Chapter V: Part 5

_Symptoms_ are difficult breathing, snuffling, a smaller current of air on the affected side, or none, sneezing, a watery, purulent, bloody, or fœtid discharge, and the appearance of the polypus when the nasal chamber is examined in a good light. If beyond reach of vision the polypus may often be felt by the finger. Care must be taken not to mistake the red, angry surface of the turbinated bones in Catarrh for a polypus. If beyond the reach of the finger, the flat sound on percussion of the nasal and frontal bones on the affected side, and the persistently diminished flow of air may serve for diagnosis. Tenderness shown on percussion is common to this and abscess of the sinuses.

_Treatment._ The horse having been cast with the diseased side uppermost and the head turned to the light, the tumor is seized with the fingers, the forceps, or hook, and drawn gently outward. The chain of the _ecraseur_ may be passed over it and slowly tightened upon the pedicle until it is cut through. This will usually obviate any laceration of the turbinated bones and consequent bleeding. In case of serious hæmorrhage check by cold water, ice, the actual cautery, or by plugging. Polypi with a broad base may be removed with a prob-pointed knife, curved on the flat, and furnished with a long handle. The mass is seized with a vulsella and detachment made by passing the knife with the concave side toward the tumor. In cases where the tumor cannot be seen or reached some have resorted to slitting up the outer wall of the nostril as far as the angle of union of the nasal and maxillary bones, care being taken to make the incision outside the upper end of the cartilage of the ala nasi. If too high to be satisfactorily reached in this way the nasal or frontal bone may be trephined over the body of the tumor as indicated by the flatness on percussion, and the operation performed through the opening thus made.

II. =Actinomycosis.= Though much more common in cattle than horses, yet the occasional occurrence of this in the face of the solipede must not pass unnoticed.

III. =Sarcoma= and =Carcinoma.= These are found growing from the periosteum, or even starting in the cancellated tissue and projecting into the nose, where they give rise to symptoms like those of fibrous polypi. Being much softer in texture and more liable to ulceration and degeneration they are likely to cause a much more offensive discharge. There is also more tendency to the implication of the submaxillary lymphatic glands. The only treatment is surgical and recurrence is always to be feared. (See Diseases of the Orbit.)

IV. =Fatty Tumors= of the nose are described by Röll and Gurlt as existing on the septum and in the sinuses. Being simple, they can be removed with great confidence as to nonrecurrence.

V. =Osseous Tumors of the Nasal walls.= These are described by Röll as osteophytes in the maxillary sinus in chronic catarrh, and by Gamgee as osteomata attached to the outer wall of the nasal chamber, which had to be detached by saw and bone forceps. I have found these latter of a soft porous structure easily detached by the knife, and in other cases dense and requiring, chisel, saw and forceps. In one instance the tumor grew from a dense hypertrophy of the maxillary bone which could not be entirely removed because the molar alveoli were implicated.

VI. =Cysts= named by Röll and others as present in the mucosa of the ethmoid cells in solipedes often contain larva of the strongylus armatus.

VII. =Angioma= may be but an exaggerated development of the abundant venous plexus and erectile tissue on the surface of the turbinated bones. There appears to be at other times an actual increase of the vascular tissue. As might be expected it has no abrupt margin, but gradually shades off into the healthy tissue. The prominent centre has a bluish red or brownish hue. It obstructs breathing, is apt to bleed under violent exertions in draught, or in contested races, and readily ulcerates with a bloody discharge. If it subsides and heals, it is followed by a whitish puckering like the so-called _cicatrix_ of glanders.

CATARRH OF THE FRONTAL SINUSES IN CATTLE. CATARRH FROM TRAUMATISM.

Extent of sinuses in cattle. Causes, blows, unequal teams, locking
horns, fracture. Pathology. Congestion, exudation, suppuration,
swelling and closure of outlet, prostration, fever, agalactia, septic
infection, ulceration, exclusion of oxygen. Symptoms. Crimson
hæmorrhage, disturbed breathing, appetite, rumination, position of
head and eyelids, percussion and temperature of forehead, fever.
Chronic form. Slow progress, emaciation, anorexia, facial expression,
hide, discharge, breath heavy or fœtid. Duration. Prognosis. Lesions
in sinuses and glands. Treatment. Cold irrigation, icebags, elevation
of head, laxatives, diuretics, dehorning, trephining, injections,
astringent, antiseptic, blister, tonics.

The gravity of this affection is a consequence of the great extent of the delicate mucous membrane which lines the frontal sinus. This cavity not only occupies the whole forehead from beneath the eyes up to the frontal crest, but extends, in the mature horned animal, into the tapering bony process which forms the basis of support for the horn. The mucosa is rendered all the more extensive by the numerous pillars and septa that pass from the outer bony plate to the inner, giving great strength to the part for purposes of offense and defence. Inflammation of this membrane is usually the result of blows on the horns, and these are much more common among working oxen than dairy cows. The immediate cause is violent contact with the yoke when the head is lowered at pasture, and from blows of a club in the hands of the driver. In countries where the yoke is a broad padded board hung from the horns and resting on the forehead traumatic injuries are much more common. The active and vigorous animal gets the greater part of the work, and the wrench and jar may induce hæmorrhage and catarrh. If the yoke is ill-made or badly fitted the case is worse. The blows sustained by horn or forehead in an ordinary fight, may also be the cause, and a partial or complete fracture of the bony support is especially hurtful when the detached horn is replaced so as to close in the cavity. Blows on the frontal crest are also dangerous.

