Part 13

Differential Diagnosis. From psorospermosis (coccidiosis) it is distinguished by its origin on the mucous membranes, and not on the skin, the skin lesion being a secondary one. In psorospermosis the primary lesion is usually on the skin, from which it extends to the mouth and especially along its floor. In psorospermosis the morbid deposit assumes the form of rounded warty-like masses, on comb or wattles; is easily propagated by inoculation, is promptly checked by antiseptics, does not tend to produce internal extension nor generalization, and on microscopic examination shows numerous spheroidal coccidia intermingled with the epidermic cells and possessing amœboid movement. By virtue of this automatic movement they make their way between and into the epidermic cells in which they multiply.

From the croupous angina of Rivolta it is distinguished by the absence of the infusoria (monocercomonas gallinæ) to which he, Delprato and Pfeiffer attributed that affection. The monocercomonas is a flagellate organism 14 μ to 25 μ in length and 5 μ to 7 μ in breadth. Its rounded end bears one flagellum as long as the body, and its acute end three flagella which give it active motions. These are found in the yellowish white swellings of the mucosa, which vary in size from a millet seed to a pea, covering a hyperæmic spot and composed of epithelial cells, blood globules—white and red,—leucocytes, granules and the infusoria. The false membrane is remarkable for its lack of consistency and its tendency to invade the mouth and gullet rather than the air passages. These infusoria are not colored by picrocarminate of ammonia, but stain by methyl-violet and then appear as round or slightly irregular hyaline bodies.

From aspergillus disease of pigeons, by the absence of the characteristic, miliary, white nodule of that disease showing caseated contents intermixed with an abundant mycelium of aspergillus fumigatus. The aspergillus disease attacks especially the mouth but may also implicate the gullet, lungs, liver, intestine and kidneys. The microscopic examination of the exudate is conclusive, by reason of the presence of the bacillus diphtheriæ columbarum, and the comparative absence of the filamentous mycelium.

Treatment. This is mainly prophylactic. The first step must be to separate the sick and healthy, destroying the former, or shutting them up in a special enclosure apart from all other birds. In the case of valuable chickens, their eggs may be set under other hens and the young raised apart from the suspected flock. This may even be attempted in pigeons, the common eggs being removed and the valuable ones put in their place under a healthy sitting dove. In the case of pigeons that have been recently through the disease they should be kept strictly by themselves, even though they may appear to have regained perfect health. The dead bodies must be burned or deeply buried. Sparrows and even rabbits dying in the vicinity must be similarly disposed of, and where the disease prevails sparrows and small birds may be exterminated as probable bearers of infection.

The purchase of strange birds must be carefully guarded, none being taken that show weeping eyes, nasal discharge, labored or wheezing breathing, and all new birds should be placed by themselves in quarantine for ten to fifteen days. Finally a thorough disinfection of the place where the sick have been is of first importance. Thorough cleaning of the poultry house, followed by a coat of white-wash, every gallon of which contains four ounces of chloride of lime, or one drachm of mercuric chloride will usually prove effective. The poultry runs should be liberally sprinkled with a solution of sulphuric or hydrochloric acid, one part to 1000. The same may be used on the building, which may further be fumigated by burning sulphur.

Poultry shows should be kept under the most rigorous sanitary supervision.

Curative treatment is only profitable in the case of specially valuable birds, and even then only, as a rule, when the disease is confined to the nose, mouth, larynx and pharynx. The affected parts may be brushed with a solution of chloride of iron (1 dr. of the tincture to 1 oz. water), nitrate of silver (2 grs. to 1 oz. water), sulphide of calcium (½ dr. to 1 oz. water), tannin (10 grs. to 1 oz.). Tincture of iodine may be applied direct, or a solution of carbolic acid or of creosote or creolin (1 part to 50) will often succeed. Thomassen recommends the removal of the false membranes and the application of boric acid followed by dry sulphur. Benoist says the majority recover when made to inhale the fumes of oil of turpentine evaporated at a gentle heat twice a day.

As internal medication, or to correct the intestinal affection, sulphate of iron may be dissolved in the drinking water, or salicylic acid may be given in pill form with molasses.

CHRONIC PHARYNGITIS.

Sequel of acute: or subacute from the first. Due to œstrus, in cattle to summer catarrh, tubercle or actinomycosis. Lymphatic horses predisposed; attends chronic indigestion; in swine tonsilitis. Symptoms: chronic cough, easily roused, wheezy or mucous; nasal discharge; low condition; lack of spirit. Lesions: congestion; softenings; erosions; cicatrices; tonsilitis; abscesses; specific deposits. Treatment: hygienic; antiparasitic; astringent; antiseptic; derivative; counter-irritant; tonic inhalations and electuaries. Bitters. Iron.

