Chapter I: Part 1

TEXT BOOK
OF
VETERINARY MEDICINE

BY

JAMES LAW, F.R.C.V.S.

Director of the New York State Veterinary College Cornell University,
Ithaca, N. Y.

VOL. II

DISEASES OF THE DIGESTIVE ORGANS—LIVER—PANCREAS—AND SPLEEN

ITHACA
PUBLISHED BY THE AUTHOR
1900

Copyright by
JAMES LAW
1900

PRESS OF
ANDRUS & CHURCH
ITHACA, N. Y.

VETERINARY MEDICINE.

DISEASES OF THE DIGESTIVE ORGANS.

Second in importance to pulmonary complaints in solipeds; equal in
ruminants. Extent of digestive organs and character of food, in
carnivora, herbivora, and omnivora. Ruminant’s stomachs. Gastric
fermentation. Foreign bodies. Torpor. Unwholesome fodder.

In the horse these maladies are only second in importance to those of the respiratory organs, while in ruminants they are equally frequent and important. The varying susceptibility of the digestive organs to disease in different families and the special proclivity of different parts of these organs may be, in great part, explained by the great variation in the food, by the relative extent of the gastro-intestinal surface, and by the amount of work devolving on the respective viscera.

In =carnivora= the entire gastro-intestinal surface is little more than half the area of the skin, for their rich animal food does not require a prolonged retention and an elaborate series of intricate processes to insure digestion and absorption. This system of organs is accordingly less liable to disorder in carnivora than in herbivora and omnivora. Add to this that the carnivorous stomach is very capacious relatively to the intestine, that the digestion of the great bulk of the food (nitrogenous elements) is nearly completed in this viscus, and that the contents of this organ are easily and completely discharged by vomiting whenever they prove irritating, and we have ample explanation of the comparative immunity of these animals from digestive disorders.

The =herbivora= stand at the opposite extreme, the gastro-intestinal surface being over double the area of the skin in the horse, and nearly three times that extent in the ox. The hard, fibrous and comparatively innutritious vegetable food of these animals necessitates its prolonged retention in the alimentary canal in order to the completion of digestion and the absorption of the nutritive constituents. Hence the great liability of the herbivora to diseases of the digestive organs.

=Omnivora= occupy a place intermediate between these two classes, as regards both the nature of the food and the extent of surface of the alimentary canal, and they are in similar ratio little liable to digestive disorders. They have besides in common with carnivora a great facility in the rejection of irritant matters by vomiting, and in thus protecting themselves against gastric and intestinal disorders.

A fair idea of the area of the intestinal surface may be given by stating the length of the canal relatively to that of the body:—in the dog : : 6 : 1, in the rabbit : : 10 : 1, in the ass and mule : : 11 : 1, in the horse : : 12 : 1, in swine : : 14 : 1, in the ox :: 20 : 1, and in the sheep : : 27 : 1. The calibre of the intestine varies however and with it the capacity. Thus in the relatively shorter intestine of the horse, the capacity is much greater in ratio with the size of the animal than is the relatively much longer intestine of the pig. The ox’s intestine though twice the length of that of the horse has little more than half the capacity.

Among =herbivora= the monogastric (horse, ass, mule), and polygastric (ruminants) animals manifest varying pathological susceptibility according to the relative development of the different digestive viscera and the habitual character of their food. The horse and other large solipeds have small stomachs (16 qts.) and capacious intestines (196 qts.). Digestion is restricted in the stomach and largely carried on in the spacious bowels. The small stomach requires to be frequently replenished in moderate amount, but, if this is secured, its liability to disease is slight while that of the intestines is very considerable. In the ox the stomachs have a total capacity of 252 qts., while that of the intestines averages 103 qts. In this animal the capacious and hard working stomach is a frequent seat of disorder, while the comparatively small intestines are to a large extent exempt. The small stomach of the horse is easily overloaded and disordered or paralyzed by an unusually full feed of grain when hungry, or one of some specially appetizing fodder, and the case is serious, as relief can rarely be obtained by vomiting. For the same reason fermentation of the gastric contents with evolution of gas and tympany usually proves fatal to the horse since relief by eructation is too often impossible. Cattle are fitted to live in damp localities where the cloven foot prevents sinking and getting bogged, and where they may draw in with the tongue a full mouthful of coarse herbage which they swallow with little mastication or admixture with saliva. This lodges in the first two stomachs, and if, from any cause, rumination is impaired, or suspended, it finds itself in conditions especially favorable to fermentation. The food too, as in the case of frosted roots, wet clover or partially ripened grain, etc., is often charged with ferments (bacteria) in a state of great vital activity, and hence the frequent tympanies of the ox. The ruminant is no less liable than the soliped to overload the stomach, and though the return of food from the first two stomachs to the mouth is a normal process, this is promptly arrested by the supervention of paresis in the overloaded and overdistended organs. This overdistension further tensely stretches and closes the lips of the œsophagean opening. The rapid swallowing of the food, with only one or two strokes of the teeth for each morsel, renders the large ruminant more liable to take in poisons, pins, nails and other injurious bodies, especially when hunger and the blunting of the sense of smell have been brought on by traveling on dusty roads. Again the large ruminants, and especially cows are wont to while away the tedious hours by chewing and unwittingly swallowing pieces of leather, cloth, bones, iron, etc. Once more the third stomach in which the food is compressed and triturated between the multiple folds, is normally comparatively dry, and is liable under dry, fibrous, heating or stimulating aliment, or in case of fever, to dry up in part or in whole, and to derange the whole process of digestion.

All herbivora are liable to disease from unwholesome fodder and the resulting affection may prove epizootic in connection with unfavorable seasons, or more local, from faulty cultivation.

The symptoms vary so much in connection with the seat and nature of the disease that it would be impolitic to attempt to generalize them.

DISEASES OF THE MOUTH.

Relative susceptibility to disease of the mouth: Food; irritants;
bits; ropes; speculum; sharp metallic bodies; micro-organisms;
functional; nervous.