The _pathology_ of the disease consists in an inflammation of the mucosa of the sinus, and the filling of that cavity with blood or, later, with a muco-purulent fluid, the escape of which is prevented by the closure of the nasal outlet by swelling. This of itself produces violent headache and much nervous disorder as witnessed by the drooping head, closed eyelids, prostration, high fever, anorexia, and in cows suppression of the milk secretion. But there is reason to believe that this is aggravated by the septic germs, which inspired with the air, were already present in the sinus, and which in the comparative absence of oxygen, in a rich culture medium and in contact with injured and debilitated tissues, assume an enhanced pathogenic rôle. This may serve to explain the ulceration of the mucosa of the sinus found in subjects that have suffered for some time. It further explains the notorious fact that the free access of air (oxygen) to the inflamed sinus is one of the most helpful therapeutic measures.

_Symptoms of the Acute Form._ When the disease is traumatic the first symptom is usually a hæmorrhage from the nose, the blood being of a bright crimson. Respiration is hurried, and appetite diminished, yet rumination may be imperfectly performed. The bleeding may be repeated for days in succession, but the ox is still capable of work. On the fifth or sixth day there is complete anorexia, rumination ceases, the head sinks resting on the manger or soil, the ears droop forward and downward, and may be swollen. The head inclines to the affected side, the corresponding horn is intensely hot, and the eyes are closed. Light percussion of the forehead on the affected side gives pain, and the sound elicited is flat and dull as compared with that from the opposite side. The temperature of the body rises 2° or more, the pulse becomes frequent, full and hard and the impulse of the heart abnormally strong. Costiveness, partially suppressed and high colored urine, and dry hot muzzle betray the fever. Unless relieved the chronic form may supervene.

SYMPTOMS OF THE CHRONIC FORM. When this comes on slowly, working oxen get emaciated, lose appetite, have the eyes dull and sunken, and the lids drooping, the coat rough and staring and the skin harsh, dry, and lacking in pliancy, the head is carried low when out of the yoke and, after shaking the head and sneezing, a glairy, slightly fœtid matter escapes from the nostril. The breath is fœtid and appears to be offensive to adjacent cattle.

This may continue for months with no other change than a more constant nasal discharge, and increasing emaciation and weakness.

_Prognosis._ This is favorable for the acute disease at the outset. But if no relief is furnished it is liable to go on to a fatal issue. Even the chronic form is curable unless the subject has already become hopelessly weak and debilitated.

In _fatal cases_ the sinuses are found to be filled with a glairy fluid and the mucosa thickened and raw or ulcerated. There may be enlargement of the pharyngeal lymphatic glands, and there may be attendant pharyngitis.

_Treatment._ The patient must have absolute rest and cold water irrigation or icebags applied to the head. The bowels may be opened by a saline, or a diuretic administered. If the head is persistently dropped it may be kept moderately elevated by a halter tied to a higher point. Should there be no relief at the end of twenty-four hours, no time should be lost in securing free admission of air to the cavity. Cruzel advises to saw off the horn at its base, as the one certain method of securing prompt improvement and speedy recovery. If a horn and its bony support have been broken off they should be at once removed and the head turned up to evacuate the accumulated glairy fluid from the sinus. From an apparently hopeless condition a few hours will suffice to restore an appearance of good health. If the horn has not been broken and it is desirable to save it, the bone may be trephined in front of the root of the horn and the liquid evacuated, or less effectively and more painfully the horn may be bored at its root by a large gimlet.

If no hæmorrhage has taken place and if active treatment has been adopted at the outset recovery may be complete in two or three days, but if the disease has been ushered in by a hæmorrhage which recurs several days in succession, amputation of the horn or trephining will be demanded. In chronic cases this should be followed by astringent and antiseptic injections and a blister may be applied to the throat or the side of the neck. In these cases too a course of mineral tonics is desirable.

CHRONIC CATARRH OF CATTLE.

Catarrh, chronic, summer aggravation, thickened, roughened, mucosa,
discharge, twigs in nose. Question of parasitism. Treatment, remove
causes, antiseptic astringents.

A remarkable form of chronic catarrh with summer aggravation exists in some of the hilly districts of New York but has not received such study as to enable us to state its true nature.

One or two in a large herd will have a loud snuffling breathing, which may subside so as to be entirely overlooked in winter, but reappears when put to pasture in the spring and continues in a marked form throughout the warm weather and until after the animal is returned to winter quarters. There appears to be little or no fever nor constitutional disturbance except what comes from the obstructed breathing, and the yield of milk may be unchanged. The symptoms would indicate a purely local disease. Yet so few are attacked out of a herd that it cannot be actively contagious.

On close examination the nasal chambers are found to be narrowed, there is manifest thickening of the mucosa, and its surface feels rough and uneven, with miliary elevations. There is of course more or less glairy discharge. If the examination is made about midsummer, the finger introduced into the nose will usually detect the ends of twigs that have been introduced into the cavity and broken off. When withdrawn these may prove individually from four to eight inches long, and some force may be required to extract them. In winter these are often absent, having been apparently dropped one by one. The absence of these sources of irritation sufficiently accounts for the manifest improvement during the colder months. In spite however of the winter remissions the disease tends to a steady advance year by year. While nothing definite is known of its pathology, the occurrence of this disease in given localities, its manifestly local nature, and its persistence when once established would suggest enquiry as to the possible existence of parasitism, bacteridian or otherwise.

Until further discovery treatment can only be of a general nature. Removal of the foreign bodies from the nose, pasturage where there is no brush to replace them, soiling when clean pastures cannot be found, and the use of astringent and antiseptic agents by insufflation or injection would be indicated.

MALIGNANT CATARRH OF CATTLE.

