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Local interests politics policy and

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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.

Infection, in traumas, meningitis, encephalitis, strangles, etc. Symptoms:


evidence of trauma, chill, hyperæsthesia irritability, drowsiness, giddiness, stupor,
spasms, paresis, coma, dilated pupils, congested mucosæ, vomiting. Location
indicated by muscular groups involved. Treatment: As in meningitis: trephining in
hopeful cases.

The formation of abscess in the cranial cavity has been referred to


in connection with injuries to the cranium and meningo-
encephalitis. It may here be said in general terms that this abscess is
a product of infection. In the horse the most common cause is
strangles, and especially such cases as run a tardy or irregular course
with imperfect softening and limited suppuration in the submaxillary
or pharyngeal region. It is to be looked on as an extension of the
purulent infection so as to cause a secondary abscess. The same may
occur in case of ordinary abscess in any distant organ. In the brain as
elsewhere suppuration may result from direct local injury as in the
case of blows by clubs, or yokes, running against walls or posts, falls,
the effects of butting, injuries by bullets and otherwise. In these
cases, as noticed under concussion, there may be two points of injury
(and two abscesses) one, in the seat of the injury, and one in a deeper
part of the brain, at the opposite wall of the cranium. Again abscess
may result in the brain from extension from a similar process going
on in the vicinity. Thus otitis extends through the middle and
internal ear to the brain, and its starting point may have been more
distant, namely, in the Eustachian tube, or pouch, or in the pharynx.
The symptoms vary according to the size of the abscess, the
rapidity of its formation and the amount of attendant congestion. In
the common cases resulting from strangles, I have usually found the
animal down, unable to rise, blind, amaurotic, with dilated pupils,
congested mucous membranes, and occasional spasmodic
movements of the limbs, neck and head. The symptoms may,
however, vary through hyperæsthesia, irritability, drowsiness,
giddiness, stupor, local or general paralysis with occasional spasms
or convulsions. There may be an initial shivering, and a rise of
temperature, yet as pressure on the brain increases it may become
normal or subnormal. In circumscribed abscess the symptoms may
be much less severe, not perhaps exceeding irritability, drowsiness,
and some paresis or local paralysis.
In some such cases one can trace the connection to some primary
disease, (traumatic injuries to the cranium, abscess of the diplöe or
sinus, parasites in the sinus, otitis, or pharyngeal disease) which
serve as an indication of the true state of things. In others there may
be circumscribed local manifestations, (anæsthesia, hyperæsthesia,
hemiplegia, paralysis of special muscular groups, or spasms of the
same ) which may indicate more or less accurately the exact seat of
the lesion. When well defined, this localization of the resultant
phenomena, serves to distinguish this and other local lesions, from
meningitis which is apt to be much more general in its diffusion. In
the carnivora and omnivora vomiting is a marked symptom.
Treatment of brain abscess is usually hopeless, yet the attendant
inflammation may be met as in other cases of meningitis. If the seat
of abscess can be ascertained surgical interference is fully warranted.
TUBERCULAR MENINGITIS.

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.

Tubercle of the encephalon has been little noticed in the lower


animals, partly because it is especially a disease of early life, while
animals usually contract tubercle later in life, and partly because
subjective symptoms are inappreciable, and the cranium is seldom
opened in post mortem examinations. As the affection usually
appears as a secondary deposit, the tubercles elsewhere go a long
way toward identifying the nature of the disease in the brain. It has
usually been found consecutive to pulmonary tuberculosis.
In a case reported by Fischœder as seen at the Bromberg abattoir,
in a 350 lbs. calf, the animal had shown weakness, stupor and a
tendency to fall toward the right. The brain lesions consisted of small
foci of tubercle on the posterior pillars of the fornix (trigone) and
adjacent parts. The left eye had on its inner aspect, near the junction
of sclerotic and cornea, a firm mass with tubercular centres,
extending inward as far as the retina. The bronchial mediastinal,
prepectoral, brachial and precrural glands were tuberculous.
In a case in a cow reported by Lesage there were unsteady gait,
impaired vision, and great timidity. Necropsy showed a suboccipital
tubercle extending into the frontal sinus and cranium, and invading
the brain near the parietal lobe for more than an inch. There were
retro-pharyngeal and pleural tubercles as well.
In a case of Routledge’s, with extensive recent exudate, the
condition advanced from apparent health to extensive paralysis in
three days, while in a case which the author obtained in slaughtering
a tuberculous herd no special nervous symptoms had been noticed
during life. Much therefore depends on the rapidity as well as the
seat of development.
The primary lesions in the brain are of the nature of miliary
tubercles in the pia mater which becomes congested, rough,
granular, and throws out a free serous secretion. Thus hydrocephalus
is a usual concomitant of the affection.
The disease is characterized by its slow advance in keeping with
gradual increase of the tubercle and is thus distinguishable from the
more acute congestions and inflammations. The earlier stages are
usually marked by nervous irritability, hyperæsthesia, intolerance of
light, closed eyelids, congested conjunctiva, grinding of the teeth and
even spasms partial or general. The second stage shows somnolence,
deepening into stupor or coma, or there may be going in a circle or
other irregular movement. Squinting usually convergent, dilated
pupils and congestion of the optic disc frequently occur. The sleep,
stupor, paralysis or coma may set in early and is usually largely due
to the amount of exudation and the rapidity of its effusion.
TUMORS OF THE BRAIN. NEOPLASMS.