Causes and Nature. Chronic pharyngitis in animals may be a simple continuation of the acute, in a milder form, or it may assume a subacute or chronic type from the first and never rise to the intensity that would characterize the acute. It may be a simple catarrhal affection or it may become more or less follicular or glandular. Again in horses it is not infrequently a result of the hibernation form of the œstrus (bots) attached to the delicate pharyngeal mucosa, and in cattle from the extension of the chronic summer catarrh, or from the local development of tubercle or actinomycosis in the walls of the pharynx or in the adjacent lymph glands. Horses of a soft, lymphatic constitution, with a heavy coat, confined in close warm stalls, and which perspire abundantly are especially liable to the affection. It may also be an accompaniment and result of chronic gastric indigestion. In swine the affection is commonly associated with tonsilitis.

Symptoms. In many cases the main symptom is a chronic cough which is aroused by any cause of irritation, feed, especially dry or fibrous fodder, cold drinking water, sudden passing from the hot stable to the cold outer air, reining in, pressure on the throat, or sudden active exertion. If the cartilages are calcified it may be impossible to rouse the cough by pressure. The cough is often dry and wheezy, rather than soft and gurgling as in the second stage of acute pharyngitis, and is repeated several times paroxysmally. In the intervals there is more or less stertor or wheezing, or a distinct rattle especially when the neck is curved by drawing the nose inward. Deglutition may be interfered with but this shows most with the first swallow, which in the case of liquids may be returned through the nose, whereas those that follow go down without difficulty. A lateral swelling of the parts above the larynx or a bulging of the parotids is not uncommon. Discharge from the nose of a mucopurulent character is usually present, but often so scanty as to be overlooked. There is usually loss of flesh and lack of vigor even if the subject is well fed.

Lesions. In the simple catarrhal form the mucous membrane of the lateral pharyngeal walls, the posterior pillars of the palate and the back of the soft palate, is red, congested, with arborescent vessels, thickening, and puckering into rugæ. The epithelium has lost its translucency, become opaque and granular, and its desquamation in spots and patches may leave erosions, ulcers more or less deep, and white drawn cicatrices. When the follicles and mucous crypts are involved (follicular) they stand out like millet seed, peas or beans, and may show ulceration or minute abscess. In pigs especially, tonsilitis is liable to be present, and the tonsillar follicles are filled and distended with tenacious mucous, a caseous granular debris, or even a cretaceous material. In the vicinity of the tonsils, minute abscesses may exist in or beneath the mucosa.

Ulceration may be the result of tubercle, glanders, actinomycosis, aspergillus, sarcoma, or some local infection, and attendant symptoms of one or other of these diseases will guide the diagnosis. Thus in tubercle there will be the implication of the adjacent lymph glands and usually of distant ones; in glanders the deposits in the nose, submaxillary lymph glands and lungs will enable one to diagnosticate; in actinomycosis the hardness of the neoplasm and the presence of the yellowish tufts which present under the microscope the concentrically arranged club-shaped elements, will show its nature; and in sarcoma or carcinoma the structure of the new tissue will decide its character. The pharyngeal muscles are the seat of granular or fatty degeneration or of fibroid change. Friedenreich speaks of a fold from the vault of the pharynx which had nearly closed the passage and had killed the horse by inability to swallow.

Treatment. Chronic pharyngitis is usually a very obstinate affection and demands careful hygienic as well as medicinal treatment. Hot, foul stables, unduly thick coats, unwholesome food, irregular feeding, excessive meals at long intervals, overwork, undue exposure to cold and wet, lack of sunshine or of grooming are to be corrected. Next, the removal of mechanical irritants such as pharyngeal bots, actinomycosis growths, etc., will be in order. Then the use of astringents and antiseptics internally and of derivatives externally will be demanded. An occasional embrocation of mustard, or the application of ammonia and oil, will often serve a good purpose, and in obstinate cases the hot iron in points will sometimes prove effective.

Internally the inhalation of the fumes of tar, carbolic acid, creolin, oil of turpentine, or of burning sulphur kept up continually or frequently repeated. Giving all drink in the form of tar water will often have a good effect. Electuaries made with boric acid, salicylate of soda, ammonium chloride or iodide, borax, with honey, molasses, liquorice, Iceland moss, or gum arabic will often prove beneficial. Agents that stimulate the mucosa may follow, such as balsams of Peru or Tolu, copaiba, cubebs, pilocarpin, wild cherry bark, or these may be combined with the former. Finally a course of tonics are usually of the first importance; iron sulphate, copper sulphate, arsenious acid, arsenite of strychnia may furnish examples.

DEPRAVED APPETITE. STUMP SUCKING. PICA. LICKING DISEASE.

