PARTURITION FEVER (COLLAPSE). MILK FEVER. PARTURIENT APOPLEXY. CALVING FEVER. PARTURITION PARESIS.

Definition. Predisposing causes: genus, breed, great milking capacity, heredity, mature age, vigor, high feeding, powerful digestion and assimilation, sudden plethora, drying up of milk, parturition, easy delivery, warm season, chills, idiosyncrasy, cardiac hypertrophy, contraction of womb, emotional excitement: Supposed causes: absorption of toxins from womb, colostrum, Schmidt treatment its significance, microbian infection and intoxication, effect of change of stable. Microbiology. Nature: Theories of nervous explosion, vaso-motor cerebral anæmia from exaggerated excitability of the uterine nerves, or from dilatation of the portal system and womb, metro-peritonitis, cerebral anæmia from congestion of the rete mirabile, etc., palsy of the ganglionic nerves, plethora, intracranial arterial tension, narcotic poisons from leucocytic or microbian source. Lesions: variable, cerebral and spinal congestion, pulmonary congestion, collapse, septic inhalation, bronchitis, dessication of ingesta in omasum and large intestine, black thick blood, yellowish gelatinoid exudates in cranium and spinal canal and under spine, glycosuria. Symptoms: time, post parturient, plethoric subject, sudden onset, comatose and violent forms, discomfort, restless movements, inappetence, moaning, mental dullness, unsteady walk, muscular weakness, compulsory recumbency, retained urine and fæces, drowsiness, somnolence, unconsciousness, stertor, venous pulse, tympany, sudden recovery, complete, with paralysis, fatal cases, violence, tossing head, trembling, cramps, convulsions, temperature. Mortality. Prevention: bleeding in plethoric, heavy milkers, purging, low diet, exercise, comfort, milking, blisters, sucking by calf, disinfection, iodine solution in udder. Treatment: in early stages bleeding, purgatives, peristalsis stimulants, antiseptics, injections, stimulants, rubefacients or cold sponging, elevation of the head, udder massage, milking, iodine injection of the mammæ.

Definition. A nervous disorder which develops suddenly in plethoric cows, heavy milkers, after calving, and is characterized by loss of senses, of consciousness and of muscular control, by hypothermia or hyperthermia, convulsions, coma, and mellituria.

Causes. While one cannot speak positively as to the essential cause of this disease, certain conditions are so constant and prominent that they must be given a high value as predisposing causes.

Genus and Breed. Milking Capacity. This is essentially a disease of cows, probably largely because of all domestic animals, cows only have been long and systematically bred to secure the greatest power of digestion and assimilation and the highest yield of milk. It is the disease not only of cows, but of milking breeds, and preëminently of individuals that give the most abundant dairy product. It is rare or unknown in scrub or common herds, while common and fatal in the best milking breeds, in advancing ratio about as follows: short horn, red polled, Normand, Swiss, Ayrshire, Flemish, Dutch, Alderney, Jersey, Guernsey, and Holstein. Heredity may be claimed, as the special predisposing qualities are hereditary.

Age has a marked influence, but this is subsidiary to the milking qualities. The disease rarely attacks a cow after the first or second calving when the system is as yet immature, and the milk yield has not reached its maximum: nor one that is past its prime and already failing in vital energy and milking qualities. The following table is from statistics compiled from veterinary records in Denmark and Bavaria:

Age, yrsCases
—3—8
421
565
6160
7171
8202
9117
10124
1144
1270
1378
and over.

It will be noted that it is in the period of the most vigorous, mature life, from the 6th to the 10th year inclusive that the great majority suffer. In a judiciously managed dairy it is the best cows that are carried at these ages, and although the very best are kept on into old age they show a steadily decreasing number of cases as they begin to fail. The disease is all but unknown in primipara.

High Feeding. Heavy and rich feeding prior to calving and immediately after, is a most prominent cause of the affection. This is so well known to owners of milking breeds, that they usually hold to the principle that the cow that is a heavy milker, should be all but starved for a fortnight before calving and for a week after. In herds where this rule is acted on the disease is rare and may be altogether unknown, and when it is neglected the malady is often very destructive.

