Definition. Susceptible Genera. Causes; gastric paresis, overloading,
cold, fear, exhaustion, poisons, fermentescible food,—new grain,
leguminosæ, frosted vegetables, ruminitis, foreign bodies in rumen,
microbian ferments. Symptoms, abdominal, general. Gases formed under
different aliments—carbon dioxide, marsh gas, hydrogen sulphide,
nitrogen, oxygen. Lesions, rupture of rumen or diaphragm, compression
or rupture of liver or spleen, petechiæ, congestion of lungs and right
heart, of cutaneous and cerebral vessels. Prevention, avoid
indigestible and fermentescible aliments, correct adynamic conditions,
tonics, avoid injurious ferments, make alimentary transitions slowly.
Treatment, exercise, bath or douche of cold water, rubbing and
kneading, rope round abdomen spirally, gag in mouth, dragging on
tongue, movement of a rope in fauces, probang, stimulants,
antiseptics, alkalies, ammonia, oil of turpentine, oil of peppermint,
alcohol, ether, pepper, ginger, soda, potash, lime, muriatic acid,
carbolic acid, creosote, creoline, sulphites, kerosene, chloride of
lime, chlorine, tar, common salt, hypochlorite of soda, magnesia,
eserine, pilocarpin, barium chloride, colchicum, lard, trochar, Epsom
salts, rumenotomy. Treatment of diseased gullet, mediastinal glands,
stomach or intestines.
_Definition._ The condition is a combination of paresis of the rumen and
gaseous fermentation of its contents. The initial step may be the
paresis or in the more acute forms the fermentation.
_Genera susceptible._ While all ruminating animals are subject to this
disorder, it is much more frequent in cattle and sheep than in goats.
_Causes._ It commences in _paresis of the rumen_ in the weak,
debilitated, convalescent or starved animals which are suddenly put on
rich, and appetizing food. Hence it is common in animals that break into
a cornbin, a store of potatoes, a field of growing corn or small grain,
or that are turned out on green food in early spring. Cadeac maintains
that paresis of the rumen is the essential cause in all cases, while the
nature of the aliments ingested fills a secondary and comparatively
insignificant rôle. According to this view the torpid stomach can
neither relieve itself through regurgitation for rumination, nor expel
through the œsophagus the constantly evolving gas which therefore
distends the viscus to excess. In support of this view may be adduced
the occurrence of tympany through fatigue, fear, cold, enlarged
(tubercular) mediastinal glands pressing on the gullet and vagus,
obstruction of the œsophagus by a solid body (choking), impaction of a
morsel of solid food in the demicanal of the calf as noticed by
Schauber, and the cessation of the normal vermicular movements of the
rumen in connection with inflammation of its coats, or extensive
inflammation elsewhere or finally of fever. Even in paralysis of the
stomach by poisons like lead, tympany may be a result. Cadeac attributes
tympany following the ingestion of green food wet with a shower, or
drenched with dew, of frosted potatoes or turnips, or of iced water, to
the paralyzing action of the cold on the rumen. This view is manifestly
too extreme, as the bloating occurs often after a warm summer shower, or
after the consumption of potatoes and other roots and tubers which have
been spoiled by frost but which are no longer at a low temperature when
consumed.
_Tympany_ may also start from the ingestion of certain kinds of _food_
which are _in a very fermentescible condition_. Green food, especially
if the animal has been unaccustomed to it, is liable to act in this way.
Clover and especially the white and red varieties, lucern (alfalfa),
sainfoin, cowpea and other specially leafy plants, which harbor an
unusual number of microbian ferments, and which contain in their
substance a large amount of nitrogenous material favorable to the
nourishment of such ferments are particularly dangerous in this respect.
All of these are most dangerous when wet with dew or when drying after a
slight shower, partly no doubt at times by reason of the chilling of the
stomach, but mainly because the ferments have been stimulated into
activity by the presence of abundance of moisture. Drenching and long
continued rains are less dangerous in this respect than the slight
showers and heavy dews, manifestly because the former wash off a large
portion of the microbes, which under a slight wetting multiply more
abundantly.
