Special Report on Diseases of the Horse (part 3 of 4)
Treatment.--Thrushes are to be treated by cleanliness, the removal of all exciting causes, and a return of the frog to its normal condition. As a rule, the diseased and ragged portions of horn are to be pared away and the foot poulticed for a day or two with boiled turnips, to which may be added a few drops of carbolic acid or a handful of powdered charcoal to destroy the offensive smell. The cleft of the frog and the grooves on its edges are then to be cleaned and well filled with dry calomel and the foot dressed with oakum and a roller bandage. If the discharge is profuse, the dressing should be changed daily; otherwise it may be left on two or three days. Where a constitutional taint is supposed to exist, with swelling of the legs, grease, etc., a purgative, followed by dram doses of sulphate of iron, repeated daily, may be prescribed. In cases where the growth of horn seems too slow a Spanish-fly blister applied to the heels is often followed by good results. Feet in which the disease is readily induced may be protected in the stable with a leather boot. If the thrush is but a sequel to other disease, a permanent cure may not be possible.
CANKER.
Canker of the foot is due to the rapid reproduction of a vegetable parasite. It not only destroys the sole and frog, but, by setting up a chronic inflammation in the deeper tissues, prevents the growth of a healthy horn by which the injury may be repaired. Heavy cart horses are more often affected than those of any other class.
Causes.--The essential element in the production of canker is the parasite; consequently the disease may be called contagious. As in all other diseases due to specific causes, however, the seeds of the disorder must find a suitable soil in which to grow before they are reproduced. It may be said, then, that the conditions which favor the preparation of the tissues for a reception of the seeds of this disease are simply predisposing causes.
The condition most favorable to the development of canker is dampness--in fact, dampness seems indispensable to the existence and growth of the parasite; the disease is rarely, if ever, seen in high, dry districts, and is much more common in rainy than in dry seasons. Filthy stables and muddy roads have been classed among the causes of canker; but it is very doubtful whether these conditions can do more than favor a preparation of the foot for the reception of the disease germ.
All injuries to the feet, by exposing the soft tissues, may render the animal susceptible to infection; but neither the injury nor the irritation and inflammation of the tissues which follow are sufficient to induce the disease.
For some unknown reason horses with lymphatic temperaments--thick skins, flat feet, fleshy frogs, heavy hair, and particularly with white feet and legs--are especially liable to canker.
Symptoms.--Usually, canker is confined to one foot; but it may attack two, three, or all of the feet at once; or, as is more commonly seen, the disease attacks first one then another, until all may have been successively affected. When the disease follows an injury which has exposed the soft tissues of the foot, the wound shows no tendency to heal, but instead there is secreted from the inflamed parts a profuse, thin, fetid, watery discharge, which gradually undermines and destroys the surrounding horn, until a large part of the sole and frog is diseased. The living tissues are swollen, dark colored, and covered at certain points with particles of new, soft, yellowish, thready horn, which are constantly undergoing maceration in the abundant liquid secretion by which they are immersed. As this secretion escapes to the surrounding parts, it dries and forms small, cheesy masses composed of partly dried horny matter, exceedingly offensive to the sense of smell. When the disease originates independently of an injury, the first evidences of the trouble are the offensive odor of the foot, the liquid secretion from the cleft and sides of the frog, and the rotting away of the horn of the frog and sole.
In the earlier stages there is no interference with locomotion, but later the foot becomes sensitive, particularly if the animal is used on rough roads, and, finally, when the sole and frog are largely destroyed the lameness is severe.
Treatment.--Since canker does not destroy the power of the tissues to produce horn, but rather excites them to an excessive production of an imperfect horn, the indications for treatment are to restore the parts to a normal condition, when healthy horn may again be secreted. In my experience, limited though it has been, the old practice of stripping off the entire sole and deep cauterization, with either the hot iron or strong acids, is not attended with uniformly good results.
I am of the opinion that recovery can generally be effected as surely and as speedily with measures which are less heroic and much less painful. True, the treatment of canker is likely to exhaust the patience, and sometimes the resources, of the attendant; but after all success depends more on the persistent application of simple remedies and great cleanliness than on the special virtues of any particular drug.
First, then, clean the foot with warm baths and apply a poultice containing powdered charcoal or carbolic acid. A handful of the charcoal or a tablespoonful of the acid mixed with the poultice serves to destroy much of the offensive odor. The diseased portions of horn are to be carefully removed with sharp instruments, until only healthy horn borders the affected parts. The edges of the sound horn are to be pared thin, so that the swollen soft tissues may not overlap their borders. With sharp scissors cut off all the prominent points on the soft tissues, shorten the walls of the foot, and nail on a broad, plain shoe. The foot is now ready for the dressings, and any of the many stimulating and drying remedies may be used; but it will be necessary to change frequently from one to another, until finally all may be tried.
The list from which a selection may be made comprises wood tar, gas tar, petroleum, creosote, phenic acid; sulphates of iron, copper, and zinc; chlorid of zinc, bichlorid of mercury, calomel, caustic soda, nitrate of silver, chlorid of lime; carbolic, nitric, and sulphuric acids.
In practice I prefer to give the newly shod foot a bath for an hour or two in a solution of the sulphate of iron made by adding 2 ounces of the powdered sulphate to a gallon of cold water. When the foot is removed from the bath it is dressed with oakum balls dipped in a mixture made of Barbados tar 1 part, oil of turpentine 8 parts, to which is slowly added 2 parts of sulphuric acid, and the mixture well stirred and cooled. The diseased parts being well covered with the balls, a pad of oakum sufficiently thick to cause considerable pressure is placed over them, and all are held in place by pieces of heavy tin fitted to slip under the shoe. The whole foot is now incased in a boot or folded gunny sack and the patient turned into a loose, dry box. The dressings are to be changed daily or even twice a day at first. When they are removed, all pieces of new horny matter which are now firmly adherent must be rubbed off with the finger or a tent of oakum. As the secretion diminishes, dry powders, such as calomel, sulphates of iron, copper, etc., may prove of most advantage. The sulphates should not be used pure, but are to be mixed with powdered animal charcoal in the proportion of one of the former to eight or ten of the latter. When the soft tissues are all horned over, the dressings should be continued for a time, weak solutions being used to prevent a recurrence of the disease. If the patient is run down in condition, bitter tonics, such as gentian, may be given in 2-dram doses twice a day and a liberal diet of grain allowed.
CORNS.
A corn is an injury to the living horn of the foot, involving the soft tissues beneath, whereby the capillary blood vessels are ruptured and a small quantity of blood escapes which, by permeating the horn in the immediate neighborhood, stains it a dark color. If the injury is continuously repeated, the horn becomes altered in character and the soft tissues may suppurate or a horny tumor develop. Corns always appear in the sole in the angle between the bar and the outside wall of the hoof. In many cases the laminae of the bar, of the wall, or of both, are involved at the same time.
Three kinds of corns are commonly recognized--the dry, the moist, and the suppurative--a division based solely on the character of the conditions which follow the primary injury.
The fore feet are almost exclusively the subjects of the disease, for two reasons: First, because they support a greater part of the body; secondly, because the heel of the fore foot during progression is first placed upon the ground, whereby it receives much more concussion than the heel of the hind foot, in which the toe first strikes the ground.
Causes.--It may be said that all feet are exposed to corns, and that even the best feet may suffer from them when conditions necessary to the production of the peculiar injury are present. The heavier breeds of horses generally used for heavy work on rough roads and streets seem to be most liable to this trouble. Mules rarely have corns.
Among the causes and conditions which predispose to corns may be named high heels, which change the natural relative position of the bones of the foot and thereby increase the concussion to which these parts are subject; contracted heels, which in part destroy the elasticity of the foot, increase the pressure upon the soft tissues of the heel, and render lacerations more easy; long feet, which by removing the frog and heels too far from the ground deprive them of necessary moisture; this, in turn, reduces the elastic properties of the horn and diminishes the transverse diameter of the heels; weak feet, or those in which the horn of the wall is too thin to resist the tendency to spread, whereby the soft tissues are easily lacerated. Wide feet with low heels are always accompanied with a flat sole whose posterior wings either rest upon the ground or the shoe, and as a consequence are easily bruised; at the same time the arch of the sole is so broad and flat that it can not support the weight of the body, and in the displacement which happens when the foot is rested upon the ground the soft tissues are liable to become bruised or torn.
It is universally conceded that shoeing, either as a direct or predisposing cause, is most prolific in producing corns. One of the most serious as well as the most common of the errors in shoeing is to be found in the preparation of the foot. Instead of seeking to maintain the integrity of the arch, the first thing done is to weaken it by freely paring away the sole; nor does the mutilation end here, for the frog, which is nature's main support to the branches of the sole and the heels, is also largely cut away. This not only permits of an excessive downward movement of the contents of the horny box, but it at the same time removes the one great means by which concussion of the foot is destroyed. As adjuncts to the foregoing errors must be added the faults of construction in the shoe and in the way it is adjusted to the foot. An excess of concavity in the shoe, extending it too far back on the heels, high calks, thin heels which permit the shoe to spring, short heels with a calk set under the foot, and a shoe too light for the animal wearing it or for the work required of him, are all to be avoided as causes of corns. A shoe so set so as to press upon the sole or one that has been on so long that the hoof has overgrown it until the heels rest upon the sole and bars becomes a direct cause of corns. Indirectly the shoe becomes the cause of corns when small stones, hard, dry earth, or other objects collect between the sole and shoe. Lastly, a rapid gait and excessive knee action, especially on hard roads, predispose to this disease of the feet.
Symptoms.--Ordinarily a corn induces sufficient pain to cause lameness. It may be intense, as seen in suppurative corn, or it may be but a slight soreness, such as that which accompanies dry corn. It is by no means unusual in chronic corns to see old horses apparently so accustomed to the slight pain which they suffer as not to limp at all. But they are generally very restless. They paw their bedding behind them at night and often refuse to lie down for a long rest. The lameness of this disease, however, can hardly be said to be characteristic, for the reason that it varies so greatly in intensity; but the position of the leg while the patient is at rest is generally the same in all cases. The foot is so advanced that it is relieved of all weight, and the fetlock is flexed until all pressure by the contents of the hoof is removed from the heels. In suppurative corn the lameness subsides or entirely disappears as soon as the abscess opens. When the injured tissues are much inflamed, as may happen in severe and recent cases, the heel of the affected side, or even the whole foot, is hot and tender to pressure. In dry corn and in most chronic cases all evidences of local fever are often wanting. It is in these cases that the patient goes well when newly shod, for the smith cuts away the sole over the seat of injury until all pressure by the shoe is removed and lowers the heels so that concussion is reduced to a minimum.
If a corn is suspected, the foot should be examined for increased sensibility of the inside heel. Tapping the heel of the shoe with a hammer and grasping the wall and bar between the jaws of pincers with moderate pressure will cause more or less flinching if the disease is present. For further evidence the shoe is removed and the heel cut away with the drawing knife. As the horn is pared out, not only the sole in the angle is found discolored, but in many instances the insensible laminae of the bar and wall adjacent are also stained with the escaped blood. In moist and suppurative corns this discoloration is less marked than in dry corn and even may be entirely wanting. In these cases the horn is soft, often white, and stringy or mealy, as seen in pumiced sole resulting from founder. When the whole thickness of the sole is discolored and the horn dry and brittle it is generally evidence that the corn is an old one and that the exciting cause has existed continuously. A moist corn differs from the dry one in that the injury is more severe. The parts affected are more or less inflamed, and the horn of the sole in the angle is undermined by a citron-colored fluid, which often permeates the injured sole and laminae, causing the horn to become somewhat spongy.
A suppurative corn differs from others in that the inflammation ends in suppuration. The pus collects at the point of injury and finally escapes by working its way between the sensitive and insensible laminae to the top of the hoof, where an opening is made between the wall and coronary band at or near the heels. This is the most serious form of corns, for the reason that it may induce gangrene of the plantar cushion, cartilaginous quittor, or caries of the coffin bone.
Treatment.--Since a diversity of opinion exists as to what measures must be adopted for the radical cure of corns, the author will advise the use of those which have proved most efficient in his hands.
As in all other troubles, the cause must be discovered, if possible, and removed. In the great majority of cases the shoeing is at fault. While sudden changes in the method of shoeing are not advisable, it may be said that all errors, either in the preparation of the foot, in the construction of the shoe, or in its application may very properly be corrected at any time. Circumstances may at times make it imperative that shoes be worn which are not free from objections; as, for instance, the shoe with a high calk; but in such cases it is considered that the injuries liable to result from the use of calks are less serious than those which are sure to happen for the want of them.
For a sound foot perfectly formed, a flat shoe, with heels less thick than the toe, and which rests evenly on the wall proper, is the best. In flat feet it is often necessary to concave the shoe as much as possible on the upper surface, so that the sole may not be pressed upon. If the heels are very low the heels of the shoe may be made thicker. If the foot is very broad and the wall light toward the heels, a bar shoe resting upon the frog will aid to prevent excessive tension upon the soft tissues when the foot receives the weight of the body. A piece of leather placed between the foot and shoe serves largely to destroy concussion, and its use is absolutely necessary on some animals to enable them to work.
Last among the preventive measures may be mentioned those which serve to maintain the suppleness of the hoof. The dead horn upon the surface of the sole not only retains moisture for a long time, but protects the living horn beneath from the effects of evaporation; for this reason the sole should be pared as little as possible. Stuffing the feet with flaxseed meal, wet clay, or other like substances, or damp dirt floors or damp bedding of tanbark, greasy hoof ointments, etc., are all means which may be used to keep the feet from becoming too dry and hard.
As to the curative measures which are to be adopted much will depend upon the extent of the injury. If the case is one of chronic dry corn, with but slight lameness, the foot should be poulticed for a day or two and the discolored horn pared out, care being taken not to injure the soft tissues. The heel on the affected side is to be lowered until all pressure is removed and, if the patient's labor is required, the foot must be shod with a bar shoe or with one having stiff heels. Care must be taken to reset the shoe before the foot has grown too long, else the shoe will no longer rest on the wall, but on the sole and bar.
I believe in cutting moist corns out. If there is inflammation, cold baths and poultices should be used; when the horn is well softened and the fever allayed, pare out the diseased horn, lightly cauterize the soft tissues beneath, and poultice the foot for two or three days. When the granulations look red, dress the wound with oakum balls saturated in a weak solution of tincture of aloes or spirits of camphor and apply a roller bandage. Change the dressing every two or three days until a firm, healthy layer of new horn covers the wound, when the shoe may be put on, as in dry corn, and the patient returned to work.
In suppurative corns the loosened horn must be removed, so that the pus may freely escape. If the pus has worked a passage to the coronary band and escapes from an opening between the band and hoof, an opening must be made on the sole, and cold baths made astringent with a little sulphate of iron or copper are to be used for a day or two. When the discharge becomes healthy, the fistulous tracts may be injected daily with a weak solution of bichlorid of mercury, nitrate of silver, etc., and the foot dressed as after operation for moist corns. When complications arise, the treatment must be varied to meet the indications; if gangrene of the lateral cartilage takes place it must be treated as directed under the head of cartilaginous quittor; if the velvety tissue is gangrenous, it must be cut away; if the coffin bone is necrosed, it must be scraped, and the resulting wounds treated on general principles. After any of the operations for corns have been performed, in which the soft tissues have been laid bare, it is best to protect the foot by a sole of soft leather set beneath the shoe when the animal is returned to work. Only in rare instances are the complications of corns so serious as to destroy the life or usefulness of the patient. It is the wide, flat foot with low heels and thin wall which is most liable to resist all efforts toward effecting a complete cure.
BRUISE OF THE FROG.
When the frog is severely bruised the injury is followed by suppuration beneath the horn, and at times by partial gangrene of the plantar cushion.
Causes.--A bruise of the frog generally happens from stepping on a rough stone or other hard object. It is more liable to take place when trotting, running, or jumping than when at a slower pace. A stone wedged in the shoe and pressing on the frog or between the sides of the frog and the shoe, if it remains for a time, produces the same results. A cut through the horny frog with some sharp instrument or a punctured wound by a blunt-pointed instrument may also cause suppuration and gangrene of the plantar cushion. Broad, flat feet with low heels and a fleshy frog are most liable to these injuries.
Symptoms.--Lameness, severe in proportion to the extent of the bruise and the consequent suppuration, is always an early symptom. When the animal moves, the toe only is placed to the ground or the foot is carried and the patient hobbles along on three legs. When he is at rest, the foot is set forward with the toe on the ground and the leg flexed at the fetlock joint. As soon as the pus finds its way to the surface the lameness improves. If the frog is examined early the injured spot may usually be found; later, if no opening exists, the pus may be discovered working its way toward the heels. The horn is loosened from the deeper tissues, and, if pared through, a thin, yellow, watery and offensive pus escapes. In other cases a ragged opening is found in the frog, leading down to a mass of dead, sloughing tissues, which are pale green in color if gangrene of the plantar cushion has set in. In rare cases the coffin bone may be involved in the injury and a small portion of it may become carious.
Treatment.--If the injury is seen at once, the foot should be placed in a bath of cold water to prevent suppuration. If suppuration has already set in, the horn of the frog, and of the bars and branches of the sole, if necessary, is to be pared thin so that all possible pressure may be removed, and the foot poulticed. When the pus has loosened the horn, all the detached portions are to be cut away. If the pus is discharging from an opening near the hair, the whole frog, or one-half of it, will generally be found separated from the plantar cushion, and is to be removed with the knife. After a few days the gangrenous portion of the cushion will slough off from the effects of the poultice; under rare circumstances only should the dead parts be removed by surgical interference. When the slough is all detached, the remaining wound is to be treated with simple stimulating dressings, such as tincture of aloes or turpentine, oakum balls, and bandages as directed in punctured wounds. When the lameness has subsided, and a thin layer of new horn has covered the exposed parts, the foot may be shod. Cover the frog with a thick pad of oakum, held in place by pieces of tin fitted to slide under the shoe, and return to slow work. Where caries of the coffin bone, etc., follow the injury the treatment recommended for these complications in punctured wounds of the foot must be resorted to.
PUNCTURED WOUNDS OF THE FOOT.
Of all the injuries to which the foot of the horse is liable, none are more common than punctured wounds, and none are more serious than these may be when involving the more important organs within the hoof. A nail is the most common instrument by which the injury is inflicted, yet wounds may happen from glass, wire, knives, sharp pieces of rock, etc.
A wound of the foot is more serious when made by a blunt-pointed instrument than when the point is sharp, and the nearer the injury is to the center of the foot the more liable are disastrous results to follow. Wounds in the heel and in the posterior parts of the frog are attended with but little danger, unless they are so deep as to injure the lateral cartilages, when quittor may follow. Punctured wounds of the anterior parts of the sole are more dangerous, for the reason that the coffin bone may be injured, and the suppuration, even when the wound is not deep, tends to spread and always gives rise to intense suffering. The most serious of the punctured wounds are those which happen to the center of the foot, and which, in proportion to their depth, involve the plantar cushion, the plantar aponeurosis, the sesamoid sheath, the navicular bone, or the coffin joint.
Punctured wounds are more liable to be deep in flat or convex feet than in well-made feet, and as a rule, recovery is neither so rapid nor so certain. These wounds are less serious in animals used for heavy draft than in those required to do faster work; for the former may be useful, even if complete recovery is not effected. Lastly, punctured wounds of the fore feet are more serious than of the hind feet, for the reason that in the former the instrument is liable to enter the foot in a nearly perpendicular line, and, consequently, is more liable to injure the deeper structures of the foot; in the hind foot, the injury is generally near the heels and the wound oblique and less deep.
Symptoms.--A nail or other sharp instrument may penetrate the frog and remain for several days without causing lameness; in fact, in many cases of punctured wound of the frog the first evidence of the injury is the finding of the nail or the appearance of an opening where the skin and frog unite, from which more or less pus escapes. Even when the sole is perforated, if the injury is not too deep, no lameness develops until suppuration is established. In all cases of foot lameness, especially if the cause is obscure, the foot should be examined for evidence of injury.
The lameness from punctured wounds, accompanied with suppuration, is generally severe, the patient often refusing to use the affected member at all. The pain being lancinating in character, he stands with the injured foot at rest or constantly moves it back and forth. In other cases the patient lies down most of the time with the feet outstretched; the breathing is rapid, the pulse fast, the temperature elevated, and the body covered with patches of sweat.
When the plantar aponeurosis is injured, the pus escapes with difficulty and the wound shows no signs of healing; the whole foot is hot and very painful. If the puncture involves the sesamoid sheath, the synovial fluid escapes. At first this fluid is pure, like joint water, but later becomes mixed with the products of suppuration and loses its clear, amber color. Suppuration generally extends up the course of the flexor tendon, an abscess forms in the hollow of the heel, and finally opens somewhere below the fetlock joint. The whole coronet is more or less swollen, the discharge is profuse and often mixed with blood, yet the suffering is greatly relieved from the moment the abscess opens.
If the puncture reaches the navicular bone the lameness is intense from the beginning; but the only certain way to determine the existence of this complication is by the use of the probe; and unless there is a free escape of synovia it must be used with the greatest of care, else the coffin joint may be opened. If the coffin joint has been penetrated, either by the offending instrument or by the process of suppuration, acute inflammation of the joint follows, accompanied with high fever, loss of appetite, etc. The ankle and coronet are now greatly swollen, and dropsy of the leg to the knee or hock, or even to the body, often follows. If the process of suppuration continues, small abscesses appear at intervals on different parts of the coronet, the patient rapidly loses flesh, and may die from intense suffering and blood poisoning. In other cases the suppuration soon disappears, and recovery is effected by the joint becoming stiff (anchylosis).
When the wound is forward, near the toe, and deep enough to injure the coffin bone, caries always results. The presence of the dead pieces of bone can be determined by the use of the probe; the bone feels rough and gritty. Furthermore, there is no disposition upon the part of the wound to heal.
Besides the complications above mentioned, others equally as serious may be met with. The tendons may soften and rupture, the hoof may slough off, quittors develop, or sidebones and ringbones grow. Finally, laminatis of the opposite foot may happen if the patient persists in standing, or lockjaw may cause early death.
Treatment.--In all cases the horn around the seat of injury should be thinned down, a free opening made for the escape of the products of suppuration, and the foot placed in a poultice. If the injury is not serious, recovery takes place in a few days. When the wound is deeper it is better to put the foot into a cold bath or under a stream of cold water, as advised in the treatment for quittor.
If the bone is injured, cold baths, containing about 2 ounces each of sulphate of copper and sulphate of iron, may be used until the dead bone is well softened, when it should be removed by an operation. The animal must be cast for this operation. The sole is pared away until the diseased bone is exposed, when all the dead particles are to be removed with a drawing knife, and the wound dressed with 3 per cent compound cresol solution or a 5 per cent solution of carbolic acid, oakum balls, and a roller bandage.
Wounds of the bone which are made by a blunt-pointed instrument, like the square-pointed cut nail, in which a portion of the surface is driven into the deeper parts of the bone, always progress slowly, and should be operated upon as soon as the conditions are favorable. Even wounds of the navicular bone, accompanied with caries, may be operated on and the life of the patient saved; but the most skillful surgery is required and only the experienced operator should undertake their treatment.
If there is an escape of pure synovial fluid from a wound of the sole, without injury to the bone, a small pencil of corrosive sublimate should be introduced to the bottom of the wound and the foot dressed as directed above.
The other complications are to be treated as directed under their proper headings.
After healing of the wounds has been effected, lameness, with more or less swelling of the coronary region, may remain. In such cases the coronet should be blistered or even fired with the actual cautery, and the patient turned to pasture. If the lameness still persists, and is not due to a stiff joint, unnerving may be resorted to in many cases with very good results. If the joint is anchylosed, no treatment can relieve it, and the patient must either be put to very slow work or kept for breeding purposes only.
"Prick in shoeing" is an injury which should be considered under the head of punctured wounds of the foot. The nails by which the shoe is fastened to the hoof may produce an injury followed by inflammation and suppuration in two days, by penetrating the soft tissues directly or by being driven so deep that the inner layers of the horn of the wall are pressed against the soft tissues with such force as to crush them. In either case, unless the injury is at the toe, the animal generally goes lame soon after shoeing, when the first evidence of the trouble may be the discharge of pus at the coronet. If lameness follows close upon the setting of the shoes, without other appreciable cause, each nail should be lightly struck with a hammer, when the one at fault will be detected by the flinching of the animal.
Treatment consists in drawing the nail, and if the soft tissues have been penetrated or suppuration has commenced, the horn must be pared away until the diseased parts are exposed. The foot is now to be poulticed for a day or two, or until the lameness and suppuration have ceased. If the discharge of pus from the coronet is the first evidence of the disease, the offending nail must be found and removed, the horn pared out, and a weak solution of carbolic acid or compound cresol injected at the coronet until the fistulous tract has healed.
CONTRACTED HEELS, OR HOOFBOUND.
Contracted heels, or hoofbound, is a common disease among horses kept on hard floor in dry stables, and in such as are subject to much saddle work. It consists in an atrophy, or shrinking, of the tissues of the foot, whereby the lateral diameter of the heels is diminished. It affects the fore feet principally; but it is seen occasionally in the hind feet, where it is of less importance, for the reason that the hind foot first strikes the ground with the toe, and consequently less expansion of the heels is necessary than in the fore feet, where the weight is first received on the heels. Any interference with the expansibility of this part of the foot interferes with locomotion and ultimately gives rise to lameness. Usually but one foot is affected at a time, but when both are diseased the change is greater in one than in the other. Occasionally but one heel, and that the inner one, is contracted; in these cases there is less liable to be lameness and permanent impairment of the animal's usefulness. According to the opinion of some of the French veterinarians, hoofbound should be divided into two classes--total contraction, in which the whole foot is shrunken in size, and contraction of the heels, when the trouble extends only from the quarters backward. (Pl. XXXV, figs. 4 and 7.)
Causes.--Animals raised in wet or marshy districts, when taken to towns and kept on dry floors, are liable to have contracted heels, not alone because the horn becomes dry, but because fever of the feet and wasting away of the soft tissues result from the change. Another common cause of contracted heels is to be found in faulty shoeing, such as rasping the wall, cutting away the frog, heels, and bars; high calks and the use of nails too near the heels. Contracted heels may happen as one of the results of other diseases of the foot; for instance, it often accompanies thrush, sidebones, ringbones, canker, navicular disease, corns, sprains of the flexor tendons, of the sesamoid and suspensory ligaments, and from excessive knuckling of the fetlock joint.
Symptoms.--In contraction of the heels the foot has lost its circular shape, and the walls from the quarters backward approach to a straight line. The ground surface of the foot is now smaller than the coronary circumference; the frog is pinched between the inclosing heels, is much shrunken, and at times is affected with thrush. The sole is more concave than natural, the heels are higher, and the bars are long and nearly perpendicular. The whole hoof is dry and so hard that it can scarcely be cut; the parts toward the heels are scaly and often ridged like the horns of a ram, while fissures, more or less deep, may be seen at the quarters and heels following the direction of the horn fibers. (Plate XXXVI, fig. 10.) When the disease is well advanced lameness is present, while in the earlier stages there is only an uneasiness evinced by frequent shifting of the affected foot. Stumbling is common, especially on hard or rough roads. In most cases the animal comes out of the stable stiff and inclined to walk on the toe, but after exercise he may go free again. He wears his shoes off at the toe in a short time, no matter whether he works or remains in the stable. If the shoe is removed and the foot pared in old cases, a dry, mealy horn will be found where the sole and wall unite, extending upward in a narrow line toward the quarters.
Treatment.--First of all, the preventive measures must be considered. The feet are to be kept moist and the horn from drying out by the use of damp sawdust or other bedding; by occasional poultices of boiled turnips, linseed meal, etc., and greasy hoof ointments to the sole and walls of the feet. The wall of the foot should be spared from the abuse of the rasp; the frog, heels, and bars are not to be mutilated with the knife, nor should calks be used on the shoe except when absolutely necessary. The shoes should be reset at least once a month to prevent the feet from becoming too long, and daily exercise must be insisted on.
As to curative measures, a diversity of opinion exists. A number of kinds of special shoes have been invented, having for an object the spreading of the heels, and perhaps any of these, if properly used, would eventually effect the desired result. But a serious objection to most of these shoes is that they are expensive and often difficult to make and apply. The method of treatment which I have adopted is not only attended with good results, but is inexpensive, if the loss of the patient's services for a time is not considered a part of the question. It consists, first, in the use of poultices or baths of cold water until the horn is thoroughly softened. The foot is now prepared for the shoe in the usual way, except that the heels are lowered a little and the frog remains untouched. A shoe, called a "tip," is made by cutting off both branches at the center of the foot and drawing the ends down to an edge. The tapering of the branches should begin at the toe, and the shoe should be of the usual width, with both the upper and lower surfaces flat. This tip is to be fastened on with six or eight small nails, all set well forward, two being in the toe. With a common foot rasp begin at the heels, close to the coronet, and cut away the horn of the wall until only a thin layer covers the soft tissues beneath. Cut forward until the new surface meets the old 2-1/2 or 3 inches from the heel. The same sloping shape is to be observed in cutting downward toward the bottom of the foot, at which point the wall is to retain its normal thickness. The foot is now blistered all round the coronet with Spanish-fly ointment; when this is well set, the patient is to be turned to pasture in a damp field or meadow. The blister should be repeated in three or four weeks, and, as a rule, the patient can be returned to work in two or three months.
The object of the tip is to throw the weight on the frog and heels, which are readily spread after the horn has been cut away on the sides of the wall. The internal structures of the foot at the heels, being relieved of excessive pressure, regain their normal condition if the disease is not of too long standing. The blister tends to relieve any inflammation which may be present, and stimulates a rapid growth of healthy horn, which, in most cases, ultimately forms a wide and normal heel. In old, chronic cases, with a shrunken frog and increased concavity of the sole, accompanied with excessive wasting of all the internal tissues of the foot, satisfactory results can not be expected and are rarely obtained. Still, much relief, if not an entire cure, may be effected by these measures.
When thrush is present as a complication, its cure must be sought by measures directed under that heading. If sidebones, ringbones, navicular disease, contracted tendons, or other diseases have been the cause of contracted heels, treatment will be useless until the cause is removed.
SAND CRACKS.
A sand crank is a fissure in the horn of the wall of the foot. These fissures are quite narrow, and, as a general rule, they follow the direction of the horny fibers. They may occur on any part of the wall, but ordinarily are only seen directly in front, when they are called toe cracks; or on the lateral parts of the walls, when they are known as quarter cracks. (Plate XXXVI.)
Toe cracks are most common in the hind feet, while quarter cracks nearly always affect the fore feet. The inside quarter is more liable to the injury than the outside, for the reason that this quarter is not only the thinner, but during locomotion receives a greater part of the weight of the body. A sand crack may be superficial, involving only the outer parts of the wall, or it may be deep, involving the whole thickness of the wall and the soft tissues beneath.
The toe crack is most likely to be complete--that is, extending from the coronary band to the sole--while the quarter crack is nearly always incomplete, at least when of comparatively recent origin. Sand cracks are most serious when they involve the coronary band in the injury. They may be complicated at any time by hemorrhage, inflammation of the laminae, suppuration, gangrene of the lateral cartilage and of the extensor tendon, caries of the coffin bone, or the growth of a horny tumor known as a keraphyllocele.
Causes.--Relative dryness of the horn is the principal predisposing cause of sand cracks. Excessive dryness is perhaps not a more prolific cause of cracks in the horn than alternate changes from damp to dry. It is even claimed that these injuries are more common in animals working on wet roads than those working on roads that are rough and dry; at least these injuries are not common in mountainous countries. Animals used to running at pasture when transferred to stables with hard, dry floors are more liable to quarter cracks than those accustomed to stables. Small feet, with thick, hard hoofs, and feet which are excessively large, are more susceptible to sand cracks than those of better proportion. A predisposition to quarter cracks exists in contracted feet, and in those where the toe turns out or the inside quarter turns under.
Heavy shoes, large nails, and nails set too far back toward the heels, together with such diseases as canker, quittor, grease, and suppurative corns, must be included as occasional predisposing causes of sand cracks.
Fast work on hard roads, jumping, and blows on the coronet, together with calk wounds of the feet, are accidental causes of quarter cracks in particular. Toe cracks are more likely to be caused by heavy pulling on slippery roads and pavements or on steep hills.
Symptoms.--The fissure in the horn is ofttimes the only evidence of the disease; even this may be accidentally or purposely hidden from casual view by mud, ointments, tar, wax, putty, gutta-percha, or by the long hairs of the coronet.
Sand cracks sometimes commence on the internal face of the wall, involving its whole thickness excepting a thin layer on the outer surface. In these cases the existence of the injury may be suspected from a slight depression, which begins near the coronary band and follows the direction of the horny fibers; but the trouble can only be positively diagnosed by paring away the outside layers of horn until the fissure is exposed. In toe cracks the walls of the fissure are in close apposition when the foot receives the weight of the body, but when the foot is raised from the ground the fissure opens. In quarter crack the opposition is true; the fissure closes when the weight is removed from the foot. As a rule, sand cracks begin at the coronary band, and as they become older they not only extend downward, but they also grow deeper. In old cases, particularly in toe cracks, the horn on the borders of the fissure loses its vitality and scales off, sometimes through the greater part of its thickness, leaving behind a rough and irregular channel extending from the coronet to the end of the toe.
In many cases of quarter crack, and in some cases of toe crack as well, if the edges remain close together, with but little motion, the fissure is dry; but in other cases a thin, offensive discharge issues from the crack and the ulcerated soft tissues, or a funguslike growth protrudes from the narrow opening.
When the cracks are deep and the motion of their edges considerable, so that the soft tissues are bruised and pinched with every movement, a constant inflammation of the parts is maintained and the lameness is severe.
Ordinarily the lameness of sand crack is slight when the patient walks, but it is greatly aggravated when he is made to trot, and the harder the road the worse he limps. Furthermore, the lameness is greater going downhill than up, for the reason that these conditions are favorable to an increased motion in the edges of the fissure. Lastly, more or less hemorrhage accompanies the inception of a sand crack when the whole thickness of the wall is involved. Subsequent hemorrhages may also take place from fast work, jumping, or a misstep.
Treatment.--So far as preventive measures are concerned, but little can be done. The suppleness of the horn is to be maintained by the use of ointments, damp floor, bedding, etc. The shoe is to be proportioned to the weight and work of the animal; the nails holding it in place are to be of proper size and not driven too near the heels; sufficient calks and toe pieces must be added to the shoes of horses working on slippery roads; also, the evils of jumping, fast driving, etc., are to be avoided.
When a fissure has made its appearance, means are to be adopted which will prevent it from growing longer or deeper; this can only be done by arresting all motion in the edges. The best and simplest artificial appliance for holding the borders of a toe crack together is the Vachette clasp. These clasps and the instruments necessary for their application can be had of any prominent maker of veterinary instruments. (Pl. XXXVI.) These instruments comprise a cautery iron, with which two notches are burned in the wall, one on each side of the crack, and forceps with which the clasps are closed into place in the bottom of the notches and the edges of the fissure brought close together. The clasps, being made of stiff steel wire, are strong enough to prevent all motion in the borders of the crack. Before these clasps are applied the fissure should be thoroughly cleansed and dried, and if the injury is of recent origin the crack may be filled with a putty made of 2 parts of gutta-percha and 1 part of gum ammoniac. The number of clasps to be used is to be determined by the length of the crack, the amount of motion to be arrested, etc. Generally the clasps are from one-half to three-quarters of an inch apart. The clasps answer equally as well in quarter crack if the wall is sufficiently thick and not too dry and brittle to withstand the strain.
In the absence of these instruments and clasps a hole may be drilled through the horn across the fissure and the crack closed with a thin nail made of tough iron, neatly clinched at both ends. A plate of steel or brass is sometimes fitted to the parts and fastened on with short screws; while this appliance may prevent much gaping of the fissure, it does not entirely arrest motion of the edges, for the reason that the plate and screw can not be rendered immobile.
If, for any reason, the measures above fail or can not be used, recourse must be had to an operation. The horn is softened by the use of warm baths and poultices, the patient cast, and the walls of the fissure entirely removed with the knife. The horn removed is in the shape of the letter V, with the base at the coronet. Care must be taken not to injure the coronary band and the laminae. The wound is to be treated with mild stimulant dressings, such as compound cresol solution, a weak solution of carbolic acid, tincture of aloes, etc., oakum balls, and a roller bandage. After a few days the wound will be covered with a new, white horn, and only the oakum and bandages will be needed. As the new quarter grows out, the lameness disappears, and the patient may be shod with a bar shoe and returned to work.
In all cases of sand crack the growth of horn should be stimulated by cauterizing the coronary band or by the use of blisters. In simple quarter crack recovery will often take place if the coronet is blistered, the foot shod with a "tip," and the patient turned to pasture.
The shoe in toe crack should have a clip on each side of the fissure and should be thicker at the toe than at the heels. The foot should be lowered at the heels by paring, and spared at the toe, except directly under the fissure, where it is to be pared away until it sets free from the shoe.
When any of the complications referred to above arise, special measures must be resorted to. For the proper treatment of gangrene of the lateral cartilage and extensor tendon and caries of the coffin bone reference may be had to the articles on quittors. If the horny tumor, known as keraphyllocele, should develop, it is to be removed by the use of the knife. Since this tumor develops on the inside of the horny box and may involve other important organs of the foot in disease, its removal should only be undertaken by a skillful surgeon.
NAVICULAR DISEASE.
Navicular disease is an inflammation of the sesamoid sheath, induced by repeated bruising or laceration, and complicated in many cases by inflammation and caries of the navicular bone. In some instances the disease undoubtedly begins in the bone, and the sesamoid sheath becomes involved subsequently by an extension of the inflammatory process. (Plate XXXIV, fig. 5.)
The Thoroughbred horse is more commonly affected than any other, yet no class or breed of horses is entirely exempt. The mule, however, seems rarely, if ever, to suffer from it. For reasons which will appear when considering the causes of the disease, the hind feet are not liable to be affected. Usually but one fore foot suffers from the disease, but if both should be attacked the trouble has become chronic in the first before the second shows signs of the disease.
Causes.--To comprehend fully how navicular disease may be caused by conditions and usages common to nearly all animals, it is necessary to recall the peculiar anatomy of the parts involved in the process and the functions which they perform in locomotion.
It must be remembered that the fore legs largely support the weight of the body when the animal is at rest, and that the faster he moves the greater is the shock which the fore feet must receive as the body is thrown forward by the propelling force of the hind legs. This shock could not be withstood by the tissues of the fore feet and legs were it not that it is largely dissipated by the elastic muscles which bind the shoulder to the body, the ease with which the arm closes on the shoulder blade, and the spring of the fetlock joint. Even these means, however, are not sufficient within themselves to protect the foot from injury; so nature has further supplemented them by placing the coffin joint on the hind part of the coffin bone instead of directly on top of it, whereby a large part of the shock of locomotion is dispersed before it can reach the vertical column represented by the cannon, knee, and arm bones. A still further provision is made by placing a soft, elastic pad--the frog and plantar cushion--at the heels to receive the sesamoid expansion of the flexor tendon as it is forced downward by the pressure of the coronet bone against the navicular. Extraordinary as these means may appear for the destruction of shock, and ample as they are when the animal is at a slow pace or unweighted by rider or load, they fail to relieve the parts completely from concussion and excessive pressure whenever the opposite conditions are present. The result, then, is that the coronet bone forces the navicular hard against the flexor tendon, which, in turn, presses firmly against the navicular as the force of the contracting muscles lifts the tendon into place. It is self-evident, then, that the more rapid the pace and the greater the load, the greater must these contending forces be, and the greater the liability to injury. For the same reason horses with excessive knee action are more liable to suffer from this disease than others, concussion of the foot and intense pressure on the tendon being common among such horses.
Besides the above-mentioned exciting causes must be considered those which predispose to the disease. Most prominent among these is heredity. It may be claimed, however, that an inherited predisposition to navicular disease consists not so much in a special susceptibility of the tissues which are involved in the process as in a vice of conformation which, as is well known, is liable to be transmitted from parent to offspring. The faults of conformation most likely to be followed by the development of navicular disease are an insufficient plantar cushion, a small frog, high heels, excessive knee action, and contracted heels. Finally, the environments of domestication and use, such as dry stables, heavy pulling, bad shoeing, punctured wounds, etc., all have their influence in developing this disease.
Symptoms.--In the early stages of navicular disease the symptoms are generally very obscure. When the disease begins in inflammation of the navicular bone, the animal while at rest points the affected foot a time before any lameness is seen. While at work he apparently travels as well as ever, but when placed in the stable one foot is set out in front of the other, resting on the toe, with fetlock and knee flexed. After a time, if the case is closely watched, the animal takes a few lame steps while at work, but the lameness disappears as suddenly as it came, and the driver doubts whether the animal was really lame at all. Later the patient has a lame spell which may last during a greater part of the day, but the next morning it is gone; he leaves the stable all right, but goes lame again during the day. In times he has a severe attack of lameness, which may last for a week or more, when a remission takes place and it may be weeks or months before another attack supervenes. Finally, he becomes constantly lame, and the more he is used the greater the lameness.
In the lameness from navicular disease the affected leg always takes a short step, and the toe of the foot first strikes the ground; so the shoe is most worn at this point. If the patient is made to move backward, the foot is set down with exceeding great care, and the weight rests upon the affected leg but a moment. When exercised he often stumbles, and if the road is rough he may fall on his knees. If he is lame in both feet the gait is stilty, the shoulders seem stiff, and, if made to work, he sweats profusely from intense pain. Early in the development of the disease a careful examination will reveal some increased heat in the heels and frog, particularly after work; as the disease progresses this becomes more marked, until the whole foot is hot to the touch. At the same time there is an increased sensibility of the foot, for the patient flinches from the percussion of a hammer lightly applied to the frog and heels or from the pressure of the smith's pincers. The frog is generally shrunken, often of a pale-red color, and at times is affected with thrush. If the heels are pared away so that all the weight is received on the frog, or if the same result is attained by the application of a bar shoe, the animal is excessively lame. The muscles of the leg and shoulder shrink away and often tremble as the animal stands at rest. After months of lameness the foot is found to be shrunken in its diameter and apparently lengthened; the horn is dry and brittle and has lost its natural gloss, while circular ridges, developed most toward the heels, cover the upper part of the hoof. When both feet are affected the animal points first one foot then the other, and stands with the hind feet well forward beneath the body, so as to relieve the fore feet as much as possible from bearing weight. In old cases the wasting of the muscles and the knuckling at the fetlock become so great that the leg can not be straightened and locomotion can scarcely be performed. The disease generally makes a steady progress without inclining to recovery--the remission of symptoms in the earlier stages should not be interpreted as evidence that the process has terminated. The complications usually seen are ringbones, sidebones, thrush, contracted heels, quartercracks, and fractures of the navicular, coronet, and pastern bones.
Treatment.--But few cases of navicular disease recover. In the early stages the wall of the heels should be rasped away, as directed in the treatment for contracted heels, until the horn is quite thin; the coronet should be well blistered with Spanish-fly ointment, and the patient turned to grass in a damp field or meadow. After three or four weeks the blister should be repeated. This treatment is to be continued for two or three months. Plane shoes are to be put on when the patient is returned to work. In chronic cases the animal should be put to slow, easy work. To relieve the pain, neurotomy may be performed--an operation in which the sense of feeling is destroyed in the foot by cutting out pieces of the nerve at the fetlock. This operation in nowise cures the disease, and, since it may be attended with serious results, can be advised only in certain favorable cases, to be determined by the veterinarian.
SIDEBONES.
A sidebone consists in a transformation of the lateral cartilages found on the wings of the coffin bone into bony matter by the deposition of lime salts. The disease is a common one, especially in heavy horses used for draft, in cavalry horses, cow ponies, and other saddle horses, and in runners and trotters.
Sidebones are peculiar to the fore feet, yet they occasionally develop in the hind feet, where they are of little importance since they cause no lameness. In many instances sidebones are of slow growth and, being unaccompanied with acute inflammation, they cause no lameness until such time as, by reason of their size, they interfere with the action of the joint. (Plate XXXIV, fig. 4.)
Causes.--Sidebones often grow in heavy horses without any apparent injury, and their development has been attributed to the over-expansion of the cartilages caused by the great weight of the animal. Blows and other injuries to the cartilages may set up an inflammatory process which ends in the formation of these bony growths. High-heeled shoes, high calks, and long feet are always classed among the conditions which may excite the growth of sidebones. They are often seen in connection with contracted heels, ringbones, navicular disease, punctured wounds of the foot, quarter cracks, and occasionally as a sequel to founder.
Symptoms.--In the earlier stages of the disease, if inflammation is present, the only evidence of the trouble to be detected is a little fever over the seat of the affected cartilage and a slight lameness. In the lameness of sidebones the toe of the foot first strikes the ground and the step is shorter than natural. The subject comes out of the stable stiff and sore, but the gait is more free after exercise.
Since the deposit of bony matter often begins in that part of the cartilage where it is attached to the coffin bone, the diseased process may exist for some time before the bony growth can be seen or felt. Later, however, the cartilage can be felt to have lost its elastic character, and by standing in front of the animal a prominence of the coronary region at the quarters can be seen. Occasionally these bones become so large as to bulge the hoof outward, and by pressing on the joint they so interfere with locomotion that the animal becomes entirely useless.
Treatment.--So soon as the disease can be diagnosed active treatment should be adopted. Cold-water bandages are to be used for a few days to relieve the fever and soreness.
The improvement consequent on the use of these simple measures often leads to the belief that the disease has recovered; but with a return to work the lameness, fever, etc., reappears. For this reason the use of blisters, or, better still, the firing iron, should follow on the discontinuance of the cold bandages.
But in many instances no treatment will arrest the growth of these bony tumors, and as a palliative measure neurotomy must be resorted to. Generally this operation will so relieve the pain of locomotion that the patient may be used for slow work; but in animals used for fast driving or for saddle purposes, the operation is practically useless. Some years ago at Fort Leavenworth I unnerved a number of cavalry horses that were suffering from sidebones, and the records show that in less than seven months all were more lame than ever. Since a predisposition to develop sidebones may be inherited, animals suffering from this disease should not be used for breeding purposes unless the trouble is known to have originated from an accident.
RINGBONE.
A ringbone is the growth of a bony tumor on the ankle. This tumor is, in fact, not the disease, but simply the result of an inflammatory action set up in the periosteum and bone tissue proper of the pastern bones. (Plate XXXIV, fig. 1.) (See also p. 313.)
Causes.--Injuries, such as blows, sprains, overwork in young, undeveloped animals, fast work on hard roads, jumping, etc., are among the principal exciting causes of ringbone. Horses most disposed to this disease are those with short, upright pasterns, for the reason that the shock of locomotion is but imperfectly dissipated in the fore legs of these animals. Improper shoeing, such as the use of high calks, a too great shortening of the toe and correspondingly high heels, predispose to this disease by increasing the concussion to the feet.
Symptoms.--The first symptom of an actively developed ringbone is the appearance of a lameness more or less acute. If the bony tumor forms on the side or upper parts of the large pastern, its growth is generally unattended with acute inflammatory action, and consequently produces no lameness or evident fever. These are called "false" ringbones. But when the tumors form on the whole circumference of the ankle, or simply in front under the extensor tendon, or behind under the flexor tendons, or if they involve the joints between the two pastern bones, or between the small pastern and the coffin bone, the lameness is always severe. These constitute the true ringbone. Besides lameness, the ankle of the affected limb presents more or less heat, and in many instances a rather firm, though limited, swelling of the deeper tissues over the seat of the inflammatory process. The lameness of ringbone is characteristic in that the heel is first placed on the ground when the disease is in a fore leg, and the ankle is kept as rigid as possible. In the hind leg, however, the toe strikes the ground first, when the ringbone is high on the ankle, just as in health, but the ankle is maintained in a rigid position. If the bony growth is under the front tendon of the hind leg, or if it involves the coffin joint, the heel is brought to the ground first. In the early stages of the disease it is not always easy to diagnose ringbone, but when the deposits have reached some size they can be felt and seen as well.
The importance of a ringbone depends on its seat and often on its size. If it interferes with the joints or with the tendons it may cause an incurable lameness, even though small. If it is on the sides of the large pastern, the lameness generally disappears as soon as the tumor has reached its growth and the inflammation subsides. Even when the pastern joint is involved, if complete anchylosis results, the patient may recover from the lameness with simply an imperfect action of the foot remaining, due to the stiff joint.
Treatment.--Before the bony growth has commenced the inflammatory process may be cut short by the use of cold baths and wet bandages, followed by one or more blisters. If the bony deposits have begun, the firing iron should always be used. Even when the tumors are large and the pastern joint involved, firing often hastens the process of anchylosis and should always be tried.
When the lower joint is involved, or if the tumor interferes with the action of the tendons, recovery is not to be expected. In many of these latter cases, however, the animal may be made serviceable by proper shoeing. If the patient walks with the toe on the ground, the foot should be shod with a high-heeled shoe and a short toe. On the other hand, if he walks on the heel, a thick-toed and thin-heeled shoe must be worn.
Since ringbone is considered to be one of the hereditary diseases, no animal suffering from this trouble should ever be used for breeding purposes.
LAMINITIS, OR FOUNDER.
Laminitis is a simple inflammation of the sensitive laminae of the feet, characterized by the general phenomena attending inflammation of the skin and mucous membranes, producing no constitutional disturbances except those dependent upon the local disease, and having a strong tendency, in severe cases, to destructive disorganization of the tissues affected.
Causes.--The causes of laminitis are as wide and variable as in any of the local inflammations, and may be divided into two classes--the predisposing and the exciting.
Predisposing causes.--From personal observation I do not know that any particular construction of foot or any special breed of horses is predisposed to this disease, neither can I find anything to warrant the assumption that it is in any way hereditary; so that while we may easily cultivate a predisposition to the disease, it does not originate without an exciting cause. Like most other tissues, a predisposition to inflammation may be induced in the sensitive laminae by any cause which lessens their power of withstanding the work imposed on them. It exists to an extent in those animals unaccustomed to work, particularly if they are plethoric, and in all that have been previous subjects of the disease, for the same rule holds good here that we find in so many diseases--i. e., that one attack impairs the functional activity of the affected tissues and renders them more easy of a subsequent inflammation. Unusual excitement by determining an excessive blood supply, bad shoeing, careless paring of the feet by removing the sole support, and high calkings without corresponding toe pieces must be included under this head.
Exciting causes.--The exciting causes of laminitis are many and varied. The most common are concussion, overexertion, exhaustion, rapid changes of temperature, ingestion of certain feeds, purgatives, and the oft-mentioned metastasis.
(1) Concussion produces this disease by local overstimulation. The excessive excitement is followed by an almost complete exhaustion of the functional activity of the laminated tissues, the exhaustion by congestion, and eventually by inflammation. But congestion here, as in all other tissues, is not necessarily followed by inflammation; for, although the principal symptoms belonging to true laminitis are present, the congestion may be relieved before the processes of inflammation are fully established. This is the condition in the many so-called cases of laminitis which recover in from 24 to 48 hours. They should be called congestion of the laminae.
Laminitis from concussion is common in trotting horses that are raced when not in condition, especially if they carry the obnoxious toe weights, and in green horses put to work on city pavements to which they are unaccustomed. Concussion from long drives on dirt roads is at times productive of the same results, notably when the weather is extremely warm, or at least when the relative change of temperature is great. But the exhaustion of these circumstances must prove an exciting cause as well as the long-continued concussion. This combination of causes must also determine the disease at times in hunters, for the weight of the rider increases the demands made upon the function of these tissues, and their powers are the sooner exhausted.
(2) Overexertion, as heavy pulling or rapid work, even when there is no immoderate concussion, occasionally results in this disease. Here also exhaustion is a conjunctive cause, for overexertion can not be long continued without exhaustion.
(3) Exhaustion is nearly as prolific a source of laminitis as is concussion, for when the physical strength is impaired, even though temporarily, some part of the economy is rendered more vulnerable to disease than others. To this cause we must ascribe those cases which follow a hard day's work, in which at no time has there been overexertion or immoderate concussion.
The tendency to laminitis in horses on sea voyages results from the continual constrained position the animal maintains on account of the rocking motion of the vessel.
If one foot has been blistered, or if one limb is incapacitated from any cause, the opposite member, doing double duty, soon becomes exhausted, and congestion, followed by inflammation, results. When one foot only becomes laminitic, it is customary to find the corresponding member participating at a later date; not always because of sympathy, but because one foot had to do the work of two.
(4) Rapid changes of temperature act as an exciting cause of laminitis by impairing the normal blood supply.
This change of temperature may be induced by drinking large quantities of cold water while in an overheated condition. Here the internal heat is rapidly reduced, the neighboring tissues and blood vessels constrained, and the blood supply to these organs greatly diminished, while the quantity sent to the surface is correspondingly increased. True, in many cases there has not been sufficient labor performed to impair the powers of the laminae, and laminitis is more readily induced than congestion or inflammation of the skin or other surface organs, because the laminae can not relieve themselves of threatened congestion by the general safety valve of perspiration. A cold wind or relatively cold air allowed to play upon the body when heated and wet with sweat has virtually the same result, for it arrests evaporation and rapidly cools the external surface, thereby determining an excess of blood to such organs and tissues as are protected from this outside influence. In many instances this happens to be some of the internal organs, as the lungs, if the previous work has been rapid and their functional activity impaired; but in numerous other instances the determination is toward the feet, and that it is so depends upon two very palpable facts: First, that these tissues have been greatly excited and are already receiving as much blood as they can accommodate consistently with health; second, even though these tissues are classed with those of the surface, their protection from atmospheric influences by means of the thick box of horn incasing them renders them in this respect equivalent to internal organs.
A more limited local action of cold may excite this disease, by driving through water or washing the feet and legs while the animal is warm or just in from work. Here a very marked reaction takes place in the surface tissues of the limbs, and passive congestion of the foot results from an interference with the return flow of blood which is being sent to these organs in excess. These are more liable to be simple cases of congestion, soon to recover, yet they may become true cases of laminitis.
(5) Why it is that certain kinds of grain will cause laminitis does not seem to be clearly understood. Certainly they possess no specific action upon the laminae, for all animals are not alike affected; neither do they always produce these results in the same animal. Some of these feeds cause a strong tendency to indigestion, and the consequent irritation of the alimentary canal may be so great as to warrant the belief that the laminae are affected through sympathy. In other instances there is no apparent interference with digestion nor evidence of any irritation of the mucous membranes, yet the disease is in some manner dependent upon the feed for its inception. Barley, wheat, and sometimes corn are the grains most liable to cause this disease. With some horses there appears to be a particular susceptibility to this influence of corn, and the use of this grain is followed by inflammation of the feet, lasting from a few days to two weeks. In these animals, to all appearances healthy, the corn neither induces colic, indigestion, nor purging, and apparently no irritation whatever of the alimentary canal.
(6) Fortunately purgative medicines rarely cause inflammation of the laminae. That it is, then, the result of sympathetic action is no doubt more than hypothetical, for when there is no derangement of the alimentary canal a dose of cathartic medicine will at times bring on severe laminitis.
