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 Diagnosis is to be based largely on the variability of the lameness
at different times, its propensity to shift from place to place, its
manifest association with exposure to cold, and with the immanence
of electric storms or change in the barometric pressure, and its
improvement under genial weather, warmth and comfort.
 SYMPTOMS OF MUSCULAR RHEUMATISM IN
HORSES.

Under usual causes, muscles tender, stiffness, groaning, loins, quarter, shoulder,
neck, chest.

Developed under conditions similar to those causing rheumatism

of the joints, rheumatism of the muscles tends to attack those of a
particular region, and to continue in these throughout the attack
rather than change to others. The affected muscles are very tender to
the touch, but usually show no swelling nor heat. The muscles are
relaxed and tend to atrophy, fever is little marked, there is
comparatively little tendency to the implication of the heart, and the
suffering and stiffness vary with the variation of the weather, or with
electric or barometric changes. When generalized, however, fever
may supervene, and the joints may be implicated (Thompson).
When the loins are affected they become extremely tender to the
touch, and the horse shows great stiffness, and groans when made to
walk and above all when turned or backed. He does not, however,
show the unsteadiness in gait and tendency to stagger that is shown
in sprain of the loins, and there is no history of a slip, fall or injury,
but an unmistakable connection with cold, exposure, change of
weather, or overfeeding on grain.
When the gluteal muscles are attacked there is intense lameness,
and dragging of the hind limb, with an acute sensitiveness of the skin
of the region, which characterizes neither disease of the hip nor of
the trochanterean bursa.
When the scapulo-humeral muscles are the seat of disease, there is
a marked stiffness, shortness of step, drooping of the head, and great
tenderness of the skin and muscles to manipulation or the use of the
currycomb. Like the other cases named it occurs suddenly, without
evidence of accident, but bearing a relation to cold or other change of
the weather, and is better or worse as the weather is more or less
genial.
When the cervical muscles are affected (torticolis), the same
features are noted, the absence of traumatic cause, the presence of a
meteorological one, or at least of cold or wet, the responsiveness of
the disease to the state of the weather, and to revulsive agents
applied to the part. The neck may be held rigidly in one position, to
one side or elevated so that there is great difficulty in getting the
nose to the ground.
The costal muscles are less frequently attacked (pleurodynia), but
the same general principles guide in diagnosis.
Seidamgrotzky alleges the constant existence of acidity of the urine
in muscular rheumatism. This may be attributed to the active trophic
changes going on in the muscles.
 SYMPTOMS OF ACUTE ARTICULAR
RHEUMATISM IN CATTLE.

Sudden onset, hyperthermia, chill, fever, acid saliva, decubitus, does not stretch
on rising, lameness, joints involved, metastasis, variability, morning and noon,
suppuration, walking on toe, secondary articular rheumatism. Course: muscular
symptoms, cardiac, pleuritic, digestive. Chronic. Muscular rheumatism: of back,
loins, shoulder, quarter, neck. Changes in blood and nutrition.

