Physalix working in Chauveau’s laboratory has found the best results from the use of weakened artificial cultures. He cultivated the microbe of Lignieres in peptonised bouillon having 6 per cent. of glycerine, and allowed successive cultures to rest (without reseeding a new culture fluid), after they have attained to their full growth. The strength of the culture is in inverse ratio to the period that elapsed between successive cultures, leading up to this one, and the first inoculation is made with the weakest product that will produce a very limited local swelling which is fully developed in 48 hours, and disappears in a few days. Three or four inoculations are made successively with cultures of gradually encreasing potency, after which immunity persists for years. It is to be understood, that an overdose will overcome the immunity at any time; also that the passage of a culture of lessened potency through a dog or Guinea pig will raise it to its original virulence. Physalix operated only on young dogs, that had not shed their milk teeth, and injected 2 to 3 c.c. of the culture as a dose with only 2.5% mortality. Others had less success.
Treatment. To secure good results in the treatment of distemper every attention must be paid to good hygiene. An open air life in summer, and a roomy, clean, well-aired, warmed building in winter are most important. Chills, foul air, and filth generally are to be carefully guarded against. Food should be moderate in amount, easily digested and nutritious. Milk is especially good (sweet, skim or buttermilk); then biscuit and milk, or in patients accustomed to animal food, lean meat, minced, scraped or pulped. Warm baths are often advantageous, but they must be given with great caution to avoid chill.
Medicinal treatment is largely symptomatic. An excessively high temperature (104° and upward) may be met by warm baths, or antipyretics—quinine, acetanilid, salicylate of soda, antipyrine, phenacetin, or even damp compresses to the sides. As a rule, however, it is not well to continue such agents as acetanilid, antipyrine or phenacetin longer than is absolutely needful to reduce excessive temperature.
Attempts have been made to check microbian proliferation by antiferments, such as quinine, calomel, creolin, phenol, and phenacetin. The tonic action of quinine specially recommends it but like all bitters it is obnoxious to a dog with a delicate stomach. Calomel is especially recommended by Fröhner as a gastric and intestinal antiseptic and its indirect action on the liver renders it valuable in many cases. Creolin and carbolic acid exhaled from saturated cloths tend to disinfect the air passages and give tone to the mucosa. My colleague Dr. P. A. Fish gave carbolic acid, 2 per cent., and afterward 4 per cent. in normal salt solution, and in doses of ½ to 1 drachm, subcutem once and twice a day. In the initial stages, it seemed often to be of great value, quieting the nervous excitement, improving the general symptoms, and in some instances apparently cutting short the affection. Trasbot recommended strong infusion of coffee, and Zippelius sodium chloride, while others gave ergotin, or better hydrogen peroxide in spray or as a draught.
Eliminative treatment. As in all depressing contagious diseases, we must favor elimination of the toxins, and in this case without risking any material encrease of debility. Calomel (7 grs.), sodium salicylate or benzoate (4 grs.), sodium bicarbonate (7 grs.), potassium iodide (4 grs.), chlorate (7 grs.), or nitrate (7 grs.) may be cited. Digitalis (1 gr.), strophanthus, or caffeine are especially recommended by their power of encreasing the tone of the heart when that has become weak or exhausted.
For the respiratory symptoms we may employ the antiseptic inhalations already named, or, in place of these, iodine or sulphurous acid. The nervous cough may be met by syrup of poppies, or anise, by morphia, or codeia. (Recipe: morphinæ hydrochloras 0.1 grams: aquæ amygdal. amar. 10 grams, aquæ distill. 150 grams. M. A teaspoonful three or more times a day. Fröhner). As expectorants, ammonium chloride (5 grs), or acetate, senega, or apomorphia (⅒ gr.), may be used. In vigorous subjects ipecacuan (½ to ¾ gr.), or antimonial wine (1 drop). Hydrogen peroxide in doses of a teaspoonful is often useful. Among counterirritants and derivatives the warm bath and cold compresses are especially valuable, or tincture of iodine, or camphorated spirit, or equal parts of aqua ammonia and olive oil serve a double purpose as furnishing at the same time an expectorant inhalant.
Special pulmonary complications must be dealt with on general principles as advised for the special diseases, bearing in mind always the profound prostration and the need to avoid depressing agents.
For conjunctival symptoms bathing with tepid water to soothe irritation and remove adhesions and crusts, may be followed by a drop of aqueous solution of pyoktanin (1:1000) under each lid, twice a day, or cocaine (3:100), or silver nitrate (½:100); may be used. Fröhner advises creolin (½:100); Cadeac, cresyl (½:100); Müller, mercuric chloride (1:2000) or boric acid (1:40). Other Collyria may be substituted (see diseases of the eye). In violent inflammations atropia will find a place and in ulcerations boric acid, silver, pyoktanin, calomel, or hydrogen peroxide. When irritation and rubbing are persistent a cocaine solution may be dropped into the eye every few hours. When the ocular troubles persist during general convalescence tonics with good nourishment and hygiene are demanded.
With digestive symptoms the attendant vomiting will usually have cleared the stomach of irritant contents. In the exceptional cases it may be unloaded by apomorphia (¹⁄₁₀₀ gr. subcutem), or ipecacuan wine a teaspoonful by the mouth. More commonly a check must be placed on persistent vomiting by bismuth nitrate (3 grs.), laudanum (5 to 10 drops), creosote (5 drops), or chloroform (5 to 10 drops), and small pieces of ice. A derivative to the epigastrium is sometimes useful. The food should be of the simplest and most easily digested kind, milk, meat-soup skimmed of fat, meat juice, scraped or pulped raw meat. Demulcents like gum water, slippery elm bark, or decoction of marsh mallow may be resorted to, and in case of extreme irritability nourishment may be given by rectal injection. As vomiting may be kept up by irritants in the intestines a tablespoonful of tincture of rhubarb may be required to be repeated twice a day until relief is secured. Calomel and chalk (1:12) in grain doses will sometimes serve a good purpose. Also dilute hydrochloric acid in water (1:60) in doses of a teaspoonful with pepsin, gentian, quinine or nux vomica will often contribute much to restore tone and function. Septic intestinal fermentations may be met with beta-naphthol, naphthalin, (7 grs.), chloral hydrate (10 grs.) lactic acid (buttermilk), or salol (5 grs.). The attendant fœtid diarrhœa may demand in addition opium or silver nitrate (½ to 1 gr.). The gastric secretion is usually suspended so that it largely passes into the intestines unchanged. Of course it should not be used along with muriatic acid.
The skin eruption is usually considered of little consequence, or, by some, beneficial (Cadeac). If treatment is desired it may consist in dusting powders, demulcent soothing dressings and perhaps stimulating liniments as found under skin diseases. It usually disappears with the elimination of the toxins and the restoration of vigorous health.