(7) Almost all the older authorities were agreed that metastatic laminitis is a reality. In my opinion metastatic laminitis is nothing more nor less than concurrent laminitis, and presents little in any way peculiar outside the imperfectly understood exciting cause. The practitioner who allows the acute symptoms of the laminitis to mislead him, simply because their severity has overshadowed those of the primary disease, may lose his case through unguarded subsequent treatment. This form of laminitis is by no means commonly met with. It may be found in conjunction with pneumonia, according to Youatt with inflammation of the bowels and eyes, and according to Law and Williams sometimes with bronchitis.
Symptoms.--Laminitis is characterized by a congregation of symptoms so well marked as scarcely to be misinterpreted by the most casual observer. They are nearly constant in their manifestations, modified by the number of feet affected, the cause which has induced the disease, the previous condition of the patient, and the various other influences which to some extent operate in all diseases. They may be divided into general symptoms, which are concomitants of all cases of the disease, subject to variations in degree only, and special symptoms, or those which serve to determine the feet affected and the complications which may arise.
General symptoms.--Usually, the first symptom is the interference with locomotion. Occasionally the other symptoms are presented first. As the lameness develops the pulse becomes accelerated, full, hard, and strikes the finger strongly; the temperature soon rises several degrees above the normal, reaching sometimes 106 deg. F.; it generally ranges between 102.5 deg. and 105 deg. F. The respirations are rapid and panting in character, the nostrils widely dilated, and the mucous membranes highly injected. The facial expression is anxious and indicative of the most acute suffering, while the body is more or less bedewed with sweat. At first there may be a tendency to diarrhea, or it may appear later as the result of the medicines used. The urine is high colored, scant in quantity, and of increased specific gravity, owing to the water being eliminated by the skin instead of the kidneys. The appetite is impaired, sometimes entirely lost, but thirst is greatly increased. The affected feet are hot and dry, and as much as possible are relieved from bearing weight. Rapping them with a hammer, or compelling the animal to stand upon one affected member, causes intense pain. The artery at the fetlock throbs beneath the finger.
Special symptoms.--Liability to affection varies in the different feet according to the exciting cause. Any one or more of the feet may become the subject of this disease, although it appears more often in the fore feet than in the hind ones. This is due to the difference of the function, i. e., that the fore feet are the bases of the columns of support, receiving nearly all the body weight during progression and consequently most of the concussion, while the hind feet become simply the fulcra of the levers of progression, and are almost exempt from concussion.
One foot.--Injuries and excessive functional performance are the causes of the disease in only one foot. The general symptoms, as a rule, are not severe, there being often no loss of appetite and no unusual thirst, while the pulse, temperature, and respiration remain about normal. The weight of the body is early thrown upon the opposite foot, and the affected one is extended, repeatedly raised from the floor, and then carefully replaced. When made to move forward the lame foot is either carried in the air while progression is accomplished by hopping with the healthy one, or else the heel of the first is placed upon the ground and receives little weight while the sound limb is quickly advanced. Progression in a straight line is more easy than turning toward the lame side.
Both fore feet.--When both fore feet are affected the symptoms are well marked. The lameness is excessive and the animal almost immovable. When standing the head hangs low down, or rests upon the manger as a means of support and to relieve the feet; the fore feet are well extended so that the weight is thrown upon the heels, where the tissues are least sensitive, least inflamed, and most capable of relief by free effusion. The hind feet are brought forward beneath the body to receive as much weight as possible, thereby relieving the diseased ones. If progression is attempted, which rarely happens voluntarily during the first three or four days, it is accomplished with very great pain and lameness at the starting, which usually subsides to an extent after a few minutes' exercise. During this exercise, if the animal happens to step upon a small stone or other hard substance, he stumbles painfully and is excessively lame in the offended member for a number of steps, owing to the acute pain which pressure upon the sole causes in the tissues beneath. The manner of the progression is pathognomonic of the complaint. Sometimes the affected feet are simultaneously raised from the ground (the hind ones sustaining the weight), then advanced a short distance and carefully replaced; at almost the same moment the hind ones are quickly shuffled forward near to the center of gravitation.
In other instances one foot at a time is advanced and placed with the heel upon the ground in the same careful manner, all causes of concussion being carefully avoided. In attempting to back the animal he is found to be almost stationary, simply swaying the body backward on the haunches and elevating the toes of the diseased feet as they rest upon their heels. In attempting to turn either to the right or left he allows his head to be drawn to the one side to its full extent before moving, then makes his hind feet the axis around which the forward ones describe a shuffling circle.
In most of cases of laminitis in the fore feet the animal persists in standing until he is nearly recovered. In other cases he as persistently lies, standing only when necessity seems to compel it, and then for as short a time as possible. If the recumbent position is once assumed, the relief experienced tempts the patient to seek it again; so we often find him down a greater part of the time. But this is not true of all cases; sometimes he will make the experiment, then cautiously guard against a repetition. Even in cases of enforced recumbency, he ofttimes takes advantage of the first opportunity and gets upon his feet, doggedly remaining there until again laid upon his side. How to explain this diversity of action I do not know; theoretically the recumbent position is the only appropriate one, except when complications exist, and the one which should give the most comfort, yet it is rejected by very many patients and, no doubt, for some good reason. It has been suggested as an explanation that when the animal gets upon his feet after lying for a time the suffering is so greatly augmented that the memory of this experience deters him from an attempted repetition. If this were true, the horse with the first attack must necessarily make the experiment before knowing the after effects of lying down, yet many remain standing without even an attempt at gaining this experimental knowledge.
The most-favored position of the animal when down is on the broadside, with the feet and legs extended. While in this position the general symptoms greatly subside; the respirations and pulse become almost normal; the temperature falls and the perspiration dries. It is with difficulty that he is made to rise. When he attempts it he gets up rapidly and "all of a heap," as it were, shifting quickly from one to the other foot until they become accustomed to the weight thrown upon them. Occasionally a patient will get up like a cow, rising upon the hind feet first. Although enforced exercise relieves the soreness to some extent, it is but temporary, for after a few minutes' rest it returns with all its former severity.
Both hind feet.--When only both hind feet are affected, they are, while standing, maintained in the same position as when only the fore ones are the subjects of the disease, but with an entirely different object in view. Instead of being there to receive weight, they are so advanced that the heels only may receive what little weight is necessarily imposed on them; the fore feet at the same time are placed well back beneath the body, where they become the main supports; the animal standing, as Williams describes it, "all of a heap."
Progression is even more difficult now than when the disease is confined to the anterior extremities. The fore feet are dubiously advanced a short distance and the hind ones brought forward with a sort of kangaroo hop that results in an apparent loss of equilibrium which the animal is a few moments in regaining. The general symptoms, or, in other words, the degree of suffering, seem more severe than when the disease affects the fore feet alone. The standing position is not often maintained, the patient seeking relief in recumbency. This fact is easily understood when we consider how cramped and unnatural is the position he assumes while standing and, if it were maintained for any considerable length of time, would, no doubt, excite the disease in the fore feet, as explained by D'Arboval.
All four feet.--Laminitis of all four feet is but uncommonly met with. The author has seen but three such cases. In all these the position assumed was nearly normal. All the feet were slightly advanced, and first one, then another, momentarily raised from the ground and carefully replaced, this action being kept up almost continually during the time the animal remained standing. The suffering is most acute, the appetite lost, and, although the patient lies most of the time, the temperature remains too high. The pulse and respirations are greatly accelerated, the body covered with sweat, and bed sores are unpleasant accompaniments.
Course.--The course which laminitis takes varies greatly in different cases, being influenced more or less by the exciting cause, the animal's previous condition, the acuteness of the attack, and the subsequent treatment. The first symptoms rarely exhibit themselves while the animal is at his work, although we occasionally see the gait impaired by stumbling, the body covered with a profuse sweat, and the respirations become blowing in character as premonitions of the oncoming disease; but, as a rule, nothing amiss with the animal is noted until he has stood for some time after coming in from work, when, in attempting to move him, he is found very stiff. Like all congestions, the early symptoms usually develop rapidly; yet this is not always the case, for often there appears to be no well-defined period of congestion, the disease seemingly commencing at a point and gradually spreading until a large territory is involved in the morbid process.
Simple congestion.--Those cases of simple congestion of the laminae, which we erroneously call laminitis, are rapidly developed, the symptoms are but moderately severe, and but one to three days are required for recovery. There are no structural changes and but a moderate exudate. This is rapidly reabsorbed, leaving the parts in the same condition as they were previous to the attack. If the congestion has been excessive, a rupture of some of the capillaries will be found, a condition more liable to exist if the animal is made to continue work after a development of symptoms has begun.
True, the majority of these last-described cases prove to be the laminitis in fact, yet the congestion may pass away and the extravasated blood be absorbed without inflammation sufficient to warrant calling it laminitis. The seat of greatest congestion will always be found in the neighborhood of the toe, because of the increased vascularity of that part, and, although at times it is limited to the podophyllous tissue alone, any or all parts of the keratogenous membrane may be affected by the congestion and followed finally by inflammation.
Acute.--In the acute form of laminitis the symptoms may all develop rapidly, or it may commence by the appearance of a little soreness of the feet which in 24 or 48 hours develops into a well-marked case. This peculiarity of development is due to one of two causes. Either the congestion is general, but takes place slowly, or it begins in one or more points and gradually spreads throughout the laminae. These acute cases generally run their course in from one to two weeks. Usually a culmination of the symptoms is reached, if the patient is properly treated, in from three to five days; then evidences of recovery are discernible in favorable cases. The lameness improves, the other symptoms gradually subside, and eventually health is regained. It is in these cases that a strong tendency to disorganization of a destructive character exists; hence it is we see so many recover imperfectly, with marked structural changes permanently remaining.
Subacute.--Subacute laminitis is most often seen as a termination of the acute form, although it may exist independent of or precede an acute attack. It is characterized by the mildness of its symptoms, slow course, and moderate tissue changes. It may be present a long time before any pathological lesions result other than those found in the acute form, and when these changes do take place they should be viewed rather as complications.
Chronic.--Chronic laminitis is a term used by many to designate any of the sequelae of the acute and subacute forms of this disease. Pure, chronic inflammation of the laminae is not very commonly met with, but is most frequent in horses that have long done fast track work. They have "fever in the feet" at all times and are continually sore, both conditions being aggravated by work. Like chronic inflammation of other parts, there is a strong tendency to the development of new connective tissue which, by its pressure upon the blood vessels, interferes with nutrition. Wasting of the coffin bone and inflammation of its covering with caries is not unusual. The continued fever and impaired function of secretion result in the production of a horn deficient in elasticity, somewhat spongy in character, and inclined to crumble. In some cases of "soreness" in horses used to hard or fast work there is evident weakness of the coats of the vessels, brought on by repeated functional exhaustion. Here slight work brings on congestion, which results in serous effusion and temporary symptoms similar to those of chronic laminitis.
Complications.--Complications concurrent with or supervening upon laminitis are frequent and varied, and are often dependent upon causes not fully understood.
Excessive purgation is one of the simplest of these, and not usually attended with dangerous consequences. It rarely occurs unless induced by a purgative, and the excessive action of the medicine is probably to be explained upon the theory that the mucous membrane sympathizes with the diseased laminae, is irritable, and readily becomes overexcited. The discharges are thin and watery, sometimes offensively odorous, and occasionally persist in spite of treatment. It may prove disastrous to the welfare of the patient by the rapid exhaustion which it causes, preventing resolution of the laminitis, and may even cause death.
Septicemia and pyemia.--Septicemia and pyemia are unusual complications and are seen only in the most severe cases in which bed sores are present or suppuration of the laminae results. They die, as a rule, within three days after showing signs of the complication.
Pneumonia.--the so-called metastatic--needs no special consideration, for in its lesions and symptoms it does not differ from ordinary pneumonia, although it may be overlooked entirely by the practitioner. Examinations of the chest should be made every day, so as to detect the disease at its onset and render proper aid.
Sidebones.--A rapid development of sidebones is one of the complications, or, perhaps better, a sequel of laminitis not often met with in practice. Here the inflammatory process extends to the lateral cartilages, with a strong tendency to calcification. The deposition of the lime salts is sometimes most rapid, so that the "bones" are developed in a few weeks; in other instances they are deposited slowly and their growth is not noted until long after the subsidence of the laminitis, so that the exciting cause is not suspected. This change in the cartilages may commence as early as the first of the laminitis; and although the trouble in the laminae is removed in the course of a fortnight the symptoms do not entirely subside, the animal retains the shuffling gait, the sidebones continue to grow, and the patient usually remains quite lame. This alteration of the cartilages generally prevents the patient from recovering his natural gait, and the practitioner receives unjust censure for a condition of affairs he could neither foresee nor prevent.
The laminitic process occasionally extends to the covering of the coronet bone, or at least concurrent with and subsequent to laminitis the development of "low ringbone" is seen, and it is apparently dependent upon the disease of the laminae for its exciting cause. The impairment of function and consequent symptoms are much less marked here than in sidebones. The coronet remains hot and sensitive and somewhat thickened after the laminitis subsides, and a little lameness is present. This lameness persists, and the deposits of new bone may readily be detected.
Suppuration of the sensitive membrane is a somewhat common complication, and even when present in its most limited form is always a serious matter; but when it becomes extensive, and especially when the suppurative process extends to the periosteum, the results are liable to be fatal. When suppuration occurs the exudation does not appear to be excessive. It is rich in leucocytes and seems to have caused detachment of the sensitive tissues from the horn prior to the formation of pus in some instances; in others the tissues are still attached to the horn, and the suppuration takes place in the deeper tissues.
Limited suppuration may take place in any part of the sensitive tissues of the foot during laminitis, and may ultimately be reabsorbed instead of being discharged upon the surface, but generally the process begins in the neighborhood of the toe and spreads backward and upward toward the coronet, finally separating the horn from the coronary band at the quarters. At the same time it spreads over the sole and eventually the entire hoof is loosened and sloughs away, leaving the tissues beneath entirely unprotected. In other instances--and these are generally the cases not considered unusually severe--the suppuration begins at the coronary band. It extends but a short distance into the tissues, yet destroys the patient by separating the hoof from the coronary band, upon which it depends for support and growth. This form of the suppurative process usually begins in front. It is this part of the coronary band that is always most actively affected with inflammation, and consequently it is here that impairments first occur.
Suppuration of the sensitive sole is more common than of the sensitive laminae and coronary band. It is present in the majority of cases in which there is a dropping of the coffin bone, and in other instances when the effusion at this point is so great as to arrest the production of horn and uncover the sensitive tissues. Except when the result of injury it begins at the toe and spreads backward, and, if not relieved by opening the sole, escapes at the heel. Suppuration of the sole is much less serious than in other parts of the foot.
If the acute constitutional symptoms developed from sloughing of the foot do not result in death, a new hoof of very imperfect horn may be developed after a time; but unless the animal is to be kept for breeding purposes alone the foot will ever be useless for work and death should relieve the suffering. When only the sole sloughs, recovery takes place with proper treatment.
Peditis.--This is the term that Williams applies to that serious complication of laminitis in which not only the laminae, but the periosteum membrane covering the bone and coffin bone also are subjects of the inflammatory process. Neither is this all; in some of these cases of peditis acute inflammation of the coffin joint is present, and occasionally suppuration of the joint. A mild form of periostitis, in which the exudation is in the outer layer of the periosteum only, is a more common condition than is recognized generally by practitioners. Intimate contiguity of structures is the predisposing cause, for the disease either spreads from the original seat or the complication occurs as one of the primary results of the exciting cause. In the severer cases in which the exudate separates the periosteum from the bone, suppuration, gangrene, and superficial caries are common results. If infiltration of the bone tissues is rapid the blood supply is cut off by pressure upon the vessels and death of the coffin bone follows. Grave constitutional symptoms mark these changes, which soon prove fatal.
In the mild cases of periostitis it is by no means easy positively to determine its presence, for there are no special symptoms by which it may be distinguished from pure laminitis. In a majority of acute cases, though, which show no signs of improvement by the fifth to seventh day, it is safe to suspect periostitis, particularly if the coronets are very hot, the pulse full and hard, and the lameness acute. In the fortunately rare cases in which the bone is affected with inflammation and suppuration the agony of the patient is intense; he occupies the recumbent position almost continually, never standing for more than a few minutes at a time; suffers from the most careful handling of the affected feet; maintains a rapid pulse and respiration, high temperature, loss of appetite, and great thirst. It is in these cases that the patient continually grows worse, and the appearance of suppuration at the top of the hoof in about two weeks after the inception of the disease proves the inefficiency of any treatment which may have been used and the hopelessness of the case. These patients die usually between the tenth and twentieth days either from exhaustion or pyemic infection.
Gangrene occurs in the periosteum as the result of excessive detachment from the bone and compression due to excessive exudation. Other parts of the sensitive tissues are subject occasionally to the same fate, and at times large areas will be found dead.
Pumiced sole is that condition in which the horny sole in the neighborhood of the toe readily crumbles away and leaves the sensitive tissues more or less exposed. It is not a complication of laminitis only, for it is seen under other conditions. Williams has described the horny tissue of pumiced sole as "weak, cheesy, or spongy, like macerated horn, or even grumous (thick, clotted)." Crumbling horn, when critically examined, shows almost an entire absence of the cohesive matter which unites the healthy fibers, while the fibers themselves are irregular and granular in appearance. Pumiced sole depends upon an impairment of the horn-secreting powers of the sensitive sole or upon a separation of the horny from the soft tissues which maintain its vitality.
Punctured wounds of the foot, accompanied with any considerable destruction of the soft tissues, present the same peculiarities of horn in the immediate neighborhood of the injury. Bruises of the sole are followed by this change when the exudation has been excessive and has separated the horn from the living tissues. True, in these cases we rarely see the soft tissues laid bare, for the reason that new horn is constantly secreted and replaces that undergoing disintegration.
Laminitis presents three conditions under which pumiced sole may appear: First, when free exudation separates the horn from the other tissues, or when the process of inflammation arrests the production of horn by impairing or destroying the horn-secreting membrane; second, when depression of the coffin bone causes pressure upon and arrests the formation of horn; and, third, when the elevation of the sole compresses the soft tissues against the pedal bone and induces the same condition.
Pumiced sole, from simple exudation and separation of tissues, is of little importance for the reason given above in connection with bruises; but when suppuration occurs in restricted portions of the foot in conjunction with laminitis, it always lays bare the tissues beneath and temporarily impairs the animal's value. Recovery takes place after a few weeks by the tissues "horning over," as in injuries attended by the same process. Depression of the coffin bone is not sufficient within itself to cause pumiced sole; for, if the relative change in the bone takes place slowly, or if the horn is thin, the sole becomes convex from gradual pressure and the soft tissues adapt themselves to the change without having their function materially impaired. But when the dropping is sudden and the soft tissues are destroyed, the horn rapidly crumbles away and the toe of the bone comes through. In many of these cases the soft tissues remain uncovered for months. When they are eventually covered it is with a thin, slightly adherent horn that stands but little or no wear. The sole being now convex, the diseased tissues bear unusual weight by coming in contact with the ground, and hence it is that these animals are generally incurable cripples.
In most cases in which the sole is raised to meet the pedal bone and pumiced sole occurs it is due not to pressure of the bone from within (for the tissues are capable of adapting themselves to the gradual change) but to impaired vitality of the sensitive tissues from the inflammation and to the constant concussion and pressure applied from without during progression. To this is to be added the paring away of the horn when applying the shoe, thereby keeping the sole at this point too thin.
Turning up of the toe.--In many cases of laminitis which have become chronic it is found that the toe of the foot turns up; that the heels are longer than natural; while the hoof near the coronary band is circled with ridges like the horn of a ram. Even in cases in which recovery has taken place, and in other diseases than laminitis, these ridges may be found in the wall of the foot. In such cases, however, the ridges are equally distant from one another all around the foot, while in turning up of the toe the ridges are wide apart at the heels and close together in front, as seen in the figure. (Plate XXXVII, fig. 4.) These ridges are produced by periods of interference with the growth of horn alternating with periods during which a normal or nearly normal growth takes place. When the toe turns up it is because the coronary band in front produces horn very slowly, while at the heels it grows much faster, causing marked deformity.
Animals so affected always place the abnormally long heel first upon the ground, not alone because the heel is too long, nor as in acute or subacute laminitis to relieve the pain, but for the reason that the toe is too short and lifted away from its natural position. To bring the toe to the ground the leg knuckles at the fetlock joint.
The pain and impairment of function in these cases always result in marked atrophy of the muscles of the forearm and shoulder, and to some extent of the pectorals, while the position of the fore legs advances the shoulder joints so far forward as to cause a sunken appearance of the breast, which the laity recognize as "chest founder."
The lesions of turning up of the toe are permanent, and are the most interesting pathologically of all the complications of laminitis.
Treatment.--The treatment of laminitis is probably more varied than of any other disease, and yet a large number of cases recover for even the poorest practitioner.
Prevention.--To guard against and prevent disease, or to render an unpreventable attack less serious than it otherwise would be, is the highest practice of the healing art. In a disease so prone to result from the simplest causes, especially when the soundest judgment may not be able to determine the extent of the disease-resisting powers of the tissues which are liable to be affected, or of what shall in every instance constitute an overexcitement, it is not strange that horse owners find themselves in trouble from unintentional transgression. If the disease were dependent upon specific causes, or if the stability of the tissues were of a fixed or more nearly determinate quality, some measures might be instituted that would prove generally preventive; but the predisposing causes are common conditions and often can not be remedied. That which is gentle work in one instance may incite disease in another. That which is feed to-day may to-morrow prove disastrous to health. Finally, necessary medical interference, no matter how judicious, may cause a more serious complaint than that which was being treated. Notwithstanding these difficulties there are some general rules to be observed that will in part serve to prevent the development of an unusual number of cases. First of all the predisposing causes must be removed when possible; when impossible, unusual care must be taken not to bring an exciting cause into operation. Under no circumstances should fat animals have hard work. If the weather is warm or the variation of temperature great, all horses should have but slow, gentle labor until they become inured to it, the tissues hardened, and their excitability reduced to a minimum. Green horses should have moderate work, particularly when taken from the farm and dirt roads to city pavements; for under these circumstances increased concussion, changed hygienic conditions, and artificial living readily become active causes of the disease. Army horses just out of winter quarters, track horses with insufficient preparation, and farmers' horses put to work in the spring are among the most susceptible classes, and must be protected by work that is easy and gradual. If long marches or drives are imperative, the incumbrances must be as light as possible and the journey interspersed with frequent rests, for this allows the laminae to regain their impaired functional activity and to withstand much more work without danger. Furthermore, it permits early detection of an attack, and prevents working after the disease begins, which renders subsequent medication more effective by cutting the process short at the stage of congestion.
All animals when resting immediately after work should be protected from cold air or drafts. If placed in a stable that is warm and without draft, no covering is necessary; under opposite conditions blankets should be used until the excitement and exhaustion of labor have entirely passed away. It is still better that all animals coming in warm from work be "cooled out" by slow walking until the perspiration has dried and the circulation and respiration are again normal. Animals stopped on the road even for a few moments should always be protected from rapid change of temperature by appropriate clothing. If it can be avoided, horses that are working should never be driven or ridden through water. If unavoidable, they should be cooled off before passing through, and then kept moving until completely dried. The same care is to be practiced with washing the legs in cold water when just in from work, for occasionally it proves to be the cause of a most acute attack of this disease. Unusual changes in the manner of applying the shoes should not be hastily made. If a plane shoe has been worn, high heels or toes must not be substituted at once; but the change, if necessary, should gradually be made, so that the different tissues may adapt themselves to the altered conditions. If radical changes are imperative, as is sometimes the case, the work must be so reduced in quantity and quality that it can not excite the disease.
Laminitis from the effects of purgatives can scarcely be guarded against. I can not determine from the cases in which I have seen this result that there are any conditions present that would warn us of danger. The trouble does not seem to depend upon the size of the purgative, the length of time before purgation begins, or the activity and severity with which the remedy acts. Medicines known to have unusually irritating effects on the alimentary canal should be used only when necessity demands it, and then in moderate doses.
Experience alone will determine what animals are liable to suffer from this disease through the use of feeds. When an attack can be ascribed to any particular feed it should be withheld, unless in small quantities. Horses that have never been fed upon Indian corn should receive but a little of it at a time, mixed with bran, oats, or other feed, until it has been determined that no danger exists. Corn is less safe in warm than in cold weather, and for this reason it should always be fed with caution during spring and summer months.
When an animal is excessively lame in one foot the shoe of the opposite member should be removed, and cold water frequently applied to the well foot. At the same time, if the subject remains standing, the slings should be used. Horses should under no circumstances be overworked; to guard against this, previous work, nature of roads, state of weather, and various other influences must be carefully considered. Watering while warm is a pernicious habit, and, unless the animal is accustomed to it, is liable to result in some disorder, ofttimes in laminitis.
Curative measures.--In cases of simple congestion of the laminae the body should be warmly clothed and warm drinks administered. The feet should be placed in a warm bath to increase the return flow of blood. In course of an hour the feet may be changed to cold water and kept there until recovery is completed. If the constitutional symptoms demand it, diuretics should be given. Half-ounce doses of saltpeter three times a day in the water answer the purpose. In cases of active congestion the warm footbaths should be omitted and cold ones used from the commencement. Subacute laminitis demands the same treatment, with laxatives if there is constipation, and the addition of low-heeled shoes. The diuretics may need to be continued for some time and their frequency increased. Regarding acute laminitis, what has been called the "American treatment" is simple and efficient. It consists solely in the administration of large doses of nitrate of potash and the continued application to the feet and ankles of cold water.
Three to four ounces of saltpeter in a pint of water, repeated every six hours, is a proper dose. The laminitis frequently subsides within a week. These large doses may be continued for a week without danger. Under no circumstances have I seen the kidneys irritated to excess or other unfavorable effects produced.
The feet should be kept in a tub of water at a temperature of 45 deg. to 50 deg. F., unless the animal is lying down, when swabs are to be used and wet every half hour with the cold water. The water keeps the horn soft and moist and acts directly upon the inflamed tissues by reducing the temperature. Cold maintains the vitality and disease-resisting qualities of the soft tissues, tones up the coats of the blood vessels, diminishes the supply of blood, and limits the exudation. Furthermore, it has an anesthetic effect upon the diseased tissues and relieves the pain.
Aconite may be given in conjunction with the niter when the heart is greatly excited and beats strongly. Ten-drop doses, repeated every 2 hours for 24 hours, are sufficient. The use of cathartics is dangerous, for they may excite superpurgation. Usually the niter will relieve the constipation; yet if it should prove obstinate, laxatives may be carefully given. Bleeding, both general and local, should be guarded against. The shoes must be early removed and the soles left unpared.
Paring of the soles presents two objections: First, while it may temporarily relieve the pain by relieving pressure, it favors greater exudation, which may more than counterbalance the good effects. Secondly, it makes the feet tender and subject to bruises when the animal again goes to work. The shoes should be replaced when convalescence sets in and the animal is ready to take exercise. Exercise should never be enforced until the inflammation has subsided; for although it temporarily relieves the pain and soreness it maintains the irritation, increases the exudation, and postpones recovery.
If at the end of the fifth or sixth day prominent symptoms of recovery are not apparent, apply a stiff blister of cantharides around the coronet and omit the niter for about 48 hours. When the blister is well set, the feet may again receive wet swabs. If one blister does not remove the soreness it may be repeated, or the actual cautery applied. The same treatment should be adopted where sidebones form or inflammation of the coronet bone follows. When the sole breaks through, exposing the soft tissues, the feet must be carefully shod with thin heels and thick toes if there is a tendency to walk on the heels, and the sole must be well protected with appropriate dressings and pressure over the exposed parts. When there is turning up of the toe, blistering of the coronet, in front only, sometimes stimulates the growth of horn, but as a rule judicious shoeing is the only treatment that will enable the animal to do light, slow work.
When suppuration of the laminae is profuse, it is better to destroy your patient at once and relieve his suffering: but if the suppuration is limited to a small extent of tissue, especially of the sole, treatment, as in acute cases, may induce recovery and should always be tried. If from bed sores or other causes septicemia or pyemia is feared, the bisulphite of soda, in half-ounce doses, may be given in conjunction with tonics and such other treatment as is indicated in these diseases.
As to enforced recumbency I doubt the propriety of insisting on it in the majority of cases, for I think the patient usually assumes whatever position gives most comfort. No doubt recumbency diminishes the amount of blood sent to the feet, and may greatly relieve the pain, so that forcing the patient to lie down may be tried, yet should not be renewed if he thereafter persists in standing.
When the animal persistently stands, or constant lying indicates it (to prevent extensive sores), the patient should be placed in slings. When all four feet are affected it may be impossible to use slings, for the reason that the patient refuses to support any of his weight and simply hangs in them. Lastly, convalescent cases must not be returned to work too early, else permanent recovery may never be effected.
DISEASES OF THE SKIN.
By JAMES LAW, F. R. C. V. S.,
Formerly Professor of Veterinary Science, etc., Cornell University.
As we find them described in systematic works, the diseases of the skin are very numerous and complex, which may be largely accounted for by the fact that the cutaneous covering is exposed to view at all points, so that shades of difference in inflammatory and other diseased processes are easily seen and distinguished from one another. In the horse the hairy covering serves to some extent to mask the symptoms, and hence the nonprofessional man is tempted to apply the term "mange" to all alike, and it is only a step further to apply the same treatment to all these widely different disorders. Yet even in the hairy quadruped the distinction can be made in a way which can not be done in disorders of that counterpart and prolongation of the skin--the mucous membrane, which lines the air passages, the digestive organs, the urinary and generative apparatus. Diseased processes, therefore, which in these organs it might be difficult or impossible to distinguish from one another, can usually be separated and recognized when appearing in the skin.
Nor is this differentiation unimportant. The cutaneous covering presents such an extensive surface for the secretion of cuticular scales, hairs, horn, sebaceous matter, sweat, and other excretory matters, that any extensive disorder in its functions may lead to serious internal disease and death. Again, the intimate nervous sympathy of different points of the skin with particular internal organs renders certain skin disorders causative of internal disease and certain internal diseases causative of affections of the skin. The mere painting of the skin with an impermeable coating of glue is speedily fatal; a cold draft striking on the chest causes inflammation of the lungs or pleura; a skin eruption speedily follows certain disorders of the stomach, the liver, the kidneys, or even the lungs; simple burns of the skin cause inflammations of internal organs, and inflammation of such organs cause in their turn eruptions on the skin. The relations--nervous, secretory, and absorptive--between the skin and internal organs are most extensive and varied, and therefore a visible disorder in the skin may point at once and specifically to a particular fault in diet, to an injudicious use of cold water when the system is heated, to a fault in drainage, ventilation, or lighting of the stables, to indigestion, to liver disease, to urinary disorder, etc.
STRUCTURE OF THE SKIN.
The skin consists primarily of two parts: (1) The superficial nonvascular (without blood vessels) layer, the cuticle, or epidermis; and (2) the deep vascular (with blood vessels) layer, the corium, dermis, or true skin. (See Pl. XXXVIII, fig. 1.)
The cuticle is made up of cells placed side by side and more or less modified in shape by their mutual compression and by surface evaporation and drying. The superficial stratum consists of the cells dried in the form of scales, which fall off continually and form dandruff. The deep stratum (the mucous layer) is formed of somewhat rounded cells with large central nuclei, and in colored skin containing numerous pigment granules. These cells have prolongations, or branches, by which they communicate with one another and with the superficial layer of cells in the true skin beneath. Through these prolongations they receive nutrient liquids for their growth and increase, and pass on liquids absorbed by the skin into the vessels of the true skin beneath. The living matter in the cells exercises an equally selective power on what they shall take up for their own nourishment and on what they shall admit into the circulation from without. Thus, certain agents, like iodin and belladonna, are readily admitted, whereas others, like arsenic, are excluded by the sound, unbroken epidermis. Between the deep and superficial layers of the epidermis there is a thin, translucent layer (septum lucidum) consisting of a double stratum of cells, and forming a medium of transition from the deep spheroidal to the superficial scaly cuticle.
The true skin, or dermis, has a framework of interlacing bundles of white and yellow fibers, large and coarse in the deeper layers, and fine in the superficial, where they approach the cuticle. Between the fibrous bundles are left interspaces which, like the bundles, become finer as they approach the surface, and inclose cells, vessels, nerves, glands, gland ducts, hairs, and in the deeper layers fat.
The superficial layer of the dermis is formed into a series of minute, conical elevations, or papillae, projecting into the deep portion of the cuticle, from which they are separated by a very fine transparent membrane. This papillary layer is very richly supplied with capillary blood vessels and nerves, and is at once the seat of acute sensation and the point from which the nutrient liquid is supplied to the cells of the cuticle above. It is also at this point that the active changes of inflammation are especially concentrated; it is the immediately superposed cell layers (mucous) that become morbidly increased in the earlier stages of inflammation; it is on the surface of the papillary layer that the liquid is thrown out which raises the cuticle in the form of a blister, and it is at this point mainly that pus forms in the ordinary pustule.
The fibrous bundles of the true skin contain plain, muscular fibers, which are not controlled by the will, but contract under the influence of cold and under certain nervous influences, as in some skin diseases and in the chill of a fever, and lead to contraction, tightening, or corrugation of the skin, contributing to produce the "hidebound" of the horseman. Other minute, muscular filaments are extended from the surface of the dermis to the hair follicle on the side to which the hair is inclined, and under the same stimulating influences produce that erection of the hair which is familiarly known as "staring coat." Besides these, the horse's skin is furnished with an expansion of red, voluntary muscle, firmly attached to the fibrous bundles, and by which the animal can not only dislodge insects and other irritants, but even shake off the harness. This fleshy envelope covers the sides of the trunk and the lower portions of the neck and head, the parts unprotected by the mane and tail, and serves to throw the skin of these parts into puckers, or ridges, in certain irritating skin diseases.
The hairs are cuticular products growing from an enlarged papilla lodged in the depth of a follicle or sac, hollowed out in the skin and extending to its deepest layers. The hair follicle is lined by cells of epidermis, which at the bottom are reflected on the papilla and become the root of the hair. The hair itself is formed of the same kind of cells firmly adherent to one another by a tough, intercellular substance, and overlapping each other, like slates on a roof, in a direction toward the free end.
The sebaceous glands are branching tubes ending in follicles or sacs and opening into the hair follicles, lined by a very vascular fibrous network representing the dermis, and an internal layer of cells representing the mucous layer of the cuticle. The oily secretion gives gloss to the hair and prevents its becoming dry and brittle, and keeps the skin soft and supple, protecting it at once against undue exhalation of water and undue absorption when immersed in that medium. Besides those connected with the hair follicles there are numerous, isolated, sebaceous glands, opening directly on the surface of the skin, producing a somewhat thicker and more odorous secretion. They are found in large numbers in the folds of the skin, where chafing would be liable if the surface were dry, as on the sheath, scrotum, mammary glands, and inner side of the thigh, around the anus and vulva, in the hollow of the heel, beneath the fine horn of the frog, on the inner side of the elbow, on the lips, nostrils, and eyelids. When closed by dried secretion or otherwise these glands may become distended so as to form various-sized swellings on the skin, and when inflamed they may throw out offensive, liquid discharges, as in "grease," or produce red, tender fungous growths ("grapes.")
The sweat glands of the horse, like those of man, are composed of simple tubes, which extend down through the cuticle and dermis in a spiral manner, and are coiled into balls in the deeper layer of the true skin. In addition to their importance in throwing offensive waste products out of the system, these glands tend to cool the skin and the entire economy of the animal through the evaporation of their watery secretion. Their activity is therefore a matter of no small moment, as besides regulating the animal heat and excreting impurities, they influence largely the internal organs through the intimate sympathy maintained between them and the skin.
Diseases of the skin may be conveniently divided, according to their most marked features, into--
(1) Those in which congestion and inflammation are the most marked features, varying according to the grade or form into (a) congestion with simple redness, dryness, and heat, but no eruption (erythema); (b) inflammation with red-pointed elevations, but no blisters (papules); (c) inflammation with fine, conical elevations, each surmounted by a minute blister (vesicle); (d) inflammation with a similar eruption but with larger blisters, like half a pea and upwards (bullae); (e) inflammation with a similar eruption, but with a small sac of white, creamy pus on the summit of each elevation (pustules); (f) the formation of pustules implicating the superficial layer of the true skin, a small portion of which dies and is thrown off as a slough, or "core" (boils); (g) the formation of round, nodular, transient swellings in the true skin (tubercles); and (h) the excessive production of scales, or dandruff (scaly or squamous affections).
(2) Diseases in which there are only deranged sensations of itching, heat, tenderness, etc. (neurosis).
(3) Diseased growths, such as warts, callosities, horny growths, cancer, etc.
(4) Diseases from parasites, animal and vegetable.
(5) Diseases connected with a specific poison, such as horsepox, erysipelas, anthrax, farcy, or cutaneous glanders, etc.
(6) Physical injuries, like wounds, burns, scalds, etc.
CONGESTION (RED EFFLORESCENCE, OR ERYTHEMA).
This is a congested or slightly inflamed condition of the skin, unattended with any eruption. The part is slightly swollen, hot, tender, or itchy, and dry, and if the skin is white there is redness. The redness is effaced by pressure, but reappears instantly when it is removed. Except in transient cases the hairs are liable to be shed. It may be looked on as the first stage of inflammation, and therefore when it becomes aggravated it may merge in part or in whole into a papular, vesicular, or pustular eruption.
Erythema may arise from a variety of causes, and is often named in accordance with its most prominent cause. Thus the chilling, or partial freezing, of a part will give rise to a severe reaction and congestion. When snowy or icy streets have been salted this may extend to severe inflammation, with vesicles, pustules, or even sloughs of circumscribed portions of the skin of the pastern (chilblain, frost-bite). Heat and burning have a similar effect, and this often comes from exposure to the direct rays of the sun. The skin that does not perspire is the most subject, and hence the white face or white limb of a horse becoming dried by the intensity of the sun's rays often suffers to the exclusion of the rest of the body (white face and foot disease). The febrile state of the general system is also a potent cause; hence the white-skinned horse is rendered the more liable if kept on a heating ration of buckwheat, or even of wheat or maize. Contact of the skin with oil of turpentine or other essential oils, with irritant liquids, vegetable or mineral, with rancid fats, with the acrid secretions of certain animals, like the irritating toad, with pus, sweat, tears, urine, or liquid feces, will produce congestion or even inflammation. Chafing is a common cause, and is especially liable to affect the fat horse between the thighs, by the side of the sheath or scrotum, on the inner side of the elbow, or where the harness chafes on the poll, shoulder, back, breastbone, and under the tail. The accumulation of sweat and dust between the folds of the skin and on the surface of the harness, and the specially acrid character of the sweat in certain horses, contribute to chafing or "intertrigo." The heels often become congested owing to the irritation caused by the short, bristly hairs in clipped heels. Again, congestion may occur from friction by halter, harness, or other foreign body under the pastern, or inside the thigh or arm, or by reason of blows from another foot (cutting, interfering, overreach). Finally, erythema is especially liable to occur in spring, when the coat is being shed, and the hair follicles and general surface are exposed and irritable in connection with the dropping of the hairs.
If due only to a local irritant, congestion will usually disappear when the cause has been removed, but when the feeding or system is at fault these conditions must be first corrected. While the coat is being shed the susceptibility will continue, and the aim should be to prevent the disease from developing and advancing so as to weaken the skin, render the susceptibility permanent, and lay the foundation of persistent or frequently recurring skin disease. Therefore at such times the diet should be nonstimulating, any excess of grain, and above all of buckwheat, Indian corn, or wheat, being avoided. A large grain ration should not be given at once on return from hard work, when the general system and stomach are unable to cope with it; the animal should not be given more than a swallow or two of cold water when perspiring and fatigued, nor should he be allowed a full supply of water just after his grain ration; he should not be overheated or exhausted by work, nor should dried sweat and dust be allowed to accumulate on the skin or on the harness pressing on it. The exposure of the affected heels to damp, mud, and snow, and, above all, to melting snow, should be guarded against; light, smooth, well-fitting harness must be obtained, and where the saddle or collar irritates an incision should be made in them above and below the part that chafes, and, the padding between having been removed, the lining should be beaten so as to make a hollow. A zinc shield in the upper angle of the collar will often prevent chafing in front of the withers.
Treatment.--Wash the chafed skin and apply salt water (one-half ounce to the quart), extract of witch-hazel, a weak solution of oak bark, or camphorated spirit. If the surface is raw use bland powders, such as oxid of zinc, lycopodium, starch, or smear the surface with vaseline, or with 1 ounce of vaseline intimately mixed with one-half dram each of opium and sugar of lead. In cases of chafing rest must be strictly enjoined. If there is constitutional disorder or acrid sweat, 1 ounce cream of tartar or a teaspoon of bicarbonate of soda may be given twice daily.
CONGESTION, WITH SMALL PIMPLES, OR PAPULES.
In this affection there is the general blush, heat, etc., of erythema, together with a crop of elevations from the size of a poppy seed to a coffee bean, visible when the hair is reversed or to be felt with the finger where the hair is scanty. In white skins they vary from the palest to the darkest red. All do not retain the papular type, but some go on to form blisters (eczema, bullae) or pustules, or dry up into scales, or break out into open sores, or extend into larger swellings (tubercles). The majority, however, remaining as pimples, characterize the disease. When very itchy the rubbing breaks them open, and the resulting sores and scales hide the true nature of the eruption.
The general and local causes may be the same as for erythema, and in the same subject one portion of the skin may have simple congestion and another adjacent papules. As the inflammatory action is more pronounced, so the irritation and itching are usually greater, the animal rubbing and biting himself severely. This itching is especially severe in the forms which attack the roots of the mane and tail, and there the disease is often so persistent and troublesome that the horse is rendered virtually useless.
The bites of insects often produce a papular eruption, but in many such cases the swelling extends wider into a buttonlike elevation, one-half to an inch in diameter. The same remarks apply to the effects of the poison ivy and poison sumac.
Treatment.--In papular eruption first remove the cause, then apply the same general remedies as for simple congestion. In the more inveterate cases use a lotion of one-half ounce sulphid of potassium in 2 quarts of water, to which a little Castile soap has been added, or use a wash with one-half ounce oil of tar, 2 ounces Castile soap, and 20 ounces water.
INFLAMMATION WITH BLISTERS, OR ECZEMA.
In this the skin is congested, thickened, warm (white skins are reddened), and shows a thick crop of little blisters formed by effusions of a straw-colored fluid between the true skin and the cuticle. The blisters may be of any size from a millet seed to a pea, and often crack open and allow the escape of the fluid, which concretes as a slightly yellowish scab or crust around the roots of the hairs. This exudation and the incrustation are especially common where the hairs are long, thick, and numerous, as in the region of the pastern of heavy draft horses. The term eczema is now applied very generally to eruptions of all kinds that depend on internal disorders or constitutional conditions and that tend to recurrences and inveteracy. Eczema may appear on any part of the body, but in horses it is especially common on the heels and the lower parts of the limbs, and less frequently on the neck, shoulder, and abdomen. The limbs appear to be especially liable because of their dependent position, all blood having to return from them against the action of gravity and congestions and swellings being common, because of the abundance of blood vessels in this part of the skin and because of the frequent contact with the irritant dung and urine and their ammoniacal emanations. The legs further suffer from contact with wet and mud when at work, from snow and ice, from drafts of cold air on the wet limbs, from washing with caustic soaps, or from the relaxing effects of a too deep and abundant litter. Among other causes may be named indigestion and the presence of irritant matters in the blood and sweat, the result of patent medicated feeds and condition powders (aromatics, stimulants), green food, new hay, new oats, buckwheat, wheat, maize, diseased potatoes, smut, or ergot in grains, decomposing green feed, brewers' grains, or kitchen garbage. The excitement in the skin, caused by shedding the coat, lack of grooming, hot weather, hot, boiled, or steamed feed conduces to the eruption. Lastly, any sudden change of feed may induce it.
The blisters may in part go on to suppuration so that vesicles and pustules often appear on the same patch, and, when raw from rubbing, the true nature of the eruption may be completely masked. In well-fed horses, kept in close stables with little work, eczema of the limbs may last for months and years. It is a very troublesome affection in draft stallions.
Treatment.--This disease is so often the result of indigestion that a laxative of 1 pound Glauber's salt in 3 or 4 quarts water or 1-1/2 pints olive oil is often demanded to clear away irritants from the alimentary canal. Following this, in recent and acute cases, give 2 drams of acetate or bicarbonate of potash twice a day in the drinking water. If the bowels still become costive, give daily 1 ounce sulphate of soda and 20 grains of powdered nux vomica. In debilitated horses combine the nux vomica with one-half ounce powdered gentian root. As a wash for the skin use 1 dram bicarbonate of soda and 1 dram carbolic acid in a quart of water, after having cleansed the surface with tepid water. Employ the same precautions as regards feeding, stabling, and care of harness as in simple congestion of the skin.
In the more inveterate forms of eczema more active treatment is required. Soak the scabs in fresh sweet oil, and in a few hours remove these with tepid water and Castile soap; then apply an ointment of sulphur or iodid of sulphur day by day. If this seems to be losing its effect after a week, change for mercurial ointment or a solution of sulphid of potassium, or of hyposulphite of soda, 3 drams to the quart of water. In these cases the animal may take a course of sulphur (1 ounce daily), bisulphite of soda (one-half ounce daily), or of arsenic (5 grains daily) mixed with 1 dram bicarbonate of soda.
INFLAMMATION WITH PUSTULES.
In this affection the individual elevations on the inflamed skin show in the center a small sac of white, creamy pus, in place of the clear liquid of a blister. They vary in size from a millet seed to a hazelnut. The pustules of glanders (farcy buds) are to be distinguished by the watery contents and the cordlike swelling, extending from the pustules along the line of the veins, and those of boils by the inflammation and sloughing out of a core of the true skin. The hair on the pustule stands erect, and is often shed with the scab which results. When itching is severe the parts become excoriated by rubbing, and, as in the other forms of skin disease, the character of the eruption may become indistinct. Old horses suffer mainly at the root of the mane and tail and about the heels, and suckling foals around the mouth, on the face, inside the thighs, and under the tail.
Pustules, like eczema, are especially liable to result from unwholesome feed and indigestion, from a sudden change of feed--above all, from dry to green. In foals it may result from overheating of the mare and allowing the first milk after she returns, or by milk rendered unwholesome by faulty feeding of the dam. If a foal is brought up by hand the souring and other decompositions in the milk derange the digestion and cause such eruption. Vetches and other plants affected with honeydew and buckwheat have been the cause of these eruptions on white portions of the skin. Disorders of the kidneys or liver are common causes of this affection.
Treatment.--Apply soothing ointments, such as benzonated oxid of zinc, or vaseline with 1 dram oxid of zinc in each ounce. Or a wash of 1 dram sugar of lead or 2 drams hyposulphite of soda in a quart of water may be freely applied. If the skin is already abraded and scabby, smear thickly with vaseline for some hours, then wash with soapsuds and apply the above dressings. When the excoriations are indolent they may be painted with a solution of lunar caustic 2 grains to 1 ounce of distilled water. Internally counteract costiveness and remove intestinal irritants by the same means as in eczema, and follow this with one-half ounce doses daily of hyposulphite of soda, and one-half ounce doses of gentian. Inveterate cases may often be benefited by a course of sulphur, bisulphite of soda, or arsenic. In all, the greatest care must be taken with regard to feed, feeding, watering, cleanliness, and work. In wet and cold seasons predisposed animals should, so far as possible, be protected from wet, mud, snow, and melted snow--above all, from that which has been melted by salt.
BOILS, OR FURUNCLES.
These may appear on any part of the skin, but are especially common on the lower parts of the limbs, and on the shoulders and back where the skin is irritated by accumulated secretion and chafing with the harness. In other cases the cause is constitutional, or attended with unwholesome diet and overwork with loss of general health and condition. They also follow on weakening diseases, notably strangles, in which irritants are retained in the system from overproduction of poisons and effete matter during fever, and imperfect elimination. There is also the presence of a pyogenic bacterium, by which the disease may be maintained and propagated.
While boils are pus producing, they differ from simple pustule in affecting the deepest layers of the true skin, and even the superficial layers of the connective tissues beneath, and in the death and sloughing out of the central part of the inflamed mass (core). The depth of the hard, indurated, painful swelling, and the formation of this central mass or core, which is bathed in pus and slowly separated from surrounding parts, serve to distinguish the boil alike from the pustule, from the farcy bud, and from a superficial abscess.
Treatment.--To treat very painful boils a free incision with a lancet in two directions, followed by a dressing with one-half an ounce carbolic acid in a pint of water, bound on with cotton wool or lint, may cut them short. The more common course is to apply a warm poultice of linseed meal or wheat bran, and renew daily until the center of the boil softens, when it should be lanced and the core pressed out.
If the boil is smeared with a blistering ointment of Spanish flies and a poultice put over it, the formation of matter and separation of the core is often hastened. A mixture of sugar and soap laid on the boil is equally good. Cleanliness of the skin and the avoidance of all causes of irritation are important items, and a teaspoonful of bicarbonate of soda once or twice a day will sometimes assist in warding off a new crop.
NETTLERASH (SURFEIT, OR URTICARIA).
This is an eruption in the form of cutaneous nodules, in size from a hazelnut to a hickory nut, transient, with little disposition to the formation of either blister or pustule, and usually connected with shedding of the coat, sudden changes of weather, and unwholesomeness or sudden change in the feed. It is most frequent in the spring and in young and vigorous animals (good feeders). The swelling embraces the entire thickness of the skin and terminates by an abrupt margin in place of shading off into surrounding parts. When the individual swellings run together there are formed extensive patches of thickened integument. These may appear on any part of the body, and may be general; the eyelids may be closed, the lips rendered immovable, or the nostrils so thickened that breathing becomes difficult and snuffling. It may be attended with constipation or diarrhea or by colicky pains. The eruption is sudden, the whole skin being sometimes covered in a few hours, and it may disappear with equal rapidity or persist for six or eight days.
Treatment.--This consists in clearing out the bowels by 5 drams Barbados aloes, or 1 pound Glauber's salt, and follow the operation of these by daily doses of one-half ounce powdered gentian and 1 ounce Glauber's salt. A weak solution of alum may be applied to the swellings.
PITYRIASIS, OR SCALY SKIN DISEASE.
This affection is characterized by an excessive production and detachment of dry scales from the surface of the skin (dandruff). It is usually dependent on some fault in digestion and an imperfect secretion from the sebaceous glands and is most common in old horses with spare habit of body. Williams attributes it to feed rich in saccharine matter (carrots, turnips) and to the excretion of oxalic acid by the skin. He has found it in horses irregularly worked and well fed and advises the administration of pitch for a length of time and the avoidance of saccharine feed. Otherwise the horse may take a laxative followed by dram doses of carbonate of potash, and the affected parts may be bathed with soft, tepid water and smeared with an ointment made with vaseline and sulphur. In obstinate cases sulphur may be given daily in the feed.
PRURITUS, OR NERVOUS IRRITATION OF THE SKIN.
This is seen in horses fed to excess on grain and hay, kept in close stables, and worked irregularly. Though most common in summer, it is often severe in hot, close stables in winter. Pimples, vesicles, and abrasions may result, but as the itching is quite as severe on other parts of the skin, these may be the result of scratching merely. It is especially common and inveterate about the roots of the mane and tail.
Treatment consists in a purgative (Glauber's salt, 1 pound), restricted, laxative diet, and a wash of water slightly soured with oil of vitriol and rendered sweet by carbolic acid. If obstinate, give daily 1 ounce of sulphur and 20 grains nux vomica. If the acid lotion fails, 2 drams carbonate of potash and 2 grains of cyanid of potassium in a quart of water will sometimes benefit. If from pinworms in the rectum, the itching of the tail may be remedied by an occasional injection of a quart of water in which chips of quassia wood have been steeped for 12 hours.
HERPES.
This name has been applied to a disease in which there is an eruption of minute vesicles in circular groups or clusters, with little tendency to burst, but rather to dry up into fine scabs. If the vesicles break, they exude a slight, gummy discharge which concretes into a small, hard scab. It is apparently noncontagious and not appreciably connected with any disorder of internal organs. It sometimes accompanies or follows specific fevers, and is, on the whole, most frequent at the seasons of changing the coat--spring and autumn. It is seen on the lips and pastern, but may appear on any part of the body. The duration of the eruption is two weeks or even more, the tendency being to spontaneous recovery. The affected part is very irritable, causing a sensitiveness and a disposition to rub out of proportion to the extent of the eruption.
Treatment.--It may be treated by oxid of zinc ointment, and to relieve the irritation a solution of opium or belladonna in water, or of sugar of lead or oil of peppermint. A course of bitters (one-half an ounce of Peruvian bark daily for a week) may be serviceable in bracing the system and producing an indisposition to the eruption.
BLEEDING SKIN ERUPTIONS, OR DERMATORRHAGIA PARASITICA.
In China, Hungary, Spain, and other countries horses frequently suffer from the presence of a threadworm (Filaria haemorrhagica Railliet, F. multipapillosa Condamine and Drouilly) in the subcutaneous connective tissue, causing effusions of blood under the scurf skin and incrustations of dried blood on the surface. The eruptions, which appear mainly on the sides of the trunk, but may cover any part of the body, are rounded elevations about the size of a small pea, containing blood which bursts through the scurf skin and concretes like a reddish scab around the erect, rigid hairs. These swellings appear in groups, which remain out for several days, gradually diminishing in size; new groups appear after an interval of three or four weeks, the manifestation being confined to three or four months of spring and disappearing in winter. A horse will suffer for several years in succession and then permanently recover. A fatal issue is not unknown. To find the worm the hair is shaved from the part where the elevations are felt, and as soon as a bleeding point is shown the superficial layer is laid open with the knife, when the parasite will be seen drawing itself back into the parts beneath. The worm is about 2 inches long and like a stout thread, thicker toward the head than toward the tail, and with numerous little conical elevations (papillae) around the head. The young worms are numerous in the body of the adult female worm. The worm has become common in given localities, and probably enters the system with feed or water.
Treatment is not satisfactory, but the affected surface should be kept clean by sponging, and the pressure of harness on any affected part must be avoided. Thus rest may become essential. The part may be frequently washed with a strong solution of potassium sulphid.
SUMMER SORES FROM FILARIA IRRITANS.
The summer sores of horses (dermatitis granulosa, boils) have been traced to the presence in the skin of another parasite, 3 millimeters in length and extremely attenuated (Filaria irritans Railliet). The sores may be seen as small as a millet seed, but more frequently the size of a pea, and may become an inch in diameter. They may appear on any point, but are especially obnoxious where the harness presses or on the lower parts of the limbs. They cause intense and insupportable itching, and the victim rubs and bites the part until extensive raw surfaces are produced. Aside from such friction the sore is covered by a brownish-red, soft, pulpy material with cracks or furrows filled with serous pus. In the midst of the softened mass are small, firm, rounded granulations, fibrinous, and even caseated, and when the soft, pultaceous material has been scraped off, the surface bears a resemblance to the fine, yellow points of miliary tuberculosis in the lung. The worm or its debris is found in the center of such masses. These sores are very obstinate, resisting treatment for months in summer, and even after apparent recovery during the cold season they may appear anew the following summer. In bad cases the rubbing and biting may cause exposure of synovial sacs and tendons, and cause irremediable injury. Even in winter, however, when the diseased process seems arrested, there remain the hard, firm, resistant patches of the skin with points in which the diseased product has become softened like cheese.
