Chapter XXIV: Part 24

The disease is found most commonly in dairy cows, but softening of the bones of mature animals has also been seen in horses and other animals. Dieckerhoff, who quotes cases in mature horses, adduces similar instances in colts under a year old, occurring enzootically, and without the specific lesions of rachitis. Seven out of sixteen broke their femurs in October, 1886, all kept on the same place, in good box stalls, and well cared for. Landois found in bones an abnormal amount of fat, ossein, water and lime salts. Grawitz found no material change in the cancellated tissue. In one district in Jutland, Stockfleth found an extraordinary number of broken legs as the result of castration of colts, which had not shown the thickening or distortions of rachitis.

_Causes._ The disease is particularly common in cows which yield a calf every year, and especially in heavy milkers, in which respect it agrees with the osteo-malacia of woman. The heavy demands upon the system for the nourishment of the fœtus and the supply of milk, undoubtedly lay the system open to attack, if they do not directly cause the disease. An early and usually a persistent feature of the malady is a _depraved appetite_, the causes of which may be read up in Vol. II. The statements there made, require some qualification, inasmuch as osteo-malacia is at times found on limestone soils with hard, calcareous water, and on rich, alluvial valley soils abounding in both clay and lime (Sarginson, Leclainche), as well as on barren sands and granite soils deficient in both lime and phosphorus. It may even appear on virgin or mucky soils after liming, which had been free from the trouble up to that time (Thorburn). The decomposition of the abundance of organic matter, hastened by the quicklime, has evidently been a contributing cause.

The excess of organic matter in the soil seems to be a considerable factor. Both Thorburn and Sarginson mention the “mossy” soils and waters, and in Lanarkshire, Scotland, and Westmoreland, England, where they practised, black muck and peats abound. This is corroborated by the prevalence of the disorder in the damp lowlands of Belgium and Jutland, in the Swiss valleys, on the damp lands of New Jersey and the Carolina seaboard, and generally on damp pastures with rank, watery herbage.

When land has been better cultivated and enriched by manure, the disease has in many cases disappeared. This has been observed in England (Sarginson), Wurtenberg, Switzerland, etc. (Leclainche).

Succulent, watery food (potatoes, turnips), have been quoted as causes, as also rank, watery grasses, deficient in nutritious solids, but such food has invariably come from habitual osteo-malacia soils. On the rich, cultivated soils of the Lothians, Scotland, cattle are fed in large numbers on turnips alone, and osteo-malacia and pica are alike unknown. It is often noticed that the fodder grown on particular (osteo-malacia) soils will cause the disease when fed elsewhere, so that the inference is that some agent derived from these soils, and which is destroyed or rendered harmless by cultivation, is carried in the food. It cannot be a mere defect of nutritive matter, as this could be counter-balanced by the simple expedient of consuming a larger ration. Leclainche has seen the disease in its worst form in herds which received a rich and varied ration, while it spared adjacent herds that were kept on rather short rations. Even young plethoric animals suffered badly, though having all they would eat of natural fodders (hay) from districts where the disease was unknown, and in addition grain, linseed cake, cooked legumes and bread. In two neighboring stables, where the stock were kept in identical conditions, receiving the same food, in equal quantity, one was decimated by the malady, while the other was spared (Leclainche).

The affection often prevails on the higher lands, which, beside having the poorer soils, are specially exposed to cold storms and frosts, so that chill enters as an accessory condition. In Westmoreland, England, the river Eden divides the affected from the sound lands; the victims are found on the west bank which receives the cold, east winds, and not at all on the east bank where the warm, soft, west winds prevail. Thorburn noticed that the majority of cases start in spring, when the animals, debilitated by the winter’s seclusion, are exposed to severe vicissitudes of temperature and driving storms, to the strain of parturition, a fresh, heavy milk yield, and moulting.

The presence of a contagion has been suggested, but if this exists it must be habitually introduced in the food or water rather than transmitted from victim to victim. The healthy will often stand beside the diseased for an indefinite length of time without injury, and in certain recent cases a change to an uncontaminated farm, or an abundant ration drawn from such sound soil, will secure immediate improvement and recovery in a few weeks. In view of such prompt recoveries it would be quite as reasonable to suspect some ptomaine or toxin taken in with the food. The question of a microbe or a microbian poison is as yet a mere hypothesis.

Cows become more susceptible with advancing age, and Dengler alone claims to have seen the disease in calves. This is unfavorable to the idea of immunity, and rather favors that of debility or cachexia.

_Lesions._ These are confined to the bones. Decalcification in the Haversian canals and cancelli, reduces the bony tissue to a thin soft plate. Yet the condition is not constant. Grawitz found no special dilatation of the canals or cancelli in colts. Nessler and others found decrease of the lime salts, Bibra and Grouven detected no marked change, and Hoffmann and Begemann found an actual excess of phosphates. Doubtless the specimens selected and the stage of the disease, whether in active progress or during convalescence, may somewhat explain discrepancies. The fat cells increase in the cancelli, with more or less hyperæmia, and even blood staining as the disease advances, the bone cells become less branching, and there may be gelatinoid exudates. The resistance of the bone is diminished, it may be indented with the finger, or scraped off with the nail, or cut with a knife. It breaks under a slight strain, and is easily crushed under the weight of the animal so that fractures and distortions of all kinds are met with. In breeding cows the earliest and most marked lesions are in the pelvic bones, but fractures of the bones of the limbs are common.

_Symptoms._ Poor condition or even emaciation, with very visible projection of the bones is common. The coat is rough, the skin tense, inelastic and hide bound, appetite variable, sometimes impaired, and nearly always perverted so that the patient will lick the manger continually or pick up and chew all sorts of objects, bones, leather, articles of clothing, pieces of wood or iron, stones, etc. The amount of food consumed may, however, be up to the normal. The most marked feature is the difficulty and stiffness of locomotion. The patient lies most of the time, rises languidly and with difficulty and moves the limbs as if each were a rigid post without joints. The hocks will knock together, and the restricted movements of the joint are often attended by cracking. Yet appetite, temperature and yield of milk may remain normal.

Later appetite and milk secretion fail, temperature rises a degree or two, the animal refuses to rise, remaining down twelve to twenty-four hours at a time, and rising first on the hind parts, and remaining on the knees for a length of time, moaning and indisposed to exert herself further. Many cases at this stage begin to improve and may get well in five or six weeks. Some will remain down for several weeks and finally get up and recover. With constant decubitus however, the animal falls off greatly, becoming emaciated and weak, the appetite may fail altogether, and the patient is worn out by the persistent fever, nervous exhaustion and poisoning from the numerous bad sores. Abscesses, sloughs and fistulæ are common over the bony prominences.

It is in these last conditions above all that fractures and distortions of the pelvic bones and less frequently of the bones of the legs occur. They occur earlier as well in connection with falls, blows, crowding by their fellows and sudden active movements of various kinds.

The disease may advance for two or three months, and in case of pelvic fractures and distortions, there may be permanent lameness, and dangerous obstruction to parturition, even though the bones should acquire their normal hardness through the deposition of lime salts.

