Transcriber’s Note:

New original cover art included with this eBook is granted to the public domain.

TEXT BOOK
OF
VETERINARY MEDICINE

BY

JAMES LAW, F.R.C.V.S.

Director of the New York State Veterinary College Cornell University, Ithaca, N. Y.

VOL. II

DISEASES OF THE DIGESTIVE ORGANS—LIVER—PANCREAS—AND SPLEEN

ITHACA

PUBLISHED BY THE AUTHOR

1900

Copyright by

JAMES LAW

1900

PRESS OF

ANDRUS & CHURCH

ITHACA, N. Y.

VETERINARY MEDICINE.

DISEASES OF THE DIGESTIVE ORGANS.

Second in importance to pulmonary complaints in solipeds; equal in ruminants. Extent of digestive organs and character of food, in carnivora, herbivora, and omnivora. Ruminant’s stomachs. Gastric fermentation. Foreign bodies. Torpor. Unwholesome fodder.

In the horse these maladies are only second in importance to those of the respiratory organs, while in ruminants they are equally frequent and important. The varying susceptibility of the digestive organs to disease in different families and the special proclivity of different parts of these organs may be, in great part, explained by the great variation in the food, by the relative extent of the gastro-intestinal surface, and by the amount of work devolving on the respective viscera.

In carnivora the entire gastro-intestinal surface is little more than half the area of the skin, for their rich animal food does not require a prolonged retention and an elaborate series of intricate processes to insure digestion and absorption. This system of organs is accordingly less liable to disorder in carnivora than in herbivora and omnivora. Add to this that the carnivorous stomach is very capacious relatively to the intestine, that the digestion of the great bulk of the food (nitrogenous elements) is nearly completed in this viscus, and that the contents of this organ are easily and completely discharged by vomiting whenever they prove irritating, and we have ample explanation of the comparative immunity of these animals from digestive disorders.

The herbivora stand at the opposite extreme, the gastro-intestinal surface being over double the area of the skin in the horse, and nearly three times that extent in the ox. The hard, fibrous and comparatively innutritious vegetable food of these animals necessitates its prolonged retention in the alimentary canal in order to the completion of digestion and the absorption of the nutritive constituents. Hence the great liability of the herbivora to diseases of the digestive organs.

Omnivora occupy a place intermediate between these two classes, as regards both the nature of the food and the extent of surface of the alimentary canal, and they are in similar ratio little liable to digestive disorders. They have besides in common with carnivora a great facility in the rejection of irritant matters by vomiting, and in thus protecting themselves against gastric and intestinal disorders.

A fair idea of the area of the intestinal surface may be given by stating the length of the canal relatively to that of the body:—in the dog : : 6 : 1, in the rabbit : : 10 : 1, in the ass and mule : : 11 : 1, in the horse : : 12 : 1, in swine : : 14 : 1, in the ox :: 20 : 1, and in the sheep : : 27 : 1. The calibre of the intestine varies however and with it the capacity. Thus in the relatively shorter intestine of the horse, the capacity is much greater in ratio with the size of the animal than is the relatively much longer intestine of the pig. The ox’s intestine though twice the length of that of the horse has little more than half the capacity.

Among herbivora the monogastric (horse, ass, mule), and polygastric (ruminants) animals manifest varying pathological susceptibility according to the relative development of the different digestive viscera and the habitual character of their food. The horse and other large solipeds have small stomachs (16 qts.) and capacious intestines (196 qts.). Digestion is restricted in the stomach and largely carried on in the spacious bowels. The small stomach requires to be frequently replenished in moderate amount, but, if this is secured, its liability to disease is slight while that of the intestines is very considerable. In the ox the stomachs have a total capacity of 252 qts., while that of the intestines averages 103 qts. In this animal the capacious and hard working stomach is a frequent seat of disorder, while the comparatively small intestines are to a large extent exempt. The small stomach of the horse is easily overloaded and disordered or paralyzed by an unusually full feed of grain when hungry, or one of some specially appetizing fodder, and the case is serious, as relief can rarely be obtained by vomiting. For the same reason fermentation of the gastric contents with evolution of gas and tympany usually proves fatal to the horse since relief by eructation is too often impossible. Cattle are fitted to live in damp localities where the cloven foot prevents sinking and getting bogged, and where they may draw in with the tongue a full mouthful of coarse herbage which they swallow with little mastication or admixture with saliva. This lodges in the first two stomachs, and if, from any cause, rumination is impaired, or suspended, it finds itself in conditions especially favorable to fermentation. The food too, as in the case of frosted roots, wet clover or partially ripened grain, etc., is often charged with ferments (bacteria) in a state of great vital activity, and hence the frequent tympanies of the ox. The ruminant is no less liable than the soliped to overload the stomach, and though the return of food from the first two stomachs to the mouth is a normal process, this is promptly arrested by the supervention of paresis in the overloaded and overdistended organs. This overdistension further tensely stretches and closes the lips of the œsophagean opening. The rapid swallowing of the food, with only one or two strokes of the teeth for each morsel, renders the large ruminant more liable to take in poisons, pins, nails and other injurious bodies, especially when hunger and the blunting of the sense of smell have been brought on by traveling on dusty roads. Again the large ruminants, and especially cows are wont to while away the tedious hours by chewing and unwittingly swallowing pieces of leather, cloth, bones, iron, etc. Once more the third stomach in which the food is compressed and triturated between the multiple folds, is normally comparatively dry, and is liable under dry, fibrous, heating or stimulating aliment, or in case of fever, to dry up in part or in whole, and to derange the whole process of digestion.

All herbivora are liable to disease from unwholesome fodder and the resulting affection may prove epizootic in connection with unfavorable seasons, or more local, from faulty cultivation.

The symptoms vary so much in connection with the seat and nature of the disease that it would be impolitic to attempt to generalize them.

DISEASES OF THE MOUTH.

Relative susceptibility to disease of the mouth: Food; irritants; bits; ropes; speculum; sharp metallic bodies; micro-organisms; functional; nervous.

These are met with in all domestic animals, but are above all common in horses, oxen and pigs, partly because of special susceptibilities and of the nature of the food, but largely by reason of the exposure of this part to mechanical injuries, especially in horses and cattle. Hard bits and the harder hands of cruel and ruthless drivers, nooses of rope tied over the lower jaw and tongue, iron stirrup, clevis, or balling iron used without cover to force the jaws apart, a large drenching horn employed as a lever for the same purpose, an extemporized Yankee bridle rudely applied or used in breaking a colt, the method of curing a balking or jibbing horse by tying a rope to his lower jaw and to a bar extending forward from the pole, pins, needles, thorns and other sharp bodies, and irritants in food or medicine are among the causes of such disorders. Then there are the many irritating microörganismal ferments in food, water, mucus, etc., and irritant and hot medicines and food to account for local inflammations.

FUNCTIONAL DISORDERS.

Among these are the convulsive closure of the jaws in tetanus, the flaccid state of the lips, cheek, and tongue in paralysis, and the pendent state of the lower jaw in paralytic canine madness. See these different subjects.

STRUCTURAL DISEASES.
INFLAMMATION OF THE LIPS, CHEILITIS.

Causes of Cheilitis: Local injuries; poisoned; envenomed; secondary disease. Symptoms: swelling; salivation; difficult prehension; cracks; blisters; ulcers; indurations. Treatment: obviate causes; astringents; antiseptics; derivatives; gravitation; for venoms antacid; antiseptic, Iodine.

Causes. Blows, pricks, wounds and bruises with bits or twitch, and other mechanical and chemical irritants, irritant vegetables, bites of leeches or snakes, stings of insects, etc. It may be a skin disease dependent on disorder of some remote organ, or a local engorgement due to a constitutional state. (See, Urticaria Surfeit, Purpura hæmorrhagica, Variola, Strangles).

Symptoms. Swelling, stiffness, heat and tenderness of the lips, with or without local abrasion, or incised or punctured wound. Food may be entirely refused from inability to take it in with the rigid tender lips, and saliva drivels from the mouth because of their imperfect apposition. Cracks, blisters and raw sores or ulcers may or may not supervene. In old standing cases the lips become indurated and comparatively immobile.

Treatment. Remove the cause whether irritants in food, or drugs, sharp pointed bodies lodged in the tissues, injuries by bit, twitch or otherwise. Local applications have comparatively little effect, being promptly removed by the tongue, yet a lotion of vinegar and honey;—of borax 10 grains and honey or glycerine 1 oz.;—or of alum in a similar medium will often prove useful. A dose of laxative medicine will favor resolution, and if there is great tumefaction, feeding thick gruels from high manger, and tying to a high rack so as to prevent drooping of the head, will favor recovery. In snake bites and stings the local application of aqua ammonia and its administration internally (horse and cow 1 oz., sheep 2 dr. in 20 times its volume of water) should be practiced; or permanganate of potash may be used.

When the heat and tenderness subside, leaving much thickening and induration it may be repeatedly painted with a lotion of one part of tincture of iodine in three parts of glycerine.

CANCROID OF THE LIPS. EPITHELIOMA.

Epithelioma: Animals susceptible; accessory causes; symptoms; lesions. Treatment: Warts and polypi. Actinomycosis: Wounds; abrasions; infection atria. Symptoms; treatment. Trombidiosis: infected regions; not compulsory parasite; European and American trombidia; distinct from chigoe. Symptoms. Treatment.

This has been observed in the cat and the horse, commencing at the angle of the mouth and doubtless partially determined in the latter animal by the irritation of the bit.

It is characterized by thickening of the tissues of the lips, in the form of small irregularly rounded masses, and tending to the formation of a spreading ulcer. The thickened tissues are invaded, pushed aside and infiltrated by epithelial or epithelioid cells, which, no longer confined to the surface as in the natural state, grow in the interior of the tissues and destroy them.

Treatment. The disease has little tendency to cause secondary deposits in other organs and may often be arrested by local measures. In its earliest stages it may be arrested by the thorough removal of the diseased structures with the knife, the resulting deformity being obviated by bringing the raw edges together by suture, so as to secure their adhesion, or the actual cautery may be used. The tendency to irritation from putrefaction products escaping from the mouth may be counteracted by occasional sponging with a weak lotion of carbolic acid (1 part to 50 of water) or an ointment of one part of very finely powdered boracic acid to two parts of simple ointment.

Leblanc has repeatedly succeeded in these cases by the use of chlorate of potash, locally and generally. The local application may be a solution of two drachms in four ounces of water, while the dose of the powder for the horse is 2 to 4 drachms daily.

Warts and Polypi. These are common on the outer and even the inner side of the lips, especially in dogs. They are easily removed by the scissors, after which their roots should be thoroughly cauterized with a pointed stick of lunar caustic or chloride of zinc.

ACTINOMYCOSIS OF THE LIPS.

In the rich river bottom lands of northern Germany and Russia where actinomyces abound actinomycosis is common in the form of papillæ of greater or lesser size on the lips and nose of horse and ox. The abrasion of these parts by thorns, thistles, stubble, dry fibrous fodders and other irritants, appears to produce a raw surface for the colonization of the germ, which is not slow to avail of the opportunity. The resulting lesions take the appearance of warty looking elevations, more or less indurated, which on section show the sulphur yellow actinomyces tufts of club-shaped cells converging to a central mycelial mass.

Treatment is simple as the disease is at first essentially local, and is easily checked by the local application of iodine. The wartlike elevations may be shaved off with a razor or cut off with sharp scissors and the surface painted once or twice daily with tincture of iodine. If there is suspicion of distant or deepseated actinomycosis the internal treatment with potassium iodide will be in order.

TROMBIDIOSIS OF THE NOSE AND LIPS. HARVEST ITCH.

In different parts of Europe and America, and especially in the warmer regions, or in sheltered gardens, shrubberies, and pastures, different species of the trombidium abound, and the young hexapod larvæ attack man and beast, burrowing under the cuticle and giving rise to extreme itching and persistent and irritating rubbing of the affected part. These parasites belong to the family of acari or mites, so that the condition they produce is one of acariasis or mange, only the offender is not a compulsory parasite, but appears to survive in certain soils and in the vegetation independently of animal hosts. Their parasitism is therefore accidental and non-essential to their survival.

The trombidian parasite usually found in Europe is the Trombidium Holosericeum or silky trombidium, so small (in its larval state) that it is just visible to the naked eye as a bright scarlet point when moving on a dark background. It was formerly called Leptus Autumnalis and is familiarly known as the red beast, bete rouge, harvest bug, etc. The common American species is of a dull brick red, so that it is less easily detected even on a dark background. It is familiarly known as the jigger, though quite distinct from the chigoe or burrowing flea of the West Indies.

The domestic herbivora get these parasites on the nose and lips while browsing on the pastures and contract an intolerable itching which may lead to violent rubbing, abrasions and scabby exudations. The skin becomes thickened, scabby and rigid, and as new accessions are constantly received the malady continues until cold weather sets in. The affection is not in any sense dangerous, and the attacks may be warded off by a daily application of one of the common parasiticides—decoction of tobacco, tar water, solution of creolin, naphthalin, etc. The mere seclusion of the infested animal indoors, without green food, will cure, as the larvæ pass through their parasitic stage in a few days and drop off.

GENERAL CATARRHAL STOMATITIS. BUCCAL INFLAMMATION.

Mature animals most subject: Causes in horse, mechanical, chemical, microbian irritants—alkalies, acids, caustics, hot mashes, ferments, fungi, rank grasses, excess of chlorophyll, clover, alfalfa, acrid vegetables, bacterial infection secondary, acrid insects in food; symptomatic of gastritis, pharyngitis, diseased teeth, specific fevers. Symptoms: Congestion and tumefaction of buccal mucosa, lips and salivary glands; Epithelial desquamation; fœtor; salivation; froth; papules; vesicles. Prognosis. Treatment: Cool soft food; antiseptics; wet applications to skin; derivatives.

This is much more common in the adult than in suckling domestic animals. None of the domestic mammals or birds can be considered immune from it, but as its causes and manifestations differ somewhat it seems well to consider it separately in the different genera.

GENERAL CATARRHAL STOMATITIS IN SOLIPEDS.

