Part 86

When a part has been frozen the usual method is to recover circulation slowly by rubbing with cold water or snow. The parts are then treated by astringent and antiseptic dressings. If the skin sloughs use antiseptics until it separates, and then treat like an ordinary sore.

Chillblains may be treated with a mixture of sweet oil, 5 ozs., oil of turpentine ½ oz., Aqua Ammonia ½ oz., oil of peppermint 1 dr., or powdered camphor 10 grs., Peru balsam 20 drops, linseed oil 2 ozs. Nourishing food and a course of iron should be given.

=Dermatitis Medicamentosa.= Medicines given by the mouth sometimes cause inveterate skin eruptions. Among these are arsenic, belladonna, bromides, iodides, mercurials, salicylates, tansy, turpentine, tar, and the carminative seeds and oils. The latter are chargeable with many eruptions in live stock fed on patent foods. In cattle treated with iodides for actinomycosis, an universal eruption and desquamation is a common condition. In all such cases the drug must be withheld, the bowels cleared out by a purgative and the elimination of any remaining irritant products favored by gentle diuretics.

ECZEMA. A BOILING OUT. A PUSTULE.

General method of eruption. Successive advancing lesions. Definition. Causes: usual factors and special susceptibility.

This term, standing for what boils out, has long been applied to vesicular eruptions on the skin, but inasmuch as the inflammation rarely stops short with vesiculation, but usually in part at least goes on to more advanced lesions, it must be held to include in many cases erythema, papules, vesicles, pustules, crusts, desquamations and erosions. All of these may coexist or succeed each other in the same subject, so that considerable latitude must be allowed to the name to cover all parts and stages of the same attack. Dermatologists have defined eczema as a non-infectious inflammation of the skin with multiform manifestations, but recent observations would indicate that it may at times, at least, be contagious, and micrococci have been found in the serum of the vesicles, while the very occurrence of pus must virtually imply the existence of a bacterial infection. Doubtless different diseases pass under this name in the different genera and species, and even in the same variety of animals, yet until we learn to discriminate sharply the one from the other, it is convenient to consider the whole as a kindred clinical group, if not a pathological entity.

Definition. An acute or more frequently, a chronic inflammation of the skin and sometimes of the mucosæ, characterized by itching, erythema, papules, vesicles, serous or sero-purulent exudation with squama or crusts and loss of hair, and usually largely due to an internal cause. The exudative condition has suggested a catarrh of the skin.

Causes. These are the usual causes of skin disease, local and general, together with a special susceptibility, under which, what are ordinary irritants produce this characteristic disease. Many local irritants can produce eczema, but again it is often the case that these factors will operate on a given susceptible subject while on another they are without much effect. This susceptibility is called a “dartrous diathesis” by the French writers, while most English and American writers are willing rather to find the hidden cause or causes in the disorder of internal organs (digestive, hepatic, urinary, generative, hæmatic, trophic, infective, plethoric, atonic).

ACUTE ECZEMA IN SOLIPEDS. DORSAL ASPECT.

Head, neck, shoulder, back, under girths, breeching, crupper. Summer. Moulting. Heavy coat. Thin skin. Youth. Symptoms: erect hair, papular groups, hot, thick rigid skin, itching, abrasion, ulceration, encrusting, pustules, white spot and hair. Treatment: laxative, cooling diet, cleanliness, pure air, shade, rest, alkalies, locally vaseline, astringents, dusting powder, anodynes, tar water, creolin, etc.

This shows itself especially on the head, the sides of the neck, under the collar, or saddle, the circingle or crupper, the breeching or general surface. In these cases the profuse secretion of sweat, and the friction of the harness is a marked local factor in its production. It often shows a preference for the summer season, the period of shedding the coat, the heavy coated animal, the animal with white, thin or delicate skin. Youth also predisposes.

