Part 18

Among agents which condense the gasses may be named ammonia, calcined magnesia, and milk of lime for carbon dioxide, and chlorine water for hydrogen.

Among agents used to rouse the torpid rumen and alimentary canal are eserine (ox 3 grs., sheep ½ gr. subcutem), pilocarpin (ox 2 grs., sheep ⅕ gr.), barium chloride (ox 15 grs., sheep 3 to 4 grs.), tincture of colchicum (ox 3 to 4 drs.). Trasbot mentions lard or butter (ox 4 oz., sheep ½ oz.), as in common use in France.

In the most urgent cases, however, relief must be obtained by puncture of the rumen, as a moment’s delay may mean death. The seat for such puncture is on the left side, at a point equidistant from the outer angle of the ilium, the last rib and the transverse processes of the lumbar vertebræ. Any part of the left flank might be adopted to enter the rumen, but, if too low down, the instrument might plunge into solid ingesta, which would hinder the exit of gas, and would endanger the escape of irritant liquids into the peritoneal cavity. In an extra high puncture there is less danger, though a traumatism of the spleen is possible under certain conditions. The best instrument for the purpose is a trochar and cannula of six inches long and ⅓ to ½ inch in diameter. (For sheep ¼ inch is ample.) This instrument, held like a dagger, may be plunged at one blow through the walls of the abdomen and rumen until stopped by the shield on the cannula. The trochar is now withdrawn and the gas escapes with a prolonged hiss. If the urgency of the case will permit, the skin may be first incised with a lancet or pen knife, and the point of the instrument having been placed on the abdominal muscles, it is driven home by a blow of the opposite palm. In the absence of the trochar the puncture may be successfully made with a pocket knife or a pair of scissors, which should be kept in the wound to maintain the orifice in the rumen in apposition with that in the abdominal wall, until a metal tube or quill can be introduced and held in the orifices.

When the gas has escaped by this channel its further formation can be checked by pouring one of the antiferments through the cannula into the rumen.

When the formation of an excess of gas has ceased, and the resumption of easy eructation bespeaks the absence of further danger, the cannula may be withdrawn and the wound covered with tar or collodion.

When the persistent formation of gas indicates the need of expulsion of offensive fermentescible matters, a full dose of salts may be administered. If the presence of firmly impacted masses can be detected, they may sometimes be broken up by a stout steel rod passed through the cannula. If the solid masses prove to be hair or woolen balls, rumenotomy is the only feasible means of getting rid of them.

In chronic tympany caused by structural diseases of the œsophagus, mediastinal glands, stomach or intestines, permanent relief can only be obtained by measures which will remove these respective causes.

CHRONIC TYMPANY OF THE RUMEN.

Causes: catarrh of rumen, impaction of manifolds, debility, paresis, peritoneal adhesions, neoplasms, concretions, sudden change in diet, gastric congestion, lesions of gullet, or of mediastinal glands. Symptoms are usually after feeding only, inappetence, rumbling, costiveness, rumen indentable. Treatment: obviate causes, give salines, acids, bitters, and water, laxative food, carminatives, antiseptics, electricity, emetic tartar, eserine, pilocarpin, barium chloride, apomorphin.

Causes. The persistence of causes of acute tympany may lead to the appearance of the condition after each meal, or even in the intervals between meals. Among the more specific causes may be named catarrhal inflammation of the rumen, impaction of the third stomach, paresis of the rumen, general debility, peritoneal adhesions affecting the viscus, tuberculosis, actinomycosis or other morbid productions in its walls, hernia of the reticulum into the chest, hard stercoral, hair or wool balls, or masses or foreign bodies in the rumen, and the ingestion of a very fermentescible quality of food. When the rumen is affected by catarrh or paresis or debility, even ordinary food will lead to tympany, but much more so any food to which the animal has been unaccustomed (green for dry, or dry for green, grain for grass or hay, or beans or peas for grain). Also food in process of fermentation, or the seat of fungoid growth.

Again, so intimately related are the different stomachs that derangement of one instantly impairs the functions of the other, and thus a slowly progressive impaction of the third stomach leads to torpor of the first, and the aggregation of more or less of its contents into solid, fermenting masses. In the same way congestion of either the third or fourth stomach impairs the functions of the rumen and induces tympany.

