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Chronic Stringhalt in the Horse
ABSTRACTS AND REPORTS.
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From the above it appears clear that bovine animals can experimentally be inoculated with glanders, and that the symptoms closely resemble those found under natural conditions, of infection in the horse. The authors cannot precisely indicate the method of overcoming the great resistance of these animals to natural and experimental infection, but think that in the above cases it was due partly to the preliminary treatment with dead glanders bacilli, and partly to the virulence of the living bacilli employed. They I.JUrpose continuing their experiments and publishing their histological researches regarding the lesions of the above cow. (Riegler and Ciuca, Arhiva Veterinara, May 19 0 5, p. 53.)
CHRONIC STRINGHALT IN THE HORSE. BASSI has long studied stringhalt with the object of discovering some method of surgical treatment. As a result of this study of the question he lays down the following principles :(I.) In horses and oxen one form of chronic stringhalt results from sudden displacement of the patella over the internal margin of the trochlea, beyond its normal limits of travel. This displacement of the patella is essentially the same as that involved in cramp, but differs from it as regards duration. It may be distinguished from others by the peculiar cracking sound produced by the patella, a sound which can be heard at all the paces at which stringhalt is shown; by the method in which the limb is moved, and by the fact that it is always completely cura ble by division of the internal tibio-patellar ligament. This form of stringhalt cannot occur in the other domestic animals, because in them two essential anatomical conditions are absent, viz, the presence of three tibio-patellar ligaments and the existence of a sort of inclined plane or saddle above the origin of the internal margin of the femoral trochlea. (2) In solipeds a second form of chronic stringhalt, due to the development of dry chronic arthritis of the hock, is very common. This form is not characterised by cracking during movement of the patella, but can be distinguished both by the gait attaching to it and by the peculiar way in which the hock and fetlock are flexed while carrying weight, and also by the manner in which the foot is brought to the ground. In this second form of stringhalt, division of tendons, aponeuroses, and ligaments has no effect, because the change in movement is of reflex origin. (3.) Occasionally and rarely a third form of chronic stringhalt, described by H ertwig, is seen. I t is due to contraction of the tensor muscle of the fascia lata. Bassi ha<; shown by two examples that it can be cured by dividing the contracted muscle. (4.) Certain forms of chronic stringhalt might be described as of nervous origin, depending as they do on diseases or lesions of the brain and spinal cord. They are seen both in horses and in dogs. These forms are usually associated with chronic, rheumatismal, or traumatic lumbago (which may in reality be a form of chronic myelitis), or again, they may form a part of the symptoms of locomotor ataxia, the existence of which. in the horse, points to chorea. In these forms of stringhalt bOlh hind limbs exhibit the disease. The disease is not accompanied hy cracking of the patella, and is not removed by myotomy or by tenotomy. There is no doubt that in many cases of chronic stringhalt in horses
126
ABSTRACTS AND REPORTS.
complete cure or great improvement follows section of the peroneus muscle, but it is also true that it often fails. These differences in result are usually explicable on the basis of the varying causes of stringhalt above indicated. Professor Dieckerhoff was of opinion that in the horse the determining cause of one form of stringhalt, termed by him idiopathic stringhalt, resulted from irritation followed by contraction and shortening of the aponeurosis of the thigh, and more particularly of that portion which descends along the anterior portion of the thigh and hock, and unites over the metatarsus with the tendon of the extensor pedis. In this belief he invented and practised an operation which consisted in dividing a portion of the aponeurosis opposite the hock. The opel ation may be performed alone, or if unsuccessful may be followed by tenotomy of the peroneus muscle. Further experience shows that unless followed by Boccar's, Dieckerhoff'~ operation is unsuccessful, and therefore it seems questionable whether the favourable result ought not to be attributed to the first rather than to the second operation. Bassi finally remarks that in horses six forms of chronic stringhalt may be detected, some curable and others incurable, and that it is desirable that the clinical forms be better studied. He abstains from considering those forms of stringhalt which sometimes accompany certain acute or chronic inflammatory diseases, particularly those which originate in the feet. The latter are perfectly well understood. (Bassi, Rezl• Gen. de Mfd. Vet. 1st Jan. 1906, p.6.)
THE INTESTINAL ORIGIN OF PULMONARY TUBERCULOSIS. VON BEHRING has recently stated on several occasions (Congress at Cassel, September 1903, and Berlin Society of Internal Medicine, 4th February 1904) that tuberculosis of adults is not brought about through the medium of the respiratory tract but is almost always a result of intestinal infection contracted during youth, and is of slow development. Calmette and Guerin have for some years been studying this question of the origin of pulmonary tuberculosis, using goats as the chief subjects of experiment. The udders of she-goats were artificially inoculated with tuberculosis by injecting into the gland, through the medium of a milk catheter (and without injuring the tissue), cultures of tubercle bacilli obtained from different sources. Young goats suckled by these foster mothers always contracted tuberculosis through the intestine. When bovine bacilli were used the young animals showed disease of the mesenteric glands with caseated tubercles, and more or less marked pulmonary lesions, which ultimately extended to the mediastinal and peribronchial glands. The retro·pharyngeal glands always proved healthy. When the udder of the mother was infected with human bacilli the mesenteric glands alone were attacked and the lungs escaped The same results followed when avain bacilli were used for infecting the udder or when the bacillus employed was that of pseudo-tuberculosis (Timothy bacillus of Moller). Young sheep, fed at successive long intervals with small quantities ('05 centigramme) of the bacilli of human or avian tuberculosis or pseudo-tuberculosis, by means of an cesophageal sound, showed no resistance to later infection with bovine bacilli introduced in similar doses into the digestive tract. The authors, using an cesophageal sound, introduced into the stomachs of two, three, or five-year-old goats, doses of '05 of fresh bovine tubercle bacilli,
12 5
From the above it appears clear that bovine animals can experimentally be inoculated with glanders, and that the symptoms closely resemble those found under natural conditions, of infection in the horse. The authors cannot precisely indicate the method of overcoming the great resistance of these animals to natural and experimental infection, but think that in the above cases it was due partly to the preliminary treatment with dead glanders bacilli, and partly to the virulence of the living bacilli employed. They I.JUrpose continuing their experiments and publishing their histological researches regarding the lesions of the above cow. (Riegler and Ciuca, Arhiva Veterinara, May 19 0 5, p. 53.)