Plethora. High Condition. Heavy feeding and high condition usually go together, and the majority of the victims are fat or in good flesh, yet a certain number are actually thin. The predisposing condition is plethora rather than fat or flesh, and this may be present in the comparative absence of flesh. The cow that is from a stock famed as heavy milkers, does not tend to lay on flesh, but, on succulent diet especially, the greater part of the nutritive matter assimilated goes to the production of milk, and she remains thin in flesh no matter how heavily she may be fed. Many such cows never go dry, but give a liberal yield of milk up to the day of calving, and if measures are taken to dry them up, it is done at the expense of a sudden plethora, as the milk giving system does not at once accommodate itself to the laying up of fat and flesh.

The drying up of the milk secretion sometime before calving in a cow which is normally a heavy milker is therefore a potent factor.

Parturition is an almost indispensable factor as the disease occurs one to seven days after that act, and only in rare and somewhat doubtful cases before it.

Easy Delivery with little nervous outlay or loss of blood, and no exhaustion is a special feature. The attack almost never occurs after a difficult parturition with considerable loss of blood and much nervous exhaustion. This should to a large extent exclude such alleged factors as shock or wearing out of nervous energy. The nervous prostration which figures so prominently in the disease, seems to be less the result of wear and tear, than of the supply of an excess of blood, which is either over-enriched, or charged with some injurious toxic matter. At the same time there is a manifest susceptibility at the parturient period which is not present at other times, and the plethora or toxin takes occasion to operate when this predisposition renders such an attack possible. The Warm Summer Season has been claimed to induce a greater number of cases, and doubtless exposure to continuous heat, tends to prostrate the nervous system and predispose to congestion, this fails to take into account the still more important element of the rich spring and early summer pastures, where the already plethoric animal is left to feed without stint, or the tempting red clover, alfalfa and other fodder crops, rich in albuminoids, which are fed liberally in a succulent condition.

Chills in cold winter weather have been similarly invoked as driving the blood from the surface to collect in internal organs, including the brain. That chills do act in this way cannot be denied, but there is no demonstration that any number of cases have been materially affected by cold.

Idiosyncrasy. Constitutional Predisposition. This must be allowed, inasmuch as that it covers all those individual conditions, functional and structural, which belong to the heavy milker, or the animal with extraordinary powers of digestion and assimilation. The same shows in the predisposition to a second attack of an animal which has survived a first one. The structural changes in the nerve centres, which occur in the primary attack, leave traces, which render these parts more susceptible at the next calving. In my own experience the violence of the disease is liable to increase with successive attacks, so that a second or third cannot be hoped to be as mild as was the former one.

Cardiac Hypertrophy. Cagny draws attention to the fact that in man and beast alike the heart undergoes hypertrophy during gestation and, above all, during its later stages. In improved breeds of cattle, and especially in milking breeds, a great development of the whole circulatory system is seen, and a large heart is a constant feature of this. This implies an increased force of cardiac systole, an increased blood tension in the arteries and capillaries, a condition which tells with special force on the soft tissues of the brain, as the violent abdominal compression in the expulsive efforts of parturition, tends to drive the blood from the great vascular viscera situated back of the diaphragm.

Parturition and the subsequent contraction of the womb and expulsion of the great mass of blood, must be accorded a prominent place among causative factors. The disease is almost restricted to the first week after parturition, and its gravity is greater the more it is related to the parturient act. Cases occurring in the first three days are usually fatal. The gravid uterus contains a very large amount of circulating blood, and when the womb contracts, the greater part of this is suddenly thrown upon the general circulation, already plethoric to an undue extent. As yet the mammæ are congested and there is no free depletion through that channel, so that there is a marked temporary plethora and vascular tension, before the system can establish free elimination and, as it were, strike a healthy balance. In this period of transient plethora there lies a source of great danger to the general system and, more particularly, to the brain.

Emotional Excitement connected with the removal of the calf is urged by Günther, Jaumain, Félizet and others as a prominent cause. This, however, must be rare, at the most; the disease does not attack the primipara that should be most susceptible to this influence, but the mature animal, at her third calving or later when she is already well accustomed to this treatment; it supervenes so quickly on parturition in many cases, that there was no opportunity for such emotion; it occurs also in cows, the calves of which have remained with them or have received no attention from them.

Absorption of Toxic Matters. The theory of a poisoning of the nerve centres is indicated in the familiar name of milk fever, suggesting an absorption, or poisonous condition of the milk. Lafosse charged the trouble on the uterine milk secreted in the cotyledons and reabsorbed in quantity. Abadie and Kaiser attributed it to the products of gastro-intestinal ferments, which acted on the nerve centres like a deadly organic alkaloid. Hartenstein incriminated the products of muscular contraction in the womb and systemic muscles during parturition. Ehrhardt invoked a similar auto-intoxication, going on before parturition and only reaching its climax in connection with that act.