Frosted articles act in a similar way, partly when still cold by the
chilling and paralyzing of the stomach, but cold or warm, by reason of
the special tendency of all frozen vegetables to undergo rapid
fermentation when thawed out. This is true of green food of all kinds
when covered by hoarfrost, of turnips, beets, potatoes, carrots, apples,
cabbage, etc., which have once been frozen, and of frosted turnips and
potato tops, though, in the case of the latter agent, a narcotic
principle is added.
In the case of Indian corn, the smaller cereal grains, and certain
leguminous plants (vetches, tares, peas, beans) which have the seed
fully formed but not yet quite hardened nor ripened, there is the double
action of a paralyzing constituent and an aliment that is specially
susceptible of fermentation.
Inflammation of the rumen, already quoted as a cause, may be determined
by hot as well as cold food, by irritant drugs and poisons, and by
narcotico-irritant and other acrid plants in fodder or pasture. In the
same way the inflammation caused by the introduction of foreign bodies
into the rumen, such as nails, tacks, needles, pins, wires, knife
blades, and masses of hair or wool may at times cause tympany.
The two main causative factors, of paresis of the rumen on the one side
and of specially fermentescible food and a multiplicity of microbian
ferments on the other, must be recognized as more or less operative in
different cases, and in many instances their combined action must be
admitted. The tympany is the symptom and culmination of a great variety
of morbid causes and conditions, and its prevention and treatment must
correspondingly vary.
_Symptoms._ The whole left side of the abdomen being occupied by the
rumen, its distension leads to an uniform swelling of that side,
differing from that caused by simple excess of solid ingesta in being
more prominent high up between the last rib and the outer angle of the
ilium, and in giving out in this region a clear tympanitic or drumlike
resonance on percussion. It has also a tense resiliency, like that of a
distended bladder, easily pressed inward by the finger but starting out
to its rotundity the moment the pressure of the finger is withdrawn. The
distension caused by overloading with solids bulges out lower down, is
not resonant but dull or flat when percussed, and yields like a mass of
dough when pressed retaining the indentation of the finger for some
time. The swelling of tympany, when extreme, rises above the level of
the outer angle of the ilium and even of the lumbar spines on the left
side, and if no relief is obtained the right side may undergo a similar
distension.
Auscultation detects an active crepitation over the whole region of the
rumen, finer in some cases and coarser in others, according to the
activity of evolution and the size of the bubbles of gas. The
crepitation is especially coarse and loud in fermentation of green food,
and of spoiled potatoes or other tubers or roots.
In all acute or severe cases, there is anorexia, suspension of
rumination, and the normal movements of the compressed bowels seem to be
largely impaired, though the anus is protruded and a little semi-liquid
fæces or urine may be expelled at intervals. The breathing is
accelerated, short, and labored. The nostrils are dilated, the nose
extended, the face anxious, the eyes bloodshot and the back arched.
Froth may accumulate around the lips, or the mouth may be held open with
the tongue pendent. Sometimes a quantity of gas may suddenly escape with
a loud noise, but without securing permanent relief. The heart beats are
violent and accelerated, the pulse increasingly small and finally
imperceptible, and the visible mucous membranes are congested and
cyanotic. Pregnant females are very liable to abort.
When the right flank as well as the left rises to the level of the
lumbar spines death is imminent, and this may take place as early as
fifteen or thirty minutes after the apparent onset of the attack. Death
may result from nervous shock, from suffocation, or from the absorption
of deleterious gases, or from all of these combined.
In the less acute cases the animal may live several hours before the
affection terminates in death or recovery. As a rule he stands as long
as he can and finally drops suddenly, the fall often leading to rupture
of the diaphragm or stomach, to protrusion of the rectum, or the
discharge of ingesta by the mouth and nose.
