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A Case of Epizootic Lymphangitis
CLINICAL ARTICLES.
inserted into the vulva of a yearling ewe at the Royal Veterinary College. Another pledget was introduced within the sheath of a wether, and a third was inserted in the vulva of a cow. An hour afterwards the piece of cotton wool was found to have dropped out of the vulva of the ewe, and the plugs were then removed from the cow and the wether. This procedure had entirely negative results in the ewe and the cow, but on 2nd October the sheath of the wether was found to be slightly swollen around the orifice. On the following day the swelling had increased, and a brownish crust or scab had formed on the skin close to the opening of the sheath. On 4th October the sheath was still more swollen and reddened, and there was a slight discharge from it. It was now impossible to expose the penis. During the following ten days the swelling persisted, while the small sore which made its appearance on 3rd October continued to spread as a red ulcerating surface around the opening of the sheath. On 15th October two small abscesses were found to have formed on the prepuce near the primary sore, and these on the following day had become converted into shallow ulcers. On the 16th a third small abscess had formed. On the 17th all the ulcers had increased in extent, and were covered with brownish crusts. After this date the sores began to heal, and had disappeared in about a fortnight. On 14th October an attempt was made to transmit the disease by means of cotton wool and discharge from this wether to another wether and a ewe, but neither of these animals became infected. An attempt to isolate from the sores an organism capable of inducing the disease also failed, and the experiments thus came to an end. It is scarcely possible that this can be a disease of common occurrence among sheep, as it is not one that can escape notice, and it must long ere this have attracted attention if it had been common. If the circumstances were favourable, the disease is evidently one that might spread indefinitely; but, since it seems to run a comparatively rapid course, and always ends in recovery, a flock infected with it one season would probably have become clean by the following season. There may, however, be exceptions to this rule, the disease being continued from one season to the next, either by a ram or a ewe that has not made a complete recovery. At anyrate, it would appear to be a not altogether needless precaution to see that newly-purchased rams are free from any sign of the disease.
A CASE OF EPIZOOTIC LYMPHANGITIS.
By
J.
M'FADYEAN,
Royal Veterinary College, London.
HISTORY teaches us that great wars have always contributed to the dissemination of disease, both among human beings and among the lower animals, and it is already evident that the recent campaign in South Africa has conformed to this rule. By that agency glanders was spread throughout the whole of the Transvaal and Orange River Colonies, as well as in Cape Colony and Natal. That was only what might have Qeen expected. What was not foreseen was that the
CLINICAL ARTICLES.
transport of horses incidental to the war might also be the means of introducing a new equine disease into Great Britain. That, however, is what appears to have happened, for the disease called" epizootic lymphangitis," hitherto unknown with us, has now obtained a footing in this country. I t has been known for some time that since the close of the late war cases of this disease have been detected among army horses, but, with the exception of the animal figured in the accompanying illustration,
apparently no case of the disease has yet been discovered among horses belonging to private persons. It is scarcely to be hoped, however, that the disease is, with this exception, still confined to horses belonging to the army, and this particular case is here referred to mainly with the object of putting veterinary surgeons in private practice on their guard against the possibility of overlooking others of the same kind. The horse figured here is a roan gelding which was brought by its owner to the College Free CUnique on account of the disease which affected its near hind leg. In the absence of my colleague, Professor Woodruff at the moment, I was asked to look at the animal, and I frankly admit that had my suspicions not been aroused by the fact that the patient was a cast army horse, I should in all probability have diagnosed the case as one of farcy, and detained the animal until it could be tested with mallein, according to the usual practice.
CLINICAL ARTICLES.
The owner stated that in the month of September last he had purchased the animal at a sale of cast army horses, but this statement was not necessary to prove the horse's history, as he had the" broad arrow" branded on the near hind quarter, and had other branded marks on both shoulders. The horse was in poor condition, and his near hind leg was swollen from the foot to the thigh. Between the coronet and the middle of the leg there were several discharging sores, and there was also a considerable raw ulcerating surface immediately above the hoof. The animal was very lame on this leg. An unburst subcutaneous nodule on the inner side of the limb, a little distance above the hock, was at once lanced, and some of the pus thus obtained was submitted to microscopic examination in the unstained state. By this simple means the nature of the disease was placed beyond any doubt, for the pus was found to contain great numbers of the so-called "cryptococcus." Subsequently the horse was tested with mallein, without eliciting the least reaction either as regards temperature or local swelling. I del not propose to discuss fully on the present occasion the differential diagnosis of this disease, and, with regard to the naked-eye appearance of the lesions, I shall only remark that I am quite unable to recognise any macroscopic character of those present in this animal from which 'one could confidently diagnose the case to be not one of ordinary farcy. Fortunately, however, as already indicated, the correct diagnosis is easily assured when a little of the pus or discharge from the lesions is examined microscopically. A magnification of 500 suffices, but one of 1000 is better, and, for reasons that will be apparent immediately, there is little or no advantage in staining the coverglass preparation. The best plan, in fact, is to place a speck of the pus on a glass slide, and apply a cover-glass with gentle pressure. The cryptococci are readily detected owing to their relatively large size, their oval outline, their bright refractile aspect, and their possession of a double-contoured envelope or capsule. The largest organisms measure about 4.u in their longest diameter, and the smallest are little more than half that size. In a preparation made from the pus of a lesion that has not burst spontaneously the majority of the cocci may be contained in the interior of the leucocytes, as many as four or five being present in one cell. The cryptococci cannot be satisfactorily stained by any of the methods in general use for the staining of bacteria. Most of them are colourless even after twenty-four hours' exposure to carbol-fuchsin at ordinary temperatures, and the result is scarcely any better when the temperature of the stain is raised to the boiling point. It Is for this reason that there is little or no advantage in staining films of pus containing the parasites; and, if preparations so treated are afterwards mounted in the customary manner in Canada balsam, the method has a positive disadvantage, inasmuch as the cryptococci are then less refractile, and the double contour of the envelope is less manifest. In a stained preparation, however, the unstained parasites may show up distinctly when included in stained cells, or when the albuminous film in which they lie has retained some of the colour of the stain. It was by taking advantage of this fact that Fig. 2 in Plate IV. was obtained.
