Costiveness is best met by injections of water, blood warm, or if there is much hyperthermia, of cold water. This latter stimulates the peristalsis more actively and at the same time lowers the temperature. By unloading the large intestines it removes irritants, without danger of encrease of congestion or diarrhœa.
If anything more is wanted for these mild cases, small doses of stimulating diuretics or diaphoretics may be given. Sweet spirits of nitre ½ oz. or liquor of acetate of ammonia 2 oz. may be given twice a day, the latter in the drinking water or gruel. In the absence of these saltpeter ½ oz, or potassium acetate ½ oz. may be given.
In the more severe cases more active treatment is resorted to, but in all cases one should avoid measures that tend to greatly depress the vital powers and especially the circulation. Heroic treatment has been all but universally condemned and yet Trasbot claims to have had excellent results from a moderate venesection (2–5 qts.) in strong, muscular, well conditioned animals. The blood became more fibrinous, the general symptoms improved and complications were far less marked. During twenty years, in a large number of cases, it had constantly the same results, restoring appetite, opening the closed eye, imparting new life, lowering temperature, and checking congestions. The results were best in all cases when it was employed early, but they were almost equally good when later congestions set in, or when the ordinary inflammatory localizations were advancing, and he found the measure hurtful only when, in the advanced stages, the animal was worn out, and destitute of all power of recuperation.
Antipyretics have been lauded and decried, and it is doubtless best to use them with due discrimination and caution. Acetanilid, the agent in most common use, is a powerful cardiac depressant, and in this disease the heart is often already dangerously weak. Yet in cases with very high temperature, seriously threatening life, acetanilid in doses of 2 drams, repeated every second or third hour until the temperature falls, and thereafter twice or thrice daily, for a day or two, may save the patient. Similarly, where there are indications of violent headache (drooping head, eyelids and ears, congested and watery conjunctiva, stupor or irresponsiveness) a dose or two of acetanilid with the same amount of sodium bromide will often give material relief. The general suffering and disorder attendant on the cephalalgia, if allowed to continue, prove a direct bar to improvement, and endanger complications that might otherwise be escaped. On the other hand, there is constant danger from too large doses, or a too long continued use of acetanilid in influenza. Phenacetin may be substituted in 2 dram doses, the action being somewhat more prompt and transient. As less dangerous than the coal tar antipyretics, we may fall back on such agents as sodium salicylate, ½ to 1 oz., or sulphate of quinia, 20 grs.
Elimination of toxins and waste products is to be secured and this is more safely conducted by the kidneys or skin than by the irritable alimentary canal. Plenty of pure cold water is one of the best and simplest resorts. Aside from this, where there is much hyperthermia, bicarbonate of potash or soda will serve the various purposes of an antidote to the acid blood, an eliminant and an antithermic. Under the same circumstances saltpeter may be resorted to in ½ oz. doses twice daily. When, however, the heart is weak it is better to employ ammoniacal or etherial diuretics:—spirits of nitrous ether, 1 oz. or liquor of acetate of ammonia, 2 to 4 ozs. By combining these with extract of belladonna and camphor a fairly standard prescription may be prepared.
Inhalations of warm water vapor, rising from hot water or a hot mash in a bucket, over one end of which a bottomless bag is drawn, while the other end receives the nose of the horse, will greatly relieve the irritation and the cough. It can be made even more soothing by introducing a little alcohol, eucalyptol, menthol, camphor, poppy-heads, or other anodyne. Or the water vapor may be set free in a close stall from a boiling tea-kettle or a steam pipe, and an admixture of sulphurous acid made by burning a few pinches of sulphur, more or less according to the size and closeness of the stall. If the stall is tight enough a steam bath may be given with much profit in the early stages.
Counter irritants applied to the throat, or, if need be, to the breast and sides of the chest will often give material relief, acting as derivatives and probably also by modifying the globulins in the exudate and thus influencing the course of the disease. In case of sore throat of a very high type it may be best to apply a compress or poultice, or even a piece of sheepskin for a day or two, until, by antithermics, cooling diuretics and soothing inhalations, the severity of the inflammation has abated. The common mustard pulp made with tepid water, rubbed in, and covered by paper, may be applied for an hour; or the soap liniment (soap 6 ozs., camphor 3 ozs., and proof spirit, liquor ammonia and linseed oil aa 1 pint) may be rubbed on repeatedly; or a blister of cantharides may be used.
The ophthalmia may be treated by a moist atmosphere, a few drops twice daily of a solution of atropine beneath the lids, a similar treatment with pyoktanin, (1:1000), or a solution of mercuric chloride (1:2000).
In case of gastro-intestinal inflammation elimination is to be sought by ⅓d the usual laxative dose, supplemented if need be, by injections. Half a pint of olive oil with 20 grs. calomel will usually be well borne. Counter irritants may be applied to the abdomen, and the bowels must be carefully watched and any inactivity or derangement corrected. A slight diarrhœa is not to be too hastily checked as it may serve at once to eliminate offensive matters and subdue mucous inflammation. Solutions of flax seed, gum, or slippery elm in the drinking water may serve a good end.
In case of cardiac weakness with intermittent or irregular pulse, hurried breathing, and an undue contrast between the violence of the heart action and the weakness of the pulse, circulatory stimulants are called for. Digitalis 10 grains twice daily, strophanthus tincture 1½ dr., strophanthin subcutem ¼ grain, caffeine 5 grains, veratrine ⅒th grain, or strychnia 2 grains.