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The use of Eserine and Stimulants in the Treatment of Colic
Eserz'ne in the Treatment of Col£c. THE
USE OF ESERINE AND STIMULANTS IN THE TREATMENT OF COLIC. BY G. C. LOWE, M. R.C.V.S., DOCKH&AD, LONDON, E.
SINCE the publication of Mr. H. C. Reeks's admirable treatise, "The Common Colics of the Horse," I have almost invariably adopted the " stimulant treatment " in cases of flatulent colic and in those of impaction of the colon. The rapidity of the patients' recovery has been so gratifying that I have altogether discarded the 'old ''sedative treatment." The following two simple cases, I trust, will serve to support the truth of Mr. Reeks's contention, that in such cases "the medicine administered should be essentially stimulative." CASE I.-" FLATULENT CoLic." On Sunday evening about 7.30 (April gth) an aged black cart-mare (rg years) was found suffering with "colic." She had been in the stable feeding heartily since midday on Saturday. A colic mixture containing ammonia was administered by the horsekeeper soon after 7·30At ro o'clock I was called. I found the large intestines considerably inflated, but not so distended as to call for immediate puncture. Pain was acute, and · the mare had not passed any f::eces since the onset. She was inclined to be violent. Examining per rectum I could not feel any obstruction or displacement. Diagnosing the case as one of intestinal tympany, I administered: eserine sulph. (2 grs.) hypodermically, and spt. ammon. arom. (2! oz.) as a draught (in water) . The mare was allowed to walk round the box and to lie down as often as she pleased, but she was prevented from rolling. Half an hour after the administration of the medicine the mare began to pass 'wind,' and with only very short intervals continued to do so throughout the next hour. I administered a second draught of spt. ammon. arom. (2! oz.) about an hour after the first. At the expiration of an hour and a half from the time of the hypodermic injection soft f::eces began to pass freely. Soon after this all signs of pain disappeared, and the mare looked about for food. CAsE II.-" IMPACTION oF CoLoN." On March 3oth I was called to a grey cart-mare (nine years) that bad been suffering with dull abdominal pain for about 24 hours, had refused food, and had not passed dung during that period. The mare was habitually a greedy feeder, and for the previous two or three days she bad spent most of her time in the stable on full rations. Some colic mixtures containing sulphuric ether bad already been administered by the owner. I found the temperature 102-103° F., and the pulse and respiration slightly accelerated. The mare was restless and lay down frequently, but the pain did not make her violent. Upon rectal examination I felt the large colon full of ingesta and like a doughy mass under my hand, but there was ljttle or no tympany. Peristalsis was not perceptible, and the rectum was almost empty. Diagnosing the case as one of impaction of the large colon, I at
186
The Veterina1y
J ournat.
once injected hypodermically eserine sulph. (2 grs.), and administered in a draught · Spt. ammon. arom. Tinct. nucis vom . .
2~ I
oz.
oz.
· Subsequently, spt. ammon. arom. (2-f oz.) was administered every two hours for a period of eight hours, and tinct. nucis vom. (r oz.) was added to the ammonia twice during that time. In the next 24 hours 2 oz. doses of spt. ammon. arom. were given five times. Within an hour after the injection of eserine the mare became more restless, peristalsis became audible and freces began to pass. The restlessness, however, soon abated, and the mare, though very weak, was relieved of pain,. the temperature becoming normal in a few hours. As soon as the pain disappeared she began to drink oatmeal gruel and eat a little hay. The evacuation of the intestines was very thorough. On the 3rd day (April rst) I gave Quinin. sulpb.
i
dr.
in a ball every eight hours. The freces regained their normal consistence on the fourth day (April 2nd). The mare was out of my hands on the fifth day (April 3rd).
PERITYPHLITIS IN THE DOG . . BY E. H . LIVESEY, M. R.C.V.S., HOVE, SUSSEX.
IN the Journal of Comparative Pathology for March last I reported a case of perityphlitis, which I had only found to be present on post-mortem examination, after treating the dog for typhus (whiCh he also had at the time). Since then I have had three more cases, one of which I think well worth recording. The patient, a half-bred calli~, was 15 years and 3 months old, and had had previous attacks of gastritis (or-perhaps typhus). I first saw him about ro p.m . one night, in violent. pain, whiCh I was informed was from acute rheumatism, and had been diagnosed as such by a medical man who attended at the house. The dog was panting and looking dreadfully uneasy ; he cried out loudly if touched, and even endeavoured to bite, being partially paralysed in the hind legs, and scarcely able to stand. After watching him I noticed that his breathing was almost entirely pectoral and that the belly was drawn up, tense, and painful to the touch. By doubling the dog forwards on my knee I somewhat relaxed the abdominal muscles and examined the bladder, as I feared the presence of a urethral calculus or a cystitis. The bladder was normal. The dog had had no bones to eat for months and I could find no obstruction in the rectum, though the prostate was rather enlarged. In the hypogastric region, however, I could distinctly feel a lump about the size of a pigeon's egg. The situation of this, together with a history of intermittent sickness, the desire for large quantities of water, the intense pain simulating acute peritonitis and the absence of any other apparent cause, led me to diagnose an intestinal obstruction probably at the ileocrecal valve. The temperature
USE OF ESERINE AND STIMULANTS IN THE TREATMENT OF COLIC. BY G. C. LOWE, M. R.C.V.S., DOCKH&AD, LONDON, E.
