same into the rectum but without positive result. All this experience had a misleading tendency, and served to divert our attention from the alimentary canal as the source of entrance of the organism. * * * * * * We were also imbued with the idea that the tick might be the means of introduction of a poison—a virus—but what virus no one knew. This theory had also to be run to death, its truth or falsity inquired into. * * * * ¥ * Cause of the Seasonal Character of the Disease—That the blood of the sheep not only possesses such a solvent action upon the louping-ill bacillus, but that this is much more in evidence during certain months of the year, and in certain individuals, is demonstrated by our series of experiments detailed in Part II., Section XXVI., p. 200. The time at which it is most bactericidal is from midsummer on to early autumn, such being the time at which the disease is quiescent. Supposing the bacillus to be in the intestine at this time, it presumably never gets a chance of passing through its walls. In the susceptible months, on the contrary, 698 SPORADIC DISEASES. the blood becomes an excellent medium for the culture of the organism even in vitro, and the bacillus will increase upon it and develop spores better than on any other nutritive basis. * * * * * % This is evidently the key to understanding why the disease breaks out at one particular season—namely, in the spring. The blood of the sheep at that time possesses less bacturicidal or protective influence than at any other. , * * * * * * But not only is this exemplified in the case of louping-ill, it holds good, even in a more remarkable degree, of braxy. During the months in which braxy prevails the sheep’s blood will, as a rule, be found to be an excellent medium upon which to grow the braxy organism. It will multiply and spore upon it with the greatest aptitude, while at other seasons—spring to late summer—it is completely bactericidal. We have failed totally to grow it on sheep’s blood during the summer months. Even where the admixture of bacillus with blood is made so strong that every field of the microscope swarms with the organism, not w single bacillus will be found after twenty-four hours’ incubation. This, in our experience, occurs with perfect constancy, every sample of blood we have employed having given the same result during the summer months. * * - & * % % The sheep would seem, in this regard, to be a peculiarly constituted animal; it suffers from seasonal or periodic germ diseases, and the periodicity in their incidence is to be accounted for by the loss of the pro- tective action of its blood at these particular times. This loss of bacteri- cidal power varies with each organism, for while louping-ill and struck reach their zenith during the spring months, braxy is a disease of the late autumn and early winter, * ar * * % * Conclusions. Braxy and louping-ill form two of a group of specific bacterial diseases. There is some amount of similarity in the symptoms of certain of the diseases of this group. This similarity frequently results in errors of identification. The primary habitat of the bacteria which are their cause is, in the whole of them, the alimentary canal. At certain seasons of the year the blood of the sheep is unable to resist the invasion of these bacteria, and death ensues. At other seasons the blood of the sheep destroys these bacteria, and at such times the animal is proof against them. The germs of this group of diseases are picked up by the animal when feeding. The fatal effect of these germs in the case of louping-ill and braxy may NEURITIS. 699 be prevented by drenching with a culture of the respective bacilli during the period of resistance. If the drenching be done at a wrong time of year, viz., during a period of susceptibility, death may follow as a result in a certain number. It has yet to be shown whether drenching methods will succeed with the other diseases of the group, but the evidence, so far as it goes, tends to show that not only is this the case, but that immunity may probably be secured against two or more of them at the same time. NEURITIS—NEURALGIA., Inflammation of the Nerves—Neuritis—When one considers the very delicate organisation of nervous tissue, and the extreme sensibility of the sensory nerves, a most striking fact presents itself,—namely, the rarity or almost total absence of inflam- mation of the nerves. The nervous substance contained within the cranium, as well as that constituting the spinal cord, is subject to inflammatory changes; but it may truly be said that, except as a result of blood alteration—as in azoturia, where the sciatic nerves, and traumatic tenanus, where the nerves con- nected with the wound and their neurilemme are oftcn found inflamed—neuritis is almost unknown, or, if it does exist, has not as yet been correctly diagnosed. Neuralgia, or pain in the course of a nerve, and recurring in some few cases at stated intervals, whilst in others the recur- tence is very uncertain, is also a disease which is rarely or never met with in the lower animals. I certainly once heard of a case which presented some signs of having neuralgia of the face, but whether it was that, or pruritus, the practitioner, under whose care the horse was placed, could not tell. The symp- toms were persistent rubbing of the face against any solid object for a certain period each day, with shaking of the head and great restlessness. The principles of treatment applicable to neuralgic diseases will entirely depend upon the cause. Ifa nerve leading from a wound be inflamed, then fomentations and emollients must be applied ; whilst belladonna should be rubbed along the course of the nerve, or, if the pain be excessive, morphia may be in- jected subcutaneously into the tissues of the painful part. Should it be considered that neuralgic pains arise from a mal- or debilitated condition of the animal generally, then measures must be resorted to which are calculated to restore the body to 700 SPORADIC DISEASES. its normal condition, and in many cases aperients, followed by nervine tonics, such as arsenic, nux vomica, iron, or, where it is deemed necessary to soothe pain, belladonna, stramonium, yellow jessamine, or the bromides, may be administered for a short period. If pain on the course of a nerve threaten to become chronic, a smart blister will be imperatively called for. CHAPTER LVII. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (I) DISEASES OF THE RESPIRATORY ORGANS. BEFORE entering upon the consideration of the particular dis. eases of the respiratory organs, it will be necessary to point out certain modes of physical examination by which the diagnosis of these diseases is accurately traced. 1. Auseultation—In its technical sense this term indicates the act of listening to the sounds of the interior by means of the ear applied to the surface of the body. Auscultation may be practised directly by applying the ear to the part; or indirectly through the medium of instruments called stethoscopes or phonendoscopes. Generally direct or immediate answers every purpose ; and in veterinary practice, at least, indirect or mediate auscultation is seldom practised. Auseultation, discovered by Laennec, was introduced into veterinary practice by Delafond and Leblanc. Many of the sounds characteristic of abnormal conditions in the human being are not heard in the lower animals; hence auscultation, as well as percussion, is less satisfactory in the hands of veterinary surgeons than in those of the physician. There are various reasons for this, and not the least of them is the fact that the thoracic walls of man are much more thinly covered with muscular tissue than those of the lower animals. Again, a large portion of the thoracic cavity in our patients is covered by the scapule, which form insuperable barriers to examination. These, in addition to the movements of the panniculus carnosus, the horizontal position of the body, oblique arrangement of the diaphragm, the pressure of the digestive 701 702 SPORADIC DISEASES. organs, and very often the restlessness of the patient, render this method of examination much less satisfactory than it otherwise would be; but, notwithstanding all these drawbacks, auscultation is of immense advantage, and by it we are enabled to arrive at conclusions that would otherwise be impossible. To become familiar with the knowledge to be acquired by auscultation much time and labour must be devoted to it, first on healthy, and afterwards on unhealthy animals; in fact the ear must be trained by long experience. The phonendoscope can be bought at any instrument maker’s, and the simpler it is the better. In applying it to the chest, its flat-shaped portion is to be accurately and firmly applied to the surface, and the opposite end in perfect apposition to the ear. When immediate auscultation is practised, care is to be taken that the ear be accurately applied to the skin, or if the state of the surface does not admit the ear, a single fold of a thin cloth only should be allowed to intervene, as the rubbing of two folds or surfaces may create a sound and puzzle the examiner. 2. Percussion—This process consists in striking upon the surface with the view of eliciting sounds, by the nature of which an opinion may be formed of the conditions of the parts beneath. Like auscultation, percussion is either immediate or mediate. The former was employed by Avenbrugger, and the latter in- vented by M. Piorry, who gave the name of “pleximeter” to the intervening body. In immediate percussion, the ends of the fingers are brought together and supported by the thumb, and the parts are struck perpendicularly to the surface, or the parts may be rapped with the knuckles of the closed hand, the force of the blows being regulated by the depths of the parts to be examined, and the size and delicacy of the animal. In the cat or dog gentle blows with the tip of the middle finger are generally sufficient. In mediate percussion, the pleximeter is generally. a flat, oval, or circular piece of ivory or gutta percha, or the left index finger of the operator, which is certainly the most convenient and best intervening body which can be had. M. Poirson of Paris recommends that percussion should be performed by means of a common sewing-thimble placed on the middle or fore finger, so as to include a small portion of air between the end of the finger and that of the thimble. The intensity of sound elicited is said to be thus greatly increased. DISEASES OF THE RESPIRATORY ORGANS. 703 Some operators substitute a small hammer for the fingers, the head being made of wood, ivory, or metal, with its percussing surface covered by a softish and somewhat elastic substance, as felt, caoutchouc or gutta-percha. The more satisfactory method, and the best and simplest, is immediate percussion by the tips of the fingers or knuckles; the part percussed to be unclothed, and struck perpendicularly to its surface, otherwise the character of the sound will sometimes be confusing. 3. Palpation—Touch is useful in the diagnosis not only of chest diseases but of many other ailments. By this method we detect tenderness, heat, coldness, fluctuations, tumours, and a variety of conditions indicative of disease. If an animal be affected with pleurisy, firm pressure in the intercostal spaces will cause wincing, grunting, or even groaning. 4. Mensuration is recommended by the French veterinarians. It has, however, found little or no favour in this country, as it is considered that an amount of disease sufficient to alter the relative size of the sides of the chest is otherwise determined than by mea- surement. In the cat, dog, and cow, the intercostal spaces are expanded and dilated in hydrothorax of one side, if of long standing ; and in some cases of chronic pneumonia in cattle I have confirmed the observations of Delafond, that one side of the chest is sometimes palpably larger than the opposite side. Mensuration as applied to the chest, says Mr. Gamgee, “consists in the application of a cord or tape to the similar parts of the two sides of the chest, in order to ascertain whether any difference exists in their relative prominence. For the larger animals a tape of three or four feet long, ana for the smaller, one of a foot and a half to two feet, may be employed. One end is placed immediately behind the withers, and the line carried downward to the middle of the sternum, which part is marked by a knot; a second measurement is made from the withers to the eighth rib, or the commencement of the cartilages of the false ribs, and similarly marked; a third measurement is made from the lower end of the third rib to the commencement of the cartilages of the false ribs; lastly, the tape may be carried from the posterior border of the shoulder along the middle region of the chest as far as the: last rib. The same measurement may then be made on the opposite side of the thorax, care being taken that they be always made at the same stage of the respiratory act, as otherwise false 704 SPORADIC DISEASES. results will be obtained. It is well, indeed, to measure the different parts after both inspiration and expiration, that any difference in the expansion of the two sides of the thorax may be ascertained.” 5. Inspection--Some symptoms are observed by inspection only—the condition of the visible membranes, the attitudes and movements of the body, the expression of the countenance, the character of the respirations, the degree of fulness, or the converse, of the several parts. In human medicine the state of the larynx can be thus detected by an instrument called a laryn- goscope, but owing to the length of the oral cavity, the dimen- sions of the velum pendulum palati, and the position of the larynx itself, the laryngoscope has not yet been made available for veterinary purposes. 6. “Succussion consists in grasping the thorax between both hands, and shaking it quickly so as to elicit sound. It is only useful when gaseous and liquid matters coexist in the pleura; in such cases, however, a splashing or churning sound may be heard. It will strike every one that this measure is only appli- cable to the smallest class of animals.”—(GAMGEE’S Domestic Animals, page 537.) I have never practised this method of examination, nor do I recommend it, and here describe-it in Mr. Gamgee’s own words. RESPIRATORY SOUNDS. The respiratory sounds, normal and abnormal, detectable by auscultation, are divided into four classes, namely, Nasal, Laryn- geal, Tracheal, and Thoracic. NASAL SOUNDS. In the normal condition a soft, to-and-fro, blowing noise, of equal intensity on both sides, is heard when the ear is approached to the nostrils. This sound is increased with exercise, and then bears a resemblance to the sound of a large bellows. There is no sound detectable through the parietes of the nose nor the sinuses of the head except after exercise, when a slight snore may be detected through the first and a murmur in the latter. In some horses the nasal sound is abnormally increased with DISEASES OF THE RESPIRATORY ORGANS. 705 exercise, and can be heard at a considerable distance from the animal, causing the horse to be termed a “high blower.” This sound is generally much greater when the animal is gently trotted or cantered than in the gallop, and is louder in the expiratory than in the inspiratory act. The increase of sound arises from flapping or crackling of the nostrils, and has no connection with any disease. “It arises,” says General Sir Frederick Fitzwygram, “from powerful muscular development in the part. If a horse so formed be pushed to its speed and continued for some time, it will be seen that it can intermit the noise at its will; and when it really becomes distressed at its pace it will have something else to do than flap about its nostrils, and the sound will then cease altogether.’—(Horses and Stables.) I have repeatedly observed that some horses will emit this sound when they are first put into training after resting for a while, but when they are brought into condition the sound entirely ceases, and I have thought that the sound was due to flaccidity of the dilatores nares muscles. In other horses, again, high blowing is due to a natural narrowness of the nostrils and nasal passages. It never seems to interfere with the horse’s usefulness, and, consequently, is not to be considered an unsoundness. Snoring is diagnostic of polypus, thickening of the Schnei- derian membrane, or some other obstruction to the passage of air through the nasal chambers. A snuffling sound indicates some disease, accompanied by discharge from the nose, as purpura, glanders, catarrh, &c. Whistling may be due to a tumefied condition of the Schnei- derian membrane. ‘This is, however, rare, and may be mistaken for a sound arising in the larynx or even in the lungs, which sometimes so retains its force within the nasal chambers as to lead one to think it originates there. Auscultation of the several parts will, however, enable the practitioner to determine where the sound originates. Sneezing or snorting indicates an irritable condition of the Schneiderian membrane, and is present in many cases in the early stages of catarrh. Sometimes I have seen it very persistent after the subsidence of the catarrhal symptoms, or existing independently of any apparent disease, coming on in paroxysms when the animal has been at work. One fit of sneezing has 45 706 SPORADIC DISEASES. followed another, causing the animal a deal of distress. Steaming the head has succeeded in allaying it in some instances, whilst in others it has been necessary to apply a blister to the face. Epistaxis, or bleeding from the nose, occurs as a symptom of various diseases, such as glanders, purpura, malignant catarrhal fever. It may also be induced by injuries, rupture of the small nasal blood-vessels during severe exertion, sneezing, or it may arise from the presence of a polypus. When arising spontane- ously or from injury, it must be arrested by the application of cold astringents or by plugging the nostril with cotton wool or tow. Peroussion applied to ‘the nasal region and sinuses of the head yield in the young horse but an indistinct resonance ; the sound increases with age as the sinuses undergo change. The presence of pus, tumours, or coagula deadens the sound. If there be an extensive accumulation of pus, or a large tumour in the sinuses, the sound is completely deadened, the bone is painful to the touch, and often bulging in appearance. AUSCULTATION OF THE LARYNX—-LARYNGEAL SOUNDS IN HEALTH AND DISEASE, In health there is a faint to-and-fro respiratory sound. In disease the laryngeal sounds are varied and important; they consist of grunting, whistling, coughing, roaring, and trumpeting. Laryngeal sounds, with the resnepiea of “ grunting,” constitute unsoundness. If they be of a temporary nature, and due to irritation or tumefaction of the mucous membrane, pressure of abscesses or tumours of a removeable nature, the unsoundness may pass away; but if of a permanent character, no matter how trifling they be, they distinctly indicate unsoundness, not only interfering with the usefulness of the horse for the time being, but generally having a tendency to increase in intensity with age, and often causing a horse to become unserviceable. I do not mean to say that a whistler or roarer is not fit for work, but I assert that the infirmity is a drawback, and an animal so affected is worth less money in the market. 1. Grunting—If a horse, when struck at or suddenly moved, emits, during expiration, a grunting sound, it is called a “ grunter.” Such a sound may or may not have any connection with disease of the larynx. A horse will grunt with pain when DISEASES OF THE RESPIRATORY ORGANS. 707 suffering from pleurisy, pleurodynia, and other diseases. Some horses habitually grunt when struck at or moved suddenly. A great number of cart-horses are so affected, and big horses of all breeds are very apt to be grunters, whilst they may be quite sound in their wind. Horses with heavy jaws and ill-set necks often emit this sound; and again any horse may do it if it has been fed for a time with bulky food. The sound is always to be regarded with suspicion, and the animal further tried for its wind, as it generally accompanies roaring or whistling. If the grunter, however, stands the tests used to detect roaring, without making any noise in its breathing, it may be considered sound Grunting is often symptomatic of occult glanders. 2. Whistling—This sound is of two kinds, a soft or moist and a dry or hard whistle. Soft whistling is due to acute laryngitis, when a considerable increase of mucus has taken place, and when the mucous membrane is temporarily swollen. When due to the presence of mucus it partakes more of a wheezing sound, and is generally diminished when the animal coughs. The sound arising from tumefaction of the laryngeal mucous membrane is greater during the inspiratory than the expiratory act. It is very similar in character to the dry sound to be described; but in addition to the sound, symptoms of catarrh, fever, or acute irritation of the larynx are present. This sound indicates a temporary unsound- ness, and in many instances it is unsafe to pronounce a decided opinion for several days or even weeks after the subsidence of other symptoms. In such instances the mucous membrane has undergone some degree of thickening; there is relaxation of the vocal cords, a want of tone in the larynx generally, that require some time to overcome. It is impossible to pass an animal of this kind as perfect, and it would be unwise to give a decided opinion until all abnormal sound has disappeared. Dry whistling—This sound has been generally looked upon as a modification of roaring. I am, however, of opinion that whistling and roaring are due to different pathological conditions of the larynx, and that they may exist independently of each other; that roaring does not always terminate in whistling, nor whistling in roaring. Whistling, like roaring, is a sound emitted more particularly during inspiration, and is due to a diminution of the calibre of. the larynx, or sometimes trachea, owing to a sash ee ‘ 708 SPORADIC DISEASES. ; ing of the mucous membrane, distortion of the neck by tight reining, the presence of an immoveable tumour in the trachea, or by any cause which diminishes the area of the passage of the air to and from the lungs. Whistling, although loudest during the inspiratory movement, is by no means always absent during the expiratory act; careful auscultation is, however, necessary to detect it. If entirely absent during expiration, the seat of the lesion causing it is to be looked for in the larynx or upper part of the windpipe. Whistling, like roaring, is often traceable to hereditary taint, and is an unsoundness. 3. Roaring.—This symptom of disease consists in a loud un- natural sound emitted during the inspiratory act. Roaring is sometimes symptomatic of acute laryngitis, and then only indi- cates a condition of temporary unsoundness ; again it may be due to a poison (see Lathyrus sativus and Lead). The cause of roaring is, however, generally found to be due in the majority of cases to atrophy and fatty degeneration of the muscles of the larynx. The origin of the paralysis is involved in some mystery; but it is generally accepted by veterinarians that, inasmuch as it is generally confined to the left laryngeal muscles, the explanation is to be found in the fact that the recurrent or ascending laryngeal nerve on the left side leaves the pneumogastric further back than on the right, and winds round the posterior aorta; whereas the right is given off opposite the first rib, winding round the dorsal artery, and consequently the left nerve is more apt to be implicated i in any disease of the chest than the right. This explanation is unsatis- factory on many accounts. Ist. Roaring is not a common sequel to pulmonary disease: 2d. Itis not an accompaniment of thoracic disease, which would most certainly be the case if the nerve were implicated in an inflammatory affection: 3d. Many roarers whose history has been known from their birth have never suffered from any chest affection, nor indeed from any disease beyond a common cold, and sometimes not even from that slight ailment: 4th. Mares and ponies are less often affected with roaring than large geldings and stallions, but are quite as sus- ceptible to chest diseases ; and lastly, dissections have failed to discover any change in the nerve trunk itself, although the animals dissected have been confirmed roarers for yeats previous to their death. DISEASES OF THE RESPIRATORY ORGANS, 709 It is very true that division or ligature of either of the recur- rents will be succeeded by roaring, and tumours involving the recurrents may cause the same symptom; and Dr. Warburton Begbie says that “no more interesting variety of local paralysis exists than that which is due to the interference with the recurrent or motor laryngeal nerve, produced by an aneurism of the arch of the aorta, or by a cancerous mediastinal tumour. Well-marked atrophy of the muscles of one side of the larynx has, under such circumstances, been found.” But in the form of disease involving the laryngeal muscles, which commonly causes roaring, there is no change in the nerve itself, nor can the loss of motor power be traced to pressure upon the nerve trunk by any tumour, aneurism, or adventitious substance. The disease of the muscles is, however, essentially nervous in its origin, and may, I think, be classified as a form of wasting palsy—paralysis atrophica—originating in the laryngeal muscles themselves. Wasting palsy is defined by Dr. William Roberts, in Reynolds’ System of Medicine, to be “an atrophic degenera- tion of certain groups of muscles, independent of any antecedent loss of mobility, or of any metallic poisoning.” T have already stated that the atrophic change is usually seen on the left side of the larynx. It, however, by no means follows that the muscles of the right side are entirely free from disease ; indeed, in many instances, they distinctly partake of the atrophic change, though to a less extent. Why the change is greater on the left than on the right side, is one of those things for which no more satisfactory explanation can be given, than why the ulcers of glanders are oftener seen in the left than in the right nostril. Roaring is generally gradually developed. At first, the sound may be intermitting, and days or even weeks may elapse during which the animal may make no noise, although put to severe exertion, as if the muscles had, at the time the sound was emitted, been debilitated from some ephemeral disturbance of nutrition. As the loss of muscular substance progresses, there is a corresponding and permanent loss of power, and what at first was intermitting is now a permanent infirmity. This intermis- sion of the sound is not, however, the ordinary method by which the disease manifests itself. More commonly the noise or roar, slight at first, gradually, but often very slowly, increases in 710 SPORADIC DISEASFS. intensity, thus marking or indicating the progress of the muscular change, and inability to dilate the laryngeal opening. Causes.—Putting aside all exciting causes of alteration of the air passages, to be hereafter mentioned as causes of roaring, I think that laryngeal muscular atrophy is due to hereditary predisposi- tion; and itis a well-known fact that certain breeds, the produce of certain sires, are nearly all roarers. I have repeatedly observed this, not only in racers, but in other breeds of horses. Indeed, 1 know one breed of Clydesdales which are nearly all roarers, both mares and horses. Horses and geldings are, however, more liable to become roarers than mares, which seldom, except where the hereditary taint is very strong, become roarers. Small ponies are scarcely ever affected, although they are subject to colds, laryngitis, and pulmonary diseases. A horse predisposed to become a roarer generally suffers from laryngeal irritation from trivial causes, and usually the infirmity appears after repeated attacks of cold and sore throat. Other causes of Roaring—Concluding that the majority only of cases of roaring are due to the condition described, it is necessary to mention that the sound may arise from other and incidental conditions which, although not so frequent, are quite as important. Roaring may be due to disease of the nose, nasal polypi, depression of the nasal bones from previous fracture (see Prin- ciples and Practice of Veterinary Surgery), osseous tumours in the nostrils; closing of one nasal chamber by false membrane or disease of the bones; tumours on the posterior nares, called “bellones ” by horse-coupers, falling into the glottidean opening, causing intermitting roaring; constriction of the trachea ; tumours in the thoracic cavity; distension of the guttural pouches; disease of the pharyngeal and parotidean lymphatic and salivary glands; tight reining; fractures of the tracheal rings, or any cause of distortion of the larynx. In addition to the sound emitted during inspiration, the roarer generally has a cough which is diagnostic, being a loud, harsh, dry sound, half roar, half cough; and the generality of roarers are also grunters. It will also be found that the sensibility of the larynx is diminished in confirmed roarers, and that consequently it is difficult to make them cough in the ordinary way by press- ing the larynx. In testing a horse for its wind, it is usually the DISEASES OF THE RESPIRATORY ORGANS. 711 practice with some to place it against a wall, and threaten it with a whip; if it grunts, it is further tested; if not, it is merely made to cough by pressing the larynx, andif the cough has a healthy sound the animal is generally passed sound. This plan is not always satisfactory, and is, to my mind, most reprehensible; as, if a horse be at an auction sale, and has its larynx pressed by forty or fifty horny handed coach- men and grooms, the chances of an attack of laryngitis are very great,—the better way is to have the animal galloped ; or if a cart-horse, to move a heavy load some little distance, when, if it be a roarer, it is sure to make a noise. Treatment of Roaring.—lIf the sound can be traced to any removeable causo, the practitioner knows what to do, but the removal of the causes of the form of roaring generally met with is, however, a matter of great importance. Many experiments have been tried; in some rare instances the application of blisters, or the actual cautery, to the skin of the laryngeal region, has succeeded, not only in arresting the progress of the atrophic change in the muscles, but in materially improving their strength and tone ; but in order that this may prove effectual, the animal is to be treated in the very earliest stages of the disease. In addition to “firing,” I have only to suggest that the chlorate of potash is worthy of trial, as it is found to have some power in arresting fatty degeneration. In very bad roaring the sound may be modified by pads attached to the bridle and fitted over the false nostril. These pads regulate the quantity of air taken in at such inspiration ; for it is observable that when aroarer is pushed in its work or paces, that the nostrils dilate greatly, thus admitting a large volume of air, which by its weight and pressure causes a further falling in of the arytenoid cartilage and an increased constriction of the laryngeal opening. If this method be inefficient, trache- otomy is to be performed, and a tube kept in the trachea for the remainder of life. Excision of the left arytenoid cartilage (presuming that the left muscles are atrophied) has been sug- gested by Gunther of Hanover, and has, I believe, been more or less successfully carried out. The operation is to be performed by making an incision through the skin into the superior part of the trachea, the collapsed cartilage seized by forceps or tenacula, and excised by means of a pair of scissors, 712 SPORADIC DISEASES. It will be apparent that a bad roarer, no matter what the means may be by which the sound is modified, is only useful for slow work ; and lastly, I have always observed that confirmed roarers become bad thrivers, and often succumb to trivial diseases. Roaring being due to a progressive disease, it is necessary that the veterinarian should reject as unsound every animal which makes the slightest roaring or whistling sound in its breathing. There are two terms in common use by horsemen—namely, “ high-blowing ” and “ thick wind.” High-blowing is a respiratory sound, caused by the nostrils ; it is principally an expiratory sound, caused by a flufing or Surting of the nostrils—-almost a snorting sound. It occurs in horses which are fresh and fit, and usually just when brought out of the stable, particularly on a frosty morning, or when joining the company of other horses, or when excited whilst hounds are in covert and waiting for a view-hallo. It is not an unsoundness, and csases as soon as the horse settles down to his work. Thick wind refers to a variety of lung sounds, or, rather, to a peculiarity of breathing due to an abnormal condition of some portion of a lung. A thick-winded horse is one which shows signs of distress and has a laboured method of breathing when subjevted to very little exertion. It may be due to lack of condition, grossness of body, to plethora, to a narrowing of smaller bronchial tubes due to a chronic bronchitis, or to a patch of consolidated Jung after an ordinary pneumonia, or due to some specific disease such as glanders. It is an un- soundness which may or may not be permanent. Many people confuse the terms thick wind and broken wind ; at the same time it is not at all unusual to find that a broken- winded horse is also a thick-winded horse, but it must be remembered that a thick-winded horse is not necessarily a broken-winded one. COUGH AS INDICATIVE OF DISEASE, Cough is the sound produced in the larynx by the violent expulsion of air from the lungs, and is symptomatic of various diseases. Cough is divided into dry and moist. DISEASES OF THE RESPIRATORY ORGANS. 713 Dry cough is divided into short, hacking, hollow, broken- winded, and spasmodic. The dry cough is symptomatic of irritation and dryness of the respiratory mucous membrane. In the early stages of laryngitis it is loud and long, becoming afterwards rasping and then moist. In chronic disease of the larynx it is loud, roaring, and often hollow. In the early stages of bronchitis it has a hollow metallic sound; it after- wards becomes moist, and is more or less painful throughout the disease. In pneumonia the cough is short, seems as if proceeding from a solid organ, and is accompanied in the later stages by a rusty, tenacious expectoration. The cough of pleurisy is dry throughout, is painful, hacking, sometimes as if cut in two, the animal being seemingly afraid to complete the act by one effort. The broken-winded cough is at first spasmodic, becoming, as the disease advances, feeble, short, and single, the animal being unable to relieve itself by the action of the chest and lungs; hence the suppressed cough becomes diagnostic. The hollow cough, a sepulchral sound, varying in intensity, indicative of chronic disease, and on this account is termed a “chronic cough.” The moist coughs indicate an inflamed and humid condition of the respiratory mucous membrane. There are various other kinds of coughs associated with dis- eases of the heart, digestive organs, and the process of dentition; these are valuable as aids to diagnosis, when studied in connec- tion with other symptoms. They are mostly dry coughs. Horses with narrow, shallow chests, weak loins, and long legs are very generally predisposed to cough from very trivial causes. TRACHEAL SOUNDS. Except at its entrance into the chest, the trachea yields no sound. At this point, however, a blowing sound—tracheo-bron- chial respiration—can be heard, more prolonged during the expiratory act. In disease this may be increased. When the bronchi contain much mucus or other fluid, a moist rattle— mucous rale—may be heard, accompanied by a wheezing, gurgling, or spumous or frothy sound. T14 SPORADIC DISEASES. THORACIC SOUNDS. The thoracic sounds are divided into pulmonary, pleural, and cardiac. The pulmonary sounds are of two kinds, namely, the vesicular and the bronchial sounds. 1. Vesicular, also called the respiratory murmur, is heard during both inspiration and expiration. During the inspiratory act it is a soft diffused murmur of a gentle breezy character: slightly harsher and more hollow during expiration, and not above one-fourth the length of that during inspiration. It is caused by the entrance and expulsion of air to and from the terminal portions of the bronchi and air sacs. The intensity of this sound is increased with exercise or other causes of quickened respiratory movements, as fever; is louder in chests thinly clothed with flesh; stronger in the young than in adults, hence, when strong, it is called “ puerile”; it is also louder when the stomach is empty. Puerile respiration depends upon the smaller size of the air vesicles, and the greater elasticity of the lung tissue ; in the very old the murmur is scarcely preceptible, and is called “ senile.” Senile respiration may also result from slow breathing, or any cause which obstructs the entrance of air into the lungs. If either modification is present to the same extent in the same region of both sides of the chest, they indicate no other condition than the natural ones above indi- cated; but if the murmur is puerile on one side and senile or absent on the other, the first indicates a compensating action of that lung, supplementary to diminished action in the other. The vesicular murmur is best heard in the superior portion of the lower third of the chest, from behind the elbow and shoulder to about the ninth rib, whence it diminishes in force, and is altogether lost over the sixteenth. In the inferior part of the chest it diminishes at the seventh, and is lost at the tenth tib. On the left side it is mixed in the lower and anterior regions, immediately behind the shoulder, with the sounds of the heart. 2, The Bronchial or Tubal sound resembles the blowing of air quickly through a tube; it is higher in pitch than the vesicular murmur, and more rapidly evolved. It is nearly as prolonged during inspiration as expiration, with a distinct interval between the two. This sound is distinct over both the middle and upper DISEASES OF THE RESPIRATORY ORGANS. 715 thirds of the chest; loudest immediately behind the scapula and caput magnum, or the nearer we can approach the ear to the bifurcation of the trachea and larger bronchial tubes; diminish- ing in intensity to the twelfth rib, where it is superseded by the vesicular, and entirely lost at about the seventeenth rib. It also diminishes in intensity as it approaches the upper part of the lower third of the chest, where it becomes lost in the vesicular sound. The tubal sound becomes diagnostic of disease when it is heard in the inferior portions of the chest. In the ox, the bronchial sound is heard much lower down in the right side, owing to the large tube which passes to the anterior lobe of the right lung. The true thoracic sounds are very often complicated with abdominal rumblings or gurglings, due to the movement of food, fluids, and gases within the alimentary canal; these are loudest in the posterior part of the chest, are irregular in their occur- rence, and bear no relationship to the respiratory movements. A little practice will soon enable the student to distinguish these from the respiratory sound. Percussion.—The sound obtained by percussing the healthy chest is loudest over those parts where the bronchial sounds are best heard, except indeed in those parts most thickly clad with muscular tissue. On the left side the resonance is very clear immediately behind the shoulder to the twelfth or thirteenth rib, where it gradually diminishes. If the parts are here struck forcibly, the intestinal resonance may be induced. Mr. Percivall has pointed out what may be easily verified in practice, that the sound along the right superior region grows louder from the posterior border of the shoulder to the last rib, whilst on the left it gradually diminishes on the same line This increase of sound on the right side is due to a resonance from the arch of the colon. If the blows are light, this sound is not brought out, and when heavy, it is more of a tympanitic character, resembling that of an emphysematous lung. Along the middle region louder sounds are elicited than either above or below, more particularly between the fifth, sixth, seventh, and eighth ribs, from whence it diminishes to the fifteenth, and then becomes tympanitic or abdominal on the left, and dull on the right side, owing to the opposition of the liver. In the inferior part of the chest the sound is weak, but clear, 716 SPORADIC DISEASES. from the fifth to the eighth rib on the right side, where it becomes dull, responding to the liver; whilst on the left side the resonance is almost absent over the fifth, sixth, and seventh ribs, opposite to the heart; it becomes clearer over the eighth, behind which it loses its intensity, and is lost at about the thirteenth rib. MORBID SOUNDS. The morbid sounds indicative of diseases of the respiratory apparatus elicited by auscultation may be divided into bronchial, pulmonary, and pleural. BRONCHIAL SOUNDS. These are of two kinds, namely, 1st. Dry; and 2d. Moist. 1. Dry sounds are subdivided into large and small, or rhonchus and sibilus. (a.) Rhonchus, a hoarse, sonorous murmur, sometimes of a humming, cooing, or snoring character, compared to the bass note of a violin or cooing of a pigeon, especially marked during expiration, but coexistent with both movements, and due to a narrowing of some part of the larger bronchial tubes. It may be heard at the front of the chest very plainly, as well as behind the shoulder. It is sometimes caused by portions of viscid mucus adhering to and obstructing the larger tubes, acting as vibrating tongues as the air passes by them. If the adherent mucus be removed by coughing, the sound may disappear for a time, and then reappear; when not removed by coughing, it may be due to tumefaction of the bronchial mucous membrane ; and if permanent in a given spot, it may arise from the pressure of a tumour or other cause which may flatten an air-tube. Rhon- chus essentially belongs to the larger tubes, denoting partial narrowing; is a dry sound, and, if uncomplicated, indicates a condition of no great danger. It is also called vibration, sonorous rhonchus, and sonorous rale, and is generally associated with bronchitis. (@.) Sibilus, Sibilant Rale, Sibilant Rhonchus.—A high-pitched whistling, hissing, clicking, wheezing sound of variable intensity and duration, coexistent with both respiratory movements, but more especially marked during inspiration, arising from tume- DISEASES OF THE RESPIRATORY ORGANS. 717 faction or accumulation of viscid mucus in the small bronchial tubes. I once heard a dairyman call this a “chaining sound,” from its resemblance to rustling of an iron chain. It is asso- ciated with bronchitis situated in the smaller tubes, and is best heard over those regions where the vesicular murmur is most audible in health. It indicates greater danger than rhonchus, and if present over a large surface of both sides, a condition of great gravity. 2. Moist sownds.—The dry, bronchial sounds are succeeded in bronchitis by moist ones, termed rales, rattles, or bubbling sounds. ‘(a.) Mucous Rhonchus or Rale—The bursting of bubbles of some size, unequal and varying in number, modified by coughing and expectoration, coexisting with both respiratory movements. It is due to the bubbling of air through liquid—mucus, blood, or pus—in bronchial tubes the size of a crow quill, heard in those regions where the tubal sound is most apparent in health. Succeeding dry rhonchus, it indicates the moist stage of bronchitis. (0.) Small bubbling Rhonchus or Rattle, subcrepitant or sub- mucous Rales or Rhonchi, succeeding sibilus, coexistent with both movements, but loudest during inspiration, and due to the bubbling of air through a more or less viscid fluid in the minute bronchial tubes at their peripheral distribution ; heard in bron- chitis affecting the smaller tubes, and during the resolution of pneumonia. (¢.) Gurgling Rattles, cavernous Rhonchi or Rales——The burst- ing of bubbles, obviously of a large size, with a hollow, gurgling sound, or a metallic sound if the bubbles be small, coexisting with both respiratory movements, is associated with vomice or excavations from tubercle, dilatation of bronchi, pus in pleura, with a bronchial fistula and deliquescence of gangrenous lung structure. PULMONARY SOUNDS. 1. Crepitations—Crepitant rale or rhonchus ; compared to the sound produced by rubbing slowly and firmly between the finger and thumb a lock of one’s hair near the ear, or to the crackling of salt when scattered over hot coals. It is heard during inspira- tion only, and indicates the primary stage of pneumonia. “ Pro- 718 SPORADIC DISEASES. bably due to the sudden expansion of delicate tissue, altered in its physical properties by the inflammatory state, and which probably undergoes minute ruptures.’—(AITKEN.) This sound is best heard in the lower third of the chest, replacing the vesi- cular murmur. After continuing for a short period it may disappear, and the vesicular murmur return, indicating the resolution of the inflammation. Usually, however, the crepita- tion becomes fainter and fainter, and is substituted by— 2. Tubal or Bronchial sound.—The tubal or bronchial sound, when heard over the inferior portions of the thorax, indicates some degree of consolidation or hepatization of the lung tissue. It shows, in fact, that the minuter ramifications of the bronchi and air vesicles have become impervious to air, by the pressure of an exudate within and upon their walls, and that the larger tubes of the part are still pervious. In health, both vesicular and tubal sounds are emitted by all parts of the lung tissue, but’ can be detected by auscultation in certain parts only. For example, the tubal sound is so loud in the upper and anterior parts of the chest, as to mask or hide the vesicular murmur to a great extent ; and, conversely, the vesicular murmur being loudest at the inferior portions, masks or renders inaudible the tubal or bronchial sound. When, however, those portions of the lungs, namely, the minute tubes and air vesicles, are rendered impervi- ous—the larger sized tubes still remaining pervious—it naturally follows that the sound emitted by air passing in and out of the larger tubes now becomes audible. In many instances, however, the tubal sound continues for a short time only, and is succeeded by— . 3. Absence of sound.—When this occurs it indicates that the exudation is excessive in quantity, that the larger as well as the smaller tubes have been rendered impervious, or that effusion has taken place into the cavity of the thorax. Consolidation of the lung tissue, and the presence of fluid in the thoracic cavity, can be recognised the one from the other— (1.) By the previous character of the sounds; and (2.) By the manner in which the absence is marked. In hydrothorax the termination of the area of absence of sound is sharply defined superiorly; above the “water line” the pulmonary sounds are generally exaggerated. In consolidation the area of absence of sound has no sharply defined limit; at the lower parts of DISEASES OF THE RESPIRATORY ORGANS. 719 the chest, and for some inches upwards, there may be no sound at all ; then faint tubal sounds are heard, which increase in intensity as the ear is moved upwards along the thoracic walls. Now and then a blowing sound is heard in consolidation of the lungs, confined as it were to the superficies of the lung, indicating hepatization of the deeper-seated portions of the organ, leaving the subpleural parts still pervious. My experience leads me to the conclusion that this superficial blowing sound is a bad symptom, indicating a creeping pneumonic inflammation, having a tendency to a fatal issue. 4, Secondary crepitations—Consolidation, as above described, is succeeded by the breaking up and absorption of the exudate. This process is marked by the advent of crepitations of a bubbling nature, slowly evolved, few in number, dissimilar and irregular in occurrence, more audible during inspiration than during expiration ; they mark the resolution of pneumonia, and are succeeded by the natural sounds more or less modified. Such are, then, the sounds of pneumonia. They are subject to modi- fications, and to be variously mixed one with the other during the various phases of the disease. PLEURAL SOUNDS. 1. Friction sound.—A grazing, rubbing, grating, creaking, irregularly jerking, superficial noise, heard more particularly in inspiration, or in both respiratory acts. It results from the rubbing together of the two opposed surfaces of the pleura, chiefly heard at the lower part of the chest, where the pulmonary organs have the greatest freedom, and is indicative of dryness of the serous surfaces, or any cause of roughness upon them. This sound is succeeded, when hydrothorax occurs, by— 2. Absence of sownd in the inferior part of the thorax, reaching to a certain line, above which the respiratory sounds are heard. As the fluid accumulates, the absence of sound ascends. In some cases of hydrothorax one or two other sounds are heard, namely, metallic tinkling, and a gurgling or splashing sound. These sounds are only heard when gas or air and fluid coexist in the pleural cavity. The metallic tinkles may occur from drops of fluid, imprisoned in false membranes, falling from the roof of the pleural cavity into the liquid beneath, or may result 720 SPORADIC DISEASES. from the bursting of bubbles of air or gas on the surface of the liquid. In the horse the pleural sounds are less distinct than in the ox and dog. The sounds termed bronchophony, pectoriloquy, egophony, and amphoric resonance, produced by modifications of the voice during articulation, do not apply to any morbid sounds heard in the lower animals. CARDIAC SOUNDS. If the ear or stethoscope be applied to the lower part of the shoulder or arm, or if the left (near) fore leg be extended, and the humerus pulled forward as far as possible, the sounds of the heart can be made out. The sounds of the heart in health are two in number: first, a longish, dull sound, then a sharp sound, succeeded by a pause, and then the recurrence of the sounds in a regular and uniform manner, provided the animal is not excited nor in any way dis- turbed. The first sound coincides with the hardening of the ventricles, the complete closure of the auriculo-ventricular valves, and the opening of the arterial orifices; is caused principally by the sudden distension of the ventricles, and is of the same nature as the noise made by all muscles in contracting against a resistance. The second sound is undoubtedly due to the sudden closure of the sigmoid (semilunar) valves at the conclusion of the ventri- cular contraction. This has been proved by experiments on living animals, the sound being destroyed by hooking back the semilunar valves. The impulse of the heart may be felt by placing the hand directly upon the left side of the chest, immediately behind the elbow. It is very distinct in flat-sided and lean animals, less distinct, or even entirely absent, in round-chested and fat ones. Diminished impulse, when not due to the above cause, indicates feebleness of the heart’s action from disease, as fatty degene- ration of its muscular tissue; hydrops pericardii, when the apex may be prevented by the effusion from coming into contact with the thoracic wall; or it may arise from weakness of the system generally, attenuation of the cardiac walls, and dilatation DISEASES OF THE RESPIRATORY ORGANS, 721 of the cavities. Emphysema of the lungs may also diminish the impulse, the enlarged lung overlapping the heart; and adhesions of the pericardium to the pleure of opposite sides may bind down the heart so that the impulse will not be felt. The impulse of the heart is temporarily increased by any cause of excitement, fear, exercise, fever, or pain. When excessive it is called palpitation. Increased impulse, when not traced to the above-named causes, or when it is easily induced, may depend upon organic disease of the heart. It is stronger than natural in hypertrophy of the cardiac walls, and particularly so if such hypertrophy is associated with dilatation. It may, in such cases, be slow, gradual, and double, and this kind of impulse is due to no other condition of the heart; indeed it is one of those few symptoms which throw light upon the condition of parts within, for, notwithstanding much observation carefully recorded, we are bound to confess that, unless cardiac diseases be ageravated, we are unable, either by the character of the sounds or impulse, to diagnose them with that certainty arrived at by those who practise on the human patient. MORBID SOUNDS. 1. A to-and-fro friction murmur, synchronous with the heart’s movements, indicates pericarditis or pericardial effusion. 2. A bellows murmur with the first sound indicates mitral insufficiency ; stricture of aortic orifice; disease of the aortic valves, or deposits on the ventricular surface of the mitral valves ; or it may depend upon an altered condition of the blood itself, as in anemia, in which case it resembles a churning sound, heard also in the large veins and arteries. These anemic murmurs vary with the condition of the blood. Sometimes there is a continuous hum heard at the base of the jugulars, and to which the French have applied the term “ bruit de diable.” 3. A bellows murmur with the second sound indicates aortic insufficiency ; roughened auricular surface of the mitral valves, or mitral obstruction. The most common sound heard in the horse is a murmur masking or hiding the second sound, and indicating semilunar insufficiency. When the murmur is double, occupying the periods of both cardiac sounds, it indicates mitral obstruction and insufficiency. a 722 SPORADIC DISEASES, The sounds of the heart may be seemingly intensified by consolidation of the lungs and by hydrothorax, and diminished by emphysema of the lungs. In some instances of consolidation the sounds may be more distinctly heard on the right than on the left side: this indicates hepatization of the right lung, with compensating dilatation of the tubes of the left one. Metallic tinkling, coincident with the cardiac impulse, is some- times associated with the booming sounds of endocarditis, PERCUSSION IN DISEASE. Supplementary to auscultation, percussion is a valuable aid to diagnosis, more especially of pleural and pulmonary diseases, 1. Increased resonance indicates dilatation of the bronchial tubes and air vesicles; if partial or confined to one side only, and if associated with dulness of the opposite side, increased resonance may merely indicate a compensatory respiratory effort. In such a case the respiratory murmur will also be increased. Augmented resonance is, however, generally associated with decrease or absence of the true respiratory sounds, and accom- panied with wheezing, creaking, crackling crepitations, indicative of pulmonary emphysema, as in broken wind, rupture of the air cells, and chronic bronchitis. 2. Diminished resonance indicates consolidation of the lungs, hydrothorax, pleural exudations, tubercles, congestion of the lungs, pulmonary apoplexy, &c. When confined to the inferior parts of the chest, replaced abruptly superiorly by increased resonance, it is diagnostic of hydrothorax. When the dulness gradually disappears, it is indicative of hepatization of the lung tissue, being greatest where the consolidation is most complete. It is stated that enlargement of the heart is indicated by an increased area of cardiac dulness ; for my own part, I have never been able to make this out in the horse, but have done so several times in cattle affected with traumatic pericarditis, when the deposit on the heart has been very considerable. CHAPTER LVIII. SPORADIC DISEASES—continued. LOCAL DISEASES—contunued. (I.) DISEASES OF THE RESPIRATORY ORGANS—continued. CATARRH AND LARYNGITIS., CATARRH. Synonyms.—Common cold, coryza, a defluxion or running at the nose, and is witnessed in the horse, ox, sheep, and other animals. Symptoms.—Catarrh is indicated by sneezing, running from the eyes, redness and dryness of the Schneiderian membrane, succeeded by a discharge, at first thin and colourless, which soon, however, becomes turbid, yellowish-white, and profuse. It is associated with a varying degree of fever, dulness, and debility. Causes.—Alternations of temperature, hot, ill-ventilated stables, exposure to wet and cold. A strong predisposition to cold exists during the process of changing the coat. Young animals, more especially if newly brought into warm stables, are pre-eminently liable to suffer In some instances it is complicated with laryngitis, and in all cases, if the animal be neglected, the catarrhal intammation is apt to spread from the nose over the whole surface of the respiratory mucous mem- brane. The mucous membrane of the mouth and air passages is very completely protected from the attacks of organisms by its vascularity, which facilitates the production and pro- pulsion of numerous phagocytes whose duty it is to keep these parts free from such pathogenic organisms. If, however, the membrane is irritated by the presence of noxious vapours 723 46—2 724 SPORADIC DISEASES. such as ammonia, &c., which are the result of bad ventilation, this phago¢ytosis will be to a certain extent inhibited. The result will be that the organisms already mentioned will obtain a growing surface in the nasal chambers and pharynx, and the animal has what is known as catarrh. The organisms chiefly concerned are staphylococci and diplococci, but possibly streptococci, which may be the streptococcus of strangles. One can easily understand how essential it is that anything which is likely to interfere with the health of the animal should be carefully avoided, as it is these debilitating causes that lower an animal’s resistance and render it susceptible to organisms which under ordinary conditions would not be pathogenic. Treatment.—This is a very simple matter if adopted in time, and consists in placing the animal in a well-ventilated loose box, clothing the body if the weather be cold, feeding upon bran mashes, boiled linseed, and a small quantity of good hay for a few days. In the early stages the nasal irritation will be much relieved by making the animal inhale steam, and this is best done by holding its head over a bucketful of hot water, and stirring the water with a wisp of hay. A few doses of nitrate of potash are beneficial in the early stages as a febrifuge and diuretic; if the supervening debility be extreme, tonics and good food are to be prescribed. Some writers recommend that a purgative should be given: this is a practice which cannot be too strongly con- demned, as in all catarrhal affections there is a tendency to the spread of the irritation, and a purgative may cause a fatal inflammation of the mucous membrane of the digestive organs ; but, provided that the effect of such treatment is not immediately fatal, a simple disorder is rendered complicated and serious, and, should the animal ultimately recover, the convalescence is much more prolonged and difficult. Any undue constipation of the bowels is best combated by laxative food, enemas of warm water, and perhaps eight or ten ounces of linseed oil. If the cough be troublesome the throat may be stimulated or lightly blistered. For the results of catarrh, see Principles and Practice of Veterinary Surgery, page 517, et seq. DISEASES OF THE RESPIRATORY ORGANS, 725 LARYNGITIS. Aoute Laryngitis—An inflammation of the lining membrane of the larynx, indicated by difficult breathing, discharge from the nose, and febrile disturbance. Pathology and Symptoms—Laryngitis is not an uncommon nor yet an unimportant disorder, sometimes killing quickly, and at all times a dangerous disease. The gravity of acute laryngitis depends upon the nature, character, and extent of the inflammation. In acute inflammation, embracing the epi- glottis and rima glottidis, there is such a rapid and extensive effusion into the submucous tissue, and formation of mucus upon the free surface of the mucous membrane, as to cause almost a total obliteration of the glottal opening, and the death of the animal from suffocation. This rapid effusion into the submucous tissue and swelling of the membranes constitute what is termed “ cedema glottidis,’ and it is to this rapid effusion that the danger to life is due. The respirations become suddenly difficult, the inspiration being particularly prolonged, and atfiended with a peculiar harsh sound, succeeded by a short expiratory movement, sometimes, but very rarely, attended by a hoarseness. The animal’s nose is protruded, the superior respiratory passages being thus made to approach as near a straight line as possible; the eyes prominent, con- junctive red and highly injected, with abundant flow of tears. There is a peculiarly anxious and distressed expression of the face, the ale of the nostrils are dilated, the nasal chambers are reddened, there is a hoarse rasping cough, sweats bedew the body, the legs and ears are cold, the latter often drooping ; the animal manifests its distress by frequently stamping with its feet—the fore ones particularly. The slightest excitement aggravates all these symptoms; the pulse, which may at first be hard and full, soon becomes rapid and indistinct—fulness generally remaining ; the visible mucous membranes now assume a livid appearance from non-oxidation of the blood ; prostration of strength becomes extreme ; the animal staggers, finally falls, and dies after a few struggles. The above is a description of by no means a common, but of an aggravated form of acute laryngitis. In many cases the symptoms are much less severe, but they partake of the general character of those above 726 SPORADIC DISEASES. described. There is generally a discharge from the nose, even in the early stages, and the act of deglutition is performed with great difficulty. In some instances this is due to the inflam- mation extending to the pharynx; in others, however, there seems to be no real pharyngeal complication, for if tracheotomy be performed, the difficulty in swallowing is immediately re- moved. It appears to me that the difficulty in swallowing is due to the momentary pressure of any liquid or solid upon the inflamed epiglottis, causing increased interruption to the ingress of air. Restore the freedom of breathing by the operation of tracheotomy, and the passage of fluids or solids from the fauces into the pharynx no longer prevents the free ingress of air, and hence the swallowing again becomes easy. In those cases, however, in which the difficulty in swallowing persists, the pharynx is inflamed, and the food is returned into the nose, tinging the mucus with its own colour. The causes are the same as those of common cold. Treatment.—In an aggravated case this must be prompt. In- halation of steam, and hot fomentations to the throat, may be tried for a short time, but if the distress.is not speedily relieved, tracheotomy is to be resorted to. In the milder cases, inhala- tions, fomentations to the throat, succeeded by blisters, with ‘febrifuges ; light, soft diet, warm clothing, comfort, and pure air, constitute the necessary treatment. It may be observed that when deglutition ig difficult, all medicines should be given in the animal’s food or water, the latter being abundantly supplied, as enforcement may cause violent fits of coughing, and even suffocation. Belladonna sometimes has a good effect in the earlier stages; it is best given as the extract, placed between the teeth. This disease is always succeeded by great prostration of strength; and in order to prevent this as much as possible, milk—in conjunction with eggs beaten up, or boiled hard and powdered—should be allowed the animal to drink, alternately with water, gruel, or linseed tea. But none of these should upon any consideration be forced upon it by horning or bottling, for, as I have already stated, this is a dangerous practice, and one calculated not only to excite violent fits of coughing in all diseases of the throat, but indigestion, and disorder of the digestive apparatus in all other ailments, and thus destroy what little appetite the patient might possess. DISEASES OF THE RESPIRATORY ORGANS. 727 Sequele.—Thickening of the mucous membrane, ulceration of the rima glottidis, atrophy of laryngeal muscles, and follicular growths upon the laryngeal entrance. Thickening of the mucous membrane is best removed by a course of iodide of potassium and blisters; ulceration of the rima glottidis, by solution of nitrate of silver applied to the part by a sponge fastened to arod. The follicular growths have been removed by the application of solution of corrosive sub- limate—forty grains to the ounce of water; and to prevent the progressive atrophy of the muscles, I would recommend a trial of the chlorate of potash. Chronic Laryngitis——(See Roaring.) CHAPTER LIX. SPORADIC DISEAS ES—continued. LOCAL DISEASES—continued. (ZL) DISEASES OF THE RESPIRATORY ORGANS—continuerd, INFLAMMATION OF THE RESPIRATORY ORGANS— BRONCHITIS. Diwvision.—This disease may, according to its seat, be arranged under four heads, namely, “ tracheo-bronchitis,” where the lower part of the trachea and larger tubes are the main seat of the inflammation ; “ bronchitis proper,” where the medium-sized bronchi are the chief seats of the disease; “capillary bron-. chitis,” where the smaller bronchi are chiefly implicated ; and catarrhal, lobular, or broncho-pneumonia, where the smallest bronchi and alveolar walls are involved in the inflammatory process. For simplicity of description I shall retain the generic term bronchitis, dividing it into acute and chronic. The character of the inflammation, whatever part of the respiratory tract may be affected, is what is understood as catar- rhal—that is, an inflammation in which, instead of an exudation rich in fibrin, there is a fluid secretion containing a large quantity of mucus and cellular elements. In this particular it differs most essentially from inflammation of the lungs, originating in the parenchyma and from pleuro-pneumonia, in which the pleural surface as well as the lung structure is involved. The exudate in these is termed “ croupous” or fibrinous. Causes—Bronchitis, wherever its seat, is generally due to exposure to cold; it may supervene on an attack of ordinary catarrh, particularly if the animal be neglected, exposed to wet and cold, or kept in ill-ventilated stables. It may also arise with- out any premonitory catarrhal symptoms in both horses and cattle during voyages by sea, particularly if the weather be rough and stormy, and the animals battened down. During 1877 the author had the opportunity of seeing bronchitis assuming the form of suffocative catarrh, and which proved fatal to many, amongst foreign horses imported at Leith. An instructive fact 728 DISEASES OF THE RESPIRATORY ORGANS. 