The apparent subsidence of the disease in winter is attributed to the coldness and comparative bloodlessness of the skin, whereas in summer, with high temperature, active circulation, and rapid cell growth, inflammation is increased, itching follows, and from the animal rubbing the part the irritation is persistently increased. The hotter the climate the more troublesome the disease.[4]
Treatment consists, first, in placing the animal in a cool place and showering the surface with cold water. The parasite may be destroyed by rubbing the surface of the wound with iodoform and covering it with a layer of collodion, and repeating the applications very 24 hours for 15 days, or until the sores heal up. Ether or chloroform, poured on cotton wool and applied to the sore for two minutes before painting it with collodion, may be used in place of iodoform.[5]
CRACKED HEELS (SCRATCHES, OR CHAPS ON KNEE AND HOCK).
This usually sets in with swelling, heat, and tenderness of the hollow of the heel, with erections of the hairs and redness (in white skins), with stiffness and lameness, which may be extreme in irritable horses. Soon slight cracks appear transversely, and may gain in depth and width, and may even suppurate. More frequently they become covered at the edges or throughout by firm incrustations resulting from the drying of the liquids thrown out, and the skin becomes increasingly thick and rigid. A similar condition occurs behind the knee and in front of the hock (malanders and salanders), and may extend from these points to the hoof, virtually incasing that side of the limb in a permanent incrusting sheath.
Causes.--Besides a heavy lymphatic constitution, which predisposes to this affection, the causes are overfeeding on grain, unwholesome fodder, close, hot, dirty stables, constant contact with dung and urine and their emanations, working in deep, irritant mud; above all, in limestone districts, irritation by dry limestones or sandy dust in dry weather on dirt roads; also cold drafts, snow, and freezing mud, washing the legs with caustic soap, wrapping the wet legs in thick woolen bandages which soak the skin and render it sensitive when exposed next day, clipping the heels, weak heart and circulation, natural or supervening on overwork, imperfect nourishment, impure air, lack of sunshine, chronic exhausting, or debilitating diseases, or functional or structural diseases of the heart, liver, or kidneys. These last induce dropsical swelling of the limbs (stocking), weaken the parts, and induce cracking. Finally the cicatrix of a preexisting crack, weak, rigid, and unyielding, is liable to reopen under any severe exertion; hence rapid paces and heavy draft are active causes.
Treatment.--In treatment the first step is to ascertain and remove the cause whenever possible. If there is much local heat and inflammation, a laxative (5 drams aloes or 1 pound Glauber's salt) may be given, and for the pampered animal the grain should be reduced or replaced altogether by bran mashes, flaxseed, and other laxative, nonstimulating feed. In the debilitated, on the other hand, nutritious food and bitter tonics may be given, and even a course of arsenic (5 grains arsenic with 1 dram bicarbonate of soda daily). When the legs swell, exercise on dry roads, hand rubbing, and evenly applied bandages are good, and mild astringents, like extract of witch-hazel, may be applied and the part subsequently rubbed dry and bandaged. If there is much heat but unbroken skin, a lotion of 2 drams sugar of lead to 1 quart of water may be applied on a thin bandage, covered in cold weather with a dry one. The same may be used after the cracks appear, or a solution of sulphurous acid 1 part, glycerin 1 part, and water 1 part, applied on cotton and well covered by a bandage. In case these should prove unsuitable to the particular case, the part may be smeared with vaseline 1 ounce, sugar of lead 1 dram, and carbolic acid 10 drops.
INFLAMMATION OF THE HEELS WITH SEBACEOUS SECRETION (GREASE, OR CANKER).
This is a specific affection of the heels of horses usually associated with the growth of a parasitic fungus, an offensive discharge from the numerous sebaceous glands, and, in bad cases, the formation of red, raw excrescences (grapes) from the surface. It is to be distinguished (1) from simple inflammation in which the special fetid discharge and the tendency to the formation of "grapes" are absent; (2) from horsepox, in which the abundant exudate forms a firm, yellow incrustation around the roots of the hair, and is embedded at intervals in the pits formed by the individual pocks, and in which there is no vascular excrescence; (3) from foot scabies (mange), in which the presence of an acarus is distinctive; (4) from lymphangitis, in which the swelling appears suddenly, extending around the entire limb as high as the hock, and on the inner side of the thigh along the line of the vein to the groin, and in which there is active fever, and (5) from erysipelas, in which there is active fever (wanting in grease), the implication of the deeper layers of the skin and of the parts beneath giving a boggy feeling to the parts, the absence of the fetid, greasy discharge, and finally a tendency to form pus loosely in the tissues without any limiting membrane, as in abscess. Another distinctive feature of grease is its tendency to implicate the skin which secretes the bulbs or heels of the horny frog and in the cleft of the frog, constituting the disease known as canker.
Causes.--The predisposing causes of grease are essentially the same as those of simple inflammation of the heel, so that the reader may consult the preceding section. Though a specific fungus and bacteria of different kinds are present, they tend mainly to aggravation of the disease, and are not proved to be essential factors in causation.
Symptoms.--The symptoms vary according to whether the disease comes on suddenly or more tardily. In the first case there is a sudden swelling of the skin in the heel, with heat, tenderness, itching, and stiffness, which is lessened during exercise. In the slower forms there is seen only a slight swelling after rest, and with little heat or inflammation for a week or more. Even at this early stage, a slight, serous oozing may be detected. As the swelling increases, extending up toward the hock or knees, the hairs stand erect, and are bedewed by moisture no longer clear and odorless, but grayish, milky, and fetid. The fetor of the discharge draws attention to the part whenever one enters the stable, and the swollen pastern and wet, matted hairs on the heel draw attention to the seat of the malady. If actively treated, the disease may not advance further, but if neglected the tense, tender skin cracks open, leaving open sores from which vascular bleeding growths grow up, constituting the "grapes." The hair is shed, and the heel may appear but as one mass of rounded, red, angry excrescences which bleed on handling and are covered with the now repulsively fetid, decomposing discharge. During this time there is little or no fever, the animal feeds well, and but for its local trouble it might continue at work. When the malady extends to the frog, there is a fetid discharge from its cleft or from the depressions at its sides, and this gradually extends to its whole surface and upon the adjacent parts of the sole. The horn meanwhile becomes soft, whitish, and fleshy in aspect, its constituent tubes being greatly enlarged and losing their natural cohesion; it grows rapidly above the level of the surrounding horn, and when pared is found to be penetrated to an unusual depth by the secreting papillae, and that at intervals these have bulged out into a vascular fungous mass comparable to the "grapes."
Treatment.--In treatment hygienic measures occupy a front rank, but are in themselves insufficient to establish a cure. All local and general conditions which favor the production and persistence of the disease must be guarded against. Above all, cleanliness and purity of the stable and air must be obtained; also nourishing diet, regular exercise, and the avoidance of local irritants--septic, muddy, chilling, etc. At the outset benzoated oxid of zinc ointment may be used with advantage. A still better dressing is made with 1 ounce vaseline, 2 drams oxid of zinc, and 20 drops iodized phenol. If the surface is much swollen and tender, a flaxseed poultice may be applied, over the surface of which has been poured some of the following lotion: Sugar of lead, one-half ounce; carbolic acid, 1 dram; water, 1 quart. All the astringents of the pharmacopoeia have been employed with more or less advantage, and some particular one seems to suit particular cases or patients. To destroy the grapes, they may be rubbed daily with strong caustics (copperas, bluestone, lunar caustic), or each may be tied round its neck with a stout, waxed thread, or, finally and more speedily, they may be cut off by a black-smith's shovel heated to redness and applied with its sharp edge toward the neck of the excrescence, over a cold shovel held between it and the skin to protect the skin from the heat. The cold shovel must be kept cool by frequent dipping in water. After the removal of the grapes the astringent dressing must be persistently applied to the surface. When the frog is affected, it must be pared to the quick and dressed with dry caustic powders (quicklime, copperas, bluestone) or carbolic acid and subjected to pressure, the dressing being renewed every day at least.
ERYSIPELAS.
This is a specific contagious disease, characterized by spreading, dropsical inflammation of the skin and subcutaneous tissues, attended with general fever. It differs from most specific diseases in the absence of a definite period of incubation, a regular course and duration, and a conferring of immunity on the subject after recovery. On the contrary, one attack of erysipelas predisposes to another, partly, doubtless, by the loss of tone and vitality in the affected tissues, but also, perhaps, because of the survival of the infecting germ.
Cause.--It is no longer to be doubted that the microbes found in the inflammatory product are the true cause of erysipelas, as by their means the disease can be successfully transferred from man to animals and from one animal to another. This transition may be direct or through the medium of infected buildings or other articles. Yet from the varying severity of erysipelas in different outbreaks and localities it has been surmised that various different microbes are operative in this disease, and a perfect knowledge of them might perhaps enable us to divide erysipelas into two or more distinct affections. At present we must recognize it as a specific inflammation due to a bacterial poison and closely allied to septicemia. Erysipelas was formerly known as surgical when it spread from a wound (through which the germ had gained access) and medical, or idiopathic, when it started independently of any recognizable lesion. Depending as it does, however, upon a germ distinct from the body, the disease must be looked upon as such, no matter by what channel the germ found an entrance. Erysipelas which follows a wound is usually much more violent than the other form, the difference being doubtless partly due to the lowered vitality of the wounded tissues and to the oxidation and septic changes which are invited on the raw, exposed surface. As apparently idiopathic cases may be due to infection through bites of insects, the small amount of poison inserted may serve to moderate the violence.
This affection may attack a wound on any part of the horse's body, while, apart from wounds, it is most frequent about the head and the hind limbs. It is to be distinguished from ordinary inflammations by its gradual extension from the point first attacked, by the abundant liquid exudation into the affected part, by the tension of the skin over the affected part, by its soft, boggy feeling, allowing it to be deeply indented by the finger, by the abrupt line of limitation between the diseased and the healthy skin, the former descending suddenly to the healthy level instead of shading off slowly toward it, by the tendency of the inflammation to extend deeply into the subjacent tissues and into the muscles and other structures, by the great tendency to death and sloughing of portions of skin and of the structures beneath, by the formation of pus at various different points throughout the diseased parts without any surrounding sac to protect the surrounding structures from its destructive action, and without the usual disposition of pus to advance harmlessly toward the surface and escape; and, finally, by a low, prostrating type of fever, with elevated temperature of the body, coated tongue, excited breathing, and loss of appetite. The pus when escaping through a lancet wound is grayish, brownish, or reddish, with a heavy or fetid odor, and inter-mixed with shreds of broken-down tissues. The most destructive form, however, is that in which pus is deficient and gangrene and sloughing more speedy and extensive.
Treatment resolves itself mainly into the elimination from the system of the poisonous products of the bacteria by laxatives and diuretics, the sustaining of the failing vitality by tonics and stimulants, above all those of the nature of antiferments, and the local application of astringent and antiseptic agents. Internal treatment may consist in 4 drams tincture of muriate of iron and one-half dram muriate of ammonia or chlorate of potash, given in a pint of water every two hours. To this may be added, liberally, whisky or brandy when the prostration is very marked. Locally a strong solution of iron, alum, or of sulphate of iron and laudanum may be used; or the affected part may be painted with tincture of muriate of iron or with iodized phenol. In mild cases a lotion of 4 drams sugar of lead and 2 ounces laudanum in a quart of water may be applied. It is desirable to avoid the formation of wounds and the consequent septic action, yet when pus has formed and is felt by fluctuation under the finger to be approaching the surface it should be freely opened with a clean, sharp lancet, and the wound thereafter disinfected daily with carbolic acid 1 part to water 10 parts, with a saturated solution of hyposulphite of soda, or with powders of iodoform or salol.
HORSEPOX, ANTHRAX, AND CUTANEOUS GLANDERS (FARCY).
These subjects are discussed under the head of contagious diseases.
CALLOSITIES.
These are simple thickening and induration of the cuticle by reason of continued pressure, notably in lying down on a hard surface. Being devoid of hair, they cause blemishes; hence, smooth floors and good bedding should be provided as preventives.
HORNY SLOUGHS (SITFASTS), OR SLOUGHING CALLOSITIES.
These are circumscribed sloughs of limited portions of the skin, the result of pressure by badly fitting harness or by irritating masses of dirt, sweat, and hairs under the harness. They are most common under the saddle, but may be found under collar or breeching as well. The sitfast is a piece of dead tissue which would be thrown off but that it has formed firm connections with the fibrous skin beneath, or even deeper with the fibrous layers (fascia) of the muscles, or with the bones, and is thus bound in its place as a persistent source of irritation. The hornlike slough may thus involve the superficial part of the skin only, or the whole thickness of the skin, and even of some of the structures beneath. The first object is to remove the dead irritant by dissecting it off with a sharp knife, after which the sore may be treated with simple wet cloths or a weak carbolic-acid lotion, like a common wound. If the outline of the dead mass is too indefinite, a linseed-meal poultice will make its outline more evident to the operator. If the fascia or bone has become gangrenous, the dead portion must be removed with the hornlike skin. During and after treatment the horse must be kept at rest or the harness must be so adjusted that no pressure can come near the affected parts. (See also page 496.)
WARTS.
These are essentially a morbid overgrowth of the superficial papillary layer of the skin and of the investing cuticular layer. They are mostly seen in young horses, about the lips, eyelids, cheeks, ears, beneath the belly, and on the sheath, but may develop anywhere. The smaller ones may be clipped off with scissors and the raw surface cauterized with bluestone. The larger may be sliced off with a sharp knife, or if with a narrow neck they may be twisted off and then cauterized. If very vascular they may be strangled by a wax thread or cord tied around their necks, at least three turns being made around and the ends being fixed by passing them beneath the last preceding turn of the cord, so that they can be tightened day by day as they slacken by shrinkage of the tissues. If the neck is too broad it may be transfixed several times with a double-threaded needle and then be tied in sections. Very broad warts that can not be treated in this way may be burned down with a soldering bolt at a red heat to beneath the surface of the skin, and any subsequent tendency to overgrowth kept down by bluestone.
BLACK PIGMENT TUMORS, OR MELANOSIS.
These are common in gray and in white horses on the naturally black parts of the skin at the roots of the tail, around the anus, vulva, udder, sheath, eyelids, and lips. They are readily recognized by their inky-black color, which extends throughout the whole mass. They may appear as simple, pealike masses, or as multiple tumors aggregating many pounds, especially around the tail. In the horse these are usually simple tumors, and may be removed with the knife. In exceptional cases they prove cancerous, as they usually are in man.
EPITHELIAL CANCER, OR EPITHELIOMA.
This sometimes occurs on the lips at the angle of the mouth and elsewhere in the horse. It begins as a small, wartlike tumor, which grows slowly at first, but finally bursts open, ulcerates, and extends laterally and deeply in the skin and other tissues, destroying them as it advances (rodent ulcer). It is made up of a fibrous framework and numerous round, ovoid, or cylindrical cavities, lined with masses of epithelial cells, which may be squeezed out as a fetid, caseous material. Early and thorough removal with the knife is the most successful treatment.
VEGETABLE PARASITES OF THE SKIN.
(Pl. XXXVIII, figs. 2, 3, 4.)
PARASITE: Trichophyton tonsurans. MALADY: Tinea tonsurans, or circinate ringworm.--This is especially common in young horses coming into training and work, in low-conditioned colts in winter and spring after confinement indoors, during molting, in lymphatic rather than nervous subjects, and at the same time in several animals that have herded together. The disease is common to man, and among the domestic animals to horse, ox, goat, dog, cat, and in rare instances to sheep and swine. Hence it is common to find animals of different species and their attendants suffering at once, the diseases having been propagated from one to the other.
Symptoms.--In the horse the symptoms are the formation of a circular, scurfy patch where the fungus has established itself, the hairs of the affected spot being erect, bristly, twisted, broken, or split up and dropping off. Later the spot first affected has become entirely bald, and a circular row of hairs around this are erect, bristly, broken, and split. These in turn are shed and a new row outside passes through the same process, so that the extension is made in more or less circular outline. The central bald spot, covered with a grayish scurf and surrounded by a circle of broken and split hairs, is characteristic. If the scurf and diseased hairs are treated with caustic-potash solution and put under the microscope, the natural cells of the cuticle and hair will be seen to have become transparent, while the groups of spherical cells and branching filaments of the fungus stand out prominently in the substance of both, dark and unchanged. The eruption usually appears on the back, loins, croup, chest, and head. It tends to spontaneous recovery in a month or two, leaving for a time a dappled coat from the spots of short, light-colored hair of the new growth.
The most effective way of reaching the parasite in the hair follicles is to extract the hairs individually, but in the horse the mere shaving of the affected part is usually enough. It may then be painted with tincture of iodin twice a day for two weeks. Germs about the stable may be covered up or destroyed by a whitewash of freshly burned quicklime, the harness, brushes, etc., may be washed with caustic soda, and then smeared with a solution of corrosive sublimate one-half dram and water 1 pint. The clothing may be boiled and dried.
PARASITE: Achorion schoenleini. MALADY: Favus, or honeycomb ringworm.--Megnin and Goyau, who describe this in the horse, say that it loses its characteristic honeycomb or cup-shaped appearance, and forms only a series of closely aggregated, dry, yellowish crusts the size of hemp seed on the trunk, shoulders, flanks, or thighs. They are accompanied by severe itching, especially at night. The cryptogam, formed of spherical cells with a few filaments only, grows in the hair follicles and on the cuticle, and thus a crust often forms around the root of a hair. Like the other cryptogams, their color, as seen under the microscope, is unaffected by acetic acid, alcohol, ether, or oil of turpentine, while the cells are turned bluish by iodin. For treatment, remove the hair and apply tincture of iodin or corrosive sublimate lotion, as advised under the last paragraph.
PARASITE: Microsporon furfur. MALADY: Parasitic pityriasis.--This attacks the horse's head where the harness presses, and leads to dropping of the hair, leaving bald patches covered with a branlike scurf, without any eruption, heat, tenderness, swelling, or rigidity of the skin. A lotion of carbolic acid 1 dram and water 2-1/2 ounces is usually applied to effect a cure.
ANIMAL PARASITES OF THE SKIN.[6]
ACARIASIS, OR MANGE.
This affection is due to the irritation of the skin caused by the presence of nearly microscopic acari, or mites. The disease varies, however, according to the species of acarus which infests the skin, so that we must treat of several different kinds of acariasis.
PARASITE: Sarcoptes scabiei equi. MALADY: Sarcoptic acariasis.--This is the special Sarcoptes of the horse, but under favorable conditions it can be transmitted to ass and mule, and even to man, and may live indefinitely on the human skin. The mite (Pl. XXXIX, fig. 1) is nearly microscopical, but may be detected with a magnifying lens among moving scurf taken from the infected skin. Like all Sarcoptes, it burrows little galleries in and beneath the scurf skin, where it hides and lays its eggs and where its young are hatched. It is therefore often difficult to find the parasite on the surface, unless the skin has been heated by a temporary exposure to the sun or in a warm room. The mite may be detected more readily by placing scrapings on black cardboard and warming, or better by macerating scabs or scrapings in a solution of caustic soda or potash and then examining them microscopically. Like other acari, this is wonderfully prolific, a new generation of fifteen individuals being possible every fifteen days, so that in three months the offspring of a single pair may produce generations aggregating 1,500,000 young. The Sarcoptes have less vitality than the nonburrowing acari, as they die in an hour when kept apart from the skin in dry air at a heat of 145 deg. F. They live 12 to 14 days apart from the skin in the damp air of a stable. On a piece of damp hide they lived till the twenty-fourth day, when they began to die, and all were dead on the twenty-eighth.
Symptoms.--The symptoms are an incessant, intolerable, and increasing itching of some part of the skin (head, mane, tail, back, etc.), the horse inclining himself toward the hand that scratches him, and moving his lips as if himself scratching. The hairs may be broken and rubbed off, but the part is never entirely bald, as in ringworm, and there may be papules or any kind of eruption or open sores from the energy of the scratching. Scabs of any thickness may form, but the special features are the intense itching and the presence of the acarus.
Treatment consists in the removal of the scabs by soapsuds, and, if necessary, a brush and the thorough application of tobacco 1-1/2 ounces and water 2 pints, prepared by boiling. This may be applied more than once, and should always be repeated after 15 days, to destroy the new brood that may have been hatched in the interval. All harness and stable utensils should be similarly treated; blankets and rubbers may be boiled, and the stalls should be covered with a whitewash of quicklime, containing one-fourth pound of chlorid of lime to the gallon.
When there are too many animals to treat by means of hand dressings, the lime-and-sulphur dip or the tobacco dip may be used and are very effective, though the cresol dips are fairly effective. These dips may be purchased and made up in the dilution called for on the container. The affected animals may be dipped when the number warrants it and facilities are available; otherwise the dips may be applied with a swab or a spray pump. Directions for constructing a dipping vat may be obtained from the United States Department of Agriculture on application. Any treatment used should be repeated in the course of 10 to 14 days. If the stables are not disinfected, animals should be removed after treatment and put in clean stables or on clean pasture for at least a month to allow the mites in the infested stables to die. Otherwise the disease may recur.
PARASITE: Psoroptes equi (Dermatocoptes equi, Dermatodectes equi). MALADY: Psoroptic acariasis.--Psoroptic mange is less common than sarcoptic mange in horses, and as the parasite (Pl. XXXIX, fig. 3) only bites the surface and lives among the crusts under the shelter of the hair, it is very easily discovered. It reproduces itself with equal rapidity and causes similar symptoms to those produced by the Sarcoptes. The same treatment will suffice and is more promptly effectual. The purifying of the stable must be more thorough, as the Psoroptes will survive twenty to thirty days in the moist atmosphere of a stable, and may even revive after six or eight weeks when subjected to moist warmth. Infested pastures will therefore prove dangerous to horses for that length of time, and, with rubbing posts, etc, should not be used.
PARASITE: Chorioptes equi (Symbiotes equi, Dermatophagus equi, Chorioptes spathiferus). MALADY: Foot mange.--The acarus (Pl. XXXIX, fig. 2) attacks the heels and lower parts of the legs, especially the hind ones, and may be present for years without extending upon the body. Like the Psoroptes; it lives on the surface, on the hairs, and among the scabs. It gives rise to great itching, stamping, rubbing of the one leg with the other, and the formation of papules, wounds, ulcerous sores, and scabs. The intense itching will always suggest this parasite, and the discovery of the acarus will identify the disease. The treatment is the same as for the Sarcoptes, but may be confined to the legs and the parts with which they come in contact.
PARASITE: Dermanyssus gallinae, or chicken acari. MALADY: Poultry acariasis.--This is a large-sized acarus, though usually miscalled "hen louse," and the disease "poultry lousiness." The mite (Pl. XXXIX, fig. 4) lives in droppings and in crevices of chicken houses, but temporarily passes on to the skin of man and of the horse and other quadrupeds, when occasion serves. It causes much irritation, with the eruption of papules or vesicles and the formation of sores and scabs. The examination of the skin is usually fruitless, as the attacks are mostly made at night and the effects only may be seen during the day. The proximity of hen manure swarming with the acari explains the trouble, and the removal of this and a white-washing with quicklime, with or without chlorid of lime, will prevent future attacks. The skin may still require bland ointments or lotions, as for congestion.
PARASITE: Larva of a Trombidium, Leptus americanus, or harvest bug, misnamed jigger (chigoe). MALADY: Autumn mange.--This parasite is a brick-red acarus, visible to the naked eye on a dark ground, and living on green vegetation in many localities. It attacks man, and the horse, ox, dog, etc., burrowing under the skin and giving rise to small papules and intolerable irritation. This continues for two or three days only from a single invasion, but will last until cold weather sets in if there is a fresh invasion daily. Horses at pasture suffer mainly on the lower part of the face. If kept indoors the disease will disappear, or if left at pasture a weak tar water or solution of tobacco may be applied to the face.
TICKS.
The wood ticks are familiar to inhabitants of uncultivated lands, and prove troublesome parasites to man and beast alike. The tick lives on bushes, and attaches itself to the mammal only to secure a feast of blood, for when gorged it drops off to sleep off its debauch on the soil. The tick produces great irritation by boring into the skin with its armed proboscis. If pulled out, the head and thorax are often left in the skin. They may be covered with oil to shut out the air from their breathing pores, or by touching them with a hot penknife they will be impelled to let go their hold.
GRUBS IN SKIN.
PARASITE: Hypoderma lineata. MALADY: Larvae (grubs) under the skin.--The larvae of a fly (probably Hypoderma lineata, whose larvae in the skin of cattle are commonly known as "warbles") are occasionally found in little sacs beneath the skin of horses. The mature larva escapes in early summer and develops into a fly. In districts where they exist the grubs should be pressed out of the skin in the course of the winter and destroyed.
LARVAE (GRUBS) ON THE SKIN, OR FLYBLOW.
The following flies, among others, deposit their eggs on open sores or on wet, filthy parts of the skin, where their larvae or grubs give rise to serious trouble: Lucilia caesar (bluebottle), Cochliomyia macellaria (screwworm fly), Musca vomitoria (meat fly), and Sarcophaga carnaria (flesh fly). To prevent their attacks, wet, filthy hair should be removed and wounds kept clean and rendered antiseptic by a lotion of carbolic acid 1 part, water 50 parts, or by a mixture of 1 ounce oil of tar in 20 ounces sweet oil, or by some other antiseptic. If the grubs are already present they should be picked off and one of these dressings freely applied.
FLIES.
A number of flies attack horses and suck their blood, producing great annoyance and in some instances death. These insects not only suck the blood, but also often instill an acid poison into the skin, and in exceptional cases transfer infectious germs from animal to animal by inoculation.
Various devices are resorted to to prevent the attacks, as to sponge the skin with a decoction of walnut or elder leaves, of tobacco, to dust with Persian insect powder, to keep a light blanket or fly net on the horse, to close doors and windows with fine screens and destroy by pyrethrum any flies that have gained admission, to remove all manure heaps that would prove breeding places for flies, to keep the stalls clean, deodorize by gypsum, and to spread in them trays of dry chlorid of lime. For the poisoned bites apply ammonia, or a solution of 1 part of carbolic acid in 20 parts of sweet oil or glycerin, or one-fourth ounce bicarbonate of soda and 1 dram of carbolic acid in a quart of water may be used.
A large number of fly repellents have been recommended, but most of them must be applied daily in order to maintain the protective effect. Among the things used are carbolic solutions, pine tar, oil of tar, fish oil, laurel oil, oil of citronella, oil of sassafras, oil of camphor, and cod-liver oil. These things must be used judiciously or they will result in poisoning or removal of the hair from the animal in some instances. Ten per cent oil of tar in Beaumont oil or in cottonseed oil was found to be safe and efficacious by Graybill.
The use of the fly-maggot trap noted under stomach worms of the horse, and of the various forms of the Hodge flytrap, is recommended.
FLEAS.
The flea of man and those of poultry, when numerous, will bite the horse and give rise to rounded swellings on the skin. To dispose of them it is needful to clear the surroundings of the grublike larvae as well as to treat the victim. The soil may be sprinkled with quicklime, carbolic acid, coal tar, or petroleum; the stalls may be deluged with boiling water and afterwards painted with oil of turpentine and littered with fresh pine sawdust, and all blankets should be boiled. The skin may be sponged with a solution of 1 part carbolic acid in 50 parts of water. Other animals should be kept free from fleas or kept away from the vicinity of the stable.
The chigoe (Pulex penetrans) of the Gulf coast is still more injurious, because it burrows under the surface and deposits its eggs to be hatched out slowly with much irritation. The tumor formed by it should be laid-open and the parasite extracted. If it bursts so that its eggs escape into the wound, they may be destroyed by introducing chloroform into the wound.
LICE, OR PEDICULI.
Two kinds of lice attack the horse, one of which is furnished with narrow head and a proboscis for perforating the skin and sucking the blood, and the other--the broad-headed kind--with strong mandibles, by which it bites the skin only. The poor condition, itching, and loss of hair should lead to suspicion, and a close examination will detect the lice. They may be destroyed by rubbing the victim with sulphur ointment, or with sulphuret of potassium 4 ounces, water 1 gallon, or with tar water, or the skin may be sponged with benzine. The application should be repeated a week later to destroy all lice hatched from the nits in the interval. Buildings, clothes, etc., should be treated as for fleas.
STINGS OF BEES, WASPS, AND HORNETS.
These are much more irritating than the bites of flies, partly because the barbed sting is left in the wound and partly because of the quantity and quality of the venom. When a swarm attacks an animal the result may prove fatal.
Treatment consists in the application of wet clay, or of a lotion of soda or ammonia, or of carbolic acid, or permanganate of potash, 2 grains to the ounce; or of sugar of lead 2 drams, laudanum 1 ounce, and water 1 pint. The embedded stings should be extracted with fine forceps or even with the finger nails.
TARANTULA AND SCORPION.
The bite of the first and the sting of the second are poisonous, and may be treated like other insect venom, by carbolated glycerin, or a strong solution of ammonia, or permanganate of potash.
SNAKE BITES.
These are marked by the double incision caused by the two fangs, by the excessive doughy (dark red) swelling around the wounds, and in bad cases by the general symptoms of giddiness, weakness, and prostration. They are best treated by enormous doses of alcohol, whisky, or brandy, or by aqua ammonia very largely diluted in water, the object being to sustain life until the poison shall have spent its power. As local treatment, if the wound is in a limb, the latter may have a handkerchief or cord tied around it above the injury and drawn tight by a stick twisted into it. In this way absorption may be checked until the poison can be destroyed by the application, of a hot iron or a piece of nitrate of silver or other caustic. A poultice of tobacco leaves is a favorite remedy, and may be used to soothe the sore after cauterization.
A treatment which has been highly recommended consists in prompt and vigorous scarification at the site of puncture and rubbing crystals of potassium permanganate into the wound.
BURNS AND SCALDS.
These subjects are discussed in the following chapter.
WOUNDS OF THE SKIN.
Wounds of the skin are fully discussed in the next chapter.
FOOTNOTES:
[3] An outbreak of quittor near Cheyenne, Wyo., which came under the author's observation, was caused by the mud through which the horses had to wade to reach the watering troughs. These troughs were furnished with water by windmills, and the mudholes were caused by the waste water. More than 50 cases developed inside of two months, or during September and October. In these 50 cases all forms of the disease and all possible complications were presented. During the rainy season at Leadville, Colo., outbreaks of quittor are common, and the disease is so virulent that it has long been known as the "Leadville foot rot." The soil being rich in mineral matters is no doubt the cause of the outbreaks. In the city of Montreal quittor is said to be very common in the early springtime, when the streets are muddy from the melting snow and ice.
[4] Descazeaux has shown that the worms found in these summer sores are probably larval forms of the stomach worms of the horse, Habronema megastoma, H. microstoma, and H. muscae. Ransom has shown that the larval stage of H. muscae develops in the common housefly, the fly becoming infested as a maggot in horse manure. Infestation with the adult worms in the stomach of the horse (Pl. V, fig. 4) may take place through the ingestion of such infested flies, or by the escape of the larva from the proboscis of the fly as it feeds on the moist lips of the horse. In view of this it may be surmised that summer sores may arise as the result of flies so infested feeding on the moisture on the skin of the horse. In some forms of summer sores along the abdomen there are found immature stages of Habronema which apparently have just escaped from the egg and which are younger than some of the stages found in the fly. In this case it is surmised that these embryos from the manure enter the soiled skin of the horse, as it lies down on dirty bedding and manure, and develop in the skin as they would ordinarily in the fly. Descazeaux calls these summer sores cutaneous habronemiasis.
Preventive measures consist in the removal of the adult worms from the stomach of the horse by the use of anthelmintics, the destruction of the embryos in the manure, fly-control measures, and the use of clean bedding.--M. C. HALL.
[5] Descazeaux recommends the application and injection of 2 to 3 per cent trypanblue, though he states that the only truly efficacious treatment is the early and complete ablation of the invaded tissue.--M. C. H.
[6] Revised by M. C. Hall.
WOUNDS AND THEIR TREATMENT.
By CH. B. MICHENER, V. S.
[Revised by John R. Mohler, V. M. D., A. M.]
DESCRIPTION OF WOUNDS.
A wound is an injury to any part of the body involving a solution of continuity or disruption of the affected parts and is caused by violence, with or without laceration of the skin. In accordance with this definition we have the following varieties of wounds: Incised, punctured, contused, lacerated, gunshot, and poisoned. They may further be classified as superficial, deep, or penetrating, and also as unclean, if hair, dirt, or splinters of wood are present; as infected when contaminated with germs, and as aseptic if the wound does not contain germs.
An incised wound is a simple cut made with a sharp body, like a knife, producing merely a division of the tissues. The duller the body the more force is required, the more tissues destroyed, and a greater time will be required for healing. In a cut wound the edges are even and definite, while those of a lacerated wound are irregular and torn. Three conditions are present as a result of an incised wound: (1) Pain, (2) hemorrhage, (3) gaping of the wound. The first pain is due to the crushing and tearing of the nerve fibers. In using a sharp knife and by cutting quickly, the animal suffers less pain and healing occurs more rapidly. The secondary pain is usually due to the action of the air and inflammatory processes. When air is kept from the wound pain ceases soon after the lesion is produced. Hemorrhage is absent only in wounds of nonvascular tissues, as the cornea of the eye, the cartilage of joints, and other similar structures. Bleeding may be from the arteries, veins, or capillaries. In the last form of bleeding the blood oozes from the part in drops. Hemorrhage from the veins is dark red and issues in a steady stream without spurting. In arterial bleeding the blood is bright red and spurts with each heart beat. This latter variety of hemorrhage is the most dangerous, and should be stopped at once before attempting any further treatment. Bleeding from small veins and capillaries ceases in a short time spontaneously, while larger vessels, especially arteries, require some form of treatment to cause complete stoppage of the hemorrhage.
HEMOSTASIA.
By this term is meant the checking of the flow of blood. It may be accomplished by several methods, such as compress bandages, torsion, hot iron, and ligatures. The heat from a hot iron will cause the immediate clotting of the blood in the vessels, and this clot is further supported by the production of a scab, or crust, over the portion seared. The iron should be at a red heat. If at a white heat, the tissue is charred, which makes it brittle and the bleeding is liable to be renewed. If the iron is at a black heat, the tissue will stick to the iron and will pull away from the surface of the wound. Cold water and ice bags quickly stop capillary bleeding, while hot water is preferable in more excessive hemorrhages. Some drugs, called styptics, possess the power of contracting the walls of blood vessels and also of clotting the blood. A solution of the chlorid of iron placed on a wound alone or by means of cotton drenched in the liquid produces a rapid and hard clot. Tannic acid, alum, acetic acid, alcohol, and oil of turpentine are all more or less active in this respect. To check bleeding from large vessels compression may be adopted. When it is rapid and dangerous and from an artery, the fingers may be used for pressing between the wound and the heart (digital compression), but if from a vein, the pressure should be exerted on the other side of the wound. Tourniquet may also be used by passing a strap around the part and tightening after placing a pad over the hemorrhage. The rubber ligature has now replaced the tourniquet and is bound tightly around the limb to arrest the bleeding. Tampons, such as cotton, tow, or oakum, may be packed tightly in the wound and then sewed up. After remaining there for twenty-four or forty-eight hours they are removed. Bleeding may sometimes be easily checked by passing a pin under the vessel and by taking a horsehair and forming a figure 8 by running it above and below the pin, thus causing pressure on the vessel. Torsion is the twisting of the blood vessel until the walls come together and form a barrier to the flow of blood. It may be accomplished by the fingers, forceps, or by running a pin through the vessel, turning it several times, and then running the point into the tissue to keep it in a fixed position.
Ligation is the third method for stopping a hemorrhage. The blood vessel should be seized with the artery forceps, a clean thread of silk passed around it, and tied about one-half inch from its end. The silk should be sterilized by placing it in an antiseptic solution so as not to impede the healing process or cause blood poisoning or lockjaw, which often follows the ligation of a vein with unsterilized material. Sometimes it will be impossible to reach the bleeding vessel, so it is necessary to pass the ligature around a mass of tissue which includes the blood vessel. Ligation is the most useful method of arresting hemorrhage, since it disturbs healing least and gives the greatest security against secondary hemorrhage.
SUTURES.
After the bleeding has been controlled and all foreign bodies removed from the wound, the gaping of the wound is noticeable. It is caused by the contraction of the muscles and elastic fibers, and its degree depends on the extent, direction, and nature of the cut. This gaping will hinder the healing process so that it must be overcome by bringing the edges together by some sort of sutures or pins or by a bandage applied from below upward. As suture material, ordinary cotton thread is good, if well sterilized, as are also horsehair, catgut, silk, and various kinds of wire. If the suture is made too tight the subsequent swelling may cause the stitch to tear out. In order to make a firm suture the depth of the stitch should be the same as the distance the stitch is from the edge of the wound. The deeper the suture the more tissue is embraced and the fewer the number of stitches required. In tying a suture the square or reef knot should be used. Closure of wounds by means of adhesive plaster, collodion, and metal clamps is not practiced to any great extent in veterinary practice.
PROCESS OF HEALING.
In those cases where perfect stoppage of bleeding, perfect coaptation of the edges of the wound, and perfect cleanliness are obtained, healing occurs within three days, without the formation of granulations, pus, or proud flesh, by what is termed first intention. If wounds do not heal in this manner they will gap somewhat and become warm and painful. Healing then occurs by granulation or suppuration, which is termed healing by second intention. The sides of the wound become covered with granulation tissue which may fill the wound and sometimes overlap the lips, forming a fungoid growth called proud flesh. Under favorable conditions the edges of the wound appear to grow together by the end of the first week, and the whole surface gradually becomes dry, and finally covered with pigmented skin, when the wound is healed. The cause of pus formation in wounds is usually the presence of germs. For this reason the utmost care should be adopted to keep clean wounds aseptic, or free from germs, and to make unclean wounds antiseptic by using antiseptic fluids to kill the microbes present in the wound. The less the injurious action of this fluid on the wound and the greater its power to kill germs, the more valuable it becomes. All antiseptics are not equally destructive, and some germs are more susceptible to one antiseptic than to another. The most important are (1) bichlorid of mercury, which is to be preferred on horses. It becomes weakened in its action if placed in a wooden pail or on an oily or greasy surface. It is used in the strength of 1 part of bichlorid to 1,000 to 5,000 parts of water, according to the delicacy of the tissue to which it is applied. (2) Carbolic acid in from 2 to 5 per cent solution is used on infected wounds and for cleaning instruments, dressings, and sponges. It unites well with oil and is preferred to the bichlorid on a greasy surface. A 5 per cent solution in oil is often used under the name of carbolized oil. (3) Aluminum acetate is an efficient and cheap antiseptic, and is composed of 1 part alum and 5 parts acetate of lead, mixed in 20 parts of water. (4) Boric acid is good, in a 2 to 4 per cent solution, to cleanse wounds and wash eyes. Compound cresol may be used in a 1 to 3 per cent solution in water. Iodoform is one of the most used of the antiseptics, and it also acts as an anodyne, stimulates granulation, and checks wound secretion. A very efficacious and inexpensive powder is made by taking 5 parts of iodoform and 95 parts of sugar, making what is called iodoform sugar. Tannic acid is a useful drug in the treatment of wounds, as it arrests hemorrhage, checks secretion, and favors the formation of a scab. A mixture of 1 part tannic acid and 3 parts iodoform is good in suppurating wounds. Iodol, white sugar, ground and roasted coffee, and powdered charcoal are all used as protectives and absorbents on suppurating surfaces. More depends on the care and the method of application of the drug than on the drug itself. On aseptic wounds use only those antiseptics that do not irritate the tissue. If care is used in the application of the antiseptic, corrosive sublimate or carbolic acid is to be recommended. In order to keep air from the wound and to absorb all wound secretions rapidly, a dressing should be applied. If the wound is aseptic, the dressing should be likewise, such as cotton gauze, sterile cotton, oakum, or tow. This dressing should be applied with uniform pressure at all times and secured by a bandage. Allow it to remain for a week or ten days if the wound is aseptic or if the dressing does not become loose or misplaced or become drenched with secretions from the wound, or if pain, fever, or loss of appetite does not develop. The dressing should then be removed, the wound treated antiseptically, and a sterilized dressing applied.
HEALING UNDER A SCAB.
This often occurs in small superficial wounds that have been kept aseptic. In order that a scab may form, the wound must not gap, secrete freely, or become infected with germs. The formation of scab is favored by astringents and styptics, such as tannic acid, iodoform, and 5 per cent solution of zinc chlorid. In case of fistulous withers, open joints, or other large, hollow wounds that can not be dressed, antisepsis may be obtained by warm-water irrigation with or without an antiseptic fluid. It should continue day and night, and never be interrupted for more than eight hours, for germs will then have gained headway and will be difficult to remove. Four or five days of irrigation will be sufficient, for granulations will then have formed and pus will remain on the outside if it forms. For permanent irrigation the stream should be very small, or drop by drop, but should play over the entire surface of the wound. It is always better to heal an infected wound under a scab, or treat it as an open wound, than it is to suture it, thus favoring the growth of the inclosed germs and retarding ultimate healing. In the latter case pus may develop in the wound, form pockets by sinking into the tissues, and cause various complications. The pockets should be well drained, either through incisions at the bottom or by drainage tubes or setons. They should then be frequently syringed out or continuously irrigated. In case proud flesh appears it should be kept down either by pressure or by caustics, as powdered bluestone, silver nitrate, chlorid of antimony, or by astringents, such as burnt alum. If they prove resistant to this treatment they may be removed by scissors, the knife, or by searing with the hot iron. The following rules for the treatment of wounds should be followed: (1) See that the wound is clean, removing all foreign bodies. (2) For this purpose use a clean finger rather than a probe. (3) All hemorrhage should be arrested before closing the wound. (4) Antiseptics should only be used if you suspect the wound to be infected. (5) When pus is present treat without closing the wound. (6) This may be accomplished by drainage tubes, absorbent dressings, setons, or continuous irrigations. (7) Protect the wound against infection while healing.
LACERATED AND CONTUSED WOUNDS.
Lacerated and contused wounds may be described together although there is, of course, this difference, that in contused wounds there is no break or laceration of the skin. Lacerated wounds, however, are, as a rule, also contused--the surrounding tissues are bruised to a greater or lesser extent. While at first sight such wounds may not appear to be as serious as incised wounds, they are commonly very much more so. Lacerations and contusions, when extensive, are always to be regarded as dangerous. Many horses die from septic infection or mortification as a result of these injuries. We find in severe contusions an infiltration of blood into the surrounding tissues: disorganization and mortification follow, and involve often the deeper seated structures. Abscesses, single or multiple, may also result and call for special treatment.
In wounds that are lacerated the amount of hemorrhage is mostly inconsiderable; even very large blood vessels may be torn apart without inducing a fatal result. The edges of the wound are ragged and uneven. These wounds are produced by barbed wire or some blunt object, as when a horse runs against fences, board piles, the corners of buildings, or when he is struck by the pole or shafts of another team, falling on rough, irregular stones, etc.
Contused wounds are caused by blunt instruments moving with sufficient velocity to bruise and crush the tissues, as kicks, running against objects, or falling on large, hard masses.
Treatment.--In lacerated wounds great care must at first be exercised in examining or probing to the very bottom of the rent or tear, to see whether any foreign body is present. Very often splinters of wood or bits of stone or dirt are thus lodged, and unless removed prevent the wound from healing; or if it should heal, the wound soon opens again, discharging a thin, gluey matter that is characteristic of the presence of some object in the part. After a thorough exploration these wounds are to be carefully and patiently fomented with warm water, to which has been added carbolic acid in the proportion of 1 part to 100 of water. Rarely, if ever, are stitches to be inserted in lacerated wounds. The surrounding tissues and skin are so weakened in vitality and structure by the contusions that stitches will not hold; they only irritate the parts. It is better to endeavor to obtain coaptation by means of bandages, plasters, or collodion. One essential in the treatment of lacerated wounds is to provide a free exit for the pus. If the orifice of the wound is too high, or if pus is found to be burrowing in the tissues beneath the opening, we must then make a counter opening as low as possible. This will admit of the wound being thoroughly washed out, at first with warm water, and afterwards injected with some mild astringent and antiseptic wash, as chlorid of zinc, 1 dram to a pint of water. A dependent opening must be maintained until the wound ceases to discharge. Repeated hot fomentations over the region of lacerated wounds afford much relief and should be persisted in.
BRUISES.
Bruises are nothing but contused wounds where the skin has not been ruptured. There is often considerable solution of continuity of the parts under the skin, subcutaneous hemorrhage, etc., which may result in local death (mortification) and slough of the bruised parts. If the bruise or contusion is not so severe, many cases are quickly cured by constant fomentation with hot water for from two to four hours. The water should be allowed about this time to become cool gradually and then cold. Cold fomentation must then be kept up for another hour or two. The parts should be thoroughly and quickly dried and bathed freely with camphor 1 ounce, sweet oil 8 ounces, or with equal parts of lead water and laudanum. A dry, light bandage should then be applied, the horse allowed to rest, and if necessary the treatment may be repeated each day for two or three days. If, however, the wound is so severe that sloughing must ensue, we should encourage it by poultices made of linseed meal, wheat bran, turnips, onions, bread and milk, or hops. Charcoal is to be sprinkled over the surface of the poultice when the wound is bad smelling. After the slough has fallen off the wound is to be dressed with warm washes of carbolic acid, chlorid of zinc, permanganate of potash, or other antiseptic. If granulating (filling up) too fast, use burnt alum or air-slaked lime. Besides this local treatment, we find that the constitutional symptoms of fever and inflammation call for measures to prevent or control them. This is best done by placing the injured animal on soft or green feed. A physic of Barbados aloes, 1 ounce, should be given as soon as possible after the accident. Sedatives, such as tincture of aconite root, 15 drops, three times a day, or ounce doses of saltpeter every four hours, may also be administered. When the symptoms of fever are abated, and if the discharges from the wound are abundant, the strength of the patient must be supported by good feed and tonics. One of the best tonics is as follows: Powdered sulphate of iron, powdered gentian, and powdered ginger, of each 4 ounces. Mix thoroughly and give a heaping tablespoonful twice a day, on the feed or as a drench.
PUNCTURED WOUNDS.
Punctured wounds are produced by the penetration of a sharp or blunt-pointed substance, such as a thorn, fork, nail, etc., and the orifice of these wounds is always small in proportion to their depth. In veterinary practice punctured wounds are much more common than the others. They involve the feet most frequently, next the legs, and often the head and face from nails protruding through the stalls and trough. They are not only the most frequent, but they are also the most serious, owing to the difficulty of obtaining thorough disinfection. Another circumstance rendering them so is the lack of attention that they at first receive. The external wound is so small that but little or no importance is attached to it, yet in a short time swelling, pain, and acute inflammation, often of a serious character, are manifested.
Considering the most common of the punctured wounds, we must give precedence to those of the feet. Horses worked in cities, about iron works, around building places, etc., are most likely to receive "nails in the feet." The animal treads upon nails, pieces of iron or screws, forcing them into the soles of the feet. If the nail, or whatever it is that has punctured the foot, is fast in some large or heavy body, and is withdrawn as the horse lifts his foot, lameness may last for only a few steps; but unless properly attended to at once he will be found in a day or two to be very lame in the injured member. If the foreign body remains in the foot, he gradually grows worse from the time of puncture until the cause is discovered and removed. If, when shoeing, a nail is driven into the "quick" (sensitive laminae) and allowed to remain, the horse gradually evinces more pain from day to day; but if the nail has at once been removed by the smith, lameness does not, as a rule, show itself for some days; or, if the nail is simply driven "too close," not actually pricking the horse, he may not show any lameness for a week or even much longer. At this point it is due to the blacksmith to say that, considering how thin the walls of some feet are, the uneasiness of many horses while shoeing, the ease with which a nail is diverted from its course by striking an old piece of nail left in the wall, or from the nail itself splitting, the wonder is not that so many horses are pricked or nails driven "too close," but rather that many more are not so injured. It is not, by any means, always carelessness or ignorance on the part of the smith that is to account for this accident. Bad and careless shoers we do meet with, but let us be honest and say that the rarity of these accidents points rather to the general care and attention given by these much-abused mechanics.
From the construction of the horse's foot (being incased in an impermeable, horny box), and from the elasticity of the horn closing the orifice, punctured wounds of the feet are almost always productive of lameness. Inflammation results, and as there is no relief afforded by swelling and no escape for the product of inflammation, this matter must and does burrow between the sole or wall and the sensitive parts within it until it generally opens "between hair and hoof." We can thus see why pain is so much more severe, why tetanus (lockjaw) more frequently follows wounds of the feet, and why, from the extensive, or at times complete, separation and "casting" of the hoof, these wounds must always be regarded with grave apprehension.
Symptoms and treatment.--A practice which, if never deviated from--that of picking up each foot, cleaning the sole, and thoroughly examining the foot each and every time the horse comes into the stable--will enable us to reduce to the minimum the serious consequences of punctured wounds of the feet. If the wound has resulted from pricking, lameness follows soon after shoeing; if from the nails being driven too close, it usually appears from four to five days or a week afterwards. We should always inquire as to the time of shoeing, examine the shoe carefully, and see whether it has been partially pulled and the horse has stepped back upon some of the nails or the clip. The pain from these wounds is lancinating; the horse is seen to raise and lower the limb or hold it from the ground altogether; often he points the foot, flexes the leg, and knuckles at the fetlock. Swelling of the fetlock and back tendons is also frequently seen and is liable to mislead us. The foot must be carefully examined, and this can not be properly done without removing the shoe. The nails should be drawn separately and carefully examined. If there is no escape of pus from the nail holes, or if the nails themselves are not moist, we must continue our examination of the foot by carefully pinching or tapping it at all parts. With a little practice we can detect the spot where pain is the greatest or discover the delicate line or scar left at the point of entrance of the foreign body. The entire sole is then to be thinned, after which we are carefully to cut down upon the point where pain is greatest upon pressure, and, finally, through the sole at this spot. When the matter has escaped, the sole, so far as it was undermined by pus, is to be removed. The foot must now be poulticed for one or two days and afterwards dressed with a compress of oakum saturated with carbolic-acid solution or other antiseptic dressing.
If we discover a nail or other object in the foot, the principal direction, after having removed the offending body, is to cut away the sole, in a funnel shape, down to the sensitive parts beneath. This is imperative, and if a good free opening has been made and is maintained for a few days, and hot fomentations and antiseptic dressings applied, the cure is mostly easy, simple, quick, and permanent. The horse should be shod with a leather sole under the shoe, first of all applying tar and oakum to prevent any dirt from entering the wound. In some instances nails may puncture the flexor tendons, the coffin bone, or enter the coffin joint. Such injuries are always serious, their recovery slow and tedious, and the treatment so varied and difficult that the services of a veterinarian will be necessary.
PUNCTURED WOUNDS OF JOINTS, OR OPEN JOINTS.
These wounds are more or less frequent. They are always serious, and often result in anchylosis (stiffening) of the joint or the death of the animal. The joints mostly punctured are the hock, fetlock, or knee, though other joints may, of course, suffer this injury. As the symptoms and treatment are much the same for all, only the accident as it occurs in the hock joint will be described. Probably the most common mode of injury is from the stab of a fork, but it may result from the kick of another horse that is newly shod, or in many other ways. At first the horse evinces but slight pain or lameness. The owner discovers a small wound scarcely larger than a pea, and pays but little attention to it. In a few days, however, the pain and lameness become excessive; the horse can no longer bear any weight upon the injured leg; the joint is very much swollen and painful upon pressure; there are well-marked symptoms of constitutional disturbance--quick pulse, hurried breathing, high temperature, 103 deg. to 106 deg. F., the appetite is lost, thirst is present, the horse reeks with sweat, and his anxious countenance shows the pain he suffers. He may lie down, though mostly he persists in standing, and the opposite limb becomes greatly swollen from bearing the entire weight and strain for so long a time. The wound, which at first appeared so insignificant, is now constantly discharging a thin, whitish or yellowish fluid--joint oil or water, which becomes coagulated about the mouth of the wound and adheres to the part in clots like jelly, or resembling somewhat the white of an egg. Not infrequently the joint opens at different places, discharging at first a thin, bloody fluid that soon assumes the character above described.
Treatment of these wounds is most difficult and unsatisfactory. We can do much to prevent this array of symptoms if the case is seen early--within the first 24 or 48 hours after the injury; but when inflammation of the joint is once fairly established the case becomes one of grave tendencies. Whenever a punctured wound of a joint is noticed, even though apparently of but small moment, we should apply without the least delay a strong cantharides blister over the entire joint, being even careful to fill the orifice of the wound with the blistering ointment. This treatment is almost always effectual. It operates to perform a cure in two ways--first, the swelling of the skin and tissues underneath it completely closes the wound and prevents the ingress of air; second, by the superficial inflammation established it acts to check and abate all deep-seated inflammation. In the great majority of instances, if pursued soon after the accident, this treatment performs a cure in about one week; but should the changes described as occurring later in the joint have already taken place, we must then treat by cooling lotions and the application to the wound of chlorid of zinc, 10 grains to the ounce of water, or a paste made of flour and alum. A bandage is to hold these applications in place, which is only to be removed when swelling of the leg or increasing febrile symptoms demand it. In the treatment of open joints our chief aim must be to close the orifice as soon as possible. For this reason repeated probing or even injections are contraindicated. The only probing of an open joint that is to be sanctioned is on our first visit, when we should carefully examine the wound for foreign bodies or dirt, and after removing them the probe must not again be used. The medicines used to coagulate the synovial discharge are best simply applied to the surface of the wound, on pledgets of tow, and held in place by bandages. Internal treatment is also indicated in those cases of open joints in which the suffering is great. At first we should administer a light physic and follow this up with sedatives and anodynes, as directed for contused wounds. Later, however, we should give quinin or salicylic acid in 1-dram doses two or three times a day.
WOUNDS OF THE TENDON SHEATHS.
Wounds of tendon sheaths are similar to open joints in that there is an escape of synovial fluid, "sinew water." Where the tendons are simply punctured by a thorn, nail, or fork, we must, after a thorough exploration of the wound for any remaining foreign substance, treat with the flour-and-alum paste, bandages, etc., as for open joint. Should the skin and tendons be divided the case is even more serious and is often incurable. There is always a large bed of granulations (proud flesh) at the seat of injury, and a thickening more or less pronounced remains. When the back tendons of the leg are severed we should apply at once a high-heel shoe (which is to be gradually lowered as healing advances) and bandage firmly with a compress moistened with a 10-grain chlorid of zinc solution. When proud flesh appears it is best kept under control by repeated applications of a red-hot iron. Mares that are valuable as brood animals and stock horses should always be treated for this injury, as, even though blemished, their value is not seriously impaired. If the subject is old and comparatively valueless, the length of time required and the expense of treatment will cause us to hesitate in attempting a cure.
