INFECTIVE GASTRO-ENTERITIS AND PNEUMONIA IN THE NEW BORN; WHITE SCOUR.

In treating of this disease in Vol. II, page 141–2, the work of Jensen, Perroncito and Nikolski is quoted, with the remark that “it is premature to specify any particular microbe as the sole cause of the affection.” Since the publication of that volume, Nocard, investigating in Ireland a very prevalent and fatal affection of new born calves, which proved fatal by “white scour” a few days after birth, or by pneumonia one or two weeks later, identified as the pathogenic agent a small, nonmotile, ovoid bacterium, taking the polar aniline stain, bleaching in Gram’s solution, failing to liquefy gelatine, or to form indol or to grow on potato. In other words it shows the general characters of the colon group of bacteria, causative of hæmorrhagic septicæmia, and classed as pasteurellas by Trevisan and Lignieres. This is not found in blood and lesions in all subjects, but is usually present in pure culture in the most acute, fatal cases. Its occasional absence later in the disease is explained, according to Lignieres, by the power possessed by these germs of robbing the healthy tissues of their power of resistance and laying them open to the attacks of other microörganisms which are usually present in abundance, but are harmless to the healthy tissues in the absence of the Pasteurella. As the disease advances, therefore, the primary pathogenic agent (the Pasteurella) is crowded out by the active growth of other bacteria, which accordingly are found in complex cultures and in great variety. In his first observations on the victims of the white scour, Nocard found only these complex cultures, of which no one variety, isolated in pure cultures in vitro, and inoculated, proved capable of causing the disease. Later he found the Pasteurella (cocco-bacillus) in impure cultures from the diseased femoro-tibial joint of one of the subjects of the affection, and the pure cultures obtained from this were virulently infective.

A few drops injected into the peritoneum of a Guinea pig, or veins of a rabbit, killed in six to eighteen hours with the lesions of hæmorrhagic septicæmia which characterize the most acute cases of white scour. The blood and viscera swarmed with the microbe.

A calf one day old had 3cc. of the culture injected into the jugular, the temperature rose in six hours, and in twenty hours the subject lay with sunken eye, retracted abdomen, a temperature of 95° F., and having the bed saturated with a yellowish, fœtid, fæcal liquid. Death took place 30.5 hours after the injection and all the lesions of acute white scour were met with.

A second calf four weeks old, which had already suffered from white scour and recovered, had an injection into the jugular of 10cc. of the same culture. In six hours he suffered a slight rise of temperature, was dull and breathed short, but in twenty hours he was completely recovered, full of life and appetite.

In other casual and experimental cases, Nocard found that when death occurred within one or two days the symptoms and lesions were mainly those of hæmorrhagic septicæmia and white scour, whereas if the calf survived several days, the impaired resistance of the tissues invited the invasion of a variety of other germs from the intestines, and infective inflammation of the lungs, joints and other organs were brought about by such secondary invasions.

An important question is as to the direct source of the primary (Pasteurella) infection. The concentration of the acute cases on the alimentary canal would strongly suggest infection through the food which in this case means the milk. But careful bacteriological examination of the milk of the dam of a calf that had just died of white scour, and of other milk secured with careful precautions from cows in an infected stable, showed that both were clear of the germ. Inoculations and culture experiments were equally fruitless.

This does not exclude the probability of the contamination of the milk, obtained under ordinary conditions, with the germ contained in the floating barn dust, or that which was adherent to the teat and udder.

Another suggestion is that the infection is derived from the infected womb prior to birth, but as Nocard justly says, if this were so, abortions would be much more prevalent, as the rapidly fatal issue of the disease would determine the prompt death of the fœtus and its expulsion. The coincidence of abortion and white scour in a herd is not uncommon, and in such cases intrauterine infection of the fœtus is not improbable, but in the great majority of cases no such coincidence exists.

We are thus thrown back on infection through the raw surface of the ruptured umbilical cord, as the rule in such cases. It may be that this has come from the vagina or vulva, but in the great majority of cases it is manifestly derived from the infecting bowel dejections and the dust caused by their desiccation. The extraordinarily rapid progress and fatal result of the acute disease, and the early abundance of the germ in the blood and liver, suggest that the microbe traverses the umbilical vein to the liver, and finding a congenial home in the blood is quickly distributed through the entire body.

Prevention must be based on the destruction and exclusion of the microbe.

A thorough disinfection of the stable with mercuric chloride has not given us uniformly satisfactory results, even when the building has been kept apparently almost immaculately clean. This argues a renewed infection through the fæces of the cows, yet it is the rule that the removal of the cow to a new or unused stable a few days before calving will usually secure the immunity of the calf. This method is however open to the objection that the removal to such calving stable of a succession of cows coming from infected premises soon introduces the infection and renders it as dangerous as the place they have left. To carry out such a plan therefore a number of new stables or sheds must be provided to be used in succession, as they become one by one contaminated.

Nocard confines his instructions to the antisepsis of parturition and of the offspring:

“Cows ready to calve should be provided with dry and clean bedding until after the birth of the calf.”

“As soon as labor sets in, the vulva, anus and perineum should be cleaned with a tepid solution of lysol in rain water: 20 grammes of lysol to each litre of water. The vagina should also be cleansed by injecting with a large syringe a great quantity of the same solution tepid.”

“As far as possible the calf should be received on a clean cloth or on a thick fresh bedding, not soiled by urine or fæces.”

“The cord should be tied immediately after birth, with a ligature kept in a lysol solution, and the cord amputated below the ligature.”

“The stump of the cord and the umbilicus should be washed with the following solution:

Rain water1 litre.
Iodine crystals2 grammes.
Potassium iodide2 grammes.”

“The disinfection of the umbilicus and cord should be completed by coating them with

Methylic alcohol1 litre.
Iodine crystals2 grammes.”

“When the alcohol has evaporated the cord and umbilicus should be covered with a thick layer of iodine collodion (1 per cent.) applied with a brush. When the collodion has dried the calf may be left to the care of the dam.”

This treatment may be changed by substituting other antiseptics, and by prompt separation of the calf from the infected stable and dam. It is also important to disinfect thoroughly and often the cow stable and calf-pen, to remove instantly any calf that may show signs of scouring or general disorder and to purify its pen and leave it unoccupied for some time.

It should be added that the period of danger is in the first few days after birth, and while the umbilicus is still unhealed. If scouring should come on later it is much more amenable to treatment. A seclusion of the calf for one week is usually sufficient to secure its escape.