GENITO-URINARY ORGANS.
In the domestic ruminants the penis exhibits a peculiar =S=-shaped curve, situated in the subpubic region (Fig. 226), so that when operation on the urethra, or even on the extremity of the penis, becomes necessary the organ must first of all be withdrawn.
The manipulation is as follows:—
The animal having been fixed by the head and front legs in a standing position, and if possible thrust against a wall, the operator stands on its left side. With his right hand he seizes the penis and the skin immediately in front of the scrotum and pushes them forward in the direction of the opening of the sheath.
The extremity is nipped between the first fingers of the left hand, and to prevent the glans slipping or escaping when the right hand is removed (for the purpose of taking a fresh hold of the body of the penis further back) the operator may reverse the free extremity of the penis so that it forms a loop, and thus secure a firmer hold. With the right hand the skin is thrust backward, a new portion of the sheath fixed, and the organ again pushed forward. In this way the penis is gradually extended. When the animal is cast, this manipulation is much easier.
URETHROTOMY IN THE OX.
Urethrotomy consists in incising the urethra, usually for the purpose of extracting a foreign body or calculus which impedes micturition. In the ox, calculi may become fixed either in the intra-pelvic portion of the urethra, though this is very rare; in the ischial curvature, or more commonly at some point in the =S=-shaped curve of the penis; or sometimes even within the sheath itself.
Urethrotomy is performed in the ischial or scrotal region, according to the point where the obstruction exists.
ISCHIAL URETHROTOMY.
Urethrotomy is performed in the ischial region either to displace or indirectly to abstract a foreign body fixed in the membranous portion of the urethra, or directly to remove one from the spongy portion opposite the ischial curve.
Calculi fixed in the intra-pelvic region are detected by rectal exploration.
The exact position of the foreign body is determined by inspection and palpation, whilst distension of the urethra by urine may be noted even before more striking symptoms appear.
The urethra can be incised by one of three methods.
The animal should be secured, if possible, in the standing position.
The =first method=, which dates back to very early times, consists in puncturing the urethra at one stroke with the fleam or lancet, and opening it more freely, after introducing a grooved director. This method is very useful where rupture of the bladder is imminent.
The extraction of a calculus fixed in the ischial region, or the manipulation of an obstruction at any other point, can afterwards be undertaken.
=Second method.= A second method consists in incising the subcutaneous tissues, layer by layer, until the urethra is reached at the ischial arch.
The operation is terminated by puncturing the urethra and enlarging the incision in an upward direction after passing a grooved director. This method minimises hæmorrhage and urinary infiltration. By previously injecting cocaine, the operation may be made practically painless.
=Third method.= Puncture of the urethra by a single stroke with a straight bistoury at the ischial arch.
The opening is enlarged in an upward direction with the same instrument.
SCROTAL URETHROTOMY.
Scrotal urethrotomy is necessary when the calculus is situated in one of the =S=-shaped curves of the penis or nearer the glans.
The operation is facilitated by casting the animal and withdrawing the penis from the sheath, but as there is considerable danger of rupturing the bladder when casting an animal with marked distension of that organ, the more serious operation should be preceded by puncturing the urethra with a fleam at the ischial arch.
By repeated moderate traction on the extremity of the glans, the =S=-shaped curve can be obliterated and the anterior portion of the penis withdrawn beyond the sheath.
One of two conditions may exist.
=First case.= Where the calculus is in the anterior, extra-prepubic portion, it is removed through an incision made directly over it. After extraction and disinfection, one or two sutures are inserted.
=Second case.= Should the calculus be situated in that portion of the penis which remains within the sheath after the fullest withdrawal of the organ, it is necessary to proceed as follows:—
(1.) The skin covering the sheath, the subcutaneous tissue, and the mucous membrane are first incised for a length of from 1¼ to 1¾ inches.
(2.) The penis is drawn through this opening; an incision is made directly over the calculus, dividing the fibrous layer, erectile tissue and mucous membrane of the urethra; the parts are disinfected and the wounds closed with sutures.
With ordinary antiseptic precautions little danger is to be feared.
Even should infiltration of urine occur, the operator need not be unduly anxious, for, provided the parts are punctured or scarified early, recovery usually follows.
PASSAGE OF THE CATHETER AND URETHROTOMY IN THE RAM.
Obstruction of the urethra in rams is more commonly caused by deposits of gravel than by single large calculi. It is generally found in highly-fed animals, in which gravel accumulates and becomes massed together at some point in the canal, often near the free extremity, where it forms a plug, causing complete retention of urine. In other cases this retention is due to a mass of sediment formed by vesical mucus and fine gravel which collects about the neck of the bladder.
Three operations have been advised for the removal of this condition:—
(1.) =Section of the Appendix of the Penis.=—When the disease is just appearing the sedimentary material may be collected at the anterior extremity of the penis behind the appendix. The shepherds in such cases remove the extremity of the penis. The resistance disappears, the plug formed of gravel yields to the pressure of urine, and micturition occurs as usual. Excision of the appendix, however, incapacitates the ram for service.
(2.) =Passage of the Catheter.=—Passage of the catheter has been recommended for the removal of deposits of gravel in the urethra, but it seems a very questionable method.
Should it be determined on, the animal must be placed on its back. The penis is then withdrawn and the double =S=-shaped curve is obliterated. An incision is made over the canal behind the appendix and a soft gutta-percha sound is passed. The sabulous accumulation is thus dispersed.
(3.) =Urethrotomy.=—Scrotal urethrotomy may be performed as in the ox.
Ischial urethrotomy is impracticable in very fat animals, but when the obstruction is about the neck of the bladder, and the animal’s condition admits of it, this operation may be performed.
The patient is fixed on its back, and a metallic or gutta-percha sound is passed into the urethra. The tissues are incised layer by layer in the direction of the sound. Once the urethra has been opened the soft magma may be washed out of the bladder by a free injection of boiled water or similar aseptic liquid.
PASSAGE OF THE CATHETER IN THE COW.
It sometimes becomes necessary to examine the bladder of the cow.
There is an obstacle, however, to the introduction of the sound into the urethral canal. The meatus urinarius is covered by a little valve which springs from the lower wall and forms behind the real opening of the urethra a cul-de-sac, into which the point of the catheter is apt to pass. The instrument usually employed is of gutta-percha, glass, or, better still, of metal, as more easily sterilised (Fig. 308). It is held like a pen, and is directed along the floor of the vagina as far as the opening of the meatus, being guided by the index finger of the left hand, which has previously been introduced. The point being very slightly depressed, it enters the cul-de-sac. It is then only necessary to reverse the movement, that is to say, raise the point, whilst gently pressing forward; a slight resistance is felt and the sound enters the bladder. If necessary the little valve may be held down by gently pressing on it with the point of the left index finger.
It is sometimes an advantage to expose the seat of operation. In such cases the lips of the vulva and the walls of the vagina may be separated by retractors or by the use of a speculum.
CASTRATION.
Castration is performed for the purpose of removing the reproductive power, either by obliterating the testicle or ovary or by suppressing their functions.
In ruminants, the testicles are elongated and placed in a vertical position, the upper portion of the scrotum presenting a constriction and the whole scrotal mass resembling in shape a cone with its base downwards.
CASTRATION OF THE BULL AND RAM.
These two animals, when destined for slaughter, are usually castrated either at birth or at latest two or three months afterwards. In Normandy, in Franche-Comté, and in England breeders castrate young bulls by torsion of the cord.
Two incisions about 1¼ to 1¾ inches in length are made on the lower extremity of the scrotum. The testicles are enucleated and the testicular cords seized with two pressure clamps, with which torsion is effected. In the South of France, in Auvergne, and in the Limousin, bulls intended for working are not castrated until after the lapse of some months, on account of the influence which the testicles have on the development of the bones and muscles. Such animals are only operated on at the age of from six months to a year, and as a rule the method employed is that of bistournage.
BISTOURNAGE.
This method of castration has been practised from time immemorial. It consists essentially of torsion of the testicular cord, and aims at obliterating the vessels which it contains, and thus bringing about atrophy of the organs served by them.
=The Bull.=—The animal is operated on in the standing position. The head is fixed to a post or ring somewhat high up, in order to check movement of the hind legs. The hind legs are also partially secured by means of ropes or two pieces of webbing passed in a running noose about the hocks and fixed above the knee. No preliminary disinfection is practised, because no wound is made.
=Manual Technique.= The operation comprises four stages:
=First stage.= The operator, standing behind the animal’s hocks, grasps the testicular cords with the hands, immediately above the testicles, and by exercising strong pressure, thrusts the latter to the extreme base of the scrotum. The movement is next reversed; seizing the base of the scrotum with the right hand, he draws it smartly downwards, whilst he places the left hand above the right, and thrusts the testicles towards the abdomen. If the testicles do not rise sufficiently high, the right hand is slipped between these and the left hand, and the testicles are thus thrust upwards towards the lower inguinal rings, slightly dilating the latter.
After this manipulation has been repeated two or three times, the scrotum, etc., become more pliable and the testicles more easily displaced. The second stage of the operation is thus facilitated.
=Second stage.= The second stage of operation may be effected by one of two methods.
Old method: The oldest method consists in allowing one of the testicles to rise towards the inguinal ring and to turn the other in a vertical plane. If, for instance, it is desired to turn the right testicle, the cord is grasped between the thumb and index finger of the left hand (Fig. 311), the lower part of the scrotum is seized with the right hand, and the object then is to slide the point of the testicle along the dorsal surface of the fingers (Fig. 311). Simultaneously the operator presses on the base of the testicle with the thumb of the left hand, thus causing a rotary movement in a vertical plane; the tail of the epididymis becomes uppermost. A certain empty space separates the testicle from the base of the scrotum.