GUNSHOT WOUNDS.
These wounds vary in size and character, depending on the size and quality of the projectile and also the tissue injured. They are so seldom met with in our animals that an extended reference to them seems unnecessary. If a wound has been made by a bullet a careful examination should be made to ascertain whether the ball has passed through or out of the body. If it has not we must then probe for it, and if it can be located it is to be cut out when practicable to do so. Oftentimes a ball may be so lodged that it can not be removed, and it then may become encysted and remain for years without giving rise to any inconvenience. It is often difficult to locate a bullet, as it is very readily deflected by resistances met with after entering the body.
The entering wound is the size of the projectile, the edges are inverted and often scorched. The wound produced in case of the bullet's exit is larger than the projectile, the edges are turned out and ragged. A bullet heated by the friction of the barrel or air often softens and becomes flattened on striking a bone or other tissue. Modern bullets that have an outer steel layer may pass through bone without splintering it. Lead bullets may split, producing two exit wounds. Spent bullets may only produce a bruise. Should bones be struck by a ball they are sometimes shattered and splintered to such an extent as to warrant us in having the animal destroyed. A gunshot wound, when irreparable injury has not been done, is to be treated the same as punctured wounds, i. e., stop the hemorrhage, remove the foreign body if possible, and apply hot fomentations or poultices to the wound until suppuration is fairly established. Anti-septic and disinfectant injections may then be used. Should pus accumulate in the tissues, openings must be made at the most depending parts for its escape. Wounds from shotguns fired close to the animals are serious. They are virtually lacerated and contused wounds. Remove all the shot possible from the wound and treat as directed for contusions. When small shot strike the horse from a distance they stick in the skin or only go through it. The shot grains must be picked out, but as a rule this "peppering" of the skin amounts to but little.
POISONED WOUNDS.
These injuries are the result of bites of snakes, rabid dogs, stings of bees, wasps, etc. A single sting is not dangerous, but an animal is often stung by a swarm of insects, when the chief danger occurs from the swelling produced. If stung about the head, the nostrils may be closed as a result of the swelling, causing labored breathing and possibly asphyxiation. Intoxication may be produced by the absorption of this poison and is manifested by staggering gait, spreading of the legs, paralysis of the muscles, difficult respiration, and a rise of temperature. Death may follow in five to ten hours.
Treatment.--Douse animal with cold water and apply any alkaline liquid, such as soapsuds, bicarbonate of soda, or weak solution of ammonia. Internally give alcohol, ether, or camphor to strengthen the heart. In case of bites by rattlesnakes, moccasin, or other poisonous snakes, a painful swelling occurs about the bitten part, which is followed by labored breathing, weakness, retching, fever, and death from collapse. The animal usually recovers if it can be kept alive over the third day. In treating the animal, a tight ligature should be passed about the part above the wound to keep the poison from entering the general circulation. Wash out the wound thoroughly with antiseptics and then apply a caustic, such as silver nitrate, or burn with a hot instrument. A subcutaneous injection of one-fourth dram of 1 per cent solution of chromic acid above the wound is also beneficial. Cold water may be applied to the wound to combat the inflammation. Bites of rabid dogs produce an infected wound, and the virus of rabies introduced in this manner should be removed or destroyed in the wound. Therefore produce considerable bleeding by incising the wound, wash out thoroughly with 10 per cent solution of zinc chlorid, and then apply caustics or the actual cautery.
HARNESS GALLS (SITFASTS).
Wounds or abrasions of the skin are frequently caused by ill-fitting harness or saddles. When a horse has been resting from steady work for some time, particularly after being idle in a stable on a scanty allowance of grain, as in winter, he is soft and tender and sweats easily when put to work again. In this condition he is liable to sweat and chafe under the harness, especially if it is hard and poorly fitted. This chafing is likely to cause abrasions of the skin, and thus pave the way for an abscess or for a chronic blemish, unless attended to very promptly. Besides causing the animal considerable pain, chafing, if long continued, leads to the formation of a callosity. This may be superficial, involving only the skin, or it may be deep-seated, involving the subcutaneous fibrous tissue and sometimes the muscle and even the bone. This causes a dry slough to form, which is both inconvenient and unsightly. Sloughs of this kind are commonly called "sitfasts" and, while they occur in other places, are most frequently found under the saddle. (See also p. 475.)
Treatment.--Abrasions are best prevented by bringing the animal gradually into working shape after it has had a prolonged rest, in order that the muscles may be hard and the skin tough. The harness should be well fitted, neither too large nor too small, and it should be cleaned and oiled to remove all dirt and to make it soft and pliable. Saddles should be properly fitted so as to prevent direct pressure on the spine, and the saddle blankets should be clean and dry. Parts of the horse where chafing is likely to occur, as on the back under the saddle, should be cleaned and brushed free of dirt.
The remedies for simple harness galls are numerous. Among them may be mentioned alcohol, 1 pint, in which are well shaken the whites of two eggs; a solution of nitrate of silver, 10 grains to the ounce of water; sugar of lead or sulphate of zinc, 20 grains to an ounce of water; carbolic acid, 1 part in 15 parts of glycerin, and so on almost without end. Any simple astringent wash or powder will effect a cure, provided the sores are not irritated by friction.
If a sitfast has developed, the dead hornlike slough must be carefully dissected out and the wound treated carefully with antiseptics. During treatment it is always best to allow the animal to rest, but if this is inconvenient care should be taken to prevent injury to the abraded or wounded surface by padding the harness so that chafing can not occur.
BURNS AND SCALDS.
These wounds of domestic animals are fortunately of rare occurrence; however, when they do occur, if at all extensive, they prove to be quite troublesome and in many cases are fatal. According to the severity of the burn we distinguish three degrees: First degree, where there is a simple reddening of the skin; second degree, where there is a formation of vesicles, or blisters; third degree, where there is a complete destruction of vitality of the tissues, such as would occur in charring from direct contact with flames or from escaping steam. Besides the burns caused by flames and steam, there are other causative agents, such as chemicals (caustic alkalis and acids), lightning stroke, and occasionally the broken trolley wires of electric railways. When a large surface of the skin is burned or scalded, the animal (if it does not die at once from shock) will soon show signs of fever--shivering, coldness of the extremities, weakness, restlessness, quick and feeble pulse, and labored breathing. No matter which agent is a factor in the production of burns, the lesions are practically of the same nature. The extent and site of the burn should lead one in the determination and course of treatment. Burns of the shoulder and those about the region of the elbow or other parts where there is much movement of the tissues are grave, and, if at all extensive, treatment should not be attempted, but the immediate destruction of the animal is advised. A burn of the third degree, where there is a destruction of the vitality of large areas of tissue, even on parts not subject to much motion, is extremely tedious to treat; in fact, it is questionable whether the treatment and keep of the animal will ever be compensated for, even though recovery does take place; this, in any event, will require at least six or eight weeks. Burns caused by lightning stroke and trolley wires are liable to occur in irregular lines, and, unless death occurs at once, they generally are not serious.
Treatment.--Treatment should be prompt and effective. If the burns are extensive, the constitutional symptoms should be combated with whisky and milk and eggs, or ammonia carbonate, strychnin, caffein, or other stimulant to prevent shock. In the local treatment, to alleviate the pain, the application of cold water in some form and the hypodermic injection of morphine are to be recommended. In burns of the first degree, where there is only a superficial inflammation, lead carbonate (white lead) ointment is very good. Carron oil (limewater and linseed oil, equal parts) is a standard remedy, but a modification of it known as Stahl's liniment is perhaps better. This is composed of linseed oil and limewater each 200 parts, bicarbonate of soda 100 parts, and thymol 1 part. The scorched surface should be covered with this liniment and then with a layer of borated gauze or absorbent cotton, to protect from the air. The application should be frequently renewed. Carbolated vaseline may be used in place of the above. In case the burn is more extensive, the following solution may be used: Picric acid 2 parts, alcohol 40 parts, water 400 parts. The lesion should be thoroughly cleansed with this solution used on absorbent cotton. The vesicles, if any appear, should be opened with a clean needle, allowing the skin to remain. Strips of gauze or absorbent cotton saturated with the solution should now be applied and renewed only occasionally. In burns of the second and third degrees more satisfactory results may be obtained with nonpoisonous, dry dressing powder, such as is used in ordinary open wounds, as tannic acid 8 parts and iodoform 1 part, or a salve made of this powder and a sufficient quantity of vaseline. When sloughing of the tissues takes place the wounds should be cleansed with a warm 3 per cent solution of carbolic acid, all loose fragments of tissue removed, and either a dry, antiseptic dressing powder or carbolated vaseline ointment applied to exclude the air. Granulation tissue (proud flesh) should be controlled by the application of silver nitrate in the form of a caustic pencil.
Burns due to mineral acids may be first treated by flushing the parts with a copious quantity of cold water or by the application of whiting or chalk. Either use a large quantity of water at the start or use the chalk first, then wash with water. If the irritant has been a caustic alkali, such as potash, lye, ammonia, or soda, then vinegar should be the first application. Stahl's liniment is probably the best general application for all burns for the first week; then this should be followed by the ordinary antiseptic wound dressings.
GANGRENE.
Gangrene, or mortification, denotes the death of the affected part, and is mostly found attacking soft tissue near the surface of the body. Gangrenous areas may occur as a result of shutting off their blood supply. Constitutional diseases, such as ergotism, anthrax, and septicemia, predispose to gangrene. As external causes we have acids and alkalies, freezing and burning, contusions and continuous pressure that interrupt the circulation. There are two forms of gangrene--dry and moist. Dry gangrene is most often seen in horses from continuous lying down (decubitus) or from uneven pressure of some portion of the harness.
Symptoms.--There is a lack of sensation due to the death of nerves. In dry gangrene the skin is leathery and harsh, while in moist gangrene the tissues are soft, wrinkled, and friable; the hair is disturbed, and the skin is usually moist and soapy and sometimes covered with blebs. The tissue surrounding the moist gangrenous patch is usually inflamed, swollen, and hot, but this is less noticeable in the case of dry gangrene. Moist gangrene often spreads and involves deeper tissue, sheaths of tendons and joints producing septic synovitis or septic arthritis leading to pyemia and death. Dry gangrene is seldom dangerous, but the rapidity of its spread will indicate its virulence.
Treatment.--The preventive treatment consists in avoiding all the influences that tend to disturb the nutrition of the tissues, such as excessive cold or heat or continuous pressure. Gangrene following decubitus may be prevented by using soft bedding and frequently turning the animal from one side to the other. In dry gangrene moist heat in the form of poultices or anointing the tissue with oils and fats will be found beneficial in hastening the dead tissue to slough off. When the outer skin begins to suppurate, it should be removed with a pair of pincers, and the patch treated as an open wound. In moist gangrene the tissue should be thoroughly disinfected with a 3 per cent solution of compound cresol, or particularly an alcoholic tincture of camphor. Continuous irritation with antiseptic fluids prevents the accumulation and absorption of poisonous liquids. Incisions into the dead tissue may be made, and when sloughing commences the tissue should be removed with forceps and the resulting wound treated as in dry gangrene.
ULCERATION.
An ulcer is a circumscribed area of necrosis occurring on the skin or mucous membrane and covered with granulation tissue. It is a process of destruction, and when this process is going on faster than regeneration can take place, we have a gnawing, or eating, ulcer. When such an ulcer increases rapidly in size it is termed a phagedenic ulcer. A fungoid ulcer is one in which the bottom of the ulcer projects beyond the edge of the skin. These ulcers secrete milky or bloody-white liquid called ichor. When the ulcer is of an ashen or leaden color, with the bottom and sides formed of dense, hard connective tissue, which gives but little discharge and is not sensitive, it is termed callous, torpid, or indolent ulcer.
Causes.--As in the case of gangrene, disturbances of circulation are among the most frequent causes. A wound to a tissue with slight recuperative power may be followed by ulceration, as in tumors. Certain germs may produce ulcers, as the glanders bacilli, which cause the ulcerations on the nasal septum in glanders.
Treatment.--This consists in removing the exciting cause at once. The secretions of the ulcer should be washed off with antiseptic solutions and the formation of granulation tissues stimulated by antiseptic salves, such as carbolated vaseline, lead ointment, or by dressings of camphor. Air should be kept from the ulcer by occlusive dressings. Where the ulcers are inflamed, warm lead water or lead water and laudanum will be found efficacious. Callous ulcers are best removed by a curette, knife, or hot iron and then treated like a common wound. Mechanical irritation should be avoided.
ABSCESSES.
These consist of accumulations of pus within circumscribed walls, at different parts of the body, and may be classed as acute and cold or chronic abscesses.
When an abscess occurs about a hair follicle it is called a boil or furuncle; when several hair follicles are involved, resulting in the formation of more than one exit for the inflammatory products, it is called a carbuncle.
ACUTE ABSCESSES.
Acute abscesses follow as the result of local inflammation in glands, muscular tissue, or even bones. They are very common in the two former. The abscesses most commonly met with in the horse (and the ones which will be here described) are those of the salivary glands, occurring during the existence of "strangles," or "colt distemper." The glands behind or under the jaw are seen to increase slowly in size, becoming firm, hard, hot, and painful. At first the swelling is uniformly hard and resisting over its entire surface, but in a little while becomes soft (fluctuating) at some portion, mostly in the center. From this time on the abscess is said to be "pointing," or "coming to a head," which is shown by a small elevated or projecting prominence, which at first is dry, but soon becomes moist with transuded serum. The hairs over this part loosen and fall off, and in a short time the abscess opens, the contents escape, and the cavity gradually fills up--heals by granulations.
Abscesses in muscular tissue are usually the result of bruises or injuries. In all cases in which abscesses are forming we should hurry the ripening process by frequent hot fomentations and poultices. When they are very tardy in their development a blister over their surface is advisable. It is a common rule with surgeons to open an abscess as soon as pus can be plainly felt, but this practice can scarcely be recommended indiscriminately to owners of stock, since this little operation frequently requires an exact knowledge of anatomy. It will usually be found the better plan to encourage the full ripening of an abscess and allow it to open of itself. This is imperative if the abscess is in the region of joints, etc. When open, we must not squeeze the walls of the abscess to any extent. They may be very gently pressed with the fingers at first to remove the clots--inspissated pus--but after this the orifice is simply to be kept open by the introduction of a clean probe, should it be disposed to heal too soon. If the opening is at too high a level another should be made into the lowest portion of the abscess so as to permit the most complete drainage. Hot fomentations or poultices are sometimes required for a day or two after an abscess has opened, and are particularly indicated when the base of the abscess is hard and indurated.
The cavity should be thoroughly washed with stimulating antiseptic solutions, such as 3 per cent solution of carbolic acid, 3 per cent solution of compound cresol, 1 to 1,000 bichlorid of mercury, or 1 per cent permanganate of potash solution. If the abscesses are foul and bad smelling, their cavities should first be syringed with 1 part of hydrogen peroxid to 2 parts of water and then followed by the injection of any of the above-mentioned antiseptics.
COLD ABSCESSES.
Cold abscess is the term applied to those large, indolent swellings that are the result of a low or chronic form of inflammation, in the center of which there is a small collection of pus. They are often seen near the point of the shoulder, forming the so-called breast boil. The swelling is diffuse and of enormous extent, but slightly hotter than surrounding parts, and not very painful upon pressure. A pronounced stiffness, rather than pain, is evinced upon moving the animal. Such abscesses have the appearance of a hard tumor, surrounded by a softer edematous swelling, involving the tissues to the extent of a foot or more in all directions from the tumor. This diffused swelling gradually subsides and leaves the large, hardened mass somewhat well defined. One of the characteristics of cold abscesses is their tendency to remain in the same condition for a great length of time. There is neither heat nor soreness; no increase nor lessening in the size of the tumor; it remains in statu quo. If, however, the animal should be put to work for a short time the irritation of the collar causes the surrounding tissues to assume again an edematous condition, which after a few days' rest disappears, leaving the tumor as before or but slightly larger. Upon careful manipulation we may discover what appears to be a fluid deep seated in the center of the mass. The quantity of matter so contained is very small--often not more than a tablespoonful--and for this reason it can not, in all cases, be detected.
Cold abscesses are mostly, if not always, caused by the long-continued irritation of a loose and badly fitting collar. There is a slow inflammatory action going on, which results in the formation of a small quantity of matter inclosed in very thick and but partially organized walls that are not so well defined as is the circumference of fibrous tumors, which they most resemble.
Treatment.--The means recommended to bring the acute abscess "to a head" are but rarely effectual with this variety; or, if successful, too much time has been occupied in the cure. We must look for other and more rapid methods of treatment. These consist, first of all, in carefully exploring the tumor for the presence of pus. The incisions must be made over the softest part and carried deep into the tumor--to its very bottom, if necessary--and the matter allowed to escape. After this, and whether we have found matter or not, we must induce an active inflammation of the tumor, in order to promote solution of the thick walls of the abscess. This may be done by inserting well into the incision a piece of oakum or cotton saturated with turpentine, carbolic acid, tincture of iodin, etc., or we may pack the incision with powdered sulphate of zinc and keep the orifice plugged for 24 hours. These agents set up a destructive inflammation of the walls. Suppuration follows, and this should now be encouraged by hot fomentations and poultices. The orifice must be kept open, and should it be disposed to heal we must again introduce some of the agents above described. A favored treatment with many, and it is probably the best, is to plunge a red-hot iron to the bottom of the incision and thoroughly sear all parts of the walls of the abscess. This is to be repeated after the first slough has taken place if the walls remain thickened and indurated.
It is useless to waste time with fomentations, poultices, or blisters in the treatment of cold abscesses, since though apparently removed by such methods, they almost invariably return when the horse is put to work. Extirpation by the knife is not practicable, as the walls of the tumor are not sufficiently defined. If treated as above directed, and properly fitted with a good collar after healing, there will not remain any track or trace of the large, unsightly mass.
FISTULAS.
Definition.--The word fistula is applied to any ulcerous lesion upon the external surface of the body which is connected by ducts, or passages, with some internal cavity. Because of this particular formation the term fistulous tract is often used synonymously with the word fistula. Fistulas may exist in any part of the body, but the name has come to be commonly accepted as applicable only to such lesions when found upon the withers. Poll evil is a fistula upon the poll, and in no sense differs from fistulous withers except in location. The description of fistula will apply, then, in the main, to poll evil equally well. Quittor presents the characteristic tubular passages of a fistula and may, therefore, be considered and treated as fistula of the foot. Fistulous passages may also be developed upon the sides of the face, through which saliva is discharged instead of flowing into the mouth, and are called salivary fistulas. A dental fistula may arise from the necrosis of the root of a tooth. Again, a fistula is sometimes noted at the umbilicus associated with hernia, and recto-vaginal fistulas have been developed in mares, following difficult parturition. Fistulas may arise from wounds of glandular organs or their ducts, and thus we have the so-called mammary or lacrimal fistulas.
Fistulous tracts are lined with a false, or adventitious, membrane and show no disposition to heal. They constantly afford means of exit to the pus or ichorous material discharged by the unhealthy parts below. They are particularly liable to develop at the withers or poll because of the exposed positions which these parts occupy, and, having once become located there, they usually assert a tendency to further extension, because the vertical and laminated formation of the muscles and tendons of these parts allows the forces of gravitation to assist the pus in gaining the deeper-lying structures and also favors its retention among them.
Causes.--Fistulas follow as a result of abscesses, bruises, wounds, or long-continued irritation by the harness. Among the more common causes of fistula of the poll (poll evil) are chafing by the halter or heavy bridle; blows from the butt end of the whip; the horse striking his head against the hayrack, beams of the ceiling, low doors, etc. Fistulous withers are seen mostly in those horses that have thick necks as well as those that are very high in the withers; or, among saddle horses, those that are very low in the withers, the saddle here riding forward and bruising the parts. In either of these locations ulcers of the skin, or simple abscesses, if not properly and punctually treated, may become fistulas. They are often caused by bad-fitting collars or saddles, by direct injuries from blows, and from the horse rolling upon rough or sharp stones. The pus burrows and finds lodgment deep down between the muscles, and escapes only when the sinus becomes surcharged or when, during motion of the parts, the matter is forced to the surface.
Symptoms.--These, of course, will vary according to the progress made by the fistula. Following an injury we may often notice soreness or stiffness of the front legs, and upon careful examination of the withers we see small tortuous lines running from the point of irritation downward and backward over the region of the shoulder. These are superficial lymphatics, and are swollen and painful to the touch. In a day or two a swelling is noticed on one or both sides of the dorsal vertebrae, which is hot, painful, and rapidly enlarging. The stiffness of the limbs may disappear at this time, and the heat and soreness of the parts may become less noticeable, but the swelling remains and continues to enlarge.
A fistulous ulcer of the poll may be first indicated by the opposition which the animal offers to the application of stable brush or bridle. At this time the parts are so sore and sensitive that there is some danger that unless handled with the greatest care the patient will acquire disagreeable stable habits. The disease in its early stages may be recognized as a soft, fluctuating tumor surrounded by inflammatory swelling, with the presence of enlarged lymphatic vessels and stiffness of the neck. Later the inflammation of the surrounding tissues may disappear, leaving a prominent tumor. The swelling, whether situated upon the head or the withers, may open and form a running ulcer, or its contents may dry up and leave a tumor which gradually develops the common characteristics of a fibrous tumor. When the enlargement has opened we should carefully examine its cavity, as upon its condition will wholly depend our treatment.
Treatment.--In the earliest stage, when there is soreness, enlarged lymphatics, but no well-marked swelling, the trouble may frequently be aborted. To do this requires both general and local treatment. A physic should be given, and the horse receive 1 ounce of powdered saltpeter three times a day in his water or feed. If the fever runs high, 20-drop doses of tincture of aconite root every two hours may be administered. The local application of cold water to the inflamed spot for an hour at a time three or four times a day has often proved very beneficial, and has afforded great relief.
Cooling lotions, muriate of ammonia, or saltpeter and water; sedative washes, such as tincture of opium and aconite, chloroform liniment, or camphorated oil, are also to be frequently applied. Should this treatment fail to check the progress of the trouble, the formation of pus should be hastened as rapidly as possible. Hot fomentations and poultices are to be constantly used, and as soon as the presence of pus can be detected, the abscess wall is to be opened at its lowest point. In this procedure lies our hope of a speedy cure. As with any simple abscess, if drainage can be so provided that the pus will run off as fast as formed without remaining within the interstices of the tissues, the healing will be rapid and satisfactory.
Attention is again called to the directions given above as to the necessity of probing the cavity when opened. If upon a careful examination with the probe we find that there are no pockets, no sinuses, but a simple, regular abscess wall, the indication for treatment is to make an opening from below so that all the matter must escape. Rarely is anything more needed than to keep the orifice open and to bathe or inject the parts with some simple antiseptic wash that is not irritant or caustic. A low opening and cleanliness constitute the essential and rational treatment.
If the abscess has already opened, giving vent to a quantity of purulent matter, and the pipes and tubes leading from the opening are found to be extensive and surrounded with thick fungoid membranes, there is considerable danger that the internal ligaments or even some of the bones have become affected, in which case the condition has assumed a serious aspect. Or, on the other hand, if the abscess has existed for some time without a rupture, its contents will frequently be found to consist of dried purulent matter, firm and dense, and the walls surrounding the mass will be found greatly thickened. In such a case we must generally have recourse to the application of caustics which will cause a sloughing of all of the unhealthy tissue, and will also stimulate a rapid increase of healthy organized material to replace that destroyed in the course of the development and treatment of the disease. Threads or cords soaked in gum-arabic solution and rolled in powdered corrosive sublimate may be introduced into the canal and allowed to remain. The skin on all parts of the shoulder and leg beneath the fistula should be carefully greased with lard or oil, as this will prevent the discharge that comes from the opening after the caustic is introduced from irritating or blistering the skin over which it flows. In obstinate cases a piece of caustic potash (fused) 1 to 2 inches in length may be introduced into the opening and should be covered with oakum or cotton. The horse should then be secured so that he can not reach the part with his teeth. After the caustic plug has been in place for 24 hours, it may be removed and hot fomentations applied. As soon as the discharge has become again established the abscess should be opened from its lowest extremity, and the passage thus formed may be kept open by the introduction of a seton. If the pipes become established in the deep tissues beneath the shoulder blade or among the spines of the vertebral column, it will often be found impossible to provide proper drainage for the abscess from below, and treatment must consist of caustic solutions carefully injected into all parts of the suppurating sinuses. A very effective remedy for this purpose consists of 1 ounce of chlorid of zinc in half a pint of water, injected three times during a week, after which a weak solution of the same may be occasionally injected. Injections of Villate's solution or alcoholic solution of corrosive sublimate, strong carbolic acid, or possibly oil of turpentine will also prove beneficial. Pressure should be applied from below, and endeavors made to heal the various pipes from the bottom.
Should the swelling become general, without forming a well-defined tumor, the placing of 20 to 30 grains of arsenious acid, wrapped in a single layer of tissue paper, in a shallow incision beneath the skin, will often produce a sloughing of the affected parts in a week or 10 days, after which the formation of healthy tissue follows. The surrounding parts of the skin should be protected from any damage from escaping caustics by the application of lard or oil, as previously suggested.
Although the successful treatment of fistulas requires time and patience, the majority of cases are curable. The sinuses must be opened at their lowest extremity and kept open. Caustic applications must be thoroughly used once or twice, after which mild astringent antiseptic washes should be persistently used until a cure is reached.
It sometimes happens that the erosions have burrowed so deeply or in such a direction that the opening of a drainage passage becomes impracticable. In other cases the bones may be attacked in some inaccessible location, or the joints may be affected, and in these cases it is often best to destroy the horse at once.
The reappearance of the fistula after it has apparently healed is not uncommon. The secondary attack in these cases is seldom serious. The lesion should be carefully cleaned and afterwards injected with a solution of zinc sulphate, 20 grains to the ounce of water, every second or third day until a cure is effected.
In fistula of the foot we see the same tendency toward the burrowing of pus downward to lower structures, or in some cases upward toward the coronet. Prior to the development of a quittor there is always swelling at the coronet, accompanied with heat and pain. Every effort should now be made to prevent the formation of an abscess at the point of injury. Wounds caused by nails, gravel, or any other foreign body which may have lodged in the sole of the foot should be opened at once from below, so as to allow free exit to all purulent discharges. Should the injury have occurred directly to the coronet the application of cold fomentations may prove efficient in preventing the formation of an abscess.
When a quittor becomes fully established it should be treated precisely as a fistula situated in any other part of the body; that is, the sinuses should all be opened from their lowest extremities, so as to afford constant drainage. All fragments of diseased tissue should be trimmed away, antiseptic solutions injected, and, after covering the wound with a pad of oakum saturated with some good antiseptic wash, the whole foot may be carefully covered with clean bandages, which will afford valuable assistance to the healing process by excluding all dirt from the affected part.
Another form of treatment for this class of infections consists in the use of bacterial vaccines. Such treatment appears to be well adapted for the purpose, and according to current veterinary literature has met with success. These vaccines are composed of several strains of the organisms usually found in these pustular infections of the horse. Two kinds of vaccines are used: First, autogenic vaccines, which consist of heated (killed) cultures of the organism or organisms which are causing the trouble and which have been isolated from the lesions; second, stock vaccines, consisting of dead organisms of certain species generally found in these lesions and which are used in diseased conditions caused by one or the other of these germs. The vaccine is administered subcutaneously by means of a syringe, but the quantity of the vaccine to be injected and the number of doses to be used should be left to the judgment of a competent veterinarian.
INFECTIOUS DISEASES.
By RUSH SHIPPEN HUIDEKOPER, M. D., Vet.
[Revised by A. Eichhorn, D. V. S.]
GENERAL DISCUSSION.
An infectious disease may be defined as any malady caused by the introduction into the body of minute organisms of the vegetable or animal kingdom which have the power to multiply indefinitely and set free certain peculiar poisons which are chiefly responsible for morbid changes. Nearly all diseases of animals for which a definite cause may be attributed are caused by bacteria; such are tuberculosis, anthrax, blackleg, lockjaw, and others. There are some diseases, as, for instance, Texas fever and rabies, which are caused by a minute animal parasite known as protozoa, while others again, like lumpy jaw and aspergillosis, are caused by fungi. Besides there are infectious diseases in which the causative agents have never been successfully isolated, as they are so small that they can not be detected by the aid of the most powerful microscope, and accordingly they are termed as ultravisible viruses. Hog cholera, foot-and-mouth disease, smallpox, and others belong to this group.
Bacteria may be defined as very minute unicellular organisms of plantlike character. They multiply either by simple division or by spore formation, the latter usually taking place when the conditions pertaining to the growth of the bacteria become unfavorable. The spores are much more resistant to destruction than the bacteria which produce them.
Another group of parasites producing disease is known as protozoa. These are more complex than bacteria, and their artificial cultivation is also much more difficult than is the case with the bacterial parasites. Of the representatives of this group, causing disease in animals, are the trypanosomes, which are the causative factors of dourine and surra, and the piroplasma, which induce Texas fever in cattle and malaria or biliary fever of horses. There are also disease-producing fungi which are responsible for certain affections in horses; among these the most important are mycotic lymphangitis, or sporotrichosis, and streptotrichosis.
The introduction of the infection may take place in various ways. The most frequent method is by ingestion. Further, the entrance of the germs may occur by inhalation, skin abrasions, wounds of any kind, through the genital organs, and at times also through the milk ducts of the teats. As a general rule infectious diseases have a period of incubation which comprises the time elapsing between the exposure to the infection and the actual appearance of the disease. This period varies in the different diseases.
The treatment of infectious diseases is, as a rule, unsatisfactory. When the symptoms have once appeared a disease is liable to run its course in spite of treatment, and if it is one from which animals usually recover, all that can be done is to put them into the most favorable surroundings. Many infectious diseases lead sooner or later to death; treatment is useless so far as the sick animals are concerned, and it may be worse than useless for those not yet affected. All animals suffering with infectious diseases are more or less directly a menace to all others. They represent for the time being manufactories of disease germs, and they are giving them off more or less abundantly during the period of disease. They may infect others directly or they may scatter the virus about and the surroundings may become the future source of infection.
Therefore, in the control of infectious diseases prevention is the most important procedure. The isolation or segregation of healthy animals from infected ones should be primarily considered, and if at any time an animal manifests the symptoms of an infectious disease it is essential to protect the others from such a source of danger. In some of the infectious diseases it may become advisable to kill the infected animals in order to avoid the spread of the disease. This is especially important in diseases which are slow in their course, such as tuberculosis. At times when diseases appear in a country where they have not been prevalent it becomes advisable and necessary to protect the healthy herds by the slaughter of all the infected animals. Pursuance of this policy has resulted in control of the foot-and-mouth disease, and has proved to be a very satisfactory method of eradication.
DISINFECTION.
Disinfection is a very important phase in the control of infectious disease. This consists in the use of certain substances which possess the power to destroy bacteria or their spores, or both. The cheapest and most available for animal diseases are ordinary freshly slaked lime, or unslaked lime in powder form, chlorid of lime, crude carbolic acid, corrosive sublimate, formalin, formaldehyde, gas, cresol, etc.
In the disinfection of stables and premises it is essential to execute the work in a most thorough manner. This may be satisfactorily accomplished by carrying out the following directions:
1. Sweep ceilings, side walls, stall partitions, floors, and other surfaces until free from cobwebs and dust.
2. Scrape away all accumulation of filth, and if woodwork has become decayed, porous, or absorbent, it should be removed, burned, and replaced with new material.
3. If floor is of earth, remove 4 inches from the surface, and in places stained with urine a sufficient depth should be replaced to expose fresh earth. All earth removed should be replaced with earth from an uncontaminated source; it would be better still to lay a new floor of concrete, which is very durable and easily cleaned.
4. All refuse and material from stable and barnyard should be removed to a place not accessible to cattle or hogs. The manure should be spread on fields and turned under, while the wood should be burned.
5. The entire interior of the stable, especially the feeding troughs and drains, should be saturated with a disinfectant, as liquor cresolis compositus (U. S. P.), or carbolic acid, 6 ounces to every gallon of water, to which 4 ounces of chlorid of lime should be added. The best method of applying the disinfectant and the lime wash is by means of a strong spray pump, such as those used by orchardists. This method is efficient in disinfection against most of the contagious and infectious diseases of animals, and should be applied immediately following any outbreak, and, as a matter of precaution, it may be used once or twice yearly.
6. It is important that arrangements be made to admit a plentiful supply of sunlight and fresh air by providing an ample number of windows, thereby eliminating dampness, bad odor, and other insanitary conditions. Good drainage is also very necessary.
If the use of liquor cresolis compositus, carbolic acid, or other coal-tar products is inadmissible because of the readiness with which their odor is imparted to milk and other dairy products, bichlorid of mercury may be used in proportion of 1 to 800, or 1 pound of bichlorid to 100 gallons of water. All portions of the stable soiled with manure, however, should first be thoroughly scraped and cleaned, as the albumin contained in manure would otherwise greatly diminish the disinfecting power of the bichlorid. Disinfection with this material should be supervised by a veterinarian or other person trained in the handling of poisonous drugs and chemicals, as the bichlorid is a powerful, corrosive poison. The mangers and the feed boxes, after drying, following spraying with this material, should be washed out with hot water, as cattle are especially susceptible to mercurial poisoning. The bichlorid solution should be applied by means of a spray pump, as recommended for the liquor cresolis compositus.
VACCINATION.
In recent years vaccination for the prevention of certain infectious diseases has been successfully developed, and without a doubt the future has a great deal in store for this phase of prevention. At the present time vaccination has been found effective against blackleg, hog cholera, anthrax, lockjaw, strangles, rabies, hemorrhagic septicemia, white scours, etc. It is always essential, of course, that the products used for the vaccination be pure and potent; also they should be employed only with the advice of competent authorities and with proper care. The biological products prepared for the cure and prevention of infections are prepared by manufacturers who, in order to conduct an interstate business, are required to obtain a license from the United States Department of Agriculture for the manufacture of such preparations.
Since July 1, 1913, the Department of Agriculture, by an act of Congress of March 4, 1913, has had control of the manufacture of biological products for the treatment of domestic animals. The numerous complaints which were received from time to time relative to the impotency of some of the preparations, and also the fact that in some instances the use of the products were directly responsible in causing outbreaks of disease, made the necessity for such control obvious. This supervision is no doubt of far-reaching importance, as it assures the users that the preparations are reliable.
INFLUENZA.
Synonyms.--Pinkeye, typhoid fever, epizooty, epihippic fever, hepatic fever, bilious fever, etc.; flevre typhoide, grippe (French); Pferdestaupe (German); gastro-enteritis of Vatel and d'Arboval; febris erysipelatodes, Zundel; typhus of Delafond.
Definition.--The term influenza is applied to a febrile, contagious, infectious disease of horses, which is characterized by a blood infection, with inflammation of the mucous membranes, which frequently involves the lungs. Inflammatory complications also occur in the form of swellings of the subcutis, tendons, and tendinous sheaths and laminae of the feet. The causative agent has not been satisfactorily established. One attack usually protects the animal from future ones of the same disease, but not always. An apparently complete recovery is sometimes followed by serious sequelae of the nervous and blood-vessel systems. Under certain conditions of the atmosphere or from unknown causes, the disease is very liable to assume an epizootic form, with tendency to complications of especial organs, as, at one period, the lungs, at another the intestines, etc.
The first description of influenza is given by Laurentius Rusius in 1301, when it spread over a considerable portion of Italy, causing great loss among the war horses of Rome and the surrounding district. Later, in 1648, an epizootic of this disease visited Germany and spread to other parts of Europe. In 1711, under the name of "epidemica equorum," it followed the tracks of the great armies all over Europe, causing immense losses among the horses, while rinderpest was scourging the cattle of the same regions. The two diseases were confounded with each other, and were, by the scientists of the day, supposed to be allied to the typhus, which was a plague to the human race at the same time. We find the first advent of this disease to the British Islands in an epizootic among the horses of London and the southern counties of England in 1732, which is described by Gibson. In 1758 Robert Whytt recounts the devastation of the horses of the north of Scotland from the same trouble. Throughout the eighteenth century a number of epizootics occurred in Hanover and other portions of Germany and in France, which were renewed early in the present century, with complications of the intestinal tract, which obtained for it its name of gastro-enteritis. In 1766 it first attacked the horses in North America, but is not described as again occurring in a severe form until 1870-1872, when it spread over the entire country, from Canada south to Ohio, and then eastward to the Atlantic and westward to California. It is now a permanent disease in our large cities, selecting for the continuance of its virulence young or especially susceptible horses which pass through the large and ill-ventilated and uncleaned stables of dealers, and assumes from time to time an enzootic form, when from some reason its virulence increases. It assumes this form also when, from reasons of rural economy and commerce, large numbers of young and more susceptible animals are exposed to its contagion.
Etiology.--The experiments of Dieckerhoff many years ago proved that the disease may be transmitted to healthy animals by intravenous injection of warm blood from affected horses.
Further investigations revealed the fact that blood from affected horses, even when passed through porcelain filters, may transmit the disease, thereby proving that the causative agent belongs to the so-called filterable viruses. This has been further substantiated by Gaffky, who showed in his recent experiments that the disease may be transmitted with defibrinated as well as with filtered blood, in which cases the typical form of influenza developed in inoculated animals in from five to six days. These findings were also substantiated by Basset. Further observations have also proved that apparently recovered animals may harbor the infection for a long time and still be capable of transmitting the disease. Such virus carriers are no doubt responsible for numerous outbreaks of this disease when, in a locality free from the disease, it certainly appears after the introduction of an apparently healthy animal.
As one attack is usually self-protective, numbers of old horses, having had an earlier attack, are not capable of contracting it again; but, aside from this, young horses, especially those about four or five years of age, are much more predisposed to be attacked, while the older ones, even if they have not had the disease, are less liable to it. Again, the former age is that in which the horse is brought from the farm, where it has been free from the risk of exposure, and is sold to pass through the stables of the country taverns, the dirty, infected railway cars, and the foul stockyards and damp stables of dealers in our large cities. Overfed, fat, young horses which have just come through the sales stables are much more susceptible to contagion than the same horses are after a few months of steady work.
Pilger, in 1805, was the first to recognize infection as the direct cause of the disease. Roll and others studied the contagiousness of influenza, and, finding it so much more virulent and permanent in old stables than elsewhere, classed it as a "stall miasm." The contagion will remain in the straw bedding and droppings of the animal and in the feed in an infected stable for a considerable time and if these are removed to other localities it may be carried in them. It may be carried in the clothing of those who have been in attendance on horses suffering from the disease. The drinking water in troughs and even running water may hold the virus and be a means of its communication to other animals, even at a distance.
The studies of Dieckerhoff, in 1881, in regard to the contagion of influenza were especially interesting. He found that during a local enzootic, produced by the introduction of infected horses into an extensive stable otherwise perfectly healthy, the infection took place in what at first seemed to be a most irregular manner, but which was shown later to be dependent on the ventilation and currents of air through the various buildings. His experiments showed that the virus of influenza is excessively diffusible, and that it will spread rapidly to the roof of a building and pass by the apertures of ventilation to others in the neighborhood. The writer has seen cases that have appeared to spread through a brick wall and attack animals on the opposite side before others even in the same stable were affected. Brick walls, old woodwork, and the dirt which is too frequently left about the feed boxes of a horse stall will hold the contagion for several days, if not weeks, and communicate it to susceptible animals when placed in the same locality. On two successive mornings a 4-year-old colt belonging to the writer stood for about 10 minutes at the open door, fully 40 feet from the stalls, of a stable in which two cases of influenza had broken out the day before: in six days the colt developed the disease. On the morning when the trouble in the colt was recognized it stood in an infirmary with a dozen horses that were being treated for various diseases, but was immediately isolated; within one week two-thirds of the other horses had contracted the disease.
Symptoms.--After the exposure of a susceptible horse to infection a period of incubation of from four to seven days elapses, during which the animal seems in perfect health, before any symptom is visible. When the symptoms of influenza develop they may be intense, or so moderate as to occasion but little alarm, but the latter condition frequently exposes the animal to use and to the danger of the exciting causes of complications which would not have happened had it been left quietly in its stall in place of being worked or driven out to show to prospective purchasers. The disease may run a simple course as a specific fever, with alterations only of the blood, or at any period it may become complicated by local inflammatory troubles, the gravity of which is augmented by developing in an animal with an impoverished blood, an already irritated, rapid circulation, and defective nutritive and reparative functions.
The first symptoms are those of a rapidly developing fever, which becomes intense within a very short period. The animal becomes dejected and inattentive to surrounding objects; stands with its head down, and not back on the halter as in serious lung diseases. In the flanks, the muscles of the croup and of the shoulders, or of the entire body it has chills lasting from 15 to 30 minutes, and frequently a grinding of the teeth which warns one that a severe attack may be expected. The hairs become dry and rough and stand on end. The body temperature increases to 104 deg., 104.5 deg., and 105 deg. F., or even in severe cases to 107 deg. F., within the first twelve or eighteen hours. The horse becomes stupid, stands immobile with its head hanging, the ears listless, and it pays but little attention to the surrounding attendants or the crack of a whip. The stupor becomes rapidly more marked, the eyes become puffy and swollen with excessive lacrimation, so that the tears run from the internal canthus of the eye over the cheeks and may blister the skin in their course. The respiration becomes accelerated to 25 or 30 in a minute, and the pulse is quickened to 70, 80, or even 100, moderate in volume and in force. There is great depression of muscular force; the animal stands limp, as if excessively fatigued. There is diminution, or in some cases total loss, of sensibility of the skin, so that it may be pricked or handled without attracting the attention of the animal. On movement, the horse staggers and shows a want of coordination of all the muscles of its limbs. The senses of hearing, sight, and taste are diminished, if not entirely destroyed. The visible mucous membranes (as the conjunctiva), from which it received the name pinkeye, and the mouth, and the natural openings become of a deep saffron, ocher, or violet-red color. This latter is especially noticeable on the rim of the gums and is a condition not found in any other disease, so that it is an almost diagnostic symptom. In some outbreaks there is much more swelling of the lids and weeping from the eyes than in others. If the animal is bled at this period the blood is found more coagulable than normal, but at a later period it becomes of a dark color and less coagulable. There is great diminution or total loss of appetite, with an excessive thirst, but in many cases cold-blooded horses may retain a certain amount of appetite, eating slowly at hay, oats, or other feed. There is some irritation of the mucous membrane of the respiratory tract, as shown by discharge of mucus from the nose, and by cough. Pregnant mares are liable to abort.
We have, following the fever, a tumefaction, or edema, of the subcutaneous tissues at the fetlocks, of the under surface of the belly, and of the sheath of the penis, which may be excessive. The infiltration is noninflammatory in character and produces an insensibility of the skin like the excessive stocking which we see in debilitated animals after exposure to cold. In ordinary cases the temperature has reached its maximum of 105 deg. or 106 deg. F. in from 24 to 48 hours from the origin of the fever. It remains stationary for a period of from 3 to 4 days without so much variation between morning and evening temperature as we have in pneumonia or other serious diseases of the lungs. At the termination of the specific course of the disease, which is generally from 6 to 10 days, the fever abates, the swelling of the legs and under surface of belly diminishes, the appetite returns, the strength is rapidly regained, the mucous membranes lose their yellowish color, which they attain so rapidly at the commencement of the disease, and the animal convalesces promptly to its ordinary good condition and health, and rapidly regains the large amount of weight which it lost in the early part of the disease, a loss which frequently reaches 30, 50, or even 75 pounds each 24 hours. For the first three days of the high temperature there is a great tendency to constipation, which should be avoided if possible by the use of the means recommended below, for, if it has been marked, it may be followed by a troublesome diarrhea.
Terminations.--The terminations of simple influenza may be death by extreme fever, with failure of the heart's action; from excessive coma, due generally to a rapid congestion of the brain; to the poisonous effects of the debris of the disintegrated blood corpuscles and the toxin of the disease; to an asphyxia, following congestion of the lungs; or the disease terminates by subsidence of the fever, return of the appetite and nutritive functions of the organs, and rapid convalescence; or, in an unfortunately large number of cases, the course of the disease is complicated by local inflammatory troubles, whose gravity is greater in influenza than it is when they occur as sporadic diseases.
Complications.--The complications are congestions, followed by inflammatory phenomena in the various organs of the body, but they are most commonly located in the intestines, lungs, brain, or vascular laminae of the feet. Atmospheric influence or other surrounding influences of unknown quality seem to be an important factor in the determination of the local lesions. At certain seasons of the year, and in certain epizootics, we find 40 and 50 per cent or even a greater percentage of the cases rendered more serious by complication of the intestines; at other seasons of the year, or in other epizootics, we find the same percentage of cases complicated by inflammation of the lungs, while at the same time a small percentage of them are complicated by troubles of the other organs; inflammatory changes of the brain, of the laminae, more rarely commence in epizootic form, but are to be found in a certain small percentage of cases in all epizootics.
Exciting causes are important factors in complicating individual cases of influenza, or in localizing special lesions, during either enzootics or epizootics. These exciting or determining causes act much as they would in sporadic inflammatory diseases, but in this case we find the animal much more susceptible and predisposed to be acted upon than ordinary healthy animals. With a temperature already elevated, with the heart's action driving the blood in increased quantity into the distended blood vessels, which become dilated and lose their contractility, with a congestion of all the vascular organs already established, it takes but little additional irritation to carry the congestion one step further and produce inflammation.
Complication of the intestines.--When any cause acts as an irritant to the intestinal tract during the course of this specific fever it may produce inflammation of the organs belonging to it. This cause may be constipation, which can find relief only in a congestion which offers to increase the function of the glands and relieve the inertia caused by a temporary cessation of activity; or irritant medicines, especially any increased use of antimony, turpentine, or the more active remedies; the taking of indigestible feed, or of feed in too great quantities, or that has been altered in any way by fungus or other injurious alterations; the swallowing of too cold water; or any other irritant may cause congestion. This complication is ushered in by colics. The animal paws with the fore feet and evinces a great sensibility of the belly; it looks with the head from side to side, and may lie down and get up, not with violence, but with care for itself, perfectly protecting the surface of the belly from any violence. At first we find a decided constipation; the droppings if passed are small and hard, coated with a viscous varnish or even with false membranes. In from 36 to 40 hours the constipation is followed by diarrhea. The alimentary discharge becomes mixed with a sero-mucous exudation, which is followed by a certain amount of suppurative matter. The animal becomes rapidly exhausted and unstable, staggers on movement, losing the little appetite which may have remained, and has exacerbations of fever. The pulse becomes softer and weaker, the respiration becomes gradually more rapid, the temperature is about 1 deg. to 1.5 deg. F. higher. If a fatal result is not produced by the extensive diarrhea the discharge is arrested in from 5 to 10 days and a rapid recovery takes place.
Complication of the lungs.--If at any time during the course of the fever the animal is exposed to cold or drafts of air, or in any other way to the causes of repercussion, the lungs may become affected. In the majority of cases, however, after three, four, or five days of the fever, congestion of the lungs commences without any exposure or apparent exciting cause. Unless this congestion of the lungs is soon relieved it is followed by an inflammation constituting pneumonia. This pneumonia, while it is in its essence the same, differs from an ordinary pneumonia at the commencement by an insidious course. The animal commences to breathe heavily, which is distinctly visible in the heaving of the flanks, the dilatation of the nostrils, and frequently in the swaying movement of the unsteady body. The respirations increase in number, what little appetite remained is lost, the temperature increases from 1 deg. to 2 deg., the pulse becomes more rapid, and at times, for a short period, more tense and full, but the previous poisoning of the specific disease has so weakened the tissues that it never becomes the characteristic full, tense pulse of a simple pneumonia.
On percussion of the chest dullness is found over the inflamed areas; on auscultation at the base of the neck over the trachea a tubular murmur is heard. The crepitant rales and tubular murmurs of pneumonia are heard on the sides of the chest if the pneumonia is peripheral, but in pneumonia complicating influenza the inflamed portions are frequently disseminated in islands of variable size and are sometimes deep-seated, in which case the characteristic auscultory symptoms are sometimes wanting. From this time on the symptoms of the animal are those of an ordinary grave pneumonia, rendered more severe by occurring in a debilitated animal. The cough is at first hacky and aborted; later, more full and moist. There is discharge from the nostrils, which may be mucopurulent, purulent, or hemorrhagic. As in simple pneumonia, in the outset this discharge may be "rusty," owing to capillary hemorrhages. We find that the blood is thoroughly mixed with the matter, staining it evenly, instead of being mixed with it in the form of clots. At the commencement of the complication the animal may be subject to chills, which may again occur in the course of the disease, in which case, if severe, an unfavorable termination by gangrene may be looked for. If gangrene occurs it is shown by preliminary chills, a rapid elevation of temperature, a tumultuous heart, a flaky discharge from the nostrils, and a fetid breath; the symptoms are identical with those which occur in gangrene complicating other diseases.
Complication of the brain.--At any time during the course of the disease congestion of the brain may occur; at an early period if the fever has been intense from the outset, but in ordinary cases more frequently after three or four days. The animal, which has been stupid and immobile, becomes suddenly restless, walks forward in the stall until it fastens its head in the corner. If in a box stall and it becomes displaced from its position, it follows the wall with the nose and eyes, rubbing it along until it reaches the corner and again fastens itself. It may become more violent and rear and plunge. If disturbed by the entrance of the attendant or any loud noise or bright light, it will stamp with its fore feet and strike with its hind feet, but is not definite in fixing the object which it is resisting, which is a diagnostic point between meningitis and rabies and which renders the animal with the former disease less dangerous to handle. If fastened by a rope to a stake or post, the animal will wander in a circle at the end of the rope. It wanders almost invariably in one direction. The pupils may be dilated or contracted, or we may find one condition in one eye and the opposite in the other.
The period of excitement is followed by one of profound coma, in which the animal is immobile, the head hanging and placed against the corner of the stall, the body limp, and the motion, if demanded of the animal, unsteady. Little or no attention is paid to the surrounding noises, the crack of a whip, or even a blow on the surface of the body. The respiration becomes slower, the pulsations are diminished, the coma lasts for variable time, to be followed by excesses of violence, after which the two alternate, but if severe the period of coma becomes longer and longer until the animal dies of spasms of the lungs or of heart failure. It may die from injuries which occur in the ungovernable attacks of violence.
Complication of the feet.--The feet are the organs which are next in frequency predisposed to congestion. This congestion takes place in the laminae (podophyllous structures) of the feet. The stupefied animal is roused from its condition by excessive pain in the feet and assumes the position of a foundered horse; that is, if the fore feet alone are affected, they are carried forward until they rest on the heels; and if the hind feet are affected, all the feet are carried forward, resting on their heels, the hind ones as near the center of gravity as possible. In some cases the stupor of the animal is so great that the pain is not felt, and little or no change of the position of the animal is noticeable. The foot is found hot to the touch, and after a given time the depressed convex sole of typical founder is recognized.
Pleurisy.--This is a rare complication, but when it does occur it is ushered in by the usual symptoms of depression, rapid pulse, small respiration, elevation of the temperature, subcutaneous edema of the legs and under surface of the belly, and we find a line of dullness on either side of the chest and an abscess of respiratory murmur at the lower part. If it is severe, there may be an effusion filling one-fourth to one-third of the thoracic cavity in from 36 to 48 hours.
Pericarditis is an occasional complication of influenza. It is ushered in by chills, elevation of the temperature; the pulse becomes rapid, thready, and imperceptible. The heart murmurs become indistinct or can not be heard. A venous pulse is seen on the line of the jugular veins along the neck. Respiration becomes more difficult and rapid. If the animal is moved the symptoms become more marked or it may drop suddenly dead from heart failure.
Peritonitis, or inflammation of the membranes lining the belly and covering the organs contained in it, sometimes takes place. The general symptoms are similar to those of a commencing pericarditis. The local symptoms are those of pain, especially to pressure on side of the flanks and belly, distention of the latter, and sometimes the formation of flatus, or gas, and constipation.
Other occasional complications are nephritis, hepatitis, inflammation of the flexor tendons and rupture of them, and abscesses.
Diagnosis.--The diagnosis of influenza is based upon continued fever, with great depression and symptoms of stupor and coma; the rapidly developing, dark-saffron, ocher, yellowish discoloration of the mucous membranes, swelling of the legs and soft tissues of the genitals. When these symptoms have become manifested the diagnosis of a local complication is based upon the same symptoms that are produced in the local diseases from other causes, but in influenza the local symptoms are frequently masked or even entirely hidden by the intense stupor of the animal, which renders it insensible to pain. The evidence of colic and congestion, which is followed by diarrhea, indicates enteritis. The rapid breathing or difficulty of respiration points to a complication of the lungs, but, as we have seen in the study of the symptoms, the local evidences of lung lesions are frequently hidden. Again, we have seen that inflammation of the feet, or founder, complicating influenza is frequently not shown on account of the insensibility to pain on the part of the animal, which indicates the importance of running the hand daily over the hoofs to detect any sudden elevation of temperature on their surface.
The diagnosis of brain trouble is based upon the excessive violence which occurs in the course of the disease, for during the intervening period or coma there is no means of determining that it is due to this complication. Severe cases of influenza may simulate anthrax in the horse. In both we have stupor, the intense coloration of the mucous membranes of the eyes, and a certain amount of swelling of the legs and under surface of the belly. The diagnosis here can be made only by microscopic examination of the blood. In strangles, equine variola, and scalma we have an intensely red, rosy coloration of the mucous membranes, full, tense pulse, and although in these diseases we may have depression, we do not have the stupor and coma except in severe cases which have lasted for several days. In influenza we have no evidence of the formation of pus on the mucous membranes as in the other diseases, except sometimes in the conjunctivae.
In severe pneumonia (lung fever) we may find profound coma, dark-yellowish coloration of the mucous membranes, and swelling of the under surface of the belly and legs; but in pneumonia we have the history of the difficulty of breathing and an acute fever of a sthenic type from the outset, and the other symptoms do not occur for several days, while in influenza we have the history of characteristic symptoms for several days before the rapid breathing and difficulty of respiration indicate the appearance of the complication. Without the history it is frequently difficult to diagnose a case of influenza of several days' standing, complicated by pneumonia, from a case of severe pneumonia of five or six days' standing, but from a prognostic point of view it is immaterial, as the treatment of both are identical. The fact that other horses in the same stable or neighborhood have influenza may aid in the diagnosis.
Prognosis.--Influenza is a serious disease chiefly on account of its numerous complications. Uncomplicated influenza is a comparatively simple malady, and is fatal in but 1 to 5 per cent of all cases. In some outbreaks, however, complications of one kind or another preponderate; in such instances the rate of mortality is much increased.
Alterations.--The chief alteration of influenza occurs in the digestive tract, and consists in hyperemia, infiltration, and swelling of the mucous membrane, and especially of the Peyer's patches near the ileocecal valve. The tissues throughout the body are found stained, and of a more or less yellowish hue. There is always found a congested condition of all the organs, muscles, and interstitial tissues of the body. The coverings of the brain and spinal cord partake in the congested and discolored condition of the rest of the tissues.