Allemani and Gratia attribute the disease to the absorption of the first milk (colostrum), and there are several considerations that strongly favor this hypothesis. The disease sets in always in connection with the parturient development and congestion of the udder and the secretion of the first milk. In exceptional cases it may even appear just before parturition. Even upon the calf the colostrum operates as an irritant and purgative. Is it wonderful that, in the parturient cow, with a high state of plethora, a highly susceptible state of the nervous system, and the various concurrent conditions already referred to above, a direct poisoning of the nerve centres should appear? It is worthy of notice that the absorption from the mammæ takes place without any metabolic change, such as occurs in the stomach and liver in the case of materials digested. It is to be presumed that the hypothetical mammary poison is delivered in the brain in its pristine condition and possessed of its full force.

The doctrine is corroborated even more strongly by the successful results of treatment by the injection of a solution of potassium iodide into the udder. The iodide solution may presumably act in one or more of several ways. It is unquestionably an antiseptic, and would tend to arrest or control microbian growth and activity, thus preventing the further formation of toxins. It has a potent deobstruent action on glandular tissue, tending not only to dry up the milk, but to hold in check the leucocytic function of producing dangerous leucomaines. There is reason to believe that with regard to some poisonous ptomaines iodine acts as a direct antidote, probably uniting with these and forming new and comparatively harmless compounds. It manifestly acts in this way in the case of cryptogamic diuresis, and in cerebral congestions arising from spoilt fodder. The iodide tends further to act as a calmative to the nerve centres, and as a diuretic, serving to eliminate the poison that may be present in the blood.

Microbian Infection or Intoxication. The doctrine has been advanced that the disease is either a microbian infection of the nerve centres or a process of poisoning by the absorbed toxins of microbes. Of the two hypothesis the latter is the more acceptable, in view of the fact, that cows in a condition of coma will sometimes recover with extraordinary rapidity. This is more likely to occur in connection with the elimination or exhaustion of a transient narcotic poison, than with a deadly microbe colonized in the brain. This hypothesis is in full accord with the acknowledged success of the iodide injections; with the observation of Bissauge, which I can endorse, that certain villages and hamlets habitually furnish cases of parturition fever, while neighboring ones, with the same breeds and apparently the same management escape; and with the observations of Russell and Wortley Axe, that the malady will sometimes be suddenly prevented in a herd, by the simple expedient of having the cows moved to a new and previously unoccupied stable, for calving and the first nine days thereafter.

In support of the doctrine of a microbian origin is recalled the fact that the disease almost invariably follows parturition, which opened the way for the introduction of bacteria by the genital passages. This is somewhat invalidated by the fact that it follows the easy parturition, in which there was no chance for the introduction of germs on hands or instruments, and does not follow dystokia in which, without question, germs have been planted abundantly in the interior of the womb. Undue weight should not be given to this objection, as the essential accessory conditions of plethora, etc., are usually largely modified in cases of dystokia.

The microbiology of the affection leaves much to be desired. Coureur and Pottiez and later Van de Velde found a streptococcus in the blood. Trinchera, Nocard, and Cozette found the common pus cocci (staphylococcus pyogenes aureus, citreus and albus) a streptococcus and a colon bacillus in the liquid squeezed from the cotyledons, and in the liquid debris on the uterine mucosa. These microbes were not found in other organs. They grew readily in artificial cultures, but we lack the final proof of a successful inoculation on a susceptible parturient subject. The whole subject is therefore still a plausible theory.

We are not however limited to the womb as the only possible field of a pathogenic microbian growth. The frequent presence of microbes in the sphincter of the teat, in the galactophorous sinus, and in the milk ducts inside the mammæ is absolutely proved. Guillebeau found on the mucosa in cases of mammitis three forms of bacillus, to which he attributed the disease. In the New York State Veterinary College we have found mammitis usually associated with a streptococcus in the milk. In one cow in the University herd which gave abundance of good milk, and rarely showed any sign of congestion, streptococcus was constantly present. In cows producing “gassy” curd, V. A. Moore and A. R. Ward found in the milk a bacillus which morphologically and in cultures resembled the colon bacillus (evidently one of the colon group). In the milk and mammary gland tissue got from other (slaughtered) cows, a micrococcus growing in yellow or buff-colored colonies predominated. (Moore and Ward). That the colon bacillus, so constant in the intestines and manure, is not always found in the milk ducts, would show that in its normal condition it is not adapted to this habitat, but when a variety appears that is so fitted, it appears to be able to maintain its place indefinitely.