Local causes. Debilitation. Polluted air. Poor diet. Symptoms,
gastro-intestinal, fever, lachrymation, turbid aqueous, photophobia,
congestion of mucosæ, generally disturbed circulation, breathing,
depression, heat of forehead, buccal petechiæ, epithelial
desquamation, abrasions, ulcers, abortion, albuminuria, local
swellings, shedding of horns, dropsy, dyspnœa. Lesions, in nasal
mucosa, subcutem, cerebral, dark blood. Prognosis. Treatment,
antiphlogistic, laxative, diuretic, tonic, locally steam, antiseptic,
astringent, trephining.

This disease occurs chiefly in cold damp marshy localities where the vital power is impaired or in cold situations exposed to severe north and east winds. In the wet cold seasons of spring and autumn it is especially prevalent. According to _Rychner_ it rarely attacks old cows but prevails among young cows and oxen. In the south of France on the contrary it appears chiefly in the hot season (June and July) and is attributed to suppressed transpiration. It prevails especially however in herds kept in small filthy stables, low in the roof, hot, close and badly aired. (Festal). In New York it appears in cattle on black muck pastures and in Minnesota on the dried up ponds.

_Symptoms._ Diarrhœa is a common premonitory symptom arising from the irritation of the intestinal canal as it is soon followed by some degree of costiveness, the dung becoming dark colored, firm and scanty. Diarrhœa reappears later. The coat stares or the beast actually shivers; the head is depressed; the roots of the horns and the forehead are hot; the eyes are sunken, swollen and red, suffused with tears, turbid in their anterior chamber (aqueous humor) and intolerant of light; The muzzle dry and hot; the mouth hot but moist with abundant saliva; the mucous membranes of the mouth, nose and vagina have a bluish red color; the pulse is rapid and more or less full or hard; impulse of the heart weak; the breathing is accelerated, the respiratory sound is heightened in intensity and a cough is frequent. Temperature 104° to 107° F. The urine is scanty and high colored. The surface of the body is alternately hot and cold, and after some time a watery fluid begins to distil from the nose.

At the end of twenty-four hours the symptoms are intensified or altered. The eyelids are more swollen and the flow of tears more profuse; the nasal discharge becomes slimy, and streaked with blood, and accumulations take place in the frontal sinuses as indicated by the increasing heat of the forehead and the dullness on percussion. In the mouth appear dark red spots, from blood extravasation, over which the epithelium sloughs off leaving raw unhealthy sores. The appetite entirely fails; dung and urine are passed painfully and with effort, and abortion frequently takes place in pregnant cows. The urine is albuminous with cell forms, and casts. The limbs appear rigid and it pains the animal to move.

From the fourth to the sixth day the ulceration appears on the mucous membrane of the nose which has often a claret color, and the nasal discharge becomes again more watery and irritating. The muzzle is swollen and a dropsical infiltration appears beneath the jaws which extends along the neck to beneath the thorax and into the limbs. Portions of the nasal mucous membrane now slough off, and similar sloughs are often seen on the skin of different parts of the body; the secreting structures of the horns and hoofs even participating so that these are easily detached or shed. Saliva flows profusely from the lips, a fetid watery diarrhœa succeeds the constipation, the dropsy becomes nearly general and death occurs on the eighth, ninth or tenth day of the illness. Convulsions and symptoms of suffocation may precede death.

In a _post mortem_ section the principal lesions are found in the nasal cavities and skin. The areolar tissue in both is the seat of an abundant serous infiltration, which has taken place into the deeper layers of the skin as well, rendering it thick, hard and unyielding. Besides the sloughs and ulcerations on the skin and mucous membranes, false membranes have been met with, on the lining membrane of the mouth and air passages. The ulcers in the nose have in many cases reached the bone, and from the abundant infiltration and softening, the membrane is easily stripped from the walls of this cavity and of the sinuses. The general infiltration appears to have reached the brain, which is described as softened and having an undue amount of liquid in its cavities. The blood contained in the vessels is dark colored and numerous patches of extravasation are visible on the mucous and serous membranes as well as in the interior of organs.

Unless the malady can be controlled in its early stages it usually proves fatal. Patients that recover after it has been well developed at times retain its effects in permanent blindness or palsy of the hind limbs.

_Treatment._ Early and vigorous antiphlogistic measures are strongly recommended by French and Italian veterinarians. Gellé and Ercolani advocate the most copious bleedings. Festal insists that all other measures are useless when this is neglected. Before adopting free sanguineous depletion the history of his practice was a record of deaths, whereas later his losses were in cases where from a failure to recognize the disease at the outset, from the existence of diarrhœa, from the patient being pregnant or from a fear that the milking properties might be impaired, bleeding was deferred. He pushed the bleeding to the extent of causing acceleration of pulse, quickened breathing and heaving of the flanks, to effect which sixteen pounds had to be abstracted on an average. If this were done early the engorgement of the muzzle had usually greatly diminished if not entirely disappeared in the course of seven or eight hours thereafter. The alleged benefit is probably largely due to elimination.

Less heroic treatment is now generally adopted. An active purgative (one and a half pounds Epsom salts) may be given even though apparently contraindicated by the premonitory diarrhœa, and a further useful derivation may be obtained by applying active friction or even stimulating embrocations to the legs.

Steam with or without sulphur dioxide may be inhaled as for ordinary _coryza_ and cold water or ice kept applied to the forehead.

Nitre in ounce doses daily or liquor of the acetate of ammonia in three ounce doses may be given after the purging has ceased. Or drachm doses of hydrochloric acid with bitters may be given thrice a day in at least a pint of water.

Where the nasal discharge persists after the subsidence of the other symptoms the sinuse should be trephined in front of the horn, and tepid water and mild astringent and antiseptic lotions injected until a healthy action has been established. Change to a dry, well drained pasture or building is desirable for both treatment and prevention.

CONTAGIOUS DISEASES OF THE NOSE.

These are omitted here to be treated under that heading.

PARASITIC DISEASES OF THE NOSE.

