Part 34

Stimulants. In debilitated subjects or with low fever or oppressed heart the stimulating diuretics like sweet spirits of nitre or liquor of the acetate of ammonia are to be preferred, and this is especially the case during convalescence. They at once sustain the flagging heart and aid in the excretion of morbid products. Digitalis is often of great value in the same sense, and as a heart stimulant nux vomica.

Some follow Todd and Bennett in seeking stimulation from alcohol, ammonia and its salts, ether, etc. When the circulation is weak or flagging these are often of value and they may even act directly on the pathogenic microbe. The inhalation of oxygen, or the solution of peroxide of hydrogen given by the mouth has often an excellent effect.

Sedatives. Aconite has become too much of a domestic remedy, nevertheless it may be used with advantage in high fever with excited heart action, to moderate the circulation and relieve the breathing. Veratrum, hydrobromic acid, bromide of sodium or ammonium, or chloral hydrate may be used as alternates or substitutes.

Compresses. Fomentations. Poultices. No measure is safer nor more promising, especially in the early stages, than the poultice jacket or compress. A blanket wrung out of hot water is wrapped around the chest, covered with a thick dry one, and held firmly attached by elastic circingles. Or soaked cotton wool is applied and covered with a dry blanket or a rubber sheet. The more acute the inflammation the more valuable is this measure.

Derivatives. As a derivative the mustard pulp rubbed in and covered with thick paper or rubber is especially valuable. In one hour it may secure a free exudation and material relief to the breathing. It may be replaced by ammonia and oil, with or without a covering, by hot water or by cantharides. This must however be used with judgment. In the early stage with a high type of inflammation and fever the surface irritation may aggravate this through sympathy; in such cases therefore the severity of the inflammation should first be moderated before using an active counterirritant. In debilitated conditions, too with an altered or depraved state of the blood and during the prevalence of a low type of the disease, sloughing may ensue from incautious blistering.

The repetition of the blister is often useful, the healing process going on simultaneously in the blistered surface and the diseased lung by virtue of nervous sympathy.

To complete recovery a course of vegetable tonics, such as gentian, nux vomica, calumba, may be given with iodide of potassium for a week or more. Constipation occurring during convalescence must always be corrected by food, (bran mashes, linseed gruel), injections, or oleaginous, saline, or aloetic laxatives. The greatest care should be exercised to secure pure air, comfort, sunshine, good grooming and general hygiene, and to prevent over-exertion during convalescence.

In the subacute types of pneumonia the fundamental difference in the treatment consists in the avoidance of all depressing remedies and the employment of stimulants and a supporting diet from the beginning. Sweet spirits of nitre and liquor of the acetate of ammonia, carbonate of ammonia or salammoniac with digitalis and strychnia may be used from the first. Vegetable tonics may be resorted to at an early stage, peroxide of hydrogen, and when expectoration is established and the fever moderated even mineral tonics may be employed. Nourishing gruels, mashes, roots, green food, and scalded oats may be used in turn to coax the appetite and not to satiate. In other respects the treatment is the same as for the acute. This form of the disease is liable to prove obstinate and persistent, and there appears to be a greater tendency to complications and so-called metastasis, as enteritis, laminitis or rheumatoid affections of the back or limbs. These when they occur must be treated as if they had arisen in ordinary circumstances, having regard meanwhile to the remaining inflammation in the lungs, for that has not necessarily been quite superseded but only alleviated.

CHRONIC PNEUMONIA. This has been described but if uncomplicated by consumption it appears to be usually only that consolidation of lung, due to the organization of exuded products into fibrous tissue, which occasionally forms a sequel of acute inflammation of the lungs. In such cases an access of circumscribed local congestion is liable to result from over-exertion, or a chronic state of irritation is maintained attended with more or less fever, inappetence, mal-assimilation, and often in the long run hectic, under which the animal is worn out. In such cases the chief indications are to avoid overwork or any undue strain upon the breathing organs, to support the patient by nourishing and easily digested food, and to control and remove any local irritation by measures indicated under the head of acute pneumonia.

CROUPOUS PNEUMONIA IN THE OX.

Subacute in many cases. Effect of temperament, and work. Acute form. Symptoms. Decubitus. Unfavorable symptoms. Prognosis. Suppuration frequent: indications. Gangrene. Colliquative Diarrhœa. Lesions, Comparison with those of lung plague. Tubercle. Treatment, bleeding, laxatives, refrigerant salts, derivatives, stimulants, tonics. Chronic form. Symptoms. Treatment.

In the large ruminants this disease tends more towards a subacute type than in the horse, and coming on insidiously from ordinary causes is liable to be confounded with the contagious pleuro-pneumonia of the bovine race. As in the horse the nervous animals show more violent symptoms. It is rare in milch cows and young cattle and more frequent in work oxen.

In the acute form the symptoms mainly agree with those of the horse. There is the same shivering, followed by a hot stage, hyperthermia, the accelerated pulse, the short quick labored breathing, heaving flanks, cough frequent, deep, hacking, and easily excited, dilating nostrils, redness of the mucous membrane, and the same indications on auscultation and percussion, care being taken to obviate misconception of natural conditions in the chest of the ox. There is in addition a dry muzzle, tenderness of the back and breast bones and wincing when they are pinched between the fingers and thumb; suspension of the appetite and rumination and in cows suppression of the secretion of milk; the mouth is often opened and the tongue protruded to facilitate breathing, and in bad cases each expiration is accompanied by a moan or grunt. In many cases the ox can lie on his flattened breastbone and maintain the breathing process, but when the disease is severe he stands no less obstinately than the horse, his elbows turned out, his nose protruded and directed towards a window or other opening.

