Definition. Attacks ox mainly. Causes: accessory causes, chills, rain
storms, night dews, hoar frost, foul or iced water, alimentary
irritants, spoiled fodder, over exertion, hot damp weather, odors of
carrion, crowding, swamps, foul stables, germs or pathogenic ferment,
in man catarrhal, diphtheritic and amœbic, amœba dysenterica, other
microbes, effect of better hygiene. Symptoms: attack sudden, languor,
trembling, weakness, weeping eyes, fever, buccal epithelial softening,
erosions, tenesmus, fœtid, liquid stools, involuntary defecation,
hemorrhoidal congestion, open anus, colics, tender right flank,
splashing on handling, anorexia, salivation, unthrifty skin,
hide-bound, cracked muzzle, later prostration, low temperature, sunken
glazed eyes, drooping head, ears, eyelids, weakness, emaciation,
alkaline, fœtid, frothy, bloody, mucous stools, with sloughs, saliva
acid, gastric liquids alkaline, bile suppressed. Duration: three days
to three weeks or chronic. Mortality 50 to 80 per cent. Complications:
mostly septic, abscess, gangrene of other organs, lungs, joints,
glands, etc. Lesions: rapid sepsis, blood deep red, coagulum loose,
venous congestion, large intestines congested, tumefied, softened,
desquamated, eroded, sloughing, necrotic, folds perforated,
cicatrizing, contents mucopurulent, bloody, putrid, microbes,
glandular lesions, implication of small intestines, stomach mouth,
liver, spleen, hepatic abscess. Diagnosis: from rinderpest by
tardiness and comparative weakness of contagion, absence of general
mucous congestion and epithelial concretions, from toxic enteritis by
same. Prevention: avoidance of causes, separation of sick,
disinfection, careful feeding. Treatment: Demulcents, antiseptics,
astringent tonics, opiates, ipecacuan, calomel, sodium sulphate with
antiseptics, antiseptic enemata of glycerine, phenol, creolin, iron
sulphate, silver nitrate, salicylic and boric acids, rest,
gravitation, careful dieting.
_Definition._ An infective, ulcerative inflammation of the large
intestine but especially of the colic and rectal mucosæ.
It is well recognized as a disease of the ox, and the older writers
allege its existence also in horses, swine and dogs, though this is not
admitted in all modern veterinary works.
_Causes._ It was formerly ascribed to improper hygiene, chills, cold
rain storms, night dews, hoar frost, malarious emanations, putrid,
stagnant or iced water, irritants in food, green, fermented or musty
food, a too liberal diet after starvation, overtaxation in very hot
weather, and bad odors from decomposing carcasses. These can only be
accepted as predisposing causes begetting a general debility, or
debility of the alimentary canal and laying that open to the attacks of
specific microbes. The close aggregation of cattle on ship-board, in
besieged cities, and in the parks of armies in the field, has apparently
contributed to the propagation of the dysentery. The removal of a victim
to a herd with free healthy range seldom starts a new center of the
disease. In all infected herds huddled in small compass there is every
facility for the propagation of a germ already present, and especially
in the commissariat of a belligerent army there are enough privations,
over-exertions and other trying conditions to favor predisposition.
Faulty food like stale bread, musty hay, have been supposed to cause it.
For man and beast alike dysentery is preëminently a disease of the
tropics, and of hot seasons, and will often subside on the advent of
cold weather.
Its propagation on given (swampy) soils, and in particular (foul)
stables strongly suggests a special germ, though for the cow this has
not been perfectly identified. Gerlach vainly attempted to inoculate it,
and it does not often propagate itself beyond the foul and infected
localities or stables, yet its persistence in them for years bespeaks
unequivocally the operation of a special pathogenic ferment.
It may also be fairly assumed that it is not necessary that the same
factor should be present in all cases alike, but that one operates
predominantly in one case and another in another. In other words
dysentery must be recognized as not one disease, but several, of which
the true pathogenic microbes have not yet been fully demonstrated, but
which are classed together because of the similarity of the attendant
lesions.
In man three distinct forms are recognized. 1. =Catarrhal dysentery=,
with frequent small stools of rosy mucus, and blood; and later pus,
scybala, passed with tenesmus, but no sloughs and little odor; 2.