There is a sudden attack with constitutional disorder, chill, staring

coat, cold horns and ears, dry muzzle, impaired appetite and
rumination, acid saliva, constipation, thirst, hurried breathing, hard
accelerated pulse and more or less hyperthermia. Then there may
come reaction with surface heat and glow. The patient inclines to lie
and when raised fails to stretch the back or the hind limbs, stands
with arched back, and walks stiffly and with more or less lameness.
The joints attacked may be determined by local strain, compression
on concussion, hence the frequency of lesions of the knees and
fetlocks. Yet any of the great joints of the limbs may suffer,—hip,
stifle, hock, shoulder or elbow—or several may be affected at once.
The disease may extend from one joint to another, may improve in
one or more, only to suffer a relapse, and may oscillate better and
worse according to the state of the weather or the exposure to cold or
warmth. Often almost helpless in the early morning, the patient
improves greatly in the heat of the sun.
The affected joint is swollen, distended with liquid, hot and tender
with considerable infiltration of the surrounding tissues, including
the tendons and their synovial sheaths. Suppuration is much more
common than in the same affection of the horse appearing to be due
to a complex infection with pus microbes. In walking in severe cases
the foot of the affected limb is planted with great care and caution
mainly on the toe and there appears to be exquisite suffering when
weight is thrown on it, so that the fetlock and knee may knuckle over
and the patient comes to the ground. Great infiltrations, fibroid, and
other hyperplasias and even calcifications are not uncommon.
Cadeac describes as secondary articular rheumatism, those
infective inflammations of the joints that follow on parturition,
abortion, omphalitis, enteritis, etc., but it is manifest that these are
special disorders due to the presence of the microbes of specific
diseases or their toxins and should be described with these rather
than with rheumatism.
The course of acute rheumatism in the ox is very uncertain. Mild
cases may recover in a few days. In others the lesions become
extensive, great hyperplasia and induration occur around the joint
and permanent stiffness and even anchylosis may supervene. The
occurrence of temporary improvements and relapses is a common
feature. The extension of the disease to other joints, tendinous
sheaths, muscles and even internal organs is to be dreaded. Extreme
tenderness of the back and loins when handled or pinched, with
groaning is a marked feature especially in cold and damp times or in
early morning. Cardiac complications show themselves by shortness
of breath, palpitations, hard intermittent, irregular or unequal pulse,
blowing murmur with the first heart sound, and other signs of
circulatory trouble. Pleuritic, pulmonic and abdominal complications
are also to be looked for. The costiveness by which acute rheumatism
is ushered in, becomes complicated by congestion of stomach and
intestine, and impaction of the first and third stomachs, great
dullness, anorexia and even nervous disorder. Colic and even
diarrhœa are occasional consequences.
Many cases subside into a chronic form which shows a variable
condition, better and worse, according to the condition of the
weather, the exposure to cold and damp, and even the changes of
diet. This may last throughout life.
 SYMPTOMS OF MUSCULAR RHEUMATISM IN
CATTLE.

This may set in with the same abruptness as articular rheumatism,

the animal in the morning after a wet, dewy or frigid night showing
general stiffness and lameness with extreme sensitiveness of the skin
and muscles along the back and loins. The animal moves slowly and
stiffly, grunting perhaps at each step and shows inappetence, fever,
dry muzzle and costiveness. This is essentially rachialgia or
lumbago. Pandiculation on rising is entirely omitted.
Not infrequently the muscles of the shoulder are mainly affected
and become exceedingly tender to manipulation. The patient seeks to
remain recumbent and when raised will get up on his hind parts and
remain thus for some time resting on the knees before he can be
made to get up in front.
When the muscles of the croup are attacked the mode of getting up
is reversed, the animal rising first on its fore feet and remaining for a
time sitting on its haunches or resting on the hocks before it gets on
the hind.
If the muscles of the neck are involved there is the same stiffness,
soreness, tenderness and twisting to one side or rigid elevation of the
neck as seen in the horse in similar circumstances.
In any case there is a tendency to extension or shifting from one
part to another, and notably to the implication of the tendons,
synovial sheaths and joints. This is especially the case in the acute
type, while chronic rheumatism may remain long confined to the
groups of muscles which are first attacked. In the acute forms too
there is the greatest liability to internal complications not only
cardiac, but according to Cruzel abdominal and thoracic as well.
 A fatal result is rare, but the impairment of appetite and digestion,
the constant and often severe suffering, the destruction of the red
globules, and the malnutrition, and increased and perverted
metabolism as shown in the pallor of the visible mucous membranes,
the steady loss of condition and advancing emaciation, the rigid, dry,
scurfy, hidebound skin, tends to wear out the subject or render it
unprofitable. In the chronic form it may last for months.
 SYMPTOMS OF RHEUMATISM IN SHEEP.

Articular rheumatism seems to be very rare in mature sheep, while

it has been recorded in lambs. Muscular rheumatism on the other
hand has been seen in connection with untimely shearing, exposure
to cold storms and cold, damp folds. The back and loins, are tender
to the touch, or in other cases the neck or hind quarter, the limbs are
carried straight and rigid, the animal moves slowly and stiffly, falls
behind the flock, and is found alone, unthrifty and emaciated. It
usually terminates in recovery though it may cause chronic disease
and distortion of the affected joints or it may even prove fatal. The
usual tendency of the morbid process to shift from joint to joint or to
muscles, is here again characteristic.
 SYMPTOMS OF ARTICULAR RHEUMATISM IN
SWINE.

