Perhaps the most important indication is to secure depletion from the overloaded portal system and liver. Where nothing better offers, a pint or quart of castor oil, or a pound of Glauber salts, or a half drachm of podophyllin and four drachms of aloes may be given. If available 1 to 1½ grains of eserine, or 7 grains of barium chloride may be given hypodermically in distilled water or that which has been raised to the boiling point. This may be supplemented by frequent injections of hot soap suds or even of laxative saline solutions. If the bowels can be roused to free secretion the removal of toxic matters from the portal blood and the delay in the progress of similar matters through the liver will go far toward securing a favorable result. When free purgation has been secured recovery can usually be counted on.
The action on the bowels must be followed up by diuretics to eliminate the offensive matters from the general system. Colchicum has been recommended because of its action in increasing the solids of the urine, and this may be combined with saltpeter or other diuretic, or the latter may be used alone and repeated twice a day. If, however, the patient can, by the free use of common salt or otherwise, be induced to drink freely of water, the elimination through the kidneys will be sufficiently secured.
The muscular weakness and paralysis that remain after the acute symptoms have subsided must be met by stimulating liniments and even blisters to the loins or affected muscles, by the internal use of strychnia (2 grs. twice daily) until the jerking of the muscles indicates that its physiological action has been secured, and by an electric current daily for ten minutes at a time through the affected nerves and muscles. Animals that have been helpless for weeks have, in our hands, recovered under such treatment, and even cases of several months’ standing, with the most extensive atrophy of the triceps, and in which the animal could barely stand, have made a satisfactory recovery.
Any remaining nephritis must be treated according to its indications.
During recovery and in the convalescent animal the diet should be laxative and non-stimulating. Bran mashes, turnips, beets, carrots, green fodder, ensilage and scalded hay may be allowed. Oats, corn, beans, peas, vetches, etc., must be carefully avoided. If the food fails to maintain the bowels in a gently relaxed condition one, two or more ounces of sulphate of soda may be added daily.
In the mild cases a good dose of purgative medicine succeeded by a course of diuretics will serve a good purpose.
In all cases alike work must be resumed very gradually. At first the animal may be walked a few hundred yards, and the pace or load and duration of exercise may be increased day by day until full work can be safely endured. In an animal that has once suffered the same gradual inuring to labor should be followed, after any short period of rest on a fairly good ration.
JAUNDICE, ICTERUS, THE YELLOWS.
Symptomatic. Causes: Mechanical obstruction of bile duct, gall-stones, hydatids, distomata, extraneous bodies, inflammation, stricture, obliteration, absence, ulceration, spasm, tumor, enlarged lymph glands, gastric tumors, pancreatic, kidney or omental tumor, aneurism, fæcal accumulation, pregnancy, ovarian tumor: Without mechanical obstruction, ptomaines and toxins, animal venoms, mineral poisons, hepatic atrophy, fear, other emotions, cerebral concussion, imperfect oxidation, excess of bile, hepatic inflammation, constipation and reabsorption of bile, experimental jaundice, balance of tension in gall ducts and blood vessels, duodenitis, compression of aorta, hæmatoidin and bilirubin, destruction of blood globules by hydroæmia, taurocholate of soda, chloroform, ether, freezing, heat, electricity, alkalies, nitrites. Hæmoglobin: Its solubility in horse. Bile acids and blood pigment. Summary of causes. Gravity of icterus. Symptoms: Coloration, yellow, orange, brown, of tissues and secretions: Tests, staining white paper, Gmelin’s test, nitric and sulphuric acids, rainbow hues: Pettenkofer’s test for bile acids, syrup and sulphuric acid, dark violet: Stranburg’s test syrupy paper and sulphuric acid, dark violet; clay colored fœtid stools; gravity.
The terms icterus and jaundice are applied to a yellowness of the mucosæ, urine, skin and tissues caused by the presence in them of the coloring matters of bile. The condition is a symptom of many different affections rather than a disease per se, yet the phenomenon is so characteristic that it has been hitherto accorded a special place and article in systematic works.