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origin, and exactly resembles, so far as its development and gravity
are concerned, the broncho-pneumonia in young infants described
by Sevestre and Lesage.
The term broncho-pneumonia, moreover, is not strictly correct, or
at least is not exclusive; for the rapid forms often exhibit lesions
other than those of broncho-pneumonia. Post-mortem examination
reveals pleurisy and pericarditis.
Pathogeny. At the outset of these attacks of broncho-pulmonary
disease, a careful bacteriological examination of the organisms to be
found in the discharge of bronchial mucus leads to the discovery of
bacilli which do not stain with Gram, and which resemble varieties of
the colon bacillus; in other cases of streptococci. At a later stage,
when the animal has become weak, microorganisms are present in
much greater variety. Nocard found in lung abscesses the bacillus of
epizootic lymphangitis. It seems that the development of various
lesions in the thoracic cavity may be due to auto-infection, i.e., to the
penetration from the intestine of germs which, after passing through
the circulation, establish themselves at some point in the lung. The
pleura is attacked at a later period as a consequence of continuity
and contiguity of tissue.
In a similar way pericarditis and even valvular endocarditis may be
produced.
Symptoms. The symptoms are similar to those of all forms of
broncho-pneumonia. Where diarrhœa has been neglected, the
conditions may apparently improve without evident cause, whilst the
respiration becomes more frequent. The patient soon suffers from
cough, and in a few hours the existence of broncho-pneumonia is
clearly apparent. Acceleration of breathing is the dominant
symptom. The respirations may rise to fifty to sixty per minute, at
which they continue, while fever sets in. On percussion the thorax
may appear of normal resonance throughout; but when pleural
lesions and exudates exist, resonance gives place to partial or
complete dulness. Should pericarditis or small cardio-pericardial
adhesions exist, they may escape observation, but if the exudate is
abundant or the adhesions multiple or of large size the usual
symptoms of pericarditis develop progressively.
On auscultation the respiratory murmur is always found to be
greatly exaggerated in the healthy parts, usually the upper portions
of the lung. On the contrary, it is attenuated or suppressed in the
affected regions. The other signs vary greatly, according to the
extent, intensity, and more or less advanced condition of the lesions.
Crepitant and bronchial râles, blowing respiration and tubal souffles,
etc., are among the symptoms.
The duration of the disease varies; some patients may be carried
off in five or six days, while others survive for one or two months, or
even longer. A few recover, but they remain thin, puny, and
atrophied, and are not worth keeping alive.
Lesions. The lesions extend to the bronchi, the pulmonary tissue,
and sometimes the pleura and pericardium. They consist in lesions
of diffuse broncho-pneumonia, pleurisy with false membranes and
parietopulmonary adherences, and pericarditis with partial cardio-
pericardial adhesions.
In rare cases abscesses caused by pyogenic streptococci may be
found.
The anterior lobes, cardiac lobes, and lower part of the posterior
lobes are those singled out for attack.
Diagnosis. The diagnosis is not difficult, provided that the
circumstances preceding the appearance of the pulmonary lesions
are known.
Prognosis. The prognosis is very grave.
Treatment. Treatment very often proves useless, because the
patients have little resisting power and are exhausted, and also
because they are suffering from a slowly progressive septicæmia. It
may, however, be worth while in the early stages to apply blisters to
the chest and administer general stimulants: alcohol in doses of 8 to
12 drachms per day, divided into two parts and mixed with milk;
acetate of ammonia in doses of ½ to 1 ounce; and tinctura digitalis 5
to 6 drops.
The primary disease of the intestine is masked by the pulmonary
symptoms, but should not be overlooked. Rice water, subnitrate or
salicylate of bismuth may be added to the milk or albuminous
solutions constituting the diet. When an epizootic of broncho-
pneumonia complicates the diarrhœa it is necessary to take all the
preventive measures which have been suggested in connection with
white scour and umbilical diseases in calves. These comprise
disinfection of the premises and local disinfection of the animals
affected.

SCLERO-CASEOUS BRONCHO-PNEUMONIA OF SHEEP.

