CHRONIC ECZEMA OF THE CARPUS AND TARSUS; MALANDERS: SALLENDERS.
Eruption in bends of carpus and tarsus and downward: Causes: lymphatic temperament, constitutional predisposition, deranged internal organs, excessive secretions, modified, congested skin, friction between dermal folds. Symptoms: stiffness, heat, thickening and redness, vesicles or oozing, crusts, erect hairs, shedding hair, squamæ, cracks, abrasions, fissures, subcutaneous engorgement, lymphangiectasis. Treatment: Cleanse, get pure air, regular exercise, non-stimulating food, avoid cold water, mud, slush, caustic soap, lime, sharp sand, foul organic matter. Massage. Light bandages. Bland ointments. Dusting powders. Rest. Iodoform. Starch. Zinc oxide. Boric acid. Magnesia. Bismuth. Lycopodion. Lead. Tannin. Pyoktannin. Stimulating ointments. Green soap. Arsenic.
The bends of the carpus and tarsus in heavy, lymphatic, coarse skinned horses are especially subject to eczema followed by a dense scabby eruption, which in the old farrier’s nomenclature was known as malanders in the fore limb and sallenders in the hind. It is not always confined to the joints but may extend down the limb, especially on the back, where the hair is coarser and the skin thicker, as far as the fetlock or even to the hoof.
In the matter of causation much depends on the general constitutional state which tends to eczema, and on the torpor or derangement of some of the internal organs the functions of which are interdependent with those of the skin. Something too must be attributed to the freer secretions of these parts in coarse bred horses, to the accumulation of such secretions and of extraneous irritants under the long hair, to the sluggishness of the circulation in the limbs which has to overcome the force of gravitation, and to friction between the thick folds of skin in flexion, and stretching in extension. Swelling of the lower limbs is at once a cause and an effect of the disease.
Symptoms. At the outset the animal may be seen to move rather stiffly, and the skin is found to be hot, thickened and if white reddened. Soon a close observation may detect the eruption of vesicles, or simply an oozing of a yellowish or bloody serum which concretes around the hairs forming an encrusted covering for the part, holding the hairs erect and bristly, and even lifting them out of their follicles. Cracks also appear in the depth of the fold, leading to a more abundant exudate, and the disease may extend around the whole surface of the limb.
In the more acute cases this may be followed by more or less depilation, dessication and recovery, but too often the condition becomes chronic, the thickened, encrusted or squamous skin continues to exude, crack and cover itself with crusts, under which the decomposing liquids macerate and irritate the exposed cuticle, and engorgment of the whole limb with hyperplasia of the connective tissue and lymphatic plexus and vessels is the result. This hyperplasia of the skin and connective tissue (elephantiasis) is also a common result of lymphangitis.
Treatment. As in other skin affections attention must first be given to removal of the causes. Ensure cleanliness, pure air, regular exercise, non-stimulating food, the avoidance of cold water, melting snow, soapy washes and all other sources of irritation. Deep mud, especially if charged with lime, sharp sand, decomposing organic matter or other irritant, is particularly offensive.
Hand-rubbing (massage) of the limbs and evenly applied light bandages are often of the greatest value in dispersing or obviating swelling.
The slighter attacks may be met at the outset by bland ointments or dusting powders and rest from all but necessary exercise. Dressing with iodoform may bring about a recovery in a few days. Starch and oxide of zinc, boric acid, magnesia carbonate, bismuth or lycopodion may give good service. Lotions of lead acetate, tannin, iron sulphate, alum, potassium permanganate or pyoktannin may be used as in other forms of eczema. In obstinate cases green soap followed by stimulating ointments or liniments, tar, oil of white birch, Canada balsam, turpentine and glycerine, oil of cade, etc., will often serve an excellent purpose. In these advanced cases an alterative such as arsenic may be employed.
ECZEMA OF ALIMENTARY ORIGIN IN CATTLE.
STARVATION MANGE. STALK DISEASE. MALT ECZEMA. POTATO ECZEMA.