With such facts before us, we must allow the possibility of poisoning by toxins of bacteria in the udder, or by compounds formed by the synthesis of such toxins and the leucomaines of the expanding udder, or by the union of the udder toxins with those from the womb. The whole subject of microbian and leucocytic causation of parturient fever is still hypothetical, yet enough is known to show the high probability of such source, and to demand a thorough investigation which will place the subject on a substantial and assured basis.

Nature. Theories of the nature of this disease are numerous and varied, and are largely based upon some restricted or one-sided view of phenomena and lesions. Coutamine considers it as the reaction of the surplus of nerve force, which was not used up in the easy parturition. The theory is somewhat fantastic as an explanation of the rapidly developing asthenia and paralysis. Billings explains the cerebral anæmia as due to vaso-constriction of the nervous capillaries produced by the exaggerated excitability of the uterine nerves. But with the easy parturition, and delivery, and the moderate contraction of the womb, without violence or spasm, the theory seems rather insubstantial. Trasbot looks on the affection as a congestion of the myelon, apparently shutting his eyes to the far more prominent encephalic symptoms. Haubner considers it as a cerebral anæmia induced by the vaso-dilatation in the portal system and abdominal viscera generally, the result in its turn of the vacuity of the abdomen, from the expulsion of the fœtus and its connections. But the womb is often found contracted and comparatively exsanguine, the plethoric condition of the cow, suddenly increased by the great mass of blood from the uterine vessels, maintains a marked general blood tension, and finally, the closed box of the cranium cannot have its blood so completely drained from it as can a part outside such a cavity. Stockfleth attributed the malady to a metro-peritonitis, and the absorption of the morbid products and poisoning, but neither a metritis nor peritonitis is a common accompaniment of the affection.

Franck who accounts for the asthenia by an anæmic condition of the brain, explains the anæmia by a pre-existing congestion and œdema of the rete mirabile at the base of the brain. He claims that sows which have also a rete mirabile in this situation sometimes suffer from parturient fever. He fails to adduce cases in the sheep and goat which also have retia mirabilia. The pregnant sheep may die of an asthenic affection, but usually before parturition. Franck’s theory is plausibly based on the anatomical and physiological conditions, for the elaborate network of vessels at the base of the brain, undergoes great distention under increased arterial tension, and with the serous effusion, compresses the brain and drives out its blood.

Palsy of the ganglionic system has been invoked, with succeeding congestion of the myelon and encephalon (Barlow, Kohne, Carsten Harms, etc.). Explanation is made that the supposed excess of nervous force fails of distribution through a lack of conductility of the nerves, and the nerve centres suffer. Binz has even found the spinal roots of the sympathetic surrounded by a thick gelatinoid exudate. The theory is, however, essentially speculative and fails to explain the origin of the disease or its connection with the recognized conditions of its occurrence.

Plethora with Arterial tension and all conditions contributing to this, as already set forth under causes must be allowed a prominent place in considering the nature of the disease. The blood globules in my experience are somewhat smaller than normal, implying the density of the plasma, and implying a direct influence on trophic and metabolic processes. Under these influences the congestion of the encephalic circulation, and notably of the rete mirabile, and a serous effusion, tend first to prostrate the nerve force, and second to render the other intracranial structures anæmic.

The direct action of a narcotic poison, leucocytic or microbian, though as yet a hypothesis merely, has much in its favor, on considerations drawn from the observed immunity in particular buildings, the sudden prostration, the promptitude of certain recoveries and the favorable results of the iodine mammary injections. The presence of sugar in the urine, most abundantly in the worst cases, implies a profound disorder in glycogenic centres (medulla, liver), and primarily no doubt in the bulb.

Lesions. These are exceedingly variable in successive cases. Congestion and effusion in the meninges, cerebral or spinal, in the rete mirabile and choroid plexus have been often noticed, and exceptionally clots of extravasated blood. In certain cases congestion and pink discoloration of portions of the brain substance (cerebral convolutions, bulb, ganglia) with marked puncta vasculosa, are found, while in others the greater part or the whole of the encephalon is anæmic. The puncta in such cases, large and dark, on the surface of the section, promptly enlarge until they may form distinct drops.