The sheep suffers from a special form of broncho-pneumonia,

which is seldom seen except in isolated cases, but which, under
exceptional circumstances, may nevertheless attack a certain number
of animals in a particular flock. It was first noticed and described by
Liénaux in 1896, and has more recently been studied by Sivori
(1899). Moussu has only seen it in flocks in the north of France.
Causation. The causes of this disease are still imperfectly
understood.
Sivori’s researches show that the disease may be referred to a
microorganism, but we do not yet know exactly by what path
infection occurs.
The agent of sclero-caseous broncho-pneumonia in the sheep
appears similar to that described by Preisz and Guinard in 1891, and
identical with the microbe of ulcerative lymphangitis of the horse
(Nocard, 1897). It is probable that infection occurs through the
respiratory apparatus.
Symptoms. The clinical development of the disease is difficult to
describe, because its course is slow and unaccompanied by well-
marked external signs.
The animals lose flesh, pant for breath when moved, drop to the
rear of the flock, cough frequently, feed badly and end by becoming
cachectic. Many suffer from the disease and yet remain in fair bodily
condition.
On post-mortem examination the lungs are found not to collapse,
having lost their elasticity, and are of a yellowish-white colour, which
is only seen in this disease. On section the pulmonary tissue appears
dense, hard, and of a fibrous and lardaceous character. At various
points nodules with fibrous envelopes and caseous, yellowish or
greenish contents are found.
When the caseous nodules are near the surface the pleura may be
chronically inflamed and thickened. The liver and kidney frequently
contain caseous lesions.
Diagnosis. The diagnosis becomes easy after the first post-
mortem examination, for the lesions discovered cannot be mistaken
for those of parasitic broncho-pneumonia, degenerated pulmonary
echinococcosis or tuberculosis. In the living animal, on the contrary,
the diagnosis is extremely difficult.
Prognosis. The prognosis is grave. No special method of
treatment is known.

PULMONARY EMPHYSEMA.

Pulmonary emphysema, i.e., exaggerated dilatation of the

pulmonary tissue by air, is not uncommon in the bovine species, and
occurs under the two classical forms—(1) alveolar or intra-lobular
emphysema limited to dilatation of the alveoli; and (2) interlobular
emphysema, produced by the entrance and diffusion of air in the
interlobular spaces in consequence of rupture of the lobules.
These two forms are very frequently associated:—
(1.) Emphysema by dilatation usually begins in the right
pretracheal lobe; also in the cardiac and even in the posterior lobes.
(2.) Interlobular emphysema begins in the same regions, but it
spreads readily in a backward direction, remaining interstitial; or, on
the other hand, becoming subpleural at the periphery of the lung.
In both cases the pulmonary tissue is pale, the blood-vessels are
partially obliterated by compression; circulation and aeration of the
blood are impeded—hence the appearance of the disturbance noted.
Causation. Emphysema is seen in adult working oxen; also, and
to an even greater degree, in aged cows. It is produced by excessive
strains in draught, or more often by the paroxysms of coughing so
common during simple or parasitic bronchitis, broncho-pneumonia,
pneumonia, chronic broncho-pneumonia, etc. Successive gestations
also produce it.
All these pathological conditions also interfere with the nutrition
of the bronchial mucous membrane, particularly of its deep-seated
muscular layer, which is then incapable of regulating the distribution
of air in the bronchial channels. The distribution being no longer
regulated by reflex action, air accumulates at certain points as a
result of the expiratory efforts made during coughing, and dilatation
of the vesicles or lobules occurs.
Diseases of the digestive apparatus, acute or chronic tympanites in
particular, may play a certain part by compressing the diaphragm,
causing expiratory efforts and fits of coughing.
Furthermore, swelling of the lymphatic glands at the entrance to
the chest, by compressing the pneumo-gastrics, provokes reflex
cough and finally emphysema.
Symptoms. Pulmonary emphysema is marked by accelerated
respiration due to diminution in the respiratory capacity, which is
often very seriously affected; to insufficient absorption of oxygen in
consequence of diminution in the space available for exchange of
gases in the lung, and to insufficiency of expiration. This acceleration
in breathing, though little marked during repose, becomes very
pronounced after exercise, or during hot weather; and under these
circumstances is accompanied by a paroxysmal, feeble but shrill
cough, without discharge. This cough without discharge is frequently
followed by swallowing.
Percussion reveals an important point, viz., increase in the normal
resonance of the thorax.
On auscultation the vesicular murmur is found to be diminished,
the respiration assumes a rough and rasping character, inspiration is
difficult, expiration painful, and often divided into two periods, as
indicated by a slight double movement of the flank. Expiration is
clearly audible. Its duration is generally less than that of inspiration,
although in some cases it is equal or even longer. It is accompanied
by sibilant and snoring râles, sometimes even mucous râles, of an
intermittent character. In rare cases there may be difficulty of
respiration, as in broken-winded horses.
Diagnosis. The diagnosis may suggest a doubt as to whether
emphysema or tuberculosis is present, but in the latter there is fever,
the general condition is poor; on percussion the thorax reveals areas
of partial dulness; and expiration is rough and prolonged, sometimes
of a blowing character, a peculiarity which is exceptional in
emphysema.
 Prognosis. The prognosis is not very grave, except where
emphysema is only an accompanying symptom of another disease,
such as chronic bronchitis, tuberculosis, etc.
Treatment. Little can be done to check the development of the
above described pulmonary lesions; but the cough may be relieved,
and the pulmonary circulation improved by assisting the heart.
The most prompt and efficacious assistance is given by digitalis in
doses of ½ to 1 drachm per day for adults, iodide of potassium in
doses of 1 to 1½ drachms, and bromide of potassium in doses of 1
drachm to guard against reflex excitability of the pneumo-gastric.
This treatment, however, should not be followed for more than five
or six days, and should then be replaced by the administration of
arsenious acid in doses of 15 grains per day, ground horse-chestnuts
in doses of 3 ounces per day, etc., etc.

