Part 76

Finally the influence of heredity is never to be over looked. The ideal system would be to have all stallions professionally examined, and licenses granted to such only as are free from this affection, and to place the owners of such horses under obligation to serve only, mares the eyes of which are sound. This might be enforced as a state or county ordinance. Serious difficulties it is true stand in the way of such a measure. The horse which has an extraordinary record on the track, and to the development of the ophthalmia of which, overwork has doubtless contributed, will be run after by breeders who seek speed at any cost, and it may be questioned whether the State has any right to interfere with the prospective profit which may be expected from the reproduction of the strain of blood. But aside from such fancy products as racers and trotters, this objection has much less force. For carriage, riding and road horses and for the draught and agricultural animal the advantage of sound eyes so greatly over balances all consideration of special values with imperfect eyes, that a statute which will prevent the propagation of such unsoundness is more than justified in every case. The importance of this will be admitted when it is considered that in the great majority of cases, the young animal is attacked after it leaves the hands of the breeder, and therefore a high price is secured for a subject which is almost certainly doomed to become blind in given surroundings. Such a law would work well in every locality. In the low, damp region where the disease prevails habitually, the unprofitable breeding would practically cease, unless a race could be secured which was proof against the infection. The value of such a race could hardly be over-estimated. On the high, dry lands, on the other hand, the natural tendency to immunity would be still further enhanced, as the most susceptible animals which contracted the disease, in even such a healthful district, could be in no sense fit for reproduction, and should therefore be doubly condemned.

In the case of the mare the proprietor is under strong temptation to ignore the sanitary measure under consideration. When her eyes fail, her value in the public market is greatly depreciated, yet she can yearly produce a foal, which is finely developed and will bring a high price if sold young, before it has been attacked by the disease. Hence the great importance, at least in the case of all horses which are not intended for exclusive use on the race course, that a law shall be strictly enforced which will put an absolute limit to the breeding from horses that have been affected with recurrent ophthalmia.

Blows, dust, sand, smoke, irritant gases, fierce light, and all sources of irritation must be avoided as in other eye diseases.

Treatment. Radical treatment for the disease is far from generally satisfactory. Too often the affected animal is still in the environment which has tended strongly to its development, and it is impossible to secure a satisfactory change. As far as possible, however, every available sanitary measure mentioned under the head of prevention should be enjoined, and largely in proportion to the thoroughness of such measures, and the slightness and recentness of the attack will be the hope of a successful treatment.

In some instances in which there appears to be a rheumatic complication, the employment of anti-rheumatic agents have proved of essential value. Powdered colchicum corms may be given twice a day in doses of 1 scruple, combined with salicylate of soda, salicylic acid, or salicin in 2 drachm doses. To these may be added bicarbonate of soda or of potash in drachm doses.

In cases attended with marked fever, hyperthermia and anorexia, antiphlogistic treatment may be desirable, but with the primary consideration that it must not be materially depleting, nor calculated to induce debility or atony. A laxative dose of aloes will sometimes benefit, but should be avoided in the absence of manifest fever. Two or three ounces of Glauber salts, twice a day, will effect the same purpose with less danger. Or saltpeter or other cooling diuretic may be given daily. In most cases bitters may be added with advantage.

In severe cases, rest is essential until the violence of the inflammation shall have abated, and a dark stall or a cloth to obscure the light is equally important.

Trasbot advises bleeding from the jugular, but such a depleting measure finds little support in England or America. =Local bleeding= from the angular vein of the eye or by leeching or cupping is not open to the same objection.

=Counter-irritants= are, however, more suitable. A stout silk thread may be inserted above the lower end of the zygomatic ridge and bathed and moved daily to prevent the lodgment of pus. Or a blister of cantharides or biniodide of mercury may be rubbed in on an area as large as a silver dollar in the same situation.

In all cases a strong solution of =atropia sulphate= (2 per cent.) may be instilled into the eye once or twice daily. Or a mixture of atropia and cocaine (1 per cent. of each) will give even greater relief. If to these is added 1 per cent. of pyoktannin we get a collyrium which is at once anæsthetic, midriatic and antiseptic. This is often of material value. Vigezzi advises a mercuric chloride lotion (1 ∶ 1000) as a collyrium, and for injection in the submucosa.

If the local inflammation runs high an astringent lotion may be applied externally on a soft rag hung over the eye and kept constantly wet. Sugar of lead or acetate of zinc may form the basis of such lotion with a little atropia or morphia added.

=Puncture of the cornea= and =iridectomy= have been strongly advocated on the ground that the disease is identical with glaucoma, but the burden of evidence is decidedly against their use as a regular method of treatment. In case of increased intraocular tension, however, the puncture of the cornea can be very profitably employed, but it should be reserved for such special cases. Theoretically, iridectomy should be advantageous in preventing a relapse, but experience has not fully sustained this. When employed, the most careful disinfection should be secured. Under rational treatment the attack subsides in ten days and the eye may appear to be restored to the normal condition in two weeks. This natural tendency to a temporary recovery has served to give a wide acceptance to the most irrational methods of treatment, which have not in any sense hastened the recovery.

As soon as active inflammation and hyperthermia subside, every attention should be given to prevent a relapse, and to this end all the measures mentioned under prevention and which can be applied to the individual case should be adopted. Among these, moderate exercise or regular work must never be omitted.

