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Differential Diagnosis. From other forms of meningitis this is
easily distinguished. Fulminant cases almost all belong to this type,
the fact of the coincident implication of brain and spinal cord is
strongly suggestive of this form, and the occurrence of many cases at
once, without any demonstrable toxic or thermic cause, is tolerably
conclusive. From tetanus there is this added distinction, that the
disease does not set in so slowly, the spasms of the neck and back are
not so persistent, and stupor sets in early, in a way that is unknown
in lockjaw. Rabies is recognized by the slow onset, the characteristic
prodromata, the mischevious disposition, the depraved appetite, and
by the history of its local prevalence. Tubercular meningitis in cattle
has a similar association with tuberculous animals in the same family
or herd, and often by the local indications of tubercle elsewhere,
emaciation, unthriftiness, cough, flocculent and gritty nasal
discharge, enlarged lymph glands, pharyngitis, mammary disease.
Treatment. With a disease so fatal prevention should be the first
consideration and especially when it appears in an enzootic form.
Even in the absence of a definite knowledge of its germ or toxin, it is
logical to avoid the locality, condition, food or water by which such
germ or toxin has presumably entered the system, together with
every unhygienic condition, which may have reduced the resistance
of the system and laid it open to the attack. The animals should be
removed to a clean, airy, building and the old one should be
thoroughly emptied, purified and whitewashed, the lime-wash
containing 4 ozs. of chloride of lime, or 1 dr. of mercuric chloride to
the gallon. Drains and gutters should have special attention and the
animals should not be returned until the stable is thoroughly dry. A
change of feed is imperative when there is any suggestion of damp,
mustiness or fermentation, and even in the absence of such
indications, since the ferments and their products may still be
present in a dried condition. It should also be an object to correct any
morbid or pyogenic condition of the pharynx, Eustachian pouch,
nose or ear, by appropriate measures and the inhalation of
sulphurous acid or chlorine may be resorted to with advantage.
As medicinal treatment Large advises to give at the outset 1 oz.
aloes with one or two drs. of solid extract of belladonna and as an
eliminant, derivative and nervous sedative there is much to be said
for it. In case the difficulty of swallowing should prove a serious
barrier a hypodermic injection of ½ dr. barium chloride, 1½ to 2 grs.
eserine, or 2 grs. hydrochlorate of pilocarpin together with ¼ grain
of atropin, may be employed. As a substitute for atropin, ergot,
potassium bromide, chloral hydrate, chloroform, or phenacetin have
been tried in different cases with varying results. Iodide of potassium
has been employed with advantage in the advanced stages and in
convalescence, and may be usefully employed in the early stages as a
sedative to the nervous system, a deobstruant and an eliminant, if
not as a direct antidote, to the toxins.
Bleeding is generally condemned, yet in acute cases where there
are indications of active brain congestion, threatening convulsions or
coma it may tend to ward off a fatal result.
Cold applications to the head are generally commended. Bags of
ice or snow, irrigation with cold water, or cooling by running water at
a low temperature, through a pipe coiled round the head or extended
along the spine, will meet the purpose. Applied continuously this
constringes the blood-vessels within the cranium as well as on its
surface, lessens the exudation, and controls the pain and spasms.
This may be advantageously associated with warm fomentations to
the feet and limbs, friction, or even the application of stimulating
embrocations to draw the blood to these parts. In the smaller
animals even warm baths may be resorted to as a derivative, cold
being meanwhile applied to the head and spine. This not only lessens
the vascular pressure within the cranium, but secures elimination of
toxic matters by both skin and kidneys. Cold pure water should be
constantly within reach.
A most important thing in the horse is to put him in slings, if he is
at all able to stand with their assistance. In decubitus he rests on his
side, with the head on the ground, and lower than the splanchnic
cavities. The result is a gravitation of blood toward the head. In the
sling, with the head fairly raised the gravitation is the other way and
the head is depleted. If the patient is too ill to be maintained in the
sling, he may be packed up with bundles of straw on each side, so
that his breast may lie on a thickly littered bed, and his head may be
elevated.
When convalescence sets in care must be taken to nourish with
non-stimulating, easily digested food, gruels, soft mashes, pulped or
finely sliced roots. In vomiting animals rectal alimentation may
become necessary. The rise of cranial temperature or the aggravation
of brain symptoms should be met as needed by the local application
of cold, and potassium iodide and iron or bitter tonics may be given
if they do not interfere with digestion.
ABSCESS OF THE BRAIN.
Little seen in cattle. Acute and chronic cases. Miliary tubercles in pia.
Hydrocephalus. Progresses slowly. Irritability, hyperæsthesia, photophobia,
congested conjunctiva, grinding teeth, spasms, squinting, dilated pupils, congested
disc, drowsiness, stupor, coma, palsy.