Causes. These may be classed as mechanical, chemical, microbian and other irritants. In the horse it is often due to the reckless administration of irritant liquids as remedies. Owing to the length of the soft palate the horse can refuse to swallow any liquid as long as he chooses, and some of the worst cases of stomatitis I have seen resulted from the retention in the mouth of caustic alkaline liquids given under the name of “weak lye.” Strong acids and caustic salts dissolved in too little water or other excipient, or suspended in liquids in which they cannot dissolve, or made into boluses which are crushed between the teeth are not infrequent conditions. Too hot mashes given to a hungry horse is another cause of this trouble. Fermented or decomposed food is often most irritating. Coachmen will sometimes induce it by attaching to the bit bags of spicy or irritant agents, to cause frothing and make the animal appear spirited.

Fungi in fodders are among the common causes. The rust of wheat (puccinia graminis), the caries of wheat (tilletia caries), the blight (erysiphe communis), ergot (claviceps purpurea), the fungus of rape (polydesmus excitiosus) and the moulds (penicillium and puccinia) have all been noticed to coincide with stomatitis, and charged with producing it. On the other hand, at given times, one or other of these cryptogams has been present extensively in the fodder without any visible resultant stomatitis. The apparent paradox may be explained by the fact that these fungi vary greatly in the irritant or harmless nature of their products according to the conditions under which they have grown, and the stage of their development at which they were secured and preserved. Ergot notoriously differs in strength in different years, on different soils, under various degrees of sunshine, shade, cloud, fog, etc. In different States in the Mississippi valley it is not uncommon to find stomatitis in horses in winter, fed on ergoted hay, while cattle devouring the same fodder have dry gangrene of feet, tail and ears. Yet in other seasons the ergot fails to produce these lesions. Rank grown, watery vegetation, especially if it contains an excess of chlorophyll is liable to cause stomatitis. Red and white clover, trefoil, hybrid and purple clover, and alfalfa have all acted more or less in this way, though in many cases, the food has become musty or attacked by bacterial ferments. Some of the strongly aromatic plants, and those containing acrid principles (cicuta virosa, œnanthe crocata, mustard, etc.) cause buccal inflammation and salivation.

The irritation in many such cases is not due to one agent only, the vegetable or other irritant may be the starting point, acting but as a temporary irritant, the action of which is supplemented and aggravated by the subsequent attacks of bacterial ferments on the inflamed, weakened or abraded tissues. The bacteria present in the mouth, food or water would have had no effect whatever upon the healthy mucosa, while they make serious inroads on the diseased. On the other hand the vegetable, mechanical or chemical irritant would have had but a transient effect, but for the supplementary action of the bacteria.

In horses that have the bad habit of retaining masses of half masticated food in the cheeks the growth of cryptogams is greatly enhanced and such food often becomes violently irritating.

Among other mechanical causes may be named pointed or barbed hairs or spines (barley awns, spikes, thorns, etc.) which, lodging in a gland orifice, or in a wound of the gum or mucosa, form a source of irritation or a centre for bacterial growth and abscess.

Again, irritants of animal origin must be named. These are not taken by choice, but when lodged in fodder, or in the pastures they are taken in inadvertently with the food. In this way poisonous insects, and especially hairy caterpillars, cantharides, potato bugs, etc., gain access to the mouth.

It must not be overlooked that stomatitis occurs as an extension, sympathetic affection or sequel of diseases of other organs. Gastritis is usually attended by redness and congestive tenderness of the tongue, especially of the tip and margins, and other parts of the buccal mucosa, notably the palate just back of the incisors, are often involved. In other cases it appears as a complication of pharyngitis, laryngitis, of affections of the lower air passages, of the teeth and periodontal membrane or of the salivary glands.

It appears also in a specific form in certain fevers, as in horsepox, pustulous stomatitis, aphthous fever and even in strangles. Mercurial stomatitis, rarely seen at the present time, is one of the worst forms of the disease, and like the infectious forms will be treated separately.

Lesions and Symptoms. At the outset and in the slighter forms of congestion there is merely heat and dryness of the buccal mucosa. Redness may show on the thinner and more delicate portions of the membrane, as under the tongue, on the frænum, and on the sublingual crest. But elsewhere it is hidden by the thickness of the epithelium, and the manifestations are merely those of suppressed secretion with local hyperthermia.

As the congestion is increased there is seen, even at this early stage, a slight thickening or tumefaction of the mucosa, especially on the gums, lips, the sublingual area, the orifices of the salivary glands, and the palate back of the upper incisors. On the dorsum of the tongue, the cheeks and lips, generally the lack of loose connective tissue tends to prevent the swelling.

With the advance of the inflammation the redness of the mucosa extends, at first in points and circumscribed patches, and later over the entire surface. The epithelium drying and degenerating in its surface layers forms with the mucus a sticky gummy film on the surface, which, mingling with decomposing alimentary matters gives out a heavy, offensive or even fœtid odor.

The different parts of the mouth are now tender to the touch, and this, with the fœtor and even bitterness of the bacterial products combine with the general systemic disturbance in impairing or abolishing appetite. In any case mastication becomes slow and infrequent, and morsels of food are the more likely to be retained, to aggravate the local condition by their decomposition.

The dry stage is followed by the period of hypersecretion, and in this the salivary glands take a prominent part, so that ptyalism (slobbering) becomes the most marked feature of the disease. The saliva mixed with the increasing secretion of mucus and the abundance of proliferating and shedding epithelium, escapes from the lips and falls in stringy masses in the manger and front of the stall. When there is much motion of the jaws and tongue it accumulates as a froth around the lips.

A careful examination of the mucosa will sometimes detect slight conical elevations with red areolæ, representing the tumefied orifices of the obstructed mucous follicles, and later these may show as minute erosions. Even vesicles have been noticed (Weber, Dieckerhoff, Kosters), but when these are present one should carefully exclude the specific stomatites such as horsepox, contagious pustular stomatitis, aphthous fever, etc.

Erosions of the mucosa and desquamation of the epithelium have been noticed in horses fed on purple (hybrid) clover, buckwheat or ergot, and in some of these cases the inflammation has extended (in white faces especially) to the skin of the face, the mucosa of the nose, and the adjacent glands, and as complications icterus, constipation, colics, polyuria, albuminuria and paresis of the hind limbs have been observed. These latter are common symptoms of cryptogamic poisoning.

Prognosis. In uncomplicated cases the disease is not a grave one, lasting only during the continued application of the local irritant, and recovering more or less speedily when that has been removed. Complications are dangerous only when due to some specific disease poison (glanders, actinomycosis, strangles, etc.), and even poisoning by the usual cryptogams of leafy or musty plants is rarely persistent in its effects.

Treatment. This resolves itself into the removal of the irritant cause and the soothing of the irritation. When the cause has been definitely ascertained the first step is easy.

In the direction of soothing treatment, a careful selection of diet stands first. Fibrous hay and even hard oats, barley or corn may have to be withheld, and green food, or better still, bran mashes, gruels, pulped roots or fruits allowed. Scalded hay or oats, ensilage, sliced roots, or ground feed may often be taken readily when the same aliments in their natural condition would be rejected or eaten sparingly.

Medicinal treatment may often be given in the drinking water which should always be allowed in abundance, pure and clean. In the way of medication chlorate of potash, not to exceed one-half to one ounce per day according to the size of the animal, may be added, together with an antiseptic (carbolic acid, borax, permanganate of potash, common salt, naphthol, creolin, hyposulphite of soda). In case of severe swelling, a cap made to fit the head with strips wet in alum and vinegar or other astringent solution maintained against the intermaxillary space may be desirable. Support for the tongue may be necessary as mentioned under glossitis.

In case of complications on the side of the bowels, liver or kidneys, laxatives, diuretics and antiseptic agents may be called for.

GENERAL CATARRHAL STOMATITIS IN CATTLE.

Dense resistant mucosa protective: Affection usually circumscribed. Action of violent irritants, and toxins of specific fevers. Mechanical irritants. Symptoms: Salivation; congestion; eruptions; erosions; ergot; acrid vegetables; caustics. Treatment: Astringents; antiseptics; refrigerants; derivatives; tonics. Removal of foreign bodies. Lesions and symptoms in sheep.

The mouth of the ox as Cadeae well says has a cuticular epithelium too thick and resistant to be easily attacked by microbes. It follows that infected inflammations are far more frequently circumscribed than in the thinner and softer buccal mucosa of the horse. The more general buccal inflammations come more particularly from the use of food that is too hot or that contains strongly irritant agents. The thickness of the buccal epithelium however, is no barrier to the local action of poisons operating from within as in rinderpest, or aphthous fever, or in malignant catarrh, nor is it an insuperable barrier to the local planting of the germs of cow pox, anthrax, actinomycosis, or cryptogamic aphtha (muguet). The wounds inflicted by fibrous food make infection atria for such germs, hence the great liability to such local inflammations, in winter when the animals are on dry feeding. For the same reason, perhaps, the prominent portions of the buccal mucosa,—the papillæ—are sometimes irritated themselves while serving as protectors for the general mucous surface, and hence they become specially involved in inflammation, which constituted the “barbs” of the old farriers. Utz records a buccal inflammation occurring in herds fed on green trefoil, first cutting, showing that even in cattle this agent may determine a general stomatitis.

Symptoms. These do not differ from those of the horse, and resemble, though often in a milder form, the buccal manifestations of aphthous fever. There is the difficulty of mastication and indisposition to take in fibrous aliment, the drivelling of saliva from the mouth, or its accumulation in froth around the lips, the frequent movement of the tongue and jaws, and the congestive redness, papular eruption, vesication, or even erosion of the affected mucous membrane. It is always necessary to guard against confounding the simple stomatitis, and the slighter infected inflammations, from the more violent infections above referred to. The special diagnostic symptoms must be found under the respective headings. The aphthous fever is not to be expected in American herds, but the stomatitis which is associated with ergot in the food is met more particularly in winter and spring, and must not be confounded with the specific disease, on the one hand nor with the simpler forms of buccal inflammation on the other. In the case of ergoted fodder the signs of ergotism in other situations will be found, in the affected animals, such for example as necrotic sloughs and sores around the top of the hoof, sloughing of the hoof or of one or more digits, or of the metatarsus, of the tip of the tail or ear; abortions, convulsions, delirium, lethargy or paralysis. If not seen in the same animals some of these forms may be observed in other members of the herd. Then the buccal lesions are in themselves characteristic: soft, whitish, raised patches of the epithelium (rarely blisters) are followed by desquamation and exposure of the red, vascular surface beneath, and this tends to persist if the ergoted fodder is persisted in.

Treatment. Simple stomatitis of the ox generally tends to spontaneous and early recovery. The simplest astringent and antiseptic treatment is usually sufficient to bring about a healthy action. Borax given in the drinking water, not to exceed four ounces per day, or the same amount mixed with syrup or honey and smeared occasionally on the tongue, or hyposulphite or sulphite of soda, or weak solutions of carbolic acid will usually suffice, after the irritant cause has been removed. Vinegar, or highly diluted mineral acids may be used but are somewhat hurtful to the teeth. Decoctions of blackberry bark or solutions of other vegetable astringents may be used as alternatives. When there is evidence of irritant matters in the stomach or bowels, a saline laxative will be advisable to be followed by vegetable bitters or other tonics. Thorns and other foreign bodies imbedded in the tongue or other part of the mouth must be discovered and removed.

CATARRHAL STOMATITIS IN SHEEP.

The more delicate buccal mucosa in these animals would render them more subject to inflammations, but this is more than counterbalanced by the mode of prehension of aliments, not by the tongue, but by the delicately sensitive lips, and further by the daintiness and care with which these animals select their food. The treatment would not differ materially from that prescribed for the ox.

GENERAL CATARRHAL STOMATITIS IN DOGS.

Causes: burns; spiced food; bones; sepsis; ferments; pin caterpillar; dental and gastric troubles. Symptoms: careful prehension and mastication; congestion; swelling; eruption; erosion; furred tongue; stringy salivation; fœtor; swelling of lips, cheeks, intermaxillary space, and pharynx. Treatment: demulcent foods; antiseptics; derivatives; tonics; care of teeth and gums.

Causes. Hot food is a common cause in hungry dogs. Spiced food in house dogs fed scraps from the table tend to congestion of mouth and stomach alike. Irritation through wounds with bones, especially in old dogs with failing teeth, and in exceptional cases the impaction of a bone between the right and left upper molars are additional causes. Putrid meat must also be recognized as a factor, the septic microbes seizing upon the wounds and spreading from this as an infecting centre. Lactic acid and other irritant products developed through fermentation of particles of food retained about the gums and cheeks soften the epithelium and irritate the sub-epithelial tissue, causing congestion. Megnin draws attention to the fact that the pin caterpillar (bombyx pinivora) found on the stalks of couch grass (Triticum repeus) produces buccal irritation when chewed and swallowed to induce vomiting. As in other animals more or less buccal congestion attends on gastric congestion and inflammation. Dental troubles are often sufficient causes.

Symptoms. The animal becomes dainty with regard to his food, picking up the smaller or softer pieces and rejecting the larger or harder. Mastication is painful and selection is made of moist or soft articles which can be swallowed without chewing or insalivation. The mouth is red and hot, and at times the mucous membrane eroded, or blistered, the lesions concentrating especially on the gums and around the borders of the tongue. The dorsum of the tongue is furred, whitish, yellowish or brownish. Saliva collects in the mouth and escapes in filmy strings from its commissures, and the odor of the mouth becomes increasingly foul. Swelling of the lips, cheeks or intermaxillary space marks the worst cases.

Treatment. Withdraw all irritant and offensive aliments. Give soups, mushes, scraped or pounded lean meat in small quantities, washing out the mouth after each meal with a 20 per cent. solution of permanganate of potash or borax or a two per cent. solution of carbolic acid. Cadeac advises against chlorate of potash on account of its known tendency to bring about hæmoglobinæmia in dogs. A laxative and bitters may be called for in case of gastritis or indigestion, and any morbid condition of the teeth must be attended to. Decayed teeth may be removed. Tartar especially must be cleaned off by the aid of a small wooden or even a steel spud and a hard brush with chalk will be useful. A weak solution of hydrochloric acid is usually employed to loosen the tartar, but this is injurious to the structure of the teeth and had best be avoided if possible. Tincture of myrrh is especially valuable both as a gum-tonic and as a deodorant and antiseptic. This may be rubbed on the irritated gums as often as the mouth is washed.

GENERAL CATARRHAL STOMATITIS IN SWINE.

