Diagnosis. This is largely based on the speedy supervention of the attack on a feed, the animal having been apparently well before, on the onset by slight colics, rapidly passing into great and continuous suffering and stupor, with tympanitic tension of the abdomen, and suppression of the intestinal movements, in the absence of any distinct or marked hyperthermia. The rapid progress to death or recovery is equally characteristic.
Treatment. In mild cases the prompt use of aromatics will sometimes succeed; tincture of pimento, anise or coriander 2 to 3 ounces, oil of peppermint, 20 to 30 drops. Stimulants, aqua ammonia, 1 to 2 drachms, largely diluted, ether 1 ounce, brandy or whisky 1 pint, will sometimes succeed. A good combination is dilute hydrochloric acid, 1 drachm, oil of turpentine 1 ounce, olive oil ½ pint.
Still more effective in the rousing of the torpid vermicular movements are eserine sulphate 1.5 grain or pilocarpin 2 grains, or barium chloride 7 grains subcutem.
These largely replace the old plan of giving a dose of aloes in bolus, yet in case of need aloes may still be given in ounce doses in cold water injections. The cold serves to rouse the vermicular movements of the bowels and sympathetically of the stomach.
Walking exercise, friction over the abdomen, and even electric currents through the epigastrium and left hypochondrium may be helpful.
In very urgent cases, 1 ounce to 2 ounces chloral hydrate is often effective. It acts as a powerful antiferment, checking further extrication of gas, and counteracts spasms of the bowels, so that gas passes more freely per anum, vermicular movements are resumed and recovery may be hoped for.
Puncture of the stomach through the external abdominal wall can only be effected by transfixing the transverse colon above which it lies and few have the hardihood to undertake this. It may, however, be punctured with comparative safety through the fourteenth to the seventeenth intercostal space in its upper half (Scammel). The overdistended stomach pressing forward on the left half of the diaphragm, applies that against the inner surface of the ribs, the lung being driven forward out of the way, and the liver and colon are also displaced, so that the trochar transfixes the skin, intercostal muscles, costal and phrenic pleura, diaphragm, peritoneum and stomach. The marked drumlike resonance on percussion indicates the best point for the puncture, and the trochar should be directed inward and slightly backward and pushed until solid resistance at its point ceases. As the intestines are usually tympanitic as well it may be requisite to puncture also the cæcum and colon, to restore the peristalsis of the alimentary tract generally. Antiseptics such as sulphurous acid, the sulphites, or hyposulphites, calcium chloride, bleaching powder, potassium permanganate or chloral hydrate, may be introduced through the cannula or by the mouth.
As far as the stomach is concerned, an effective relief can be had through the probang or stomach pump. A small one-half inch hollow probang may be safely passed through the nose and gullet into the stomach, and any gas or liquid allowed to escape. With proper attachments this may be fixed to a stomach pump and the viscus exhausted of all available liquid, after which an equal amount is pumped in and again withdrawn, until the contents are reduced to a normal amount. The water pumped in may be rendered antiseptic by sodium chloride, sodium bisulphite, or other antiferment, so that further extrication of gas will be prevented. If it is necessary to use the ordinary probang or stomach tube introduced through the mouth, great care must be taken in introducing it to see that the soft palate does not deflect it downward into the larynx. Its presence in the gullet above and beyond the larynx can be felt by manipulation from without, and until this is ascertained it should on no account be pushed onward.
The importance of a measure of mechanical relief such as this, is the greater that the stomach of the soliped is non-absorbing, and relief from undue pressure of contents can only be had by their passage upward or downward. Then again, the horse cannot vomit like the carnivora and omnivora, nor regurgitate like ruminants, and if left to himself with engorged stomach, his case is hopeless indeed.
The contingent weakness in cases of recovery may demand careful feeding and a course of bitter tonics.