These are met with in all domestic animals, but are above all common in horses, oxen and pigs, partly because of special susceptibilities and of the nature of the food, but largely by reason of the exposure of this part to mechanical injuries, especially in horses and cattle. Hard bits and the harder hands of cruel and ruthless drivers, nooses of rope tied over the lower jaw and tongue, iron stirrup, clevis, or balling iron used without cover to force the jaws apart, a large drenching horn employed as a lever for the same purpose, an extemporized Yankee bridle rudely applied or used in breaking a colt, the method of curing a balking or jibbing horse by tying a rope to his lower jaw and to a bar extending forward from the pole, pins, needles, thorns and other sharp bodies, and irritants in food or medicine are among the causes of such disorders. Then there are the many irritating microörganismal ferments in food, water, mucus, etc., and irritant and hot medicines and food to account for local inflammations.

FUNCTIONAL DISORDERS.

Among these are the convulsive closure of the jaws in _tetanus_, the flaccid state of the lips, cheek, and tongue in _paralysis_, and the pendent state of the lower jaw in _paralytic canine madness_. See these different subjects.

STRUCTURAL DISEASES.
INFLAMMATION OF THE LIPS, CHEILITIS.

Causes of Cheilitis: Local injuries; poisoned; envenomed; secondary
disease. Symptoms: swelling; salivation; difficult prehension; cracks;
blisters; ulcers; indurations. Treatment: obviate causes; astringents;
antiseptics; derivatives; gravitation; for venoms antacid; antiseptic,
Iodine.

_Causes._ Blows, pricks, wounds and bruises with bits or twitch, and other mechanical and chemical irritants, irritant vegetables, bites of leeches or snakes, stings of insects, etc. It may be a skin disease dependent on disorder of some remote organ, or a local engorgement due to a constitutional state. (See, Urticaria Surfeit, Purpura hæmorrhagica, Variola, Strangles).

_Symptoms._ Swelling, stiffness, heat and tenderness of the lips, with or without local abrasion, or incised or punctured wound. Food may be entirely refused from inability to take it in with the rigid tender lips, and saliva drivels from the mouth because of their imperfect apposition. Cracks, blisters and raw sores or ulcers may or may not supervene. In old standing cases the lips become indurated and comparatively immobile.

_Treatment._ Remove the cause whether irritants in food, or drugs, sharp pointed bodies lodged in the tissues, injuries by bit, twitch or otherwise. Local applications have comparatively little effect, being promptly removed by the tongue, yet a lotion of vinegar and honey;—of borax 10 grains and honey or glycerine 1 oz.;—or of alum in a similar medium will often prove useful. A dose of laxative medicine will favor resolution, and if there is great tumefaction, feeding thick gruels from high manger, and tying to a high rack so as to prevent drooping of the head, will favor recovery. In snake bites and stings the local application of aqua ammonia and its administration internally (horse and cow 1 oz., sheep 2 dr. in 20 times its volume of water) should be practiced; or permanganate of potash may be used.

When the heat and tenderness subside, leaving much thickening and induration it may be repeatedly painted with a lotion of one part of tincture of iodine in three parts of glycerine.

CANCROID OF THE LIPS. EPITHELIOMA.

Epithelioma: Animals susceptible; accessory causes; symptoms; lesions.
Treatment: Warts and polypi. Actinomycosis: Wounds; abrasions;
infection atria. Symptoms; treatment. Trombidiosis: infected regions;
not compulsory parasite; European and American trombidia; distinct
from chigoe. Symptoms. Treatment.

This has been observed in the cat and the horse, commencing at the angle of the mouth and doubtless partially determined in the latter animal by the irritation of the bit.

It is characterized by thickening of the tissues of the lips, in the form of small irregularly rounded masses, and tending to the formation of a spreading ulcer. The thickened tissues are invaded, pushed aside and infiltrated by epithelial or epithelioid cells, which, no longer confined to the surface as in the natural state, grow in the interior of the tissues and destroy them.

_Treatment._ The disease has little tendency to cause secondary deposits in other organs and may often be arrested by local measures. In its earliest stages it may be arrested by the thorough removal of the diseased structures with the knife, the resulting deformity being obviated by bringing the raw edges together by suture, so as to secure their adhesion, or the actual cautery may be used. The tendency to irritation from putrefaction products escaping from the mouth may be counteracted by occasional sponging with a weak lotion of carbolic acid (1 part to 50 of water) or an ointment of one part of very finely powdered boracic acid to two parts of simple ointment.

Leblanc has repeatedly succeeded in these cases by the use of chlorate of potash, locally and generally. The local application may be a solution of two drachms in four ounces of water, while the dose of the powder for the horse is 2 to 4 drachms daily.

=Warts and Polypi.= These are common on the outer and even the inner side of the lips, especially in dogs. They are easily removed by the scissors, after which their roots should be thoroughly cauterized with a pointed stick of lunar caustic or chloride of zinc.

ACTINOMYCOSIS OF THE LIPS.

In the rich river bottom lands of northern Germany and Russia where actinomyces abound actinomycosis is common in the form of papillæ of greater or lesser size on the lips and nose of horse and ox. The abrasion of these parts by thorns, thistles, stubble, dry fibrous fodders and other irritants, appears to produce a raw surface for the colonization of the germ, which is not slow to avail of the opportunity. The resulting lesions take the appearance of warty looking elevations, more or less indurated, which on section show the sulphur yellow actinomyces tufts of club-shaped cells converging to a central mycelial mass.

_Treatment_ is simple as the disease is at first essentially local, and is easily checked by the local application of iodine. The wartlike elevations may be shaved off with a razor or cut off with sharp scissors and the surface painted once or twice daily with tincture of iodine. If there is suspicion of distant or deepseated actinomycosis the internal treatment with potassium iodide will be in order.

TROMBIDIOSIS OF THE NOSE AND LIPS. HARVEST ITCH.