Morbid conditions affecting the functions of the œsophagus and interfering with rumination and eructation of gas are familiar causes. For example, strictures and saccular dilations of the tube, and enlargements—tubercular, sarcomatous, actinomycotic,—of the mediastinal glands.

The symptoms do not differ from those of acute tympany excepting that they are less severe; and are continuous or remittent, suffering a material aggravation after feeding. Rumination may be suppressed or tardy, the bowels also are torpid, the fæces glazed, and the ordinary intestinal rumbling little marked. When the tympany has temporarily subsided, the knuckles, pressed into the left side, can often be made to strike against the hard, solid impacted mass of ingesta. Symptoms of impacted manifolds may also be patent and the patient steadily loses condition.

Treatment must be directed toward the removal of the special cause of the trouble, and if this cannot be secured, as in tuberculosis, the case is hopeless. In cases of solid masses in the rumen the free use of common salt with a drachm of hydrochloric acid, and one grain strychnine with each meal, and a free access to water may succeed. The food had best be restricted to gruels and sloppy mashes. The daily use of electricity through the region of the paunch is an important accessory. The common salt may be increased as required, so as to keep up a very relaxed condition of the bowels.

In obstinate cases of this kind puncture may be resorted to and an attempt made to break down the impacted masses with a steel rod introduced through the cannula. Should this also fail the solid masses or foreign bodies may be extracted by rumenotomy.

In simple catarrh of the rumen the continued use of strychnine with gentian, and sulphate of iron, may prove successful under a carefully regulated diet. Oil of turpentine, balsam of copaiba, or balsam of tolu may also prove useful, or in other cases extract of hamamelis, or of wild cherry bark. While strychnine and electricity are to be preferred to rouse the muscular activity of the viscus, such agents as tartar emetic, emetine, apomorphin, eserine, pilocarpin and barium chloride are recommended and may be resorted to in case of necessity.

OVERLOADED (IMPACTED) RUMEN.

Definition. Causes, excess of rich unwonted food, gastric torpor, paresis, starvation, debility, partially ripened, poisonous seeds, paralyzing fungi or bacteria, lead, cyanides, congestion of rumen, chlorophyll, acrids, dry, fibrous innutritious food, lack of water, enforced rest on dry food, over-exertion, salivary fistula or calculus, diseased teeth or jaws, senility. Symptoms, suspended rumination, inappetence, anxious expression, arched back, bulging pendent left flank, impressible, no friction sounds, excessive crepitation, hurried breathing, colics, grunting when moved, diarrhœa, stupor, cyanosis. Signs of improvement. Phrenic rupture. Diagnosis from tympany, pneumonia, or gastro-intestinal catarrh. Treatment, hygienic, antiseptic, stimulants, puncturing, purgation, rumenotomy.

Definition. The overdistension of the rumen with solid food is characterized by two things, the excess of ingesta which produces the torpor or paresis which is common to all over-filled hollow viscera, and the comparative absence of fermentation and evolution of gas. If the ingesta is of a more fermentescible nature the rapid evolution of gas occurs before this degree of repletion with solid matters can be reached, and the case becomes one of tympany, but if the contents are comparatively lacking in fermentability they may be devoured in such quantity as to cause solid impaction.

Causes. Overloading of the rumen is especially common as the result of a sudden access to rich or tempting food to which the animal has been unaccustomed. Accidental admittance to the cornbin, breaking into a field of rich grass, clover, alfalfa, corn, sorghum, vetches, tares, beans, peas, or grain, or into a barrel of potatoes or apples will illustrate the common run of causes. A pre-existing or accompanying torpor or paresis of the stomach is a most efficient concurrent cause, hence the affection is especially common in animals debilitated by disease or starvation, but which have become convalescent or have been suddenly exposed to the temptation of rich food. For the same reason it is most likely to occur with food which contains a paralyzing element, as in the case of the following when they have gone to seed but are not yet fully ripened: Rye grass, intoxicating rye grass, millet, Hungarian grass, vetches, tares and other leguminosæ, and to a less extent, wheat, barley, oats and Indian corn. The same may come from the paralyzing products of fungi or bacteria in musty fodder or of such chemical poisons as lead, and the cyanides.

A catarrhal affection of the rumen, and the congestion produced by irritant plants, green food with an excess of chlorophyll, and the whole list of irritants and narcotico-acrids, will weaken the first stomach and predispose to overdistension.