DISEASES OF THE PLEURA.

Primary inflammation of the pleura is very rare in animals of the

bovine species, but secondary diseases of this membrane, on the
other hand, are frequent.

ACUTE PLEURISY.

Cruzel, Fabry, and a number of practitioners have described the

occurrence in working animals of acute pleurisy à frigore or
serofibrinous pleurisy in consequence of severe, sudden variations in
temperature, or prolonged chills. At the present day it seems fairly
well established that pneumonia, and not pleurisy, is commonest
under such conditions, and Moussu disclaims ever having seen
primary pleurisy. On the other hand, pleuritic effusions are very
common in contagious pleuro-pneumonia, secondary pleurisy due to
pericarditis produced by foreign bodies, septic broncho-pneumonia
or broncho-pneumonia due to foreign bodies, and the pleurisy which
accompanies septicæmia consequent on parturition, etc. These forms
of disease, however, are not simple serofibrinous pleurisy, but septic
or suppurative pleurisy, still little understood in veterinary surgery.
 Tuberculosis of the pleura, although very frequent, is rarely
accompanied by marked exudation. Like secondary disseminated
pleural carcinoma, it usually assumes the vegetative and adhesive
form, with adhesions of greater or less extent between the lung and
wall of the chest.
Symptoms. In all these morbid conditions the symptoms vary
greatly, and it would be difficult to give an accurate general
description of them.
In acute pleurisy à frigore shivering attacks, moderate fever,
dulness, loss of appetite, interference with rumination, dryness of the
skin, rapid wasting and intercostal pain, first indicated by dull colic,
constitute the usual symptoms.
The respiration is short and irregular, interrupted when the
exudation is abundant. Pressure over the intercostal spaces produces
pain, as does strong percussion. Percussion reveals an area of
dulness bounded above by a horizontal line.
Auscultation shows the respiratory murmur to have disappeared
throughout the zone of dulness, and reveals the presence of a soft
pleuritic souffle (a soft tubal souffle quite different from that of
contagious pleuro-pneumonia) when pleural exudation is abundant.
In septic or suppurative pleurisy fever is higher, loss of appetite more
marked, wasting more rapid, and depression extreme, with, however,
identical local symptoms.
Diagnosis. The diagnosis of pleural exudation presents little
difficulty, because of the peculiar characters of the dulness and the
pathognomonic indications obtained by auscultation. The exudation
is usually unilateral, the mediastinum being very resistant and not
perforated in the ox.
By passing the needle of a Pravaz’s syringe with antiseptic
precautions through the intercostal space a little fluid may be drawn
off and the diagnosis formed, the form and nature of the pleurisy
being simultaneously established. The liquid extracted can be
examined bacteriologically, and can be grown on nutritive media, or
inoculated into experimental animals.
The prognosis is grave, because in the ox pleurisy is very often of
a secondary character. The outlook varies, however, with the form of
the pleurisy and the nature and virulence of the infecting organism.
 Treatment. Treatment consists firstly in applying an energetic
vesicant like antimonial ointment or liquid cantharides blister;
internally diuretics such as soda bicarbonate, nitrate of potash, resin,
and decoctions of pellitory, dogs’ grass, etc., may be given. If thought
desirable the chest may be tapped and the pleural cavity washed out
with an antiseptic solution.

