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Human Physiology in Nutshell 4th

Edition Dr. A.K. Jain


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The diseased areas should then be dressed with some fatty
substance, to soften the crusts and enable them to be removed
without injury.
Dressings are useless unless these crusts have been removed, for
the spores are always in the deepest recesses and in the follicles, so
that the drugs employed never come in contact with them.
Once the skin is cleansed, numerous chemical substances may be
utilised, the solutions being applied for several days in succession.
Amongst them may be mentioned tincture of iodine, oil of cade, 10
per cent. solution of sulphate of iron, and solution of perchloride of
iron. Such drugs, however, must not be used for a long time, as they
all attack the skin to some extent.
When the patches are small and well defined the following mixture
proves very efficacious:—

Crystallised carbolic acid } Equal parts.


Tincture of iodine }
Chloral hydrate }

Two or three applications generally prove successful.


Despite the natural activity of the spores, which are capable of
germination after three months’ desiccation, some medicines are
useful, although it is necessary, in order to judge of their effects, to
wait for the renewal of the skin, hair follicles, and hair.
Where the disease is generalised this form of treatment is scarcely
practicable, or at least it becomes more difficult.
Nevertheless, by dressing with soft soap the disease may be cured
in a few months. The soap should remain on the skin for some hours
and then be washed off, after which dressings of creolin, lysol, or
chloral solution, etc., should be employed.

RINGWORM IN THE SHEEP, GOAT, AND PIG.

Little information regarding the dermatomycoses of the sheep,


goat, and pig is available. Allowing for modifications due to the
nature of the coat, the symptoms of recorded cases seem to indicate
a close relationship with ringworm in the horse and ox.
In sheep suffering from ringworm, the wool is at first matted into
small irregular tufts, which grow larger and more numerous. The
coat appears felted together at various points. The neck, chest,
shoulders and back exhibit crustaceous patches covered with
branlike epidermal scales, and the animals suffer from marked
pruritus, which causes them to rub and injure the coat.
Ringworm is very obstinate in the goat.
Two pigs described by Siedamgrotsky showed irregular, rounded
patches, due to trichophyton, from 1 inch to 2 inches in diameter,
reddish in tint, without exudation, but covered with abundant scales.
In the pig ringworm attacks the croup, sides of the chest, flanks
and sides of the abdomen, but is commonest on the back and outside
of the quarters. It forms red isolated patches, from 1 to 2 inches in
diameter, covered with miliary vesicles, which in turn are replaced by
brown crusts. The bristles remain unchanged, and are not shed or
broken. There is no pruritus. Contagion from pig to pig occurs
readily. The disease may be conveyed from oxen to pigs through the
medium of litter removed from the cowsheds to the piggery.
Gerlach was unable to inoculate sheep or pigs with ringworm from
the ox. Perroncito mentions a case of contagion from the ox to a
lamb. Schindelka has seen sheep contract ringworm as a result of
confinement to sheds previously occupied by oxen suffering from the
disease.
Siedamgrotsky successfully inoculated two pigs and two sheep
with ringworm from the horse and a goat with the bovine form of the
disease. The two pigs inoculated two others by contact. Contagion
from the goat to the ox was noted in the canton of Zürich in 1852.
Fuller particulars on these heads will be found in a series of
articles by Neumann in the Revue Vétérinaire, January to June,
1905.
In 1876 Laillier communicated to a French medical society a letter
written by Lespiau describing an endemic of trichophyton disease in
the cantons of Céret and Arles-sur-Tech. Thirty-four persons,
including twenty-eight children, were affected. A dog was first
attacked and seems to have inoculated a pig, which in these districts
often lives with the human family. The pig inoculated the human
beings. A moist season appears to have favoured the development of
the disease. The parts principally attacked were the head, eyebrows,
cheeks, and neighbourhood of the genital organs. The subjects
showed considerable pruritus.
CHAPTER IV.
WARTS IN OXEN.

