Part 15

Treatment.—Rest is necessary, as even under the most favorable circumstances a cure is difficult to effect. The animal can not stand exertion and should not be compelled to undergo it. It should have much the same general care and medical treatment prescribed for the acute form. Arsenious acid in tonic doses (3 to 7 grains) three times daily may be given. As arsenic is irritant, it must be mixed with a considerable bulk of moist feed and never given alone. Arsenic may be given in the form of Fowler's solution, 1 ounce three times daily in the drinking water. An application of mustard applied to the breast is a beneficial adjunct. The diet should be the most nourishing. Bulky feed should not be given. Linseed mashes, scalded oats, and, if in season, grass and green-blade fodder are the best diet.

THE LUNGS.

The lungs (see Pl. VII) are the essential organs of respiration. They consist of two (right and left) spongy masses, commonly called the "lights," situated entirely within the thoracic cavity. On account of the space taken up by the heart, the left lung is the smaller. Externally, they are completely covered by the pleura. The structure of the lung consists of a light, soft, but very strong and remarkably elastic tissue, which can be torn only with difficulty. Each lung is divided into a certain number of lobes, which are subdivided into numberless lobules (little lobes). A little bronchial tube terminates in every one of these lobules. The little tube then divides into minute branches which open into the air cells (pulmonary vesicles) of the lungs. The air cells are little sacs having a diameter varying from one-seventieth to one two-hundredth of an inch; they have but one opening, the communication with the branches of the little bronchial tubes. Small blood vessels ramify in the walls of the air cells. The air cells are the consummation of the intricate structures forming the respiratory apparatus. They are of prime importance, all the rest being complementary. It is here that the exchange of gases takes place. As before stated, the walls of the cells are very thin; so, also, are the walls of the blood vessels. Through these walls escapes from the blood the carbonic acid gas that has been absorbed by the blood in its circulation through the different parts of the body; through these walls also the oxygen gas, which is the life-giving element of the atmosphere, is absorbed by the blood from the air in the air cells.

CONGESTION OF THE LUNGS.

Congestion is essentially an excess of blood in the vessels of the parts affected. Congestion of the lungs in the horse, when it exists as an independent affection, is generally caused by overexertion when the animal is not in a fit condition to undergo more than moderate exercise. Very often what is recognized as congestion of the lungs is but a symptom of exhaustion or dilatation of the heart.

The methods practiced by the trainers of running and trotting horses will give an idea of what is termed "putting a horse in condition" to stand severe exertion. The animal at first gets walking exercises, then after some time he is made to go faster and farther each day; the amount of work is daily increased until he is said to be "in condition." An animal so prepared runs no risk of being affected with congestion of the lungs, if he is otherwise healthy. On the other hand, if the horse is kept in the stable for the purpose of laying on fat or for want of something to do, the muscular system becomes soft, and the horse is not in condition to stand the severe exertion of going fast or far, no matter how healthy he may be in other respects. If such a horse be given a hard ride or drive, he may start off in high spirits, but soon becomes exhausted, and if he is pushed he will slacken his pace, show a desire to stop, and may stagger or even fall. Examination will show the nostrils dilated, the flanks heaving, the countenance haggard, and the appearance of suffocation. The heart and muscles were not accustomed to the sudden and severe strain put upon them; the heart became unable to perform its work; the blood accumulated in the vessels of the lungs, which eventually became engorged with the stagnated blood, constituting congestion of the lungs.

The animal, after having undergone severe exertion, may not exhibit alarming symptoms until returned to the stable; then he will be noticed standing with his head down, legs spread out, the eyes wildly staring or dull and sunken. The breathing is very rapid and almost gasping; in most cases the body is covered with perspiration, which, however, may soon evaporate, leaving the surface of the body and the legs and ears cold; the breathing is both abdominal and thoracic; the chest rises and falls and the flanks are powerfully brought into action. If the pulse can be felt at all it will be found beating very frequently, one hundred or so to a minute. The heart may be felt tumultuously thumping if the hand is placed against the chest behind the left elbow, or it may be scarcely perceptible. The animal may tremble all over. If the ear is placed against the side of the chest a loud murmur will be heard and perhaps a fine, crackling sound.

