Part 93

Of nervous hæmorrhages we have the experimental examples of Bouchard and Simon from section of the sympathetic nerve in animals, also those of Glen and Mathieu from irritation of the sciatic in dogs with common salt. In man the nervous causation has been seen in hysteria, under profound nervous shock, in sclerosis of the cord, and even as the result of auto-suggestion. This influence is constantly operative in violent inflammations in which diapedesis and minute hæmorrhages into the affected tissues are marked phenomena, and under such a cause the gland ducts especially are the seat of transudation. When the skin is abraded, cracked, or blistered it occurs also on the surface of the exposed derma.

Symptoms. With active local congestion or inflammation the blood usually oozes in drops from the surface, and drying concretes into dark red crusts. In other instances, however, it drops from the surface, or even flows, producing anæmia and even death. Into such cases hæmophilia presumably enters. Hæmorrhagic swellings like wheat kernels or beans also form in the skin.

Treatment. Apart from the contagious and parasitic diseases, and scurvy, the general treatment will be styptic. Cold water, ice, snow, a stream from a hose, solutions of tannin, matico, iron chloride or sulphate, alum or gelatine may be employed. Internally the iron salts, gelatine, atropine, ergot, lead acetate, or quinia may be given. In hæmophilia the gelatine especially should be tried both locally and generally. When it is possible, as in the case of the head, gravitation should be availed of. Elsewhere a compress bandage may be used.

ULCERATION. GANGRENE. BED SORES.

Causes: inflammation, exudation, obstructed circulation, lesions in trophic nerve centres, sclerosis, toxins, ergot, caustics, freezing, gangrene, microbes, cryptogams, spoiled fodder, white skins, buckwheat, insolation. Symptoms: inflammation, molecular disintegration, dry sloughs. Treatment: camphorated spirit or vaseline, antiseptics, phenol, salicylic acid, iodoform, iodine, creolin, lysol, tar, detach sloughs.

In all cases in which the skin is violently inflamed, and particularly when the seat of an abundant exudation or infiltration which blocks circulation and retards nutrition, the tissues are especially liable to death, molecular or by sloughing, and formation of bedsores. As a general cause lesions of the trophic centres in the medulla and cord must be accepted as a cause of the imperfect nutrition and lack of vitality. This is seen in sclerosis of the cord, but may appear as the result of poisoning of the myelon as well as the gangrenous tissues by absorbed toxins. Again a common cause of circumscribed cutaneous gangrene is the capillary contraction and obstruction of ergotism. This usually involves all the tissues, soft and hard, at the distal end of a member or organ, causing the separation of all at one common level, but in less severe forms the skin only sloughs, in the form of round or irregular masses, usually around the coronet, and the resulting sores heal up under an appropriate diet. Cauterization and freezing may be a further occasion of gangrene. Finally, the local operation of the microbes of gangrene, determines both ulceration and sloughing. Cryptogams on spoiled fodders (trefoil, lupins, vetches, rusty gramineæ) are also charged with developing gangrene.

White skins or white patches on the skin are especially liable to suffer as in cases of fagopyrism and “grease”. The action of the solar rays in summer must therefore be accepted as a concurrent cause.

Symptoms. The first symptoms are usually those of cutaneous congestion or inflammation. Redness, swelling, pitting on pressure, or tension, are accompanied or followed by vesicles, chaps or erosions. The margins of the sores become thick and irregular, often undermined, and they gradually increase by breaking down of tissue in their depth or on their margin. In other cases patches of skin dry or wither up, either in superficial layer or throughout its entire thickness, and these dried extra vascular sloughs are gradually detached by granulation beneath. The surrounding tumefaction is always extensive and the sores may expose the deep seated structures—tendons, ligaments, fascia, bones, joints—causing widespread destruction.

Treatment. If the disease is due to capillary occlusion of nervous origin, compresses with camphorated spirit, followed by camphorated vaseline may be of advantage. If otherwise, antiseptics will be in order: carbolated vaseline, salicylic acid cream, iodoformed vaseline, a weak iodine ointment, creolin, or lysol in water, tar water. When the dead tissues are partially separated the detachment may be hastened with knife or scissors and the sores treated like a septic sore.

CUTANEOUS HYPERTROPHY. ELEPHANTIASIS. PACHYDERMIA.

Chronic thickening of skin and lymph plexuses, horse hind limb after eczema, grease, glanders, ox neck and head, knees, shoulder. Calcification. Treatment: laxatives, diuretics, exercise, elastic bandage, friction, astringents, iodine.