Warts are cutaneous tumours, real papillomata, which most


commonly attack young animals such as heifers. As a rule they are
pedunculated, smooth, wrinkled or deeply cracked on the surface,
but in some cases they are sessile.
Causation. The cause is difficult to ascertain. It has been referred
to the growth of bacteria (Bacterium porri) in the superficial layers
of the skin. It is at least certain that warts can be transmitted by
inoculation or through the medium of cutaneous injuries.
Symptoms. On their first appearance warts consist in
hypertrophy of the cutaneous papillæ, which become covered with
layers of actively growing epidermis and end by projecting above the
general surface. The lesions may remain isolated, or they may
become confluent or unite at their base. This form is fairly common,
the warts attaining the size of a man’s fist or more.
The disease attacks the most tender portions of the skin, such as
that covering the udder, internal surface of the thighs, lower
abdominal wall, region of the elbow, posterior surface of the ears,
etc. In rarer cases warts may be seen on the limbs.
When they extend over a considerable surface they become
infected, suppurate and give rise to various complications, the most
serious being pyæmia. The patients lose condition and value.
Diagnosis. The diagnosis is easy. It has been proved that warts
are contagious, not only as between animal and animal, but as
between animal and man.
Prognosis. Warts are not dangerous to life, but they diminish the
value of the animals, particularly that of milch cows when the teats
are affected.
Treatment. Leaving out of account internal medication with
calcined magnesia, many medicines that are still recommended are
of comparatively little value.
Peuch and Cruzel recommend friction with oil of cade. Repeated
cauterisation with nitric acid is declared to give good results by
destroying the new tissue.
These modes of treatment, however, are impracticable in dealing
with large multiple lesions, nor does the elastic ligature give much
better results.
Total removal with the scissors or bistoury, or simply tearing out
by hand, is preferable to any other course. Troublesome bleeding
may follow, but is rarely of great importance. It usually stops in a few
minutes, even where small arteries of the size of several millimètres
in diameter have been divided. As a measure of precaution, however,
the little wounds may be touched with the red-hot blade of the
thermo-cautery.
The écraseur is rarely required. The smaller warts are generally
sessile, and can be removed with a bistoury or a sharp curette. The
removal of those about the udder requires considerable precaution to
avoid injuring the teats.

Fig. 267.
All the growths are usually removed at one operation; Moussu has
thus taken away 30 lbs. weight without the slightest ill effect. After
the wounds have been washed with an antiseptic, the raw surfaces
are powdered with a mixture of equal parts of boric acid, tannin, and
calcined alum; cicatrisation occurs in a few days.

URTICARIA IN THE PIG.

This disease usually attacks pigs during the spring or summer,


producing characteristic cutaneous lesions, which, however, are of a
benign character. It seems to arise from some form of alimentary
intoxication.
Symptoms. At first the dominant symptoms point to disturbance
of digestion. The appetite is lost, and the bowels may be confined or
there may be diarrhœa. This is sometimes accompanied by vomiting,
and by fever.
The symptoms may develop fully in from six to twelve hours;
sometimes the skin is covered with slightly prominent reddish
patches, varying in size from ⅓ of an inch to 1¼ inches in diameter.
The patches may also become confluent and form large, irregular
red or violet flattened swellings, sensitive to the touch and spread
over the upper and lateral portions of the body. Only in exceptional
cases is there any oozing of blood.
In favourable cases recovery takes place in forty-eight hours, and
even in grave cases in from five to six days.
Diagnosis. It is sometimes very difficult to distinguish this
condition from swine erysipelas, particularly in the first few cases,
although the congested or hæmorrhagic patches occupy different
positions.
The prognosis is usually favourable.
Treatment. The disease being unquestionably of digestive origin,
the animals should be kept without food and receive repeated doses
of mild purgatives according to their age and condition, sulphate of
soda, 4 to 12 drachms, or calomel, 1½ to ·8 grains. Recovery is rapid.
SCLERODERMA.

This term is applied to a disease characterised by thickening and


hardening of the skin. Up to now it has been described only in the
pig, and principally in male animals or old animals of either sex.
The symptoms are difficult to detect, and in many cases are only
discovered after slaughter. Without any change in external
appearance, the skin becomes thick, hard and sclerosed over limited
or extensive areas, and is thus transformed into hard, rigid,
inextensible and inelastic plates, sometimes as much as 1 to 2 inches
in thickness. The change usually commences about the dorsal region,
and extends irregularly towards the chest and sometimes towards
the limbs.
The patient thus becomes imprisoned in a kind of cuirass, which
interferes with its movements and causes unaccountable stiffness.
Palpation of the skin gives the impression of a piece of wood, for it is
hard and resistant over the affected regions, whilst over the belly,
inner surface of the thighs, and region of the elbow, it retains its
usual pliability.
The patient exhibits no other symptoms, the principal functions of
the body appearing to be properly performed. There is no fever, but
in time the animals lose condition and waste away.
Causation. This disease is also well known in man, but no
general agreement exists regarding its nature. Some refer it to
disturbance of the thyroideal function, though scleroderma is quite
different to myxœdema. Others attribute it to changes in the
cutaneous blood-vessels, others, again, to peripheral neuritis
accompanied by atrophic disturbance. Nothing, however, is proved.
The apparent lesions are limited to hypertrophic sclerosis of the
dermis, with progressive atrophy of the layers of subcutaneous
adipose tissue.
The diagnosis is comparatively easy.
The prognosis is grave, because it is never known how rapidly
the disease may develop.
No method of treatment being known, the animals should at once
be slaughtered.
CHAPTER V.
SUBCUTANEOUS EMPHYSEMA.

