Williams follows a popular fashion in describing under the above names an affection which may be only a form of equine influenza, but which may be named by itself until its true place can be defined by proof of its actual pathogenic microörganism.
Beside the general constitutional disturbance, this condition is distinguished by marked hyperthermia (103° to 104°), swollen, congested, watering eyelids, cough, strong pulse becoming gradually feeble, firmly coagulating blood, irritable bowels, painful passage of fæces, and, above all, a frequent movement of the feet indicative of discomfort and followed by swelling, often excessive, of the limb or limbs, by a cutaneous and subcutaneous exudate. These various phenomena may all be but manifestations of the rather protean disease, equine influenza, and the cellulitis but variations of the rheumatoid and arthritic forms which are so common in the regular type of that disease in cold or wet climates, or seasons. Williams claims that a prominent danger is the formation of clots in the heart and large vessels and advocates the free use of the salts of ammonia and potash with stimulants. The treatment does not essentially differ from that of equine influenza except in the call for special applications to the inflamed eyes and infiltrated limbs.
PETECHIAL FEVER. ACUTE HÆMORRHAGIC—ANASARCOUS—TOXÆMIA.
Synonyms. Definition. Causes, obscure, bacteria variable, pus microbes no active contagion, toxic products, any toxin causing vaso-dilatation, examples, toxins from fermenting ingesta, debility; impaired innervation, nutrition and function; gravitation; primary and secondary forms: predisposing diseases. Lesions: petechiæ and slight blood extravasations in skin, subcutis, mucosa, submucosa, serosæ, and solid tissues, largest in soft tissues; round cutaneous swellings one to two inches across, patches, cracks, oozing, fissures, sloughs, section shows yellow serous and blood infiltrations, capillaries greatly dilated, infiltrated thickened mucosæ, blocked nasal passages, ulcers, serous and bloody discharges, pharynx, larynx, lungs, stomach, intestines, kidneys, blood firm or diffluent. Symptoms: Hyperthermia, nasal petechiæ, extravasation, pink or yellow oozing, swellings on nose, lips, face, limbs, oozing, cracks, sloughs, turning up of toe from detachment of the flexors, metastasis from skin to lungs, or abdomen, dyspnœa, colics, serous or bloody diarrhœa. Course. Duration: acute two days, average one to three weeks, tardy one to two months, Diagnosis: from glanders, anthrax, urticaria, malignant œdema, horse pox. Mortality. Prognosis: 50 per cent.: hopeless and grave indications. Sudden retrocession. Treatment: excellent sanitary conditions, cleanliness, air, light, green food or mashes, pure water, laxative food, or salts, diuretics, alkaline diuretics, vaso-motor contractors, antiseptics, quinine, strychnine, phenic acid, lysol, ichthyol, sulphites, etc.; locally aluminium acetate, cold water, scarification, nasal injections and tubes, tracheal iodine injections, argentum colloidale intravenously, antistreptococcic serum subcutem, Menveux’s solution.
Synonyms. Purpura Hæmorrhagica; Morbus Maculosus; Anasarca (Fr.); Typhus: Anthrax; Dropsy of Connective Tissue; Mal de Tete de Contagion; Coryza Gangrenosa; Malleus Gangrenosa; Charbon Blanc; Diastashemia; Leucophlegmasia.
Definition. An acute (or subacute), toxæmic, generally secondary disease, manifested by capillary dilatation and petechiæ on the mucosæ, skin, serosæ and elsewhere, and attended by extensive effusions of lymph and blood into the skin and connective tissue, to form hot, tender, nodular, diffused, or general swellings.
Causes. The causes of petechial fever are not clearly made out. Bacteria are found in the early exudate, but these are not constant in kind and it is not unreasonable to suspect that these may be results rather than causes of the lesions. On the other hand there may be an as yet undiscovered organism present, the products of which are capable of producing the disorder. Or the latter may be due to a combination of the toxins of two or more. Among the bacteria found may be named: The pus microbes, cocci, streptococci, staphylococci, and bacilli, have been found and adduced as causes, also diplococci, the bacillus hæmorrhagicus of Kolb, the streptococcus of strangles, the microörganism of contagious pneumonia and that of influenza, with a variety of others too great and too inconstant to be accepted as proof of cause. The fact that rarely more than one animal suffers in the same stable at the same time might be held to oppose the idea of contagion and of a definite organized germ.
Hence the theory of its causation by the presence in the system of the toxic products of bacteria rather than the bacteria themselves. (Dieckerhoff.) Cadeac supposes that any toxin which causes capillary dilatation may determine the disease, and calls attention to the fact that the injection of mallein (a vaso-dilator) aggravates the phenomena of petechial fever and determines enormous local exudations and engorgements. He notes further the potent vaso-dilator action of the products of strangles, contagious pneumonia, and influenza which are among the most frequent antecedents of petechial fever. Dieckerhoff also looks on the phenomena as the result of poisoning by the absorbed toxins of the microbes of suppuration, which modify the nutritive changes in the walls of the capillaries and determine exudations and hæmorrhages. Zschokke thinks that there is infection of the intima of the capillaries, with the formation of coagula. Clots are not found, however, apart from hæmorrhages.
The toxin theory receives indirect support from the absence of the same specific lesions in simple mechanical congestion of the capillaries and veins. Ranvier had no such results from tying the veins of a rabbit’s ear. Roger tied the auricular veins of the rabbit, and then cut the sensory nerves without effect: he then destroyed the cervical sympathetic ganglion, when there supervened marked exudation, lasting for three days. The complete blocking of veins by pressure or aseptic ligature, does not produce a spreading œdema, whereas in ordinary suppurative phlebitis, with abundance of toxins in the tissues this is a constant result.
The toxin theory does not fully account for those cases that occur suddenly, without any manifest pre-existing disease, and as the result apparently of cold and chill. On the other hand, it is only a very small proportion of horses exposed to the same degree of cold and chill that contract petechial fever, and it might well be surmised that in these few an unknown focus of suppuration or other lesion existed prior to the chill or that toxins having the requisite devitalizing and vaso-dilating properties had been absorbed from fermentations in the bowels or elsewhere. The mere exposure is harmless to the very great majority of subjects.