In different parts of Europe and America, and especially in the warmer regions, or in sheltered gardens, shrubberies, and pastures, different species of the trombidium abound, and the young hexapod larvæ attack man and beast, burrowing under the cuticle and giving rise to extreme itching and persistent and irritating rubbing of the affected part. These parasites belong to the family of acari or mites, so that the condition they produce is one of acariasis or mange, only the offender is not a compulsory parasite, but appears to survive in certain soils and in the vegetation independently of animal hosts. Their parasitism is therefore accidental and non-essential to their survival.

The trombidian parasite usually found in Europe is the Trombidium Holosericeum or silky trombidium, so small (in its larval state) that it is just visible to the naked eye as a bright scarlet point when moving on a dark background. It was formerly called Leptus Autumnalis and is familiarly known as the red beast, _bete rouge_, _harvest bug_, etc. The common American species is of a dull brick red, so that it is less easily detected even on a dark background. It is familiarly known as the _jigger_, though quite distinct from the _chigoe_ or burrowing flea of the West Indies.

The domestic herbivora get these parasites on the nose and lips while browsing on the pastures and contract an intolerable itching which may lead to violent rubbing, abrasions and scabby exudations. The skin becomes thickened, scabby and rigid, and as new accessions are constantly received the malady continues until cold weather sets in. The affection is not in any sense dangerous, and the attacks may be warded off by a daily application of one of the common parasiticides—decoction of tobacco, tar water, solution of creolin, naphthalin, etc. The mere seclusion of the infested animal indoors, without green food, will cure, as the larvæ pass through their parasitic stage in a few days and drop off.

GENERAL CATARRHAL STOMATITIS. BUCCAL INFLAMMATION.

Mature animals most subject: Causes in horse, mechanical, chemical,
microbian irritants—alkalies, acids, caustics, hot mashes, ferments,
fungi, rank grasses, excess of chlorophyll, clover, alfalfa, acrid
vegetables, bacterial infection secondary, acrid insects in food;
symptomatic of gastritis, pharyngitis, diseased teeth, specific
fevers. Symptoms: Congestion and tumefaction of buccal mucosa, lips
and salivary glands; Epithelial desquamation; fœtor; salivation;
froth; papules; vesicles. Prognosis. Treatment: Cool soft food;
antiseptics; wet applications to skin; derivatives.

This is much more common in the adult than in suckling domestic animals. None of the domestic mammals or birds can be considered immune from it, but as its causes and manifestations differ somewhat it seems well to consider it separately in the different genera.

GENERAL CATARRHAL STOMATITIS IN SOLIPEDS.

_Causes._ These may be classed as mechanical, chemical, microbian and other irritants. In the horse it is often due to the reckless administration of irritant liquids as remedies. Owing to the length of the soft palate the horse can refuse to swallow any liquid as long as he chooses, and some of the worst cases of stomatitis I have seen resulted from the retention in the mouth of caustic alkaline liquids given under the name of “_weak lye_.” Strong acids and caustic salts dissolved in too little water or other excipient, or suspended in liquids in which they cannot dissolve, or made into boluses which are crushed between the teeth are not infrequent conditions. Too hot mashes given to a hungry horse is another cause of this trouble. Fermented or decomposed food is often most irritating. Coachmen will sometimes induce it by attaching to the bit bags of spicy or irritant agents, to cause frothing and make the animal appear spirited.

Fungi in fodders are among the common causes. The rust of wheat (puccinia graminis), the caries of wheat (tilletia caries), the blight (erysiphe communis), ergot (claviceps purpurea), the fungus of rape (polydesmus excitiosus) and the moulds (penicillium and puccinia) have all been noticed to coincide with stomatitis, and charged with producing it. On the other hand, at given times, one or other of these cryptogams has been present extensively in the fodder without any visible resultant stomatitis. The apparent paradox may be explained by the fact that these fungi vary greatly in the irritant or harmless nature of their products according to the conditions under which they have grown, and the stage of their development at which they were secured and preserved. Ergot notoriously differs in strength in different years, on different soils, under various degrees of sunshine, shade, cloud, fog, etc. In different States in the Mississippi valley it is not uncommon to find stomatitis in horses in winter, fed on ergoted hay, while cattle devouring the same fodder have dry gangrene of feet, tail and ears. Yet in other seasons the ergot fails to produce these lesions. Rank grown, watery vegetation, especially if it contains an excess of chlorophyll is liable to cause stomatitis. Red and white clover, trefoil, hybrid and purple clover, and alfalfa have all acted more or less in this way, though in many cases, the food has become musty or attacked by bacterial ferments. Some of the strongly aromatic plants, and those containing acrid principles (cicuta virosa, œnanthe crocata, mustard, etc.) cause buccal inflammation and salivation.

The irritation in many such cases is not due to one agent only, the vegetable or other irritant may be the starting point, acting but as a temporary irritant, the action of which is supplemented and aggravated by the subsequent attacks of bacterial ferments on the inflamed, weakened or abraded tissues. The bacteria present in the mouth, food or water would have had no effect whatever upon the healthy mucosa, while they make serious inroads on the diseased. On the other hand the vegetable, mechanical or chemical irritant would have had but a transient effect, but for the supplementary action of the bacteria.

In horses that have the bad habit of retaining masses of half masticated food in the cheeks the growth of cryptogams is greatly enhanced and such food often becomes violently irritating.

Among other mechanical causes may be named pointed or barbed hairs or spines (barley awns, spikes, thorns, etc.) which, lodging in a gland orifice, or in a wound of the gum or mucosa, form a source of irritation or a centre for bacterial growth and abscess.

Again, irritants of animal origin must be named. These are not taken by choice, but when lodged in fodder, or in the pastures they are taken in inadvertently with the food. In this way poisonous insects, and especially hairy caterpillars, cantharides, potato bugs, etc., gain access to the mouth.

It must not be overlooked that stomatitis occurs as an extension, sympathetic affection or sequel of diseases of other organs. Gastritis is usually attended by redness and congestive tenderness of the tongue, especially of the tip and margins, and other parts of the buccal mucosa, notably the palate just back of the incisors, are often involved. In other cases it appears as a complication of pharyngitis, laryngitis, of affections of the lower air passages, of the teeth and periodontal membrane or of the salivary glands.