Climatic influences. Rheumatoid. Joints attacked. Muscles. Decubitus. Stiff,

rigid, steps on toes, grunts, swelling, heat, tenderness, chaps, cracks, suppurations,
inappetence, emaciation, metastasis, cardiac disorder. Duration; course. Chronic
form. Muscular form. Diagnosis from trichinosis. Connection with arthritis.
Metastasis. Remissions.

The pig which shows an extreme sensitiveness to climatic

vicissitudes and cold winds, fleeing instantly to his lair on their
advent, is yet protected by his subcutaneous fat, so that he is not a
frequent victim of simple rheumatism. Leblanc attributes it to
unwholesome pens. Chaussade to too rapid fattening (overfeeding).
Rheumatoid attacks are very common at the onset of hog cholera,
swine plague and other infectious diseases, when they are probably
but local manifestations of the general infection.
The lesions are mainly concentrated in the stifle, hock, knee and
fetlock. In some cases the dorsal and lumbar muscles suffer and
there is arching of the back with great tenderness on manipulation.
In other cases the muscles of the quarter or shoulder are involved as
shown by their stiffness and extreme sensibility to touch.
The pig is found down, indisposed to rise, and when up, stands
drawn together with limbs rigid and feet resting on the toes. He will
often point one toe to the ground repeatedly, before resting on the
foot, or shift the weight uneasily from foot to foot. If moved he grunts
plaintively and if handled squeals.
The affected joints may be surrounded by hot tender swellings or
they may be nearly normal in outline, but they are always very
sensitive to pressure and above all to flexion and extension, and the
skin is usually hyperæmic and red. There may be engorgements of
the lymphatics on the inner side of the limbs, and chaps and cracks
in the flexures of the joints. Suppurations may follow (Graignard)
suggesting a complex infection.
There is little appetite and though the disease becomes subacute or
chronic there is a steady loss of condition or at least a failure to
thrive.
Benion’s reference to a coincident or sequent inflammation of the
respiratory or digestive organs and Spinola’s similar reference to
pleurisy are strongly suggestive of swine plague and hog cholera. Any
manifest disposition to shift from one part to another and any
concurrent disorder of the heart, other than simple palpitation is
strongly confirmatory of rheumatism.
The disease tends to recovery in from four to twenty days, or to
pass into the chronic form. In this state the symptoms are materially
mitigated. Fever is absent, but the appetite, digestion and
assimilation are poor, the animal remains stunted, emaciated or
unthrifty, there is a disposition to lie most of the time under the
litter, and when up it moves stiffly with short steps, semi-flexed
joints and upright digits. Sometimes the joints are permanently
swollen and rigid by reason of thickening and shortening of the
binding ligaments, by the organization of false membranes or by
anchylosis.
Muscular Rheumatism in Swine. This appears to be rarely
seen as an independent disease, but appears at times to coincide with
the arthritic form. In such cases the back is arched and very sore to
the touch or to pressure. It must be distinguished from the muscular
soreness of trichinosis which occurs in infested localities, after
trichinous food or water, is preceded by digestive disorder and
diarrhœa, and by the passage of the nearly microscopic worms in the
stools, and is independent of arthritis.
Muscular rheumatism leads to atrophy of the muscles, especially
those of the quarters, and this may resemble, somewhat, partial
paraplegia from disease of the spinal cord. Its connection with
arthritis, its tendency to shift from place to place, to undergo
ameliorations and relapses, and its exquisite tenderness, serve to
distinguish it from paralysis.
 SYMPTOMS OF ARTICULAR RHEUMATISM IN
THE DOG.

Articular rheumatism rare. Femoro-tibial joints, bilateral, remissions.

Exudation, swelling of joint; muscular atrophy, weakness, swaying, staggering,
falling, paresis. Chronic, muscular rheumatism common, back, loins, neck,
general, stiff, painful movement, decubitus, muscles tender, yelps, stiff neck, wry-
neck. Masseteric. Painful defecation and urination. Metastasis. Cardiac symptoms.
Pleurodynia. Digestive troubles. Emaciation, weakness, atony, paraplegia.
Diagnosis from strongylus, stephanurus, and cysticercus.