In the lungs areas of collapse, and of dark red congestion and infiltration are common, mostly as the result of the entrance of alimentary or medicinal matters into the bronchia owing to palsy of the pharynx. Such materials can be found in the bronchial tubes.

The third stomach and the large intestine may be impacted, the contents more or less baked and glossy on the surface, and coincident congestions of the mucosa are not uncommon. In some instances, however, the contents are soft and pultaceous and the absence of mucous congestions is remarkable.

The womb rarely shows characters differing from the condition which is normal to the first few days after parturition.

The blackness and thickness of the blood has been noted by practically all observers. This is partly the result of its density, but doubtless also of the undetermined toxins which are operative in the disease.

Yellowish gelatinoid exudates have been found in the subdorsal and sublumbar regions, as well as the cranium and spinal canal.

Glucose appears to be constantly present in the urine, and in excess in the more violent and fatal cases: from 1.19 grm. per litre in slight cases to 41.8 grms. in a fatal one (Nocard). Albumen may be present, though probably only when local inflammation has supervened.

Symptoms. The conditions of the attack should be noted. This is a disease of the first six days after parturition, rarely seen in the second week, and never after the fourteenth day. It is very exceptional before parturition, yet Müller quotes 47 cases in 1107 births. The breed, condition, milking qualities, plethora, feeding, etc., of the patient are, as already noted important data in diagnosis. The onset is sudden without premonitory symptoms.

Two very distinct types are met with, the comatose and violent or spasmodic, which, however, merge into each other by insensible gradations, and may follow each other.

From twelve to seventy hours after an easy parturition there suddenly appear signs of discomfort. Feeding and rumination cease, the calf is neglected, there may be plaintive moaning, the eyes seem dull and clouded, the eyelids drooped, the conjunctiva red, the pulse normal for parturition, sometimes extra strong, the breathing excited often with moans or grunts. The senses are dulled, the walk is unsteady, the feet being abducted and planted like clumps, or the legs sway, perhaps cross each other, remain semi-bent, and soon give way leaving the animal prostrate, resting on the sternum and abdomen, or later on the ribs, with head extended. Attempts may still be made to rise, but this is rarely accomplished unless when improvement sets in. This is the condition in which the patient is usually found, being the first to be noticed by the owner. The bowels are torpid, the urine retained in the bladder, and the animal may remain thus in a drowsy condition, without changing from the sterno-ventral decubitus, or dropping the head on the ground until improvement sets in. The head rests on the shoulder or upper flank. If held outward or forward the upper border of the neck has an S shaped outline.

More commonly the somnolence increases, passing into a complete torpor and insensibility, the eye may be touched without causing winking, pricking or other injury causes no further response, the patient turns upon its side, with its head extended on the ground. She may lie in this condition with no sign of vital activity save pulsation and breathing, and the latter is liable to be slow and stertorous by reason of the paralysis of soft palate and larynx. The jugulars usually show a venous pulse. Fermentations in the inactive paunch cause the evolution of gas with tympany, which still further obstructs the breathing, and reacts injuriously on the nerve centres. The normal eructations from the rumen may continue, with liquids and floating solids, and in the paralytic state of the throat these too often pass in part into the bronchia, causing septic bronchitis and pneumonia. The same is liable to follow the administration of liquids, the irritant drugs passing into the larynx, trachea and lungs. The pulse becomes soft, small and finally almost imperceptible. It may be 50, 60 and upward.

In favorable cases, defecation may still occur, or the rectum once emptied may fill again through the continuance of peristalsis, the milk continues to be secreted, and in one to four days, spontaneous defecation and micturition may be resumed, and the patient may get on its limbs and commence feeding. There is usually at first a little weakness of the limbs, but this is transient and health is restored in a very short time. The suddenness of the improvement is often as marked as of the attack. The patient is left prostrate and insensible, without giving any response when the eyeball is touched and in two or three hours it is found on its feet, eating, with eyes bright and clear.

Some patients, however, are restored to ordinary sensation, intelligence and appetite, while the hind limbs remain paralytic, or paretic, and the station and gait both weak and uncertain for days or even weeks. In such cases there have been presumably structural changes in the nerve centres, which require time for repair.