It has been noted that the disease is usually confined to well defined areas, and that even in these it has its periods of abatement and recrudescence so that given years are osteo-malacia years. In the department of l’Aube, France, Leclainche, particularly noted the enzootics of 1865–6, 1870, 1875–6, and 1883–4.

_Prognosis._ The gravity of the affection varies greatly under different conditions. Some outbreaks are mild while others are very severe, and the prognosis must vary with this gravity. Again at the decline of an enzootic the disease is more benign and less ruinous. A case in its very earliest stage is much more hopeful, than one that is far advanced, with bones extensively softened or even broken, digestion and assimilation badly impaired, and infecting sores and sloughs on different parts of the body. Isolated cases are usually much milder than when the affection has gathered strength enough to determine an enzootic.

_Treatment._ This will vary with the predominance of the causes, essential or accessory. In some cases the suspension of the injurious food and a rich alimentation on well grown fodders from sound lands will meet every need. Green clover, alfalfa, and other leguminous products, ground oats, beans, peas, linseed cake, rape cake, cotton seed and vetches may be especially named. Even animal food may be availed of, and cases are recorded in which cows have themselves hunted for snails and frogs and devoured them greedily. The free access to common salt, and a liberal supply of bone meal are helpful. Iron and bitter tonics, (gentian, quinine, salicine, nux, copperas, tincture of iron) and cod liver oil, in pint doses daily, have been found advantageous. Apomorphia has been found especially valuable in correcting the preverted appetite, and stimulating digestion.

Where it is feasible to move the affected herd from the unwholesome pasturage or locality to one in which the aliment is rich and the disease unknown, success usually follows the change.

On poor, uncultivated lands where the disease appears yearly, or at short intervals, intensive culture with heavy manuring, and the heavy feeding of the herd on grain products, linseed cake, etc., will often banish the trouble.

Care should be taken to change the water as well as the food.

Finally every drain upon the system should be lessened or stopped. The milk may be dried up and the animal should not be bred. Sweet, dry buildings, pure air, sunshine and grooming are important auxiliaries.

In severe outbreaks, in high conditioned animals, the owner often consults his interest, in sending the victims to the butcher as soon as the affection shows itself and before time has been allowed for the inevitable emaciation and loss.

Some, on osteo-malacia lands, have profited by changing the entire herd every two years, as they become rapidly worn out under successive attacks.

As local derivatives, oil of turpentine, hot vinegar, tincture of iodine and biniodide of mercury have been employed. Open sores are treated with antiseptic lotions, creolin, lysol, carbolic acid, iodine lotions, iodoform, etc.

RAREFYING OSTEITIS. OSTEOPOROSIS. OSTEO-MALACIA OF THE HORSE. BIG HEAD.

Definition. Distinction from rachitis. Process of rarefaction, cell
proliferation, congestion, solution of earthy salts and fibrous
matrix, osteoclasts, Howship’s lacunæ. Dried bone light, spongy,
friable, though enlarged in repaired cases, dense, heavy. Face
lesions. Dyspnœa. Dropping teeth. Causes: microbian hypothesis,
disturbance of bone nutrition, faulty food, lack of bone salts, cellar
stables, floor on ground, malaria, cold, damp soils, city life, early
life, breed, asses and mules, breeding. Nature. Symptoms: illness,
inappetence, lifelessness, early fatigue and perspiration, stiffness,
lameness, distortions, stumbling, knuckling, arthritis, tender puffed
joints, thickened softened bones, facial swellings, narrowing of
intermaxillary space, chisel teeth, difficult mastication, shedding
teeth, emaciation, marasmus. Phosphates in urine when disease is
active. Relation to exostosis. Prevention and treatment. Hygienic,
move from cellar stable, or ground floor, secure air space under
floor, ventilation, warmth, sunshine, grain feeding, pasture, change
food, rest, salicylates, salicin, salol, phenacetin, blisters,
phosphates, bone dust, phosphorus, bitters, iron, barium chloride.

_Definition._ A form of osteo-malacia occurring in the mature as well as in the growing horse, characterized by the absorption of earthy salts from the walls of the cancelli and Haversian canals with excessive production of the organic basis and cell elements and enlargement, softening, lightness and fragility of the bones.

It differs from rachitis essentially in this that while the latter attacks the young growing bone at the chief seats of growth, under the periosteum and in the epiphyseal ligament, and therefore especially on the surface of the true bony tissue, osteoporosis attacks the formed and often the mature bone in its interior, producing attenuation of the walls of its vascular canals and cancellar cavities and increase of their fibro-cellular contents. Both result in enlargement of the bone, but in rachitis this is determined largely by deposition on the surface while in osteoporosis it takes place by expansion from within. The further distinction that rachitis appears enzootically and osteoporosis sporadically applies only to localities in which the latter is not common. At different points on Long Island, in New Jersey and on the rich soils in the Mississippi valley and on the Atlantic and Gulf coasts, osteoporosis often prevails enzootically and has its recrudescences like rachitis.

The process of rarefaction and softening may be thus stated. In the Haversian canals and narrow spaces there is an active proliferation of cells and increase of vascularity, with a gradual solution and removal, not only of the earthy salts, but also of the fibrous matrix in the walls of these spaces. As in the normal changes in bone, the absorption appears to be effected through the large cells or osteoclasts grouped around the blood vessels. In the osseous tissue, which abuts on the vascular tissue, are to be found excavations, simple or irregular, (Howship’s lacunæ), containing granular cells and the larger osteoclasts. In a similar manner bone is softened and absorbed in connection with tubercle, or the pressure of tumors, aneurisms, actinomycosis. In case of recovery, repair takes place by the disposition of new bone, so that the enlarged and rarefied bone may in the end become harder than before. This applies especially to the cancellated bone. On the articular ends of the affected bones, the granulation tissue makes its way into and through the cartilage of incrustation with resulting active disease of the joint.

The condition of the bone is well illustrated in the dried or macerated specimen. Taken from a bad case in the active stage of the disease, it crumbles under pressure and weighs as light as a sponge, whilst from an advanced or recovered case, it is hard and resistant, and weighs as much more than the normal bone as it exceeds it in bulk. The morbid rarefaction usually affects the whole skeleton more or less, yet in perhaps the majority of cases; the change is greatest in the bones of the face, and the resulting distortions are usually symmetrical on the two sides. It may show mainly in the maxilla, which is thickened to twice or even five times its normal thickness, it may show in rounded, general swelling of the nasal and superior maxillary bones and those around the orbit, or it may involve the turbinated bones, the vomer and even the cartilaginous nasal septum. Loosening and evulsion of the molar teeth is common and snuffling breathing may occur as in rachitis affecting the nasal bones of dogs and swine.