CHRONIC PLEURISY.

Chronic pleurisy is frequent in aged animals, but usually assumes

the form of local adhesive pleurisy. The adhesions between the lung
and pleura are more or less extensive; they result from verminous
broncho-pneumonia, echinococcosis, external injuries, etc. Clinically
this form is of no importance, and is almost impossible to diagnose.
During the development of pleural tuberculosis, on the contrary,
adhesive dry pleurisy is frequent, and sometimes becomes so well
marked that almost the whole of the opposing pleural surfaces may
become united.

PNEUMO-THORAX.

The name pneumo-thorax is given to the condition produced by

the entrance of air or gas into one of the pleural cavities.
The accident is usually produced by rupture of the parenchyma of
the lung and of the pleura, a rupture which produces a
communication between the alveoli or a bronchus and the
corresponding pleural cavity. As soon as the rupture occurs air
passes from the lung into the pleural cavity, and the lung collapses in
consequence of the resilience of its elastic constituents.
Under other, much rarer, circumstances pneumo-thorax occurs in
consequence of gas generated in the digestive tract passing into the
pleural spaces. The condition then makes rapid progress, and death
occurs in a few days.
 Symptoms. The symptoms
are well defined. As soon as
the accident occurs the animal
exhibits extremely marked and
sudden dyspnœa,
accompanied by heaving at the
flank or general agitation of all
the muscles of the body. One
of the lungs, in fact, has
suddenly been called on to
perform the functions of both,
and at first it naturally has
great difficulty in meeting this
demand.
The heaving at the flank and
the general agitation of the
body muscles is due to the fact
that the regularity and rhythm
of contraction of the
diaphragm are disturbed, and
the mechanical conditions
have become different on the Fig. 171.—Schema illustrating open
two sides. From the first, pneumo-thorax. Right lung
respiration is moaning and collapsed; pericardium and heart
expiration becomes rapid, displaced towards the right.
stertorous and deep, while the
face is anxious-looking, and
the nostrils are dilated as though the animal was on the point of
suffocation. On examining the animal from in front or behind, the
thorax is easily seen to be wanting in symmetry, the side on which
the pneumo-thorax has occurred being immobile as compared with
the sound side. The latter, moreover, is dilated in order to
compensate for the loss of function of the collapsed lung.
Percussion reveals greatly increased resonance on the side of the
pneumo-thorax. On the other hand, the opposite side yields a normal
sound.
Auscultation reveals an increase of the respiratory murmur on the
side which is still acting and, on the contrary, complete and total
suppression of the respiratory murmur on the affected side. On
applying the ear to the chest wall, a large soft, amphoric souffle of
well-marked metallic character is heard. This is particularly clear on
respiration, giving the impression of the existence of a large cavity
beneath the ear. The sighing sound heard on auscultation of the
chest wall is louder than that heard externally or over the region of
the nostrils or larynx; and it seems to be reinforced, as though by the
resonance of a large cavity with thin metallic walls. Once or twice per
minute, moreover, a sound may be heard like that of dropping water.
It is of a very special character, resembling that produced by drops
falling to the bottom of a hollow metallic vase, and setting up
prolonged vibration.
As secondary symptoms the heart’s action is accelerated, the
number of beats rising to 80 or even 120 or 130 beats per minute;
appetite is lost; slight tympanites develops as a result of rumination
and eructation being suspended; the peristaltic movements of the
rumen are interrupted, and constipation develops.
Diagnosis. The diagnosis of pneumo-thorax is easy, and the
condition can scarcely be mistaken for any other except
diaphragmatic hernia; but the indications derived from percussion
and auscultation are so different in the two cases that they need not
be further emphasised.
The task becomes more difficult, however, when an attempt is
made to identify the exact form of pneumo-thorax, for three
principal varieties are recognised.
In open pneumo-thorax, the first and most frequent form, air
passes from the lung into the pleura at each inspiration, and flows
back from the pleural cavity towards the bronchus at each expiration.
The intra-pleural pressure is then approximately equal to the intra-
bronchial pressure, and undergoes similar oscillations. (It should be
noted that the aperture in the lung is seldom sufficiently large to
establish an absolute equality of pressure between the bronchus and
the pleural cavity. Respiration, therefore, though very seriously
impeded, generally continues in a modified form.)