=Third stage.= Torsion of the cord. The testicle having been rotated, the cord must be twisted so that the vessels may be obliterated. The left hand continues grasping the cord, which is then brought in front of the testicle, whilst with the right hand the testicle is pushed backwards and is made to describe a semi-circle. The cord was previously on the left side; it is now on the right, and simultaneously the testicle passes from right to left.
In completing the turn the hands must not be changed, and, above all, must not let go their hold; and the cord is pushed forwards and towards the right with the right hand, whilst the testicle is pushed backwards and to the left with the left hand. The cord and the testicle resume their original position; one complete turn has been effected. These manipulations are repeated several times, and the cord soon assumes the appearance of a large, hard, tense string. To ensure obliteration seven or eight turns should be made in the case of the bull and four or five in that of the ram.
Torsion of the right testicle being complete, the gland is thrust towards the upper part of the scrotum and the left testicle is submitted to the same manipulation, the position of the hands, however, being reversed.
=Fourth stage.= Fixation of the testicles in the inguinal region. Both testicles having been thrust upwards as far as possible into the inguinal region, the scrotum is ligatured below them. Tape or thick cord should be used, to guard against gangrene of the lower portions of the scrotum. A considerable œdematous swelling soon occurs, and when at the end of twenty-four or forty-eight hours infiltration is well developed, the ligature should be removed.
Dubourdieu has described a different method, in which the testicle is rotated in a horizontal plane. The position of the hands is then different. The left testicle, for instance, being at the base of the scrotum, the cord is grasped with the right hand opposite the base of the testicle, and the tail of the epididymis and the testicle are held with the whole hand whilst being rotated. If care is taken to fix the cord with the right hand, rotation is more rapid and easier than in the preceding method.
=Difficulties in Operation.=—Bistournage is highly commended in France on account of its avoiding all the complications resulting from sanguinary operations. Nevertheless it presents great difficulties, particularly in bulls of from two to three years of age, in which the testicles are hard to manipulate on account of their size, the thickness of the connective tissue, and sometimes because of abnormal adhesions. In such cases the preliminary manipulation alone sometimes extends over half an hour.
Bistournage is of doubtful efficacy when the testicles are small and round, because after the ligature has been applied the testicular cord tends to untwist, and the shape of the testicles readily lends itself to such movements. If untwisting occurs, the operation fails.
=Consequences of the Operation.=—The operation is often followed by more or less violent attacks of colic; the animal may suffer for five or six hours, after which it recovers.
If torsion has been clumsily performed, or if the ligature becomes displaced, the testicle may descend and the cords untwist; the latter then appear to have lost the firm, tense consistence which they presented after operation. To prevent slipping of the ligature and untwisting of the cord, Guittard suggests the use of an iron needle, with which the scrotum is pierced through the median line, just beneath the testicles when at their highest position; above this is placed the ligature, which then cannot possibly slip.
The Basque operators, in order to avoid untwisting, exercise vigorous traction from above downwards after rotating the testicle. In this way ruptures occur which diminish the elasticity of the cord and the epididymis, and tend to check the untwisting of the former.
When the operation has succeeded the testicles gradually atrophy. They do not disappear completely, and may sometimes be found several years later of the size of a hazel-nut or a chestnut and of fibrous consistence. It need scarcely be said that in the event of bistournage failing, cutting operations can always be resorted to.
MARTELAGE.
The process of martelage consists in mutilating with a mallet the testicular cord whilst still covered by all its envelopes. This mutilation injures the walls of the arteries, causing the formation of a clot, which cuts off the supply of blood to the testicle and causes the gland to atrophy.
The practice is very ancient.
The animal is fixed by the horns as if for bistournage, and the limbs are secured by two strips of webbing or two ropes, as in the former case, though some practitioners neglect the latter precaution.
Two cylindrical rods the size of broomsticks and a wooden mallet or farrier’s hammer are the instruments employed.
The method, however, is barbarous, cruel, and of doubtful value. It would never be countenanced in England.
CASTRATION BY CLAMS.
Castration of bulls by means of clams has been practised in many different forms.
=Castration by the Exposed Method.=—The operation is the same as in the horse, the scrotum being incised on either side, and the dartos, connective tissue, tunica vaginalis scroti, and tunica vaginalis testis being divided. Short clams are applied to the cord, and the lumen of the arteries is completely obliterated in five to six days, when the clams can be removed.
Instead of an incision being made for the removal of each testicle, the scrotum and dartos may be divided in the middle line, after which incisions may be made to the right and left respectively, exposing the fibrous tissue and enabling the testicles to be enucleated. A clam may then be applied to each cord, or the two cords may be included in one pair of clams.
This method has the advantage of inflicting less injury on the scrotum, a point which is of some importance in animals destined for slaughter.
=Castration by the Covered Method.=—This operation is identical with the preceding, except that the incision of the scrotum does not involve the cremaster and fibrous tunic, or the tunica vaginalis scroti.
CASTRATION BY TORSION.
The cord may be twisted throughout its entire length or torsion may be limited to a part of the cord, hence the two methods hereafter described.
(a) =Limited Torsion.=—The testicles are exposed as in castration by the open method. The cord is then drawn forward and fixed by means of forceps applied just outside the scrotum; ¾ to 1 inch below this point the torsion forceps are applied. The cord is slowly twisted, and usually ruptures about the centre of the fragment included between the two pairs of forceps.
(b) =Direct or Unlimited Torsion.=—=First stage.= The testicle is exposed, as in castration by the covered method.
=Second stage.= The cord and vaginal tunic are twisted by grasping the testicle, which is protected with a piece of clean linen.
CASTRATION WITH THE ACTUAL CAUTERY.
The testicles are exposed, the cords are seized with clams and divided separately or together with a sharp-bladed cautery at a white heat. The eschar so produced is sufficiently dense to obliterate the vessels.
CASTRATION BY THE ELASTIC LIGATURE.
This method has been largely employed during the last ten or fifteen years. It consists in applying to the upper part of the scrotum several turns of a tensely stretched round or square rubber thread. The two ends of the rubber thread are crossed and tied with string. About the seventh or eighth day the testicles may be removed with a knife close to the ligature, provided the process of delimitation is well advanced.
The chief objection to this method lies in the fact that the scrotum is destroyed, which lowers the value of the animal from a commercial point of view.
CASTRATION OF THE RAM.
Most of the preceding methods may be used in castrating rams, but certain special methods are more generally employed. These we shall shortly mention.
=Castration by Bistournage.=—The method is exactly similar to that in the bull. The animals are placed in the position shown in the figure, except that the hind limbs are extended and held in that position by the operator’s knees or feet. The process is only applicable to animals of four or five months old.
=Castration by Tearing.=—This method is only practised by shepherds, and on animals a few days or at most a month old. The base of the scrotum is snipped off with scissors, the testicles are enucleated, and each in turn is seized and torn away with a sudden snatch. Even though a considerable length of cord is removed with the testicle, bad results seldom follow, provided the subject is not of greater age than that mentioned.
=Castration by Ligature.=—This method consists in passing a stout ligature in the form of a running knot over the neck of the scrotum and, by means of two short pieces of wood, drawing it tight. The method, however, is not to be recommended, as it not infrequently leads to tetanus.
CASTRATION OF BOARS AND YOUNG PIGS.
For castration boars should be cast on the left side, and three legs at least firmly secured together (Fig. 317). The best method is that of limited torsion. Care should be taken to avoid dragging the cord downwards during the operation, for the testicular artery ruptures readily, and fatal abdominal hæmorrhage may follow.
As the subjects are apt to wallow in the litter after the operation a strip of iodoform gauze should be applied and secured by one or two sutures. This is removed on the third or fourth day.
On young pigs the operation is simpler. The animal is cast on the left side and firmly held, the left hind limb being extended and the right drawn towards the right shoulder.
The testicles are grasped each in turn with the left hand, whilst with the right they are exposed by a single sweep of the bistoury. The testicles are removed by torsion with artery forceps. Many laymen simply use the hands, the cord being grasped between the left thumb and index finger, whilst torsion is effected by the right index finger thrust between the vas deferens and the body of the testicle.
CASTRATION OF CRYPTORCHIDS.
Cryptorchids are very rare amongst cattle and sheep, as the testicles enter the scrotum during intra-uterine life. The internal inguinal ring in the pig being of very small size, the condition is more common in that animal.
The same process is employed in castrating cryptorchid bulls, rams, or boars. The animal is thrown on one side and securely fixed. A vertical incision is made in the region of the flank, varying in length from 4 to 5 inches in the bull, 2 to 2½ inches in the ram, and 4 to 5 inches in the pig. The abdominal cavity is examined, the testicle found, and a ligature applied to the cord, after which the testicle is removed.
Another method consists in employing the écraseur for division of the cord.
To avoid subsequent complications antiseptic precautions should be taken.
=Complications after Castration.=—Whatever the method employed, swelling of a more or less abundant character always develops during the few days immediately succeeding the operation. It is, however, of little importance.
Should antiseptic precautions be neglected, suppuration, septicæmia, tetanus, and sometimes scirrhous cord may follow.
FEMALE GENITAL ORGANS.
=Examination with the Speculum.=—In the cow certain diseases of the vagina, bladder, neck of the uterus, and even of the uterus itself, may necessitate visual examination in addition to the manual examination commonly employed. Under such circumstances a special speculum is introduced in a closed condition, being afterwards opened and dilated to the required extent.
