In strangles, from puncture, kicks, blows, foreign bodies in food,
larva, cysts, large or small, creamy or cheesy, open into bowel or
peritoneum, infective peritonitis. Symptoms: rigor, ill health,
unthrift, colics, tender abdomen, tympany, painful movements, lying,
rising, turning, going downhill, rectal exploration, phlegmonous
swelling, pus passed by anus. Treatment: open when it points on
abdominal wall, or when near rectum, antiseptics, support strength,
careful dieting, antipuruleut agents.
This is most common as an irregular form of strangles, the abscess
forming in connection with the mesenteric glands or on the walls of the
intestine. Small abscesses may also implicate the mucous glands or
Peyer’s patches as a result of catarrhal enteritis. Less frequently an
abscess forms in the seat of the puncture of the colon for tympany, or
in connection with blows, kicks, punctures with stable forks, nails and
other pointed objects. Foreign bodies entering with the food and the
cysts of the larvæ of the sclerostomata will also give rise to
suppuration.
These abscesses may attain a large size, especially in strangles, and
involve adhesions between the bowel and other viscera, or the walls of
the abdomen. Or they may be small like peas or beans scattered along the
coats of the intestine or between the folds of the mesentery. They may
be inspissated to the consistency of thick cream or rich cheese, and
they may rupture into the intestine, through the abdominal walls or into
the peritoneum. In the last case infective peritonitis sets in usually
with fatal results.
_Symptoms._ These are generally obscure. There may have been noticed a
rigor, and there are always marked indications of ill health, dullness,
lack of spirit or appetite, dryness and erection of the hair, hide
bound, insensibility of the loins to pinching, colics after meals,
tenderness of the abdomen, tympany, groaning when lying down or rising,
when turned around short, or when walked down hill. Sometimes the
abscess can be distinctly felt by the hand in the rectum. When it
implicates the abdominal walls there is usually a diffuse phlegmonous
swelling, at first soft and pasty, then firm and solid, and finally
softening and fluctuating in the center. Sometimes there is the
evacuation of pus by the anus or of the investing membrane of the
abscess, and this may be expected to herald recovery. In case of
infective peritonitis there are the usual symptoms of stiff movement,
the bringing of the feet together under the belly, abdominal tenderness,
trembling, hyperthermia, cold ears and limbs, cold perspirations, great
dullness and prostration, small, weak or imperceptible pulse, hurried
breathing and gradual sinking.
_Treatment._ This is most favorable when the abscess approaches the
surface so as to be punctured through the abdominal walls. In other
cases it is so situated that it can be punctured with trochar and
cannula through the rectum. In such a case it may be evacuated and
injected with a nontoxic antiseptic, the puncture and injection being
repeated as wanted. In the internal and deeply seated abscesses we must
seek to support the general health, give pure air, easily digestible and
nourishing food, and agents that may be hoped to retard suppuration.
Hyposulphite of soda in ½ oz. doses, or sulphide of calcium in scruple
doses, may be repeated two or three times a day.