Other alterations are dependent entirely upon the complications. If the lungs have been affected, we find effusions identical in their intimate nature with those of simple pneumonia, but they differ somewhat in their general appearance in not being so circumscribed in their area of invasion. The alterations of meningitis and laminitis are identical with those of sporadic cases of founder and inflammation of the brain.
Treatment.--While the appetite remains the patient should have a moderate quantity of sound hay, good oats, and bran; or even a little fresh clover, if obtainable, can be given in small quantities. It is not so important that a special diet shall be observed as that the horse shall eat a moderate quantity of nourishing feed, and he may be tempted with any feed of good quality that he relishes. He should be placed in a well-ventilated box stall away from other horses. Grass, roots, apples, and milk may be offered and, if relished, allowed freely. To reduce the temperature the safest simple plan is to inject large quantities of cold water into the rectum. Antipyrene may be used with alcohol or strychnia. Derivatives in the form of essential oils and mustard poultices, baths of alcohol, turpentine, and hot water, after which the animal must be immediately dried and blanketed, serve to waken the animal from the stupor and relieve the congestion of the internal organs. This treatment is especially indicated when complication by congestion of the lungs, intestines, or of the brain is threatened. Quinin and salicylic acid in 1-dram doses will lower the temperature, but too continuous use of the former in some cases increases the depression. Iodid of potash reduces the excessive nutrition of the congested organs and thereby reduces the temperature; again, this drug in moderate quantities is a stimulant to the digestive tract and acts as a diuretic, causing the elimination of waste matter by the kidneys. Small doses of Glauber's salt and bicarbonate of soda, used from the outset, stimulate the digestive tract and prevent constipation and its evil results.
In cases of severe depression and weakness of the heart digitalis can be used with advantage. At the end of the fever, and when convalescence is established, alcohol in one-half pint doses and good ale in 1-pint doses may be given as stimulants. To these may be added 1-dram doses of turpentine.
In complications of the intestines camphor and asafetida are most frequently used to relieve the pain causing the colics; diarrhea is also relieved by the use of bicarbonate of soda, nitrate of potash, and drinks made from boiled rice or starch, to which may be added small doses of laudanum.
In complication of the lungs iodid of potash and digitalis are most frequently indicated, in addition to the remedies used for the disease itself.
Founder occurring as a complication of influenza is difficult to treat. It is, unfortunately, frequently not recognized until inflammatory changes have gone on for several days. If recognized at once, local bleeding and the use of hot or cold water, as the condition of the animal may permit, are most useful, but in the majority of cases the stupefied animal is unable to be moved satisfactorily or to have one foot lifted for local treatment; the only treatment consists in local bleeding above the coronary bands and the application of poultices.
During convalescence small doses of alkalines may be kept up for a short time, but the greatest care must be used, while furnishing the animal with plenty of nutritious, easily digestible feed, not to over-load the intestinal tract, causing constipation and consequent diarrhea. Special care must be taken for several weeks not to expose the animal to cold.
Prevention.--In order to prevent the introduction of the disease it is advisable to isolate newly purchased animals for at least a week. Further, the stabling of healthy horses in sales and feed stables should also be guarded against. At the beginning of an outbreak the disease may be checked by immediate isolation of the affected horses, by taking the temperatures of the healthy animals, and by the segregation of those showing a marked elevation.
Bacterial vaccines are now being prepared for the prevention of this disease and also for its cure, but to date the results are not convincing as to the beneficial action of these products. Since the cause of the disease has not yet been satisfactorily determined it is difficult to conceive how immunity could be produced with the aid of the germs which enter into the preparation of these products. The reports would indicate, however, that vaccines exert a favorable influence upon the course of the disease, probably preventing severe complications which under ordinary conditions are the principal factors in determining the severity of the outbreak.
CONTAGIOUS PNEUMONIA.
Synonyms.--Edematous pneumonia; stable pneumonia; equine pleuropneumonia; influenza pectoralis equorum; pleuropneumonia; influenzal pneumonia; Brustseuche (German).
Contagious pleuropneumonia is an acute contagious disease of horses manifesting itself either as a croupous pneumonia or a pleuropneumonia with complications in the form of serous infiltrations of the subcutaneous tissues and tendons.
Etiology.--Investigators of this disease incriminated various kinds of microorganisms as the cause of this affection. Transmission experiments were usually negative with these organisms. This was also the case in attempts to transmit the disease by feeding with affected parts of the lungs, intestinal contents, and nasal discharge; likewise by intravenous or subcutaneous injections of blood and of emulsions made from nasal discharge, urine, the lung, and other organs.
The most recent experimental results of Gaffky and Lueber proved that at least at the beginning of the disease the bronchial secretion contains the infection. Upon killing horses affected with the typical forms of the disease on the third or fourth day of the affection the air passages are usually found to be filled with a yellowish, tenacious, germ-free secretion with which they succeeded in infecting healthy colts. The virus has not been isolated. The possibility of its being a protozoan is suggested by the above-named investigators through their observations of round or rod-shaped bodies in the round cells of the secretions.
Two organisms were formerly especially considered to play an important part in the cause of the disease, the Streptococcus pyogenes equi, which has been isolated from most cases of the disease, and the Bacillus equisepticus, which by some investigators was considered to be the cause of contagious pleuropneumonia. Although there is no doubt as to the presence of these microorganisms in most of the cases, their association with the cause of this disease, however, is now doubted, especially since attempts to transmit the disease with pure cultures of these germs failed to reproduce the typical form of the disease. They, however, are of great significance in connection with the pathological changes occurring in connection with the infection and probably are the determining factor in the course of the disease. They exert their action after the animal has already been attacked by the true virus, and then produce the inflammatory changes attributed to these secondary invaders.
This disease is the adynamic pneumonia of the older veterinarians, who did not recognize any essential difference in its nature from an ordinary inflammation of the lungs, except in the profound sedation of the force of the animal affected with it, which is a prominent symptom from the outset of the disease. Again, this same prostration of the vital force of the animal, combined with the staggering movement and want of coordination of the muscles, caused it for a long time to be confounded with influenza, with which at certain periods it certainly has a strong analogy of symptoms, but from which, as from sporadic pneumonia, it can be separated very readily if the case can be followed throughout its whole course.
Infectious pneumonia is a specific inflammation of the lungs, accompanied with interstitial edema and inflammation of the tissues of these organs and a constitutional disturbance and fever. It causes a profound sedation of the nervous system, which may be so great as to cause death. It is sometimes attended with pleurisy, inflammation of the heart or septic complications, which also prove fatal.
Old, cold, damp, foul, unclean, and badly drained and ventilated stables allow rapid dissemination of the disease to other horses in the same stable and act as rich reservoirs for preserving the contagion, which may be retained for over a year.
The virus is but moderately volatile, and in a stable seems rather to follow the lines of the walls and irregular courses than the direct currents of air and the tracts of ventilation. Prof. Dieckerhoff found that the contagion of influenza was readily diffusible throughout an entire stable and through any opening to other buildings, but he also found that the contagion of infectious pneumonia is not transmissible at any great distance, nor is it very diffusible in the atmosphere. A brick wall 8 feet in height served, in one instance, to prevent the infection of other animals placed on the opposite side from a horse ill with the disease, while others placed on the same side and separated from the focus of contagion only by open bars in the stall were infected and developed the disease in its typical form.
Symptoms.--The symptoms differ slightly from those of a frank, fibrinous pneumonia, but not so much by the introduction of new symptoms as by the want of or absence of the distinct evidences of local lesions which are found in the latter disease. All the pneumonias throughout the whole course of the trouble are less marked and less clearly defined.
The symptoms may develop slowly or rapidly. If slowly, there is fever and the animal gives a rare cough which resembles that of a heavy horse affected with a slight chronic bronchitis; it becomes somewhat dejected and dull, at times somnolent, and has a diminished appetite. This condition lasts for several days, or the disease may begin with high fever, and the symptoms described below are severe and develop in rapid sequence. The respiration increases to 24, 30, or 36 to the minute, and a small, running, soft pulse attains a rhythm of 50, 70, or even more beats in the sixty seconds. The heart, however, contrary to the debilitated condition of the pulse, is found beating violently and tumultuously, as it does in anthrax and septic intoxication. The mucous membranes of the eyes and mouth and of the genital organs are found somewhat edematous, and they rapidly assume a dirty, saffron color, at times approaching an ocher, but distinguishable from the similar coloration in influenza by the want of the luster belonging to the latter and by the muddy, dull tint, which is characteristic throughout the disease.
Suddenly, without the preliminary rales which precede grave lesions of the lungs in other diseases, the blowing murmur of pneumonia is heard over a variable area of the chest, usually, however, much more distinctly over the trachea at the base of the neck and directly behind the shoulder on each side of the chest. In some cases the evidence of lung lesion can be detected only over the trachea. The lesions of the lungs may be scattered throughout both lungs, involving numerous small areas, or they may be confined to and more or less fully occupy one or two lobes. Occasionally there is a general involvement of both lungs. The body temperature has now reached 104 deg. or 105 deg. F., or in extreme cases even a degree higher. The debility of the animal is great without the stupefaction or evidence of cerebral trouble, which is constant with such grave constitutional phenomena in influenza or severe pneumonia. The animal is subject to occasional chills, and staggers in its gait. The yellow coloration of the visible mucous membrane is rendered pale by infiltration of the liquid of the blood into the tissues; the pulse may become so soft as to be almost imperceptible, the heart movement and sounds being at the same time exaggerated. The animal loses flesh rapidly, and dropsies of the extremities, of the under surface of the belly, or of the internal organs may show themselves.
Terminations.--These symptoms may gradually subside after five to eight days, with an improved appetite the inanition may cease and the animal commence to nourish its impoverished blood and tissues; the pulse becomes stronger and the heart more regular and less tumultuous; the mucous membranes assume a brighter and more distinct color; the difficulty of respiration is removed, and the animal may make a recovery. When death occurs it is usually directly due to heart failure; in some cases it is caused by asphyxia, owing to the great amount of exudation into the lung tissue, rendering its further function impossible.
Complications.--The pulmonary complications of infectious pneumonia are secondary inflammatory or necrotic changes in the lungs themselves. Suppuration at times takes place in the bronchi and may extend to the lung tissue. In this case mucous rales develop which are most distinctly heard over the trachea and on the sides of the chest directly behind the shoulders. With the development of the mucous rales, to be heard on auscultation, we have a more purulent discharge from the nostrils, similar to that of a chronic or subacute bronchitis. If the inflammation has been of some standing, cavernous rales may be heard, indicating the destruction of a considerable portion of lung tissue and the formation of a cavity. The effects of this more acute inflammatory process are not appreciable in the general condition of the animal, except to weaken it still further and add to its debilitated and emaciated cachexia. Gangrene sometimes occurs. A sudden rise of the body temperature of 1 deg. or 2 deg., with a more enfeebled pulse and a still more tumultous heart, develop simultaneously with the appearance of a discharge from the nostrils. This discharge is gray in color, serous or watery in consistency, mixed with the detritus of broken-down lung tissue, and sometimes contains clots of blood, or in more serious cases may be marked by a quantity of fluid blood from a hemorrhage, which proves fatal. The discharge is fetid to the smell. The animal emaciates rapidly. On examination of the lungs mucous rales are heard in the larger bronchi, cavities may be found at any part of these organs, and points of lobular pneumonia may be detected.
A very serious complication is an inflammation of the heart muscle. This is shown by a very weak and rapid pulse, great prostration, some filling of the lungs. This complication nearly always terminates in death. Other complications which may be mentioned are inflammation of the kidneys, blood poisoning, congestion of the brain, and inflammation of the tendinous sheaths and the tendons of the legs.
Diagnosis.--As fever is the first symptom of infectious pneumonia, it is useful during an outbreak of this disease to make daily temperature measurements of the exposed horses, so that the first indication of disease may be discovered and the horse removed from contact with those that are sound.
Prognosis.--The mortality in this disease may be as high as 25 per cent, but it is usually not more than 10 per cent. If there is a special tendency to complications of some sort, the mortality is increased.
Alterations.--At the time of death from infectious pneumonia we frequently find septic changes and the evidences of putrefaction. The solidification of the lung tissue is found irregular in shape and high around the root of the lungs and the large bronchi, and is generally covered by sound lung tissue. The anterior lobes of the lungs are usually entirely affected. The diseased portion appears of a gray-yellowish color, somewhat watery, and tears readily. Matter is found in the air tubes which form gutters through the jellylike mass of the diseased lung. Abscesses from the size of a nut to larger masses may be found throughout the lungs. The blood is dark in color, fluid, or only clotted into soft, jellylike masses. Masses of gangrenous or dead-black tissue may be present.
Treatment.--Bleeding is not to be used, because it would only still further weaken an already enfeebled animal; antimony or the alterants would increase the depression of a too-depraved constitution. There is in this disease no acute congestion of a particular organ to draw off by depletive measures, nor any violent blood current to be retarded, for fear of hypernutrition of any special part.
Revulsives do good, as they excite the nervous system and awaken the torpor of the weakened blood vessels, which aid in the reestablishment of the functions. As in other diseases, mustard poultices may be applied over the belly and sides of the chest, but caution must be used in the employment of blisters, as ugly ulcers may result from their action on a tissue of weakened vitality. Setons are dangerous from the great tendency in this disease to septic complications. Repeated friction of the legs by hand-rubbing and warmth by bandaging and by rubbing the surface of the body with turpentine and alcohol, which is immediately to be dried by rough towels, will excite the circulation and stimulate the emunctories of the skin.
Stimulants are given internally from the outset of the disease. Turpentine in 1-dram doses regulates the heart and excites the kidneys to carry off waste matter, but if repeated too frequently may disturb the already delicate digestive system. Alcohol rectifies the latter danger, and is a useful stimulant to the heart and digestive system, if given with care in small doses. It is an antiputrid, and is especially indicated when septic complications and gangrene are present. The aromatics and bitter tonics are useful; gentian and tea in warm decoction form a useful menstruum for other remedies. Digitalis is a useful remedy. Strychnin and quinin may be given throughout almost the whole course of the disease. The various preparations of iron are astringents and excitants to the digestive system. Carbolic acid is an antiputrid which is of marked benefit in edematous pneumonia; it should be given in small doses diluted in alcohol.
Salicylic acid may be given in 1 or 2 dram doses every few hours. It is much used for troubles of the serous membranes, lowers the temperature, and is of value in this disease in preventing the exudation into the tissue of the lungs. The alkalines, as the sulphate and bicarbonate of soda, the nitrate of potash, and very small doses of the iodid of potash, should be employed to regulate the digestive tract, the kidneys, and the other excreting glands, and to stimulate absorption of the waste matter.
The biological products enumerated under the treatment of the catarrhal form of influenza are also recommended for this disease. The bacterial vaccines in particular are being employed to a great extent, but the results are not uniformly satisfactory, especially with regard to prevention. They might, however, exert a beneficial influence against an attack of the secondary invaders and complications. A serum is also being prepared especially for the treatment of this disease, and since this is obtained from animals which have been highly immunized against the various organisms found in association with influenza it no doubt is beneficial, especially when the life of the animal is threatened. Such serum, however, should be used in sufficiently large doses, as repeated experience has proved that small doses have no beneficial action on the disease.
More recently salvarsan is being highly recommended for the treatment of the pneumonic form of influenza, and by many investigators it is considered as a specific for this affection. A single injection of this preparation is supposed to result in a rapid clearing of the lungs and the recovery of the animal is hastened. The cost of this product, however, at the present time, is exorbitant, and it should be considered only in the treatment of very valuable animals.
The same procedure as given for influenza should be carried out in the prevention of this affection.
The diet demands the strictest attention from the outset. In many of the fevers the feed has to be diminished in quantity and regulated in the quality of its heat-producing components during the acute part of the disease, so as to lessen the material for combustion in the inflamed organs. In edematous pneumonia, on the contrary, all the feed that can possibly be digested and assimilated must be given. Choice must be made of the richest material which can be handled by the weakened stomach and intestines without fatiguing them. Good, sound hay should be chopped short and dampened or partly boiled; in the latter case the hay tea can be reserved to use as a drink. Oats may be preferred dry or in other cases are taken better scalded; in most cases, however, it is better to give slops of oatmeal, to which may be added a little bran, barley flour, or boiled milk and wheat flour. Pure cow's milk, not too rich in fatty matter, may be given alone or with beaten eggs; frequently the horse has to be coaxed with the milk diluted with several parts of water at first, but will soon learn to drink the pure milk. Apples and carrots cut up raw or boiled are useful, and fresh clover in small quantities will frequently stimulate the appetite. In other words, various feeds and combinations should be given to the horse. Throughout the course of the disease and during convalescence the greatest attention must be taken to cleaning the coat thoroughly so as to keep the glands of the skin in working order, and light, warm covering must be used to protect the animal from cold or drafts of air.
STRANGLES.
Synonyms.--Distemper; colt-ill; catarrhal fever; one form of shipping fever; febris pyogenica.
Definition.--Strangles is an infectious disease of the horse, mule, and ass, seen most frequently in young animals, and usually leaving them immune from future trouble of the same kind.
It appears as a fever lasting for a few days, and is usually associated with an abscess formation of lymph glands, especially those under the jaw, which have a tendency to break on the outside. It usually leaves the animal after convalescence perfectly healthy and as good as it was before, but sometimes leaves it a roarer or is followed by the development of deep-seated abscesses which may prove fatal.
Causes.--The cause of strangles is infection by direct contact with an animal suffering from the disease, or indirectly through contact with the discharges from an infected animal, or by means of the atmosphere in which an infected animal has been. There are many predisposing causes which render some animals much more subject to contract the disease than others. Early age, which has given it the popular name of colt-ill, offers many more subjects than the later periods of life do, for the animal can contract the disease but once, and the large majority of adult and old animals have derived an immunity from previous attacks. At 3, 4, or 5 years of age the colt, which has been at home, safe on a meadow or in a cozy barnyard, far from all intercourse with other animals or sources of contagion, is first put to work and driven to the market town or county fairs to be exposed to an atmosphere or to stables contaminated by other horses suffering from disease and serving as infecting agents. If it fails to contract it there, it is sold and shipped in foul, undisinfected railway cars to dealers' stables, equally unclean, where it meets many opportunities of infection. If it escapes so far, it reaches the time for heavier work and daily contact on the streets of towns or large cities, with numerous other horses and mules, some of which are sure to be the bearers of the germs of this or some other infectious disease, and at last it succumbs.
The period of the eruption of the last permanent teeth, or the end of the period of development from the colt to an adult horse, at which time the animals usually have a tendency to fatten and be excessively full-blooded, also seems to be a predisposing period for the contraction of this as well as of the other infectious diseases. Thoroughbred colts are very susceptible, and frequently contract strangles at a somewhat earlier age than those of more humble origin. Mules and asses are much less susceptible and are but rarely affected. Other animals are not subject to this disease, but there is a certain analogy between it and distemper in dogs. After exposure to infection there is a period of incubation of the disease, lasting from two to four days, during which the animal enjoys its ordinary health.
Symptoms.--The horse at first is a little sluggish if used, or when placed in its stable is somewhat dejected, paying but moderate attention to the various disturbing surroundings. Its appetite is somewhat diminished in many cases, while in some cases the animal eats well throughout. Thirst is increased, but not a great deal of water is taken at one time. If a bucket of water is placed in the manger the patient will dip its nose into it and swallow a few mouthfuls, allowing some of it to drip back and then stop, to return to it in a short time. The coat becomes dry and the hairs stand on end. At times the horse will have chills of one or the other leg, the fore quarters, or hind quarters, or in severe cases of the whole body, with trembling of the muscles and dryness of the skin.
If the eyes and mouth are examined the membranes are found reddened to a bright rosy color. The pulse is quickened and the breathing may be slightly accelerated. At the end of two days a cough is heard and a discharge begins to come from the nostrils. This discharge is at first watery; it then becomes thicker, somewhat bluish in color, and sticky, and finally it assumes the yellowish color of matter and increases greatly in quantity.
At the outset the colt may sneeze occasionally and a cough is heard. The cough is at first repeated and harsh, but soon becomes softer and moist as the discharge increases. Again, the cough varies according to the source of the discharge, for in light cases this may be only a catarrh of the nasal canals, or it may be from the throat, the windpipe, or the air tubes of the lungs, or even from the lungs themselves. According to the organ affected the symptoms and character of cough are similar to those of a laryngitis, bronchitis, or lung fever caused by ordinary cold.
Shortly after the discharge is seen a swelling takes place under the jaw, or in the intermaxillary space. This is at first puffy, somewhat hot and tender, and finally becomes distinctly so, and an abscess is felt, or having broken itself the discharge is seen dripping from a small opening. When the discharge from the nostrils has fully developed the fever usually disappears and the animal regains its appetite, unless the swelling is sufficient to interfere with the function of the throat, causing pain on any attempt to swallow. At the end of four or six days the discharge lessens, the soreness around the throat diminishes, the horse regains its appetite, and in two weeks has regained its usual condition. Old and strong horses may have the disease in so light a form that the fever is not noticeable; they may continue to eat and perform their ordinary work as usual and no symptom may be seen beyond a slight discharge from the nose and a rare cough, which is not sufficient to worry any but the most particular owner. But, on the other hand, the disease may assume a malignant form or become complicated so as to become a most serious disease, and even prove fatal in many cases. Inflammation of the larynx and bronchi, if excessive, produce violent, harsh coughing, which may almost asphyxiate the animal. The large amount of discharge may be mixed with air by the difficult breathing, and the nostrils, the front of the animal, manger, and surrounding objects become covered with a white foam. The inflammation may be in the lung itself (lobular pneumonia) and cause the animal to breathe heavily, heave at the flanks, and show great distress. In this condition marked symptoms of fever are seen, the appetite is lost, the coat is dry, the horse stands back in its stall at the end of the halter strap with its neck extended and its legs propped apart to favor breathing. This condition may end by resolution, leaving the horse for some time with a severe cough, or the animal may die from choking up of the lungs (asphyxia).
The swelling under the jaw may be excessive, and if the abscess is not opened it burrows toward the throat or to the side and causes inflammation of the parotid glands and breaks in annoying fistulas at the sides of the throat and even up as high as the ears. Roaring may occur either during a moderately severe attack from inflammation of the throat (larynx), or at a later period as the result of continued lung trouble. Abscesses may develop in other parts of the body, in the poll, in the withers, or in the spaces of loose tissue under the arms, in the fold of the thigh, and, in entire horses, in the testicles.
During the course of the disease, or later, when the animal seems to be on the road to perfect recovery, abscesses may form in the internal organs and produce symptoms characteristic of disease of those parts.
Roaring, plunging, wandering in a circle, or standing with the head wedged in a corner of the stall indicate the collection of matter in the brain. Sudden and severe lung symptoms, without previous discharge, point to an abscess between the lungs, in the mediastinum; colic, which is often continuous for days, is the result of the formation of an abscess in some part of the abdominal cavity, usually in the mesentery.
Pathology.--The lesions of strangles are found on the surface of the mucous membranes, essentially of the respiratory system, and in the loose connective tissue fibers of the internal organs and glands, and consist of acute inflammatory changes, tending to the formation of matter. The blood is unaltered, though it is rich in fibrin, and if the animal has died of asphyxia it is found dark colored and uncoagulated when the body is first opened. If the animal has died while suffering from high fever the ordinary alterations throughout the body, which are produced by any fever not attended by alteration of blood, are found.
Prevention.--Healthy horses should be separated from the infected animals, and the stables in which the disease has occurred should be thoroughly disinfected. Since the disease frequently occurs annually on infected premises, systematic disinfection should be practiced after an outbreak. The stables, as well as all utensils which might have come in contact with the infection, should be thoroughly disinfected. By such practices recurrences of the disease may be prevented.
Treatment.--Ordinary light cases require but little treatment beyond diet, warm washes, moistened hay, warm coverings, and protection from exposure to cold. The latter is urgently called for, as lung complications, severe bronchitis, and laryngitis are often the results of neglect of this precaution. If the fever is excessive, the horse may receive small quantities of Glauber's salt (handful three times a day) as a laxative, bicarbonate of soda or niter in one-dram doses every few hours, and small doses of antimony, iodid of potash, aconite, or quinin. Steaming the head with the vapor of warm water poured over a bucket of bran and hay, in which belladonna leaves or tar have been placed, will allay the inflammation of the mucous membranes and greatly ease the cough.
The swelling of the glands should be promptly treated by flaxseed poultices and bathing with warm water, and as soon as there is any evidence of the formation of matter it should be opened. Prompt action in this will often save serious complications. Blisters and irritating liniments should not be applied to the throat. When lung complications show themselves the horse should have mustard applied to the belly and to the sides of the chest. When convalescence begins great care must be taken not to expose the animal to cold, which may bring on relapses, and while exercise is of great advantage it must not be turned into work until the animal has entirely regained its strength.
Bacterial vaccines are now being extensively used for the prevention and treatment of this disease. They are prepared from the specific germ of the disease and frequently exert a very beneficial influence. A serum is also being prepared from horses, which is injected with gradually increasing doses of this germ. This serum possesses considerable curative value and may prove especially valuable in cases in which the animals have failed to respond to other forms of treatment, or when valuable animals are affected with the disease.
PURPURA HEMORRHAGICA.
Synonyms.--Anasarca; petechial fever; morbus maculosus.
Definition.--This disease is a septic bacterial intoxication, acute and infectious in character, and is manifested by edematous swellings of the subcutaneous connective tissue, and hemorrhages on the mucous membrane and in the internal organs.
A previous attack of influenza is a common predisposing cause of this disease, which appears most frequently a few weeks after convalescence is established. It occurs more frequently in those animals which have made a rapid convalescence and are apparently perfectly well than it does in those which have made a slower recovery.
Anasarca commences by symptoms which are excessively variable. The local lesions may be confined to a small portion of the animal's body and the constitutional phenomena be nil. The appearance and gravity of the local lesions may be so unlike, from difference of location, that they seem to belong to a separate disease, and complications may completely mask the original trouble.
In the simplest form the first symptom noticed is a swelling, or several swellings, occurring on the surface of the body--on the forearm, the leg, the under surface of the belly, or the side of the head. The tumefaction is at first the size of a hen's egg; not hot, little sensitive, and distinctly circumscribed by a marked line from the surrounding healthy tissue. These tumors gradually extend until they coalesce, and in a few hours we have swelling of the legs, legs and belly, or the head, to an enormous size; they have always the characteristic constricted border, which looks as if it had been tied with a cord. In the nostrils are found small reddish spots, or petechiae, which gradually assume a brownish and frequently a black color. Examination of the mouth will frequently reveal similar lesions on the surface of the tongue, along the lingual gutter, and on the fraenum. If the external swelling has been on the head, the petechiae of the mucous membranes are liable to be more numerous and to coalesce into patches of larger size than when the dropsy is confined to the legs. The animal may be rendered stiff by the swelling of the legs, or be annoyed by an awkward swollen head, which at times may be so enormous as to resemble that of a hippopotamus rather than that of a horse. During this period the temperature remains normal; the pulse, if altered at all, is only a little weaker; the respiration is only hurried if the swelling of the head infringes on the caliber of the nostrils. The appetite remains normal. The animal is attentive to all that is going on, and, except for the swelling, apparently in perfect health.
In from two to four days, in severe cases, the tissues can no longer resist the pressure of the exuded fluid. Over the surface of the skin which covers the dropsy we find a slight serous sweating, which loosens the epidermis and dries so as to simulate the eruption of some cutaneous disease. If this is excessive we may see irritated spots which are suppurating. In the nasal fossae the hemorrhagic spots have acted as irritants, and, inviting an increased amount of blood to the Schneiderian membrane, produce a coryza or even a catarrh. We may now find some enlargement and peripheral edema of the lymphatic glands, which are fed from the affected part. The thermometer indicates a slight rise in the body temperature, while the pulse and respiration are somewhat accelerated. The appetite usually remains good. In the course of a few days the temperature may have reached 102 deg., 103 deg., or 104 deg. F.
Fever is established, not an essential or specific fever in any way, but a simple secondary fever produced by the dead material from the surface or superficial suppuration, and by the oxidization and absorption of the colloid mass contained in the tissues. The skin may suppurate or slough more or less over the areas of greatest tension or where it is irritated by blows or pressure. The great swelling about the head may by closure of the nostrils interfere seriously with breathing. Internal edema may occur in the throat, lungs, or intestines. Septicemia, or blood poisoning, may result from anasarca.
Terminations.--The simple form of the disease most frequently terminates favorably on the eighth or tenth day by resolution or absorption of the effusion, with usually a profuse diuresis, and with or without diarrhea. The appetite remains good or is at times capricious.
Death may occur from mechanical asphyxia, produced by closure of the nostrils or closure of the glottis. Metastasis to the lungs is almost invariably fatal, causing death by asphyxia, Metastasis to the intestines may cause death from pain, enteritis, or hemorrhage.
Excessive suppuration, lymphangitis, and gangrene are causes of a fatal termination by exhaustion. Mortal exhaustion is again produced by inability to swallow in cases of excessive swelling of the head.
Peritonitis may arise secondary to the enteric edema, or by perforation of the stomach or intestines by a gangrenous spot. Septicemia terminates fatally with its usual train of symptoms.
Alterations.--The essential alterations of anasarca are exceedingly simple; the capillaries are dilated, the lymphatic spaces between the fibers of the connective tissue are filled with serum, and the coagulable portion of the blood presents a yellowish or citrine mass, jellylike in consistency, which has stretched out the tissue like the meshes of a sponge. Where the effusion has occurred between the muscles, as in the head, these are found dissected and separated from each other like those of a hog's head by the masses of fat. The surface of the skin is desquamated and frequently denuded of the hair. Frequently there are traces of suppuration and of ulceration. The mucous membrane of the nose is found studded with small, hemorrhagic spots, sometimes red, more frequently brown or black, often coalesced with each other in irregular-sized patches and surrounded by a reddish zone, the product of irritation. If edema of the intestines has occurred, the membrane is found four or five times its normal thickness, reddish in color, with hemorrhages on the free surface. Edema of the lungs leaves these organs distended. The secondary alterations vary according to the complications. There are frequently the lesions of asphyxia; externally we find ulcers, abscesses, and gangrenous spots and the deep ulcers resulting from the latter. The lymphatic cords and glands are found with all the lesions of lymphangitis. Again are found the traces of excessive emaciation, or the lesions of septicemia. Except from the complications the blood is not altered in anasarca.
Diagnosis.--The diagnosis of anasarca must principally be made from farcy or glanders. In anasarca the swelling is nonsensitive, while sensitive in the acute swelling of farcy. The nodes of farcy are distinct and hard and never circumscribed, as in the other disease. The eruption of glanders on the mucous membranes is nodular, hard, and pelletlike. The redness disappears on pressure. In case of excessive swelling of the head in anasarca, there may occur an extensive sero-fibrinous exudation from the mucous membranes of the nose, poured out as a semifluid mass or as a cast of the nasal fossae, never having the appearance or typical oily character which it has in glanders. The inflammation of the lymphatic cords and glands in anasarca does not produce the indurated character which is found in farcy.
Prognosis.--While anasarca is not an excessively fatal disease, the prognosis must always be guarded. The majority of cases run a simple course and terminate favorably at the end of 8 or 10 days, or possibly, after one to two relapses, requiring several weeks for complete recovery. Effusion into the head renders the prognosis much more grave from the possible danger of mechanical asphyxia. Threatened mechanical asphyxia is especially dangerous on account of the risk of blood poisoning after an operation of tracheotomy. Edema of the viscera is a most serious complication. The prognosis is based on the complications, their extent, and their individual gravity, existing, as they do here, in an already debilitated subject.
Treatment.--The treatment of anasarca may be as variable as are the lesions. The indications are at once shown by the alterations and mechanism of the disease, which we have just studied.
Hygiene comes into play as the most important factor. Oats, oat-and-hay tea, milk, eggs--anything which the stomach or rectum can be coaxed to take care of--must be employed to give the nutriment, which is the only thing that will permanently strengthen the tissues; they must be strengthened in order to keep the capillaries at their proper caliber.
Laxatives, diaphoretics, and diuretics must be used to stimulate the emunctories so that they may carry off the large amount of the products of decomposition which result from the stagnated effusions of anasarca. Of these the sulphate of soda in small, repeated doses, the nitrate of potash and bicarbonate of soda in small quantity, or the chlorate of potash in single large doses will be found useful. Williams cites the chlorate of potash as an antiputrid. Stimulants and astringents are directly indicated. Spirits of turpentine serves the double purpose of a cardiac stimulant and a powerful, warm diuretic, for the kidneys in this disease will stand a wonderful amount of work. Camphor can be used with advantage. Coffee and tea are two of the diffusible stimulants which are too much neglected in veterinary medicine; both are valuable adjuncts in treatment of anasarca, as they are during convalescence at the end of any grave disease which has tended to render the patient anemic. Dilute sulphuric and hydrochloric acids are, perhaps, the best examples of a combination of stimulant, astringent, and tonic which can be employed. The simple astringents of mineral origin, sulphates of iron, copper, etc., are useful as digestive tonics; I doubt whether they have any constitutional effect. The vegetable astringents, tannic acid, etc., have not proved efficacious in my hands. Iodid of potash in small doses serves the triple purpose of digestive tonic, denutritive for inflammation, and diuretic. Among the newer forms of treatment are diluted Lugol's solution injected into the trachea, anti-streptococcus serum and colloidal silver solution injected into the circulation. No one but a qualified veterinarian would be competent to apply these remedies.
Externally.--Sponging the swollen parts, especially the head, when the swelling occurs there, is most useful. The bath should be at an extreme of temperature--either ice cold to constrict the tissues or hot water to act as an emollient and to favor circulation. Vinegar may be added as an astringent. When we have excessively denuded surfaces, suppuration, or open wounds, disinfectants should be added to the wash.
In cases of excessive swelling, especially of the head, mechanical relief may be required. Even in country practice, punctures of the part should be made with the hot iron, as no other disease so predisposes to septic contamination. When mechanical asphyxia is threatened tracheotomy may be demanded. With the first evidence of dyspnea, not due to closing of the nostrils or glottis, or with the first pawing which gives rise to a suspicion of colic, a mustard plaster should be applied over the whole belly and chest. The sinapism will draw the current of the circulation to the exterior, the metastasis to the lungs or intestines is prevented, and the enfeebled nervous system is stimulated to renewed vigor by the peripheral irritation. The organs are encouraged by it to renewed functional activity; the local inflammation produced by it favors absorption of the exudation. The objection to the use of blisters is their more severe action and the danger of mortification. Septicemia, when occurring as a complication, requires the ordinary treatment for the putrid diseases, with little hope of a good result.
After recovery the animal regains its ordinary health, and there is no predisposition to a return of the disease.
HORSEPOX, OR EQUINE VARIOLA.
Synonyms.--Variola equina; pustular grease; phlyctenold herpes.
Definition.--Horsepox is a specific, infectious fever of the horse, attended by an eruption of pustules, or pocks, over any part of the skin or on the mucous membranes lining the various cavities in the body, but chiefly, and often exclusively, upon the pasterns and fetlocks. The eruption may commence upon the lips, or about the nostrils or eyes.
This disease was described by the early Roman agricultural writers and by the veterinarians of the eighteenth century. It received its first important notice from the great Jenner, who confounded it with grease in horses, since animals with this disease are very liable to have the eruption of variola appear on the fetlocks. He saw these cases transmit the disease to cattle in the byres and to the stablemen and milkmaids who attended them, and furnish the latter with immunity from smallpox, which led to the discovery of vaccination. Horsepox is also frequently mistaken for the exanthemata attending some forms of venereal disease in horses.
Variola in the horse, while it is identical in principle, general course, complications, and lesions with variola in other animals, is a disease of the horse itself, and is not transmissible in the form of variola to any other animal; nor is the variola of any other animal transmissible to the horse. Cattle and men, if inoculated from a case of horsepox, develop vaccinia, but vaccinia from the latter animals is not so readily reinoculated into the horse with success. If it does develop, it produces the original disease.
Causes.--The direct cause of horsepox is infection. A large number of predisposing causes favor the development of the disease, as in the case of strangles, and this trouble, like almost all contagious diseases, renders the animal which has had one attack immune. The chief predisposing cause is youthfulness. Old horses which have not been affected are less liable to become infected when exposed than younger ones. The exposure incident to shipment, through public stables, cars, etc., acts as a predisposing cause, as in the other infectious diseases. The period of final dentition is a time which renders it peculiarly susceptible.
Dupaul states that the infection is transmissible through the atmosphere for several hundred yards. The more common means of contagion is by direct contact or by means of fomites. Feed boxes and bridles previously used by horses affected with variola are probably the most frequent carriers of the virus, and we find the lesions in the majority of cases developed in the neighborhood of the lips and nostrils. Coition is a frequent cause. A stallion suffering from this disease may be the cause of a considerable epizootic, as he transmits it to a number of brood mares and they in turn return to the farms where they are surrounded by young animals to which they convey the contagion. The saddle and croup straps are frequent agents of infection. The presence of a wound greatly favors the inoculation of the disease, which is also sometimes carried by surgical instruments or sponges. Trasbot recites a case in which a set of hobbles, which had been used on an animal suffering from variola, were used on a horse for a quittor operation and transmitted the disease, which developed on the edges of the wound.
Symptoms.--There is a period of incubation, after an animal has been exposed, of from five to eight days, during which there is no appreciable alteration in the health. This period is shorter in summer than in winter. At the end of this time small nodes develop at the point of inoculation and the animal becomes feverish. The horse is dull and dejected, loses its appetite, and has a rough, dry coat with the hairs on end. There is moderate thirst. The respirations are somewhat quickened and the pulse becomes rapid and full. The body temperature is elevated, frequently reaching 104 deg. or 105 deg. F. within 36 or 48 hours from the appearance of the first symptoms.
The visible mucous membranes, especially the conjunctivae, are of a bright rosy red. In the lymphatic, cold-blooded, and more common horses these symptoms of fever are less marked; even with a comparatively high temperature the animal may retain its appetite and work comparatively well, but these cases, if worked and overheated, are liable to develop serious complications.
At the end of from three and a half to four days the eruption breaks out, the fever abates, and the general symptoms improve. The eruption in severe cases may be generalized; it may be confined to the softer skin of the nose and lips, the genital organs, and the inside of the thighs, or it may be localized in the neighborhood of a wound or in the irritated skin of a pair of greasy heels. It consists of a varying number of little nodes which, on a mucous membrane, as in the nostrils or vagina, or on soft, unpigmented skin, appear red and feel at first like shot under the epidermis. These nodes soften and show a yellowish spot in the center when they become pustules. The epidermis is dissolved and the matter escapes as a viscid fluid at first citrine and later cloudy and purulent, which dries rapidly, forming scabs; if these fall off or are removed they leave a little shallow, concave ulcer which heals in the course of five or six days. In the softer skin if pigmented the cicatrices are white and frequently remain so for about a year, when the pigment returns. The lips or genital organs of a colored horse, if covered with a number of small white spots about the size of a pea, will usually indicate that the animal has been affected with the horsepox.
At times the pustules may become confluent and produce large, superficial, serpentine ulcers on the membrane of the nostrils, around the lips or eyelids, or on the borders of wounds and in greasy heels; in this case the part becomes swollen, hot, painful, and is covered with a profuse discharge of matter. In this form there is frequently a secondary fever lasting for a day or two.
In severe cases there may be a suppurative adenitis, or inflammation of the lymphatic glands which are fed from the affected part. If the eruption is around the nostrils and lips, the glands between the jaws (submaxillary) form abscesses as in a case of strangles; if the eruption is in a pair of greasy heels abscesses may form in the fold of the groin (inguinal). There may be so much tumefaction of the nostrils as to produce difficulty in breathing.
Complications.--A case of horsepox may be attended with various complications of varying degrees of importance. Adenitis, or suppuration of the glands, has just been mentioned. Confluent eruptions irritate the part and induce the animal to rub the inflamed part against the manger or scratch it in other ways and thus produce troublesome ulcers, which may leave ugly scars. Irritation of the mucous membrane of the nose causes severe coryza with purulent discharge.
The eruption may occur in the throat or in the air tubes to the lungs, developing an acute laryngitis or bronchitis. If the animal is exposed to cold, or worked so as to engorge the lungs with blood at the termination of the specific fever, just when the eruption is about to localize, it may be determined to the lungs. In this case we have a short, dry cough, labored breathing, the development of a secondary fever of some gravity, and all the external symptoms of a pneumonia. This pneumonia differs, however, from an ordinary pneumonia in the symptoms furnished by the examination of the lungs themselves. In place of a large mass of the lung tissue being affected the inflammation is disseminated in smaller spots over the entire lung.
Diagnosis.--The diagnosis of horsepox is to be based on the presence of a continuous fever, with rosy mucous membranes, for several days and the appearance of the characteristic eruption. If the eruption is in the nasal cavities, marked by a considerable discharge and attended with submaxillary abscesses, it may be confounded with strangles. If the throat is affected, it may be confounded with an angina (laryngitis or pharyngitis), but in the latter the local trouble precedes or is concomitant with the fever, while in the former the fever precedes the local trouble by several days. Variola may be confounded with bronchitis or pneumonia if complicated with these troubles and the eruption is absent from the exterior, but it is of little moment, as the treatment for both is much the same. When the eruption is in the neighborhood of the genital organs the disease has been mistaken for dourine. In variola the eruption is a temporary one; the nodes and pustules are followed by shallow ulcers and rapid cicatrization unless continued in the vagina or on the penis by the rubbing of the walls and filth which accumulates; there are apt to be pustules at other parts of the body. In the venereal disease the local trouble commences as a papule and breaks into an ulcer without having formed a pustule. The ulcer has not the convex rosy appearance of that of the less serious discharge; the symptoms last for a longer period, by which time others aid in differentiating the two. In glanders the tubercle is hard and, after breaking into an ulcer, the indurated bottom remains, grayish or dirty white in color, ragged, and exuding a viscous, oily discharge. There is no disposition to suppuration of the neighboring glands. In variola the rosy shallow ulcer and healthy pus, with the acutely tumefied glands, should not be mistaken, at least after a day. I have seen in mules acute glanders which required a day's delay to differentiate from strangles; at that time the farcy buds appeared.
Prognosis.--The average case of horsepox runs a course of dejection, loss of appetite, and more or less fever for about four days, followed by a rapid convalescence, and leaves the animal as well and as sound as before. If the eruption has been excessive or confluent, the ulcerations may act as irritants and render the animal unfit for use for several weeks. Laryngitis, pharyngitis, bronchitis, and pneumonia in this disease are not of greater gravity than they are when occurring from other causes. The spots denuded of pigment left by the pustules on the lips and genitals may temporarily depreciate the value of the animal to a slight degree.
Treatment.--As this is a disease unattended by alterations of the blood itself, although a specific fever, and is of a sthenic type, active remedies are admissible and indicated. The horse should be placed on a low diet (little or no oats)--bran mashes, a moderate quantity of good, sound hay, a few carrots or apples, which will act as laxatives; also slop feed. Barley flour is more cooling for mashes than bran or oatmeal. Water may be given as the animal desires it, but it should not be cold; if a half bucketful of water is kept in the manger, the horse will take but a few swallows at a time. One-dram doses of nitrate of potash or 1-ounce doses of sweet spirits of niter are useful in the drinking water. If the fever is high, the antipyretics are indicated: Sulphate of quinin in 1-dram doses; iodid of potash in 1-dram doses; infusion of pine tops, of juniper leaves, of the aromatic herbs, or of English breakfast tea are useful in the later stages. If complications of the air passages or lungs are threatened, a large mustard poultice should be applied to the belly and sides of the chest. Oxid of zinc ointment should be used on confluent eruptions, and if the ulceration is excessive it may have to be touched with caustic.
Great care must be taken to keep the animal protected from cold drafts of air or other exposure. Blankets or sheets should be used on the body and bandages on the legs. After convalescence is established, nutritious feed of easy digestion and walking exercise are all that is needed, except perhaps a little Glauber's salt to prevent constipation.
Prophylactic treatment.--When horsepox breaks out among a large number of horses, especially on a farm where there are a number of colts, it may be assumed that the greater majority will contract the disease, and it is more economical that they should have it and be through with it at once. If the weather is moderate, all the animals which have not been affected can be inoculated, which will produce the disease in a mild form, with the eruption at a point of election, and render the danger of complication a minimum one. For inoculation the discharge from the pustules of a mild case should be selected and inoculated by scarification on the belly or the under surface of the neck.
ANTHRAX.
Synonyms: Carbuncle, splenic fever, splenic apoplexy, etc.; charbon, sang de rate (French); Miltzbrand (German).
Definition.--Anthrax is a severe and usually fatal contagious disease, characterized by chills, great depression and stupor of the animal, and a profound alteration of the blood. It is caused by the entrance into the animal's body of a bacterium, known as the Bacillus anthracis, or its spores.
Practically all animals are susceptible to anthrax. The herbivora are especially susceptible, in the following order: The sheep, the ox, and the horse. The guinea pig, the hog, the rabbit, mice, and other animals die quickly from its effects. Man, the dog, and other omnivora and carnivora may be attacked by it in a constitutional form as fatal as in the herbivora, but fortunately in many cases develop from it only local trouble, followed by recovery.
Anthrax has been a scourge of the animals of the civilized world since the first written history we have of any of their diseases. In 1709-1712 extensive outbreaks of anthrax occurred in Germany, Hungary, and Poland. In the first half of the nineteenth century it had become an extensively spread disease in Russia, Holland, and England, and for the last century has been gradually spreading in the Americas, more so in South America than here. In 1864, in the five governments of Petersburg, Novgorod, Olonetz, Twer, and Jaroslaw, in Russia, more than 10,000 horses and nearly 1,000 persons perished from the disease.
Causes.--The causes of anthrax were for a long time attributed entirely to climatic influence, soil, and atmospheric temperature, and they are still recognized as predisposing factors in the development of the disease, for it is usually found, especially when outbreaks in a great number of animals occur, in low, damp, marshy countries during the warm seasons. It is more frequent in districts where marshy lands dry out during the heat of summer and are then covered with light rains. Decaying vegetable matter seems most favorable for nourishing and preserving the virus.
The direct cause of anthrax is always infection of a previously sound animal, either directly from a diseased animal or through various media which contain excretions or the debris from the body of one previously infected.
The specific virus of anthrax was first discovered by Davaine in 1851. He recognized microscopic bodies in the form of little rods in the blood of animals suffering from anthrax. It was not, however, till a quarter of a century later that Pasteur defined the exact nature of the bacillus, the mode of its propagation, and its exact relationship to anthrax as the sole cause of the disease. In the animal body the bacilli have a tendency to accumulate in the spleen, liver, and elsewhere, so that these organs are much more virulent than the muscles or less vascular tissues. When eliminated from the animal in the excretions, or when exposed to outside influences by the death of the animal and the disintegration of the tissues, the body of the rod is destroyed and the spores only remain. These spores, which may be called the seeds of the bacilli, retain their vitality for a long period; they resist ordinary putrefaction; they are unchanged by moisture; and they are not affected by moderate heat. If scattered with the debris of a dead animal on the surface of the ground, they may remain around the roots of the grass in a pasture or may be washed to the nearest low-lying ground or marsh. If buried in the body of an animal dead from anthrax, they may be washed deep into the ground, and in later years (in one proved case 17 years) be brought to the surface and infect other animals. They are frequently brought to the surface of the earth, having been swallowed by earthworms, in the bodies of which they have been found.
This accounts for the outbreaks at the time of the first rains after a dry season. During the latter the earthworm goes deep in the ground in search of moisture; it finds the spore which has been washed there in past years, swallows it, and afterwards brings it to the surface. The virus is carried with the wool from infected sheep and remains in it through the process of manufacture into cloth. The spores remain in the hides of animals which have died of anthrax and retain their vitality throughout months of soaking in the tanners' pits, the working of the harness maker or the cobbler, and after the oiling of the completed leather. The dried spores in the dust from any of these products may be carried by the atmosphere.
Infection of an animal takes place through inoculation or contact of the bacillus or its spores with an abraded surface or mucous membrane, on a sound animal. In an infected district horses may eat with impunity the rich pasturage of spring and early summer, but when grass gets low they crop it close to the ground, pull up the roots around which the virus may be lodged, and under these conditions the animals are more apt to have abrasions of the lips or tongue by contact with dried stubble and the dirt on the roots; this favors the introduction of the germs into the system. The virus may be introduced with feed and enter the blood-vessel system from the stomach and intestines. If in the dust, dried hay, or on the parched pasture of late summer, the virus may be inhaled and be absorbed from the lining of the lungs. If in harness leather, it needs but an abrasion of the skin, as the harness rubs it, to transfer the spore from the leather to the circulation of the animal.
The writer saw a case of anthrax occur in a groom from the use of a new horse brush. The strap which passes over the back of the hand inoculated an abrasion on the knuckle of the first finger, and in 12 hours a "pustule" had formed and the arm had become infected.
Symptoms.--The symptoms of anthrax usually develop with extreme rapidity. The horse is dejected and falls into a state of profound stupor, attended with great muscular weakness. The feeble, indolent animal, if forced to move, drags its legs. There are severe chills, agitation of the muscles, symptoms of vertigo, and at times colicky pains. The mucous membranes turn a deep ocher or bluish-red color. The body temperature is rapidly elevated to 104 deg. or 105 deg. F. The breathing is increased to 30 or 40 respirations in the minute and the pulse is greatly accelerated, but while the arteries are soft and almost imperceptible, the heart beats can be felt and heard, violent and tumultuous. In some cases, when inoculation is through the skin, large subcutaneous swellings appear; these may involve a leg, a shoulder, one side of the body, or the neck or head. The swelling is at first hot and painful, but afterwards it becomes necrotic and sensation is lost. The symptoms last but two, three, or four days at most, when the case usually terminates fatally. An examination of the blood shows a dark fluid which will not clot, and which remains black after exposure to the air. After death the bodies putrefy rapidly and bloat up; the tissues are filled with gases, and a bloody foam exudes from the mouth, nostrils, and anus, and frequently the mucous membranes of the rectum protrude from the latter. The hairs detach from the skin. Congestion of all the organs and tissues is found, with interstitial hemorrhages. The muscles are friable and are covered with ecchymotic spots. This is especially marked in the heart.
The black, uncoagulated, and incoagulable blood shows an iridescent scum on its surface, which is due to the fat of the animal dissolved by the ammonia produced by the decomposed tissues. The serum oozes out of every tissue and contains broken-down blood, which, when examined microscopically, is found to have the red globules crenated and the leucocytes granular. A high power of the microscope also reveals the bacteria in the shape of little rodlike bodies of homogeneous texture with their brilliant spores.
The lymphatic ganglia are increased four, five, six, or ten times their natural size, enlarged by the engorgement of blood. The spleen shows nodulated black spots containing a muddy blood, which is found teeming with the virus. This organ is much enlarged and is quite friable. The mucous membranes of the intestines are congested and reddish brown; the surface of the intestines is in many places denuded of its lining membrane, showing fissures and hemorrhagic spots. The liver has a cooked appearance; the kidneys are congested and friable; the urine is red; the pleura, lungs, and the meninges are congested, and the bronchi of the lungs contain a bloody foam.
Treatment.--Treatment of anthrax in animals by medicinal means has not proved satisfactory. In cases of local anthrax an incision of the swelling followed by the application of disinfectants sometimes causes good results. In such cases, however, the danger of disseminating the infection from the wounds tends to make this procedure inadvisable unless great care is taken.
Good results are obtained from the use of serum in the treatment of the disease. For this purpose 30 to 100 cubic centimeters should be administered subcutaneously or intravenously. If no improvement is noticed within 24 hours the injection should be repeated. In a number of instances afforded to test the curative value of the serum in cases of anthrax in man and animals splendid results were obtained.
The prophylactic treatment formerly consisted in the avoidance of certain fields and marshes which were recognized as contaminated during the months of August and September and had been occupied the years in which the outbreaks usually occurred. It underwent, however, a revolution after the discovery by Pasteur of the possibility of a prophylactic inoculation or vaccination which granted immunity from future attacks of the disease similar to that granted by the recovery of an animal from an ordinary attack of the disease.
This treatment consists in the use of a vaccine which is made by the artificial cultivation of the virus of anthrax in broth and in the treatment of it by means of continued exposure to a high temperature for a certain time, which weakens the virus to such extent that it is capable of producing only a very mild and not dangerous attack of anthrax in the animal in which it is inoculated, and thus protects it from inoculation of a stronger virus. The production of this virus, which is carried on in some countries at the expense of the governments and is furnished at a small cost to the farmers in regions where the disease prevails, in this country is made in private laboratories only.
At the present time very good results are being obtained with vaccination consisting of an injection of highly potent anthrax serum on one side of the animal and a vaccine on the other side. This method of treatment requires only a single handling of the animals and further possesses advantages over the Pasteur treatment in that it immediately makes animals immune. In the numerous applications of this form of treatment very good results have been obtained and the immunity produced thereby visually lasts at least one year. The vaccinated animals should be kept for a period of ten days to two weeks from exposure, since during that period they are at times even more susceptible to the disease, and therefore care should be taken not to reduce their vitality.
Prevention.--In attempts to control the disease it is essential, aside from protective vaccination, to prevent the reinfection of localities. For this purpose it is essential, if possible, to drain thoroughly and keep under cultivation the infected areas before animals are permitted to pasture on them. The complete destruction of all anthrax carcasses is also very important. This is best accomplished by burning, but as this method of disposal is impracticable in many localities, deep burial may be found to be better. Covering the carcasses within their graves with quicklime adds another valuable precaution against further dissemination of the infection. No animal dying from anthrax should ever be skinned or cut open, as the blood from these sources is one of the most dangerous means of spreading the infection, being charged, while in the animal, with great numbers of bacilli, which quickly turn into spores as soon as spread about upon the face of the ground. All discharges from the body openings should also be burned or buried deeply, as they are frequently of a virulent character.
GLANDERS AND FARCY.
(Pls. XL-XLII.)
Definition.--Let it be understood at the outset that glanders and farcy are one and the same disease, differing only in that the first term is applied to the disease when the local lesions predominate in the internal organs, especially in the nostrils, lungs, and air tubes, and that the second term is applied to it when the principal manifestation is an outbreak of the lesions on the exterior or skin of the animal. The term glanders applies to the disease in both forms, while the term farcy is limited to the visible appearance of external trouble only; but in the latter case internal lesions always exist, although they may not be evident.
Glanders is a contagious constitutional disease of the genus Equus (the horse, ass, and mule), readily communicable to man, the dog, the cat, the rabbit, and the guinea pig. It is transmitted with difficulty to sheep and goats, and cattle seem to be entirely immune. It runs a variable course and usually produces the death of the animal affected with it. It is characterized by the formation of neoplasms, or nodules, of connective tissue, which degenerate into ulcers, from which exude a peculiar discharge. It is accompanied with a variable degree of fever, according to the rapidity of its course. It is subject to various complications of the lymphatic glands, of the lungs, of the testicles, of the internal organs, and of the subcutaneous connective tissue.