Causes: Irritants; ferments; noose on jaw; specific poisons. Symptoms: Careful feeding; thirst; frothy lips; champ jaws; redness; swelling; fœtor. Treatment: Cooling, astringent, antiseptic lotions; mushy food; derivative; tonics.

Causes. Swine suffer from simple stomatitis when exposed to thermal, mechanical or chemical irritants. Food that is too hot, or that which is hard and fibrous, or that which contains spikes and awns, capable of entering and irritating gland ducts or sores, or food which is fermented or putrid, food or medicine of an irritant character. The habit of catching and holding swine with a running noose over the upper jaw, and the forcing of the jaws apart with a piece of wood in search of the cysticercus cellulosa are further causes. In several specific infectious diseases inflammation of the mucous membrane with eruption or erosion is not uncommon. Thus aphthous fever is marked by vesicular eruption, muguet by epithelial proliferation and desquamation, hog cholera and swine plague by circumscribed spots of necrosis and erosion. Patches of false membrane are not unknown, and local anthrax, tubercle and actinomycosis are to be met with. Inflammation may start from decaying teeth.

Symptoms are like as in other animals, refusal of food, or a disposition to eat sparingly, to select soft or liquid aliments, to swallow hard materials half chewed or to drop them, to champ the jaws, and to seek cold water. Accumulation of froth around the lips is often seen, and the mouth is red, angry, dry, and hot, and exhales a bad odor.

Treatment does not differ materially from that adopted in other animals. Cooling, astringent, antiseptic lotions, honey and vinegar, and in case of spongy or eroded mucosa, tincture of myrrh daily or oftener. Soft feeding, gruels, pulped roots, or well kept ensilage may be used, and clean, cool water should be constantly within reach. In case of overloaded stomach or indigestion a laxative followed by bitter tonics will be in order.

CATARRHAL STOMATITIS OF BIRDS. PIP.

Causes: hurried breathing; local irritants; exposure; filthy roost. Symptoms: gaping; roupy cry; epithelial pellicle on tongue, larnyx. or angle of the bill. Treatment: pick off pellicle; smear it often with glycerized antiseptic. Remove accessory and exciting causes.

This form of inflammation of the tongue of birds is characterized by the increased production and desiccation of the epithelium so that it takes on a horny appearance. According to Cadeac it may accompany various inflammatory affections of the air passages, which cause hurried breathing with persistently open bill, and thus entail evaporation of the moisture. More commonly it has its primary cause in local inflammation of the surface in connection with damp, cold, draughty hen-roosts, and above all, the accumulation of decomposing manure and the exhalation of impure gas. Even in such cases the abnormal breathing with the bill open is an accessory cause of the affection.

Symptoms. The breathing with open bill should lead to examination of the tongue, but above all if at intervals the bird with a sudden jerk of the head emits a loud shrill, raucous sound, which reminds one of the cough of croup. The tip and sides of the tongue are found to be the seat of a hard, dry, and closely adherent epithelial pellicle, which suggests a false membrane.

Treatment. The common recourse is to pick or scrape off the indurated epithelial mass, leaving a raw, bleeding surface exposed. This is then treated with a solution of borax, or chlorate of potash. Cadeac deprecates this treatment as useless and dangerous, and advises the disintegration of the dry epithelial mass with a needle taking care not to prick nor scratch the subjacent sensitive tissue, and to wash with a 5 per cent. solution of chlorate of potash. A still more humane and effective method is to make a solution of hyposulphite of soda in glycerine and brush over the affected surface at frequent intervals. This may be conveniently applied through the drinking water.

In case of implication of the lower air passages or lungs, the treatment must be directed to them, and soft, warm, sloppy food and the inhalation of water vapor will prove of great advantage. Secure clean, sweet, dry pens, pure air, and sunshine. (See pseudo membranous enteritis.)

LOCAL STOMATITIS.

Division of circumscribed buccal inflammations: palatitis; gnathitis gingivitis; glossitis. Causes: injuries; acrid; venomous or caustic agents; diseased teeth; foreign bodies in gland ducts; malformed jaws; infections, etc. Symptoms: salivation; difficult prehension and mastication; dropping half masticated morsels; distinctive indications of different caustics; abrasion; abscess; slough; infective disease lesions. Treatment: for palatitis, massage by hard corn ears, scarification, laxatives; for gnathitis, care for teeth and ducts, astringent washes, eliminate mercury; for glossitis, remove cause, use antidote to venom, or to chemical irritant, astringent, antiseptic lotions or electuaries, evacuate abscess, soft, cool diet, elevate the head, suspend the tongue.

Localized inflammations in the buccal cavity are named according to the portion of the lining membrane attacked;—palatitis if seated in the roof of the mouth; gnathitis if restricted to the cheeks; gingivitis if to the gums; and glossitis if to the tongue.

Palatitis. Lampas. Congestion of the hard palate behind the upper front teeth. This is usually seen in young horses during the period of shedding the teeth and is caused by the irritation and vascularity consequent on teething. The red and tender membrane projects beyond the level of the wearing surfaces of the upper incisors, and may materially interfere with the taking in of food. A common practice in such cases is to feed unshelled Indian corn, the nibbling of which seems to improve the circulation in the periodontal membrane and by sympathy in the adjacent palate. Superficial incisions with the lancet or knife will usually relieve, and may be followed by mild astringent lotions if necessary. If apparently associated with costiveness or gastric or intestinal irritation a dose of physic will be demanded. Nothing can excuse the inhuman and useless practice of burning the parts with a hot iron.

Gnathitis. Inflammation of the Cheeks. Usually resulting as a distinct affection from irregular or overgrown teeth, or the entrance of vegetable spikes into the gland ducts, these cause local swelling and tenderness, slow imperfect mastication, dropping of food half chewed, accumulation of food between the cheeks and teeth, thickening, induration and sloughing of the mucous membrane with excessive fœtor.

Treatment. Consists in correcting the state of the teeth and ducts and using one of the washes recommended for glossitis.

Gingivitis. Inflammation of the gums. This is either connected with the eruption of the teeth in young animals and to be corrected by lancing the swollen gums and giving attention to the diet and bowels; or it is due to scissor-teeth or to the wear of the teeth down to the gums in old horses; or it is dependent on diseased teeth, or mercurial poisoning, under which subjects it will be more conveniently considered. Barley awns or other irritants must be extracted.

Glossitis, Inflammation of the Tongue. Causes. Mostly the result of violence with bits, ropes, etc., with the teeth, or with the hand in giving medicine; of scalding food, of acrid plants in the food: of irritant drugs (ammonia, turpentine, croton, lye, etc.), or of sharp, pointed bodies (needles, pins, thorns, barley and other barbs, etc.) which perforate the organ. In exceptional cases leech and snake bites are met with especially in cattle, owing to the tongue being exposed when taking in food. Local infections and those of the specific forms, determine and maintain glossitis.

Symptoms: Free flow of saliva, difficulty in taking in food or drinking, and red, swollen, tender state of the tongue, which in bad cases hangs from between the lips. The mucous membrane may be white, (from muriatic acid, alkalies, etc.), black, (from oil of vitriol, lunar caustic, etc.), yellow, (from nitric acid, etc.), or of other colors according to the nature of the irritant. It may be raised in blisters, may present red, angry sores where the epithelium has dropped off; may become firm and indurated from excessive exudation; may swell and fluctuate at a given point from the formation of an abscess; or may become gangrenous in part and drop off. Breathing is difficult and noisy from pressure on the soft palate. There is usually little fever and death is rare unless there is general septic infection.

Treatment will depend on the cause of injury. In all cases seek for foreign bodies imbedded in the organ and remove them. If snake bites are observed use ammonia or potassium permanganate locally and generally, or cholesterin as a local application. If the irritation has resulted from mineral acids, wash out with calcined magnesia lime water, or bicarbonate of soda or potash. If from alkalies (lye) use weak vinegar. If from caustic salts employ white of egg, vegetable-gluten, boiled linseed, slippery elm, or other compound of albumen or sheathing agent. In ordinary cases use cold astringent lotions, such as vinegar and water; vinegar and honey; borax, boric or carbolic acid, chlorate of potash, alum or tannin and honey. Poultices applied around the throat and beneath the lower jaw are often of great value. The bowels may be relieved if necessary by injections, as it is usually difficult to give anything by the mouth. If ulcers form touch them daily with a stick of lunar caustic or with a fine brush dipped in a solution of ten grains of that agent in an ounce of distilled water. For sloughs use a lotion of permanganate of potash, one drachm to one pint of water, or one of carbolic acid, one part to fifty of water. If an abscess forms give a free exit to the pus with the lancet, and afterward support the system by soft nourishing diet, and use disinfectants locally. As in all cases of stomatitis, the food must be cold gruels or mashes, or finely sliced roots will often be relished.

The mechanical expedient of supporting the tongue in a bag is essential in all bad cases, as if allowed to hang pendulous from the mouth inflammation and swelling are dangerously aggravated.

APHTHOUS STOMATITIS. FOLLICULAR STOMATITIS.

Causes: in horse, ox, dog; rough, fibrous food, blistering ointments, bacteria. Symptoms: general stomatitis, and special; papules with grayish centres and red areolæ, vesiculation, ulceration. Treatment: Astringent, antiseptic, derivative, tonic, stimulant.

This is a rare affection in ruminants where the thickness of the epithelial covering appears to be a barrier to infection or injury, while it is common in the more delicate and sensitive buccal mucosa of the horse and dog. In the horse the ingestion of irritant plants with the food and the penetration of vegetable barbs into the mucous follicles may be charged with causing the disease, while in both horse and dog the licking of blistering ointments and the local action of fungi and bacteria are factors in different cases.

Symptoms. With the ordinary symptoms of stomatitis, there appear minute firm, whitish, circular elevations representing the openings of the inflamed mucous or salivary follicles, having a reddish areola, and grayish white vesicular centre. They may amount to a line or more in diameter, and on bursting leave red cores or ulcers. The whole mouth may be affected or the disease may be confined to the lips, gums or tongue.

Treatment. Beside the general astringent washes, this affection is greatly benefited by the local use of antiseptics, as sulphite or hyposulphite of soda, 2 drachms in a quart of water. Borax, permanganate of potash, carbolic acid or other antiseptic in suitable solution may be substituted. Saline laxatives are often useful to remove sources of irritation in stomach and intestines, and iron salts (chloride or nitrate) in full and frequently repeated doses may be given internally. Ulcers may be cauterized and soft food and pure water given from an elevated manger.

ULCERATIVE STOMATITIS. GANGRENOUS STOMATITIS.

Causes: specific disease poisons; debility; rachitis; cancer; chronic suppuration; irritation—mechanical, chemical, thermic, venomous, etc. Symptoms: difficult, imperfect prehension and mastication, salivation, bleeding, swollen, puffy epithelium, blisters, extending erosions, deep or spreading. Duration. Treatment: correct constitutional fault, tonics, soft, digestible food, antiseptics, mild caustics.

This is characterized by the formation of necrotic spots and patches of the buccal epithelium, with desquamation, and the formation of more or less rodent ulcers of the sub-epithelial mucosa. Like other ulcerative processes it is usually due to microbic invasion, and in this way it may supervene on other and simpler forms of stomatitis. It also varies in its manifestations and nature according to the genus of animal, and the specific microbe present.

ULCERATIVE STOMATITIS IN SOLIPEDS.

Causes. Apart from the ulcerations and erosions of specific diseases (glanders, horsepox, pustulous stomatitis, aphthous fever, etc.,) this condition is especially liable to appear in anæmic and debilitated subjects (Cauvet), as in rachitis (Friedberger and Fröhner), cancer (Cadeac) chronic internal abscess (Cadeac), etc. As an exciting cause and as a means of furnishing an infection atrium for the microbes of ulceration all conditions of simple lesion of the mucous membrane—mechanical, chemical, thermic, venomous, etc., are operative. Dieckerhoff has described it in connection with diphtheritic rhinitis, Friedberger with a nasal and conjunctival catarrh, Zeilinger and Kohler with aphthous fever, Mobius and Hackbarth with trefoil poisoning.

Lesions and Symptoms. There is the usual dainty feeding and disposition to masticate imperfectly or even to drop the partly insalivated morsels, working of the lips, the formation of froth on their margins, and the drivelling of saliva in long strings or filaments. As the disease advances this becomes bloody and fœtid. The local lesions may be at first like white pulpy spots of softened and degenerating epithelium, which is exceptionally, raised in blisters. This is followed by desquamation and the formation of open sores which are indolent, and show a disposition to further erosion and extension. They may be rounded or irregularly indented in their borders, and contain a brownish, blackish or greenish viscid debris. They vary widely, however, in general appearance and in their disposition to speedy or sluggish healing, being apparently influenced by the nature of the pathogenic microbe and the susceptibility of the subject. In some cases the molecular degeneration extends deeply into the mucosa, and even over the edges of the lips into the adjacent skin. Recovery and complete cicatrization may take place in one week, or successive outbreaks may take place in the same animal lasting in all for months as in Cadeac’s case associated with chronic abscess of the mesentery.

Treatment. The first consideration is to correct the debility on which the affection is based. Iron and bitter tonics, mineral acids, and nourishing food given in the form of soft mashes, pulped roots, or farinas, which will require little mastication, and the antiseptic cleansing of the mouth after each meal are the main features of the treatment. As antiseptics, vinegar is inimical to the microbes of the mouth, which affect alkaline media, borax, boric acid, carbolic acid, sulphurous acid, the sulphites and hyposulphites, permanganate of potash, chlorate of potash, creolin, and sulphate or chloride of iron furnish a sufficient choice of comparatively nontoxic agents. Ulcers may be touched with tincture of iodine, lunar caustic, or sulphate of copper.

ULCERATIVE STOMATITIS (DIPHTHERIA) IN CALVES.

Accessory causes. Infection. Experimental inoculation. Bacillus, grows on blood serum. Lesions in mouth, nose, air passages, intestines, digits. Symptoms: difficult sucking, fever, swollen, whitish spots on buccal mucosa, phagadenic sores, fœtor, symptoms of extending disease, anorexia, debility, prostration. Duration. Diagnosis from foot and mouth disease, from actinomycosis, from tuberculosis. Prevention: cleanliness, antisepsis, segregation, diet of dam, sterilized milk. Treatment: antiseptic and eliminating: locally antiseptic.

This has been observed at frequent intervals in calves, as a serious, fatal, communicable disorder occurring in the first few weeks of life.