Before inserting the speculum, however, the genital passages should be cleaned, and the speculum itself smeared with vaseline. It penetrates readily with moderate pressure.
Heifers and similar animals require a special (small) instrument (Fig. 318).
In certain circumstances, moreover, it is preferable to use retractors, with which local examination is easier. These can be applied at either side of the vagina and drawn apart, thus exposing the depths of the genital tract.
CASTRATION OF THE COW.
The operation of castrating the cow is very old, and was mentioned by both Aristotle and Pliny. Many other descriptions of it have since been given. But more recently the manual technique has been considerably simplified and very fully described.
=Utility.=—The operation is practised for the cure of nympho-mania; also to prolong the period of milk-yielding and to facilitate fattening.
As regards nympho-mania, it is only of value where the excessive excitement is due to disease of the ovaries.
Under ordinary conditions the secretion of milk diminishes more or less, and becomes very slight after eight or nine months from calving. If, however, the cow is castrated under favourable circumstances, lactation continues for several months, sometimes for several years, beyond this period. It is said that castrated cows yield milk of a more constant composition and richer in butter fat, casein, and mineral salts than those which are not castrated, although the point cannot be said to have been fully established.
To obtain the best results the subjects should have attained their maximum yield of milk and be from five to seven years old. The best period is six weeks to two and a half months after calving. Neglect of these considerations is liable to be followed by inappreciable, doubtful, or bad results.
The influence of castration on fattening is explained by the suppression of œstrum.
=Manual Technique.=—An ovariotome with a hidden blade and an écraseur with an extra long stem are the only instruments required. The animals should be prepared for some days by diminishing their food supply and administering gentle laxatives.
Acute or chronic lesions of the genital tract should be held to contra-indicate operation, and it should be noted that tuberculous animals are particularly liable to awkward complications.
On the day of operation an abundant enema is given, to empty the rectum, after which the vagina is washed out freely with a lukewarm solution of some non-irritant antiseptic. The hind quarters, and particularly the neighbourhood of the anus, vulva, base of the tail, etc., should be carefully washed and disinfected with a solution of lysol, cresyl or carbolic acid.
The patients are secured in a standing position, a rope being passed in the form of the figure =8= around the hind limbs above the hocks, and the animal is then firmly thrust against a wall by several strong assistants.
The operator’s hands and instruments must be rigorously disinfected.
The operation comprises three stages:
=First stage.= Puncture of the vagina.
=Second stage.= Finding and securing the ovaries.
=Third stage.= Ablation.
The hand is smeared with sterilised oil, and, grasping the ovariotome, is passed into the vagina, which contracts on it and on the forearm. Within a short time, however, which may vary between two or three minutes and a quarter of an hour, the vagina becomes distended and its walls rigid, so that the operator is able to continue his manipulations more easily. This is the moment for effecting puncture, after an examination of the pelvic organs through the vaginal walls.
The blade of the ovariotome is advanced until fully exposed, and the point is brought directly above the neck of the uterus, about ¾ to 1¼ inches from it. By a sharp movement the instrument is then thrust directly forward, dividing the wall of the vagina in the median line.
The blade is next retracted into its sheath and the instrument dropped on to the floor of the vagina. The right index finger is at once passed through the orifice so made into the peritoneal cavity, in order to make certain that all the membranes have been divided. By pressing on and slightly tearing the tissues the middle finger is then introduced alongside the index. Only these two fingers should be passed into the peritoneal cavity.
In order to secure the ovaries it then suffices (Fig. 321) to thrust forward the base of the vagina, allowing the two fingers to glide over the body of the uterus and thence downward over its side to the point where the horns of the uterus originate. Here the fingers meet the ovary, which is readily recognisable on account of its size and shape (those of a walnut). The gland is nipped between the index and middle fingers, and is drawn into the vagina through the operative opening.
In order to remove the ovary the operator seizes the écraseur with the left hand, a loop of chain about an inch long projecting, and slides the instrument along his right forearm. The arm must be retained in the vagina, the fingers grasping the ovary. The organ is slipped into the loop of the écraseur, which is then manipulated with the left hand until the pedicle is divided. To prevent hæmorrhage the screw of the écraseur should only be turned at the rate of about twice a minute. The ovary when separated is left on the floor of the vagina, the fingers being again introduced into the abdominal cavity to secure the second one. This is removed in precisely the same way.
The pedicles of the ovaries are released, and at once return to the peritoneal cavity, while the operator, in withdrawing his hand, brings with it the knife and the ovaries themselves. The lips of the operative incision come together again spontaneously as the vagina contracts.
This operation is followed by slight colic, which, however, need not cause alarm.
=Complications: Hæmorrhage.=—If the incision is unskilfully performed, it may in exceptional cases result in injury of the terminal portion of the aorta or the iliac arteries. The blood then streams past the operator’s hand, and the animal dies of internal hæmorrhage in a few minutes; nothing can be done.
If there is undue haste in manipulating the écraseur, the pedicle of the ovary is cut rather than crushed, the vessels close imperfectly, and grave hæmorrhage may occur.
In cases where hæmorrhage is slight the peritoneal clot is readily reabsorbed; but should the animal happen to be tuberculous or its vessels in any other way diseased, free hæmorrhage may occur and may eventually be followed by fatal peritonitis. Hernia of the intestine through the vagina is a rare complication nowadays, on account of the small dimensions of the perforations. In former times, when larger incisions were made, it occurred rather frequently.
=Abscess Formation.=—Suppuration of the wound and peritonitis or vaginitis are caused solely by the neglect of antiseptic precautions.
Pelvic peritonitis following an operation is indicated, like ordinary acute peritonitis, by loss of appetite, peritonism, colic, etc.
Even where peritonitis is avoided a local abscess often forms in the vaginal wall owing to infection of the operation wound. The symptoms are delayed for several days, sometimes for a fortnight after operation, and consist in straining efforts, moderate peritonism, diminution in appetite, etc. Vaginal or rectal examination reveals the character and extent of the disease. The abscess should be punctured through the vagina.
Finally, it may happen that castration does not prevent the recurrence of œstrum. The ovarian pedicle may have been divided too close to the glandular tissue, a fragment of which has remained adherent to the pedicle.
Certain other operative complications are also possible in dealing with cows suffering from nympho-mania which have developed cysts, tumours, or abscesses of the ovaries. It is then necessary to enlarge the incision in the vagina and take particular precautions not to rupture the cysts or abscesses in the peritoneal cavity. The operator must proceed cautiously and modify his technique according to circumstances.
CASTRATION OF THE SOW.
Castration of the sow has been practised since very ancient times. The operation is performed on animals intended for fattening, and at all ages between six weeks and maturity.
=Anatomical Arrangement of the Genital Organs.=—Before performing ovariotomy in the sow it is indispensable to understand the special arrangement of the genital organs. The uterine horns are very long and folded on themselves, forming convolutions which give them somewhat the appearance of small loops of intestine. Nevertheless they can readily be distinguished by the touch, for they are much smaller in size than the latter.
In young sows, two to three months old, they are of about the thickness of a small pencil. Differentiation is more difficult in sows that have borne litters, but as the ovaries alone are withdrawn, leaving the horns of the uterus uninjured, this distinction is unimportant.
The horns of the uterus are suspended in the peritoneal cavity by means of very extensive, well-developed, and very lax ligaments, and, as the horns of the uterus lie at a very acute angle one to the other, the ovaries are very close to the median line of the abdomen. The length and yielding character of the parts and the close apposition of the ovaries explain why the latter can be found and extracted through a single incision in the flank, either on the right or left side.
An ordinary convex bistoury or a special knife and two artery forceps are the instruments employed.
=Manual Technique.=—The animal is cast on the right or left side, preferably on the right, so that the right index finger can be employed. Full-grown sows should always be muzzled. In the case of young animals, the limbs should be grasped by assistants, the hind limbs being crossed one over the other and drawn backwards.
Antiseptic applications are highly desirable, although they are usually neglected when a layman directs the operation.
The operator places himself close to the animal’s back. The incision may be made in one of three different places.
Certain practitioners recommend a vertical incision about 2 to 2¼ inches in length, commencing at the external angle of the ilium, or ⅓ of an inch in front of it, and prolonged downwards; others make a horizontal incision parallel with the vertebral axis; and, lastly, some believe that an oblique incision following the direction of the “cord of the flank” is just as advantageous. A vertical or oblique incision is probably the best.
The operation comprises four stages:
=First stage.= Incision of the skin and subjacent muscles.
=Second stage.= Perforation of the peritoneum and discovery of the ovaries.
=Third stage.= Ablation of the ovaries or of the ovaries and horns of the uterus.
=Fourth stage.= Suture of the wound.
The tissues are divided layer by layer. The skin is formed into a longitudinal fold and divided in a vertical direction, and the subjacent muscular layers are then divided with the bistoury. The tissues are next broken through layer by layer with the index finger until the parietal peritoneum is reached. This membrane is then fissured, or at least scraped with the nail, and perforated with a sudden sharp thrust of the index finger.
This practice, however, has the disadvantage of sometimes causing the parietal peritoneum to strip away from the wall of the abdomen, which greatly increases the difficulties of operation. It is better, therefore, to grasp the peritoneum with a small pair of forceps, draw it outwards, and secure it so as to puncture it with more certainty. When experience has been acquired this precaution will be unnecessary.