One can scarcely fail to recognize a case of congestion of the lungs when brought on by overexertion, as the history of the case indicates the nature of the ailment. In all cases of suffocation the lungs are congested. It is also seen in connection with other diseases.

Treatment.—If the animal is attacked by the disease while on the road, stop him immediately. Do not attempt to return to the stables. If he is in the stable, make arrangements at once to insure an unlimited supply of pure air. If the weather is warm, out in the open air is the best place, but if too cold let him stand with head to the door. Let him stand still; he has all he can do, if he obtains sufficient pure air to sustain life. If he is encumbered with harness or saddle, remove it at once and rub the body with cloths or wisps of hay or straw. This stimulates the circulation in the skin, and thus aids in relieving the lungs of the extra quantity of blood that is stagnated there. If you have three or four assistants, let them rub the body and legs well until the skin feels natural; rub the legs until they are warm, if possible. When the circulation is reestablished, put bandages on the legs from the hoofs up as far as possible. Throw a blanket over the body and let the rubbing be done under the blanket. Diffusible stimulants are the medicines indicated—brandy, whisky (or even ale or beer if nothing else is at hand), ether, and aromatic spirits of ammonia. A drench of 2 ounces each of spirits of nitrous ether and alcohol, diluted with a pint of water, every hour until relief is afforded, is among the best remedies. Or, give a quarter of a pint of whisky in a pint of water every hour, or the same quantity of brandy as often, or a quart of ale every hour, or 1 ounce of tincture of arnica in a pint of water every hour until five or six doses have been given. If none of these remedies are at hand, 2 ounces of oil of turpentine, shaken with a half pint of milk, may be given once, but not repeated. The animal may be bled from the jugular vein. Do not take more than 5 or 6 quarts from the vein, and do not repeat the bleeding. The blood thus drawn will have a tarry appearance.

When the alarming symptoms have subsided active measures may be stopped, but care must be used in the general treatment of the animal for several days, for it must be remembered that congestion may be followed by pneumonia. The animal should have a comfortable stall, where he will not be subjected to drafts or sudden changes of temperature; he should be blanketed and the legs kept bandaged. The air should be pure, a plentiful supply of fresh, cold water always in the stall; and a diet composed principally of bran mashes, scalded oats, and, if in season, grass. When ready for use again the horse should at first receive only moderate exercise, which may be daily increased until he may safely be put to regular work.

PNEUMONIA, OR LUNG FEVER.

Pneumonia is inflammation of the lungs. The chief varieties of pneumonia are catarrhal—later discussed in connection with bronchitis, under the name of broncho-pneumonia—and the fibrinous or croupous variety. The latter form receives its names from the fact that the air spaces are choked with coagulated fibrin thrown out from the blood. This causes the diseased portions of the lungs to become as firm as liver, in which condition they are said to be hepatized. As air is excluded by the inflammatory product, the diseased lung will not float in water.

The inflammation usually begins in the lower part of the lung and extends upward. The first stage of the disease consists of congestion, or engorgement, of the blood vessels, followed by leakage of serum containing fibrin from the blood vessels into the air passages. The fluids thus escaping into the air cells and in the minute branches of the little bronchial tubes become coagulated.

The pleura covering the affected parts may be more or less inflamed. A continuance of the foregoing phenomena is marked by a further escape of the constituents of the blood, and a change in the membrane of the cells, which becomes swollen. The exudate that fills the air cells and minute bronchial branches undergoes disintegration and softening when healing commences.

The favorable termination of pneumonia is in resolution that is, a restoration to health. This is gradually brought about by the exuded material contained in the air cells and lung tissues being broken down and softened and absorbed or expectorated through the nostrils. The blood vessels return to their natural state, and the blood circulates in them as before. In the cases that do not terminate so happily the lung may become gangrenous (or mortified), an abscess may form, or the disease may be merged into the chronic variety.