Among the unfavorable symptoms may be mentioned increasing anxiety and distress, a more oppressed breathing, the animal standing constantly in one position with legs apart, elbows turned out, his nose extremely raised, nostrils widely dilating, mouth open, tongue protruded, the expiratory grunt deep and prolonged, the cough infrequent and so weak as to be almost inaudible, being rather like a forced expiration, and the pulse rapid, feeble or imperceptible. The prognosis is favorable in moderate cases subjected to early treatment.

The termination by suppuration is more frequent than in the horse. The general symptoms are ameliorated, appetite and rumination return though they remain capricious and irregular, there remains the double action of the flanks, the dry, rough muzzle, the tense, inelastic skin, frequently varying in temperature, the beast shivers at intervals, the cough is weak and often repeated, a yellowish thick discharge takes place from the nose, weakness and emaciation increases and the animal dies in from twenty to thirty days.

Gangrene of the lung sometimes supervenes and is indicated by similar symptoms as in the horse. In severe and prolonged cases a violent fetid diarrhœa often supervenes and hastens a fatal result.

The post mortem lesions are similar to those of the horse. The cut surface of the hepatized lung, however, is divided into irregular red spaces by intersecting yellow lines—hence the name of marbled lung, from a supposed resemblance to that stone. The red spaces represent the pulmonary lobules and the whitish lines the surrounding areolar tissue which being especially abundant in ruminants and pigs stands out prominently when infiltrated with the yellowish exudation. There is then nothing specific in this appearance as has been erroneously supposed, it is merely the result of the different conformation of the lung in these animals and is always seen in the hepatized lung unless when from extravasation of blood into its substance the redness is rendered uniform. The amount of exudate into the interlobular tissue is, however, never so great as in lung plague.

The greater frequency of suppuration in the lung of the ox, as well as the greater tendency to tubercular deposit in prolonged cases are additional features in the diseased lungs.

Treatment. Blood-letting should be employed only with precautions, as in the horse. A saline laxative (1 lb. Epsom salts and ½ lb. molasses) may be used with advantage and safety early in the disease though in advanced stages it may sometimes prove dangerous from the tendency to diarrhœa. If constipation appears at a late stage injections of warm water and a mild laxative (6 ounces sulphate of soda) only, should be given. The purgative may be followed by the same neutral salts and in the same doses as for the horse. Counterirritants are of equal value. A mustard poultice may be kept on for several hours, or a mixture in equal parts of oil of turpentine, ammonia, and olive oil may be actively rubbed over both sides of the chest and repeated daily until tender. In Denmark a prompt and efficient blister is made with 1 part of Croton oil and 10 parts each of sulphuric ether and spirits of wine. This is rubbed actively over the chest and washed off as soon as a sufficient effect has been produced. It must be carefully watched to prevent blemishing.

In the low types of the disease and during convalescence stimulants and tonics are to be employed as recommended for the horse.

CHRONIC PNEUMONIA. Gellé describes a chronic form of this disease in cows. For about a month the patient became increasingly emaciated, there was a frequent, dry, weak cough, lifting of the flanks, and expiration double and accompanied by a moan. All these symptoms were aggravated by gentle exercise. Percussion detected dullness at the lower part of the lung and auscultation a distinct crepitating râle. The pulse was weak and rapid, the mucous membranes red and tumid, skin dry, ears and horns cold, appetite small and capricious, rumination rare, excrements soft, and milk almost dried up.

The treatment is by diuretics with vegetable tonics and stimulants and active counterirritation over the chest. Gellé considers the malady as all but incurable unless active blistering is promptly employed so soon as the malady has assumed the chronic form and before extensive structural changes have taken place in the lungs.

CROUPOUS PNEUMONIA IN SHEEP.

Causes, damp, cold soils, inclement weather, cold rains, hard driving, shearing or washing in cold weather, change to a cold climate, or from a warm barn, hot barns, heavy fleeces, sudden plethora. Symptoms, in congestive cases, in inflammatory. Treatment, preventive, hygienic, antiphlogistic, laxative, febrifuge, derivative.

This disease is not infrequent in these animals, occurring enzootically in low, wet pastures; or from cold storms of wind, sleet or drenching rains, particularly after hard driving, or shearing; or from washing during inclement weather. Dressing with mercurial ointment in cases of scab is a frequent cause of pneumonia and death in Lincolnshire and various other English counties. Lastly M. Seron in Hurtrel d’Arboval’s “Dictionaire” describes its prevalence in Seine-Inférieure among low conditioned sheep subjected abruptly to a very nutritious diet. The hot buildings, heavy fleeces, and sudden plethora, appear to conduce to dangerous pulmonary congestions. The symptoms do not differ materially from those seen in the ox except so far as they are modified by the fact that the disease often terminates fatally before hepatization has been established and the symptoms and post mortem appearances are those of congestion and sanguineous engorgement of the lung rather than of hepatization.

This engorged state of the lungs it is which has led Youatt and others to describe them erroneously as “gangrenous” and shepherds to name the disease “rot of the lights.” The condition is that of acute congestion and analogous to that seen in congested lungs in the horse.

The treatment ought to be chiefly preventive and will consist in the avoidance of the causes above indicated.

When the disease has set in, fresh air, and general comfort, bleeding if in the very earliest stages and in a strong patient, purging (3 ounces sulphate of soda and ¼ lb. treacle in warm gruel) and a free supply of nitre (about ½ an ounce daily to each) in the water or gruel supplied are the leading indications. As a counterirritant aqua ammonia acts well being sufficiently confined by the fleece.