The incision being made and the finger introduced into the abdomen, the operator, who kneels against the animal’s back, searches for the ovaries with his index finger. The upper ovary of the side in which the incision has been made will be found immediately in contact with the parietal peritoneum, and the operator must take care not to displace it by untimely or careless manipulation, which may thrust it away among the loops of intestine. The finger being doubled up in the form of a hook, the ovary is seized and drawn out. Sometimes it may be easier to withdraw the uterine horn, leaving the search for the ovary until a little later.
The first ovary having been discovered, its pedicle is seized between the left thumb and index finger or the jaws of pressure forceps, and then the search is continued for that of the opposite side. In young sows the horn of the uterus may be followed up from its extremity (ovarian extremity) towards its origin (bifurcation of the body of the uterus) and the search continued along the horn of the uterus of the opposite side, which is followed in the reverse direction from its base towards its extremity until the second ovary is found.
The most difficult stage is that at which the change is made from one horn to the other, for this is the moment when the contraction of the parts is most violent, the animal’s struggles most energetic and the pain most acute, so that great care must be taken not to let go the horn which has already been secured.
When the second ovary appears at the external orifice, it is secured like the preceding, and both are removed by torsion. The horns of the uterus are then freed and returned to the abdominal cavity, the wound is thoroughly disinfected and united with from one to three interrupted sutures passed through the skin. The animal is then allowed to rise. Complications are rare.
In small females the uterine horns are often removed by torsion along with the ovaries. In adults, only the ovaries are removed.
=Subsequent Precautions: Operative Accidents.=—The patients are kept on low diet for some days after operation. Accidental stripping away of the peritoneum at the seat of operation may sometimes result in the formation of a little abscess when the wound has been infected. This is diagnosed by direct examination or palpation. The lips of the wound are then opened in order to permit the pus to escape and avoid peritonitis. Should the horns of the uterus or the broad ligaments be roughly manipulated, they may be torn to some extent, but this rarely causes grave complications.
Bleeding from the incision in the abdominal wall is of little importance.
Hernia rarely occurs, for the opening in the peritoneum is of very small size.
In rare cases, and when care is not used, a portion of the intestine may be sutured to the margin of the wound. The intestine then becomes adherent to the abdominal wall, but grave results seldom follow.
SUTURE OF THE VULVA
In cases of recurrence after reduction of an inversion of the uterus or the vagina it may become necessary to suture the vulva in order to control the effects of straining.
Several forms of suture are employed; the best are probably those of Rainard and Strebel.
=Simple Suture.=—Simple suture may be formed of very flexible copper wires. Three are usually inserted, one at the base, one about the middle, and one near the upper third of the vulval opening. The ends of each suture are knotted and drawn moderately tight over the opening, then one of the ends of the highest knot is united vertically to an end of the middle knot, and the latter in its turn is similarly secured to the lowest knot.
To be reliable, sutures should embrace the entire thickness of the lips of the vulva.
=Rainard’s Suture.=—Rainard’s suture consists only of two oblique stitches, crossed in the form of the letter “=X=,” starting from the upper third of one of the lips of the vulva and terminating in the lower third of the opposite lip. The ends are tied opposite the centre of the vulval opening.
=Strebel’s Suture.=—Strebel’s suture consists of three stitches inserted transversely. The material employed is galvanised wire, sharpened at one end and rolled into a flat spiral at the other. Each wire, which plays the part of a needle, is inserted separately, and is afterwards twisted into a spiral by means of special forceps, the excess of length being thus taken up until the lips of the vulva are brought closely in contact.
In practice, in order to avoid the cutting and irritant effect of such sutures and to increase their efficiency, two rectangular pieces of leather are applied on either side through holes in which the actual metallic sutures are passed. West’s vulval clamp is better than sutures. It is very popular in England.
TRUSSES.
Trusses applied for the purpose of preventing prolapsus of the genital organs are now almost entirely given up, as they very imperfectly achieve their object.
Lund’s truss, shown in the illustration (Fig. 325), is perhaps the most efficient of those which survive. The essential portion of this is of metal, and is approximately of the shape of the letter “=V=.” The two ends may be separated and drawn together at will by means of a cord. This apparatus is held in contact with the vulva by means of strings which pass through eyes in the metallic triangle and are secured to a collar placed on the neck or to a girth secured round the chest.
SECTION OF THE SPHINCTER OF THE TEAT.
This operation is performed to render easily pervious the ends of teats which have undergone contraction as a consequence of changes in the sphincter or from some other cause.
The animals are secured, and the teat to be operated on having been grasped between the index finger and thumb of the left hand, the point of the little cutting instrument shown in Fig. 326 is introduced into the opening of the teat, and it is then thrust in as far as the shoulder on the cutting edges.
DILATATION OF THE ORIFICE OF THE TEAT.
The results of the above operation not always proving permanent, and cicatricial contraction often following after a few weeks’ time, forced dilatation by means of the conical tubes shown (Fig. 327) has been generally substituted for it. Three instruments of varying thickness are usually sufficient. Forced dilatation may be effected at a single operation, and has not the drawback of causing cicatrices.
ABLATION OF THE MAMMÆ.
Ablation of the mammæ is rather frequently necessary, principally in cases of gangrenous mammitis, of prolonged, continuous suppuration, or of grave mammitis, where death would otherwise follow.
Provided the anatomical structure of the parts is known (Fig. 327) ablation does not present any insuperable difficulty.
In the cow, either two lateral quarters or the entire udder must be removed. The lines of incision through the skin should first of all be traced.
One half of the udder may be removed by the following method:
=First stage.= Elliptical incision through the skin, including the two teats of one side.
The lines of incision should extend backwards sufficiently high to enable the vessels at the base of the gland to be easily ligatured.
=Second stage.= Dissection and breaking down of the subcutaneous and intermammary connective tissue. The anterior mammary vein must be ligatured.
=Third stage.= Isolation of the mamma from the front backwards, and ligature of the vessels of supply. Extirpation.
=Fourth stage.= Suture and drainage of the operative wound with iodoform gauze.
This operation appears to cause formidable injuries, the abdominal tunic and the muscles of the flat portion of the thigh being largely exposed, but in reality the wound is less grave than might be supposed, and healing occurs in a comparatively short time, provided none of the diseased tissue is left.
The dressing is renewed at intervals of two or three days, and when cicatrisation proceeds regularly it may be omitted and replaced by antiseptic irrigation.
In the ewe and she-goat the operative technique is identical:
=First stage.= Elliptical incision, including the teat.