_Causes._ We are still in the dark as to the essential cause of rarefaction of bone. There is a growing tendency to suspect a microbian origin, and many facts are held to point in that direction. It seems to have been unknown in England in the early part of the 19th century, and is not noticed by Blaine, Youatt, Percivall nor other of the early writers. In Varnell’s cases the same man had two farms not far apart and equal in soil, drainage and stabling, stocked with horses bred from the same parents with the same kind and amount of feed and work, yet on one farm six cases of osteoporosis occurred, and on the other not a single case. McNeil, in charge of street car stables, found the disease destructively prevalent in the best appointed stables and absent from others in the worst hygienic condition. In a superior stable with 220 horses he had 47 cases in two years, and in a fine stable with 100 horses he had 26 cases in the same length of time. In the poorer stables, the horses bred in the same way on all kinds of soils and with no difference in feeding nor management escaped. It is the common experience in Europe and America that a farm or district, which has been previously free from the disease suddenly has an outbreak in enzootic form, and this will last for a year or two, then remit only to appear with its old force after an interval of some years. Even during the active prevalence of the disease on one or on several adjacent farms, others in the immediate vicinity, and differing in no appreciable way, geologically, hydrostatically, in buildings, food, water, general management nor work, completely escape. Berus, Hoskins and other city veterinarians have noticed, that it was almost the rule, that a fresh horse put in the stall of one that had suffered from osteoporosis soon contracted the disease.

W. L. Williams noticed on two different farms in Central Illinois, on which the disease suddenly appeared, that for years after the comparative subsidence of the affection there was an unusual prevalence of spavins, splints, ringbones and other diseases of the bones. Meyer has noticed that cases sent from Cincinnati into the country, and that have got well, will succumb to the affection if brought back into the city stables in which they originally contracted it.

All of this points very strongly to one of two things; either a pathogenic germ in the system of the affected animal; or the presence of a pathogenic microbe in the stable, water, or other part of the environment, the toxic products of which are taken into the animal system.

But as yet no specific pathogenic microbe has been demonstrated so that this doctrine must still be held as a mere plausible hypothesis.

Many veterinarians with long experience in such cases absolutely deny contagion. The hypothetical contagion undoubtedly extends slowly, and uncertainly from animal to animal, probably, like actinomycosis, taking place mainly through the soil, or some outside medium, rather than by direct contact; or a special susceptibility on the part of the individual animal may be necessary to render it effectual.

_Accessory Causes_ can be spoken of more confidently but even of these no one, nor small group, can be advanced as essential. The process of bone nutrition is readily disturbed by a variety of conditions, and such disturbances may easily become the occasion of weakening the resisting power and mayhap of admitting the hypothetical microbe to get in its pathogenic work.

_Faulty food_ has been a favorite explanation. A lack of lime in the soil and fodder seems, at times, to have had a baneful effect, if only, in lowering the general tone and impairing the nutrition. Yet we see osteoporosis on limestone soils (New York, etc.), and in animals generously fed on grain. The same remarks apply to phosphorus and phosphates. Their deficiency apparently contributes to the production of the disease, and yet under other conditions, their abundance is no barrier to its development. The excess of free phosphorus produces osteitis and it is held by some that an over-abundance of phosphates acts in the same way. It has been sought to incriminate a too nitrogenous diet in some cases, and in others one too rich in fat or carbohydrates. The many cases in Philadelphia and Pennsylvania were mostly in animals that had been well fed and were in good condition when attacked (Marshall).

Special food may be the direct cause, bran diet has been already noted. Hinebauch found an acute osteitis with bone softening and arthritis in horses fed on millet, green, partially matured and ripe. Horses elsewhere have fed on millet, without such results, but not perhaps, in the same environment, nor in presence of the hypothetical microbe. Millet is not the sole nor common cause of osteoporosis, but there is reason to suspect that it is at times an important accessory cause.

Of all prejudicial conditions none is to be so dreaded as _unwholesome stables_. Of 200 cases reported by Berus, in Brooklyn, almost all were in cellar stables or those with floors laid on the soil. Meyer finds that “most all cases can be traced to an unwholesome atmosphere, or gases arising from vaults, sewers, cellars, filthy streams, or from a hollow space under the floor.” Harbaugh says every case was stabled in damp, ill-drained, unventilated and badly lighted buildings. The worst outbreak was in a basement with a damp wall, on one side, and none suffered except those that stood next to this wall. The horses standing on the opposite side, which was on a level with the ground outside, escaped. Removal from a cellar stable to the floor above, put a sudden stop to the appearance of new cases. James, of St. Louis, found 20 successive cases in a stable on a dirt floor, and Jasme, of Charlestown, finds nearly all his many cases on earth floors in malarial regions.

_Malaria_ has been blamed, especially by southern observers, accustomed to see the disease on the warm alluvial seaboard and river bottoms. That this environment predisposes to the disease, by undermining the health, is doubtless the case, but in spite of occasional remissions in the symptoms, malarial germs cannot be set down as the constant cause. One of the worst cases I ever saw, with every bone in the body soft, spongy and light, developed at Inglis Green laundry, Edinburgh, where malaria is absolutely unknown, but where the brook received large quantities of chlorine.

_Cold_ is an undoubted factor, though the disease is most prevalent in our warm southern states. Many veterinarians have noticed its coincidence with rheumatism, in which cold is so often the dominating accessory cause. Some have even suspected that it is only a modified type of the rheumatic condition. Hinebauch found his cases of _millet disease_ in cold basement barns, or with leaking roofs, so that the floor and bedding were constantly wet. He found that cold always aggravated the disease, and bad air even more so, while salicylates seemed to have a marked curative influence.

_Damp soils_ should be named in this connection. These not only chill the air by evaporation, and condense the cold dews at night, contributing to produce the extremes of hot noon day and cold night temperature, with corresponding disturbances of the bodily health, but they favor the preservation of the infinitesimal forms of life (bacteria, protozoa) and therefore of the hypothetical microbe of the disease.

_City life_ is a most potent cause. Berus tells us that hundreds of horses die yearly in Brooklyn of osteoporosis, and that if sent early to the country a large proportion recover. The same is true of New York City and Philadelphia. Of Cincinnati, Meyer says that he has failed to find a case more than five miles outside the city limits, and that cases sent to the country make a partial or complete recovery. If returned to their former city stables, nearly all contract the disease anew within a year.

Many cases, however, are found in the country and often within a circumscribed area. These indicate, as in the city cases, a localized cause, bacteridian or otherwise.

_Early life_ predisposes, the majority of cases taking place before the sixth or seventh year, yet the disease occurs at all ages up to twenty years and over.

_Breed_ does not seem to make a material difference, and though Shetland ponies have acquired a bad reputation, their propensity to become fat and soft, their too often idle, pampered life, and the confined quarters in which they are frequently kept, account for much of the mortality.

_Asses and mules_ habitually escape, even in the South, where the latter animal is so numerous and often so poorly kept. In Hinbauch’s millet disease, the mules suffered more than the horses.

_Breeding horses_, male and female, have often acute attacks and die early. The drain on the system and confinement seem to act injuriously.