History.--Glanders is one of the oldest diseases of which we have definite knowledge in the history of medicine. Absyrtus, the Greek veterinarian in the army of Constantine the Great, described it with considerable accuracy and recognized the contagiousness of its character. Another Greek veterinarian, Vegetius Renatus, who lived in the time of Theodosius (381 A. D.), described, under the name of "malleus humidus," a disease of the horse characterized by a nasal discharge and accompanied by superficial ulcers. He recognized the contagious properties of the discharge of the external ulcers, and recommended that all animals sick with the disease be separated at once with the greatest care from the others and should be pastured in separate fields, for fear the other animals should become affected.
In 1682 Sollysel, the stable master of Louis XIV, published an account of glanders and farcy, which he considered closely related to each other, although he did not recognize them as identical. He admitted the existence of a virus which communicated the disease from an infected animal to a sound one. He called special attention to the feed troughs and water buckets as being the media of contagion. He divided glanders into two forms--one malignant and contagious and the other benign--and he stated that there was always danger of infection.
Garsault in 1746 said that "as this disease is communicated very easily and can infect in a very short time a prodigious number of horses by means of the discharges which may be licked up, animals infected with glanders should be destroyed."
Bourgelat, the founder of veterinary schools, in his "Elements of Hippiatry," published in 1755, establishes glanders as a virulent disease.
Extensive outbreaks of glanders are described as prevailing in the great armies of continental Europe and England from time to time during the periods of all the wars of the last few centuries.
Glanders was imported into America at the close of the eighteenth century, and before the end of the first half of the last century had spread to a considerable degree among the horses of the Middle and immediately adjoining Southern States. This disease was unknown in Mexico until carried there during the Mexican War by the badly diseased horses of the United States Army. During the first half of the last century a large body of veterinarians and medical men protested against the contagious character of the disease, and by their opinion prevailed to such an extent against the common opinion that several of the Governments of Europe undertook a series of experiments to determine the right between the contesting parties.
At the veterinary school at Alfort and at the farm of Lamirault in France several hundred horses which had passed examination as sound had placed among them glandered horses under various conditions. The results of these experiments proved conclusively the contagious character of the disease.
In 1881 Bouchard, of the faculty of medicine in Paris, assisted by Capitan and Charrin, undertook a series of experiments with matter taken from the farcy ulcer of a human being. They afterwards continued their experiments with matter taken from horses, and in 1883 succeeded in showing that glanders is caused by a bacterium which is capable of propagation and reproduction of others of its own kind if placed in the proper media. In 1882 the specific germ of glanders was first discovered and described by Loeffler and Schuetz in Germany.
When we come to study the etiology of glanders, the difference of susceptibility on the part of different species of animals, or even on the part of individuals of the same species, and when we come to find proof of the slow incubation and latent character of the disease as it exists in certain individuals, we understand how in a section of country containing a number of glandered animals others can seem to contract and develop the disease without having apparently been exposed to contagion.
Causes.--The contagious nature of glanders, in no matter what form it appears, being to-day definitely demonstrated, we can recognize but one cause for all cases, and that is contagion by means of the specific virus of the disease. The causative organism is known as the Bacillus mallei.
In studying the writings of the older authors on glanders, and the works of those authors who contested the contagious nature of the disease, we find a large number of predisposing causes assigned as factors in the development of the malady.
While a virus from a case of glanders if inoculated into an animal of the genus Equus will inevitably produce the disease, we find a vast difference in the contagious activity of different cases of glanders. We find a great variation in the manner and rapidity of the development of the disease in different individuals and that the contagion is much more liable to be carried to sound animals under certain circumstances than it is under others. Only certain species of animals are susceptible of contracting the disease, and while some of these contract it as a general constitutional malady, in others it develops as only a local sore.
In acute glanders the contagion is found in its most virulent form, as is shown by the inevitable infection of susceptible animals inoculated with the disease, while the discharge from chronic semilatent glanders and farcy may at times be inoculated with a negative result; again, in acute glanders, as we have a free discharge, a much greater quantity of virus-containing matter is scattered in the neighborhood of an infected horse to serve as a contagion to others than is found in the small amount of discharge of the chronic cases.
The chances of contagion are much greater when sound horses, asses, or mules are placed in the immediate neighborhood of glandered horses, drink from the same bucket, stand in the next stall, or work in the same wagon, or are fed from feed boxes or mangers which have been impregnated by the saliva and soiled by the discharge of sick animals. Transmission occurs by direct contact of the discharges of a glandered animal with the tissues of a sound one, either on the exterior, when swallowed mixed with feed into the digestive tract, or when dried and inhaled as dust.
The stable attendants serve as one of the most common carriers of the virus. Dried or fresh discharges are collected from the infected animals in cleaning, harnessing, feeding, and by means of the hands, clothing, the teeth of the currycomb, the sponge, the bridle, and the halter, and are thus carried to other animals.
An animal affected with chronic glanders in a latent form is moved from one part of the stable to another, or works hitched with one horse and then with another, and may be an active agent in the spreading of the disease without the cause being recognized.
Glanders is found frequently in the most insidious forms, and we recognize that it can exist without being apparent; that is, it may affect a horse for a long period without showing any symptoms that will allow even the most experienced veterinarian to make a diagnosis. An old gray mare belonging to a tavern keeper was reserved for family use with good care and light work for a period of eight years, during which time other horses in the tavern stable were from time to time affected with glanders without an apparent cause. The mare, whose only trouble was an apparent attack of heaves, was sold to a huckster who placed her at hard work. Want of feed and overwork and exposure rapidly developed a case of acute glanders, from which the animal died, and at the autopsy were found the lesions of an acute pneumonia of glanders grafted on chronic lesions, consisting of old nodules which had undoubtedly existed for years.
In a case that once came under the care of the writer, a coach horse was examined for soundness and passed as sound by a prominent veterinarian, who a few months afterwards treated the horse for a skin eruption from which it recovered. Twelve months afterwards it came into the hands of the writer, hidebound, with a slight cough and a slight eruption of the skin, which was attributed to clipping and the rubbing of the harness, but which had nothing suspicious in its character. The horse was placed on tonics and put to regular light driving. In six weeks it developed a bronchitis without having been specially exposed, and in two days this trouble was followed by a lobular pneumonia and the breaking of an abscess in the right lung. Farcy buds developed on the surface of the body and the animal died. The autopsy showed the existence of a number of old glanderous nodules in the lungs which must have existed previous to purchase, more than a year before.
Public watering troughs and the feed boxes of boarding stables and the tavern stables of market towns are among the most common recipients for the virus of glanders, which is most dangerous in its fresh state, but cases have been known to be caused by feeding animals in the box or stall in which glandered animals had stood several months before. While the discharge from a case of chronic glanders is much less liable to contain many active bacilli than that from a case of acute glanders, the former, if it infects an animal, will produce the same disease as the latter. It may assume from the outset an acute or chronic form, according to the susceptibility of the animal infected, and this does not depend upon the character of the disease from which the virus was derived.
The animals of the genus Equus--the horse, the ass, and the mule--are those which are the most susceptible to contract glanders, but in these we find a much greater receptivity in the ass and mule than we do in the horse. In the ass and mule in almost all cases the period of incubation is short and the disease develops in an acute form. We find that the kind of horse infected has an influence on the character of the disease; in full-blooded, fat horses of a sanguinary temperament, the disease usually develops in an acute form, while in the lymphatic, cold-blooded, more common race of horses the disease usually assumes a chronic form. If the disease develops first in the chronic form in a horse in fair condition, starvation and overwork are liable to bring on an acute attack, but when the disease is inoculated into a debilitated and impoverished animal it is apt to start in the latent form. Inoculation on the lips or the exterior of the animal is frequently followed by an acute attack, while infection by ingestion of the virus and inoculation by means of the digestive tract is often followed by the trouble in the chronic latent form.
In the dog the inoculation of glanders may develop a constitutional disease with all the symptoms which are found in the horse, but more frequently the virus pullulates only at the point of inoculation, remaining for some time as a local sore, which may then heal, leaving a perfectly sound animal; but while the local sore is continuing to ulcerate, and specific virus exists in it, it may be the carrier of contagion to other animals. In man we find a greater receptivity to glanders than in the dog, and in many unfortunate cases the virus spreads from the point of inoculation to the entire system and destroys the wretched mortal by extensive ulcers of the face and hemorrhage or by destruction of the lung tissue; in other cases, however, glanders may develop, as in the dog, in local form only, not infecting the constitution and terminating in recovery, while the specific ulcer by proper treatment is turned into a simple one. In the feline species glanders is more destructive than in the dog. The point of inoculation ulcerates rapidly and the entire system becomes infected.
While a student the writer saw a lion in the service of Prof. Trasbot, at Alfort, which had contracted the disease by eating glandered meat and died with the lung riddled with nodules. A litter of kittens lapped the blood from the lungs of a glandered horse on which an autopsy was being made, and in four days almost their entire faces, including the nasal bones, were eaten away by rapid ulceration. Nodules were found in the lungs. A pack of wolves in the Philadelphia Zoological Garden died in 10 days after being fed with the meat of a glandered horse. The rabbit, guinea pig, and mice are especially susceptible to the inoculation of glanders, and these animals are convenient witnesses and proofs of the existence of suspected cases of the glanders in other animals by the results of successful inoculations.
The primary lesion in any form is a local point in which occurs a rapid proliferation of the cell elements which make up the animal tissue with formation of new connective tissue, with a crowding together of the elements until their own pressure on one another cuts off the circulation and nutrition, and death takes place in them in the form of ulceration or gangrene. Following this primary lesion we have an extension of infection by means of the spread of the bacilli into those tissues immediately surrounding the first infected spot, which are most suitable for the development of simple inflammatory phenomena or the specific virus. The primary symptoms are the result of specific reaction at the point of inoculation, but at a later time the virus is carried by means of the blood vessels and lymphatic vessels to other parts of the body and becomes lodged at different places and develops in them; again, when the disease has existed in the latent form in the lungs of the animal and the virus is wakened into action from any cause, we have it carried to various parts of the body and developing in the most susceptible regions or organs. The points of development are most frequently determined by the activity of the circulation and the effects of exterior irritants. For example, if a horse which has been so slightly affected with the virus of glanders that no symptoms are visible is exposed to cold, rain, or sleet, or by the rubbing of the harness on the body and the irritation of mud on the legs, the disease is liable to develop on the exterior in the form of farcy, while a full-blooded horse which is employed at speed and has its lungs and respiratory tract gorged with blood from the extreme use of these organs will develop glanders as the local manifestation of the disease in the respiratory tract.
The previous reference to the existence of glanders under the two forms more commonly differentiated as glanders and as farcy, and our reference to the various conditions in which it may exist as acute, chronic, and latent, show that the disease may assume several different phases. Without for a moment losing sight of the fact that all these varied conditions are identical in their origin and in their essence, for convenience of study we may divide glanders into three classes--chronic farcy, chronic glanders, and acute glanders with or without farcy.
CHRONIC FARCY.
Symptoms.--In farcy the symptoms commence by formation of little nodes on the under surface of the skin, which rapidly infringe on the tissues of the skin itself. These nodes, which are known as farcy "buds" and farcy "buttons," are from the size of a bullet to the size of a walnut. They are hot, sensitive to the touch, at first elastic and afterwards become soft; the tissue is destroyed, and infringing on the substance of the skin the disease produces an ulcer, which is known as a chancre. This ulcer is irregular in shape, with ragged edges which overhang the sore; it has a gray, dirty bottom and the discharge is sometimes thin and sometimes purulent; in either case it is mixed with a viscous, sticky, yellowish material like the white of an egg in consistency and like olive oil in appearance. The discharge is almost diagnostic; it resembles somewhat the discharge which we have in greasy heels and in certain attacks of lymphangitis, but to the expert the specific discharge is characteristic. The discharge accumulates on the hair surrounding the ulcer and over its surface and dries, forming scabs which become thicker by successive deposits on the under surface until they fall off, to be replaced by others of the same kind; and the excess of discharge may drop on the hairs below and form similar brownish yellow crusts. The farcy ulcers may retain their specific form for a considerable time--days or even weeks--but eventually the discharge becomes purulent in character and assumes the appearance of healthy matter. The surface of the gangrenous bottom of the ulcer is replaced by rosy granulations, the ragged edges are beveled off, and the chancre is turned into a simple ulcer which rapidly heals.
The farcy buttons occur most frequently on the sides of the lips, the sides of the neck, the lower part of the shoulders, the inside of the thighs, or the outside of the legs, but may occur on any part of the body.
We have next an irritation of the lymphatic vessels in the neighborhood of the chancres. Those become swollen and then indurated and appear like great ridges underneath the skin; they are hot to the touch and sensitive. The cords may remain for a considerable time and then gradually disappear, or they may ulcerate like a farcy bud itself, forming elongated, irregular, serpentine ulcers with a characteristic, dirty, gray bottom and ragged edges, and pour out a viscous, oily discharge like the chancres themselves.
The essential symptoms of farcy are, as above described, the button, the chancre, the cord, and the discharge. We have in addition to these symptoms a certain number of accessory symptoms, which, while not diagnostic in themselves, are of great service in aiding the diagnosis in cases where the eruption takes place in small quantities, and when the ulcers are not characteristic.
Epistaxis, or bleeding from the nose without previous work or other apparent cause, is one of the frequent concomitant symptoms in glanders, and such hemorrhage from the nostrils should always be regarded with suspicion. The animal with farcy frequently develops a cough, resembling much that which we find in heaves--a short, dry, aborted, hacking cough, with little or no discharge from the nostrils. With this we find an irregular movement of the flanks, and on auscultation of the lungs we find sibilant or at times a few mucous rales. Another common symptom is a sudden swelling of one of the hind legs; it is found suddenly swollen in the region of the cannon, the enlargement extending below to the pastern and above as high as the stifle. This swelling is hot and painful to the touch, and renders the animal stiff and lame. On pressure with the finger the swelling can be indented, but the pits so formed soon fill again on removal of the pressure. In severe cases we may have ulceration of the skin, and serum pours out from the surface, resembling the oozing which we have after a blister or in a case of grease. This swelling is not to be confounded with the stocking in lymphatic horses or the edema which we have in chronic heart or in kidney trouble, as in the last the swelling is cool, not painful, and the pitting on pressure remains for some time after the latter is withdrawn. It is not to be confounded with greasy heels. In these the disease commences in the neighborhood of the pastern and gradually extends up the leg, rarely passing beyond the neighborhood of the hock. The swollen leg in glanders almost invariably swells for the entire length in a single night or within a very short period. When greasy heels are complicated by lymphangitis we have a condition very much resembling that of farcy. The swelled leg in farcy is frequently followed by an outbreak of farcy buttons and ulcers over its surface. In the entire horse the testicles are frequently swollen and hot and sensitive to the touch, but they have no tendency to suppuration. The acute inflammation is rapidly followed by the specific induration, which corresponds to the local lesions in other parts of the body.
Chronic farcy in the ass and mule is an excessively rare condition, but sometimes occurs.
CHRONIC GLANDERS.
Symptoms.--In chronic glanders we find the same train of inflammatory phenomena, varying in appearance from those of chronic farcy only by the difference of the tissues in which they are situated. In chronic glanders there is first the nodule, from the size of a shot to that of a small pea, which forms in the mucous membranes of the respiratory tract. This may be just inside the wings of the nostrils or on the septum which divides the one nasal cavity from the other, and may be easily detected, or it may be higher in the nasal cavities on the turbinated bones, or it may form in the larnyx itself or on the surface of the trachea or deep in the lungs.
The nodules, which are first red and hard and consist of new connective tissue, soon soften and become yellow; the yellow spots break and we have a small ulcer the size of the preceding nodule, which has a gray, dirty bottom and ragged edges and is known as a chancre. This ulcer pours from its surface a viscous, oily discharge similar to that which we have seen in the farcy ulcer. The irritation of the discharge may ulcerate the lining mucous membrane of the nose, causing serpentine gutters with bottoms resembling those of the chancres themselves. If the nodules have formed in large numbers, we may have them causing an acute inflammation of the Schneiderian membrane, with a catarrhal discharge which may mark the specific discharge, or that which comes from the ulcers and resembles the discharge of strangles or simple inflammatory diseases.
The eruption of the ulcers and discharge soon cause an irritation of the neighboring lymphatics; and in the intermaxillary space, deep inside of the jaws, we find an enlargement of the glands, which for the first few days may seem soft and edematous, but which rapidly becomes confined to the glands, these being from the size of an almond to that of a small bunch of berries, exceedingly hard and nodulated. This enlargement of the glands is found high on the inside of the jaws, firmly adherent to the base of the tongue. It is not to be confounded with the puffy, edematous swelling, which is not separated from the skin and subcutaneous connective tissues found in strangles, in laryngitis, and in other simple inflammatory troubles.
These glands bear a great resemblance to the indurated glands which we find in connection with the collection of pus in the sinuses; but in the latter disease the glands have not the extreme nodulated feel which they have in glanders. With the glands we find indurated cords, feeling like balls of tangled wire or twine, fastening the glands together.
The essential symptoms of glanders are the nodule, the chancre, the glands, and the discharge. With the development of the nodules in the respiratory tract, according to their number and the amount of eruption which they cause, we may find a cough which resembles that of a coryza, a laryngitis, a bronchitis, or a broncho-pneumonia, according to the location of the lesions. In chronic glanders we find the same accessory symptoms that occur in chronic farcy, the hemorrhage of the nose, the swelling of the legs, the chronic cough, and, in the entire horse, the swelling of the testicles.
On healing, the chancres on the mucous membranes leave small, whitish, star-shaped scars, hard and indurated to the touch, and which remain for almost an indefinite time. The chancres heal and the other local symptoms disappear, with the exception of the enlargement of the glands, and we find these so diminished in size that they are scarcely perceptible on examination. During the subacute attacks, with a minimum quantity of local troubles, in chronic glanders and in chronic farcy the animal rarely shows any degree of fever, but does have a generally depraved appearance; it loses flesh and becomes hidebound; the skin becomes dry and the hairs stand on end. There is a cachexia, however, which resembles greatly that of any chronic, organic trouble, but is not diagnostic, although it has in it certain appearances and conditions which often render the animal suspicious to the eye of the expert veterinarian, while, without the presence of local lesions he would be unable to state on what he has based his opinion.
ACUTE GLANDERS.
Symptoms.--In the acute form of glanders we find the symptoms which we have just studied in chronic farcy and in chronic glanders in a more acute and aggravated form. There is a rapid outbreak of nodules in the respiratory tract which rapidly degenerate into chancres and pour out a considerable discharge from the nostrils. There is a cough of more or less severity according to the amount and site of the local eruption. Over the surface of the body swellings occur which are rapidly followed by farcy buttons, which break into ulcers; we find the indurated cords and enlargement of the lymphatics.
Bleeding from the nose, sudden swelling of one of the hind legs, and the swelling of the testicles are liable to precede an acute eruption of glanders. As the symptoms become more marked the animal has difficulty of respiration, the flanks heave, the respiration becomes rapid, the pulse becomes quickened, and the temperature becomes elevated to 103 deg., 104 deg., or 105 deg. F.
With the other symptoms of an acute fever the general appearance and station of the animal is that of one suffering from an acute pneumonia, but upon examination, while we may find sibilant and mucous rales over the side of the chest, and may possibly hear tubular murmurs at the base of the neck over the trachea, we fail to find the tubular murmur or the large area of dullness on percussion over the sides of the chest which belongs to simple pneumonia.
Diagnosis.--When there is doubt as to the diagnosis, the mallein test, the inoculation test, or the complement-fixation test may be employed. The mallein test is made by injecting mallein (a sterilized extract from a culture of glanders bacilli) beneath the skin. If the horse has glanders there results a febrile reaction and a swelling at the point of injection. If the horse does not have glanders the mallein has no effect or, at most, it produces a slight swelling only at the point of injection. The inoculation test consists in the inoculation of a susceptible animal (usually a guinea pig) with some of the suspected discharge from the nose or a farcy ulcer. If the material is properly used, and if it contains bacilli of glanders, the experimental animal will develop the disease.
The eye test is now universally accepted as a very satisfactory means of diagnosing glanders. This consists in dropping into an eye of a suspected animal a specially prepared solution of mallein, as a result of which in an infected animal the inflammation develops in the eye, resulting in a discharge which varies in intensity from a mucopurulent character to a thick, sticky pus. The eyelids may also swell and many times become glued together. The reaction usually appears in from 8 to 20 hours after the introduction of the mallein.
Neither of these tests should be put into use except by a competent veterinarian. The complement-fixation test is a highly specialized laboratory test and can be carried out only by one versed in laboratory technique. (See Bureau of Animal Industry Bulletin 136.)
The post-mortem examination of the lungs shows that the pneumonia of glanders is a lobular, V-shaped pneumonia scattered throughout the lungs and caused by the specific inflammatory process taking place at the divergence of the smaller air tubes of the lungs. In some cases of acute glanders the formation of nodules may so irritate the mucous membrane of the respiratory tract and cause such a profuse discharge of mucopurulent or purulent matter that the specific character of the original discharge is entirely masked. In this case, too, for a few days the submaxillary space may so swell as to resemble the edematous, inflamed glands of strangles, equine variola, or laryngitis. This condition is especially liable to be marked in an acute outbreak of glanders in a drove of mules.
Cases of chronic farcy and glanders, if not destroyed, may live in a depraved condition until the animal dies from general emaciation and anemia, but in the majority of cases, from some sudden exposure to cold, it develops an acute pneumonia or other simple inflammatory trouble which starts the latent disease and the animal has acute glanders.
In the ass, mule, and plethoric horses acute glanders usually terminates by lobular pneumonia. In other cases the general symptoms may subside. The symptoms of pneumonia gradually disappear, the temperature lowers, the pulse becomes slower, the ulcers heal, leaving small, indurated cicatrices, and the animal may return to apparent health, or may at least be able to do a small amount of work with but a few symptoms of the disease remaining in a chronic form. During the attack of acute glanders the inflammation of the nasal cavities frequently spreads into the sinuses or air cells, which are found in the forehead and in front of the eyes on either side of the face, and causes abscesses of these cavities, which may remain as the only visible symptom of the disease. An animal which has recovered from a case of acute glanders, like the animals which are affected by chronic glanders and chronic farcy, is liable to be affected with emphysema of the lungs (heaves), and to have a chronic cough. In this condition it may continue for a long period, serving as a dangerous source of contagion, the more so because the slight quantity of discharge does not serve as a warning to the owner or driver as profuse discharge does in the more acute cases.
At the post-mortem examination of an animal which has been destroyed or has died of glanders we find evidences of the various lesions which we have studied in the symptoms. In addition to this, we find nodules similar to those which we have seen on the exterior throughout the various organs of the body. Nodules may be found in the liver, in the spleen, and in the kidneys. We may find inflammation of the periosteum of the bones, and we have excessive alterations in the marrow in the interior of the bones themselves. Both these conditions during the life of the animal may have been the cause of the lamenesses which were difficult to diagnose.
In one case which came under the observation of the writer, a lame horse was destroyed and found to have a large abscess of the bone of the arm, with old nodules of the lungs. When an animal has died immediately after an attack of a primary, acute case of glanders, we find small V-shaped spots of acute pneumonia in the lungs. If the animal has made an apparent recovery from acute glanders, and in cases of chronic farcy and chronic glanders, no matter how few the external and visible symptoms may have been, there is a deposit of nodules--small, hard, indurated nodes--of new connective tissue to be found in the lungs. When these have existed for some time we may find a deposit of lime salts in them. These indurated nodules retain the virus and their power to give out contagion for almost an indefinite time, and predispose to the causes which we have studied as the common factors in developing a chronic case into an acute case; that is, an inflammatory process wakens their vitality and produces a reinfection of the entire animal. The blood of an animal suffering from chronic glanders and farcy is not virulent and is unaltered, but during the attack of acute glanders, while the animal has fever, the blood becomes virulent and remains so for a few days.
Treatment.--Almost the entire list of drugs in the pharmacopoeia has been tested in the treatment of glanders. Good hygienic surroundings, good feed, with alteratives and tonics, frequently ameliorate the symptoms, and often do so to such an extent that the animal would pass the examination of any expert as a perfectly sound animal. While in this case the number of nodules of the lungs, which are invariably there, may be so few as not to cause sufficient disturbance in the respiration as to attract the attention of the examiner, yet they exist, and will remain there almost indefinitely, with the constant possibility of a return of acute symptoms.
It is probable that some horses may recover from glanders if the infection is slight, but it will not do to depend upon this except under the most stringent veterinary supervision. With good care, good feed, good surroundings and little work, an animal affected with glanders may live for months or even years in a state of apparently perfect health, but with the first deprivation of feed, with a few days of severe hard work, with exposure to cold or with the attack of a simple fever or inflammatory trouble from other causes, the latent seeds of the disease break out and develop the trouble again in an acute form.
In several celebrated cases horses which have been affected with glanders have been known to work for years and die from other causes without ever having had the return of symptoms; but allowing that these cases may occur, they are so few and far between, and the danger of infection of glanders to other horses and to the stable attendants is so great, that no animal which has once been affected with the disease should be allowed to live unless repeated mallein tests have shown him to have become free from taint of glanders.
In all civilized countries, with the exception of some of the States in the United States, the laws are most stringent regarding the prompt declaration on the part of the owner and attending veterinarian at the first suspicion of a case of glanders, and they allow indemnity for the animal. When this is done, in all cases the animal is destroyed and the articles with which it has been in contact are thoroughly disinfected. When the attendants have attempted to hide the presence of the disease in a community, punishment is meted out to the owner, attending veterinarian, or other responsible parties. Several States have passed excellent laws in regard to glanders, but these laws are not always carried out with the rigidity with which they should be.
SPOROTRICHOSIS (MYCOTIC LYMPHANGITIS).
By JOHN R. MOHLER, V. M. D., Assistant Chief, Bureau of Animal Industry.
This disease has previously been known in this country as epizootic lymphangitis, or pseudo-farcy. It is a chronic, contagious disease, particularly of equines, caused by a specific organism, the Sporotrichum schenckii, and characterized by a suppurative inflammation of the subcutaneous lymph vessels and the neighboring lymph glands. Owing to the fact that this affection does not spread as an epizootic and that its causal factor is a fungus, the name sporotrichosis has been suggested.
The disease in man was first described by Schenck and by Beurmann and Gougerot. Carougeau observed its occurrence among horses and mules in Madagascar, while in the United States it was first observed by Pearson in Pennsylvania in 1907, although it is probable that it had existed for many years in various parts of this country. Page and Frothingham were first to recognize its mycotic nature in the United States. More recently Meyer has also made valuable contributions with regard to the existence of this affection. Its presence has been definitely established in Ohio, Iowa, California, and North Dakota, and there is a probability of its existence in Indiana and several Western States.
Bacteriology.--The sporotrichum is 2 microns thick, cylindrical and segmented, having more or less branching threads, which bear spores at the end. In the pus they occur as slightly ovoid bodies 3 to 5 microns long, which are somewhat pointed toward the poles, have a sharp double contour, and only on artificial cultivation at a temperature of over 18 deg. do they develop into the characteristic spore-carrying threads.
The period of incubation varies greatly, extending from three days to four months, or even longer. In artificial inoculations with pus through wounds in the skin, inflammation and swelling of the lymph vessels may be noticed in ten to sixty days; these vessels show in their course a development of hard nodules, from which abscesses form.
The natural infection without doubt is caused through superficial wounds, such as galls, barbed-wire cuts, or through various stable utensils, harness, bandages, insects, etc. Solipeds are mostly susceptible, but cattle may also be infected.
Symptoms.--The inflammation of the lymph vessels is usually first observed on the extremities, especially on one or both hind legs; it may also appear on the forelegs, shoulder, or neck, and more rarely on the rump, udder, and scrotum. The lesions, as a rule, develop in the tissue adjacent to the place of inoculation. In the early stages of the disease the lymph vessels appear very hard and thickened, and along their course hard nodules develop, ranging in size from a pea to a hen's egg. Later these nodules soften, burst spontaneously, and discharge a thick, yellowish pus. The surface of the resulting ulcers or abscess cavities soon fills up with exuberant granulations which protrude beyond the surface of the skin, giving it a fungoid appearance. The affected extremities are considerably enlarged, similar to cases of simple lymphangitis. In rare cases the mucous membrane of the nostrils may also become affected, showing yellowish flat elevations and ulcerations, and these may extend by metastasis to internal organs. In cases in which the mucous membrane is affected, the submaxillary lymph gland may also become enlarged and suppurate.
The constitutional symptoms accompanying this disease are not very marked and may be altogether absent. There is usually only a very slight fever, which seldom runs over 102 deg. F. The appetite is not impaired except in the advanced cases.
Lesions.--The anatomical changes are most marked in the skin and the subcutaneous tissues. They may become 2 to 3 inches thick and indurated as the result of fibrous-tissue formation, owing to the inflammation present. On the baconlike cut surface suppurative areas and granulating sores may be noticed of various sizes, also enlarged lymph vessels filled with clotted lymph mixed with pus. The neighboring lymph glands are usually enlarged and frequently contain suppurating foci. Rarely the internal organs may show metastatic abscesses.
Diagnosis.--The diagnosis is based on the characteristic appearance of the ulcerations, which show exuberant granulation of a bright red color, inverted edges, and a thick, creamy, glutinous discharge. These manifestations differentiate the disease from glanders, in which the ulcers are craterlike, do contain exuberant granulations, and the discharge is of a viscous, oily character. The submaxillary and other nodes as well as the corded lymphatics in glanders are more firmly attached to the adjacent tissues, and are therefore less movable. In some chronic cases of sporotrichosis, however, the lesions may closely resemble those of farcy, and in these cases the microscopical examination of the pus will disclose the nature of the affection. In the pus the causative organism can be easily seen in the unstained specimen, and is recognized by its size, shape, and highly refractory double outline. Furthermore, the injection of mallein in cases of sporotrichosis will be attended with negative results.
Treatment.--At the onset of the disease treatment consists in entire extirpation of the nodules, in case the lesions are localized. In cases in which the nodules have formed abscesses, their opening is recommended, followed by the application of the actual cautery or a 1 to 250 solution of bichlorid of mercury. It must be borne in mind that the organism is quite resistant to antiseptics, and the best results will be obtained from the application of a solution of a strong antiseptic following the opening of the lesions. Internally, potassium iodid is recommended in 2-dram doses, dissolved in drinking water, twice a day.
In the most favorable cases recovery results in from five to seven weeks; as a rule, however, it requires several months.
In order to prevent the spreading of the disease the affected animals should be isolated, the products of the disease should be destroyed, and the stable should be disinfected with very strong liquid disinfectants in consideration of the resistance of the causative organism.
RABIES, HYDROPHOBIA, OR MADNESS.
Rabies is a contagious disease, which is usually transmitted by a bite and by the introduction of a virus contained in the saliva of an affected animal. It may, however, be transmitted in other ways. It is characterized by symptoms of aberration of the nervous system and invariably terminates fatally. It is accompanied with lesions, inflammation, and degeneration in the central nervous system. It is a disease that is most common in the dog, but is transmitted to the horse, either from dogs or from any other animal affected with it. (See also remarks on page 244.) As a disease of the horse it is invariably the result of the bite of a rabid animal, usually a dog.
Perhaps no disease in medicine has been the object of more controversy than rabies. Certain medical men of prominence have even doubted its existence, and many others have claimed for it a spontaneous origin. The experience of ages, however, has shown that contagion can be proved in the great majority of cases, and, by analogy with other contagious diseases, we may only believe that the development of one case requires the preexistence of a case from which the virus has been transmitted. Pasteur has further added to our knowledge of the disease by showing that a virus capable of cultivation exists in the nervous system, especially in the lower part of the brain (medulla oblongata) and in the anterior part of the spinal column. He has further shown that that portion of the nervous system which contains the virus, the exact nature of which has not yet been demonstrated, will retain it for a very long time if kept at a very low temperature or if left surrounded by carbolic acid; but if the nerve matter, which is virulent at first, is exposed to the air and is kept from putrefaction by substances which will absorb the surrounding moisture, it will gradually lose its virulence and become inoffensive in about fifteen days. He has also further shown that the action of a weak virus on an animal will prevent the development of a stronger virus, and from this he has formulated his method of prophylactic treatment. This treatment consists in the successive inoculation of portions of the nerve matter containing the virus from a rabid animal which has been exposed to the atmosphere for thirteen days, ten days, seven days, and four days, until the virulent matter which will produce rabies in any unprotected animal can be inoculated with impunity. A curious result of the experiments of Pasteur is that an animal which has first been inoculated with a virus of full strength can be protected by subsequent inoculations of attenuated virus repeated in doses of increasing strength.
Innumerable attempts have been made to discover the causative agent, and investigators have announced the finding of many of the lower forms of animal and vegetable life as the pathogenic factor. Among the recently described causes, certain protozoanlike bodies found in the ganglionic cells in 1903 by Negri, and termed Negri bodies, are of a very suggestive nature. Negri claims that these bodies are not only specific for rabies, but that they are protozoa and the cause of the disease. His work has been corroborated by investigators in all parts of the scientific world. An examination of the vitality of these bodies will show a striking resemblance to the vitality of an emulsion of the virulent tissue. Thus, they have been found to be quite resistant to external agencies, such as putrefaction, drying, etc., and are about the last portion of the nerve cell to survive the advance of decomposition. They are also found in more than 96 per cent of the cases of rabies examined, but have not been proved to exist in other diseases.
Valenti states, as his strongest evidence of the protozoan nature of the bodies, that the virus of rabies is neutralized in test tubes by quinin, while no other alkaloid has this property. As a result of the work performed in the New York City Board of Health laboratory, Park claims that Negri bodies are found in animals before the beginning of visible symptoms, and evidence is given that they may be found early enough to account for the infectiousness of the central nervous system. These bodies are now almost universally considered as diagnostic of rabies, and in the pathological laboratory of the Bureau of Animal Industry their detection in the nerve cells of the brain suffices for a diagnosis of rabies without animal inoculations. In case these granular bodies are not found in a suspected animal, the plexiform ganglion is next examined, and should negative results still be obtained, the inoculation of rabbits is then made as a last resort. It is indeed rare that positive results are obtained from the latter method after the first two methods have been negative, but it has occurred occasionally in cases in which the animal had been killed in the early stages of the disease.
Symptoms.--From the moment of inoculation by the bite of a rabid dog or other rabid animal or by other means, a variable time elapses before the development of any symptoms. This time may be eight days or it may be several months; it is usually about four weeks. The first symptom is an irritation of the original wound. This wound, which may have healed completely, commences to itch until the horse rubs or bites it into a new sore. The horse then becomes irritable and vicious, and it is especially susceptible to moving objects, excessive light, noises, the entrance of an attendant, or any other disturbance will cause the patient to be on the defensive. It apparently sees imaginary objects; the slightest noise is exaggerated into threatening violence; the approach of an attendant or another animal, especially a dog, is interpreted as an assault and the horse will strike and bite. The violence on the part of the rabid horse is not for a moment to be confounded with the fury of the same animal suffering from meningitis or any other trouble of the brain. But in rabies there is a volition, a premeditated method, in the attacks which the animal will make, which is not found in the other diseases. Between the attacks of fury the animal may become calm for a variable period. The writer attended a case in which, after a violent attack of an hour, the horse was sufficiently calm to be walked 10 miles and only developed violence again an hour after being placed in the new stable. In the period of fury the horse will bite at the reopened original wound; it will rear and attempt to break its halter and fastenings; it will bite at the woodwork and surrounding objects in the stable. If the animal lives long enough it shows paralytic symptoms and falls to the ground, unable to use two or more of its extremities, but in the majority of cases in its excesses of violence it does physical injury to itself. It breaks its jaws in biting at the manger or fractures other bones in throwing itself on the ground and dies of hemorrhage or internal injuries. At times throughout the course of the disease there is an excessive sensibility of the skin which, if irritated by the touch, will bring on attacks of violence. Throughout the course of the disease the animal may have appetite and desire water, but on attempting to swallow has a spasm of the throat which renders the act impossible. This latter condition, which is common in all rabid animals, has given the disease the name of hydrophobia (fear of water).
In a case under the care of the writer a horse, four weeks after being bitten on the forearm by a rabid dog, developed local irritation in the healed wound and tore it with its teeth into a large ulcer. This was healed by local treatment in 10 days, and the horse was kept under surveillance for more than a month. On the advice of another practitioner the horse was taken home and put to work; within 3 days it developed violent symptoms and had to be destroyed.
Diagnosis.--The diagnosis of rabies in the horse is to be made from the various brain troubles to which the animal is subject; first by the history of a previous bite of a rabid animal or inoculation by other means; second, by the evident volition and consciousness on the part of the animal in its attacks, offensive and defensive, on persons, animals, or other disturbing surroundings. The irritation and reopening of the original wound or point of inoculation is a valuable factor in diagnosis. Diagnosis after death may be made by microscopic examination for Negri bodies or by the inoculation of rabbits, as already mentioned.
Recovery from rabies may be considered as a question of the correctness of the original diagnosis. Rabies is always fatal.
Treatment.--No remedial treatment has ever been successful. All the anodynes and anesthetics, opium, belladonna, bromid of potash, ether, chloroform, etc., have been used without avail. The prophylactic treatment of successive inoculations is being used on human beings, and has experimentally proved efficacious in dogs, but would be impracticable in the horse unless the conditions were quite exceptional.
DOURINE.
By JOHN R. MOHLER, V. M. D., Assistant Chief, Bureau of Animal Industry.
Dourine (also known as maladie du coit, equine syphilis, covering disease, breeding paralysis) is a specific infectious disease affecting under normal conditions only the horse and ass, transmitted from animal to animal by the act of copulation, and due to an animal parasite, the Trypanosoma equiperdum.
History.--It is described as having existed as early as 1796 in the Eastern Hemisphere, and was more or less prevalent in several of the European countries, including France, Germany, Austria, and Switzerland, during the first half of the nineteenth century. Its presence was recognized for the first time in the United States in 1886, when an outbreak occurred in Illinois. Since then the existence of the disease has been observed at irregular intervals in numerous other States, including Nebraska, Iowa, Montana, Wyoming, New Mexico, North Dakota, and South Dakota.
Symptoms.--There are many variations in the symptoms of dourine, and this is particularly true of the disease as it occurs in this country. Two distinct stages may be noted which vary somewhat from those described in textbooks, but probably no more than could be expected when differences of climatic conditions and methods of handling are taken into consideration.
The first stage chiefly concerns the sexual organs and therefore differs somewhat in the male and female. In the second stage the symptoms indicating an affection of the nervous system are more prominent and are not dependent upon the sex of the animal.
Following a variable period of incubation of from 8 days to 2 months, there is seen in the stallion an irritation and swelling about the penis and sheath. In a few days small vesicles or blisters may appear on the penis, which later break, discharging a yellowish, serous fluid and having irregular, raw ulcers. The ulcers show a tendency to heal rapidly, leaving scars which are permanent. There may be more or less continuous dripping from the urethra of a yellowish, serouslike fluid. Stallions may show great excitement when brought in the vicinity of mares, but service is often impossible because of the fact that a complete erection of the penis does not occur.
In the mare the first symptoms may be so slight as to be overlooked. The disease, being the result of copulation, usually begins with inflammation of the vulva and vagina. There may be a mucopurulent discharge, which may be slight or profuse in quantity, agglutinating the hairs of the tail. The mare may appear uneasy and urinate frequently. Vesicles may appear on the external vulva and mucous membrane of the vulva and vagina which later rupture and form ulcers. On the dark skin of the external vulva the scars resulting from healing of the ulcers are white, more or less circular in outline, from one-eighth to half an inch in diameter, and pitlike. This depigmentation of the skin about the external genitals is permanent.
Urticarial eruptions or plaques which break out over various parts of the body are a frequent symptom seen in animals of either sex. These are sharply defined and edematous swellings of the skin about the size of a half dollar or may be even larger. The usual locations of these plaques are the croup, belly, and neck.
The intensity of the symptoms mentioned which are significant of the early stage of the disease may vary to a wide extent and in many instances be so mild as to escape the attention of any but the most careful observer. They commonly disappear after a brief period. The apparent recovery, however, is not permanent, for such animals after a period of variable length manifest constitutional or nervous symptoms. These may not appear for several months or even years. They consist of a general nervous disorder with staggering, swaying gait, especially in the hind limbs. The animal generally becomes emaciated, the abdomen assuming a tucked-up appearance. The first indication of paralysis will be noted in traveling, when the animal fails to pick up one of the hind feet as freely as the other, or both may become affected at the same time, at which time knuckling is a common symptom. Labored breathing is occasionally noted. When the paralysis of the hind limbs starts to appear the disease usually progresses rapidly. The horse goes down, is unable to rise, and dies in a short time from nervous exhaustion. The appetite usually remains good up to the last.
Although a case of dourine may now and then recover, as a rule the disease is present in the latent stage. Bad weather, exposure, insufficient feed, and complicating diseases like influenza, distemper, or in fact any condition which tends to lower the vitality of the animal, may hasten the termination of the disease.
Diagnosis.--The complement-fixation test furnishes by far the most reliable means of diagnosis and is especially valuable in a chronic affection of this character, when the symptoms manifested are variable and frequently so obscure as to escape observation. This is a laboratory test requiring special facilities and the services of a trained bacteriologist.
Treatment.--Little benefit can be obtained from medicinal treatment, nor is such treatment desirable in this country, where the disease has existed only in restricted areas, and where sanitary considerations demand its prompt eradication.
INFECTIOUS ABORTION IN MARES.
Infectious abortion (also known as contagious abortion, epizootic abortion, enzootic abortion, slinking of colts) is a disease of mares which from a specific cause results in the premature expulsion of the fetus and its membranes from the uterus. It is characterized by an inflammatory condition of the female reproductive organs.
The contagious nature of the disease had not been recognized until recently, the disease being principally attributed to various conditions, such as traumatic influences, various infectious diseases, spoiled feed, drugs, and other factors. Ostertag was the first to study premature births in mares, attributing as the cause of the same a streptococcus, which he was supposed to have been able to use successfully in artificially producing abortion, either by inoculations or feeding. His findings could not be substantiated by other investigators.
The earliest appearance of the disease in this country was in 1886, at which time it caused considerable damage to the horse-breeding industry in the Mississippi Valley. Smith and Kilbourne investigated an outbreak in Pennsylvania in 1893, at which time they incriminated another germ belonging to the paratyphus B group as the causative factor of the disease. These findings have been subsequently substantiated by many investigators abroad, as well as in this country, notably so by De Jong, Dassonville, and Riviere, and by Good and Meyer. More recently very valuable information was contributed to our knowledge on this disease by Schofield, of Canada, especially with regard to the biological tests for diagnosis. Good suggested "Bacillus abortivus equinus" as the name for the specific organism.
The causative agent of this disease is not identical with the germ causing abortion in cattle. It exerts its action, however, in a similar manner, and appears to have, under certain conditions, a predilection for the genital organs of the mare, where it induces certain morbid changes whereby a premature expulsion of the fetus is the result. The germ is usually present in the fetal membranes and also in the aborted fetus. Mares may harbor the infection without disclosing any apparent ill effects. It appears to exert its influence mainly upon the female genital organs, where it may induce an inflammatory condition of the uterus.
The infected animals may carry the fetus through the normal period of pregnancy, giving birth to either a normal or a weak colt, or again abortion may take place at any time during pregnancy, mostly, however, from the sixth to the ninth month.
Symptoms.--The symptoms suggestive of abortion are frequently entirely absent. At times the abortion may be ushered in by symptoms of colicky pains, restlessness, and periodical straining; these, however, are by no means constant, especially if the abortion takes place in the early months of pregnancy. The genital organs are usually swollen, showing a mucous discharge. Immediately before abortion the symptoms are more aggravated. Following abortion the discharge is more characteristic, being of a dark-brown color, sometimes even bloody, and contains streaky or flaky pus. The fetal membranes in all cases are not expelled with the aborted fetus, but there is a tendency toward retention of these membranes, which frequently has serious consequences upon the health of the animal. At times it becomes necessary to resort to manual removal of the afterbirth, and the inflammation of the uterus and a chronic discharge usually follow such conditions. The expelled fetuses, as a rule, die soon after the abortion, and if the expulsion has taken place at a time close to its full term the fetuses are usually poorly developed and subject to various kinds of digestive and septic disorders. The fetuses do not disclose any particular abnormal appearance on external examination; in many cases, however, the post-mortem examination reveals inflammatory changes of various organs.
The method of infection has not yet been satisfactorily established; nevertheless it is essential that we consider as the principal mode of infection the ways which have been proved for the contagious abortion in cattle. These are especially by ingestion; that is, by taking up the germs with the feed, water, or other means, which have become contaminated with the germs. The infection through the genital organs is probably not so frequent, but in this regard the stallion no doubt plays an important role in the spreading of the disease. Schofield considers this method of infection as the principal source of spreading the disease.
It must be considered that in infected stables the germs may be present throughout the premises, and by keeping animals which have aborted in such stables a contamination of feed and utensils may continually take place, since the aborted mares usually discharge a considerable quantity of material which is often heavily charged with the germs. The germ is taken up by the body with the feed or water, passing from the intestines into the blood, and from there is carried to the genital organs, where it finds suitable conditions for its development. Milk from an infected mare may also contain the germ, and colts may become infected by sucking the milk of infected mothers. In such instances the infection may remain dormant until the colt develops and becomes pregnant, when the organism, finding a condition suitable for its development, produces the disease.
On the other hand, stallions used in covering infected mares may be carriers of the germs, and when used for the breeding of healthy animals may in this manner readily transmit the disease to them.
Diagnosis.--Contagious abortion may be diagnosed by the changes which occur in the fetal membranes, and also in the expelled feces. In order, however, to substantiate a diagnosis with certainty, demonstration of the germ by microscopical examination is necessary. The occurrence of frequent abortions among the mares in a stable is also an additional evidence of the contagious character of the malady. It must be considered that at times infected mares may carry the fetus to full maturity, in which case the diagnosis is possible only by blood examinations in a laboratory.
Infected animals usually abort only once; however, in a certain proportion of cases they may abort even two, three, or four times in succession.
Animals which establish a tolerance for the infection, and carry the fetus to full maturity, may nevertheless remain a source of danger for spreading the disease.
The tests used in laboratories for the diagnosis are the agglutination and complement-fixation tests, by which the disease may be diagnosed from a sample of blood from a suspected animal. Such tests, however, have to be confined to the laboratories, which are equipped for such work.
Treatment and prevention.--Medicinal treatment is usually of no avail, and all efforts should be directed toward the prevention of the disease. Various medicinal agents have been recommended and are being exploited for the treatment, but to the present time no satisfactory evidence has been established as to their merits. Bacterial vaccines prepared from the specific organism have been given limited trials, but to date they can not be considered as entirely satisfactory, since it will require considerable experience with them before their usefulness can be definitely established.
The prevention should consist largely in sanitary measures directed toward the disinfection of premises and animals. (For a method for disinfection of premises see article under that heading.)
The following procedure is advised for the disinfection of animals: To prevent a stallion from carrying the infection from a diseased mare to a healthy one the sheath and the penis should be disinfected with a solution of 1/2 per cent of compound cresol solution, lysol, or trikresol, or a 1 per cent carbolic acid or 1 to 1,000 potassium permanganate solution in warm water. For this purpose it is advisable to use a soft-rubber tube with a large funnel attached to one end, or an ordinary syringe and tube would serve the purpose. The tube should be inserted into the sheath, and the foreskin held with the hand to prevent the immediate escape of the fluid. In addition to this the hair of the belly and inner side of the thighs should be sponged with an antiseptic. This disinfection should invariably precede and follow every service.
With regard to the mares, a period of three months should elapse between abortion and a subsequent breeding, and especially if there is any evidence of a discharge the breeding of the animal should not be undertaken. The mare showing signs of abortion should be immediately isolated and the fetus and membranes should be burned. The fetus should never be dragged across a barnyard or stable, but should be removed by other means by which the contamination of the premises may be prevented. The stall in which the animal aborted should be thoroughly disinfected and the genital organs of the mare washed daily with a disinfectant. The antiseptic washing recommended for the treatment of the stallions prior to and after breeding should be also used for the irrigation of the uterus of mares which have aborted. This treatment should be continued daily until all evidence of discharge has ceased. The isolation of the animal should be carried out for at least one month after the evidence of a discharge has ceased.
By carefully and persistently carrying out the sanitary measures it may be possible to control and finally eradicate the disease.
NAVEL ILL OF COLTS.
Navel ill of colts is also known as joint ill, omphalophlebitis, septic arthritis of sucklings, and pyosepticemia of the newly born. The unfavorable outlook after the appearance of the disease, together with the fact that the disease when present requires the attention of a veterinarian, demands that the breeder concern himself with its prevention.
The disease is caused by a microorganism and several bacteria have been suspected of being responsible. Every one of the suspected organisms is found abundantly in manure and objects contaminated with manure. The infective material gains entrance into the colt through the open umbilical cord as a result of its coming into contact with litter, floors, or discharges from its dam contaminated by one of the organisms which cause the trouble. There are cases on record in which the infection has taken place before birth, and while some investigators assert that this method is the principal mode of infection still, in a large number of cases, the prophylactic measures adopted to guard against the infection through the navel cord have given good results. Since infection before birth can not be controlled satisfactorily, we are justified, for all practical purposes, in preventing navel ill by guarding against the infection through the cord at birth or soon afterwards.
Cleanliness of stables where pregnant mares are kept must be insisted upon. This is especially necessary where outbreaks of navel ill have been known to exist. Mares in the last stages of gestation should be placed in a box stall which has previously been cleaned and disinfected. The bedding should be frequently renewed and the external genitals and neighboring tissues should be kept clean and disinfected with a 2 per cent solution of carbolic acid or 1 per cent liquor cresolis compositus, or any other reliable disinfecting agent. Operations for opening abscesses and removal of afterbirths from cows should not be executed in the immediate vicinity of mares in an advanced stage of pregnancy.
The foal when dropped should be placed on clean bedding. In any event the cord of the foal should be washed in a disinfectant solution and tied at about 1-1/2 inches from the navel with a band or string which has previously been soaked in a disinfectant solution. With a sharp pair of scissors the navel cord is then severed about one-half inch below the band and again disinfected. The ligature should not be tightened, however, until pulsation of the vessels in the cord has ceased. The stump of the cord is then painted with strong carbolic-acid solution, tincture of iodin, or a mixture of equal parts of tincture of iodin and glycerin. The stump should be washed daily with a disinfectant and either painted with iodin mixture or carbolic acid or dusted with some reliable antiseptic healing powder. After five days the parchmentlike dried stump may be cut off and the navel wound washed with a disinfectant solution and dusted with powder until healed.
The cases of navel ill resulting from infection before birth can not well be guarded against. By keeping mares, advanced in pregnancy, in good physical condition, the fetus will be expelled immediately upon the opening of the uterine cavity.
Once the infection of the navel cord has set in, the cord should not be ligated but should be washed in a disinfectant solution and a veterinarian called for the subsequent treatment.
INFECTIOUS ANEMIA OR SWAMP FEVER.
By JOHN R. MOHLER, V. M. D., Assistant Chief, Bureau of Animal Industry.
Infectious anemia of horses, known also by a number of other names, as swamp fever, American surra, malarial fever, typhoid fever of horses, the unknown disease, no-name disease, plains paralysis, and pernicious anemia, has recently been the subject of much investigation. The cause of the disease has now been definitely determined as an invisible virus, which is capable of passing through the pores of the finest porcelain filters, like the infection of foot-and-mouth disease, rinderpest, hog cholera, and similar diseases. The disease is most prevalent in low-lying and badly drained sections of the country, although it has been found on marshy pastures during wet seasons in altitudes as high as 7,500 feet. Therefore proper drainage of infected pastures is indicated as a preventive. It is also more prevalent during wet years than in dry seasons. It usually makes its appearance in June and increases in frequency until October, although the chronic cases may be seen in the winter, having been contracted during the warm season.
Cause.--It has been conclusively proved that infectious anemia is produced by an invisible filterable organism which is transmissible to horses, mules, and asses by subcutaneous inoculation of blood serum. The virus which is present in the blood may be transmitted to a number of equines in a series of inoculations by injecting either the whole blood, the defibrinated blood, or the blood serum which has been passed through a fine Pasteur filter, thus eliminating all the visible forms of organismal life, including bacteria, trypanosoma, piroplasma, etc. This virus has also been found to be active in the carcass of an affected animal 24 hours after death.
Following the injection of the infectious principle there is a period of incubation which may extend from ten days to one and one-half months, at the end of which time the onset of the disease is manifested by a rise of temperature. If uncomplicated, the infection runs a chronic course, terminating in death in from two months to one and one-half years, or even longer. The probability of the virus being spread by an intermediate host, such as flies, mosquitoes, internal parasites, etc., is now receiving careful investigation.
From experiments already conducted it appears that this disease, formerly supposed to be confined to Manitoba and Minnesota, is more or less prevalent in Kansas, Nebraska, Colorado, Wyoming, Montana, North Dakota, Virginia, Texas, and New York. It also occurs in Europe, having been reported in Germany under the name of infectious anemia and in France as infectious typho-anemia.
Symptoms.--The disease is characterized by a progressive pernicious anemia, remittent fever, polyuria, and gradual emaciation in spite of a voracious appetite. It begins to manifest itself by a dull, listless appearance and by general weakness, the animal tiring very easily. This stage is followed closely by a staggering, swaying, uncertain gait, the hind legs being mostly affected. There is also noted a weakness and tenderness in the region of the loins, and at the same time the pulse, though weak, stringy, and intermittent, increases in rapidity and may run as high as 70. The temperature may rise to 103 deg. F. or higher, remaining high for several days, and then dropping to rise again irregularly. Toward the end of the disease the temperature occasionally remains persistently high. The horse may improve for a time, but usually this improvement is followed by a more severe attack than the first. Venous regurgitation is sometimes noticed in the jugular before death. The quantity of urine passed is enormous in some cases. Death finally occurs from exhaustion or syncope.
The blood shows a slight decrease in the number of white blood cells, while there is a gradual but marked diminution of red corpuscles, the count running as low as 2,000,000 per cubic millimeter, the normal count being 7,000,000. If the blood is drawn from such an animal, the resulting red clot will be about one-fifth of the amount drawn. Occasionally a slow dripping of blood-tinged serum from the nostrils is observed as a result of this very thin blood oozing from the mucous membranes. Petechiae, or small hemorrhagic points, are sometimes noticed on the nictitating membrane and conjunctiva, while paleness of the visible mucous membranes of the nose and mouth is usually in evidence, although they may have a yellow or mahogany tinge. Often a fluctuating, pendulous swelling may appear on the lower lip, point of elbow, sheath, legs, under the belly, or on some other pendent portion, especially late in the disease, which is indicative of poor circulation, thinning of the blood, and consequent loss of capillary action.