=Second stage.= Breaking through of the intermammary connective tissue partition and the subcutaneous tissue. Ligature of the anterior mammary vein.
=Third stage.= Isolation of the mamma from the front backwards. Ligature of the vessels of supply. Extirpation.
=Fourth stage.= Suture and drainage.
INDEX.
PAGE
Abdominal cavity, diseases of, 478
Ablation of the mammæ, 771
Abomasal indigestion, 182
Abomasum, 114 „ hernia of the, 493 „ obstruction of the, 194 „ strongylosis of, in the ox, 268
Abortion, epizootic, in cows, 553
Acariasis, non-psoroptic forms of, 645
Accessory glands of the genital apparatus, 597
Accidental phlebitis, 396
Acid theory in diseases of bones, 3
Acids, caustic, poisoning by, 217
Acne in the sheep, 606
Acorns, poisoning by, 228
Acquired herniæ, 489
Actinomycosis, 672
Actual cautery, castration with the, 758
Acute cystitis, 511 „ deep-seated glossitis, 131 „ eczema, 599 „ enteritis, 203 „ gastric indigestion in swine, 185 „ gastritis, 188 „ inflammation of the gastric compartments, 186 „ laryngitis, 333 „ mammitis, 573 „ metritis, 550 „ nephritis, 528 „ parotiditis, 134 „ peritonitis, 478 „ pleurisy, 361 „ tuberculosis, 704 „ vaginitis, 544
Æsculaceæ, 246
Agalaxia, 587
Agaricaceæ, 225
Alkalies, caustic, poisoning by, 217
Aloes, poisoning by, 221
Alsinaceæ, 229
Ambrosiaceæ, 256
Amputation of the claw, 730
Anæmia in cattle, 268 „ lambs, 268 „ sheep, 268
Anæsthesia, 726
Annual mercury, poisoning by, 256
Anomalies, physiological, 567
Anus, 116 „ imperforate, 742
Apiaceæ, 247
Apocynaceæ, 251
Apparatus of locomotion, 730
Aragallus spicatus, poisoning by, 237
Arsenic, poisoning by, 218
Arsenical dips, 632
Arteries, examination of, 371
“Arthritis of milch cows”, 99
Articular rheumatism, 89 „ causes, 89 „ complications, 91
Articulations, diseases of, 45
Ascites, 483
Asclepiadaceæ, 252
Aspergilli, pneumo-mycosis due to, 350
Barberry family, 235
Beech family, 228
Beef measles, 79 „ cause, 79 „ symptoms, 81 „ where prevalent, 79
Bell-flower family, 255
Berberidaceæ, 235
Biceps femoris, 70
Bile ducts, cancer of, 282
Bilharziosis in cattle and sheep, 439
Bistournage, 751
Bitter milk, 591
Bladder, diseases of the, 511 „ eversion of the, 519 „ paralysis of the, 519
Bleeding, 727 „ in the pig, 728 „ in sheep, 727
Blood, diseases of the, 406 „ examination of, 372 „ poisoning in sheep and lambs in New Zealand, 415 „ -vessels, diseases of, 396
Blood-wort family, 228
Bloody flux in calves and lambs, 271
Blue milk, 590
Boars, castration of, 759
Bog spavin in the ox, 46
Bone, actinomycosis of, 681 „ tumours, 30
Bones and articulations, tuberculosis of the, 701
Bones, diseases of, 3 „ „ acid theory, 3 „ „ inflammation theory, 4 „ „ theory of insufficiency, 3
Bovine animals, calculi in, 515 „ piroplasmosis, 416
Box family, 246
Brain, tuberculosis of the, 702
Braxy, 435
Bronchi, 333
Bronchitis, 336 „ chronic, 337 „ pseudo-membranous, 339 „ simple acute, 337 „ verminous, in sheep and cattle, 340
Broncho-pneumonia, gangrenous, due to foreign bodies, 351 „ infectious, 354 „ of sucking calves, 356 „ sclero-caseous, of sheep, 358
Bryony, poisoning by, 256
Buckwheat poisoning, 606
Bull, castration of the, 751
Bunch-flower family, 227
Bursal sheath of the flexor tendons, distension of, 49
Butneriaceæ, 235
Butter, milk without, 589
Buxaceæ, 246
Calculi in bovine animals, 515 „ urinary, in sheep, 518
Calculus formation, 514
Calves, depraved appetite in, 160 „ diarrhœic enteritis in, 212 „ dysentery in, 210 „ goitre in, 453 „ intestinal coccidiosis of, 271 „ lumbricosis of, 267 „ mycotic stomatitis in, 124 „ necrosing stomatitis in, 123
Calving, dropping after, 461
Campanulaceæ, 255
Cancer of the bile ducts, 282 „ liver, 282
Cancerous pericarditis, 375
Canker, 40 „ treatment, 41
Capillary system, examination of, 372
Carbolic acid poisoning, 221 „ dips, 633
Cardiac anomalies, 374
Carduaceæ, 256
Carrot family, 247
Caseous lymphadenitis of the sheep, 453
Casting, control of oxen by, 723
Castor oil cake, poisoning by, 257
Castration, 751 „ complications after, 760 „ by clams, 756 „ the covered method, 757 „ „ elastic ligature, 758 „ „ exposed method, 757 „ torsion, 757 „ of boars and young pigs, 759 „ „ the bull and ram, 751 „ „ „ cow, 761 „ „ cryptorchids, 760 „ „ the ram, 759 „ „ „ „ by bistournage, 759 „ „ „ „ „ ligature, 759 „ „ „ „ „ tearing, 759 „ „ „ sow, 765 with the actual cautery, 758
Catarrhal gastritis in swine, 190 „ stomatitis in sheep, 122 „ „ general, in swine, 126
Catheter, passage of the, in the cow, 750 „ „ „ „ ram, 749
Cattle, anæmia in, 268 „ bilharziosis in, 439 „ diarrhœa in, 268 „ hæmorrhagic septicæmia in, 716 „ parasitic gastro-enteritis in, 268 „ pseudo-membranous pharyngitis in, 141 „ verminous bronchitis in, 340
Caustic acids, poisoning by, 217 „ alkalies, poisoning by, 216
Cerebral congestion, 456 „ tumours, 459
Changes in the milk, 587
Chaps, 568
Chemical dyspepsia, 195
Chenopodiaceæ, 229
Chorioptic mange, 636, 640, 642
Chronic bronchitis, 337 „ cystitis, 513 „ diarrhœa, 207 „ eczema, 600 „ enteritis, 207 „ gastritis, 194 „ glossitis, 132 „ indigestion, 194 „ mammitis, 581 „ metritis, 552 „ nephritis, 530 „ parotiditis, 136 „ pericarditis, 389 „ peritonitis, 481 „ pleurisy, 362 „ simple synovitis, forms of, 45 „ tympanites, 194 „ vaginitis, 546
Circulation, organs of the, 370
Circulatory apparatus, 727
Clams, castration by, 756
Claw and third phalanx, disarticulation of the, 731 „ amputation of the, 730 „ surgical dressing for a, 730
Claws, congestion of the, 31
Clément’s bath, 623
Clotted milk, 589
Cœnurosis, 467
Colchicum poisoning, 256
Cold water, colic due to ingestion of, 162
Colic, 116 „ as a result of strangulation, 167
Colic due to invagination, 163 „ in the ox, 162
Common salt, poisoning by, 217
Complications after castration, 760
Condylomata, 38
Congenital herniæ, 487
Congestion, pulmonary, 343 „ of the claws, 31 „ „ kidneys, 527 „ „ liver, 280 „ „ udder, 570
Congestive colic, 162
Conjunctivitis, 662
Contagious disease (takosis) of goats, 412 „ mammitis in milch cows, 580 „ vaginitis, 545
“Contagious foot disease”, 41
Contraction of the sphincter, 567
Control of pigs, 725 „ sheep and goats, 725 „ oxen, 720 „ „ by casting, 723 „ general, of oxen, 722
Contusions of the sole, 31
Convallariaceæ, 228
Copper poisoning, 221
Coryza, gangrenous, 320 „ simple, 319
Cotton cake, poisoning by, 257
Covered method, castration by the, 757
Cow, castration of the, 761 „ „ „ complications in, 764 „ passage of the catheter in the, 750
Cows, epizootic abortion in, 553
Cowper’s glands, 597
Cow-pox, 665 „ and human variola, 669
Cracks, 568
Creolin bath, 324
Croupal vaginitis, 545
Crowfoot family, 230
Crushing a foreign body in the œsophagus, 735
Cryptorchids, castration of, 760
Cysticerci, infection with, 73
Cysticercosis, 290 „ peritoneal, 485
Cysticercus disease of the pig, 73
Cystic parasites of animals, table of, 73
Cystitis, acute, 511 „ chronic, 513
Cysts of the udder, 585
Defæcation: examination of fæcal material, 118
Demodecic mange, 643
Depraved appetite, 158 „ „ in calves and lambs, 160 „ „ „ the ox, 158
Diaphragmatic herniæ, 496
Diarrhœa, chronic, 207 „ in cattle, 268 „ „ lambs, 268 „ „ sheep, 268
Diarrhœic enteritis in calves, 212
Digestive apparatus, 734 „ „ diseases of, 106 „ „ fistulæ of, 500 „ „ parasites of, 263 „ „ semiology of, 106
Digestive tract, tuberculosis of the, 699
Dilatation of the œsophagus, 149 „ „ orifice of the teat, 770
Disarticulation of the claw and third phalanx, 731 „ „ two first phalanges, 732
Diseases of the bladder, 511 „ „ blood, 406 „ „ kidneys, 527 „ „ liver, 279 „ „ lymphatic system, 444 „ „ mouth, 106 „ „ œsophagus, 109 „ „ pharynx, 108 „ „ salivary glands, 108 „ „ stomach, 110, 169 „ „ rumen, 110 „ „ peritoneum and abdominal cavity, 478 „ „ urinary apparatus, 502 „ produced by distillery and sugar factory pulp, 259 „ transmissible to man through the medium of milk, 593
Distillery and sugar factory pulp, diseases produced by, 259
Distomatosis, 293
Disturbance in the milk secretion, 587
Dogbane family, 251
Dropping after calving, 461
Dysentery in calves, 210 „ „ and lambs, 271
Dyspepsia, 194 „ motor, 195 „ secretory or chemical, 195
Echinococcosis of the liver, 283 „ suppurative, 288
Ectopia of the heart, 374