This affection seems to be rare in the dog. What is known as

rheumatism in this animal, consists in an inflammation with
hyperplasia around the articular ends of the long bones, the new
material being partly fibrous and partly calcified. It shows a special
predilection for the femoro-tibial and confines itself mainly to the
inner side of the head of the tibia. Here the swelling may reach the
size of a walnut, The whole head of the tibia and lower end of the
femur are however often involved, entailing a general enlargement of
the joint. It follows the general rule of rheumatism in usually
attacking both stifle joints at once, and also in alternate
ameliorations and relapses. Less frequently other joints are affected.
In all such cases the joints become overdistended and swollen, partly
by synovia, and partly by surrounding exudate, the muscles of the
quarter and thigh become atonic, soft and flaccid, and are steadily
atrophied. The dog shows a lack of strength in the hind parts,
swaying, staggering or even falling, and advancing to a marked
paresis. The malady follows a chronic course, lasting for months, a
year, or more.
 SYMPTOMS OF MUSCULAR RHEUMATISM IN
THE DOG.

Muscular rheumatism is common in dogs. It is most common and

most marked in the back and loins, though the neck may suffer, or
the disease may be generalized. It is painful to move and the subject
seeks to be as much as possible undisturbed. He walks stiffly and
slowly, carrying the limbs with as little movement of the joints as
possible, and in bad cases yelps occasionally from sudden pain. He
can no longer be tempted to go up or down stairs or to make any
special effort. When touched on the back or loins he will wince, cry
out, or even snap at the offender. In some cases the pain is so acute
that even a feint to touch the back will draw out a yelp. If the neck is
affected it may be held so stiffly that the dog can barely reach the
ground to find his food, or if unilateral the head is turned to one side.
Even the muscles of the jaws may be affected, causing prehension
and mastication to be difficult and imperfect. Defecation and
urination are also interfered with and the straining may draw forth
plaintive cries.
The rapid shifting of the morbid process from one group of
muscles to another is often very striking, and if one pronounces on
the exact seat of the disease, it is liable to be speedily rendered
inexact by a sudden change of place. There is further a great
disposition to the implication of the heart and especially the valves.
This is shown by irregularity and inequality of the pulse by
intermissions and palpitations, by a blowing murmur with the first
heart sound and by oppressed breathing.
Short, shallow breathing is also caused when the intercostal
muscles are attacked (pleurodynia). Various digestive troubles are
also common, to which the difficult defecation and impacted rectum
largely contribute.
 Emaciation makes more or less progress, and the muscles of the
hind parts especially become weak and atonic until marked paresis
or actual paraplegia sets in, and the hind limbs are extended
backward and dragged helplessly. In fat, sluggish, overfed and
pampered animals the lack of control of the hind limbs may come on
at an early stage. Stiffness due to strongylus gigas in the kidney or
stephanurus or cysticercus cellulosa in the lumbar muscles must not
be mistaken for rheumatism.
 PREVENTION AND TREATMENT OF
RHEUMATISM.

Prevention. Avoid known causes, untimely clipping, exposed buildings, over-

fatigue, chills, cold rains, dews and frosts, disorders of liver and bowels, sweets,
spiced food, overfeeding, constipation, torpid liver, injuries to joints or tendons.
Treatment: warm stall and clothing, laxative food in moderation, purgatives, aloes,
castor oil, jalap, saline enemas, colchicum, alkalies, trimethylamine, acetate of
ammonia, salicylic acid, salicylates, salicine, oil of gaultheria, salicine for
debilitated. Large doses hourly or every two hours. Less effective in chronic cases.
Heart failure. Salol. Salophen. Phenocoll. Antipyrin. Acetanilid. Pilocarpin. Tartar
emetic. Dover’s powder. Ammonium acetate. Chamomile. Boneset. Hot baths and
packs, with cold on head. Hand-rubbing. Hot drinks. Nauseants. Hot iron.
Anodyne liniments. Rubefacients. Blisters. Salicylate of methyl and other
salicylates. Quinine and potassium iodide. Tincture of muriate of iron. In chronic
cases, tonics, cod liver oil, arsenic, guaiacum, potassium iodide. Essential oils.
Electricity.