Lesions.--After death the carcass is found to be very much emaciated and anemic, the visible mucosa being very pale. This marked absence of adipose tissue makes the skinning of the animal a difficult task. Subcutaneous and intermuscular edema and hemorrhages are frequently observed, although in many cases it is remarkable to see how few macroscopic lesions may be present. The predominating and most constant lesion is probably the petechiae, so often observed in the muscle or on the serous membranes of the heart. The heart is generally enlarged and may be the only organ to show evidence of disease. In other cases the lungs may be studded with petechiae, with a serous exudate present in the thoracic cavity. In addition to the petechiae already noted, the pericardial sac generally contains an increased quantity of fluid. The abdominal cavity may show peritonitis and a hemorrhagic condition of the intestines, which probably result from overfeeding in consequence of the ravenous appetite. The liver, although usually normal, sometimes presents a few areas of degeneration. The spleen is at times found to be enlarged and covered with petechiae. The kidneys may appear normal or anemic and flaccid, but microscopically they usually show a chronic parenchymatous degeneration. The lymph glands may be enlarged and hemorrhagic.
Diagnosis.--The diagnosis of the disease is not difficult, especially in advanced stages. The insidious onset, remittent fever, progressive emaciation and anemia, unimpaired or ravenous appetite, staggering gait and polyuria are a train of symptoms which make the disease sufficiently characteristic to differentiate it from other diseases affecting horses in this country. The peculiar relapsing type of fever, the great reduction in the number of red blood cells, and the absence of eosinophila are sufficient to differentiate it from the anemias produced by internal parasites, while it may be readily distinguished from surra by the nonsusceptibility of cattle and by the great ease with which the trypanosoma may be found in the latter affection.
Prognosis.--The prognosis of the disease is very unfavorable. Veterinarians in different sections of the country where it is prevalent report a mortality of 75 per cent or even higher. Recovery takes place only when treatment is begun early or when the animal has a long convalescent period.
Treatment.--The treatment of the disease has so far been far from satisfactory. The iodid, permanganate, and carbonate of potash have been used. Arsenic, axytol, quinin, and silver preparations have been suggested, but all have been uniformly without success. Intestinal antiseptics have been resorted to, and the results are encouraging but not altogether satisfactory. Symptomatic treatment seems to be the most dependable. For instance, Davison, of this bureau, was able to reduce greatly the mortality from this affection by giving an antipyretic of 40 grains of quinin, 2 drams of acetanilid, and 30 grains of powdered nux vomica four times daily. In the late stages, with weak heart action, alcohol should be substituted for acetanilid. Cold-water sponge baths may be given, and in addition frequent copious injections of cold water per rectum, which has a beneficial effect in reducing the temperature and in stimulating peristalsis of the bowels, which, as a result of the disease, show a tendency to become torpid during the fever. Purgatives, on account of their debilitating effect, should not be given unless absolutely necessary, but laxatives and easily digested feeds should be given instead. Not infrequently a dirty yellowish tinge of the visible mucous membranes has been observed, in which cases 20 grains of calomel in from 2 to 4 drams of aloes in a ball, or 2-dram doses of fluid extract of podophyllin, may be given. Following the subsidence of the fever, a tonic should be administered, composed of the following drugs in combination:
Arsenious acid grams 2 Powdered nux vomica do 28 Powdered cinchona bark do 85 Powdered gentian root do 110
These should be well mixed and one-half teaspoonful given to the affected animal at each feed.
As in the case of all other infectious diseases, the healthy should be separated from the sick horses and thorough disinfection of the infected stables, stalls, litter, and stable utensils should be carried out in order to prevent the recurrence of the disease. As a disinfectant the compound solution of cresol, carbolic acid, or chlorid of lime may be used, by mixing 6 ounces of any one of these chemicals with 1 gallon of water. One of the approved coal-tar sheep dips may also be used to advantage in a 5 per cent solution (6 ounces of dip to 1 gallon of water). The disinfectant solution should be applied liberally to all parts of the stable, and sufficient lime may be added to the solution to make the disinfected area conspicious.
Investigations are now in progress with a view of producing a vaccine or serum that will protect horses that have been exposed to the disease.
SURRA.
By CH. WARDELL STILES, PH. D.
Professor of Zoology, United States Public Health Service.
Surra is not known to occur in the United States, but it is more or less common in the Philippine Islands and India. It is caused by a microscopic, flagellate animal parasite, known as Trypanosoma evansi, 20 to 34 mu long by 1 to 2 mu broad, which lives in the blood and destroys the red blood corpuscles. In general the disease is very similar to and belongs in the same general class with tsetse-fly disease, or nagana, of Africa and mal de caderas, of South America.
Surra is a wet-weather disease, occurring chiefly during or immediately after heavy rainfalls, floods, or inundations.
Surra attacks especially horses, asses, and mules, but it may occur in carabao, camels, elephants, cats, and dogs, and has been transmitted to cattle, buffaloes, sheep, goats, rabbits, guinea pigs, rats, and monkeys. No birds, reptiles, amphibia (frogs, etc.), or fish are known to suffer from it. It attacks both male and female animals, young and old. Australian breeds of horses and white and gray mules are said to be more susceptible than animals of other breeds and color.
Surra in equines and camels is said to be an invariably fatal disease, but cattle occasionally recover from it. There is no history of a definite onset of the disease, and the condition is progressive, usually with a number of relapses. The period of incubation may vary somewhat; in experimental cases it is from 2 to 75 (usually 6 to 8) days, according to conditions. The duration varies with the species of animal attacked, their age, and general condition. The average duration in the horse is reported at less than two months, though some cases may terminate fatally in less than one to two weeks.
Method of infection.--All evidence now available seems to indicate that surra is strictly a wound disease, namely, that the parasite may enter the body only through a wound of some kind. Apparently by far the most common method is through wounds produced by biting flies whose mouth parts are moist with the infected blood of some animal bitten by the same flies immediately before biting the healthy animal. Crows may also transmit the infection by pecking at sores on a diseased animal, soiling their beaks with blood, and transferring this infected blood to a healthy animal. Likewise, if a scratch is made on a horse and then infected blood is rubbed on the scratch, the horse will become diseased. If, in experiment, infected blood is fed to a healthy animal, the latter may contract surra in case it has an abraded or wounded spot in the mouth; but if no part of the lining of the alimentary canal is wounded, infection does not take place. Thus dogs and cats may contract the disease by wounding the lining of the mouth (as with splinters of bone) while feeding on the carcasses of surra subjects. All available evidence indicates that under normal conditions of pregnancy the disease is not transmitted from mother to fetus.
There is a popular view that surra may be contracted by drinking stagnant water and by eating grass and other vegetation grown upon land subject to inundation, but there is no good experimental evidence to support this view: Probably the correct interpretation of the facts cited in support of this theory is that biting flies are numerous around stagnant water and in inundated pastures; hence, that a great number of possible transmitters of the disease are present in these places.
Symptoms.[7]--The invasion of this disease when contracted naturally is usually marked by symptoms of a trivial character; the skin feels hot, and there may be more or less fever; there is also slight loss of appetite, and the animal appears dull and stumbles during action; early a symptom sometimes appears which may be the first intimation of the animal's indisposition, and which, as a guide to diagnosis, is of great importance; it is the presence of a general or localized urticarial eruption. If the blood is examined microscopically, it may be found to present a normal appearance; but in the majority of cases a few small, rapidly moving organisms will be observed, giving to the blood, as it passes among the corpuscles, a peculiar, vibrating movement, which if once observed will not easily be forgotten. If the parasite has not been discovered in the blood for several days, the symptoms mentioned above may be the only ones noticed, and, as a rule, when treated with febrifuges, the horse quickly improves in health and the appetite returns. This condition does not last for more than a few days, when the animal is again observed to present a dull and dejected appearance, and on examination well-marked symptoms are found; the skin is hot, the temperature more or less elevated--101.7 deg. to 104 deg. F.; the pulse full and frequent--56 to 64 beats a minute; the visible mucous membranes may appear clean, but the conjunctival membranes, especially those covering the membrana nictitans, are usually the seat of dark-red patches of ecchymosis, varying in size in different animals. There is more or less thirst and slight loss of appetite; the animal eats its grain and green grass, but leaves all or a portion of the hay with which it has been supplied. At the same time there are slight catarrhal symptoms present, including lacrimation and a little mucous discharge from the nostrils. Occasionally at this period of the disease the submaxillary glands may be found enlarged and perhaps somewhat tender on manipulation. One symptom is markedly absent, namely, the presence of rigors or the objective sign of chilliness. In addition, it will be noted that there is some swelling and edema of the legs, generally between the fetlock and the hock, which pits but is not painful on pressure, and in case of horses there may be also some swelling of the sheath at this stage of the disease. When the fever and concomitant symptoms have declared themselves for a short period, one thing becomes especially noticeable in every animal attacked, namely, the rapidity with which it loses flesh. If the blood has been examined microscopically during the second period of fever, at first a few parasites will have been observed in it, which day by day increase in number and reach a maximum, where they remain for a varying period, or at once suddenly or gradually disappear during the period of apyrexia. After the fever and the accompanying symptoms have for the second time been present for a few days--the period varying from one to six--the animal is found to have lost the dull, dejected appearance and to look bright. The temperature has fallen and, in some cases, has attained normal or even subnormal limits. The visible mucous membranes are clean, and the conjunctival petechiae begin to fade; the pulse, however, will be found to be weak and thready in character, but the appetite excellent, and, in fact, if it were not for the loss of flesh and slight edema of the legs, there would be little to show that the animal was sick. Unfortunately, however, this condition does not continue for any great length of time, for again the temperature is elevated; in the course of a few hours the thermometer registers a still higher degree, the animal is dull and dejected, and by the following day the visible mucous membranes present a yellow tinge; large ecchymoses, dark in color, appear on the conjunctival membranes, the action of the heart is irritable, the pulse full and quick, or at times intermittent, and regurgitation may be observed in the jugulars, the breathing is quickened, and the individual respirations are shallow. On watching an animal in this condition it may be noticed that it takes seven or eight very short inspirations, followed by a much more prolonged and sonorous one; at the same time the breathing is more abdominal than thoracic in character. On examination of the legs it will be found that the swelling and edema have increased considerably, and that on the under surface of the abdomen, where previously it was confined to the sheath, it has now commenced to spread forward along the subcutaneous tissue between the skin and the muscles. During the whole of this time the appetite will have varied little, and the evacuations will be only slightly, if at all, altered in character. In the blood a repetition of the previous events takes place, the parasites make their appearance and increase to a maximum and again suddenly or gradually disappear, according to the length of the fever period. These periods, alternating with and without fever, may go on for a considerable time. The progress of the disease is variable and greatly depends upon the condition of the animal attacked, the weak one succumbing very rapidly, but each return of the fever brings with it, as a rule, an increase in the severity of the symptoms. There is increased yellowness of the membranes, fresh crops of petechiae on the conjunctiva, a collection of gelatinous material at the inner angle, which at times becomes red in color from an admixture of blood, and which on microscopic examination is found to contain a varying number of the surra parasites; increased swelling and edema of the extremities and abdomen, which now extends between the fore limbs and up the chest. During this time the wasting has been steadily progressive, especially of the muscles of the back and those surrounding the hip joint and the glutei.
Toward the termination of the disease it will be noticed that an animal is disinclined to move, and when made to do so there is manifest loss of power over the hind quarters, somewhat simulating a slight partial paralysis, and the hind quarters of the animal reel from side to side. In connection with this it may be noted that frequently there is paralysis of the sphincter ani and a dilated condition of the anus. These symptoms taken together point to some interference with the normal functions of the spinal cord in the lower dorsal and lumbar regions, and are probably owing to pressure caused by an exudation within the spinal membranes. In many cases shortly before death the heart's action becomes exceedingly violent, shaking the whole frame at each beat, so that the sound can be heard at some distance from the animal. In some of these cases the animal may suddenly drop dead; in others the emaciation and weakness become so pronounced that it falls to the ground, and, after a short struggle, succumbs to the disease. In other cases, again, the animal falls to the ground and appears to be suffering from acute pain, struggles violently, sweat covers the body, and respiration is very hurried. The struggles soon exhaust the patient's strength, and for a time it lies quiet; soon, however, the struggles commence again, continuing until death occurs. In some cases the appetite is voracious.
The symptoms of the disease as observed in experimentally inoculated animals are as follows: Twenty-four hours after the subcutaneous injection of a small quantity of surra blood, in the great majority of cases, a small circumscribed and somewhat raised swelling is noticed at the seat of the inoculation. After forty-eight hours the tumor has increased in size and is accompanied with some edema; it presents a certain amount of tension of the parts involved, and is generally tender on manipulation. These conditions continue to increase, until by the fourth day the tumor may measure 3 or 4 inches in; one direction by 2 or 3 in the other, and raised to the extent of an inch or an inch and a half above the surrounding tissues, or in some cases the tumor presents an almost circular form throughout. It will be also found that, if the tumor is firmly grasped, it is not fixed, but can be lifted up from the subcutaneous tissue. According to the nature and quantity of the inoculated blood, these symptoms rapidly present themselves, and either attain a maximum or are retarded until, varying from the fourth to the thirteenth day, the tumor at the seat of inoculation will be found to have lost a certain amount of its tension and tenderness. From this date the swelling and edema gradually begin to grow less, until finally, after a period of 10 to 14 days, the only sign left of the former swelling is a slight thickening of the skin over the point of the injection; but at the moment when the tension and tenderness of the parts at the seat of inoculation become suddenly decreased a symptom of the utmost clinical importance takes place, namely, at that moment the parasite of surra enters the blood of the general circulation.
The temperature on the day of inoculation, and, in fact, for several days afterwards, may remain normal in character, there being only a few degrees difference between the morning and evening observations. In other cases there may be a slight rise from the first evening, and a gradual progressive rise until the swelling at the seat of inoculation shows signs of reduction in size, when the temperature generally takes a decided rise again, and may attain 104 deg. or 105.8 deg. F. This elevation will last a varying period of from two to six days, and on the day following its onset the ordinary symptoms of fever will be noticed, and in addition there will be petechiae on the conjunctival membranes, lacrimation, a slight mucous discharge from the nose, and in severe cases some edema of the lower portion of the legs, and perhaps of the sheath in horses. At the termination of the period of fever the temperature will be found to have fallen to normal or nearly so; the animal will present a brighter aspect, and there is every appearance of its return to health; in a few days, however, the animal again appears dull and half asleep; the temperature is elevated, a relapse takes place, and a repetition of all the symptoms in the primary paroxysm, including the reappearance of the parasite, is observed.
Diagnosis.--A diagnosis may also be established by the complement-fixation or agglutination tests with the sera from suspected animals. This, however, can be carried out only in laboratories and requires special facilities for its execution.
Treatment.--No satisfactory treatment is known. Intravenous injections of Fowler's solution of arsenic give temporary relief, but relapses occur. In view of the great economic importance of this disease, it would not be advisable to attempt to treat any sporadic cases should they occur in this country. On the contrary, the animals should be slaughtered immediately and their carcasses promptly burned.
OSTEOPOROSIS OR BIGHEAD.
By JOHN R. MOHLER, V. M. D., Assistant Chief, Bureau of Animal Industry.
Osteoporosis is a general disease of the bones which develops slowly and progressively and is characterized by the absorption of the calcareous or compact bony substance and the formation of enlarged, softened, and porous bone. It is particularly manifest in the bones of the head, causing enlargement and bulging of the face and jaws, thereby giving rise to the terms "bighead" and "swelled head," which are applied to it. The disease affects horses, mules, and asses of all ages, classes, and breeds, and of both sexes, and is found under all soil, dietetic, and climatic conditions. It may occur in sporadic form, but in certain regions, such as South Africa, Australia, Madagascar, India, Hawaii, and in this country it seems to be enzootic, several cases usually appearing in the same stable or on the same farm, and numerous animals being affected in the same district. In the United States the disease has been found in all the States bordering the Delaware River and Chesapeake Bay, in some of the New England States, and in many of the Southern States, especially in low regions along the coast. In Europe the disease appears to be quite rare, and is usually described as a form of osteomalacia, a disease which is not uncommon among cattle of that continent. The opinion that bighead is only a form of osteomalacia, however, can not be accepted, nor can the infrequency of the former among European horses and the frequency of the latter among other live stock be conceded on the argument which has been presented, namely, that the better care which horses receive prevents them from becoming affected. In the Southwest, where osteomalacia, or creeps, has not infrequently been observed among range cattle by the writer, no case of osteoporosis of the horses using the same range has been noted, although the latter animals are given no more attention than the cattle.
The appropriate treatment of osteomalacia in cattle is so effective that if osteoporosis were a similar manifestation of disease a similar line of treatment should prove equally efficacious. However, this is not the fact. On the other hand, the occurrence of osteomalacia on old, worn-out soil, or on land deficient in lime salts, or from eating feed lacking in these bone-forming substances, or drinking water with a lime deficiency, is in perfect accord with our knowledge of the disease. But osteoporosis may occur on rich, fertile soil, in the most hygienic stables, and in animals receiving the best of care and of bone-forming feeds with a proper amount of mineral salts in the drinking water.
Cause.--The cause of this disease still remains obscure, although various theories have been advanced, some entirely erroneous, others more or less plausible; but none of them has been established. Thus the idea that feeding fodder and cereals poor in mineral salts and grazing in pastures where the soil is poor in lime and phosphates will cause the disease has been entirely disproved in many instances. Others have considered that the disease starts as a muscular rheumatism which is followed by an inflammatory condition of the bones, terminating in osteoporosis. The idea that the disease is contagious has been advanced by many writers, although no causative agent has been isolated. Numerous experiments have been made by inoculating the blood of an affected horse into normal horses without results. A piece of bone taken by Pearson from the diseased lower jaw of a colt was transplanted into a cavity made for it in the jaw of a normal horse, but without reproducing the disease. Petrone believes that the Micrococcus nitrificans causes osteomalacia in man as a result of its producing nitrous acid, which dissolves the calcareous tissues, and when injected into dogs in pure culture a similar disease is produced. It is probable that if this work is confirmed a somewhat similar causative factor will be discovered for osteoporosis.
Elliott considers the latter disease to be of microbic origin, the result of climatic conditions, and divides the island of Hawaii into two districts, in one of which the rainfall is 150 inches annually, where bighead is very prevalent, and the second of which is dry and rarely visited by rain, where the disease is unknown. Removal of animals from the wet to the dry district is followed by immediate improvement and frequently by recovery. In the wet district horses in both good and bad stables take the disease, but in the dry districts no unfavorable or unhygienic surroundings produce the affection. As both native and imported horses are equally susceptible, there is no indication of an acquired immunity to be observed.
Theiler has recently stated that his experiments in transfusing blood from diseased to normal horses were negative, and has suggested that the causative agent may be transmitted by an intermediate host only, as in the case of Texas fever. He draws attention to this method of spreading East African coast fever, although blood inoculations, as in osteoporosis, are always without result. We know that coast fever is infectious, and that it can not be transmitted by blood inoculations, but is conveyed with remarkable ease by ticks from diseased cattle. That the cause has not been observed may be accounted for by its being invisible even to the high magnification of the microscope.
On some farms and in some stables bighead is quite prevalent, a number of cases following one after another. On one farm of Thoroughbreds in Pennsylvania all the yearling colts and some of the aged horses were affected during one year, and on a similar farm in Virginia a large proportion of the horses for several years were diseased, although the cows and sheep of this farm remained unaffected.
Symptoms.--The commencement of the disease is usually unobserved by the owner, and these symptoms which do develop are generally not well marked or are misleading unless other cases have been noted in the vicinity. Until the bones become enlarged the symptoms remain so vague as not to be diagnosed readily. The disease may be present itself under a variety of symptoms. If the bones of the hock become affected, the animal will first show a hock lameness. If the long bones are involved, symptoms of rheumatism will be the first observed, while if the dorsal or lumbar vertebrae are affected indications of a strain of the lumbar region are in evidence. Probably the first symptom to be noticed is a loss of vitality combined with an irregular appetite or other digestive disturbance and with a tendency to stumble while in action. These earlier symptoms, however, may pass unobserved, and the appearance of an intermittent or migratory lameness without any visible cause may be the first sign to attract attention. This shifting and indefinite lameness, involving first one leg and then the other, is very suggestive, and is even more important when it is associated with a tendency to lie down frequently in the stall and the absence of a desire to get up, or the presence of evident pain and difficulty in arising.
About this time, or probably before, swelling of the bones of the face and jaw, which is almost constantly present in this disease, will be observed. The bones of the lower jaw are the most frequently involved, and this condition is readily detected with the fingers by the bulging ridge of the bone outside and along the lower edge of the molar teeth. A thickening of the lower jawbone may likewise be identified by feeling on both sides of each branch at the same time and comparing it with the thinness of this bone in a normal horse. As a result mastication becomes difficult or impossible and the teeth become loose and painful. The imperfect chewing which follows causes balls of feed to form which drop out of the mouth into the manger. Similar enlargements of the bones of the upper jaw may be seen, causing a widening of the face and a bulging of the bones about midway between the eyes and the nostrils. In some cases the nasal bones also become swollen and deformed, which, together with the bulging of the bones under the eyes, gives a good illustration of the reason for the application of the term bighead.
Other bones of the body will undergo similar changes, but these alterations are not so readily noted except by the symptoms they occasion. The alterations of the bones of the spinal column and the limbs, while difficult of observation, are nevertheless indicated by the reluctance of the animal to get up and the desire to remain lying for long periods of time. The animal easily tires, moves less rapidly, and if urged to go faster may sustain a fracture or have a ligament torn from its bony attachments, especially in the lower bones of the leg. An affected horse weighing 1,000 pounds was seen by the writer to fracture the large pastern bone from rearing during halter exercise.
The animal becomes poor in flesh, the coat is rough and lusterless, and the skin tight and harsh, producing a condition termed "hidebound," with considerable "tucking up" of the abdomen. The horse shows a short, stilted, choppy gait, which later becomes stiffer and more restricted, while on standing a position simulating that in founder is assumed, with a noticeable drop to the croup. The animal at this stage usually lies down and remains recumbent for several days at a time. Bed sores frequently arise and fractures are not uncommon in consequence of attempts to arise, which complications, in addition to emaciation, result in death.
The disease may exist in this manner for variable periods extending from two or three months to two years. The termination of the disease is uncertain at best, but is likely to be favorable if treatment and a change of feed, water, and location is adopted in the early stages of the malady.
Lesions.--As has been stated, the bones are the principal tissues involved. The nutrition of the bone is disturbed, as is indicated by the diminished density or rarefaction of the bony substances, the increase in the size or widening of the Haversian canal and the medullary cavity, and the enlargement of the network of spaces in the spongy tissue, the absorptive changes following the course of the Haversian system. In this process of absorption there are formed within the substance of the bone areas of erosion, indentations, or hollow spaces of irregular shape. These spaces increase in size and become confluent, causing an appearance resembling some varieties of coral. The affected bone may be readily incised with a knife, the cut surface appearing finely porous. This porous area is soft, pliable, and yields easily to the pressure of the finger. It has been shown by chemical analysis that the bone of an osteoporotic horse, when compared with that of a normal horse, shows a reduction in the amount of fat, phosphoric acid, lime, and soda, but a slight increase in organic matter and silicic acid. The bones lose their yellowish-white appearance, becoming gray and brittle. The affected bones may be those of any region or portion of the body. Besides the change already noted in the bones of the face, the ends of the long bones, such as the ribs, are involved, and may be sectioned, though not so readily as the facial bones. The bones of the vertebrae are also frequently involved, necessitating great care in casting a horse, as the writer has seen several cases of broken backs in casting such animals for other operations. The marrow and cancellated tissue of the long bones may contain hemorrhages and soft gelatinous material or coagulated fibrin. The internal organs are usually normal, but a catarrhal condition of the gastrointestinal tract may be noted as the result of the improper mastication, resulting from the enlargement of the jaws and soreness of the teeth.
Treatment.--The affected animal should be immediately placed under new conditions, both as to feed and surroundings. If the horse has been stable fed, it is advisable to turn it out on grass for two or three months, preferably in a higher altitude. If the disease has been contracted while running on pasture, place the animal in the stable or corral. In the early stages of the disease beneficial results have followed the supplemental use of lime given in the drinking water. One peck of lime slaked in a cask of water and additional water added from time to time is satisfactory and can be provided at slight expense. This treatment may be supplemented by giving a tablespoonful of powdered bone meal in each feed, with free access to a large piece of rock salt, or the bone meal may be given with four tablespoonfuls of molasses mixed with the feed. Feeds containing mineral salts, such as beans, cowpeas, oats, and cottonseed meal, may prove beneficial in replenishing the bony substance that is being absorbed. Cottonseed meal is one of the best feeds for this purpose, but it should be fed carefully. The animal should not be allowed to work at all during the active stage of the disease, nor should it be used for breeding purposes.
FOOTNOTES:
[7] This summary of symptoms is based upon work by Lingard.
HORSESHOEING.
By JOHN W. ADAMS, A. B., V. M.,
Professor of Surgery and Lecturer on Shoeing, Veterinary Department, University of Pennsylvania.
Bad and indifferent shoeing so frequently leads to diseases of the feet and in irregularities of gait, which may render a horse unserviceable, that it has been thought appropriate to conclude this book with a brief chapter on the principles involved in shoeing healthy hoofs.
In unfolding this subject in the limited space at my disposal, I can only hope to give the intelligent horse owner a sufficient number of facts, based on experience and upon the anatomy and physiology of the foot and leg, to enable him to avoid the more serious consequences of improper shoeing.
Let us first examine this vital mechanism, the foot, and learn something of its structure and of the natural movements of its component parts, that we may be prepared to recognize deviations from the normal and to apply the proper corrective.
GROSS ANATOMY OF THE FOOT.
(Pls. XXXII-XXXIV.)
The bones of the foot are four in number, three of which--the long pastern, short pastern, and coffin bone, placed end to end--form a continuous straight column passing downward and forward from the fetlock joint to the ground. A small accessory bone, the navicular, or "shuttle," bone, lies crosswise in the foot between the wings of the coffin bone and forms a part of the joint surface of the latter. The short pastern projects about 1-/2 inches above the hoof and extends about an equal distance to it. (See also page 395.)
The pastern and the coffin bone are held together by strong fibrous cords passing between each two bones and placed at the sides so as not to interfere with the forward and backward movement of the bones. The joints are therefore hinge joints, though imperfect, because, while the chief movements are those of extension and flexion in a single plane, some slight rotation and lateral movements are possible.
The bones are still further bound together and supported by three long fibrous cords, or tendons. One, the extensor tendon of the toe, passes down the front of the pasterns and attaches to the coffin bone just below the edge of the hair; when pulled upon by its muscle this tendon draws the toe forward and enables the horse to place the hoof flat upon the ground. The other two tendons are placed behind the pasterns and are called flexors, because they flex, or bend, the pasterns and coffin bone backward. One of the tendons is attached to the upper end of the short pastern, while the other passes down between the heels, glides over the under surface of the navicular bone, and attaches itself to the under surface of the coffin bone. These two tendons not only flex, or fold up, the foot as the latter leaves the ground during motion, but at rest assist the suspensory ligament in supporting the fetlock joint.
The foot-axis is an imaginary line passing from the fetlock joint through the long axes of the two pasterns and coffin bone. This imaginary line, which shows the direction of the pasterns and coffin bone, should always be straight--that is, never broken, either forward or backward when viewed from the side, or inward or outward when observed from in front. Viewed from one side, the long axis of the long pastern, when prolonged to the ground, should be parallel to the line of the toe. Viewed from in front, the long axis of the long pastern, when prolonged to the ground, should cut the hoof exactly at the middle of the toe.
Raising the heel or shortening the toe not only tilts the coffin bone forward and makes the hoof stand steeper at the toe, but slackens the tendon that attaches to the under surface of the coffin bone (perforans tendon), and therefore allows the fetlock joint to sink downward and backward and the long pastern to assume a more nearly horizontal position. The foot-axis, viewed from one side, is now broken forward; that is, the long pastern is less steep than the toe, and the heels are either too long or the toe is too short. On the other hand, raising the toe or lowering the heels of a foot with a straight foot-axis not only tilts the coffin bone backward and renders the toe more nearly horizontal, but tenses the perforans tendon, which then forces the fetlock joint forward, causing the long pastern to stand steeper. The foot-axis, seen from one side, is now broken backward--an indication that the toe is relatively too long or that the heels are relatively too low.
The elastic tissues of the foot are preeminently the lateral cartilages and the plantar cushion. The lateral cartilages are two irregularly four-sided plates of gristle, one on either side of the foot, extending from the wings of the coffin bone backward to the heels and upward to a distance of an inch or more above the edge of the hair, where they may be felt by the fingers. When sound, these plates are elastic and yield readily to moderate finger pressure, but from various causes may undergo ossification, in which condition they are hard and unyielding. The plantar cushion is a wedge-shaped mass of tough, elastic, fibro-fatty tissue filling all the space between the lateral cartilages, forming the fleshy heels and the fleshy frog, and serving as a buffer to disperse shock when the foot is set to the ground. It extends forward underneath the navicular bone and perforans tendon, and protects these structures from injurious pressure from below. Instantaneous photographs show that at speed the horse sets the heels to the ground before other parts of the foot--conclusive proof that the function of this tough, elastic structure is to dissipate and render harmless violent impact of the foot with the ground.
The horn-producing membrane, or "quick," as it is commonly termed, is merely a downward prolongation of the "derm," or true skin, and may be conveniently called the pododerm (foot skin). The pododerm closely invests the coffin bone, lateral cartilages, and plantar cushion, much as a sock covers the human foot, and is itself covered by the horny capsule, or hoof. It differs from the external skin, or hair skin, in having no sweat or oil glands, but, like it, is richly supplied with blood vessels and sensitive nerves. And, just as the derm of the hair skin produces upon its outer surface layer upon layer of horny cells (epiderm), which protect the sensitive and vascular derm, so, likewise, in the foot the pododerm produces over its entire surface soft cells, which, pushed away by more recent cells forming beneath, lose moisture by evaporation and are rapidly transformed into the corneous material which we call the hoof. It is proper to regard the hoof as a greatly thickened epiderm having many of the qualities possessed by such epidermal structures as hair, feathers, nails, claws, etc.
The functions of the pododerm are to produce the hoof and to unite it firmly to the foot.
There are five parts of the pododerm, easily distinguishable when the hoof has been removed, namely: (1) The perioplic band, a narrow ridge from one-sixteenth to one-eighth of an inch wide, running along the edge of the hair from one heel around the toe to the other. This band produces the perioplic horn, the thin varnishlike layer of glistening horn, which forms the surface of the wall or "crust," and whose purpose seems to be to retard evaporation of moisture from the wall. (2) The coronary band, a prominent fleshy cornice encircling the foot just below and parallel to the perioplic band. At the heels it is reflected forward along the sides of the fleshy frog, to become lost near the apex of this latter structure. The coronet produces the middle layer of the wall, and the reflexed portions produce the "bars," which are, therefore, to be regarded merely as a turning forward of the wall. (3) The fleshy leaves, 500 to 600 in number, parallel to one another, running downward and forward from the lower edge of the coronary band to the margin of the fleshy sole. They produce the soft, light-colored horny leaves which form the deepest layer of the wall, and serve as a strong bond of union between the middle layer of the wall and the fleshy leaves with which they dovetail. (4) The fleshy sole, which covers the entire under surface of the foot, excepting the fleshy frog and bars. The horny sole is produced by the fleshy sole. (5) The fleshy frog, which covers the under surface of the plantar cushion and produces the horny frog.
The horny box or hoof consists of wall and bars, sole and frog. The wall is all that part of the hoof which is visible when the foot is on the ground (see fig. 8). As already stated, it consists of three layers--the periople, the middle layer, and the leafy layer.
The bars (see fig. 1c) are forward prolongations of the wall, and are gradually lost near the point of the frog. The angle between the wall and a bar is called the "buttress." Each bar lies against the horny frog on one side and incloses a wing of the sole on the other, so that the least expansion or contraction of the horny frog separates or approximates the bars, and through them the lateral cartilages and the walls of the quarters. The lower border of the wall is called the "bearing edge," and is the surface against which the shoe bears. By dividing the entire lower circumference of the wall into five equal parts, a toe, two side walls, and two quarters will be exhibited. The "heels," strictly speaking, are the two rounded soft prominences of the plantar cushion, lying one above each quarter. The outer wall is usually more slanting than the inner, and the more slanting half of a hoof is always the thicker. In front hoofs the wall is thickest at the toe and gradually thins out toward the quarters, where in some horses it may not exceed one-fourth of an inch. In hind hoofs there is much less difference in thickness between the toe, side walls, and quarters. The horny sole, from which the flakes of old horn have been removed, is concave and about as thick as the wall at the toe. It is rough, uneven and often covered by flakes of dead horn in process of being loosened and cast off. Behind the sole presents an opening into which are received the bars and horny frog. This opening divides the sole into a body and two wings.
The periphery of the sole unites with the lower border of the wall and bars through the medium of the white line, which is the cross section of the leafy horn layer of the wall and of short plugs of horn which grow down from the lower ends of the fleshy leaves. This white line is of much importance to the shoer, since its distance from the outer border of the hoof is the thickness of the wall, and in the white line all nails should be driven.
The frog, secreted by the pododerm covering the plantar cushion or fatty frog, and presenting almost the same form as the latter, lies as a soft and very elastic wedge between the bars and between the edges of the sole just in front of the bars. A broad and shallow depression in its center divides it into two branches, which diverge as they pass backward into the horny bulbs of the heel. In front of the middle cleft the two branches unite to form the body of the frog, which ends in the point of the frog. The bar of a bar shoe should rest on the branches of the frog. In unshod hoofs the bearing edge of the wall, the sole, frog, and bars are all on a level; that is, the under surface of the hoof is perfectly flat, and each of these structures assists in bearing the body weight.
With respect to solidity, the different parts of the hoof vary widely. The middle layer of the wall is harder and more tenacious than the sole, for the latter crumbles away or passes off in larger or smaller flakes on its under surface, while no such spontaneous shortening of the wall occurs. The white line and the frog are soft-horn structures, and differ from hard horn in that their horn cells do not under natural conditions become hard and hornlike. They are very elastic, absorb moisture rapidly, and as readily dry out and become hard, brittle, and easily fissured. Horn of good quality is fine grained and tough, while bad horn is coarse grained and either mellow and friable or hard and brittle. All horn is a poor conductor of heat, and the harder (drier) the horn the more slowly does it transmit extremes of temperature.
THE PHYSIOLOGICAL MOVEMENTS OF THE HOOF.
A hoof while supporting the body weight has a different form, and the structures inclosed within the hoof have a different position than when not bearing weight. Since the amount of weight borne by a foot is continually changing, and the relations of internal pressure are continuously varying, a foot is, from a physiological viewpoint, never at rest. The most marked changes of form of the hoof occur when the foot bears the greatest weight, namely, at the time of the greatest descent of the fetlock. Briefly, these changes of form are: (1) An expansion or widening of the whole back half of the foot from the coronet to the lower edge of the quarters. This expansion varies between one-fiftieth and one-twelfth of an inch. (2) A narrowing of the front half of the foot, measured at the coronet. (3) A sinking of the heels and a flattening of the wings of the sole. These changes are more marked in the half of the foot that bears the greater weight.
The changes of form occur in the following order. When the foot is set to the ground the body weight is transmitted through the bones and sensitive and horny leaves to the wall. The coffin bone and navicular bone sink a little and rotate backward. At the same time the short pastern sinks backward and downward between the lateral cartilages and presses the perforans tendon upon the plantar cushion. This cushion being compressed from above and being unable to expand downward by reason of the resistance of the ground acting against the horny frog, acts like any other elastic mass and expands toward the sides, pushing before it the yielding lateral cartilages and the wall of the quarters. This expansion of the heels is assisted and increased by the simultaneous flattening and lateral expansion of the resilient horny frog, which crowds the bars apart. Of course, when the lateral cartilages are ossified, not only is no expansion of the quarters possible, but frog pressure often leads to painful compression of the plantar cushion and to increase of lameness. Frog pressure is therefore contraindicated in lameness due to sidebones (ossified cartilages). Under the descent of the coffin bone the horny sole sinks a little; that is, the arch of the sole around the point of the frog and the wings of the sole become somewhat flattened. All these changes of form are most marked in sound unshod hoofs, because in them ground pressure on the frog and sole is pronounced; they are more marked in fore hoofs than in hind hoofs.
The movement of the different structures within the foot and the changes of form that occur at every step are indispensable to the health of the hoof, so that these elastic tissues must be kept active by regular exercise, with protection against drying out of the hoof. Long-continued rest in the stable, drying out of the hoof, and shoeing decrease or alter the physiological movements of the hoof and sometimes lead to foot diseases. Since these movements are complete and spontaneous only in unshod feet, shoeing must be regarded as an evil, albeit a necessary one, and indispensable if we wish to keep horses continuously serviceable on hard, artificial roads. However, if in shoeing we bear in mind the structure and functions of the hoof and apply a shoe whose branches have a wide and level bearing surface, so as to interfere as little as may be with the expansion and contraction of the quarters, in so far as this is not hindered by the nails, we need not be apprehensive of trouble, provided the horse has reasonable work and his hoofs proper care.
GROWTH OF THE HOOF.
All parts of the hoof grow downward and forward with equal rapidity, the rate of growth being largely dependent upon the amount of blood supplied to the pododerm, or "quick." Abundant and regular exercise, good grooming, moistness and suppleness of the hoof, going barefoot, plenty of good feed, and at proper intervals removing the overgrowth of hoof and regulating the bearing surface, by increasing the volume and improving the quality of the blood flowing into the pododerm, favor the rapid growth of horn of good quality; while lack of exercise, dryness of the horn, and excessive length of the hoof hinder growth.
The average rate of growth is about one-third of an inch a month. Hind hoofs grow faster than fore hoofs and unshod ones faster than shod ones. The time required for the horn to grow from the coronet to the ground, though influenced to a slight degree by the precited conditions, varies in proportion to the distance of the coronet from the ground. At the toe, depending on its height, the horn grows down in 11 to 13 months, at the side wall in 6 to 8 months, and at the heels in 3 to 5 months. We can thus estimate with tolerable accuracy the time required for the disappearance of such defects in the hoof as cracks, clefts, etc.
Irregular growth is not infrequent. The almost invariable cause of this is an improper distribution of the body weight over the hoof--that is, an unbalanced foot. Colts running in soft pasture or confined for long periods in the stable are frequently allowed to grow hoofs of excessive length. The long toe becomes "dished"--that is, concave from the coronet to the ground--the long quarters curl forward and inward and often completely cover the frog and lead to contraction of the heels, or the whole hoof bends outward or inward, and a crooked foot, or, even worse, a crooked leg, is the result if the long hoof be allowed to exert its powerful and abnormally directed leverage for but a few months upon young plastic bones and tender and lax articular ligaments. All colts are not foaled with straight legs, but failure to regulate the length and bearing of the hoof may make a straight leg crooked and a crooked leg worse, just as intelligent care during the growing period can greatly improve a congenitally crooked limb. If breeders were more generally cognizant of the power of overgrown and unbalanced hoofs to divert the lower bones of young legs from their proper direction, and, therefore, to cause them to be moved improperly, with loss of speed and often with injury to the limbs, we might hope to see fewer knock-kneed, bow-legged, "splay-footed," "pigeon-toed," cow-hocked, interfering, and paddling horses.
If in shortening the hoof one side wall is, from ignorance, left too long or cut down too low with relation to the other, the foot will be unbalanced, and in traveling the long section will touch the ground first and will continue to do so till it has been reduced to its proper level (length) by the increased wear which will take place at this point. While this occurs rapidly in unshod hoofs, the shoe prevents wear of the hoof, though it is itself more rapidly worn away beneath the high (long) side than elsewhere, so that by the time the shoe is worn out the tread of the shoe may be flat. If this mistake be repeated from month to month, the part of the wall left too high will grow more rapidly than the low side whose pododerm is relatively anemic as a result of the greater weight falling into this half of the hoof, and the ultimate result will be a "wry," or crooked foot.
THE CARE OF UNSHOD HOOFS.
The colt should have abundant exercise on dry ground. The hoofs will then wear gradually, and it will only be necessary from time to time to regulate any uneven wear with the rasp and to round off the sharp edge about the toe in order to prevent breaking away of the wall.
Colts in the stable can not wear down their hoofs, so that every four to six weeks they should be rasped down and the lower edge of the wall well rounded to prevent chipping. The soles and clefts of the frog should be picked out every few days and the entire hoof washed clean. Plenty of clean straw litter should be provided. Hoofs that are becoming "awry" should have the wall shortened in such a manner as to straighten the foot-axis. This will ultimately produce a good hoof and will improve the position of the limb.
CHARACTERISTICS OF A HEALTHY HOOF.
A healthy hoof (figs. 1 and 8) is equally warm at all parts, and is not tender under pressure with the hands or moderate compression with pincers. The coronet is soft and elastic at all points and does not project beyond the surface of the wall. The wall (fig. 8) is straight from coronet to ground, so that a straightedge laid against the wall from coronet to ground parallel to the direction of the horn tubes will touch at every point. The wall should be covered with the outer varnishlike layer (periople) and should show no cracks or clefts. Every hoof shows "ring formation," but the rings should not be strongly marked and should always run parallel to the coronary band. Strongly marked ring-formation over the entire wall is an evidence of a weak hoof, but when limited to a part of the wall is evidence of previous local inflammation. The bulbs of the heels should be full, rounded, and of equal height. The sole (fig. 1) should be well hollowed out, the white line solid, the frog well developed, the middle cleft of the frog broad and shallow, the spaces between the bars and the frog wide and shallow, the bars straight from the buttress toward the point of the frog, and the buttresses themselves so far apart as not to press against the branches of the frog. A hoof can not be considered healthy if it presents reddish discolored horn, cracks in the wall, white line, bars, or frog, thrush of the frog, contraction or displacement of the heels. The lateral cartilages should yield readily to finger pressure.
VARIOUS FORMS OF HOOFS.
As among a thousand human faces no two are alike, so among an equal number of horses no two have hoofs exactly alike. A little study of different forms soon shows us, however, that the form of every hoof is dependent in great measure on the direction of the two pastern bones as viewed from in front or behind, or from one side; and that all hoofs fall into three classes when we view them from in front and three classes when we observe them in profile. Inasmuch as the form of every foot determines the peculiarities of the shoe that is best adapted to it, no one who is ignorant of, or who disregards the natural form of, a hoof can hope to understand physiological shoeing.
FORMS OF FEET VIEWED FROM IN FRONT AND IN PROFILE.
Whether a horse's feet be observed from in front or from behind, their form corresponds to, or at least resembles, either that of the regular position (fig. 2), the base-wide or too-wide position (fig. 3), or the base-narrow position (fig. 4).
By the direction of the imaginary line passing through the long axes of the two pasterns (figs. 2, 4, 5) we determine whether or not the hoof and pasterns stand in proper mutual relation.
In the regular standing position (fig. 2) the foot-axis runs straight downward and forward; in the base-wide position (fig. 3) it runs obliquely downward and outward, and in the base-narrow position (fig. 4) it runs obliquely downward and inward.
Viewing the foot in profile, we distinguish the regular position (fig. 5b) and designate all forward deviations as acute-angled (long toe and low heel, fig. 5a), and all deviations backward from the regular (steep toe and high heel, fig. 5c) as steep-toed, or stumpy. When the body weight is evenly distributed over all four limbs, the foot-axis should be straight; the long pastern, short pastern, and wall at the toe should have the same slant.
A front hoof of the regular standing position.--The outer wall is a little more slanting and somewhat thicker than the inner. The lower border of the outer quarter describes the arc of a smaller circle--that is, is more sharply bent than the inner quarter. The weight falls near the center of the foot and is evenly distributed over the whole bottom of the hoof. The toe forms an angle with the ground of 45 deg. to 50 deg. and is parallel to the direction of the long pastern. The toe points straight ahead, and when the horse is moving forward in a straight line the hoofs are picked up and carried forward in a line parallel to the middle line of the body, and are set down flat. Coming straight toward the observer the hoofs seem to rise and fall perpendicularly.
A hoof of the base-wide position is always awry. The outer wall is more slanting, longer, and thicker than the inner, the outer quarter more curved than the inner, and the outer half of the sole wider than the inner. The weight falls largely into the inner half of the hoof. In motion the hoof is moved in a circle. From its position on the ground it breaks over the inner toe, is carried forward and inward close to the supporting leg, thence forward and outward to the ground, which the hoof meets first with the outer toe. Horses that are toe-wide ("splay-footed"--toes turned outward) show all these peculiarities of hoof-form and hoof-flight to a still more marked degree and are therefore more prone to "interfere" when in motion.
A hoof of the base-narrow position is awry, but not to so marked a degree as the base-wide hoof. The inner wall is usually a little more slanting than the outer, the inner half of the sole wider than the outer, and the inner quarter more curved than the outer. The outer quarter is often flattened and drawn in at the bottom. The weight falls largely into the outer half of the hoof. In motion the hoof breaks over the outer toe, is carried forward and outward at some distance from the supporting leg, thence forward and inward to the ground, which it generally meets with the outer toe. The foot thus moves in a circle, whose convexity is outward, a manner of flight called "paddling." A base-narrow horse, whose toes point straight ahead, frequently "interferes," while a toe-narrow (pigeon-toed) animal seldom does.
A regular hoof (fig. 5b), viewed from one side, has a straight foot-axis inclined to the horizon at an angle of 45 deg. to 50 deg.. The weight falls near the center of the foot and there is moderate expansion of the quarters.
An acute-angled hoof (fig. 5a) has a straight foot-axis inclined at an angle less than 45 deg. to the horizon. The weight falls more largely in the back half of the hoof and there is greater length of hoof in contact with the ground and greater expansion of the heels than in the regular hoof.
Upright or stumpy hoof.--In the upright or stumpy hoof (fig. 5c) the foot-axis is straight and more than 55 deg. steep. The hoof is relatively short from toe to heel, the weight falls farther forward, and there is less expansion of the heels than in the regular hoof.
Wide and narrow hoofs.--Finally, there are wide hoofs and narrow hoofs, dependent solely upon race and breeding. The wide hoof is almost circular on the ground surface, the sole but little concave, the frog large, and the quality of the horn coarse. The narrow hoof has a strongly "cupped" sole, a small frog, nearly perpendicular side walls, and fine-grained, tough horn.
Hind hoofs are influenced in shape by different directions of their pasterns much as front feet are. A hind hoof is not round at the toe as a front hoof is, but is more pointed. Its greatest width is two-thirds of the way back from toe to heel, the sole is more concave, the heels relatively wider, and the toe about 10 deg. steeper than in front hoofs.
EXAMINATION PRELIMINARY TO SHOEING.
The object of the examination is to ascertain the direction and position of the limbs, the shape, character, and quality of the hoofs, the form, length, position, and wear of the shoe, the number, distribution, and direction of the nails, the manner in which the hoof leaves the ground, its line of flight, the manner in which it is set to the ground, and all other peculiarities, that at the next and subsequent shoeings proper allowances may be made and observed faults corrected. The animal must, therefore, be observed both at rest and in motion.
At rest, the observer should stand in front and note the slant of the long pasterns. Do they drop perpendicularly, or slant downward and outward (base-wide foot), or downward and inward (base-narrow foot)? Whatever be the direction to the long pastern, an imaginary line passing through its long axis, when prolonged to the ground, should apparently pass through the middle of the toe. But if such line cuts through the inner toe the foot-axis is not straight, as it should be, but is broken inward at the coronet, an indication that either the outer wall of the hoof is too long (high) or that the inner wall is too short (low). On the contrary, if the center line of the long pastern falls through the outer toe the foot-axis is broken outward at the coronet, an indication that either the inner wall is too long or the outer wall too short.
The observer should now place himself at one side, two or three paces distant, in order to view the limb and hoof in profile. Note the size of the hoof in relation to the height and weight of the animal, and the obliquity of the hoof. Is the foot-axis straight--that is, does the long pastern have the same slant as the toe, or does the toe of the hoof stand steeper than the long pastern (fig. 6c)? In which case the foot-axis is broken forward at the coronet, an indication, usually, that the quarters are either too high or that the toe is too short.
If the long pastern stands steeper than the toe (fig. 6a) the foot-axis is broken backward, in which case the toe is too long or the quarters are too low (short). In figures 6a and 6c the dotted lines passing from toe to quarters indicate the amount of horn which must be removed in order to straighten the foot-axis, as shown in figure 6b. Note also the length of the shoe.
Next, the feet should be raised and the examiner should note the outline of the foot, the conformation of the sole, form and quality of the frog, form of the shoe, wear of the shoe, and the number and distribution of the nails. Does the shoe fully cover the entire lower border of the wall? or is it too narrow, or fitted so full on the inside that it has given rise to interfering? or has the shoe been nailed on crooked? or has it become loose and shifted? is it too short, or so wide at the ends of the branches as not to support the buttresses of the hoof? Does the shoe correspond with the form of the hoof? Are the nails distributed so as to interfere as little as possible with the expansion of the quarters? are there too many? are they too large? driven too "fine" or too high? These are questions which the observer should put to himself.
Note carefully the wear of the old shoe. It is the unimpeachable evidence of the manner in which the hoof has been set to the ground since the shoe was nailed to it, and gives valuable "pointers" in leveling the hoof. Wear is the effect of friction between the shoe and the ground at the moment of contact. Since the properly leveled hoof is set flat to the ground, the "grounding wear" of a shoe should be uniform at every point, though the toe will always show wear due to scouring at the moment of "breaking over." Everything which tends to lengthen the stride tends also to make the "grounding wear" more pronounced in the heels of the shoe, while all causes which shorten the stride--as stiffening of the limbs through age, overwork, or disease--bring the grounding wear nearer the toe.
An exception should be noted, however, in founder, in which the grounding wear is most pronounced at the heels.
If one branch of the shoe is found to be worn much thinner than the other, the thinner branch has either been set too near the middle line of the foot (fitted too close), where it has been bearing greater weight while rubbing against the ground, or, what is much more often the case, the section of wall above the thinner branch has been too long (too high), or the opposite section of wall has been too short (too low). "One-sided wear, uneven setting down of the feet, and an unnatural course of the wall are often found together." How much an old shoe can tell us, if we take time and pains to decipher its scars!
The horse should next be observed at a walk and at a trot or pace, from in front, from behind, and from the side, and the "breaking over," the carriage of the feet, and the manner of setting them to the ground carefully noted and remembered. A horse does not always move just as his standing position would seem to imply. Often there is so great a difference in the form and slant of two fore hoofs or two hind hoofs that we are in doubt as to their normal shape, when a few steps at a trot will usually solve the problem instantly by showing us the line of flight of the hoofs and referring them to the regular, base-wide, or base-narrow form.
No man is competent either to shoe a horse or to direct the work till he has made the precited observations.
PREPARATION OF THE HOOF FOR THE SHOE.
After raising the clinches of the nails with a rather dull clinch cutter ("buffer") and drawing the nails one at a time, the old shoe is critically examined and laid aside. Remaining stubs of nails are then drawn or punched out and the hoof freed of dirt and partially detached horn. The farrier has now to "dress" the overgrown hoof to receive the new shoe; in other words, he has to form a base of support so inclined to the direction of the pasterns that in motion this surface shall be set flat upon the ground. He must not rob the hoof nor leave too much horn; either mistake may lead to injury. If he has made a careful preliminary examination he knows what part of the wall requires removal and what part must be left, for he already knows the direction of the foot axis and the wear of the old shoe and has made up his mind just where and how much horn must be removed to leave the hoof of proper length and the foot axis straight.
A greatly overgrown hoof may be quickly shortened with sharp nippers and the sole freed of semidetached flakes of horn. The concave sole of a thick-walled, strong hoof may be pared out around the point of the frog, but not so much as to remove all evidences of exfoliation. The wall should be leveled with the rasp till its full thickness, the white line, and an eighth of an inch of the margin of the sole are in one horizontal plane, called the "bearing surface of the hoof." The bars, if long, may be shortened, but never pared on the side. The branches of the sole in the angle between the bars and the wall of the quarters should be left a little lower than the wall, so as not to be pressed upon by the inner web of the shoe. "Corns," or bruises of the pododerm, are usually a result of leaving a thick mass of dry, unyielding horn at this point. The frog should not be touched further than to remove tags or layers that are so loose as to form no protection. A soft frog will shorten itself spontaneously by the exfoliation of superficial layers of horn, while if the frog is dry, hard, and too prominent it is better to soften it by applying moisture in some form, and to allow it to wear away naturally than to pare it down. It is of advantage to have the frog project below the level of the wall an amount equal to the thickness of a plain shoe, though we rarely see frogs of such size except in draft horses. The sharp lower border of the wall should be rounded with the rasp to prevent its being bent outward and broken away. Finally, the foot is set to the ground and again observed from all sides to make sure, that the lines bounding the hoof correspond with the direction of the long pastern.
THE SHOE.
The shoe is an artificial base of support, by no means ideal, because it interferes to a greater or less degree with the physiology of the foot, but indispensable except for horses at slow work on soft ground. Since a proper surface of support is of the greatest importance in preserving the health of the feet and legs, it is necessary to consider the various forms of shoes best adapted to the different forms of hoofs. Certain properties are common to all shoes and may be considered first. They are form, width, thickness, length, surfaces, borders, "fullering," nail holes, and clips.
Form.--Every shoe should have the form of the hoof for which it is intended, provided the hoof retains its proper shape; but for every hoof that has undergone change of form we must endeavor to give the shoe that form which the hoof originally possessed. Front shoes and hind shoes, rights and lefts, should be distinctly different and easily distinguishable.
Width.--All shoes should be wider at the toe than at the ends of the branches. The average width should be about double the thickness of the wall at the toe.
Thickness.--The thickness should be sufficient to make the shoe last about four weeks and should be uniform except in special cases.
Length.--This will depend upon the obliquity of the hoof viewed in profile. The acute-angled hoof (fig. 5a) has long overhanging heels, and a considerable proportion of the weight borne by the leg falls in the posterior half of the hoof. For such a hoof the branches of the shoe should extend back of the buttresses to a distance nearly double the thickness of the shoe. For a hoof of the regular form (figs. 5b and 8) the branches should project an amount equal to the thickness of the shoe. In a stumpy hoof (fig. 5c) the shoe need not project more than one-eighth of an inch. In all cases the shoe should cover the entire "bearing surface" of the wall.
Surfaces.--The surface that is turned toward the hoof is known as the "upper," or "hoof surface," of the shoe. That part of the hoof surface which is in actual contact with the horn is called the "bearing surface" of the shoe. The "bearing surface" should be perfectly horizontal from side to side, and wide enough to support the full thickness of the wall, the white line, and about an eighth of an inch of the margin of the sole. The bearing surface should also be perfectly flat, except that it may be turned up at the toe ("rolling-motion" shoe, fig. 5 a, b, c.) The surface between the bearing surface and the inner edge of the shoe is often beaten down or concaved to prevent pressure too far inward upon the sole. This "concaving," or "seating," should be deeper or shallower as the horny sole is less or more concave. As a rule, strongly "cupped" soles require no concaving (hind hoofs, narrow fore hoofs).
Borders.--The entire outer border should be beveled under the foot. Such a shoe is not so readily loosened, nor is it so apt to lead to interfering.
Fullering.--This is a groove in the ground surface of the shoe. It should pass through two-thirds of the thickness of the shoe, be clean, and of uniform width. It is of advantage in that it makes the shoe lighter in proportion to its width and, by making the ground surface somewhat rough, tends to prevent slipping.