In still slighter cases relief comes through vomiting or more commonly
through frequent and abundant belching of gas, the swelling of the
flanks subsides, rumbling of the bowels may again be heard, and usually
there is a period of diarrhœa.
_Gases present._ When the rumen is punctured before or after death so as
to give exit to the gas in a fine stream it proves usually more or less
inflammable, the lighted jet burning with a bluish flame. The usual
inflammable ingredients are carbon monoxide, hydrogen carbide (marsh
gas) and hydrogen sulphide, yet the relative proportion of the gases
varies greatly with the nature of the food and the amount of gas
evolved, carbon dioxide being usually largely in excess. The following
table serves to illustrate the variability:
─────────┬─────────┬─────────┬──────────┬─────────┬─────────┬─────────
│ │ │ │Lameyran │ │
│ │ Gmelin, │ │ and │ │
Gas. │Pflüger. │ from │Lassaigne.│ Fremy, │ Vogel. │ Raiset.
│ │ clover │ │ from │ │
│ │ │ │ clover. │ │
─────────┼─────────┼─────────┼──────────┼─────────┼─────────┼─────────
CO │ 60–80│ 5│ 29│ 5│ 27│ 74.23
CO │ 28–40│ │ │ │ │
CH │ │ 15│ 6│ 15│ 48│ 23.46
HS │ │ 80│ │ 80│ │
O │ │ │ 14.7│ │ │
N │ │ │ 50.3│ │ 25│ 2.22
─────────┴─────────┴─────────┴──────────┴─────────┴─────────┴─────────
The most elaborate observations on this subject are those made by
Lungwitz on the different aliments kept in closed vessels at the body
temperature, and on similar agents fed for days as an exclusive aliment
to oxen provided with a fistula of the rumen for purposes of collection.
He found carbon dioxide to be the predominating gas in all cases, but
that it was especially so in extreme tympanies and varied much with the
nature of the food. The following table gives results:
Percentage of CO_{2}.
Buckwheat (Polygonum fagopyrum) 80
Alfalfa (Mendicago Sativa) 70–80
Clover (Trifolium pratense) 70–80
Meadow grass 70–80
Indian corn (Zea Maïs) 70–80
Spurry (Spergula arvensis) 70–80
Hay of alfalfa or clover 70–80
Oats with cut straw 70–80
Yellow Lupin (Lupinus luteus) 60–70
Vetch (Vicia sativa) 60–70
Oats cut green 60–70
Potato tops 60–70
Potatoes 60–70
Meadow hay 60–70
Leaves of beet 50–60
Leaves of radish 50–60
Cabbage 40–50
The marsh gas varied from 16 to 39 per cent., being especially abundant
in cases of abstinence. It should, therefore, be in large amount in the
tympanies which accompany febrile and other chronic affections. Hydrogen
sulphide was found only in traces, recognizable by blackening paper
saturated with acetate of lead. Oxygen and nitrogen were in small amount
and were attributed to air swallowed with the food. In the work of
fermentation the oxygen may be entirely used up.
_Lesions._ These are in the main the result of compression of the
different organs, by the overdistended rumen. Rupture of the rumen is
frequent. The abdominal organs are generally bloodless, the liver and
spleen shrunken and pale, though sometimes the seat of congestion or
even hemorrhage. Ecchymoses are common on the peritoneum. The right
heart and lungs are gorged with black blood, clotted loosely, and
reddening on exposure. The right auricle has been found ruptured.
Pleura, pericardium and endocardium are ecchymotic. The capillary system
of the skin, and of the brain and its membranes, is engorged, with, in
some instances, serous extravasations.