It appears also in a specific form in certain fevers, as in horsepox, pustulous stomatitis, aphthous fever and even in strangles. Mercurial stomatitis, rarely seen at the present time, is one of the worst forms of the disease, and like the infectious forms will be treated separately.

_Lesions and Symptoms._ At the outset and in the slighter forms of congestion there is merely heat and dryness of the buccal mucosa. Redness may show on the thinner and more delicate portions of the membrane, as under the tongue, on the frænum, and on the sublingual crest. But elsewhere it is hidden by the thickness of the epithelium, and the manifestations are merely those of suppressed secretion with local hyperthermia.

As the congestion is increased there is seen, even at this early stage, a slight thickening or tumefaction of the mucosa, especially on the gums, lips, the sublingual area, the orifices of the salivary glands, and the palate back of the upper incisors. On the dorsum of the tongue, the cheeks and lips, generally the lack of loose connective tissue tends to prevent the swelling.

With the advance of the inflammation the redness of the mucosa extends, at first in points and circumscribed patches, and later over the entire surface. The epithelium drying and degenerating in its surface layers forms with the mucus a sticky gummy film on the surface, which, mingling with decomposing alimentary matters gives out a heavy, offensive or even fœtid odor.

The different parts of the mouth are now tender to the touch, and this, with the fœtor and even bitterness of the bacterial products combine with the general systemic disturbance in impairing or abolishing appetite. In any case mastication becomes slow and infrequent, and morsels of food are the more likely to be retained, to aggravate the local condition by their decomposition.

The dry stage is followed by the period of hypersecretion, and in this the salivary glands take a prominent part, so that ptyalism (slobbering) becomes the most marked feature of the disease. The saliva mixed with the increasing secretion of mucus and the abundance of proliferating and shedding epithelium, escapes from the lips and falls in stringy masses in the manger and front of the stall. When there is much motion of the jaws and tongue it accumulates as a froth around the lips.

A careful examination of the mucosa will sometimes detect slight conical elevations with red areolæ, representing the tumefied orifices of the obstructed mucous follicles, and later these may show as minute erosions. Even vesicles have been noticed (Weber, Dieckerhoff, Kosters), but when these are present one should carefully exclude the specific stomatites such as horsepox, contagious pustular stomatitis, aphthous fever, etc.

Erosions of the mucosa and desquamation of the epithelium have been noticed in horses fed on purple (hybrid) clover, buckwheat or ergot, and in some of these cases the inflammation has extended (in white faces especially) to the skin of the face, the mucosa of the nose, and the adjacent glands, and as complications icterus, constipation, colics, polyuria, albuminuria and paresis of the hind limbs have been observed. These latter are common symptoms of cryptogamic poisoning.

_Prognosis._ In uncomplicated cases the disease is not a grave one, lasting only during the continued application of the local irritant, and recovering more or less speedily when that has been removed. Complications are dangerous only when due to some specific disease poison (glanders, actinomycosis, strangles, etc.), and even poisoning by the usual cryptogams of leafy or musty plants is rarely persistent in its effects.

_Treatment._ This resolves itself into the removal of the irritant cause and the soothing of the irritation. When the cause has been definitely ascertained the first step is easy.

In the direction of soothing treatment, a careful selection of diet stands first. Fibrous hay and even hard oats, barley or corn may have to be withheld, and green food, or better still, bran mashes, gruels, pulped roots or fruits allowed. Scalded hay or oats, ensilage, sliced roots, or ground feed may often be taken readily when the same aliments in their natural condition would be rejected or eaten sparingly.

Medicinal treatment may often be given in the drinking water which should always be allowed in abundance, pure and clean. In the way of medication chlorate of potash, not to exceed one-half to one ounce per day according to the size of the animal, may be added, together with an antiseptic (carbolic acid, borax, permanganate of potash, common salt, naphthol, creolin, hyposulphite of soda). In case of severe swelling, a cap made to fit the head with strips wet in alum and vinegar or other astringent solution maintained against the intermaxillary space may be desirable. Support for the tongue may be necessary as mentioned under glossitis.

In case of complications on the side of the bowels, liver or kidneys, laxatives, diuretics and antiseptic agents may be called for.

GENERAL CATARRHAL STOMATITIS IN CATTLE.

Dense resistant mucosa protective: Affection usually circumscribed.
Action of violent irritants, and toxins of specific fevers. Mechanical
irritants. Symptoms: Salivation; congestion; eruptions; erosions;
ergot; acrid vegetables; caustics. Treatment: Astringents;
antiseptics; refrigerants; derivatives; tonics. Removal of foreign
bodies. Lesions and symptoms in sheep.

The mouth of the ox as Cadeae well says has a cuticular epithelium too thick and resistant to be easily attacked by microbes. It follows that infected inflammations are far more frequently circumscribed than in the thinner and softer buccal mucosa of the horse. The more general buccal inflammations come more particularly from the use of food that is too hot or that contains strongly irritant agents. The thickness of the buccal epithelium however, is no barrier to the local action of poisons operating from within as in rinderpest, or aphthous fever, or in malignant catarrh, nor is it an insuperable barrier to the local planting of the germs of cow pox, anthrax, actinomycosis, or cryptogamic aphtha (muguet). The wounds inflicted by fibrous food make infection atria for such germs, hence the great liability to such local inflammations, in winter when the animals are on dry feeding. For the same reason, perhaps, the prominent portions of the buccal mucosa,—the papillæ—are sometimes irritated themselves while serving as protectors for the general mucous surface, and hence they become specially involved in inflammation, which constituted the “_barbs_” of the old farriers. Utz records a buccal inflammation occurring in herds fed on green trefoil, first cutting, showing that even in cattle this agent may determine a general stomatitis.

