CEREBELLAR DISEASE.
Cerebellum and coördination. Pressure on adjacent parts renders results uncertain. Generic symptoms, ataxia, titubation. Marked symptoms with rapid morbid progress. Treatment: tonic, hygienic.
Whatever functions are exercised by the cerebellum there is no doubt of its control over muscular coördination. It is quite true that disease of any other part of the brain causing effusion, exudation or intracranial pressure will more or less completely arrest the functions of the cerebellum just as disease of the cerebellum producing intracranial pressure will derange the functions of other parts of the encephalon. The general symptoms produced in this way cannot therefore be accepted as indicating the precise localization of an intracranial disease. Dullness, stupor, coma, dilated pupils, choked discs, optic neuritis, and vomiting, are in this sense generic symptoms, which may in the absence of fever indicate dropsy, exudation, apoplexy, tumor, concussion or other lesion, and with hyperthermia may indicate encephalitis or meningitis. But if in the absence of these symptoms and of aural disease there should appear ataxia, swaying unsteady gait, and staggering, there is a strong presumption of cerebellar disease. This may also be manifested by the other and generic symptoms already mentioned only the diagnosis is not then so certain. Again cerebellar disease may exist without the ataxia and lack of balance, but probably only in cases in which the progress is slow and the organ has had ample time to accommodate itself to the as yet comparatively restricted lesions. The result may be a mere defect of muscular tone, or it may extend to an almost absolute loss of contractility, or it may be of any intermediate grade.
Treatment, which is eminently unsatisfactory, consists in improving the general health and tone, by corroborant medicines and conditions of life, and training the muscles by carefully graduated exercise and even electricity.
BULBAR PARALYSIS. DISEASE OF MEDULLA OBLONGATA.
Impaired innervation of bulbar nerves. Paresis of lips, tongue, and larynx. Roaring. Rapid pulse. Glycosuria, albuminuria. Ptosis. Twitching eyelids. Dysphagia. Paralysis. Treatment, rest, cold to head, laxatives, nerve stimulants, tonics, electricity.
The bulb is intimately connected with the origin of the hypoglossal, glosso-pharyngeal, spinal accessory, vagus, facial, and trifacial nerves and active disease in the bulb is therefore likely to entail impairment of the function of several of these nerves. In man this is recognized in chronic progressive bulbar paralysis, which almost always affects the lips, tongue and larynx advancing steadily though slowly to a fatal termination. In degenerative lesions there is modified voice, difficulty of swallowing, rapid pulse, and laryngeal paralysis (especially of the arytenoid muscles). The implication of the root of the vagus may be inferred from the arrest of inhibition of the heart, and from glycosuria or albuminuria. Occasionally the ocular and palpebral muscles are involved causing ptosis, or twitching of the muscles. When the facial (7th) nerve is implicated, paralysis of one or both sides of the face may be marked, including often the ears. When the glosso-pharyngeal, the difficulty of swallowing is a prominent feature, and when the spinal accessory, spasm or paralysis of the neck. In the worst cases death supervenes early, by reason of interference with the respiratory and cardiac functions.
The treatment of these affections is usually very unsatisfactory, though in meat producing animals it may sometimes be desirable to preserve them in preparation for the butcher. Rest, in hyperæmic cases, cold to the head and purgatives, and in those in which fever is absent, small doses of nerve stimulants (strychnia) and tonics (phosphorus, phosphates, ammonia-sulphate of copper, zinc sulphate, silver nitrate) may be tried. A course of arsenic and carefully regulated electrical stimuli may at times give good results.
LOCO POISONING. OXYTROPIS LAMBERTI. ASTRAGALUS MOLLISSIMUS
Astragalus Hornii: A. Lentiginosus: A. Mollissimus: Oxytropis Lamberti: O. Multifloris: O. Deflexa: Sophora Serecia: Malvastrum Coccinium: Corydalis Aurea. In dry regions. Cause, a psychosis. Emaciation. Lassitude. Impaired sight. Illusions. Vice. Refuses other food. Contradictory views. Experiments by Dr. Day.