In fatal cases, death may occur quietly from apoplexy, cerebral compression, or narcotism, or it may be preceded by a period of marked excitement or disorderly muscular movements. Lifting of the head, throwing it alternately on the shoulder and on the ground, trembling of head, members and body, cramps or jerking of the limbs or of other parts, drawing the hind limbs up against the abdomen, and again extending them, rolling of the eyes, loud, noisy, irregular, embarrassed breathing and a running down pulse are often marked features.

The temperature range is peculiar. At the start there may be some hyperthermia 103° or 104°; with the advance of the disease it tends to become lower, 98°, 96°, or 94°. When improvement sets in, it rises again promptly to the normal.

Cadeac describes a special form which is ushered in by great restlessness, bellowing, throwing the head to right and left, grinding the teeth, sucking the tongue, salivation, licking of certain parts of the body, spasms in the neck, back or limbs, and prompt recovery, or lapse into the comatose condition as above described. It proved less fatal than the ordinary comatose type, but seems to depend on similar conditions.

Prognosis. Mortality. The disease is very deadly, the mortality in time past having reached 40, 50 or even 60 per cent., the gravity increasing as the disease set in nearer to parturition. Cases occurring on the first or second day were mostly fatal, those at the end of the first week were hopeful, and those occurring during the second week were very hopeful. With the Schmidt (iodine) treatment the mortality is claimed to be reduced to 16 or 17 per cent.

Prevention. Measures directed toward the lessening of plethora tend to remove one of the most fruitful causes of the disease and though not invariably successful, are yet of great value. The most direct is the abstraction of blood in the last fortnight of pregnancy, to the extent of 6 or 8 quarts. This tends to secure a lessening of the blood tension, and blood density, but there is the drawback of a created tendency to a subsequent increase in blood formation to make up the loss. This measure should be reserved for cows that are very plethoric, extra heavy milkers and such as have already suffered from the disease.

Purgatives will measurably secure the same end without the same degree of danger. One to two pounds of Epsom or Glauber salts in the last week of gestation, or at latest when labor pains set in, tend not only to remove solid or impacted masses from the first and third stomachs, and inspissated contents from the large intestines, but to secure a free depletion from the portal system. If not before, this should always be given immediately after parturition to cows in extra high condition, heavy milkers, and that have had a short and easy delivery.

Restriction of food for a week before and as long after parturition is of equal importance. A very limited supply of aqueous, easily digested, and laxative food (roots, sloppy bran mashes, fresh grass, ensilage) will meet the demand.

Exercise in the open air is of great value in giving tone to the muscles, and especially the nervous system, and in stimulating the emunctories and other functions.

In the cold season protection against cold draughts and chills must be seen to, and in the hot season the avoidance of an excess of solar heat and above all of the confined impure air of the barns.

At midsummer and later, there is often great danger in the rich clover and alfalfa pasture, or soiling crop, with which the cow will dangerously load her stomach, and the only safe course is to remove predisposed animals and shut them up in a bare yard or box-stall. Under such simple precautions herds that had formerly suffered severely, have had the disease virtually put a stop to.

In individual cases other measures are indicated. When the udder has reached an enormous size and development, and is gorged with milk, days before parturition, it should be systematically milked. The irritation in the gorged gland is quite as likely to induce premature parturition, as is milking, and, at the worst, the result is not so bad as an attack of parturition fever.

Basing his advice on the fact that parturition fever does not follow a case of severe dystokia, Cagny applies sinapisms on the loins, croup and thighs of a fleshy, plethoric, heavy milking, parturient cow. Proof of their efficacy is not obtainable.

Félizet advises leaving the calf with its dam for one week. Kohne doses the cow with nux vomica: Harms, with tartar emetic.

In view of the probability of a bacterial infection the cow should be taken to a clean, pure, well-aired stable a day or two before calving, having been first cleansed from adherent filth, and sponged all over with a 4 per cent. solution of carbolic acid.

To prevent diffusion of infection Bournay recommends antiseptic injection of the womb immediately after calving. Bissauge adds that the stable should be disinfected after every case of parturition fever, the manure carefully removed and the ground scraped and well watered with a disinfectant.

For fleshy, plethoric, predisposed cows, the iodine injection of the udder should be applied immediately after calving. A measure of this kind which is so successful as a curative agent, and which brings such circumstantial evidence of the production of a poison (leucomaine or ptomaine) in the mammary gland, can hardly fail to be even more effective as a prophylactic than as a therapeutic resort.