Eczema, 599 „ acute, 599 „ chronic, 600 „ due to feeding with potato pulp, 603 „ sebaceous or seborrhœic, 601
Elastic ligature, castration by the, 758
Emphysema, pulmonary, 359 „ subcutaneous, 659
Encephalitis, 458
Endocarditis, 394
Enteritis, 203 „ acute, 203 „ chronic, 207 „ diarrhœic, in calves, 212 „ hæmorrhagic, 206
Epizootic abortion in cows, 553
Equisetaceæ, 225
Ergot family, 223
Ergot of rye, poisoning by, 223
Ergotism, 223
Ericaeæ, 249
Euphorbiaceæ, 244
Eventration, 499
Eversion of the bladder, 519
Exostoses, 27
Exposed method, castration by the, 757
External ischio-tibial muscle, rupture of the, 70
Exudative pericarditis due to foreign bodies, 376
Eyes, diseases of the, 661
Facial sinuses of sheep, œstrus larvæ in the, 330 „ „ trephining the, 745
Fæcal material, examination of, 118
Fagaceæ, 228
Fagopyrism, 606
False sturdy, 330
Fasciola hepatica, 294
Felon, 41
Female genital organs, examination of, with the speculum, 760
Femoro-tibial articulation, luxation of the, 61 „ „ symptoms, 62 „ „ treatment, 63
Femur, luxation of, 56 „ „ „ symptoms, 57 „ „ „ treatment, 58
Fennel, poisoning by, 249
Ferments, lactic, 588
Fern family, 225
Fetlock joint, distension of the synovial capsule of the, 48 „ strain of, 54
Figwort family, 255
Fistula, parotid, 136
Fistulæ, milk, 569 „ of the digestive apparatus, 500
Flax family, 244
Flexor metatarsi, rupture of the, 72 „ tendons, distension of the bursal sheath of, 49
Food, poisoning due to, 215
Foot, diseases of the, 31 „ rot, 43 „ „ symptoms, 43 „ „ treatment, 44 „ scab, 636
Foreign bodies causing diseases of the eyes, 661 „ „ exudative pericarditis due to, 376 „ „ gangrenous broncho-pneumonia due to, 351 „ „ gastric disturbance due to, 198 „ „ migration of, from the reticulum, pneumonia due to, 348
Foreign bodies, pneumonia due to, 347
Foreign body in the œsophagus, crushing a, 735 „ „ „ „ submucous dissection of, 736
Fractures, 20
France, bovine piroplasmosis in, 424
Frontal sinus, trephining the, 745 „ „ purulent collections in, 327
Gangrenous broncho-pneumonia due to foreign bodies, 351 „ coryza, 320 „ mammitis in goats, 584 „ „ of milch ewes, 583
Gaseous indigestion, 170
Gastric compartments, acute inflammation of, 186 „ „ tumours of the, 202 „ disturbance due to foreign bodies, 198 „ indigestion, acute, in swine, 185
Gastritis, 186, 188–194
Gastro-intestinal strongylosis in sheep, 263
Gastrotomy, 739
“Gathered Nail”, 37
General diseases, 4
Genital apparatus, 542 „ „ accessory glands of the, 597 „ malformations, 560 „ organs, male, 594 „ „ tuberculosis of the, 700
Genito-urinary organs, 747 „ regions, 502
Gid, 467
Glands, mammary, diseases of, 565
Glans penis and sheath, polypi of, 506
Glossitis, 130 „ acute, deep-seated, 131 „ chronic, 132 „ nodular sclerosing, 133 „ superficial, 130
Goat, demodecic mange in the, 644 „ mange in the, 641 „ ringworm in the, 653
Goats, control of, 725 „ gangrenous mammitis in, 584
Goitre in calves, 453 „ lambs, 453
Goosefoot family, 229
Grass family, 226 „ tick, life history of, 432
Grease, 41
Hæmaturia, 520
Hæmodoraceæ, 228
Hæmorrhagic enteritis, 206 „ „ in calves and lambs, 271 „ septicæmia in cattle, 716
Hæmorrhagic septicæmia, infective diseases confused with, 718
Haunch, hygroma of, 67
Heart, ectopia of the, 374
Heat stroke, 442
Heath family, 249
Hellebore, poisoning by, 234
Helminthiasis, intestinal, in ruminants, 275
Hemlock, poisoning by, 248
Hepatitis, nodular necrosing, 280
Hernia, inguinal, in young pigs, 741 „ of the abomasum, 493 „ „ intestine, 494 „ „ rumen, 490 „ perineal, of young pigs, 487
Herniæ, 487, 741 „ acquired, 489 „ congenital, 487 „ diaphragmatic, 496 „ treatment of, 495
Hock, hygroma of the point of the, 68 „ joint, distension of the synovial capsule of the, 46 „ „ strain of, 55 „ region, distension of the tendon sheaths in, 46
Hoose, 340
Horn core, trephining the, 745
Horns, anatomy of, 21 „ detachment of, 23 „ fissuring of, 24 „ fractures of, 21, 25 „ splints for, 26 „ treatment of, 25
Horse-chestnut family, 246
Horsetail family, 225
Human variola and cow-pox, 669
Husk, 340
Hydro-nephrosis, 531
Hydro-pneumo-thorax, 366
Hygroma of the haunch, 67 „ „ knee, 65 „ „ point of the hock, 68 „ „ point of the sternum, 69 „ „ stifle, 67 „ „ trochanter of the femur, 67
Hygromas, 64
Hypericaceæ, 246
Hypocreceæ, 223
Hypodermosis in the ox, 646
Impaction of the omasum, 179 „ „ rumen, 175
Imperforate anus, 742 „ condition of the teat, 567 „ vagina, 560
Impetigo in the pig, 605
Indigestion, 170 „ abomasal, 182 „ acute gastric, in swine, 185 „ as a result of over-eating, 175 „ chronic, 194
Infectious broncho-pneumonia, 354
Infectious diseases, 665 „ pyelo-nephritis, 533 „ pseudo-rheumatism in adults, 99 „ „ „ symptoms, 100 „ „ „ treatment, 103 „ rheumatism in young animals, 94 „ „ „ causes, 94 „ „ „ symptoms, 95
Infective diseases, confused with hæmorrhagic septicæmia, 718
Inflammation of the sheath, 506 „ „ submaxillary salivary gland, 137
Inflammatory diseases, 570
Inguinal hernia in young pigs, 741
Insolation, 460
Interdigital space, inflammation of the, 38
Internal infectious phlebitis, 398
Interstitial mammitis, 574
Intestinal helminthiasis in ruminants, 275 „ tuberculosis, 699
Intestine, 116 „ hernia of the, 494
Invagination, colic due to, 163
Inversion and prolapsus of the rectum, 743
Iodine poisoning, 22
Iodism, 222
Iodoform poisoning, 222
Ischial urethrotomy, 747
Ischio-tibial muscle, external, rupture of the, 70
Issues, 728
Joints, luxation of, 56
Keratitis, 662
Kidney worm of swine, 539
Kidneys, congestion of the, 527 „ diseases of the, 527
Knee, distension of tendon sheaths in the region of, 49 „ hygroma of, 65 „ joint, distension of the synovial capsule of the, 47 „ strain of, 53
Lactic ferments, 588
Lambs, anæmia in, 268 „ blood poisoning in, in New Zealand, 415 „ depraved appetite in, 160 „ diarrhœa in, 268 „ goitre in, 453 „ intestinal coccidiosis of, 271 „ parasitic gastro-enteritis in, 268
Laminitis, 32 „ symptoms, 33 „ treatment, 34
Laparotomy, 740
Larkspur poisoning in sheep, 231
Laryngitis, 333 „ acute, 333 „ pseudo-membranous, 333
Larynx, 333 „ examination of, 313 „ tumours of, 335
Lathyrism, 243
Lead poisoning, 220
Licking habit, 158
Lily of the valley family, 228
Lime and sulphur dips, 627 „ „ prejudice against, 628
Linaceæ, 244
Liver, 119 „ cancer of, 282 „ congestion of, 280 „ diseases of, 279 „ echinococcosis of, 283 „ rot, 293
Liver fluke (Fasciola hepatica), 294 „ disease, 293
Local affections, 20
Locomotion, apparatus of, 730 „ organs of, diseases of, 1 „ gait in, 1 „ inspection for, 1 „ palpation and pressure to detect, 1 „ percussion in, 1
Louping-ill, 429
Lumbar prurigo, or “trembling,” in sheep, 475
Lumbricosis of calves, 267
Lund’s truss, 770
Lungs, 343
Lupines, poisoning by, 241
Luxation of the femoro-tibial articulation, 61 „ „ femur, 56 „ „ patella, 58 „ „ scapulo-humeral joint, 63
Lymphadenitis, 448
Lymphatic glands, tuberculosis of, 696 „ glandular apparatus, topography of, 445 „ system, diseases of, 444
Lympho-cythæmia, 448
Lymphogenic diathesis, 448
Magnoliaceæ, 229
Magnolia family, 229
Maize, poisoning by the male tufts of, 226
Male genital organs, 594
Malformations, genital, 560
Malignant œdema, 415
Mammæ, ablation of the, 771
Mammary glands, diseases of, 565 „ toxæmia, 461
Mammitis, 571 „ acute, 573 „ chronic, 581 „ contagious, in milch cows, 580
Mammitis, gangrenous in goats, 584 „ „ of milch ewes, 583 „ interstitial, 574 „ parenchymatous, 575
Mange, 611 „ chorioptic, 636, 640, 642 „ demodecic, 643 „ in the goat, 641 „ „ ox, 638 „ „ pig, 642 „ psoroptic, 614, 639 „ sarcoptic, 638, 641 „ symbiotic, 636
Manual technique in bistournage, 752 „ „ castration of the cow, 762 „ „ „ „ sow, 766
Martelage, 756
Maxilla, actinomycosis of the, 673
Maxillary sinus, purulent collections in, 329 „ „ trephining the, 745
Measles, beef, 79 „ pork, 78
Mechanical pneumonia, 347
Mediastinum, diseases of structures enclosed within the, 368 „ tuberculosis of the, 697 „ tumours of, 369
Medicated milk, 591
Melanthaceæ, 227
Meliaceæ, 244
Meningitis, 456
Mercurial poisoning, 219 „ stomatitis, 128 „ „ nature of, 129
Metritis, 547 „ acute, 550 „ chronic, 552 „ septic, 547
Microbic changes in milk, 588