729 in connection with these cases was that it appeared only after rough and stormy passages; when the weather was fine no cases were observed. It also arises from the absorption of septic matters, as seen in post-parturient septic broncho-pneumonia, particularly when the foetal membranes are retained, and in the so-called corn-stalk disease in American cattle described by Billings (see p. 188), and as a result of drinking water tainted with the putrefactive products of animal matters. A similar condition is described by Poels, Holland, and Professor E, Lienaux, Brussels, as septic pleuro-pneumonia in calves, and in which they have demonstrated a mobile ovoid microbe -001 mm. to -0015 long by -0005 mm. in breadth, identical in appearance to the one observed by Nocard, Billings, and myself (see Plate VI?). Bronchitis, like laryngitis, may be caused by the inhalation of irritant matters, more particularly smoke—which form is usually very acute with hemorrhagic frothy discharge, and terminates fatally—and by the accidental entrance of foreign materials, as medicines or food, into the bronchial tubes. In- flammation of the bronchial tubes arising from the latter cause usually occurs in horned cattle, often as a sequel to parturient apoplexy, in which affection the power of deglutition is in a great measure lost, and where the sensibility of the glottis is, during the comatose stage, greatly diminished or entirely absent. In such cases fluid medicines incautiously administered enter the trachea and bronchi, and these may cause immediate death by suffocation, or if not immediately fatal, induce a severe and perhaps fatal inflammation. Bronchitis is probably always the result of a bacterial invasion, usually those facultative organisms of the Pasteurella type. These organisms may set up the initial condition, but may not persist; still, having com- menced the inflammatory process, they prepare the ground, as it were, for organisms which ordinarily would not be pathogenic, and this would account for the prolonged course of the disease. Again, during the state of coma, semi-fluid ingesta are apt to flow into the mouth through the flaccid esophagus, particularly if the cow lies with its head and anterior extremities lower than the posterior ones. In parturient apoplexy there is also very often during the earlier stages some extent of antiperistaltic action of the cesophagus, with eructations of gases from the rumen ; along with such gases semi-fluid ingesta gain entrance 730 SPORADIC DISEASES. into the fauces, and owing to the paralyzed state of the glottis fall into the larynx and trachea. Catarrh or bronchitis, from other than mechanical causes, may, particularly in cattle, if the accompanying cough be long and powerful, cause some degree of vomition. The food thus vomited, or in other words coughed up, sometimes gains entrance into the trachea, and causes a fatal issue. Along with Mr. Borthwick, Kirkliston, I saw cases of this ina herd of Irish cattle brought to Scotland, which were suffering from bronchitis and gastric irritation from neglect and exposure. Four of the herd became much worse than the rest , one died, and the other three were slaughtered. In all of them the bronchial tubes were filled with ingesta, ejected into the fauces during violent fits of coughing. Again, in several specimens of the lungs of American cattle slaughtered at Liverpool, supposed to be affected with pleuro-pneumonia, food was found in the bronchi. Is it not possible that during a rough voyage cattle may suffer to some extent from sea-sickness, and even vomition, and that the vomited matters may gain access into the trachea and bronchi? In others of the condemned American cattle the irritation was associated with the presence of filaria in the bronchi. Both the ingesta and the parasites were present only in a minority of the diseased lungs examined, and could there- fore be only looked upon as accidental concomitants. Food sometimes gains access into the trachea in the course of dissolution, or even after death, particularly if the rumen be rather full of moist food; it will then be found in the greatest abundance in the trachea and larger bronchi, whereas in those instances in which it has been in the tubes for some time before death, the food will often have disappeared from the larger into the smaller tubes and air cells. I have witnessed one case of fatal bronchitis in the horse, due to the entrance of vomited ingesta into the bronchi. Some days prior to its death fifteen minims of Fleming’s tincture of aconite had been administered; this brought on attempts at vomition and great distress. The animal’s respiration continued very highly accelerated after the effects of the aconite had passed off, and continued until the animal died. A post mortem examination revealed the fact that vomition had occurred, an 1 that the small quantity of food thus expelled had entered the larynx, and gained access to the bronchi. BRONCHITIS. 731 ACUTE BRONCHITIS, Symptoms.—Bronchitis consists of congestion of the bronchial tissues, associated at first with dryness, narrowing, and rigidity, and subsequently moisture, dilatation, and relaxation of the tubes. Owing to these changes, the vibrating sounds caused by the passage of air through the inflamed bronchi undergo variations, which indicate pretty clearly the dry ur moist condition of the parts, or, as some term it, the dry or moist catarrh. % G ine sti ee i aN le seca Mee cele StS a Fic. 75.—Small healthy bronchus in acute bronchitis, occluded by a plug of catarrhal secretion. —350 diam. a, Catarrhal plug ; 5, Epithelium lining bronchus ; ¢, Surrounding adventitious coat infiltrated with cells, —(From American ox condemned at Liverpool for pleuro-pneumonia. ) As the symptoms are developed, the cough becomes hoarse, ringing, loud, and paroxysmal ; the respirations are in some instances greatly accelerated, indeed out of all proportion to the pulse. For example, the pulse may be seventy or eighty per minute, and the respirations as numerous, or even more 80: this indicates bronchitis affecting the smaller tubes and alveolar walls—catarrhal pneumonia—collapse of a more or less exten- sive area of lung structure, or even occlusion of non-inflamed bronchi and air vesicles by the gravitation into them of the catarrhal fluid, as shown in the woodcut. 732 SPORADIC DISEASES. Bronchitis of the larger tubes is naturally less dangerous than the other two, and only proves fatal by inducing the two above- mentioned conditions, namely, collapse and occlusion of a more or less extensive breathing surface. Amongst the foreign horses above alluded to, it was noticed, where the discharge of muco-purulent matter was most profuse, although some of the animals seemed to recover from the febrile disturbance and accelerated breathing of the acute stage, that they succumbed in from fourteen to thirty days afterwards from gangrene of the collapsed lungs, or putrefaction of the fluid incarcerated in the bronchi and air cells; both of these conditions being expressed by fcetor of the breath, exhaustive diarrhea, metastatic inflammations of the articulations and feet, complete loss of appetite, rapid emaciation, fluttering pulse; at first great elevation of temperature—106° F. or more; partial sweats upon the body, gasping respiration, some abdominal pain, and other signs of general septiczemia. In no case of pure bronchitis is the breathing painful, but short and quick, the thoracic as well as the abdominal muscles being brought into full play; this distinguishes it from the breathing characteristic of pleurisy, in which the ribs are more or less fixed and the respirations abdominal. In ordinary cases of bronchitis the animal is dull, listless, sometimes semi-comatose; hangs its head; is generally thirsty; ropy saliva fills the mouth, which is hot and moist. The visible mucous membranes are injected, and present a varying degree of lividity, due to non- oxidation of the blood. The animal stands in a corner or moves listlessly about. If in a box, and the door be open, it stands with its head to the open air, from which it evidently obtains relief. The bowels are generally somewhat constipated, the feeces covered with mucus, but they easily respond to purgatives, showing that the alimentary mucous membrane participates in the irritation. The urine is high-coloured, scanty, and if examined will be found to contain urea, mucus, and colouring matter in excess, and the chlorides in diminished quantities. As already stated, bronchitis of the larger tubes is not ordinarily a fatal disease, but when affecting the smaller bronchi and alveoli, particularly if associated with a profuse discharge of a yellowish coloured, more or less tenacious fluid, which occludes the smaller bronchi and air cells, it is the most fatal chest disease that the author is acquainted with. This tendency to gravitation of the BRONCHITIS. 733 catarrhal fluid is explained by the fact that the columnar and ciliated epithelium are shed in the earlier stage of the attack, and take no part whatever in the after changes which ensue. It is never seen again till the signs of acute inflammation, such as distension of the vessels and cedema of the basement membrane, have passed off. Subsequently it is gradually reproduced. The muco-purulent material thus incarcerated is driven or impacted by the ramrod-like action of the inspirated air into the periphery of the smaller tubes and vesicles, and there con- stitutes those masses which may undergo putrefaction in the horse, causing septicaemia, as already explained, and caseous masses, mistaken for tubercle in the ox. The physical signs of bronchitis are as follows :—Percussion returns a more or less resonant sound, but auscultation will enable the practitioner to detect the nature and extent of the bronchial inflammation. Rhonchus, confined to the upper and middle third of the chest, with true respiratory murmur over the lower part, will indicate inflammation of the larger and middle sized bronchial tubes, and a condition of comparatively little danger. Szbilus, heard at the lower parts, indicates a condition of much greater danger, and that the disease involves the smaller tubes and air vesicles. Inspiration is generally short- ened, expiration prolonged, and more distinctly accompanied by the abnormal sounds. These sounds are succeeded at a later stage by moist bubbles, rattles, or rales—mucous rales. At first the discharge expelled by coughing is thick, tenacious, and gela- tinous, or watery and scant. The lower animals do not, however, expectorate in the true sense of the word ; some discharge issues from the nose, but the greater part of what is coughed up falls into the fauces, and-is swallowed. As the disease advances, however, a profuse discharge issues from the nostrils, and the inflammation gradually subsides. The cough becomes less hoarse, more vigorous, and even more frequent than at first ; but it gradually disappears, the discharge becomes again thinner, clearer, and ‘eventually ceases. In some instances all sounds disappear from a certain part of the lungs. This is due to occlusion of the tubes and vesicles by the catarrhal secretion, or to more or less collapse of the vesicular tissue, dependent on obstruction to the passage of air during inspiration by glutinous or inspissated mucus. This collapse is often confined to individual lobules, which are thus 734 SPORADIC DISEASES. condensed, heavy, indurated, and of a dark colour, and may ulti- mately become hepatised, atrophied, or even emphysematous. PATHOLOGY AND MORBID ANATOMY. Inflammation of the bronchial tubes, like that affecting other mucous membranes, is attended with changes in their epi- thelium, the secretion of the glands, and in the surrounding tissues. It is rare to meet with a fatal case of bronchitis during its earlier stages, and but for the accidental slaughter in Liverpool of the American cattle already referred to, it would have been difficult to have given the details of the morbid anatomy. The appearance of the lung in the earlier stage of bronchitis, with collapse, that is to say, when it is observed prior to the commencement of secondary changes or phenomena, is as follows :—There are patches over its surface that have fallen below the level of surrounding parts; sometimes these depres- sions measure an eighth of an inch in depth; they are of a bluish-purple colour, and variable in size. The parts around them are of a light pink hue, and are either healthy or in a more or less emphysematous condition. Fic. 76.—Portion of lung from American ox slaughtered at Liverpool, and showing bronchitis in the very earliest stages (a a, collapsed lobules) from obstruction of tubes. The elevations (b}, non-collapsed lobules) are slightly emphysematous. The depressions consist of certain lobules ina state of collapse arising from occlusion of their bronchial tubes by pus or other material. The collapsed portions are bluish-purple in colour; non-crepitant, and depressed, resembling foetal lungs, sinking slowly in water. Collapse of the lung tissue—atelectasis—induces more or less BRONCHITIS. 735 congestion and subsequent inflammation; consequently it is found that broncho-pneumonia often succeeds bronchitis, due to the absence of the expansion and contraction of the air vesicles which normally aid the pulmonary circulation, and to arrestment of the blood-flow owing to imperfect «ration. This congestion is soon succeeded by effusion of serum, and the bluish-purple collapsed portions become darker in colour and less resistant in consistence. They, however, retain some degree of elasticity, for, if not too rudely pulled out, they do not tear as in pleuro-pneumonia; if cut into and exposed to the atmo- sphere for a few minutes, the bluish-purple colour becomes bright scarlet. It is important to bear in mind that the pneumonic process which supervenes in bronchitis is principally confined to those portions of the lungs in which collapse has taken place. Sometimes the collapse is isolated, invading but small portions of the lungs: this condition is not rarely witnessed in parasitic bronchial disease. These limited collapsed portions vary in size, are rather wedge-shaped, and have their apices towards the obstructed bronchus. The lung tissue surrounding them may be more or less congested, or it may be emphysematous, but no juice is exuded from them when cut into, as in acute pleuro-pneumonia. Professor Gairdner was, I believe, the first to show that con- densation of the vesicular substance occurs as a result of mucous or other obstruction in the air-tubes leading to the condensed portion. It is at first sight difficult to understand how incom- plete obstructions of the bronchi—and these obtain much more frequently than absolutely complete occlusion—cause collapse. One would suppose that some quantity of air would gain access into the vesicles, but such is apparently not the case; and it seems that the air gradually finds its way out by the edges of the obstructing substance. The expiratory force, so long as there is air in the vesicles, constantly tends to dislodge the obstructing body by pushing it towards the wider (proximal) end of the tube, whilst the inspiratory drives it inwards towards the narrower tubes, which it effectually occludes. The entrance of air is thus more or less effectually opposed, and its exit permitted, so that ultimately the vesicles beyond become completely emptied ; in fact the plug acts as a valve, allowing the air to pass in one direction, but opposing its passage in the other. Where the 736 SPORADIC DISEASES, obstruction is complete from the commencement, the air is absorbed. It had been supposed by Laennec that the emphysema, or, more correctly, the over-distension with air of the parts surround- ing the collapsed lobules, was due to what he thought a fact, that the act of inspiration was more powerful than that of expiration, so that though air could be drawn through the obstruction, it could not be breathed out. In consequence, it accumulated in the ultimate pulmonary vesicles, became expanded by heat, and so acted mechanically as a dilator. Dr. Gairdner, however, pointed out that expiration is a much more powerful act than inspiration, and that there is never any difficulty in causing expulsion of air, provided always there be no obstruction in the tubes. Emphysema, then, does not occur in the vesicles connected with obstructed tubes, but in those which are adjacent. When the lungs are free from disease the column of air presses equally in all the tubes and vesicles ; but when one portion connected with any obstruction is collapsed, then the adjacent parts are over expanded, so as to occupy the space previously filled by the former. Ata later stage the contents of the obstructed bronchi are pushed by the weight of the descending or inspired atmosphere into the most minute bronchi, alveoli, and air vesicles, always from the centre towards the periphery, and appear as minute white points beneath the pleural surface. They are well shown in the figure. Fic. 77,—Pleural aspect of pulmonary lobe from American ox slaughtered at Liverpool ; alveoli filled with muco-purulent matter; pleural surface intact. The microscopic examination revealed broncho-pneumonia in some of the alveoli (see fig. 79); whilst others showed no traces of inflammation (see fig. 75), but were merely filled with the inhaled bronchial secretions, BRONCHITIS, 737 On cutting into the lungs, it will be found that the large and small tubes, and sometimes the trachea, contain an amount of fluid. This condition, as well as the collapse, is limited in the majority of instances to the small or anterior lobes of the lungs, and rarely, except by extension, affects the large lobes, not only in ordinary but in mechanical bronchitis. This fact is of importance, as pleuro-pneumonia contagiosa, with which the disease under consideration has been confounded, generally commences in the larger lobes, either in their centres or towards their posterior edges. The fluid contained in the tubes is thick, and has a yellow colour; in the trachea it is more or less frothy; and is abundant in the smaller bronchi. as shown in the figure. Fie. 78.—Section of portion of lung ; the external aspect is shown in fig. 77. The larger (a) and smaller bronchi and air vesicles (b) filled with purulent matter. If the lungs in this condition be squeezed, little pellets of yellow matter are pressed out: sometimes these pellets are too small to be seen by the naked eye, and require the aid of a magnifying glass. If the bronchitis be associated with catarrhal pneumonia, elevated patches will be apparent on the cut surface, having a greyish-red colour. They are soft to the touch, and if squeezed, the same muco-purulent matter exudes from them, or from a small bronchus which may happen to communicate with the particular group of vesicles implicated. Dr. Hamilton, in his series of papers on bronchitis published in the Practitioner for 1879, states it is a matter of difficulty in man to get at the first change which ensues in the bronchi in acute catarrh. He has, however, been able to verify his obser- vations by an examination along with myself of the lungs of American cattle slaughtered in the earlier stages of cone 738 SPORADIC DISEASES. in fact before any external signs of disease were manifested. He says—* On careful comparison, however, of many cases, we feel assured that the first deviation visible is a relawation and distension of the abundant plexus of blood-vessels ramifying in the inner fibrous coat, immediately beneath the basement membrane —that is to say, of the branches of the bronchial artery. They become engorged with blood, so that on transverse section they appear like little cavities distended with blood corpuscles. Ina few hours afterwards the basement membrane! becomes much more apparent than it usually is, and at the same time more clear and homogeneous, while the surface is thrown into many folds. These changes in the basement membrane are appa- rently due to its becoming cedematous, serous fluid being infil- trated into it from the underlying plexus of distended vessels; and we shall see that, as the acute irritation continues, this cedematous state of the basement membrane becomes more and more a well-marked feature. The next change, so far as we have been able to calculate, occurs in from twenty to thirty Fic. 79.—Bronchus (medium sized) in acute bronchitis.—(American ox slaughtered at Liverpool.) (a) Deep layer of epithelium, germinating and throwin off catarrhal cells. (b) Inner fibrous coat, infiltrated with inflammatory cells. (480 diam.) The columnar epithelium shed. 1 The basement membrane is not so apparent in the lower animals as in man. BRONCHITIS. 739 hours after the primary distension of the vessels, and consists in the loosening and desquamation of the columnar epithelium at the foci of greatest congestion. “The columnar epithelium is thus shed at a very early stage of the attack, and takes no part whatever in the after changes which ensue. It is never seen again until the other signs. of acute inflammation, such as the distension of the vessels, and cedema of the basement membrane, have passed off. Subse- quently we shall see that it is gradually reproduced. The cause of this desquamation of the columnar epithelium seems to be the cedema of the basement membrane loosening its under- lying attachments, very much in the same way as the vesicles which form in an acute inflammatory affection of the skin loosen the attachments of the superficial layer. of epidermis. The removal of this protective covering from the mucous membrane naturally leaves the latter in an exposed condition, and no doubt the feeling of rawness experienced in acute catarrh of the bronchi is due to the cold air acting upon an over-stimulated and exposed mucous membrane. And, further, it can easily be understood that, where this desquamation takes place to an inordinately great extent, the loss of the ciliary action of the columnar cells will seriously interfere with expectoration, and tend to cause the catarrhal products to gravitate downwards towards the smaller bronchi and air vesicles. This description essentially coincides with what Socoloff found experimentally in animals (Virchow’s Archiv, vol. lxviii, p. 611), in which he in- duced an artificial bronchitis by the injection of irritants, such as potassic bichromate, into the air passages. He states that one of the first changes which ensued was the desquamation of the columnar cells, and that they took no part in the catarrhal inflammatory process.” This early shedding of the columnar cells, and their non-reproduction until after the subsidence of the inflammatory process, is a fact of real importance, as it goes a long way to explain the occurrence of those caseous tumours mis- taken for tubercle, and so often confounded with that growth. The pneumonic process, which may supervene either by ex- tension of the inflammatory process from the tubes to the alveoli, or the irritation of inhaled inflammatory products subsequent to collapse, is, in the earlier stage, commonly limited to scattered groups of air vescicles, hence the term lobular which is applied 47—2 740 SPORADIC DISEASES. to it. It causes the portions affected to appear as scattered, ill- defined nodules of consolidation, irregular in size, and passing insensibly into the surrounding tissue, which is variously altered by collapse, emphysema, and congestion. These nodules are of a reddish-grey colour, faintly granular or smooth, slightly elevated, and soft in consistence. As they increase in size they may become confluent; and in a more advanced stage they become paler, drier, firmer, and to some extent resemble ordinary grey hepatization. Microscopically examined, they are seen to consist of cellular elements accumulated in the alveoli. The disease may, as already remarked, terminate fatally by the absorption of the putrescent catarrhal products, by gangrene of the collapsed lungs, or by sudden effusion of fiuid into the bronchi, constituting what is termed suffocative catarrh. Ifa fatal termination does not ensue, the contents of the alveoli undergo degeneration, and are gradually removed, by discharge, or by absorption ; or, by coalescence, form caseous masses, which may become encapsuled, undergo the calcareous change, and thus become innocuous; or may induce a diathesis favourable to x, and to symptoms Fie. 80.—Acute catarrhal pneumonia (American ox).— Section through several air vesicles. Shows the alveolar cavities filled with large granular catarrhal cells (c). (8) Catarrhal cells sprouting from the alveolar wall. (a) Coagu- lated mucus in which the catarrhal cells lie.—(480 diam.) simulating phthisis pulmonalis in the horse—that is to say, an BRONCHITIS, 741 accumulation of catarrhal products, epithelial and other cells, within the pulmonary alveoli; cellular infiltration and thickening of the walls of the alveoli and bronchi; increase in the inter- lobular connective tissue, with, in some instances, the occurrence of fibrinous masses, intermixed with leucocytes in the alveoli, as demonstrated by Zenker of Dresden, but without the occurrence of tubercular tumours (grapes) in the serous membranes and parenchyma of organs. In all cases of bronchitis the bronchial glands undergo some change. In the earlier stages they are increased in size, contain the products of the bronchitis conveyed by the lymph tract; become more or less ‘friable in consistence; and in’ more advanced bronchial inflammation distended with catarrhal ele- ments; both glands and contents undergoing the caseous meta- morphosis, the products of which may either liquefy or become infiltrated with calcareous matter. TREATMENT. Venesection is to be avoided ; indeed bronchitis is character- ised by depression and debility from its earliest stages. In the very commencement of the disease the irritation is generally modified by a moderate dose of opium. In the horse, ox, and sheep remedies termed expectorants are quite useless, having no effect. In the dog, however, they are said to act. They are antimonial wine, ipecacuanha, hyoscyamus, &c.; but I do not think that they are of much service, and are not to be compared to chloral hydrate in from two to four grain doses. The great principle of treatment, however, in all animals after the very earliest stage of the disease has passed off—when, and then only, it may be possible to cut short the attack by a full dose of opium—is to assist in promoting the natural course and termina- tion of the inflammation. It has already been pointed out that in the earlier stages the bronchi are dry, and that subsequently they become moist; and as the moist stage becomes, as it were, matured, the irritation disappears. Such, then, is the natural course, and the practitioner is to assist in promoting this by causing the animal to inhale steam, medicated or simple, the medicated steam being made by adding camphor, creosote, or carbolic acid to the hot water. When the discharge is profuse, 742 SPORADIC DISEASES. indicating the involvement of a large area of tubes, and a con- dition of real danger, the inhalation of steam is of the utmost importance, as such inhalation modifies the viscidity of the catarrhal fluid, and facilitates its discharge from the bronchi. And in order to prevent as much as possible the putrefaction of the catarrhal product, such steam should be medicated with carbolic acid. In addition to this the sides are to be bathed with hot water, and rubbed over with oil or a weak liniment to keep off the sensation of cold. If the bowels are costive, enemas are to be administered, but on no account are aloetic purgatives to be given; for obstinate constipation—a very rare complication —a, moderate dose of oil may be given. It is far better, however, to keep the alimentary canal in proper order by enticing the animal to eat laxative food, such as linseed mashes, carrots, or grass, ifin season. Some practitioners recommend that sulphate of magnesia be given in four-ounce doses daily in the horse’s water until the bowels respond. For my own part I have found that horses generally refuse to drink such water, although they may suffer much from thirst; and I generally content myself with ordering half-ounce doses of nitrate of potash twice daily in the water or mash. Good nursing, warm clothing, pure air, and a good stable or loose box, are essentials which are not to be forgotten. In the course of bronchitis, it will frequently be observed that symptoms simulating those of diabetes insipidus become de- veloped ; the animal becomes very thirsty and urinates profusely. These need not cause any alarm ; they are due to the absorption and elimination of effete materials and various salts—chloride of sodium particularly—which have been retained, probably in the inflamed part, during the active stage of the disease. If the patient be freely supplied with water, and enticed to partake of good food, the diabetic symptoms pass off, and the animal will speedily become convalescent. Should debility remain, with cough and irritation, hyoscyamus and tonics are to be administered ; and if the case threatens to become chronic, a blister may be applied to the ‘throat and breast, and the iodide of potassium prescribed. Chronic bronchitis in the horse may cause what is termed thick wind, chronic cough, and eventually emphysema from rupture of the rigid and altered air vesicles and small bronchi. BRONCHITIS. 743 Metastatic or embolic broncho-pneumonia results as a sequel to septic metritis, absorption of products from septic wounds, or from impure drinking water or tainted food. CHRONIC BRONCHITIS, As indicated by a loud, metallic cough, emaciation and debility, is not an infrequent disease, particularly in horned cattle, and is due to thickening of the bronchial and alveolar walls, and to caseous masses. It is best treated by hydrocyanic acid, in doses varying from Tl xx. to Tl lx., Scheele’s strength, in combination with nitrate of potash and bicarbonate of soda, twice per day, a strong blister to the breast, and careful housing and nursing. A morbid change, termed bronchiectasis or dilatation of the bronchial tubes, arising from a chronic interstitial pneumonia, induced by acute croupous pneumonia, broncho-pneumonia, pleurisy, and .the inhalation of solid irritating particles, is witnessed in the human being. It is characterised by thick- ening of the interlobular septa and alveolar walls; and when the fibrosis is extensive, the lung is diminished in size, the tissue is smooth, dense, being in parts almost cartilaginous in consistence, and irregularly mottled with black pigment. The alveolar structure of the lung is in most parts destroyed, and on section the dilated bronchi are seen as numerous large open- ings scattered over its surface. The dilated bronchi frequently become the seat of secondary inflammatory processes, which may lead to ulceration, and ultimately to extensive excavations of the indurated tissue; but there is a complete absence of caseous changes. The pleura is almost invariably thickened and adherent, the new formation in the earlier stages usually contains new blood-vessels, but later the tissue contracts, and the vessels become destroyed ; the contraction of the false membrane may also induce deformity of the chest, and twist the neck to one side. I have seen a case similar to the above description in a dog in which the lungs contained quantities of sand. This dog had been several years in Africa hunting with its master. Before death it was observed that the right side of the chest was depressed, and this was found to be due to carnification and contraction of the adherent lung and connecting new formation, CHAPTER LX. SPORADIC DISEASES—continued. LOCAL DISEASES—continued, (1) DISEASES OF THE RESPIRATORY ORGANS—continued. CHRONIC EMPHYSEMA OF THE LUNGS. Crronic Emruysema of the lungs is of two kinds, namely—(1.) Vesicular, due to enlargement and dilatation of the air cells, with gradual effacement of the blood-vessels distributed over their walls. There is anemia of the affected parts, a tendency to dila- tation of the right cardiac ventricle, and a disposition to anasarca of the limbs. The dilated cells vary in size, and when very large it is probable that several vesicles are dilated into one cavity by rupture of the vesicular walls and partitions. These dilatations may be clearly seen through the pulmonary pleura, as they protrude from the surface of the lungs; they are pale, sometimes quite white, the tissue drier than natural. Vesicular emphysema is seen in chronic broken wind, and is due, as already explained, to degeneration of the bronchial tissues. It is, however, a result of bronchitis, and several theories are put forward to explain the origin of emphysema. Dr. Elliotson considers that a want of due expansion of the lungs is the most common cause. He says—“ Whatever prevents any one part of the lungs from expanding when the thorax expands, whether it be a material obstruction of the bronchial ramifications or a compression of them, or whatever else, it will occasion those parts which remain dilatable to keep dilated in a corresponding increased degree, in order to fill up the vacuum which the ex- pansion of the chest occasions. When we inspire we dilate the chest, and the air rushes down the trachea, and the lungs follow 744 CHRONIC EMPHYSEMA OF THE LUNGS. 745 the dilated portions. If there be any part of the lung that will not dilate, then other parts are over-dilated to fill up the vacuum, and in that way those parts which we distend are over- distended, in order to compensate for the want of distension in other parts; and when once over-distended they are often unable to recover themselves, just as is the case in other parts of the body—the urinary bladder for example. 2. Interlobular Enyphysema, or accumulation of air or gases in the meshes of the connective lung tissue, may arise from rup- ture of the walls of the air vesicles. This result of rupture is, however, an uncommon occurrence, for generally, when the cells are ruptured, they break one into another, and form permanent enlargements, with rigid walls, by coalescence ; but acute emphy- sema is, however, seen in various diseases, especially of horned cattle, from rupture of air cells or from the evolution of gases, which infiltrate and distend the pulmonary areolar tissue. It may be induced artificially by the injection of the bicarbonate of soda into the veins. It is also seen in an animal which has been destroyed by “blowing,” «we, by forcing air into the jugulars. Snarry, of York, in a private letter to me, records several cases of subcutaneous emphysema in cattle, the symptoms of which were as follows :— The breathing is short, catchy, the air expelled by a double effort, and often associated with a grunting or moaning expira- tory sound. In most cases the head is drooping, eyes dull, and the ears flaccid; whilst in others the animal manifests great anxiety, and even some amount of dread or terror, as if each respiratory movement were a source of pain, and possibly there is actual pain, caused by the tissues being dissected by each ingress of air; indeed it may be said that when the patient has completed one respiratory movement its seems to dread the pain of the next. There is always some stiffness of gait, particu- larly when turned round, and in many instances a subcutaneous emphysematous swelling makes its appearance, sometimes on the first day, but more frequently on the second, third, or fourth day, or even later, after the manifestation of illness. This emphysematous swelling may be first noticed on one or both sides of the chest, the loins—one or both loins ; but it gradually, sometimes quickly, extends from its original seat to neck, head, 746 SPORADIC DISEASES, back, sides,—in fact all over the body. The crepitations may not be very pronounced at first, probably from the fact that the emphysema is deep-seated, and mechanically pushing the superimposed tissue in the outward direction; but in a very short time the crackling sounds emitted on pressing the parts leave no doubt as to its true nature. The bowels are generally constipated, and some recover when free action of the bowels has been established. Some of Mr. Snarry’s cases occurred prior, others subsequent, to parturition. In none of the cases was there any great elevation of temperature, 103° F. being the highest. TREATMENT. No permanent benefit can be expected from any treatment. Much relief may, however, be afforded by caretul dieting, keeping the bowels regular, and when the paroxysms of dyspnoea are very great, by the administration of sulphuric ether, chloral hydrate, or the bromide of ammonium. A horse thick in the wind, or suffering from chronic cough, is an unsound animal. CHAPTER LXI. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (Z) DISEASES OF THE RESPIRATORY ORGANS—continued. CONGESTION OF THE LUNGS—PULMONARY APOPLEXY—MECHANICAL ENGORGEMENT. Apart from inflammation of the lungs, which will be described immediately, the lower animals, particularly the horse, are apt to suffer from congestion of the true pulmonary blood-vessels, ae., the branches of the pulmonary artery. This congestive condition is not only seen during the progress of many diseases, such as laminitis, traumatic arthritis, enteritis, pneumonia, heart affections, and various prostrating epizootics ; but often originates in the horse during severe exertion, more especially in the hunting-field when the animal is not “in condition,” or is taxed beyond its strength. As a question of jurisprudence, the occurrence and results of congestive pneumonia, or, more correctly, pulmonary apoplexy, is a matter of some import- ance, for many instances have occurred, and will doubtless again occur, of horses dying from this affection within a few days after purchase, and the seller has been more than once mulcted in damages to the full value of the animal. In order to bring a horse into “ condition ” for severe exertion, it is necessary that it be gradually trained. First of all, it is for a time walked for one or two hours daily, in order that the locomotor muscles be gradually brought into tone for stronger and severer work ; then it is trotted, and afterwards galloped and sweated. Useless fat is thus removed, and the muscles of locomotion, as well as those of respiration, are brought into a condition and tone which enable them to perform the severest and fastest exertion; the tone and power of the heart are alsu 747 748 SPORADIC DISEASES. increased and elevated, whereby it is enabled to pump an in- creased supply of blood to all parts of the body, in order to maintain their strength and integrity during the time they are so greatly taxed. In fact, it may be said that the horse’s respira- tory organs—wind—circulation, and muscular action, are elevated into a high state of functional perfection by careful training, and a horse in this condition will perform during a long run with the hounds or on the race-course, without danger to his health and life. But if a horse that is not thus trained—not in condition, no matter how good its health might be—is suddenly put to severe and prolonged exertion, when neither its muscular. pulmonary, nor circulatory systems are fit to undergo the fatigue consequent thereon, it will be seen that, first of all, the breathing becomes frequent and distressed; the heart beats tumultuously, but with little impulsive force; the voluntary muscles, conse- quent upon want of tone and exhaustion, obey the will im- perfectly. It goes “all abroad,” as the horseman says. The breathing becomes more and more distressed, and at last it falls, and perhaps dies from actual suffocation, consequent upon the pulmonary vessels being overloaded with non-oxidized blood; and after death the lungs are found gorged with blood, black in colour, and prone to rapid decomposition, giving origin to the expression “black as your hat, and rotten as a pear,” and to the idea that the animal had suffered from some chronic disease. In giving an opinion on a case of this kind, the veterinarian must bear in mind that the blackness, tendency to putrescence, or even deliquescent condition of the lung tissue, are results of acuteness of attack, and not of any previous dis- ease; and it may always be accepted that mere engorgements and blackness, without the formation of an exudate, are positive evidence that the disease is not of long standing. Another cause of congestion of the lungs is actual want of air in badly ventilated stables, the congestion here arising from the stop-cock action of the pulmonary capillaries already described —(see Death by Suffocation)—which contract, and prevent, as it were, as much as possible the passage of impure blood into the left side of the heart and systemic circulation. Pulmonary apoplexy is also termed hemorrhagic infarction, and, as ex- plained by Dr. Yeo, is “ universally admitted to depend ona local impediment to the circulation, such as an embolus impacted CONGESTION OF THE LUNGS. 749 in an artery. There being no arterial anastomosis in the lung, such a plug has a very marked effect. The embolus cuts off the normal supply of blood from the part, and the pressure in the arterial branches beyond the stoppage falls to zero. The blood, however, can still find its way through the capillaries into the branches at the distal side of the plug. The branches of the occluded artery are thus reduced to the condition of occluded veins, and as they have none but capillary connections, they may be said to form blind ends to the adjacent arteries. The blood then trickles into these arterial branches and fills them, but no outward flow can take place, therefore they become intensely engorged with stagnant blood. Under these circumstances, ‘the inner coat of the vessel is deprived of its nutrition, for which the constant renewal of the blood is required. This starvation of the minute vessels renders them unfit for their function ; they lose their power of retaining the blood, which escapes into the neighbour- ing textures, forming the dense black consolidation now known as hemorrhagic impaction.” SYMPTOMS. The symptoms of pulmonary apoplexy are very distressing. The animal stands with outstretched legs, and seems to fight for breath ; the nostrils will be seen opening and closing quickly, the flanks to heave rapidly ; the eyes are blood-shot and wild, or sunken and dull; there is a tremor all over the body; the legs and ears are deathly cold, and cold sweats bathe the body: the pulse is small and indistinct (“the oppressed pulse of pneu- monia” of the old writers), perhaps beating from 100 to 150 per minute in extreme cases; the heart’s action tumultuous, but without strength. In some cases there will be some discharge of frothy blood from the nose ; in others hemoptysis is absent, and if the jugular or other vein is opened, the blood trickles from it, black, thick, and scanty. Death occurs by apnoea.* 1 The term apnoea is used by physiologists to indicate a condition of breathless ness induced by excess of oxygen (Handbook for the Physiological Laboratory, by Sanderson and others, page 318), and by pathologists that of suffocation or asphy xia, 750 SPORADIC DISEASES. TREATMENT. In the first place, it is necessary to have the horse so placed that it can obtain as much pure air as possible. It is therefore to be tied with its head to the box or stable door, the body is to be smartly rubbed, not knocked, with wisps of hay or straw; and afterwards warmly clothed. When the surface of the body and extremities are very cold, I have found it to be a good practice to place the feet in hot water and bathe the legs for several minutes, then rub them over with a stimulating embro- cation, and bandage them in thick flannel as high as possible. If proper bandages cannot be obtained, hay or straw ropes are to be substituted. The medical treatment must be that which is calculated to equalise and balance the circulation, and for these purposes stimulants are to be recommended, such as the ethers, spirits, wine, or even ale when nothing else can be obtained. I have also found that the tincture of arnica, in one or two ounce doses, acts very satisfactorily; it seems to stimu- late the cutaneous circulation, and on this account is well calculated to restore the equilibrium of the circulation. If the congestion does not give way to the above treatment, bleeding is to be resorted to, in order to relieve the pressure on the pul- monary vessels, and the engorgement of the great veins and right side of the heart ; from four to six quarts of blood may be with- drawn with safety, but it is better not to repeat it. I am of opinion that it is a cruel practice, and one calculated to do harm, to apply mustard or other powerful irritant to the sides. Horses, when thus treated, begin to be excited in a few minutes after the irritant has been applied, paw, move about, lie down, and perhaps roll in pain; the breathing becomes more accelerated, aud loss ot strength rapidly follows. I hold it to be imperative that the veterinarian should enjoin perfect quietude and repose, and if anything is to be applied to the sides or breast, let it be warm water, in order to soothe and calm the distressed sufferer. After the symptoms of congestion have passed away, it is not improbable but that they may be succeeded by those of inflam- mation of the lungs. Bearing in mind the probability of this sequel, the treatment of the animal for some days must be of the most careful description; the diet must be light, sparing, aud easy of digestion; the water must be supplied abundantly, CONGESTION OF THE LUNGS. 751 and even in the earliest stage, if the animal be thirsty, water is to be freely allowed; doses of nitrate of potash given in the water or mash; the air of the stable must be abundant and pure —but the horse is not to be exposed to draughts—and the body kept warm by clothing. POST MORTEM APPEARANCES. The post mortem appearances are, congestion of the pulmonary vessels, with rupture of some of them, and extravasation of blood into the parenchyma, constituting pulmonary apoplexy, whilst others are plugged by emboli. The lungs resemble the spleen, and the term splenification has been applied to this condition. When cut into, the lungs present a deep, dark, purple colour, the vessels are filled with dark blood of a tarry consistence, whilst here and there, interspersed throughout the lung substance, darker points are seen, indicating where extra- vasation has occurred. Although much heavier and more condensed than natural, the lung tissue will generally float in water; thus differing from the condition of hepatization, which is present when death has occurred from pneumonia. The right side of the heart and great veins are filled with blood of a dark appearance and tarry consistence. The left side of the heart also contains some quantity of blood of the same appearance and consistence. It may be stated that hypostatic congestion may occur post mortem or during the death struggle. This always occurs in the most depending part of the lungs, is to be distinguished by its situation and the antecedent symptoms, the animals having died from other diseases, and is not to be confounded with any diseased condition of the lungs. CHAPTER LXII. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (I.) DISEASES OF THE RESPIRATORY ORGANS—continued. INFLAMMATION OF TITE LUNGS—LOBAR (SPORADIC) PNEUMONIA, Sijnonyms and Varieties—Peripneumonia; peripneumonia vera (as opposed to peripneumonia notha, or capillary bronchitis); febris pneumonica ; acute pneumonia ; chronic pneumonia ; lobar pneumonia ; interlobular pneumonia (an affection of the inter- lobular tissue); primary pneumonia, secondary pneumonia (signifying differences in origin); specific or glanderous pneu- monia, 1 retain the terms sporadic and lobar, as being indica- tive of the origin as well as of the seat of the disease. PATHOLOGY. Congestion or engorgement of the lungs has been already described as a result of arrested pulmonary circulation arising from over-exertion, debility of the heart’s action, embolism, or to any other circumstance preventing the due arterialization of the venous blood, and causing hemorrhage from or stasis in the terminal branches of the pulmonary artery. Inflammation of the lungs is a disease in which all the textures of the pulmonary substances are more or less involved ; and this distinction may be made between congestive and in- flammatory pneumonia, that, in the first the lesion lies primarily in the pulmonary vessels, and, in the second, in tissues supplied by the branches of the nutrient vessels of the lungs, namely, the bronchial arteries, the pulmonary branches becoming sub- sequently involved, and having no inconsiderable share in 752 INFLAMMATION. OF THE LUNGS. 753 furnishing the exudative materials, which characterise the con- dition of hepatization or consolidation that occurs in pneumonia. The various changes which occur in the course of pneumonia are—1st. Arterial injection, characterised by a brighter colour, and dryness of the pulmonary tissue, a condition indicated by harsh respiration and crepitating sounds. 2d. The arterial injection is succeeded by a condition of engorgement, congestion of the pulmonary vessels, and incipient cedema of the lung. The substance of the lung is engorged with blood and bloody serum ; externally it is of a dark red colour, and crepitates but slightly under pressure ; it also pits under the finger, and is more easily torn than healthy lung; is heavier than natural, inelastic ; its cells are filled with liquid, mixed with air. On being cut a large quantity of bloody serosity escapes from the cut surface, which is frothy in the earlier stages from admixture with air. This, along with the commencing consolidation, proves that the effusion has been poured into the bronchial tubes and air vesicles as well as into the pulmonary tissue. During this stage the lung tissue will still float in water, although it is heavier and less crepitant than natural. If a very thin section be made, and examined microscopically, the capillaries will be found filled with blood; the air vesicles enlarged and granular, with incipient division of their nuclei; and exudation corpuscles, mingled with red globules, which have escaped from the vessels, are seen in the alveoli. 3d. Red Hepatization—lIf the inflammation continue, other changes occur in the lung substance. The lung is red externally and internally ; is solid, sinks in water, and no longer crepitates under pressure ; it, however, tears easily and breaks down under pressure; and on this account Andral objected to the term hepatization, and termed the second stage of pneumonia red softening—ramollissement rovge. The colour is less livid than in the earlier stage, being a dull reddish-brown, becoming brighter on exposure to the air. This reddish-brown colour is never very uniform, and in some animals diversity of colour is very marked: thus in the ox the inflamed lungs present such a variety of colour as to cause the term “marbled” to be applied to it. This is due to the very distinctly lobulated anatomical character of the ox’s lungs, and the consecutive nature of the lobar pneumonia. Dark red spots indicate the 48 754 SPORADIC DISEASES. earlier or second stage and the grey spots the third or later stage of the disease, which is called— 4th. Grey Hepatization, termed by Andral ramollissement gris, or grey softening. In the horse, perhaps the term grey softening may not be inappropriate, but in the ox solidification expresses the condition much more accurately. The cut surface of the part which has run on to this stage presents a grey tint, the redness of the preceding stage having passed away, and the granular character is less distinct. In the horse, dog, &c. the tissue has very often lost its firmness, and has become soft and pulpy, and an abundant dirty-looking puriform material oozes from the cut surfaces. In the ox the grey portions are generally smooth, glistening, and firm. In some instances the smooth, glistening appearance is observed in the inflamed lungs of horses, but the firmness is rarely so great as in the lungs of oxen, in which the tissues of consolidated parts retain their marbled appearance, and acquire a resisting character, or are transformed into a more or less firm cheesy material. In some instances, however, the grey exudate, even in the ox, is broken down into a more or less pulpy material. If a portion of hepatized lung be torn, and the torn surface examined with a magnifying glass, the tissue will appear to be composed of a crowd of small red granulations, lying close to each other, air vesicles clogged up, thickened, and made red by the inflammation. In the catarrhal form of pneumonia com- monly seen in the horse, the exudative products are mostly accumulated in the interior of the air vesicles, but in the exudative form (croupous) seen in the ox, and in cases of pleuro- pneumonia in the horse, the exuded materials not only fill the air vesicles but the interstices of the pulmonary connective tissue. Suppuration of the lung is a more advanced state of grey hepatization ; the lung is softer, yellower, and more pulpy, but the condition is not materially distinct from the others, as pus cells are present in the advanced stages of pneumonia, and the distinc- tion between softening, grey hepatization, and suppuration is more one of terms than of reality. Diffuse suppuration of the lungs is not rarely witnessed in newly calved cows; exposed to wet and cold, it runs a rapid course, terminating fatally in three or four days, the lungs being engorged with puriform materials. It isa INFLAMMATION OF THE LUNGS. 755 remarkable thing that suppuration of the lungs very rarely runs on to the formation of abscesses when the inflammation is not due to a specific cause, such as glanders or pyzemia. I have certainly seen abscesses in the lungs of both oxen and horses, but the event is a very rare one, and Sir Thomas Watson endeavours to account for the rarity of pulmonary abscesses in a very ingenious manner. He says—“ When I was speaking of inflammation in general, I pointed out to you the remarkable influence which the presence of air in contact with the inflamed part has in accelerating or determining the event of suppuration. In a recent cut through the skin the admission or the exclusion of the air to the cut surface will make all the difference between the adhesive and the suppurative inflammation ; and so in other cases which I then mentioned, and will not now trouble you by repeating. Now it seems to me that the same principle obtains in inflammation of the lung. First, there is an effusion of serum and blood, then of lymph and blood ; but the air, passing into the surrounding sounder tissue, and penetrating for a time even the inflamed portion itself, causes the suppurative process to super- sede the adhesive; and so no wall of circumvallation is formed by the coagulable lymph, as is the case in areolar tissue when not accessible by the air.’—(Watson’s Lectures, page 81.) Gangrene is more generally a result of congestion than of inflammation of the lungs, but its occasional occurrence in pneu- monia is indisputable. Sometimes it occupies a large portion of the lung, and is not circumscribed, sometimes it is more limited. The affected parts are dark, dirty olive or greenish- brown in colour; foetid in odour; moist, wet, and diffluent in consistence. The occurrence of mortification has been ascribed to thrombosis occurring in the branches of the pulmonary artery —(Huss, Carswell)—and to the destructive effect of the in- flammatory process destroying the vitality of the tissue, or to an arrest of the circulation by the excessive accumulation of its products in the interior of the air cells. Pneumonia may be double (bilateral) or single (unilateral), that is to say, it may affect one or both lungs; double pneumonia is, however, very uncommon. I have for many years carefully noted the site of pneumonia, and have found that the inflamma- tion is much more commonly situated in the right than in the left lung, both in horses and in cattle, in epizootic, sporadic, 48—2 756 SPORADIC DISEASES. and contagious pneumonia; that, generally speaking, the inflam- mation commences in the inferior portions of the lungs; that it invades the tissue from below, upwards; that in all cases the bronchi are more or less involved in the inflammatory process ; and that when the pneumonia is superficial, the pleura partici- pates in the inflammatory process, losing its normal colour and translucence, becoming opaque, and covered with a layer of fibrinous material; that the exudation, whether it be into the parenchyma or on the surface, is fibrinous. When the disease originates deeply within the lung substance, the pleurisy may be and occasionally is absent. When the pulmonary inflammation terminates in resolution, or a gradual return of the lung to its normal condition—and this termination is the most frequent one in ordinary pneumonia, provided the animal be properly treated—the exudates liquefy, undergo fatty degeneration and disintegration, and become so altered that they can be removed by absorption, and as the softened matters become absorbed, the circulation is gradually restored, and the lung slowly attains its normal character. In glanderous pneumonia, the exuded materials are trans- formed into an ichorous, infecting, puriform fluid, and in pleuro- pneumonia-bovina contagiosa they undergo a caseous necrotic change; the inflammatory process meanwhile continuing in other portions of the lungs until a large part of them becomes consolidated, impervious to air, and the animal dies from suffo- cation and anemia. The various stages of pneumonia are manifested by certain sounds detectable by the ear when applied to the sides of the chest. In the first stage, and previous to the occurrence of much engorgement, a crackling sound is heard, mingling with the vesicular murmur, over the inflamed part; the sound is of the smallest and finest kind of crepitation, similar to that emitted by salt when thrown on hot coals. As the inflammation ad- vances the crepitations become more and more pronounced, until they entirely supersede the vesicular murmur. These crepitations do not remain long; they are superseded either by a return of the vesicular murmur, indicating the resolution of the inflammation by a tubular sound, or an entire absence of sound.—(See Auscultation.) INFLAMMATION OF THE LUNGS. 757 ETIOLOGY. The causes of sporadic pneumonia are similar to those of bron- chitis, laryngitis, &c., namely, exposure to cold and wet, sudden chills, and housing in very cold, draughty stables. Horses kept in ill-ventilated stables are undoubtedly rendered susceptible to many diseases, and to pneumonia amongst the rest, but they will bear impure air even better than cold draughts blowing directly upon them. I have repeatedly observed that the slightest cold contracted by a horse kept in a draughty stable has almost in- variably been succeeded by pneumonia, and that if the animal were not removed to a more comfortable situation the disease tended to a fatal termination. It has already been stated that inflammation may succeed the congestive condition induced by severe exertion; it may also be induced by irritating gases; smoke of burning hay and straw; foreign bodies entering the lungs from the bronchi, examples of which are not uncommon in cows, as sequele to parturient apoplexy, where medicine finds its way into the trachea and bronchial tubes, and in horses choked by irritating and powerful remedies, such as ammonia. Direct injuries to the lung through wounds in the thoracic walls are not always succeeded by much inflammation, the lungs appearing to have remarkable powers of recovery from direct injury, provided it be not crushed, or that foreign bodies or extravasated blood are not forced into the wound in its tissue. Pneumonia may also be induced by any material altering the composition of the blood, epizootic influences, purpura, anthrax ; accidental products accumulating in the blood; mechanical or solid materials (thrombi) formed elsewhere, and conveyed to the lungs by the blood, as in phlebitis; infecting influences of materials conveyed to the lungs, as in pyemia or glanders. It may be the result of passive congestion arising from disease of the heart or weakness of the circulation, induced by exhausting diseases or old'age; or it may be the localisation of a specific disease, as in pleuro-pneumonia contagiosa. The above-mentioned causes must be considered as pre- disposing causes only. A cold intermittent draught tends to the lowering of an animal’s vitality, equally as much as placing a fowl in an ice-box will render it susceptible to anthrax. (It 1 758 SPORADIC DISEASES. must not be concluded, however, that ventilation is to be interfered with in any way—vide Treatment.) It is extremely probable that all congestions of the lungs are the result of microbic infection acting upon an organism already weakened by unhygienic conditions, over-exertion, improper food, &c., with the sole exception of acute congestion, which is the result of over-exertion ; the disease known now as infectious pneu- monia is undoubtedly, as its name implies, of microbie origin, but the specific organism is not definitely known. One of the Pasteurellas has been considered as the cause, but this is not even certain, and much work is being done on the subject. SYMPTOMS. The symptoms of pneumonia, namely, the greatly accelerated respiratory movements, oppressed pulse, and other signs of excitement described by Youatt, Gamgee, and others, are not by any means diagnostic of pulmonary inflammation. In many cases the breathing in the earlier stages is not difficult, and one is often surprised upon auscultating the chest to find that con- solidation has proceeded to a great extent without any very distinct symptoms having been presented. In the earlier stages, the symptoms are acceleration of the pulse ; in very many instances it will average eighty beats per minute; hotness of the mouth, and elevation of the temperature to 103°, 104,° or even 106°; there is a dry, dull cough, coldness of the extremities, and some degree of rigor. In some instances the disease is ushered in by a severe rigor, succeeded by a hot stage; the mucous membranes are red and injected, the con- junctivee presenting sometimes a rusty yellow tinge; the animal does not lie down, and if loose wanders occasionally about in a dull, depressed manner, now and then eating a mouthful of food. It is stated that the animal stands with its limbs outstretched and head protruded. I have, however, failed to observe this, except in very acute and congestive cases, until the disease has made considerable progress. There is some degree of constipa- tion, but the feeces are mixed with flakes of mucus; the bowels are irritable, and do not tolerate purgatives. If complicated with pleurisy, the breathing is more distressed, abdominal, and painful, but in pure pneumonia there is an absence of any very painful symptoms. I have carefully noted the breathing in INFLAMMATION OF THE LUNGS. 759 many cases of pneumonia, and found that the respiratory move- ments may not be above twenty per minute for several days after attack—a difference so slight from the normal number, that one is apt to overlook it altogether. The observations of Dr. W. Gairdner, that “the dyspncea of pure pneumonia is a mere accele- ration of the respiration, without any of the heaving or straining inspiration observed in bronchitis, or in cases when the two diseases are combined,” hold good both in horses and cattle ; but congestive paroxysms are not at all infrequent during the pro- gress of the malady, during which the breathing is not only greatly accelerated, but also laborious and distressed. As the disease advances, the respiratory movements become somewhat accelerated, until the period of crisis, when usually the breathing becomes much quickened. As a clinical fact, it may be stated that the fever continues for some days—five, eight, or sometimes longer—and that it then gradually subsides, the pulse falling several beats per minute, the mouth becoming cool, the elevation of the temperature gradually subsiding, the appetite returning; the secretion of urine, which during the febrile period had been scanty, of a high specific gravity, loaded with urea, and deficient in chlorides, is now abundant. ‘ Whilst these symptoms of re- turning health are becoming apparent, it will be found that the respiratory movements are increased in rapidity, and auscultation will reveal the fact that consolidation of the lung increases dur- ing the subsidence of the febrile symptoms. This had led some pathologists to conclude that all pneumonias are specific fevers terminating by an exudation into the lung tissue, in the same manner as variolous fever terminates in an eruption on the skin. I cannot agree with this view, inasmuch as the pneumonia is a concomitant condition from the com- mencement, and I look upon the exudative process as affording relief to the febrile symptoms, in the same manner as an ordi- nary swelling gives relief in such diseases as lymphangitis and ordinary inflammation of areolar tissue. It will be seen that pneumonia is dangerous during two stages: first, during the early fever, which may destroy life by its intensity ; and, secondly, during the period of lung hepatization, which may prove fatal by so altering the lung tissue as to pro- duce suffocation. These, then, are the two periods during which the practitioner 760 SPORADIC DISEASES. has to exercise his skilland care. In some instances death may occur subsequent to the consolidative stage from rapid deli- quescence of the inflammatory products, extensive suppuration, or contamination of the blood by degraded exudates absorbed into the circulation. In human medicine, the absence of the chlorides in the urine during the earlier stages, and their return in increased quantities in the convalescent stage, is looked upon as of great importance. This is a matter which requires further observations in veteri- nary practice. In most instances, a discharge of a rusty-tinged more or less viscid material from the nose is observed in the horse. This is sometimes streaked with blood; it is not, however, a constant symptom, as in all probability much of what might be expectorated by the human being is swallowed by the lower animals. The character of the discharge is signifi- cant; in bronchitis and catarrhal pneumonia it is more or less purulent, and if excessive, indicates a condition of great danger. In croupous pneumonia it is amber coloured, viscid, but not abundant. It is agreed upon by all observers that a horse will not lie dona during the intensity of any chest disease. This is not a diagnostic sign of any particular affection of the horse, as it will per- sistently stand while suffering from many other maladies. The ox will lie on the sternum during all the stages of pul- monary diseases. When the breathing is very rapid, the horse will stand with the elbows turned outwards, and the toes turned inwards. If great prostration succeeds, the position of the limbs is altered. It will then stretch its feet apart; the elbows will be turned inwards, and it will balance the trunk upon the extremities. The pulse of pneumonia is very variable ; sometimes full, with a degree of hardness ; sometimes full and soft; at other times it is small, irregular, intermittent, or double—the latter condition marking a congestive condition of the pulmonary vessels and right side of the heart and veins, as well as an anemic state of the arterial system. In ordinary pneumonia, running its course to a favourable ter- mination, the period of consolidation, which is indicated by absence of sound, or a small degree of tubular breathing, is succeeded by the advent of secondary and larger crepitations, which increase INFLAMMATION OF THE LUNGS. 761 in number and intensity for two or three days, then, gradually diminishing, are superseded by the normal respiratory sounds. To sum up, it may be stated that the diagnostic signs are those revealed by auscultation and percussion. First of all, small crepitations, indicating injection of the nutrient arteries and dryness of the lung tissue; secondly, tubular breathing, or absence of sound, indicative of engorgement and consolidation ; and thirdly, the reappearance of the crepitations, now of a larger character, pointing out that the exudate is undergoing metamorphosis, and becoming absorbed. The secondary crepitations are sometimes of a bubbling char- acter, and if associated with sunken eyes, a wrinkled expression, and feebleness of the pulse, indicate a condition of great gravity, either of extensive suppuration or of moist gangrene. Both these conditions may be associated with foetor of the breath, the latter particularly being accompanied by a horrible odour. During all the stages of pneumonia, increased dulness is elicited by percussion. Inflammation of both lungs, or double pneumonia, must be regarded as'a source of very serious danger from the great im- pediment it presents to the breathing, and deaths from it are much more numerous than from the single form. It is, how- ever, very rarely met with. Pneumonia is sometimes latent, and may remain undiscovered perhaps until after the animal’s death. In all cases of ill-defined maladies, it is necessary that the chest be thoroughly examined, when disease of a very grave nature may occasionally be detected, although the animal has never presented any very evident signs of serious lung disease. During the prevalence of epizootics, pneumonia is apt to assume a marked adynamic or typhoid form, attended with an early breaking down of the pulmonary tissue. This is, however, rare, and the most common form of chest disease met with is a combination of pneumonia with pleurisy, in which the symp- toms of both diseases are inseparably blended. Acute pneumonia, especially if associated with bronchitis, is sometimes complicated with laminitis or inflammation of the feet—(See Principles and Practice of Veterinary Surgery.) Acute inflammation may terminate in a chronic form of pneu- monia, in which the inflammatory products undergo fibrous or 762 SPORADIC DISEASES, caseous degeneration, keeping up a continued degree of irrita- tion, unfitting the animal for work, and gradually destroying life by inducing anemia, glanders, or hydrothorax. The symptoms of non-contagious pneumonia and pleuro-pneumonia in the ox are much more acute than those of pleuro-pneumonia contagiosa. Hemoptysis, or bleeding from the lungs, is not generally asso- ciated with pneumonia, but may be witnessed in congestion, accidental rupture of vessels, glanders, purpura, and in a passive form in some epizootic disease or influenza; in which case I have seen the blood of a dark colour, and not frothy as in ordi- nary hemoptysis. TREATMENT. Bleeding.