Causes. It has been attributed to unhygienic conditions of the dams, close, damp, impure stables, unwholesome or spoiled food, and privations of various kinds, and these, in all probability, increase the susceptibility. The congestion and traumatism connected with the cutting of the teeth is another predisposing cause. The ultimate cause is, however, the contagious element and the disease has been conveyed to healthy lambs by the introduction into their mouths of the necrotic products from the diseased subjects (Dammann). Sheep inoculated in the conjunctiva presented violent conjunctivitis in forty-eight hours. Inoculated rabbits died of septicæmia. Mice showed the same symptoms as calves, while guinea pigs showed an abscess only at the seat of inoculation (Löffler).

The identity of the germ has not been fully demonstrated. Dammann found a micrococcus, but testimony from the inoculation of its pure cultures is wanting, and the buccal mucosa of the sucking calf is full of varied germs some of which are irritating and pathogenic to an injured mucosa.

Löffler found in the epithelial concretions (false membranes) of the mouth and intestines, a bacillus of half the thickness of the bacillus of malignant œdema, five times as long as broad and usually connected with its fellows to form filaments. He failed to obtain cultures of this in nutrient gelatine, but grew it successfully in blood serum from a calf. Transferred to fresh serum the culture failed. The pure culture does not seem to have been tried on the calf.

According to Dammann the lesions occur indiscriminately in the mouth, the nose, the larynx, trachea, lungs, the intestinal canal and the interdigital space.

It has been suggested that the mouth of the calf rendered susceptible by the congestion caused by suction, is infected by licking the previously infected umbilicus.

Symptoms. There are the usual symptoms of indisposition to suck, salivation, redness of the buccal mucosa, and general indisposition. In two or three days the mucosa shows raised, pulpy, white or grayish patches about a line in diameter. These gradually soften and break down and in four or five days leave dark red angry sores one-sixth to one-third inch in diameter dotted with grayish points and surrounded by a congested areola. These exhale an offensive odor and tend to extend in superficial area and in depth, invading indiscriminately the various subjacent tissues. The lips may be perforated, the muscles, cartilages, periosteum, and periodontal membrane invaded, the teeth may be shed, and the alveoli filled with the offensive debris of ulceration. Swelling of the throat may follow from implication of the pharynx and its lymph glands, symptoms of laryngitis, bronchitis, and pneumonia may succeed, also infective gastritis and enteritis. These various parts may be infected by the direct transference of the infecting saliva, but the germ is also held to be transmitted through the blood to implicate distant organs.

Appetite is gradually lost, a blackish, fœtid diarrhœa, sets in and the calf is sunk in a profound prostration and debility due partly to the enforced abstinence and colliquative diarrhœa, but much more to the absorption of toxic matters. Death may ensue from the sixth to the twelfth day. In case of recovery a month may be requisite for the completion of convalescence.

Diagnosis. This has to be distinguished especially from aphthous fever by the absence of the large, and clearly defined vesicles of that disease, by the fact that the mammary region and interdigital spaces usually escape, and especially by the immunity of the dam and of other more mature animals. From actinomycosis of the tongue it is diagnosed by its more rapid progress, by the marked constitutional depression, and prostration, and by the absence of the marked induration of the actinomycotic organ (holzzunge) and by the sulphur yellow pin head-like nodules of actinomyces. Tuberculosis is rare in the first weeks after birth in calves, and never makes the rapid progress nor causes the profound depression of this disorder.

Prevention. The first object must be to destroy the infection, and the second to obviate the susceptibility of the young animal. The clearing away of all accumulations of litter, filth, and even fodder from the stable proper, including the stalls where the dams lie, should be followed by a thorough whitewashing or disinfection, with sulphate of copper or of iron, or even mercuric chloride, (1:500.) If the disease has already appeared in a stable the calves should be penned singly to avoid the possibility of infection through sucking each others navels. In all cases an antiseptic (tannin, carbolic acid) should be applied to the navel of the new born. The food of the dam and nurse should be nutritive and free from any suspicion of mustiness or decomposition, and when possible the calf should be allowed to draw its own milk from the teat. When this cannot be allowed, artificial feeding should be surrounded by all the safeguards, named under acute indigestion of calves.

Treatment. Cadeac strongly recommends ½ oz. common salt daily with the food, or alcohol ¾ oz., or a strong infusion of coffee mixed with the milk. Lenglen advises quinoa in the form of tincture, ½ to 1 oz. McGillivray sulphate of soda. Tincture of chloride of iron 30 drops in an ounce of water with each meal would be an excellent resort.

Locally antiseptics are our main reliance. Naphthol, naphthalin, salicylic acid, or salicylate of soda, may be applied directly to the diseased mucous membrane. Tincture of chloride of iron in water (1:2) is one of the best agents (James). Carbolic acid 1 drachm in 6 oz. water, and 1 oz. alcohol has been used safely and with excellent results (Lenglen). Like most other antiseptics, however, this latter must be used with caution as regards the amount. No actively poisonous antiseptic is admissible. The antiseptic should be swabbed over the whole interior of the mouth after each meal.

In case of deep gangrenous masses excision and antiseptics are demanded.

ULCERATIVE STOMATITIS IN LAMBS AND KIDS.

Causes: Accessory, locality, youth, debility, unsuitable food, impure air, parasitism, contagion. Bacteria. Symptoms: difficult sucking, frothing, salivation, buccal redness and swelling, white, softened patches, suppuration, granulation, fœtor, emaciation, debility, bowel symptoms, respiratory. Duration. Treatment: Artificial feeding, antisepsis, disinfection, mild caustics, etc.

Causes. This has been noticed as an enzootic affection in young and debilitated animals, while the mature and more robust ones escape. Anæmic lambs, those that are fed on watery, innutritious materials (potatoes, grains, waste of sugar factories), those kept in close confinement, indoors, and those that suffer from distomatosis show the disease. Impure air, damp, dark places and impure water have their influence. The disease is manifestly contagious, but the infecting microbe has not been demonstrated. It was formerly supposed to be the oidium albicans, the fungus of muguet, but Neumann demonstrated its absence, and though he found leptothrix buccalis, bacilli, spirochcæte and micrococci he failed to show that any one of these in pure culture would cause the disease. Rivolta charged it on bacterium subtile agnorum and Berdt on the polydesmus exitiosus which according to him the sheep contract from eating rape cake. The withdrawal of the cake led to a rapid recovery.

Symptoms. The disease may begin insidiously without at first very marked symptoms. Sucking is painful and infrequent, an acid froth collects about the mouth, and white patches appear on the gums or other part of the buccal mucosa, with at times redness and swelling, and the separation of the gums from the teeth. The white epithelial patches soften and are easily detached, leaving bright red patches, which bleed easily, and tend to extension and coalescence. These are covered by a viscid mucopurulent matter, and may become the seat of granulations, or they may involve the subjacent tissues in ulceration causing evulsion of the teeth, or necrosis of the jaw bone. The odor of the mouth is fœtid. Prostration and emaciation set in, and often bear a ratio to the extension of the disease to the digestive and respiratory organs. This is manifested by uneasy movements of the hind feet, shaking of the tail, frequent lying down and rising, constipation or diarrhœa: or by cough, snuffling breathing, swelling of the submaxillary and pharyngeal glands, and hurried, oppressed breathing. The complication of vesicular and pustular eruption has been noticed. Death may occur in eight or ten days, or more commonly recovery ensues.

Treatment must proceed on the same lines as in the calf. Artificial feeding on gruels, with antiseptic washes for the mouth at each meal are indicated. Chlorate of potash, chloride of lime, borax, sulphites and hyposulphites of soda, carbolic acid, and the salts of iron afford an ample field for selection. For ulcers, a pointed stick of nitrate of silver, or a solution of muriatic acid in three times its volume of water, applied by means of a glass rod or pledget of cotton will serve a good purpose.

ULCERATIVE STOMATITIS IN SWINE.

Causes: improper food; filthy pens; debility; toxins of specific diseases; microbian infection. Symptoms: inappetence; grinding teeth; champing jaws; salivation; fœtor; buccal swelling and redness; pulpy spots; desquamation; ulcers; pharyngeal, enteric and osseous complications. Treatment: Segregation; disinfection; local antiseptic washes; tonics.

This is the Scorbutus of Friedberger and Fröhner, the gloss-anthrax of Benion.

Causes. It has been attributed to insufficient or irritant food, to damp, close pens, and to chronic debilitating diseases and all these act as predisposing causes. In gastritis and in infectious fevers like hog cholera, swine plague, and rouget (hog erysipelas) the spots of congestion and petechiæ on the buccal mucous membrane may become the starting points for ulcerative inflammations. These conditions appear, however, to be supplemented by infection from bacteria present in the mouth or introduced in food and water, and as in the case of other domestic animals the most successful treatment partakes largely of disinfectant applications.

Symptoms. Loss of appetite, grinding of the teeth, champing of the jaws, the formation of froth round the lips, fœtor of the breath, redness of the gums and tongue, and the formation of vesicles or white patches which fall off leaving red angry sores. These may extend forming deep unhealthy ulcers, with increasing salivation and fœtor. As the disease advances the initial dullness and prostration become more profound, and debility and emaciation advance rapidly. Unless there is early improvement an infective pharyngitis, or enteritis sets in, manifestly determined by the swallowing of virulent matters from the mouth, and swelling, redness and tenderness of the throat, or colics and offensive black diarrhœa hasten a fatal issue. Rachitis may be a prominent complication, as it seems in some instances to be a predisposing cause.

Treatment. Isolate the healthy from the diseased and apply disinfection to all exposed articles and places. Employ local antiseptics as on the other animals. Sulphuric or hydrochloric acids in 50 times their volume of water, or tincture of iron, chlorate of potash, or chloride of ammonia, or borax have been used successfully. Bitters and aromatics have also been strongly recommended.

ULCERATIVE STOMATITIS IN CARNIVORA.

Causes: dietary causes; constitutional debilitating diseases; dental disorders; microbian infection; microbes. Symptoms: difficult sucking or mastication; salivation; dullness; prostration; mucosa red with gray patches, erosions, and ulcers; fœtor; loose teeth; excess of tartar. Extensions to face, throat, lymphatics, nose, eyes, stomach, liver, bowels. Duration. Treatment: clean teeth; antiseptics; mild caustics; stimulants.

Causes. This affection is more common in this class of animals than in the herbivora, being apparently dependent in great part on their artificial habits of life, the sweet and stimulating diet and the derangement of the digestive organs. The lowering of the general health in connection with privation or disease and especially canine distemper, rachitism or indigestion must be recognized as predisposing causes, while the accumulation of tartar on the teeth, or the decay of the teeth themselves, constitutes a potent exciting local cause. In connection with such cretaceous deposits the decomposing elements of the food collect, and the irritant products of their fermentation lead to disease of the gums, congestion and ulceration. Superadded to this is the bacteridian infection of such diseased parts, through which the ulceration is started, maintained and extended. This infection is not that of a specific microbe, but usually of a multiplicity of germs, one or more of the bacteria that live habitually in the healthy mouth, taking the occasion of the existence of a wound, or of a reduction of vitality to colonize the mucosa which would otherwise have remained sound. The microbes actually found in the ulcers are very varied. Pasteur isolated a spirillum, Fiocca the bacillus salivarius septicus, others have found pus bacilli, and in sucking kittens the bacillus coli communis.

But the attempts made to convey the disease to healthy mouths by the transfer of the microbes have usually failed (Pasteur, Netter, Cadeac). To establish their pathogenic action therefore, it appears to be necessary to furnish a susceptible mucosa as well as an infecting microbe. This explains why the disease does not spread as an infection, the average mouth is immune and it is only when it becomes the seat of a wound, bruise or other injury, or when the general system has become so reduced that the resisting power is a minor quantity, that the hitherto harmless germ becomes actually pathogenic.

Symptoms. There is indisposition to suck or eat, the patient leaves the teat or the food, and looks dull, depressed and disposed to lie down apart. There is evident salivation and on opening the mouth we may find the offensive odor, the tartar covered teeth with red or ulcerated gums, and on the cheeks, lips and tongue dark red patches of congestion, or whitish or yellowish gray, soft, pulpy spots of disintegrating epithelium. This is followed by shedding of these epithelial patches, and the formation of rounded ulcers of a line in diameter or less. These are tender, and bleed readily. They may extend to the skin of the lips, or deeply into the mucosa, the muscles or bones, and the attendant morbid process may cause loosening and evulsion of the teeth. There may be implication of the pharynx, the lymph glands, the nose, the eyes, the stomach, the liver, or the intestines with corresponding symptoms. Death may supervene in from six to thirty days, or a more or less speedy recovery may take place.

Treatment. The first step as a rule is to remove the tartar from the teeth. This is often done with a wooden spud dipped in a weak solution of hydrochloric acid. A steel scraper will usually act well and without the solvent action of the acid.

Next will come the removal of all diseased teeth which are operating as local irritants and as centres for infectious microbes and their hurtful products.

Then antiseptics in the form of liquids applied as in the other animals with each meal, will be necessary to counteract infective action, and give the tissues an opportunity to re-establish their integrity. Cadeac recommends a 10 per cent. solution of oil of thyme, as a safe and efficient application. Boric acid, borax, salol, salicylic acid, tannic acid, sulphurous acid, or carbolic acid largely diluted may be substituted. Internally iron tonics and bitters are of great value in improving the tone of the system and securing antisepsis of the intestinal canal. The sulphites too may be given with advantage internally. In depressed conditions alcoholic stimulants may be used both as local antiseptics and general stimulants. As in other animals ulcers may be touched with a rod dipped in tincture of iodine, or a strong solution of chloride of zinc, or nitrate of silver.

MERCURIAL STOMATITIS.

Animals suffering. Causes: mercurial baths, ointments, blisters and surgical dressings; mercurial vapors; deposits on vegetation; rat poisons; malicious poisoning. Lethal dose in horse, ox, sheep and goat. Mature and old eliminate more slowly. Symptoms; Salivation; red, swollen buccal mucosa; gingivitis; loosening of teeth; fœtor; ulceration; anorexia; gastro-intestinal tympany; loose, fœtid stools; fever; weakness; dyspnœa; langor; blood extravasation in nose, mouth, throat, bowels, womb, skin; abortion; skin eruptions. Lesions in mouth, stomach, intestines, serosæ, kidneys, muscles, encephalon. Treatment; stop the introduction of mercury; as antidote potassium sulphide; emetic; cathartic; mucilaginous and albuminous antidotes; potassium iodide as an eliminating agent. Locally potassium sulphide or chlorate. Iron tonics.