In a second variety, termed “valvular pneumo-thorax,” air passes
freely from the lung into the pleural cavity, but is unable to return
from that cavity towards the lung, because a flap of tissue acts as a
valve and closes the orifice at the commencement of expiration. As
soon as intra-pleural pressure rises above that of the inspiratory
effort, the valve remains permanently closed.
In the third variety, called “closed pneumo-thorax,” the orifice of
communication is obstructed by some mechanism, and the pleural
sac only contains a film of air.
In practice, valvular pneumo-thorax is recognised by the
movement of the thoracic wall (which in open and closed pneumo-
thorax remains depressed), as well as by extreme intensity of the
dyspnœa and attacks of threatened suffocation. Closed pneumo-
thorax, which is only a termination and a stage in the cure of open
pneumo-thorax and of valvular pneumo-thorax, is suggested by
progressive improvement in the symptoms. Scientifically it is very
easy to make this diagnosis by putting a manometric apparatus in
communication with the pleural cavity by means of a simple hollow
needle provided with a thick-walled rubber tube.
In open pneumo-thorax the liquid column in the manometer
undergoes rhythmic oscillations corresponding to the respiratory
movements; in valvular pneumo-thorax the intra-pleural pressure
increases progressively until it becomes higher than the external
pressure; and finally, in closed pneumo-thorax, the column of the
manometer assumes a certain level at which it rests.
Prognosis. The prognosis is very variable, according to the
primary cause of the accident. Animals might recover, but
economically there is little advantage in preserving them when the
diagnosis is assured, except in cases of animals of great value, and
when the primary disease admits of it.
Causation. Pneumo-thorax may be produced by various causes.
The most frequent cause in large animals is pulmonary
echinococcosis, during the course of which a peripulmonary vesicle,
after having injured several lobules, one of the air passages or even a
bronchiole, may break through the pleura, thereby setting up direct
communication between the bronchi and the pleural cavity.
To pulmonary tuberculosis, with peripheral softened tubercles,
perforating simultaneously into an alveolus or a small bronchus and
into the pleura, must be assigned the second place.
Vesicular and interstitial subpleural pulmonary emphysema is also
a frequent cause of pneumo-thorax, the pleura being ruptured over
the emphysematous points.
Finally, and exceptionally, an abscess of the lung may open into
the pleura and form sinuses, which may establish a communication
between the digestive reservoirs and pleural sacs; but such accidents
produce pyo-pneumo-thorax and septic pleurisy of a rapidly fatal
character.
The diagnosis of pneumo-thorax, and even of its varieties, does
not, however, enable one to form a prognosis; the important point is
to ascertain the original cause.
Treatment. It may be said of pneumo-thorax that no treatment
exists, and that the position is one of expectancy. In fact, we possess
no means of directly dealing with such diseases as echinococcosis,
tuberculosis, or emphysema. For this reason it is best as a rule to
advise slaughter. Nevertheless, when the condition is due simply to
pulmonary echinococcosis of a discrete character, there is some
chance that after several months the animal may recover
spontaneously. The communicating orifice becomes closed by
reparative processes (cicatricial contraction, the formation of a false
membrane, limited adhesion between the two walls of pleura, etc.);
the layer of air imprisoned within the pleural cavity is progressively
absorbed, provided that it has not been accidentally infected; the
collapsed and partially splenised lung progressively regains its
function under the inspiratory efforts, and after some months
complete recovery may occur. This termination cannot always be
confidently predicted, because complications may arise at any
moment; under no circumstances can complete recovery be
anticipated when the primary disease is tuberculous.
In cases of valvular pneumo-thorax with extreme oppression,
attacks of suffocation threatening death as a consequence of
excessive intra-pleural pressure, displacement of the mediastinum
towards the opposite side, compression of the heart, and functional
disturbance of the sound lung, it may be worth considering whether
the attacks of suffocation and threatened asphyxia can be modified
or removed by preventing the excess of intra-pleural pressure. By
simply passing a stout hollow needle through one of the intercostal
spaces, the intra-pleural pressure may be reduced to that of the
external atmosphere, and the effects of compression removed. This,
however, is a last resort, and has no permanent effect.
 HYDRO-PNEUMO-
THORAX AND PYO-
PNEUMO-THORAX.