Migration of foreign bodies from the reticulum, pneumonia due to, 348
Milch cows, contagious mammitis in, 580 „ ewes, gangrenous mammitis of, 583
Milk, bitter, 591 „ blue, 590 „ changes in the, 587 „ clotted, 589 „ diseases transmissible to man through the medium of, 593 „ fever, 461 „ fistulæ, 569 „ medicated, 591 „ microbic changes in, 588 „ mucous, viscous, or thready, 589 „ preservation of, 591 „ putrid, 589 „ red, 590 „ secretion, disturbance in the, 587 „ thready, 589 „ viscous, 589 „ without butter, 589 „ yellow, 590
Milkweed family, 252
Molasses refuse, poisoning by, 258
Motor dyspepsia, 195
Mouth, diseases of, 106, 121
Mucous milk, 589
Muguet, 124
Muscles and tendons, diseases of, 70 „ parasitic diseases of, 73
Muscular rheumatism, 92
Mushroom family, 225
Mycotic stomatitis in calves, 124
Myelo-cythæmia, 448
Nails, picked-up, 37
Nasal cavities, 319 „ „ examination of, 311 „ „ tumours of, 325 „ gleet, 326 „ sinuses, purulent collections in, 326
Neck, actinomycosis of the, 675
Necrosing stomatitis in calves, 123
Nephritis, acute, 528 „ chronic, 530 „ suppurative, 537
Nervous system, 456
Nettle family, 229
New-born animals, septicæmia of, 406 „ „ umbilical phlebitis of, 399
New Zealand, blood poisoning in sheep and lambs in, 415
Nitrates of potash and soda, poisoning by, 217
Nodular necrosing hepatitis, 280 „ sclerosing glossitis, 133
Non-psoroptic forms of acariasis, 645
Nympho-mania, 562
Obstruction of the abomasum, 194
Œsophageal obstructions, 152 „ „ treatment, 154 „ sounds, 155
Œsophagitis, 145
Œsophagotomy, 156, 736
Œsophagus, 734 „ dilatation of, 149 „ diseases of, 109, 145 „ ruptures and perforations of, 157 „ stricture of, 148
Œstrus larvæ in the facial sinuses of sheep, 330
Oleaceæ, 251
Olive family, 251
Omasum, 113 „ impaction of the, 179
Omphalo-phlebitis, 402
“Open arthritis”, 51
“Open Synovitis, 49
Operations, 720
Ophthalmia, verminous, of the ox, 663
Organs of circulation, semiology of, 370 „ locomotion, diseases of, 1 „ „ „ methods of examination in, 1
Orifice of the teat, dilatation of the, 770
Osseous cachexia, 7 „ „ causes of, 14 „ „ history of, 8
Osseous cachexia, phases of, 9–11 „ „ symptoms of, 8, 11 „ „ treatment of, 18
Ostitis, suppurating, 29
Ovary, tumours of the, 559
Over-eating, indigestion as a result of, 175
Over-exertion, 442
Ovine pasteurellosis, 263 „ piroplasmosis, 425
Ox, colic in the, 162 „ demodecic mange in the, 644 „ depraved appetite in the, 158 „ hypodermosis in the, 646 „ mange in the, 638 „ strongylosis of the abomasum in the, 268 „ urethrotomy in the, 747 „ verminous ophthalmia of the, 663
Oxen, canker in, 40 „ control of, 720 „ „ by casting, 723 „ „ the limbs, 720 „ warts in, 655
Panaritium, 41
Pancreas, 119
Papaveraceæ, 235
Papillomata, verrucous, of the udder, 586
Paralysis of the bladder, 519
Parasites, cystic, of animals, table of, 73 „ of the digestive apparatus, 263
Parasitic diseases of muscles, 73 „ gastro-enteritis, 268 „ „ in cattle, 268 „ „ in lambs, 268 „ „ in sheep, 268
Parenchymatous mammitis, 575
Parotid fistula, 136 „ glands, actinomycosis of the, 675
Parotiditis (Parotitis), 134, 136
Parturient apoplexy, 461
Passage of the catheter in the cow, 750 „ „ „ ram, 749
Passing the probang, 735
Patella, luxation of, 58 „ „ bandage for, 60 „ „ symptoms, 59 „ „ treatment, 60
Patellar synovial capsule, inflammation of, 45
Pea family, 236
Pelvis, fractures of, 20
Pericarditis, 375 „ cancerous, 375 „ chronic, 389 „ exudative, due to foreign bodies, 376 „ simple acute, 375 „ specific, 375
Perineal hernia of young pigs, 487
Perinephritis, 537
Peripneumonia and pneumonia, differences between, 347
Perisporaceæ, 223
Peritoneal cysticercosis, 485
Peritoneum, diseases of, 478
Peritonitis, 478 „ acute, 478 „ chronic, 481
Persistence of the urachus, 508
Phallaceæ, 225
Pharyngeal polypi, 143
Pharyngitis, 138
Pharynx, actinomycosis of the, 675 „ diseases of, 108, 134
Phlebitis, 396 „ accidental, 396 „ internal infectious, 398 „ umbilical, 402 „ „ of new-born animals, 399 „ utero-ovarian, 398
Phosphorus poisoning, 219
Phthiriasis, 608
Physiological anomalies, 567
Phytolaccaceæ, 229
Pica, 158
Picked-up nails, 37
Pig, cysticercus disease of the, 73 „ „ „ „ cause of, 74 „ „ „ „ examination fo, 77 „ „ „ „ symptoms of, 75 „ „ „ „ treatment, 78 „ demodecic mange in the, 644 „ impetigo in the, 605 „ mange in the, 642 „ pneumonia of the, 710, 714 „ ringworm in the, 653 „ urticaria in the, 656 „ verrucous endocarditis of the, 710, 713
Pigs, control of, 725 „ ringing, 734 „ tonsilitis in, 138 „ young, castration of, 759 „ „ inguinal hernia in, 741 „ „ perineal hernia of, 487
Pink family, 229
Piroplasmosis, 416
Plantar aponeurosis, injury to, 38
Plants poisonous to stock, 223
Pleura, diseases of, 361
Pleuræ, 343
Pleurisy, acute, 361 „ chronic, 362
Plugs, 728
Plum family, 236
Pneumonia due to foreign bodies, 347 „ „ migration of foreign bodies from the reticulum, 348 „ mechanical, 347 „ mycosis due to aspergilli, 350 „ of the pig, 710 „ simple, 343
Pneumo-thorax, 362
Poaceæ, 226
Poisoning, 213 „ by acorns, 228 „ „ aloes, 221 „ „ annual mercury, 256 „ „ Aragallus spicatus, 237 „ „ arsenic, 218 „ „ bryony, 256 „ „ castor oil cake, 257 „ „ caustic acids, 217 „ „ „ alkalies, 216 „ „ common salt, 217 „ „ cotton cake, 257 „ „ ergot of rye, 223 „ „ fennel, 249 „ „ hellebore, 234 „ „ hemlock, 248 „ „ lupines, 241 „ „ male tufts of maize, 226 „ „ molasses refuse, 258 „ „ nitrates of potash and soda, 217 „ „ poppies, 235 „ „ ranunculaceæ, 234 „ „ smut of barley, 224 „ „ St. John’s wort, 246 „ „ sweet sorghum grass, 226 „ „ tartar emetic, 218 „ „ vetches, 243 „ „ white loco weed, 237 „ „ wild chervil, 248 „ carbolic acid, 221 „ colchicum, 256 „ copper, 221 „ due to food, 215 „ iodine, 222 „ iodoform, 222 „ larkspur, in sheep, 231 „ lead, 220 „ mercurial, 219 „ phosphorus, 219 „ strychnine, 222 „ tobacco, 254
Pokeweed family, 229
Polypi of the glans penis and sheath, 506 „ pharyngeal, 143
Polypodiaceæ, 225
Poppies, poisoning by, 235
Poppy family, 235
Post-partum paralysis, 461
Potato family, 252 „ pulp, eczema due to feeding with, 603
Preservation of milk, 591
Pricks and stabs in shoeing, 36
Primrose family, 251
Primulaceæ, 251
Probang, passing the, 735
Probangs, 155
Prolapsus and inversion of the rectum, 743
Prostate, 597
Prunaceæ, 236
Pseudo-membranous bronchitis, 339 „ laryngitis, 333 „ pharyngitis in cattle, 141 „ pharyngitis in sheep, 142
Pseudo-pericarditis, 390
Pseudo-rheumatism, 94 „ „ infectious, in adults, 99
Psoroptic mange, 614, 639
Psorospermosis in calves and lambs, 271
Pulmonary congestion, 343
Pulmonary emphysema, 359
Pulse, examination of, 371
Puncture, in exploration of the rumen, 112 „ of the rumen, 737
Purulent collections in the frontal sinus, 327 „ „ „ maxillary sinus, 329 „ „ „ nasal sinuses, 326
Putrid milk, 589
Pyelo-nephritis, infectious, 533
Pyo-pneumo-thorax, 366
Rachitis, 4 „ symptoms of, 5 „ treatment of, 7
Ragweed family, 256
Ram, castration of the, 751, 759 „ passage of the catheter in the, 749 „ urethrotomy in the, 749
Ranunculaceæ, 230 „ poisoning by, 234
Rectal exploration, 116
Rectum, prolapsus and inversion of the, 743
Red milk, 590
Respiratory apparatus, 311, 745 „ „ examination of, 311 „ „ tuberculosis of the, 690
Reticulitis, 186
Reticulum, 113
Retro-pharyngeal glands, tuberculosis of, 696
Rheumatism, 89 „ articular, 89 „ infectious forms of, 94 „ muscular, 92
Ring-bone, 28
Ringing pigs, 734
Ringworm, 649 „ in the sheep, goat, and pig, 653
Rot-mould family, 223
Rowels, 728
Rumen, 737 „ examination of the, 110 „ hernia of the, 490 „ impaction of the, 175 „ puncture of the, 737
Rumenitis, 186
Ruminants, intestinal helminthiasis in, 275
Rupture of the external ischio-tibial muscle, 70 „ „ flexor metatarsi, 72
Ruptures and perforations of the œsophagus, 157
“Salivary abscesses”, 137
Salivary glands, diseases of, 108, 134
Salpingitis, 555
Salpingo-ovaritis, 555
Salt common, poisoning by, 217
Sand crack, 34 „ symptoms, 35 „ treatment, 35
Sarcoptic scabies, 612 „ mange, 638, 641
Saturnism, 220
Scab, 611, 614 „ dips, arsenical, 632 „ „ carbolic, 633 „ „ Clément’s bath, 623 „ „ creolin bath, 624 „ „ lime and sulphur, 627 „ „ Tessier’s bath, 622 „ „ tobacco and sulphur, 626 „ „ Trasbot’s bath, 623 „ foot, 636