_Symptoms._ These do not differ from those of the horse, and resemble, though often in a milder form, the buccal manifestations of aphthous fever. There is the difficulty of mastication and indisposition to take in fibrous aliment, the drivelling of saliva from the mouth, or its accumulation in froth around the lips, the frequent movement of the tongue and jaws, and the congestive redness, papular eruption, vesication, or even erosion of the affected mucous membrane. It is always necessary to guard against confounding the simple stomatitis, and the slighter infected inflammations, from the more violent infections above referred to. The special diagnostic symptoms must be found under the respective headings. The aphthous fever is not to be expected in American herds, but the stomatitis which is associated with ergot in the food is met more particularly in winter and spring, and must not be confounded with the specific disease, on the one hand nor with the simpler forms of buccal inflammation on the other. In the case of ergoted fodder the signs of ergotism in other situations will be found, in the affected animals, such for example as necrotic sloughs and sores around the top of the hoof, sloughing of the hoof or of one or more digits, or of the metatarsus, of the tip of the tail or ear; abortions, convulsions, delirium, lethargy or paralysis. If not seen in the same animals some of these forms may be observed in other members of the herd. Then the buccal lesions are in themselves characteristic: soft, whitish, raised patches of the epithelium (rarely blisters) are followed by desquamation and exposure of the red, vascular surface beneath, and this tends to persist if the ergoted fodder is persisted in.

_Treatment._ Simple stomatitis of the ox generally tends to spontaneous and early recovery. The simplest astringent and antiseptic treatment is usually sufficient to bring about a healthy action. Borax given in the drinking water, not to exceed four ounces per day, or the same amount mixed with syrup or honey and smeared occasionally on the tongue, or hyposulphite or sulphite of soda, or weak solutions of carbolic acid will usually suffice, after the irritant cause has been removed. Vinegar, or highly diluted mineral acids may be used but are somewhat hurtful to the teeth. Decoctions of blackberry bark or solutions of other vegetable astringents may be used as alternatives. When there is evidence of irritant matters in the stomach or bowels, a saline laxative will be advisable to be followed by vegetable bitters or other tonics. Thorns and other foreign bodies imbedded in the tongue or other part of the mouth must be discovered and removed.

CATARRHAL STOMATITIS IN SHEEP.

The more delicate buccal mucosa in these animals would render them more subject to inflammations, but this is more than counterbalanced by the mode of prehension of aliments, not by the tongue, but by the delicately sensitive lips, and further by the daintiness and care with which these animals select their food. The _treatment_ would not differ materially from that prescribed for the ox.

GENERAL CATARRHAL STOMATITIS IN DOGS.

Causes: burns; spiced food; bones; sepsis; ferments; pin caterpillar;
dental and gastric troubles. Symptoms: careful prehension and
mastication; congestion; swelling; eruption; erosion; furred tongue;
stringy salivation; fœtor; swelling of lips, cheeks, intermaxillary
space, and pharynx. Treatment: demulcent foods; antiseptics;
derivatives; tonics; care of teeth and gums.

_Causes._ Hot food is a common cause in hungry dogs. Spiced food in house dogs fed scraps from the table tend to congestion of mouth and stomach alike. Irritation through wounds with bones, especially in old dogs with failing teeth, and in exceptional cases the impaction of a bone between the right and left upper molars are additional causes. Putrid meat must also be recognized as a factor, the septic microbes seizing upon the wounds and spreading from this as an infecting centre. Lactic acid and other irritant products developed through fermentation of particles of food retained about the gums and cheeks soften the epithelium and irritate the sub-epithelial tissue, causing congestion. Megnin draws attention to the fact that the pin caterpillar (bombyx pinivora) found on the stalks of couch grass (Triticum repeus) produces buccal irritation when chewed and swallowed to induce vomiting. As in other animals more or less buccal congestion attends on gastric congestion and inflammation. Dental troubles are often sufficient causes.

_Symptoms._ The animal becomes dainty with regard to his food, picking up the smaller or softer pieces and rejecting the larger or harder. Mastication is painful and selection is made of moist or soft articles which can be swallowed without chewing or insalivation. The mouth is red and hot, and at times the mucous membrane eroded, or blistered, the lesions concentrating especially on the gums and around the borders of the tongue. The dorsum of the tongue is furred, whitish, yellowish or brownish. Saliva collects in the mouth and escapes in filmy strings from its commissures, and the odor of the mouth becomes increasingly foul. Swelling of the lips, cheeks or intermaxillary space marks the worst cases.

_Treatment._ Withdraw all irritant and offensive aliments. Give soups, mushes, scraped or pounded lean meat in small quantities, washing out the mouth after each meal with a 20 per cent. solution of permanganate of potash or borax or a two per cent. solution of carbolic acid. Cadeac advises against chlorate of potash on account of its known tendency to bring about hæmoglobinæmia in dogs. A laxative and bitters may be called for in case of gastritis or indigestion, and any morbid condition of the teeth must be attended to. Decayed teeth may be removed. Tartar especially must be cleaned off by the aid of a small wooden or even a steel spud and a hard brush with chalk will be useful. A weak solution of hydrochloric acid is usually employed to loosen the tartar, but this is injurious to the structure of the teeth and had best be avoided if possible. Tincture of myrrh is especially valuable both as a gum-tonic and as a deodorant and antiseptic. This may be rubbed on the irritated gums as often as the mouth is washed.

GENERAL CATARRHAL STOMATITIS IN SWINE.

Causes: Irritants; ferments; noose on jaw; specific poisons. Symptoms:
Careful feeding; thirst; frothy lips; champ jaws; redness; swelling;
fœtor. Treatment: Cooling, astringent, antiseptic lotions; mushy food;
derivative; tonics.

_Causes._ Swine suffer from simple stomatitis when exposed to thermal, mechanical or chemical irritants. Food that is too hot, or that which is hard and fibrous, or that which contains spikes and awns, capable of entering and irritating gland ducts or sores, or food which is fermented or putrid, food or medicine of an irritant character. The habit of catching and holding swine with a running noose over the upper jaw, and the forcing of the jaws apart with a piece of wood in search of the cysticercus cellulosa are further causes. In several specific infectious diseases inflammation of the mucous membrane with eruption or erosion is not uncommon. Thus aphthous fever is marked by vesicular eruption, muguet by epithelial proliferation and desquamation, hog cholera and swine plague by circumscribed spots of necrosis and erosion. Patches of false membrane are not unknown, and local anthrax, tubercle and actinomycosis are to be met with. Inflammation may start from decaying teeth.