=Diphtheritic dysentery=, with thin watery bloody discharges having a
pronounced cadaveric odor; also tenesmus, sloughs, and increasingly
offensive smell; 3. =Amœbic dysentery= with frequent bloody mucus
stools, tenesmus sloughs and fœtor, but with distinct remissions or
intermissions. With the latter, amœbæ are found abundantly and more so
in the more acute cases with alkaline stools. They are found in the
fresh warm stools, 5 to 8 times the size of a red blood globule and
oval, pyriform or irregular in form, with nucleus and nucleolus.
Kartulis and Hlava succeeded in inducing dysentery in cats and dogs by
injecting pure culture of the amœba, and the former testifies that dogs
in Egypt take the disease spontaneously, and their stools contain the
same amœba coli as is found in man.
Cunningham who investigated the subject in India found amœba in the
bowels of healthy men, and also abundantly in the fæces of horses and
cows, which have naturally the requisite alkaline reaction.
The mere presence of the amœba therefore may not be sufficient to cause
the disease, but with the requisite predisposition and an alkaline
condition of the intestinal contents, it is manifestly an important
factor in the disease.
The causative microbes in other forms of dysentery have not been
identified, but under the requisite irritation and local debility one
can easily conceive of the ordinary bacterial ferments of the intestine,
concurring with others introduced from without, in determining the
morbid condition. With better hygiene the disease is steadily
diminishing in man and beast, though violent epizootics (in cattle)
still appear in connection with wars (siege of Belfort, 1870, Zundel),
and carriage by sea in hot climates (Mediterranean trade, Bouley).
_Symptoms._ The disease sets in suddenly, yet prodromata may
occasionally be observed, such as dullness, langor, trembling over the
flanks and elbows, weakness, prominent, weeping, congested eyes, and low
moans when moved. Then follow hyperthermia, at first slight, heat of the
mouth without injection, epithelial concretions or erosions and diarrhœa
(sometimes there is straining without passage at first). Then follows a
period of profuse and fœtid discharge, with relaxed or open anus, the
liquids escaping involuntarily and smearing the tail, perineum, thighs
and hocks, and the protruded mucosa showing dark red congestions and
even commencing erosions. Colicy pains, slight at first, have now become
intense, and the right side of the abdomen is very tender to the touch
and fluctuates noisily when manipulated. Appetite and rumination are
lost. Salivation may be present, the saliva falling in films to the
ground. The buccal epithelium is softened, loosened and easily detached
by the finger, leaving raw sores. The temperature which has risen slowly
(not as in rinderpest abruptly) may reach 106°. The hair becomes dry,
the skin harsh, rigid, and firmly adherent to the deeper parts, and
often cold, while the muzzle is hot, dry and even cracked.
At a still more advanced stage, the pulse is small, the temperature
lowered, the animal very weak and unsteady and inclined to lie, great
emaciation, sunken glazed eye, drooping head, ears and eyelids, and a
general fœtor from the skin as well as the dejections, which attracts
crowds of flies. By this time there may be passed only bloody mucus
mixed with eschars, and having a most repulsive odor.
It is a noticeable fact that the fæces are alkaline, and in man the
saliva is acid and destitute of its glycogenic properties, the stomach
secretions are alkaline and no longer peptogenic, and the secretion of
bile is arrested until improvement sets in.
_Course._ _Duration._ Some mild cases recover in two or three days, and
in violent cases death may occur at this early date. More commonly the
disease continues for two or three weeks before ending in death or
recovery. Some merge into the chronic form and may last for months and
die in a condition of marasmus. These last cases become mere walking
skeletons, with pallid mucosæ, sunken eyes, scurfy hide-bound skins
covered with vermin, and the frequently everted rectum is congested and
covered with ulcers and eschars. _Mortality_ is _from_ 50 to 80 per
cent.
_Complications._ Most complications are in the direct line of septic
infection. Among the most common are hepatic abscess, gangrenous
pneumonia, and extensive gangrene of the intestinal walls. In man
arthritis, paralysis, parotitis and other secondary affections are seen.
In the animal as well we may expect necrotic centres in any organ, from
the supervention of a general septicæmia.
_Lesions._ The carcasses putrefy with extraordinary rapidity being as a
rule pervaded by septic microbes and their toxins. The blood is of a
deep red, loosely and imperfectly coagulated, and accumulated in the
veins and subcutaneous connective tissue.