Pneumonia may be directly induced by any of the influences named as general causes for diseases of the organs of respiration, but in many instances it is from neglect. A common cold or sore throat may be followed by pneumonia if neglected or improperly treated. An animal may be debilitated by a cold, and when in this weakened state may be compelled to undergo exertion beyond his strength; or he may be kept in a badly ventilated stable, where the foul gases are shut in and the pure air is shut out; or the stable may be so open that parts of the body are exposed to drafts of cold air. An animal is predisposed to pneumonia when debilitated by any constitutional disease, and especially during convalescence if exposed to any of the exciting causes. Foreign bodies, such as feed accidentally getting into the lungs by way of the windpipe, as well as the inhalation of irritating gases and smoke, ofttimes produce fatal attacks of inflammation of the lung and bronchial tubes. Pneumonia is frequently seen in connection with other diseases, such as influenza, purpura hemorrhagica, strangles, glanders, etc. Pneumonia and pleurisy are most common during cold, damp weather, and especially during the prevalence of the cold north or northeasterly winds. Wounds puncturing the thoracic cavity may cause pneumonia.

Symptoms.—Pneumonia, when a primary disease, is ushered in by a chill, more or less prolonged, which in many cases is seen neither by the owner nor the attendant, but is overlooked. The breathing becomes accelerated, and the animal hangs its head and has a very dull appearance. The mouth is hot and has a sticky feeling to the touch; the heat conveyed to the finger in the mouth demonstrates a fever; if the thermometer is placed in the rectum the temperature will be found to have risen to 103 deg. F. or higher. The pulse is frequent, beating from fifty or sixty to eighty or more a minute. There is usually a dry cough from the beginning, which, however, changes in character as the disease advances; for instance, it may become moist, or if pleurisy sets in, the cough will be peculiar to the latter affection; that is, cut short in the endeavor to suppress it. In some cases the discharge from the nostrils is tinged with blood, while in other cases it has the appearance of muco-pus. The appetite is lost to a greater or less extent, but the desire for water is increased, particularly during the onset of the fever. The membrane within the nostrils is red and at first dry, but sooner or later becomes moist. The legs are cold. The bowels are more or less constipated, and what dung is passed is usually covered with a slimy mucus. The urine is passed in smaller quantities than usual and is of a darker color.

The animal prefers to have the head where the freshest air can be obtained. When affected with pneumonia a horse does not lie down, but persists in standing from the beginning of the attack. If pneumonia is complicated with pleurisy, however, the horse may appear restless and lie down for a few moments to gain relief from the pleuritic pains, but he soon rises. In pneumonia the breathing is rapid and difficult, but when the pneumonia is complicated with pleurisy the ribs are kept as still as possible and the breathing is abdominal; that is, the abdominal muscles are now made to do as much of the work as they can perform. If pleurisy is not present there is little pain. To the ordinary observer the animal may not appear dangerously ill, as he does not show the seriousness of the ailment by violence, as in colic, but a careful observer will discover at a glance that the trouble is something more serious than a cold. By percussion it will be shown that some portions of the chest are less resonant than in health, indicating exclusion of air. If the air is wholly excluded the percussion is quite dull, like that elicited by percussion over the thigh.

By auscultation important information may be gained. When the ear is placed against the chest of a healthy horse, the respiratory murmur is heard more or less distinctly, according to the part of the chest that is beneath the ear. In the very first stage of pneumonia this murmur is louder and hoarser; also, there is a fine, crackling sound something similar to that produced when salt is thrown in a fire. After the affected part becomes solid there is an absence of sound over that particular part. After absorption begins one may again hear sounds that are of a more or less moist character and resemble bubbling or gurgling, which gradually change until the natural sound is heard announcing return to health.