_Symptoms_ are like as in other animals, refusal of food, or a disposition to eat sparingly, to select soft or liquid aliments, to swallow hard materials half chewed or to drop them, to champ the jaws, and to seek cold water. Accumulation of froth around the lips is often seen, and the mouth is red, angry, dry, and hot, and exhales a bad odor.

_Treatment_ does not differ materially from that adopted in other animals. Cooling, astringent, antiseptic lotions, honey and vinegar, and in case of spongy or eroded mucosa, tincture of myrrh daily or oftener. Soft feeding, gruels, pulped roots, or well kept ensilage may be used, and clean, cool water should be constantly within reach. In case of overloaded stomach or indigestion a laxative followed by bitter tonics will be in order.

CATARRHAL STOMATITIS OF BIRDS. PIP.

Causes: hurried breathing; local irritants; exposure; filthy roost.
Symptoms: gaping; roupy cry; epithelial pellicle on tongue, larnyx. or
angle of the bill. Treatment: pick off pellicle; smear it often with
glycerized antiseptic. Remove accessory and exciting causes.

This form of inflammation of the tongue of birds is characterized by the increased production and desiccation of the epithelium so that it takes on a horny appearance. According to Cadeac it may accompany various inflammatory affections of the air passages, which cause hurried breathing with persistently open bill, and thus entail evaporation of the moisture. More commonly it has its primary cause in local inflammation of the surface in connection with damp, cold, draughty hen-roosts, and above all, the accumulation of decomposing manure and the exhalation of impure gas. Even in such cases the abnormal breathing with the bill open is an accessory cause of the affection.

_Symptoms._ The breathing with open bill should lead to examination of the tongue, but above all if at intervals the bird with a sudden jerk of the head emits a loud shrill, raucous sound, which reminds one of the cough of croup. The tip and sides of the tongue are found to be the seat of a hard, dry, and closely adherent epithelial pellicle, which suggests a false membrane.

_Treatment._ The common recourse is to pick or scrape off the indurated epithelial mass, leaving a raw, bleeding surface exposed. This is then treated with a solution of borax, or chlorate of potash. Cadeac deprecates this treatment as useless and dangerous, and advises the disintegration of the dry epithelial mass with a needle taking care not to prick nor scratch the subjacent sensitive tissue, and to wash with a 5 per cent. solution of chlorate of potash. A still more humane and effective method is to make a solution of hyposulphite of soda in glycerine and brush over the affected surface at frequent intervals. This may be conveniently applied through the drinking water.

In case of implication of the lower air passages or lungs, the treatment must be directed to them, and soft, warm, sloppy food and the inhalation of water vapor will prove of great advantage. Secure clean, sweet, dry pens, pure air, and sunshine. (See pseudo membranous enteritis.)

LOCAL STOMATITIS.

Division of circumscribed buccal inflammations: palatitis; gnathitis
gingivitis; glossitis. Causes: injuries; acrid; venomous or caustic
agents; diseased teeth; foreign bodies in gland ducts; malformed jaws;
infections, etc. Symptoms: salivation; difficult prehension and
mastication; dropping half masticated morsels; distinctive indications
of different caustics; abrasion; abscess; slough; infective disease
lesions. Treatment: for _palatitis_, massage by hard corn ears,
scarification, laxatives; for _gnathitis_, care for teeth and ducts,
astringent washes, eliminate mercury; for _glossitis_, remove cause,
use antidote to venom, or to chemical irritant, astringent, antiseptic
lotions or electuaries, evacuate abscess, soft, cool diet, elevate the
head, suspend the tongue.

Localized inflammations in the buccal cavity are named according to the portion of the lining membrane attacked;—_palatitis_ if seated in the roof of the mouth; _gnathitis_ if restricted to the cheeks; _gingivitis_ if to the gums; and _glossitis_ if to the tongue.

=Palatitis. Lampas. Congestion of the hard palate behind the upper front teeth.= This is usually seen in young horses during the period of shedding the teeth and is caused by the irritation and vascularity consequent on teething. The red and tender membrane projects beyond the level of the wearing surfaces of the upper incisors, and may materially interfere with the taking in of food. A common practice in such cases is to feed unshelled Indian corn, the nibbling of which seems to improve the circulation in the periodontal membrane and by sympathy in the adjacent palate. Superficial incisions with the lancet or knife will usually relieve, and may be followed by mild astringent lotions if necessary. If apparently associated with costiveness or gastric or intestinal irritation a dose of physic will be demanded. Nothing can excuse the inhuman and useless practice of burning the parts with a hot iron.

=Gnathitis. Inflammation of the Cheeks.= Usually resulting as a distinct affection from irregular or overgrown teeth, or the entrance of vegetable spikes into the gland ducts, these cause local swelling and tenderness, slow imperfect mastication, dropping of food half chewed, accumulation of food between the cheeks and teeth, thickening, induration and sloughing of the mucous membrane with excessive fœtor.

_Treatment._ Consists in correcting the state of the teeth and ducts and using one of the washes recommended for glossitis.

=Gingivitis. Inflammation of the gums.= This is either connected with the eruption of the teeth in young animals and to be corrected by lancing the swollen gums and giving attention to the diet and bowels; or it is due to scissor-teeth or to the wear of the teeth down to the gums in old horses; or it is dependent on diseased teeth, or mercurial poisoning, under which subjects it will be more conveniently considered. Barley awns or other irritants must be extracted.

=Glossitis, Inflammation of the Tongue.= _Causes._ Mostly the result of violence with bits, ropes, etc., with the teeth, or with the hand in giving medicine; of scalding food, of acrid plants in the food: of irritant drugs (ammonia, turpentine, croton, lye, etc.), or of sharp, pointed bodies (needles, pins, thorns, barley and other barbs, etc.) which perforate the organ. In exceptional cases leech and snake bites are met with especially in cattle, owing to the tongue being exposed when taking in food. Local infections and those of the specific forms, determine and maintain glossitis.