CHRONIC STRINGHALT IN THE HORSE. BASSI has long studied stringhalt with the object of discovering some method of surgical treatment. As a result of this study of the question he lays down the following principles :(I.) In horses and oxen one form of chronic stringhalt results from sudden displacement of the patella over the internal margin of the trochlea, beyond its normal limits of travel. This displacement of the patella is essentially the same as that involved in cramp, but differs from it as regards duration. It may be distinguished from others by the peculiar cracking sound produced by the patella, a sound which can be heard at all the paces at which stringhalt is shown; by the method in which the limb is moved, and by the fact that it is always completely cura ble by division of the internal tibio-patellar ligament. This form of stringhalt cannot occur in the other domestic animals, because in them two essential anatomical conditions are absent, viz, the presence of three tibio-patellar ligaments and the existence of a sort of inclined plane or saddle above the origin of the internal margin of the femoral trochlea. (2) In solipeds a second form of chronic stringhalt, due to the development of dry chronic arthritis of the hock, is very common. This form is not characterised by cracking during movement of the patella, but can be distinguished both by the gait attaching to it and by the peculiar way in which the hock and fetlock are flexed while carrying weight, and also by the manner in which the foot is brought to the ground. In this second form of stringhalt, division of tendons, aponeuroses, and ligaments has no effect, because the change in movement is of reflex origin. (3.) Occasionally and rarely a third form of chronic stringhalt, described by H ertwig, is seen. I t is due to contraction of the tensor muscle of the fascia lata. Bassi ha<; shown by two examples that it can be cured by dividing the contracted muscle. (4.) Certain forms of chronic stringhalt might be described as of nervous origin, depending as they do on diseases or lesions of the brain and spinal cord. They are seen both in horses and in dogs. These forms are usually associated with chronic, rheumatismal, or traumatic lumbago (which may in reality be a form of chronic myelitis), or again, they may form a part of the symptoms of locomotor ataxia, the existence of which. in the horse, points to chorea. In these forms of stringhalt bOlh hind limbs exhibit the disease. The disease is not accompanied hy cracking of the patella, and is not removed by myotomy or by tenotomy. There is no doubt that in many cases of chronic stringhalt in horses
126
ABSTRACTS AND REPORTS.
complete cure or great improvement follows section of the peroneus muscle, but it is also true that it often fails. These differences in result are usually explicable on the basis of the varying causes of stringhalt above indicated. Professor Dieckerhoff was of opinion that in the horse the determining cause of one form of stringhalt, termed by him idiopathic stringhalt, resulted from irritation followed by contraction and shortening of the aponeurosis of the thigh, and more particularly of that portion which descends along the anterior portion of the thigh and hock, and unites over the metatarsus with the tendon of the extensor pedis. In this belief he invented and practised an operation which consisted in dividing a portion of the aponeurosis opposite the hock. The opel ation may be performed alone, or if unsuccessful may be followed by tenotomy of the peroneus muscle. Further experience shows that unless followed by Boccar's, Dieckerhoff'~ operation is unsuccessful, and therefore it seems questionable whether the favourable result ought not to be attributed to the first rather than to the second operation. Bassi finally remarks that in horses six forms of chronic stringhalt may be detected, some curable and others incurable, and that it is desirable that the clinical forms be better studied. He abstains from considering those forms of stringhalt which sometimes accompany certain acute or chronic inflammatory diseases, particularly those which originate in the feet. The latter are perfectly well understood. (Bassi, Rezl• Gen. de Mfd. Vet. 1st Jan. 1906, p.6.)
THE INTESTINAL ORIGIN OF PULMONARY TUBERCULOSIS. VON BEHRING has recently stated on several occasions (Congress at Cassel, September 1903, and Berlin Society of Internal Medicine, 4th February 1904) that tuberculosis of adults is not brought about through the medium of the respiratory tract but is almost always a result of intestinal infection contracted during youth, and is of slow development. Calmette and Guerin have for some years been studying this question of the origin of pulmonary tuberculosis, using goats as the chief subjects of experiment. The udders of she-goats were artificially inoculated with tuberculosis by injecting into the gland, through the medium of a milk catheter (and without injuring the tissue), cultures of tubercle bacilli obtained from different sources. Young goats suckled by these foster mothers always contracted tuberculosis through the intestine. When bovine bacilli were used the young animals showed disease of the mesenteric glands with caseated tubercles, and more or less marked pulmonary lesions, which ultimately extended to the mediastinal and peribronchial glands. The retro·pharyngeal glands always proved healthy. When the udder of the mother was infected with human bacilli the mesenteric glands alone were attacked and the lungs escaped The same results followed when avain bacilli were used for infecting the udder or when the bacillus employed was that of pseudo-tuberculosis (Timothy bacillus of Moller). Young sheep, fed at successive long intervals with small quantities ('05 centigramme) of the bacilli of human or avian tuberculosis or pseudo-tuberculosis, by means of an cesophageal sound, showed no resistance to later infection with bovine bacilli introduced in similar doses into the digestive tract. The authors, using an cesophageal sound, introduced into the stomachs of two, three, or five-year-old goats, doses of '05 of fresh bovine tubercle bacilli,