Among these may be named:

LEECH BITES.

Form of wound, leeches in posterior nares, discharge of blood, mucus,
sneezing, snorting, dysphagia, anorexia, unthriftiness, anæmia.
Treatment, removal, sodium chloride, tar fumes, ether on sponge.

Though it more commonly attacks the mouth and lips yet the leech (Hirudo Decora) will sometimes fasten itself inside the nose when that is plunged in water. Its bite is to be recognized by its triangular shape. When taken in by the mouth it may fasten itself in the posterior nares where it is difficult to recognize its presence. In the anterior nares it can be readily discovered and removed, but in the posterior nares it may maintain its hold indefinitely. There appear in the nasal discharge streaks or clots of blood which may also show at the corners of the mouth. Sneezing, snorting, and difficulty of deglutition, may draw attention to the trouble, and in protracted cases signs of anæmia, inappetence, unthriftiness and general weakness. The most effective treatment is to remove the leech with the fingers, but as they cannot always be reached in this way, an injection of a strong solution of common salt may be used. Blaise succeeded by burning tar under the nose twice a day, and Louvigny by introducing a staff bearing a sponge soaked in ether.

COCCIDIAN CATARRH IN RABBITS.

Coccidia in rabbit’s nose, etc., inflammation, fatality. Treatment,
sulphur dioxide.

Zurn describes a contagious catarrh of rabbits caused by the presence in the mucosa of the nose, pharynx, Eustachian tubes and middle ears of myriads of coccidia. They create acute irritation and prove fatal in many cases. Embedded in the mucosa they are difficult to reach with medicinal agents, yet the free parasites may be destroyed by frequent fumigations with sulphurous acid, or by spraying or injecting the nose with its solution.

LARVA OF ŒSTRUS OVIS (GRUB) IN THE NASAL SINUSES OF SHEEP.

Season of attack by fly, hibernation, botfly of sheep, mode of attack,
embryo, defensive acts of sheep, habitat of larva, mature larva, its
exit, chrysalis in soil, its transformation. Symptoms, sneezing,
snuffling, rubbing of nose, lachrymation, unsteadiness, discharge,
respiratory digestive and febrile disturbances, emaciation, septic
action. Lesions, larva, congestions of mucosa, brain. Treatment,
warmth, errhine, parasiticides, mechanical extractors, trephining,
injections. Prevention, newly turned furrow, quicklime, tar. Other
larva in nose.

Sheep are especially subject to the attacks, in summer and autumn and in warm sunny barns even in winter, of the Œstrus (Cephalemia) Ovis, the larva of which hibernates in the nasal sinuses or turbinated bones.

The =sheep-bot-fly= is only about four lines in length, of a light yellowish or slightly brownish gray hue, hairy, with dull black transverse lines on the upper surface of the thorax, and a lighter color on the abdomen where the black lines are more broken. The transparent, colorless wings extend beyond the body: winglets are long and cover the poisers: abdomen is formed of five rings.

They appear during the whole summer hiding away in walls, stumps and grass, unless when pairing or pursuing the sheep to deposit their young. The mode of attack is difficult to follow on account of the small size, gray color and rapid flight of the fly and fear and shyness of the sheep. It cannot be doubted, however, that they approach and drop on the margin of the nostril, the larva previously hatched from the egg. The old authors describe the deposition of the egg on the margin of the nostril and its prompt hatching by the animal heat, but the observations of Brown, Kelly, Cockrill, Riley and Ormerod abundantly prove that the fly is viviparous. Cockrill obtained no less than 300 live hatched larvæ from one fly caught while pursuing a sheep.

The sheep seek to avoid the fly by resorting to dry dusty roads where they lie with the nose close to the ground, or they stand with the nose close to the soil and between their fore legs. At other times they will collect in a dense phalanx with their heads directed toward the centre of the mass and held low so that the fly cannot reach them. The moment the fly touches the nose they shake the head, stamp with the feet, and gallop off with the nose close to the ground, looking from side to side to see if the fly pursues and frequently smelling at the grass as if apprehensive of other flies hidden there. If such appear they instantly turn and scamper to other parts of the field or take refuge in a dry dusty place or gravel bank.

The =young larva= when deposited on the nostril speedily makes its way up and takes refuge in the cavities of the turbinated bones and the frontal and maxillary sinuses, where it passes the winter feeding on the mucus and the purulent discharges determined by its presence. When mature it leaves the nose and assumes the chrysalis form in the soil.

The =mature larva= is narrow anteriorly, broad behind: its upper surface is prominent and rounded, lower surface flat, and furnished at the anterior of each ring after the third, with a series of pointed tubercles or spines: the cephalic end bears the buccal organs directed downward, and bearing two great hooks connected with the hard framework of the pharynx and recurved downward, backward and outward; mouth small; antennæ thick and short placed above the buccal organs: the inferior part of the last ring projects beyond the upper portion and is furnished with two nodules with intervening spines: pentagonal patches of stigmata on the last ring: very small anterior stigmata between the first and second rings. The color is white with brown spines, stigmata and transverse striæ. Length seven lines to one inch.

When dropped from the nostril in the course of summer they pass into chrysalis in one or two days; and after a residence of six or eight weeks in the soil emerge as the perfect fly.

=Morbid Symptoms Caused by the Larvæ in the Head.= =Grub in the Head.= These bear a close relation to the number of larvæ present. If there are only two or three no trouble may result. If many there is muco-purulent discharge from the nose, sniffling breathing, frequent sneezing and snorting expelling mucus and even blood; shaking of the head; rubbing of the nose on the fore legs or other objects; weeping eyes; and occasional unsteadiness of the gait.

In the worst cases the respiration becomes sighing, wheezing or even snoring; the mouth open; head pendent; appetite fails; a dull, apathetic condition ensues with grinding of the teeth rolling of the eyes, and, rapidly advancing emaciation.