By subcutaneous emphysema is meant the condition produced by


the entrance of air or gas into the subcutaneous and interstitial
connective tissue. Emphysema may remain localised or it may
become generalised, according to the nature and extent of the lesion
which causes it, and the points where emphysema is developed.
Subcutaneous emphysema is common in the sheep and ox.
Symptoms. Sometimes the symptoms of subcutaneous
emphysema are extremely well defined. They consist in the presence
of diffuse or limited crepitant swellings which may appear at various
points—in the flank or the entrance to the chest; more rarely in the
region of the elbow, etc.
The limits of crepitation may be ascertained by palpation, while
percussion produces a peculiar abnormal sound. The subcutaneous
tissue and very often the interstitial tissue appear as though blown
out.
Emphysema may be generalised. Such an accident is rare, but may
occur in the ox as well as in the sheep and goat.
Provided the emphysema remains confined to the subcutaneous
tissue, the animals are not necessarily in danger. Where, however, it
also extends to the interstitial tissue, and particularly if the cause to
which it is due continues, death may result in a very short time. This
occurs, for example, when the emphysema extends into the
mediastinum, and thus gains the pleura and lung.
The symptoms of emphysema are then complicated with
respiratory and circulatory disturbance and with signs of asphyxia.
Causation. Subcutaneous emphysema may be produced in many
different ways.
If, for example, in puncturing the rumen the canula be carelessly
withdrawn so that the skin is slightly separated from the subjacent
tissues, gas may pass from the rumen into the channel produced by
the instrument. It then becomes distributed throughout the
subcutaneous tissue, and if the cutaneous opening is displaced its
escape is confined to the connective and interstitial tissues in the
region of the flank. Diffuse suppuration may then be set up in these
parts, and may extend far beyond them.
In the ox emphysema rarely becomes generalised, but in the sheep
and goat extension is more common; the patients perish of
intoxication, caused by reabsorption of septic gases.
Under other circumstances emphysema may be due to an injury in
some region where the connective tissue is loose and pliable, as for
instance the region of the elbow, the internal surface of the shoulder,
or the fold of the flank. Every time the animals move the tissues are
displaced, and air being drawn in, it is imprisoned by the valve-like
action of the injured part and gradually finds its way into the
subcutaneous tissue.
Accidental injuries to the trachea, particularly injuries produced by
dogs biting sheep or goats, are always accompanied by local
emphysema, unless the wounds in the skin and trachea correspond,
which rarely happens. At every respiration a portion of the air
expelled passes into the peritracheal tissue, from which it gradually
invades neighbouring parts, and may attain the mediastinum, etc.
The injured animal thus inflates its own tissues and dies from
asphyxia.
The open lesions due to pulmonary echinococcosis, and the
accidents associated with pneumo-thorax, tuberculous caverns and
abscesses, or pulmonary emphysema may become points of
departure for local, general, interstitial or subcutaneous emphysema.
The diagnosis of accidental emphysema presents no difficulty,
for the local swellings can only be mistaken for those of black-
quarter. In the latter disease, however, fever is a constant
accompaniment, whilst in simple emphysema it is absent.
Nevertheless, it is well to remember the possibility of
complications due to compression, asphyxia, and even intoxication.
The prognosis may be very hopeful or very grave. Everything
depends on the primary lesion, and it is therefore important that the
practitioner should know how to interpret the course of affairs.
Treatment. In slight cases the best method is to immobilise the
parts and await developments, but in grave cases, for instance where
the trachea is much injured, the animal should at once be
slaughtered.
Scarification, cutaneous incisions, and massage were formerly
recommended as a means of aiding the escape of gas accumulated in
the tissues. Such methods, however, are useless, and have the
disadvantage of causing numerous suppurating wounds.
Provided the initial wounds are not seriously infected and the
animals are kept quiet, in a well-ventilated place, the gas gradually
becomes reabsorbed, and healing may take place in a fortnight or
three weeks.
SECTION IX.
DISEASES OF THE EYES.