When pneumo-
thorax is set up, it
rarely remains simple.
In the great majority of
cases the pleura
becomes infected,
either directly, by the
lesion which has
determined the
pneumo-thorax
(tubercle, superficial
abscess, actinomycotic
lesion, etc.), or
secondarily, by the
penetration of germs
from the air or from the
bronchus
(echinococcosis,
Fig. 172.—Hydro-pneumo-thorax. I, Point emphysema). Simple
of adhesion of the pleura; P, healthy lung; pneumo-thorax then
Ps, splenised lung; E, liquid or purulent becomes converted into
exudate; Ca, air cavity constituting hydro-pneumo-thorax
pneumo-thorax; C, heart. or pyo-pneumo-thorax,
according to
circumstances—that is to say, whether the exudation into the pleural
cavity is of a simple character or is of the nature of pus.
Symptoms. Hydro-pneumo-thorax is characterised by the signs
common to true pneumo-thorax, which constitutes the primary
lesion, viz., sudden difficulty in breathing, exaggerated unilateral
resonance, amphoric souffle accompanied by a sound like that of
drops of water falling into a metallic vessel, and by the signs of
secondary exudative pleurisy, viz., moderate fever, dulness over the
lower zones of the chest, limited above by a horizontal line, slight
splashing sound, and a soft distant pleuritic souffle.
 All the secondary symptoms—loss of appetite, suppressed
rumination, sighing, accelerated pulse, etc.—are found in a more or
less accentuated form.
In pyo-pneumo-thorax fever is more marked, while the signs noted
on auscultation and percussion are identical, and are accompanied
by digestive disturbance and marked œdema of the wall of the chest,
which can be seen or detected by palpation.
Diagnosis. The diagnosis is relatively easy when the lesion is
secondary; but the difficulty (as in simple pneumo-thorax) is to
identify the exact character of the primary affection.
On the other hand, pyo-pneumo-thorax and hydro-pneumo-thorax
are not always complete; adhesions of very varying character may
exist between the lung and the chest wall; hence it is impossible to
group together all the possible symptoms.
Diagnosis is facilitated by aseptically puncturing the chest with a
Pravaz’s syringe.
Prognosis. The prognosis is extremely grave even in cases of
hydro-pneumo-thorax. Treatment is useless, for even allowing that
the primary disease might be cured, this process of cure, after
reabsorption of the transudate, would be extremely tedious, and the
animals would long remain in poor condition.
Treatment. In hydro-pneumo-thorax no treatment is advisable.
Nothing is gained by thoracentesis, at least at an early stage, or
before the lesion causing the pneumo-thorax has closed.
In pyo-pneumo-thorax, on the contrary, the theoretical course is to
evacuate the pus and completely wash out the pleural sac with
lukewarm non-irritant solutions of antiseptics.
 CHAPTER V.
DISEASES OF STRUCTURES ENCLOSED WITHIN THE MEDIASTINUM.