The large intestines are the special seat of the disease, the walls
being found hyperæmic, with concentration especially on the mucous
surface which is red, congested, infiltrated, tumefied so that it is
easily detached under pressure by the finger, or broken down into a
putrid pulp. At other points the epithelium or the whole mucosa has been
detached leaving ulcers, varying from mere erosions to the deep and even
perforating sores, through which the putrid contents escape into the
abdominal cavity. At other points the surface is covered by necrotic
masses surrounded by a swollen margin of living mucosa. Elsewhere the
eschars have been detached and the granulating base and margin have
contracted into more or less perfect cicatrices. The contents of the
affected bowel may be largely mucopurulent, or it may be mixed with
blood, with eschars and putrilage from the sores and at times with small
packed masses of food, but in all cases it is very putrid and repulsive.
It always contains the elements of blood and exudation, together with
many microbes, the predominance of individual species suggesting the
main factors in the pathogenesis. Peyers’ patches and the solitary
glands are often the seat of infiltration and ulceration. Virchow points
out that in man the lesions are largely concentrated in the flexures of
the colon in which the ingesta is longer delayed, and the very
convoluted arrangement of the viscus in cattle may be one reason of
their special predisposition to the disease.
The small intestines are exceptionally implicated, and the abomasum red,
congested, ecchymosed and even ulcerated. The mouth and pharynx are
often congested, with erosions and ulcerations on the gums and tongue.
The mesenteric glands are red and swollen or pigmented of a dark gray
color, and these or the adjacent connective tissue may be the seat of
abscess. The liver is enlarged congested, of a yellowish red color, with
granular degeneration and softening. Hepatic abscess is rare in cattle.
The spleen is engorged with black blood and distinctly enlarged.
_Diagnosis._ Dysentery is distinguished from rinderpest by the slower
advance of the hyperthermia, by the absence of buccal concretions of
epithelium, and of vaginal congestion, and above all by the absence of
the virulent contagion by which the rinderpest spreads widely and
rapidly, irrespective of special unwholesome environment. The lesions of
dysentery are concentrated on the large intestines, while in rinderpest
they are extended over the whole alimentary canal, and do not spare
other mucosæ.
From toxic gastro-enteritis it is distinguished by the absence of any
history or lesions showing the ingestion of a poison and by the
concentration of the lesions on the large intestines whereas in
poisoning with irritants, the stomach and small intestines are the most
liable to suffer.
_Prevention._ Precautions against overcrowding on board ship in hot
seasons, and the maintenance of cleanliness are prime considerations. In
commissariat herds close crowding must be avoided, feeding should be
done at different points for six or eight cattle at each, the yards
should be frequently changed, or carefully cleared of manure and
sprinkled with a solution of 3 per cent. sulphuric acid. In case an
animal is attacked it should at once be removed and killed, and its
offal and the yard where it has been, disinfected. Food and drinking
water should be specially wholesome.
_Treatment._ Mild cases may be successfully treated by the use of
mucilaginous draughts, (boiled flaxseed, mallow, slippery elm, gum
arabic) with antiseptics (salicylic acid or salicylate of soda 2 to 3
drs., salol 1 dr., creosote 1 dr., sulphate or chloride of iron 1 dr.)
every three hours.
In the more severe cases the most varied treatment has been resorted to.
Formerly opiates and astringents were largely employed, practically
shutting up the poison in the intestine. Ipecacuan in large and
frequently repeated doses had the advantage of soliciting the action of
both liver and bowels, but however useful, it has gradually declined in
public confidence.
An eliminating and antiseptic treatment has at present the most general
acceptance. Seven grains of calomel has been given every two hours for
two or three days in succession. Still more recently 2 to 4 ozs.
sulphate of soda every three hours with hot water and antiseptics
(salicylates, sulphites, salol, boric acid, creolin, naphthol) have been
substituted. Even more important is the washing out of the large
intestine by antiseptic enemata. These should be very copious and
frequently repeated so as not only to render the contents of the rectum
and colon antiseptic but to secure the discharge of the offensive
matters as they are produced. The agents may be glycerine, carbolic
acid, creolin, sulphate of iron, nitrate of silver, salicylic or boric
acid. If the animal can be made to stand on an inclined plane with its
hind parts elevated it will favor the penetration and retention of the
liquid. Perfect rest is a most important accessory.
In case of recovery the return to ordinary diet should be gradual.