Symptoms. There is usually erection or roughness of the hair, and the formation at such points of minute papules like small peas collected in groups. The skin may feel hot, thickened, lacking in pliancy, not to be pinched up in folds, the panniculus is contracted and manipulation shows tenderness. Soon the papules flatten and desicate and more or less violent itching sets in. The patient rubs or scratches himself, causing deep red congestion of the surface or even abrasion, or ulceration. Apart from abrasion the skin becomes covered with crusts or even scales which agglutinate tufts of hairs and dry up and desquamate.

In other cases the eruption advances from the condition of papules to that of vesicles and even of pustules, though finally drying up with the same pruritus as in the papular form.

In either case the affected parts are more or less depilated, red if on unpigmented skin, grayish and scabby or scurfy if on the darker. At times, after recovery, the patch remains devoid of pigment and hairs growing from it are white.

Treatment. It is usually desirable to clear out the prima viæ by aloes or Glauber salts, to resort to a carefully regulated, non-heating diet, to clean the skin of all concretions from sweat or otherwise, to give pure air and shade and to protect the animal from active exertion, profuse sweating and friction by harness or otherwise. In the early stages benefit will often come from the use of alkalies, especially sodium bicarbonate. Locally an inunction with vaseline to soften crusts, and the subsequent removal of these with tepid water, may be followed by some soothing or astringent application, always bearing in mind that what is soothing to one skin is irritant to another. Dusting powders (starch, lycopodion, magnesium carbonate, oxide of zinc, calamine, bismuth) will often do good; soothing lotions or liniments (lead acetate with laudanum, lime water and olive oil; sodium bicarbonate in well boiled gruel of oatmeal or marsh mallow; zinc oxide or sulphate in water or glycerine or as ointment in vaseline, etc, etc). In chronic stages with much squama and pruritus tar water or ointment; a lotion of tar and alcohol; creolin lotion; chloral lotion; or other stimulant application may be used.

CHRONIC ECZEMA OF THE HEAD IN SOLIPEDS.

Affects face, eyelids, cheeks. Symptoms: papules, vesicles, dry, rigid skin, scurf, glistening, shedding hairs. Treatment: as in eczema; antiseptics.

Footnote 1:

Acute eczema of the heels. See chapped heels and grease.

The cheeks and forehead are the most liable to suffer in this affection, yet the eyelids and the parts below the inner canthus may participate in connection with the escape of tears and the disease of the lachrymal sac or ducts. It has been seen in the young when strangles had merged into skin eruption, but also in the aged and independently of that affection.

Symptoms. Following strangles the papules or vesicular eruption may have passed leaving the skin thick, rigid, dry and scurfy. The pigment may be increased and the hairs are usually shed in connection with atrophy of their follicles and rubbing of the itching surface, so that the cuticle is smooth, glabrous and even glistening. In implication of the lachrymal apparatus, there is shedding of hairs beneath the eye or the wet matted condition of those that remain.

Treatment. In strangles use a lotion of silver nitrate or sodium hyposulphite to destroy the local infection. In other cases treat as for ordinary eczema.

CHRONIC MOIST ECZEMA (IMPETIGO) AT THE MANE AND TAIL.

Fleshy neck, thick mane and tail, lymphatic constitution, profuse perspiration, lack of cleanliness, alkaline soaps, plethora, foul stable, pus microbes. Symptoms: itching or tenderness, shedding hair, thinning of mane and tail, skin thickened, ridges and folds, tenderness, moisture, crusts raise hairs from follicles, fœtor, sores and ulcers, matted hairs. Treatment: remove general and local causes, cleanse, cool, pure stable, clip, reduce grain; cooling, laxative food, soothing or stimulating applications, zinc oxide, talc, olive oil and diachylon plaster, iodoform, silver nitrate, oil of cade, or of white birch, sulphur iodide, Canada balsam and sulphur, green soap, dusting powders, ointments.

This condition is especially common in horses with a profusion of long hairs in the mane and tail, and in the heavy draught animal with a thick, fleshy neck. In such the skin is very sensitive, and when profuse perspiration soaks the skin, or concretes and decomposes about the roots of the hairs, the local irritation necessary to the production of the eruption is present. A lack of careful grooming is therefore a common cause, yet soap left in washing the mane or tail may be no less injurious. Plethora has its influence in many cases, and the ammoniacal fumes from a wooden stable saturated with excretions are not to be ignored. Finally in cases accompanied by pustular eruption, the pus microbes must be recognized as factors.