This has been especially seen in the sheep, dog and ox, and less frequently in other domestic animals.

Causes. In sheep the use of baths containing corrosive sublimate, or of mercurial ointment for acariasis or other cutaneous parasitism. In other animals it comes mostly from licking mercurial dressings applied to the skin—calomel, red precipitate, mercurial ointment, protoiodide of mercury. The red iodide being more irritating is less frequently taken in. The modern extensive usage of mercuric chloride solutions as surgical antiseptics opens up a new channel of infection. In the injection of the uterus or of large abscesses, or in the daily irrigation of large wounds a dangerous amount may be absorbed. The application of this agent as a caustic in cases of tumors is correspondingly dangerous. Vapors from metallic mercury in confined spaces as in ships’ holds, or from fires on which the mercurial compounds have been thrown, are ready means of poisoning, acting primarily on the air passages and lungs and later on the mouth. The condensation of mercury on vegetation and other food products in the vicinity of factories where mercury is handled (Idria) affects domestic animals directly. Finally the small animals are poisoned by eating the mercurial rat poisons, and all animals are subject to malicious mercurial poisoning, with sublimate especially.

Stomatitis with fatal pharyngitis and enteritis will result in the horse from 2 drs. of corrosive sublimate. About one-half of this may poison the ox, and one-fourth the sheep or goat. Ruminants are more susceptible to the toxic action of mercury than monogastric animals, one evident reason being the long delay of the successive doses in the first three stomachs, so that finally a large quantity passes over at once into the fourth stomach and duodenum for absorption. The old too are more readily poisoned than the young, as the functions of the kidneys are more impaired in age and the poison is not eliminated with the same rapidity.

Symptoms. Mercurial stomatitis is a local manifestation of a general poisoning. Salivation is one of the most prominent phenomena, the watery saliva falling in streams from the angles of the mouth. The buccal mucosa generally becomes red and swollen and the tongue becomes indented at the edges by pressure against the molars. The gums especially suffer and the teeth raised in their sockets by the swelling of the periodontal membrane, become loose, and easily detached. The mucosa of the gums becomes soft and spongy, bleeds readily under pressure and soon shows erosions and ulcers. This condition extends to the lips, cheeks and lower surface of the tongue while the upper surface of the latter organ, the fauces and pharynx commonly escape. The breath and buccal exhalations are very offensive, and the animal loathes food, and has little power of mastication or deglutition. Sometimes the ulcers extend even to the bones.

Along with these local symptoms there are usually gastro-intestinal irritation, tympany, inappetence, continuous rumbling in the belly; badly digested fœtid stools, often diarrhœa, small weak pulse, hyperthermia, accelerated breathing, cough, and great langor and prostration. A tendency to blood extravasation is shown in sanguineous fæces, epistaxis, bleeding from the mouth, the throat or the womb and even into the skin. Pregnant females may abort. The eyes are dull and sunken, and the conjunctiva yellow. Eczematous or pustular eruptions may appear on the skin on the nose, lips, neck, back, loins, croup or perineum.

Lesions. In addition to the lesions described above, there are usually gastro-intestinal inflammation, œdema of the peritoneum and pleura, in the lung as well as in the serosæ, (pneumonia is not uncommon especially in sheep), intestines, kidneys and muscles, hæmorrhagic spots are not uncommon, the blood forms a loose black coagulum, and the encephalon is anæmic and softened.

Treatment. The first consideration is to cut off the supply of mercury. Mercurial applications on the skin should be washed off with tepid water and if necessary soap. An application of sulphide of potassium will precipitate the mercury in an insoluble form. For mercurial agents in the alimentary canal an emetic may be given (if the animal is one susceptible to emesis) followed by a saline laxative. This may be combined with or followed by raw eggs, mucilage, wheat gluten or other albuminoid, sulphide of potash or sulphur, to precipitate the mercury and prevent its absorption. Later, when the bowels have been cleared, iodide of potassium in small doses will serve to dissolve and remove what mercury may be lodged in the tissues.

Locally one of the best applications is chlorate of potash as a mouth wash, 2 drs. to the quart of water. To this may be added tannic acid or other vegetable astringent and even alcohol.

Finally a course of iron and bitter tonics will serve a good purpose in restoring the general tone.

STOMATITIS FROM CAUSTICS.

Caustic Alkalies; symptoms, lesions and antidotes. Caustic Acids; symptoms, lesions and antidotes. Caustic salts; symptoms, lesions and antidotes.

Caustic Alkalies (soda, potash, ammonia and their carbonates) often cause stomatitis. What is supposed to be weak lye, given to counteract indigestions, colics, and tympanies often proves dangerously irritating, and some of the worst forms of stomatitis we have ever seen in the horse originated in this way. As the animal refused to swallow, the caustic liquid lay in the mouth and virtually dissolved the epithelium and surface layers of the fibrous mucosa. The surface in such a case is usually of a deep red, and where the cuticular covering remains, it is white and corrugated. The antidote is a weak, non-irritant acid, such as vinegar, boric, citric, or salicylic acid. When the caustic alkali has been thoroughly neutralized in this way the ordinary treatment for catarrhal stomatitis may be followed. The attendant gastritis must receive its special treatment.

Caustic Acids. Sulphuric, nitric and hydrochloric acids act by abstracting liquids and charring the tissues. The lesions from strong sulphuric acid turn black, those due to nitric acid, yellow, (zanthoproteic acid,) and those due to muriatic acid are white, with the characteristic odor of chlorine. The antidote in such cases is a non-irritant basic agent, such as chalk, lime water, soapsuds, calcined magnesia, and mucilaginous liquids, albumen, gluten, flax seed, with opium. The same agents are applicable to the attendant gastritis and when the acids are thoroughly neutralized the treatment is as for simple inflammation.

Caustic Salts. Among caustic salts may be named mercuric chloride, sulphates of copper and iron, chlorides of iron and zinc, tartar emetic. These may be treated by albumen, blood, white of egg, milk, gluten, mucilage and other sheathing, protecting agents which will form with the salts insoluble and harmless coagula. The subsequent treatment will follow the lines marked out for simple stomatitis. To prevent infection of the raw surface Cadeac recommends: tannic acid 1 oz., benzo-naphthol 3 drachms, powdered gentian 6 drachms, honey, sufficient to make an electuary.

MYCOTIC STOMATITIS IN FOALS, CALVES AND BIRDS. THRUSH. MUGUET.

Oidium (saccharomyces) albicans; a parasite of the young; cultures. Symptoms in foals and calves; congested buccal mucosa; curd-like concretions; erosions. Diagnosis from rinderpest. Treatment; disinfection; sunshine; open air; exercise; locally antiseptics.

This is a form of stomatitis manifested by a raised white patch on the mucous membrane and determined by the presence of the oidium albicans (saccharomyces albicans), a cryptogam discovered by Berg in 1842 in thrush in children. It is closely allied to the mucor, and attacks only the young and feeble. The white crust consists of epithelial cells intermingled with an abundance of the white mycelium and oval spores of the fungus. Andry in his artificial cultures found that it was pearly white when grown on gelatine, dirty white on potato, and snow white on carrot.

Foals and Calves. Symptoms. The buccal mucosa red, congested and tender, shows here and there white curdy looking elevations, or red erosions caused by the detachment of such masses. These bear a strong resemblance to the concretions seen on this mucosa in rinderpest, but are easily recognized by the absence of the attendant fever, and by the discovery, under the microscope, of the specific microphyte. The eruption may extend to the pharynx and œsophagus and interfere fatally with deglutition, but usually it merely renders sucking painful and is not serious.

Treatment. It is always well to destroy floating germs by cleansing and whitewashing the stable, and to invigorate the young animals by sunshine, free air and exercise. Locally the most effective agent is the old favorite remedy borax which arrests the growth of the parasite whether in artificial cultures, or in the mouth. The powder may be rubbed into the sores or it may be mixed with honey or molasses and used as an electuary. As substitutes boric acid, salol, thymol, chlorate of potash, or permanganate of potash may be used.

Birds. The affection has been twice observed as occurring in the œsophagus and crop of two chickens. Martin tried in vain to inoculate it on other fowls, and Neumann failed to convey it from child to chicken by feeding. The element of individual susceptibility was manifestly lacking. From its seat in the crop the malady passed unnoticed during life. In cases that can be recognized, treatment would be the same as in young mammals.

PARALYSIS OF THE TONGUE. GLOSSOPLEGIA.

Causes: Nervous lesions—central or peripheral, parasitic, inflammatory, infectious, traumatic or degenerative. Symptoms: unilateral and bilateral. Treatment: remove cause; use nerve stimulants, embrocations, blisters, frictions, galvanism, suspension of tongue.

Paralysis of the tongue depends on a lesion of the medulla oblongata, or of the 7th or 12th cranial nerve. The central lesions may be connected with cœnurus or other parasites in the brain, hydrocephalus, meningitis, cerebro spinal meningitis, infectious pneumonia, abscess (strangles), and tumors. The distal or nerve lesions may be due to neuroma, tumors, traumas, lacerations, bruises, or violent distension of the tongue. Parotitis, abscess of the guttural pouch and tubercle may be added as occasional causes. As direct traumatic injuries those caused by wearing a poke by a habitual fence-breaker, excessive dragging on the tongue in operations on the mouth, and compression of the tongue by a loop of rope passed over it, require mention.

Symptoms. In unilateral paralysis the affected half of the tongue remains soft and flaccid and is liable to be crushed between the teeth, the active muscles of the opposite half pushing the organ over to the paralyzed side. In bilateral paralysis the tongue hangs out of the mouth, and being crushed and torn by the teeth, it swells up, and may even become gangrenous.

Treatment. Will vary according to the cause. After removal of the central or nervous lesions, the remaining functional paralysis may be treated by strychnia, internally or hypodermically, by frictions or stimulating embrocations to the intermaxillary region, or by electricity. The tongue must be suspended in a sling to prevent œdema, inflammation and wounds by the teeth. In bad cases of bilateral traumatic glossoplegia in meat producing animals it has been advised to have the subject butchered.

DISEASES OF THE SALIVARY GLANDS.

Modifications of the secretion are commonly simple excess or deficiency, with a correspondingly high or low specific gravity of the product. There may, however, be a virulent element as in the case of rabies.

SUPPRESSION OF SALIVARY SECRETION. XEROSTOMIA.

Causes; fever; vascular vacuity, after bleeding, diarrhœa, etc.; destruction of glands; Calculus. Symptoms; slow, difficult mastication; digestive disorder. Treatment; remove mechanical obstruction; correct constitutional disorder; employ stimulation to gland—pilocarpin, electricity.

Entire suppression of salivary secretion is usually the result of some other disease. It may be a manifestation of the general tendency to retain water in the febrile system, or it may be an indication of vacuity of the vascular system as after bleeding, profuse diarrhœa, diuresis, or diaphoresis, or it may be the result of the entire destruction of a salivary gland or the obstruction of its duct by some foreign body or calculus. In proportion to the completeness of the suppression, mastication and deglutition become difficult or impossible. The condition must be met by the removal of the cause which is operative in the particular case. The treatment may be surgical for the removal of obstructions, or medical with the view of overcoming anæmia, fever, profuse secretions from other emunctories, or the simple physiological inactivity. To meet the last indication small doses of pilocarpin, or the application of a gentle current of electricity will usually succeed.

EXCESSIVE SECRETION OF SALIVA. SALIVATION. PTYALISM.

Causes; a symptom of other diseases, of the mouth, teeth, throat or stomach; rank aqueous vegetation, lobelia, pilocarpin, muscaria, tobacco, mustard, and other acrid vegetables; caustic alkalies, acids, salts; compounds of mercury, gold, copper, iodine; palsy of lips; harsh bit; fungi on clover, sainfoin, etc. Symptoms; salivary escape; frequent deglutition; thirst; disordered digestion, etc. Treatment; remove cause; astringent washes; sedatives; embrocations to the glands.

This is often a symptom of some other affection such as aphthous fever, dumb rabies, epilepsy, stomatitis, pharyngitis, dentition, caries and other diseases of the teeth, wounds and ulcers of the mouth, gastric catarrh, etc. In other cases it is due to direct irritants in the food or medicine, as very rank, aqueous, rapidly grown, spring grass, lobelia, pilocarpin, muscarin, tobacco, wild mustard, colchicum, pepper, garlic, ginger, irritant and caustic alkalies, acids and salts, and the compounds of mercury, gold, copper, or iodine employed locally or internally. The application of mercurials to the skin is especially liable to salivate cattle and dogs, partly because of a special susceptibility to the action of this metal and partly from the tendency of these animals to lick the medicated surface. Paralysis of the lips causes a great flow of saliva from the mouth though no more than the normal amount is secreted. The irritation of a large or harsh bit will increase the secretion and still more the former habit of attaching to it small bags of spicy or irritant chemicals. Certain fungi determine salivation. Mathieu saw profuse salivation in horses, cattle and sheep fed on clover and sainfoin which had become brown.

Symptoms consist in the profuse flow of saliva, either in long stringy filaments, or if there is much movement of the jaws, in frothy masses; frequent deglutition; increased thirst and disordered digestion (tympany, inappetence, colics, constipation, diarrhœa). In mercurial salivation there may be loose teeth, swollen, spongy, ulcerated gums, tympany, rumbling, and the passage of fœtid flatus and soft ill-digested stools.

Treatment consists in removing the cause, whether this is to be found in faulty food or drink, diseased teeth or gums, disordered stomach, or the irritant food medicine or poison ingested. If more is wanted simple astringent washes like those recommended for stomatitis and a free access to pure water will often suffice. Tartar emetic or opium has been known to succeed in obstinate cases. Friction over the parotid or submaxillary gland with camphorated spirit, tincture of iodine or soap liniment is sometimes required. In mercurial salivation chlorate of potash is especially to be commended, and when the bowels have been unloaded of the agent, iodide of potassium will hasten its elimination from the tissues and blood.

DILATED SALIVARY DUCTS. SALIVARY CALCULUS. SALIVARY FISTULA.