—The abstraction of blood was considered the sheet- anchor in pneumonia. Percivall says—“I wiil take it for granted that pneumony, either in its congestive or inflammatory form, has set in ; which being the case, it becomes the imperative duty of the practitioner, without any regard whatever as to the state of the pulse or the condition of his patient, to abstract blood the moment he is called in. Generally speaking, a large orifice in the jugular vein is to be preferred to a small one; in cases of imminent danger it is absolutely indispensable. The quantity of blood to be abstracted must be as great as the patient will bear ; and our sure guide in this is the effect which the efflux of blood has upon the pulse at the jaw. While the blood is flowing, keep your fingers applied upon the submaxillary artery ; so long as you feel that pulsating, so long may the stream of blood be continued ; but the instant the vessel collapses under the pressure of the fingers, and pulsation is no more perceptible, let the blood- can be removed and the vein pinned up. . . . The quantity of blood we shall be able to draw on the first occasion will vary in different subjects and under modified circumstances ; it may amount to a couple of gallons, it may not exceed a couple of quarts. . . . A second blood-letting is often borne better than a first. When the quantity taken in the first instance has has been but small and inadequate, if we will only wait a few hours until reaction appears to have taken place, we shall com- monly be able fully to accomplish our object. Six, twelve, or twenty-four hours after the first full blood-letting, guided by the INFLAMMATION OF THE LUNGS. 763 exigencies of the case, principally by the state of the breathing and pulse, it may become necessary to repeat the bleeding, regulating the quantity, as before, by the perception of the pulse at the jaw. I have found it requisite to bleed thrice during the first eighteen hours.”—(PERCIVALL’s Hippopathology.) This was the belief and doctrine not only of Percivall, Youatt, and others, but of Professor Dick, who taught and maintained its correctness up to the time of his death. A glance at the pathology of the disease, no less than actual statistics, will enable any unpre- judiced observer at once to see the fallacy of the doctrine; and veterinary surgeons, with but few exceptions, have been long convinced that bleeding most materially increases the mortality of the disease. The experience of the medical profession has led them also to arrive at a similar opinion, and Dr. Wilson Fox, in Reynolds’ System of. Medicine, sums up the conclusions upon this head as follows :-— “(1.) That indiscriminate bleeding immensely increases the mortality of the disease. “(2.) That it is especially fatal in old people and young children, in patients of exhausted constitutions, and in those suffering from chronic diseases, and particularly in Bright's disease. “(3.) That it is absolutely unnecessary in the majority of cases of young adults and also young children. « (4.) That in the vast majority of cases it has no influence whatever either in cutting short the disease, or in lessening its duration or diminishing the pyrexia, but that occasionally these results appear to follow its use when practised early. “(5.) That in the majority of cases it hinders the critical fall of temperature and delays convalescence. “(6.) That in the majority of cases, as shown especially by Dr. Bennett’s and Dietl’s data, recovery is equally, if not more rapid, when it is not practised as when it is resorted to. “(7.) That in a few cases a moderate venesection may be necessary in the early stages to avert immediate danger of death from asphyxia.” The above conclusions have reference to moderate bleeding only, repeated bleedings being condemned by Dr. Fox as “a system whose impropriety it is scarcely needful to discuss further.” 764 SPORADIC DISEASES, Bleeding, then, can only be safely practised in the very earliest stages of a few exceptional cases, in which symptoms of dyspncea are very urgent; and even then it must not be pushed so as to debilitate, for more horses die from the prostration of strength. at later periods than from the occasional suffocative effects of the earlier and congestive stages. Bleeding in some cases, no matter when it is practised, seems to ‘afford a relief to the breathing, but this effect is only tem- porary, and disappears in a very short time, the rapidity of the respiratory movements in pneumonia being dependent on cedema or consolidation, conditions upon which the withdrawal of blood can have but little or no effect. . Convinced of the inutility and danger of venesection, many veterinarians, undoubtedly influenced by the teaching of Dr. Tod, fell into the other extreme, and treated pneumonia by large and repeated doses of stimulants. What possible good effect this kind of treatment has upon an ordinary case of pneumonia is beyond my comprehension; it can only add to the irrita- tion of the inflamed part, and increase the amount of exudation, if pursued in the earlier stages. I have seen it extensively tried, and must confess the results have been most disastrous. In the later stages, during the deliquescence and absorption of the exudate, if the pulse be small, or in any degree presenting the double or dicrotonous character, when the system is de- pressed by the obnoxious effects of large quantities of effete materials in the blood, moderate doses of stimulants are both necessary and beneficial. The practitioner should, however, wait until the consolidative stage has to some extent disappeared, and secondary crepitations established. Four or six ounces of whisky or brandy may then be given two or three times a day; not every hour, as recommended by some practitioners. . The effect of the first doses must be carefully noted ; if they stimulate the appetite, they are to be repeated; but if they cause distress in the breathing, or any signs of exacerbation, they are to be discontinued. Calomel, opium, digitalis, tartar emetic, seem to have no effect in curtailing the duration of the malady. Opium is only admis- sible when the pneumonia is associated with pleuritic pain. Purgatives are inadmissible in the horse on account of the sympathetic and irritable condition of the alimentary mucous membrane. INFLAMMATION OF THE LUNGS. 765 If constipation be extreme, enemas, or a small dose of oil, are to be preferred to the more active cathartics. Aloes is contra- indicated, and should never be given. In horned cattle a saline cathartic may be given in the early stages, for the purpose of unloading the stomachs and alimentary canal, and thus give greater freedom to the respiratory movements. Nitrate of potash given dissolved in the animal’s drinking water seems to diminish the amount of exudation, and modify the fibrinous condition of the blood. It has also a cooling or detergent effect upon the system generally, modifying the pyrexia, and, by acting upon the kidneys, assists in the excre- tion of effete materials from the blood. In some instances, particularly when the kidneys remain torpid, its diuretic effect:is increased by a few doses of colchicum. - But the administration of the nitre or the colchicum should not be persevered in too long, as they both tend to debilitate, and whenever free diuresis is established, they should be discontinued. In some instances, particularly if the patient be debilitated or out of condition, spirits of nitrous ether may be substituted for the potash salt. Blisters—For many years I have held that the application of the so-called counter-irritants, whether they be cantharidine blisters, mustard, turpentine, or any other powerful irritant, is not only useless but dangerous in the earlier stages, and uncalled for when convalescence is progressing favourably. In the earlier stages, they add to the distress, prevent the freedom of the respiratory movements, and increase both the fever and fibrinous condition of the blood; and large cantharides blisters, the cantharidine of which is absorbed into the blood, induce a condition of blood poisoning. characterised by albumi- nuria and great prostration, and by irritating the urinary pas- sages increase both the distress and the fever. I am glad to find that this conclusion—a conclusion, I may state, which has met with much opposition—is endorsed by physicians. Dr. Wilson Fox says—* Blisters, in the earlier stages of. pneumonia, are to be considered as both useless and as greatly increasing the distress of the patient. When resolution is progressing favourably, they also appear to be quite unnecessary. In a few cases when resolution is delayed, or when there is evidence of a small amount of pleuritic effusion, they may, I believe, in adults be occasionally employed with apparent advantage. In children 766 SPORADIC DISEASES. they are almost invariably inapplicable. Warm fomentations or poultices to the sides often give great relief to the pain. I have by no means satisfied myself that any advantage accrues during the acuter stages from any more irritant appli- cations, whether mustard or turpentine, though in cases of threatening collapse, or when dyspnea is severe, they have occasionally appeared to afford relief.” — (See Rrynoups’ System of Medicine, vol. iii., p. 701.) | In the horse the application of either mustard or turpentine causes very great distress, a high state of excitement, an increase of the febrile disturbance, and often tends to hasten a fatal termination. For these reasons the indiscriminate employment of such remedies is highly condemnable. Fomentations to the sides, however, afford relief; and they should be persistently employed in all cases marked with rapid or distressful breathing. When the extremities remain very cold, the return of warmth and circulation will be much assisted by frictions, or the applica- tion of a mild embrocation and bandages; and, to sum up, it may be stated that the successful treatment of pneumonia consists in the following essentials :—1st. Placing the patient in a well- ventilated loose box, where the air is pure, abundant, but not too cold. Within the last few years, the administration of oxygen by inhalation has found much favour—the respirations, the pulse, and the general condition of the patient being much improved after each inhalation of ten minutes’ duration. If the air be impure, suppuration of the lungs to an extreme extent will be apt to be established, as impure air contains organic germs in great abundance, and these, gaining access to the inflamed part, increase the tendency to the formation of pus. In the winter months, especially if the weather be cold, I have noticed that coldness of the air increases the pulmonary inflammation, and that after a very cold night an animal has been in a state of approaching collapse in the morning. To prevent the occurrence of the mortality from the above cause, veterinary establishments ought to be furnished with loose boxes, where the air can be artificially warmed to a temperature of at least 65° F. 2d. The surface of the body, extremities, and head are to be kept warm by suitable, but not too heavy, clothing ; frictions, and the application of non-irritating stimu- INFLAMMATION OF THE LUNGS. 767 lants to the extremities, being useful in cases where they are deathly cold. 8d. The horse is to be allowed as much cold water as it will drink; but it is not advisable to allow it to drink a large quantity at once. If it be permitted free access to water whenever it pleases, by placing it in its box or stall, it will generally partake of it in sufficient but not over-abundant quantity. 4th. The febrile condition must be treated according to the intensity of the symptoms. If the fever be high, nitrate or chlorate of potash is to be administered, but if, on the con- trary, the fever be of an adynamic type, carbonate of ammonia with camphor may be given in the form of a ball, in addition to the potash salt, and it is found that hyposulphite of soda in the drinking water is of great value. 5th. If the bowels be constipated, they are to be carefully regulated by a moderate dose of oil, and by enemas. 6th. During resolution of the inflammation care must be taken that nothing be done to check the action of the excretory organs. Should moderate diarrhcea or increased diuresis come on, they are on no account to be checked, as they are merely critical discharges, whereby the effete materials in the blood are eliminated from the economy. 7th. In the earlier stages the food is to be simple, laxative, cooling, and nutritious. Bran and boiled linseed mashes, a moderate allowance of good hay, roots if in winter, or grass ifin summer. During the later stages strong food, as oats, beans, with grass or roots, are to be allowed in moderation; and should the appetite be bad, stomachic stimulants, as spirits of nitrous ether, with gentian or nux vomica, are useful adjuncts; but should the patient refuse to feed, milk and eggs are to be freely supplied. This it will drink if stinted in its water; it should never be forced upon it by horning, nor should gruels, hay tea, large doses of ale, porter, &c., be forced upon it. I may state, in conclusion, that in all cases where depression and debility are prominent symptoms, with a small, feeble, rapid pulse, stimulants should be cautiously used, and if after a few doses they appear to do no good, they are to be discon- tinued, and the case left without much meddling or inter- ference ; and that bleeding is but rarely called for, and only in cases where the dyspnea is great, and the danger to life imminent. Even then it is not to be pushed to the extreme recommended by some writers and teachers. 768 SPORADIC DISEASES. It must be borne in mind, as already pointed out in the chapter on Degenerations, that pneumonia, pleurisy, bronchitis, and other diseases, even of a mild type, are apt to terminate fatally in overfed and pampered animals, such as those kept for show purposes, no matter how discreetly they are treated ; for in such animals the vital organs—heart, liver, kidneys, &c.—will be found in such a state of degeneration as to prevent the per- formance of their functions under the altered conditions of induced disease. So long as the animals are not subjected to any trivial cause of disease, function seems to be performed; but whenever the system is subjected to any trial, such as a chill, fatigue, parturition, &c., the powers of the altered organs are wholly or partially lost, and death is the result. CHAPTER LXIII. SPORADIC DISEASES—continued, LOCAL DISEASES—continued. (.) DISEASES OF THE RESPIRATORY ORGANS—continueu. PLEURISY—PLEURITIS. INFLAMMATION, partial or general, of the serous membrane that lines the cavity and covers the viscera of the thorax, attended with effusion of serum, exudation of lymph, or, rarely, the formation of pus. Pleuritis, or a combination of it with pneumonia, is the most common form of chest inflammation met with during the pre- valence of the easterly winds of spring and early summer, and has been fully described at page 405. In the lower animals, exposure to cold is the most common cause of pleurisy. It has followed clipping when an animal has been exposed to cold, and Duvieusart states that he has seen three hundred cases of pleurisy in a flock of sheep shorn in February, thirty of which died—(GamGEE’s Domestic Animals.) It will sound strange to veterinary surgeons to be told that cold is now believed to have no effect in causing pleurisy in the human being : such, however, is the belief. Pleuritis in the horse often partakes of a rheumatic character ; the inflammation being induced by the same cause—cold— and assuming a Siailae metastatic type and character, chang- ing its seat from the pleura, sometimes to the pericardium, endocardium, or to the ligamentous or tendinous structures of the extremities. In more than one instance navicular disease has succeeded an attack of pleurisy, and I have one specimen in my possession showing ossification of the heart 769 49 770 SPORADIC DISEASES. caries and eburnation of the navicular bone, as results of acute navicular arthritis succeeding an attack of rheumatic pleurisy. At the outset the inflammatory phenomena commence in the subpleural tissue, the blood-vessels of which become congested. At first the congestion presents an irregularly spotted appear- ance; the spots, however, multiply rapidly, and the red colour becomes diffuse by their confluence. . In other instances the pleural surface presents a streaky appearance, whilst in others the whole of the pleura, pulmonalis and costalis, presents a bright red congested appearance over its surface. The secretion of the pleural surfaces is at first sus- pended, and if the ear be applied to the side of this stage a dry friction sound will be heard. The dryness of the membrane is very shortly succeeded by effusion of serum, and the formation of an exudate which has a tendency to become organized into a false membrane, causing the adhesion of the two pleural surfaces. It is important that the time in which these false membranes ray be formed be clearly ascertained. The experiments of Andral throw some light upon this subject, which is important to the veterinarian as a question of jurisprudence. Andral made experiments upon the pleura of rabbits by injecting acetic acid into them. He sometimes found at the end of nineteen hours soft, thin, false membranes, traversed by numerous anastomosing red lines. In other rabbits, placed under circumstances which appear to be exactly similar, no such result had taken place at the end of a much longer period; and the pleura contained only a serous or puriform liquid, mixed with unorganized flakes of lymph. Experiments performed by myself upon healthy subjects (horses) in 1874 proved that a false membrane, presenting some degree of organization, may be found in twenty-four hours after the injection of an irritant into the pleural sac, and that the puriform appearance mentioned by Andral is an evidence of an inflammation of longer standing, arising from degeneration of the inflammatory products. It may be briefly stated that all cases of pleuritis terminate either in the exudation of lymph, which may liquefy and be re-absorbed, or in the formation of a permanent false mem- brane. But the most ordinary result is effusion of serum, PLEURISY. 771 constituting a limited hydrothorax, even to invasion of the walls of the thorax, a natural result of a diffuse and intense inflammation; and that in pleuro-pneumonia contagiosa of the ox there is often oedema of the thoracic walls without actual hydrothorax. Pleurisy may be either double or single; generally it is single, and confined to the right side. Pleurisy is sometimes, but very rarely, caused by direct violence to the thoracic walls. Pleurisy is often secondary to other diseases, such as septic broncho-pneumonia—the transit or corn-stalk disease of American cattle—and of many forms of blood poisoning. It has been said that all pleurisies. in. the horse are the result of invasion by the streptococcus of strangles, and that @ similar condition in man is always the result of tubercle bacilli. It is, perhaps, going a little too far to say this, as although streptococcus may often be the cause of pleurisy in the horse, it is also frequently found that a non-purulent exudate may exist. It is probable that pleurisy, as in the majority of other inflammations, is directly the result of microbic invasion, but no particular organism can be credited with the cause in all cases. The same may be said of rheumatic affections. This is a condition also most probably the result of bacterial infection, and a condition in which the serous membranes are particularly liable to attack, so that occasionally the pleura suffers. SYMPTOMS. The disease at the outset is characterised by some degree of rigor, very often a mere chill, manifested by a staring coat, and coldness of the surface of the body. This is, however, succeeded by signs of pain, often mistaken for colic, during which the horse paws, and perhaps lies down and rolls; it eventually becomes stiff and sore, and if suddenly approached, or if rapped upon the affected side, will groan. The acts of respiration are performed rapidly and incompletely, the ribs are fixed, the respiration is mostly abdominal, and a hollow line extends along the inferior border of the false ribs, from the sternum across the flank to the anterior spine of the ium. A 49—2 TLD SPORADIC DISEASES. dry, short, painful cough supervenes; the pulse is hard and quick. If the side be closely examined, the muscles covering the affected part will be noticed to tremble or quiver; this lasts but a short time only, and is succeeded by diminished motion. These signs, as well as the pain upon pressure, indicate that the intercostal muscles participate in the inflammation, and that pleurisy is generally associated with pleurodyria, first described by Haycock. When the pleurodynia, or inflammation of the muscles, is very intense the animal moves in a very rigid manner, steps slowly and very short; is greatly dejected, the back is arched, the skin exhibits great tenderness when subjected to pressure. I may state that I have seen some cases that were so stiff and sore as i fall when compelled to move. Hydrothorac.—When an animal dies of pleurisy, especially 4 if it has survived the first stage, a considerable amount of effusion of serum will be found, constituting dropsy of the chest, or hydrothorax. In some instances a large quantity may be found in a day or two, and in some rare cases without any perceptible disease of the pleura. ‘ The symptoms of hydrothorax are short, quick, laboured respiration ; the pulse small, quick, soft, often intermitting; auscultation reveals absence of sound in the inferior part of the chest, or a sound resembling that of drops of water falling into a well, as has been already explained. The hydrothorax in the horse generally invades both sides of the cavity of the thorax, for a communication exists owing to the loose diaphanous or web-like structure of the mediastinum, as pointed out by Rigot, Delafond, and Bouley. This natural communication is in-some instances obliterated by exudation of lymph on the mediastinal surface, in which the hydrothorax will be confined to the one side. In other instances the serous effusion, confined in sacs of adventitious products, will be con- fined to certain circumscribed parts of the chest only. The liquid effused is composed of serum mixed with flakes of lymph, and is generally more or less clear upon the surface, turbid in the lower parts from admixture with particles of exudative materials ; it is sometimes, however, tinged, with blood. If the clear lignid be placed in a glass and left at rest, it generally separates into clot and serum, proving that it contains the con- stituents of fibrin, which coagulate on exposure to the atmosphere. PLEURISY. 773 In forty-three cases observed by M. St. Cyr, the offusion from the first to the seventh day presented a port wine colour in nine cases,a sero-sanguineous appearance in six, muddy or greyish in three. From the eighth to the fifteenth day the port wine colour was observed in two, the sero-sanguineous in three, muddy greyish in four, and limpid in six. From the sixteenth to the thirtieth day the colour was limpid in five cases, and after the thirtieth it was also limpid in three cases. M. St. Cyr draws the conclusion that the liquid begins to clear up towards the end of the second week, and that it is clear after the twenty- fifth or thirtieth day, and that this is the epoch from the acute to the chronic state of pleurisy. English veterinarians generally maintain that the advent of hydrothorax is manifested by an apparent improvement of the pleuritic symptoms. They state that the pulse falls, the breath- ing becomes easier, &c. This is so far true, but is not diagnostic, as the abatement of the symptoms indicates the subsidence of the pain and fever, and that the dry condition ofthe pleura has passed on to that of increased effusion, its natural sequence. Now, if the effusion continue or remain unabsorbed, or is poured out in greater quantities than can be taken up by absorp- tion, it naturally follows that the condition of hydrothorax will be the result; if, on the contrary, the effusion be moderate in quantity, or if absorbed, it as naturally follows that the improve- ment of the symptoms is but the forerunner of convalescence. In addition to increasing difficulty of breathing, a difficulty sometimes so great as to call into operation the action of muscles other than those of respiration, extending even to the caudal ones, causing an upward and downward motion of the tail similar to that of a pump handle, the other characteristic signs are dropsical swellings, commencing generally at the sternum, extending along the floor of the abdomen, and finally invading the areolar tissue of the extremities; flapping of the. nostrils, protrusion of the head, and increased roundness or bulging of the ribs, and the hair of the mane and tail is easily pulled out. In some instances of hydrothorax the legs remain unnaturally fine, even to the fatal termination. It may be mentioned that the appetite is capricious, and that the symptoms generally are subject to variations—the diagnostic ones being those detected by percussion and auscultation. 774 SPORADIC DISEASES. TREATMENT. The treatment of pleurisy in its acute stage differs but little from that of pneumonia, unless, indeed, the pleuritic pain be acute, then opium is essentially necessary. In the very earliest stage of the inflammation, when the pain is usually most acute, a dose of tincture of opium, in combination with a pint of linseed oil, has usually a very decided anodyne effect, particularly if its soothing effect be assisted by warm fomentations to the affected side. The opium may be repeated if the pain continues; usually, however, the acute pain subsides in a few hours; and, provided the pulse remain hard, aconite may take the place of the opium. If the pulse be soft and showing little irritation, but little treatment, beyond warm fomentations to the sides, clothing the animal warmly, allowing it to drink freely of cold water, in which an ounce of potash nitrate is daily dissolved, and supplying it with nutritious, easily digestible food. is necessary. The fomentations to the sides are not, however, to be neglected, so long as the breathing remains at all laborious; experience having taught me that they not ouly soothe the irritation and pain, but that they most materially promote convalescence, and diminish the tendency to hydro- thorax and death, but they should not be applied for more than half an hour at a time; their too long-continued application often becomes annoying to the animal and causes restlessness. Bleeding, although often indicated by the hardness of the pulse, seldom does any good; it certainly has no effect on the duration of the disease, even in cases where its primary effects have seemed to afford relief to the pain and respiratory embar- rassment; and in the majority of instances where it has been indiscriminately performed, it has delayed the convalescence, increased the tendency to hydrothorax, and increased the rate of mortality. Blisters —Of the application of the so-called counter-irritants, I can only repeat what I have taught, that with rare exceptions they are injurious. Veterinarians, however, generally maintain otherwise; and in support of their arguments appeal to the practice of physicians, who, with rare exceptions, until lately practised this method of treatment. Within the last few years opinion has greatly changed ; and in the latest book on medicine, namely, “ Reynolds’,’*Dr. Austin, article Plewrisy, page 942, PLEURISY. G75 vol. iii., says—‘‘ The treatment by so-called ‘ counter-irritation,’ as pursued by many physicians, is no less repugnant to me than is that by mercury or bleeding. Let me make two admissions :— In the first place, the mere application of a mild mustard plaster, or, still better, of a hot poultice or epithem, undoubtedly may give some ease, perhaps even arrest incipient inflammation; and the use of ‘ small flying’ blisters, in the limited attacks of pleurisy, which are so common in phthisis, undoubtedly appears to give relief in many cases. But the use of large blisters, especially if kept open, appears to me both useless and often prejudicial.” I need not here repeat what must be already self- evident, that blisters, especially those extensive ones ordinarily applied, only increase the pain, the embarrassment of breathing, the general febrile condition, and the tendency to excessive effusion and exudation. There are instances, however, in which the application of a moderate mustard liniment proves beneficial; these are the cases in which the disease makes but little pro- gress towards recovery, in which the symptoms remain without much alteration for better or worse for some days. This con- dition is characterised by languor, prostration of strength, a pulse standing about eighty, with scanty secretion of high-coloured urine, a continued elevation of the bodily temperature, capri- ciousness of the appetite, and a respiratory embarrassment. From the tenth to the fourteenth day after attack, the above symptoms being present, the application of the mustard liniment, and succeeding warm fomentations to the sides, promotes the ab- sorption of exuded materials, stimulates the system generally, and increases the excretion of effete materials from the economy, evidenced by diuresis, improvement of pulse and respiratory movement, and a rapidity of convalescence, which otherwise could not have been established. In thus applying the cutane- ous stimulants care must be taken that their effects do not exceed that of stimulation or gentle irritation; if the appli- cation be sufficiently strong to induce soreness of the sides, it is calculated to do harm, not only by increasing the pain, but also by exaggerating the adynamic or typhoid condition. In no instance where resolution is progressing satisfactorily should this treatment be applied. The colchicum, as recommended for pneumonia, may ad- vantageously be administered in combination with iodide of 776 SPORADIC DISEASES. potassium, or the vegetable or mineral tonics, as the case may be, when absorption and excretion of the inflammatory pro- ducts are not progressing satisfactorily. When debility and anemia are associated symptoms, I have found the salts of iron, more especially the tincture of the terchloride, to have a marked effect in promoting the absorption of the inflamma- tory products, fluid and solid. I have a far higher opinion of the effects of iron salts than of iodine or iodide of potassium. The practitioner is, however, at liberty to combine the iodine with the iron. Paracentesis Thoracis——In all cases where effusion is excessive, no time should be lost in giving relief to the symptoms of dis- tress by the operation of tapping. Ido not mean to advocate early tapping in cases of effusion, being strongly of opinion that absorption of the fluid is calculated to save more lives than its evacuation; but when danger to life is imminent from its excessive quantity, the operation should never be delayed until prostration and debility are associated with the dyspncea. The most successful method of performing paracentesis thoracis is by means of an instrument, consisting of a trocar and cannula, guarded by a tap, by which a small quantity of the fluid is with- drawn, the exact nature of which can be identified. If fiuid be present it can be withdrawn, an elastic pipe being attached to the tap, and the serum allowed to flow into water. Should the fluid be purulent or too thick to flow through the cannula, a suction syringe is to be applied, the force of which is to be sufficiently strong to cause its evacuation. Dr. Bowditch’s rules for performing this operation are as follows :—“ Find the inferior limit of the sound lung behind, aud tap two inches higher than this on the pleuritic side, at a point in a line let fall perpendicularly from the angle of the scapula. Push in the intercostal space here with the point of the finger, and plunge the trocar quickly in at the depressed part ; be sure to puncture rapidly, and to a sufficient depth, as you may be balked by the false membranes oceluding the cannula. “Tt will sometimes happen that with the greatest care and trouble we are unable to get a flow of fluid at the part where we first puncture; it is then our duty to try elsewhere, for our failing may be owing to unusual thickness of the false mem- branes in the lowest inch or two of the pleural cavity. We thereupon repeat the puncture a little higher up, and further PLEURISY, [77 towards the axillary line, and here we perhaps find fluid; at any rate, no harm has been done by the two punciares. “The circumstances under which paracentesis ought to be performed for pleurisy are the following :— “ Ist. In all cases of pleurisy, at whatever date, where the fluid is so copious as to fill one pleura, and begins to compress the lung of the other side ; for in all such cases there is the possibility of sudden and fatal orthopnea. “ 2d. In all cases of double pleurisy, when the total fluid may be said to occupy a space equal to half the united dimensions of the two pleural cavities. / “ 3d. In all cases where, the effusion being large, there have been one or more fits of orthopnea. “ 4th. In all cases where the contained fluid can be suspected to be pus, an exploratory puncture must be made; if purulent,. the fluid must be let out. “ Sth. In all cases where a pleuritic effusion occupying as much as half of one pleural cavity has existed so long as one month, and shows no sign of progressive absorption.” In our patients the puncture can be made in the fifth of sixth intercostal space, and as near to the anterior margin of the rib as possible. It is usual to divide the skin with the lancet, and to stretch it before introducing the trocar, so that, when the fluid is withdrawn, the external wound is not directly opposed to that in the tissues. By this method admission of air into the cavity of the thorax is prevented. Physicians are agreed that it is not necessary to extract the whole of the fluid, and that the removal of just so much as may be necessary to relieve substantially the mechanical distress will, in most cases, give the necessary spur to the natural process of absorption, by means of which the rest of the fluid will be taken up. Should the cannula become blocked up by fibrinous coagula, and the escape of the fluid thus prevented, a whalebone probe must be introduced. After the operation the animal’s strength must be maintained by good food and stimulating tonics, such as nux vomiea, ferrous sulphate in. combination with hydro-muriatic acid. If the animal does not feed, it should be supplied with milk and eggs instead of its drinking water for a day or so; but, for reasons already given, all such food must be partaken by, not forced on, the animal, CHAPTER LXIV. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (K.) DISEASES OF THE HEART AND ITS MEMBRANES, THE weight of the heart of the horse varies according to the animal’s weight and size—from 8 to 20 lbs; the average, how- ‘ever, is about 10 lbs. In the ox, sheep, and pig the weight of the heart is to that of the weight of the body as 1 in 220, andin the dog as 1 in 90. Anything much above this average is indicative of hypertrophy. Heart diseases, although rare in the lower animals compared with their frequency in man, and much more difficult of diagnosis, are neither infrequent nor unimportant. For the convenience of description they may be arranged under two heads, namely—1s¢. Diseases of the heart and valves ; 2d, Diseases of the cardiac membranes. 1st. Diseases of the heart are divided into functional and organic. (a.) Functional derangement of the heart, characterised by palpitations, irregularity, or intermittence of the pulse, may arise from debility, indigestion, blood poisoning, as in purpura, hemo- albuminuria, epizootic catarrhal fever, &c. Palpitation of the heart is often due to dyspepsia, disappear- ing with the indigestion and reappearing with another attack, both in the horse and dog. It also arises from nervousness, and if a nervous animal be approached rapidly and roughly, the beatings of the heart are often distinctly heard; and if the pulse be felt, it may be irregular and intermitting. If one were immediately to form a diagnosis that these results were due to heart disease, a few minutes’ further observation would point out the error. Palpitations and irregularities are symptomatic of other dis- orders, when they occur occasionally only, and when other signs 778 DISEASES OF THE HEART AND ITS MEMBRANES. 779 of heart disease are absent ; if persistent, they indicate, separately or conjointly, some organic lesion of the heart or its membranes. Repeated examinations of the patients are necessary before forming a conclusion. (b.) Organic Discases.—Carditis, or inflammation of the sub- stance of the heart, is always circumscribed ; a general or diffused inflammation, which would be immediately fatal in consequence of destruction of function, is fortunately never witnessed. Partial or circumscribed carditis, unless it be due to injuries, and asso- ciated with exocardial effusion and exudation, presents no symptoms during life, and is only discoverable post mortem by the presence of a small abscess or circumscribed deposits of lymph ; but although the cardiac walls are not subject to inflam- mation, they undergo various alterations inimical to the well- being of the animal, and may be described as follows. 1. Hypertrophy.—tThis may be of three kinds :— (1.) Simple hypertrophy, where the walls are merely thickened without alteration of the cavity. (2.) Eccentric hypertrophy, where the walls are thickened and the cavities enlarged. (3.) Concentric hypertrophy, where the walls are thickened and the cavities diminished. These conditions are manifested by a more or less persistent palpitation or increased cardiac force, the cardiac sounds being often heard upon both sides of the chest. They are due to some obstruction to the circulation consequent upon chronic pul- monary disease, constriction of some of the large vessels, and are best combated by a moderate diet, freedom from excitement, and, if depending upon broken wind or any impediment to the pulmonary circulation, by small doses of arsenic. The most common organic change which occurs in the hearts of horses and dogs is that due to atrophy and fatty degeneration. This change is generally met with in aged subjects, and in those which have been pampered and irregularly exercised. Itis also a result of pericarditis, and as a sequel to epizootic diseases in which the pericardium has been involved. It is also induced by blood affections, as purpura, azoturia, and scarlatina. During life the progress of atrophy and degeneration is mani- fested by a more or less slowly increasing debility of the circulation, exemplified by diminished cardiac impulse, irregu- 780 SPORADIC DISEASES. larity of the pulse, and a tendency to cedema of the extremities, with difficulty or inability on the part of the animal to perform ordinary labour. I have repeatedly watched the progress of this disease, and have found that when the animal is near death there has been capriciousness of the appetite, extreme muscular debility, a pecu- liar rusty-red appearance of the visible mucous membranes, and a want of correspondence between the pulse and the contraction of the heart. The cardiac sounds have been often loud, amount- ing to palpitation, but the impulse has been feeble, and the pulse weak and irregular, arising from the fact that the feeble cardiac impulse is not transmitted. In hypertrophy of the heart, more particularly that of the left ventricle, when the walls are increased in thickness, and the cardiac contractions proportionately strong, the bleod is, propelled into the arteries with increased force, and the pulse is strong and hard, so long as the circulation is unimpeded by aortic obstruction ; but when the heart is atrophied, or its walls attenuated, and its cavities enlarged, the pulse will be of the opposite character—soft, weak, and irregular. If the hyper- trophied heart’s action be intermitting, the strong pulse will. be intermitting also; but in atrophy the pulse will be intermitting and irregular, even providing that the beatings of the heart be regular in their succession. The post mortem examinations reveal the heart apparently enlarged, but the enlargement is due to dilatation of its cavities and attenuation of its walls. The muscular structure of the whole organ presents a pale or fawn-coloured appearance, is soft to the touch ; and when examined microscopically, the most notice- able change is the absence of the transverse strize of the muscular fibres, with here and there true fatty degeneration. In the dog, atrophy of the muscular fibres is generally due to fatty infil- tration, which, pressing upon the muscular fibres, cause their removal by absorption. But in the horse the change is more commonly found in the sarcous elements themselves, by which they first lose their truly muscular characteristics and their power of contractility, and finally become converted into a fatty material. I cannot recommend any treatment calculated to arrest the progress of this change in the horse, but would suggest that the chlorate of potash (which has the power of arresting some DISEASES OF THE HEART AND ITS MEMBRANES. 781 dlegenerations) might be administered. For the dog, mild purga- tives, regular exercise, and light food. constitute the best treat- ment, for, as already pointed out, the atrophy is generally simple, except in old dogs—depending upon the pressure of the fatty infiltration. PERICARDITIS. Inflammation of the pericardium is often associated with epizootic diseases. In the ox it frequently arises traumatically. When not arising from injury, its causes are similar to those of pulmonary diseases and rheumatism, with which it is often associated. There are but few instances of epizootic pleuro-pneumonia in the horse but are complicated with in- flammation of the pericardium ; indeed, during some seasons, epizootic diseases partake of the rheumatic type, and involve not only the pleura, pericardium, and endocardium, but also the fibrous structures of other parts of the body. Symptoms.— In addition to general signs of fever, which is often of a severe type, there is a peculiar irritability and hardness of the pulse, indicative of irritability of the heart; the pulse isa short, angry beat, and the heart’s action is often irregular; some- times bounding and violent, at other times feeble and fluttering. There is coldness of the extremities, and acceleration of the respiratory movements. Leblanc, who is followed by Percivall, Gamgee, and others, says that a marked contrast between the violent heart-beats and smallness of the pulse are characteristic signs of endocarditis, and that they are very important in distinguishing endocarditis from pericarditis. I cannot confirm this conclusion, having repeatedly witnessed these symptoms in pericarditis unassociated with disease of the endocardium. Generally, however, both membranes are implicated in the inflammation, and it is a most difficult matter, in the lower animals at least, to distinguish between the two affections. Associated with this inflammation, spasms or cramps of the superficial muscles are often witnessed. Most frequently the cramps are confined to the muscles of the pectoral region and neck ; but occasionally those of the posterior extremities are also more or less violently affected. The physical sign of pericarditis is a to-and-fro friction sound, resembling a rasping murmur, 782 SPORADIC DISEASES. synchronous with the cardiac movements. This sign is subject to variety in tone and degree, depending upon the nature and extent of the exudation or effusion. If much fluid be present, the sound becomes lost, being replaced by a dull, churning noise; as the effusion diminishes by absorption, the to-and-fro friction sound returns, unless, indeed, the pericardium has become generally adherent to the heart’s surface. If this sound be associated with a deep-seated blowing or bellows murmur, which sometimes begins to be distinguished when the other ceases, or, in the words of Watson, appears to supervene upon it or to take its place, the combination of sounds indicates an affection of both the external and internal membranes—peri- carditis and endocarditis. Dr. Stokes says, “that in respect of morbid anatomy, cases of pericarditis may be arranged into three classes. In the first class are to be placed those in which there is a slight though general effusion of coagulable lymph. In the second, those in which there is superadded the secretion of serum in abundance, causing distension of the pericardial sac. In the third class are to be placed those cases in which signs of muscular excitement; if not of myocarditis, are added to the preceding conditions. “As the disease advances from the first to the last of these forms, there is progressive increase in the violence of the in- flammation, denoted in the second form by the occurrence of excessive serous effusion, and in the last by the altered and impaired condition of the heart itself. Death tends to occur by syncope, induced by paralysis of the left ventricle. The muscular substance of the heart is paralyzed, being of a dirty brown or yellow colour, flabby, and easily torn—a condition which speedily leads to passive dilatation of the heart, aa cachexia, and dropsy.” Post mortem examinations,as conducted in the dissecting rooms, go to prove that pericarditis, as evidenced by alterations of structure, is not such a common form of disease as endocarditis. In the human being it is stated that about thirty-three per cent. of cases examined post mortem, varying from the ages of eighteen to thirty-nine, and about seventy-one per cent. from ages between forty-eight and eighty, show white spots in the heart. These white spots are supposed by some pathologists to be due to previous pericarditis, and by others to attrition from rubbing DISEASES OF THE HEART AND ITS MEMBRANES. 783 of the part against the pericardium applied to the sternum, induced by dilatation of the heart or impeded action of the lungs. These white spots are seldom met with in the peri- cardium of the horse, whilst they are not uncommon on the endocardial surface. Traumatic Pericarditis—In ruminants, particularly cattle, foreign bodies often find their way into the pericardium, wound- ing both it and the heart. Whilst the carditis so induced is circumscribed, and merely surrounds the point of puncture, the pericardial inflammation and exudation involve the whole surfaces of the membrane. Cattle are exceedingly fond of chewing and swallowing all sorts of substances ; for example, nothing seems to give greater pleasure to a cow than to have an old boot or other piece of leather in its mouth, and this it will chew at with evident gratification. An old brush is also a dainty morsel, and I have seen as a consequence of this that the pericardium has been pierced by the brush nail. Many kinds of sharp-pointed materials have been found in the pericardium of cows. I have seen hair-pins, horse-nails, needles, table-knife, iron wire, &c. &e.; and, as a matter of fact, the smarter the maids are in a dairy the greater the danger of this disease amongst the cattle, for smart dairymaids use numerous hair-pins, some of which become lost amongst the food and are swallowed by the cows. In some instances the foreign body is gradually forced from the chest into the thoracic walls, as proved by the following three cases related to me by Mr. Malcolm Walker, V.S., Alex- andria, Dumbartonshire, in a letter dated August 1888 :— “The first was an Ayrshire milch cow, said to be off her feed for a few days. On examining her, I found the pulse weak and irregular, the rumen impacted and flatulent. I ordered a tonic ball to be given three times a day, the ball containing ginger 3i., carb. ammonia 3ii., made up with treacle. In two days she seemed better ; she had been ruminating occasionally, the pulse still weak, irregular, and an anxious look about her. I saw her again in two days, when she appeared much worse; the nose poked out, small, weak, irregular pulse; laborious breathing, dropsical swelling below the sternum; the sounds of the 784 SPORADIC DISEASES. heart almost inaudible. I then diagnosed it traumatic disease of the heart, ordered tonics, stimulants, and good nourishment. The swelling on the chest increased to a considerable size. I punctured it in several places, and it gradually diminished ; the appetite slowly returned, and the cow seemed to improve every day and get all right again for a few weeks ; but she still had the anxious look, and a grunt when she moved about. I was called to see her again in about four weeks after the first attack ; the owner said she was very lame in the off fore leg, I had her taken out of the byre, which was dark, and found her lame, caused by a swelling on the off side of the chest, immediately above the sternum and close to the point of the elbow. This swelling being hard, and very painful to the touch, I suspected the presence of some foreign body. I made a free incision into it and introduced my finger, and felt the sharp point of a needle. I enlarged the wound so as to admit my finger and thumb, then I got hold of a very large darning- needle and took it out; it was the largest needle of the sort I ever saw,—it was 5 inches long. I treated the wound with fomentations and carbolic dressings for about two weeks, then I had it thoroughly washed and examined, and found a small dark-coloured cord, which came away with a gentle pull. As long as this cord remained in the wound there was a very offensive smell from it, but very soon after it was removed the wound healed up and the cow did well. “The second case was in a milch cow, that had been treated four weeks by another practitioner for indigestion. I at once suspected some chest disease, from the grunt she had, and her thin, emaciated appearance. I went to the left side of the chest to auscultate, when my cheek came in contact with a very painful nodule, about the size of an egg. I examined it carefully, and felt something hard in its centre. I cut down on this hard spot, and came on the point of a needle, which I removed with the forceps, it being over the average size of darning-needles too (4% inches). The grunt immediately left her, and the appetite improved every day. I dressed the wound the same as in the first case, and removed the cord in three weeks. The wound healed quickly, and the cow is now as well as ever she was. “The third case came under my notice on the Ist of this month (August). This cow had been treated by another. practitioner for some days (for what I don’t know). The owner told me she had been off her feeding and wasting away for some time. I observed a swelling on the left side of the chest, above the sternum, and close to the point of the elbow. This swelling was also very painful to the touch ; it was about the size of my two hands. After manipulating it carefully, I could feel the hard nucleus that I felt in the others. I cut down on it, and got hold of a darning-needle of a smaller size, and DISEASES OF THE HEART AND ITS MEMBRANES. 785 half of the eye broken off. I ordered the wound to be treated with fomentations and dressed with carbolic liniment. I have not seen the cow since, but the owner writes me stating that she appears all right, and feeding well. I expect to see her about the end of this week to remove the cord, as in the others. “T may mention that all these wounds, after the needles were removed up to the time the cord or slough was taken away, had a very offensive smell,” Traumatic pericarditis is generally manifested very insidi- ously, diagnostic symptoms being often absent for long periods after the foreign body has been swallowed, no symptoms being present, so long as it remains in the digestive cavity, nor during its course to the heart, until it materially interferes with the functions of that organ. I have repeatedly observed instances where cows have presented no other sign of disease than an occasional attack of flatulence or indigestion, and have been sleek and well-doing, until the act of parturition, when they have rapidly succumbed, and the post mortem has revealed the pericardium immensely thickened, adherent at its surfaces, and the exudate in a condition of organisation, sometimes of a con- sistence resembling cartilage; the adhesions between the reti- culum, diaphragm, and mediastinum and the walls of the canal being so organised as to leave no doubt of the lengthened. period since the injury had been inflicted; the act of parturition, more especially the contractions of the abdominal muscles, having evidently altered the position of the hitherto quiescent foreign body, and thus excited a fresh attack of inflammation. More commonly, however, the symptoms of the lesion have become gradually diagnostic; at first symptomatic of indigestion, with capriciousness of the appetite, flatulence, and eructation of gases, and gradual emaciation. After a while, the pulse becomes exceedingly small; the jugular veins are distended; there is also a well-marked jugular thrill or pulse, extending even as high as the bifurcation of those veins, associated sometimes with palpitation of the heart. To these succeed cedema of the inter- maxillary areolar tissue, gradually extending down the neck to the dew-lap ; in some instances clonic spasms of the superficial, particularly the cervical muscles. Continental writers state that the diagnostic symptoms ‘of traumatic from simple pericarditis 786 SPORADIC DISEASES. are a loud gurgling cardiac sound and eructation of gages, The gurgling sound is supposed to arise from the greater con- sistency of the pericardial effusion, and its admixture with various gases. The eructations are supposed to arise from the communication between the pericardium and stomach, allowing the gas formed in the former to pass into the latter, and thence into the mouth. If these latter symptoms were constant, their importance and value would be beyond doubt. I have, however, seen cases in which neither eructations, gurglings, nor splash- ing were detectable, and in 1857 I reported two cases in the Veterinarian, in which absence of all cardiac sounds was men- tioned, this absence of sound being ascribed by me at the time to the thickness and plasticity of the exudate rendering all sounds inaudible. In some instances there is a painful cough and disturbance of the respiratory movements ; in other cases cough is absent, and the respiratory movements unaffected, or even slower than natural. The post mortem examination tends to prove that the pericardial exudations are of varying ages, and that the animal has suffered from repeated attacks of pericarditis. This conclu- sion is arrived at by the fact that two or three, or even four layers of exudation, more or less separable one from the other, are found ; the older exudate presenting the appearance of a corneous change, being in consistence similar to cartilage, and not easily cut with a knife; then another layer of exudation of apparently more recent origin; then another layer or two of more recent origin still, all being more or less tinged with the chemically altered metal. In some instances the pericardial surfaces are intimately adherent one to another ; in others they are here and there connected loosely by bands of lymph, separated from each other by a turbid fluid, whilst in others the exudate is prevented from becoming adherent by the interposition of fluid. It is, however, more or less vascular, and gradually assumes the appearance of a villous membrane. Unless the foreign body can be removed as in Mr. Walker's cases, it is obvious ‘that no treatment can be suggested for this form of pericarditis, and it is advisable to make the best of the animal before emaciation renders it worthless. For the pre- vention of this, attendants on cattle should be enjoined to see that the food be free from any of the above-named foreign bodies. When cattle are attended by females the danger is greater from the pins, &c. worn in the dress becoming mixed with the food. DISEASES OF THE HEART AND ITS MEMBRANES. 787 The treatment of idiopathic pericarditis must be directed to allay pain and undue irritability. For this end aconite is re- commended ; if pain be great, repeated doses of opium are to be administered ; the bowels are to be kept regular by moderate doses of oil, and the absorption of the effusion promoted by diuretics. It was supposed at one time that calomel had the power of causing the removal of the exudate, and it was conse- quently largely employed; but its administration is now generally condemned, and Sir Thomas Watson confesses, in the following remarkable words, that the hope which he once cherished that the inflammation could be controlled by the constitutional influence of mercury has faded away. He says—“ Pericarditis has been known, not seldom, to spring up while the patient was already under mercurial salivation. I am obliged therefore to recant the advice which I was formerly in the habit of giving in respect of mercury as a remedy for acute pericardial inflam- mation.” If debility be present, the weakened heart must be supported and invigorated by moderate doses of stimulants in combination with opium. Bleeding, except to relieve urgent symptoms in the earlier stages of the disease, had better be withheld, as there is a strong tendency to an early diminution of the cardiac energy. Blisters are not called for in the earlier stages of the disease, but their application may, in some rare instances, be necessary to promote the absorption of the effusion. Tonics, more especially the salts of iron, prove useful in pro- moting the absorption of the effused fluids, and are to be given alternately or in combination with diuretics or the iodide of potassium. In the rheumatic form colchicum is indicated. Digitalis, so highly recommended by some authors, appears to me to act injuriously ; it destroys the appetite, is uncertain in its action on the heart, and, if persevered in, its toxic, cumulative effects are apt to cause serious derangement. To sum up, it may be stated that warm fomentations to the the side, warm clothing, bandages to the legs, with careful administration of remedies calculated to relieve such urgent symptoms as may arise during the progress of the disease, and allowing the animal a plentiful but not over-abundant supply of easily digestible nutritious food, are the general principles of safe treatment. If there be danger of death from hydrops pericardii manifested by orthopnea, obstruction 1p ar aaa 50— 788 SPORADIC DISEASES. circulation, and a serious interference with the heart’s action, paracentesis is to be performed; a small trocar being used, which is to be introduced carefully at the side of the sternum, between the cartilages of the fifth and sixth ribs. ENDOCARDITIS. As a sequel to articular rheumatism, endocarditis is a more frequent form of disease than the last described one. It is an inflammation of the membrane lining the cavities of the heart, and presents symptoms similar to those of pericarditis; the difference being that in its purity the blowing sound—the “bellows murmur” already referred to—takes the place of the to-and-fro friction sound. The marked venous pulse, and the want of correspondence between the pulse and the cardiac impulse, laid down as diagnostic of this disease by Leblanc and Gamgee, are seen in other cardiac affections, and are of no diagnostic value. I am, however, of opinion that the clonic spasms of the superficial muscles, already mentioned, along with hurried breathing and a tendency to syncope, if the head be suddenly elevated, or the animal in any way disturbed, are more marked in this than in any other cardiac affection. It is very true that in cardiac degeneration there is a tendency to syncope from debility of the circulation. This condition, how- ever, differs from acute endocarditis by the absence of febrile disturbance. Endocarditis is much more fatal than any other acute cardiac affection, for the reasons that it is often associated with a mal-condition of the blood; that it leads to valvular alterations, and to a deposition of fibrinous coagula on the valves, which destroy life by interfering with the circulation of the blood, or, carried away by the blood to other parts of the body, by obliterating the capillaries of other organs, leading to softening, abscesses, or sudden death, or undergoing degradation by poison- ing the circulatory fluid. Morbid Anatomy—the first effect of inflammation of endo- cardium is seen in the form of red spots, streaks, and patches. The redness is always most intense in the neighbourhood of the valves, which in some instances lose their integrity, ana become ruptured or detached from their tendinous cords. Supervening upon this, lymph is exuded both into the substance of the DISEASES OF THE HEART AND ITS MEMBRANES. 789 membrane and upon its free surface. That upon the free surface is often washed away by the current, but, generally speaking, it is found between the folds and upon the free surfaces, constituting warty excrescences upon the valves. In a specimen now before me, obtained from a cow which had three months prior to death suffered from rheumatic arthritis, there are no less than five-and-twenty of these excrescences, more or less organised, attached to the surfaces of the tricuspid valve. They vary in size from a pin head up to a large nut; some of them being in the auricle and some in the ventricle, attached not only to the valves but to the chorde tendinex, carne columne, and musculi pectinati, whilst the spaces be- tween the tendinous cords are filled with coagulated blood. In the left side of the heart there are also traces of deposition within the mitral valve, having the shape of irregular white spots. It will be thus seen that there is not only a deposition upon the free surfaces, but also an exudation in the membrane itself. In some instances the valves become ulcerated, and even the cardiac walls perforated, establishing a communication between the two cavities. The growths of endocarditis differ from those clots or coagula which form during or after the agony of death, and they must not be confounded with the corpora aurantii, which are generally more or less enlarged in aged subjects. The coagula, which form during or after death, are not adherent to the parietes, are soft and easily removed. In the treatment of endocarditis particular care must be taken to pursue no treatment calculated to lower the heart’s action, as debility of the circulation greatly favours the tendency to coagu- lation of the blood in the heart, and the consequent formation of these coagula. For the same reason, remedies which have the power of modifying the coagulation of the blood, such as the nitrate of potash, or, when debility is present, the bicarbonate of ammonia, are to be prescribed; and for the reason that inflam- mations, artificial and natural, increase the fibrinous condition of the blood and its tendency to coagulation, blisters, setons, and all other remedies which constitute the so-called counter-irritant treatment, are to be avoided. The treatment recommended for pericarditis is applicable for endocarditis, with this exception, that those sedatives which diminish the cardiac energy are to be 790 SPORADIC DISEASES. carefully and cautiously administered. They are certainly use- ful, more particularly aconite, in relieving disquietude and irritability ; but they should be given in small doses only, and for the reason above stated, that all remedies calculated to lower the action of the heart promote the tendency to fibrinous coagulation. The results of endocarditis are various diseases or alterations in the form and structure of the valves, leading to ulceration, perforation, pulmonary apoplexy, and ultimately to the death of the animal. DISEASES OF THE VALVES. For various reasons, such as the distance of the heart from the thick and muscular thoracic walls, valvular diseases are exceed- ingly difficult of diagnosis. They are generally due to a change of structure, caused by endocarditis, mechanical rupture, or morbid growths. The result is imperfect valvular action, indi- cated by difficulty of breathing when the animal is subjected to exercise, the venous or jugular pulse, the so-called vertigo or megrims, sometimes a tendency to cedema of the limbs, and modifications of the cardiac sounds. These modifications are as follows:—A bellows murmur with the first sound indicates mitral disease or insufficiency; a bellows murmur with the second sound indicates aortic insufficiency. Beyond this my experience does not enable me to describe more definitely any train of symptoms which are of diagnostic value. Indeed, I have repeatedly found the cardiac sounds modified, a distinct venous pulse, and irregularity of the heart’s action in various conditions unassociated with valvular diseases. For example, the jugular pulse, which would lead one to conclude that the regurgitations were due to tricuspid incompetency, is generally present in various alterations of the cardiac walls, and in peri- carditis, whether it results idiopathically or traumatically. Practically it may be stated that an animal suffering chronically from the above symptoms is only fit for the slowest kind of work. Ulcerative and warty endocarditis are said by Ziegler to differ only in the degree of their intensity. In the one there is a growth of white fibrous and elastic tissue in the valvular reduplications, which is sometimes absorbed; at other times the valves become thickened, form abnormal adhesions, and DISEASES OF THE HEART AND ITS MEMBRANES. 