A course of tonics embracing preparations of iron and bitters, is equally essential, and may be begun as soon as fever and active inflammation subside.

Special lesions, like corneal opacities and ulcers, must be treated as in other affections.

=Jurisprudence.= The question of the right to return upon the seller a horse attacked with recurrent ophthalmia has been beset with difficulty, mainly because of the intermissions during which, to the ordinary observer, the eyes may appear sound. In France a period of thirty days is allowed in which to return such a horse after purchase. This is, however, too narrow a margin as the second attack may not appear until after two, four or six months. It does, however, provide for the return of the worst cases in which the recurrence is likely to take place at an early date. Another provision is that a suspected horse may be put in pound under veterinary observation for thirty days, in anticipation of a second attack, and if such fails to appear the purchaser is debarred from returning him.

In many cases the symptoms during an attack and between attacks are such as to identify the recurrent inflammation, and the expert can pronounce positively as to the nature of the malady. In other cases there is a degree of uncertainty, and the animal must either be returned on the general plea of diseased eyes, if they can be shown to have been faulty at the time of sale, or otherwise the horse must be put in the hands of a veterinarian and the seller notified of the action, until it can be shown whether it is the recurrent disease or not. If it can be shown that the disease is the recurrent affection the seller is responsible at common law for selling a diseased animal for a sound one. If on the other hand, it is a non-specific ophthalmia, it must be shown that it existed prior to sale, and that a warranty of soundness was given, in order to hold the seller responsible.

PANOPHTHALMITIS.

General suppurative inflammation of eye. Experimental cases. From traumas. Diagnosis; foul wound, violent eye inflammation, yellow purulent appearance, high fever, involves second eye. Treatment: antiseptic, enucleation.

This term has been applied to a general purulent inflammation of the eye resulting from infection with pus germs entering from without through traumatic injuries, or by reason of inflamed tissues, or on the other hand, reaching the eye as a general infection through the blood. It may begin therefore, as conjunctivitis, scleritis, or keratitis, and gradually extend to active infection of the iris, choroid, and ciliary body.

Möller produced an experimental case in a foal by the injection of the staphylococcus pyogenes aureus into the anterior chamber. In 24 hours there was violent inflammation: the eyelids were closed, the conjunctiva dark red, and a mass of glairy pus under the eyelid. The cornea was cloudy throughout, though still dimly transparent so that the accumulating pus in the anterior chamber could be seen. The iris was strongly dilated and the eyeball abnormally tense. The second day the bulb was visibly enlarged, the eyelids greatly swollen, the conjunctiva infiltrated so as to cause chemosis, and the cornea completely opaque. The infiltration of the orbit caused the eyeball to protrude from its sheath. A high fever set in and on the fifth day the foal died.

Cases in the lower animals are usually the result of direct infection through some traumatic lesion of the eye.

The special feature of the disease is the rapid and abundant production in all parts of the eye of pus cells until the whole organ has become a bag of pus.

The chief diagnostic symptoms are the presence of a foul wound, the rapid advance of the phlegmonous inflammation of the conjunctiva and lids, the yellowish opacity of the cornea, and, if visible, of the aqueous humor, the prominence of the entire eyeball, the high attendant fever and the early destruction of the eye. In the domestic animals the sympathetic irritation of the second eye has not been observed so commonly as in man. If the patient survives, the pus makes its way slowly to the surface, and escapes, and the cavity granulates and heals with contraction of the eye into a small nodular mass.

The treatment of the condition is essentially antiseptic and should be made preventive if possible, as there is little hope of saving the eye if the suppurative inflammation has been already established. The wound should be treated at the earliest moment with antiseptic lotions, sublimate solution (1 ∶ 5000) or potassium permanganate solution (1 ∶ 100) or pyoktannin (1 ∶ 1000), or creolin (1 ∶ 100). When inflammation has actually set in, these should be used still more assiduously by frequent injection under the lids, or by inserting antiseptic cotton between these and the bulb.

=Enucleation.= When the eye has become a virtual abscess the quickest and most perfect relief is secured by the complete extirpation of the eyeball. The patient is narcotized by ether or chloroform, and a thread or hook being passed through the cornea, the globe is quickly dissected out by curved scissors. Bleeding may be checked by pressure with cotton wool steeped in tincture of the muriate of iron, and later the wound may be dressed with stupes wet with a mixture in equal parts of standard solution of sulphurous acid, glycerine and water.

GLAUCOMA.

Sea green pupil. Causes: intraocular pressure from serous choroiditis, deranged fifth nerve, increased blood pressure, inflammatory obstruction of sclero-corneal canal, irritation of the ciliary ganglion. Symptoms: excessive tension and firmness of the globe, anterior chamber shallow, iris contracted, sluggish, pupil grayish or yellowish green, cupping of optic disc, pulsations of retinal arteries. Acute inflammatory form, simple form, secondary form. Convexity of pupil with synechia. Traumas. Luxations. Atheromas. Lesions: inflammation of the iris, choroid, ciliary body or cornea, round cell infiltration, cupped optic disc, atrophy of optic nerve, hydrophthalmos. Treatment: massage, puncture of aqueous, iridectomy, eserine, cocaine, antiseptic bandage.