_Nature._ Until we know the essential cause or causes of osteoporosis, we must be in doubt as to its pathology. We are even debarred from pronouncing authoritatively upon the essential identity or difference of the various forms of softening, or rarefaction of bone. In obedience to the clinical manifestations and structural changes, rachitis, fragilitas ossium and osteoporosis have been separately described, but we cannot positively say that they are not all due to one essential cause, manifesting itself differently according to the activity of trophic processes in the bones of the victim. In the growing foal the active developmental processes in the epiphyseal ligament and periosteum may determine that the symptoms shall be pre-eminently those of rickets, yet we often see these complicated by the facial and other lesions of osteoporosis. Both may be the result of one etiological factor, or there may be a complex disease resulting from the presence of two. Again in the pregnant cow in which the relaxation of the ischio-pubic symphysis and pelvic ligaments means a profound change in the bone nutrition at this point, the presence of the hypothetic microbe, or other essential factor, may determine a decalcifying and fragility of the pelvic bones generally. Again in the mature male and non-breeding female, in the absence of the disturbing conditions of nutrition just named, the vascular elements in the Haversian canals and cancelli may determine the simple rarefaction and expansion of the bone which characterizes osteoporosis. When present in the bone in any of these conditions, acids doubtless fulfill an important rôle in the decalcifying and softening process, but behind these it may be surmised that there is an unknown cause or causes, which it is for the bacteriologist, chemist or botanist to discover.

_Symptoms._ These are largely the same as in brain disease. There may be first a period of illness, with poor appetite, lack of spirit and energy, early perspiration and fatigue, or if at large, leaving the herd, soon followed by some stiffness of gait and lameness, which may be intermittent, disappearing under exertion, or shifting from one joint or limb to another after the manner of rheumatism. Sometimes it shows in stiffness of the neck, so that the patient finds difficulty in lowering the head to graze; in others the back and loins are stiff and arched so that the animal has difficulty in rising and turns slowly and painfully; in still other cases the dorsal and lumbar vertebræ are depressed so that the back is hollow. Even before the manifestation of lameness, the affected limb may stand forward at the fetlock or knee, the gait is clumsy and awkward, and the patient may suddenly stumble and fall, showing little or no power of prompt recovery of balance. A horse, and especially a young horse, with this habit of stumbling is always to be suspected. The long bones of the limbs tend to enlarge or thicken, and this is likely to be more uniform than in rachitis, and not to be confined so much to the epiphysis. The implication of the stifle, hock or other joint, with marked synovial distention, and mobility or dislocation of the patella, is common and may be the earliest manifestation of illness. The bones of the face usually show early changes. The superior maxillary and nasal bones, beneath the zygomatic spine and infra-orbital foramen and along the line of the molar alveoli become especially bulging and rounded, the other facial and cranial bones suffering to a lesser degree. In the lower jaw, also, the disease predominates along the region of the molar alveoli, and the loosening of the molars permits them to deviate inward so that the grinding surfaces come perceptibly nearer to the median line, and the outer half of the tooth is rapidly worn while the inner edge projects as a sharp cutting ridge (chisel teeth).

For the same reason, the softening branches of the lower jaw deviate inward, tending to still further destroy the due approximation of the upper with the lower molars, and to diminish the breadth of the intermaxillary space. The great thickening of the rami of the maxilla tends still further to reduce the intermaxillary furrow.

Fractures and detachment of tendons and ligaments are common results of the rarefaction, a portion of the bone often remaining adherent to the tendon.

Cary gives the following statistics of fifteen cases: lame in the fore limbs 11 (mostly shoulder), in hind limbs 11 (mostly hip and stifle), stiff in loins 8, unable to rise without aid 3, had indented ribs 4, had shifting lameness 8, had chronic indigestion 6; mares 5; geldings 8; mules 2; ages were—_one_ 3 years, _five_ 6 years, _three_ 7 years, _one_ 8 years, _two_ 9 years and _three_ 10 years.

When the bones are enlarged their softness and friability may be shown by pricking with a needle, which will often freely penetrate the rarefied bony tissue. It should be first rendered antiseptic by dipping in strong carbolic acid.

From the first the general health fails, there is difficulty in mastication, digestion is more or less impaired, nutrition is imperfect and muscular flabbiness, weakness and wasting advance more or less rapidly. In advanced cases emaciation is often a marked feature.

Examination of the urine gives valuable indications, though the results obtained have been supposed to be contradictory. While rarefaction of the bone is advancing rapidly the urine is charged with an excess of phosphates in ratio with the activity of the morbid process. When on the other hand the disease has come to a standstill and the process of repair in the rarefied bones has begun, the absence of phosphates is no less characteristic. A patient therefore may show greatly enlarged and softened bones with persistent lameness, and yet the urine may show little or no phosphate. The phosphaturia may, therefore, be made the basis of a reasonable prognosis. Excess of phosphates indicates an active pathological process, with an uncertain outcome, while the absence of phosphates indicates an arrest of rarefaction and holds out good hope of recovery.

I have long observed the same in cases of obstinate and intractable spavins, splints, ringbones and other bone diseases. Phosphaturia bespeaks a faulty nutrition of the bone and explains the failure of remedial measures, while lack of phosphates in the urine, or a reduction to the normal amount is likely to become a guarantee of improvement under local treatment. The treatment however, must be first constitutional to correct the condition of malnutrition and then local to correct the osteitis.

_Prevention and treatment._ As in rachitis hygienic measures give the most uniformly good results. The change of stable is especially demanded from a cellar or basement stable, one with joists laid on the ground or one with an earth floor saturated with urinary and feculent products. In different cases an enzootic has been arrested, coincidently with the removal of the stock to the floor above, and in others with the removal of the filth saturated earth beneath a ground floor, and the laying of a new floor with ample space beneath for the free circulation of air. In the same line would be thorough drainage of the site and to carry off liquid manure to a well ventilated receptacle. Exposure to cold and wet is to be sedulously avoided as greatly favoring the onset of the disease, and hurrying the milder cases into a fatal activity. Free air and sunshine are all important and it is the universal experience that city cases taken early and sent to dry, sunny pastures, mostly recover, or at least undergo marked amelioration. The fact that certain cases originate during an open air life does not invalidate this position but merely shows that other pathogenic conditions may be too potent to be overcome by this hygienic one.

A liberal allowance of sound grain is essential to success, even in the case of patients sent to pasture. Those that have recovered or improved at pasture, should be retained in the country and on no account returned to the same city stables in which they contracted the disease. Even in the country a different stable should be secured if possible.

Any food that has manifestly contributed to the disease, should be withheld (bran, millet, musty or fermented food or that drawn from particular fields).

Overwork must be forbidden, and indeed any work at all during the active stage of the disease. The victim should also be withdrawn from breeding, at least until it has fully recovered the normal consistency of its bone.

In cases aggravated by cold or wet, or which show the rheumatic propensity to shift from place to place, sodium salicylate in ounce doses several times a day may appear to benefit, and as a germicide this may be tried on all cases. Salicin, salol, or phenacetin may be used as substitutes. Where the disease has been largely localized, blisters have appeared to be beneficial.