791 contract the orifices. Fibrinous exudates form on the surfaces of the valves, and these, when carricd away, are conveyed to the lungs, if on the right side, or to the brain, kidneys, &c. when on the left side, inducing embolism. Warty excrescences on the valves, observed in cases of swine fever, have been supposed to be the result of or associated with that disease ; but according to Mr. Cope (Report of Board of Agriculture, 1894), out of 3065 hearts taken from suspected cases ui swine fever, 1039 were found to have that disease, and out of this number 270 showed disease of the valves, but of these only 107 were asso- ciated with swine fever. This shows that disease of the valves in the pig is induced by other causes than as well as swine fever. It appears that the slightest wound on the surface of the valves is followed by a fatal endocarditis, said to be induced by micro-organisms, which are harmless in the normal circula- tory apparatus. The Staphylococcus aureus, Streptococcus pyogenes, and the cocci of septicemia have induced similar conditions. ANGINA PECTORIS. The condition termed angina pectoris, or breast-pang, a dis- ease characterised by agonizing pain and distress in the human being, undescribed, so far as I am aware, in the lower animals, is a form of disease which I believe sometimes affects the horse. This disease, in man, is defined as a pain or spasm referable to the lower part of the sternum, extending to the left scapula and root of the neck, and manifesting itself in paroxysms of great severity. I feel confident that in one horse I have seen this condition in a well-defined form. The subject in question was an aged eart-horse brought for my examination in the year 1873. For twelve months previous the horse had done but little work, owing to the fact that when he was excited by work or exercise he manifested the most exquisite agony in the near (left) fore limb, the muscles of which, more particularly the pectorals and those of the neck, became violently convulsed, the limb itself being alternately rigidly fixed by muscular contraction and powerlessly paralyzed, so that the animal was quite unable to use it, and if forced to move he painfully dragged the limb, or sometimes fell to the ground. Whilst at rest the paroxysms seldom occurred, 792 SPORADIC DISEASES. but I noticed that there was a continual spasmodic twitching of the above-mentioned muscles, as well as a dread on the part of the animal when suddenly approached. On examining the heart and circulation there was a distinct jugular pulse, great irregularity of the heart’s action, a loud cooing or blowing sound and strong impulse, indicative of hypertrophy, and such a want of correspondence between the cardiac energy and feeble pulse as to lead me to the conclusion that the horse was suffering from valvular incompetency or impediment, to overcomewhich, hypertrophy of the cardiac walls had become established. Angina pectoris is supposed by physicians to be due to dilatation of the cardiac cavities, degeneration of the walls, some condition of the aortic valves which permits the regurgitation of blood into the heart, or some sudden impediment to the coronary circulation. The condition of the horse in question pointed to the conclusion that the cause was due to aortic impediment. Unfortunately I lost sight of the animal, and I am unable to confirm this view by any post mortem examination. The latest theories upon the cause of this painful malady are as follows :— (1.) Neuralgic affection, commencing for the most part in pneumogastric nerve, and spreading in different directions. (2.) That it is due to such an acceleration of the movements of the blood, by exercise or otherwise, that it arrives at the heart faster than it can be transmitted onwards, and accumulates in its cavities so as painfully to distend them. (3.) Ossification of the coronary arteries, which, by failing to supply sufficient blood to the cardiac walls, so impairs their strength that the heart is incapable of contracting upon the increased quantity of blood within its cavities, brought about by exertion or excitement. CYANOSIS. The blue disease described by some veterinary authors, and depending upon non-closure of the foramen ovale, is a condition which is only met with, and that very rarely, in very young animals. It is due to admixture of the venous with the arterial blood in the left cavities of the heart, owing to the foramen of communication existing in foetal life remaining pervious after birth. It is manifested by blueness of the visible mucous DISEASES OF THE HEART AND ITS MEMBRANES. 7938 membranes, difficulty in breathing, and coldness of the surface. Animals so affected live but a short time. ECTOPIA CORDIS. Misplacement of the Heart—The most common form of cardiac misplacement is that in which the heart is situated outside the chest. I have specimens in my possession in which both ventricles and auricles are outside the chest, and in which the heart communicates with the interior of the body through large foramina in the sternum. CHAPTER LXV. SPORADIC DISEASES—continued. LOCAL DISEASES—continued, (L.) AFFECTIONS OF THE DIAPHRAGM. SPASM OF THE DIAPHRAGM, OFTEN confounded with palpitation of the heart, is generally caused by over-exertion, such as a fast run in the hunting-field ; it is also sometimes seen in tetanus. Its most prominent symptom is a convulsive motion or jerking of the whole body, accompanied by a dull, thumping noise, unconnected with the pulsation of the heart, emanating posterior to that organ in the region of the diaphragm. In some instances the impulse of the heart is barely perceptible ; the pulse is small and weak, and there is great difficulty in breathing. The spasmodic movements of the diaphragm are not synchronous with the pulse: this, along with the fact that the sound proceeds from parts posterior to the heart, at once points out the difference between this affection and cardiac palpitation. Treatment.—Generally speaking, a good diffusible stimulant, with warm clothing and quietude, is all that is necessary. Should the symptoms continue, opium is to be administered, and if at any time the dyspncea be great, and the animal in danger of dying from apncea, it may be necessary to abstract a moderate quantity of blood in order to relieve undue pul- monary congestion. RUPTURE OF THE DIAPHRAGM. Many cases of this lesion are reported by veterinarians. I am afraid, however, that in most of them the rupture has been post qo4 AFFECTIONS OF THE DIAPHRAGM. 795 mortem, arising from the pressure of the intestines, distended with gases evolved after death. It is stated that the rupture, when occurring during life, is always found in the tendinous portion of the muscle, and that that occurring post mortem is in the fleshy part of it. In nearly every subject brought for dissection, if kept unopened until the abdomen has become much distended, the diaphragm is found ruptured. I am not acquainted with any symptoms diagnostic of this lesion, except those of abdominal pain, distressed breathing, and general disturbance. Mr. Robin- son of Greenock tells me, however, of a case in which for two days prior to death there was general uneasiness, pawing with the fore feet, and, what might be looked upon as diagnostic, a dark patch of perspiration was seen to be constantly present on the skin opposite the diaphragm on one side. On making a post mortem a knuckle of intestine was found in the cavity of the thorax, forced through a round aperture in the diaphragm, opposite the patch of perspiration. Beyond this, I can gather no reliable information from the writings of veterinary authors which would justify me in laying down any rules for its re- cognition. If I were to do so, what I might state would he calculated more to mislead than to enlighten. Should the lesion be found post mortem in the tendinous portion, or if at any time the gap be stained with extravasated blood, the probabilities are that it occurred during life. CHAPTER LXVL SPORADIC DISEASES—continued. LOCAL DISEASES—continued, (M.) DISEASES OF THE DIGESTIVE ORGANS. WITH very rare exceptions, diseases of the digestive apparatus are results of errors in feeding. Some of them have been already discussed under the head of Dietetic Diseases, and need not again be referred to. I may here, however, briefly observe that horses are best kept in health and working condition when fed upon an admixture of food requiring thorough mastication, and that horned cattle are best kept in health when, in addition to the more nutritious aliments, they are freely supplied with food requiring remastication, such as hay, grass, or straw. Observations on the diseases of digestive organs point to the conclusion that in the horse the intestines are more liable to suffer from disease than the stomach; whilst in the ox and sheep the reverse is the case; and in the dog, consequent upon its power of vomition, the stomach is more rarely disordered than one would be led to expect from the nature of its food, &c. In the horse the stomach is a simple organ, small in comparison to the size of the animal, and in contrast with the volume of the intestines. It is but slightly called into action during the diges- tive process, and provided the food be properly masticated and incorporated with the salivary secretions, it is arrested for a short time only in the stomach, but is passed onward into the intestinal canal, where the process of digestion is completed. On this ac- count the intestines are more liable to disease. It is also a remark- able fact that easily digested food, if given over-abundantly, is apt to derange the small intestines, whereas food containing much woody fibre, such as over-ripe hay, more particularly rye-grass, coarse straw, &c., accumulates in the large intestines, and there causes derangement, inflammation, and even paralysis of the intestinal muscular tissue. It is also a fact worthy of notice, that if food be given artificially prepared by boiling or steam- ing, it is retained in the stomach itself, and if given over- 796 DISEASES OF THE DIGESTIVE ORGANS. 797 abundantly, causes distension, inflammation, paralysis, and even rupture. This is accounted for by the circumstance that food thus imperfectly prepared for digestion is retained or imprisoned by the action of the pyloric structures, and thus distends the stomach by its bulk, or by gases evolved by the process of fermentation, which is apt to ensue. By bearing these facts in remembrance, the practitioner will to some extent be able to arrive at a correct idea of the seat of gastric or intestinal disease. The food of the horse contains an abundant quantity of starchy materials, and the process by which these are rendered soluble commences in the mouth, not only by their admixture with the salivary secretions, but by a chemical change, through which the non-soluble starch is converted into dextrine and grape sugar, and made fit for the action of the intestinal, biliary, and gastric secretions, and for absorption by the vessels of the gastric and intestinal walls. For the purpose of performing this process the horse is provided with twenty-four mill-stones, in the form of molar teeth, which have the power of crushing and triturating the hardest food, and of an extensive system of salivary organs, which secrete—most actively during the process of mastication —a fluid which most effectively blends with, and chemically changes, the food thus triturated. On this account we find that, when horses are sufficiently but not over-abundantly fed with dry food of a proper quality, the stomach rarely suffers from disease. An error in the diet, however, or a sudden change from one kind of food to another, not only deranges the stomach, but the intestinal canal as well. Tn the ox and sheep, the large and complicated stomach not only digests, but also prepares the food for digestion. For example, ruminating animals eat and swallow the coarsest food very rapidly, and they are provided with a large receptacle for its retention, in which it undergoes maceration and reduction to smaller particles by a slow churning movement in the rumen and reticulum, which facilitates its trituration during the process of rumination and after-solution by the digestive fluids. Without entering further into a physiological consideration of the process of digestion, it will be seen that the stomach of the ox much more actively participates in the process of digestion than that of the horse, and that it is thus rendered more liable to. disorder in its first and second, as well as its third and fourth compartments, than the simple, single stomach of the horse. CHAPTER LXVIL SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (V.) DISEASES OF THE STOMACH. INDIGESTION WITHOUT ENGORGEMENT. From various causes, such as improper food, the process of dentition, diseases of the teeth causing imperfect mastication, ravenous feeding, the presence of other diseases, debility of the stomach itself resulting from some constitutional predisposition, or from food given at uncertain and rare intervals, a condition of indigestion is induced in the horse. In young animals the same is induced by draughts of cold milk; removal from the dam at too early an age, or, what is commonly the case in some districts, compelling the dam to work shortly after the birth of the offspring, and allowing it to suckle at rare intervals and when the dam is heated. Symptoms.—In the horse the symptoms are, loss of appetite, or depravity and capriciousness of it, manifested by the animal eating at irregular intervals, or having a desire to eat filth— bulimia—with sourness of the mouth, and usually increased thirst; the animal soon becomes hide-bound, has a dry, scurfy skin, there is irregularity of the bowels, and frequent escape of flatus by the anus. If caused by imperfectly masticated food, such as whole oats or coarse hay, these may be found in the feces. In addition to the above diagnostic symptoms, there may be a dry cough, or irregularity of the pulse, which may be slower or faster than natural; colicky pains may also be present in some cases, occurring more particularly in an hour or two after the animal has partaken of food; whilst in others, fits of giddiness—megrims—and even paralysis occur, the latter con- dition being not seldom seen in cattle, and very often in dogs. -In the young the above symptoms are more commonly associated with diarrhcea than in the older animal, in which constipation is generally present. The feces often resemble the colour of the food: for example, if the horse be fed on 798 DISEASES OF THE STOMACH. 799 dark-coloured hay or clover, the feces will be dark-coloured also; if, on the contrary, it be fed on oats, the feces will be light in colour; and in the young animal, when fed on milk, it will often resemble it both in colour and. consistence, mixed, however, with large masses of curdled milk, and often very fetid. i have often noticed that when indigestion is induced by clover, the urine is very dark in colour, and deposits a thick, almost brick-coloured sediment. This condition of urine, how- ever, need not cause any apprehension, as it is often seen in the clover-fed animal without any disease being present. The urinary deposit mostly consists of carbonate of lime, the tinge being due to the colouring matter of the food. Indigestion, however, is a fertile source of deposits in the urine, which result from imperfect nutrition of the tissues, or a chemical change in the constituents of the blood-plasma, due to the products being imperfectly prepared, or containing some material unfit for healthy nutrition, as already referred to in the former parts of this work. Treatment.—Carefully inquire into the cause, and remove it. If due to the process of dentition, the presence of unshed crowns of the temporary teeth irritating and wounding the mouth, or to any irregularity of the dental apparatus, these must be attended to according to the directions laid down under their several heads. In all instances where such causes are not in operation, even when the cause cannot be traced to the food, it will be necessary to make some alteration in the diet, and to examine the various alimentary matters in order to detect the offending one if possible. If diarrhoea be not excessive, and the animal thereby much debilitated, it will be advisable to give a mild aperient or a moderate cathartic. To the young animal a dose cf castor or linseed oil; to the older, a moderate dose of aloes, combined with a vegetable bitter, ginger, or gentian. After the laxative has operated, I have found that the bicarbonate of soda, with gentian, or, where the stomach seems much debilitated, nux vomica, to have a most beneficial effect, not only improving the appetite, and removing the acidity—pyrosis or “ heartburn ”— which is usually present—manifested by a tendency to lick the walls or other cold or alkaline materiai—but strengthening and improving the gastric apparatus. 800 SPORADIC DISEASES. It may be here stated that the mineral tonics, particularly the salts of iron, are inadmissible, and generally do harm in the earlier stages of gastric debility, or indigestion, often destroying what little appetite remains, and becoming combined with sulphuretted hydrogen in the intestines, tinging the feces a black colour—a certain sign in all instances that the iron is not digested or absorbed into the circulation, where alone it can be beneficial, and that it is doing harm. It is very true that even in health large doses of iron salts tinge the feces, but moderate doses have not this effect to any great extent. In some cases the alkaline-bitter treatment fails in having the desired effect. When this occurs the mineral acids, particularly the nitro-muriatic, may prove beneficial. In foals and calves pepsine can be administered, as in all probability the indigestion is due to imperfect secretion of the gastric glands; even in the older animal this is often presumably the case, and more especially when the disorder occurs without apparent cause, the same remedy will prove beneficial. It is almost needless to observe that the dieting of the animal is to be carefully conducted, and that pure air, moderate exercise, and good grooming are essen- tials to good digestion. Occurring in the winter, if the animal be thickly clothed with hair, clipping will act almost magically, restoring the digestion and appetite, which may have been long impaired, notwithstanding remedies, in the course of a few hours. In the cow, chronic indigestion, as exemplified by recurring tympanites and other symptoms similar to those observed in the horse, and when not occurring from recognisable external causes or other diseases, is often due to the presence of some foreign body in the rumen or reticulum, removeable in some instances by the operation of rumenotomy, hereafter to be described. In all chronic indigestions of the cow this operation is recommend- able. I have repeatedly performed it successfully, even where no foreign body has been found, the mere removal of the long- retained food having been sufficient to restore the organ to its healthy condition. In young calves, indigestion, associated with convuisive fits, is sometimes due to hair-balls; these after a time become gradually disintegrated by the movements of the stomach, and the symptoms may slowly disappear. In rare instances hair-balls are found in fully grown cattle, and, as in calves, result from the animals licking each other. In calves DISEASES OF THE STOMACH. 801 the symptoms of urgency are often relieved by stimulants, such as the carbonate of ammonia or turpentine; should the indi- gestion, however, remain for a considerable period, recourse must be had to the operation already referred to. It may be here mentioned that common salt given in the food promotes digestion in all animals. In the dog indigestion is mani- fested by frequent retchings or vomitings and fcetor of the breath, and is best treated by a brisk purgative, antacids, and a restricted diet. INDIGESTION WITH ENGORGEMENT—IMPACTION OF THE STOMACH— PLENALVIA—-GASTRIC TYMPANITES—HOVEN. Distension of the stomach may arise from repletion with solid food, or from the evolution of gases arising from solids or liquids contained within it undergoing the process of fermenta- tion, or disengaged from the gastric walls when the stomach is empty, as occurring in conditions of great prostration. The causes in the Horse—Impaction of the stomach results from the ingestion of food too abundant in quantity, or greedily swallowed and imperfectly masticated. In those parts of the country where the cooking of food for horses is a common custom, it is found that deaths from diseases and lesions of the digestive apparatus are very common. From the reasons already hinted at, namely, that it is necessary for the food to undergo not only the process of trituration by the teeth, but that it requires to be chemically altered by combination with the saliva, it will be understood that food prepared in any other way, as cooking by boiling and steaming, is unfitted to be acted upon by the stomach, and is consequently retained within it—the animal meanwhile continuing to eat—until its walls become distended, paralyzed, or even ruptured. Some kinds of food, nutritious in themselves, and theoretically calculated to be proper for the horse, are found practically to be highly dangerous. Wheat, for example. which is highly nutritious, containing, according to Sir H. Davy, 955 parts of nutritious matter in 1000, is found to be improper, deranging the stomach, causing purgation, laminitis, and death. Barley again has a similar effect, and for these reasons is found to be an improper article of diet in Britain. Barley is, however, used with great success in India and the East generally. The 51 802 SPORADIC DISEASES. consequences of its feeding are not noticeably bad, and where fed naturally, cases of colic are no more frequent than at home. It is used either crushed or parched, the former &iving the best results. In fact, the Arabs train their horses for racing on it. It must not be given in such large quantities as oats, and animals should be fed oftener. This latter fact is necessary with all foods. The horse’s stomach is arranged to take small quantities at a time, and therefore feeding should be frequent—at least four times, but preferably five times, a day. When, however, from various circumstances, such as damaged crops, it becomes compulsory to cook the food, it is necessary that it be given with the greatest caution, in small quantities, and at intervals. Bran again, so useful an article when com- bined with other foods, or as an occasional mash, if given in large quantities, is retained undigested, and induces a condition of repletion which often proves fatal. Some kinds of hay, musty or otherwise damaged, or too ripe previous to being cut, barley and foreign straw, are also common causes of impaction ; whilst green foods, particularly when animals are first put upon them, or if given too abundantly, not only induce engorgement, but also undergo fermentation in the stomach, and thus induce tympanitis. In horned cattle and sheep the same conditions are produced, most commonly by damp grasses, turnip-tops, maltcums, clovers, &c.; indeed it may be stated that various foods, if given over- abundantly, will cause tympanites,but none so speedily as green clover. In horned cattle, tympanites—hoven or blown—arising from retention of food in the rumen, frequently accompanies other diseases. It is wonderful how great a quantity of food is found in the rumen of an animal which has died from a disease which has existed for several days or even weeks. In many instances, where an animal suffering from pleuro-pneumonia has not partaken of any solid food for a period extending perhaps over a fortnight, it has been found that the rumen contains several bucketfuls of alimentary matters. The rumination having been suspended, there has been no true digestion, and the food partaken of prior to the occurrence of the illness has lain, as it were, in a mass in the inert and paralyzed rumen, having a tendency to undergo fermentation, and thus induce tympanites. DISEASES OF THE STOMACH. 803 An additional cause of retention in the rumen is found in disease of the salivary glands. Fluorens asserted that from the period of feeding to that of rumination there is a constant abundant secretion of saliva, which is constantly swallowed; if this be stopped, the contents of the rumen become hard and unfit for regurgitation. In this way rumination is suspended, and tympanites induced. These observations have been con- firmed by Colin, who also found that if the parotid ducts were opened, and the secretion thus prevented from flowing into the mouth, rumination became suspended. The act of vomition, rarely performed by the horse, occurring only as a symptom of a grave lesion or disease, might be easily performed by ruminants; in fact the regurgitation of the food during the act of rumination indicates this facility, but vomition itself seldom occurs. It is not my purpose to enter into a physiological discussion upon this matter, but merely to state that I am of opinion that vomition is rendered difficult in the horse by folds of mucous membrane at the cardiac orifice, and that, if from any cause, such as inordinate distension or rupture of the stomach itself, flaccidity, dilatation, or paralysis of the lower end of the ceso- phagus—the ruge become unfolded, and the cardiac orifice opened—that vomition can and does occur. The valve of Gurlt, which is described by some authors as a spiral valve at the cardiac opening of the stomach, has no existence. The true source of the rarity of the act in ruminants is, I think, satisfactorily pointed out by Mr. J. S. Gamgee, and is due to the fact that these animals are nauseated with great difficulty. I have, however, witnessed very forcible vomition in cattle suffering from indigestion, as well as the passive return of food into the mouth, which occurs during the profound coma of parturient apoplexy. Indeed, upon more than one occasion such ingesta have found their way into the trachea and bronchial tubes, and have caused a fatal pneumonia in two or three days after recovery from the parturient disease. The dog, pig, and cat are easily nauseated by various remedies, and vomit with great facility. Symptoms in the Ox and Sheep—Tympanites is diagnosed by a swelling on the left side, which may appear during the time the animal is feeding, or shortly after; the breathing is difficult and 51—2 804 SPORADIC DISEASES. laborious, becoming more so as the gas is generated and as the swelling increases. The oppression of the breathing is mani- fested by the general appearance of the animal ; there is expan- sion of the nostrils, moaning during the expiratory movement, eructations, dribbling of saliva from the mouth, and some degree of uneasiness ; rumination is suspended ; the bowels soon become constipated, and if the tympanites is extreme, there will be a prominence and wildness of the eye which is characteristic of obstruction to the entrance of air into the lungs. The moan or grunt, which is heard not only in tympanites, but in various forms of indigestion, even when unaccompanied by distension, is.similar to that of pleuro-pneumonia; and on this account indigestion has been mistaken for pleuro-pneumonia, and credit claimed for curing the latter disease when it had no existence. The moan of indigestion is rather more prolonged, and resembles a groan more than the grunt of pleuro-pneumonia, The gases evolved have been found to be composed of carburetted hydrogen, sulphuretted hydrogen, carbonic acid, and in some cases carbonic oxide. Unless relieved, the animal will die, either from pressure of the distended stomach upon the diaphragm, causing suffocation, or from the absorption of noxious gases into the circulation. In some instances, tympanites is chronic, and, as already stated, may depend upon the presence of foreign bodies in the rumen. Treatment.—In very urgent casees, the most effectual treat- ment is that of puncturing the rumen with a trocar, and allowing the gases to escape through the cannula. The operation is to be performed on the most prominent part of the swelling, and at equal distances from the spine of the ilium, last rib, and trans- verse processes of the lumbar vertebre. When the symptoms are not very urgent, tympanites can be relieved by stimulants and stomachics, such as carbonate of ammonia, turpentine, alcoholic preparations, or the vegetable spices, particularly if given in warm ale. After the symptoms of urgency have been removed, cathartics are to be prescribed, such as salts, with croton and aromatics, care being taken that the animal be kept upon a restricted diet for some days after recovery. When the tym- panites becomes chronic, stomachic stimulants, particularly nux vomica, are to be prescribed; but if, along with the attention to dieting, they fail to give relief, it may be necessary to open the rumen, when the cause may be detected and removed. . DISEASES OF THE STOMACH. 805 IMPACTION OF THE RUMEN WITH SOLID MATTERS. The symptoms are similar to the above, with the exception that the swelling, resonant when tapped with the fingers in tympanites, is dough-like and pits on pressure. In some instances I have noticed that the pitting remains for a consi- derable period after the pressure is removed, indicating that the coats of the rumen have lost their muscular tonicity, and that its movement is in abeyance, or entirely lost. I have also noticed that in such cases medicinal remedies do harm until the viscus has been to some extent emptied, and that the best method of doing this is to perform rumenotony before the powers of life become exhausted. The best method of performing this operation is as follows :— After securing the animal by the nose, with its right side to the wall, plunge a sharp bistoury into the rumen, commencing the puncture midway between the last rib and the spine of the ilium, and from four to five inches from the points of the trans- verse processes of the lumbar vertebra, cut downwards until the wound is large enough to admit the hand. Some practitioners recommend that a towel or handkerchief be introduced into the wound, in order to prevent the food fall- ing into the peritoneal cavity. I find it much better to place a suture at the lower part of the incision through the lips of the double wound. When this is done, the contents are to be removed by the hand; the parts are then to be thoroughly cleaned ; the incision in the stomach to be first stitched up, its edges being turned inwards, so as to get the peritoneal coat into apposition. The best material for the sutures is small catgut or fiddle-string. The external wound may then be closed with a stronger suture of strong waxed twine, over which a stiff pitch plaster it to be applied. Cathartics are to be administered, succeeded by vegetable bitters, more especially nux vomica, and the animal is to be carefully fed. In less urgent cases, where the rumen still retains some tone and power of movement, removal of the impaction is to be effected by cathartics and stimulants, the best cathartic for this purpose being an admix- ture of croton, aloes, and sulphate of magnesia, succeeded by a plentiful supply of fluids, treacle, and an occasional dose of ginger or ammonia. To restore tone to the rumen when debili- tated, common salt dissolved in cold water has been recommended. 806 SPORADIC DISEASES. This can do no harm, and failing other remedies, may be given in tympanites and impaction. IMPACTION OF THE THIRD STOMACIIL. Variously termed fardel-bound, vertigo, maw-bound. This is a very popular disease, some writers ascribing every case of constipation to impaction of the omasum, basing their con- clusions upon the fact that the contents of this viscus are in a dry and hard condition when examined after death. But seeing that this is its natural state, and that, when animals have died from what appeared to be obstinate constipation, its contents have been found moister than natural, I have arrived at the conclusion that what is supposed to be impaction of the third stomach is in reality an inflammation of the mucous membrane of the true stomach—abomasitis—or true gastric inflammation. Ido not mean, however, to state that the third compartment does not participate in the disorders of the others; but, on the contrary, that disease commencing in the rumen, reticulum, or abomasum, soon involves the third compartment. I shall not, therefore, separate the description of this disease from abomasitis. In the gastritis of ruminants a highly disturbed condition of the nervous system is a distinguishing symptom, evidenced either by a high state of delirium, coma, or convulsive fits, indicative of disturbance of the brain proper, or by paralysis of the posterior extremities, when the area of the disturbance is limited to the posterior parts of the spinal cord. Paralysis, convulsions, and coma are also frequently seen in dogs when suffering from gastric affections, and the same may be said, but in a less degree, of the horse. In addition to the above symptoms, the gastritis of ruminants is characterised by more or less diarrhcea, soon succeeded by an apparent obstinate constipation, which, however, is not due to an obstruction by impacted food, but to cessation of the peristaltic action of the intestines, the contents of the stomachs being found generally more or less fluid after death. In many instances the animal strains violently, and passes both blood and mucus, showing that the inflammation has extended into the intestinal canal, and it is said that a hard swelling may be detected on the right side, arising from distension of the third DISEASES OF THE STOMACH. $07 stomach. In many cases, however, general swelling of the abdomen, tympanites, supervenes early in the disease, and greatly adds to the animal’s suffering. Outbreaks of gastritis prevail in some parts of Scotland during the spring and early summer, and is known by the term “grass staggers ;” and Mr. Clark of Coupar-Angus, in a paper read before the Scottish Metropolitan Veterinary Association, July 4th, 1894, has given an able description of this disease after an experience of twenty years in a district where the disease prevails to a remarkable extent. He states that animals of all ages and breeds become attacked when placed in fields favour- able to the development of the disease, such fields being generally poor land or good land poorly treated, and which have been sown with too large a portion of rye-grass and too small a quantity of permanent grasses. When the quantity of rye-grass has been diminished, and that of the permanent ones increased, the disease has disappeared from land known to be favourable to its development. The disease appears in about a month after the cattle have been turned out, and to disappear upon the advent of the white clover, which occurs from the 10th to 15th of June in Mr. Clark’s district. The disease is dangerous on first year’s grass, less so on the second, and rarely, if ever, on a third year’s crop; but it has been known not to attack on the first, but during the second year’s crop. Artificial feeding seems to diminish and modify attacks, but prevention can only be effectual by the diminution of the quantity of rye-grass sown, increase of the natural ones, and better treatment of the land. The premonitory symptoms are obscure: the animal loiters about, feeding occasionally, and when lying down there is a flapping or restless movement of the ears and intermittent tremors at the elbow and flank, and any excitement, even at this stage, such as driving from the field, is apt to induce loss of vision. The next symptom is purging, the faces being black and watery, with entire loss of appetite, failure of milk, grinding of the teeth, aecelerated pulse, cold extremities, blindness, but the sense of hearing seems to be very acute. There is no elevation of temperature. 808 SPORADIC DISEASES. In three days the crisis is reachcd, when the animal may become intensely excited, bellows fiercely, presses the head against the walls, and has violent tremors; and, if unfastened, scrambles up against the walls, and gives every evidence that it is suffering pain of the most formidable character. The post mortem reveals acute gastro-enteritis, involving the abomasum and small intestines, and in the rapidly fatal cases the contents of the omasum are in a soft and normal condition, —thus doing away with the idea that the disease is due to impaction of the maniplies (omasum); but if the disease has been more prolonged before death or slaughter, it will then be found that the food is hardened and the walls of the viscus covered with small red or congested spots, “ which,” Mr. Clark states, and I agree with him, “has given rise to the erroneous opinion that the animal has suffered from obstinate constipation. Such, I feel certain, is not the case, the hardened or dry con- dition being the result and not the cause of the disease.” Mr. Clark thinks that the disease is induced by an irritant, being also more or less narcotic in character, causing malassimilation of food, and as a result non-nutrition of blood, accompanied by inflammation of the true stomach and intestines, this being the only constant morbid condition found on post mortem inspection. The treatment recommended as the most successful is linseed oil as a purgative, Epsom salts being highly objectionable, and calculated to reduce the chances of recovery. A large per- centage of cases are fatal, and bleeding has proved injurious. When brain symptoms set in, benefit can be obtained by the application of cold water to the head. When the animal is in good condition Mr. Clark advises slaughter, and mentions that some farmers are under the necessity of renting grass parks—permanent pasture—to tide over the dangerous period of May and June. Professor Dick said he was successful in treating this disease by repeated bleeding, even to faintness, large doses of purgative medicines given in large quantities of gruel, cold water to the head, &c. He, however, considered the disease to be mere im- paction. At the present time no one would think of pursuing such an irrational course in cases of acute gastritis ; and having the knowledge that the constipation results from loss of function rather than impaction, we will do well to recommend a DISEASES OF THE STOMACH. 809 course of treatment calculated more to modify that inflam- mation than to overcome the seeming constipation. For this purpose sedatives, such as aconite or belladonna, with antacids—bicarbonate soda or potash—and one or at most two moderate doses of an oleaginous aperient, with an abundant supply of fluids for the animal to drink, fomentations to the abdomen, and enemas, are to be prescribed. This treatment is much more calculated to save life than the indiscriminate use of powerful cathartics and stimulants. I speak advisedly, having witnessed many animals destroyed by the administration of repeated doses of cathartics in order to overcome constipation in this affection, the parties prescribing not being perhaps aware that an inflamed part loses its function, and that before the function and the peristaltic movement of the bowels can be restored the subsidence of the inflammation is essential, and that such inflammation is much more likely to be increased than diminished when the inflamed tissue is irritated by drastic cathartics or other remedies, which are supposed to rouse up the action of the bowels. If passage of the feeces is not restored in the course of twenty-four hours after the administration of the aperient, it does not follow that it is necessary to repeat it; time must always be allowed in all inflammatory diseases for the inflammation to subside, and for the weakened or debilitated parts gradually to resume their normal functions. The late Professor Strangeways was very successful in the treatment of this affection. At the commence- ment he gave a dose of oil, with sedatives, and after the febrile symptoms had to some degree subsided, from eight to twelve ounces of sulphate of magnesia, fifteen grains of quinine, and a few drops of sulphuric acid, ample time being allowed before any additional cathartic was given. It was very seldom necessary to repeat the medicine, as the bowels became gradually restored to their natural healthy condition. Impaction of the stomach in the dog and cat are naturally overcome by vomition, which also occurs sometimes in the pig, but should this not occur, an emetic is to be administered. The dog suffers from catarrhal inflammation of the stomach— gastrorrhea—induced by improper food, or occasionally by enzo- otic influences, in which there is a high degree of fever, hot nose, blood-shot eyes, and quick pulse, abdominal pain, constipation, and frequent or almost constant attempts to vomit; a dense 810 . SPORADIC DISEASES, mucus tinged with bile being sometimes thrown up. The most successful treatment consists in allaying the gastric irritation by small doses of hydrocyanic acid and antacids, and when this is effected, gently moving the bowels by a small dose of castor oil. Enemas my, however, be beneficially employed in the earlier stages, and if the abdomen be tender or swollen, fomentations or a warm bath. If the strength seem to fail, the pulse small, &c., stimulants are to be cautiously given. As a rule, however, they do more harm than good, and if the first dose is not succeeded by visible improvement they are to be discontinued. SYMPTOMS OF GASTRIC IMPACTION IN THE HORSE. Pawing with the fore feet, especially the near one, eructations of gas, sometimes attempts at vomition, with occasional discharge of saliva from the mouth, some degree of fulness of the abdomen, colicky pains, tremors of the superficial muscles, particularly those in the region of the left shoulder, with partial sweats upon the body, are more particularly the symptoms of this disease. True gastritis, except from the action of direct irritants, such as poisons, is but seldom seen in the horse; its stomach may be distended even to rupture, without any marks of inflammation being discoverable after death. When inflammation of the stomach is induced by arsenious acid, the symptoms are great pain with uneasiness, the animal alternately getting up and lying down, tympanitic abdomen, faeces mixed with mucus, the saliva foetid, and its secretion in- creased, mouth hot, extremities cold, nausea, purging, and great prostration of strength with delirium. When the irritation is caused by the bichloride of mercury, there is, in addition to the above symptoms, a profuse discharge of saliva from the mouth. The antidotes for arsenical poisons are the hydrated sesquoxide of iron, chalk, albumen, or magnesia, and for the mercury salt, white of eggs, the symptoms of irritation being combated by opium, oleaginous purgatives, and demulcents. TREATMENT OF IMPACTION OF THE STOMACH IN THE HORSE. Aloetic purgatives; if combined with tympanitis, oil, turpen- tine, or ammonia; enemas, fomentations to the abdomen; care at all times being taken that the animal be prevented from DISEASES OF THE STOMACH. 811 throwing itself suddenly down and causing a fatal lesion, nainely— RUPTURE OF THE STOMACH. The symptoms are, sudden tremors, particularly of the fore extremities; in many cases extension of the near fore limb, profuse perspiration, great prostration of strength; the animal breathes heavily, staggers in its walk, looks round to the flanks, and is generally seized with symptoms of vomiting, during which the head is suddenly depressed, the nose brought down to the sternum by spasmodic contractions of the inferior cervical muscles, and in many cases there occurs an actual expulsion of food from both the mouth and nostrils. The value of vomition as a diagnostic symptom of rupture of the stomach is certainly very great. Occurring in rupture of the stomach, it is said to be due to the muscular coat having first given way, thus allowing the mucous membrane to pro- trude, and the ruge of the cardiac orifice to become unfolded. This conclusion is true in part only, for vomition will occur in rupture of the colon or other intestine, and in dilatation of the cesophagus. It must, however, be admitted that the act of vomition is much more complete in rupture of the stomach and dilatation of the cardiac orifice than it is in any in- testinal lesion. The differential symptoms of rupture of the stomach, which occurs in the great curvature towards its pyloric portion, and a paralyzed condition of the cardiac orifice, are chiefly those manifested by the general condition of the animal. In rupture, prostration and rapid sinking of the animal powers are very extreme, the pulse feeble and fluttering, and death soon closes the scene; whilst in the other condition, though sweats bedew the body, and the animal exhibits extreme agony, the vital powers still remain tolerably strong; the pulse, though frequent, still retains some fulness, and the surface of the body and extremities are never deathly cold as in rupture. Abdominal pain, as ordinarily manifested by rolling, striking violently at the belly, &c., is not a constant symptom of rupture. In some cases the animal will stand immoveable, breathing heavily, being seemingly afraid to perform any movement which may increase its anguish ; in other instances, the ordinary symp- toms of abdominal pain, combined even with delirium, are present, 812 SPORADIC. DISEASES. I have observed that all medicinal remedies increase the severity of the symptoms. This is undoubtedly due to their escaping into the peritoneal cavity. Mr. Percivall asks the questions— Can vomiting take place after rupture? Will the real stomach retain any power of ejection? Would ejection of the contents upwards be produced by the abdominal muscles and diaphragm without the aid of the stomach? And replies, “I should very much doubt it. I should rather feel inclined to the opinion that the act of vomiting should be taken as a proof of the entireness of the stomach. At all events,” he says, “we may have rupture happen without vomiting; and, consequently, we must cease to regard that symptom as pathognomonic, though we may justly consider it, in company with others, as one throwing much light upon the nature of the case. Our guides, in the absence of any one infallible pathognomonic sign, must be—the history of the case, the subject of it, the circumstances attending it, the inflated or enlarged condition of the abdomen, the symptoms of colic or gripes ceasing and becoming succeeded by cold sweats and tremors, the pulse, from being quick and small and thready, growing still more frequent, and at length running down and becoming altogether imperceptible; the countenance denoting gloom and despondency of the heaviest character, with or with- out vomiting.” This graphic description contains some errors. For example, the enlargement of the abdomen is not generally associated with rupture; on the contrary, the belly in some instances is smaller than natural, the abdominal muscles being rigid and tense from tonic spasm, and the condition of rupture is undoubtedly as- sociated with vomition, for it not unfrequently happens that the animal dies immediately after that act. In addition to impaction from over-feeding, the stomachs ot old horses particularly become ruptured from degeneration of their walls. When this occurs the gastric walls are exceedingly thin, and atrophied for some distance around the breach; and if examined microscopically the tissues are found to have lost their histological character, being reduced to a granular debris or an oily material. There is no treatment for this lesion; and if the veterinary surgeon is satisfied that it has occurred, he will do well to order the animal to be put out of its misery. CHAPTER LXVIIL SPORADIC DISEAS ES—continuea. LOCAL DISEASES—continued. (0.) DISEASES OF THE BOWELS. CONSTIPATION. THE bowels of some horses are naturally torpid. Constipation, however, may be looked upon more as a symptom than as a disease in itself. So long as the animal remains in health there is no necessity to employ active remedies for the removal of constipation, and all that is necessary is to give an occasional bran or linseed mash. Should the condition be caused by the nature of the food, such food must be changed, and one of a more laxative description substituted. In many diseases constipation results from debility of the bowels, and is to be overcome by remedies, the action of which on the healthy body may be considered astringent in virtue of their tonic effects, such as the salts of iron, cinchona bark, gentian, nux vomica, and other tonics and bitters. Constipation may also arise from paralysis of some portion of the intestines, and if large and repeated doses of cathartics be administered, a fatal termination may be looked for, either from their toxic effects upon the system generally, or their direct irritation on the intestinal canal. It is, therefore, advisable to act cautiously in all cases of constipation, to allow plenty of time for the paralyzed bowel to regain its tone, to rouse it by stimulants and nervine tonics, and to administer enemas, which may contain turpentine. One symptom of paralysis of the bowels is diagnostic, namely, the absence of intestinal murmurs. Another may be mentioned of not infrequent occurrence, 813 814 SPORADIC DISEASES, especially if the paralysis be in the large intestines, namely, a dilated, dry, and non-contractile condition of the rectum, which feels, when the hand is introduced, as a large cavity with passive walls. COLIC, Colic is of two kinds, namely, Ist. Spasmodic; and 2d. Flatulent. Spasmodic Colic—A spasmodic contraction of the muscular coats of the intestines, which may run on to inflammation, due to improper food, sudden changes of diet, exhaustion from over- work, particularly if associated with long fasting, and to other cir- cumstances, trivial in themselves, and quite insufficient as causes if uncombined with other disturbing influences. For example, a drink of cold water is often supposed to cause colic. Now water, no matter how abundantly it might be drank, as is witnessed in diabetes, does not cause colic; but if an animal be exhausted by a long journey, or bathed in profuse perspira- tion, cold water may then cause disturbance and abdominal pain. Subcutaneous injections of chloride of barium, 12 to 15 grains, or of physostigma, 2 grains, are exceedingly serviceable in non- inflammatory constipation, but exceedingly dangerous where the condition is associated with signs of inflammation. Colicky pains are also symptomatic of intestinal concretions, parasites, introsusception, mesenteric abscesses, and of diseases of other organs, such as the pleura, kidneys, liver, &c. On this account colic has been divided by some authors into true and false; the true including the colicky pains arising from all intestinal diseases involving structural change, and the false those from other causes. Amongst other causes of colicky pains may be enumerated mesenteric abscesses, succeeding strangles or other suppurative disease, ulcers in the stomach, the irritation of numerous para- sites, cancer, and chronic inflammation and thickening of the intestinal walls. I have seen two cases of chronic induration of the duodenum and pylorus. The symptoms in both were as follows:— Capricious appetite, slight colicky pains succeeding in about two hours after a meal, a peculiar staring appearance of the eye, hanging back in the stall to the full length of the collar shank, a peculiar frightened look, irregularity of the heart’s action, the DISEASES OF THE BOWELS. 815 pulse sometimes slower, sometimes faster than natural, but always irregular; gradual emaciation and death. The post mortem appearances, a thickening of the submucous areolar tissue, which presents a whitish and fibrous character, and being united most intimately with the mucous and muscular coats, which were both pale, thickened, and contained much trans- lucent material. The whole mass was firm, and resisted the knife. Symptoms.—When colic is truly intestinal the symptoms are, sudden pain, pawing, kicking at the belly, looking round at the flanks, lying down, rolling, struggling in a variety of ways, or lying outstretched ; then suddenly rising, shaking the body, and remaining for a short period free from pain. After a short interval, however, the symptoms return, sometimes in an aggravated, occasionally in a modified form, and this occurs again and again, until the animal is either relieved or dies from enteritis, pain, and exhaustion. During the paroxysms of pain the breathing is accelerated, sighing, or panting, the pulse is observed to rise in frequency, and to become more or less full and hard; during the intervals of ease it may fall to its normal condition. At the commencement of the attack there is generally a frequent evacuation of small quantities of feces, which are sometimes: hard, sometimes soft ; the urine is passed in small quantities, or there are frequent but ineflectual attempts to micturate; and if an examination be made per rectwm, the bladder will very often be found full and distended, the urine being retained by a firm contraction of its neck. In some instances, more especially if the animal has been fed on moist grasses, potatoes, or unripe corn, there is diarrhoea and escape of much fetid flatus. The seat of the spasm is sometimes in the small, often in the large intestines; the symptoms during life, however, do not enable us to ascertain this with certainty. I have, however, observed that pawing with the fore feet, frequently looking round to the side, with very acute and sudden pains, point to the small intestines as being the seat of the spasm. In some instances there has been violent agony, a tendency to rear, and to kick savagely with one hind foot, when the disease has been confined to the small intestines, whilst a disposition to back or press the hind quarters against a wall or other solid object is almost a constant symptom of impaction of the colon. Flatulent colic, whether occurring primarily or subsequent 816 SPORADIC DISEASES. to an attack of spasmodic, is a condition from which much more serious results are to be apprehended than the spasmodic. Its causes are—weakness of digestion, but most commonly food which easily undergoes fermentation, such as raw potatoes, green clover, a mixture of maltcums and brewer’s grains, wheat, and boiled food. In this form of colic the expression of pain, though not so acute, is much more constant than in the spasmodic form; the abdomen is more or less tensely swollen, and resonant upon percussion; the pulse soon becomes rapid and feeble, the breathing difficult and mostly thoracic, the extremities become cold, there is more or less delirium, the animal reels to and fro; twitching of the muscles, retraction of the lips, and if relief be not afforded, death ensues either from asphyxia, blood poisoning from ab- sorption of gases, or rupture of some portion of the intestines. When the animal lies down or rolls it is observed that it per- forms these acts much more carefully than when suffering from spasm. Tympanites may arise independently of any cognizable ex- trinsic cause. Occurring during the progress of another disease, it is always to be looked upon as indicative of a very grave condition, that the animal powers are so exhausted as to be bordering upon dissolution, and becoming amenable to chemical laws. ' Tympanites also occurs in obstructions of the intestinal canal from calculi, tumours, or other mechanical causes, and generally indicates the approach of death. Treatment of Spasmodice Colic—Slight attacks are often per- manently relieved by tincture of opium, with spirit of nitrous ether, administered as a draught with water, or with eight to ten ounces of linseed oil. If relief be not afforded, say in half an hour, and if the colic be not associated with inflammatory symptoms, an attempt must be made to remove the source of irritation by means of cathartics or aperients. The late Professor John Gamgee recommended as the sole treatment the administration of a ball containing from eight to ten drachms of aloes, according to the size of the horses, if fed upon dry food ; but if the food were of a succulent nature smaller doses were to be given, with enemas of warm water. He condemned the use of anodynes and stimulants. Other practitioners prefer to give from twelve to twenty ounces of linseed oil, combined DISEASES OF THE BOWELS. 817 with a stimulant such as carbonate of ammonia, spirit of nitrous ether, or with oil of turpentine; others prefer tincture of opium ; others belladonna or tincture of aconite, Indian hemp, chloral hydrate, and other fancied anodyne or stimulating drugs. For my own part, I now prefer linseed oil with tincture of opium and spirit of nitrous ether, followed, if necessary, by sodium hyposulphite, one or two ounces dissolved in water, at intervals of three or four hours, with an occasional enema of warm water. -All cases of bowel affections should be examined per anum at the commencement of the attack, as there is a possibility of detecting and removing a cause lodged in the rectum. The enema tube should consist of guttapercha piping at least four feet long, with a rounded nozzle, and introduced by gentle—not forcible—pressure as far as possible into the bowel. If the urinary bladder be distended, pressure from the rectum with the palm of the hand will often assist the act of urination ; if this be insufficient, relief must’ be given by means of the catheter. In many parts of the country colic is looked upon as a disorder of the urinary organs by non-professional people, and from the fact that the first sign of recovery is often the act of urination, countenance is given to this opinion. There is doubtless a spasmodic contraction of the constrictor vesice in the majority of colic cases; and relaxation of this spasm is a concomitant of that of the intestines; hence rapid recovery generally takes place after the act of micturition. When the contents of the bowels are found by rectal examina- tion to be hard, an attempt should be made by manipulation or kneading with the hand in the rectum to break down the impacting masses, and thus assist the bowels to resume the peristaltic action. In conclusion, it may be stated that if the attack be a very slight one, a single dose of the opiate will often give permanent relief. There is one thing that I should warn the practitioner about, and that is, no certain dependence can be placed upon this, and that in all cases where the animal cannot be watched for some time afterwards the aperient is not to be omitted; and upon no account is a horse attacked late at night, and thus relieved, to be left without the aperient being administered, for it has often happened that when all are asleep in bed the pains have returned, and the horse in the morning found dying or dead. ait Se 62 be amr 818 SPORADIC DISEASES. Treatment of Flatulent Colic—In addition to the administra- tion of an aperient for the removal of the cause, it becomes essentially necessary that the symptoms of urgency be promptly relieved. Carbolic acid or the hyposulphite of soda to some extent averts fermentation and the further formation of gases, and thus prove very useful. If, however, the tympanites be severe, or seem to increase under the prescribed treatment, the colon should be immediately punctured with a Toop trochar and cannula, to enable the gases to escape, and thus give im- mediate and permanent relief. The method of procedure is as follows :—Select the most prominent part of the swelling, which is generally about midway between the last rib and anterior spine of the ilium, upon the off—right—side; asepticise the spot, then make an incision with a small bistoury, and introduce the point of the trochar rather obliquely upwards, in order to allow the escape by drainage of any fluid which may be afterwards exuded, and thus prevent the formation of an abscess ; when the bowel is punctured, the stilette is withdrawn, when the gas will be freely expelled; and in order to prevent further fermentation it will be necessary to inject, by means of a Toop syringe, through the cannula, about three-quarters of an ounce of pure carbolic acid, dissolved in twenty ounces of warm water, into the intestine. I feel confident that we have saved many horses in the College practice since adopting this treatment. If the tympany is not entirely removed by the escape of the gases, the operation may be performed on the opposite flank with great benefit. There is no danger in the operation : in one case it was performed thirteen times, giving relief of several hours’ duration after each puncture, in a case of tympany associated with a large calculus in the colon. The horse lived several days, and on making an examination of the seats of puncture only three or four small reddish spots were seen, with no. sur- rounding inflammation. IMPACTION OF THE COLON. As already stated, animals over-abundantly fed, or kept upon food containing much woody fibre, are liable to suffer from the » accumulation of such matters in the colon and cecum, The diagnostic characters of this, in addition to symptoms of general abdominal pain, are a tendency to push backwards, to press the DISEASES OF THE BOWELS. 819 tail against any solid object, to resist by violent straining the introduction of the hand and enemas into the rectum. In some cases the hard and impacted mass may be felt by the hand introduced into the rectum, and there is also some enlargement or distension of the abdomen. The propriety of administering cathartics by the mouth for the relief of this condition is a question of very great importance, for it has often happened that rupture of the colon has occurred in the course of some hours—generally about twenty—after the administration of an aloetic ball, the condition of the intestinal canal, when examined post mortem, having been found as follows :—The stomach and small intestines more or less emptied of alimentary matters, or containing large quantities of fluid; the large intestines distended with a mass of more or less hardened material, or partly hard and partly soft; the mucous membrane sometimes highly congested, sometimes pallid, but ruptured, and the contents more or less escaped, as in ruptured stomach, into the peritoneal cavity. I have repeatedly wit- nessed this, and the question has arisen in my mind whether the rupture has not been induced by the contents of the small intestines having been forced into the already over-burdened large ones by the action of the purgative. Concluding that this was the case, I have injected aloetic solutions into the rectum, and endeavoured to excite the commencement of purgation in the large intestines. In some instances this has succeeded, whilst in others it has failed; the failure has been due to the expulsion of the medicine by the animal. I have found it the best method to dissolve two ounces of aloes in a pint of hot water, and to administer it with a syringe having a long flexible tube, at a temperature of about 90°F. If this be retained for an hour or two, it generally has some effect, but if immediately expelled, it ought to be repeated. I am well aware that writers on materia medica will say that the specific action of aloes is limited to the large intestines and rectum, no matter how it gains entrance into the economy, and that this result will be obtained by its administration by the mouth. My experience leads me to the conclusion that, although it may irritate the posterior bowel during its exit from the body, its primary effect is to stimulate the peristaltic action and glandular secretion of that part of the intestines with which it first comes in contact. Rupture of the colon from impaction, or when eae from 52— 820 SPORADIC DISEASES. degeneration of its muscular coat, is manifested by symptoms similar to those of rupture of the stomach. If occurring from impaction, it will be found that the passage of enemas, which had previously been difficult, owing to the violent straining or resistance of the animal, becomes suddenly easy; the hand introduced into the rectum meets with little or no resistance, the intestine itself being dilated and paralyzed. DISEASES OF THE RECTUM. The condition of degeneration observable in the stomach and colon is sometimes met with in the rectum, causing a gradually decreasing contractile power of the bowel, in consequence of which the fecal matters accumulate to an inordinate extent, and are only expelled by violent straining and contraction of the abdominal muscles. In such instances, it is observed that the feeces of the horse, which in its normal condition is divided into globular pellets, is discharged from the body as a huge mass, resembling a large German sausage, and as thick asa man’s leg. I have observed this condition, which may be denominated paralysis of the rectum, as a result of injury of the spine or sacro-lumbar nerves, and independently of injury in old horses habitually kept upon coarse, indigestible food. When resulting from injury, it has sometimes disappeared, either spontaneously, as the lesion which caused it became repaired, or by the assis- tance of nervine tonics, more particularly nux vomica, and blisters to the sacro-lumbar region. In many instances, it has been necessary to empty the bowel by the hand four or five times daily, and to administer enemas to prevent pain and colicky symptoms. Rupture of the rectum has sometimes occurred from this cause. Rupture of the rectum has algo occurred within my experience from the formation of an aneurism of the hemorrhoidal arteries, the pressure of the aneurismal tumour having caused atrophy, not only of the muscular and peritoneal, but also of the mucous coat of the intestine, and rupture of these being caused by some sudden effort; hemorrhage has occurred both into the intestinal canal and peritoneal cavity. Rupture has also been witnessed as a result of a tumour, and as an accident during parturition. Accidental rupture of the rectum, posterior to its peritoneal DISEASES OF THE BOWELS. 821 lining, is not necessarily fatal; but if anterior to the termina- tion of the peritoneum, the escape of fzcal matters aud of blood into the peritoneal cavity will cause death. In one case, where the rectum was pierced by the foot of the foal during parturition, causing a recto-vesical fistula, I was enabled to bring the lips of the wound together by metallic suture, and induce their ultimate union, the mare eventually doing well. Inversion of the rectum is caused by violent straining during parturition, or attempts to expel fecal matters; as a result of paralysis; in the coma and spinal paralysis witnessed in parturient apoplexy in the cow; and in pigs it is a common occurrence owing to constipation. In dogs it results from the impaction of bones or other hard bodies in the bowel, causing violent straining. Its reduction in all animals must be preceded by thoroughly emptying the bowel of all sources of irritation. When this is effected, the bowel, thoroughly washed and oiled, is to be carefully returned into its proper position, and retained there by a suture across the anus, or a rope or truss properly adjusted (West’s clamp), and the sense of pain and irritation soothed by opium. For several days the bowel is to be carefully emptied by the hand, or enemas, and the animal fed upon a restricted diet. Purgatives are to be avoided; the bowel may, however, be lubricated with oleaginous enemas. In recurring inversion, which commonly happens in the pig, excision of the protruded intestine may be successfully per- formed; and in all cases where it is found impossible to return the bowel, the engorged mucous membrane is to be care- fully dissected from the subadjacent structures, and a reduction thus effected. It now and then happens that the sphincter of the anus closes firmly, forming a constricted neck, preventing the return of blood to such an extent that the protruded intestine speedily becomes gangrenous. If the sufferings of the animal be not very great, it is generally advisable to allow a short time to elapse before removing the sphacelated mass, in order that new adhesions may form; but if the animal suffers severely, it is advisable to insert sutures for the purpose of causing union between the gut and anal opening, and at once remove the whole protruded mass with a sharp bistoury, the subsequent pain and straining being alleviated by a full dose of opium. When several feet of the intestine are protruded, as sometimes happens after parturition, it becomes an impossibility to return 822 SPORADIC DISEASES. it. The intestine is generally lacerated from being trodden upon, and humanity renders it necessary that the animal should be put out of its sufferings. HAIMORRHOIDS OR PILES. With the exception of the dog, the domestic animals rarely suffer from piles, which consist at first of congestion of the mucous membrane at the verge of the anus, and subsequently of dilatation of the hemorrhoidal veins, constituting small tumours. These sometimes protrude outside the anus, and bleed frequently. The diagnostic symptoms of piles are switching of the tail, and a tendency to rub it against the wall; pain during the act of defecation, and the feces being tinged with blood. The dog sits on its haunches and pulls itself along in that position. The examination of the anus will reveal the presence of vascular tumours, and of much congestion and swelling of the mucous membrane and skin. Treatment.—The cause of hemorrhoids depends upon some obstruction to the portal circulation, constipation, and frequently on retention of hardened feeces in the rectum; the treatment must therefore be directed to the removal of these by manipula- tion, gentle laxatives, and a restricted diet. The uneasiness may be modified by fomentations, enemas, and the application of some mild astringent. Astringent ointments are also useful, more particularly an ointment consisting of equal parts of oak galls and hog’s lard; the benzoate of zinc ointment is also a useful application. Preparations of adrenalin, especially the ointment, if properly made, are particularly useful in the case of small dogs. It being non-irritating and easy of application, the effect is almost instantaneous in those objectionable cases of pet dogs who, by the irritation produced, perform gymnastic feats in their endeavour to remove the cause of irritation. IMPERFORATE ANUS. A congenital malformation met with in all the domesticated animals, particularly in the pig. It gives rise to symptoms of colic, and generally proves fatal shortly after birth. In some DISEASES OF THE BOWELS. 