_Prevention._ This would demand the avoidance or correction of all those
conditions which contribute to tympany. In fevers and extensive
inflammations, when rumination is suspended, the diet should be
restricted in quantity and of materials that are easily digested (well
boiled gruels, bran mashes, pulped roots, etc.,) and all bulky, fibrous
and fermentescible articles must be proscribed. In weak conditions in
which tympany supervenes on every meal, a careful diet may be
supplemented by a course of tonics, carminatives and antiseptics such as
fœungrec oxide of iron, hyposulphite of soda and common salt, equal
parts, nux vomica 2 drs. to every 1 ℔. of the mixture. Dose 1 oz. daily
in the food, or ½ oz. may be given with each meal.
Musty grain and fodder should be carefully avoided, also mowburnt hay,
an excess of green food to which the stock is unaccustomed, clover after
a moderate shower, or covered with dew or hoarfrost, frosted beet,
turnip, or potato tops, frosted potatoes, turnips or apples, also
ryegrass, millet, corn, vetches, peas with the seeds fairly matured but
not yet fully hardened. When these conditions cannot be altogether
avoided, the objectionable ration should be allowed only in small amount
at one time and in the case of pasturage the stock should have a fair
allowance of grain or other dry feed just before they are turned out.
Another precaution is to keep the stock constantly in motion so that
they can only take in slowly and in small quantity the wet or otherwise
dangerous aliment.
When it becomes necessary to make an extreme transition from one ration
to another, and especially from dry to green food, measures should be
taken to make the change slowly, by giving the new food in small
quantities at intervals, while the major portion of the diet remains as
before, until the fæces indicate that the superadded aliment has passed
through the alimentary canal. Another method is to mix the dry and green
aliments with a daily increasing allowance of the latter. Some have
avoided the morning dew and danger of fermentation by cutting the ration
for each succeeding day the previous afternoon and keeping it in the
interval under cover.
_Treatment._ Various simple mechanical resorts are often effective in
dispelling the tympany. Walking the animal around will sometimes lead to
relaxation of the tension of the walls of the demicanal and even to some
restoration of the movements of the rumen with more or less free
eructation of gas. The dashing of a bucket of cold water on the left
side of the abdomen sometimes produces a similar result. Active rubbing
or even kneading of the left flank will sometimes lead to free belching
of gas. The same may be at times secured by winding a rope several times
spirally round the belly and then twisting it tighter by the aid of a
stick in one of its median turns.
A very simple and efficient resort is to place in the mouth a block of
wood 2½ to 3 inches in diameter and secured by a rope carried from each
end and tied behind the horns or ears. This expedient which is so
effective in preventing or relieving dangerous tympany in choking
appears to act by inducing movements of mastication, and sympathetic
motions of the œsophagus, demicanal and rumen. It not only determines
free discharge of gas by the mouth, but it absolutely prevents any
accession of saliva or air to the stomach by rendering deglutition
difficult or impossible. A similar effect can be obtained from forcible
dragging on the tongue but it is difficult to keep this up so as to have
the requisite lasting effect. Still another resort is to rouse
eructation by the motions of a rope introduced into the fauces.
The passing of a hollow probang into the rumen is very effective as it
not only secures a channel for the immediate escape of the gas, but it
also stimulates the demicanal and rumen to a continuous eructation and
consequent relief. Friedberger and Fröhner advise driving the animals
into a bath of cold water.
Of medicinal agents applicable to gastric tympany the best are
stimulants, antiseptics and chemical antidotes. Among stimulants the
alkaline preparations of ammonia hold a very high place. These, however,
act not as stimulants alone, but also as antacids and indirectly as
antidotes since the alkaline reaction checks the acid fermentation which
determines the evolution of the gas. They also unite with and condense
the carbon dioxide. Three ounces of the aromatic spirits of ammonia, one
ounce of the crystalline sesquicarbonate, or half an ounce of the strong
aqua ammonia may be given to an ox, in not less than a quart of cold
water. Next to this is the oil of turpentine 2 oz., to be given in oil,
milk, or yolk of egg. But this too is an antiferment. The same remark
applies to oil of peppermint (½ oz.), the carminative seeds and their
oils, and the stronger alcoholic drinks (1 quart). Sulphuric or nitrous
ether (2 oz.) may be given in place. Pepper and ginger are more purely
stimulant and less antiseptic. Other alkalies—carbonate of potash or
soda, or lime water may be given freely.