Nail holes.--The shoe must be so "punched" that the nail holes will fall directly on the white line. They should be confined to the fore half of front shoes, but may occupy the anterior two-thirds of hind shoes. For a medium-weight shoe three nail holes in each branch are sufficient, but for heavier shoes, especially those provided with long calks, eight holes are about right, though three on the inside and four on the outside may do.
Clips.--These are half-circular ears drawn up from the outer edge of the shoe either at the toe or opposite the side wall. The height of a clip should equal the thickness of the shoe, though they should be even higher on hind shoes and when a leather sole is interposed between the shoe and hoof. Clips secure the shoe against shifting. A side clip should always be drawn up on that branch of the shoe that first meets the ground in locomotion.
SPECIAL FEATURES AND FITTING THE SHOES.
A shoe for a regular hoof (figs. 7 and 8) fits when its outer border follows the wall closely in the region of the nail holes and from the last nail to the end of the branch gradually projects beyond the surface of the wall to an eighth of an inch and extends back of the buttresses an amount equal to the thickness of the shoe. The shoe must be straight, firm, air-tight, its nail holes directly over the white line, and its branches far enough from the branches of the frog to permit the passage of a foot pick. Branches of the shoe must be of equal length.
In fitting a shoe to a hoof of regular form we follow the form of the hoof, but in base-wide and base-narrow hoofs, which are of irregular form, we must pay attention not only to the form of the hoof but also to the direction of the pasterns and the consequent distribution of weight in the hoof, because where the most weight falls the surface of support of the foot must be widened, and where the least weight falls (opposite side of the hoof) the surface of support should be narrowed. In this way the improper distribution of weight within the hoof is evenly distributed over the surface of support.
A shoe for a base-wide hoof should be fitted full on the inner side of the foot and fitted close on the outer side, because the inner side bears the most weight. The nails in the outer branch are placed well back, but in the inner branch are crowded forward toward the toe.
A shoe for a base-narrow hoof should be just the reverse of the preceding. The outer branch should be somewhat longer than the inner.
A shoe for an acute-angled hoof should be long in the branches, because most of the weight falls in the posterior half of the foot. The support in front should be diminished either by turning the shoe up at the toe or by beveling it under the toe (fig. 5a).
A shoe for a stumpy hoof should be short in the branches, and for pronounced cases should increase the support of the toe, where the most of the weight falls, by being beveled downward and forward.
In many cases, especially in draft horses, where the hoofs stand very close together, the coronet of the outer quarter is found to stand out beyond the lower border of the quarter. In such cases the outer branch of the shoe from the last nail back must be fitted so full that an imaginary perpendicular dropped from the coronet will just meet the outer border of the shoe. The inner branch, on the other hand, must be fitted as "close" as possible. The principal thought should be to set the new shoe farther toward the more strongly worn side. Such a practice will render unnecessary the widespread and popular fad of giving the outer quarter and heel calk of hind shoes an extreme outward bend. Care should be taken, however, that in fitting the shoe "full" at the quarter the bearing surface of the hoof at the quarter be not left unsupported or incompletely covered, to be pinched and squeezed inward against the frog. This will be obviated by making the outer branch of the shoe sufficiently wide and punching it so coarse that the nails will fall upon the white line.
Hot fitting.--Few farriers have either the time or the skill necessary to adjust a cold shoe to the hoof so that it will fit, as we say, "air-tight." Though the opponents of hot fitting draw a lurid picture of the direful consequences of applying a hot shoe to the hoof, it is only the abuse of the practice that is to be condemned. If a heavy shoe at a yellow heat be held tightly pressed against a hoof which has been pared too thin, till it embeds itself, serious damage may be done. But a shoe at a dark heat may be pressed against a properly dressed hoof long enough to scorch, and thus indicate to the farrier the portions of horn that should be lowered without appreciable injury to the hoof and to the ultimate benefit of the animal.
Nailing.--The horse owner should insist on the nails being driven low. They should pierce the wall not above an inch and five-eighths above the shoe. A nail penetrating the white line and emerging low on the wall destroys the least possible amount of horn, has a wide and strong clinch, rather than a narrow one, which would be formed near the point of the nail, and, furthermore, has the strongest possible hold on the wall, because its clinch is pulling more nearly at a right angle to the grain (horn tubes) of the wall than if driven high. Finally, do not allow the rasp to touch the wall above the clinches.
THE BAR SHOE.
The bar shoe (fig. 9) has a variety of uses. It enables us to give the frog pressure, to restore it to its original state of activity and development when, by reason of disuse, it has become atrophied. It gives the hoof an increased surface of support and enables us to relieve one or both quarters of undue pressure that may have induced inflammation and soreness. The bar of the shoe should equal the average width of the remainder of the shoe and should press but lightly on the branches of the frog. The addition of a leather sole with tar and oakum sole-packing allows us to distribute the weight of the body over the entire ground surface of the hoof.
THE RUBBER PAD.
Various forms of rubber pads, rubber shoes, rope shoes, fiber shoes, and other contrivances to diminish shock and prevent slipping on the hard and slippery pavements of our large cities are in use in different parts of the world. In Germany the rope shoe (a malleable-iron shoe with a groove in its ground surface in which lies a piece of tarred rope) is extensively used with most gratifying results. It is cheap, durable, easily applied, and effective.
In the large cities of England and the United States rubber pads are extensively used. They are rather expensive, but are quite efficient in preventing slipping on polished and gummy pavements, though not so effective on ice. Figure 11 is an illustration of one of the best of many rubber pads. The rubber is stitched and cemented to a leather sole and is secured by the nails of a three-quarter shoe. Such a pad will usually last as long as two shoes. They may be used continuously, not only without injury to the hoof, but to its great benefit. The belief, unsupported by evidence, that rubber pads "draw the feet" keeps many from using them. A human foot encased in a rubber boot may eventually be blistered by the sweat poured upon the surface of the skin and held there by the impervious rubber till decomposition takes place with the formation of irritating fatty acids; but there is no basis for an analogy in the hoof of a horse.
OTHER SPECIAL FORMS.
Some drawings, designed to illustrate shoeing in connection with "interfering" and "forging," and other special conditions, are shown in figures 13 to 18.
INDEX.
Abdomen-- dropsy, in foal, or ascites, description and treatment, 193 dropsy, or ascites, description, symptoms, and treatment, 86 limbs, and perineum, dropsy affecting, description and treatment, 180 sheath, and penis, swelling, cause and treatment, 171
Abnormal presentations at birth, 197-202
Abortion, description, cause, symptoms, and treatment, 182
Abscess-- and inflammation of lymphatic glands, descriptions, symptoms, treatment, 272 in lung and suppuration, symptoms, 127
Abscesses-- acute, description and treatment, 500 cold, description and treatment, 501 description, 500 in throat, treatment, 62
Acari, parasites of eye, 296
Acariasis, or mange, note, 478
Achorion schoenleini, vegetable parasite of skin, description, 478
Adams, John W., chapter on "Horseshoeing", 583-605
Air embolism, or air in veins, note, 270
Albuminoid poisoning, hemoglobinuria, azoturia, azotemia, symptoms, prevention, and treatment, 141
Aloes, use against bots in horses, 93
Amaurosis, or palsy of nerve of sight, causes, symptoms, and treatment, 231, 295
Amnion, dropsy, description and treatment, 180
Anasarca, or purpura hemorrhagica, causes, symptoms, treatment, etc., 531, 533
Anatomy and physiology of brain and nervous system, 210
Anemia-- of brain, causes, symptoms, pathology, and treatment, 223 spinal, symptoms and treatment, 234
Aneurism-- description, symptoms, pathology, and treatment, 265 one form caused by Strongylus vulgaris, 265
Anidian monsters, or moles, description, 179
Animal parasites, description of kinds, 478
Ankle-- and fetlock, skin, note, 397 fetlock, and foot, diseases, chapter by A. A. Holcombe, 395-457
Ankles, cocked, or knuckling, description, causes, and treatment, 400
Anthrax-- definition, causes, symptoms, and treatment, 540-544 prevention by destruction of bacteria, 544 vaccination as preventive, 544
Apoplexy, or cerebral hemorrhage, causes, symptoms, pathology, and treatment, 220
Arteries-- description, 249 diseases, or arteritis, and endarteritis, description, symptoms, pathology, and treatment, 263
Artery-- constriction, description, 265 rupture, description, symptoms, and treatment, 266
Arthritis, open joints, broken knees, and synovitis, cause and treatment, 357
Ascaris equorum, intestinal worm, note, 90
Ascites, or dropsy of abdomen, description, symptoms, and treatment, 86, 193
Asthma, heaves, or broken wind, definition, symptoms, and treatment, 128
Atheroma of veins and arteries, description, 264
Autogenic vaccines, description, 506
Autumn mange, description and treatment, 480
Azotemia, hemoglobinuria, azoturia, poisoning by albuminoids, symptom, prevention, and treatment, 141
Azoturia, hemoglobinuria, azotemia, poisoning by albuminoids, symptoms, prevention, and treatment, 141
Bacillus equisepticus, cause of pneumonia, 522
Bacteria, kinds responsible for pneumonia in horses, 522
Bacteria vaccines, kinds and uses, 506, 531
Balls, or pills, description and manner of administering, 44
Bar shoe, uses, 601
Bees, wasps, and hornets, stings, treatment, 485
Beets as feed, 56
Bichlorid, use in disinfection, 509
Bighead (osteoporosis)-- chapter by John R. Mohler, 578-582 symptoms, lesions, and treatment, 580
Biliary calculi, or gallstones, symptoms and treatment, 90
Bilocular cavity, or calculus in sheath, or preputial calculus, description and treatment, 163
Birth, abnormal presentations at, 197-202
Black pigment tumors, or melanosis, description and treatment, 476
Bladder-- calculus, or stone, and tumor affecting, 190 diseases growths, symptoms and treatment, 151 eversion, description and treatment, 152 inflammation, cystitis, or urocystitis, symptoms and treatment, 149 irritable, cause and treatment, 150 neck, spasms affecting, causes, symptoms, and treatment, 146, 225 paralysis, description and cause, 230 paralysis, symptoms and treatment, 148 stone, vesical calculus, or cystic calculus, description, symptoms, and treatment, 159 worm of kidney, 146
Bleeding-- after castration, treatment, 170 from lungs, or hemoptysis, causes, description, and treatment, 127 from nose, causes and treatment, 103 or flooding from womb, treatment, 205 skin eruptions, or Dermatorrhagia parasitica, description and treatment, 469
Blisters, inflammation, or eczema, description and treatment, 464
Bloat colic, cause, symptoms, and treatment, 73
Blood-- circulation of heart, description, 248 clots in walls of vagina, 207 medicine administered into veins, 48 medium of disease transmission, 511 of penis, extravasation, cause and treatment, 167 spavin, bog spavin, and thoroughpin, description and treatment, 356
Blood vessels-- and heart, diseases, remarks, 250 heart, and lymphatics, diseases, chapter by M. R. Trumbower, 247-273 physiology and anatomy, 247
Bloody urine, or hematuria, cause and treatment, 141
Blowing, high, description, 110
Bluebottle (Lucilia caesar), note 481
Bog spavin, blood spavin, and thoroughpin, description and treatment, 356
Boil of eyelid, description and treatment, 282
Boils-- or Dermatitis granulosa, 469 or furuncles, description and treatment, 466
Bone-- hip, fracture, or on innominatum, description, symptoms, prognosis, and treatment, 341 premaxillary, fractures, description and treatment, 336 spavin. See Spavin
Bones-- cannon, fractures, description, symptoms, and treatment, 350, 395 cranial, fractures, causes, symptoms, and treatment, 335 diseases, description, 309 dislocations and luxations, cause, symptoms, and treatment, 361 of face, fractures, description, and treatment, 366 of fetlock and foot, description, 395 of hip, fractures, causes, 188 one system of locomotion, 299, 301 sesamoid, fractures, cause, symptoms, prognosis, and treatment, 352
Botfly, habits and treatment, 93
Bots, injury to horses, symptoms, and treatment, 93-94
Bowels, twisting, volvulus, or gut-tie, cause, symptoms, and treatment, 72
Brain-- and membranes, inflammation, description, 212, 213 and nervous system, anatomy, and physiology, 210 anemia, causes, symptoms, pathology, and treatment, 223 compression, causes, symptoms, and treatment, 221 concussion, causes, symptoms, treatment, and prevention, 222 congestion, or megrims, description, causes, symptoms, treatment, and prevention, 217 description, 211 dropsy, or hydrocephalus, causes, symptoms, and treatment, 223
Bran, value as feed, 55
Broken knee, open joints, synovitis, and arthritis, cause, prognosis, and treatment, 357
Broken wind, heaves, or asthma, definition, symptoms, and treatment, 128
Bronchitis-- and broncho-pneumonia, description, symptoms, and treatment, 120 chronic, description and treatment, 110
Broncho-pleuropneumonia, description, 126
Broncho-pneumonia and bronchitis, description, symptoms, and treatment, 120
Bruise of frog, causes, symptoms, and treatment, 425
Burns and scalds, treatment, 483, 496
Calculi-- biliary, or gallstones, symptoms and treatment, 90 or stones, in intestines, description, symptoms, and treatment, 71 or stones, in stomach, symptoms and treatment, 70 renal, description, symptoms, and treatment, 158 ureteric, description and treatment, 158-159 urinary, classification, 157 urinary, stone, or gravel, 154,156
Calculus-- in sheath, or bilocular cavity, or preputial calculus, description, and treatment, 163 or stone, and tumor in bladder, 190 urethral, or stone in urethra, description, symptoms, and treatment, 162 vesical, stone in bladder, or cystic calculus, description, symptoms, and treatment, 159
Calk wounds, description and treatment, 405
Callosities-- description, 475 sloughing, horny sloughs, or sitfasts, description and treatment, 475, 496
Cancer, epithelial, or epithelioma, description and treatment, 477
Canker-- of foot, description, causes, symptoms, and treatment, 418 or grease (inflammation of heels with sebaceous secretion), description, causes, symptoms, and treatment, 472
Cannon bone-- description, 395 fractures, description, symptoms, and treatment, 350
Capped elbow, cause, symptoms, and treatment, 379
Capped hock, cause, symptoms, and treatment, 385
Capped knee, description, cause, treatment, etc., 383
Carbolic acid, use in disinfection, 509
Carbon disulphid, use against worms in horse, 93, 94
Cardiac enlargement, or hypertrophy of heart, description, symptoms, and treatment, 260
Caries of cartilage, or tumor of haw, description and treatment, 284
Carrots, value as feed, 56
Cartilaginous quittor, description, causes, symptoms, and treatment, 415
Cartilago nictitans, or winking cartilage (the haw), description, 276
Castration-- bleeding after operation, treatment, 170 by covered operation, method, 172 of cryptorchids, or ridglings, method, 169 of mare, method, 172 of stallions, method, 168 pain after operation, treatment, 170 successful method, 169
Cataract, remarks, 295
Catarrh-- chronic, nasal gleet or collection in sinuses, causes, symptoms, and treatment, 99 gastrointestinal, or indigestion, cause, symptoms, and treatment, 76 nasal, or cold in head, symptoms, and treatment, 98
Cerebral hemorrhage, or apoplexy, causes, symptoms, and treatment, 220
Cerebritis, causes, symptoms, and treatment, 212
Cerebrospinal meningitis, so called, or forage poisoning, causes, symptoms, and treatment, 237
Cervical choke, description, 63, 64
Chaff for feeding, 54
Chaps on knee and hock, scratches, or cracked heels, description, causes, and treatment, 470
Chest walls, wounds penetrating, description and treatment, 131
Chicken acari, or Dermanyssus gallinae, animal parasite of skin, 480
Chigoe, or jigger-- larvae of Trombidium, Leptus americanus, animal parasite of skin, 480 Pulex penetrans, bite, treatment, 482
Choke-- cervical, description, 63, 64 pharyngeal, cervical, and thoracic, symptoms and treatment, 63
Chorea, or St. Vitus dance, description and treatment 227
Chorioptes-- bovis (Symbiotes equi, Dermatophagus equi), animal parasite of skin, 480 spathiferus, animal parasite of skin, 480
Choroiditis, cause, symptoms, and treatment, 288
Chronic bronchitis, description and treatment, 110
Circinate ringworm, or Tinea tonsurans, description, symptoms, treatment, 477
Circulation organs, methods of examination, 13
Clubfoot, description, 398
Clysters, or enemas, description and manner of administering, 48
Cocked ankles, or knuckling, description, causes, and treatment, 400
Coffin joint, description, 396
Coffinbone, description, 396
Cold in head, or nasal catarrh, symptoms and treatment, 98
Colic-- bloat, cause, symptoms, and treatment, 73 cramp, or spasmodic, cause, symptoms, and treatment, 74 flatulent, cause, symptoms, and treatment, 73 obstruction, caused by impaction of large intestine, symptoms, and treatment, 68 specific forms, 66 wind, cause, symptoms, and treatment, 73 worms, description, symptoms, and treatment, 90-94 tympanitic, cause, symptoms, and treatment, 73
Colt. See Foal.
Compression of brain, causes, symptoms, and treatment 222
Concussion-- of brain, causes, symptoms, and treatment, 222 spinal, causes and treatment, 235
Conformation-- of foot, faults, 398 of horse, 10
Congenital scrotal hernia, description and treatment, 82
Congestion-- active, causes, 30 and inflammation of skin, description of kinds, 461 and inflammation of testicles, or orchitis, causes, symptoms, and treatment, 164 description, 30 of brain, or megrims, causes, symptoms, treatment, etc., 217 of heart, description and symptoms, 263 of lungs, description and treatment, 111 of skin, red efflorescence, or erythema, description and treatment, 461 of skin, with small pimples, or pauples, description and treatment, 463 of spine, cause, symptoms, and treatment, 233 passive, causes, 31
Conjunctives, or external ophthalmia, description, causes, symptoms, and treatment, 285
Constipation, or costiveness, cause and treatment, 70, 181
Constitution of horse, 10
Consumption, or tuberculosis, note, 128
Contagious pneumonia, discussion, 521-527
Convulsions, description and treatment, 226
Cord-- spermatic, strangulated, cause and treatment, 170 spermatic, tumors, causes and treatment, 171 spinal, description, 212
Corn, or maize, how to feed, 55
Cornea-- ulcers, treatment, 288 white specks and cloudiness, cause and treatment, 288
Corns, description, causes, symptoms, and treatment, 421
Coronary band, description, 397
Coronet-- description, 396 fractures, symptoms and treatment, 351
Costiveness, or constipation, cause and treatment, 70, 181
Cough, chronic, description, 131
Cracked heels, or scratches, causes and treatment, 470
Cramp-- of hind limb, or spasm of thigh, description and treatment, 226 or spasmodic, or colic, cause, symptoms, and treatment, 74
Cramps-- of hind limbs, cause and treatment, 181 or spasms, causes and treatment, 226
Cranial bones, fractures, causes, symptoms, and treatment, 335
Cranium, tumor within, description of kinds, 224
Cresol, use in disinfection, 579
Crookedfoot, description, 399
Croup and diphtheria, mistakes in diagnosis, 108
Cryptorchids, or ridglings, castration, method, 169
Curb of hock, cause, symptoms, and treatment, 374
Currying, value as preventive of bots, 94
Cutaneous quittor, description, causes, symptoms, and treatment, 407
Cuticle, description, 459
Cyanosis of newborn foals, description, 263
Cylicostomum spp., parasite, danger and remedies, 92-93
Cystic calculus, or stone in bladder, description, symptoms, and treatment, 159
Cystic disease of wall of womb, or vesticular mole, description and treatment, 179
Cysticercus, parasite of eye, 297
Cystitis, inflammation of bladder, or urocystitis, symptoms and treatment, 149
Dermanyssus gallinae, or chicken acari, animal parasite of skin, 480
Dermatitis granulosa, or boils, 469
Dermatocoptes equi, animal parasite of skin, 480
Dermatodectes equi, animal parasite of skin, 480
Dermatophagus equi, animal parasite of skin, 480
Dermatorrhagia parasitica, or bleeding skin eruptions, description and treatment, 469
Dermis, or true skin, description, 459
Descazeaux, study of summer sores, note, 470
Diabetes-- insipidous, diuresis, polyuria, or excessive secretion of urine, causes, symptoms, and treatment, 138 mellitus, saccharine diabetes, glycosuria, or inosuria, causes, symptoms, and treatment, 139
Diaphragm-- rupture, cause and symptoms, 133 spasm, or thumps, description and treatment, 132, 225
Diaphragmatic hernia, description, 85
Diarrhea, causes, symptoms, and treatment, 77
Dieckerhoff, experiments in disease transmission, note, 511
Digestive organs, diseases, chapter by Ch. B. Michener, 49-94
Digestive tract, examination, 20
Dilatation-- of heart, description, causes, symptoms, and treatment, 261 of veins, varicose, or varix, causes and treatment, 269
Dioctophyme renale, roundworm of kidney, 146
Diphtheria and cramp, mistakes in diagnosis, 108
Dips, use against mange in horses, 479
Diseases, fundamental principles of, chapter by Rush Shippen Huidekoper, 27-43
Disinfection, directions and materials, 508-509
Dislocations and luxations of bones, causes, symptoms, treatment, etc., 361
Distemper, cause, symptoms, and treatment, 527-531
Diuresis, polyuria, diabetes insipidus, or excessive secretion of urine, causes, symptoms, and treatment, 138
Douche, nasal, in administering medicines, 47
Dourine, or maladie du coit-- article by John R. Mohler, 562-564 description and treatment, 562 symptoms and treatment, 562-564
Drench, methods, 45
Dropsies, synovial, remarks, 355
Dropsy-- general, of fetus, description and treatment, 193 of abdomen in foal, or ascites, description and treatment, 193 of abdomen, or ascites, description, symptoms, and treatment, 86 of amnion, description and treatment, 180 of brain, or hydrocephalus, causes, symptoms, and treatment, 223 of limbs, perineum, and abdomen, description and treatment, 180 of scrotum, or hydrocele, symptoms and treatment, 166 of womb, cause, symptoms, and treatment, 179
Dysentery, description, causes, symptoms, and treatment, 79
Echinococcus-- parasite of eye, 296 parasite of kidney, 146
Ectropion and entropion, or eversion and inversion of eyelid, causes and treatment, 283
Eczema, or inflammation with blisters, description and treatment, 464
Edematous pneumonia, definition, causes, symptoms, treatment, etc., 521-527
Elbow-- capped, cause, symptoms, and treatment, 379 muscles, sprains, causes, symptoms, and treatment, 368
Electric shock, causes, description, and treatment, 246
Electuries, or pastes, description, and manner of administering, 45
Embolism-- air, or air in veins, note, 270 and thrombus, description, symptoms, and treatment, 267
Embryotomy of parts at abnormal births, 202
Emphysema, or swelling of fetus with gas, description and treatment, 194
Encephalitis, cause, symptoms, and treatment, 212
Endarteritis, and arteritis, description, symptoms, and treatment, 263
Endocarditis, or inflammation of lining membrane of heart, cause, symptoms, and treatment, 252
Enemas, or clysters, description, and manner of administering, 48
Engorgement colic, description, symptoms, and treatment, 66
Enteritis, definition, 66
Entropion and ectropion, or inversion and eversion of eyelid, causes and treatment, 283
Epilepsy, or falling fits, symptoms and treatment, 227
Epithelial cancer, or epithelioma, description and treatment, 477
Epithelioma-- degeneration of penis, or papilloma, 167 or epithelial cancer, description and treatment, 477
Equine variola, or horsepox, causes, symptoms, treatment, etc., 535-540
Eruptions, bleeding skin, or Dermatorrhagia parasitica, description and treatment, 469
Erysipelas, description, cause, and treatment, 474
Erythema, congestion of skin, or red efflorescence, description and treatment, 461
Esophagus-- dilatation, causes, symptoms, and treatment, 65 or gullet, treatment for foreign bodies, 62 stricture, description and treatment, 65
Eversion-- and inversion of eyelid, or ectropion and entropion, causes and treatment, 283 of bladder, description and treatment, 152 or womb after difficult parturition, treatment, 205
Exostosis, cause, description, and treatment, 309
Extravasation of blood of penis, causes and treatment, 167
Eye-- diseases, chapter by James Law, 274-297 examination, 277 haw, or winking cartilage, description, 276 lachrymal apparatus, 277 muscles, description, 276 palsy of nerve of sight, or amaurosis, causes, symptoms, and treatment, 295 parasites, affecting, description of different kinds, 296 watering, or obstruction of lachrymal apparatus, description and remedies, 285
Eyeball-- description, 274 tumors affecting, 296
Eyelid-- diseases, description of different kinds, 279 inflammation, causes and treatment, 280 inversion and eversion, or entropion and ectropion, causes and treatment, 283 sty, or furuncle (boil), affecting, description and treatment, 282 torn, or wounds affecting, description and treatment, 284 warts and tumors affecting, description and treatment, 283
Face bones, fractures, description and treatment, 336
Facial paralysis, cause and symptoms, 230
Fainting, or syncope, symptoms and treatment, 259
Farcy-- and glanders, definition, causes, etc., 544-557 chronic, symptoms, 550
Fatty degeneration of heart, causes, symptoms, and treatment, 261
Favus, or honeycomb ringworm, description and treatment, 478
Feces, impaction of rectum, 191
Feed-- kinds to give, 51 musty and moldy, effect on digestive organs, 53 preparation, 57
Feeding, corn, 55
Feet, interfering, causes, symptoms, and treatment, 399
Femur, fracture, cause, symptoms, and treatment, 347
Fetlock-- and ankle skin, note, 397 and foot bones, description, 395 ankle, and foot, diseases, chapter by A. A. Holcombe, 395-457 joint, description, 396 knuckling, causes, symptoms, and treatment, 372 sprain, causes, symptoms, and treatment, 402
Fetus adherent to walls of womb, description, cause, and treatment, 192 excessive size, 192 general dropsy, description and treatment, 193 or foal, prolonged retention, cause and treatment, 181 swelling with gas, or emphysema, description and treatment, 194 tumors, or inclosed ovum, description and treatment, 194
Fever, description, causes, and treatment, 38-43
Fibrous bands constricting and crossing neck of womb, description and treatment, 191
Fibrous constriction of vagina or vulva, cause and treatment, 191
Filaria-- conjunctivae, parasite of eye, 297 equina, parasite of eye, 297 haemorrhagica, threadworm causing skin disease, 469 irritans, parasite causing summer sores, description and treatment, 469 multipapillosa, threadworm causing bleeding skin eruptions, 469 palpebralis, parasite of eye, 296
Fistulas, causes, symptoms, and treatment, 502-506
Fits, falling, or epilepsy, symptoms and treatment, 227
Flatfoot, description, 398
Flatulent colic, cause, symptoms, and treatment, 73
Flea, or pulex, prevention and treatment of bite, 482
Flesh fly (Sarcophaga carnaria), note, 481
Flexor-- metatarsis, rupture, description, cause, symptoms, and treatment, 377 pedis perforans, description, 397 pedis perforatus, description, 397 tendons or their sheath, and suspensory ligaments, sprains, cause, symptoms, and treatment, 371
Flies, method of attacking horses; prevention and treatment for bite, 481
Flooding, or bleeding from womb, treatment, 205
Flukes, occurrence in horses, note, 90
Flyblow, or grubs in skin, description and treatment, 481
Foal-- contractions of muscles, description and treatment, 194 monstrosities, description of kinds, causes, and treatment, 194 natural presentation, 185 prolonged retention, cause and treatment, 181 water in head, or hydrocephalus, description and treatment, 192
Foals, newborn, cyanosis affecting, description, 263
Foot-- anatomical review, 395, 583 and fetlock bones, description, 395 canker, causes, symptoms, and treatment, 418 conformation, faults, 398 fetlock, and ankle, diseases, chapter by A. A. Holcombe, 395-457 mange, description and treatment, 480 punctured wounds, description, symptoms, and treatment, 426 sand-cracks, causes, symptoms, and treatment, 432 sole description, 397 See also Hoof.
Forage poisoning, or cerebrospinal meningitis, symptoms and treatment, 237
Forearm, fracture, description, cause, symptoms, and treatment, 345
Founder, or laminitis-- acute, subacute, and chronic, description, 447-449 complications, 449 curative measures, 455 description and causes, 441 following parturition, cause, 207 sequel of superpurgation, 79 symptoms, 444 treatment and prevention, 453
Fractures-- causes and symptoms, 322 description of different kinds, 322 of different bones, description, 335 prognosis and treatment, 328
Frog-- bruises, causes, symptoms, and treatment, 425 description, 397
Frostbites, description, symptoms, and treatment, 405
Furuncle-- or boil, description and treatment, 466 or sty (boil), of eyelid, description and treatment, 282
Gaffky, investigation of pneumonia infection, note, 522
Galls, harness, or sitiasts, description and treatment, 475, 496
Gallstones, or biliary calculi, symptoms, and treatment, 90
Gangrene-- or mortification, causes, 127 or mortification, description, symptoms, and treatment, 498
Gas, swelling of fetus, or emphysema, description and treatment, 194
Gastritis, definition, 66
Gastro-enteritis, description, symptoms, and treatment, 80
Gastrointestinal catarrh, or indigestion, description, cause, symptoms, and treatment, 76
Gastrointestinal parasites, description and treatment, discussion by Maurice C. Hall, 90-94
Gastrophilus, spp., injury to horses, symptoms and treatment, 93-94
Generative organs, diseases affecting, chapter by James Law, 164-209
Genito-urinary passages, method of medication, 48
Gentian, use against pinworms in horses, 91
Gestation, extra-uterine, description, symptoms, and treatment, 178
Glanders-- acute, symptoms, 553 and farcy, definition, causes, etc., 544-557 chronic, symptoms, 552 treatment, 556
Glands-- lymphatic, description, symptoms, and treatment, 271 sebaceous, description, 460 sweat, description, 461
Gleet-- inflammation of urethra, or urethritis, symptoms and treatment, 153 nasal, chronic catarrh, or collection in sinuses, causes, symptoms, and treatment, 99-101
Glossitis, description and treatment, 60-61
Glottis, spasm, description, 225
Glycosuria, saccharine diabetes mellitus, or inosuria, causes, symptoms, and treatment, 139
Grains for feeding, 54
Grasses, important feed, 56
Gravel, urinary calculi, or stone, description, and causes, 154, 156
Grease or canker, causes, symptoms, and treatment, 472
Grubs-- or flyblow, description and treatment, 481 under the skin, description and treatment, 481
Grunting, testing, 109
Gullet, or esophagus, treatment for foreign bodies, 62
Gunshot wounds, description and treatment, 494
Gut-tie, volvulus, or twisting of bowels, cause, symptoms, and treatment, 72
Guttural pouches, description and treatment, 119
Habronema, spp., cause of summer sores, etc., note, 470
Hairs on skin, description, 460
Harbaugh, W. H., chapter on "Diseases of respiratory organs", 95-133
Harness galls, or sitiasts, description and treatment, 475, 496
Harvest bug, larvae of Trombidium, Leptus americanus, jigger (chigoe), animal parasite of skin, 480
Haw-- or winking cartilage of the eye, description, 276 tumor, or caries of cartilage of the eye, description and treatment, 284
Hay, kinds for feeding, 53
Heart-- adventitious growths, description, symptoms, and treatment, 258 anatomy and physiology, 247 and blood vessels, diseases, remarks, 250 blood vessels, and lymphatics, diseases, chapter by M. R. Trumbower, 247-273 circulation of blood, description, 248 congestion, description, and symptoms, 263 dilatation, description, causes, symptoms, and treatment, 261 fatty degeneration, description, causes, symptoms, and treatment, 261 hypertrophy, or cardiac enlargement, description, symptoms, and treatment, 260 inflammation of lining membrane, or endocarditis, cause, description, symptoms, and treatment, 251 inflammation of muscular structure, or myocarditis, symptoms, alterations, and treatment, 251 inflammation of sac inclosing, or pericarditis, causes, symptoms, and treatment, 255 inflammatory diseases, description and treatment, 251 palpitation, description, symptoms, and treatment, 259 rupture, description and cause, 262 valvular disease, description, symptoms, and treatment, 257 weakness, causes, symptoms, and treatment, 262
Heat exhaustion, sunstroke, or heat stroke, symptoms, pathology, treatment, and prevention, 219
Heaves, broken wind, or asthma, definition, symptoms, and treatment, 128
Heels-- contracted, or hoofbound, description, causes, symptoms, and treatment, 429 cracked, scratches, or chaps on knee and hock, description, causes, and treatment, 470 inflammation, with sebaceous secretion, grease, or canker, description, causes, symptoms, and treatment, 472
Hematuria, or bloody urine, cause and treatment, 141
Hemiplegia, or paralysis of on side, or half the body, description and symptoms, 228
Hemoglobinuria, azoturia, azotemia, poisoning by albuminoids, symptoms, prevention, and treatment, 141
Hemoptysis, or bleeding from lungs, causes, description, and treatment, 127
Hemorrhage-- process of healing and method of treatment, 486 spinal, symptoms and treatment, 225
Hemorrhoids, or piles, description and treatment, 81
Hemostasia, description and treatment, 485
Hepatitis, or inflammation of liver, symptoms, causes, and treatment, 87
Hernia-- congenital scrotal, description and treatment, 82 diaphragmatic, description, 85 inguinal, description, symptoms, and treatment, 83 of womb, description and treatment, 189 or rupture, description of different kinds, 82 scrotal, cause, 82 umbilical, description and treatment, 84 ventral, description and treatment, 83
Herpes, description and treatment 468
High blowing, description, 110
Hip-- bone, or os innominatum, description, symptoms, and treatment, 341 bones, fractured, causes, 158 joint, luxation, description and treatment 363 lameness, description, symptoms, and treatment, 369
Hock-- and knee, chaps or scratches, description, causes, and treatment, 470 capped, cause, symptoms, and treatment, 385 curb, cause, symptoms, and treatment, 374 fractures, note, 350
Holcombe, A. A., chapter on "Diseases of ankle, fetlock, and foot", 395-457
Honeycomb ringworm, or favus, description and treatment, 478
Hoof-- bound, or contracted heels, description, causes, symptoms, and treatment, 429 description, 397 growth, 588 healthy, characteristics, 590 physiological movements, 587 preparation for the shoe, 596 See also Foot.
Hoofs-- unshod, care, 590 various forms, 591
Hornets, bees, and wasps, treatment for stings, 483
Horny sloughs (sitfasts), or sloughing callosities, description and treatment, 475, 496
Horse, sick-- attitude and general condition indicative of disease, 8 conformation and constitution, 10 danger from silage as feed, 56-57 examination, chapter by Leonard Pearson, 7-26 history of diseases necessary in examination, 8 parasites, intestinal, and injuries from them, 90-94
Horsepox, or equine variola, causes, symptoms, and treatment, 535-540
Horses-- anatomy, description, 300 danger from silage as feed, 56-57
Horseshoes. See Shoe.
Huidekoper, Rush Shippen, chapter on "Infectious diseases", 507-582
Humerus, fractures, symptoms and treatment, 345
Hydrocele, or dropsy of scrotum, symptoms and treatment, 166
Hydrocephalus-- or dropsy of brain, causes, symptoms, and treatment, 223 or water in head, of foal, description and treatment, 192
Hydrophobia. See Rabies.
Hydrothorax, treatment, 126
Hypertrophy of heart, or cardiac enlargement, description, symptoms, and treatment, 260
Hypoderma-lineata, note, 481
Icterus, jaundice, or yellows, description and treatment, 88
Impaction-- of large intestine, cause of obstruction colic, symptoms and treatment, 68 of rectum with feces, 191
Indigestion, or gastrointestinal catarrh, description, causes, symptoms, and treatment, 76
Infectious anemia-- chapter by John R. Mohler, 569-572 cause and localities infected, 569 diagnosis and treatment, 571 symptoms and lesions, 570
Infectious diseases-- chapter by Rush Shippen Huidekoper, 507-582 general discussion, 507-508
Inflammation-- acute, of kidneys, or acute nephritis, causes, symptoms, and treatment, 143 and abscess of lymphatic glands, description, symptoms, and treatment, 272 and congestion of skin, description of kinds, 461 and congestion of teats and udder, symptoms and treatment, 208 and congestion of testicles, or orchitis, causes, symptoms, and treatment, 164 chronic, of kidneys, causes, symptoms, and treatment, 145 description, symptoms, termination, and treatment, 32-38 local, and abscess of lymphatic glands, description, symptoms, and treatment, 272 of bladder, cystitis, or urocystitis, symptoms and treatment, 149 of brain and its membranes, description, 193, 212, 213 of eyelids, causes and treatment, 280 of heels, with sebaceous secretion, grease, or canker, description, causes, symptoms, and treatment, 472 of lining membrane of heart, or endocarditis, cause, description, symptoms, and treatment, 251 of liver, or hepatitis, symptoms, causes, and treatment, 87 of membranes, a complication of influenza, 518 of membranes of spinal cord, causes, symptoms, and treatment, 232 of muscular structure of heart, or myocarditis, symptoms, alterations, and treatment, 251 of nerve, or neuritis, cause, symptoms, and treatment, 236 of pharynx, description, 103 of sac inclosing heart, or pericarditis, causes, symptoms, pathology, and treatment, 255 of substance of spinal cord, or myelitis, causes, symptoms, pathology, and treatment, 233 of urethra, urethritis, or gleet, symptoms and treatment, 153 of womb and peritoneum, symptoms and treatment, 207 with blisters, or eczema, description and treatment, 464 with pustules, description and treatment, 465
Inflammatory diseases of the heart, description and treatment, 251
Influenza, definition, symptoms, termination, complications, and treatment, 510-521
Inguinal, hernia, description, symptoms, and treatment, 83
Inhalation, manner of administering medicines, 47
Injections, methods of administering medicines, 47
Inosuria, saccharine diabetes, diabetes mellitus, or glycosuria, causes, symptoms, and treatment, 139
Insufflation, description, 46
Interfering-- and speedy cuts, description, symptoms, prognosis, and treatment, 387 of feet, causes, symptoms, and treatment, 399
Intestinal-- paralysis, cause, 230 worm, or Ascaris equorum, note, 90
Intestines-- and stomach, diseases, remarks, 65 calculi, or stones, description, symptoms, and treatment, 71 large, impaction, cause of obstruction colic, symptoms and treatment, 68 paralysis, description and treatment, 72 spasms, 225
Intussusception, or invagination, description, symptoms, and treatment, 71
Invagination, or intussusception, description, symptoms, and treatment. 71
Iritis, causes, symptoms, and treatment, 288
Irritation, nervous, of skin, or pruritus, description and treatment, 468
Jaundice, icterus, or yellows, description and treatment, 88
Jaw, lower, fracture, description, causes, and treatment, 337
Jigger, or chigoe, Leptus americanus, animal parasite of skin, 480
Joint-- hip, luxation, description and treatment, 361 shoulder, displacement, description and treatment, 363
Joints diseases, note, 354 open, cause, prognosis, and treatment, 357
Kidneys-- acute inflammation, or acute nephritis, causes, symptoms, and treatment, 143 chronic inflammation, causes, symptoms, and treatment, 145 bladder worm and roundworm affecting, 146 tumors, note, 146
Knee-- broken, cause, prognosis, and treatment, 357 capped, description, cause, symptoms, prognosis, and treatment, 383 fracture, cause, symptoms, prognosis, and treatment, 347 or hock, chaps, scratches, or cracked heels, description, causes, and treatment, 470
Knees, sprung, cause, symptoms, and treatment, 373
Knuckling-- of fetlock, description, causes, symptoms, and treatment, 372 or cocked ankles, description, causes, and treatment, 400
Labor pains, premature, cause, and treatment, 186
Lachrymal apparatus of eye-- description, 277 obstruction, or watering eye, description and remedy, 285
Lameness-- definition, physiology and description, 303 how to detect the seat, 307 how to discover, 304 its causes and treatment, chapter by A. A. Liautard, 298-394 of hip, description, symptoms, prognosis, and treatment, 369 of shoulder, description, causes, symptoms, and treatment, 365
Laminae, sensitive, description, 398
Laminitis. See Founder.
Lampas, description and treatment, 60
Laryngismus paralyticus, or roaring, description and treatment, 108, 230
Laryngitis, or sore throat, description, symptoms and treatment, 103
Larynx, spasms, description and treatment, 107
Law, James-- chapter on "Diseases of the eye", 274-297 chapter on "Diseases of the generative organs", 164-209 chapter on "Diseases of the skin", 458, 483 chapter on "Diseases of the urinary organs", 134-163
Lead poisoning, or plumbism, causes, symptoms, and treatment, 245
Leptus americanus, or harvest bug, animal parasite of skin, 480
Leucorrhea, description and treatment, 208
Liautard, A., chapter on "Lameness: Its causes and treatment", 298 394
Lice, or pediculi, description and treatment for bite, 482
Ligament-- suspensory, description, 396 suspensory, rupture, description, symptoms, and treatment, 403
Ligaments-- description and functions, 302 suspensory, sprains, causes, symptoms, prognosis, and treatment, 371
Limbs-- hind, cramp, cause and treatment, 181 perineum, and abdomen, dropsy, description and treatment, 180
Lime-and-sulphur dip, use against mange in horse, 479
Linseed, ground, value as laxative, 55
Liver-- diseases, remarks, 87 inflammation, or hepatitis, symptoms, causes, and treatment, 87 rupture, causes, symptoms, and treatment, 88
Lockjaw, or tetanus, causes, symptoms, prevention, and treatment, 241
Locomotor ataxia, or incoordination of movement, description, 230
Loins, sprains, description, cause, symptoms, and treatment, 392
Lueber, investigation of pneumonia infection, 522
Lucilia caesar, or bluebottle, and L. hominivorax, or screwworm fly, note, 481
Lung-- abscess, and suppuration, symptoms, 127 fever, or pneumonia, description, symptoms, and treatment, 113
Lungs-- bleeding, or hemoptysis, causes, description, and treatment, 127 congestion, description and treatment, 111 description, 111
Luxations and dislocations of bones, cause, symptoms, and treatment, 361
Lymphangitis, causes, symptoms, and treatment, 272
Lymphatic-- glands, local inflammation, and abscess affecting, description, symptoms, and treatment, 272 system, diseases, description, 271
Lymphatics, heart, and blood vessels, diseases, chapter by M. R. Trumbower, 247-273
Madness, rabies, or hydrophobia, cause, symptoms, treatment, and prevention, 244, 559
Maize, or corn, how to feed 55
Maladie de coit, or dourine, description and treatment, 562
Mange-- autumn, and mange of foot, description and treatment, 480 horse, treatment, 479 or acariasis, note, 478
Mare-- castration, method, 172 pregnant, hygiene, 177 sterility, causes and treatment, 172
Masturbation, or self-abuse, remedy, 168
Meat fly, or Musca vomitoria, note, 481
Medicines, methods of administering, chapter by Ch. B. Michener, 44-48
Megrims, or congestion of brain, description, causes, symptoms, treatment, etc., 217
Melanosis, or black pigment tumor, description and treatment, 476
Membrane-- lining, of heart, inflammation, or endocarditis, cause, description, symptoms, and treatment, 252 of nose, thickening, symptoms and treatment, 101
Membranes-- inflammation, a complication of influenza, 518 mucous, visible, and skin may indicate disease, 11 of brain, inflammation, description, 212, 213 of spinal cord, inflammation, causes, symptoms, and treatment, 232
Meningitis-- causes, symptoms, and treatment, 212 spinal, causes, symptoms, pathology, and treatment, 232
Metatarsi, flexor, rupture, description, cause, symptoms, and treatment, 377
Michener, Ch. B.-- chapter on "Diseases of the digestive organs", 49-94 chapter on "Methods of administering medicines", 44-48 chapter on "Wounds and their treatment," 484-506
Microsporon furfur, vegetable parasite of skin 478
Mohler, John R.-- chapter on "Dourine", 562-564 chapter on "Infectious anemia", 569-572 chapter on "Mycotic lymphangitis", 557-559 chapter on "Osteoporosis, or bighead", 578-582
Mold, silage, danger to horses, 56-57
Mole, vesicular, or cystic disease of walls of womb, description and treatment, 179
Moles, or anidian monsters, description, 179
Monstrosities in foal, description of kinds, causes, and treatment, 194
Moonblindness, or periodic ophthalmia, causes, symptoms, treatment, 291
Mortification, or gangrene. See Gangrene.
Mouth, diseases, remarks, 60
Mucous membranes, visible, and skin may indicate disease, 11
Mules, danger from silage as feed, 56-57
Musca vomitoria, or meat fly, note, 481
Muscles-- and tendons, diseases, 365 contraction in foal, description and treatment, 194 of elbow, sprain, causes, symptoms, and treatment, 368 of eye, description, 276 one system of locomotion, 299, 300
Mycotic lymphangitis-- and glanders, differentiation, 557 chapter by John R. Mohler, 557-559 diagnosis and treatment, 558 symptoms and lesions, 558
Myelitis, or inflammation of substance of spinal cord, causes, symptoms, and treatment, 233
Myocarditis, or inflammation of muscular structure of heart, symptoms, alterations, and treatment, 251
Nasal-- catarrh, or cold in head, symptoms and treatment, 98 douche, used in administering medicines, 47 gleet, chronic catarrh, or collection in sinuses, causes, symptoms, and treatment, 99 polypus, description and treatment, 102
Navel-- discharge of urine, or persistent urachus, description and treatment, 151 string, constriction of a member, description, 192
Navicular-- bone, description, 396 disease, description, causes, symptoms, and treatment, 435
Neck of womb, twisting, description and treatment, 189
Nephritis, acute, or acute inflammation of kidneys, causes, symptoms, and treatment, 143
Nerve-- inflammation, or neuritis, cause, symptoms, and treatment, 236 tumor, or neuroma, cause, symptoms, and treatment, 236
Nerves-- injuries, description and treatment, 237 spinal, designations, 212
Nervous system-- and brain, anatomy and physiology, 210 diseases affecting, chapter by M. R. Trumbower, 210-246 examination, 23
Nettlerash, surfeit, or urticaria, description and treatment, 467
Neuritis, or inflammation of a nerve, cause, symptoms, and treatment, 236
Neuroma, or tumor of a nerve, cause, symptoms, and treatment, 236
Nose-- bleeding, causes and treatment, 103 membrane, thickening, symptoms and treatment, 101
Nostrils, tumors and wounds, treatment, 97
Obstruction colic, cause, 68
Open joints. See Joints.
Ophthalmia-- external, or conjunctivitis, description, causes, symptoms, and treatment, 285 internal, causes, symptoms, and treatment, 288 periodic, or moonblindness, causes, symptoms, and treatment, 291
Optic nerve, paralysis, or amaurosis, cause, 231
Orchitis, or congestion and inflammation of testicles, causes, symptoms, and treatment, 164
Os innominatum, or hip-bone fracture, description, symptoms, and treatment, 341
Os pedis, or third phalanx, fractures, cause and treatment, 352
Osteoporosis, or bighead, chapter by John R. Mohler, 578-582
Ostitis, cause, symptoms, and treatment, 309
Overreach, description, symptoms, and treatment, 404
Ovum, inclosed, or tumors of fetus, description and treatment, 194
Oxyurus equorum, parasite, symptoms and treatment for, 91
Palpitation of heart, description, symptoms, and treatment, 259
Palsy-- of nerve of sight, or amaurosis, causes, symptoms, and treatment, 295 of paralysis, description and causes, 228
Pancreas and spleen, diseases, remarks, 90
Papilloma, epithelioma, or degeneration of penis, 167
Papules, or congestion of skin with small pimples, description and treatment, 463
Paralysis-- facial, symptoms and cause, 230 general, cause, 228 of bladder, description and cause, 140, 230 of hind legs, cause and treatment, 181 of intestines, cause, 72, 230 of one side or half the body or hemiplegia, description and symptoms, 228 of optic nerve, or amaurosis, cause, 231 of penis, cause and treatment, 167 of pharynx, description and treatment, 61 of rectum and tail, cause, 230 or palsy, description and causes, 228 transverse, of hind extremities, or paraplegia, description and symptoms, 229 treatment, 231
Paraphymosis and phymosis, description and treatment, 171
Paraplegia, or transverse paralysis of hind extremities, cause and treatment, 229
Parasites-- animal, of skin, description of kinds, 478 causing worm colic, 91, 92, 93 gastrointestinal, 90-94 in eye, description of kinds, 296 specific kinds affecting urinary organs, 146 vegetable, of skin, description of kinds, symptoms, and treatment, 477
Parasitic pityriasis, description and treatment, 478
Parturition-- different presentations, 197 difficult, from narrow pelvis, cause and treatment, 186, 188 symptoms, 185
Pastern joint, description, 396
Pastes, or electuaries, description and manner of administering, 45
Pasture, relation to worms in horses, 93
Patella-- fracture, description, 349 pseudoluxations, descriptions, symptoms, cause, and treatment, 363
Pearson, Leonard, chapter on "Examination of a sick horse", 7-26
Pediculi, or lice, description and treatment for bite, 482
Pelvis-- and vagina, tumors affecting, description and treatment, 188 bones, fracture, different kinds, 341 narrow, cause of difficult parturition, cause and treatment, 188
Penis-- degeneration, papilloma, or epithelioma, 167 extravasation of blood and paralysis, cause and treatment, 167 sheath, and abdomen, swelling, cause and treatment, 171 warts, treatment, 167
Pericarditis-- a complication of influenza, 518 or inflammation of sac inclosing the heart, causes, symptoms, and treatment, 255
Perineum, limbs, and abdomen, dropsy, description and treatment, 180
Periostitis, cause, symptoms, and treatment, 309
Peritoneum and womb, inflammation, symptoms and treatment, 207
Peritonitis-- a complication of influenza, 518 description, symptoms, and treatment, 85
Phalanx, first, second, and third, fracture, cause, symptoms and treatment, 351, 352
Pharyngeal polypus, description and treatment, 102
Pharyngitis, description and treatment, 61
Pharynx-- inflammation, description, 103 paralysis, description and treatment, 61
Phlebitis, or diseases of veins, description, causes, symptoms, and treatment, 268
Phymosis and paraphymosis, description and treatment, 171
Physiology and anatomy of brain and nervous system, 210
Piles, or hemorrhoids, description and treatment, 81
Pills, or balls, description and manner of administering, 44
Pimples, small, or congestion of skin, description and treatment, 463
Pinworm, description and treatment, 91
Pityriasis, or scaly skin disease, description and treatment, 467
Plantar cushion, description, 398
Pleurisy-- a complication of influenza, 518 description, symptoms, and treatment, 122
Pleurodynia, symptoms and treatment, 131
Pleuropneumonia, description and treatment, 126
Plumbism, or lead poisoning, causes, symptoms, and treatment, 245
Pneumonia-- contagious, causes, symptoms, treatment, etc., 521-527 infection, transmission, 521-522 or lung fever, description, symptoms, and treatment, 113
Poisoning-- albuminoid, or azotemia, symptoms, prevention, and treatment, 141 forage, or cerebrospinal meningitis, causes, symptoms, and treatment, 237 lead, or plumbism, causes, symptoms, and treatment, 245
Poll evil, description, causes, symptoms, treatment, 502-506
Polypus-- description and treatment, 102 pharyngeal, description and treatment, 102
Polyuria, diuresis, diabetes insipidus, causes, symptoms, and treatment, 138
Pouches, guttural, description and treatment, 119
Poultry, acariasis, description and treatment, 480
Powders, manner of administering, 44
Pregnancy-- duration, 177 mare, hygiene, 177 medication, 175
Premaxillary bone, fracture, description and treatment, 336
Preputial calculus, calculus in sheath, description and treatment, 163
Presentations at birth, abnormal, 197-200
Pruritis, or nervous irritation of skin, description and treatment, 468
Pseudoluxations of patella, description, symptoms, cause, and treatment, 363
Psoroptes equi, animal parasite of skin, 480
Psoroptic acariasis, description and treatment, 480
Ptyalism, or salivation, description and treatment, 61
Pulex-- or flea, prevention and treatment for bite, 482 penetrans, or chigoe, bite, treatment, 482
Pulse, how to count, 13
Purpura hemorrhagica-- description, symptoms, and treatment, 270 or anasarca, causes, symptoms, and treatment, 531
Pustules, inflammation, description and treatment, 465
Quittor, description of different kinds, 407
Rabies-- description, symptoms, and treatment, 244-245, 559-562 fatality of, 562
Ransom, study of flies and worms, 470
Rectum-- and tail, paralysis, cause, 230 impaction with feces, 191 methods of administering medicines, 47
Red efflorescence, or erythema, description and treatment, 461
Renal calculi, description, symptoms, and treatment, 158
Respiratory organs-- description, 95 diseases, chapter by W. H. Harbaugh, 95-133 methods of examination, 16
Retinitis, causes, symptoms, and treatment, 288
Ribs, fractures, description, symptoms, and treatment, 339
Ridglings, or cryptorchids, castration method, 169
Ringbone, description, causes, symptoms, and treatment, 313, 439
Ringworm-- circinate, or Tinea tonsurans, description, symptoms, and treatment, 477 honeycomb, or favus, description and treatment, 478
Roaring and thick wind, description and treatment, 108, 230
Roundworm of kidney, 146
Roundworms, horse, dangers and treatment, 90-91
Rubber pads in shoes, uses, 601
Rupture-- of an artery, description, symptoms, and treatment, 266 of diaphragm, causes and symptoms, 133 of flexor metatarsi, description, cause, symptoms, and treatment, 377 of heart, description and cause, 262 of liver, cause, symptoms, and treatment, 89 of stomach, result of engorgement, colic, symptoms, and treatment, 66, 67 of suspensory ligament, description, symptoms, and treatment, 403 of vagina, description and treatment, 207 or hernia, description of different kinds, 82 or laceration of womb, causes and treatment, 206
Saccharine diabetes, diabetes mellitus, glycosuria, or inosuria, causes, symptoms, and treatment, 130
Sacrum, fractures, description and treatment, 341
St. Vitus dance, or chorea, description and treatment, 227
Salivation, or plyalism, description and treatment, 61
Sand-cracks of foot, description, causes, symptoms, and treatment, 432
Sarcocele, description and treatment, 165
Sarcophaga carnaria, or flesh fly, note, 481
Sarcoptes, scabiei equi, animal parasite of skin, 478
Sarcoptic acariasis, description, symptoms, and treatment, 478
Scalds and burns, treatment, 483, 496
Scaly skin disease, or pityriasis, description and treatment, 467
Scapula, fracture, cause, symptoms, and treatment, 344
Scorpion and tarantula, treatment for sting or bite, 483
Scratches, or chaps on knee and hock, or cracked heels, causes and treatment, 467
Screw-worm fly, or Lucilia hominivorax, note, 481
Scrotal or congenital hernia, cause, description, and treatment, 82
Scrotum, dropsy, or hydrocele, symptoms and treatment, 166
Sebaceous glands, description, 460
Self-abuse, or masturbation, remedy, 168
Serum, use against strangles and anthrax, 531, 544
Sesamoid bones, fracture, cause, symptoms, treatment, etc., 352