Symptoms. There may be marked itching or extreme tenderness of the part affected or in the absence of both there may occur a gradual shedding of the long hairs, so that an increasing thinness of the mane and tail (rat tail) becomes apparent. The skin covering the affected parts is thickened, inflamed and thrown into ridges and folds, one rubbing against another. The surface feels moist or is covered by crusts formed by the condensation of the moist exudate, and embracing the hairs and drawing them out of their follicles. Beneath the concretions the skin is soaked in the tenacious fœtid liquid discharge. The hair follicles become atrophied in connection with the evulsion of the hairs, or under congestion the hairs stand rigidly erect, and bristly or curly. As the freer secretion abates, the exudate become more purely scally or encrusted, but the skin remains thickened and thrown into folds. Under the inveterate rubbing or gnawing the skin is often extensively abraded and large open sores are formed which are indolent and slow to heal. That matting together of the hairs which has been known as plica Polonica is often the result of the disease of the hair follicles and the accumulation of scabs which takes place in this disease, rather than to a special infection like gregarina (coccidiosis).

Treatment. The first consideration must be to remove all general and local causes of eczema, insure perfect cleanliness and good grooming in any case in which these may been lacking, purify the air of the stable if that has been foul, procure a cool environment when that has been too hot, clip the patient if habitually soaked with perspiration by reason of a heavy coat, suspend or moderate the work if that has been too exacting, withhold a heating grain ration (corn, buckwheat, barley, wheat, peas, beans), and furnish cooling, laxative, easily digested food. In the cases before us the acute, irritable stage has usually passed, so that the more stimulating applications may be safely used, yet in many old standing cases a fresh eruption may have taken place, which would demand for a time the most soothing applications only. Apart from such cases the more stimulating dressings are applied at once.

The affected surface is exposed by clipping or shaving off the long hairs, thus at once removing a source of heat and irritation and allowing of the direct and thorough application of the dressing. Among the astringent and stimulant applications oxide of zinc ointment and benzoated oxide of zinc are among the simplest and least likely to irritate, but the stronger applications can usually be borne. The Lassar paste consists of two parts each of finely powdered talc and zinc oxide, four parts of vaseline and three per cent. of salicylic acid. Oxide of bismuth may substitute the zinc oxide. Three parts of olive oil and four of diachylon plaster melted together and stirred until cool, makes another mildly astringent and sedative application. Iodoform 1 dr. to an ounce of vaseline is an excellent agent. A mixture of iodoform and tannin is used as a dusting powder by Friedberger and Fröhner: or silver nitrate solution (6:100) may be used. Tar ointment (1:8) with a little subcarbonate of potassium added makes an excellent application. Oil of cade and oil of white birch may be used in the same way, the latter being the most desirable as a rule. Ammonia chloride of mercury as an ointment (1:10), often acts well and the black wash, formed by the decomposition of calomel with potash is often serviceable. Iodide of sulphur and vaseline (1:10) is often an excellent resort. An ointment of equal parts of Canada balsam and sulphur or iodide of sulphur in four parts of vaseline is often effective. Other valuable preparations are ointments (10%) of ichthyol, naphthol, chrysarobin or pyrogallol. Hebra’s last resort of green soap is never to be forgotten, the affected skin being thickly smeared with the soap which is left to dry on, and is repeated and rubbed in, for several days in succession. It may seem at first to aggravate the disease by reason of the solution and removal of the covering of the vesicles or pustules and the exposure of a pink sensitive surface, but day by day this improves and the skin becomes smooth and more natural. After a few days of this treatment, it may, if necessary, be followed by astringent or stimulant dressings, or the varied medicaments may be incorporated with the soap so as to form one dressing to be applied from the first. When a healthy action has been once established, all that is required further may be cleanliness, with the use of bland dusting powders or ointments to establish the cure.