These are all surgical diseases and are to a large extent inter dependent. The impaction of the calculus in the duct leads to overdistension of the duct posterior to the obstruction, and the rupture or incision of the distended duct, determines the fistula. It is only necessary here to point out the seat of these lesions: the distended sublingual ducts constituting a more or less rounded swelling to one side of the frænum lingui, the Whartonian duct forming a tense rounded cord from the papilla back of the lower incisor teeth backward on the inner side of the lower jaw, and the Stenonian duct forming a similar tense cord from near the middle of the cheek down around the lower border of the jaw in company with the submaxillary artery and backward on the inner side of its curved border to the parotid gland.

For the more precise lesions, symptoms and treatment of these, see a work on surgery.

INFLAMMATION OF THE PAROTID GLAND. PAROTITIS.

Causes: traumatic; calculus; grains; barley and other beards; infecting microbes. Symptoms: fever, dullness, buccal heat, salivation, difficult mastication, swelling of gland and duct, protruded nose, stiff neck, fœtor, dyspnœa, facial paralysis, induration of gland, abcess. Diagnosis from pharyngitis, abcess of guttural pouch or pharyngeal glands; from tumors. Treatment: avoidance of causes; derivation; astringent, antiseptic washes; wet antiseptic bandages to throat; cool pultaceous diet. Open abscess and disinfect. For induration deobstruents. For sloughing antiseptics.

This may be caused by traumatism, such as incised punctured or bruised wounds. Wounds inflicted by the goad, by horns, and even by the yoke in cattle must be looked on as factors. It occurs from obstruction of the salivary ducts by calculi, or by grains, seeds, or pebbles introduced from the mouth; from their irritation by the beards of barley and other plants (brome, rye, wheat, etc.); and from the localization in the gland of specific inflammations like strangles, pyæmia, canine distemper, tuberculosis and pharyngitis. In most of these cases infective microbes are prominent factors. They enter with penetrating bodies from the skin; they extend through the weakened and debilitated tissues in bruises; they penetrate the Stenonian duct with the various foreign bodies from the mouth; irrespective of foreign objects they make their way up the duct by continuous growth from the buccal orifice; in case of calculus or other obstruction their extension is favored by the local congestion and debility and by the stagnation of the saliva above the point of arrest. When present these microbes even favor the deposition of the salivary salts and formation and increase of calculi so that the affection may advance in a vicious circle, the microbes favoring calculus and the calculus favoring the increase of microbes.

Symptoms. In the horse in particular there may be premonitory symptoms of fever, dullness, heat of the mouth, ptyalism, slow and imperfect mastication, and the retention of food in the cheeks.

The Stenonian duct becomes swollen and painful. The parotid becomes hard, hot, tender, and is surrounded by a softer pitting infiltration which may extend down around the entire throat, and even along the intermaxillary region to the chin. When the canal is obstructed it may stand out as a thick rope-like resilient swelling extending around the lower border of the jaw and upward toward the cheek as far as the point of obstruction. When one parotid only is involved, the contrast with the other is quite marked. The head is extended and carried stiffly. When the nose is depressed, or when the head is turned to one side or the other, the patient gives evidence of suffering from compression or stretching of the inflamed region. The breath and mouth exhale an offensive odor, determined by the decomposition of mucus and of the retained food products.

Among remote effects may be named dyspnœa and threatened suffocation from pressure on the pharynx and laryngeal nerves, and facial paralysis from pressure on the seventh nerve.

The disease may go on to induration and remain permanently in this condition, or it may suppurate and discharge through the skin, into the pharynx or through the duct of Stenon. It may communicate with both the duct and the skin and determine a fistula. When suppuration occurs there is an access of fever, a chill may be noticed, the swelling becomes more tense, harder, more tender to the touch, and even emphysematous, and finally points internally or externally. This may take place from the fifth to the tenth day or later. When it opens into the duct it may be seen oozing from the orifice in the cheek when the mouth is opened, and in case the jaws are suddenly parted, it may escape in a jet. In such a case and especially if the microbes have come originally from the food the odor is very fœtid. The abscess is not always single and when multiple the pus may escape externally by a variety of orifices. The pus is usually whitish, yellowish or grayish and creamy, but it may be grumous or bloody or serous and of a most offensive odor. In exceptional cases the gland becomes more or less gangrenous and such parts, exposed in the wound are hard, bloodless and insensible, and add very materially to the fœtor. This may lead to general septic infection, or the necrosed masses may slough off and the cavities fill up by granulations.

Diagnosis. Parotitis is distinguished from pharyngitis and abscess of the guttural pouch by the absence of cough and nasal discharge; from abscess of the pharyngeal glands it is differentiated by the limitation of the hard swelling to the parotid gland and by the superficial seat of the resulting abscess. The co-existence of active inflammation serves to distinguish it from ordinary tumors.

Treatment. By way of prevention, the avoidance of injuries by yokes, forks, pokes, and goads is important. Also the disinfection of the mouth by a liberal supply of pure water and even by antiseptic washes:—borax, boric acid, creolin, tannin, chlorate of potash. Also by the removal of foreign bodies or calculi from the canal.

When the inflammation has set in, a saline laxative is often of value. Wash the mouth with a solution of vinegar and salt, or other antiseptic, repeating this at least after every meal. The swollen, painful gland may be covered with a damp compress or anointed with vaseline to which may be added a little creolin, naphthol, carbolic acid or salicylic acid, together with lead acetate and belladonna or other anodyne. The diet must be soft, cool mashes, sliced or pulped roots or any bland agent that will demand little or no mastication. Cool, fresh water should be allowed ad libitum. When the laxative has set, it may be followed by cooling diuretics such as nitrate or acetate of potash.

If suppuration occurs it should be opened as soon as the pus can be definitely recognized, and the cavity treated antiseptically to prevent further local or general infection by the microbes. In deep abscess there is a certain danger of wounding blood vessels and salivary ducts, but this can be to a certain extent obviated by making an incision through the skin only and then boring the way into the abscess with a grooved director or the points of closed scissors. When the cavity is penetrated the pus will ooze out through the groove or between the scissor blades. When the pus has been evacuated the cavity should be washed out two or three times a day with mercuric chloride solution (1 : 1000), or permanganate of potash solution (1 : 100).

When the gland becomes indurated and indolent seeming to merge into the chronic form it may be stimulated to a healthier action by a cantharides blister, or it may be subjected to daily massage, or to a daily current of electricity for ten or fifteen minutes. If the inflammation is slight or unrecognizable, the surface of the gland may be daily painted with tincture of iodine, and iodide of potassium maybe given internally, in daily doses of ½ to 1 drachm.

Gangrene, the result of septic microbes, a weak system or too severe treatment, may be met by astringent and antiseptic agents locally, and by tonics, stimulants and a generous diet internally.

In cattle the disease usually responds readily to local antiseptics, and stimulating germicidal embrocations. Camphorated spirit, alone or combined with tincture of iodine; cantharides ointment with carbolic acid; and camphor and phenol may be cited as examples.

SUB MAXILLARY ADENITIS. MAXILLITIS.

Mostly in solipeds and unilateral. Causes; traumatic; calculus; infections; ablation of papillæ. Symptoms; tardy mastication; salivation; buccal heat and fœtor; submaxillary swelling and tenderness; morsels retained under tongue; papilla and duct swollen, tender and firm; abscess. Treatment; remove causes; dislodge foreign bodies; antiseptic lotions and packing.

This is rarely seen in other animals than solipeds, is mostly unilateral, and due to the introduction of microbes along with vegetable spikes (barley awns, brome, wheat or oat spikes or glumes) or other foreign bodies. It may also be caused by calculi obstructing the duct. The orifice of each duct, to one side of the frænum lingui, is imperfectly closed by a triangular valvular projection, which in some countries is erroneously cut off as a diseased product (barbs), thus opening the way for the introduction of foreign objects. The microbes are usually pus germs and tend to abscess of the gland. As in the case of the Stenonian duct the presence of these germs tends to the precipitation of the salivary salts and the formation of calculi.

Symptoms. The animal may seem hungry, but masticates tardily and imperfectly, and may even drop morsels partly chewed. He prefers ground feed to whole, and soft mashes to ground feed, while hay and other fibrous aliments may be altogether rejected. Salivation may be excessive, the secretion drivelling from the lips, the mouth may feel hot and the submaxillary salivary gland swollen and tender. This may be detected in the intermaxillary space, but is especially noticeable along the lower and lateral aspect of the tongue. If the mouth is opened and the tongue drawn to one side a mass of food may be found to one side of the frænum lingui, and beneath this the projecting, red inflamed papilla which covers the Whartonian orifice. Extending backward from this the duct is felt as a thickened cord, and when this is compressed a purulent liquid flows from the orifice. The mouth becomes offensively fœtid.

The tendency is to suppuration, and if this is determined in the Whartonian duct only, by the presence of foreign bodies, calculi, or microbes it may recover in connection with an abundant muco purulent discharge and a free secretion of saliva. If it occurs in the gland tissue itself by reason of the penetration of the microbes into the follicles, the tendency is to circumscribed abscess, which may point and burst by the side of the root of the tongue, or externally in the intermaxillary space. In the first case the tongue is displaced upward and to the other side of the mouth by the hard, firm swelling, which is felt on one side beneath the back part of that organ, and later there is the wound, the profuse muco purulent discharge, and intense fœtor. If on the other hand the abscess forms nearer the skin, there is the firm, painful intermaxillary swelling, which finally points and bursts discharging pus of a septic odor. It may be mixed with the foreign bodies that have penetrated through the canal, with morsels of necrosed gland tissue and with blood.

Treatment. The first consideration is to extract any foreign bodies which have lodged in the duct causing irritation and infection. The finger passed along the line of the swollen duct may detect the seat of such foreign body by the extra swelling, and may extract it by manipulation from behind forward. This may sometimes be assisted by the introduction of a grooved director as far as the foreign body, or even by a catheter which can be made to distend the canal in front of the object and open the way for its easier passage. In case of failure and in all cases of the introduction of small bodies like vegetable awns or spikes pilocarpin may be given to cause an excessive secretion and thus as it were purge the canal of its offensive contents. Incision of the canal over the foreign body is the dernier resort.

This accomplished, the injection of antiseptic solutions (permanganate of potash, boric acid), and the liberal use of pure water and detergent lotions in the mouth (vinegar, borax, carbolic acid or salicylic acid in solution) will go far to establish a cure. In case of an abscess bursting internally the antiseptic solutions should be injected into its cavity. When the abscess bursts externally this is doubly demanded, as the introduction of aerial germs tends to produce very unhealthy action. The cavity may be stuffed with carbolized, or iodoform, or acetanilid cotton, or with boric or salicylic acid.

SURGICAL LESIONS OF THE SALIVARY GLANDS.

Among these may be named calculi of the Stenonian and Whartonian ducts, ranula, stenosis and fistulæ of these ducts, tumors, special infections like actinomycosis.

TONSILITIS IN PIGS, AND OTHER ANIMALS.

Causes; debilitating, climatic, microbian. Symptoms; fever, dullness; lies under litter; ears and tail droop; watery eyes; anorexia; vomiting; pharyngeal swelling; buccal redness and fœtor; tonsils swollen with pus or caseous mass in follicles; cough dry and hard, later loose. Abscess. Calculus. Course. Treatment; antiseptic electuaries; embrocations; laxatives; diuretics; tonics.

This is seen in both the acute and chronic form. In the former it has the general causes and symptoms of pharyngitis. There is more or less fever, dullness, a disposition to lie with head extended and buried in the litter, ears drooping, eyes watering and red, carelessness of food, deglutition painful, and liable to be followed by vomiting. The mouth is red and hot, the breath fœtid and the tonsils swollen, and their alveoli filled with muco purulent matter or at times with a fœtid cheese-like product. The cough is at first dry and hard and later loose and gurgling.

In the chronic form there is general swelling of the tonsils with the overdistension of the follicles by the above mentioned whitish putty-like masses, which are often even calcareous. These are due to the proliferation of microbes which find in these alveoli a most favorable field for their propagation. A similar condition is found in the carnivora and to a less extent in the horse, in keeping with the restricted development of the amygdalæ in these animals. It may be attended by ulceration, or in rare cases by the formation of veritable calculi in the follicles of the tonsils.

The gravity of the disease is largely determined by the nature of the infecting microbe and the debility and susceptibility of the animal attacked. The affection usually ends in recovery, but may go on to grave local ulceration, and general infection.

Treatment consists largely in astringent and antiseptic applications to the buccal mucous membrane. In the acute forms frequent smearing of the mouth with electuaries of honey or molasses and borax, boric acid, salammoniac, chlorate or permanganate of potash, and the application of stimulating embrocations to the skin around the throat. In other cases solutions of tincture of chloride of iron, or of tincture of iodine can be used with profit. The iron can be swallowed with advantage, but it is objectionable to pour liquid rapidly into the mouth of the pig, because of the danger of its entering the lungs and setting up fatal pneumonia. A better way is to apply it to the interior of the mouth and fauces on a swab or sponge dipped in the liquid. Short of this one of these agents may be mixed with the drinking water, or muriatic acid may be used in the same way, though at some detriment to the teeth. The general health must at all times be attended to. Any costiveness may be corrected by Glauber salts or jalap, and elimination through the kidneys must be sought through the use of nitrate of potash or other diuretic.

CALCULI IN THE TONSILS.

Diagnosis and treatment of tonsillar calculi; spud; acid dressings. Trauma of soft palate by stick, probang, file, molar. Abscess of palate. Treatment; laxative; expectorant; antiseptic; lancing. Cleft palate and hare lip.

Rudimentary as these organs are in the equine race they are important enough to have become the seat of hard calculous masses. These have been found by Goubaux and Blanc in old asses, and by the author in old horses. They vary in size from a pin’s head to a pea and consist of concentric layers of a granular material arranged around a central nucleus, which is usually a foreign body introduced with the food. This nucleus is usually of a vegetable nature, while the enveloping material is made up largely of the imprisoned and degenerated epithelium of the follicle. Both diagnosis and treatment are difficult in such cases. The adventitious masses should be dislodged by the aid of a smooth, blunt metallic spud, and the surface thereafter washed or swabbed with an antiseptic and astringent solution. Swabbing with a solution of hydrochloric acid will tend to dissolve and remove them.

INJURIES TO THE SOFT PALATE AND FAUCES.