The mediastinum is a space enclosed in the median plane of the

thorax by the approach of the two opposite layers of pleura. Needless
to say, at those points where the layers are in apposition, the space is
theoretical only. It extends from the suprasternal region to the dorsal
subvertebral region, and encloses all the vessels which pass from or
to the base of the heart, the trachea, the œsophagus, the pneumo-
gastric, diaphragmatic and cardiac nerves, etc., as well as the
pericardial sac and the heart. The organs most frequently affected
are the lymphatic glands lodged in the thickness of the mediastinum,
the glands placed at the entrance to the chest, the bronchial glands,
and the glands situated in the posterior mediastinum.
Inflammation of the mediastinum may coincide with inflammation
of the mediastinal layers of the pleura; but this can only be detected
on post-mortem examination. The lesions which can be recognised
during life are simple inflammation of glands, resulting from
pulmonary or pleural diseases, tuberculous inflammation of glands,
and the presence of cancerous tumours of the mediastinum and
hypertrophy of glands due to lymphadenitis.
Simple inflammation of the lymphatic glands is secondary and
consecutive to broncho-pneumonia, verminous bronchitis, infectious
bronchitis, etc.
It produces reflex irritation by compressing the pneumo-gastric
and laryngeal nerves, and is indicated by loud, spasmodic coughing.
Treatment consists in administering iodide and bromide of
potassium, terpine, in doses of 1 drachm per day for adults, essence
of turpentine and tar water.
Tuberculous inflammation of glands, inseparable from pulmonary
tuberculosis, has very special characteristics peculiar to tuberculosis.
Inflammation due to lymphadenitis is also very easy to diagnose as
a rule, in consequence of the symmetrical enlargement of lymphatic
glands elsewhere.
 TUMOURS OF THE MEDIASTINUM.

Sarcomata, carcinomata, lymphomata, and lympho-sarcomata all

occur in the mediastinum. They attack young healthy animals, and
sometimes develop with such rapidity that in a few weeks they
become generalised and invade the heart, lungs, and principal
viscera. Their cause is as yet unknown.
Symptoms. At first sight the symptoms are much like those of
pericarditis caused by foreign bodies. They consist in deformity of
the presternal region, swelling of the jugulars, submaxillary œdema,
irregular pretracheal tumefaction, etc.
The tumour, whatever its nature, commences in the mediastinum,
develops towards the entrance to the chest, where it projects, and
before long produces in the pretracheal region clearly marked
œdematous swelling.
Between the two first ribs the tumour compresses the carotids, the
jugulars, the nerve trunks, and also the trachea and œsophagus,
producing difficulty in the return circulation, especially in the
jugulars, swelling in the submaxillary space, loss of appetite and
dyspnœa.
Palpation affords indication of a tumour of soft consistence,
bosselated, more or less adherent to the skin, usually painless on
pressure, and of irregular development. Compression of the
œsophagus interferes with the deglutition of rough forage, impedes
rumination, prevents eructation, and thus produces trifling but
permanent tympanites.
The heart is affected reflexly or directly as a result of
generalisation of the tumour, and the pulse may rise to 70 or even
120 per minute.
During the first stages neither auscultation nor percussion points
to any pulmonary lesion. At a later stage the lung itself may be
affected. The other important functions are normal.
Animals suffering from sarcoma, carcinoma, or lympho-sarcoma
of the mediastinum waste very rapidly, lose appetite, become
feverish, and soon develop cachexia.
Diagnosis. The diagnosis of tumour of the mediastinum is easy,
because of the well-marked character of the apparent symptoms.
 Prognosis. The prognosis must be regarded as extremely grave,
and in most cases fatal, for there is no active method of intervention,
extirpation being impossible.
There is no treatment. The animal should at once be slaughtered.
 SECTION IV.
THE ORGANS OF CIRCULATION.

SEMIOLOGY OF THE ORGANS OF CIRCULATION.

