TREATMENT OF TUBERCULOSIS.
Like all deadly infectious diseases in the lower animals, tuberculosis is not to be profitably treated as a rule. In the case of specially valuable breeding animals, in which the prospective progeny will pay for large outlay, and when the disease is in its incipient stage, treatment may be warranted. The patient should be thoroughly separated from other animals, kept in the open air, or, in our northern winters, in roomy, well ventilated buildings facing the south, well lighted, kept immaculately clean, frequently whitewashed, and well drained. If there are more than one case every precaution named under the head of prevention must be adopted. Exercise to keep the muscular system in good tone is called for, but never to fatigue. Hence, a sheltered pasturage is ideal. Feeding must be liberal including a ration of grain or seeds, and oil bearing seeds like linseed, rape seed or cotton seed may be specially named. Cod liver oil alone, or etherized is often of great value, with iron and bitters continued for weeks or months. In the case of specially valuable animals one may use a pneumatic cabinet the principle of which is to diminish the air pressure on the body at large by an exhaust, while pure air for breathing, at the ordinary atmospheric pressure, is introduced through a tube furnished with a face piece fitting around closely beneath the eyes. This serves the purpose of attracting (sucking) the blood toward the skin and other tissues from the lungs, which in their turn are compressed by the air at the atmospheric pressure. Pulmonary congestion is in this way lessened, exudates are absorbed, necrotic tissue removed, sepsis counteracted, hæmatosis encreased, circulation of both blood and lymph stimulated, digestion and nutrition improved, and general health invigorated.
Active grooming and even the stimulating effect of cold douches may be invoked, the skin being rubbed actively until dry and warm.
If the circulation is poor, a stimulating steam or hot water bath of fifteen minutes followed by a cold sponge and rubbing till dry may be profitably substituted. In such cases it is well to put a cold sponge on the head while in the bath.
Medicated inhalation is often valuable especially when the lesions are on, or near the bronchial mucosa. In 1868, Dewar met with most successful results from inhalation of sulphurous acid gas impregnating the atmosphere as strongly as the patient can breath without discomfort. His own groom who had given up work because of advanced phthisis, under treatment of half an hour three times a day, became ruddy, gained weight, and betook himself to work again. In rabbits which I inoculated with human sputa, the same year, all died tuberculous excepting one which I fumigated three times a day for weeks. This rabbit remained plump and well.
As an example of a still more irritating inhalant, I watched the case of a phthisical man who secured employment on the government disinfecting corps, in Chicago, in purifying the lung-plague-infected stables with chloride of lime solution, and who very soon began to improve, gaining weight and strength, his cough meanwhile subsiding.
Cervello’s use of formalina by inhalation though well spoken of by its inventor would seem too irritating on the delicate lungs, however good it is as an antiseptic.
Inhalants may be conjoined with the pneumatic cabinet.
Among agents used to moderate the cough may be named codeine, morphia, cherry laurel water, wild cherry bark, guaiacol, menthol, syrup of Tolu, or chloroform, or alcohol inhalation.
As an internal antiseptic, carbonate of creosote has often proved beneficial.
Mustard blisters on the skin covering the tubercle is claimed by Knopf to act beneficially by attracting the microbes from the delicate lungs to the more robust skin and connective tissue, where they can be better disposed of by the more abundant leucocytes.
He has also found excellent results in complex infections in animals from the use of Marmorek’s streptococcic serum in doses of 10cc., followed after the second dose by 5cc. every 24 hours. In other cases it failed of the effect (reduction to normal temperature) evidently indicating that the hyperthermia was maintained by other microbes than the streptococcus. The principle is good, and perhaps at some time in the future a bacteriological examination of the sputum may reveal the microbes present and suggest the sera for such complications.
The introduction of air into the peritoneum has long been known to exercise a retarding and curative action on abdominal tuberculosis. At the present writing my colleague, V. A. Moore, is experimenting by pumping air and oxygen into the peritoneum and pleuræ in cattle slightly affected, with encouraging results.
I should add that isolated superficial tubercles may often be excised to advantage, and the part dressed antiseptically.
It is only in exceptional cases, however, that one is warranted in preserving and running the danger of spreading the tubercle bacillus for the advantage that can be secured to individual animals from treatment.