Fatal cases are not uncommon but most frequently the larvæ reaching maturity are dropped and health is promptly re-established. Septic poisoning from decomposition of dead larvæ and debris is a dangerous complication.

_Lesions._ These consist in the presence of the larvæ in the sinuses, with violently congested, purple ulcerated mucous membranes and collections of pus. The mere presence of the grub is not conclusive as the majority of the sheep harbor two or three from October to June.

_Treatment._ It is advised to place the sheep in a warm building to encourage the parasites to come out of their recesses and then introduce some agent to destroy them or to induce their expulsion by sneezing. The value of the hot building is probably hypothetical unless the larvæ are approaching maturity. The following agents are used:—moderately strong solutions of salt, vinegar, carbolic acid, creosote (1 part to 100 parts of water), or carbonate of ammonia, lime water, snuff, or even such irritants as quick lime, oil of turpentine or hellebore. These last must be used with caution as they are liable to induce fatal inflammation of the air passages though no larva is present.

By passing a feather up the nostril twisting it round and then withdrawing it some grubs can usually be withdrawn and there is no harm in first dipping the feather in some of the milder agents mentioned above. But the larvæ in the sinuses can never be reached in this way.

In dangerous cases it is best to trephine the outer plate of bone covering the frontal sinuse and wash out freely with tepid water, lime water, or benzine. The operation may be performed close in front of the root of the horn if there is one, or to the inner side of the lower part of the eye if there is not. A semi-circular flap of skin is to be turned upward and backward sufficiently large to allow the use of a trephine ⅓ inch in diameter, which is to be used as for _Cœnurus Cerebralis_. The opening being made the sinuse is to be syringed freely for some time until the parasites come from the nose in the stream of liquid. The wound heals very promptly. In the absence of a trephine use a gimlet.

_Prevention._ Some turn up a furrow in the pasturage, in which the sheep may burrow their noses and evade the fly, others lay down quicklime in covered boxes which has the further advantage of inducing sneezing and favoring expulsion of the entering parasites. But perhaps the best plan is to procure a log and bore a number of holes in it with a two inch augur; place salt in the holes and smear their margins with tar, and renew it often. The sheep then takes a protective dressing with every lick of salt.

=Œstrus Purpureus= (Brauer) is a species which infest the nose, etc., of the Syrian sheep, and =Cephalemia Maculata= (Wedl) one which infests the nasal chambers of the Egyptian buffalo and camel.

NASAL CATARRH IN DOG AND HORSE FROM LINGUATULA (PENTASTOMA) TAENIOIDES.
RHINARIA TAENIOIDES.

Form. Family. Habitat when mature, and immature. Development.
Symptoms, sneezing, discharge, irritability, ill-temper, shaking the
head, rubbing nose, parasites in discharge. Treatment, injections,
trephining. Prevention.

This parasite has a worm-like body, but is closely allied to the mites and belongs to the Arachnida. It differs from the mite in having but four short limbs retractile and protractile and furnished with sharp claws. The body is thickest toward the anterior end and prolonged and narrow posteriorly; marked by about 90 rings; head rounded off abruptly, mouth broadly open, with a horny lip; integument with numerous openings or stigmata (respiratory); _male_ 7 lines long by a line broad in its anterior part genital orifice on the front part of the abdomen in the median line; _female_ 3 to 4 inches long, by 3 or 4 lines broad anteriorly; genital opening at the end of the tail. _Reproduction_ oviparous.

_Habitat._ Nasal chambers and sinuses of the dog, wolf, goat, and horse.

_Pentastoma Denticulata._ The young partially developed _P. Taenioides_. Has all the rings except the two first, garnished with fine sharp recurved spines; legs more slender with accessory booklets; length 2 lines; breadth ½ line.

_Habitat._ Cysts in the lungs, liver, mesenteric glands, etc., of the hare, porpoise, goat, sheep and other mammals, not excepting man.

_Development._ Leuckart found that the adult Pentastomata copulate in the nasal chambers, as many as half a million of eggs being fertilized in a single female; that these eggs are discharged with the nasal mucus and falling on vegetables are taken in by herbivora; their shells are digested and destroyed in the stomach, and the liberated embryos perforate the intestinal walls and encyst themselves in various organs. The encysted embryo varies from ¹⁄₅₀₀ to ¹⁄₄₀ inch in length, is rounded and blunt anteriorly but very thin posteriorly with the tail slightly curved toward the ventral aspect. It is several months before the feet, cutaneous spine and generative organs are developed, and during this period it undergoes several moultings. Finally it leaves its cyst and may live free in the cavities in the body of its host, and if it does not escape from the body it finally constructs a new cyst and then dies. If the host is eaten by a carnivorous animal the liberated pentastomata reach the nose either from the lips or pharynx and in a few months more acquire their complete development. They must reach the nose of the horse by their presence in the food or water.

_Symptoms Caused by the Pentastoma._ No morbid symptoms have been traced to the young encysted condition of the parasite. Yet it would not be surprising if their presence in large numbers in the mesenteric glands and liver should give rise to troubles of assimilation, sanguification, biliary secretion and the like. Frerichs says they are more common in the human liver in Germany than echinococcus, but adds that they have no clinical importance.

In their mature condition however they cause considerable irritation and nasal discharge when present in large numbers. In dogs there is running from the nose the discharge containing an abundance of the ova, restless, fretful habits, sometimes a morbid readiness to bite, frequent shaking of the head and rubbing of the face.

The _treatment_ would be to trephine the sinuses and inject lotions impregnated with creosote, carbolic acid or naphtha. From the danger to man of becoming infested it is important to ascertain the true nature of any nasal discharge of the dog especially in countries like Germany and Egypt in which this parasite is common.