823 instances the anal opening is well formed, but the rectum at a short distance from it forms a cul de sac, which is not continuous with the alimentary canal. In other instances the anal opening is permanently closed by skin, the bowel ter- minating in a pouch underneath it. When this condition is met with, relief is possible by puncturing the intestine, thus forming an artificial anus. CHAPTER LXIX. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (0.) DISEASES OF THE BOWELS—continued. INFLAMMATORY DISEASES OF THE INTESTINES— ENTERITIS. ENTERITIS, or inflammation of the bowels, may safely be stated to be the most rapidly fatal inflammatory disease to which the horse is liable, destroying life in the course of a few hours. Indeed, it is very doubtful whether the disease recognised as enteritis by veterinarians is a true inflammation at all, as its course and progress, rapid termination, and post mortem ap- pearances tend to confirm the opinion that it partakes more of the nature of apoplexy than of inflammation. It is very true that impaction, constipation, intussusception, the presence of calculi, or the action of irritant poisons, may cause great congestion and inflammation of the intestinal membranes; but the disease to be described originates sud generis, and very often without the occurrence of an immediate and recognisable cause of direct irritation. This fact has led some practitioners of very great experience, amongst whom may be mentioned the late Mr. Lawson of Manchester, to arrive at the conclusion that enteritis never originates in colic, spasmodic or flatulent. Many writers assert that enteritis is situated in the small intestines, more particularly in the ileum and jejunum. My experience, however, leads me to the conclusion that it is more comnionly situated in the cecum and colon than in any other part of the intestinal canal, but no portion of the tube is exempt. The only recognisable causes are, over-fatigue, cold 624 DISEASES OF THE BOWELS. 825 from exposure, or from washing with very cold water whilst the animal is heated, and thereafter inadequately clothed. PATHOLOGY. Various writers state that the inflammation is situated in the muscular coat. This is evidently a mistake, as the congestion is of the greatest severity in the mucous membrane, the redness of which is of a deep venous colour, approaching to blackness, in patches of various extent, and associated in many cases with extravasation of blood into the canal. Of course, when such extreme congestion of the mucous membrane exists, all the coats are more or less implicated, but the primary and gravest condition is limited to the mucous membrane. The submucous tissue is generally much thickened; there is loss of cohesion, the mucous membrane being easily stripped from its attachments; some effusion of serum into the intes- tinal canal, causing purging in cattle and dogs; but in the horse purging seldom or never occurs, though the contents of the bowels may be found fluid after death. This seeming con- stipation results from paralysis or loss of function, and is marked by complete retention of the fecal matters. In some rare in- stances enteritis may terminate favourably in the horse; but in the great majority of cases mortification results, or the animal dies from the debilitating effects of hemorrhage into the intes- tinal canal, or from prostration of the nervous system induced by pain. Gangrene may result in eight or ten hours, the animal rapidly succumbing. In some instances, however, death may not result for several days. In one instance a horse lived for a period of five days, the bowel being found sphacelated, the process of ulceration having commenced at the edges of the gangrenous patch. It is very rarely that ulceration occurs in the horse, but it may be witnessed both in cattle and dogs. SYMPTOMS. The first noticeable signs are those of abdominal pain; generally, however, they are preceded by some degree of con- stitutional disturbance, rigors, accelerated breathing, repeated evacuations of small quantities of feces, and general depression ; 826 SPORADIC DISEASES. the mucous membranes soon become deeply congested, the mouth dry, the tongue contracted, and now and then of a brownish colour, the appetite of course being lost; the pulse is hard, wiry, and quick; the belly is tender upon pressure; the abdominal muscles more or less contracted; and if tympanites be absent the belly may seem tucked up and smaller than natural. By- and-by the symptoms of dulness and depression give place to those of excitement and pain; the horse stamps the ground with the feet, strikes at the belly, lies down, but much more carefully than in spasmodic colic, or makes feints to do so; it may roll upon its back; turns its eyes anxiously towards the flanks, pants, blows, and sweats with pain. There are no sharp paroxysms of pain with intervals of ease as in colic, but the pain is constant, distressful, and agonizing; in some cases so much so, that the sufferer seems afraid to express it, except by a most anxious expression, which is a characteristic and diag- nostic symptom. Now and then the animal will stand persis- tently with the head in a corner, and paw the ground for hours together with one or both fore feet alternately. The pulse is hard, wiry, and quick, often ranging from 80 to 120 beats per minute; and as the disease advances, it becomes thready and impercep- tible; the animal sighs, or even groans with pain; the perspira- tion runs off the body; the skin is never dry, at one time hot, at another cold; the countenance becomes haggard, the eyes expressive of delirium, pupils dilated. The horse may throw itself about in a most dangerous manner, or walk round its box incessantly ; then it will stand, balance itself, its legs give way, when it may fall and die after a few convulsive struggles, or suddenly all symptoms of pain may subside; it will then stand quiet, and even drink or endeavour to feed; its breathing becoming more or less tranquillized ; but the haggard expression of the face still remains; the pulse continues thready and imperceptible; cold sweats bedew the body; the belly becomes tympanitic ; gangrene has now sét in; it trembles incessantly ; the legs and ears are deathly cold; the mouth cold; the breath told, and even foetid; the lips drop pendulous; the eyes become more amaurotic, and after a varying interval death closes the scene, the bowels remaining inactive to the last. If, however, in three or four hours from the commencement of attack there be some abatement of the symptoms; if the surface of the body DISEASES OF THE BOWELS, 827 become dry, if there be a passage of flatus or feces, the pulse becoming fuller and softer, and the characteristic anxiety leave the expression, a favourable termination may be anticipated. This, however, is rarely the case. TREATMENT. Concluding that the constipation which is so prominent a symptom in enteritis is due to obstruction from alimentary matters, veterinarians generally administer powerful cathartics. It has, however, been shown quite conclusively that it is always dangerous to propel fecal matters through an inflamed portion of bowel; and that in most cases the effort is useless, so far as exciting peristaltic action in the inflamed portion is concerned. Purgatives, however, stimulate and excite the muscular and excretory action of the healthy intestines anterior to the in- flamed part; the result of this is, that the inflamed part becomes more and more distended, inflammation is increased, the blood- vessels become ruptured ; it becomes softened, and its vitality is ultimately destroyed. It is therefore a fact that the inflamed part, the function of which is lost, consequent upon the inflam- mation, affords an impediment, and that purgatives, as a rule, have no true purgative effect—that is to say, they do not cause the discharge of fecal matters by the anus. Two great principles are therefore recognised, namely—first, to relieve pain, and, second, to arrest as far as possible all move- ment of the intestines; and for these purposes opium is to be administered in large doses. For the horse, one, two, or even four drachms of the powder may be administered, suc- ceeded by smaller quantities at short intervals, or by the sub- cutaneous injection of morphia (the solution of the meconate of morphia being recommended. The first subcutaneous injection should contain, in addition to 5 to 8 grains of morphia, a half grain of atropia; but the atropia should not be repeated for at least twenty-four hours, whilst the morphia may be administered every few hours, according to the severity of the symptoms. In addition, hot fomentations to the abdomen are useful; and they should be continuously applied for at least an hour at a time. Enemas of warm water may also be gently administered : they are not, however, to be repeated too often, and if at any time they increase the pain, they should be discontinued. 828 SPORADIC DISEASES. Tf, after the abatement of the active symptoms, the bowels remain torpid (as they generally do), the practitioner is by no means to attempt the removal of this torpidity by the adminis- tration of cathartics or aperients of any kind; for if the animal is to recover, it must be dependent upon the restoration of function and tone to the inflamed bowel; and it is well known that for this end perfect quietude of the inflamed part must be maintained. The advisability of bleeding in enteritis will depend entirely upon the condition of the animal. If the pulse be moderately full, if depression be absent, an abstraction of blood commen- surate with the strength of the vital powers will be followed generally by abatement of the symptoms, and if performed early is beneficial. Should the appetite return, great care must be taken that the food be of the simplest and of the most easily digestible kind, such as scalded bran and boiled linseed given in moderate quantities; the eating of dry food being prevented by amuzzle. Care must also be taken, when the functions of the bowels are restored, that no undue accumulation of faecal matters be allowed to remain in the rectum. The question of adminis- tering stimulants during the acute stage will also greatly depend upon the condition of the animal; they usually do more harm than good, but if tympanites be present, one or two doses may be tried. If they give relief they may be continued, but if, on the contrary, they aggravate the pain or seem to have no effect, they are to be discontinued. It must not be lost sight of that antiseptics, such as carbolic acid or hyphosulphite of soda, in proper doses are important factors in counteracting putrefaction of the contents of inflamed bowels, and the rapid gangrene of the inflamed part, as well as a septic condition of the blood. If, however, they fail to reduce the tympany, relief by puncture must be immediately given (see Treatment of Flatulent Colic). CHAPTER LXxX. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (0.) DISEASES OF THE BOWELS—continued. INTUSSUSCEPTION AND VOLVULUS. INTUSSUSCEPTION (from intus, within, and suscipio, to receive), and volvulus (from volvo, to roll up), a twisted bowel. Under these names various forms of entanglement of the intestines, giving rise to abdominal pain, enteritis, and death, have been described. INTUSSUSCEPTION, By intussusception is meant the prolapse or slipping of a portion of intestine into the cavity of that immediately pos- terior te it. In consequence of this the natural course of the intestines is interrupted by a kind of knot, consisting of three successive portions of bowel; the immediate effect of which is obstruction to the passage of the intestinal contents, and to the return of blood from the imprisoned portions of intestine in- volved, along with which some portion of the mesentery must be included. ; Both the small and large intestines are subject to it in all the domesticated animals. When, as is generally the case, it occurs in the large intestine, the cecum caput coli is that usually in- volved, and instances have occurred, both in horses and cattle, of recovery after sloughing of the invaginated cecum. Within my own experience, a cow treated by me, after seven days of obstinate obstruction of the bowels, expelled the gangrenous portion, measuring several inches in diameter, and the animal recovered. 829 830 SPORADIC DISEASES. Mr. Aitken, V.S., Dalkeith, has a case on rocord of a cow which recovered after five days of illness, the gangrenous portion being expelled with the feces. Before recovery from intussusception can occur, it is necessary that the opposed peritoneal surfaces become adherent, and the imprisoned portion separated by ulceration. . Invagination of the small intestines, owing to the severity of the inflammation, is necessarily fatal. Symptoms.—In the cow already mentioned, the symptoms were those of enteritis and obstinate constipation. The treatment con- sisted in the administration of opium. In Mr. Aitken’s case drastic cathartics were administered from the commencement. The symptoms in the horse, as related by the late Mr. John Field, are as follows :—“ Pain ; restlessness, in some cases approaching to madness, unrestrainable; wandering about; rolling on the back; sweating, in some cases profuse; crouching; sitting on the hind quarters, almost diagnostic; anxious countenance ; frequent feeble pulse ; belly at first of natural size, subsequently fuller, in some cases distended, dependent upon the locality of the intussusception; membranes, in advanced stage, turgid, injected; mouth moist and clean, or furred and offensive; respiration accelerated ; continued restlessness; rearing with fore-legs into manger, and standing upon that point d’apput, looking back from side to side; extremities cold; pain absent, tranquil; sighing or snorting; death. The sighing may exist in some cases and not in others, and in some retching and vomiting.” I am, however, of opinion that there is no diagnostic symptom of volvulus, intussusception, calculus, or strangulation of the intestines in the horse; that the above symptoms are common to all, characteristic of none. In the dog and pig, however, vomiting of stercorous matters is generally witnessed; but even in these animals this symptom may be induced by any cause of obstruction. Stones accidentally swallowed, pieces of bone arrested in the small intestines, are frequent sources of obstruc- tion in the dog. Treatment.—It has been proposed to cut down upon and mechanically remove the source of mischief. I think, however, that the operation would be as bad as the lesion. If intus- susception be due to contraction of one portion of intestine, and DISEASES OF THE BOWELS. 831 the slipping in of that contracted portion into the healthy portion behind, remedies calculated to relieve spasm may prevent its occurrence, but cannot overcome it when once established. VOLVULUS, OK TWISTED BOWEL, May occur in either the small or large intestines, and, like strangulation of the intestines by pedunculated tumours, or from their entrance into the inguinal canal or the foramen of Fic. 81.—Twist of the bowel. Winslow, are but rarely witnessed, even in the horse, and their exact diagnosis is attended with difficulty. It is true that some practitioners assert that when a horse resists the introduction of the hand into the rectum by straining, that it is indicative of volvulus of the colon; but if, on the contrary, the rectum be found passively distended—hollow—that it indicates impaction and paralytic loss of function of that bowel. I have seen many cases in my time, and can safely say that these diagnoses are unsupported by extended observation. Many theories have been advanced to explain the etiology of volvulus. 886 SPORADIC DISEASES. the retention, relief must be afforded by the introduction of the catheter, and it is highly important, in all cases where animals retain the recumbent posture, to examine the condition of the bladder, and afford the necessary relief by the introduction of the catheter. Sometimes, however, the evacuation may be effected by firm but not violent pressure upon the bladder with the open hand introduced into the rectum, taking care that the mucous membrane of the rectum be not injured by the finger nails or by too violent pressure. In introducing the catheter in the cow, care must be taken not to injure the thin, delicate, membranous valve which guards the urethral opening; and in order to introduce the catheter without causing injury, the valve is to be lifted upwards by the finger, and the point of the catheter carefully introduced beneath it. If retention be due to the accumulation of dirt within the sheath of the penis, it may not be necessary to introduce the catheter, but to wash the parts thoroughly with soap and warm water; a little carbolic acid in the latter will render this operation much less offensive to the nostrils by destroying the fetid smell. INCONTINENCE OF URINE. This is the reverse of retention, being a continual flow of urine. It arises from a variety of causes, namely, paralysis of ‘°° ° the sphincter vesicee, the muscular power of the walls of the bladder remaining intact; calculi; and from pervious urachus shortly after birth. For the treatment of the two latter causes see Principles and Practice of Veterinary Surgery; and for that arising from paralysis cathartics may be necessary, succeeded by nux vomica and can- tharides, with injections of cold water into the rectum. “ Incontinence is said to occur in pigs after eating of poly- gonum, hydropiper, and lapathifolium.”—(GAMGEE.) The following terms are applied to the checked discharges of urine :—suppression—ischuria ; painful discharge of little urine —dysuria; and the passage of urine in drops—strangury. CHAPTER LXXXI. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (7.) HYSTERIA. CoNCURRENT with the period of vestrum in the female, the following symptoms—clenching of the jaws, grinding the teeth, difficulty of swallowing, some degree of trismus, squinting of the eyes, tonic spasms, alternating with those of a clonic kind, continual kicking in an irregular uncontrolled manner with one or both hind feet, stamping of the fore feet, and other signs of nervous excitement, have been observed in the mare and female ass. In one case that I saw, the two fore shoes and one hind shoe had been thrown off by the violent kicking and stamping. Attempts were made to remove the remaining one, which was loose; they were, however, unavailable, as the slightest touch caused a most violent kicking. The animal would fall, the whole trunk and neck being perfectly rigid, whilst the limbs continually moved in a violent and spasmodic manner. The power of volition seemed to be completely lost. The gluteal muscles were exceedingly hard and prominent. The rapid opening and closing of the vulva and its highly injected mucous membrane indicated the hyperasthesia of the genital organs. Urine was passed abun- dantly, at first pale and watery, but afterwards highly coloured, and loaded with solid matters. In another case the symptoms were rather different. The animal was prostrate, rigid, with its eyes turned upwards, as if in a trance. They were both bled, and an endeavour was made to nauseate them with aloes, and to allay the nervous irritability with opium. One recovered, the other died. For the prevention of this condition I can only suggest that the sexual desire be gratified if possible, whenever such a state of excitement short of the above presents itself. 887 CHAPTER LXXXII. SPORADIC DISEASES—continued. LOCAL DISEASES—continued. (U.) DISEASES CONCURRENT WITH OR IMMEDIATELY SUCCEEDING PARTURITION. ACCIDENTAL conditions connected with parturition, requiring the aid of a surgeon, will be found fully described in the Principles and Practice of Veterinary Surgery, as it is my intention to confine my present observations to those of a more purely medical character. Under the common term “‘ milk fever” at least three separate diseases are generally described, namely, parturient fever, parturient apoplexy, and acute metritis, already described. PARTURIENT FEVER. Definition —A. benign form of fever, seen in the cow, mare, &c., occurring about the second or third day after parturition, and generally terminating in recovery in from twenty-four to forty-eight hours. The symptoms are those characteristic of general febrile dis- turbance; the pulse generally full and strong, the breathing accelerated, the visible mucous membranes injected, the secretion of milk suspended, the mammary gland hard and slightly erythematous, bowels constipated. The cow may assume the recumbent posture, but the power of maintaining the standiny one is not lost, nor are there any signs of unconsciousness or of cerebral disturbance. Unlike parturient apoplexy, it attacks animals of all ages, but it is most commonly met with after the first parturition, and is induced by cold, or some dietetic error, 888 INFLAMMATION OF THE WOMB. 889 and seems to be connected with that condition of excitement associated with the secretion of milk, Treatment—The treatment of this affection is very simple, a mild oleaginous purgative, combined with a dose of the spirits of nitrous ether, warm clothing, and a restricted diet being all that is required. ACUTE METRITIS, OR INFLAMMATION OF THE WOMB. A very fatal form of inflammation, occurring in a few hours or within two or three days after parturition. Whilst parturient apoplexy and parturient paralysis are generally met with in the cow, acute metritis, or, more correctly, metro-peritonitis, attacks the cow, mare, ewe, the bitch, and the sow. Pathology—A diffuse inflammation, primarily situated in the mucous membrane of the uterus, soon, however, extending to the uterine veins, giving rise to the formation of clots or thrombi, and extending to the peritoneum and intestines. The inflammation is characterised by its tendency to spread rapidly over a large surface, and by the rapid formation of an abundant quantity of a dark chocolate-coloured fluid exudation, which stains the tissues of the organs involved, and is poured out upon the free surface of the uterine mucous membrane, from whence it is discharged per vaginam, and which, by its acridity, causes much irritation and straining—tenesmus. Examined microscopically, it is found to consist of the débris of disintegrated blood globules, pus, and blood corpuscles, and an abundant quantity of granular material slightly intermixed with shreds of imperfect lymph floating in a reddish-coloured serosity. This affection may be looked upon as being due to pyemic or ichoremic poisoning, the whole mass of blood becoming altered in its character, dark, feebly coagulable, with the appear- ance of secondary spots of inflammation and ecchymosis in the lungs, the brain, and other organs. The occurrence of the disease is due to over-fatigue, as from over-driving immediately prior to the act of parturition, wounds inflicted upon the uterus or vagina during difficult delivery, the retention of the foetal membranes, which, rapidly decomposing, infect the blood by absorption of the putrescent products. It 890 SPORADIC DISEASES. may also be induced by obesity (more particularly in the bitch), exposure to cold, or any other debilitating influence. Such predisposing causes are, as far as possible, always to be avoided, and the strictest hygienic conditions observed at this critical period. The organisms which set up metritis may be various, but the commonest are B. coli, staphylococci and streptococci. The latter are the most dangerous as so fre- quently tending to result in septicemia. It will be seen, therefore, that every care should be taken in sterilising all instruments, hands, &c., when dealing with parturient cases. It is extraordinary what an amount of septic material may, in many cases, be introduced to a cow’s womb without causing any trouble (see Septicemia and Parturient Fever, p. 462); but this is no reason why the intelligent eal should take any risks, and especially so when dealing with mares aud bitches. The disease may occur within a few hours after parturition, or its appearance may be protracted to the third or fourth day. and the chances of a favourable termination are in accordance with the lateness of the attack. If occurring within the shorter period, it is almost invariably fatal. Symptoms.—Restlessness, paddling of the hind feet, loss of appetite, almost a total suppression of milk, the few drops that might be squeezed from the mammary gland being of a bluish tint, thin, and watery, sometimes of a reddish or even chocolate colour, containing granular matter, more or less curdled in appearance, and exhaling a peculiar odour. The vulva is small, contracted ; the vaginal mucous membrane sometimes of a dark purple hue, or a deep red colour, with petechial spots and purple streaks, There is violent straining, discharge of a coffee-coloured, foetid liquid, and, as the disease advances, an exhaustive fcetid diarrhea. The prostration of strength is extreme; the pulse is feeble, thready, and very rapid; the heart’s action tumultuous; the belly tympanitic; the surface of the body cold. So long as sufficient’ strength remains, the animal will frequently lie down and rise again ; will kick the belly, and show other signs of abdo- minal pain; and in the mare these symptoms are sometimes com- plicated with those of inflammation of the feet. As the debility increases, the animal will be unable to maintain the standing posture, but whilst recumbent, will still manifest symptoms of INFLAMMATION OF THE WOMB. 891 abdominal pain by. rolling from side to side, looking round at the flank, and by violent attempts to regain its feet; the pulse becomes feebler and feebler ; the breathing hurried and thoracic ; at last the eye becomes amaurotic, and complete unconsciousnes sets in; the animal dying in from twelve hours to perhaps two days after attack. Whilst practising in Mold, I had the opportunity of seeing this disease extensively. Mold at that time was the terminal station of the railway, and calving cows were driven in from long distances in Wales for the purpose of being conveyed to the English markets. They would sometimes calve on the road, and were of necessity driven onwards with the rest of the herd, and too often succumbed to this fatal malady. Treatment.-—Bleeding, purgatives, and depressants of all kinds hasten the fatal termination, and the only hope of recovery must be based upon attempts to restore the diminished vital powers by the administration of alcoholic stimulants, the removal of the uterine and abdominal pain by sedatives and fomentations to the loins and abdominal walls, and to destroy the septic properties of the contents of the uterus, and soothe its irritated and inflamed mucous membrane by injections of warm water containing opium and antiseptics, such as “Condy’s Fluid,’ hyposulphite of soda, or carbolic acid largely diluted. It must be remembered, however, that carbolic acid preparations must not be used in bitches, as they are extremely susceptible to poisoning by such prepara- tions. It is now generally conceded that the use of antiseptics of an astringent nature is, as a general rule, to be avoided. Boiled sterile water should be used for douching and washing out internal cavities such as the uterus. Astringents coagu- late the serous effusions, and so form a suitable culture medium for the many micro-organisms which lie in the deeper © structures, and which are not killed by the application of the antiseptic. Moreover, the phagocytes are also killed, as easily as the organisms, by the antiseptic douche; thus a strong defence is broken down, and by the above-mentioned coagu- lation of the serous effusion diapedesis is impeded. Amongst ewes the disease is known by the term * inflam- mation,” and great success has been obtained in its treatment by the application to the inflamed uterus of carbolic acid one 892 SPORADIC DISEASES. part, olive oil ten parts. The same treatment is applicable to other animals. Contagious Mammitis—All mammites may be said to be contagious, inasmuch as they are all due to the infection of the gland by micro-organisms, which under certain conditions find a suitable nidus, and produce the usual symptoms of inflammation. There are numerous special organisms that can be cited, excluding the ones referred to below. Staphylo- cocci, B. coli, streptococci, and diplococci are associated with such conditions. Injuries to the udder may not result in microbie invasion, but in the majority of cases they do, as the damaged tissue loses its resistance, and organisms find their way in. Specific diffuse tubercular mammitis may be diagnosed roughly by its slowly progressive character, and the fact that the affected quarter tends to progressively increase in size and become harder and larger than its fellows; whereas in other inflam- matory conditions, known as garget, after the first acute inflammatory symptoms have subsided, the functional activity is so reduced that the quarter wastes, and usually becomes smaller than its fellows. To justify a diagnosis of tubercle in the udder it is essential to find the organisms by inoculation of guinea-pigs (vide tubercle), and so differentiate it from the somewhat similar lesions caused by actinomycosis. Another specific form of contagious mammitis is that which now prevails very largely at home, in our Colonies, and in many foreign countries, and sometimes rages as an enzootic, or even assumes an epizootic, type. It is stated by Nocard and Mollereau to be due to a rounded or ovoid micrococcus 1:25 mw in length by 1 pw in thickness, and forming long, straight or sinuous chains, sometimes bilobed by way of * division, and found in the milk and the walls of the excretory ducts. It is aérobic and anaérobic, and its growth in cultures is arrested by weak solutions of boracic acid, and by a 8 per cent. solution of carbolic acid, and it is recommended that the milkers of cows thus affected should wash their hands, previous to milking, with this ecarbolic solution. Unless the disease be checked at its onset, there is a great probability of it assuming a malignant type, and terminating in gangrene and death of the patient. INFLAMMATION OF THE WOMB. 893 Experimental inoculations with pure cultures into the teat have reproduced the disease in the'cow and goat. Even on the first day the milk from the inoculated udders was swarm- ing with micrococci, had an acid reaction and a curdled appearance, and finally the uddcr became inflamed. A fatal form of gangrenous mammitis is seen in milch ewes—said by Nocard to be due to a micrococcus 0:24 uw in diameter, associated in groups of four or more, but never in chains, stainable by Gram’s method, anaérobic, coagulating the milk and turning it sour. Curdling of milk, as well as other changes—viz., putrefaction, viscous milk, blue milk, red milk, and yellow milk—are all due to various microbes, and should be counteracted by cleanliness and the application of antiseptics, such as boracic acid. CHAPTER LXXXIII. PARASITIC DISEASES. REMARKS ON CLASSIFICATION—NEMATODA—TREMA. TODA—CESTODA— ACANTHOCEPHALA-—-DIPTERA— TRACHEARIA—TABLES OF ENTOZQA. CLASSIFICATION OF PARASITES. PARASITES are distinguished as Hndoparasites when living in the interior of their hosts, and as Ectoparasites when external. With the Zetoparasites we have at present nothing to do, but will confine our attention entirely to the Hndoparasites. Among the most important endoparasitic animals or Entozoa are those spoken of collectively as “worms,” including not only round- worms resembling the earth-worms (Lumbricus terrestris), and hence popularly spoken of as ZLumbricoids, but also worms resembling a band or a tape (tape-worms), or a leaf (flukes), as well as the thorny-headed worms (Hchinorhynchus). The round-worms and thorn-headed worms form together the class Nemathelminthes, while the flukes and the tape-worms constitute the class Platyhelminthes. These two classes form the parasitic division of Cuvier’s sub-kingdom VERMES. These classes are further broken up into natural orders; thus the class Memathelminthes includes the two orders Nematoda and Acanthocephala, and the class Platyhelminthes the two orders Trematoda or flukes, and Cestoda or tape-worms. These natural orders are further subdivided into families, genera, and species. Then, again, it must not be forgotten that there are other kinds of internal parasites, commonly designated “bots.” These creatures are not usually classed with the entozoa, or helminths proper, because they are merely the larval stages 894 CLASSIFICATION OF PARASITES, 895 of growth of various species of gadfly. These flies are generally included in the genus Estrus of entomologists, the stride form- ing a rather numerous family of the class INsEcTA, and belonging to the order called Diprera. As the attention of the profes- sion is often called to these singular creatures, it will be desirable to give a brief account of their development and habits. There is yet another series of internal parasites, long ago called Pentastomes, from the notion that they were furnished with five mouths. These worms are also occasionally brought under the notice of the practitioner of veterinary medicine; and in one remarkable instance recorded by the late Professor Dick, three of these entozoa caused the death of a valuable sporting dog. These Pentastomes, in fact, are allied to the true ticks, and therefore must be grouped along with all those spider-like creatures, which, in common with the spiders them- selves, breathe by means of peculiar air-vessels termed trachez. In other words, the Pentastomes belong to the order TRACHEARIA, forming a division of the class ARACHNIDA. It thus appears that, without taking into consideration certain minute parasitic organisms belonging to the lowermost class of animals, and misnamed “cattle plague bodies,” we have to deal with no less than six well-marked crders of invertebrate animals, one or more species of each of these orders being liable to play the part of parasite within the body of some one or other of our various domesticated animals. The pathogenic role played by these parasites has not hitherto received the attention that it deserves. The amount of disease indirectly set up by these intestinal parasites is enormous. The special study of intestinal parasites has, until quite recently, been treated as being more or less superfluous, but each day tends to dispel such an erroneous notion. It is not that these parasites in themselves do very much harm, but it is the predisposition to harm which they incite. The point of attachment of even a bot, not to mention the grosser lesions caused by the larger intestinal worms, becomes to all intents and purposes a wound, and such wound may be the means of bacterial organisms being introduced to the animal’s economy. The fight for existence against pathogenic organisms is already very intense, and the aid to these organisms which parasites of the larger animal type give is considerable. 896 PARASITIC DISEASES. Giles and Baldrey in India have pointed out that some of the ravaging outbreaks amongst sheep are in all probability induced by these means. An animal’s strength is sapped, and resistance to disease lowered, by the constant drain of nourish- ment for the large numbers of intestinal parasites, so that at the first onslaught, by comparatively harmless pathogenic organisms, the animal succumbs. We all know to what an extent kennels are sometimes decimated by the persistency amongst puppies of attacks by intestinal parasites, and how such infected animals are the first to succumb to distemper, eczema, and pneumonia. The subject of parasitism is, therefore, one worth consider- ably more attention on the part of the practitioner than it has had hitherto. Treatment in this field has mostly been left to the quack and retailer of patent nostrums, but the time has arrived when the order must be changed. To such of the parasites as have an especial interest for the profession, and which are included in one or other of the six orders, namely, Nematropa, Tremaropa, Crstopa, ACANTHO- cePHALA, Diprera, and TracHuEaria, the reader’s attention is now invited. CLASSIFICATION OF ENTOZOA, Sus-Kinepom VERMES (WoRMs). Cl. I. Platyhelminthes (Flat-worms). (N.O. 1.) Cestoda. (Fam. a.) Tceniade (Tape-worms). Gen. Tenia. (Fam. b.) Bothriocephalide (Pit-headed worms). Gen. Bothriocephalus. (N.O. 2.) Trematola (Flukes), Gen. Distoma. Schistosoma or Bhilharzia. Amphistoma. Cl. IL. Nemathelminthes (Round-worms). (N.O. 1.) Nematoda (Round-worms proper). (Group a.) Polymyaria. Gen. Ascaris. Lustrongylus. Filaria. Sprroptera, NEMATOD.. 897 (Group b.) Meromyaria. Gen. Oayuris. Strongylus. Ankylostuma or Dochmius, (Group ¢.) Holomyaria. Gen. Zrichina. Trichocephalus. (N.O. 2.) Acanthocephala (Thorn-headed worms). Gen. Echinorrhynchus. Sus-Kinapom ARTHROPODA. Cl. I. Insecta. N.O. Diptera. Fam. stride. Gen. Gstrus ; the larvze of some species are Entozoa. Cl. II. Arachnida. N.O. Trachearia. Gen. Pentustoma. NEMATODA. This order is treated of first because it iricludes the parasites emphatically called ‘‘ worms.”’ When a horse is said to have worms, we know that in nine cases out of ten the animal is passing lumbricoids of large size (Ascaris megalocephala), or it is troubled with maw-worms (Ozyuris curvula). In like manner, when a dog is said to have worms, it is either meant that the animal is passing or throwing up round-worms (Ascaris marginata), or that it is parting with the falsely so-called maw-worms, which, after all, are neither more nor less than the free and independent segments or proglottides of some species of tape-worm. Worms in cattle and sheep are not often spoken of as such, and little attention is paid to those of the pig. With the cat, however, it is far other- wise, for we have known veterinarians whose assistance has been eagerly sought in view of ridding this domestic pet of its internal enemies, and especially of the nematode entozoon called Ascaris mystax. In addition to. the above, there are other species belonging to the nematode order, to which a larger interest is, or ought to be, attached by the 57 898 PARASITIC DISEASES. professional man. To this series belong the little flesh-worm (Trichina spiralis); the thread-worm which occasions the “lamb disease” (Strongylus filaria); the very similar nema- tode that produces husk or hoose in cattle (Strongylus micrurus) ; and the worm which gives rise to aneurisms in the horse and ass (Strongylus armatus). No member of the veterinary pro- fession should be totally unacquainted with the natural history of these important species of parasite. The Strongylus jilaria of sheep and calves causes parasitic bronchitis from its presence in the bronchial tubes. The development of these parasites is comparatively simple, the mature worms are ovoviviparous and the embryos are expelled on the pastures, where they moult, further develop, and live for some time, until again taken up by cattle or sheep to com- plete their evolution. They are taken in either with wet grass or water, and from the stomach find their way to the lungs. The Strongylus rufescens, a very minute worm, is found in the lung tissue of sheep, and often causes a pneumonia. They may become encysted and set up a tubercular condition which has been called pseudo-tuberculosis. The eggs are hatched in the mucus of the bronchial tubes and their terminals, and the embryos are expelled with the mucus therefrom. They can live a long time in damp places, and whilst there, moult and prepare for invasion of their special host. We have not an entire knowledge of the course of develop- ment undergone by all of the above-mentioned nematodes. It is true that, with more or less deviation from a common plan, all of them must pass through similar stages of growth, from the time of their first formation in the egg up to the period of sexual maturity. All, moreover, must in some way or other conform to a known law of their existence, which involves in many species at least one change of residence and skin before they can acquire the adult condition within the body of the last or ultimate bearer. Herein lies the difficulty in tracing out the development of most of the species; nevertheless, from the facts already made known by experimental research, it is not too much to hope that we shall hereafter become possessed of a knowledge of all the more important phenomena connected with the development of the nematode worms. The Trichina spiralis, as ordinarily known, is a small sexually NEMATODA. 899 immature nematode, usually found lodged within capsules or cysts, and occupying the muscles of some animal, such as the rat, the pig, or of man himself. When the little worm is removed from the cyst, its entire length will be found not to exceed the j,th of an inch. In its full-grown or sexually mature state it is still a very minute worm; the males measuring only the ysth of an inch, whilst the females, which are more than as large again, reach to about ith of an inch. The professional importance of the trichina more directly concerns the medical man than the veterinarian; nevertheless, since the human disorder termed trichiniosis takes its origin from the consumption of animal food, especially pork, it is clearly the duty of the latter to understand the nature of the malady thus provoked, and to acquaint himself with the phenomena of the parasite’s development. ‘The experiments of various helmintho- logists, and especially those of Davaine, have distinctly proved that when small animals, such as rats, rabbits, and cats, are largely infected, they, like man himself, readily succumb to the disease. ‘In the case of larger animals, a very great amount of infection is necessary to give rise to any external symptoms. So complete, indeed, does this immunity appear to be, that a pig experimented on at the Royal Veterinary College showed no sign of the disorder, although from subsequent post mortem evidences it was calculated that its flesh contained sixteen millions of living worms. Until very lately we flattered ourselves that in England and Scotland there was no such thing as trichina existing in our home-reared porkers; but so far as the former division of the country is concerned, this immunity can no longer be said to exist. Not only have several English fed pigs been found to harbour spiral flesh-worms, but in the year 1871,* asrecorded by Dr. Dickenson, an outbreak of trichiniasis occurred in a farmer's family in Cumberland, this attack resulting from the consump- tion of pork reared by themselves. As Mr. Gamgee has well remarked, “If pigs are permitted to swallow the germs of human parasites, as in Ireland and in many British piggeries, we must expect hams, bacon, and pork sausages to be charged with the . embryonic forms of human entozoa.” Very much more, of course, might be said on this subject in relation to questions * And as lately as this year, 1909. 579 900 PARASITIC DISEASES. of hygiene; but our object in these pages is merely to show the necessity of a general acquaintance with the subject. The symptoms, whether occurring in man or animals, are generally believed to be due to the wounds and consequent irritation set up by the worms during their wanderings in the tissues of the host; but whilst this is true as a cause of the phenomena occurring in the second stage of the disease, it is obvious that the earliest symptoms, often accompanied with diarrhcea, are due to intestinal irritation alone. Some authors have, indeed, contended that there is no such thing as traumatic injury caused by the wandering parasites, but our best experi- mentalists in helminthology are one and all in favour of the view here advocated. Whilst many admirable memoirs have been written on the structure and development of trichina (the literature of the subject being of very great extent), we have on the whole satisfied ourselves that the clearly enunciated statements and conclusions of Leuckart are worthy of every confidence. The following is a brief réswmé of his conclusions, given almost in his own words :— 1. Trichina spiralis is the juvenile state ofa little round-worm. 2. The mature TZrichina inhabits the intestinal canal of numerous warm-blooded animals, especially mammals, 3. The intestinal Zrichine attain sexual maturity on the second day after their introduction into the stomach. 4. The eggs are developed within the parent worm into minute filaria-like embryos, which are born free from the sixth day onwards. The new-born young soon commence wandering, penetrat- ing the intestinal walls, and passing directly through the abdominal cavity into the muscles of the host. 6. The directions in which they proceed are in the course of the intermuscular connective tissues, the majority of the embryos resting in the muscles of the abdomen and thorax. 7. The embryos penetrate the separate muscular bundles, and at the expiration of fourteen days they will have acquired the size and organization of the spiral flesh-worm. 8. Soon after the intrusion of the parasite the infested muscular fibre loses its original structure; and after a ar NEMATODA. 901 while the spot occupied by the rolled-up entozoa becomes spindle-shaped, within which the well-known lemon- shaped cysts are formed. 9. The further development of the muscle trichine is alto- gether independent of the formation of these cysts, the walls of which become hardened by calcareous deposi- tion, and thus, moreover, males and females are already distinguishable in the larval state. 10. The immigration of the young parasites in large numbers produces very serious or even fatal consequences; and thus it happens, that in proportion to the quantity of imported parasites the symptoms resulting will be either severe, dangerous, or even fatal. Tt has been stated by some writers that even pigs occasion- ally display symptoms of trichiniasis, the signs of the disease in the animal being loss of appetite, quiescence, aversion to all kinds of movement, and even partial paralysis of the limbs. In the human subject it is well known that the symptoms are much more severe, many of the patients enduring the most intolerable agony, resembling acute rheumatism, until at length death mercifully comes to put an end to their sufferings. Here it will not be out of place to mention that cats are liable to be affected with another disease very closely resembling trichiniasis, which may appropriately be called olulaniasis. The disorder is occasioned bya minute trichina-likenematode termed by Leuckart Olulanus tricuspis. It gains access to the lungs in the larval state, producing death by suffocation. Our knowledge of the history of the development of the larger round-worms is very incomplete; nevertheless the causes of the prevalence of these worms in particular localities and during certain seasons are not far to seek. It is clear that their final stage of growth is accomplished with great rapidity, otherwise we should not meet with lumbricoidsin pigs and puppies scarcely three weeks old. Large round-worms have also been found in very young colts. The ordinary lumbricoids of the horse, of the pig, and of man, so very closely resemble each other, that by some they are regarded as mere varieties of one species (Ascaris megalocephala, A. suilla, and A. lumbricoides). Whether they are so or not is of little practical moment, for it seems. quite 902 PARASITIC DISEASES. certain that a perfect knowledge of the earlier stages of develop- ment of any one of them would furnish a clue as to what obtains in the others. It is probable also that the lumbricoids of the dog and cat undergo similar changes. The eggs of the common round-worm have been kept alive by Davaine for more than five years; and various observers have watched their development in fresh water up to the stage of imperfectly devéloped embryos, and have kept them alive in this condition for three months. , Dr. Davaine administered some of his five-year-old embryos to rats, and had the satisfaction of finding a few of their eggs in the feces, with their embryos still living, and striving to get out of the shells. He administered others to a cow, also introducing some into the stomachs of dogs in small linen-covered flasks. As a general result, it may be said that the embryos escaped from their shell; but the contents of those eggs in which the process of yolk-segmentation had not arrived at the stage of embryonal formation remained undigested. So far back as the year 1853 Verloren reared embryos in the eggs of the dog’s round-worm within a period of fifteen days in distilled water. Dr. Cobbold has also reared the embryos of this species (Ascaris marginata) in fresh water, and has kept them alive for a period of seventeen months. Atthe expiration of this period, and during the warm weather, some of them escaped from their shells. According to Davaine, the eggs of many nematodes will readily retain their vitality though long exposed to dryness, but their contents will not go on developing during this period of exposure. In the case of Ascaris tetraptera of the mouse, however, embry- onal formation gozs on in spite of the absence of external mois- ture. He has noticed the same thing in the oxyurides of rodents. Dryness does not even destroy the eggs of Ascaris lumbricoides and Trichocephalus dispar. It would seem, in short, that the eggs of nematodes, which normally take up their residence in cats, dogs, and carnivorous animals which reside in arid regions, will develop embryos in ovo without a trace of moisture. Davaine is of opinion that it is not necessary that nematode embryos should pass through the body of any intermediary bearer; and he believes that they are often directly transferred to the stomach of their appropriate hosts whilst adhering in the condition of an impalpable dust to the coats of their bearers, NEMATODA, 903 whence they are detached by the animals themselves when licking the fur. With the eggs of Ascaris megalocephala Dr. Cobbold has performed several experiments, having reared the embryos in simple fresh water, and found them capable of escap- ing from their shells during warm weather. He also succeeded in rearing these larve in pond mud, noticing at the same time that after their exclusion they grew more or less rapidly up to a certain point, after which they appeared to stop, as if waiting transference to some host for the further accom- plishment of their larval growth. The addition of horse-dung to the soft wet mud in one case, and of cow-dung in another, neither appeared to advance nor retard the process of embryonal growth so long as the embryos remained in their shells. On the other hand, when the embryos were reared in simple horse- dung, purposely kept moist, they attained a higher degree of organization than did those which were reared in water and wet mud. Having watched hundreds of these larve under varying conditions, Cobbold came to the conclusion that after their escape from the egg, their growth, strength, and activity are favoured, if they happen to have gained access to fluid media containing impurities. Ditch or muddy pond water would appear to be eminently favourable to the development of the escaped larve up to a certain stage of growth. That warmth is eminently favourable to the development of all kinds of parasites is a well-established truth; and in the case of most nematodes it appears to be absolutely essential to the formation and hatching of the embryos. Take the case of Oxyuris, for example. As Leuckart observes (Die Menschlichen Parasiten, Bd. ii., s. 326), ‘One only needs to expose the eggs of the human thread-worm to the action of the sun’s rays ina moistened paper envelope, when in five or six hours the tadpole- shaped embryos become slender elongated worms, which are not unlike the sexually mature oxyurides in form, exhibiting rather lively movements under the influence of the warmth.” The power of warmth is thus very obvious in the case of oxyuris, since without a certain degree of temperature the earliest em- bryonal change cannot:be accomplished. As in the oxyuris of man, these early changes are sometimes accomplished whilst the eggs, discharged from the maternal worm, still lie in the feces or rectum of the bearer; so also it is probable that similar 904 PARASITIC DISEASES. changes occur in the eges of Oxyuris curvula whilst they still remain in the rectum of the horse. According to Leuckart, the escape of the embryos of the human oxyuris ordinarily takes place when the eggs are swallowed by a new human bearer; but from the observations of Heller, it is also quite certain that any person may infest himself by swallowing the eggs which have come from oxyurides dwelling in his own person. In either case the escape of the embryos from the egg is brought about by the action of the gastric juice acting upon the egg-shell. The further changes resulting in the formation of the perfectly mature oxyuris are accomplished within the alimentary canal of the bearer. Here we have cases in which the adult sexual form of the parasite lays eggs in the alimentary canal of its host. Favoured by the warmth and moisture of the alimentary canal, the embryo reaches a certain stage of development while still enclosed within its egg-shell. If these eggs, expelled with the feces, reach a new host, the embryo is hatched, and develops into a sexual adult. This is the mode of development in T'richocephalus affinis, and almost certainly in Oxyuris vermicularis of man, Oxyuris curvula of the horse, and Ascaris lumbricoides. Thus Dr. Heller found, post mortem, young round-worms, of the species Ascaris lmbricoides, in the intestines of an imbecile. There were eighteen specimens, the largest of which had only acquired the length of about half an inch, whilst the smallest gave a long diameter of only 2°75 millimétres, or let us say roughly the ninth part of an inch. Thus Heller, in part at least, bridged over the gap which had formerly existed between the size of the embryo at the time of expulsion from the egg and the large-sized ones which alone had been formerly observed in the alimentary canal, and in this case we are almost certain that the cggs are hatched in the alimentary canal, where the embryos attain sexual maturity. The mode of development is usually slightly different in Ascaris and Strongylus, where the eggs have a thin shell, and the embryo enjoys for a time a non-parasitic existence in water or mud. Here it grows in size, but develops no sexual organs, Sometimes it accidentally attaches itself as a parasite to a fresh-water mollusc, but it undergoes no change there. Eventually, gaining access to a proper host, it reaches sexual maturity, and the cycle of its life is repeated. NEMATODA. 905 The researches of Looss in Egypt have shown that dochmius of man—or, as it is now more commonly called, ankylostoma— gains entrance to the intestine in an extraordinary way. The larval forms are hatched in water and from there gain access to the bare human skin, a naked foot or hand, the armed larvee rapidly penetrate the unbroken skin, leaving only a slight reddened spot, they remain in the subcutaneous tissue for a time, and then, by an instinct or natural law, find their way through the blood-stream or lymphatics to the lungs; from there they bore their way into the intestine, where they attain sexual maturity and set up the well-known symptoms called Ankylostomiasis or Miners’ disease. Infection is probably the same in the domesticated animals, where, as Baldrey and others have shown, in India considerable anemia is set up in sheep and dogs infested with these parasites. It is possible also that some embryos are swallowed in drinking water, and thus gain direct entrance to the intestine. It is these parasites that are so often the cause of serious attacks of pernicious anemia in packs of hounds. The con- ditions under which they live facilitate contagion, and the infection is often of a very fatal nature. In the case of some of the strongyles, there can be no doubt that the earlier larval transformations are undergone after the eggs have been expelled and lodged within soft soil or mud. Leuckart has proved this in the case of Strongylus hypostomus, whose rhabditiform young cast their first skin in about three weeks, at which time, as happens with many other larval nematodes, they part with their tails. The case is still more complicated when the nematode re- quires two hosts to complete its metamorphosis. In some cases it is the egg which is taken into the first or intermediate host, in other cases it is the larva. We have a good example of a parasite requiring two hosts in the case of the Spiroptera obtusa of the mouse. The eggs pass out of the alimentary canal of the mouse, and are eaten by the meal-worm. The eggs are hatched, and the larva, after living in the meal-worm for alout five weeks, forms round itself a capsule of connective tissue. If meal-worms containing these encysted larve are eaten by mice, the larve leave their capsules and become the sexually mature Spiroptera obtusa of the mouse. The Filaria sanguinis 906 PARASITIC DISEASES. hominis, or Filaria Bancrofti, is another good example of a parasite which requires two hosts. The sexually mature worm is found in the human tissues, and is viviparous, producing numerous larve, which make their way into the blood. The blood is sucked by mosquitoes, and thus the larve get into the mosquito, where they increase in size, and undergo various changes. The larval filaria lose their sheaths in the stomach of the mosquito, penetrate the abdominal wall, and arrive finally at the proboscis of the mosquito, where they wait until the warm-blooded host is bitten, to which they gain entrance, and find their way to the lymphatics; there they become sexually mature, the females become gravid, and so the cycle is completed. The researches of Roé have shown that the filaria known as Filaria immitis, is propagated by both Anopheles and Culex mosquitoes. The adult filaria live in the heart of the dog, numerous embryos are expelled by the mature females and taken up by the mosquitoes from the peripheral blood, and their cycle continued as explained above. Lingard has endeavoured to show that the disease known as Bursattee is due to a filaria which sets up the irritation resulting in the formation of the chronic indurated calcareous ulcerations characteristic of this infection, although the results of his experiments hardly appear conclusive. Lingard and others in India, Tuck and Ford in the Straits Settlements, have shown the frequent presence of mature filaria attached to the endothelium of the aorta in cattle and horses, where they excite a nodular condition, but no demonstrable pathogenic symptoms, unless cases of anemia from no ascribable cause may be taken as such infection. The Filaria papillosa of the horse is apparently harmless when in the peritoneum, but dangerous when in the eye, from the inflammatory condition it sets up in that organ. Pease has shown that embryonic filaria are responsible for setting up a condition of cedematous swellings of the skin, resembling secondary dourine. In all these cases, except the eye-worm, their presence can, as a rule, only be diagnosed by the finding of embryos in the circulation, and, as in the case of man, these embryos may be only demonstrable in the peripheral circulation at night, at NEMATODA. 907 which time mosquitoes bite. The Filaria hemorrhagica, causing the so-called bloody sweat of horses in Hungary, and the filaria causing summer sores, may be found by a superficial examination of the diseased part of the skin, which will show the embryos. It will be seen, therefore, that filariasis is by no means uncommon in cattle and horses, but its pathogenicity is at present but ill-understood, and the difficulties of showing to what extent it exists,and the amount of demonstrable disease set up,are very considerable. Several cases are on record of the Filaria Medinensis affect- ing dogs and other animals. The life-history of this filaria differs from others in having for its host the fresh-water cyclops known as Cyclops quadricornis. The larve are extruded from the mature female and gain entrance to fresh water ; here they gain entrance to the cyclops, where they go through various metamorphoses, and eventually become ingested into a fresh host by means of the drinking water. The embryos, as a rule, find their way to the subcutaneous connective tissue, usually at one of the extremities; here the mature female becomes gravid and increases very much in size. The irritation so produced causes a small ulceration, which by stimulating with cold water, cause the female to extrude embryos, and gain entrance to water, where the cycle is again carried on. It is probable that the species affecting animals are different to those affecting man, but the symptoms to which they give rise are the same. The first thing noticed is a small punctured hole, through which the head of the Dracunculus Medinensis can be seen. The method of removing it is by very careful and persistent traction ; if the worm be broken off, considerable trouble is likely to arise, as its total length may exceed several feet. Natives in various parts of the East who are affected with this worm twist it round a piece of stick, gradually with- drawing it, an operation which may take days or even weeks. A third example of a nematode requiring two hosts is the Trichina spiralis. The sexually mature worm lives in the. alimentary canal, and is viviparous, producing numerous larvae, which make their way out of the alimentary canal into the muscles, where they encyst. When flesh containing the sexnally immature larve is eaten, the cystic stage comes to a 908 PARASITIC DISEASES. close, and sexual maturity is attained in the alimentary canal, where the larve are again produced. The eminent Russian traveller Fedtschenko observed the primary larval changes to take place in the young of the filaria known as the guinea-worm during their sojourn in the alimen- tary canal of Cyclopes, these entomostracous crustaceans being destined to play the part of intermediary bearers. In like manner, there can be little doubt that the young of the strongyles, which occasion husk and lamb disease, undergo their primary changes of development either within soft mud alone, or within the bodies of small slugs and other minute denizens of herbage, or possibly within the bodies of larval insects and minute entomostracans inhabiting ponds, ditches, and running streams. It thus seems that whilst some nema- todes can accomplish their developmental processes without any lengthened sojourn outside their final bearer, others, on the contrary, require particular, varied, and prolonged condi- tions which shall enable them to undergo certain preliminary changes altogether exterior to and apart from the bodies of their ultimate hosts. In short, as Leuckart points out, we have two distinct groups of strongyles: those which lead a free life in their larval state, undergoing a certain grade of development in mud and water ; and those which pass through certain larval changes of growth within the bodies of insects and other intermediary bearers. So much for the natural history of the nematoda, or order of thread-worms and round-worms, on which much more might be said, were we not limited to a general view of all the groups of internal parasites. As itis, the reader will not fail to perceive that, speaking generally, it is now clearly understood how cattle and sheep and other animals obtain one frequent form of lung disease. It is almost needless to add that the labours of hel- minthologists have thus contributed largely towards the forma- tion of rational principles on which to base successfully botha radical and prophylactic method of treatment. PLATYHELMINTHES. The flukes and tape-worms which belong to this class have flattened bodies, hence the name Platyhelminthes or flat-worms. They are hermaphrodite, and are usually furnished with organs TREMATODA, 909 of attachment, such as suckers and hooks. By being herma- phrodite it is understood that each segment of the tape-worm has both male and female organs, but each segment or zdoid does not impregnate itself. The spermatozoids of one segment gain entrance through the genital openings to another segment of either the same individual or another worm, and the same is the case with the flukes or flat-worms. Usually there is an alternation of generations, i.e., the young one is not like its parent, but must pass through various metamorphoses in order to reach the adult form. TREMATODA. This order comprises the flukes; and it is of great interest to the veterinarian, inasmuch as he is occasionally consulted in reference to the well-known disease in sheep termed rot. This disorder is unquestionably due to the presence of the common liver fluke (Distoma hepaticwm), a parasite that is seldom more than an inch in length. Other animals than sheep are liable to be infested by it, but, except in the case of cattle, hares, and rabbits, it only very rarely occasions severe disease. In about a score of instances a similar entozoon has been detected in the human body. Similar ones also infest the horse. For many years past investigations have been conducted with the special purpose of ascertaining the manner in which cattle and sheep infest themselves with this parasite ; we have succeeded in tracing out all the stages of growth of the common fluke, and researches amongst the trematodes generally have enabled observers to arrive at conclusions of the highest prac- tical importance. Intelligent cattle-breeders and agricul- turists have all along observed that rot was particularly virulent after long-continued wet weather, and more especially gc when there had been a succession of such seasons; and further, that the flocks grazing in low pastures and marshy districts were much more liable to invasion than those which pastured on higher and drier grounds; but, what is most interesting, they also observed that an exception occurred in the case of those sheep feeding in the extensive salt- water marshes bordering our eastern shores. It was probably this latter circumstance which suggested the common and useful practice of mixing salt with the food of sheep and cattle, 910 PARASITIC DISEASES. both as a preventive and curative agent. At all events, as will appear in the sequel, the intelligible explanation of the good effected by this simple practice, is intimately associated with a correct understanding of the mode of development of the parasite in question. The symptoms, treatment, and pathological appearances con- nected with rot are not here discussed, the present chapter being limited to the natural history of the entozoa. Even within this limitation the subject is too large to be treated of exhaustively and in detail; but for all practical purposes it is probably sufficient to follow the plan we have adopted in the case of trichina, namely, to offer a series of conclusions, such as appear to be well established by the independent re- searches of various helminthologists. In this connection it is only necessary to add that the labours of Steenstrup, Leuckart, Van Beneden, Pagenstecher, Moulinie, Davaine, Filippi, and Simonds have played a most conspicuous part. 1. The liver fluke, in its sexually mature state (Distoma hepaticum) gives rise to the disease commonly called rot; this affection being also locally termed coathe (Dorsetshire, Devon), iles (Cornwall) and bane (Somer- setshire). In France it is known as the Cachezie aqueuse, and more popularly as pourriture. In Ger- many the epidemic disease is called egelseuche, and in a more limited sense either die Fdaule or die Leberkrankheit. 2. The rot is especially prevalent during the spring of the year, at which time the fluke itself, and innumerable multitudes of the free eggs, are constantly escaping from the alimentary canal of the bearer. The impregnated eggs are thus ordinarily transferred to open pasture- grounds, along with the feces of the bearer. 8. As it has been shown by dissections that the liver of a single sheep may harbour several hundred flukes, and as also a single adult fluke is capable of throwing off several thousand eggs, it is certain that any rot-affected flock is capable of distributing millions of fluke germs in the egg condition. ‘ TREMATODA. 