In low condition: erythema, hæmorrhagic extravasations, or vesicles on tail, lips, fore legs, udder. Trombidium holosericeum. Malt or potato eczema: marc eczema on legs and body. Causes: feeding on marc only, skins, green potatoes, fermenting. Attack in ratio with marc eaten. Worst on new stock, and feeding cattle. Calves have diarrhœa, children eruption. Bean trefoil and milk sickness act similarly. Solanin. Unaffected by boiling. Season. Field. Chlorophyl. Narcosis absent. Is brain adaptable? Other ingredients inoperative. Eczema ceases with change of food: is not inoculable. Symptoms: fever, costiveness, inappetence, red mucosæ, weeping, stringy salivation, debility, emaciation, black diarrhœa. May lie with extended head, grinding teeth, tympany, lethargy, coma. Pig and dog vomit. Abortion. Redness, swelling, stiffness on pasterns: may extend to whole body: exudations: thick crusts: erect or shed hairs: rigid thickened, folded, cracked skin, buccal mucosa may suffer: abscess, sloughs. Mortality slight and up to 20 per cent. Lesions: congestions of small intestine, brain and muscle. Treatment: stop or lessen the marc adding grain: turn to pasture: locally bathe, cold or tepid: lead lotions: dusting powders: tannin: blue stone: creolin: cresol: tar or birch oil: carbolic acid.
The skin of cattle seems to suffer more than that of other animals in connection with the ingestion of poisons. In starved or very low conditioned animals, eruptions are met with which may be in the form of a simple erythema, a hæmorrhagic extravasation in spots, or an eruption on the end of the tail in the form of epidermic concretions or pustules (impetigo). Among the vineyards it is common to find an eruption with papules and vesicles on the lips, fore legs and udder of cows which were fed on the succulent young shoots and leaves of the grape vine. In cases of this disease, Railliet and Moreau have found a great number of the silky trombidium larvæ (harvest bug), and accordingly attribute the affection exclusively to their attacks. The growth of the vine on the warmest and sunniest exposures, the most favorable to the propagation of this acarus, gives much support to this conclusion.
Malt or Potato Eczema. On the continent of Europe where potatoes are largely used for distillation and the production of starch, herds of cattle are fed often almost exclusively on the refuse or marc, and in such herds an eczematous eruption of the legs and exceptionally of the body is a familiar occurrence.
Causes. The disease has been definitely traced to an exclusive dietary on potato marc, and still more so to the skins, to tubers rendered green by exposure to the sun, and to the distillery potato refuse which has undergone fermentation. Thus 80 litres of the pulp daily without dry food will determine a violent attack in the animal consuming it, while the animal consuming 40 litres has it much milder (Friedberger and Fröhner). It attacks animals living in the best conditions of cleanliness and pure air, and the essentially toxic quality of the cause may be deduced from the fact that newly bought animals, which are not yet habituated to it suffer the most, that fattening cattle are the common victims, while work oxen which perspire more freely and milch cows escape, yet calves fed upon their milk may suffer from diarrhœa and infants from a cutaneous eruption (Johné). The poison it is to be inferred is eliminated in the milk. Similar examples of the protecting of the milch animal by elimination of the poison through the milk are found in bean trefoil (cytisus) which poisons the milk while proving harmless to the goat which yields it, and the poison of milk sickness which is deadly to cattle which are not giving milk, and harmless to the milch cow, yet deadly to those that consume her milk.
The exact nature of the poison is as yet uncertain, and as solanin is the only toxic principle so far discovered in potato, this has been held tentatively to be the essential cause. The amount of solanin in young and germinated potatoes has been given by Cornevin as follows:
| Germinated tubers | Young tubers. | |
|---|---|---|
| The entire tuber contains | 0.21 | 0.16 |
| The central fleshy part | 0.16 | 0.12 |
| The parings and pickings | 0.24 | 0.18 |
The toxic strength of the marc is not impaired by boiling, cooking or other culinary treatment, and the same is true of solanin. The toxicity is greatest after the potato has been subjected to germination, or when it has become green by exposure to the sun, and in these conditions the solanin is increased. The toxicity of the marc is higher in certain years, and in the product of certain fields, than in others, and this is in keeping with the effect of environment in modifying the products of a plant. The increased production of chlorophyl under the action of sunlight is associated with a material increase of the amount of solanin. Until therefore another toxic product can be shown to be the essential cause of this affection the solanin must be charged with this result. This conclusion would be more inviolable if the animals attacked showed other symptoms of solanin poisoning such as narcotism, vertigo, stupor and paralysis, and the absence of these may perhaps be due to the gradual advance of the toxic action, and the progressive immunizing of the animal system. The brain may be able to accommodate itself more readily than the skin.