CLINICAL ARTICLES.
379
The fact that epizootic lymphangitis has now been introduced into this country shows that it was an unwise procedure to bring back army horses from South Africa, and it was still more unwise to sell such returned horses to private persons. The horse here referred to had no sign of the disease for some weeks after he was bought by his last owner; but, in view of the long period of incubation which the disease is known to have, and the fact that many cases have occurred in the army since the early part of the year, there can hardly be a doubt that the animal was infected at the time of purchase. Some thousands of horses are known to have been spread about the country in this way, and the footing which the disease has thus obtained in Great Britain and Ireland may prove to be permanent.
FIVE CASES OF HODGKIN'S DISEASE IN THE LOWER ANIMALS.
By
J.
M'FADYEAN,
Royal Veterinary College, London.
AT the present time it appears to be impossible to frame a precise definition for the terms Hodgkin's disease, lymphadenoma, and lymphoma, as they are applied in human pathology. The terms appear to be applied almost indifferently to any case in which there is, as a primary lesion, general .or wide-spread enlargement of the lymphatic glands, provided this is not accompanied by a great increase in the number of leucocytes in the circulating blood, and provided no bacteria can be found in the enlarged glands. The first of these 'reservations excludes cases of lymphatic leu cocyth
2B
"Transactions of the Pathological Society of London," VoL LUI. p. 306.
inserted into the vulva of a yearling ewe at the Royal Veterinary College. Another pledget was introduced within the sheath of a wether, and a third was inserted in the vulva of a cow. An hour afterwards the piece of cotton wool was found to have dropped out of the vulva of the ewe, and the plugs were then removed from the cow and the wether. This procedure had entirely negative results in the ewe and the cow, but on 2nd October the sheath of the wether was found to be slightly swollen around the orifice. On the following day the swelling had increased, and a brownish crust or scab had formed on the skin close to the opening of the sheath. On 4th October the sheath was still more swollen and reddened, and there was a slight discharge from it. It was now impossible to expose the penis. During the following ten days the swelling persisted, while the small sore which made its appearance on 3rd October continued to spread as a red ulcerating surface around the opening of the sheath. On 15th October two small abscesses were found to have formed on the prepuce near the primary sore, and these on the following day had become converted into shallow ulcers. On the 16th a third small abscess had formed. On the 17th all the ulcers had increased in extent, and were covered with brownish crusts. After this date the sores began to heal, and had disappeared in about a fortnight. On 14th October an attempt was made to transmit the disease by means of cotton wool and discharge from this wether to another wether and a ewe, but neither of these animals became infected. An attempt to isolate from the sores an organism capable of inducing the disease also failed, and the experiments thus came to an end. It is scarcely possible that this can be a disease of common occurrence among sheep, as it is not one that can escape notice, and it must long ere this have attracted attention if it had been common. If the circumstances were favourable, the disease is evidently one that might spread indefinitely; but, since it seems to run a comparatively rapid course, and always ends in recovery, a flock infected with it one season would probably have become clean by the following season. There may, however, be exceptions to this rule, the disease being continued from one season to the next, either by a ram or a ewe that has not made a complete recovery. At anyrate, it would appear to be a not altogether needless precaution to see that newly-purchased rams are free from any sign of the disease.
A CASE OF EPIZOOTIC LYMPHANGITIS.
By
J.
M'FADYEAN,
Royal Veterinary College, London.
