Treatment. Salicylate of soda and antipyrin still form the two most efficacious drugs, particularly the first, which may almost be regarded as a veritable specific in rheumatism. The doses vary with the size of the patients, from 2½ to 7 drams per day. These doses are continued for six to eight days consecutively. Some authors prefer salicylic acid, which, however, is more irritant, in doses of 15 to 75 grains. Tartar emetic, in doses of 2½ to 4 drams per day until purgation is established, is also said to have proved of great value in the hands of the older practitioners. Local treatment comprises stimulating frictions with camphorated alcohol, ammonia, and oil of turpentine. Such applications are usually of great service, particularly when associated with methodical massage of the affected parts. These modes of treatment should be supplemented with a proper dietary and the administration of tepid, diuretic fluids as required.
INFECTIOUS FORMS OF RHEUMATISM OR PSEUDO-RHEUMATISM.
Under the head of infectious rheumatism or pseudo-rheumatism may be grouped joint diseases of a rheumatic type accompanying various general or local diseases in young animals and adults: diseases of the umbilicus, rachitis, peripneumonia, retention of the fœtus, dysentery, etc. These diseases are characterised by articular symptoms, which sometimes appear early, sometimes only when the disease itself is declining, and develop suddenly or gradually, the joint cavities themselves either being directly invaded by the agents of the primary disease or remaining exempt. These pseudo-rheumatic attacks are due to the localised action of microbic toxins on the articular synovial membranes. Sometimes the serous membranes of the large body cavities are also implicated.
This theory explains the development of acute arthritis without the presence of gonococci during the course of an attack of blenorrhagia in man, and may be applied in respect of certain forms of arthritis or synovitis without the presence of microbes in domestic animals.
INFECTIOUS RHEUMATISM IN YOUNG ANIMALS.
Causation. To explain the occurrence of infectious rheumatism in young animals a variety of causes has been invoked, such as bad feeding, the absence of that purgation which usually follows the action of the mother’s first milk (i.e., colostrum), and clears the bowel of meconium, the effect of heredity, of chills, of insufficient food, and of unduly abundant or very rich food, which has been said to produce indigestion and its various complications.
All these causes may play a certain part in favouring the development of infectious rheumatism, but none constitutes the direct cause.
Lecoq and Loiset in their investigations regarding this disease in colts mentioned the almost invariable existence of lesions in the umbilical region. Bollinger in 1869 recognised the possibility of infection by way of the umbilical vein. Röll and Guillebeau are of the same opinion, and Morot’s excellent study shows that here must be sought the most frequent point of origin of the articular symptoms. In animals born in dirty stables the umbilical cord becomes infected at the time of birth, or its cicatrix a few days later. The result is the development of rapidly fatal septicæmia, suppuration in the wound, omphalitis, omphalo-phlebitis, or umbilical arteritis; and to this infection are due the various complications, which may appear almost immediately, as in the case of septicæmia of calves, or may be deferred for a shorter or longer interval, for so long indeed that the umbilicus may appear to have healed externally (infectious pneumonia and endocarditis, infectious arthritis, etc.). The umbilical cord and the tissues surrounding the cicatrix form excellent culture grounds for those microorganisms which always exist in such abundance in litter and manure; and there is, therefore, no difficulty in understanding why in dirty stables infection so readily occurs. The infective agents may be of very varying kinds, a fact which explains the difference in the symptoms which follow umbilical infection; although ovoid bacteria, streptococcus pyogenes, and the bacilli of necrosis seem most common.
Omphalitis and omphalo-phlebitis are not the only diseases capable of producing infectious rheumatism in young animals. Certain infections resembling dysentery and diarrhœic enteritis are also its frequent forerunners. In young animals even rachitis, which is accompanied by various digestive disorders, may serve as the point of origin for infectious rheumatism and all its complications.
In older animals—i.e., in animals from five to six months, or even twelve to fifteen months—infectious rheumatism may occur without a clearly defined cause. It then develops with the symptoms and lesions of that condition known as “osteomyelitis of adolescence” in human pathology. These forms of osteomyelitis are due to infection with streptococci and staphylococci. In veterinary medicine the pathogeny has not yet been accurately ascertained.