In domesticated animals, apart from parasitic diseases, the


diseases of the eye which particularly deserve description and offer a
special clinical interest are very few. These are the diseases that
affect the globe of the eye or the organs annexed to it.
FOREIGN BODIES.
Foreign bodies become lodged on the internal surface of the
eyelids, in the folds of the conjunctiva, in the thickness of the cornea,
and sometimes, though rarely, in the anterior chamber, the lens, or
the vitreous humour. They include particles of grit or dust, the awns
and glumes of grain, etc.
The eyes are half closed and the conjunctiva is swollen, whilst the
eye weeps and the animals dread the light.
Diagnosis. This is somewhat difficult, for the parts rapidly
become very sensitive, and the animals violently resist examination.
When the foreign body penetrates the anterior chamber or the lens,
it produces suppuration or traumatic cataract.
Before anything can be done it is often necessary to render the
parts anæsthetic by instilling a few drops of cocaine solution into the
eye.
The foreign body may then be discovered by close observation. If
the pain is very intense, and great resistance is offered to opening the
eye, the practitioner may confine himself to passing a soft camel-hair
brush saturated with cocaine solution over the surface of the eye and
into the conjunctival sacs. The brush loosens, and often removes, the
offending body. In the absence of a camel-hair brush, the little finger,
covered with a piece of fine linen, may be used.
Where the parts cannot be touched owing to the resistance of the
animal, lukewarm solutions of antiseptics such as boric acid may be
occasionally injected into the eye by means of a syringe, but care
must be taken to prevent the animal injuring itself against the
syringe by sudden movements.
CONJUNCTIVITIS AND KERATITIS.
Inflammation of the conjunctiva and inflammation of the cornea
almost always occur together, and reciprocally induce one another
when of a certain degree of intensity. They may be simple, that is to
say, produced by simple causes, or they may be specific, and of a
contagious character.
Simple inflammation is caused by the action of cold, draughts,
dust, or mechanical injuries. Specific inflammations, the nature of
which is still little understood, occur in the ox and goat. They are
very contagious, and may successively attack all the animals of a
herd.
The symptoms of acute and specific inflammation differ very
little. They comprise congestion, lachrymation, chemosis, a certain
amount of suppuration, and sometimes superficial ulceration of the
cornea. The patients suffer very acute pain, avoid the light, present
all the symptoms of photophobia, and are affected with spasm of the
orbicularis muscle.
In simple cases these symptoms frequently disappear, provided
the byres are kept clean and astringent eye-washes are applied.
In contagious keratitis, however, the cornea may suppurate and
even become perforated after a few weeks.
Treatment. The chief object of treatment under any
circumstances must be to insure the most perfect cleanliness both of
the globe of the eye and the conjunctival sacs.
The eye must, therefore, be irrigated with lukewarm water, the
stream being injected beneath the lids. Each irrigation is followed by
the use of an anodyne and astringent eye-wash containing borate of
soda or sulphate of zinc, combined if necessary with cocaine.

Distilled water 100 parts.


Borate of soda 4 „
Hydrochlorate of cocaine 1 „

But saturated solution of boric acid is simple, and no less effective.