The semiology of the circulatory apparatus comprises the clinical

examination of the heart, arteries and veins, and the examination of
the pulse and blood.
Heart. In animals of the bovine species, the heart is situated in
the thoracic cavity opposite the third, fourth, fifth and sixth ribs,
nearly in the median plane of the thorax, and inclined from front to
back at an angle of 70 degrees.
The pericardial sac touches the extremity of the sternum where it
is in immediate contact with the lower insertion of the diaphragm.
This peculiar arrangement favours the development of pericarditis
due to foreign bodies.
On the left side the pericardial sac may come in direct contact with
the internal surface of the thoracic cavity opposite the lower
extremity of the third, fourth, and sometimes fifth ribs. At all other
points the pulmonary lobes, as expanded during inspiration,
separate it from the thoracic wall.
Although the pericardium and heart are situated in the median
plane, percussion and auscultation should be performed on the left
side, since the anterior and cardiac lobes of the left lung are less
developed than those of the right; but the heart can be auscultated on
the right side, as is advisable at times.
In the healthy ox there exists an area of the left thoracic wall which
may be called the cardiac zone, on a level with which are heard the
normal heart sounds. In diseased conditions this zone or area may
vary in size, and the sounds may be modified.
 The heart can be examined by inspection, palpation, percussion,
and auscultation.
Under ordinary conditions inspection reveals nothing in well-
nourished animals; but in very thin subjects and in those suffering
from recent cardiac lesions or pseudo-pericarditis, a rhythmic
movement of the chest wall is sometimes detected.
Palpation is performed by placing the open hand on the cardiac
zone. In this way the cardiac shock can be felt, its degree of intensity
judged, and, in an imperfect manner, its rhythm.
Percussion by means of the fingers or a pleximeter discloses the
extent of the physiological area of partial dulness, due to the
presence of the heart, as well as its variations in pathological
conditions, particularly in pericarditis with marked exudation.
In such cases
there may even
be complete
dulness when the
distended
pericardium
thrusts upwards
the
corresponding
pulmonary lobe,
and comes in
contact with the
internal surface
of the thoracic
wall, or, in cases
of pericardial
pneumatosis,
exaggerated
resonance, and a
tympanitic
sound.
Auscultation is
carried out either Fig. 173.—Schema of a section through the chest
directly or by the opposite the heart. Pg, Left lung; Pd, right lung;
stethoscope or cp, right and left pleural cavities; P, pericardium;
the l, l1, cardiac lobes of the lung interposed between
phonendoscope. the pericardium and thoracic wall.
The normal or
pathological
sounds of the heart are thus ascertained, as well as the intensity of
the cardiac beats and sounds, the frequency of the rhythm, etc.
When injuries have occurred which cause murmurs, it is best to
use the stethoscope and to apply it at the points where murmurs are
heard at their maximum intensity, i.e., exactly at the spot where the
cardiac shock is noted, and towards the base, in the region where the
great arterial trunks begin.
In the latter case it is often useful to draw the left fore leg forward.
Arteries. The arteries are rarely the seat of lesions that can be
detected by examination, and therefore such examination is usually
limited to noting the state of the pulse.
Arteritis and thrombosis of arteries are rare, and although lesions
of atheroma have been discovered in certain chronic diseases, such
as tuberculosis, chronic diarrhœa, etc., they are difficult to detect,
even on examination per rectum of the bifurcation of the aorta.
Pulse. The examination of the pulse, on the contrary, is of great
importance. In animals of the bovine species the pulse may be taken
at a number of different points, such as the submaxillary artery, on
the side of the lower jaw: in the case of very thin animals at the radial
within and in front of the elbow joint; at the internal saphenous
artery, at the height of the mamma or scrotum; or at the coccygeal
artery, at the base of the tail.
This examination reveals the frequency (50 to 60 per minute), the
quality, whether strong, feeble, imperceptible, etc., the regularity,
etc., etc.
Veins. The veins are more easily examined than the arteries, on
account of their superficial position in most cases.
Inspection and palpation are the only means of examination.
Inspection shows the degree of fulness or collapse, and also the
existence or absence of what has been termed venous pulse.
Venous pulse occurs only at the lower extremity of the jugulars. It
is very frequent in animals of the bovine species, and in thin animals
is not necessarily a pathological symptom. It is due to reflux of blood