Chronic thickening of the skin is most commonly seen in horses as a sequel of lymphangitis in the hind limb, the engorgment of the lymph plexus and thickening of its walls being associated with a general productive inflammation and thickening of the derma until the fetlock may be thirty inches or more in diameter. It may follow eczema, grease or chronic glanders. In cattle a productive dermatitis in the region of the head and neck, has led in the experience of the author to a similar distention of the lymph vessels and morbid thickening of the skin. The pads and calluses which form on the knees of the camel and on other parts subject to friction, furnish examples of hypertrophy of another kind. Again the thick dense cutaneous plates on the shoulders of the old boar may serve to illustrate a physiological hypertrophy. The writer has seen thickening of the skin in the seat of an incision made in spaying the pig and the deposition of earthy salts so as to form a distinct calcification.

Treatment is very unsatisfactory, yet something may be done by laxatives, diuretics, regular exercise, an evenly applied elastic bandage when in the stable, massage and the use of astringent and dilute iodine ointments. It is much more important to prevent the lesion by cutting short the morbid condition on which it depends. When developed, attention is usually given to prevent its advancement and to utilize the animal at slow work.

ICHTHYOSIS. FISH-SKIN DISEASE.

This consists in a scaly formation of the epidermis which is also formed in excess, and is supposed to be dependent on disordered trophic innervation. In new born calves suffering in this way Van Stettin found an excess of phosphate of lime in the epidermis. The calves usually die in a few days.

FURUNCULUS. BOIL.

Definition: pustule with necrotic core. Digital region. Microbes. Symptoms: Prevention: antisepsis. Treatment: phenol, iodine, alcohol, boric or salicylic acid, iron, bitters, calcium sulphide, sulphur, sodium sulphite.

A deep seated inflammation of the derma resulting in suppuration with the formation of a central adherent necrotic slough or core.

Boils are not uncommon on the digital region of horses in winter; or where the parts are exposed to street mud containing an abundance of decomposing organic matter. They are unquestionably due to pyogenic microbes, and have been largely associated with staphylococcus pyogenes aureus. As they often come out in successive crops, it may be assumed that the second focus is infected from the first, or that there is a special susceptibility in the particular animal system, or that both these factors contribute to the result. Debility, and traumas contribute to bring about the infection.

Symptoms. A nodular, hot, and very painful swelling, implicating the substance of the true skin, and surrounded by a hot, swollen zone, progresses to suppuration in the centre, yet when it bursts, or is opened, a core or small mass of necrotic, tough, fibrous tissue is found to be firmly adherent in the center of the bottom of the sore.

Prevention. Must be sought in sustaining the general health and in preserving the greatest cleanliness of stables and skin. Washing with a weak antiseptic solution when returning from muddy streets may be of use.

Treatment. When developing, the application of carbolic acid in crystal or on the end of a glass rod may often relieve the pain and destroy the microbes. Next day the part may be painted with tincture of iodine. If already opened the phenol may still be applied and followed after five minutes by alcohol to check the caustic action. Or boric or salicylic acid may be applied. To counteract the constitutional tendency, iron, bitters and other tonics and antiseptics, calcium sulphide, sulphur and sodium sulphite may be given.

HYPERPLASIA OF THE SKIN.

Productive inflammations and tumors of the skin are common in domestic animals but as they are essentially surgical lesions, they will be better considered under that head. We may name papilloma, warts, fibroma, melanoma, epithelioma, sarcoma, adenoma, carcinoma, dermoid cysts. Parasitic and microbian diseases of the skin will be found under their respective headings.

ALOPECIA CONGENITA. CONGENITAL BALDNESS.

Cases of this kind have been met with in foals and calves, which were born entirely bald or with only a few thin delicate hairs scattered over the surface. In a calf observed by the author, and which lived for several months, the body was almost absolutely bald, and the mouth remained edentulous, a coincidence which has been observed in other cases. The teeth belong to the same class of embryonic tissues as the epidermis, and a failure in the development of the one is likely to entail a corresponding failure of the other. Schneidemühl observed that the few hairs present in such cases were especially delicate and brittle.

ALOPECIA. POST PARTEM. ALOPECIA AREATA.

Normal shedding. Shedding out of time; laminitis, dropsy, exudative dermatitis, acariasis, ringworm, traumas, folliculitis. Debility, excessive lactation, starvation, petechial fever, spoiled fodder. Without apparent cause, alopecia areata, neurosis, micrococci, disease of derma. Symptoms: general disorder has general shedding. Local disorder extends from a centre. In horse with increased pigmentation. Treatment: correct general causes, use hair stimulants, cantharides, kerosene, tar, pilocarpin, mercuric chloride, cresol, iodine, balsam of Peru, silver nitrate. Arsenic.