Among agents that act more exclusively as antiseptics may be named:
muriatic acid 1 to 1½ drs. largely diluted in water; carbolic acid,
creosote or creolin, 4 drs. largely diluted; sulphite, hyposulphite or
bisulphite of soda 1 oz.; kerosene oil ½ pint; chloride of lime 4 drs.;
chlorine water 1 pint; wood tar 2 oz. The latter agent is a common
domestic remedy in some places being given wrapped in a cabbage leaf,
and causing the flank to flatten down in a very few minutes as if by
magic. The extraordinarily rapid action of various antiseptics is the
most conclusive answer to the claim that the disorder is a pure paresis
of the walls of the rumen. The affection is far more commonly and
fundamentally an active fermentation, and is best checked by a powerful
antiferment. Even chloride of sodium (½ lb.) and above all hypochlorite
of soda or lime (½ oz.) may be given with advantage in many cases.
Among agents which condense the gasses may be named ammonia, calcined
magnesia, and milk of lime for carbon dioxide, and chlorine water for
hydrogen.
Among agents used to rouse the torpid rumen and alimentary canal are
eserine (ox 3 grs., sheep ½ gr. subcutem), pilocarpin (ox 2 grs., sheep
⅕ gr.), barium chloride (ox 15 grs., sheep 3 to 4 grs.), tincture of
colchicum (ox 3 to 4 drs.). Trasbot mentions lard or butter (ox 4 oz.,
sheep ½ oz.), as in common use in France.
In the most urgent cases, however, relief must be obtained by _puncture
of the rumen_, as a moment’s delay may mean death. The seat for such
puncture is on the left side, at a point equidistant from the outer
angle of the ilium, the last rib and the transverse processes of the
lumbar vertebræ. Any part of the left flank might be adopted to enter
the rumen, but, if too low down, the instrument might plunge into solid
ingesta, which would hinder the exit of gas, and would endanger the
escape of irritant liquids into the peritoneal cavity. In an extra high
puncture there is less danger, though a traumatism of the spleen is
possible under certain conditions. The best instrument for the purpose
is a trochar and cannula of six inches long and ⅓ to ½ inch in diameter.
(For sheep ¼ inch is ample.) This instrument, held like a dagger, may be
plunged at one blow through the walls of the abdomen and rumen until
stopped by the shield on the cannula. The trochar is now withdrawn and
the gas escapes with a prolonged hiss. If the urgency of the case will
permit, the skin may be first incised with a lancet or pen knife, and
the point of the instrument having been placed on the abdominal muscles,
it is driven home by a blow of the opposite palm. In the absence of the
trochar the puncture may be successfully made with a pocket knife or a
pair of scissors, which should be kept in the wound to maintain the
orifice in the rumen in apposition with that in the abdominal wall,
until a metal tube or quill can be introduced and held in the orifices.
When the gas has escaped by this channel its further formation can be
checked by pouring one of the antiferments through the cannula into the
rumen.
When the formation of an excess of gas has ceased, and the resumption of
easy eructation bespeaks the absence of further danger, the cannula may
be withdrawn and the wound covered with tar or collodion.
When the persistent formation of gas indicates the need of expulsion of
offensive fermentescible matters, a full dose of salts may be
administered. If the presence of firmly impacted masses can be detected,
they may sometimes be broken up by a stout steel rod passed through the
cannula. If the solid masses prove to be hair or woolen balls,
rumenotomy is the only feasible means of getting rid of them.
In _chronic tympany_ caused by structural diseases of the œsophagus,
mediastinal glands, stomach or intestines, permanent relief can only be
obtained by measures which will remove these respective causes.