Part 14

A surgical operation often places the disease in abeyance for many months, but, unless in the case of the removal of a diseased organ which has acted as a factor, this is not permanent. Hence in man transient benefit has been secured from operations on the eyes, the brain, the testicles, the ovaries, etc. In local (Jacksonian) epilepsy, which can be traced to a definite cortical area in the brain, the trephining of the skull and the excision of the cortex at that point, has given temporary relief, with a local palsy, but too often the irritation from the resulting cicatrix has in time aroused the disorder anew. Even independently of the removal of the cortex, the trephining has been successfully resorted to, by savage as well as civilized peoples, securing a temporary relief. Though not in practice in veterinary medicine it seems as if this were even more applicable than in man. It would be fully justified if it preserved for a year or more an animal in usefulness which must otherwise be destroyed, even if the disease should return at the end of this time.

Plunge or douche baths (60° to 70° F.) and rubbing dry will often tone up the nervous system, and a course of bitters, or iron, or both, may prove valuable. An outdoor life and moderate muscular exercise are important.

=During a convulsion= the animal should be freed from all harness, halters, girths, etc., that would impair respiration, the jaws may be kept apart with a cloth to prevent biting the tongue, and the animal held with head and neck in natural position. To arrest the spasms the best agent is amyle nitrite inhaled from a handkerchief. It may be replaced by a mixture in equal parts of chloroform and ether. Or rectal injections may be given of chloral. Nitro-glycerine will sometimes cut short an attack or prevent it. Small animals may have the body immersed in a warm bath, and cold applied to the head. Congested buccal and conjunctival mucosæ would indicate cold to the head, while pallor would suggest warm fomentations.

When the fit is over the animal should be kept in a quiet, dark place until the excitement or stupor has completely passed.

ECLAMPSIA. CONVULSIONS. SPASMS.

Definition: functional convulsions from peripheral irritation. From dentition, helminths, uterine disease, nursing (anæmia). Treatment. Injuries to cranial bone.

Eclampsia (convulsions) is difficult to define as distinct from epilepsy, the present tendency however appears to be to apply this term to cases in which the spasms are of a purely functional nature as far as the brain is concerned and caused by peripheral nervous irritation. Whereas in epilepsy there is some organic disease or disorder of the brain itself. Therefore the convulsions of anæmia, of teething, and of parasitism, would come under this heading being curable by the removal of the distant source of irritation, while the spasmodic seizures, that are due to central nervous lesions and are not exclusively dependent on peripheral irritation would be classed as epilepsy. In other words reflex epilepsies with no central brain disorganization would be classed as convulsions.

Eclampsia from =Dentition= is seen especially in young cats, dogs and pigs when cutting-teeth, and may be obviated by lancing the gums, extracting diseased or milk teeth entangled on the crowns of their successors, and by a slight laxative with bromides.

Eclampsia from =Helminthiasis= has been already referred to under epilepsy. The main object is the expulsion of the worms, after which nerve sedatives and tonics will be valuable.

Eclampsia from =Uterine Disease= has been noticed by Albrecht, in cows shortly after calving, the symptoms being spasms of the neck, persistent extension or turning of the head, grinding of the teeth, loss of consciousness, convulsive movements of the legs, rolling of the eyes, and slow recovery. The same symptoms have been observed in goats and have been supposed to depend on a reflex from the irritated womb. Another supposable cause is the absorption of toxic products from the womb and vagina. Manifestly the removal of the after birth and the disinfection of the womb, should be here employed along with the ordinary nerve sedatives.

Eclampsia in =Nursing Female Dogs= has long been attributed to anæmia by English veterinarians. It occurs especially in high bred bitches, when nursing a large litter and some weeks after parturition when the puppies have grown large and vigorous, with proportionately increased demands on the maternal source of supply. The dam shows an emaciated aspect, with restless anxious eyes, a wearied expression, and a generally exhausted appearance. There is weakness and swaying behind, or complete inability to use the limbs, the animal goes down, trembles violently and shows clonic spasms of the extensors of the legs, the neck, the back, the face and the eye. Breathing is accelerated, stertorous and labored, the heart beats violently the mucous membranes are congested, and the mouth is opened with convulsive movements of the jaws and throat. The attack is readily distinguished from epilepsy, by the retention of sensation, and by the absence of involuntary passages from the bowels, or kidneys. Recovery is likely to be secured if the puppies or most of them are removed early enough and the bitch sustained by nourishing food, and tonics. The spasms may be combatted by the antispasmodics and nerve sedatives employed in epilepsy. Chloroform, morphia, phenacetin, acetanilid, urethane have been specially commended. Beef teas, cod liver oil, and iron may be resorted to and free outdoor exercise and sunshine should be secured.

General convulsions are common in connection with direct injury to the brain and more particularly of its coverings, (cranial bones, meninges). In such cases the irritation which otherwise starts at a distance and reaches the brain through the afferent nerves, or the modification of the circulation acts directly on the gray matter. It is interesting to note in this connection that the evacuation of the cerebral fluid, which removes the soft support of the water cushion and allows the brain to come in contact with the hard bony walls, determines an access of convulsions. In cases of convulsions attendant on mechanical injury to the cranium surgical interference will be in order.

CHOREA. ST. VITUS DANCE.

