When infectious arthritis is diagnosed, it is still necessary to resort to the same methods if the uterine symptoms persist, and to complete the treatment by local applications.
The best method of local treatment seems to consist in puncturing the articulation aseptically, removing almost all of the liquid exudate, and immediately thereafter firing the skin covering the joint in points or lines.
If treatment has been invoked too late, if plastic arthritis with the formation of fibrous bands within the joint and destruction of the cartilages and calcification of ligaments, etc., already exists, there is no economic object in undertaking treatment. Fattening may be attempted, or the animals may be handed over to the butcher, if wasting is not too far advanced.
The use of cold douches, plaster bandages, blisters containing nitrate of mercury, painting with sulphuric acid, etc., are too inconvenient and too inefficient to be recommended in actual practice. Similarly, the salicylate of soda, which is so useful in simple rheumatism, has no real superiority over diuretics in this condition.
SCURVY-SCORBUTUS.
Definition. “Scurvy is a subacute or chronic trophic disorder characterised by debility, inanition, anæmia, swelling and bleeding of the gums, gingival ulceration, dropping of the teeth, and petechial or more extensive hæmorrhages and exudations in the skin, serosa, and solid tissues.”
Causes. “Among the lower animals, pigs especially suffer, when kept in close, foul quarters and fed on a monotonous and insufficient ration. Formerly scurvy ... was attributed to an exclusive diet of salt food; to excess of sodium and deficiency of potassium salts; to the absence of fresh vegetables; to tainted food, etc. In pigs the food and environment are usually chiefly at fault, the subjects have been kept ... in foul buildings, in a hot, moist atmosphere, and with an uniform diet of maize or other unvarying and insufficient ration. Röll attaches great importance to putrid food. Benion has found the affection mainly in obese swine, the forced feeding and intestinal fermentations manifestly operating as factors. Hess and others attribute the disease in pigs to the germ of erysipelas. Stengel has produced purpuric disease in animals by inoculation of the extravasated blood from human scurvy patients. Muller and Babès found a slender bacillus and streptococci in the tissues of scorbutic gums.... There is considerable presumption of the existence of a microbian cause, the efficiency of which is dependent on the unhygienic conditions above stated, while these unwholesome conditions are equally non-pathogenic in the absence of the microbe.”
Lesions. “The blood is black and incoagulable or clots loosely, rigor mortis is slight, changes may be found in the number and character of the white and red blood globules, but are not constant; there is usually an excess of sodium salts and deficiency of potassium ones, and there is marked petechiation of the skin, mucosæ and serosæ. The bone marrow may be abnormally red and the bones fractured at the epiphyses, or carious.... The gums are softened, swollen, red and uneven, with hæmorrhagic discoloration, erosions, necrotic areas and ulcers.”
Symptoms. “Anorexia or fastidious appetite, prostration, debility and sluggish, indifferent movements, are followed by the local lesions on the skin and gums. On the skin appear petechiæ and extravasations, which often implicate the bristles, so that they may be shed or pulled out with ease, the bulbs appearing dark and blood-stained (bristle rot). These may be followed by necrotic sloughs, and deep ulcers that are slow to heal. The gums are red and swollen, with hæmorrhagic spots, and bleed on the slightest touch. Erosions, sores, and ulcers are not uncommon; the tongue is dry and furred, and the mouth exhales a fœtid odour. The teeth may become loose in their sockets. Swelling of the joints ... may be noticed, and lameness or stiffness from muscular or intermuscular extravasation. Blood effusions into ... the eye have been noticed, and paralytic or comatose symptoms from similar effusions on the brain. In the absence of improvement the patient becomes more and more debilitated and exhausted, and death may be preceded by profuse exhausting diarrhœa.”
“Prognosis is unfavourable in advanced cases, and when the faulty regimen cannot be corrected.”