Phosphates and phosphorus have been lauded by German veterinarians, but in other hands, and when the morbid process was active they have proved useless, or even hurtful. Bone dust or phosphate of lime or soda may be freely used at any time and appears to act as a general tonic, beside supplying lime and phosphoric acid which may possibly be availed of for bone nutrition. Phosphorus and phosphorated oil in excess always softens the bone and much more so when this process is already excessive. In small doses (gr. ⅙ to ½) and after the process of rarefaction has ceased, it is valuable in hastening bone consolidation and fitting the patient to return to work.

Bitters, iron and other tonics are valuable in improving the general tone and indirectly the bone nutrition.

Cary had prompt improvement in connection with intravenous injection of barium chloride once a week for four weeks, and ½ oz. doses of sodium salicylate thrice a day. It remains to be seen whether or not this is generally applicable.

OSTEO-MALACIA IN OTHER ANIMALS.

The internal softening and rarefaction of bones in mature animals has been noted in dogs by Pillvax and Röll, in lambs by Haubner, in pigs by Haubner and Anaker, and in goats by different observers. The genuineness of these cases has been questioned by Cadiot and Leclainche, by Virchow and by others, but in the present uncertainty as to the dividing lines between rarefaction, rachitis and other diseases, they deserve notice in this connection.

In _dogs_ the lesions are mostly in the young and are largely rachitic, yet the enormous swelling of the facial bones, and especially of the superior maxillary in the comparatively mature animal suggests osteo-malacia. As in rachitis there are usually impaired digestion, unthriftiness, slow, stiff movements and lack of life and vigor.

In _goats_ Virchow believes the disease to be neither rachitic nor osteo-malacia, basing his opinion on the lesions in the bones: “On the maxillary bones of goats there are often found peculiar formations in which the parts that have already assumed osseous structure, have failed to fix the earthy salts. The tumor, which forms a circumscribed swelling on the upper or lower maxillary bone, is soft and easily cut with the scalpel, with at certain points only, a hard resistant material. It is a simple osteoid chondroma, though veterinarians for some reason associate it with rheumatism.” Profuse salivation is present.

In _lambs_ it is according to Haubner an atrophy with destructive ulceration of the bones of the face, complicated by purulent infiltration of the medullary spaces. “The incisors, and later the molars, fall one by one, because of the changes in the alveoli, the gums swell, become violet, red, and ulcerate, the ulcers extending through the hard palate into the nose, and causing a highly offensive discharge from both nose and mouth.

In _pigs_ the disease has been mainly seen in connection with insufficient or unwholesome food, and badly balanced rations, and especially with fermented swill and an exclusive maize diet. The symptoms are shown in the limbs and face, especially (“snuffles”), as noted under rachitis.

_Prevention and treatment_ are to be sought in avoidance of the obvious causes, and in applying the same line of tonic treatment as in the larger animals.

INDEX.

Abnormal conditions of the hair, 456.

Abrasions, 455.

Abscess behind eye, 350.
of brain, 125.
of spine, 175.

Acariasis, 460.

Acetone in urine, 198.
test for, 198.

Acne, 343.
in horse, 504.

Acromegaly, 133.

Acute eczema in dogs, 492, 495.
in solipeds, 475.
keratitis, 378.
myelitis, 154.

Adenoma of the gland of Harder, 357.

Akinesis, 2.

Albinism, 399.

Albumen in urine, 199.
test for, 199.

Alcoholic intoxication, 147.

Alimentary origin, eczema of, in cattle, 482.

Allantoin, 199.

Alopecia areata, 524.
congenita, 524.
postpartum, 526.

Alterations in glands and ducts, structural, 456.

Amaurosis, 442.

Amblyopia, 442.

Amyloid kidney, 246.

Anæsthesia, 9.

Analgesia, 10.

Anal sphincter, 21.

Aniline poisoning, 148.

Animal parasites, 456.

Ankyloblepharon, 337.

Anophthalmos, 446.

Aperture in iris, congenital, 399.

Aphthous conjunctivitis, 371.
fever, 460.

Apoplexy, 84.
cerebral, 84.
of spinal cord, 170.

Arteria hyaloidea, persistent, 436.

Arthritis, rheumatic, in horse, 536.
urica, 554.

Articular rheumatism in cattle, 542.
in the dog, 547.
in horse, 536.
in sheep, 545.
in swine, 545.

Artificial eye, 449.

Astragalus Mollissimus, 135.

Ataxia, 5, 165.

Atheroma, 425.

Atresia of lachrymal puncta, 351.

Atrophy, 442.
degenerative, of nerves, 6.
of ovary, 280.
of the eyeball, 446.
of nerves, 189.

Bacillus diphtheriæ avium, 372.

Bacteria in encephalitis, 97.

Baldness, congenital, 524.

Balking, 26.
jurisprudence of, 28.
treatment of, 30.

Bed sores, 520.

Black cataract, 396.

Bladder, anomalies of, 261.
atony of, 258.
eversion of, 260.
hernia of, 261.
parasites, 259.
rupture of, 260.
spasm of neck of, 259.
tumors of, 259.

Big head, 579.

Bile in urine, 200.

Birds, gout in, 554.

Blebs, 454.

Blennorrhœa, 366.

Blepharadenitis, 343.

Blepharitis, 340.

Blepharophymosis, 339.

Blepharospasm, 337.

Blind staggers, 69.

Blisters, 454.

Bloody sweat, 518.

Boil, 454, 522.

Brain, abscess of, 125.
concussion of, 80.
congestion of, 90.
cortical lesions of, 13.
disease, 572.

Brain, pressure on, 13.
tumors of, 128.

Bright’s disease, acute, 220.

Bronchocele, 560.

Buckwheat erythema, 470.

Bulbar paralysis, 134.

Bullæ, 454.
in horse, ox, pig and dog, 507.

Buphthalmos congenitus, Hydrophthalmos or, 427.

Burns, 460.

Cachexia ossifraga, 573.

Calculus of prostate, 278.
renal, 247.

Callositas, 455.

Callosities, necrotic, 455.

Calorica, dermatitis, 473.

Caloricum, erythema, 468.

Calving fever, 299.

Cancer of prostate, 278.

Canker, 515.

Canthoplasty, 337.

Capsule of lens, opacity of, 428.

Carbon disulphide poisoning, 150.

Carbuncle, 454.

Carbunculus, 454.

Cardiac accelerating centre, 21.
inhibition, 15.

Carpus, chronic eczema of, 480.

Caruncle, lachyrmal, diseases of the, 356

Casts, composition of urinary, 201.
in urine. 201.

Catalepsy, 36.

Cataract, 393, 428.
anterior capsular, 428, 429.
anterior polar, 428.
black, 396, 428.
blood pigment on capsule, 429.
capsular, 428.
cortical, 428.
diabetic, 428.
discission, 433.
immature or unripe, 428.
lenticular, 428.
mature or ripe, 428.
nuclear, 428.
polar, 428.
posterior capsular, 428.
posterior polar, 428.
ripe, mature or, 428.
senile, 428, 429.
soft, in the young, 433.
suction of lens, 435.
traumatic, 428.
unripe, immature or, 428.