Treatment. With the state of plethora and congestion about the head in the early stages the question of bleeding at once arises. If early enough while there is a full bounding pulse, and as yet no sign of great loss of muscular control it is often very beneficial, as much as 6 quarts or more being withdrawn. It is well however to avoid cording the neck, which must increase the vascular tension in the brain, and to trust rather to digital compression of the vein. The blood should be drawn from a large opening in a full free stream, and may be stopped when the pulse softens. In the more advanced condition, with paralysis and more or less dulling of the senses, or coma, bleeding may be dangerous rather than useful. There is then serious pressure on the brain, with serous effusion, and perhaps blood extravasation, and in any case anæmia, and this latter may be dangerously or even fatally increased by the lessening of the blood pressure, without any compensating advantage in the way of reabsorption of the effusion. In such cases eliminating agents are a safer resort.

Purgatives commend themselves, but with the drawback of a too tardy action. Now however with the peristaltic stimulants given hypodermically this objection is largely obviated. Pilocarpin 1½ gr., and eserine 3 grs. will often secure a noticeable movement of the bowels in the course of fifteen minutes, implying a corresponding motion onward in the bowels more anteriorly, and even of the contents of the gastric cavities. If there is already palsy of the muscles of deglutition, this may be repeated several times at intervals of four or five hours. If however deglutition is still well performed a purgative of one or two pounds Epsom salts, with 10 drops croton oil, and 1 oz. oil of turpentine may be given by the mouth. Should this operate, it will supplement and carry on even more effectively the work of the hypodermic agents, and even lessen the density, plasticity and tension of the blood and act as a potent derivative from the brain.

A compromise may be made by giving aloes 2 ozs., croton oil 20 drops in bolus; or 1 to 2 ozs. sulphate of soda in solution may be injected subcutem.

In any case oil of turpentine or other antiseptic is of great value in the stomach in preventing fermentation and tympany, and thereby obviating a whole series of troubles such as: cerebral disturbance by nervous shock and blood pressure; impaired respiration and hæmatosis by pressure on the diaphragm; and eructations of food to the pharynx and its inhalation or gravitation into the lungs.

It is always well to clear out the rectum by injections, when if there is any indication of pharyngeal paralysis most of the remedies may be given by this channel.

Stimulants (ammonia carbonate, alcohol, anise, fennel, ether, nux, etc.) have been largely employed by the mouth and may be by the rectum. In the absence of spasms I have relied largely on nux or strychnia.

When the skin chills, some have sought to heat it by enveloping the posterior half of the body in cotton or wool soaked in turpentine, by applying sinapisms, or by moving over the surface a warming-pan containing red hot charcoal.

More generally cold in the shape of cold water, ice or snow has been applied to the cranium and spine. Theoretically the anæmic brain might be thought to forbid this, but clinically it often operates well, possibly by inducing a sympathetic contraction of the vessels in and around the nerve centres and thus indirectly favoring the resumption of active circulation and the reabsorption of effusions.

An elevated position of the head is no less important. It favors the return of blood from the brain by gravitation, and in this way improves the intracranial circulation, and the resumption of normal function. A halter, or a rope around the horns, may be tied to a beam overhead, or the head may be laid on thick bundles of straw which will keep it up to or above the level of the chest, and in this way not only is gravitation ensured, but the brain is protected against the violent blows and concussions, which come from dashing the head on the ground.

Frequent rubbing of the udder and drawing of the milk, is an excellent means of depletion, a removal of a source of irritation, and presumably an extraction of part of the offending poison. It should never be neglected. But of all known methods of treatment the iodine injection furnishes the greatest hope of success.

Injection of the mammæ with Iodine. Iodide of potassium 100 grains (200 grs. in the case of a very large udder) are dissolved in a quart of water which has been boiled for 15 minutes, the solution cooled to 104° F. and injected in equal parts into the four quarters, which have been just milked out clean. The glands are then manipulated so as to work the solution into all the recesses of the milk tubes and follicles. If the patient does not get on its legs at the end of twelve hours, the glands may be milked out and injected anew. In nearly 2000 cases the recoveries reached an average of nearly 83 per cent. In serious or advanced cases with structural changes of a grave nature, a good result cannot be hoped for. The injection does not forbid the concurrent use of other approved measures.