When a fatal termination is approaching all the symptoms become intensified. The breathing becomes still more rapid and difficult; the flanks heave; the animal stares wildly about as if seeking aid to drive off the feeling of suffocation; the body is bathed with sweat; the horse staggers, but quickly recovers his balance; he may now, for the first time during the attack, lie down; he does so, however, in the hope of relief, which he fails to find, and with difficulty struggles to his feet; he pants; the nostrils flap; he staggers and sways from side to side and backward and forward, but still tries to retain the standing position, even by propping himself against the stall. It is no use, as after an exhausting fight for breath he goes down; the limbs stretch out and become rigid. In fatal cases death usually occurs in from 10 to 20 days after the beginning of the attack. On the other hand, when the disease is terminating favorably the signs are obvious. The fever abates and the animal gradually improves in appetite; he takes more notice of things around him; his spirits improve; he has a general appearance of returning health, and he lies down and rests. In the majority of cases pneumonia, if properly treated, terminates in recovery.

Treatment.—The comfort and surroundings of the patient must be attended to first. The quarters should be the best that can be provided. Pure air is essential. Avoid placing the animal in a stall where he may be exposed to drafts of cold air and sudden changes of temperature. It is much better for the animal if the air is cold and pure than if it is warm and foul. It is better to make the animal comfortable with warm clothing than to make the stable warm by shutting off the ventilation. From the start the animal should have an unlimited supply of fresh, cold drinking water. Blanket the body. Rub the legs until they are warm and then put bandages on them from the hoofs up to the knees and hocks. If warmth can not be reestablished in the legs by hand rubbing alone, apply dry, ground mustard and rub well in. The bandages should be removed once or twice every day, the legs well rubbed, and the bandages replaced. Much harm is often done by clipping off hair and rubbing in powerful blistering compounds. They do positive injury and retard recovery, and should not be allowed. Much benefit may be derived from hot application to the sides of the chest if the facilities are at hand to apply them. If the weather is not too cold, and if the animal is in a comfortable stable, the following method may be tried: Have a tub of hot water handy to the stable door; soak a woolen blanket in the water, then quickly wring as much water as possible out of it and wrap it around the chest. See that it fits closely to the skin; do not allow it to sag so that air may get between it and the skin. Now wrap a dry blanket over the wet hot one and hold in place with three girths. The hot blanket should be renewed every half hour, and while it is off being wetted and wrung the dry one should remain over the wet part of the chest to prevent reaction. The hot applications should be kept up for three or four hours, and when stopped the skin should be quickly rubbed as dry as possible, an application of alcohol rubbed over the wet part, and a dry blanket snugly fitted over the animal. If the hot applications appear to benefit, they may be tried on three or four consecutive days. Unless every facility and circumstance favors the application of heat in the foregoing manner, it should not be attempted. If the weather is very cold or any of the details are omitted, more harm than good may result. Mustard may be applied by making a paste with a pound of freshly ground mustard mixed with warm water. This is to be spread evenly over the sides back of the shoulder blades and down to the median line below the chest. Care should be taken to avoid rubbing the mustard upon the thin skin immediately back of the elbow. The mustard-covered area should be covered with a paper and this with a blanket passed up from below and fastened over the back. The blanket and paper should be removed in from one to two hours. When pneumonia follows another disease, the system is always more of less debilitated and requires the careful use of stimulants from the beginning. To weaken the animal still further by bleeding him is one of the most effectual methods of retarding recovery, even if it does not hasten a fatal termination.

Another and oftentimes fatal mistake made by the nonprofessional is the indiscriminate and reckless use of aconite. This drug is one of the most active poisons, and should not be handled by anyone who does not thoroughly understand its action and uses. It is only less active than prussic acid in its poisonous effects. It is a common opinion, often expressed by nonprofessionals, that aconite is a stimulant. Nothing could be more erroneous; in fact, it is just the reverse. It is one of the most powerful sedatives used in the practice of medicine. In fatal doses it kills by paralyzing the very muscles used in breathing; it weakens the action of the heart, and should not be used. Do not give purgative medicines. If constipation exists, overcome it by an allowance of laxative diet, such as scalded oats, bran, and linseed mashes; also, grass, if in season. If the costiveness is not relieved by the laxative diet, give an enema of about a quart of warm water three or four times a day.