_Prevention._ Deny raw offal of herbivora to dogs.

AFFECTIONS OF THE THROAT.

_Sore throat_, _Angina_, _Cynanche_—is a generic name applied to a series of inflammatory affections of the various structures about the throat. If the _larynx_ is specially inflamed the disease is known as _laryngitis_, if the _pharynx_, as pharyngitis, if there are exudations forming false membranes it is _croupous_ or _diphtheritic_, or if associated with some general febrile affection, it takes its name accordingly, _influenza_, _strangles_, _distemper_, or _scarlatina_, as the case may be.

LARYNGITIS IN THE HORSE.

ANGINA LARYNGITIS, CYNANCHE LARYNGEA, ETC.

Causes, mechanical, cold, irritants, extension, diet, close stables,
infectious disease. Symptoms of acute form, head extended, throat
swollen, tender larynx, cough, in early stage, after exudation,
wheezing in inspiration, dysphagia, fever, œdena glottidis, spasms,
dyspnœa, successive discharges. Lesions, tumefaction, softening,
friability, redness (ramified or not), erosions of mucosa, œdema.
Course, duration, sequelæ, cough, roaring. Subacute form, chronic
form, in old debilitated animals, in those reined too tightly, in
those which perspire with difficulty or bear heavy coats. Symptoms,
local, in breathing, cough, effect of cold air, or water or of dust.
Sequelæ, ossified cartilages, roaring, emphysema, bronchiectasis.
Treatment, hygienic, soothing, sheepskin, compress, poultice, mustard,
sulphur dioxide, laxative, neutral salts, expectorant, sedative,
derivative, tracheotomy, with trochar and cannula, with scalpel,
tracheotomy tubes. Insufflation, injection. In chronic laryngitis,
electuaries, mustard, derivatives, astringents, caustics, tonic
inhalations.

_Causes._ These are the ordinary causes of chest diseases. As special causes may be noted severe compression of the larynx as in roughly and repeatedly _coughing_ an animal; the sudden contact of piercing cold air, of irritant gases, powders or liquids with the membrane, and the rapid, forcible and continuous current of condensed air through the glottis during severe exertion.

Among the general causes the most fruitful are the high feeding, hot, close stables, heats and chills, and other circumstances attendant on domestication. Laryngitis may be an extension from coryza, pharyngitis, bronchitis or pneumonia. It may further be but a local manifestation of influenza or strangles, contagious pneumonia, etc. The disease is _acute_, _subacute_, or _chronic_.

_Symptoms of acute form._ All acquainted with horses can recognize the general symptoms of sore throat. The nose is elevated and protruded to avoid compression of the larynx; it is carried stiffly for the same reason. There is some swelling around the throat or beneath the root of the ears. If the cartilages of the larynx are compressed between the finger and thumb, or if pressure is made in the median line below upon the connecting crico-thyroid membrane the patient instantly coughs and throws up the head to avoid a repetition of the suffering. This tenderness of the larynx to touch is peculiar to laryngitis and serves to distinguish it from pharyngitis. The cough is at first very hard and painful and only gives way to a soft mucous type when a free mucous exudation puts an end to the tense, thickened and dry state of the mucous membrane. The inspiratory act is accompanied by a whistling or deep bass sound, particularly after the slightest exertion. This may be heard at times during expiration as well, though not invariably so. Sometimes the animal drops the food from his mouth after mastication, because of the pain attendant on swallowing, but this is really a symptom of coexisting pharyngitis, and its absence implies the nonexistence of that complication. There is usually a slight pasty swelling between the branches of the lower jaw.

There are besides the general symptoms of fever more or less marked, such as increased temperature, accelerated pulse, red injected eyes and nose, slightly hastened breathing, the expiration being effected by a double lifting of the flank as in broken wind, etc.

In two or three days in favorable cases exudation takes place from the mucous membrane, the cough becomes softer and less frequent, the local tenderness decreases and the general symptoms subside.

If otherwise the symptoms may become more intense, and breathing may get loud and difficult in connection with thickening and rigidity of the mucous membrane, or a serous exudation into it and beneath it (œdema glottidis) which by closing the glottis renders breathing almost impossible. The same distressing symptoms may arise from spasm of the larynx excited by the inflammatory action. As arising from thickening or infiltration of the membrane these symptoms may come on comparatively slowly, but in the case of spasm they appear suddenly and have periods of intermission, reappearing on succeeding days and usually at the earlier part of the night. In such circumstances the loud, noisy breathing is heard at a considerable distance, the horse stands obstinately still, the fore feet apart, his elbows turned out to allow a firm action of the chest, the flanks working laboriously, the head low, the nose protruded, the nostrils widely dilated, the mouth open, the eyes standing out from their sockets red and wild looking, and the face constrained and pinched, the whole expression being that of intense agony from impending suffocation.

_Lesions._ In cases where death has supervened, perhaps in connection with another disease, the laryngeal mucosa, especially on and above the glottis, is soft, tumid, friable, with ramified or uniform redness and petechial spots. The epithelial layer may be softened, disintegrated and shed, leaving pointed or larger erosions, which are, however, usually superficial. In case of œdema glottidis the mucosa and submucosa are thickened by an abundant exudate which may extend to the connective tissue outside the larynx as well. In aggravated cases there may be dark red or brownish red discolorations of the mucosa.

_Course, Duration._ Fortunately these aggravated forms of the disease are rare and unless the patient perishes during such an attack or the inflammation extends down toward the chest, laryngitis rarely proves fatal. Its duration is from twelve to fifteen days. Its extension to the lungs may be suspected when the extreme tenderness of the throat subsides without any corresponding improvement in the health. Examination of the chest will then rarely fail to detect the presence of disease.