Common features of group. Ruminants; depraved appetite; objects swallowed: hair balls. Sheep eating wool in winter. Pigs eat bristles. Puppies swallow marbles, etc., wantonly. Solipeds swallow hair, plaster, earth, sand, and lick manger or rack. Fowls eat their feathers. Causes: soil exhaustion, lack of lime, soda, potash, phosphorous; relation to osteo malacia; granitic or sandy soils, peat, muck, causative; digestive disorder; faulty food; yearly breeding and heavy milking; constant stabling; dry seasons. Course: chronic. Lesions; emaciation; anæmia; serous exudate; catarrh of the bowels. Treatment: soil; good fodder; salts of soda, potash and lime, phosphates; tonics; apomorphine. Wool eating; example: digestive disorders; emaciation. Treatment: open air; good fodder; salts of the bones and soft tissues; clip nurses; apomorphine.

Definition. We have here a class of morbid habits, which cannot be referred to any constant lesion or group of lesions, and which appear in certain cases to result from example and to constitute nothing more than a bad habit.

Symptoms. Ruminants without any appreciable cause, lick the clothes of their care-takers, chew and swallow articles of clothing of all kinds, bones, old shoes, gloves, socks, cuffs, collars, small forks, pocket-knives, nails, wires, needles, coins, stones, lumps of clay, hair, which may give rise to secondary troubles of a more or less serious kind. Pregnant cows are especially subject to this infirmity. The small pointed objects like pins, needles, ends of wires, etc., which are mostly taken by accident with the food are especially apt to be entangled in the alveoli of the reticulum and make their way to the heart, with fatal effect, or through the abdominal walls creating a fistula. Hair aggregates with saliva, mucus and phosphates, to form balls in the first two or three stomachs. Other indigestible objects may also become encrusted and prove sources of irritation. Licking the skin of another animal is doubtless at times encouraged by the taste of the salts of perspiration, but in other cases it has all the appearance of a mutual kind service as the cow with itching head will walk up and present it to its fellow which rarely fails to respond to the invitation. Stump licking is not uncommon.

=Sheep= shut up in the winter get in the habit of chewing each other’s wool, thus virtually depilating their fellows and accumulating wool balls in their stomachs.

=Pigs= when running at large eat human fæces often infecting themselves with the cysticercus cellulosa, and devour their own or their fellows’ bristles, which form ovoid and irritating aggregations in the stomach.

=Puppies= are proverbial for swallowing every small object that comes in their way, coal, pebbles, marbles, leather, hair, etc., with the result of inducing nausea and vomiting, or more seriously, wounds of the stomach, gastritis and enteritis. In older dogs the habit is more likely to imply rabies.

=Solipeds= will lick and swallow each others hair, eat off the hair from each other’s tails and manes, eat their clothing, lick the wall plaster, earth or sand, and even the manger or rack. The last named habits are usually connected with disease.

=Fowls= can digest almost anything they swallow, but if they take to picking their feathers, they create serious injury to the skin and indirectly to the general health.

Causes and Nature. In general terms it may be said that the causes of depraved appetite are very numerous, so that the trouble must be looked upon as a symptom of many morbid conditions in place of a disease sui generis.

Heredity has been invoked as a cause, mainly, it would appear, because the disease appears enzootically on certain exhausted soils, or in herds kept in the same unhygienic conditions. In such cases the real cause is usually to be found in faulty conditions of soil, water, buildings, food, etc., on the correction of which the trouble disappears. When, however, from a long continuance of unhygienic conditions, a weakness of constitution is transmitted from parent to offspring, such hereditary debility may be accepted as a predisposing factor.

An exhausted soil, lacking especially the elements of lime and phosphorus, is a common cause, though by no means the only one. Nessler who analyzed the hay and water, furnished to cattle suffering from this disease in the Black Forest found a notable absence of the soda salts. In others in which osteo malacia was the prominent symptom the lack was in phosphate of lime as well. In the nature of things the soil that has been continuously cropped to exhaustion is robbed of both earthy and alkaline salts, and the animals fed on its exclusive products suffer not only as regards the nutrition of the bone, but also of the soft parts. Hence Trasbot says that in osteo malacia, pica is never absent. Roloff and Röll hold that it is the first symptom of osteomalacia. In South Africa where the land has been cropped with oats year after year without manure and as long as it will bear, the disease became prevalent in the street car horses fed on the oats, and was corrected by the addition of phosphates, or phosphate bearing food, to the ration. In the older dairying farms of New York which have been kept under grass for a great length of time, and all the milk products sold off, depraved appetite in all its forms is quite frequent. Where the land is originally light and sandy and naturally deficient in lime, osteo malacia is often a concurrent disorder. The two conditions may however occur independently of each other, and especially may pica appear alone, in keeping with the greater solubility of the soda and potash salts and the readiness with which these can be washed out of the soil, while the less soluble lime salts in part remain.