_Symptoms_: Free flow of saliva, difficulty in taking in food or drinking, and red, swollen, tender state of the tongue, which in bad cases hangs from between the lips. The mucous membrane may be white, (from muriatic acid, alkalies, etc.), black, (from oil of vitriol, lunar caustic, etc.), yellow, (from nitric acid, etc.), or of other colors according to the nature of the irritant. It may be raised in blisters, may present red, angry sores where the epithelium has dropped off; may become firm and indurated from excessive exudation; may swell and fluctuate at a given point from the formation of an abscess; or may become gangrenous in part and drop off. Breathing is difficult and noisy from pressure on the soft palate. There is usually little fever and death is rare unless there is general septic infection.

_Treatment_ will depend on the cause of injury. In all cases seek for foreign bodies imbedded in the organ and remove them. If snake bites are observed use ammonia or potassium permanganate locally and generally, or cholesterin as a local application. If the irritation has resulted from mineral acids, wash out with calcined magnesia lime water, or bicarbonate of soda or potash. If from alkalies (lye) use weak vinegar. If from caustic salts employ white of egg, vegetable-gluten, boiled linseed, slippery elm, or other compound of albumen or sheathing agent. In ordinary cases use cold astringent lotions, such as vinegar and water; vinegar and honey; borax, boric or carbolic acid, chlorate of potash, alum or tannin and honey. Poultices applied around the throat and beneath the lower jaw are often of great value. The bowels may be relieved if necessary by injections, as it is usually difficult to give anything by the mouth. If ulcers form touch them daily with a stick of lunar caustic or with a fine brush dipped in a solution of ten grains of that agent in an ounce of distilled water. For sloughs use a lotion of permanganate of potash, one drachm to one pint of water, or one of carbolic acid, one part to fifty of water. If an abscess forms give a free exit to the pus with the lancet, and afterward support the system by soft nourishing diet, and use disinfectants locally. As in all cases of stomatitis, the food must be cold gruels or mashes, or finely sliced roots will often be relished.

The mechanical expedient of supporting the tongue in a bag is essential in all bad cases, as if allowed to hang pendulous from the mouth inflammation and swelling are dangerously aggravated.

APHTHOUS STOMATITIS. FOLLICULAR STOMATITIS.

Causes: in horse, ox, dog; rough, fibrous food, blistering ointments,
bacteria. Symptoms: general stomatitis, and special; papules with
grayish centres and red areolæ, vesiculation, ulceration. Treatment:
Astringent, antiseptic, derivative, tonic, stimulant.

This is a rare affection in ruminants where the thickness of the epithelial covering appears to be a barrier to infection or injury, while it is common in the more delicate and sensitive buccal mucosa of the horse and dog. In the horse the ingestion of irritant plants with the food and the penetration of vegetable barbs into the mucous follicles may be charged with causing the disease, while in both horse and dog the licking of blistering ointments and the local action of fungi and bacteria are factors in different cases.

_Symptoms._ With the ordinary symptoms of stomatitis, there appear minute firm, whitish, circular elevations representing the openings of the inflamed mucous or salivary follicles, having a reddish areola, and grayish white vesicular centre. They may amount to a line or more in diameter, and on bursting leave red cores or ulcers. The whole mouth may be affected or the disease may be confined to the lips, gums or tongue.

_Treatment._ Beside the general astringent washes, this affection is greatly benefited by the local use of antiseptics, as sulphite or hyposulphite of soda, 2 drachms in a quart of water. Borax, permanganate of potash, carbolic acid or other antiseptic in suitable solution may be substituted. Saline laxatives are often useful to remove sources of irritation in stomach and intestines, and iron salts (chloride or nitrate) in full and frequently repeated doses may be given internally. Ulcers may be cauterized and soft food and pure water given from an elevated manger.

ULCERATIVE STOMATITIS. GANGRENOUS STOMATITIS.

Causes: specific disease poisons; debility; rachitis; cancer; chronic
suppuration; irritation—mechanical, chemical, thermic, venomous, etc.
Symptoms: difficult, imperfect prehension and mastication, salivation,
bleeding, swollen, puffy epithelium, blisters, extending erosions,
deep or spreading. Duration. Treatment: correct constitutional fault,
tonics, soft, digestible food, antiseptics, mild caustics.

This is characterized by the formation of necrotic spots and patches of the buccal epithelium, with desquamation, and the formation of more or less rodent ulcers of the sub-epithelial mucosa. Like other ulcerative processes it is usually due to microbic invasion, and in this way it may supervene on other and simpler forms of stomatitis. It also varies in its manifestations and nature according to the genus of animal, and the specific microbe present.

ULCERATIVE STOMATITIS IN SOLIPEDS.

_Causes._ Apart from the ulcerations and erosions of specific diseases (glanders, horsepox, pustulous stomatitis, aphthous fever, etc.,) this condition is especially liable to appear in anæmic and debilitated subjects (Cauvet), as in rachitis (Friedberger and Fröhner), cancer (Cadeac) chronic internal abscess (Cadeac), etc. As an exciting cause and as a means of furnishing an infection atrium for the microbes of ulceration all conditions of simple lesion of the mucous membrane—mechanical, chemical, thermic, venomous, etc., are operative. Dieckerhoff has described it in connection with diphtheritic rhinitis, Friedberger with a nasal and conjunctival catarrh, Zeilinger and Kohler with aphthous fever, Mobius and Hackbarth with trefoil poisoning.

_Lesions and Symptoms._ There is the usual dainty feeding and disposition to masticate imperfectly or even to drop the partly insalivated morsels, working of the lips, the formation of froth on their margins, and the drivelling of saliva in long strings or filaments. As the disease advances this becomes bloody and fœtid. The local lesions may be at first like white pulpy spots of softened and degenerating epithelium, which is exceptionally, raised in blisters. This is followed by desquamation and the formation of open sores which are indolent, and show a disposition to further erosion and extension. They may be rounded or irregularly indented in their borders, and contain a brownish, blackish or greenish viscid debris. They vary widely, however, in general appearance and in their disposition to speedy or sluggish healing, being apparently influenced by the nature of the pathogenic microbe and the susceptibility of the subject. In some cases the molecular degeneration extends deeply into the mucosa, and even over the edges of the lips into the adjacent skin. Recovery and complete cicatrization may take place in one week, or successive outbreaks may take place in the same animal lasting in all for months as in Cadeac’s case associated with chronic abscess of the mesentery.