HISTORY teaches us that great wars have always contributed to the dissemination of disease, both among human beings and among the lower animals, and it is already evident that the recent campaign in South Africa has conformed to this rule. By that agency glanders was spread throughout the whole of the Transvaal and Orange River Colonies, as well as in Cape Colony and Natal. That was only what might have Qeen expected. What was not foreseen was that the
CLINICAL ARTICLES.
transport of horses incidental to the war might also be the means of introducing a new equine disease into Great Britain. That, however, is what appears to have happened, for the disease called" epizootic lymphangitis," hitherto unknown with us, has now obtained a footing in this country. I t has been known for some time that since the close of the late war cases of this disease have been detected among army horses, but, with the exception of the animal figured in the accompanying illustration,
apparently no case of the disease has yet been discovered among horses belonging to private persons. It is scarcely to be hoped, however, that the disease is, with this exception, still confined to horses belonging to the army, and this particular case is here referred to mainly with the object of putting veterinary surgeons in private practice on their guard against the possibility of overlooking others of the same kind. The horse figured here is a roan gelding which was brought by its owner to the College Free CUnique on account of the disease which affected its near hind leg. In the absence of my colleague, Professor Woodruff at the moment, I was asked to look at the animal, and I frankly admit that had my suspicions not been aroused by the fact that the patient was a cast army horse, I should in all probability have diagnosed the case as one of farcy, and detained the animal until it could be tested with mallein, according to the usual practice.
CLINICAL ARTICLES.
The owner stated that in the month of September last he had purchased the animal at a sale of cast army horses, but this statement was not necessary to prove the horse's history, as he had the" broad arrow" branded on the near hind quarter, and had other branded marks on both shoulders. The horse was in poor condition, and his near hind leg was swollen from the foot to the thigh. Between the coronet and the middle of the leg there were several discharging sores, and there was also a considerable raw ulcerating surface immediately above the hoof. The animal was very lame on this leg. An unburst subcutaneous nodule on the inner side of the limb, a little distance above the hock, was at once lanced, and some of the pus thus obtained was submitted to microscopic examination in the unstained state. By this simple means the nature of the disease was placed beyond any doubt, for the pus was found to contain great numbers of the so-called "cryptococcus." Subsequently the horse was tested with mallein, without eliciting the least reaction either as regards temperature or local swelling. I del not propose to discuss fully on the present occasion the differential diagnosis of this disease, and, with regard to the naked-eye appearance of the lesions, I shall only remark that I am quite unable to recognise any macroscopic character of those present in this animal from which 'one could confidently diagnose the case to be not one of ordinary farcy. Fortunately, however, as already indicated, the correct diagnosis is easily assured when a little of the pus or discharge from the lesions is examined microscopically. A magnification of 500 suffices, but one of 1000 is better, and, for reasons that will be apparent immediately, there is little or no advantage in staining the coverglass preparation. The best plan, in fact, is to place a speck of the pus on a glass slide, and apply a cover-glass with gentle pressure. The cryptococci are readily detected owing to their relatively large size, their oval outline, their bright refractile aspect, and their possession of a double-contoured envelope or capsule. The largest organisms measure about 4.u in their longest diameter, and the smallest are little more than half that size. In a preparation made from the pus of a lesion that has not burst spontaneously the majority of the cocci may be contained in the interior of the leucocytes, as many as four or five being present in one cell. The cryptococci cannot be satisfactorily stained by any of the methods in general use for the staining of bacteria. Most of them are colourless even after twenty-four hours' exposure to carbol-fuchsin at ordinary temperatures, and the result is scarcely any better when the temperature of the stain is raised to the boiling point. It Is for this reason that there is little or no advantage in staining films of pus containing the parasites; and, if preparations so treated are afterwards mounted in the customary manner in Canada balsam, the method has a positive disadvantage, inasmuch as the cryptococci are then less refractile, and the double contour of the envelope is less manifest. In a stained preparation, however, the unstained parasites may show up distinctly when included in stained cells, or when the albuminous film in which they lie has retained some of the colour of the stain. It was by taking advantage of this fact that Fig. 2 in Plate IV. was obtained.
CLINICAL ARTICLES.
379
The fact that epizootic lymphangitis has now been introduced into this country shows that it was an unwise procedure to bring back army horses from South Africa, and it was still more unwise to sell such returned horses to private persons. The horse here referred to had no sign of the disease for some weeks after he was bought by his last owner; but, in view of the long period of incubation which the disease is known to have, and the fact that many cases have occurred in the army since the early part of the year, there can hardly be a doubt that the animal was infected at the time of purchase. Some thousands of horses are known to have been spread about the country in this way, and the footing which the disease has thus obtained in Great Britain and Ireland may prove to be permanent.
FIVE CASES OF HODGKIN'S DISEASE IN THE LOWER ANIMALS.
By
J.
M'FADYEAN,
Royal Veterinary College, London.
AT the present time it appears to be impossible to frame a precise definition for the terms Hodgkin's disease, lymphadenoma, and lymphoma, as they are applied in human pathology. The terms appear to be applied almost indifferently to any case in which there is, as a primary lesion, general .or wide-spread enlargement of the lymphatic glands, provided this is not accompanied by a great increase in the number of leucocytes in the circulating blood, and provided no bacteria can be found in the enlarged glands. The first of these 'reservations excludes cases of lymphatic leu cocyth
2B
"Transactions of the Pathological Society of London," VoL LUI. p. 306.