Catarrhal conjunctivitis, simple acute, 360.

Catarrh of the urethra, 262.

Catheterization, 264.
of bitch, 267.
of bull, 266.
of cow, 267.
of dog, 266.
of horse, 264.
of mare, 266.
of ram, 266.

Cattle, alimentary eczema of, 482.
chronic eczema in, 488.
moist eczema of the tail, neck, chine and dewlap, 487.

Central canal of the spinal cord, dilatation of, 178.

Centre for dilating pupil, 21.

Cerebellar disease, 133.

Cerebellum, 17.

Cerebral cortex, lesions of, 13.
hæmorrhage, 84.
hyperæmia, 90.

Cerebro-spinal lesions in rheumatism, 536.
meningitis, 118.

Cervical lateral columns, transverse section of, 21.

Cervix vesicæ, imperforate, 261.

Chafing, 460.
intertrigo of, 466.

Chalazion, 344.

Chapped heels in horse, 508.

Chaps, 455.

Chloroform, action on dog, 23.

Choked disc, 440.

Cholesteatomata, 129.

Cholesteatoma of spine, 175.

Chondroma of spine, 176.

Chorea, 63.

Choroid, detachment of the, 403.
rupture of the, 403.
tumor of, 403.

Choroiditis, 402.
suppurative form, 403.

Chronic eczema of the back in dog, 497.
keratitis, 382.

Cicatrices, 455.

Coloboma iridis, 399.
palpebrarum, 336.

Compression of spinal cord, 175.

Concussion of the brain, 80.

Congenital aperture in iris, 399.
hydrophthalmos or buphthalmos, 427.

Conical cornea, 388.

Conjunctiva, burns of, 360.
dermoid tumor of the, 375.
lipoma of, 375.

Conjunctiva, melanosis of, 375.
neoplasms of the, 375.
polypus of, 375.
wounds of, 359.

Conjunctival sac, foreign bodies in the, 358.

Conjunctivitis, aphthous, 371.
catarrhal, simple acute, 360.
chronic, 364.
diphtheritic, in birds, 371.
follicular, 374.
in herbivora, infectious, 368.
phlyctenular, 371.
purulent, 366.
variolous, 370.

Constitutional diseases, 528.
vice, maladies due to a, 460.

Contagious pustular dermatitis, 504.

Convulsions, 61.

Convulsive twitching, 66.

Cornea, conical, 388.

Corneæ, ectasia, 388.
xerosis (epithelialis), 376.

Cornea, foreign bodies in, 378.
inflammation of the, 378.
opacity of, 384.
pigment spots on, 384.
tumors of the, 388.
ulcer of, 385.
wounds of the, 377.

Corneal staphyloma, 387.

Cornu cutaneum, 455.

Corpora nigra, cysts of, 323.
quadrigemini, 16.

Corpus striatum, 17.

Cortical localization, 17.

Cotton seed, poisoning with, 381.

Cracks, 455.

Cracked heels in horse, 508.

Creatinin in urine, 198.
test for, 198.

Crevasses, 455.

Cripple, 573.

Crossed hemiplegia, 3.

Crura cerebra, 16.

Crustæ, 454.

Crusts, 454.

Cryptogams in encephalitis, 97.

Cutaneous eruptions in sheep, 490.
hæmorrhage, 518.
hypertrophy, 521.

Cutaneum, cornu, 455.

Cyanuric acid, 199.

Cyclitis, 393, 400.

Cystic ovary, 287.

Cystitis acute catarrhal, 253.
acute croupous, 255.
chronic catarrhal, 256.
Cystitis, in dog, 257.
in ox, 257.

Cysts of the iris and corpora nigra, 401.

Dacryo-adenitis, 351.

Dacryo-cystitis, 353.

Dandruff, 454.

Degeneration, Waller’s law of, 7.

Delirium, 30.

Dermatitis, 460, 472.
calorica, 473.
contagious pustular, 504.
erythematous, 465.from mechanical injury, 472.
medicamentosa, 473.
traumatica, 472.
Venenata, 473.

Dermatomata, 455.

Dermatosis, microbian, 460.
parasitic, 460.

Dermoid cysts of ovary, 291.
tumor of the conjunctiva, 375.

Detachment of the choroid, 403.
of the retina, 439.

Diagnosis of skin diseases, 458.

Diphtheritic conjunctivitis in birds, 371.

Diplococcus (streptococcus) pneumoniæ equina, 397.

Disc, choked, 440.

Diseases of the nervous system, 1.
of the skin, 453.
urinary organs, 190.
skin, diagnosis of, 458.
skin, general causes of, 456.

Disease, white skin, 470.

Dislocation of the globe of the eye, 447.
of the lens, 435.

Dog, acute eczema of the, 492.
chronic eczema in the, 496.
myelitis in, 161.

Dogs, acute eczemas in, 495.

Double pupil, 399.

Dropsy of cerebral ventricles, 110.
of eyelids, 341.

Dry keratitis, 376.

Ducts and glands, structural alterations of skin, 456.

Dyskinesis, 5.

Earthy phosphates, test for, 197.

Eclampsia, 61.
of nursing bitches, 62.

Ectasia (bulging) of the sclera, 389.
corneæ, 388.

Ectropion, 346.

Eczema, 474.
acute general, 495.
acute, in solipeds, 475.
acute, of the dog, 492.
caudal, 495.
chronic, in cattle, 488.
chronic, in the dog, 496.
chronic, of the carpus and tarsus, 480.
chronic, of the head in solipeds, 476.
impetiginous, 495.
interdigital, 495.
in sheep, 489.
in swine, 490.
of alimentary origin in cattle, 482.
of elbow and hock in dog, 497.
of head, ears, etc., 497.
of the back in dog, 497.
malt, 482.
moist, chronic, at the mane and tail, 477.
moist, of the pasterns in the ox, 486.
moist, of the tail, neck, chine and dewlap of cattle, 487.
potato, 482.
rubrum, 493.
acute, in dogs, 495.

Egg impaction in oviduct, 293.

Electric shock, 80.

Elephantiasis, 521.
pachydermia, 456.

Embolism of spinal cord, 168.

Emphysema of eyelids, 342.

Encanthis, 356.

Encephalic congestion, 90.
lesions, 13.

Encephalitis calorica, 98.
from bacterial products, 97.
from cryptogams, 97.
from exertion, 98.
from lead, 99.
from narcotics, 96.
from parasites, 99.
from poisons, 99.
from travel, 98.
from tumors, 99.
treatment of, 107.

Encephaloid of spine, 176.

Encephalon, pressure on, 13.

Endocarditis in rheumatism, 534.

Entropion, 345.

Epilepsy, 47.
jurisprudence of, 57.
partial, 48.
treatment of, 58.