Scabies, 611 „ in sheep, 611
Scapulo-humeral joint, luxation of the, 63
Sclero-caseous broncho-pneumonia of sheep, 358
Scleroderma, 657
Sclerostoma pinguicola (kidney worm), 539
Scorbutus, 104
Scrophulariaceæ, 255
Scrotal urethrotomy, 748
Scurvy, 104
Sebaceous or seborrhœic eczema, 601
Secretory dyspepsia, 195
Section of the sphincter of the teat, 770
Semiology of the digestive apparatus, 106 „ „ organs of circulation, 370
Septic metritis, 547
Septicæmia of new-born animals, 406
Serous membranes, tuberculosis of, 694
Setons, 728
Sheath, inflammation of, 506
Sheep, acne in the, 606 „ anæmia in, 268 „ bilharziosis in, 439 „ blood poisoning in, in New Zealand, 415 „ caseous lymphadenitis of the, 453 „ catarrhal stomatitis in, 122 „ control of, 725 „ diarrhœa in, 268 „ gastro-intestinal strongylosis in, 263 „ larkspur poisoning in, 231 „ œstrus larvæ in the facial sinuses of, 330 „ parasitic gastro-enteritis in, 268 „ pseudo-membranous pharyngitis in, 142 „ ringworm in the, 653 „ scab, 614 „ scabies in, 611 „ sclero-caseous broncho-pneumonia of, 358 „ “trembling,” or lumbar prurigo, in, 475 „ ulcerative stomatitis in, 125 „ urinary calculi in, 518 „ verminous bronchitis in, 340
Shoeing, stabs and pricks in, 36
Shoulder, strain of, 52
Simple acute bronchitis, 337
Simple acute pericarditis, 375 „ coryza, 319 „ pneumonia, 343 „ stomatitis, 121
Sinuses, examination of, 312
Skin, diseases of, 599 „ tuberculosis of the, 703
Smut of barley, poisoning by, 224 „ family, 224
Solanaceæ, 252
Sole, contusions of the, 31
Sow, anatomical arrangements of the genital organs in the, 765 „ castration of the, 765 „ operative accidents in, 768
Spavin in the ox, 27
Specific pericarditis, 375
Speculum, examination of female genital organs with the, 760
Sphincter of the teat, contraction of the, 567 „ „ section of, 770
Spurge family, 244
Stabs and pricks in shoeing, 36
Sternum, hygroma of the point of the, 69
Stifle, hygroma of the, 67 „ joint, strain of, 54
Stink-horn family, 225
St. John’s wort family, 246 „ poisoning by, 246
Stock, plants poisonous to, 223
Stomach, diseases of the, 110, 169
Stomatitis, 121 „ catarrhal, in sheep, 122 „ general catarrhal, in swine, 126 „ mercurial, 128 „ mycotic, in calves, 124 „ necrosing, in calves, 123 „ ulcerative, in swine, 127 „ in sheep, 125
Strain of the fetlock, 54 „ „ hock joint, 55 „ „ knee, 53 „ „ shoulder, 52 „ „ stifle joint, 54
Strains of joints, 52
Strangulation, colic as a result of, 167
Strawberry-shrub family, 235
Stricture of the œsophagus, 148
Strongylosis of the abomasum in the ox, 268
Strychnine poisoning, 222
Sturdy, 467
Subcutaneous connective tissue, diseases of the, 599 „ emphysema, 659, 738
Submaxillary salivary gland, inflammation of, 137
Sucking calves, broncho-pneumonia of, 356
Sugar factory pulp, diseases produced by, 259
Superficial glossitis, 130
Suppurating ostitis, 29
Suppurative echinococcosis, 288 „ nephritis and perinephritis, 537
Surgical dressing for a claw, 730
Suture of the vulva, 768 „ „ „ Rainard’s suture, 769 „ „ „ simple suture, 768 „ „ „ Strebel’s suture, 769
Sweet sorghum grass, poisoning by, 226
Swine, acute gastric indigestion in, 185 „ catarrhal gastritis in, 190 „ fever, 710 „ general catarrhal stomatitis in, 126 „ ulcerative stomatitis in, 127 „ kidney worm of, 539
Symbiotic (chorioptic) mange, 636
Synovial capsule of the hock joint, distension of, 46 „ „ „ fetlock joint, distension of, 48 „ „ „ knee joint, distension of, 47 „ membranes, diseases of, 45
Synovitis, 45
Takosis, 412
Tartar emetic, poisoning by, 218
Taxaceæ, 226
Taxus baccata, 226
Teat, dilatation of the orifice of the, 770 „ imperforate condition of the, 567 „ section of the sphincter of the, 770
Tendon sheaths, distension of, 48 „ „ „ in the hock region, 46 „ „ „ in the region of the knee, 49
Tendons and muscles, diseases of, 70
Tessier’s scab dip, 622
Testicle, tumours of the, 594
Tetanus, 670
Thorax, examination of, 315
Thistle family, 256
Third stomach, impaction of the, 179
Thready milk, 589
Thrush, 124
Tobacco and sulphur dip, 626
Tobacco poisoning, 254
Tongue, actinomycosis of the, 674
Tonsilitis in pigs, 138
Tonsils, diseases of, 134
Torsion, castration by, 757 „ of the uterus, 556
Trachea, 333 „ examination of, 314
Tracheotomy, 746
Trasbot’s scab dip, 623
Traumatic arthritis, 51 „ articular synovitis, 51 „ lesions, 568 „ synovitis, 49 „ tendinous synovitis, 50
“Trembling,” or lumbar prurigo, in sheep, 475
Trephining the facial sinuses, 745 „ frontal sinus, 745 „ horn core, 744 „ maxillary sinus, 745
Trichiniasis-trichinosis, 84
Trochanter of the femur, hygroma of the, 67
Truss, Lund’s, 770
Trusses, 769
Trypanosomata, diseases produced by, 426
Tuberculosis, 682
Tuberculosis, acute, 704 „ in sheep, goats, and pigs, 705 „ of serous membranes, 694 „ „ bones and articulations, 701 „ „ lymphatic glands, 696 „ „ the brain, 702 „ „ „ digestive tract, 699 „ „ „ genital organs, 700 „ „ „ respiratory apparatus, 690 „ „ „ skin, 703
Tuberculous septicæmia, 704
Tumours, bone, 30 „ cerebral, 459 „ of the gastric compartments, 202 „ „ larynx, 335 „ „ mediastinum, 369 „ „ nasal cavities, 325 „ „ ovary, 559 „ „ testicle, 594 „ „ udder, 585 „ „ uterus, 559
Turn-sick, 467
Tympanites, chronic, 194
Udder, congestion of the, 570 „ cysts of the, 585 „ tuberculosis of the, 701 „ tumours of the, 585 „ verrucous papillomata of the, 586
Ulcerative gastritis, 191 „ stomatitis in sheep, 125 „ „ swine, 127
Umbilical phlebitis, 402 „ „ of new-born animals, 399
Umbrella-tree family, 244
Urachus, persistence of the, 508
Urethrotomy in the ox, 747 „ „ ram, 749
Urinary apparatus, diseases of the, 502 „ calculi in sheep, 518 „ lithiasis, 514
Urticaceæ, 229
Urticaria in the pig, 656
Ustilaginaceæ, 224
Utero-ovarian phlebitis, 398
Uterus, torsion of the, 556 „ tumours of the, 559
Vaccine, preparation of, 669
Vaccinia, 665
Vagina, imperforate, 560
Vaginitis, 543 „ acute, 544 „ chronic, 546 „ contagious, 545 „ croupal, 545
Veins, examination of, 372
Verminous bronchitis in sheep and cattle, 340 „ conjunctivitis, 662 „ ophthalmia of the ox, 663
Verrucous endocarditis of the pig, 710, 713
Verrucous papillomata of the udder, 586
Vesiculæ seminales, 597
Vetches, poisoning by, 243
Viciaceæ, 236
Viscous milk, 589
Vulva, suture of the, 768
Warbles, 646
Warts in oxen, 655
Whitlow, 41
White loco weed, poisoning by, 237
Wild chervil, poisoning by, 248
Wounds or traumatic lesions, 568
Yellow milk, 590
Yew family, 226 „ poisoning, 226
BRADBURY, AGNEW & CO. LD., PRINTERS, LONDON AND TONBRIDGE
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BY THE SAME AUTHOR.
Royal 8vo, 438 pages, 406 illustrations.
A Handbook of Horse-shoeing.
With Introductory Chapters on the Anatomy and Physiology of the Horse’s Foot. The section on the “Practice of Shoeing” contains 54 full-page plates and descriptive notes supplied by ALBERT WHEATLEY, F.R.C.V.S.
60 large pages (14½ × 10 inches), 315 illustrations.
An Atlas of Veterinary Surgical Operations.
Demy 8vo, 42 pages, 16 full-page plates.
A Surgical Operating Table for the Horse.
Royal 8vo, 618 pages, 95 illustrations.
Studies in Clinical Veterinary Medicine and Surgery.
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The Practice of Veterinary Surgery.
VOL. I.—OPERATIVE TECHNIQUE.
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The Practice of Veterinary Surgery.
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VOL. III.—REGIONAL SURGERY.
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TRANSCRIBER’S NOTES
1. Silently corrected obvious typographical errors and variations in spelling. 2. Retained archaic, non-standard, and uncertain spellings as printed. 3. Re-indexed footnotes using numbers. 4. Enclosed italics font in underscores. 5. Enclosed bold font in =equals=. 6. Denoted superscripts by a caret before a single superscript character or a series of superscripted characters enclosed in curly braces, e.g. M^r. or M^{ister}. 7. Denoted subscripts by an underscore before a series of subscripted characters enclosed in curly braces, e.g. H_{2}O.
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