911. A. Such flukes as have accidentally escaped their host per anum do not exhibit powers of locomotion sufficient to enable them to undertake migrations. Their slight movements, however, subserve the purpose of concealing them in the grass where they have fallen, and also, probably, aid in the further expulsion of eggs, which latter can only pass from the oviduct in single file, one at a time. 5. After the death of the escaped flukes, the further dis- persion of the eggs is facilitated by the subsequent decomposition of the parent worm, and also by its disintegration, occasioned by the attacks of insects. It has been calculated that the uterus of a full-grown fluke may contain upwards of forty thousand eggs. 6. By the agency of winds, rains, insects, the feet of cattle, dogs, rabbits, and other animals, as well as by man himself, the freed ova are dispersed and carried to con- siderable distances ; and thus it is that a considerable proportion of them ultimately find their way into ponds, ditches, canals, pools of all kinds, lakes and running streams. 7. The eggs at the time of their expulsion exhibit the already segmented yolk in a state of fine division. The egg contents continue to develop outside the parent’s body ; the granular matrix finally becoming transformed into a ciliated embryo, which, when set free, follows the habit of infusorial animalcules in general by swimming rapidly in the water. The escape of the embryo is effected at the anterior pole of the egg-shell, which is furnished with a lid that opens in consequence of the action of prolonged immersion, aided by the vigorous movements of the contained embryo. 8. The ciliated, free, swimming embryo of the common fluke, at the time of its birth, exhibits the figure of an inverted cone, its anterior extremity, which is broad and somewhat flattened, supporting a central proboscis-like papilla. PARASITIC DISEASES. A small pigment spot, placed dorsally, and having tho form of a cross, is supposed to be a rudimentary organ of vision. After the lapse of a few days the cilia fall off, the embryos then assuming the character of planaria- like creeping larvee. 9. Notwithstanding its abridged locomotive powers, the non- ciliated larva sooner or later gains access to the body of an intermediary bearer (the Limnea trunculata or the Limnea druncatula; the Dicrocelium lanceolatum has for intermediate host the Planorbis marginata ; both are common fresh-water molluscs), within whose tissues it becomes transformed into a kind of sac or sporocyst. In this condition the larva is capable of developing other larve in its interior by a process of budding. The sporocysts vary in character, and when highly organised are called redie; they are often also called nurses; the latter term being generally applicable to all forms of trematode larve which reproduce by internal budding. 10. The progeny of the more highly organised “nurses” (sporocysts or redic) are furnished with tails, in which characteristic stage of growth they constitute the well- known cercarie or higher trematode larve. In this stage they migrate from their intermediary molluscan hosts, and pass into the water to lead for a time an independent existence. 11. The pup or encysted cercarize are at length passively transferred, along with its fodder or its drink, into the digestive organs of the ultimate host; and it is thought that the cysts serve the purpose of a protective covering until the larve have passed into the true or digestive stomach, in which organ the action of the gastric juice, by dissolving the sac, liberates the pupe. From the stomach the tailless larve succeed in entering the common liver duct and its branches, in which situation they rapidly acquire all those internal organs which characterise the adult flukes. In this way the life cycle is completed. TREMATODA, 913 From the researches of Van Beneden, and especially also of Pagenstecher, it would further appear that the degree of multi- plication of the larve and the extent of their organisation are largely affected by varying states of the season, in association with other co-ordinating external conditions. This conclusion is important practically. For example, the highly organised germ-sacs or sporocysts (redie) are capable, under favourable climatic states, of developing not only the ordinary tailed cercarie in their interior, but also new germ-sacs. It would seem, further, that there is no recognisable limit either to the variety or to the extent of larval fluke development. No wonder, therefore, that an accidental concurrence of favour- able conditions, such as happens in particular seasons, should be followed by the disastrous outbreaks recognised as epizootics of rot. As we cannot regulate the character of the seasons, so neither can we prevent the occurrence of many epizootics. Helminthological science, however, does enable us to lessen the amount of digease, by affording an adequate insight into the nature of the causes concerned in its production. The Distoma hepaticum and the Dicocelia lanceolatum are the two species of fluke found in the liver of sheep, &c. The former is distinguished from the latter by the absence of the small spines in the cuticle. The knowledge, for instance, that the snail (Limnea truncu- lata) harbours the cercaria of the fluke points to the necessity for the destruction of these molluscs in places subject to fluke disease, as an easy means of eradicating the infection, in the same way that the destruction of mosquitoes prevents the spread of malaria in man. Guided by indications of the order just mentioned, Dr. Rowe, of Mount Battery, Goulburn District, Victoria, has proposed a somewhat rough-and-ready method of stamping out the rot, which disease, by the way, appears to be far more constant as an epizootic in Australia than it is with ourselves. In brief, the plan suggested was to burn the whole of the grass where rot-affected sheep have been pasturing, to destroy the diseased animals themselves, and, after a time, to restock with sound animals. There can be little doubt that this method would prove effective for a while; but since, to insure a permanent result, 58 914 PARASITIC DISEASES. a frightful sacrifice would have to be made in the first instanco, it is to be feared that the experiment could not be undertaken without severe and rather unconstitutional legal enactments. Moreover, supposing the colony were rendered entirely free from rot, the original exciting cause, which we are told brought the malady into the country somewhere about the year 1855, might again reintroduce the disorder. On this subject, how- ever, the reader will do well to consult the notice of Dr. Rowe’s observations, as recorded in the Veterinarian for February, 1873. In perusing the communication in question, it should be borne in mind that the observations proceed from the pen of an observant and extensive stock-owner. BILHARZIOSIS. This disease is caused by the presence of a parasite of the same family as fluke, or Distoma hepaticum. Montgomery, in India, has lately drawn attention to the prevalence of the parasite schistosomum in animals in that country. He was unable to trace any pathogenic lesions as a result of their presence in equines and bovines ; but Baldrey, in the Punjaub, has shown that their presence in sheep is clearly associated with & pernicious anzmia and ulcerations of the intestines. The mature worms, unlike the other trematodes, are not herma- phrodite, but havea separate male and female. They usually inhabit the blood-vessels of the mesenteric region, and their presence is liable to be overlooked, as they are very small and difficult to isolate in the vessels. Their presence may, however, be more certainly known by the demonstration of their charac- teristic eggs, which always show a spinous extremity at one end, rarely at the side. The adult female lays her eggs in the mesenteric vessels, from which they become deposited in submucous intestinal or rectal tissue ; here they tend to set up irritation, which may result in ulceration. They are finally expelled, and the larva hatch in fresh water. The eggs may sometimes be found by an examination of the faces, or by inserting a long, blunt spoon into the rectum and gently scraping the mucous membrane. In cases where they exist, at a post mortem examination they can always be found by examining a BILHARZIOSIS. 915 scraping of the deeper mucous lining of the intestine, usually at some ulcerated part, with a magnification of 50 to 100. Their further life-history is unknown. In man they set up a train of dangerous symptoms characterised by hematuria. This is due to the fact that the mature worms are generally in the rectal veins, and the eggs find their way to the submucous tissue of the bladder, from which point they are expelled. The eggs will not hatch in urine, but require admission to fresh water before doing so. This phenomenon may easily be observed under the microscope with fresh schistosomum eggs. The mature female, having expelled all her eggs, dies; and it Fic. 84.—Scraping of a hemorrhagic Fic. 85.—Scraping of a hemorrhagic area, showing ova of Schistosomum area, showing ova of Schistosonvwm spindalis. x 50. Bamfordi. x 5). Found in mesenteric vessels of cattle. From mesenteric vessels of bull. is often the case that many eggs may be found in the vessels, but no mature parasites. It is probable that the intermediate life-history of bilharzia is similar to fluke, and that infection takes place in the same way. The male is wider than the female, and the ventral sucker is very prominent; he carries enfolded in his body the female, in the so-called gynecophoric canal. The anterior and posterior extremities of the female are free, and she is narrower than the male. It is possible that Bilharzia crassa ig the same in animals as in man, and this constitutes a distinct danger to human beings. The male schistosomum is 14 mm. long; the female, 20 mm. lone. The eggs are 016 to 018 mm. long. ; 58—2 916 PARASITIC DISEASES, CESTODA. This natural order of flat-worms has acquired its name from the circumstance that most species in the adult condition resemble a tape or band, hence also the common name tape- worm. Sometimes, however, the resemblance to a tape fails altogether, as is conspicuously the case with the little tape-worm of the dog (Tenia echinococcus). The absence of a mouth and of an alimentary canal are very characteristic of the order, so that in the tape-worm we have an animal feeding by the process of osmosis. If an adult tape-worm be examined we find that it consists of segments. The anterior segment is differently constructed from all the rest, and is variously designated as the head, nurse, or - scolex. Behind the anterior segment or head follows a chain of segments for reproductive purposes, the generative segments or proglottides. These generative segments are produced by a process of budding from the head. In the same worm we find them at all stages of development, unripe, half-ripe, or com- pletely ripe segments, the youngest nearest the head. It is quite important to observe that the head produces all the rest of the worm by a process of budding, so that if all the body be removed and the head left behind, the worm will be again reproduced. The head or scolex, in addition to its power of continually budding off chains of segments, is provided with organs by means of which it fastens itself to the wall of the alimentary canal. These organs of attachment in the Bothriocephalus take the form of two longitudinal grooves, hence the name, while in the Tenia the sides of the head are provided with four sucking dises. In addition to the four suckers, some tape-worms (Tenie armate) have circles of heoks anterior to the suckers, each hook formed in-a little pocket. These hooks have sharp projecting points, which serve as anchors for the tape-worm. Their presence or absence, their size, form, and number, are often very characteristic, and their examination is often facili- tated by the use of caustic potash, in which the hard chitinous material of which they are composed is insoluble. Following the head comethe youngest segments, as yet narrow and short, and not plainly distinguishable from one another, CESTODA. 917 often spoken of as the neck. Proceeding backwards from the ‘neck, the segments become broader and longer, and more distinct from one another. The hindmost segments have reached the full size, are capable of separating from the others, and can even have an independent existence for a time. Ultimately these detached segments wander out of the body, or are expelled with the feces, when they die and decay; but the ripe eggs provided with their hard shells retain their vitality, and are ready, under favourable conditions, to undergo a series of metamorphoses, whose final term is the adult tape-worm. Each segment is provided with a complete set of male and female reproductive organs, so that, if we take into account the fact that the segments can detach and lead for a time an in- dependent existence, we may regard each segment or proglottis as a complete hermaphrodite individual, although another segment is necessary to perform the act of fecundation. In the youngest segments the sexual organs are not yet developed, but in the half-ripe segments the male and female organs are distinguishable, whereas in the completely ripe segments the uterus loaded with its eggs is the conspicuous part. The form of the uterus of the ripe segment is very characteristic, and may be readily observed by pressing the ripe segments between two slips of glass, and examining with the naked eye or a pocket lens. For example, in the Bothriocephalus the uterus has the form of a rosette, whereas in the Tenia it is usually tree-like, and by counting the number of uterine branches we are often able to determine the species. At the game time the sexual openings can be observed—(1.) On the margin, and alternately right and left, i.e., on the left margin of one segment, on the right margin of the next, on the left margin of the’third,and soon, ¢.g., Teniacenurus, Tenaserrata, Tenia marginata, and most Tenia; (2.) Two marginal openings for each segment, one on the right margin and one on the left (only in Tenia cucumerina and Tenia expansa) ; (8.) Openings not marginal, but in the middle of the ventral surface, ¢.g., Bothriocephalus. If the eggs from the uterus of a ripe segment of a Tenia be examined, they appear to the naked eye as coloured points, and under the microscope as round or oval bodies. The shell is 918 PARASITIC DISEASES. thick, and is seen to consist of little prisms cemented together. In the interior of the shell the embryo is visible as a little solid body provided with six hooks. Theeggs of the Bothriocephalus present quite a different appearance. These eggs are hatched when they gain access to the ali- mentary canal of a suitable host, which is rarely the same as the host of the adult Tenia. Stimulated by the warmth and acted upon by the gastric juice of the alimentary canal, the shell is more or less dissolved, and the six-hooked embryo or Proscolex becomes free. Helped by its hooks, the embryo bores its way through the wall of the alimentary tract, and is carried along with the blood, or otherwise, to some place suited for its further development ; it may be the connective tissue, muscles, liver, lungs, or even the brain, as is the case with the Conurus cerebralis in the brain of sheep. Having reached a suitable resting-place, the solid embryo drops its hooks, and, acting asa foreign body, causes local exudations and new formations of granular matter and connective tissue. Thus the surrounding tissues form nutritive material and a connective tissue capsule for the solid embryo. The embryo, fed at the expense of the surrounding tissues, rapidly grows in size, losesitssolid character, and becomes a hollow sac filled with fluid. In this condition the creature is spoken of as a cystic- or bladder-worm, or more commonly as a measle or a hydatid, and this cystic stage is quite comparable with the sporocyst of atrematode-worm. Thecystic- worm, still enclosed in its capsule, undergoes further important changes. Atone or more points in its wall a process of budding takes place, each bud growing inwards in the form of a hollow pocket, in the interior of which the suckers, or suckers and hooks, are developed. Hach bud has now the form of an invaginated tape-worm head, and when evaginated is quite like that of the adult tape-worm, differing mainly from it in being hollow. _In other cases the cystic-worm undergoes more complex changes, the buds developing not into tape-worm heads, but into secondary cysts, while the buds on the secondary cysts become the tape-worm heads, as is the case in Echinococcus cysts. These different kinds of cystic-worms, which are merely the larval stages of tape-worms, have received different names. (1.) Cysticercus—eyst filled with serum, and provided with only one head. CESTODA. 919 (2.) Cysticercoid—cyst without serum, only one head. (3.) Cenwrus—ecyst filled with serum, and provided with many heads. (4) Echinococcus, primary cyst, gives rise to secondary cysts filled with serum, each secondary cyst producing numerous heads. (5.) Acephalocyst, without heads. Thus the tape-worm egg, when hatched, gives rise to a six- hooked embryo, the six-hooked embryo changing into a cystic- worm, with one or more tape-worm heads, and that is the end of one part of its development. The cystic-worm having developed its heads, can remain for a length of time without undergoing further change, cases being known in which human beings have carried an Echinococcus cyst for over thirty years. But if flesh, lung, liver, or brain containing cystic-worms be eaten by certain animals, then a new course of development begins. The head of the young worm comes out of the cyst, which is digested by the gastric juice, the head being protected from the action of the juice by the carbonate of lime with which it is loaded. The head is now free, attaches itself to the intestinal wall, and begins rapidly to form a chain of segments, which develop their sexual organs and their eggs, and thus we have now the cystic-worm changed into an adult Tenia, with its head and segments. The ripe seg- ments containing the eggs detach and get out of the body, and now the eggs are again ready to commence anew their life cycle. The development of the Bothriocephalus differs in several respects from that of the Tenia. The egg-shell is provided with a lid. In its interior the embryo is formed, the outer layer of cells forming the ciliated coat, and the central mass of cells the six-hooked embryo. The ciliated embryo comes out of the shell by the opercular aperture, and by means of its cilia swims about in the water. Experiments have shown that the embryos of Bothriocephalus latus can develop into a sexually mature worm without passing through a cystic stage. The eggs were taken and kept for six months in fresh water till the embryos were formed. A very young pup was supplied with milk containing these eggs and the ciliated embryos. On the 10th July the pup was fed with the eggs, and on the 25th August it passed a 920 PARASITIC DISEASES, Bothriocephalus latus 424 cm. long—that is, about 17 inches. On the 9th September it was killed, and three Bothriocephalt were found in its intestines. Interesting as are the phenomena connected with the origin and development of the various tape-worms found infesting our domesticated animals, it is not necessary for the practitioner of veterinary medicine to acquaint himself with the natural history details of all the forms which are apt to come under his notice ; nevertheless he will find it useful to have a general knowledge concerning some of them. Thus, he should know that no less than six different kinds of tape-worm infest the dog. Of these, he should be further aware that one (Tenia serrata) is acquired by swallowing the larvee (Cysticercus pisiformis) which reside in the bodies of rabbits and hares; that another (Tenia marginata) is obtained by devouring the larve (Cysticercus tenuicollis) which reside in the viscera of the sheep and pig; that another (Tenia coenurus) is obtained by ingesting the larve (Canurus cerebralis) which infest the brains of sheep and other animals; that another (Tenia echinococcus) is developed when the dog swallows the larve (Echinococcus veterinorum) found in the viscera of various animals, especially the pig; and lastly, that yet another (T’enia cucwmerina) results from swallowing the dog louse (Trichodectes latus), or the dog flea (Pulex serraticeps), which harbours its representative cysticercus or measle. To describe minutely all the changes through which these and other tape-worms allied to them pass, would require a separate treatise. We are concerned chiefly to present a general view of the subject; and, perhaps, in further illustrating the phenomena of tape-worm life, we cannot do better than select that particular species which, in its larval state, gives rise to the familiar disease, variously termed vertigo, gid, staggers, and sturdy. Practical veterinarians liave repeatedly asked in what manner sheep become affected with gid. For them it is not sufficient to be told that the sheep obtains the worms from the dog on the one hand, and that the dog in its turn obtains tape- worm from the sheep. There are, as we have seen, several tape-worms liable to reside in the dog, and only one of these cestodes is concerned in the matter at issue, and that is the Tenia cenurus. If the head of a yearling affected with gid be opened, one or CESTODA. 921 several hydatids will be found in the brain. These hydatids must not be confounded with the common and often much larger hydatids found in the viscera of various animals, nor with the slender-necked hydatids liable to infest the abdomen of the sheep. : The brain-hydatids in question are cenuwri, being readily recognized by their polycephalous character; that is to say, they are furnished with numerous processes termed heads. The full-grown gid hydatid is always lodged within a sheath or cyst, and when removed, whether by operation or post mortem, invariably displays these heads at the surface. To the naked eye, indeed, the heads may merely exhibit the ap- pearance of minute whitish granulations,. especially if they happen to be inverted and retracted within the walls of the hydatid. The ccenurus otherwise presents the general appearance of an ordinary bladder-worm, containing in its interior a clear, amber-coloured, watery fluid. On subjecting the so-called heads to microscopic examination, they will be found to display a double crown of minute hooks in front, besides four sucking discs, such as are commonly seen on the head of an ordinary tape-worm. A single large ccenurus may support several hundreds of these heads; each head in reality representing a young tape-worm. This re- lationship has been proved by experiment. If, for example, a fresh ccenurus be given to a dog, each of the hundred or more heads becomes converted into a tape-worm, having characters quite distinct from all the other tape-worms that are liable to infest the dog. About eleven weeks would be necessary for the tape-worm to assume its perfect or sexually mature condi- tion. Thus, in one experiment, where only five days were allowed to elapse before the canine bearer was killed, the heads were found alive, and separated from the hydatid, but dis- playing no trace of any body. In a second experiment, where three weeks elapsed, the young and sexually immature tape- worms had only attained the length of one inch and a half. In a third experiment, where the interval extended to two months, the tape-worms had acquired a length of eighteen inches; but the eggs, even then, were not perfectly developed. A period of three months being somewhat more than suffi- cient for the maturation of the gid tape-worm, the perfect ova will by this time be found escaping from the dog along with its 922 PARASITIC DISEASES. feces. These eggs, in common with those of other tape-worms display six-hooked embryos in their interior. Wherever the infested dog wanders and passes excrement per anum, there will it be privileged to distribute the ova. The eggs, if left to themselves, would do no harm; but by various agencies they are further distributed over the pastures where yearlings and sheep are grazing. Millions of tape-worm germs are thus annually scattered far and wide. In due course the ova are swallowed by grazing animals. When the ova have arrived within the true digestive stomach, the gastric juice dissolves the shells, and the minute six-hooked embryos forthwith make their escape. They speedily set about migrating on their own account ; and having, by means of the hooks in question, bored their way into the blood-vessels, they are carried to and fro in the current of the circulation. By virtue of some selective capacity they seem to know when they have arrived within the vessels of the brain, in which organ, after escaping the vessels, they bore their way to the final resting-place. Here, by a process of transformation, they part with their hooks, and gradually acquire the bladder-worm state, in which con- dition they vary in size from a pin’s head to that of a large walnut. To attain the perfect polycephalous state, they require a period of about ten weeks, and thus the whole cycle of development is accomplished within something like five months. It must be allowed that the process of development above recorded is one of the most astonishing of all the biological phenomena with which the naturalist is acquainted. Not merely are the necessary changes of host remarkable, but the characteristics marking each phase in the life-history of the entozoon itself are still more noteworthy. At one time of its career the creature is a mere bladder-worm, at another an elongated tape-worm, at another a minute six-hooked embryo, and finally, once more, a bladder-worm. But this is not all; inasmuch as its development, in one very important particular, differs from the process undergone by the ordinary beef and pork tape-worms (Tenia mediocanellata and Tenia solium). Thus, whilst the egg of the common tape-worm is only capable of developing onward into a single sexually mature tape-worm, the solitary egg of the Tenia cenurus, as we have seen, becomes transformed into a multitude of tape-worms. In this respect, CESTODA. 923 it is true, our parasite is, in some sense, eclipsed by another tape-worm that is resident in the dog (Tenia echinococcus) ; but, with this exception, we know of nothing comparable to it within the limits of cestode reproduction. Amongst the other tape-worms of general interest to the professional man are those which are derived from the con- sumption of pork and beef. The measles of pork (Cysticercus cellulosus) are transformed into the T'’enia solium, whilst those of beef (Cysticercus bovis) are transformed into the Tenia mediocanellata. These tape-worms, as such, are only known to infest the human body. The tape-worms of cattle and sheep, as well as those of the horse, probably all belong to that group of tape-worms whose larve are normally resident in the bodies of insects and other non-vertebrated animals. This explains why their separate developmental histories have not hitherto been fully made out by helminthologists. Those who desire further details on this head should con- sult the standard treatises of Leuckart and Kuchenmeister, Neumann’s “ Parasites,’ or Cobbold’s manual of the parasites of our domesticated animals, in which the medical and sanitary importance of the beef tape-worm is dwelt upon at considerable length. Lastly, we desire to call particular attention to the fact that cysticerci or measles have been found in mutton. These small cystic-worms are undoubtedly the representatives of a distinct species of tape-worm that probably resides in the human bearer. Some account of the parasite (Cysticercus ovis) is given in the supplement to Cobbold’s larger treatise on Entozoa (p. 80), the selfsame entozoon being much more recently and fully described by Dr. Maddox in the Monthly Microscopical Journal for June 1873. We now know, therefore, that mutton and beef, as well as pork, may become measled; these three kinds of measles being perfectly distinct from each other, and all severally derivable from different species of tape-worm. It is now known that these ovine cysts were undeveloped Cysticercus tenuicollis, and that the Tenia tenella of man was a small-sized Tenia solium or Tenia saginata. 924 PARASITIC DISEASES. ACANTHOCEPHALA, As already stated, this order of helminths is represented by a parasite which occasionally takes up its residence in the intes- tines of the pig. It is known as the large thorn-headed worm, or Echinorhynchus gigas. The male commonly measures three or four inches in length ; whilst the female often exceeds fifteen inches, examples having been recorded beyond two feet. The head is furnished with an armed proboscis, by means of which the worm anchors itself securely within the mucous membrane of the small intestines. This parasite is tolerably abundant in France and Germany, but very little is known of it in England. Professor Verrill, writing for the ‘‘ Report of the Connecticut Board of Agriculture,” speaks of this parasite as ‘“‘the com- monest and most injurious intestinal worm found in swine. These parasites,” he adds, ‘‘not unfrequently perforate the walls of the intestine, and stray into other parts of the viscera, producing serious disease. Sometimes the intestine of a hog is found perforated by so many of these holes that it cannot _ be used in the manufacture of sausages. In severe cases the hogs are weak in the loins, and have the membranes in the corners of the eyes swollen, watery, and lighter coloured than usual. The excrement is hardened and highly coloured, and the animal often keeps up a continual squealing and grunting, especially in the morning. Such hogs are generally cross and morose, biting and snarling at their companions, but usually too weak to defend themselves if attacked in return, and easily thrown down. Finally, the weakness increases until the poor creatures are unable to walk about or to stand.” Although the development of the E:chinorhynchus of the hog has never been fully traced, there can be little doubt that its mode of development is precisely similar to that known to occur in other members of the genus. Dr. Guido Wagener has fur- nished us with some admirable illustrations of the eggs and embryos of various species (Sieb. and Koll., Zettsch., vol.ix.), but it remained for Leuckart to explain that these creatures during growth exhibit the characteristic phenomena of alternate genera- tion (Gott. Nachrichten, 1862). His experimental investigations were chiefly made with E. proteus and E. filicollis. Professor Leuckart caused some fresh water-crustaceans (Gammari) to * ACANTHOCEPHALA. 925 swallow the eggs of these small thorn-headed worms, and he had the satisfaction of observing that in a few days the embryos quitted their egg-shells and passed into the bodies of the unsus- pecting intermediary bearers. After a series of further changes (which Leuckart regarded as comparable to those of a true alternate generation, and not simply metamorphotic), the young parasites rapidly increase in size; the original skin of the embryo being cast off ‘‘ as soon as the echinorhynchus occupies the whole interior of the embryo.” The young parasites acquire sexual organs whilst still lodged within the intermediary bearers, so that, within about a week after they are transferred to the intestinal canal of their proper and ultimate piscine host, their development into the adult state is completed. What ordinarily takes place in the case of these echinorhynchi of the fish must more or less appertain to the echinorhynchi of the hog. Swine, as we all know, are not very particular as to what they eat or drink, consequently they have abundant opportunities of swal- lowing insects, gammari, entomostracous crustaceans, or other minute creatures which are destined to harbour the larve of acanthocephalous parasites. According to Schneider the eggs of the Echinorhynchus gigas are discharged in the feces of the pig, which harbours the sexually mature adult. The eggs are devoured by maggots, and, reaching the stomach, are hatched. The embryos, which are provided with spines, bore their way into the body cavity of the maggot where they develop a young Echinorhynchus in their interior. The maggots are in turn devoured by the pig, in which the Echinorhynchus again reaches sexual maturity and produces ova. DIPTERA. As remarked at the commencement of this chapter, some of the flies are apt to prove troublesome as internal parasites. With those dipterous or two-winged insects which, as external parasites, occasion suffering to animals, we have here little or nothing to do; but since some of these forms of insect life play the double part of attacking their victims from within as well as from without, it is desirable to speak of such of them as fairly, in one phase of their life, come under the gencral class of internal parasites. 926 PARASITIC DISEASES, In this relation there is a particular group of insects that distinguishes itself above all the others. This is the so-called bot-producing family, comprising various forms of gadflies (Gistride). As enemies of the horse, ox, and sheep, the gadflies have acquired notoriety from the earliest times. Thus they origin- ally obtained their family title from the ancient Greeks, who called the gadfly of cattle the Oistros (Oterpos, from Ola, I impel ; Latin, Zstrus). When any person became unduly excited they said he hada fit of the Oistros. One can readily see the force of this expres- sion after noticing, how outrageously excited and furious a herd of cattle becomes when attacked by gadflies. As, however, it is not with the gadflies, viewed in the light of external enemies or parasites, that we have here to deal, we may dismiss this part of the subject by observing that, in the case of cattle, the gadflies have the ingenuity to select as their victims young beasts from two to three years old. The hide of an older beast is more difficult to pierce. Since different species of gadfly attack different animals, and several kinds of fly, in the larval state, infest one and the same animal, it is desirable to speak of the forms belonging to our various domestic animals separately. In the first place we will consider those of the horse. The common gadfly of the horse (Gstrus equt) attacks the animal whilst grazing late in the summer ; its object being not to derive sustenance, but to deposit its eggs on the coat; and this it accomplishes by means of a glutinous material causing the ova to adhere to the hairs. The parts of the animal selected are chiefly those of the shoulder, base of the neck, and inner part of the fore legs, especially about the knees; for in these situations the horse will have no difficulty in reaching the ova with its tongue. When from any cause the animal licks those parts of the coat where the eggs have been placed, the moisture of the tongue, aided by warmth, hatches the ova, and in some- thing less than three weeks from the time of the deposition of the eggs, the larve thus make their escape. As maggots, they arenext transferred to the mouth, and ultimately to the stomach of the equine bearer along with food and drink. Of course a great many larve perish during this passive mode of immigra- DIPTERA. 927 tion ; some being dropped from the mouth, and others being crushed in the fodder during mastication. It has been calcu- lated that out of the many hundreds of eggs deposited on a single horse, scarcely one out of fifty of their contained larve arrive within the stomach. Notwithstanding this waste, we are all of us familiar with the circumstance that the interior of an animal’s stomach may become completely covered with the larve in the condition of “bots.” Whether few. or many, they are retained in this singular abode chiefly by means of two large cephalic hooks, which are inserted into the mucous membrane. As soon as the bots have attained their perfect growth, as such, they voluntarily loosen their hold, and allow themselves to be carried along the alimentary canal until at length they make their escape with the feces. It is said that during their passage through the intestinal canal they not unfrequently re- attach themselves to the mucous membrane, thereby occasioning severe intestinal irritation. When thus lodged in the neighbour- hood of the anus they seriously inconvenience the animal. In all cases, however, they sooner or later fall to the ground. When once transferred to the soil they bury themselves beneath the surface in order to undergo the change whereby they are transformed from the bot state into the pupa condition. At length, having remained in the soil for a period of six or seven weeks, they finally emerge from their pupal envelope or cocoon, in the active life-phase of the imago or perfect dipterous insect. It thus appears that these creatures in the formof bots ordinarily pass about eight months of their lifetime in the digestive organs of the horse. ° That bots are capable of giving rise to severe disease in the horse there cannot be any reasonable doubt, but it is not often that the disorder is correctly diagnosed, since it is only by the passage of the larve, or by their adherence to the verge of the anus, that the practitioner can be made aware of their presence. We are not called upon to dwell on this fact of the subject in the present chapter, but may remark in passing that Mr. J. 8. Woods, V.S., has published in the Veterinarian a case of tetanus ina mare associated with the larve of @istrus equi, and Mr. J. T. Brewer, V.S., has also given a case in the same journal, where the duodenum of a horse was perforated by bots. 928 PARASITIC DISEASES, Several other species of Gistrus victimize the horse; one of the most formidable of these being the 2. hemorrhoidalis. This fly is especially annoying in the initiatory stages of the attack, because, unlike the common species, it selects the lips and nostrils as the principal locality for the lodgment of the ova. According to Bracey Clark the mere sight of the insect produceg extreme agitation, the horses wildly galloping to and fro in their usually vain endeavours to evade these winged tormentors. The common bot-fly of the ox (@strus bovis) passes through transformations similar to those undergone by the gadflies of the horse. It differs, however, in one important particular ; for, in place of acquiring its larval condition as a bot within the stomach, it takes up its residence for that purpose beneath the animal’s hide. In this situation its presence gives rise to the formation of small tumours, termed warbles. The facts, in short, are as follows :—Selecting, as before remarked, young beasts in good condition, the fly lights on the back on either side of the spine. The animal darts away in alarm, often bellowing furi- ously and frightening its companions. The whole herd forth- with rush about in a frantic manner; and it is said that the mere buzzing of the insects is sufficient to render yoked animals quite unmanageable. Ina short time the insect succeeds in perforating the skin by means of an ovipositor, one egg being deposited in each opening. After a time the egg is hatched, and the young during growth produces sufficient inflammation to lead to the formation of the well-known warbles. Within the tumour the bot is placed with its head downwards, its tail being applied to a small external opening in the warble, in order that it may receive sufficient air for the purposes of- respiration. When the bots are mature they make their escape, and fall to the ground, burying themselves in the turf, or hiding under- neath stones. During the process of metamorphosis the skin of the bot becomes transformed into a cocoon, and in course of time the pupa or chrysalis stage is completed. In this state it remains as a grub for a month or six weeks, at the expira- tion of which period the lid of the cocoon comes off, and the perfect insect or imago is set free. The common bot-fly of the sheep (Gistrus ovis) neither chooses the stomach nor the back of its bearer as a place of residence during its acquisition of the larval condition, termed the bot. DIPTERA. 929 This insect may be regarded as a worse tormentor than either of its common congeners above mentioned. It attacks the nostrils of the sheep, and the distress thus occasioned is so great that the poor animals, in order to avoid:the flies, will often bury their nostrils in the dusty hollows of cart-ruts, further protecting their heads with the fore feet. The members of any flock thus attacked will also collect together in groups, and jostle against one another with their heads downwards, so as to avoid the flies as much as possible. When struck by the fly they stamp the ground violently, and exhibit other signs of distress, sometimes amounting to agony: According to Mr. Riley, as quoted by Verrill, the young larva is itself deposited at the margin of the sheep’s nostrils, having quitted the egg whilst yet within the oviduct of the parent insect. Be this as it may, the young larve, having once gained access to the nasal passages, have no difficulty in retaining their hold, at the same time that they cause fresh distress to the unhappy bearer. Within the frontal sinuses they firmly anchor themselves by means of a pair of cephalic hooks, and in this situation they remain until they have perfected this stage of their larval development. Con- sidering the situation of these creatures, there need be no astonishment at the fact that their presence sometimes gives rise to terrible sufferings on the part of the sheep; the afflicted animals occasionally perishing under the inflammatory action thus set up. Stock-owners and farmers term this disease grub in the head, and it is often asserted by them that the grubs gain access to the substance of the brain itself. They are perfectly sure they have seen maggots in the brain, and no arguments of the veterinarian, derived from a study of the osteology of the sheep's head, will serve to convince them that they are in error. Without dwelling upon this point, we have further to observe that the perfected bots usually pass from the nostrils to the ground by the same way that they entered, and thenceforward, having penetrated the soil, they accomplish their subsequent metamorphosis in a manner very similar to that of their con- geners. The pupal state is acquired in about two days, but they remain concealed in the soil for a period of six or eight weeks. At the expiration of this period the lid of the cocoon is raised, and the insect prisoner makes its escape in the usual manner. 59 930 PARASITIC DISFASES. In perusing the above remarks, it will be noticed that, if Mr. Riley’s statements are to be accepted as correct, the gadfly of the sheep reproduces viviparously. This isa point of consider- able interest, since, so far as we are aware, all the other gadflies bring forth their young in the egg condition. According to Verrill, who quotes from the First Annual Report on the Noxious Insects of Missouri (given in the Connecticut publication already cited) for 1868, Mr. Riley states that Mr. Cockrill had removed upwards of three hundred living larve from the body of a single gadfly. Soon after the flies have effected their escape from the cocoon, they set about operations for the continuance of the species; and as they are neither furnished with a mouth nor other means of taking in nourishment, it is obvious that the pleasures they enjoy during the winged state must be exceed- ingly short-lived. Of late years, since the knowledge of protozoan diseases has improved, the importance of flies of the order Diptera has greatly increased from the point of view of economy. It is now known definitely that the varieties of disease due to trypanosomata are spread by various dipterous insects, the more important being that family known as Glossina and the family Tabanade. The Glossina, or tsetse-flies, have nine species. They are greyish or yellowish-brown, dull-coloured flies 5-7°75 mm. long. During life and while at rest their wings are charac- teristically crossed over the back, exactly like the. blades of a pair of scissors. Metamorphosis is incomplete or pupiparous—i.e., larva, pupa, adult. There are no eggs. The fly is exclusively confined to Africa, except one species, the Glossina tachinoides, in Arabia. The Glossina palpalis, fusca, and other species convey sleeping sickness. Glossina morsitans is the agent conveying nagana. Stomozxys calcitrans, or stable-fly, is common in England, but it is not known to produce disease. It has four stages in its life cycle—egg, larva, pupa, and imago, or adult. Eggs are laid in manure heaps, etc., usually in large quantities together, so that careful search will render their destruction — easy; moisture is absolutely essential for their existence. Tabanade (horse-flies, clegs, breeze-flies, etc.). Usually a large and ferocious fly measuring from a half to one inch DIPTERA. 931 long. Eggs are laid on leaves of plants in clusters, and these develop into larve and pupe. A species of this fly is con- cerned in the transmission of surra in India. Hippoboscide resemble Glossina in their metamorphosis. They are known as forest-flies, and are said to be the cause of the spread of disease. It has been known or suspected for some time that the common house-fly (ALusca domestica), or the blow-fly (Calliphora vomitaria), can be the mechanical means of conveying disease from animal to animal, by the mere fact of carrying disease- producing germs on their feet and depositing them on a sore or on some food material. Ticks have of late become of very great interest to the veterinarian, since it is known that they are active agents in the spread of piroplasmosis and spirillum fever. Formerly they were considered as parasites, simply causing annoyance ~ and harm to the skins, wool, food, &c., but now there are graver reasons for their systematic study. The Izodoide or tick family belong to the Arachnoide, a family of the Arthropode, and are closely allied to the spiders and scorpions. They are of the sub-family mites known as Ixodidae. The Izodide are divided into the Argaside, having no scutum, and the Izodide, having a scutum. Of the Argaside there are only two families, the Argas and the Ornithodoros, the former having the rostrum entirely invisible from above, the latter having at least the tips of the palpi visible. The Ixodide are divided into the Rhipicephaline, having the rostrums shorter than broad, and the Ixodide, having the rostrum longer than broad. The former are, again, divided into Boophilus, Rhipicephalus, Hemaphysalis, and Dermacentor ; the latter into Ixodes, Hyalomma, Amblyomma, and Aponoma. The differentiation into species from these groups is un- necessary here, and we need only mention the chief species concerned in spreading disease. Rhipicephalus appendiculatus conveys East Coast fever. R. annulatus, Texas fever. R. Australis, red-water, in Australia. The infective parasite is transmitted through the mature female to the larve, which are alone capable of transmitting the disease. 59—2 932 PARASITIC DISEASES. Bilious fever of the horse by probably Hyalomma Egyptium. Bilious fever of the dog by H. Leachi. Heart-water in cattle by Amblyomma hebreum. Hemoglobinuria in Europe by Ixodes reduvius. “Trembling,” or Louping-ill in sheep, Ixodes reduvius. Spirillum fever by Ornithodorus moubata. In the dog only the adult tick conveys the disease, the larve and nymph being innocuous. In East Coast fever the ticks contract the infection as larve or nymphs, and convey it to cattle when they are nymphs or adults. All ticks are very resistant, especially the Bont tick in South Africa, which also conveys Hast Coast fever, and for this reason special methods of dipping and other precautionary measures are rigorously enforced. TRACHEARIA, As with the dipterous insects, sc with the members of this large order or division of arachnidans. Whilst many species are externally parasitic, only a very small number can in any true sense be called entozoa. One species, however, of the present group is not only internally parasitic in the larval state, but also in the full-grown or sexually mature condition ; conse- quently it has even more right to be regarded as an entozoon than any of the gadflies. The parasite in question is the Pen- tastoma tenioides. In the adult state, this worm occupies the nasal and frontal sinuses of the dog, sheep, and horse; and in one of its larval stages it is founl either encysted or free in the viscera of the various animals, especially ruminants, as well as in man himself. The larva, which is commonly described as the Pentastoma denticulatum, usually measures about one-fifth of an inch in length; but the adult males are three-quarters of an inch long, whilst the females occasionally measure as much as four inches from head to tail. The history of the development of these curious parasites is somewhatremarkableand of great practicalinterest. The female discharges her eggs whilst within the nose of the dog. From the nasal passages the eggs are constantly discharged by sneezing and otherwise. They are thus scattered by the canine host in TRACHEARIA, 933 all directions, and by the drying of the slime they adhere very readily to vegetable and other matter. Afterwards, on being transferred tothe stomach of ruminating and otheranimals, their embryonic contents are set free by the dissolution of the shells. The embryos, which are furnished with two pairs of claws, then bore their way into the liver and other viscera. They next be- come encysted and change their skins. After atime, the larve are set free, but their wanderings are ordinarily of no avail, unless portions of the infested animal are brought in contact with the nose of the ultimate bearer. In the case of the dog, this commonly happens when the animal is engaged in devouring portions of fresh viscera carelessly flung to it. The larve are thus brought in contact with the dog’s nose, and then, by means of the hooks and spines with which they are armed, the young pentastomes readily adhere to the nose, and in a short while crawl up the nasal passages, where they rapidly acquire sexual maturity. It is not so clear how they make their way into the nasal cavities of the sheep and horse ; but in all probability some larve escape from the bodies of their intermediary bearers into open pastures, and thence into the nasal organs whilst these animals are grazing. Dogs that frequent knackeries and slaughter-houses are particularly liable to become infested by the adult parasite. Such larve as do not succeed in escaping their cysts perish by calcareous degeneration. To the veterinarian these facts of development are chiefly important as explaining how dogs contract the parasite; and although instances of suffering from these entozoa may not be common, there is every reason to believe that examples of the kind are not unfrequently overlooked. It is certain that dogs sometimes suffer severely from worms in the nose, the parasites giving rise to nasal catarrh, accompanied by fotid discharges. There is one remarkable case on record, in which death was occasioned by pentastomes. This is the instance already men- tioned as having been made public by Professor Dick in the pages of the Veterinarian for 1840. The communication is most interesting and instructive. Three of these parasites having wandered into the fauces and trachea of the dog, its death resulted, partly from spasm of the laryngeal muscles, and partly from inflammation of the left lung, accompanied by excessive bronchial secretion. In short, the animal was suffocated. 934 PARASITIC DISEASES, ASCARIDES AND LUMBRICTI. The Ascaris megalocephala of the horse and Ascaris suilla of the hog are considered by some helminthologists to be identical with the Ascaris lumbricoides of man. Dr. Cobbold and others take exception to this conclusion, and consider that they are distinct species. These worms, best known amongst veterinarians as the lwm- brici, resemble the common earth-worm in size and shape ; the males are shorter than the females, which sometimes measure from twelve to sixteen inches in length. They are found in the small intestines; sometimes, but rarely, in the stomach. If few in number, they occasion no inconvenience to the bearer; but if numerous, and particularly if they intest the stomach, they, like bots, may cause colic, indigestion, unthriftiness, and emaciation. After the death of the bearer, several of them are generally found matted together, and coiled up in the form of a ball, leading one to conclude that they have thus caused an obstruction during life. Numerous observations in the dis- secting room enable me to state that they assume this form after the death of the host; that they congregate together, interlace one with the other, very shortly after the animal which they infest has died. In the dog, round-worms—Ascaris marginata—especially if they enter the stomach, cause convulsive fits, vomiting, and sometimes death. Oxyuris curvula, or better known to veterinarians as ascarides, are small white worms—needle or whip worms—which com- monly infest the intestine, and very often the colon (and the noucous membranes of these viscera), being very abundant in the flexures of that intestine; when mature they descend to the rectum. They escape by the anus, and cause irritation, manifested by the horse rubbing its tail against any hard substance, such as the walls of its stable, or whisking it about in an irritable manner. If the anus and perineum be ex- amined, small masses of a yellowish-white-looking substance will be found adhering to the skin; these are the eggs of the worms discharged from the body. Treatment.—lIt is a difficult matter to destroy these parasites. Sometimes an aloetic cathartic will cause the expulsion of numer- ous lumbrict from the horse, but the remedy is uncertain. Oil ASCARIDES AND LUMBRICI. 9385 of turpentine stands in high repute, and doubtless is more anthelmintic than any other in the horse, but it cannot always be depended upon. Aconite, in some instances, will cause the expulsion of the parasites, as is seen when it is employed in the treatment of inflammatory diseases. When associated with emaciation and debility, the salts of iron prove of much service; they not only have the effect of destroying the worms, but, by causing an improvement in the general health of the animal which they infest, render it an unfit habitat for the parasites, for it is a well-known fact that when the condition of the animal’s body is weakly, it is more liable to be infested by parasites of various kinds. In the dog, emetics will sometimes cause the expulsion of the Ascaris marginata when in the stomach; if these fail, santonine, in from three to five or eight grain doses, according to the size of the animal, or the ethereal extract of the male shield fern, is to be administered every second or third day, taking care to watch their action upon the patient, as santonine will some- times cause straining and other signs of irritation. The oxyuris may sometimes be destroyed in great numbers by enemas, consisting of decoctions of quassia, gentian, or even wormwood. These enemata are to be frequently repeated, and their action may be aided by purgatives. The introduction of a small piece of mercurial ointment into the rectum is a very common practice in some parts of the country, and if seems to answer very well, not only preventing the migration of the parasites, but actually destroying them. There are many other remedies recommended by helmintho- logists, many of which are very serviceable, whilst others are only caleulated to do harm. I need only refer to the insane practice of administering ground glass and other mechanical irritants, in order to warn the reader against what is absurd. Other nematode worms infesting the lower animals, and found in the blood-vessels and eyes, are briefly referred to in my work on Veterinary Surgery, to which the reader is referred. CHAPTER LXXXIV. PARASITIC DISEASES—continued. DISEASES CAUSED BY NEMATODA OR ROUND-WORMS. ' ¢ ' PARASITIC DISEASE OF THE LUNGS. In the calf and lamb, bronchial irritation, arising from the presence of nematode parasites, termed strongyles, is of frequent occurrence, and is variously termed The Husk, Hoose, Phthisis pulmonalis verminalis, and Parasitic bronchitis. -In the lamb, the parasite, termed Strongylus filaria, is from one to two and a half inches long; the female is white, larger than the male, which is of a yellowish-white colour, and its body is of uniform size, but tapered at both ends. The head is short, stumpy, rather angular, but not tuberculated as in other strongyles. Extending from the mouth is a short cesophagus, entering the stomach, from which a straight intestine is continued nearly to the extreme end of the tail. The tail of the female is pointed; the oviducts, filled with eggs and live young, extend into the vulva, which is situated close to the anus. The anatomical situation of the parasites in the lungs of lambs and sheep is not always the same. In lambs they are found not only in the bronchial tubes, but also in the lung- substance, whilst in sheep they are generally encysted in the parenchyma of the lungs, giving them the appearance of being filled with small tubercular deposits; indeed, the disease was for a long time looked upon as a true tubercular affection. The lungs of sheep which have been the hosts of these para- sites are thickly covered with numerous small nodules, varying in size from a pin-head to a hemp-seed, or even larger, and resembling small vesicles or blisters. Some are filled with a 936 PARASITIC DISEASE OF THE LUNGS. 937 clear fluid; others contain a soft material, consisting of granular matter; whilst others are hard and gritty—and all contain minute worms coiled upon themselves. The likeness to tuberculous lesions is enhanced in all these parasitic affections of the lungs. When examined micro- scopically, it will be seen that the nodule has numerous giant cells, in many of which are coiled up the small embryonic forms of the worm, or the vacuole-like space from which it has escaped. Their residence within a giant cell does not in any way inter- fere with their growth and progress. The varying degrees of hardness and consistence of the nodules mark their age; the vesicle seems to be their earliest development; the soft, solid condition a more mature condi- tion; and the gritty state shows that the wall has undergone calcification, and that the worm has been lodged in the lung tissue for a considerable period. The presence of these parasites in the lung does not always cause irritation or inconvenience to the host. The lungs of sheep killed in the primest condition are found loaded with them. Occasionally, however, they induce debility, anemia, and cause death, more particularly in lambing ewes, at or about the period of parturition. Many ewes died from this cause during the lambing season 1874. In lambs, however, the parasites find their way through the softer lung structure into the bronchial tubes, and there give rise to irritation, and to the symptoms of the “lamb disease.” Tt is supposed that the parasite is developed in the lamb only, and that those found encysted in the lungs of sheep have been long imprisoned as it were by a boundary line of plastic in- flammation, which finally becomes calcified, and offers an impassable barrier to the movement of the strongyle. Whilst admitting the greater frequency of the affection in lambs than in sheep of a more mature age, I cannot subscribe to the above conclusion, as the results of examinations of the lungs of four or even five year old ewes have shown con- clusively that many cysts are not in a state of calcification—a condition that they certainly would be in, if the parasitic invasion had occurred when they were lambs. The manner by which parasites gain access to the lungs has been a matter of contro- versy. Dr. Hdward Crisp, in an essay on this disease, for which 938 PARASITIC DISEASES. a prize of £380 was awarded by the Bath and West of England Agricultural Society, accounts for their presence in the lungs by direct passage into the trachea from the mouth, where they have been forced from the stomach during the act of rumination. Mr. Dickinson, M.R.C.V.8., Boston, Lincolnshire, Professor Armatage, as well as Professor Gamgee, oppose this view. Mr. Dickinson says—“ The idea entertained of a direct passage of these to the lungs appears to me paradoxical and in nowise probable. Their migration, I am inclined to believe, is a work of ‘time; and hence, as I have frequently observed, the parasites abound in the alimentary canal in large numbers, give rise to aggravated symp- toms which terminate fatally when no worms or their eggs are to be detected by the naked eye, at least in the lungs or bronchi.” Professor Armatage informs me he has also observed this in many instances. Mr. Armatage says—‘ The presence of Strongy- lus filaria in the lungs of lambs and sheep, I think, cannot be explained by any theory which describes—no matter with what minute exactness and elaborate detail—the unnatural and, I might add, almost impossible mode of their passing direct through the windpipe to these organs. Weall know, as possess- ing some slight knowledge of physiology, how a hair, a bread- crumb, drop of water, &c., will irritate the glottis or entrance to the windpipe, and give rise to the most painful and convulsive coughing. These are, however, objects of an inanimate charac- ter, and irritate by mere presence. How much greater, then, would be the effects of a live worm or worms insinuating them- selves on the delicate structures, and especially when the natural barbs or hooklets, as described by Professor Simonds, are put in operation. The supposition, I think, suffers much under the great probability that violent coughing taking place on the entrance of a worm or worms would entirely expel them. If they are expectorated in large numbers from the recesses of the bronchial tubes, they will most assuredly be compelled to evacuate much more rapidly at their entrance to the windpipe.” The same gentleman further says—‘ We must not overlook the important fact that young lambs are principally affected. In them the tissues are more easily pierced, and their passage from the lung tissue to the bronchial tube readily effected. In older animals they remain enveloped within a matrix of cretified sub- stance and metamorphosed lung tissue, in order, as it were, to PARASITIC DISEASE OF THE LUNGS. 939 guard against their effects. If their passage to the lungs were always more direct, the opposite would be the case, and our old animals would die as rapidly as the young ones.” Professor Gamgee says—‘‘ The migration from the mouth or alimentary canal to the lungs certainly requires a more com- plete explanation than has hitherto been given.” There is no doubt in my mind but that the ova and young parasites taken up with the food, in the first place gain access from the alimentary canal into the circulation, and are conveyed into the lung-substance, where they are deposited, the parasites when mature piercing the tissues and entering the bronchial tubes, and there cause the irritation symptomatic of the disease, whilst those remaining encysted in the lung cause little or no inconvenience. It is very true that in many instances the para- sites are found fully matured in the digestive canal, and doubt- less the conclusions of Dr. Crisp are due to this fact. We can, however, easily understand that the heat and moisture of the stomach are quite sufficient to cause the ova to hatch and some of the embryos to mature in the intestinal canal, whilst other embryos pierce the intestinal wall and are taken into the circulation, and mature only when they have been deposited in their proper habitat; and a few may become fully developed in the blood. I have on two occasions seen the parasite in the cavities of the heart and in the blood-vessels ; and I think this fact conclusively points out the correctness of this view of their migration. The tenacity of life in the young strongyle is very great. Ercolani found that they showed signs of life on being moistened after drying for thirty days, and at other times after having been immersed in spirits of wine at 30°, or in a solution of alum and corrosive sublimate-——(GAMGEE.) The number of embryo worms in the lungs of one sheep is very great ; if to these we add those hatched in the digestive canal, we can easily understand, when these are severally discharged from the infected animal, how a pasture may become infected with parasites and ova to such an extent as to infect a whole flock. Dr. Crisp says the disease is due to over-stocking, and especially to the feeding of lambs off a second crop of clover atter the first crop has been consumed by sheep. The mere feeding of lambs with the second crop of clover, after the first has been con- 940 PARASITIC DISEASES. sumed by sheep, would not of itself be sufficient to cause an outbreak of the lamb disease; but when we consider that a very large number of sheep are infested with the parasites, from which they seem to suffer no harm, we can easily understand how, by the expulsion of some of these from the affected, a pasture may become fouled by the parasites and their ova. It is more than probable that the Strongylus filaria is taken in during ingestion, and from the stomach or intestines finds its way to the lungs as already explained. We know, however, that the disease prevails particularly in low, damp situations; on lands subjected to be flooded by the overflowing of rivers, or after heavy rains occurring during early autumn or the latter part of summer. Symptoms.—These are subject to some modification, depending upon the seat of the parasites. In the majority of cases, they are found in the lungs, in others in the lungs and digestive organs, whilst in others again they are found in the stomach and bowels only—the lungs being entirely free from them. When in the intestinal canal the symptoms are those of dysentery, with foetid stools; there is much tenesmus or straining, and occasionally clots of foetid blood are discharged per rectum. The lodgment of the parasites in the pulmonary tissue and bronchial tubes cause, in the lamb, irritation and inflammation, indicated by cough, rubbing the nose on the ground, and accelerated re- spiratory movements, whilst in the more mature animal—the sheep—the presence of the parasite may induce no diagnostic signs, even in those which succumb, and it is only after death that the cause of the emaciation and anemia, which may have been present during life, is discovered. In many cases the abdominal symptoms are accompanied by depraved appetite, intense thirst, and even colicky pains. When the parasites are in both the lungs and bowels, there will be a combination of pulmonary and enteric irritation, and very rapid sinking. If the expectoration and alvine discharges be carefully examined some of the parasites are sometimes discoverable. Treatment.—This naturally divides itself into preventive and curative. To prevent the disease, lambs require to be fed on fresh pastures; second and third year crops are to be avoided, specially if they have been previously grazed by sheep. If the PARASITIC DISEASE OF THE LUNGS. 941 Seasons are damp, the flocks are to be pastured on the hill sides, or on dry pastures ; and if the grass be scarce, it 1s to be supple- mented by artificial food. ; To cure the disease, or rather to destroy its cause—the para- sites—inhalations of chlorine gas have been recommended. In using this agent great care must be taken that it be sufficiently diluted with air, so as not to destroy the patient as well as the parasite, for I have heard of individuals who have applied it sufficiently strong to destroy all their patients. It is therefore better to compel the animals to inhale it from the chloride of lime, to which sulphuric acid has been added, than to manu- facture it in the ordinary way, namely, by the admixture of common salt, peroxide of manganese, and sulphuric acid. Should the animals be thought too weakly to stand the chlorine gas, sulphurous acid may be substituted, and this is so cheap and so much safer than the chlorine that I much prefer it. It is made by burning sulphur, which, combining with oxygen during the combustion, gives off fumes of sulphurous acid. Of course it will be understood that when animals are made to inhale either of these gases, they are to be confined in some building. When the parasites are in the intestines, several doses of turpentine are to be administered. The debility from which the animals suffer is best combated by stimulating food, as the cakes, to which the sulphate of iron—from ten to twenty grains for each lamb— has been added. Rock salt should also be allowed the animals to lick, or a small quantity of common salt added to the food. Hoose in Calves—This disease very closely resembles that in lambs; and is caused by a parasite termed the Strongylus micrurus (Mehlis), which gains access to the pulmonary tissue and bronchial tubes through the circulation, the ova being absorbed from the digestive canal. This parasite is very tenacious of life, and will be seen to be quite lively in the pulmonary organs several days after the death of its host. It is one of the armed strongyli, has a filiform body, and a mouth with three papille. This disease prevails in low-lying districts, on land near rivers, more especially after heavy floods, and is mostly seen in the months of August, September, and even October, in calves under one year old, and very rarely in those rising two years old.? * I found this parasite in the lungs of several full-grown American oxen during the spring of 1879. 