Anything which lessens the normal vermicular movements of the rumen and hinders regurgitation and rumination tends to impaction, and hence an aliment which is to a large extent fibrous, innutritious, and unfermentable, such as hay from grass that has run to seed and been threshed, the stems of grasses that have matured and withered in the pastures, fodder that has been thoroughly washed out by heavy rains, sedges, reedgrass, rushes, chaff, finely cut straw, and in the case of European sheep, the fibrous tops of heather contribute to this affection. Lack of water is one of the most potent factors, as an abundance of water to float the ingesta is an essential condition of rumination. Hence pasturage on dry hillsides, prairies or plains, apart from streams, wells or ponds is especially dangerous unless water is supplied artificially, and the winter season in our Northern states, when the sources of drinking water are frozen over, and when the chill of the liquid forbids its free consumption, is often hurtful.

Gerard attributes the affection to constant stabulation. This, however, has a beneficial as well as a deleterious side. It undermines the health and vigor, and through lack of tone favors gastric torpor and impaction, but it also secures ample leisure for rumination, which is so essential to the integrity of the rumen and favors the onward passage of its contents. With dry feeding and a restricted water supply it cannot be too much condemned, but with succulent food and abundance of water the alleged danger is reduced to the minimum.

Active work and over exertion of all kinds must be admitted as a factor. At slow work the ox can still ruminate, but in rapid work or under heavy draft this is impossible, and the contained liquids may pass over from rumen to manifolds conducing to impaction of the former, or fermentations may take place, swelling up the mass of ingesta and distending the walls of the first stomach. Similarly, cattle and sheep that are hurried off on a rapid march with full stomachs are greatly exposed to both tympany and impaction.

In speaking of dry, fibrous food and lack of water as factors, we must avoid the error of supposing that succulent or aqueous food is a sure preventive. In a catarrhal condition of the rumen or in a state of debility, impaction may readily occur from the excessive ingestion of luscious grass, wheat bran, potatoes, apples, turnips, beets, or cabbage.

Finally defects in the anterior part of the alimentary tract may tend to impaction. Salivary fistula or calculus cutting off the normal supply of liquid necessary for rumination, tends to retention and engorgement. Diseased teeth and jaws interfering with both the primary and secondary mastication has the same vicious tendency. Old cows, oxen and sheep in which the molar teeth are largely worn out, suffer in the same way, especially when put up to fatten or otherwise heavily fed. In this case there is the gastric debility of old age as an additional inimical feature.

Symptoms. These vary with the quantity and kind of ingesta also to some extent with the previous condition of the rumen, sound or diseased. They usually set in more slowly than in tympany. On the whole the disease appears to be more common in the stable than at pasture. The animal neither feeds nor ruminates, stands back from the manger, becomes dull, with anxious expression of the face, arching of the back and occasional moaning especially if made to move. The abdomen is distended but especially on the left side, which however hangs more downward and outward and tends less to rise above the level of the hip bone than in tympany. If it does rise above the ilium this is due to gas and it is then elastic, resilient and resonant on percussion at that point. The great mass, and usually the whole of the paunch is nonresonant when percussed, retains the imprint of the fingers when pressed, and gives the sensation of a mass of dough. The hand applied on the region of the paunch fails to detect the indication of movements which characterize the healthy organ. The ear applied misses the normal friction sound, but detects a crepitant sound due to the evolution of bubbles of gas from the fermenting mass. This is especially loud if the impaction is one of green food or potatoes, even though the gas remains as bubbles throughout the entire fermenting mass, instead of separating to form a gaseous area beneath the lumbar transverse processes.

The respiration is hurried, labored and accompanied with a moan, the visible mucosæ are congested, the eyes are protruded and glassy from dilatation of the pupils, the feet are propped outward, and the head extended on the neck. There may be signs of dull colicy pains, movements of the tail and shifting of the hind feet, in some cases the patient may even lie down but never remains long recumbent. There may be occasional passages of semi-liquid manure, though usually the bowels are torpid and neither passages nor rumbling sounds on the right side can be detected. When moved the animal usually grunts or moans at each step, and especially when going down hill, owing to the concussion of the stomach on the diaphragm. In cases due to green food the irritation may extend to the fourth stomach and intestines and a crapulous diarrhœa may ensue. The temperature remains normal as a rule. The disease is more protracted than tympany, yet after several hours of suffering and continual aggravation the dullness may merge into stupor, the mucosæ become cyanotic and death ensues from shock, asphyxia, or apoplexy.