Prevention. This consists in the avoidance of all known causes of

the disease and must vary to some extent for different genera of
animals. The avoidance of cold and exposure, of clipping at
unsuitable seasons, of exposed sites for buildings (north and
northwest exposures, narrow valleys and ravines), of over-fatigue, of
perspiration and subsequent chilling, of cold rains, dews and frosts,
of inactivity, or habitual overloading of the liver and bowels, and of
local injuries of joints or tendons. House dogs especially should be
protected from sweets, spiced food, frequent feeding, constipation
and torpid liver.
Treatment. One of the most important considerations is a warm
stall or building, or warm clothing including loose woolen bandages
on the legs, in the horse. Laxative food is called for.
 In acute cases and especially in fat pampered dogs, and in all cases
associated with torpid or disordered liver, a preliminary laxative will
be of great service, and others should be given later as demanded.
The horse may have aloes or salines, and saline enemata may be
given to all animals when called for throughout the progress of the
disease. Pigs may take 1 or 2 drops croton oil, or like dogs they may
be given castor oil or jalap. Torpid liver and constipation must
always be carefully guarded against.
To cut short the attack much reliance was formerly placed on
colchicum which increases the elimination of solids in the urine, and
on alkalies, which beside the theoretic antagonism to acidity are at
once chologogne and diuretic. The action was somewhat slow but on
the whole satisfactory, usually abating the suffering very materially
in the course of a few days. To the horse or ox ½ dram doses of
colchicum were given daily in combination with 4 to 6 drams of
bicarbonate of soda; pigs of 100 lbs. may take 1 grain of the former to
10 grains of the latter; a shepherd’s dog may take half the amount
just named. Trimethylamine proved even more effective than
colchicum, and acetate or citrate of ammonia, soda, or potassium
was often substituted for the carbonate.
But the modern treatment of rheumatism dates from 1876, when
the introduction of salicylic acid and later sodium salicylate, salicine
and ol. gaultheriæ gave to such treatment an efficacy previously
unknown. Salicylic acid acts very harshly on the gastric mucosa, and
with sensitive stomachs is advantageously replaced by sodium
salicylate, into which it is transformed in any case in the blood.
Salicine which is held to be transformed into salicylic acid in the
system, is specially recommended for its bitter and tonic action
exercised in the stomach and prior to such transformation. In
debilitated subjects, therefore, and in those that suffer from the
characteristic rheumatic reduction of the red blood globules it would
be somewhat preferable. As a prompt and effective anti-rheumatic
agent however it appears to be somewhat less reliable than sodium
salicylate or ammonium salicylate. Ol. gaultheriæ may be better
borne by the stomach of the dog and pig than the salicylates, the dose
being 10 to 15 drops thrice a day.
The secret of success with all of these salicylate compounds, lies in
the speedy saturation of the system with the drug, rather than in its
moderate and continuous administration. The horse or ox may take
½ oz. repeated every two hours for ten hours if relief is not obtained
earlier. The pig may take 20 grains, and the dog 5 to 10 grains at
similar intervals. It is not desirable, however, to continue this
indefinitely, and therefore when immediate relief has been secured it
is well to give the agent but twice or thrice a day, and resort in part to
the alkaline treatment. If the salicylates fail to relieve when pushed
energetically for ten hours, there is reason to fear that the case is not
one of genuine rheumatism.
The salicylates are less applicable to chronic cases and may be
even dangerous when the heart is affected, as they tend to render the
heart’s action slower and weaker, and thus add to the dangers of
hypo-hæmoglobin, and heart failure. A similar caution applies to an
excessive use of alkalies and especially of compounds of potassium
which depress the heart action.
As substitutes for the salicylates, salol, salophen, phenocoll,
antipyrin and acetanilid have been largely resorted to. The first is
safe and trustworthy and does not irritate the stomach nor interfere
with digestion. It may be given to horse or ox in a dose of 3 drams,
thrice a day, to the pig in 10 grain, and to the dog in 5 grain doses.
Hübner had good success with pilocarpine hydrochlorate
hypodermically (4 grains for a 7 months colt,) but this was not
equally successful in the hands of Siedamgrotzky. Other sudorifics
like tartar emetic, Dover’s powder, ammonium acetate, hot or spiced
drinks (chamomile, boneset,) hot baths, hot air baths, and wet packs
have been used successfully and may still be employed in suitable
cases. The opium is often very helpful in relieving intense suffering,
and beside or in place of the Dover’s powder internally, morphia may
be injected subcutem over the affected region. The main objection to
its use is its tendency to lock up the liver and bowels. Liquor of the