Episcleritis, 389.

Epispadias, 262.

Epithelial xerosis, 376.

Erosions, 455.

Eruptions, cutaneous, in sheep, 490.
distillery waste, 460.
granular skin, in swine, 492.
of nervous origin, 7.

Erythema, 453, 465.
buckwheat, 470.
caloricum, 468.
from irritants, 471.
solar, 468.

Erythematous dermatitis, 465.

Essential oils, action on dog, 23.

Ewes, neurasthenia in pregnant, 179.

Excrescences, 455.

Exophthalmic goitre, 564.

Exophthalmos, 338, 426.

Extraction, linear, of the lens, 434.

Eye, artificial, 449.
defects, blemishes, etc., 318.
diseases of, 316.
desirable features of, 316.
dislocation of the globe of, 447.

Eyeball, atrophy of, 446.

Eyelash turned in, 344.

Eyelids adherent to bulb, 339.
deficiency of, 336.
dropsy of, 341.
emphysema of, 342.
inability to close, 338.
inflammation of, 340.
narrow opening between, 337.
organic union of, 337.
seborrhœa of, 343.
tumors of, 348.
wounds of, 333.

Eyelid, tubercle of, 344.
turned in, 345.
turned out, 346.

Eye, systematic inspection of, 320.

Face, convulsive twitching of, 66.

Fagopyrism, 470.

Falling sickness, 47.

Fallopian tubes, inflammation of, 292.

Fatty degeneration of the kidney, 244.

Female generative organs, diseases of, 279.

Filaria hæmorrhagica, 518.

Fish-skin disease, 522.

Fissures, 455.

Fistula of lachrymal sac, 352.
recto-vesical, 261.

Follicular conjunctivitis, 374.

Foreign bodies in the conjunctival sac, 358.
in the cornea, 378.
in the iris, 398.

Fracture of the orbit, 348.

Fragilitas ossium, 573.

Furuncle, 454.

Furunculus, 454, 522.

Gadfly, panic from, 24.

Gangrene, cutaneous, 520.

Generative organs, diseases of female, 279.

Genital centre, 21.

Giantism, 133.

Glands and ducts, structural alterations in skin, 456.

Glaucoma. 422.
acute inflammatory, 424.
secondary, 424.
simple, 424.

Glioma of spine, 176.

Globe of the eye, dislocation of, 447.

Glomerulitis, 225.

Glucose in parturition fever, 308.
in urine, 200.
test for, 200.

Glycogenic centre, spinal, 21.

Glycosuria, 200.

Goitre, 560.
congenital, 561.
cystic, 562.
exophthalmic, 564.
fibrous, 562.
hypertrophic, 562.
its distribution, 561.
varicose, 562.

Goll, column of, 21.

Gout, 554.

Granular skin eruption in swine, 492.

Grapes, 515.

Grease, 512.

Growth, horny, 455.

Hair, abnormal conditions of, 456.
nodular swelling of, 526.
splitting of, 526.

Hallucinations, 11, 22.

Harder, gland of, adenoma of the, 357.

Hare-eye, 338.

Hæmatidrosis, 518.

Hæmatopedesis, 518.

Hæmatorrachis, 170.

Hæmaturia, 200, 204.
prevention of, 208.
treatment of, 208.

Hæmoglobinuria, 200.

Hæmophilia, 518.

Hæmorrhage, cutaneous, 518.
into spinal cord, 170.
on ovary, 282.
retinal, 439.

Hippuric acid, 197.

Hippuric acid, test for, 198.

Head, convulsive movements of, 67.

Health, nervous control in, 1.

Heart lesions in rheumatism, 534.

Heat exhaustion, 39.
treatment of, 40.
papules, 499.

Hemianæsthesia, 3.

Hemiplegia, 3.

Hemispasm, 4.

Hernia of ovaries, 279.

Hordeolum, 343.

Horny growth, 455.

Horsepox, 515

Hyaloidea, persistent arteria, 436.

Hydrocephalus, chronic, 110.
jurisprudence of, 116.
treatment of, 116.

Hydro-metra, 296.

Hydronephrosis, 248.

Hydrophthalmos or buphthalmos congenitus, 427.

Hymen, imperforate, 298.

Hyperæsthesia, 8.
cutaneous, 8.
muscular, 8.
to cold, 8.
visceral, 9.

Hyperalgesia, 10.

Hyperkinesis, 4.

Hyperplasiæ, 455.

Hyperplasia of the skin, 523.

Hypertrophy, cutaneous, 521.
of the prostate, 274.

Hypospadias, 262.

Hypoxanthin, 199.

Ichthyosis, 522.

Immobility, 110.

Impetigo, 477.
digital, 512.
of pigs, 491.

Incoördination, 5.
in cerebellar disease, 133.

Indican in urine, 197.
test for, 197.

Infection in osteo-malacia, 575.
in osteoporosis, 581.

Inferior columns, transverse section of, 20.

Inflammation of the cornea, 378.
of the optic nerve, 440.
of the sclera, 389.

Inhibition, cardiac, 15.
respiratory, 15.

Insolation, 39.

Internal ophthalmia, 390.

Intertrigo, 466.
of chafing, 466.

Iridis, coloboma, 399.

Iris, congenital aperture in, 399.
cysts of the, 401.
foreign bodies in the, 398.
prolapse of the, 390.
tuberculosis of, 401.

Iritis, simple, 395.
symptomatic or metastatic, 397.

Irritants, animal, 460.
erythema from, 471.
external, maladies from, 460.
ingested, maladies due to, 460.
vegetable, 460.

Irruption, vesicular in pigs, 491.

Itching, 9.

Keracele, 455.

Keratitis, acute, 378.
chronic, 382.
dry, 376.

Keratoconus, 388.

Keratoglobus, 388.

Kidney, acute congestion of, in carnivora, 218.
in cattle, 214.
in horse, 209.
in sheep and goat, 216.
in swine, 217.
treatment, 213.
amyloid, 246.
atrophy of, 241.
fatty degeneration of, 244.
hypertrophy of, 240.
lardaceous, 246.
waxy, 246.

Lachrymal caruncle, disease of, 356.
tumors of, 356.
gland, disease of, 351.
puncta, obstruction of, 351.
sac, catarrh of, 353.
fistula of, 352.

Lachrymo-nasal duct, stenosis of, 355.

Lactic acid in rickets, 568.

Lagophthalmos, 338.

Limbs, disorderly movements of, 69.

Lead poisoning, 141.

Lens, dislocation of the, 435.
linear extraction of the, 434.
opacity of the, 428.

Leucin in urine, 199.
test for, 199.

Leucoma, 384.

Leucorrhœa, 298.

Lichen, 499.

Lightning stroke, 82.

Linear extraction of the lens, 434.

Lipoma of spine, 176.

Lips, flapping of, 68.

Localization in ass’s brain, 17.
in dog’s brain, 18.
of nervous lesions, 12.
of nervous troubles, 17.

“Loco” poisoning, 135.