The other constituents of the potato or of the marc fail to produce the eruption under other conditions: the alcohol in brewers and distillers’ grains, the acetic, lactic and butyric acids in the refuse of starch, beet sugar and canning factories, the potash in turnips and other roots, the yeast ferment in brewers’ grains. The acarus of foot mange (symbiotis bovis) is rarely present in the affected animal though the eruption in the same situation would strongly suggest its presence and lead to a search for it. Moreover the eczema appears at once in a large number of animals, affecting a large area without evidence of slow and steady progression and disappears with equal rapidity in many cases when the diet is changed. Finally the eczema has not been successfully propagated by inoculation which conveys mange infallibly from animal to animal.
Symptoms. The disease is associated with slight fever, costiveness, impaired appetite, hyperæmia of the mucosæ, epiphora, viscous salivation, muscular weakness, and finally emaciation and black diarrhœa. The gravity of these symptoms varies, being greater when the animals have eaten the leaves and stems, the raw potatoes in their skins, the young shoots and parings, or green potatoes which have been sunned. The animals may lie most of their time stretching themselves out with head extended on the ground, they may grind the teeth, may have pulse small and rapid, tympany, lethargy, coma and even paraplegia but these severe symptoms are exceptional and almost altogether confined to the cattle of distilleries which receive an exclusive diet of potato marc. In the pig and dog vomiting has been noticed (Cornevin). Pregnant animals may abort.
The local symptoms begin with redness and swelling of the skin around the pasterns, especially of the hind limbs, stiffness and a disposition to lie most of the time; then small flattened vesicles appear, isolated or confluent, which bursting, form extended, raw patches the abundant exudations of which concrete into thick crusts. The hairs stand erect and are abnormally thick at their roots. The eruption may extend to the whole limb, the scrotum, mamma, tail and body at large, so that in severe cases it is practically universal. The skin becomes thick, rigid, hide bound, wrinkled and folded with intervening cracks. As a rule, however, the eruption is confined to the limbs, scrotum, mammæ and tail. In some extensive and persistent cases the buccal mucosa suffers, particularly on the pad on the upper jaw, which shows extensive and irregular ulcers with purulent centre and swollen, congested margin. Abscesses may develop in the skin and subcutem and sloughing of the integument is not unknown.
Mortality is slight as a change of food is usually made and a recovery ensues in a few weeks. Yet Baranski noted 20 per cent. of deaths in Galicia, mostly in old, worn out animals which had been stabled for a length of time.
Lesions. On examination, post mortem, there are found hyperæmia and inflammation of the small intestine, some congestion of the cerebral meninges, and a red, bloody condition of the muscular system.
Treatment. The toxic provender must be stopped, or reduced to 20 or 30 litres of pulp daily, supplemented by sound wholesome dry fodder. Marker claims that 70 quarts daily of the potato marc may be given if combined with a fair ration of Indian corn. Turning out doors to pastures usually effects a speedy cure.
Local treatment is rarely demanded but when the irritation is great it may be soothed by bathing with cold or tepid water, lead lotion, glycerine and lead lotion, or by the application of ointments of lead, tar, oil of cade or birch, or carbolic acid. Dusting powders of zinc oxide, starch, lycopodium, boric and tannic acids may also be employed. Decoction of oak bark or solution of blue stone is often used, also creolin or cresol one part, to alcohol five parts.
It is rarely necessary to use other than the cooling and astringent lotions, yet the persistence of irritable sores, ulcers and crusts must be treated as in other chronic skin affections.