SINCE the publication of Mr. H. C. Reeks's admirable treatise, "The Common Colics of the Horse," I have almost invariably adopted the " stimulant treatment " in cases of flatulent colic and in those of impaction of the colon. The rapidity of the patients' recovery has been so gratifying that I have altogether discarded the 'old ''sedative treatment." The following two simple cases, I trust, will serve to support the truth of Mr. Reeks's contention, that in such cases "the medicine administered should be essentially stimulative." CASE I.-" FLATULENT CoLic." On Sunday evening about 7.30 (April gth) an aged black cart-mare (rg years) was found suffering with "colic." She had been in the stable feeding heartily since midday on Saturday. A colic mixture containing ammonia was administered by the horsekeeper soon after 7·30At ro o'clock I was called. I found the large intestines considerably inflated, but not so distended as to call for immediate puncture. Pain was acute, and · the mare had not passed any f::eces since the onset. She was inclined to be violent. Examining per rectum I could not feel any obstruction or displacement. Diagnosing the case as one of intestinal tympany, I administered: eserine sulph. (2 grs.) hypodermically, and spt. ammon. arom. (2! oz.) as a draught (in water) . The mare was allowed to walk round the box and to lie down as often as she pleased, but she was prevented from rolling. Half an hour after the administration of the medicine the mare began to pass 'wind,' and with only very short intervals continued to do so throughout the next hour. I administered a second draught of spt. ammon. arom. (2! oz.) about an hour after the first. At the expiration of an hour and a half from the time of the hypodermic injection soft f::eces began to pass freely. Soon after this all signs of pain disappeared, and the mare looked about for food. CAsE II.-" IMPACTION oF CoLoN." On March 3oth I was called to a grey cart-mare (nine years) that bad been suffering with dull abdominal pain for about 24 hours, had refused food, and had not passed dung during that period. The mare was habitually a greedy feeder, and for the previous two or three days she bad spent most of her time in the stable on full rations. Some colic mixtures containing sulphuric ether bad already been administered by the owner. I found the temperature 102-103° F., and the pulse and respiration slightly accelerated. The mare was restless and lay down frequently, but the pain did not make her violent. Upon rectal examination I felt the large colon full of ingesta and like a doughy mass under my hand, but there was ljttle or no tympany. Peristalsis was not perceptible, and the rectum was almost empty. Diagnosing the case as one of impaction of the large colon, I at
186
The Veterina1y
J ournat.
once injected hypodermically eserine sulph. (2 grs.), and administered in a draught · Spt. ammon. arom. Tinct. nucis vom . .
2~ I
oz.
oz.
· Subsequently, spt. ammon. arom. (2-f oz.) was administered every two hours for a period of eight hours, and tinct. nucis vom. (r oz.) was added to the ammonia twice during that time. In the next 24 hours 2 oz. doses of spt. ammon. arom. were given five times. Within an hour after the injection of eserine the mare became more restless, peristalsis became audible and freces began to pass. The restlessness, however, soon abated, and the mare, though very weak, was relieved of pain,. the temperature becoming normal in a few hours. As soon as the pain disappeared she began to drink oatmeal gruel and eat a little hay. The evacuation of the intestines was very thorough. On the 3rd day (April rst) I gave Quinin. sulpb.
i
dr.
in a ball every eight hours. The freces regained their normal consistence on the fourth day (April 2nd). The mare was out of my hands on the fifth day (April 3rd).
PERITYPHLITIS IN THE DOG . . BY E. H . LIVESEY, M. R.C.V.S., HOVE, SUSSEX.
IN the Journal of Comparative Pathology for March last I reported a case of perityphlitis, which I had only found to be present on post-mortem examination, after treating the dog for typhus (whiCh he also had at the time). Since then I have had three more cases, one of which I think well worth recording. The patient, a half-bred calli~, was 15 years and 3 months old, and had had previous attacks of gastritis (or-perhaps typhus). I first saw him about ro p.m . one night, in violent. pain, whiCh I was informed was from acute rheumatism, and had been diagnosed as such by a medical man who attended at the house. The dog was panting and looking dreadfully uneasy ; he cried out loudly if touched, and even endeavoured to bite, being partially paralysed in the hind legs, and scarcely able to stand. After watching him I noticed that his breathing was almost entirely pectoral and that the belly was drawn up, tense, and painful to the touch. By doubling the dog forwards on my knee I somewhat relaxed the abdominal muscles and examined the bladder, as I feared the presence of a urethral calculus or a cystitis. The bladder was normal. The dog had had no bones to eat for months and I could find no obstruction in the rectum, though the prostate was rather enlarged. In the hypogastric region, however, I could distinctly feel a lump about the size of a pigeon's egg. The situation of this, together with a history of intermittent sickness, the desire for large quantities of water, the intense pain simulating acute peritonitis and the absence of any other apparent cause, led me to diagnose an intestinal obstruction probably at the ileocrecal valve. The temperature