The injection is easily made with a caoutchouc tube of five feet long fitted to a teat tube at one end and to a funnel at the other. The tube is inserted in the teat, and the funnel at a height of five feet receives the liquid, which readily passes into the teat. When ready to pass the tube from one teat to another, an assistant pinches the caoutchouc tube just below the funnel, until the insertion has been made. Every precaution must be taken against sepsis. The udder, teats and hands, must be washed with soap, and treated with a 3 per cent. solution of lysol. The teat tube and funnel are boiled. The caoutchouc tube is washed and irrigated with a solution of mercuric chloride (1:1000), and then with one of boric acid (3:100).

DISEASES OF THE EYE.
DESIRABLE FEATURES IN THE EYE.

The eye in the physiognomy. Broad forehead. Full eyes. Both eyes alike. Iris smooth, lustrous. Media translucent. Pupil sensitive to light. Convexity median, uniform. Pupil black in ordinary light. Lids open and mobile. Sclera light pink. Tears clear, limpid without overflow. Lids thin, delicate, margins evenly curved. Whole eye responsive to moving objects. Defects: small eye: semi-closed, thick, sluggish lids; convex cornea: sunken eye: projecting eye: weeping eye: blear eye: watch eye: irresponsive iris: dilated pupil: unequal eyes: flat cornea; ovoid cornea.

Much of the expression of the face depends upon the eyes, and in animals as in man it is difficult to find compensations for a forbidding countenance. Perfect, sound, intelligent eyes are always pleasing; imperfect, defective, sunken or lifeless eyes mar the whole expression. The following points may be specially noted:

1st. Ample breadth between the orbits. This is of great importance in the horse, in which we seek for intelligence, courage and indomitable energy. This confirmation does not indicate the size of brain, as the cranium is situated higher up, but by placing the eyes well outward, it indicates a wider range of vision, and usually implies large, clear eyes, and since interdependent parts tend to correspond in development and quality, this commanding vision bespeaks a large, active brain, intelligence, docility and activity.

2d. Full, prominent eyes. This may be excessive, either through primary conformation or disease. Abnormal convexity of the cornea implies myopia. But within normal limits the prominent eye suggests good health, condition and vigor, with ample cushions of fat under the bulb and a sound, well-developed condition of the eyeball and its muscles.

3d. Both eyes equal in all respects. Any variation in size, shape, color, fullness, clearness or in any other respect is at best unsightly, and implies not only defect but often disease as well.

4th. The iris should be lustrous, uniform in color and even in surface. Whether dark brown as in the horse, or yellow as in the dog, it should be brilliant. Any part that lacks lustre, being lighter brown, or yellow and dull like a dead leaf, usually indicates previous disease and a tendency to further trouble. Albinos and those in which the pigment is congenitally absent in patches must be considered as exceptions, yet, even in them, the peculiarity cannot be held to add to the beauty.

5th. All the Media (Cornea, aqueous humor, lens and vitreous) must be perfectly clear and translucent. The slightest cloudiness or opacity in any of these is a serious blemish and usually indicates disease, past or present.

6th. The pupil should promptly and freely respond to light and darkness by contraction and expansion. Absence or tardiness of movement indicates impaired vision, from disease of the eye, its nerves, or their nerve centres.

7th. Each cornea should have a median convexity, uniform in all directions implying the absence of myopia, preshyopia and astigmatism. Any deviation from this will interfere with the perfection of sight, and endanger shying and other troubles.

8th. Under ordinary light the pupil should appear black throughout. In the larger animals such dilation of the pupil as to expose the tapetum lucidum under such circumstances implies impaired vision (amblyopia, amaurosis), inflammation of the iris or undue intraocular pressure. A white color or spot shows cataract.

9th. The lids must be open and mobile without excessive dilation. Tardily moving or semi-closed lids, distorted by scar or angle, everted or inverted, are unattractive and usually imply disease in the eye, nerves or brain.

10th. The unpigmented portion of the sclera should be light pink. The dark red of congestion and the pallor of anæmia are equally objectionable.

11th. The tears must be clear, limpid and confined within the lower lid. Any milkiness, flocculency or overflow is indicative of disease.

12th. The eyelids must be thin, delicate, evenly and uniformly curved along the borders, and fringed by an abundance of strong, prominent and well directed lashes. Puffiness or swelling betrays inflammation, dropsy, anæmia, parasitism or other disorder, angularity of the upper lid an internal ophthalmia, and depilation or wrong direction of the lashes, local disease.

13th. The eye should respond instantly, by movement, to new objects and noises, without showing undue irritability or restlessness. The intelligent apprehension of the objects will introduce an aspect of calmness and docility.