_Treatment._ The first consideration is to correct the debility on which the affection is based. Iron and bitter tonics, mineral acids, and nourishing food given in the form of soft mashes, pulped roots, or farinas, which will require little mastication, and the antiseptic cleansing of the mouth after each meal are the main features of the treatment. As antiseptics, vinegar is inimical to the microbes of the mouth, which affect alkaline media, borax, boric acid, carbolic acid, sulphurous acid, the sulphites and hyposulphites, permanganate of potash, chlorate of potash, creolin, and sulphate or chloride of iron furnish a sufficient choice of comparatively nontoxic agents. Ulcers may be touched with tincture of iodine, lunar caustic, or sulphate of copper.

ULCERATIVE STOMATITIS (DIPHTHERIA) IN CALVES.

Accessory causes. Infection. Experimental inoculation. Bacillus, grows
on blood serum. Lesions in mouth, nose, air passages, intestines,
digits. Symptoms: difficult sucking, fever, swollen, whitish spots on
buccal mucosa, phagadenic sores, fœtor, symptoms of extending disease,
anorexia, debility, prostration. Duration. Diagnosis from foot and
mouth disease, from actinomycosis, from tuberculosis. Prevention:
cleanliness, antisepsis, segregation, diet of dam, sterilized milk.
Treatment: antiseptic and eliminating: locally antiseptic.

This has been observed at frequent intervals in calves, as a serious, fatal, communicable disorder occurring in the first few weeks of life.

_Causes._ It has been attributed to unhygienic conditions of the dams, close, damp, impure stables, unwholesome or spoiled food, and privations of various kinds, and these, in all probability, increase the susceptibility. The congestion and traumatism connected with the cutting of the teeth is another predisposing cause. The ultimate cause is, however, the contagious element and the disease has been conveyed to healthy lambs by the introduction into their mouths of the necrotic products from the diseased subjects (Dammann). Sheep inoculated in the conjunctiva presented violent conjunctivitis in forty-eight hours. Inoculated rabbits died of septicæmia. Mice showed the same symptoms as calves, while guinea pigs showed an abscess only at the seat of inoculation (Löffler).

The identity of the germ has not been fully demonstrated. Dammann found a micrococcus, but testimony from the inoculation of its pure cultures is wanting, and the buccal mucosa of the sucking calf is full of varied germs some of which are irritating and pathogenic to an injured mucosa.

Löffler found in the epithelial concretions (false membranes) of the mouth and intestines, a bacillus of half the thickness of the bacillus of malignant œdema, five times as long as broad and usually connected with its fellows to form filaments. He failed to obtain cultures of this in nutrient gelatine, but grew it successfully in blood serum from a calf. Transferred to fresh serum the culture failed. The pure culture does not seem to have been tried on the calf.

According to Dammann the lesions occur indiscriminately in the mouth, the nose, the larynx, trachea, lungs, the intestinal canal and the interdigital space.

It has been suggested that the mouth of the calf rendered susceptible by the congestion caused by suction, is infected by licking the previously infected umbilicus.

_Symptoms._ There are the usual symptoms of indisposition to suck, salivation, redness of the buccal mucosa, and general indisposition. In two or three days the mucosa shows raised, pulpy, white or grayish patches about a line in diameter. These gradually soften and break down and in four or five days leave dark red angry sores one-sixth to one-third inch in diameter dotted with grayish points and surrounded by a congested areola. These exhale an offensive odor and tend to extend in superficial area and in depth, invading indiscriminately the various subjacent tissues. The lips may be perforated, the muscles, cartilages, periosteum, and periodontal membrane invaded, the teeth may be shed, and the alveoli filled with the offensive debris of ulceration. Swelling of the throat may follow from implication of the pharynx and its lymph glands, symptoms of laryngitis, bronchitis, and pneumonia may succeed, also infective gastritis and enteritis. These various parts may be infected by the direct transference of the infecting saliva, but the germ is also held to be transmitted through the blood to implicate distant organs.

Appetite is gradually lost, a blackish, fœtid diarrhœa, sets in and the calf is sunk in a profound prostration and debility due partly to the enforced abstinence and colliquative diarrhœa, but much more to the absorption of toxic matters. Death may ensue from the sixth to the twelfth day. In case of recovery a month may be requisite for the completion of convalescence.

_Diagnosis._ This has to be distinguished especially from aphthous fever by the absence of the large, and clearly defined vesicles of that disease, by the fact that the mammary region and interdigital spaces usually escape, and especially by the immunity of the dam and of other more mature animals. From actinomycosis of the tongue it is diagnosed by its more rapid progress, by the marked constitutional depression, and prostration, and by the absence of the marked induration of the actinomycotic organ (holzzunge) and by the sulphur yellow pin head-like nodules of actinomyces. Tuberculosis is rare in the first weeks after birth in calves, and never makes the rapid progress nor causes the profound depression of this disorder.

_Prevention._ The first object must be to destroy the infection, and the second to obviate the susceptibility of the young animal. The clearing away of all accumulations of litter, filth, and even fodder from the stable proper, including the stalls where the dams lie, should be followed by a thorough whitewashing or disinfection, with sulphate of copper or of iron, or even mercuric chloride, (1:500.) If the disease has already appeared in a stable the calves should be penned singly to avoid the possibility of infection through sucking each others navels. In all cases an antiseptic (tannin, carbolic acid) should be applied to the navel of the new born. The food of the dam and nurse should be nutritive and free from any suspicion of mustiness or decomposition, and when possible the calf should be allowed to draw its own milk from the teat. When this cannot be allowed, artificial feeding should be surrounded by all the safeguards, named under acute indigestion of calves.