Epizootic lymphangitis of the nasal cavities in the horse

ABe>TRACTS A:"ID REPORT.

abscess caused by a needle (one case); multiple suppurative peritomtIs following suppurative metritis (one case); weakness of the heart (three cases); interstitial emphysema of the lung (one case); multiple necrosis of the liver, spleen, and lung (one case); in forty-two cases the paralysis of the rumen was due to a foreign body passing forwards from one of the stomachs (usually the reticulum). (3.) Acute Tympanites.- Twenty-one cases were observed, about equally distributed between the spring and autumn. The cause was usually feedmg on clover or cabbage leaves. Tympanites due to clover feeding seems the more dangerous, as the mixture of gases and masticated clover seems very intimate and the ga~es have great difficulty in escaping. Treatment consists in placing the animal with the hind quarters lower than the fore, massaging the flank region, exciting mastication by placing a straw rope in the mouth, and giving equal parts of dilute hydrochloric acid and spirits of wine in doses of a dessertspoonful every half-hour. Eber thinks very little of the "gas-absorbing" drugs. He considers It needless to pass the probang, provided the front quarters are placed sufficiently high. In Switzerland the usual treatment for tympanites is to drive the ox up a steep slope; it usually is cured by the time it reaches the top. Eber condemns the indiscriminate practice of puncture of the rumen. He considers it indicated when the animal cannot rise and is in danger of asphyxia. If the .cesophagus is blocked by a fragment of carrot, etc., the probang should be passed. Should this fail, the obstruction can be left to the softening and Ilubricating action of the saliva, whilst the dangers of tympanites can be neutralised by puncture of the rumen. (4.) Chronic Tympanites.-The cause of permanent dilatation of the rumen is usually to be found in tuberculous hyperplasia of the mediastinal lymph glands, leading to partial compression of the cesophagus. In one case ·examined post-mortem by Eber the medlastitlal glands were enlarged as a -consequence of leucremia. (Eber, Zeitsc/lr. f Tie rill. , X. Jahrgang, 5 and 6 Heft.; ex. Deuts. Tierdrztl. TVocltens, 1906, p. 669.)

EPIZOOTIC LYMPHANGITIS OF THE NASAL CAVITIES IN THE HORSE. N OCARD has reported a case of invasion of the pituitary membrane of the horse by the cryptococcus equi, and Gotti and Brazzola another of blastomycosis of the nasal chambers in the same animal. Nocard's description especially closely resembles that of the lesions of glanders of tre nostril. It is certain that the cryptococcus very rarely attacks the pituitary membrane; but it is more commonly found in the conjunctiva. From a clinical and sanitary point of view descriptions of cases in which -epizootic lymphangitis and glanders may be confused are interesting. From the infirmary of a regiment of artillery at Pisa Dr Marcone received the head of a horse killed on account of serious lesions of the respiratory passages, which lesions had rapidly extended to both nasal fossre. The left side of the face presented a nodulated cord stretching from near the left nostril to the posterior extremity of the zygomatic ridge. Both submaxillary glands were symmetrically enlarged, hard, and bosselated. Only about the nose and face did the skin present any lesion suggesting glanders. The wings of the nostril, particularly of the left, were much thickened and indurated. The skin was covered with crusts, beneath which were little follicular points, each containing a drop of thick pus which could be squeezed -out by pressure. The skin around the entrance to the nostril and the adjacent mucous

68

ABSTRACTS AND REPORT.

membrane was thickened, rough, dotted over with innumerable depressions and elevations, varying in size between the head of a pin and that of a grain of hemp, covered with a thick greyish-brown, adherent exudate, here and there mixed with blood. The tissues were so thickened that the opening of the false nostril was partly effaced, and every trace of the inferior opening of the lachrymal canal had disappeared. The two nasal foss~ having been opened by lateral incisions, the mucous membrane was seen to have undergone profound changes. The inferior turbinated bone was greatly enlarged, the mucous membrane was roughened, and here and there showed depressions the size of a lentil. Beyond the turbinated bone was a little excavated ulcer penetrating the mucous membrane and the subjacent tissues. The margins of this ulcer projected above the level of the neighbouring mucous membrane, forming a corded edge of a purplish-red colour. The edges themselves presented little irregularities and were undermined, like those of a superficial abscess. (In abscesses this result is due to the destructive influence of the pus on the central portion of the tissue covering the part.) The base of the ulcer was covered with pultaceous material of a purplish-red tint. Except for its size, this lesion resembled aU the others. The mucous membrane surrounding the isolated ulcers was bluish in colour, as was the remainder of the mucous membrane throughoutt the nasal chambers. The ulcers exhibited no inflammatory reaction zone. All along the free margin of the turbinated bone the mucous membrane was covered with numerous miliary nodules, round, elliptical, or linear in form, and whitish-yellow in colour, contrasting strongly with the bluish tint of the membrane itself. They projected beyond the surrounding tissues and almost all exhibited a deeper-coloured, umbilicated centre. Where these nodules were confluent the turbinated bone was thickened and presented elevations and depressions, while the mucous membrane had entirely disappeared. At other points the mucous membrane covering the turbinated bone had undergone marked change. Similar lesions had occurred on the other turbinated bones, and on both sides of the septum nasi. The portions of the mucous membrane lining the incurved surfaces of the turbinated bones and the space comprised between the turbinated bones themselves showed no miliary nodules or depressions, but were covered with tumours. Altogether about a dozen of various sizes were remarked, some being united to form bosselated new growths. Those which were able to develop freely, and which were not of very large size, were rounded; other and smaller growths were almost spherical. Three, characterised by their peculiar form and colour, were situated at the external extremity of the right inferior turbinated bone and projected into the cavity. Almost all the swellings possessed a short, broad pedicle. Between the turbinated bones they were cylindrical in shape. Across the antrum the new growth on the left side had invaded the maxillary tissue, where it had developed to such a degree as to destroy the mucous membrane and bone and attack the alveoli of the teeth, which, opposite the third and fourth molars, were reduced merely to periosteum. One swelling, almost as large as a pigeon's egg, was situated near the centre of the nasal septum, which was perforated over a space as large as a halfpenny_ On either side of the septum at this point was a large polypus, the pedicle of which traversed the perforation. The mucous membrane, though still intact. was bluish or of a dark red colour. The new growths were yellowish-red in colour, contained numerous vessels, of small size, and were soft, flabby, and myxomatous in appearance. The cut surface was marbled and divided by reddish, grey, or yellow septa. The growths varied in size between a split pea and a fowl's egg. ' High up on the nasal septum were flattened nodules as large as a lentil or even a haricot bean, whitish-yellow in colour, sometimes with an arborescent