These are tumors formed largely of the peculiar fat which is found
in bile and brain matter, and that crystallizes in flat oblong scales
with a notch at one corner. The tumors are usually connected with
the choroid plexus and developed beneath the pia mater, and may be
of any size from a pea to a hen’s egg, or in exceptional cases a sheep’s
kidney. As a basis there is a stroma of connective tissue permeated
by blood vessels from the plexus. Groups of spherical or polygonal
cells fill the interstices while fusiform cells are found in the stroma.
There is a variable amount of phosphate or carbonate of lime which
in oldstanding cases may give a cretaceous character to the mass.
These constitute sandy tumors (psammomata).
Cholesteatomata are especially common in old horses and are
manifestly connected with congestion of the choroid plexus and
exudation. In a recent case or in a case which has shown a recent
cerebral hyperæmia, we may find a central mass of yellowish
cholesterine, and surrounding this an abundant yellow gelatinoid
exudation. This latter is rich in cholesterine which fails to dissolve
along with the rest of the exudate on the occurrence of resolution,
and is therefore laid up as the solid fatty material. For the same
reason the fatty element is usually laid on in layers, one
corresponding to each access of local hyperæmia and exudation. The
great tendency to calcareous degeneration has been attributed to the
abundance of phosphate of lime in the cerebral exudate.
The symptoms of these tumors are exceedingly uncertain. Many
such tumors of considerable size have been found after death in
animals in which no disease of the brain had been suspected during
life. In these it is to be inferred that the accretions were slow,
gradual, and without any serious congestion. In other cases the
tumor is attended by paroxysms of vertigo, or indications of
hyperæmia or meningitis, which will last for several days and
gradually subside. It is reasonable to suppose that the tumors are
largely the result of such recurrent attacks of encephalitis, and are no
less the cause of their recurrence. The intervals of temporary
recovery correspond to the subsidence of hyperæmia and the
reabsorption of the liquid portion of the exudate. The manifestations
during an access correspond directly to those met with in
encephalitis. As in that affection there is usually an initial period of
excitement and functional nervous disorder tending to more or less
somnolence, stupor, paralysis or coma, with long intermissions of
apparently good health. In other cases the stupor or paretic
symptoms may persist up to the fatal issue.
MELANOMA OF THE ENCEPHALON.
As already noted these sandy tumors are often the advanced stage
of cholesteatomata, the abundance of the phosphate of lime leading
to its precipitation in the neoplasm. The same cretaceous deposit
often takes place in old standing tumors of other kinds, as in
melanoma, and fibroma so that the sandy neoplasm may be looked
upon as a calcareous degeneration of various forms of intracranial
tumors. The same tendency to calcareous deposit is seen in the tuber
cinereum (pineal body) of the healthy brain which has taken its name
from the contained gritty matter. This tendency to the precipitation
of earthy salts may be further recognized in the osteid tumors which
occasionally grow from the dura mater.
The gritty tumors are especially found in the older horses in which
the tendency is greatest to extension of ossification and calcic
degenerations.
Like other tumors these may attain a considerable size before they
give rise to any very appreciable symptoms, but having attained a
given development—often the size of a walnut, they become the
occasion of nervous irritation, delirium and disorder, as indicated
under encephalic hyperæmia and inflammation, cholesteatomata,
etc. There may, however, be drowsiness, stupor, coma, or paralysis as
the exclusive symptom, or there may be spasms and convulsions.
MYXOMA OF THE BRAIN.
The term loco is of Spanish origin and has come to us through the
Spanish speaking residents on the cattle raising plains and the
Pacific Coast. The word is defined to mean mad, crazy, foolish. It has
been applied indiscriminately to a disease in stock manifested by
these symptoms, and to a variety of leguminous plants, found
growing on the western lands and supposed to cause the disease in
question. The plants complained of are Astragalus Hornii, and A.
Lentiginosus (Griesbach) in California, A. Mollissimus (Torrey) and
Oxytropis Lamberti (Purshiana) in Colorado and New Mexico. Other
allied species, and like these found also in the other Rocky Mountain
States, Sophora Serecia, Oxytropis Multifloris, O. Deflexa,
Malvastrum Coccinium, and Corydalis Aurea var. Occidentalis have
been less confidently charged with producing the disease.
These plants grow on poor, dry, sandy or gravelly soils, and having
great power of resisting drought, are often in fair growth, and
present an abundant mass of leaves when surrounding vegetation is
withered up. Hence, it is alleged, the animals are driven to use it
when nothing else is obtainable and once accustomed to it, the desire
for more becomes a veritable craze or neurosis, and the victim
searches for it and devours it to the exclusion of other food.
The following quotations may serve to illustrate the effects alleged:
Among the symptoms first noticed are loss of flesh, general
lassitude and impaired vision; later the animal’s brain seems to be