But although sore throat is rarely fatal its effects are not unimportant nor trivial. It occasionally merges into a chronic form, with a hacking cough, tenderness to pressure and an increased liability to other diseases of the air passages. More frequently it is followed by wasting and fatty degeneration of the laryngeal muscles and the horse becomes a confirmed _roarer_. In all cases it leaves a greater susceptibility to a second attack.

=Subacute Laryngitis.= This form has been chiefly seen in young animals and up to eight years old. At the outset its symptoms are moderate but as it is usually associated with serous effusions in and around the mucous membrane the symptoms above mentioned as indicating imminent danger of suffocation may suddenly appear and life can only be preserved by opening the trachea.

=Chronic Laryngitis.= This may follow the acute form or it may come on independently and by slow degrees. It may accompany nasal catarrh, or chronic bronchitis. Old animals which have had heavy draught work and repeated attacks of sore throat, are frequent subjects of it, and as Fergusson has pointed out it is most prevalent among horses whose throats have been compressed by the inconsiderate use of the bearing rein. Reynal has observed it often in horses that are sweated with difficulty, and in those which remain long wet from the length and thickness of their winter coats.

_Symptoms._ When acute laryngitis passes into the chronic form all the symptoms subside except a slight nasal discharge, the cough, tenderness of the larnyx, and _roaring_. The cough is dry, short, and hacking, rarely soft, and is heard mainly when the animal feeds, when he leaves the hot stable for the cold air, and after drinking cold water. During exercise, it is equally excited, the cough becoming harder, and the horse extending his head and neck as if to disengage some body from its throat. The subject may in nearly all other respects maintain the appearance of vigorous health.

_Course, etc._ This disease is liable to prove obstinate and if of old standing, often incurable. Unless checked, the continued congestion and irritation of the larynx, the frequent, hacking cough, and the consequent violent distension of the lungs bring about extensive and irreparable structural changes. Among these may be mentioned ossification of the cartilages of the larnyx; paralysis of the left laryngeal nerve with wasting of the muscles to which it is distributed, and _roaring_; dilatation of the bronchial tubes, and permanent distension and rupture of the air cells (emphysema, broken wind, heaves).

_Treatment._ _Acute form._ Unless in the very mildest cases unaccompanied by fever, repose is essential. If available, a roomy, clean, dry, and airy loose box should be allowed, care being taken to avoid draughts of cold air and to secure a soft equable temperature neither too hot nor too cold. Blankets should be used and even flannel bandages applied loosely to the legs if the weather is cold, or, if there is any tendency to chills and shivering. The nostrils must be steamed as directed for _coryza_. A piece of sheepskin with the wool turned in may be tied around the throat and up to the ears. In very acute cases a linseed meal poultice or wet pack may be applied to the throat, while in the milder forms, a mustard poultice or a lotion of Spanish flies or other stimulant may be employed. Unless the malady has an epizootic type, with prostration and a weak, rapid pulse, the bowels may be opened by a laxative (3 or 4 drachms, aloes), and the water or gruel the animal daily drinks should contain ½ to 1 ounce nitre. As an expectorant the patient may take salammoniac 1 oz. daily in the drinking water, or this agent may be evaporated from a clean chafing dish every two hours and inhaled. Or he may take carbonate of potash or soda, or iodide of potassium. If the cough is troublesome, half a drachm of Dover’s powder may be given thrice a day or 1 grain chloride of apomorphine every hour. Bromide of potassium or sodium may also be resorted to. Inhalations or spray of sulphurous acid, or vapor of oil of turpentine and insufflations of calomel may benefit as local applications. The diet must be confined to sloppy bran mashes, cut roots, or boiled barley, or oats. Hay should be withheld in the more acute cases until improvement appears. Under treatment such as the above and even without the medicinal part of it, the great majority of cases will do well.

In cases attended with high fever with strong full pulse and bright red nasal membrane, the purgatives and diuretics are especially called for, and the former should have their action encouraged by frequent hot water injections. Twenty drop doses of the tincture of aconite repeated four times a day, or ten drops every three hours, will be further useful.

When the symptoms are of such a type as portend the access of paroxysms of threatened suffocation, bleeding has been strongly recommended, but unless resorted to in the first twenty-four or forty-eight hours is rarely admissible. Also in weakened constitutions and when the fever is of a low type, with small, weak pulse and general dullness and prostration, the temporary relief obtainable from bloodletting will not often counterbalance the danger of increasing weakness, and the loss of recuperative power. In all such cases the application of a strong mustard poultice for several hours in succession, until an abundant effusion has taken place, into the skin and beneath it, has often the best effect by virtue of its depletive and derivative action. Active friction of the limbs to improve their circulation and increase their temperature is also useful.

=Tracheotomy.= When suffocation becomes imminent not a moment must be lost in performing _tracheotomy_. This operation is always available in threatened suffocation from obstruction to the passage of air in the nostrils and throat.

Different methods of opening the windpipe have been resorted to. One is by means of a cannula and trochar at least three-fourths of an inch in diameter and about five inches long and with two large oval orifices in the middle of the cannula, and on opposite sides. This is made to transfix the windpipe with its investing skin and muscles from side to side in the middle of the neck, care being taken to pass it in the interval between two adjacent cartilaginous rings. The trochar is now withdrawn and the orifice in the cannula corresponding to the interior of the windpipe, the animal is enabled to breath freely through the tube. The cannula has only then to be secured in its place by a tape carried round the neck.