Definition. Susceptible animals. Causes: nervous lesions inconstant, youth, debility, anæmia, microbian toxins, cerebral embolism, rheumatism, trophic alterations in nerve cells, fright. Lesions: variable in seat and character, congestion of perforated space, corpus striatum, Sylvian convolutions, gray matter at root of posterior horn of spinal cord, etc., experiments of Chauveau and Wood. Symptoms: =dog=, local twitching, fore limb, one or both, neck, head, maxilla, eyelids, eyeballs, hind limbs, trunk, rhythmic, less when recumbent, usually absent in sheep, roused by excitement: =horse=, head neck, fore limb, trunk: =cattle=, head, neck, limbs: =swine=, hind limbs, neck, head: severe cases lead to exhaustion, emaciation, marasmus, paralysis. Duration: weeks, months, years. Treatment: laxative, tonic, hygienic, arsenic zinc sulphate, strychnia, sedative, belladonna, conium, cannabis Indica, chloral, acetanilid, trional, etc., icebags or ether spray to spine, cold douches, outdoor life.

Definition. A neurosis characterized by constant twitching of muscles or of groups of muscles, and which usually ceases during sleep.

Animals Susceptible. This disease is especially common in the dog, but has been recognized also in the horse, ox, cat and pig.

Causes. Much difference of opinion exists as to the true cause of chorea. In many cases no nervous lesion has been found and therefore the disease has been pronounced purely functional. The victims are as a rule the young, weak and debilitated so that anæmia has been held to be the main causative factor. Then in dogs the affection is a common sequel of distemper and hence it has been attributed to toxic matters (microbian, etc.) in the blood. It should be added that European writers attribute the rhythmic spasms which follow distemper to eclampsia, epilepsy or tic, and claim that the contractions must be irregular or arhythmic in order to constitute chorea. English and American writers, however, have attributed less importance to this point and consider that the constancy and persistency of the contractions in the dog, differentiate an affection from both eclampsia and epilepsy and relate it rather to chorea. Tic as illustrated in cribbiting is certainly not constant nor rhythmical nor is it a habit beyond the control of the will.

Among other alleged causes of chorea is embolism of the arteries of the brain or spinal cord. Angel Money went so far as to inject a fluid containing arrowroot, starch granules and carmine into the carotids of animals, and produced movements closely resembling those of chorea. Another theory connects chorea with the rheumatic poison. Some English writers find more than 80 per cent. of all cases in man associated in some way with rheumatism, but in Philadelphia, Sinkler found that not more than 15 pet cent. showed such a relation. D. C. Wood as the result of necropsies of a number of choreic dogs reached this conclusion: “Owing to emotional disturbance, sometimes stopping of various vessels of the brain, or sometimes the presence of organic disease, there is an altered condition of the ganglionic cells throughout the nerve centres. If the cause is removed and the altered condition of the nerve cells goes only so far, it remains what we call a functional disease. If it goes so far that the cells show alteration, we have an organic disease of the nervous system.”

In man the element of sudden fright is awarded a high position in the list of causes.

Lesions. Constant morbid changes of structure have not been established in chorea. On the contrary in the many careful necropsies of choreic subjects some lesion of brain or spinal cord has been almost always found. Dickinson always found congestion of some part of the brain or spinal cord, but most constantly of the substantia perforata, the corpora striata and the beginning of the Sylvian fissure. In the cord the cervical and dorsal regions were the most commonly affected, and preëminently the gray matter at the root of the posterior horn. The bilateral symmetry of the contractions in cases of unilateral lesions, has been held to discredit the theory of embolic origin, yet this may be explained by mutual relation of the ganglia of the two sides and their coördination of function.

The question of the relative importance of the encephalic and spinal lesions has been also debated. Chauveau believed that by section of the cord in choreic dogs, he had proved that the spasms were of medullary origin. Wood on the other hand found that the choreic movements persisted after section of the cord, and seemed warranted in the conclusion that the movements originated in the cord. The probability is, that with the cord intact, the primary source of the morbid movement may reside either in the encephalon or the cord. In chorea, following distemper, I have found marked congestion of the encephalon and its meninges.

Symptoms. In the dog the twitching may be confined to one fore leg, or it may extend to both and then usually implicates the neck and head. In other cases the lower jaw, the head, the eyelids or even the eyeballs may be the seat of the twitching motions and in still others the hind limbs and trunk are also implicated. In nearly all cases the tendency is to a continuous rhythmic action, which may moderate without actually ceasing while the animal lies down, but which usually stops altogether during deep sleep. When it intermits at other times it can commonly be roused into activity by exciting the animal in any way.

In the horse the muscles affected may be those of the head and neck, of the fore limb (Hering), of head, limbs and trunk (Leblanc).

In cattle the movements have affected the neck and head and the fore or hind limbs (Anacker, Schleg).

In young pigs the hind limbs, the neck and head have been chiefly involved in the spasms (Hess, Vervey).

If the affection is slight it may not seriously impair the general health, but in proportion to its severity and the constancy and generalization of the spasms and the consequent muscular waste and exhaustion, the animal becomes gradually worn out and emaciated and dies of paralysis and marasmus.

Duration. In favorable cases recovery may ensue in a few weeks; in others the disease becomes chronic and will last for months or years.

Treatment. Among the first indications are fresh air and wholesome easily digestible food. The removal of any source of intestinal irritation should be sought by bland laxatives. As the health is usually low, a course of iron tonics is nearly always in order.