acetate of ammonia fills at once the rôle of a potent diaphoretic, an
antacid, and an eliminant.
In the use of baths and packs it is well to consider the condition of
the patient. If the surface is cold with little reaction, and if the attack
has supervened on exposure, or chill, persistent hot applications are
indicated. Dogs and other small animals should have full hot baths
lasting for 15 or 20 minutes, and while in full glow may be quickly
sponged with cold water and rubbed dry in blankets, great care being
taken to avoid exposure or chill when damp. Or for these and the
larger animals as well, a hot air or steam bath may be applied under
similar precautions. A cold wet wrapping on the cranium will tend to
relieve cerebral congestion during the administration of the hot bath.
In horses and cattle surface heat and sudation may be secured by
active rubbing with wisps of straw, of both body and limbs, or by
covering the neck and trunk with large bags containing a small
amount of chaff, sand or grain hot from an oven. Hot carminative or
alcoholic drinks are excellent adjuvants, and even sedatives or
nauseants (opium, veratrum, aconite, tobacco). Another resort is to
pass a hot smoothing iron an indefinite number of times over the
affected region. The part may be finally wrapped in cotton.
In cases where the temperature runs high, on the other hand, and
when the surface glows, this dread of chill and reaction may be
dismissed. For the small animal a bath starting at 70° F. may be
gradually lowered to 60° or 50° F. Or a full pack may be employed, a
sheet wrung out of cold water being closely wrapped around the
body, and covered at all points with two or more dry woolen
blankets, care being taken to avoid the entrance of air and the
occurrence of evaporation from the inner, damp layer. This cools the
surface and the blood returning inwards, and in fifteen or twenty
minutes it should induce free perspiration. It may be kept up twenty
to thirty minutes and may be repeated as often as there is a serious
rise of temperature. A less energetic method is the mere sponging of
the surface with cold water. In all such cases friction is a valuable
accessory.
Anodynes and revulsives are often applied to the affected parts
with good results. In very acute cases (especially articular), lotions
and liniments of salicylic acid or salicylate of soda with laudanum,
aconite, or chloral hydrate may be used. In the less violent cases
camphorated spirit, soap liniment, or a combination of essential oils
(gaultherium, turpentine, cajeput, origanum, peppermint) with aqua
ammonia and sweet oil may secure great relief. Mustard or essential
oil of mustard in vaseline is an excellent alternate. Finally active
cantharidine blisters are usually most effective. These are applied
over the affected joints or muscles and if the inflammation shifts to
other parts it is followed up until it finally disappears. A concurrent
alkaline treatment, and more important still, absolute rest, will serve
to protect the heart to some extent, against a metastasis from the
exterior. It has been supposed that the beneficial action of the blister
is in ratio with the amount of exudate, and hence cantharides has
been highly esteemed in this connection. Friedberger and Fröhner
have used tincture of iodine and biniodide of mercury.
The local application of anti-rheumatic agents would embrace all
the salicylates, oil of wintergreen and guaiacol, the latter mixed with
an equal amount of glycerine. Methyl salicylate has been strongly
recommended for external use.
Stengel covers the surface with lint smeared with salicylate of
methyl ointment, and then applies a plaster bandage over all. This
removes muscular spasm, pain and swelling and is rarely required
for longer than a few days.
In cases in which salicylates fail, other agents have been resorted
to in man and to a lesser extent in the lower animals. Greenhow
strongly advocates a combination of quinine and potassium iodide
internally, while Russell Reynolds has successfully employed tincture
of muriate of iron in large doses repeated every three hours.
In chronic cases these would especially commend themselves as
calculated to repair the general health and overcome the loss of
hæmoglobin. In chronic rheumatism a course of tonics is often the
best resort, and in dogs especially cod liver oil has benefited when all
else had failed. Arsenic too (3 to 8 drops Fowler’s solution thrice
daily) has been beneficial in both dogs and pigs. In other cases iodide
of iron has been helpful. So also with gum guaiacum given in
combination with potassium iodide. In such cases too, treatment by
alkalies and salicylates may be called for, and close attention should
always be given to secure a free action of the liver, bowels and
kidneys. The local treatment recommended for acute rheumatism,
(hot baths, frictions with essential oils and above all blisters of
mustard or cantharides) is even more applicable to the chronic. A
firm bandage over a covering of cotton wool, and a systematic
application of electricity will often help. Warmth, a run at grass in a
sheltered sunny paddock, moderate exercise and a nutritious and
easily digestible diet are important conditions.
 GOUT. PODAGRA. ARTHRITIS URICA.