The region of the fauces is sometimes injured by sharp pointed bodies swallowed in the food, by the giving of boluses on the end of a pointed stick, or by the careless use of a probang or of a file upon the posterior molars. An overgrown last molar will sometimes lacerate the velum. In other cases the inflammation of sore throat is especially concentrated on this part, giving rise to cough, difficulty of swallowing, redness, infiltration and swelling of the parts, and even abscess. In the dog it is often associated with tonsilitis.

Treatment. A laxative is usually desirable to be followed by salammoniac or chlorate of potash. In case of actual traumatic lesions, the astringent and antiseptic lotions advised for tonsilitis will be in order, and if abscess is recognized it should be opened promptly.

CLEFT PALATE.

In exceptional cases the soft palate has failed to unite in the median line, and is represented by two lateral flaps separated by a v-shaped hiatus in the middle. In a specimen in the N. Y. S. V. College, taken from a trotting colt, the fissure is continued forward for several inches between the palatine bones and the palatine processes of the superior maxillary, establishing a direct communication between the mouth and nasal chambers. In still other instances the fissure is continued forward between the maxillary and anterior maxillary bones, throwing the whole length of the buccal and nasal chambers into one irregular cavity, and forming harelip.

It would be possible to remedy some of these conditions by plastic operation, but the value of the young animal will rarely warrant any such resort.

CATARRHAL PHARYNGITIS.

Causes: traumatic; thermic; gaseous; medicinal; chemical; physiological irritants; in solipeds, cattle, swine, dogs; debility; exposure; cold baths; youth; age. Microbes in solipeds, cattle, dogs, birds; facultative microbes. Symptoms: constitutional; difficult swallowing; nasal rejection of water; pharyngeal swelling and tenderness; extended head carried stiffly; cough loose; salivation; in cattle, grinding of teeth; in dogs, rubbing of chops; buccal heat and redness; often fœtor. Course. Duration. Diagnosis from parotitis, from abscess of guttural pouch, from pharyngeal tuberculosis, from actinomycosis, from adenitis and phlegmonous pharyngitis, from specific fevers affecting the pharynx. Lesions: redness and swelling of mucosa, epithelial degeneration, elevations, erosions, and ulcers; lesions of tubercle, glanders, rabies, anthrax, actinomycosis, etc. Prevention. Treatment: soothing; dietetic; laxative; expectorant; eliminating; locally antiseptic astringents in solid, liquid, or vapor; embrocations and blisters; tonics.

Causes. As in stomatitis the starting point of pharyngitis is usually in a local injury or a systemic condition which lowers the vitality of the pharyngeal mucous membrane. It may come in all animals from the hot air of burning buildings, from acrid gases inhaled, food, drink or medicines given at too high a temperature, from caustic alkalies, acids or salts, from physiological irritants like croton, euphorbium, cantharides, from barley and other spikes entangled in the follicles, from drinking freely of iced water. In solipedes there are the injuries caused by giving boluses on pointed sticks, and the wounds caused by tooth files in careless hands, and by coarse fibrous fodder, which has been swallowed without due mastication. In cattle injury comes from foreign bodies impacted, from the rough use of probang, rope or whip and even of the hands in relieving choking. Swine have the part scratched and injured by rough or pointed objects which they bolt carelessly with the food. Dogs and especially puppies are often hurt by solid and irritant bodies that they play with, and swallow accidentally or wantonly. They also suffer at times from the pressure of a tight or badly adjusted collar.

The system is debilitated and rendered more susceptible by chills consequent on exposure to cold blasts, or draughts, or rain or snow, when heated and exhausted, by cold damp beds, by pre-existing disease, by underfeeding and by overwork. In the larger animals this may come from the excessive ingestion of iced water, while in dogs the plunging in rivers, ponds or lakes may chill.

The weakness of early age and old age have a perceptible predisposing influence especially in solipeds and carnivora.

Finally as in other catarrhal inflammations the local action of disease germs on the mucous membrane must ever be borne in mind. These may be the germs of specific diseases localized in the pharynx;—in Solipeds the streptococcus of strangles, the bacillus of glanders, the diplococcus (streptococcus) of contagious pneumonia, the germ of influenza, and actinomyces;—in Cattle the bacillus tuberculosis, the bacillus of anthrax, actinomyces, the germs of aphthous fever and of pseudomembranous angina; in dogs canine madness and distemper;—in birds the bacillus of pseudomembranous pharyngitis.

In addition to such specific germs the micrococci, streptococci and bacilli which are normally present and harmless in the mouth and pharynx, enter, colonize and irritate the debilitated tissues in case of trauma, inflammation or constitutional disorder and serve to perpetuate and aggravate the affection.

Symptoms. Acute pharyngitis is manifested by impaired or lost appetite, dullness, weakness, by difficulty in deglutition, by the rejection through the nose of water or other liquids swallowed, by swelling over the parotid and above the larynx, and by a disposition to keep the head extended on the neck and the nose raised and protruded. Fever is more or less marked according to the severity of the attack the temperature being raised in mild cases to 100°, and, in the more violent, to 104° or 106°. The pulse and breathing may be excited, amounting sometimes to dyspnœa, the throat is tender to the touch and its manipulation rouses a cough, the nasal mucosa is congested and the buccal membrane, and especially along the margin of the tongue may be red and angry. Salivation is shown more or less, in solipeds the saliva accumulating especially during mastication in froth and bubbles at the commissures of the mouth, while in ruminants the grinding of the teeth or frequent movement of the jaws in the absence of food or actual mastication leads to a free escape of the filmy liquid at the same points. Dogs will rub the jaws with the foot as if to remove some irritating object from the mouth. In the last named animals the swelling of the tonsils, fauces and pharyngeal mucous membrane, may be seen marked by patches and spots of varying redness and swelling, covered with glairy or opaque mucopurulent secretions, or particles of food, or even showing erosions.

The cough of pharyngitis is painful, paroxysmal, and softer and more gurgling (even in the early stages) than that of laryngitis or bronchitis. It is roused by handling the throat, by swallowing, by a draught of cold air or by passing out of doors, in dogs by opening the mouth, and in cattle by pulling on the tongue which causes pain and resistance. The cough is followed by the rejection, mainly through the nose in solipeds, but also through the mouth in other animals, of a glairy mucus or an opaque mucopurulent discharge often mixed with and discolored by the elements of food or in bad cases by blood.

The course of the disease is comparatively rapid, and it usually ends in recovery in seven to fifteen days, in cases that are not complicated by dangerous local infections.

Diagnosis is mainly based on the stiff carriage of the neck with the nose elevated, the swelling and tenderness of the throat, manipulation above the larynx rousing the cough, the soft or rattling nature of the cough, the ejection of liquids and foods through the nose, the movements of the jaws apart from mastication and the salivation. From parotitis it is distinguished by the concentration of the swelling and tenderness to the deepseated region above the larynx, by the abundance of the discharge, by the ejection of liquids through the nose, and by the readiness with which the cough is aroused. From abscess of the guttural pouch it is differentiated by the more continuous discharge from the nose, rather than the intermittent one. From tuberculous pharyngeal glands by its acute nature, by the absence of the glandular swellings in which the tuberculosis is concentrated, also by the absence of tubercles in other parts of the body. From actinomycosis by its more rapid progress and by the absence of the hard indurated cutaneous or subcutaneous swellings, and of the open sores with minute sulphur colored granules that mark that affection. From adenitis and phlegmonous pharyngitis it is distinguished by the absence of the glandular swelling and dyspnœa which attend on that affection. From the various fatal febrile affections, the germs of which may be localized in the throat, it may be diagnosed by the absence of the more profound constitutional disturbance, and of the more characteristic local symptoms of these which are seldom altogether awanting, though often greatly modified.

Lesions. Beside the thick covering of mucopurulent and alimentary matters, the pharyngeal mucosa, when washed, shows redness, ramified or reticulated, more or less swelling amounting at times to œdema, a soft friable consistency, which like the œdema may in bad cases extend into the submucous tissue, granular elevations, and raw abrasions caused by the destruction and removal of the epithelium. In some instances the ulcers may become quite extensive.

In the more specific inflammations (tubercle, glanders, rabies, aphthous fever, contagious pneumonia, anthrax, actinomycosis), the lesions will vary according to the specific nature of the disease.

Prevention. Avoid the various thermal, chemical, mechanical, and unhygienic causes already referred to, and the exposure to such infectious diseases as are liable to localize themselves in the throat.

Treatment. A piece of blanket or sheepskin placed round the throat with the wool turned inward, a moderately warm stall with pure air, and a diet composed of soft, warm or tepid mashes, (all hard or fibrous food, oats, hay, etc. being withheld) are important conditions.

If costiveness exists a dose of Glauber salts for the larger animals, and of jalap for the small, may be useful. Or pilocarpine or eserine may be given hypodermically. Following this, mild saline diuretics will serve at once to eliminate offensive products of the disease and lower the general temperature.

The most important resorts however, are the local applications of dilute acids, astringents and antiseptics to the pharyngeal mucosa, mouth and nostrils. In severe cases benefit may be derived from inhalation of water vapor, but this is rendered far more effective by the addition of vinegar, carbolic acid, creolin, camphor, tar, or sulphurous acid. The last may be obtained by the frequent burning of a carefully graduated quantity of sulphur in the stall, the others by mixing them with hot water, saturating cloths hung in the stall, or sprinkling them on sand laid on the floor.

Chlorate of potash or borax may be dissolved in the drinking water, care being taken not to exceed the physiological dose. Mercuric chloride (1:2000) may be used to wash the lips and nostrils, but cannot be safely injected into mouth or nose. Powdered alum or tannic acid may be used by insufflation.

As a mouth wash and general medicament a saturated solution of chlorate of potash in tincture of muriate of iron, diluted by adding thirty drops to the ounce of water, may be given every hour or two. Or a solution of chlorine water diluted so as to be non-irritating, may be substituted with somewhat less effect. Even a weak solution of hydrochloric acid may be employed.

Borax may be used in a solution of 2 per cent., or carbolic acid in one of 1 per cent., or bisulphite of soda in the proportion of ½ oz. to the pint, or salicylate of soda ½ oz. to the pint of water. The same agents may be made into electuaries with honey or molasses and smeared every hour or two on the tongue or cheek. In such cases the addition of powdered liquorice, and, if the suffering is acute, of extract of belladonna will serve an excellent purpose.

The danger of infection of the stomach and bowels may be met by combining with the above or administering separately salol in doses of 2 to 3 drachms or naphthol in doses of 4 to 5 drachms to the larger animals. For sheep or swine one-fourth of these doses may be given, and for a shepherd’s dog one-sixteenth to a twentieth.

As alternate antiseptics may be named, boric acid, permanganate of potash and salicylate of bismuth. These from their comparative absence of taste are especially useful in carnivora.

Counter-irritants to the throat are useful. For the horse, sheep, dog and cat, use equal parts of strong aqua ammonia and olive oil. For the solipeds a cantharides blister. For cattle or swine equal parts of strong aqua ammonia and oil of turpentine with a few drops of croton oil, or grains of tartar emetic.

Finally during convalescence a course of iron and bitters may be useful, especially in debilitated subjects.

PHLEGMONOUS PHARYNGITIS.

Submucous inflammation and abscess. Solipeds especially. Specific, or due to microbian pus infection. Traumatism; from foreign bodies in tonsillar and mucous follicles, from rough, fibrous food, instruments, etc.

As a sequel of catarrhal pharyngitis. Symptoms; as in catarrhal form, with more swelling and tenderness, glandular swelling, dyspnœa, and difficulty in swallowing; local induration followed by fluctuation and pointing. Complications; asphyxia, laryngeal œdema, purulent or inhalation pneumonia, pharyngeal fistula, palsy of vagus, secondary abscesses, septicæmia. Lesions, local, general. Treatment; General and local, fomentation—hot or cold and antiseptic. Embrocations. Lancing. Tracheotomy.

As distinguished from catarrhal pharyngitis this is inflammation of the submucous tissue and adjacent lymph glands, tending to abscess.

It is especially common in solipeds and rather rare in other classes of domestic animals. As a specific infectious disease it has its type in strangles (infectious adenitis), also in cattle in the complicated infection of purulent tubercle, but apart from such it is often the result of the penetration of the pus microbes from a catarrhal pharynx into the lymph plexuses and lymph glands. Traumatism may play an important part in causation as when vegetable barbs, awns, chaff or seeds, or strong hairs or bristles enter the open mouths of the mucous follicles, or the tonsillar cavities. Similarly trouble may arise from scratches by tough, fibrous fodder, from pricks by pointed or cutting instruments, by fractures of the hyoid, or by bruises by probangs, or tooth rasps. An overgrowth of the last molar, and a resulting wound and ulcer of the soft palate, and the presence of local deposits like those of glanders and actinomycosis, are other occasions of the entrance of the pus organisms. It will be recognized that this affection is not necessarily due to a difference in the infecting organism, but rather of the tissue involved, the microbes gaining the submucous tissues and expending their violence on these instead of confining their ravages to the surface layers of the mucosa. For this reason the deeper or phlegmonous affection may supervene on a catarrhal inflammation which may have already persisted for several days.

Symptoms. Beside the general phenomena of catarrhal pharyngitis, this form of the malady is characterized by a greater swelling and tenderness of the throat, extending from ear to ear, and from the trachea forward in the intermaxillary space; by nodular and painful swellings of the pharyngeal lymph glands, by the greater difficulty of deglutition, the muscular tissue being involved; by wheezing breathing amounting at times to violent roaring and threatened asphyxia. Perspiration on the throat, the ear, the side of the head or neck, of the fore arm, or of the dorsal region is not uncommon, and has been attributed to the compression of the vagus, or of the superior cervical ganglion of the sympathetic by the swelling. Fever usually runs higher than in simple catarrhal pharyngitis, which may be partly accounted for by the implication of the deeper and important structures but also in no small degree by the entrance into the circulation of the ptomaines and toxins, which in the catarrhal affection escape largely from the inflamed surface.

The resulting abscess is usually in or near a gland or group of lymph glands. The part passes through the usual succession of changes, of soft pitting swelling; firm, tense, painful condition in which the exuded lymph has coagulated; and softening and fluctuation which progresses from the centre toward the circumference. The abscess points variously according to its seat. If in the intermaxillary space it opens externally. If sub-parotidean or peripharyngeal it may burst inwardly into the pharynx or outwardly through the skin. If supra-pharyngeal (retro-pharyngeal), it may be so thickly encapsulated in unyielding walls that it may remain long indolent and inactive becoming a cold or chronic abscess. When an abscess opens into the pharynx, there is a sudden and copious flow of pus by the nose, and it may be by the mouth and a simultaneous subsidence of the inflammation.