942 PARASITIC DISEASES, Sometimes the worms are very numerous in the trachea and bronchial tubes, and not unfrequently one finds them congre- gated together, after the animal’s death, in a perfect ball, effectually obstructing the windpipe. I have watched the movements of the embryos of this para- site under the microscope, and have seen them burst through the walls in which they have been enclosed, and make their escape. This parasite has also been found in the air passages of the horse and ass. A similar affection has been observed in the pig, the parasite being called Strongylus suis. In poultry the disease termed the “ gapes” is caused by a parasite called Syngamus trachealis. The Symptoms in the Calf.—The seat of the irritation is indicated by a bronchial cough, ‘‘ husk or hoose,” loss of flesh, a varying degree of constitutional disturbance, and death by suffocation if the sufferer be not relieved. If any mucus be coughed up and examined, the parasites (Strongylus micrurus) may be discovered. Bronchial irritation occurring in calves during summer or autumn should always be looked upon with suspicion, and its source thoroughly inquired into. If any calves be dead, a careful examination ought to be made, in order that the pathological condition of the lungs should be determined. If none are dead, the mucus from the nose should be examined, when in all probability some of the parasites will be discovered. Treatment—The calves are to be warmly housed if the nights be cold; the affected animals are upon all occasions to be removed from the healthy; not that the disease is con- tagious in itself, but that the parasites or their ova, discharged from the sick, are apt to gain access into the bodies of the healthy, and for the same reason the healthy should be removed to fresh pasture and to dry situations, as the fields upon which the disease has prevailed will, for a time at least, be tainted by the parasites and ova. Inhalations of chlorine or sulphurous acid are recommended. If this be carefully done, the sufferers may be kept surrounded by either of these for about fifteen minutes each day, until the disease disappears; two or three inhalations are generally sufficient. If inhalation be objected to, turpentine may be administered in gruel daily, or, what has succeeded well with PARASITIC DISEASE OF THE LUNGS. 943 me, from ten to twenty minim doses of Scheele’s hydrocyanic acid, with carbonate of soda, and some bitter stomachic, as gentian or chamomile, twice per day. The acid seems not only to have the effect of destroying the parasites, but also of allaying the bronchial irritation in a very short space of time. The “ gapes” in fowls, due to a parasite in the air passages, the Syngamus trachealis, and indicated by gaping, gasping for breath, sneezing, and frequent attempts at swallowing, is best treated as recommended by Professor Cobbold and others. “ First. When the worm has taken up its abode in the trachea of fowls and other domesticated birds, the simplest plan consists, as Dr. Wiesenthal long ago pointed out, in stripping a feather from the tube to near the narrow end of the shaft, leav- ing only a few uninjured webs at the tip. The bird being secured, the webbed extremity of the feather is introduced into the windpipe. It is then twisted round a few times and with- drawn, when it will usually happen that several of the worms are found attached. In some instances this plan entirely suc- ceeds. But it is not altogether satisfactory, as it occasionally fails to dislodge all the occupants. “ Secondly. The above method is rendered more effectual when the feather is previously steeped in some medicated solution which will destroy the worms. Mr. Bartlett, superintendent of the Zoological Society’s Gardens, employs for this purpose salt, or a weak infusion of tobacco; and he informs me that the simple application of turpentine to the throat externally is sufficient to kill the worms. To this plan, however, there is the objection that, unless much care be taken, the bird itself may be injuriously affected by the drugs employed. « Thirdly. The mode of treatment recommended by Mr. Montagu appears worthy of mention, as it proved successful in his hands, although the infested birds were old partridges. One of his birds had died from suffocation; but he tells us that change of food and change of place, together with the infusion of rue and garlic instead of plain water to drink, and chiefly hemp-seed, independent of the green vegetables which the grass plot of the menagerie afforded, recovered the others in a very short time.’ “ Fourthly. The plan I have here adopted, by way of experi- ment, of opening the trachea and removing the worms at once, This method is evidently only necessary when the disease has 944 PARASITIC DISEASES. advanced so far that immediate suffocation becomes inevitable ; or it may be resorted to when other methods have failed. In the most far-gone cases, instant relief will follow this operation, since the trachea may with certainty be cleared of all obstructions. “ Lastly. The most essential thing to be observed, in view of putting a check upon the future prevalence of the disease, is the total destruction of the parasites after their removal.” Intra-tracheal injections for hoose in calves—Recent experi- ments have demonstrated that drugs may be injected into the trachea with impunity, and that hoose may be most advan- tageously treated with remedies administered by this method. Turpentine, prussic acid, carbolic acid, and creosote may be used in this way. The turpentine and creosote should be mixed with either oil, or an emulsion of oil, water, and alkali, as in the following :—B. Ol. tereb., 3ij. ; ol. olivee, 2j.; potassse carb., gr. xx. ; aque, 3j. Inject this quantity daily for three days. The injections are given with the hypodermic syringe. Make a small incision through the skin at the site for tracheotomy, pass the needle of the syringe into the trachea between two of the rings, and inject. Corrosive sublimate, one of the most powerful parasiticides known, might be tried in the form of intra-tracheal injection— gr. } to gr. } in Ziijj. or 3iv. of water. PARASITIC GASTRIC CATARRH.—(Gastrorrhwa Parasitica.) A disease of the fourth stomach of the sheep, caused by the presence of the nematode worm called the Strongylus contortus. The following is a short history of an outbreak of disease in sheep induced by this parasite, and to which my attention was called by Mr. Connochie, V.S., Selkirk, in March of this year, 1884. It appears that the owner of the sheep in question had placed his lambs, after weaning time, upon a very luxuriant pasture, but from the nature of the autumn of 1883, which was very wet, the grass became rank and the soil damp, notwithstanding it had been previously well drained both on the surface and underground. After thriving well for some time, they began to lose flesh very rapidly, and gave other indications of disease; they were then removed to another pasture of good clean grass, and shortly afterwards placed on turnips, oats, and Indian corn. This change seemed to have the desired effect, as they commenced to thrive and lay on flesh; but in the month of February 1884, when nearly fat and fit for the butcher, the now hoggets suddenly PARASITIC DISEASE OF THE LUNGS. 945 presented signs of disease, Their appetite at first became capri- Cious ; they then ceased eating their food altogether, but would devour earth or any rotten or decaying vegetable matter. From this time other and more serious symptoms soon developed themselves, such as great restlessness, lying down and sud- denly TisIng again, pawing with the feet and showing signs of abdominal pain. The bowels now became very irritable, and from being constipated became very loose, the evacuations being like muddy water. At this stage a most unnatural desire for water was evinced, the sheep roaming about in search of it, and when driven away from it, immediately returning to it. Along with this insatiable thirst, there was also an almost con- stant desire to urinate, the urine passed being as clear as water. The cough now became hacking, but intermittent, each fit of coughing continuing until the animal succeeded in ejecting a quantity of frothy mucus, which relieved it for a time only, as the fits soon returned and became more frequent; during the intervals a flow of watery saliva continued to drivel from the mouth, accompanied by a constant grinding of the teeth, and a continual twitching of the nostrils and upper lips. During the development of the above symptoms the hoggs had most rapidly lost flesh, the adipose and muscular tissues being rapidly atrophied; the abdomen becoming greatly dis- tended, causing the animal to present a most miserable appear- ance. All the above symptoms increased gradually and steadily, until death closed the scene. After trying various remedies without success, Mr. Connochie advised the owner, Mr. Elliot, Hollybush, Galashiels, to call me into consultation. Before seeing the sheep in consultation with Mr. Connochie, one carcase was sent to the College for examination. In the lungs of this sheep the Strongylus filaria was found, but not in great numbers ; the parasites were also found in the blood- vessels of the lungs, causing embolism; and in the fourth stomach the Strongylus contortus was found in great numbers. After this examination I visited Hollybush, and saw several sheep in an ad- vanced stage of the disease,and, in addition to the above symptoms, furnished by Mr. Connochie, found that the majority presented agoravated symptoms of cedema of the head, affecting the nostrils and interfering with the breathing, and involving the intermaxil- lary space and inferior cervical region as low down as ake breast. 946 PARASITIC DISEASES. On making a post mortem examination of one sheey killed for the purpose it was found that the Strongylus filaria was absent, but that the true stomach (abomasum) contained a quantity of a dirty looking fluid, in which the Strongylus contortus could be seen wriggling in great numbers. The parasites were so small as to be seen in the fluid with difficulty by the naked eye, but by gently moving the walls of the viscus, the whole fluid would seem to be one seething, fermenting mass of wriggling, moving worms; whilst the body of the animal was very anemic, the muscular tissue greatly; wasted and very pallid, the fat fairly abundant, but presenting the very white appearance seen in liver-rot and other anemic diseases, The Strongylus contortus has been studied in Germany by Gerlach particularly, and the following is a brief resumé of his conclusions. The Strongylus contortus occurs in the fourth stomach of the ~ sheep and goat, and when present in large numbers causes disease (Magenwiirmerseuche). At the same time, as was first noticed by Gerlach, the Strongylus filaria is usually present in the lungs. In the summer the Strongylus filaria is most abundant; in autumn the Strongylus filaria and Strongylus contortus are almost equally numerous; while in winter the Strongylus contortus pre- vails, and the Strongylus filaria has almost disappeared. Hence the stomach disease caused by Strongylus contortus breaks out in winter and spring in those lambs which have survived the lung disease of summer and autumn.? These facts agree with what was observed at Hollybush, namely,—l1st. The appearance of disease early in the autumn amongst the sheep. This would be due to the lung disease caused by Strongylus filaria. 2d. The recovery of many of the sheep affected when the diet was changed, i.c., when removed to a clean pasture, and 3d. The appearance of the disease later on in the season, in February 1884, and resulting from the Strongy- lus contortus, confirmed by the post mortem examinations, in one of which only a few Strongyli filarice were found. From this connection between these worms, Gerlach was led to make the following experiments :—Eges of Strongylus filaria were given to healthy goats and lambs, and, four months after the feeding, Strongylus contortus was found to be present. From these experiments Gerlach concluded that Strongylus contortus 1 The Strongylus contortus is prevalent in Jamaica in districts where animals are confined to ‘‘ pond water " and is injurious to cattle and destructive to sheep and goats, PARASITIC DISEASE OF THE LUNGS, 94:7 could develop from the eggs of the Strongylus jfilaria, but there is no doubt that his conclusion was erroneous, the two species being absolutely distinct. The name Strongylus contortus occurs first in the writings of Rudolphi, and the species was described from specimens found in the month of November in the fourth stomach of a lamb. Fabricius also found them in the intestine. Description.—The body is cylindrical, red or white, and tapers very gradually towards the anterior extremity, where is the mouth, which is unprovided with papille or other appendages, and leads into the muscular pharynx, rather more than 1 mm. in length, in a worm 25 mm. long. The male is smaller than the female, and is from 10 to 16 mm. in length, and 0-2 mm. in diameter. The terminal bursa consists of two elongated ovoid lobes, each of which is supported by five ribs, and attached to the left lobe is a smaller one, supported by two ribs. There are two spicules about 0°5 mm. in length, each one tapering to a fine point, which is slightly curved outwards. Under a high power each point is seen to be tipped by a small knob. The female is from 18°30 mm. in length, and 0:3 mm. in dia- meter. The body tapers very suddenly to an extremely fine point, and about 3 mm. in front of this is the genital opening, furnished with two papille, of which the left is much larger than the right. The uterus is convoluted, hence the name Contortus. Symptoms.—The symptoms of the stomach disease caused by the Strongylus contortus are, according to Gerlach, not sufficiently marked to allow of a certain diagnosis. The animals are languid and dejected, and tend to become lean and anemic; the excre- ment is thin and brown, mixed with slime, or at times with blood. At last cachexia occurs, and death ensues from starva- tion (Erschépfung). On post mortem examination the fourth stomach is found with hundreds of the Strongylus contortus covering its surface. Treatment.—Good food is recommended, eg., roasted malt, seeds, lupine hay or lupine seeds, and the following medicines :— Chabert’s oil, ‘ ‘ : 1 part. Oil of turpentine, : : 3 parts. The dose being one tea-spoonful per day. Kamala has been recommended, and the picrate of potash is highly spoken of by Zurn. Go—2 948 PARASITIC DISEASES, Rabe used picrate of potash in the small dose of 0°12 grm., or about 2 grains per day for three days, and was successful in his treatment. The picrate of potash was given in thick linseed mucilage. The doses of picrate of potash as given by Zurn are— For alamb 0°30 grm. or about 5 grains. For a sheep 1°25 grms. or about 20 grains. Divided into two doses per day. Thymol, which is said to be so specific in human anky- lostomiasis, might be tried in these strongyle infections of the- stomach and upper part of the intestine. It is now believed that the ova of these parasites, passed from the body of their host, retained their vitality in damp places only, and that where nice bites of green grass, such as that growing on the sides of open drains and damp spots in pastures otherwise dry, are sources of danger, the parasitic ova becoming ingested with such grasses. The prevention of the disease by the destruction of the worms should be attempted by first digging up, where possible, all such green grasses, and inverting the sods. 2d. By a liberal application of salt to the land, and, where possible, an allowance of it to the sheep. During wet seasons the above precautions are impossible, and all that can be done is to remove to the driest pastures, give corn where possible, and an allowance of common salt in the food. STRONGYLUS TETRACANTHUS. In March 1873, an Iceland pony rising two years old, which had been under my care for some weeks, died from what appeared to be an exhausting disease, and, as stated in a letter to Dr. Cobbold, there were no very marked signs of the presence of parasites during life. The appetite was good; there was no cough ; and we were led to suppose that there were worms by the absence of disease more than anything else. There was gradual emaciation, but no diarrhcea, and at no time were the feces foetid. As bearing upon the discovery of this parasite, I may state that Dr. Knox, who wrote in the Hdinburgh Medical and Surgical Journal for 1836, says—* On two occasions my friend Mr. Dick found parts of the large intestines of a horse present- ing the following appearance: the gut being simply laid open so as to exhibit the mucous membrane, a number of dark STRONGYLUS TETRACANTHUS. 949 spots are observed, evidently exterior to the inner membrane.” And, further on, speaking of the worms, he adds : « They have no cyst, and vary from the tenth of an inch to a length of at least seven-tenths. They have a digestive tube divided into humerous compartments or sacculated ; a mouth unarmed.” ; Professor Dick’s own statements, as communicated by Dr. Knox, are particularly interesting. He says: ‘I have found Fre. 87. Microscopic appearance of Strongylus tetracanthus embedded in mucous mem- brane of Iceland pony, described in the text, These worms wero of 2 bright red colour, (About 100 diameters. ) these worms in several horses, and at different stages of their growth, from the size of a pin-point to that of an inch and a half in length, and in two instances in the blood-vessels. “They seem almost always to produce a bad form of diarrhoea, and seem to depend on the food or situation in which the animal has been previously kept. The horses I have found affected with these have always been running out previous to their be- coming ill.” During the spring of 1874 I had again the opportunity of studying the disease caused by this parasite, or rather parasites, for I am of opinion that there were at least two kinds present in the subjects examined by me, some being embedded in the intestinal walls and others in the intestinal canal, the latter being a reddish-looking worm, very similar to a small earth- worm, from two to three inches in leneth. Those embedded in the intestinal walls, as well as the appearance of the intestines, are delineated in the above woodcuts, £50 PARASITIC DISEASES, I may state that all the ponies affected were rising two years old, and that several had: died before my opinion was sought. They had been imported from Iceland during the summer and autumn of 1873, and thriven tolerably well until late in the winter. They were at pasture during the whole winter and spring, being allowed hay in addition to what they could graze. There were many older animals amongst them, the lot being a large one, all of which were quite free from the parasites, The question naturally arises, Are these parasites peculiar to Iceland? and at the first glance, my own experience would compel me to answer in the affirmative; but the observations of others at once point to the conclusion that other than Icelandic ponies are subject to the invasion, and Dr. Cobbold has arranged. the following list of those who have written upon the subject :— Fic. 88,—Appearance of mucous membrane of colon of Iceland pony, natural size. “ Dick.—‘ Worms at different stages of growth;’ in MS. to Dr. Knox, 1836. “ Knox.— Animals similar to Trichina,’ in Edin. Med. and Surg. Journ. (loc. cit.) “ Diesing.—‘ Nematoideum equi caballi ;’ Syst. Helm., vol. ii. 1851. “ Littler.— Extremely small ascarides ;’ in a letter to Mr Varnell ; The Veterinarian, 1864, p. 202. “ Varnell.—‘ Entozoa in various stages of growth ;’ The Veterz- nartian, ut supra, p. 265. “ Wilkams.—‘ Entozoa from the intestinal walls ;’ in MS. to the author, March 13, 1873. “ Cobbold.—Trichonema arcuata, a new species’ of nematode (with description as below). STRONGYLUS TETRACANTHUS, 951 “Body spindle-shaped, more narrowed posteriorly than in front ; head truncate, with circular mouth, cup-shaped buccal cavity, and muscular cesophagus ; tail of the male drawn out to a long fine point, that of the female being abruptly pointed ; reproductive papilla of the female situated at the lower part of the upper third of the body. “Size.—Males, J; to $ of an inch in length, by z35 to zig in breadth ; the females averaging 4, of an inch in length by gy in breadth.” The opinion that this was a new species of nematode was found to be a mistake, as even Cobbold had referred to it in 1873, and Kiichenmeister in 1857. Symptoms.—In the pony under observation in 1873 diarrhea was absent throughout. Mr. Justus Littler, who was then a student with me, was able, however, to see some points of re- semblance in the symptoms to those described by his father in the letter to Mr. Varnell, above mentioned. In the lot observed in 1874, diarrhoea of a foetid character, along with a more or less rapid emaciation, was present in all the cases, and 1 conclude that, in conjunction with the ages of the affected animals, diarrhea and emaciation may be considered as diagnostic symp- toms. Four of the 1874 lot were so reduced as to be unable to stand; they were recumbent, very quiet, with pallid mucous membranes; the appetite was, however, good. The question again arises, Was the diarrhcea due to the presence of the larger worms in the intestinal canal? and one is led to conclude that, from the fact that none were discovered in the first case, this symptom arose from this cause, and that so long as the parasites were passive in the intestinal walls they did not cause superaction of the bowels, but as they became matured and burst through the tissue surrounding them, they irritated the intestines and caused purgation. In addition to the dark spots on the mucous membrane of the colon, delineated in the woodcut, the intestinal glands were, in all the cases examined, more or less enlarged, many of them containing pus and what appeared to be the débris of the parasites. In every instance the dark spots, which in reality indicated the seat of the worms, were confined to the colon. An experiment was made with the flesh of the first pony upon some fowls, and, as stated by me in my letter to Dr. Cobbold, two of them died, with the livers and other viscera filled with parasitic ova and embryos. 952 PARASITIC DISEASES. Mr. Cawthron of Hadlow has found these parasites enveloped in cysts of vegetable débris. Treatment—In the cases treated in 1874 we were successful in every instance by administering two-drachm doses of the oil of turpentine night and morning, along with eggs and milk well beaten up. The eggs and milk were administered, not only for the reason that they form a good vehicle for turpentine, but to afford nourishment and support to the debilitated animals. This is a very interesting subject, requiring further investiga- tion, and it may turn out that the larger worms are a more mature form of the smaller specimens, or that they are a distinct form altogether. TRICHINOSIS, The Trichina spiralis is a minute round-worm, measuring about ;'; of an inch in length, originally found in the muscular tissue of pigs, cats, dogs, badgers, etc., and transmissible by ingestion of trichinosed flesh to other animals, and to man; but, according to some observers, carnivorous birds are exempt from the invasion of the parasite. The anterior extremity of the worm is rather pointed, its posterior thick and rounded ; has immature sexual organs, and lies coiled up in an oval cyst. The cyst, which measures about , of an inch in length, appears to be no essential part of the worm, but forms around it after it has taken up its location ; the walls of the cyst are laminated, transparent, and thick, generally studded externally with calcareous matter. The trichina cysts occupy the striated muscular tissue, and in some specimens it has been estimated that each cubic inch of the striped muscles of an infected hog may contain from thirteen to thirty-five thousand worms. The cysts appear in the muscles as minute white grains, visible to the naked eye, and with their long diameter corresponding to the direction of the muscular fibres. In a cat experimented upon by Leuckart each ounce of muscle was calculated to contain 325,000 trichine; and Dr. Cobbold estimates that a man of medium bulk may easily harbour 20,000,000. Dr. Bellfield and Mr. Atwood, at Chicago, fed a rat, weighing two ounces, with infected pork in small quantities every two or three days for six weeks. No impair- ment in the health of the rat resulted ; it was then killed, and TRICHINOSIS. 953 its body was found swarming with living trichine; the ob- servers estimated there were no less than 100,000 in the whole carcase, They also found that rats may be fed occasionally with small numbers of trichine without in any way disturbing the health; and the inference drawn from these experiments has been, that any animal or man may take live trichinew in small numbers occasionally without injury. These observers further believe that many more human beings than have been hitherto supposed are infected with trichine; indeed that the majority of us are carrying these worms in our muscles. So sure have they felt of this fact, that one of them ate twelve living trichinze on 20th November 1878, and after more than three weeks had elapsed—when the case was reported—not the slightest etfect had been experienced. These gentlemen also discovered that small portions of sulphurous acid dissolved in the brine in which hams are pickled will kill the trichinz. The per-centage of acid was not then fully determined, but the amount is so small that it is no detriment to the meat for commercial purposes. This worm was first discovered by Professor Owen in 1835 in a piece of a man’s muscle, which presented a peculiarly speckled appearance. These specks were found by Professor Owen—as had been previously shown in similar instances by Tiedman and Mr. Hilton—to consist of minute encysted entozoa, which he named TJrichina spiralis owing to its hair-like and spirally coiled form; but until 1860 it was only known as a pathological curiosity. At that date, however, Zenker of Dresden showed that, however harmless the encysted parasite might be, the gravest symptoms, and even death itself, might be caused after its reception into the bowels, during the process of its reproduc- tion which then ensued, and during that of the migration thence of the young trichine into the voluntary muscles. ne: It is not yet determined how long the larval trichine retain their vitality, but there is no doubt that they may live encysted in the muscular tissue for many years, and retain life after the death and putrefaction of their host. They do, however, perish in situ sooner or later, and usually undergo calcareous change, When the trichine capsules are swallowed, they are dissolved by the gastric juice, and the contained parasites set free; they then rapidly undergo development, and attain sexual maturity, 954 PARASITIC DISEASES. the female acquiring a length of 3 inch, the male ,4. The males are filled with sperm-corpuscles, and the females densely stocked with ova, which are hatched within the uterus, from whence the living embryos escape into the intestinal canal of the host, and at once commence active migration. They first attach themselves to the intestinal mucous membrane, eat through the intestinal walls, and find their way to the small vessels and lymphatics of the bowels, from which they are con- veyed by the blood stream to all parts of the body. They have been found during this period in almost every part of the organism ; in the intestinal walls ; in the abdominal cavity, in the mesentery and mesenteric glands, in the connective tissue, and, in an as yet unencapsuled condition, in the muscular tissue itself. The immature trichins taken into the stomach become mature on the second day; on the sixth and following days, up to the end of the second or even third week, the embryos are born, and commence operations, and probably reach their destination in a week or two, and by the end of a month or a little more have come to the conclusion of their labours. Although the trichine fix their abode in the striped muscular tissue, they are rarely if ever found in that of the heart, but are often specially abundant in the muscles of the larynx. The experiments of Dr. Bellfield and Mr. Atwood support the conclusions of previous observers, that the manifestations of disease in animals experimentally infected vary according to the number of trichine introduced; if these have been few in number, no ill consequences have resulted, but when more numerous, the disease has been of an aggravated or even fatal character. Symptoms—The symptoms of trichinosis in man, as con- cisely described in Tanner’s Practice of Medzcine, are as follows :— “The symptoms of trichiniasis vary in degree, being mild or severe according as only a few or many of the worms have been swallowed, as well as in proportion to the number of the progeny and the extent of their migrations. Thus, Dr. Althaus remarks that in the epidemic of Burg, near Magdeburg, a woman who had eaten a quantity of raw pork with bread, fell ill and died; her child, who had sucked a spoon used by the mother, suffered slightly and recovered—According to the accounts given by most authors, the earliest symptoms are loss of appetite and TRICHINOSIS. 955 general malaise; to which succeed nausea and retching, prostra- tion, diarrhcea, a sense of thorough indisposition, and a painful stiffness about the neck and arms and legs. This pain is due to the immigration of the young trichinw into the muscles; and it is accompanied with high fever, and an cedematous swelling about the eyelids and face. The pulse is frequent, and there are copious offensive perspirations ; but although the temperature of the body is raised it does not reach the same height as in typhus and typhoid fever. For some days the stiffness of the limbs continues to increase; while all the muscles seem to be painful and swollen and very sensitive to the touch. The movements of the intercostal muscles in respiration are attended with suffering, so that repose is impossible; while there will be troublesome hiccup if the diaphragm be invaded, with hoarseness and less of voice where the laryngeal muscles get inhabited. Neuralgia of a very severe description, in the cceliac and mesen- teric plexuses, has likewise been present in certain cases. When a large quantity of trichinous meat has been eaten, so that the immigration of the trichinz into the muscles is great, the patient may lie almost paralyzed in a state of great exhaustion. The facial cedema generally lasts about a week, its disappearance being followed by swelling of the feet and legs, and ultimately of the trunk. There is no effusion, however, into any of the cavities; nor does the urine become albuminous, although it is always lessened in quantity and may be loaded with urates. About the beginning of the fourth week the patient is in a pitiable condition. The pulse and respirations are very frequent, the tongue is red and dry, the pain is severe, the sweating is profuse, the mouth can scarcely be opened, no sleep can be obtained, and there is great anxiety or delirium; death not un- frequently occurring with all the symptoms of profound exhaus- tion. Such complications as pneumonia, peritonitis, and pleurisy with effusion, are not uncommon. In favourable cases, however, the pain and swelling and diarrhoea abate ; the oppression of the chest passes off; sleep is obtained ; a desire for nourishing food is evinced; the power of the limbs is regained ; and there is only left great anemia, with a falling off of the hair, &c. The parasites have taken up their abode in the muscles, and have fortunately become encysted.” It appears that the symptoms are much more severe in the 956 PARASITIC DISEASES. human being than in the lower animals; and Dr. Cobbold men- tions that a pig experimented upon at the London Veterinary College, and in which it was calculated that about sixteen millions of encysted trichine had been developed, manifested no symptoms of suffering; other pigs, however, showed much general disturbance and suffering, arising from the irritation of the worms in the intestines, and during their passage into the muscular tissues. The irritation of the alimentary canal, which lessens towards the end of the first week after pigs have swallowed trichine, is denoted by loss of appetite, vomiting, colic, tympanitis, and diarrhcea; dulness, arching of the back whilst standing ; and pigs incline to lie down and hide themselves in their litter in this as in many other diseases. These symptoms, with the exception of the diarrhcea, generally disappear in from six to eight days. When the trichine have been numerous, the membraneous passage of a great number of them have, in the experience of Leuckart, induced in some a fatal peritonitis; and in others, a form of enteritis, with ejection of false membrane. “The muscular symptoms appear towards the termination of the second or during the third week after the ingestion of the trichinosed flesh; while the intestinal phenomena become less marked, and the fever increases in intensity. At this stage the patient is often lying; in walking, it carries its back raised and the limbs stiff, and manifests signs of pain; mastication, opening the mouth, and swallowing are difficult; the voice is harsh, husky, and weak; the respirations laboured and loud; cuta- neous cedema appears in different places, together with the intense pruritis already alluded to; the conjunctival membrane is most frequently infected, and emaciation rapidly sets in. If the number of migratory trichine is very great, death may be the result, though this is somewhat rare in the pig. Usually the different symptoms disappear gradually, and it is only in very debilitated animals that convalescence is slow. The presence of trichine in the muscles does not appear to exert any subsequent influence on the development or fattening of the animals which harbour these strange creatures; on the contrary, it has been stated that they fatten more readily than before they were infested.”—(FLEMING’s Sanitary Science and Police.) The de- termining test, however, is the discovery of the parasites in the intestinal discharges, or in fragments of muscular tissue extracted by a harpoon. TRICHINOSIS. 957 The vitality of the trichine is not destroyed unless the meat in which they are contained is exposed to the influence of the heat of boiling water for a sufficient time to insure that every particle of it has been acted upon by that degree of heat. The mere toasting of ham or bacon is insufficient to destroy the worms, and smoked ham and German sausages are, unless well cooked, sources of danger. Many remedies have been suggested for the destruction of the trichine in the treatment of the disease, more particularly picric acid, picro-nitrate of potash and benzole, carbolic acid, sulpho-carbolate of soda, &c., but none of these have been proved to have any effect ; indeed, in trichinous pork of a pig killed with picric acid, the worms were found alive by W. Miller of Homburg. CHAPTER LXXXV, PARASITIC DISEASES—continued. TREMATODA. ROT IN SHEEP. Rot is a disease of low Jands, marshy grounds, and wet seasons, and observers are agreed that the flooding of pastures suffices to taint them for a season, owing to the dissemination of the Distomata ; for it is pretty satisfactorily proved that the ova of the fluke pass out through the intestines of the sheep, and fall on the pastures. The ova hatch in moist places, and become transformed into ciliated embryos, which, when set free, swim rapidly in the water, and thus spread over pastures in wet seasons. Remarkable outbreaks of this disease have occurred in Eng- land. Professor Simonds, in his essay, records the outbreaks of 1809, 1816, 1824, 1830, 1853, and 1860. “In the outbreak of 1853-54 many thousands of sheep were swept away, and not only in undrained districts, but also in others of a more healthy character. But since 1830, however, no outbreak can at all be compared to the one of the autumn of 1860. Speaking in general terms, it may be affirmed that all the western and southern counties of England, together with several of the eastern and midland, suffered to a ruinous extent. As in former years so in this, the attacks of the disease were due to an excess and long continuance of wet weather. 1860 will long be remem- bered by agriculturists, not only as producing the rot among sheep, but likewise for its baneful effects on the root crops, as also on the hay and corn harvests.” 1872 again was a wet year, and rot was very prevalent, appearing on land that was con- sidered sound during ordinary seasons. 958 ROT IN SHEEP, 959 In conjunction with the Distomata in the liver, it is not an unusual thing to find other parasites infesting the bodies of sheep. Strongyles in the abomasum, intestines, and lungs, cysticerci, &e.— indeed symptoms similar to those of rot—are sometimes present independent of the fluke, and this circumstance has led some erroneously to conclude that the debilitated condition of the sheep renders it a favourable habitat for the parasite; that, in fact, the mal-condition induced by damp food is the cause of the disease and not the effect, hence it is termed watery cachexia, cachexia aguosa, by some writers. It is important that this disease be distinguished in its earliest stages, and in order to enable the sheep-farmer to do this, the following rules are given by Mr. Beattie in the Transactions of the Highland and Agricultural Society of Scotland, vol. iii. 1807 :— “The first thing to be observed is in the spring, when they are dropping their lambs. A sound ewe in good order drops a lamb covered with a thick and yellow slime, which the ewe licks off it, and the rule is, the sounder and the higher condition the ewe is in, the darker and thicker will be the slime; but when they observe a ewe drop a lamb covered with thin watery bubbles, and very white, they note her down as unsound. « About the month of September, when they intend to dispose of their draught ewes, they put all their sheep into a fold, and draw them by the hand; that is, they catch them all, viz., the ewes they design to sell any of, and clapping their hand upon the small of the back, they rub the flesh backwards and for- wards betwixt their fingers and thumb and the ends of the short ribs. If the flesh is solid and firm, they consider her as sound ; if they find it soft and flabby, and if, when they rub it against the short ribs, it ripples, as we term it—that is, a sort of crackling is perceived—as if there was water or blubber in it, they are. certain she is unsound. This is the most certain of all symp- toms, but is not to be discerned with any degree of certainty but by an experienced hand ; for although, as I have here related it, it seems a very simple affair, and easily acquired, yet it is well known that many shepherds, who have followed sheep all their lives, never arrive at anything like certainty in judging by the hand, whilst men of superior skill will seldom be mistaken, and will draw by no other rule. Yet still it must be acknow- 960 PARASITIC DISEASES. ledged that the seeds of this disease will sometimes lie so ‘occult as to baffle all skill, and that no man can, with absolute certainty, draw a flock tainted with the rot. There is another method, to which men of inferior skill resort, which is more easily acquired. They take the sheep’s head between their hands, and press down the eyelids; they thereby make the sheep turn its eyeball, so that they get a view of the vessels in which the eyeball rolls. If these are thin, red, and free of matter, they consider the sheep as sound ; but if they are thick, of a dead white colour, and seem as if there was some white matter in them, they are confident she is rotten. This is a pretty general rule, and easily discerned ; but I think it is not so certain as when they are judged by the back; for in firm heathy lands the eye of a sheep is far redder than it is in sheep upon grassy lands; and in some bogey lands, the eye is never very red, be the sheep ever so sound, so that there you cannot so well judge by the eye; but when you see the eye of a sheep a good deal whiter and thicker, and more matter in it (I mean the vessels in which the eyeball rolls) than the run of the flock amongst which it feeds, you have reason to suspect it is not sound.” In some instances the progress of the rot is very rapid, but usually it is slow and insidious. At first the affected animals appear to thrive very fast, but inactivity and dulness supervene ; the mucous membranes become pallid, the flesh wastes, the general surface of the skin loses its ruddy colour, becomes dry and devoid of that oily condition which is natural to the fleece of the sheep. As the disease progresses, the flanks become hollow, the back tigid, weak and tender about the loins, as evinced by wincing when this part is pressed by the hand, and the spine sticks out prominently ; the fleece drops off in patches, the belly enlarges, the eyes become yellow, and dropsical swellings appear in dif- ferent parts of the body, particularly around the throat. There is often much thirst, depravity of the appetite, diarrhcea, general stupor, the pulse is weak, the heart’s action tumultuous, and anemic murmurs are heard. As demonstrated by Delafond and others, the blood is deficient in albumen, thin, watery, and on this account the serum transudes through the walls of the vessels, collects in the loose areolar tissue of the depending parts of the body and in the cavities, constituting the condition of dropsy which is seen in rot. ROT IN SHEEP, 961 Professor Simonds states that a dry scaly state of the skin on the inner parts of the thighs, particularly where it is uncovered with either wool or hair, is early recognised, and that an ex- amination of the eye will materially assist in determining the question of disease. “If the lids are everted, the membrana nictitans being pressed forward, it will be found that in the early stages of the malady, and especially if the animal has been excited by being driven a short distance, the vessels of the con- junctiva are tinged with a pale or yellowish-coloured blood, and that the whole part has a moist or watery appearance. Later on the same vessels are blanched, and scarcely to be recognised, excepting perhaps one or two, which present a similar watery condition, or are turgid with dark-coloured blood.” In some cases these symptoms are complicated by others, induced by strongyles in the air passages and alimentary canal. PATHOLOGICAL ANATOMY. The tissues of the body are generally wasted, flabby, pale or yellow, and watery; there is an absence of the firmness and colour of healthy mutton. The peritoneal cavity contains a more or less abundant quantity of serum, which may be of a clear straw colour, or more or less yellow, in which occasionally fragments of lymph and false membranes are floating;. the digestive organs are remarkably blanched; the liver is hard, scirrhous, irregularly knotted on its surface and margins, and sometimes united by false membranes to the surrounding organs. In colour it is either a dirty chocolate brown, deeper in some parts than others, or has a yellowish tint, intermixed with pale yellow spots. Flukes are found in the bile ducts, which are filled with a dark thick secretion; on further examination the ducts are found sacculated at various points, the distended por- tions generally containing many flukes massed together. The canal walls are much thickened in some places, and coated with calcareous matter on their internal surface. Professor Simonds mentions a case where a concretion was found as large asa hen’s egg, which, when broken up, was found to contain about a dozen dead flukes. He also states that “ the coats of the ductus hepaticus, as also of the ductus communis choledicus, are not nnfrequently so thick. as to be upwards of ten times their normal 61 962 PARASITIC DISEASES. substance, and likewise as hard as to approach the nature ot cartilage.” Respecting the number of the flukes, the greatest variation exists. Dr Cobbold says—“The presence of a few flukes is totally insufficient to cause death; consequently, when a sheep dies from rot or is killed at a time when the disease has seriously impoverished the animal, then we are sure to find the organ occupied by many dozen, many score, or even several hundred flukes. Thus from a single liver Bidlow obtained 800, Leuwenhoeck about 900, and Dupuy upwards of 1000 specimens. Even the occurrence of large numbers only destroys the animal by slow degrees, and possibly without producing much physical suffering, excepting perhaps in the later stages. Associated with the above described appearances, one not unfrequently finds a few flukes in the intestinal canal, whilst a still more interesting pathological feature is seen in the fact that the bile contained in the liver ducts is loaded with flukes’ eggs. In some cases there cannot be less than tens or even hundreds of thousands. Not afew may also be found in the intestinal canal, and in the excreta about to be voided.” And lastly, says the same author, “it need scarcely be added that it is by no means unfrequent to find one or even several other kinds of entozoa coexisting with the fasciola in the same sheep, the most common form being that of the larval echinococcus.” TREATMENT. All observers agree that the growth and development of the fluke is impossible on dry land, and that the disease is unheard of on dry pastures except during wet seasons, and as the “rot,” once established, is difficult to overcome, it behoves the flock- master to pay every attention to its prevention. For this pur- pose it is necessary that unsound sheep pastures should, after being drained, for a time at least, be applied to other purposes. During moist seasons, and when there is a fear of the disease appearing on sound pastures, the natural food should be supple- mented by cakes, corn, beans, or other nutritious diet, in addi- tion to common salt and the sulphate of iron, As to the beneficial effect of common salt, all writers are agreed that it prevents the development of the parasites, for it wore LL ROT IN SHEEP. 963 is tolerably certain, as mentioned by Dr. Cobbold, that the larve of the Fasciola hepatica exists only in the bodies of fresh-water snails. Seeing this is the case, and that sali marshes are exempt from the invasion of the fasciola, would not the applica- tion of common salt to the land be worthy of a trial ? For sheep that are actually affected but little can be done, at least in the way of a permanent cure. If the disease be slight, its progress may be retarded, and the animals made fit for the butcher, by removing them to a dry pasture, supplying them liberally with food of a highly nutritious nature, and adminis- tering salines and tonics. BILHARZIA. The wasting symptoms, edema, and anemia described are those noticed in animals in which bilharzia and their eggs were found. The treatment and hygienic principles adopted in fluke disease have also been recommended for schistosomum infection. 61—2 CHAPTER LXXXVL PARASITIC DISEASES—continued, CESTODA. THE most important. disease of stock caused by this order of parasites is that variously termed STURDY, TURNSICK, OR GID. This is a species of vertigo induced by the Cenurus cerebralis, which is the hydatid or larval form of the tape-worm, called the Tenia cenurus. Many conclusive experiments have been made in this and other countries, recorded in works on helminthology, which proves that the mature Tenia cenwrus infests the intes- tines of the dog, from which perfect segments are expelled. These segments, falling on the pastures where sheep are feeding, : are swallowed along with the herbage, and, as explained by Dr. Cobbold, the six-hooked embryos, escaped from the ova con- tained in the segments, commence their wandering in the tissues of the higher animal, and, by virtue of their selective capacity, escape from the blood-vessels of the brain, and bore their way to their final resting-place in that organ. Even when the brain is reached, it by no means follows that every embryo attains its full growth. Indeed, it is only usual for one to flourish, some- times two of equal size, but seldom more. It has, however, been observed that when one hydatid cyst has been removed, that another has developed in a different part of the brain. This proves that the brain serves as a proper habitat to one or at most to two hydatids at a time. This disease attacks cattle as well as sheep, but in this country it seldom attacks any but sheep, its victims being lambs under 964 CESTODA, 965 one year old, sheep above two years old being rarely affected. It prevails to a great extent on unenclosed lands, and for the reason that shepherds have to be assisted by dogs, whilst on enclosed pastures, and where sheep are unattended by dogs, the disease is scarcely known. Symptoms.—The usual form of sturdy is that due to the location of a hydatid in one of the cerebral hemispheres. The sheep so affected, when caused to move, turns from right to left, or left to right, as the case may be; but when the parasite is lodged be- tween the hemispheres, the animal steps high, and goes forward in a straight line; the head is then carried upwards, and there may be a varying degree of amaurosis in one or both eyes. Sometimes the animal becomes both blind and deaf, and is un- able to follow its companions. When the hydatid is lodged in the cerebellum, the animal’s movements are performed without control. The head is elevated; the limbs are moved with diffi- culty and automatically; one or two steps are taken forward, when the animal starts with a bound, but immediately falls, and is unable to rise for a time. When the animal is first affected the symptoms are generally severe, from the congestion and irritation ; as the contents of the skull adapt themselves to the hydatid, the brain symptoms sub- side more or less; but as the parasite grows, the symptoms become more severe, until paralysis is induced, and the animal can no longer stand. As many tumours and hydatids of different species are found in the brain which do not induce symptoms of sturdy, Davaine believes that the nervous substance is irritated by the heads of the parasite, which protrude from the bladder, and by means of their hooks and sucking discs penetrate the brain substance nearly two lines in depth. As the ccenurus grows, the animal becomes more and more emaciated, and death occurs, unless the sheep be relieved naturally or artificially. The natural method is by the bones of the skull becoming absorbed, the skin acci- dentally broken, and evacuation of the hydatid. This is, however, very rare. The bones of the skull, however, are generally softened, and if in about three weeks after the first manifestation of the symptoms the head be pressed with the thumb, a remarkable degree of softening will be found at one part of it, as if the skull 966 PARASITIC DISEASES. were wanting in that particular spot. Into this softened spot a trocar and cannula are introduced, and after the trocar is with- drawn—leaving in the cannula—a syringe is applied to the latter, and the bladder extracted. “The prevention of the hydatid disease,” says a writer in the Agricultural Gazette, “must begin at its source, and the first step is to expel the tape-worm from the intestines of the dog or dogs which are employed in the farm. It may be objected that this measure will be applied too late to remedy the mischief if the existence of the tape-worm is not suspected until some of the flock become affected with “ gid ;” but in fact the existence of tape-worm should always be suspected, and dogs should be treated periodically with areca nut as a measure of precaution. A dose of half a drachm to two drachms of the grated nut may be given now and then with safety, even when the tape-worm segments are observed, and if the remedy is not followed by the expulsion of a worm, the animal may be deemed secure. A second important means of prevention is to prevent the infection of dogs by destroying bladder worms immediately on their re- moval, instead of throwing them either to the dogs or in places where the animals can easily discover them. If this plan were universally adopted cystic entozoa would soon be diminished in number, and one source of loss to the stock-owner be averted. Sheep suffer from the entrance of embryos, which are expelled from the intestines of the dogs. Dogs become infested with the tape-worm in consequence of introduction into their digestive organs of the larval forms of the parasites, which exist in the brain of the sheep, being given to them, or placed within their reach. This interchange can be prevented by the exercise of a little common care. “Sheep which are pastured on common lands, or fields through which a right of way exists, are exposed to risks of various kinds from which animals in isolated positions are exempt, and under such circumstances it is impossible to apply any effectual measures of prevention. In the case of “gid” some amount of danger is incurred from wild animals; foxes, for instance, may harbour the Tenia cenurus, and a few sheep may here and there become infested with bladder worms from eating the eggs ex- pelled from the intestines of those animals, but these causes of infection are occasional and remote, and do not materially affect CESTODA, 967 the main question. Of the method of prevention, if the Tenia senurus were to be expelled from every dog in the country, and effectually destroyed, the disease “ gid,” among sheep, would be very rare indeed. “ In reference to the treatment of the disease we have nothing to urge. Puncture or removal of the cyst in many cases alleviates the distress which the animal suffers, but permanent cure is rare, and, knowing this, the farmer wisely consigns the animal to the butcher. He should, however, always bargain for the return of the head, which contains the parasite, in order that he may burn, bury, or otherwise destroy it, and thus render thousands of embryos inert.” The various other diseases caused by teenie, in different stages of development, and other parasites, almost too numerous to mention, are not intended to be described in the present work ; helminthology being a specialty upon which many works have been written. In connection with this I may refer to one small work, namely, The Internal Parasites of our Domesticated Animals, by Dr. Cobbold, as being a book which deals exclusively with the entozoa of interest to the veterinarian. Under the able direction of Dr. Tommasi, an Italian edition of this manual has been published at Florence. The reader is re- commended to Raillet and also to Macqueen’s translation of Neumann’s parasites. I may, however, state that I have found areca-nut, with the etherial extract of the male shield fern, to be the most certain remedy for the expulsion of tape-worms, a tabular arrangement of which is given on the following page. The drawings of the parasites have been mainly taken from Zurn, also from Heller, Krabbe, Leuckart, Cobbold, Kuchen- meister, and others. 968 PARASITIC DISEASES. TABULAR ARRANGEMENT OF ENTOZOA, “N. O. Nematopa, Genus Ascaris. (a.) A, megalocephala of horse and ass ; found in the small intestine, occasionally passing from the duodenum to the gall ducts. (b.) A. lumbricoides of man, pig, cattle; found in small intestine, The Ascaris of the pig is sometimes reckoned as a different species, viz., A. suilla. (c.) A. mystax of cat and dog; rarely in man. Found in the small intestine. The Ascaris of the dog is sometimes reckoned as a different species, viz., A. marginata. Genus Eustrongylus. (a.) E. gigas of dog, horse, cattle, and very rarely man ; found. in the kidneys, bladder, and areolar tissue, beneath the peritoneum ; sometimes free in the peritoneal cavity ; also in the heart of the dog. Genus Filaria. Species (a.) F. lachrymalis of horse and ox; found in the lachrymal ducts. » (0.) F. papillosa of the horse, ox, and ass; found in the globe of the eye, said to be in the anterior chamber, but usually in a eyst within the cornea, also in the peritoneal and thoracic cavities, in the diaphragm and abdominal muscles, and in the arachnoid membrane of the brain. » (¢) F. tmmitis of the dog; found in heart, pulmonary arteries, and blood, hence spoken of as Heenvatozoa. » (d.) F. trispinulosa of the dog; found by Gescheidt in the capsule of the crystalline lens. Genus Spiroptera (Filarta of some authors). Species (a.) S. megastoma of the horse; found in tumours usually at the cardiac end, more rarely at the pyloric end, of stomach ; when these tumours are pressed, pus and bundles of the worms are obtained. 8. microstoma of the stomach of the horse is considered as a large variety of S. megastoma, but never found inside the tumours, » (0.) &. sanguinolinta of the dog and wolf; found in tumours of the esophagus and stomach. NEMATODA, 969 Species (c.) S. strongylina of the pig, &. ; found in the stomach. »n (a) S. scutata cesophagea bovis of ox, also described in the horse ; found in the mucous membrane of cesophagus. Worms supposed to be the same are found in tongue of pig and oesophagus of sheep. » (e.) S&S. hamulosa of the common fowl. » (f.) S. cineinnata (Onchocerca reticulata) of horse ; found in the foot ligaments wound round the elastic fibres. Larval forms of nematodes are found in tumours in the sub-mucous layers of the wall of the alimentary canal. Genus Oxyuris. Species (a.) O. curvula of the horse and ass; found very frequently in the cecum and colon. » (0.) O. vermicularis of man; found in the large intestine and rectum, Genus Dochmius (Strongylus of some authors). Species (a.) D. hypostomus of the sheep, goat, and other ruminants; found in the intestine. » (b.) D. tubceformis of the cat; found in the duodenum. » (¢.) D. trigonocephalus of the dog; found in the stomach and small intestine. A variety is declared to exist in the right side of the heart. » (a) D. cernuus of sheep ; found in small and large intestine. » (¢) D. duodenalis (Anchylostoma duodenale) of man ; found in duodenum Genus Schlerostomum. Species (a.) Schlerastomum armatus of horse, or equinum ; sexually mature adults found in cecum and colon, seldom in the duodenum, in the pancreas and tunica vaginalis of testis; the larval forms in aneurisms in the in- testinal arteries, &c.; the eggs come out with the excrements and develop free living larval forms in water; the free living larve get into alimentary canal with the water, and thence into the blood- vessels, where they cause aneurisms; becoming sexually mature they leave the aneurisms, and bore their way into the alimentary canal, where they copulate. (b.) Schlerostomum tetracanthus of horse; found in small in- testine and cecum ; the larval forms are free under the epithelium or enclosed in capsules in the mucous 970 PARASITIC DISEASES. membrane of the large intestine, where they attain sexual maturity, and then leave the mucous mem- brane and enter the alimentary canal. Species (c.) S. dentatus of pig; found in large intestine. » (d.) Syngamus trachealis, from the trachea and bronchial tubes of fowls. » (¢) 8. radiatus of the ox, and several other ruminants. From the small intestine and colon. » (f.) 8. venulosus of the goat ; found in the small intestine. » (g.) S. micrurus of cattle, horse, and ass ; found in aneurisms of the arteries of the cow, and in the trachea and bronchial tubes. In the tough, yellow mucus of the air passages and bronchi they are to be found in countless numbers. Species (h.) 8. filaria of sheep and goat, camel, &c.; found in the trachea, bronchial tubes, and lung-parenchyma. The ripe worms are coughed up and die. From the bodies of the dead females the embryos come forth. When they get into water they develop further, and live as free nematodes (or possibly as parasites on an intermediate host). These gain access to the stomach of the sheep with the water, wander into the lungs, and encyst in the parenchyma. When mature they leave the parenchyma for the bronchi, The forms described as Nematoideum ovis pulmonale are considered as embryos of 8. filaria. » (@) S. paradoxus of the pig; found in the trachea and bronchial tubes. » (&.) S. filicollis of the sheep; met with in the small intestine, » (1) S. ventriecsus of cattle ; found in small intestine. » (m.)S. injlatus of cattle, rare ; found in colon. » (n.) 8. contortus of sheep and goat; found in the abomasum, usually associated with 8. filaria. Stephanurus dentatus of pig; found in or about the kidneys. The kidney-worm of the Americans; Leuckart’s Sclerostoma pinguicola. Genus Trichina, Species (a.) T. spiralis; sexually mature adults in alimentary canal producing living young, which bore their way into the muscles, and encyst, forming the immature larval T. spiralis ov Muscle Trichina; found in man, pig, ox, rabbit, rat, &e. NEMATODA. 971 Genus Trichocephalus, Species (a.) T. dispar of man. » (0.) T. affinis of sheep and goat; rare in cattle ; found in cecum. » (c.) TZ. depressiusculus of the dog ; found in the cecum. » (d.) T. crenatus of the pig and wild boar; found in the large intestine. N.O. Trematopa. Genus Distoma (Fasciola of some authors). (1.) Distoma hepaticum.—Leaf-like form, with a small sucker round the mouth, and a little behind this a ventral sucker, also small. Habitat, gall ducts and gall bladder (usually only in spring) of sheep, cattle, goat, and pig. Rarely in horse, ass, cat, and very rare in man. (2.) Distoma, or Dicrocelium lanceolatum.— Lance-like form, with a tolerably large ventral sucker. Habitat, gall ducts and gall bladder of sheep, cattle, goat, pig. Wandering specimens also in blood-vessels and heart. (3.) Distoma campanulatum, according to Ercolani, occurs in the liver of the dog. (4.) Distoma conjunctum, found in the bile ducts of Indian dogs. (5.) Distoma species have been found in muscles of pig, more parti- cularly in the diaphragm. Genus Amphistoma. (1.) Amphistoma conicum, cone-shaped, thick posteriorly, with a large sucker at the posterior end. Habitat, paunch of cattle. (2.) Amphistoma truncatum of cat. Genus Hemistoma—Holostoma. (1.) Hemistoma alatum of dog, wolf, and fox; found in small intestine. (2.) Hemistoma cordatum of cat. Genus Gastrodiscus. (1.) Gastrodiscus polymastos, a disc-shaped trematode found by Dr. Sonsino in Egyptian horses. 972 PARASITIC DISEASES. N. O. Crstopa. (Fam. 1.) Teniade. Mature Worns. Hasitat. LARVAL, CystTIc, oR Hypativ Srace. Common Habitat, wo wn cu . Diplydium can- inum. . Tenia coenurus . Tenia medio- | Intestines of man. canellata. . Tenia solium - Do. of do. . Tenia serrata -|. Do. of dog. Do. of dog, cat, and man. Intestines of dog. Cysticercus bovis. Cysticercus cellu- lose. Cysticercus pisi- formis. Cryptocystes in the Trichodectes latus and Pulex serraticeps. Cenurus cere- bralis. Muscles of horned cattle. Muscles of pigs. Entrails of hares and rabbits. Body of dog louse — Trichodectes latus. Brain of herbivora. 14, Tenia fasciata, 6. Tienia echino- Do. of do. | Echinococcus vete-| So-called bladder coccus or hy- rinorum. worms, in liver, datid tape- heart, lungs, worm. bones, &c. 7. Tenia margin- Do. _ of do., | Cysticercus tenui-| Liver, walls of ata, wolf, &c. collis,or slender-| bile ducts, me- necked hydatid.| sentery, pleura, I aatiaie iaphragm, &c., of sheep and igs. 8. Tenia crassi- Do. of cat. | Cysticercus fascio- | Liver of rat and colis. laris. mouse. Tenia whose Cystic forms are unknown. 1. Tenia nana of man. 2. Tenia expansa of ox, sheep, gazelle, chamois, &c. 8. Teenia denticulata of ox (France and Germany). 4. Tenia plicata of small intestines and stomach of horse. 5. Tenia mamillana: large intestines of horse. 6. Tenia perfoliata : caecum, and sometimes sniall intestines of horse. 7. Tenia infundibuliformis, } 8, Tenia proglotina, ’ 9. Tenia crassula, 10. Teenia malleus, Common fowl, water fowl, pigeon, 11. Tenia lanceolata, and other domestic birds. 12. Tenia setigera, 13. Tenia sinuosa, (Fam. 2.) Bothriocephalide, or Pit-headed Tape-Worms. Bothriocephalus latus: intestines of dog. Bothriocephalus cordatus, Bothriocephalus fuscus, Bothriocephalus reticulatus, Bothriocephalus dubius, Not recognised in this country. a ee ed TANIA CCENURUS. ( Segment X 6 Fic, 2. ; Fig. l.—Lire History. Fertilised Ovum _Tenia Coenurus, Sees Ovum, with, cenurus Six-hooked cerebralis Embryo. \ ‘plteltcoied secre, (gee “siuaui3as odtz a1y, squeuidas adi-jpey sary TANIA MARGINATA. \ Fic. 7. / TANIA TANIA ECHINOCOCCUS. CUCUMERINA. Fic. 5. Fic. 6; b. cercus. &. Cysti- - id. AN vie a. te \ Q, b. Head. ~ ) \. Hook Y @ 9 Nat. size 2d seg ‘ ge Pe eee ne eae ae ge Fie 1. T. SERRATA. Fic. 2.—TAENIA SOLIUM e&. Ripe segment X 6, ' Hooks. ss Hw om Suckers, Cysticercus pisiformis, a. 7. Head eva- IS ginated. c. Ripe Segment Fie. 5. TANIA GRASSICOLLIS.| Segment x 6 \ Fit) T Tr. see. of ea a. Ovum of Boclitiocephalus Head Brus (Nat. size) Head (mag.) Six-hooked Embryo casting its hr eee es | eer Sa ence Fic. 1. Head. ASCARIS MEGALOCEPHALA, (Male.) 1G. &—HeEapb AND TAIL OF A. LUMBRICOIDES (Male). read Fic. 3. . fa ASCARIS LUM- BRICOIDES, (Dissected.) Fic. 2. SCARIS MEGA~ LOCEPHALA. (Femate.) “se813 snjAZuossng jo wnagG 2 Fd a & m ec & r 3 2 ” pas c & es) 2 & Ss 2 L 8 JO das Fic. 8? OxyuRIS VERMICU- LARIS. ‘yeued Arpjuawi y Fic. 9. 4 DEVELOPMENT OF £4) Vulva. O, VERMICULARIS. Fig. 10 Uterus. “WINANAD STEnAXO Fic. 11. Spermatozolds of Ascaris. Fic. 1.—FILaria PAPILLOSA. (Female.) Fic. 2. A F. tens A ale.) “" Fig. 7. ee Huav or S Piraria. / Fic. 4. TAIL END OF F. PApILiosa. Fie. 10. DIssECTIONS OF S. ARMATUS. Fic. & Tait oF §. Pivaria. Heap or S. ARMATUS. \\\) Teeth. (Nat. size.) Fic. 9. STRONGYLUS ARMATUS. Larva, Fie. 12. Bursa oF S. _ARMATUS. or T. SPIRALIS. (Female.) Two conical appendages. Fic. 18,—TRICHOCEPALUS AFFINIS. [) }Cloaca. gg a Female. h Male be FUP he SNANE VY Riemae Fic. 3. Fic. 6, Fic, 1,—Lire Hisrory. Bac, CitIaTep Emprvo. AmrHIsTomMuM Encysted Form. ~ Distomum Lanceocatum. Nat. size. HEPAT ICUM. Fic. 10,—Larva or Fic. 18.—Pentastomum Teniomes. (Female.) --Mouth. ! AF ic. 14.—PentTastomum ea DenricuLatum. PLATE xx Strongylus Refuseens in alveoli of Sheep’s Lungs. (x 200.) Fie. 4. Strongylus Contortus.— Bursa of Male. Strongylus Contortus, rie papille of Female. : cs (x 650. GENERAL INDEX For detailed and consecutive information the reader ts referred to the Special Index on page 979. PAGE Abdominal Vertigo . é . 623 Abortion, Infectious . » . 206 Abscesses, Strumous . . 871 Necrotic, in Liver . 865 Acanthocephala ; - 894, 924 Acephalocyst . ‘ ‘ . 919 Aconitina . 7 : - 600 Actinomycosis . 542 Adventitious Substances in Brain and Cranial Cavity 647 African (South) Horse- Sickness . 342 Agglutinins ‘ . 148 Aitken, Dr., on N osology » 123 Albuminuria. 536, 881 Alfort Veterinary School, Experi- ! ments in Septicemia . 102 Amyloid Degeneration of Tissue. 57 Anemia . : ‘ 77 Anatomy, Morbid : 4 Angina Pectoris : j . 791 Ankylostomiasis . : » 905 Anthrax . . ‘ . 284 5 Apoplectic . . - 3803 3 Bacillus of . A . 290 3 Enteric é : 303 4 Fever . 297, 302 », Inoculation for Preven- tion . . : . 296 Anus, Imperforate . 822 Apoplexy, Anthracic . 3 . 802 = Cerebral . . . 681 sia from Congestion . 634 is Pulmonary ‘ . 747 Splenic . 302 Arloing on Pathogenic Microbe of Pleuro- Pneumonia. 187 Armatage, Professor, on Para- sitic Diseases of Lungs . - 938 Arsenic Poisoning . 607 Ascarides . ¢ F 897, 901, 934 Ascites 7 . 847 Asthma (Broken Wind) ‘ . 