Definition. Affects birds, dogs, perhaps pigs. Causes: excess of nitrogenous food,
imperfect oxidation, impaired metabolism and elimination. Susceptibility of birds
in confinement. Xanthin bases. Nuclein. Hepatic torpor. Contracted kidney. Affects
tissues of little vascularity. Lesions: chalky deposits around joints, and in internal
organs. Solubility of biurate of soda in synovia, serum, etc. Symptoms: arthritis,
joint tenderness, resting on breast, hard or fluctuating swellings, desquamation,
ulceration, chalky urates. Diagnosis: test for biurate. Treatment: less albuminoid
diet, eliminating salts, colchicum, piperazin, surgical and antiseptic dressing.

Definition. An arthritis characterized by periodical exacerbations,

by the deposit of sodium biurate in and around the joints and at
times in other parts of the body, and by more or less constitutional
febrile disturbance during the paroxysms.
Animals susceptible. Among the lower animals the disease has
been noticed almost exclusively in birds, which even normally
excrete so much uric acid that the liquid may be semi-solid as found
in the cloaca or in the droppings. While this is a constitutional
peculiarity in the bird yet it is enhanced in connection with an
abundant diet of rich nitrogenous materials, as in forced feeding, and
in old animals in which the eliminating action of the kidneys is more
or less impaired. Ebstein has shown that gout can be produced in
birds by tying the ureters. All domesticated birds, chickens, turkeys,
pigeons, ostriches, geese, ducks, Guinea fowl, have been found to
suffer. A case of gout has been reported in a dog, and Pradal has
described it as existing in swine, but the symptoms given are more in
accord with articular rheumatism.
Causes. The causes of gout are overfeeding especially on highly
concentrated nitrogenous food, acid sweets, and in turn sweet and
acid alcoholic drinks, an excess of uric acid in the blood and tissues,
imperfect oxidation of albuminoids, impaired metabolism, imperfect
elimination of uric acid, and impaired innervation. Probably no
single morbid condition is in itself sufficient to induce the disease
but a combination of several, unquestionably operate in many cases.
The uric acid theory is favored by the constant presence of this
acid in considerable amount in the blood of birds, and by Ebstein’s
experiment in tying the ureters, but it has to face the fact that young
and active birds living in the open air, and hunting for their food do
not suffer, that it is usually scanty in the blood of man just before an
attack, that Gilman Thompson failed to produce any symptoms of
gout by injecting into the blood of animals more uric acid than the
amount which they normally excrete in twenty-four hours, that the
familiar symptoms of uric acid poisoning are not at all those of gout,
and that the excess of uric acid in leucæmia, anæmia and pneumonia
produces no such symptoms. In addition to excess of uric acid some
other factor is required.
Xanthin bases (Xanthin, hypoxanthin, etc.) found in the blood by
various observers, are derived from albuminoids, especially nuclein
and nuclein bases, including in man caffein and theine, and being
closely allied to uric acid are believed to have a nearly similar action.
Various forms of abnormal metabolism are invoked as the cause of
uric acid and gout, and Haig and Vaughan hazard the theory that the
breaking down of the nuclein is an important factor. This and other
metabolisms are attributed to the local action of the uric acid and
urates, and again to a fault in innervation. The imperfect action of
the liver where the uric acid should be largely resolved into the more
soluble urea, and of the kidneys through which it should be promptly
excreted must be attributed to a nervous source. Levison
incriminates the granular, contracted, inactive kidneys.
Ebstein attaches great importance to impaired nutrition in the
affected tissues which undergo necrotic changes that pave the way
for the deposition of urates in their substance. This is somewhat
sustained by the occurrence of the local deposits in tissues in which
circulation and nutritive changes are slow, and in older animals in
which not only are the osseous tissues more calcic and less vascular,
but the articular lamella has been formed by cretefaction of the bone
and cartilage. Haig suggests that in the old, the joints are less
vascular and less alkaline, and more sensitive to cold. On the other
hand those in the greatest vigor of life are more ravenous, digest