Existence inferential with similar external tumors. Cholesterine tumors on


plexus of lateral, third or fourth ventricle: pea to egg: in old; concentric layers with
abundant exudate. Symptoms: slight, or excitability, dullness, vertiginous
paroxysms with sudden congestions, as in encephalitis, sopor, stupor, paresis,
coma. Melanoma: mainly meningeal; pea to walnut; with skin melanomata in gray
or white horses. Cases. Pigmented sarcomata. Diagnosis, inferential. Psammoma:
advanced cholesteatoma, melanoma, fibroma, etc.: osteid tumors. Nervous
irritation, delirium, spasms, nervous disorder, and paroxysms. Myxoma: contains
mucin: cells (in homogeneous matrix) round, spindle-shaped or stellate. Changes
to fat (cholesterin). Œdematous connective tissue, neoplasm. Myxolipoma. Myxo-
cystoid. Symptoms.

Tumors in the brain are not marked by distinct pathognomonic


symptoms, so that their presence is to be inferred as a probability
rather than pronounced upon as a certainty.
The most common forms in the horse are cholesterine
(cholesteatoma), melanotic (melanoma), sandy, gritty (psammoma),
and fibrous (fibroma).
CHOLESTEATOMA.

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.

Black pigment tumors have been found in connection with the


brain and especially the meninges, varying in size from a pea to a
walnut, and as a rule, secondary to similar formations elsewhere.
They are most common in gray horses which have turned white, and
may give rise to gradually advancing nervous disorder. Bouley and
Goubaux record a case of this kind attended with general paralysis.
W. Williams reports the case of an aged gray stallion with
melanomata on the meninges and in the brain substance which were
associated with stringhalt of old standing. Mollereau in a vertiginous
horse found a pigmented sarcoma in the right hemisphere between
the gray and white matter, and like an olive in size and shape. There
were melanomata around the anus. (Annales de Medecine
Veterinaire, 1889). So far as such have been examined they follow
the usual rule in melanomata in having a sarcomatous structure.
While it is impossible to make a certain diagnosis without opening
the cranium, the condition may be suspected, in gray horses, when
melanotic tumors are abundant in the usual external situations
(anus, vulva, tail, mammæ, sheath, lips, eyelids, etc.), and when
brain symptoms set in and progress slowly in such a way as to
suggest the gradual growth of a tumor.
Treatment is hopeless, since if they have invaded the brain, the
tumors are likely to be multiple in the organ, and numerous and
widely scattered elsewhere.
PSAMMOMATA (GRITTY TUMORS) OF THE
BRAIN.

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.

Myxoma is a tumor in which mucoid elements or a gelatinoid


degeneration and infiltration containing mucin is a prominent
feature. The mucous tissue which constitutes the tumor may differ
little from ordinary connective tissue except that the intercellular
spaces contain mucin. Histologically the tissue consists of cells
embedded in a homogeneous matrix. The cells may be of various
forms, round, (in recent formations) and spindle-shaped or star-
shaped, but especially the latter, in the older. When incised a fluid
containing mucus escapes in greater or less abundance. While this
has properties resembling albumen it is distinguished by the fact that
the precipitate thrown down in it by alcohol is softened and
redissolved on the addition of water. The precipitate thrown down in
an albuminous liquid is insoluble in water.
The formation of this mucous exudate is liable to be followed by fat
so that Virchow considered it as antecedent to fat formation. This is
especially noticeable in the early stages of the cholesteatomata of the
choroid plexus of the horse, in which, as observed by Fürstenberg,
Lassaigne, and Verheyen, the new formation is at first a myxoma,
which later becomes filled up with cholesterine.
Recent observations tend to discredit the alleged distinctive
character of myxoma. The meshes of all connective tissue contain a
perceptible amount of mucin. Œdematous subcutaneous connective
tissue contains this mucin in greater proportion and approximates to
the condition of mucous tissue. The umbilical cord, which has been
long advanced as the physiological type of mucous tissue, has been
shown to consist of ordinary connective tissue with an abundance of
fluid in its meshes.
Koster denies that the myxoma is a special type of tumor, and
holds that it is only a condition that may arise in any tumor which
contains connective tissue. In other words, myxoma is only an
œdematous condition of the connective tissue neoplasm—fibroma,
sarcoma, carcinoma, etc.—due to passive congestion or other
circulatory disturbance.
As seen in the brain of the horse the formation is usually of the
nature of a myxo-lipoma, as the final outcome is usually the
cholesterine bearing mass. In other cases the connective tissue
spaces become further distended with the viscous, gelatinoid liquid
and form veritable cysts—myxoma-cystoides.
In tumors of this kind affecting the choroid plexus the chain of
symptoms is essentially the same as given under cholesteatoma and
the prognosis is nearly equally grave. It need only be said that in
recent cases in which there is as yet little permanent tissue, measures
may sometimes be hopefully adopted, to secure the reabsorption of
liquid constituents, and even perchance to remove some obvious
cause of passive congestion upon which the effusion depends.
ACROMEGALY. HYPERTROPHY OF THE
PITUITARY BODY.