Among the complications of the affection are asphyxia, œdema glottidis; abscess of the guttural pouch; rupture of an abscess into the larynx, and the descent of pus into the lungs; the entrance of saliva and alimentary matters into the lungs; gangrenous pneumonia; pharyngeal fistula; pressure on the vagus and paralysis of the pharynx or larynx; secondary abscesses; septicæmia.

Lesions. Besides the general inflammatory lesions some rather remarkable ones have been observed. Fractured hyoid, dissection of the mucous from the muscular coat, by aliments, for nearly the whole length of the œsophagus (Brückmüller), purulent infiltration of the supra-pharyngeal muscles (Wakefield), ulceration of the pharyngeal or guttural sac mucosa, or even gangrene, purulent effusion in the tonsils, around the hypoglossal nerve, the lingual branch of the fifth, or the vagus, embolic inflammations, suppurations or gangrene of the bronchia, and implication of the lung tissue and pleura. Catarrhal enteritis and fatty liver and kidney are common.

Treatment. Beside the general measures advised for catarrhal pharyngitis, this type demands especially measures to moderate the intensity of the suffering, and when abscess appears inevitable to hasten its maturation. The first demand is met by hot fomentations persistently applied to the throat. This may be done by spongio-piline, or simply by well washed wool or cotton bound upon the throat and wet at frequent intervals with water rather hotter than the hand can bear. The addition of a little carbolic acid will secure at once some local anæsthesia and a measure of antisepsis. In warm weather the substitution of cold water has been resorted to with apparently good effect. If adopted it should be frequently removed so as to keep up the constant action of cold and moisture. These have been especially recommended in dogs injured by a tight or ill-fitting collar.

When suppuration appears imminent as shown by the dense, hard, circumscribed phlegmon, stimulating embrocations may be used to hasten its progress. Camphorated spirit is suitable for carnivora and sheep. It may be combined with tincture of cantharides for horses. For cattle and swine, oil of turpentine may be added, the three being used in equal proportions. A liniment of ammonia and oil may be used more or less frequently and energetically according to the relative thickness and insensibility of the skin of the animal affected.

When matter has formed and fluctuates, it should be at once evacuated and the cavity treated by antiseptic dressings. In this way secondary abscesses, septic infections, molecular ulcerations and other injurious sequelæ may be largely obviated.

In case of threatened asphyxia the dernier resort of tracheotomy is always available, and this often acts very favorably in improving the æration of the blood, in restoring the flagging vital functions which depend on hæmatosis, and in removing the friction and irritation consequent on the passage of air through the narrowed and tender passages.

SUPRA-PHARYNGEAL (RETRO-PHARYNGEAL) ABSCESS.

A sequel of phlegmonous pharyngitis. Symptoms; masked by its depth; pharyngeal wheezing or roaring with little local swelling; difficult swallowing; resisting tissues tend to chronicity. Results; pharyngeal fistula, burrowing along œsophagus, rupture into chest or blood-vessels, lymphadenitis, compression of vagus, or jugulars, permanent infected cavity with small orifice. Diagnosis from pus in guttural pouches. Treatment; external opening; antisepsis.

This is a natural result of phlegmonous pharyngitis, but it is possessed of so great importance alike in its chronicity and its results that it seems to deserve a special article. Like its initial morbid condition it is especially common in the soliped, and like that may be traceable to strangles, influenza, and local traumatism.

The symptoms are at first those of phlegmonous pharyngitis, and, if the local swelling, induration and tenderness are less marked than in other cases, it is due to the location of the inflammatory lesion deeply between the pharynx and the atlas and occiput. Indeed the moderate aspect of the external swelling, conjoined with the noisy wheezing or violent roaring, may be taken as important diagnostic indications. The supra-pharyngeal region is so closely confined on its lateral aspects, by the union of the fascia of the sternomaxillaris and mastoido-humeral muscles, that the swelling is confined in the early stages just as the pus is later. As this resistant fascia prevents any relief by lateral expansion, the engorged tissues press downward on the softer and less resistant upper wall of the pharynx and seriously impair both respiration and deglutition. Similarly when pus has formed, these lateral fibrous barriers, reënforced by organized lymph, stand in the way of the advance of the pus toward the skin, and lead it to dissect its way downward toward the pharynx. Even here the thickening of the tissues by the organized products of the lymph will often interpose a serious bar, and the pus remains pent up indefinitely, a source of wheezing, roaring and impaired deglutition, and a constant threat of secondary abscess or septic infection. Even the dense fibroid tissues may soften and degenerate and the pus may make its way spontaneously to the pharynx, or less frequently through the skin of the parotid, or intermaxillary region, or into the œsophagus or larynx. A fistula of the pharynx opening externally and allowing the escape of alimentary matters has been often noticed. These are especially liable to follow puncture of the abscess.

Among the less common sequelæ are fistula of the œsophagus; purulent pneumonia in connection with the purulent dissection of the œsophagean walls and rupture into the chest (Fichet, Schneider); ulceration of the blood vessels in the cow (Jonge); adenitis and lymphangitis of the neck, and the thoracic glands, followed by pericarditis and pleurisy (Cadeac); multiple embolic abscesses of internal organs (Dieckerhoff); compression and degeneration of the vagus nerve, with consequent respiratory and digestive troubles (Baudon); and compression and obstruction of the jugulars with passive congestion of the brain and vertigo. (Delamotte, Debrade). Even when the abscess opens into the pharynx the orifice is usually small, the pus escapes imperfectly, and food materials enter and the fistula may thus persist for a length of time. The same imperfect discharge is liable to take place with an external orifice and the pent up pus becomes inspissated, caseated and even calcified.

Diagnosis. Supra-pharyngeal abscess is to be distinguished from pus in the guttural pouches, by the lack of coincidence of the discharge with the dependence of the head in grazing, eating roots or drinking from a bucket; by the absence of the intermission when the head is elevated; and by the fact that the discharge is less frequently limited to the one nostril. The hearing too is less likely to be affected.

Treatment. As soon as the presence of pus can be recognized it should be evacuated. This is often attempted through the roof of the pharynx, but with such an opening there is always danger from the entrance and decomposition of alimentary matters. If fluctuation can be felt externally, it is better to be opened through the skin. The integument may be incised with a lancet, and the tissues further penetrated by manipulations with the finger nail, a grooved sound or the point of closed scissors. In this way the vessels and nerves are pushed aside and the dangers of hemorrhage, fistula and paralysis avoided. The cavity must be irrigated with an antiseptic solution (carbolic acid 3:100; or acetate of aluminum 1:20).

PSEUDOMEMBRANOUS (CROUPOUS) PHARYNGITIS.

False membranes not due to a common microbian cause. Accessory causes in solipeds; caustics, smoke infection. Lesions: Congestion, necrosis; croupous exudate, extending to patches on bowels and bronchia; kidney infarctions; blood altered. Symptoms: fever, dyspnœa, mucous rattle in throat, swelling, painful, difficult deglutition, yellow or cyanotic mucosæ, pinched face, weakness, prostration. Duration. Diagnosis. Treatment, as for catarrhal pharyngitis with antiseptics by inhalation and electuary. Iron.

Pharyngites attended by the formation of false membranes are met with in all the domestic animals and may be grouped together as a special class. The collection of these in one group, however, must not be taken to imply that all of these, as met with in the different animals have the same pathology, and are due to one invariable cause. Above all it must not be inferred that they are identical with the malignant diphtheria of the human being. The bacillus diphtheriæ hominis isolated by Klebs in 1883, and proved pathogenic by Löffler in 1884, has not been successfully inoculated upon any of the larger domestic animals, and has not been found in any of the casual pseudomembranous pharyngitis of these animals. The common feature of the group is to be found in the formation of the false membrane, and the fact that a given disease is placed in the group must not be held to apply to any special character, of microbian origin, nor communicability by infection.

PSEUDOMEMBRANOUS PHARYNGITIS IN SOLIPEDS.

Cases of pharnygitis with false membranes have been seen in horses by Delafond, Targue, Rey, Bouley, Riss, Sonin, Robertson, Dieckerhoff and Schneidemühl.

They have been attributed to various causes, as caustic alkalies and acids, the smoke of a burning building (Bouley, Rey, Riss), to an infection which operated on dogs and horses (Robertson), to bacteria and other irritants.

Lesions. The mucous membrane of the mouth, pharynx and even the nares presents active inflammation with branching redness, petechiæ, circumscribed foci of necroses, and false membranes of a grayish, yellowish, reddish, greenish or blackish color. These are formed of a pellicle consisting mainly of fibrine and epithelium, pus globules and numerous cocci, and ovoid bacteria. The false membranes have been found on other parts of the intestinal canal (colon, cæcum); and broncho-pneumonia and pulmonary dropsy have been concomitants. The effect of the toxic products is seen in hæmorrhagic inflammation and infarctions of the kidneys, and in a black color of the somewhat diffluent blood.

Symptoms. Besides the usual phenomena of pharyngitis, there is intense hyperthermia (105°–106°), hurried breathing threatening suffocation, painful cough roused by the slightest pressure on the swollen throat and often causing the discharge from the nose of shreds of false membrane. Auscultation of the pharynx gives a loud gurgling sound. Deglutition is very difficult and painful, liquids and even solids being rejected through the nose. The face is pinched and anxious and the mouth is often held open and the tongue pendant. Weakness and prostration are marked symptoms from the first, and the walk may be unsteady and swaying. The visible mucous membranes are congested and usually have a more or less deep tinge of yellow. The disease makes rapid progress and may prove fatal under six days. When it takes a favorable turn, recovery and convalescence may be equally prompt.

Unless the expectoration of false membrane is detected, such cases are difficult of diagnosis, though a fair inference may be deduced from the extreme severity of the symptoms, and the unusual degree of prostration which is present. When a pharyngeal speculum, passing through the nose, can be availed of, it may become possible to reach a more definite conclusion.

Treatment. Beside the measures advised for catarrhal pharyngitis (poultice, counter-irritants, laxatives, antithermics, alkalies, etc.), the main reliance must be placed on antiseptics. Persistent inhalations of warm water vapor with carbolic acid, creolin, tar, lysol, camphor or sulphurous acid are in order: also a mixture of one or other of these agents or of boric acid, bisulphite of soda, or salicylic acid in honey or molasses to be frequently smeared on the teeth. One of the best agents is the saturated solution of chlorate of potash in tincture of muriate of iron, of which a drachm may be added to three ounces of water and given every hour or two. Calomel may be injected through the nose during inspiration, by means of an insufflator, care being taken not to exceed the physiological dose.

PSEUDOMEMBRANOUS PHARYNGITIS IN CATTLE.

Most common in calves. Inoculations successful on rabbits, mice and sheep. Bacillus: its cultural characteristics. Predisposing causes. Symptoms: nasal mucosa congested; false membranes; snuffling, wheezing breathing; painful, rattling cough; agonized expression; salivation; bowel disorder. Course. Duration. Lesions; intense congestion and false membranes. Treatment: as for horse; special antiseptics; solvents; anodynes; tracheotomy.

This has appeared especially in calves, and though apparently readily transmissible among the young, it rarely attacks aged cattle. Cadeac and others inoculated it on guinea pigs and rabbits without success. Dammann, on the other hand, had his inoculated rabbits die in twenty-four hours with hemorrhages in the seat of inoculation. Löffler inoculated it hypodermically on mice and produced extensive infiltration of the entire walls of the abdomen, and often of the peritoneum including the surface of the liver, kidneys and intestines, on which was formed a thick, yellowish exudate containing the microbe. Damman claimed to have successfully inoculated the sheep as well.

Causes: Microbe. Löffler found in the deeper layers of the exudate a long delicate bacillus, five or six times as long as broad, and about half the thickness of the bacillus of malignant œdema. Several bacilli were usually joined so as to form long filaments. These failed to grow in nutrient gelatine, or sheep blood serum, but grew readily in the blood serum of the calf.

Beside the specific microbe Cadeac enumerates as predisposing causes: sudden chills, rapid changes of temperature, suppression of perspiration, inhalation of irritant gases, swallowing of irritant liquids, and traumatic injuries.

Symptoms. The nasal mucosa is violently congested, reddened, thickened, and covered at intervals by false membranes which block the normally narrow passages and produce snuffling, wheezing, and difficult breathing. The throat is swollen, and tender, the slightest touch producing a painful gurgling cough which leads to the discharge of mucopurulent matter, shreds of false membrane and even blood. These membranes may be seen on the nose or mouth. There is high fever, rapid, small pulse, cyanosed mucous membranes, pinched countenance, and usually open mouth, pendant tongue and drivelling saliva. There may be either constipation or diarrhœa.

The course of the malady is rapid, death sometimes supervening in 24 to 48 hours. Recovery and convalescence may be prompt, or the disease may last for weeks.

Lesions. The congestion is intense and may invade the mouth, nose, pharynx, larynx and bronchia, with at intervals the patches of yellowish white false membranes. These may be soft and diffluent when recent, and tough and resistant when of longer standing. The deeper layers are often bloodstained. Preitsch has seen them extend to the gullet, paunch and manifolds, and attended with considerable ulceration of the subjacent mucous membrane.

Treatment. This does not differ materially from that recommended for the horse. Among the additional antiseptics employed have been, iodoform, oil of turpentine, sulphide of calcium, silver nitrate and coal tar. To loosen and detach the false membranes ipecacuan and sulphates of soda and magnesia have been largely resorted to. Papayin and pepsin might be tried. Also as anodynes digitalis, morphia, aconite and belladonna. Finally tracheotomy has been employed when asphyxia seemed imminent.

PSEUDOMEMBRANOUS PHARYNGITIS IN SHEEP.

Cause; infected dust on susceptible subject; inoculation. Symptoms; movement of jaws; frothy lips; salivation; viscid nasal discharge; difficult swallowing and breathing; swollen tender throat; extended head; anorexia; cyanosis; open mouth; cough expels shreds of false membrane; asphyxia. Lesions. Treatment; Glauber salts or muriatic acid in water; antiseptic fumigation and drinking water; antisepsis of the pharynx.