"\H~TRACTS

AND REPORT.

surface. They resembled little submucc>Us abscesses, and were formed of a delIcate succulent framework, yielding, when scraped, a whitish-yellow material streaked with blood. The exudate found in the nasal chambers, the scrapings from the diseased membrane, the nodules both large and small, the mass of the large polypi, and all forms of the lesions yielded myriads of cryptococci. Both the large and small growths contained nests of cryptococci in a state of pure culture, surrounded and supported by thin delicate fibrils. The case shows the possibility of primary epizootic lymphangitis of the nasal foss:e and of the sinuses. The skin showed no disease. The cord on the face was secondary to the nasal affection, the lymphatic vessels of the nose emptying into the lymph glands of the pharynx, neck, etc. Tokishige thinks that the localisations on the lips and around the nostrils are secondary, the horse infecting these parts by biting the affected portions of the skin. This may certainly be one method of inoculation, but it was not the method in the above case. Proof of the possibility of primary infection of the mucous membrane by cryptococci is afforded by cases of epizootic lymphangitis of the conjunctival membrane, especially of the membrana nictitans, which occur frequently. Specific proof is given by the case described. Primary epizootic lymphangitis of the nasal foss
ADS'! RACTS AND REPOR1.

idea of glanders, which never produces tumour growths on the mucous membranes. The presence of cryptococci is easily demonstrated in the dischargE', and, better still, in the exudate from the wounds. Failing a microscopic examination, one might try diagnostic inqculations. In this case, however, auto-inoculation is useless, and experimental animals must be used. The rewlts require very careful interpretation. Organisms accidentally present with the cryptococci sometimes give rise to the formation of abscesses, which might be attributed to glanders. Did the dog react with greater constancy to glanders it might be used with advantage, since Tokishige declares that it is refractory to the cryptococcus. It is unnecessary, however, to dwell on experimental inoculation, because the ascertained facts so far as the cryptococcus is concerned are so few, and further study of the question is necessary. In all cases proved to be due to cryptococci Professor Oreste of the Naples school has had negative results trom the mallein test. (Marcone, Rev. Gen. de .lI1Cd. Vet., 19°7, p. 249.)

A

CLINICAL AND EXPERIMENTAL RESEARCH ON PERNICIOUS ANJEMIA OF THE HORSE. (INFECTIOUS TYPHO-ANJEMIA.)

CARRE and Vallee have been grtatly struck by the close similarity of the symptoms shown by horses affected with the abdominal form of influenza (jieore tiphoide) and those suffering from the acute forms of typho-anremia_ They declare their inability, clinically, to differentiate between the abdominal forms of influenza without visceral lesions or with a predominance of gastrointestinal symptoms, and infectious, rapidly progressive, typho-amemia. Besides, such of their colleagues as have seen patients suffering from the severe form of typho-anremia experimentally produced by inoculation with blood from patients coming either from La Meuse or from La Marne, have always diagnosed the cases as typical influenza of the abdominal variety. Many veterinary surgeons in the infected districts describe the grave forms of typho-anremia under the names of "influenza," "infectious influenza," etc., and, as has been remarked, a similar mistake has been made by even so distinguished an experimenter as M. Lignieres, who classifies progressive pernicious anremia as a chronic form of his equine pasteurellosis. Carre and Vallee, however, are absolutely opposed to this idea, and believe the two diseases entirely distinct. Published cases which suggest that the abdominal type of influenza in the horse cannot be inoculated are, in their opinion, of no value, and cannot be used as arguments against the positive results obtained by Dieckerhoff. Arloing, who denies the inoculability of this disease, always used very small doses of blood containing various microbes, only kept his experimental animals for six to ten days, and even destroyed one which on the fifth day showed very marked fever. The study of influenza in the horse must be approached anew on the basis of inoculating fresh horses with blood from cases of the disease, and under the conditions mentioned hereafter. Only in this way can the group of diseases known as influenza be satisfactorily investigated. Nature of the Virus. Bacteriological Study.-In their search for the virus the experimenters directed their attention especially to the blood. The first interesting point to be discovered was that the quantity of blood inoculated appears to have no appreciable effect on the course of the disease. Injected intravenously, large doses of 75°,3°°, 250, and 200 cc. of defibrinated blood or of serum from diseased animals gave no better results than later inoculations