Luxatio bulbi, 447.

Macula, 384.

Maculæ, 453.

Maladies, skin, due to a constitutional vice, 460.
due to ingested irritants, 460.
due to toxic products of the system, 460.
from external irritants, 460.

Malanders, 480

Mange, red, 493.

Medulla, disease of, 134.

Megrims, 69.

Meibomian glands, disease of, 343.

Melanoma of the brain, 130.
of spine, 175.

Mellituria, 200.

Membrana nictitans, hypertrophy of, 357.
lesions of, 357.
tumors of, 357.

Membrane, persistent pupillary, 400.

Meningitis, cerebro spinal, 118.
tubercular, 127.

Meningo-encephalic congestion, 90.

Meningo-encephalitis, 94.

Meningo-myelitis in the dog, 161.

Metastatic iritis, symptomatic or, 397.

Microbes in nervous disease, 2.
in parturition fever, 304.
in udder, 305.

Microbian dermatosis, 460.

Microphthalmos, 446.

Milk fever, 299.
poisonous in nervous disorder, 8.

Millet disease, 582.

Modified secretions of skin, 456.

Moist eczema, chronic at the mane and tail, 477.
of the pasterns in the ox, 486.

Monoplegia, 3.
cerebral, 4.

Monospasm, 4.

Moonblindness, 404.

Motor disorders, 2.
tracts in brain, 14.

Muscular balance, lack of, 450.
rheumatism in cattle, 544.
rheumatism in the dog, 548.
rheumatism in horse, 540.
sense tract, 21.

Musty fodder in encephalitis, 97.

Mydriatics, 331.

Myelitis, 154.
chronic, 165.
in the dog, 161.

Myosin coagulated under heat, 41.

Myxoma of the brain, 131.

Nebula, 384.

Necrotic callosities, 455.

Neoplasms of brain, 128.
of the conjunctiva, 375.

Nephritis, 219.
acute, 220.
chronic, 234.
interstitial, 225.
purulent, 228.
suppurative, 225.
treatment, 225.
tubular, 225.

Nerve, optic, inflammation of the, 440.
optic, paralysis of the, 442.

Nerves, atrophy of, 189.

Nerve trunk, pressure on, 9.

Nervous centres, respiratory, 14.
disease, diagnosis of, 2.
disease, microbes in, 2.
disease, symptoms of, 2.
disorders, diagnosis of, 12.
functional, 13.
structural, 12.
lesions, destructive, 12.
organs, irritation of, 12.
system, diseases of, 1.

Neuralgia, 184.
of ovary, 281.

Neurasthenia in pregnant ewes, 179.

Neuritis, 181.
ascendens, 441.
descendens, 441.
optic, retro-bulbar, 441.

Neurosis, 456.

Nictitans, membrana, lesions, 357.

Nigra, corpora, cysts of, 401.

Nitro-benzol poisoning, 149.

Nodules, 453.

Nose, rhythmic movements of, 68.

Nystagmus, 452.

Oblique focal illumination of the eye, 324.

Occluded pupil, 400.

Oöphoritis, 284.

Opacity of the cornea, 384.
of the lens or its capsule, 428.
of the vitreous, 437.

Ophthalmia, enzootic, 368.
internal, 390.
periodic, 404.
of solipeds, recurrent, 404.

Ophthalmoscope, 328.

Optic nerve, inflammation of the, 440.
paralysis of, 442.

Optic neuritis, retro-bulbar, 441.

Optic thalamus, 17.

Orbit, fracture of, 348.
periostitis of, 350.
tumors of, 350.
wounds of, 349.

Oscillatory movement of the eye, 452.

Osteomalacia, 573.
in pigs, dogs, goats and lambs, 489.
of the horse, 579.

Osteoporosis, 579.
treatment of, 587.

Ovarian cysts, 287.
tumors, 292.

Ovaries, absent, 280.
atrophy of, 280.
hernia of, 279.
supernumerary, 281.
undeveloped, 280.

Ovary and womb, malposition of, 279.
dermoid cysts of, 291.
hæmorrhage on, 282.
inflammation of, 284.
irritable, 281.

Oviduct, diseases of, 293.
egg impaction in, 293.
eversion of, 293.
imperforate, 293.
inflammation of, 295.
polypus of, 293.

Oxalic acid in rickets, 568.
in urine, 198.
test for, 198.

Ox, moist eczema of the pasterns, 486.

Oxytropis Lamberti, 135.

Pachydermia, 521.
elephantiasis, 456.

Pain, insensibility to, 10.

Palpebral fissure, widened, 338.

Panic, 23.
treatment, 24.

Panophthalmitis, 390, 403, 421.
enucleation, 422.

Papilloma of spine, 176.

Papulæ, papules, 453.

Paræsthesia, 9.

Paralysis, 2, 175.
local, 4.
of ocular muscles, 450.
of the optic nerve, 442.
sensory, 9.

Paraplegia, 3.

Parturient apoplexy, 299.

Parturition collapse, 299.
fever, 299.

Parturition fever, prevention, 311.
fever, treatment, 313.
paresis, 299.

Parasites, animal, 456.
of the bladder, 259.
of the kidney, 248.
vegetable, 456.

Parasitic dermatosis, 460.

Paresis, 2.

Pasterns, moist eczema of, in the ox, 486.

Pemphigus, 507.

Pericarditis in rheumatism, 535.

Perinephritis, 230.

Perineuritis, 181.

Periodic ophthalmia, 404.

Perioöphoritis, 284.

Periostitis of orbit, 350.

Persistent arteria hyaloidea, 436.
pupillary membrane, 400.

Perspiratory centre, 16.

Phenol in urine, 198.
test for, 198.

Phlyctenæ, 454.

Phlyctenular conjunctivitis, 371.

Phosphates in rickets, 568.
in urine, 196.
in urine in osteoporosis, 587.

Phosphorus in rickets, 567.

Phymata, 455.

Phthiriasis, 460.

Phthisis bulbi, 446.

Physical properties of urine, 192.

Pigs, impetigo of, 491.
vesicular irruption in, 490.

Pilous cysts of ovary, 291.

Pimples, 453.

Pinguecula, 375.

Pitchy affection, 491.

Pituitary body, hypertrophy of, 133.

Pityriasis in dog and cat, 503.
in cattle, 503.
in horse, 501.

Pleuritic lesions in rheumatism, 535.

Plumbism, 141.

Podagra, 544.

Poisoning by aniline, 148.
by carbon disulphide, 150.
with cotton seed or cotton seed meal, 381.
by lead, 141.
by “loco”, 135.
by nitro-benzol, 149.

Poliomyelitis, 154.

Polypi of oviduct, 293.

Polyuria, of nervous origin, 8.

Pons, 16.

Prickly heat, 499.

Prolapse of the iris, 390.

Prostate, abscess of, 269.
cancer of, 278.
cysts of, 278.
hyperæmia of, 267.
hypertrophy of, 274.
tuberculosis of, 277.

Prostatic calculus, 278.