The more common plan is by introducing a tube through a circular opening made in the trachea. For this operation are needed, scissors, knife with a thin narrow blade, needle and thread, and tracheotomy tube. The common tube is about an inch in diameter, four to five inches long bent upon itself so as to fit into the trachea, and furnished with a flat shield to slits in which cords may be attached to fix it in its place. A second variety is only long enough to reach into the windpipe. It is provided with a flattened shield externally and from its inner extremity projects downwards at right angles a plate curved so as to adapt it to the form of the interior of the trachea. There is an additional plate to fit into the upper part of the tube, provided with two lips projecting from it at right angles; the outer lip is screwed to the shield after the tube has been introduced into the wind pipe and the inner lip is thus fixed inside the ring of the trachea, immediately above the opening and effectually prevents any displacement of the tube.

In operating the animal is kept standing with the head as nearly as possible in the natural position. The hair is removed from the skin beneath the windpipe between the middle and upper thirds of the neck. The skin having been rendered tense, (without displacement) by the fingers and thumb of the left hand, an incision is made in the median line from above downwards, for about two inches and is carried through the muscles so as to expose two rings of the trachea. The needle and thread are passed through the membrane connecting the two rings, and with the knife a semi-circular piece of cartilage is cut from each of the two adjacent rings. The thread in the connecting membrane prevents them from being drawn in by the rush of air. It only remains to introduce the tube and fix it in position.

Not only does tracheotomy obviate immediate danger of suffocation, but by removing the source of irritation in the continuous and forcible rush of air through the narrowed and inflamed tube, and in securing for the blood a freer æration and a purer constitution it often induces a rapid change for the better in the character of the inflammatory action. The wound may be daily cleansed and dressed with sodium hyposulphite.

Some veterinarians following the example of Bretonneau and Trousseau have treated sore throat from the first by what is called the abortive treatment. For this purpose a long whalebone prob with a pledget of tow firmly attached to its end and covered with powdered alum is introduced through the mouth into the pharynx and larynx even. Violent paroxysms of coughing are induced, but cures are affected in from two to five days. Under Delafond’s treatment calves and foals recovered in twenty-four hours. A more modern method is to inject a solution by means of a hypodermic syringe inserted between the upper rings of the trachea.

Milder treatment such as the inhalation for an hour several times a day, of the fumes of burning sulphur and water vapor will be found generally successful. The air should be impregnated with sulphur fumes only so far as can be breathed without inducing coughing on the part of the patient. Such measures should not divert attention from the necessity for general care, a control of diet, clothing, air, the state of the bowels, nor from local external applications to the throat.

=Treatment of Chronic Laryngitis.= The patient should have a loose airy box with an equable temperature. The avoidance of work and exposure must be sought for the time. Green food, cut roots, boiled grain, or bran mashes, with little or no hay, or other dry food, must be given. The bowels must be regulated. An electuary compound of linseed meal, molasses, and a drachm of belladonna extract to every tablespoonful of the mixture, may be given to the extent of a tablespoonful smeared on the inner side of the cheek twice daily. A mustard poultice to the throat has often a good effect. Light firing over the larynx is sometimes beneficial.

If secretion is defective and cough hard and dry chloride of ammonium, carbonates or bicarbonates of soda, potash or ammonium or borax, in solution or in gaseous form, may be given, the various bitters being at the same time drawn upon as tonics. If secretion is excessive, with a loose gurgling cough, astringents are indicated like ferric sulphate or chloride, (½ dr.), or they may be applied as spray: alum or iron alum five grains to the ounce, zinc sulphate or sulphocarbolate two grains to the ounce, silver nitrate one-half grain to the ounce. These may be introduced through the nose with the head elevated, or in small genera through the fauces. Tar, oil of turpentine, creosote, carbolic acid or eucalyptol may be inhaled from hot water.

PHARYNGO-LARYNGITIS IN CATTLE.

Susceptibility. Causes, symptoms, cough, salivation, wheezing,
lachrymation, muzzle dry, tender throat, dysphagia, disturbed
innervation and circulation, hyperthermia. Duration. Abscess.
Treatment, laxative, local treatment, lancing.

Cattle are less subject to sore throat than horses. The skin appears less sensitive to the influences of cold and heat. The ox is not subjected to the same severe exertions. It is rarely seen to sweat, the moisture passing off from the surface as insensible perspiration only. The disease, however, recognizes the same causes as in the horse, though these are manifestly less injurious.

_Symptoms._ The disease usually affects at once the larynx and pharynx so that the symptoms are somewhat modified. In the simplest form there is only a small, hacking cough, a flow of saliva from the mouth and some loss of appetite but no fever. In more acute cases the breathing is loud and wheezing, the cough, soft and rattling, is followed by a free discharge of mucous from the mouth, the nostrils and eyes are red, the muzzle dry, the pulse accelerated and full, the throat tender to the touch, and swallowing difficult, part of the food and drink being rejected through the nose. If the larynx is chiefly involved the loud noise in breathing is the predominant symptom and sometimes almost the only one.

_Course, etc._ The cough and other symptoms are usually moderated with the access of the abundant secretion on the second or third day, and recovery is perfect on the eighth to the fifteenth. If abscess results, to which there is a far greater liability than in the horse, it may not burst till the twentieth day and the case is correspondingly protracted. This should be carefully distinguished from the deposits of tubercle which take place around the throat in cattle. In rare cases the disease becomes chronic.

_Treatment_ does not differ from that advised for the horse except in the greater safety of purgatives which must in this case be saline (Epsom or glauber salts one to two pounds), and in the greater ease with which local treatment can be applied owing to the shortness of the soft palate. When abscess forms it must be encouraged by poulticing and opened with the knife or lancet as soon as it points.

LARYNGITIS IN SHEEP.

Infrequency. Causes, damp lands, storms, close buildings, clipping.
Symptoms, cough, sneezing, discharge, snuffling, oral breathing,
tender throat. Treatment, ventilation, warm water vapor, sulphur
dioxide, salines.