Like other portions of the brain the pituitary body is subject to


degenerations and diseases of various kinds. This is particularly
mentioned here because of the occasional association of its
hypertrophy with the trophic processes of different parts of the body.
Along with an over-development of the limbs, and less frequently of
the body, an enormous increase of the hypophysis has been found,
and the one condition has naturally been set down as the result of the
other. In some such instances, of overgrowth, however, some other
blood glands, such as the thyroid or thymus, have been found to be
hypertrophied, so that at present it is difficult to do more than notice
the association observed between the two conditions.
CEREBELLAR DISEASE.

Cerebellum and coördination. Pressure on adjacent parts renders results


uncertain. Generic symptoms, ataxia, titubation. Marked symptoms with rapid
morbid progress. Treatment: tonic, hygienic.

Whatever functions are exercised by the cerebellum there is no


doubt of its control over muscular coördination. It is quite true that
disease of any other part of the brain causing effusion, exudation or
intracranial pressure will more or less completely arrest the
functions of the cerebellum just as disease of the cerebellum
producing intracranial pressure will derange the functions of other
parts of the encephalon. The general symptoms produced in this way
cannot therefore be accepted as indicating the precise localization of
an intracranial disease. Dullness, stupor, coma, dilated pupils,
choked discs, optic neuritis, and vomiting, are in this sense generic
symptoms, which may in the absence of fever indicate dropsy,
exudation, apoplexy, tumor, concussion or other lesion, and with
hyperthermia may indicate encephalitis or meningitis. But if in the
absence of these symptoms and of aural disease there should appear
ataxia, swaying unsteady gait, and staggering, there is a strong
presumption of cerebellar disease. This may also be manifested by
the other and generic symptoms already mentioned only the
diagnosis is not then so certain. Again cerebellar disease may exist
without the ataxia and lack of balance, but probably only in cases in
which the progress is slow and the organ has had ample time to
accommodate itself to the as yet comparatively restricted lesions.
The result may be a mere defect of muscular tone, or it may extend to
an almost absolute loss of contractility, or it may be of any
intermediate grade.
Treatment, which is eminently unsatisfactory, consists in
improving the general health and tone, by corroborant medicines
and conditions of life, and training the muscles by carefully
graduated exercise and even electricity.
BULBAR PARALYSIS. DISEASE OF MEDULLA
OBLONGATA.

Impaired innervation of bulbar nerves. Paresis of lips, tongue, and larynx.


Roaring. Rapid pulse. Glycosuria, albuminuria. Ptosis. Twitching eyelids.
Dysphagia. Paralysis. Treatment, rest, cold to head, laxatives, nerve stimulants,
tonics, electricity.

The bulb is intimately connected with the origin of the


hypoglossal, glosso-pharyngeal, spinal accessory, vagus, facial, and
trifacial nerves and active disease in the bulb is therefore likely to
entail impairment of the function of several of these nerves. In man
this is recognized in chronic progressive bulbar paralysis, which
almost always affects the lips, tongue and larynx advancing steadily
though slowly to a fatal termination. In degenerative lesions there is
modified voice, difficulty of swallowing, rapid pulse, and laryngeal
paralysis (especially of the arytenoid muscles). The implication of the
root of the vagus may be inferred from the arrest of inhibition of the
heart, and from glycosuria or albuminuria. Occasionally the ocular
and palpebral muscles are involved causing ptosis, or twitching of
the muscles. When the facial (7th) nerve is implicated, paralysis of
one or both sides of the face may be marked, including often the ears.
When the glosso-pharyngeal, the difficulty of swallowing is a
prominent feature, and when the spinal accessory, spasm or
paralysis of the neck. In the worst cases death supervenes early, by
reason of interference with the respiratory and cardiac functions.
The treatment of these affections is usually very unsatisfactory,
though in meat producing animals it may sometimes be desirable to
preserve them in preparation for the butcher. Rest, in hyperæmic
cases, cold to the head and purgatives, and in those in which fever is
absent, small doses of nerve stimulants (strychnia) and tonics
(phosphorus, phosphates, ammonia-sulphate of copper, zinc
sulphate, silver nitrate) may be tried. A course of arsenic and
carefully regulated electrical stimuli may at times give good results.
LOCO POISONING. OXYTROPIS LAMBERTI.
ASTRAGALUS MOLLISSIMUS

Astragalus Hornii: A. Lentiginosus: A. Mollissimus: Oxytropis Lamberti: O.


Multifloris: O. Deflexa: Sophora Serecia: Malvastrum Coccinium: Corydalis Aurea.
In dry regions. Cause, a psychosis. Emaciation. Lassitude. Impaired sight.
Illusions. Vice. Refuses other food. Contradictory views. Experiments by Dr. Day.

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

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