In contagious keratitis the eye lotion may contain 2 to 3 per cent.
of nitrate of silver, the excess of silver being neutralised by washing
out with a weak solution of common salt. After three or four
applications this should be changed for a saturated solution of boric
acid.
VERMINOUS CONJUNCTIVITIS.
This form of conjunctivitis, described by Rodes in 1819, is due to
the presence of the Filaria lachrymalis, which varies in length
between ⅜ of an inch and 1 inch.
Like ophthalmia, the disease attacks cattle reared in wet localities.
Symptoms. The symptoms are those of acute conjunctivitis, and
consist first of lachrymation, then of injection of the blood-vessels of
the conjunctiva, together with swelling of the eyelids and
photophobia. The animals keep the eye closed, and display extreme
sensitiveness. Here again cocaine proves of value.
Examination is rather difficult, the worms being sometimes
displaced towards the cornea or membrana nictitans, although more
commonly they remain hidden in the folds of the mucous membrane
towards the point where the membrana nictitans is inserted. It is,
therefore, necessary to thoroughly expose the folds of the mucous
membrane in order to discover them.
In time conjunctivitis becomes complicated with diffuse
ulceration, keratitis, and sometimes with ophthalmia and
suppuration of the eye.
Diagnosis. The diagnosis is rather troublesome, and cocaine is of
great assistance.
Prognosis. This is rather grave.
Treatment. The object of treatment is the complete removal of
the parasites. This can sometimes be attained by means of the finger,
a pair of forceps, or a very clean feather.
Treatment is completed by injecting an antiseptic and anti-
parasitic eye lotion for several days, lest some of the worms should
remain hidden in the folds of the mucous membrane. One per cent.
creolin or 1 in 2,000 sublimate solution may be used.
If in some exceptional case it is difficult to remove the parasites,
they may be got rid of by injections or free irrigation. The stream of
liquid, pointed in different directions, distends the mucous
membrane and washes away the foreign bodies on its surface.
VERMINOUS OPHTHALMIA OF THE OX.
This ophthalmia is due to the presence of a small worm, ⅔ of an
inch to 1¼ inches in length, which has been regarded as the larval
form of the Filaria cervina of the serous cavities.
It is very common in animals which are kept permanently in low-
lying meadows particularly in some parts of France, as for instance
in Normandy, in the departments of the Sarthe and the Mayenne.
Not infrequently it occurs as an epizootic, and is then regarded as a
contagious ophthalmia. Verminous ophthalmia occurs chiefly during
the spring and autumn.
Symptoms. The disease is accompanied by lachrymation, signs of
conjunctivitis, and fear of light. Very soon the media of the eye
become turbid, the sclerotic and cornea are injected, and finally
exhibit marked opalescence.
On examination the eye appears extremely sensitive; in fact, it can
scarcely be touched unless cocaine solution is previously applied.
The parasites, two or three as a rule, but in exceptional cases from
five to seven in number, are seen rolled up within the anterior
chamber of the eye. A week after the beginning of the attack,
however, they begin to move about, and are then found close behind
the cornea, upon the lens, or suspended in the aqueous humour.
The irritation produced sets up inflammation of Descemet’s
membrane and the cornea, together with iritis, and, secondly,
keratitis and changes in the lens.
Unless treatment is adopted verminous ophthalmia inevitably
ends in cataract.
Diagnosis. Diagnosis is always uncertain on account of the
difficulty of examination. When the cornea is very opaque
examination necessarily gives a negative result.
The prognosis is grave.
Treatment. Eye lotions containing tincture of aloes, creolin,
corrosive sublimate, etc., have been suggested, but are practically
useless, because they can have no action on a parasite enclosed
within the globe of the eye. The most logical treatment consists in
aseptic puncture of the anterior chamber of the eye towards its lower
border with a cataract needle.
The escaping liquid carries with it the parasites, and recovery is
then only a matter of time, provided the wound does not become
inflamed. The great danger consists in inflammation and
suppuration of the eye. This, however, can be avoided by antisepsis
and by applying a surgical wool dressing, which can be left in place
for a few days.
SECTION X.
INFECTIOUS DISEASES.
COW-POX—VACCINIA.
The name cow-pox, or vaccinia, is employed to describe a special
disease which in animals of the bovine species is characterised by the
development of pustules at points where the skin is fine, and more
particularly the mammary region.
It can be conveyed both to man and the domestic animals.
This disease has been known from time immemorial, and it would
appear that first of all in the East and later in England it was a
general belief that its attacks rendered human beings proof against
small-pox. Medical men, it must be admitted, long regarded this
belief as a popular delusion, as is proved by their continuing to
practise inoculation with true small-pox material.
Jenner in 1770 was the first to declare the truth of this popular
opinion, and by his wise foresight to confer on humanity one of the
most beneficent discoveries ever made, although the weight of
modern opinion is in favour of the identity of cow-pox and human
variola. Having observed that milkmaids who happened to have
small cuts or sores about the hands sometimes contracted the
disease in a mild form, and that they did not afterwards suffer from
small-pox, he was struck with the advantages consequent on such a
discovery, and having proved the possibility of inoculating human
beings artificially, he immediately formulated the principles of
vaccination. A child eight years of age was vaccinated with cow-pox,
and afterwards inoculated with pus from a small-pox patient. It
contracted vaccinia in consequence of the first inoculation, but
entirely resisted the attempt to inoculate it with small-pox.
Vaccination had been discovered.
Jenner furthermore proved that cow-pox was transmissible from
cow to cow and from man to man, but it seemed to him that the
original disease was to be sought elsewhere, and that the pustular
affection originated primarily with the horse. The horse is sometimes
the subject of a pustular disease called horse-pox; this disease when
inoculated in man confers immunity against small-pox, just as does
cow-pox, and Jenner believed that the disease did not attack cows

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