567 973 Atrophy, Definition of . . + Different from Gan- grene. : : 35 of Brain. . Auscultation as means of ‘Diag. nosis. : . 701, Azoturia Bacteriolysins .. ‘ . : Baldrey, Captain, on Cattle Plague (note) 5 a on Intestinal Worms . . - 896, 905, Bang, Professor (of Copenhagen), on Suppression of Tuberculosis Beale, Dr., ov Cattle Plague Beattie (Highland and Agricul- tural Society) on Rot in Sheep Beneke, on Oxaluria . - Bilharziosis 3 Bissange on Potato Poisoning Black-Leg : 2 Black Spaud . Black Water (Hzematuria) - ‘ Bladder, Inflammation of nae titis) . 2 Bladder-Worm . A - . Blood, Changes in— Anemia (Hydremia, Oli- gemia) . Accompanied by’ Ana- sarcous Swellings Changes caused by Treatment of Coagulation : : Defective Secretion, pro- ducing . . Deficiency of Fibrin Hyperemia or Congestion . Defective Secretion Diminished Cardiac Power * PAGE 48 49 650 706 557 145 151 914 383 151 959 565 914 602 314 465 536 884 918 974 Blood, Changes in (continued)— Hyperemia or Congestion (continued)— Gravitation . Treatment Leukemia, or Leucocythzmia Lipemia, or Fatty Blood Mellitemia : c Polyemia, Plethora Septicemia Definition Artificial Induction Koch’s Experiments. Transformation of Chyle and Tissues causing A . Blood, Constituents of Blood Diseases . Septic Z Borthwick, Inquiry as to Tick Paralysis : Bothriocephalus Worm) . Bots (Larvee of Gad- fly) Bowels, Diseases of . ‘ Bowel, "Twisted (Volvulus) | Bowhill on Hemorrhagic a cemia Box Poisoning (Buxus semper- virens) . Brauell (of Dorpat) on Cattle Plague . Braxy (Septicemia Gangrenosa) >, in Sheep. ‘ Broken Wind (Asthma) Bronchial Sounds Indicative of Disease os : P . Bronchitis F Broncho-, ‘orCatarrhal Pneumonia Brotherston on Louping-Ill Brown-Séquard on pera ete, Bursattee : Caderas, Mal de 7 . 473, Cake Poisoning (Castor Oil and Croton Seed) . ‘ Calcareous Degeneration of Tissue Caleuli, Renal. Calmette, Professor, ‘on Tuber- culin ‘ Calorific Functions, ‘Symptoms furnished by . . Cardiac Sounds in Disease ; (Pit - headed Catarrh Catarrhal Fever (Malignant) of Ox as »» (Panzootic) Pneumonia ‘ 5 Cattle Plague . . : Causes of Disease, Exciting Predisposing . (For details see these headings.) INDEX. ° PAGE Ceely on Transmission of Small- ox to Cattle . : 3 : Cellular Theory of Infection 93 | Cellulitis, Epizootic (Pink- eye) 405, 96 | Cephalic Diseases 82 | Cerebral Apoplexy 98 | Cerebritis . 89 | Cerebro- -Meningitis : 82 | Cestoda (Tape-worms) . 894, 101 | Chabert’s Disease , 101 | Charbon (or Anthrax) . : 102 », Essential : ‘ 103 | Cholera (Hogy Chorea.. , ‘ 85 | Cirrhosis . 67 | Cobbold on Nematodes, ete. ‘ 471 s, on Strongylus Tetra- 456 canthus Cocciodosis : i ; ; 539 | Coenurus . Ccenurus Cerebralis, producing 919 Sturdy in Sheep 895 | Coit, Maladie du é 813 | Coital Exanthema of Cattle 831 | Colchicum Poisoning . Colic . 3‘ 395 | Colloid Degeneration of Tissue Colon, Impaction of . F 601 | Congestion, Definition of . 35 of Lungs 156 of Liver . 464 Coins ita (of Selkirk) on "Para- 102 sitic Gastric Catarrh : . 567 | Constipation 2 3 Contagion . 716 | Contagious Diseases . : . 728 3 a due to Para- 188 sites . 668 sa ie due to Proto- 658 208 . . 906 | Cornstalk Disease ‘i Cough as Indicative of Disease . 492 | Cow-pox (Variola Vaccina) Crepitations in Disease 3 581 | Croup 2 - : s . 55 | Cyanosis . . ¢ : . 883 | Cysticercus s Cystitis (Inflammation of Bladder) 881 | Cystic-worm . Cytolysis . : : : . 45 720 | Darnel Grass Poisoning . . 723 | Davaineon Nematodes . . 439 on Trematodes 406 Death, Modes of 188 » Beginning at Brain 147 - “i at Blood 12 35 i at Heart ‘ 6 53 at Lungs Degenerations of Tissue 214 139 417 617 681 617 622 916 . 814 284 304 321 615 130 188 712 717 399 792 918 884 918 145 604 902 910 . 109 117 119 110 112 50 INDEX. * 975 PAGE PAGE Degenerations, Caleareous . » 55 | Evans on Sutra . . 486 as Fatty . Z - 53 | Exanthema (Coital) of Cattle | 482 " Metamorphoses - 53 | Exciting Causes of Disease— a7 Mucoid, Colloid, Food and Water . 12, 17 Pigmentary, and. Geological Formation . » 19 Amyloid . 3 15F Heat and Cold . 3 . 28 Delafond on Anthrax. : . 807 Mechanical . 3 . » 12 Diabetes Insipidus j . 554 Overwork . - 22 55 Mellitus 89, 875 See tens Imperfect . 21 Diagnosis . 3 é 4 | Exostoses . ‘ - 650 Diaphragm, Diseases of . . 794 Diarrhemia 5 : i: . 441 | Fare: . 250 Diarrhea . 837 a Degeneration of Tissue | 53 Dick, Professor, on Cattle Plague, Infiltration - . 60 et passim - 159 6 it different from 3 3 on Strongylus Fatty Degene- Tetracanthus. 948 ration . - 68 Dietetic Diseases é - 550 | Ferment contained in Secretions Digestive Organs, Diseases of | 796 of Animals. ‘ » «75 Diphtheria 2 401 | Fevers— Diptera (Two-winged Insects) 894, 924 Anthrax. . 297, 302 Disease, Exciting Causes of . 12 Bilious (Tropical) . - 534 Diseases, Classification of . - 122 Eruptive or Petechial . - 441 Distemper, Canine : . 276 Hectic : « 461 Distoma Hepaticum . - 909 Malignant Catarrhal of Ox. 439 Dixon, J. C., Cases of ‘Liver Panzootic Catarrhal . . 406 Disease . : i Fs . 857 Parturient . 462, 888 Dochmius . . 905 Rheumatic . i 544 Dog Mercury Poisoning ‘ - 603 Scarlet (Searlatina) : - °450 Douglass, Hon. A., Experiments Splenic z - 3802 in connection with Texas Fever 505 Swine . “ 3 . 321 Dourine . ; 4 473 Texas . ‘ - 284, 495 Dropsy of Abdomen . 847 Tick (in Dog) a : . 534 Dysentery . . 7 844 Traumatic. . . . 459 Filarie * 906 Eber, Dr. A. (of Petes) 2 Fleming, Dr., on Variola Equina 282 Tuberculin . . 876 + on Rabies, etpassim 234 Echinococcus. - 919 on Trichinosis . 956 Echinorrhyncus Gigas . 924 | Flukes ‘(Trematoda) ‘ : - 894 Eclampsia, Parturient . - 645 | Foxglove Poisoning . 606 Ectoparasites . 894 | Friedberger and Froéhner on Coital Ectopia Cordis (Displacement of of son Exanthema of Cattle . . 484 Heart) . ° é Eczema Contagiosa . 199 | Gall-stones ‘ : . 866 Eggeling and toss Ber- Gamgee on Cattle Plague . 154, 158 lin) on Stomatitis Purulosa . 267 >, on Parasitic Diseases of Emphysema pe of ae 744 Lungs a . 938 Encephalitis. . 622 » on Variola Ovina . » 225 Endocarditis . : 5 788 » on Azoturia . : 557 Endoparasites . . 894 1», on Encephalitis, etc., et Enteritis . «824 passim =. . . 622 Entozoa . . 894, 968 | Gangrene, Progressive . . 101 Enzootic Diseases. ; . 405 | Gapesin Fowls. . - . 948 Epilepsy . 612 | Gastric Tympanites . 2 . 891 Enicobe Cellulitis (Pink eye) 405, ph Gastrorrhoea Parasitica . - 944 Diseases Gid (Sturdy). . 964 i Lymphangitis_. : 372 Glanders' . : . 250 A Pneumonia of Horse . 425 | Glossina (Tsetse- fly) ‘ - 930 Erysipelas in Swine . . . 335 | Glosso- anthrax... -299, 305 Etiology, Definition of - 4 | ‘*Grease” in Horse ‘ - 282 976 - INDEX. PAGE : PAGE Grub in Head (strus.ii Sheep) 928 | Inoculation for Prevention of— Grunting as Symptom of Disease Anthrax (Charbon) 296 of Respiratory Organs 706 Pleuro-Pneumonia . ~ 182 Quarter-Ill (or Black-Leg) 318 Hematuria 883 Swine ee (Pasteur’s Hemo- ‘Albuminuria (Red Water) 536 Method) 339 Hemolysins 145 Tuberculosis a, ogee 375 Hemorrhagic Septicemia . . 893 | Intestinal Concretions 833 Hemorrhoids (Piles) . ‘ - 822 | Intussusception of Bowel 829 Heart and _ its Membranes, Ixodic Anemia . 495 Diseases of 788: | Ixodide (Tick Family) 931 Hellmann (of St. Petersburg), Discoverer of Mallein Test 266 | Jaundice (Icterus) . ~ 863 Hemiplegia : : 663 » Malignant, of Dog « 534 Hemlock Poisoning 592 | Java Bean Poisoning . . - 600 Hepatitis (Inflammation of Liver) 853 | Jenner, Dr., on Cow-pox . 213, 217 Hepatization of Lungs 753 | Jessen, Professor, on Cattle Histology, Morbid. : 4 Plague . 7 . : » 150 Hog Cholera. 321 Hoose (Parasitic Disease of Lungs) 936 | Kidneys, Diseases of . . 870 Horse-Sickness (South African) . 342 | Klein on Swine Fever 321, 326 Humoral Theory of Infection . 139 | Knox on Strongylus Tetracanthus 948 Husk (Parasitic Disease of Lungs) 936 | Koch, Dr. Robert, on Anthrax . 288 Hutcheon, Mr.D.,onCattlePlague 163 8 », onCattle Plague Hutcheon, Dr, on Jaundice in 149, 167 Dog (Tick Fever) 535 oe », on Contagious Huxley, Professor, on Coagula- Diseases 125 tion of the Blood . 72 ‘a », on Septicemia 103 Hydremia . 77 ,», _ on Tuberculosis 348 Hydrothorax 772 Krause, Dr., on Cattle Plague 164 Hydruria . : . . . 554 Hyperemia . 77, 90 | Laryngitis . 725 Hypertrophy, Definition of 64 | Lathyriasis 588 Hysteria 887 | Lead Palsy : 572 Lead Poisoning (Plumbism) 572 Icterus (Jaundice) . F 863 | Leuckhart on Nematodes . 900, 908 Immunity . . . 148 a6 on Trematodes . 910 Impaction of Rumen . 805 at on Acanthocephala . 924 ‘5 of Colon . 818 | Leucocythemia . poe a 8B Infection, Theories of (Cellular, Leukemia . . 82 Humoral, Opsonic) . 189 | Lewis, Dr. Timothy, on Surra 486 Infectious Abortion 206 | Lingard on Surra 490 Pneumonia of Swine . 334 Lipemia . 3 : . 98 Infiltration, Fatty . ; - 60 | Liver, Diseases of 849 Inflammation of— Lobar Pneumonia 425 Bladder (Cystitis) i; 884 | Local Diseases . . 612 Brain (Phrenitis, Cerebritis) 617 | Lockjaw (Tetanus) . . 885 Bowels (Enteritis) 824 | Loodiana Disease 284, 299 Heart (Endocarditis) 788 | Lounsbury, ©. P., Heres on Kidneys (Nephritis) 877 Texas Fever . 504 Larynx (Laryngitis) 725 | Louping-Tl (Trembling) 666 Liver (Hepatitis) 853 | Lumbrici 934 Lungs (Lobar Pneumonia) . 752 | Lumbricoids 894 Mamme 892 | Lungs, Congestion of. 747 Nerves (Neuritis) 699 », Inflammation of 752 Pericardium 781 » Parasitic Diseases of 936 Pleurse : 769 | Lupinosis . : 587 Spinal Cord (Spinitis) . 652 | Lymph Produetion (for vaccina- Womb (Metritis) 889 tion) 5 Influenza . 405 Lymphangitis, i pizootic . 272 INDEX. 977 PAGE PAGER McCall, Professor, on Lathyriasis 585 ; Opsonins . , 182 McCall, Professor, on Java Bean Osmosis . ‘ 89 poisoning, et passim 601 | Oxaluria 563 McDougal, Dr. R. Stewart, on Oxyurus Curvula 934 Lathyriasis . 583 MacFadyean, Professor, on Pleuro- Palpation in Disease as means of pneumonia. 194 Diagnosis 708 MacFadyean, Professor, on Tuber- Pancreas, Diseases of. 867 culosis, et passim . : . 852 | Panzootic Catarrhal Fever . 406 Mad Staggers . ‘ 5 - 622 | Paracentesis Thoracis. 776 Mal de Caderas . ‘ . 473, 492 | Paraffin Oil ere 577 Maladie du Coit. : 475 | Paralysis . 657 Malignant ey Fever of 46 (Tick) i in Sheep 539 - 439 | Paraplegia . 660 - si J sunning of Dog . 534 | Parasites, Facultative and Obliga- 5 (dema . . 459 tory 126 53 Pustule . r . 804 | Parasitic Diseases 894 Mammitis . . 892 ‘3 Bronchitis . 936 Marcet, Dr., on Cattle ¢ Plague - 150 3 Gastric Catarrh 944 Mellitemia| » 89 | Parturient Fever 462 - Meniére’s Disease ‘: ¥ . 620 | Parturition, Diseases connected Meningitis, Cerebro- . 622 with : 888 Metritis (Inflammation of Womb) 889 | Pasteurellosis 3 2 . 393 Microbes, Classification of . 128 | Pasteur on Anthrax . 288, 293, 313 Modes of Death . . ‘ . 109 | Pasteur’s Mode of preparing Vac- Monkshood Poisoning : . 599 cine for Rabies 240 Morbid Anatomy fs é 3 4 0 Preventive Inoculation », _ Histology . 4 for Swine Erysipelas 339 Mucoid Degeneration of Tissue . . 57 | Pathogeny, Definition of é 4 Mucous Membrane, Sympioms Pathology, Definition of 4 furnished by . 27 | Pentastoma Tznioides 934 Muir Il. 536 | Pentastomes (Trachearia) . 895 Murchison, Dr., on Cattle Plague Percussion in Disease as means 153, 159 of Diagnosis . : . 702, 722 Pericarditis ‘ . 781 Nagana (Tsetse-fly Disease) 478, 491 | Petechial Fevers 4 441 Neerotie Abscesses in Liver . 865 | Peyer’s Glands (in Distemper) 278 Nemathelminthes . : 894 » Patches (in Cattle Hague 153 Nematoda . 894, 897 Phosphorus Poisoning 609 Nephritis (Inflammation of Kid- Phrenitis (Phrenzy) . 622 neys) . 877 | Pigmentary Degeneration of Nervous System, Diseases of . 612 Tissue . 57 Neuralgia . F ‘: ‘ . 699 | Pink-eye (Epizootic Cellulitis) 405, 417 Neuritis. , 699 | Piroplasmosis 5, 534 Nocard,. Professor E, on Dourine 476 Platyhelminthes ‘ th 908 Nocard, Professor E., on Pleuro- Plenalvia . . 801 pneumonia . 190 | Plethora a ‘ 82 Nocard, Professor E., on Tuber- Pleural Sounds in Disease . 719 culosis, ef passim . 352 | Pleurisy (Pleuritis) 769 Nosology, or Classification of Pleuro- Pneumonia of Cattle 170 Disease . : a 4, 122 of Horse 425 Nutrition, Increased . : . 64 Plumbism (Lead Poisoning) 572 Pneumonia, Catarrhal . 188 Cidema, Malignant . . 840, 459 a5 Epizootic, of Horse. 425 Gstrus. é : . 895, 926 ae Lobar (Sporadic) . 752 Cstride . 7 895, 926 ¥ Septic, of Calves and Oligemia . 2 ; x NG Lambs . 468 Olulaniasis ‘ ; ‘ . 901 | Pneumo-Enteritis (Hog Cholera) 321 Opisthotonos 386 | Poisoning— Opsonic Theory of Infection . 139 Aconitine 600 62 978 INDEX. PAGE PAGE Poisoning (continuwed)— Rot in Sheep. . 909, 958 Arsenic ‘ 607 3 4 DE: Rowe’ s Plan for Box (Buxus sempervirens) . 601 Extirpation . 914 Cake (Castor Oil and Croton Royal Commission on Tubercu- Seed) . 581 losis, Report of . : . 3858 Colchicum . . 595 Rumen, Impaction of . F . 805 Darnel Grass. ‘ . 604 Dog Mercury. a - 603 | Salt (or Brine) Poisoning . . 609 Foxglove . : 3 606 poe Poisoning . - 610 Hemlock . 5 . 592 | Sanderson and Bristowe, Drs. ,on Java Bean . F - 600 Cattle Plague . "158, 161 Lead (Plumbism) ‘ . 572 } Sanderson and Bristowe, Drs., on Monkshood. 3 ‘ . 599 the Pulse j » 80 Paraffin Oil. ; . . 577 | Sapremia . : . 462 Phosphorus. : . - 609 Boarlatina (Searlet Fever) . . 450 Potato . . . 602 | Schroeder, Dr. E. C. (of Washing: Rhododendron . ‘ 578 ton), on Tuberculin. i 879 palt = . ' . 609 | Scrofula . : = erl Saltpetre . ; . 610 | Secretions, Symptoms furnished Sulphate of Zine. . 610 by . . 48 Yew . ‘i , 579 Semiology : . 4, 24 Polyemia . : . : - 82 | Sepsin : : j - 103 Polyuria . : F . 554 | Septiceemia : : . 101 Potato Poisoning 7 - 602 sf Gangrenosa, or Braxy 464 Precipitin . 144 Hemorrhagica . - 893 Predisposing Causes of Disease— Septic Blood Diseases . 3 - 456 Influence of Age. ; 6 | Septic Pneumonia of Calves and >» of Breed, Colour, Lambs . 468 Temperament . 9 | Sheep-pox (Variola Ovina) . 223 » of Heredity . + 11 | Sibilus (Sibilant Rale) : . 716 », Of Previous Disease 11 | Simonds, Professor, on Cattle », of Sex and Con- Plague i 154, 159 formation. : 8 | Simonds, Professor, on Rot in Prognosis . 4 Shee 958 Protozoa as Productive of Disease 120 | Simonds, Professor, on Variola Pulmonary Sounds in Disease . 717 Ovina . . 223 Pulse, Importance of, asSymptom 30 | Sleepy Staggers . 7 5 ‘ 622 Purpura Hemorrhagica . . 441 | Sounds Indicative of Disease . 713 Pustule, Malignant . 4 . 804 | South African Horse Sickness . 342 Spinal Cord, Diseasesof . . 652 Quarter-Ill : 314 | Spinitis . ‘ é . 652 Spirillosis in Horse . ‘ 343 Rabies é $ 3 234 | Spirochetosis . é . 3844 Rectum, Diseases of . 820 | Spleen, Diseases of . : . 867 Red Water (Hamo- Albuminuria) 536 | Splenic Apoplexy . » . 802 Renal Caleuli . 883 » Fever . : é . 802 Respiratory Organs, Diseases of. 701 | Stercoremia . . 461 si Functions, Symptoms Stomach, Diseases of. : 798 furnished by . 421 45 Impaction of . . 801 Rheumatic Fever : . 544 Staggers . . 622 Rheumatism. : ’ 544 | Stomatitis Pustulosa Contagiosa 267 Rhododendron Poisoning . . 578 | Strumous Abscesses . fs . 3871 Rhonchus . . 716 | Sturdy. ; » 964 Rinderpest (Cattle Plague). . 147 | Sulphate of Zine Poisoning 610 Roaring in Diseases of ey Succussion as means of Diagnosis 704 Organs . 708 | Superpurgation . . . 889 Robertson, W. “(of Kelso), on Surra (Trypanosoma Evansi) 478, 485 Diphtheria. 401 | Swine Erysipelas ‘ ‘ « B35 Ross, Dr. George N., on Opsonins 132 | Swine Fever . 3 . 821 Rot, due to Distoma Hepaticum. 909 1» Infectious Pneumonia in . 334 INDEX. 979 PAGE PAGK ping Viegas ‘ ‘ me Rares grt Trichinosis 899, 952 ymptomatology : opical Bilious Fever . 534 Son ae oo Disease rypancrome Evansi (Surra) 473, 485 eneral Definition ‘ » 24 rypanosomiasis _ . : 471 Symptoms furnished by — Tsetso- -fly (Glossina) . . 930 Calorific Function : 2 44 ne Disease (Nagana) 473, 491 oe Membranes : ys Se pare in = Memos ulse . : F of Brain 649 Respiratory Functions . 41 | Tuberculin 372 Secretions . J Pe 43 | Tuberculosis . - . 348 Surface of Body 29 | Tumours . ¥ . 647 Syphilis of Horse (Douriis) 473 | Turnsick (Sturdy or Gid) : . 964 Strongylus Armatus . : . 898 | Twisted Bowel (Volvulus) . 831 3 noe oe . Tympanites (Gastric) . . 801 i ‘ilarius ‘ ” net : : ea Disease of Heart . . 790 » escen. riola Equina . 232 ” Tetracanthus 948 a : Seiaa, 293 Vacei Tabanide (Horse-flies) : . 930 | Vertigo, ‘Abdominal re Tenia, Coenurus, Serrata, etc. 896, 917 | Villemin on Glanders 257 Tape-worms (Cestoda) 894, 908 | Virchow on Glanders . , 257 Hetnga Glodkjaw) wie . Volvulus (Twisted Bowel) . 831 er. ; Thiele, Dr. Basil, on Cow-pox 216 Thoracic Sounds in Disease 714 |! bee Malcolm, on Heart 733 Theray-headed “Worma ‘(acan- “Warbles, produced by Estrus . 928 thocephala) . . 894, 924 Watson, Sir Thomas, on Modes Tick Fever (of Dog) . ° 534 f Death Tick Paralysis (of Bice) | . 539 Whi ‘lin Disc [R 109 Toxeuia. 456, 459 is pe in Diseases 0 espira. - 4 Intestinal . - . 461 woe ie ee ov Tracheal Sounds in Disease 718 : ah ae Si Pl 469 Trachearia ‘ 895, 932 | Woodhead, Dr. Sims, ‘on euro- Traumatic Fever ; . 459 yrneamonia Pleuro-P ie Trelut on Maladie du Coit . «482 FRY) Dt y ORD TOULO® meumonia 19 Trematoda (Flukes) 894, 909 Trembling (bene) 666 | Yeo, Dr., on Congestion of Lungs 747 Trismus . . 3886 » , on Pleuro-Pneumonia . 177 Trichina spiralis : 898,907 | Yew Poisoning . 579 SPECIAL INDEX. BLOOD DISEASES. Actinomycosis . 542 | Maladie du Coit. e'. Od . 478 ‘Animals affected . 542 | Mal de Caderas - . 473, 492 Treatment . 5438 Prevalence and Symptoms . 492 Black Water. 536 Post mortem Appearances . 494 Coital Exanthema of Cattle 484 | Malignant Jaundice of ne vee Dourine 3 . 473 Fever) s 534 Contagion : 479 | Muir-Tll . 536 General Symptoms ma Deen (Tsetse-fly Disease) 473, 491 Nocard on . 476 | Piroplasmosis 495 Post mortem Appearances 480 Equine (Tropical Treatment . 479 Bilious Fever in India) . . 584 Trelut on 482 | Red Water 536 62—2 980 INDEX. PAGE PAGH Surra (Trypanosoma Evansi) 473,485 | Texas Fever (continued)— Lewis, Dr. T., on . 486 Prevention and Treatment . 500 Lingard, Dr.,on . 490 Summary . 533° Symptoms . . 490 | Tick Fever (talignant Jaundice Texas Fever (Ixodic Anemia) 281, 495 of Dog) . 3 . 534 Cases in Jamaica 617 | Tick ‘Paralysis j in Sheep . . 539 Destruction of Ticks 523 Inoculation Experiments . 541 Etiology . . 497 Inquiry by Mr. Borthwick . 589 Experiments by Hon. A. Trypanosomiasis . 471 Douglass . 505 Description of Trypanosomes 471 Experiments by L. J. Roberts 508 Tsetse-fly Disease (Nagana) 473, 491 Lounsbury's Report . 504 Symptoms in Horse . - 491 Post mortem Appearances 498 CONTAGIOUS DISHASES. Anthrax (Charbon)— Anthrax Fever . . 297, 3 in Man (Essential Charbon) . i in Pigs and Poultry ” Apoplectic, in Cattle and ene ‘5 Enteric Bacillus of . x A 5 Glosso- Anthr ax. . 299, History and Etiology . Influence of Flies and Worms » of Temperature and Morasses . Inoculation for Prevention . Pathological Anatomy Preventive Treatment . Sources of Infection Splenic Fever and Apoplexy Synonyms and Definition Treatment . Varicties . Black-Leg (see Quarter- Il). Broncho- or Catarrhal Pneu- monia . 3 : : Canine Distemper Cause . Complications Definition . Pathology and Symptoms 277, Treatment . 2 Cattle Plague (Rindexpest}— Definition . Directions for preparing Bile Pathology and Symptoms . Synonyms . 2 . Treatment . . ; Cocciodosis Cornstalk Disease Croup— Symptomsand Treatment 399, 302 304 305 802 3803 290 305 | 285 287 286 296 3806 312 295 308 284 310 297 314 188 276 276 279 276 278 231 147 166 148 147 163 346 188 400 Diphtheria— DefinitionandSymptoms . 401 Treatment . 7 . . 404 Distemper (see Canine) ‘ . 276 Eczema Contagiosa— Definition . 5 . . 199 Effect on Milk. 3 . 201 Pathology . F - ~ 199 Sequele . ; . 203 Symptoms in Cattle : 199 59 in Sheep and Pigs 205 Treatment . 203 Epizootic Lymphangitis— Definition and Hee . 272 Symptoms. . 274 Treatment . ¢ F . 275 Farey (see Glanders) : 250 Glanders and Farcy (Equina)— Acute Farcy .. . - 262 » Glanders . ; 255 Antiseptic Preventive Tr eat- ment . . . 265 Bacilli of Glanders . 255 Causes and Precursors . . 251 Chronic Farcy . . . 264 » Glanders z . 258 Contagion . 252 Definition and History . 250 Mallein Test . 266 Stomatitis Pustulosa Con- tagiosa (Report by Eggeling and Ellenberger of Prim 267 Virchow and Villemin on . 257 Hemorrhagic Septiceemia (or Pas- teurellosis)— Bowhill’s Report ‘ . 395 Definition and Names. . 893 Hog Cholera (Pneumo-Enteritis) 321 Infectious Abortion— Bang, Professor, on . . 209 Causes of . 7 : . 206 Nocard, Professor, on . . 207 Infectious Abortion (conéinwed)— INDEX. PAGE Prophylaxis . : « 212 Treatment . . . 210 Malignant G@idema . 340 Pasteurellosis (see Hemorrhagic Septicemia) . . 893 Pleuro-Pneumonia Contagiosa— Definition . - 170 Inoculation (Dr. Willens) 182 5 (Thiernesse and Degive) 185 Pathogenic Microbe - 187 Pathology and Symptoms . 170 Post mortem Appearances 174 Prevention . . 181 Pneumo-Enteritis (Hog Cholera) 321 Quarter-I11 (or er Causes 317 Definition ‘ 314 Disposal of Carcase 317 Preventive Inoculation 318 Symptoms . 315 Rabies— Causes . : 236 Definition and History 284 Fleming, Dr., on 3 234 In Dog . 242 In Wolf and Hyena 241 Materies Morbi . ‘ 238 Pasteur’s Experiments 210, 247 Pathology and Symptoms . 239 Pathological Anatomy 248 Preventive Treatment . 246 Symptoms in Horse 245 Rinderpest (Cattle Plague) 147 a in Sheep . 168 South African Horse-Sickness . 342 Spirillosis in Horse . 3843 Spirochetosis_ . . 344 Swine Erysipelas— Pasteur’s Method of Pre- ventive Inoculation . 339 Post mortem Anpeainees 337 Symptoms . Fi - 3836 Varieties . 335 Swine Fever (Pneumo- -Enteritis)— Causes, Pathology and Symp- toms : . 822 Definition and Synonyms 321 Swine Fever (continued) — Morbid Anatomy i Swine, Infectious Pneumonia in—- Symptoms and Post mortem Appearances Swine Plague— Definition and Synonyms Symptoms and Treatment . Tetanus (Lockjaw)— Antitetanin Bacillus Tetani . : Definition and Prevalence . Symptoms . ‘ 3 Treatment . Tuberculosis— Bang, Professor, on Definition . 7 Inoculation, Method of Microscopic Appearances Post mortem Appearances Report of Royal Commis- sion. 2 z Strumous Abscegses Suggestions for Suppression Symptoms in Birds . : <5 in Cattle 55 in Dog . is in Horse in Pig $5 . Treatment of Bovine . Tuberculin . Variola Equina— Fleming, Dr., on Variola Ovina— Definition, History, my nyms ss. Gamgee, Professor, on. Simonds, Professor, on Pathology and Symptoms Post mortem Appearances Prevention and Treatment . Variola Vaccina— Causes Ceely’s Experiments Definition, Se eRe Syno- nyms _ Jenner on Lymph Production Treatment . ‘ ENZOOTIC AND EPIZOOTIC DISEASES. Epizootic Pneumonia or Pleuro- Pneumonia of the Horse, Lobar Pneumonia . Post mortem Appearances Semiology . 3 Treatment Influenza : : 425 429 426 431 405 Malignant Catarrhal Fever of the Ox . Symptoms ‘ Treatment . ; Panzootic Catarrhal Fever . Etiology . . . Morbid ‘Anatomy 981 PAQE 327 334 332 333 391 388 385 386 389 383 348 375 349 372 358 371 382 869 353 367 364 366 370 372 232 223 225 223 226 231 231 220 214 213 213 221 220 439 439 440 406 407 417 982 INDEX. PAGE Panzootic Catarrhal Fever (con- Pink-eye (Epizootic ais) 405, 417 418 tinued)— Etiology . Pathology . i - 409 Mortality . : 424 Sequelae . . 416 Post mortem Appearances - 423 Symptoms . : 5 410 Symptoms . j . 419 Treatment . : 413 Treatment . - «424 ERUPTIVE OR PETECHIAL FEVERS. Purpura Hemorrhagica .. . 441 | Purpura Hemorrhagica en Causes . 444 Treatment . - 447 Definition, "Pathology and Scarlatina (Scarlet Fever) - 450 Symptoms . . 441 Semiology . - 3 . 451 Post mortem Appearances . 446 Treatment . ‘ : » 4538 PARASITIC DISEASES. : A. Classification of Parasites (Ec- A. Classification of Parasites (con- toparasites, Endoparasites tinwed)— or Entozoa, Lumbricoids). 894 Diptera (Two-winged In- ine sects) (continued)— een Ankylostoma and Anky- Nemathelminthes . . 894 lostomiasis : » 905 Acanthocephala . 894 Ascarides . ‘ 897, 901 Nematoda . : - 894 Bursattee(noteon) . 906 Platyhelminthes . . 894 Cobbold on Nematodes 903 Cestoda , ‘ . 894 Davaine on Nematodes 902 Trematoda . : 894 Development, Modes Belonging to Sub-Kingdom Ve ermes of - 903, 905 (Parasitict). Filaria (Immitis, Papil- losa, etc.) . Fi » 906 DETAILED. Olulaniasis (note on) . 901 Acanthocephala . . 924 Strongylus Armatus . 898 Echinorrhyneus Gigas . 924 * Filarius . 898 Ascarides . 934 3 Micrurus . 898 Bilharziosis (Baldrey on). 914 Rufescens . 898 Cestoda (Tape- worms) . 916 Trichina Spiralis . 898, 907 Bothriocephalus (Pit- Trichiniasis (note on) . 899 headed Worm) . 919 Leuckarton 900 Cystic. or Bladder- Platyhelminthes (Flat- worms . 7 . 918 worms) : - 894, 908 Acephalocyst . 919 Trachearia . . . 932 Ccenurus : 919 Pentastoma Tenioides. 932 Cysticercus . . 919 Trematoda - 909 Echinococcus . 919 Conclusions supported Diptera (Two - winged In- by Davaine, Leuckart, sects) 925 and others . 910 Glossina (Tsetse-fly) 930 Distoma Hepaticum, Ixodide (Tick Family). 931 Rot due to 5 909 CGstrus (Gad-fly) . «923 Rowe, Dr., Plan for Cstrus Bovis, producin g Extirpation of Rot . 914 ‘“‘Warbles” . 928 | B. List of Diseases— » Ovis (‘Grub in Hoose (Husk) . . . 936 Head”). 928 Parasitic Bronchitis . 936 Tabanide (Horse- fies) 930 », Disease of Lungs 936 Lumbrici. 2 934 Armatage, Professor, on 938 Oxyurus Curvula . . 984 Caused by Rimongylae Nematoda 3 897 Filarius . ; 936 B. List of Diseases (continued)— Parasitic Bronchitis (con- tinued)— Gamgee on . “Gapes ” inFowls (Cots. bold on) Hoose in Calves (Symp- toms and Treatment) Symptoms, General Treatment Parasitic Gastric Catarrh (Gastrorrhea Para- sitica) Connochie (of Selkirkon) Description, Symptoms, and Treatment . Strongylus Cause of . Rot in Sheep . 909, Beattie (Highland and ae Epa on . : Contortus INDEX. PAGE 938 943 941 940 940 944 944 947 944 958 959 B. List of Diseases (continwed)— Rot in Sheep (continued)— Simonds, Professor, on. Pathological Anatomy . Treatment . Strongylus Tetracanthus, Diseases due to. Cobbold on . ' Dick, Professor, on Knox, Professor, on Symptoms Treatment Sturdy, Turnsick, or ‘Gid . Ccenurus Cerebralis, Cause of . 3 Symptoms ‘ Trichinosis, Trichiniasis . . Fleming, Dr., on . : Owen’s Discovery of Worm (1835) Symptoms SEPTIC BLOOD DISEASES. Braxy (Septicemia Gangrenosa). 464 Etiology and Pathology 466 Symptoms . : 464 Treatment . 467 Hectic Fever 461 Malignant idema 459 Symptoms . 460 Parturient Fever 462 SPORADIC Rheumatism— Acute (Rheumatic Fever) . 544 Etiology and Senay 544 Chronic. 545 Pathology 546 Treatment (Horse) 547 ” (Ox) 549 DIETETIC DISEASES. Asthma (Broken - Etiology 567 Pathology . 568 Symptoms . 570 Treatment . 571 Azoturia— Examination of Urine . 560 Symptoms . 557 Treatment . - + 561 Diabetes Insipidus, Polyuria, Hydruria— Etiology 554 Pathology - 555 556 Therapeutics Septic Pneumonia of Calves and Lambs: Symptoms . Treatment . Stercoremia, or Intestinal Tox- emia. : : 4 Traumatic Fever . . DISEASES. Lathyriasis— ie ane R. 8. meet Syneptoms 4 in Horse Lupinosis . Root Tubercle of Legurainose Symptoms . Over- Poedliing Oxaluria Condition of Urine. Etiology and Semiology ; Treatment . Plumbism (see Lead Poisoning) . Polyuria (see Diabetes) Poisoning— Aconitine Arsenic 2 Box (Buxus sempervirens) : Cake one Oil and Croton Seed) ; Description of Seeds Leather’s Treatment Treatment 983 PAGE 958 961 962 948 950 948 948 951 952 964 964 965 952 956 953 954 468 468 470 461 459 583 585 587 588 591 551 563 565 564 566 572 554 600 607 601 581 582 581 583 984 Poisoning (continued)— Colchicum . : Musgrave’s Treatment . Darnel Grass : Dog Mercury (Mereurialis perennis) . Foxglove . Hemlock , Analysis. Cnanthe crocata . Water Hemlock . Java Bean . ; ppc McCall’ 's Treat- Lead ahve, Lead Palsy) Definitionand Symptoms References to F. Dun's Materia Medica. Treatment . : . Monkshood (Aconite) . Paraflin Oil. Phosphorus. Potato. : ‘ Bissange’s Treatment . Rhododendron Salt or Brine Saltpetre . Sulphate of Zine « Yew . . Treatment LOCAL DISEASES. A. Nervous System, Diseases of— Chorea Symptoms i in Dog. Treatment : Epilepsy . . Symptoms Treatment B. Cephalic Diseases— Cerebritis (Inflammation of Brain Substance) Meniére’s Disease. C. Encephalitis (Inflammation of Brain and Membranes), Cerebro- Meningitis, Phrenitis, Coma, ete. . Etiology . Gamgeeon Morbid Anatomy Symptoms i Treatment : - D. Cerebral Apoplexy— Morbid Anatomy . ‘ Semiology. a E, Apoplexy from Congestion— Etiology . ‘ : Post mortem Appearances Prognosis. INDEX. PAGE E. Apoplexy from engesbon 595 (continued) — 598 Semiology 604 Treatment Parturient Eclampsia Treatment °. 606 | F. Adventitious Substances in 592 Brain— 594 Enlargement of Pineal 595 Body : 594 Exostoses. . 600 Hy perenny and Atrophy Brain 5 . 601 Hilanoats of Brain . 572 Softening of Brain . ; 572 Tubercular Deposits in Meninges . 574 Tumours. : 575 | G. Spinal Cord, Diseases of— 599 Spinitis : 577 Chronic Spinitis 609 Treatment 602 | H. Paralysis. : 602 Hemiplegia . 578 Louping-I]l (or Trembling) 609 Beard, of ean 610 Report : 610 Brotherston, Mr., ‘on 579 Influence of Pasture 580 sft of Ticks. », of Weather Symptoms . . Neuritis, Neuralgia . Paraplegia 7 615 Reflex Paraplegia ‘ 615 | I. Respiratory Organs, Diseases 616 of— 612 1. Diagnostic : 613 Diagnosis by— 614 (a) Auscultation . (b) Percussion (c) Palpation 617 (d) Inspection 620 (e) Succussion Auscultation of Larynx, detecting— (a) Grunting : ‘ 622 (b) Whistling 626 (c) Roaring . 622 Cough as indicative of 628 Disease. . . 622 Percussion in Disease 5 629 Sounds, indicative of Disease— 633 (a) Bronchial : 631 (1) Bubbling, Gur- gling, Mucous 634 Rhonchus . 638 (2) Rhonchus, Sibilus 638 , (b) Cardiac . ‘a 3 PASE 686 639 645 646 651 650 650 651 651 649 647 652 655 656 657 663 666 695 668 668 670 669 667 699 660 661 701 702 703 704 706 707 708 712 722 717 716 720 I. Respiratory Organs, Diseases of (continwed)— Sounds, indicative of Disease (continued)— (c) Morbid . (d@) Nasal (e) Pleural . 3 (f) Pulmonary: (1) Crepitations ; (2) Tubal Sounds (g) Thoracic: (1) Vesi- cular; (2) Tubal Sounds. . (A) Tracheal . 2. Phenomenal : Bronchitis— Acute (Pathology) » (Symptoms) ie treatment Chronic Catarrh— Causes and Symptoms . Treatment J Congestion of Lungs Post mortem Appearances Symptoms F Treatment . j Emphysema of Lungs— (a) Vesicular . (0) Interlobular Inflammation of Lungs, or Lobar Pneumonia Arterial Injection . Etiology Grey Hepatization Red Si Sa Symptoms Treatment Laryngitis Pathology Sequelae Symptoms Treatment Pleurisy (Pleuritis) . Hydrothorax Paracentesis Thoracis Symptoms ‘Treatment K. Heart and its Membranes, Diseases of — Functional Derangement Organic Disease . Angina Pectoris Cyanosis . Ectopia Cordis Endocarditis Hypertrophy . ‘ Pericarditis Symptoms Traumatic INDEX. PAGE 721 704 719 714 713 734 731 741 743 723 724 747 751 749 750 744 745 752 753 757 754 763 758 762 725 725 727 725 726 769 772 776 771 774 778 779 791 792 793 788 779 781 781 783 K. Heart and its Membranes, Diseases of (continwed)— Organic Disease (continued )-- Walker’s Report . Valvular Disease L. Diaphragm, Diseases of— Rupture . Spasm . : M. eee Organs, Diseases N. Stomach, Diseases of — Gastric Impaction in Horse Gastric Tympanitis . Causes in Horse ‘3 Cattle 9 Sheep Treatment Impaction of Rumen Impaction of Stomach Impaction of Third Stomach . Indigestion without En- gorgement ‘ Symptoms Treatment . Indigestion with Engorge- ment z Plenalvia . Rupture of Stomach. | O. Bowels, Diseases of— Ascites irony of Abdo- men) Causes . Symptoms and Treat- ment . Colic, Spasmodic and Flatulent . Treatment . Constipation Diarrhea Symptoms Treatment Dysentery Causes . Symptoms and Treat- ment Enteritis . i Pathology and Symp- toms. 5 Treatment Hemorrhoids, or Piles Impaction of Colon . Imperforate Anus Intestinal Concretions— Oat-hair and Mixed Caleuli . Phosphatic Caleuli Intussusception : Symptoms . a oy Treatment : 985 PAGE 783 790 794 794 796 810 801 801 802 803 804 805 801 806 798 798 799 801 801 811 847 847 848 814 816 813 837 837 838 844 844 845 824 825 827 822 818 822 834 833 829 830 831 986 INDEX, PAGE O. Bowels, Diseases of (continued)— Rectum, Rupture of. 5 Inversion of Superpurgation Treatment Volvulus . P. Liver, Diseases of— Congestion Symptoms Treatment Gall-Stones Inflammation (Hepatitis) . Causes and Symptoms . Chronic Cases ‘ Dixon's, Mr. J. C., Cases Treatment ‘ Jaundice (Icterus) Causes . Treatment Necrotic Abscesses . Softening and Bughets Causes . Treatment Q. Spleen and Pancreas, Diseases of ‘ ‘i R. Kidneys, Diseases of Albuminuria Symptoms and Treat- ment ° . 820 821 839 841 831 849 851 852 866 853 854 855 857 855 863 863 864 865 860 861 862 867 870 881 882 R. Kidneys, Diseases of (con- tinued)— Diabetes Mellitus . . Floating Kidney Hematuria Nephritis (Inflammation of Kidneys) . Causes and Symptoms . . Post mortem Appearances Treatment . S és Renal Calculi . ‘ 8. Cystitis (Inflammation of Bladder) . e Symptoms and Treat. ment Incontinence of Urine Retention of Urine . T. Hysteria 5 ‘i U. Parturition Diseases con- nected with)— Fever. Definition and Symptoms Mamuitis ; Metritis (Inflammation of Womb) Pathology s Symptoms . 7 Treatment . ‘ . BAILLIERE, TINDALL AND COX, 8, HENRIETTA STREET, COVENT GARDEN PAGE 875 883 883 877 878 879 880 883 884 884 886 884 887 888 888 892 889 889 890 891 CATALOGUE OF William R. Jenkins Co.’s Works Concerning HORSES, CATTLE, SHEEP, SWINE, Etc. 1909 (*) Designates New Books. (t) Designates Recent Publications. ANDERSON. ‘Vice in the Horse” and other papers on Horses and Riding. By E. L, Anderson. Size, 6x 9, cloth, illustrated............ 0. cece eee eee 1 75 ARMSTEAD. ‘The Artistic Anatomy of the Horse.” A brief description of the various Anatomical Struc- tures which may be distinguished during Life through the Skin. By Hugh W. Armstead, M.D., F.R.C.S. With illustrations from drawings by the author. Cloth oblong, 10 X124....... cece eee eens 3 75 BACH. ‘How to Judge a Horse.” A concise treatise as to its Qualities and Soundness; Including Bits and Bitting, Saddles and Saddling, Stable Drainage, Driv- ing One Horse, a Pair, Four-in-hand, or Tandem, ete.. By Capt. F.W. Bach. Size, 5x73, clo., fully illus.1 00: BANHAM, “Tables of Veterinary Posology and Thera. peutics,”? with weights, measures, etc. By Geo. A- Banham, F.R.C.V.S. New edition. Cloth, size- 4 x 51-2, 192 pages..............000- Sere 1 00: BAUCHER. ‘‘Method of Horsemanship.” Including the Breaking and Training of Horses. By F. Baucher. (Temporarely out of print). BELL. (*)**The Veterinarian’s Call Book (Perpetual).’” By Roscoe R. Bell, D.V.S., editor of the American. Veterinary Review. Completely revised. A visiting list, that can be commenced at any time and used until full, containing much useful informa-- tion for the student and the busy practitioner. Among contents are items concerning: Prescription writing; Veterinary Drugs; Poisons; Solubility of Drugs; Composition of Milk, Bile, Blood, Gastric Juice, Urine, Saliva; Respiration; Dentition ; Temp- erature, etc., etc. Bound in flexible leather, with flap and pocket... ....cecceeecceseeerecenenenear 1 26 BITTING. ‘‘Cadiot’s Exercises in Equine Surgery.’ See ‘‘Cadiot.’ BRADLEY. *“‘Qutlines of Veterinary Anatomy.” By O. Charnock Bradley, Member.of the Royal ol- lege of Veterinary Surgeons; Professor of Anatomy in the New Veterinary College, Edinburgh. The author presents the most important facts of veterinary anatomy in as condensed a form as possible, consistent with lucidity. 12mo.: Complete in three parts. Part I.: The-Limbs (cloth) ..c.ccecscversiavees 1 25 Part II.: The Trunk (paper) ............002 00 1 25 Part IIl.: The Head and Neck (paper).......... 1 25 THE SET COMPLET: so iessse quia serdis: conan odnmveisens's 3 25 CADIOT. “Exercises in Equine Surgery.” By P. J. Cadiot. Translated by Prof. A. W. Bitting, D.V.M. Edited by Prof. A. Liautard, M.D.V.M. Size, 6x ae cloth, illustrated......... 0... cece eee eee eee — ‘‘Roaring in Horses.” Its Pathology and aden: This work represents the latest development in oper- ative methods for the alleviation of roaring. Each step is most clearly defined by excellent full-page illustrations. By P. J. Cadiot, Professor at the Veterinary School, Alfort. Translated by Thos. J. Watt Dollar, M.R.C.V.S., etc. Cloth, size 5 1-4x 71-8, 77 pages, illustrated......... 6. ccc cence ewe eee eee 75 — ‘Studies in eae Veterinary Medicine and Surgery.” By P. J. Cadiot. Translated, edited, and supplemented with 49 new articles and 34 illustrations by Jno. A. W. Dollar, M.R.C.V.S. Cloth, size 7 x 93-4, 619 eee 94 black and white illustrations,,................ 5 25 —(*)**A Treatise on Surgical Therapeutics of the Domestic Animals.” By P. J. Cadiot and J. Almy. Translated by Prof. A. Liautard, M.D.,V.M- General Surgery.—Means of restraint of animals, general anesthesia, local anesthesia, surgical anti- sepsis and asepsis, hematosis, cauterization, firing, Diseases Common to all- Tissues.—Inflammation, abscess, gangrene, ulcers, fistula, foreign bodies, traumatic lesions, complications of traumatic les- ions, granulations, cicatrices, mycosis, virulent diseases, tumors. Diseases Special to all Tissues and Affections of the Extremities.—Diseases of skin and cellular tis= sue, of serous bursae, of muscles, of tendons, of tendinous synovial sacs, of aponeurosis, of arteries, of veins, of lymphatics, of nerves, of bones, of articulations. Cloth, size 6 x 9, 580 pages, 118 illustrations..... 4 50 CAMPBELL and LECROLX. (*)‘* Essentials of Para- sitology,’’ with a brief discourse on ZooLOGY. Size 5 3-4 x 8 1-2, 96 pages, with three Charts......... 1 00 CHAPMAN. ‘Manual of the Pathological Treatment of Lameness in the Horse,” treated solely by mechanical means. By George T. Chapman. Cloth, size 6 x 9, 124 pages with portrait................ 2 00 CLARKE. ‘Chart of the Feet and Teeth of Fossil Horses.” By W. H. Clarke. Card, size 91-2 x12.. 25 —‘* Horses’ Teeth.”? Fourth edition, re-revised, with second appendix. Cloth, size 6 1-4 x 7 1-2, 322 pp., illus..2 60 CLEAVELAND. ‘“*Pronouncing Medical Lexicon.” Pocket edition. By C. H. 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Cloth, size 6 x 9, 28 full page illustrations.................46 1 50 DALRYMPLE. (*)“Veterinary Obstetrics.” A compen- dium for the use of advanced students and Practi- tioners. By W. H. Dalrymple, M.R.C.V.S., -principal of the Department of Veterinary Science in the Louisiana State University and A. & M. College; Veterinarian to the Louisiana State Bureau of Agriculture, and Agricultural Experiment Stations. Second edition revised. Cloth, size 6x9 1-4,162 pages, 61 illustrations..... ......... (jaGekiacen Bawwaige 2 50 DALZIEL. “Breaking and Training Dogs.” Part I, by Pathfinder. Part II, by Hugh Dalziel. Cloth, Wlustrated wcoisavawanargasec ene sencGeg sare erres 2 50 — “The Collie.” By Hugh Dalziel. Paper, illustrated.... 50 — “The Diseases of Dogs.” Causes, symptoms and treatment. By Hugh Dalziel. Illustrated. Paper.............. 50 — “he Fox Terrier.” By Hugh Dalziel. Paper, 50; clo.1 00 — “The Greyhound.” Cloth, illus..... ........seeeeeeees 1 00 — “The St. Bernard.” Cloth, illustrated........... weee-1 00 DANCE. ‘Veterinary Tablet.” By A. A. Dance. Chart, 17 x 24, mounted on linen, folded in a cloth case for the pocket, size 3 3-4x 61-2. Shows ata glance the synopsis of the diseases of horses, cattle and dogs; with their cause, symptoms and cure......... Jets 108 DE BRUIN. (*)** Bovine Obstetrics.» By M. G. De Bruin Instructor of Obstetrics at the State Veterinary School in Utrecht. Translated by W. E. A. Wyman, formerly Professor of Veterinary Science at Clemson A. & M. College, and Veterinarian to the South Carolina Experiment Station. Cloth, size 6 x 9, 382 pages, 77 illustrations. ............ cc cece ee eens .5 00 Synopsis of the Essential Features of the Work 1, Authorized translation. 2. The only obstetrical work which is up to date. 3. Written by Europe’s leading authority on the subject. 4, Written by a man who has practiced the art a lifetime. 5. Written by a man who, on account of his eminence as. bovine practitioner and teacher of obstetrics, was selected by Prof. Dr. Frodhner and Prof. Dr. Bayer (Berlin and Vienna), to discuss bovine obstetrics both practically and scientifically. i 6. The only work containing a thorough differential diag- nosis of ante and post partum diseases. 7. The only work doing justice to modern obstetrical surgery and therapeutics. ritten by a man whose practical suggestions revolu-- tionized_ the teaching of veterinary obstetrics even in the great schools of ae be : 9. The only work dealing fully with the now no longer obscure contagious and infectious diseases of calves, 10. Absolutely original and no compilation. 11. The only work dealing fully with the difficult problem of teaching obstetrics in the colleges. | . . The only work where the practical part is not over- shadowed by theory. . : . . . A-veterinarian, particularly if his location brings him in contact with obstetrical practice, who makes any pretence toward being scientific and in possession of modern knowledge upon this- subject, will not be without this exce]lent work, as it is really a very valuable treatise.—Prof. Roscoe R. Bell, in the American Veterinary Review. 3 In translating into English Professor De Bruin’s excellent text- book on Bovine Obstetrics, Dr. Wyman has laid British and American veterinary surgeons and students under a debt of gratitude. The works represents the happy medium between the booklets which are adapted for cramming purposes by the student, and the ponderous tomes which, although useful to the teacher, are not exactly suited to- the requirements of theeveryday practitioner . . . Wecanstrongly recommend the work to veterinary students and practitioners.—-The Journal of Comparative Pathology and Therapeutics. DOLLAR. (*)*‘Diseases: of Cattle, Sheep, Goats and Swine.”? By G. Moussu and Jno. A. W. Dollar, M.R.C.V.S. Size6 x 9 1-2, 785 pages, 329 illustrations in the text and 4 full page plates...... Se stee manele NOE — (f(A Hand-book of Horse-Shoeing,” with introductory chapters on the anatomy and physiology of the horse’s foot. By Jno. A. W. Dollar, M.R.C.V.S., with the collaboration of Albert Wheatley, F.R.C.V.S. Cloth, size 6 x 8 1-2, 433 pages, 406 illustrations ..4 75- DOLLAR (continued) — (t) ‘Operative Technique.” Volume 1 of ‘‘The Practice of Veterinary Surgery.” Cloth, size 6 3-4 x 10, 264 pages, 272 illustrations. ............ccc cece seen es soe eeee 3 75 — * General Surgery.” Volume 2 of ‘‘The Practice of Veters inary Surgery.” In preparation. — (+)* Regional Veterinary Surgery.” Volume 3 of ‘The Practice of Veterinary Surgery.” By Drs. Jno. A. W. Dollar and H. Moller. Cloth, size 6 1-2 x10 853 and xvi pages, 315 illustrations................. 6 25 -— **Cadiot’s Clinical Veterinary Medicine and Surgery.” See ** Cadiot.” — **Cadiot’s Roaring in Horses.”? See ‘“ Cadiot.” DUN. ‘Veterinary Medicines, their Actions and _Uses.°? By Finlay Dun, V.S., late lecturer on Materia Medica and Dietetics at the Edinburgh Veterinary College, and Examiner in Chemistry to the Royal College of Veterinary Surgeons. Edited by James Macqueen, F.R.0.V.S. Tenth revised English edition, OlOth, 8120: 6°" 9 ooo o ec einee'des pes oboe sess eesces 3 75 FLEMING. ‘The Contagious Diseases of Animals.” Their influence on the wealth and health of nations and how they are to be combated. Paper, size 5 x 71-2, DO PAZOBic ca cieww vacvaasiene es os 44 ee sees as dasee sees 25 — ‘Human and Animal Variole.” A Study in Comparative Pathology. Paper, size 5 1-2 x § 1-2, 61 pages.... 25 — ‘Parasites aud Parasitic Diseases of the Domesticated Animals.” By L. G. Neumann. Translated by Dr. Fleming. See ‘‘ Neumann.” — ‘¢Qperative Veterinary Surgery.” Vol. I, by Dr. Geo. Fleming, M.R.O.V.S, This valuable work, one of the most practical treatises yet issued on the subject in the English language,is devoted to the common opera- tions of Veterinary Surgery; and the concise descrip- tions and directions of the text are illustrated with numerous wood engravings. Cloth, size 6 x 91-4, 285 and xviii pages, 343 illustrations................. 2 75 (*)Vol. II, edited and passed through the press by W. Owen Williams, F.R.C.V.S. Cloth, size 6 x 9 1-4, 430 and xxxvii pages, 344 illustrations............ 3 25 — “Roaring in Horses.” By Dr. George Fleming, F.RC.V.S. Its history, nature, causes, prevention and treatment. Cloth, size 5 1-2 x 8 3-4, 160 pages, 21 engravings, 1 colored plate.............eeeeeeees 1 50 — “Veterinary Obstetrics.” Including the Accidents and Dis- eases incident tv Pregnancy, Parturition, and the Early Age in Domesticated Animals. By Geo. Fleming, F.R.C.V.S. Cloth, size 6 x 8 3-4, 758 pages, illus.6 25 BOTPHIEE (*)**A Manual of General Histology.” By Wm. S. Gorttheil, M:D., Professor of Pathology in the American Veterinary College, New York; etc., etc. Histology isthe basis of the physician’s art, as Anatomy is the foundation of the surgeon’s science. Only by knowing the processes of life can we under- stand the changes of disease and the action of remedies; as the architect must know his building materials, so must the practitioner of medicine know the intimate structure of the body. To present this knowledge in an accessible and simple form has been the author's task. Second edition revised. Cloth, size 5 1-2 x 8, 152 pages, 68 illustrations...1 00 GRESSWELEL. ‘Diseases and Disorders of the Horse.” A Treatise on Equine Medicine and Surgery, being a contribution to the science of comparative pathology. By Albert, Jas. B. and Geo. Gresswell. Cloth, size 5 3-4 x 8 3-4, 227 pages, iustrateds sccsawarioncs 1 75 — “The Bovine Prescriber.” For the use of Veterinarians and Veterinary Students. Second edition, revised and enlarged, by James B. and Albert Gresswell, M.R.C.V.S. Cloth, size, 5 x 7 1-2, 102 pages...... 75 — “The Equine Hospital Preseriber.” For the use of Veter- inary Practitioners and Students. Third edition re- vised and enlarged, by Drs. James B. and Albert Gresswell, M.R.C.V.S. Cloth, size 5 x 71-2, 165 POS OB ors cer aces aseesuigecadeerttige 8 died iseaare: dora dre seeeniens ae eon gaye 75 — Manual of “The Theory and Practice of Equine Medicine.” By James B. Gresswell, F.R.C.V.8., and Albert Gresswell, M.R.C.V.S. Second edition revised, Cloth, size 5 1-4 x 7 1-2, 539 pages................ 275 — (t+) “Veterinary Pharmacopaia and Manual of Comparative Therapy.” By George and Charles Gresswell, with descriptions and physiological actions of medicines, by Albert Gresswell. Second edition revised and enlarged. Cloth, 6 x 8 3-4, 457 pages............ 3 60 HASSLOCH. “A Compend of eterinaey Materia Medica and Therapeutics.” | By Hassloch, VS., Lecturer on Materia Medica es "Therapeutics, and Professor of Veterinary Dentistry at the New York College of Veterinary Surgeons and School of Compa- rative Medicine, N. Y. Cloth, size 51-4 x 71-2, 225 PAS OS Hin secon sans daxraerataidittinaaaieaka. 6 eeesa 1 60 HEATLEY. ‘The Stock Owner’s Guide.”? A handy Medi- cal Treatise for every man Who owns an ox or cow, By George S. aki M.R.C.V.S. Cloth, size- 5 1-4 x 8, 172 pageS......cccceeeenceeeeeeeeseeees 1 26. HILL. (+)*The Diseases of the Cat? By J. Woodroffe Hill, F.R.C.V.S. Cloth, size 5 1-4 x 71-2, 123 pages, PWS EL ATO .52.85,<- -az- cane a. dreaie xpacavelccnves nounovsnat ie onlavate 1 25 Written from the experience of many years’ prac- tice and close pathological research into the maladies to which our domesticated feline friends are liable—a subject which it must be admitted has not found the prominence in veterinary literature to’ which it is undoubtedly entitled. — “The Management and Diseases of the Dog.” By J. Woodroffe Hill, F.R.C.V.S. Cloth, size 5 x 71-2, extra fully illustrated. HINEBAUCH. “Veterinary Dental Surgery.” Sy T. D. Hinebauch, M.S.V.S. For the use of Students, Prac. titioners and Stockmen. Cloth, size 51-4 x 8, 256 pages; llustrated.< .cn5cs0san gesineacrenaaceiaicleeecara 2 00 HOARE. (*)‘‘A Manual of Veterinary Therapeutics and Pharmacology.” By E. Wallis Hoare, F.R.C.V.S. Cloth, size 5 1-4 x 7 1-4, xxvi plus 780 pages......4 75 HOBDAY. (+) The Castration of Cryptorchid Horses and the Ovariotomy of Troublesome Mares.” By Frederick T. G. Hobday, F.RC.V.S. Cloth, size 5 3-4.x 83-4, 16 pages, 34 illustrations,.......... 1 75 HUNTING. (t+) The Art of Horse-shoeing. A manual tor Horseshvers. By William Hunting, F.R.C.V.S., ex-President of the Royal College of Veterinary Sur- geons. One of the most up-to-date, concise books of its kind in the English language. Cloth, size6x9 1-4. 126 pages, 96 illustrationS........... cece rece eee 1 00 JENKINS. (*)** Anatomical and Physiological Model of the Cow.”? Half life size. Composed of superposed plates, colored to nature, showing internal organs, muscles, skeleton, etc., mounted on strong boards, with explanatory text. Size of Model opened, lu ft. x 3 ft., closed 3 ft. x 1$ ft........... 00 eee 12 00 — ‘6 Anatomical and Physiological Model of the Horse.” Half life size. Size of Model 38 x 41in........ 12 00 Models also in smaller sizes of the Horse, Cow, Dog, Sheep and Pig, at $3.50 each. JONES. (*)*The Surgical Anatomy of the Horse.” By Jno. T. Share Jones, M.R.C.V.S. Parts I, Il and III ready. To be completed in four parts. Each: part—paper, $4.25; cloth, $5.00. KOBERT. “Practical Toxicology for Physicians and Students °® By Professor Dr. Rudolph Kobert, Medical Director of Dr. Brehmer’s Sanitarium for Pulmonary Diseases at Goerbersderf in Silesia (Prus- sia), late Director of the Pharmacological Institute, Dorpat, Kussia. Translated and edited by L. H. Friedburg, Ph.D. Authorized Edition. Practical knowledge by means of tables which occupy little space, but show at a glance similarities and. differ- ences between poisons of the same group. Also rules for the Spelling and Pronunciation of Chemical Terms, as adopted by the American Association for the Ad- vancement of Science. Cloth, 6 1-2x 10, 201 pp..2 50 KOCH. ‘Etiology ef Tuberculosis.” By Dr. BR. Koch. ’ Trauslated by T. Saure. Ctoth, size 6 x 91-4, 97 pages........ snes eo pieia ores so oiura eiayecesetecadermiacr aed eekpiers 1 00 LAW. ‘*Farmers’ Veterinary Adviser.” A Guide to the Prevention and Treatment of Disease in Domestic Animals. By Prof. James Law. Cloth, size 5 1-4 x 7 1-2, illustrated..............0005 eiveeesad 00 LIAUTARD. (t+)** Animal Castration.” A concise and practical Treatise on the Castration of the Domestic Animals. The only work on the subject in the English language. By Alexander Liautard, M.D.,V.S. Having a fine portrait of the author. Tenth edition revised and enlarged. Oloth, size 5 1-4 x 7 1-2, 165 pages, 45 illustrations,.......... 0.0.0 cece eee ee 2 00 . . » The most complete and comprehensive work on the Sabet en English veterinary literature.—American Agri- cul . — **Cadiot’s Exercises in Equine Surgery.’? Translated by Prof. Bitting and edited by Dr. Liautard. See ‘* Cadiot.” — ‘A Treatise on Surgical Therapeutics of the Domestic Animals.”? By Prof. Dr. P. J. Cadiot and J. Almy, Translated by Prof. Liautard. See ‘* Cadiot.” — *“*How to Tell the Age of the Domestic Animal.” By Dr. A. Liautard, M.D., V.S. Standard work upon this subject, concise, helpful and containing many illustrations. Cloth, size 5 x 71-2, 35 pages, 42 illustrations..... Sawa rales ease aceon Siaiwswicdecnne OO — ‘*Lameness of Horses and Diseases of the Locomotory Apparatus”? By A. Liautard,M.D.,V.S. This work is the result of Dr. Liautard’s many years of experi- ence. Oloth, size 5 1-4 x 7 1-2, 314 pages.........2 69 “LIAUTARD (continued). — (*)** Manual of Uperatare Veterinary Surgery.” By A. Liautard, M.D., V.M. Engaged for years in the work of teaching this special department of veterinary medicine, and having abundant opportunities of realizing the difficulties which the student who earnestly strives to perfect himself in his calling is obliged to encounter, the author formed the deter- mination to facilitate his acquisition of knowledge, and began the accumulation of material by the com- pilation of data and arrangement of memorandum, with the recorded notes of his own experience, the fruit of a long and extended practice and a careful study of the various authorities who have illustrated and organized veterinary literature. Revised edition, with complete index. Cloth, size 6 1-4 x 9, xxx and 803 pages, 563 illustrations. .............0ccee cece eee 5 00 — ‘¢Pellerin’s Median Neurotomy in the Treatment of Chronic Tendinitis and Periostosis of the Fetlock.” Translated by Dr. A. Liautard. See ‘* Pellerin.” — **Vade Mecum of Equine Anatomy.” By A. Liautard, M.D.V.S. For the use of advanced students and veterinary surgeons. Third edition. Cloth, size 5 x 7 1-2, 30 pages and 10 full page illustrations of HH SAPESELOS go issie: cs seteccearersieccuwtarsve wi aeesvaiy “pereveraiirareyete 2 00 — Zundel’s ‘* The Horse’s Foot and Its Diseases.” See ‘* Zundel.” LONG. “Book of the Pig.” Its selection, Breeding, Feeding andManagement. Cloth.............. 4.60 LOWE. (})§* Breeding Racehorses by the Figure System.”? Compiled by the late C. Bruce Lowe. Edited by William Allison, ‘‘ The Special Commis- sioner,” London Sportsman, Hon. Secretary Sporting League, and Manager of the International Horse Agency and Exchange. With numerous fine illustra- tions of celebrated horses. Cloth, size 8 x 10, 262 pages...... lsu vancnsvabatatvedgyaheosutauarelana assievavevaliarandeavecesd 7 60 LUDLOW. ‘Science in the Stable”; or How a Horse can be Kept in Perfect Health and be Used Without Shoes, in Harness or under the Saddle, With the Reason Why. Second Edition. By Jacob R. Ludlow, M.D. Late Staff Surgeon, U. S. Army. Paper, size 41-2 x 5 3-4, 166 pages......... cc cceeeceesecees --. 60 UPTON. ‘*Horses: Sound and Unsound,” with Law relating to Sales and Warranty. By J. Irvine Lupton, F.R.C.V.S. Cloth, size 6 3-4 x 71-2, 217 pages, 28 illustrations.............-+++. aisrawasteey 1 26 WFADYEAN. (t)** Anatomy of the Horse’? Second edition completely revised. A Dissection Guide. By John M’Fadyean, M.B., B.Sc., F.R.S.E. Cloth, size 6 X 83 4, 388 pages, illustrated.............. 5 50 This book is intended for Veterinary students, and offers to them in its 48 full-page colored plates, 54 illustrations and excellent text, a valuable and practical aid in the study of Veterinary Anatomy, especially in the dissecting room. — **Comparative Anatomy of the Domesticated Animals.”? By J..M’Fadyean. Protusely illustrated, and to be issued in two parts. Part I—Osteology. ready. Size 51-2 x 81-2, 166 pages, 132 illustrations. Paper, 2 50; cloth..... 276 (Part II in preparation.) MAGNER. ‘Standard Horse and Stock Book.” By D. Magner. Uomprising over 1,000 pages, illustrated with 1756 engravings. . Leather binding..........6 (0 MILLS. ‘How to Keep a Dog in the’ City.’ By Wesley Mills, M.D,D.V.s. It tells how to choose, manage, house, feed, educate the pup, how to keep him clean and teach him cleanliness. Paper, size 5 x 71-2, MOPAR SS is 2g ci dutm Aiea seh ad. Beeieredntees mince a eaer No 25 MOHLER. ‘Handbook of Meat Inspection.” By Robert Ostertag, M.D. ‘Translated by Earley Vernon Wilcox, A.M., Ph.D. With an introduction by John R. Mohler, V.M.D., A.M. See “ Ostertag.” MOLLER — DOLLAR. _ (t)**Regional Veterinary Surgery.” See ‘‘ Dollar.” MOSSELMAN-LIEN AUX, *¢Manual of Veterinary Microbiology.”»> By Professors Mosselman and Liénaux, Nat. Veterinary College, Cureghem, Belgium. Translated and edited by R. R. Dinwiddie, Professor of Veterinary Science, College of Agriculture, Arkansas State University. Cloth, size 512 x 8, 342 pages, WIMSOPAtO De once bs cae ee es na GME SAD ne 2 00 MOUSSU._ (*)**Diseases of Cattle, Sheep, Goats and Swine.”? See ‘* Dollar.” NEUMANN. (*)A Treatise on Parasites and Parasitic Diseases of the Domesticated Animals.” A work to which the students of human or veterinary medi- cine, the sanitarian, agriculturist or breeder or rearer of animals, may refer for full information regarding the external and internal Parasites—vegetable and animal—which attack various species of Domestic Animals. A Treatise by L. G. Neumann, Professor at the National Veterinary School of Toulouse, Translated and edited by Geo. Fleming, C.B., LL.D., F.ROC.V.S. Second edition, revised and edited by James Macqueéen, F.R.C.V.8., Professor at the Royal Veterinary College, London. Cloth, size 6 3-4 x 10, xvi +-698 pages, 365 illustrations .............:.6.75 Wal me NOCARD. “The Animal Tuberculoses, and their Relation . NUNN. to Human Tuberculosis.” By Ed: Nocard, Prof. of the Alfort Veterinary College. Translated by H. Scurfield, M.D. Ed.; Ph. Camb. Cloth, 5x 7 1-2, 143 pages..1 00 Perhaps the chief interest to doctors of human medicine in Professor Nocard’s book lies in the demonstration of the small part played by heredity, and the great part played by contagion in the propa- gation of bovine tuberculosis. (*)* Veterinary Toxicology.” By Joshua A. Nunn, F.RC.V.S. The study of toxicology is intimately blended with other biological sciences, particularly physiology and chemistry, both of which 1t on many occasions overlaps. A carefully arranged and com- plete index is given in the front of the volume. Cloth, size 6.x 83-4, vii + 191 pages...,.........- 175 OSTERTAG. (*) “Handbook of Meat Inspection.” By Robert Ostertag,M D. Authorized Translation by Earley Vernon Wilcox. A.M., Ph.D. With an intro- duction by John R. Mohler, V.M.D., A.M. The work is exhaustive and authorative and has at once become the standard authority upon the subject Second edition, revised. Cloth, size 6 3-4 x 9 3-4, 920 pages, 260 illustrations and 1 colored plate. ............ 7 60 PALCIN, (*)**A Treatise on Epizootic Lymphangitis.” By Capt. W. A. Pallin, F.R,C.V.S. In this work the. author has endeavored to combine his own experience with that of other writers and so attempts to give a clear and complete account of a subject about which there is little at present in English veterinary liteza- ture. Cloth, size 5 3-4 x 81-2, 90 pages, with 17 fine full page illustrations ..:....s0s. caseses nwa sawsces 1 25 PEGLER. ‘ Goat Keeping for Amateurs.” Paper, a TG PACES, UNOStALSU. iigcre sein nuncaReSEawesees 5 PELLERIN. ‘Median Neurotomy in the Treatment of Chronie Tendinitis and Periostosis of the Fetlock.”’ By C. Pellerin, late repetitor of Clinic and Surgery to the Alfort Veterinary School. Translated, with Addi- tional Facts Relating to It, by Prof. A. Liautard, M.D., V.M. Having rendered good results when performed by himself, the author believes the operation, which consists in dividing the cubito-plantar nerve and in excising a portion of the peripherical end, the means of improving the conditions, and consequently the values of many apparently doomed animals. Agricul- ture in particular will be benefited. Phe work is divided into two parts. The first covers the study of Median Neurotomy itself; the-second, the exact relations of the facts.as observed: by the- author. Boards, 6 x 9-1-2,61 pages, illustrated. .1 00 PETERS. ‘A Tuberculous Herd—Test with Tuber culin.” By Austin Peters, M.R.C.V.S., Chief Inspector of Cattle for the New York State Board of Health during the winter of 1892-93. Pamphlet... .25 ROBERGE. ‘The Foot of the Horse,” or Lameness and all Diseases of the Feet traced to an Unbalanced Foot Bone, prevented or cured by balancing the foot. By David Roberge. Cloth, size 6x9 1-4, 308 pages, (lustrated .sscocieu s sak ose wsveenersacweses weer’ 6 00 SESSIONS. (*)* Cattle Tuberculosis,” a Practical Guide to the Agriculturist and Inspector. By Harold Sessions, F.R,C.V.S., etc. Second edition. Size5x 71-4, vi + 120 PAaBeSs cc cciceossec pin eee ew Ved odoweeRe ERE 1 00 The subject can be understood by those who have to deal particularly with it, yet who, perhaps, have not had the necessary training to appreciate technical phraseology. SEWELL. ‘The Examination of Horses as to Sound- ness and Selection as to Purchase.” By Edward Sewell, M.R.C.V.S. Paper, size 51-2 x 8 1-2, &6 PAgEE, illustrated with 8 plates in color............... 1 60 It is a great advantage to the business man to know something of the elements of law, and nobody ought either to buy or own a horse who does not know something about the animal. That something ae book gives, and gives in a thoroughly excellent way.. SMITH. (*)‘* A Manual of Voeriiary Physiology.” By Vet. Capt. F. Smith, C.M.S., C.V.8., Examiner in Physiology, Royal College’ oe einer Surgeons, author of ‘“‘A Manual of Veterinary Hygiene.” A completely revised and enlarged edition just pub- lished. Cloth, 6 x 8 3-4, 720 pp, 102 illust’ns.....4 25 The whole book has been carefully revised and brought up to date. All the important advances of the last few years have been embodied. The chapter on the nervous system has been specially revised by Prof. Sherrington, whose remarkable work on the ‘‘spinal dog” has been introduced. A special point is made of the bearing of physiology on pathology, and the utilization of physiology to the better understanding of every-day practice. The book is written by a veterin- ary surgeon for veterinary practitioners and students, and is the only work in the English language which can claim to be purely veterinary. — (*)* Manual of Veterinary Hygiene.” Third edition revised. Cloth, size 5 1-4 x 7 1-2, xx + 1036 pages, anh ane illustrations ais GSAS eis wise 4. Ser Hue. 8 pM ETS aslo Recognizing the rapid advance and extended fela of the subject since the previous issue, the author has entirely re-written the work and enlarged its scope, whieh is brought thoroughly up to date. Oon- tains over 500 more pages than the second edition. STRANGEWAY. (°*)*‘Veterinary Anatomy.”? Edited by I. Vaughan, F.L.S., M.R.O.V.S. New 12th American. edition revised. Cloth, size 6 1-4 x 9 1-2, 625 pages,. 224 illus...... Pree reer eieseaes sisesvesceesB 00 SUSSDORF. “Six Large Colored Wall Diagrams.” By Prof. Sussdorf, M.D. (of Gottingen). Text translated. by Prof. W. Owen Williams, of the New Veterinary College, Edinburgh. Size, 44 inches by 30 inches. 1.—Horse. 4.—Ox. 2.-- Mare. 5.—Boar and Sow. 3.—Cow. 6.—Dog and Bitch. The above are printed in eight or nine colors. Showing the position ef the viscera in the large- cavities of the body. Price, unmounted........... ...... exeranetd-d,"s 1 75 each ‘* mounted on linen, with roller... .... 350 «“« VAN MATER, “A Text Book of_ Veterinary Oph- thalmology.”? By George G. Van Mater, M.D., D.Y.S., Professor of Ophthalmology in the American Veterinary College; Oculist and Aurist to St. Martha’s Sanitarium and Dispensary; Consulting Eye and Ear Surgeon to the Twenty-sixth Ward Dispensary; Eye and Ear Surgeon, Brooklyn Eastern District Dispen- sary, etc. Illustrated by one chromo lithograph plate- and 71 engravings. Cloth, 6 x 9 1-4, 151 pages...3 00 . We intend to adopt this valuable work as a text book.—E. J. Creely, D.V.S., Dean of the San Francisco- Veterinary College. VETERINARY DIAGRAMS in Tabular Form. Size, 284 in. x 22inches. Price per set of five....4 00 Mounted and folded in case...............-00--. 7 00 Mounted on roller and varnished........-...... 10 00 No.1. ‘The External Form and Elementary Anas. tomy of the Horse.” Eight colored illustrations— 1. External regions; 2. Skeleton; 3. Muscles (Superior Layer); 4. Muscles (Deep Layer); 5, Respiratory Ap- paratus; 6. Digestive Apparatus; 7. Circulatory Ap- paratus ; 8. Nerve Apparatus ; with description....1 26- Mounted on roller and varnished................ 2 25 No. 2. ‘*The Age of Domestic Animals.” Forty-two figures illustrating the structure of the teeth, indicat- ing the Age of the Horse, Ox, Sheep, and Dog, with full description ........... cece cece eee e cece eee eees 75 Mounted on roller and varnished.............65. 2 00 No. 3. ‘The Unsoundness and Defects of the Horse.” Fifty figures illustrating—1. The Defects of Confor- mation; 2. Defects of Position ; 3. Infirmities or Signs of Disease; 4. Unsoundnesses ; 5. Defects of the Foot; with full description................+. Shane eens sates 75 Mounted on roller and varnished...............- 2 00- . ‘VETERINARY DIAGRAMS (continued) No.4. ‘The Shoeing of the Horse, Mule and Ox.” Fifty figures descriptive of the Anatomy and Physio- logy of the Foot and of Horse-shoeing............. 75 Mounted on roller and varnished........... eee 2 00 No.5. ‘The Elementary Anatomy, Points, and But- cher’s Joints of the Ox.” Ten colored illustrations —1, Skeleton; 2. Nervous System; 3. Digestive System (Right Side) ; 4. Respiratory System ; 5. Points of a Fat Ox; 6. Muscular System; 7. Vascular System; 8. Digestive System (Left Side); 9. Butcher’s Sections of a Calf; 10. Butcher’s Sections of an Ox; with full CESCHPtlON x ss sacrinaw oe weds sea Silla digi eeta 1 25 Mounted on roller and varnished WALLEY. ‘A Practical Guide to Meat Inspection.” By Thomas Walley, M.R.C.V.S., late principal of the Edinburgh Royal (Dick) Veterinary College; Pro- fessor of Veterinary Medicine and Surgery, ete, Fourth Edition, thoroughly revised and enlarged by Stewart Stockman, M.R.C.V.S., Professor of Pathology, Lecturer on Hygiene and Meat Inspection at Dick Veterinary College, Edinburgh. Cloth, size 5 1-2 x 8 1-4, with 45 colored illus., 295 pages.....3 00 WILCOX. (*)**Handbook of Meat Inspection.» By Robert Ostertag, M.D. See ‘‘ Ostertag.” WILLIAMS. “Principles and Practice of Veterinary Medicine.” Author’s edition, entirely revised and illustrated with numerous plain and colored plates. By W. Williams, M.R.C.V.S. Cloth, size 53-4 x 8 3-4, BOS Dae CSc, ca vnssin casera Padana Ged warinnases -7 50 — ** Principles and Practice of Veterinary Surgery.” Author’s edition, entirely revised and illustrated with numerous plain and colored plates. By W. Williams, M.R.C.V.S. Cloth, size 61-2 x 91-4, 756 PAC OSi esac in sea ascent hyo aver cvsrsy persis Badevaacsieleyereenel 7 50 WINSLOW. (*)**Veterinary Materia Medica and Therapeu- tics.”? By Kenelm Winslow. B.A.S., M.D.V., M.D., (Harv.); formerly Assistant Professor of Therapeutics in the Veterinary School of Harvard University ; Fellow of tiie Massachusetts Medical Society ; Surgeon to the Newton Hospital, etc. : Sixth Edition, Revised The most complete, progressive and seientific book on the subject in the English langnage. The recognized authority on Veterinary Materia Medica and the stan- dard text-book on the subject in veterinary colleges. Cloth, size 6 1-4 x 9 1-4, xii + 8/9 pages....... ...6 00 ‘WINSLOW (continued), —(") The Production and Handling of Clean Milk, including Practical Milk Inspection, and Essentials of Milk Bacteriology.” By H. W. Hill, M.D. Cloth 614x937 xiv plus 367 pages, 101 illustrations, including 1 col- ored and 16 full page plates.................006- 3 25 A complete, plain, practical and authoritative guide to the production, inspection, analysis, hand- ling and distribution of milk for veterinary, agricultural and dairy students, farmers, health officers, milk inspectors, practical dairymen, sani- tarians, country gentlemen, physicians and others interested in-matters pertaining to dairying and hygiene. WYMAN. (*)** Bovine Obstetrics”? By M. G. De Bruin. Translated by W. E. A. Wyman, M.D.V.,V.S. See also ‘‘ De Bruin.” _ aor of the Principles of Veterinary Surgery.” . A. Wyman, M.D.V.,V.8. Cloth, size6 x 9 an _ Haw SIN Se MOEMAORS WOE Vine eeaa we eeNS 3 50 Concerning this new work attention is called to the following points: 1.—It discusses the subject upon the basis of veterinary investigations. 2.—It does away with works on human pathology, histology, etc. 3.—It explains each question thoroughly both from a scientific as well as a practical point of view. 4.—It is writen by one knowing the needs of the student. 5.—It deals exhaustively with a chapter on tumors, heretofore utterly neglected in veterinary pathology. 6.—The only work in English specializing the subject. 7.—The only work thoroughly taking into consideration American as well as European investigations, 8.—Offering practical hints which have not appeared in print, the result ot large city and country practice. — (ts ne Clinical Diagnosis of Lameness in the Horse.” By W. E. A. Wyman, D.V.S., formerly Professor of Veterinary Science, Clemson A. & M- College, and Veterinarian to the: South Carolina Experiment Station. Cloth, size 6 x 9 1-2, 182 pp., 32 illus....2 50 — (t)* Tibio-peroneal Neurectomy for the Relief of Spavin Lameness.”? By W. E. A. Wyman, M.D.V., V.S. Boards, size 6 x 9, 30 pages, illustrated........... 50 Anyone wanting to perform this operation should procure this little treatise; he will find it of considerable help.—The Veterinary J ournal. ZUILL. “Typhoid Fever; or Contagious Influenza. in the Horse.” By Prof. W. L. Zuill, MeN Pamphlet, size 6 x 9 1-4, 29 pages..............006 ZUNDEL. ‘The Horse’s Foot and Its Diseases.” By A. Zundel, Principal Veterinarian of Alsace Lorraine. Translated by Dr. A. Liautard, V.S. Cloth, size 5x7 3-4, 248 pages, illustrated.................. 2 00 Any book sent prepaid for the price. Send for Complete Descriptive Catalogue WILLIAM R. JENKINS CO. 851 and 853 Sixth Avenue, NEW YORK.. 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