JAUNDICE OF THE NEW-BORN. ICTERUS NOUVEAUX NÉS.

In mules; less frequently in horses and cattle. Bacteridian.

Predisposition from alleged miscegeneration. Offspring of lymphatic

mares. Spoiled fodders, foul buildings, exposure, infection by

umbilicus. From gastro-enteritis, diarrhœa, dysentery. Congenital.

Symptoms: refuses the teat, scours, red urine, palpitation, colics,

perspirations, inflammations, or abscesses of navel, arthritis, other

internal disorders. Death from exhaustion or in convulsions. Or

symptoms subside and pass in 15 days. Diagnosis: prostration,

palpitation, icterus, and bloody urine with omphalitis. Streptococci.

Prognosis: with hæmaturia nine-tenths fatal. Lesions: icterus, heart

soft, flabby, lungs congested, general ecchymosis, blood black, clot

diffluent, liver congested, enlarged, spleen, swollen, softened with

spots of brownish yellow, meconium bloodstained, kidneys swollen,

congested, points of infarction or necrosis, urine bloody, navel

lesions. Treatment: for congenital cases improve hygiene for dams; for

offspring, antiseptics to navel, shelter, warm box; aloes to dam, or

oil to colt, antiseptics internally, demulcents, stimulants,

derivatives, opium, water, alkalies.

This has been observed in cattle (Kitt), and in horses (Levrier,

Bernadin, Lhomme) but above all in mules (Villa-Roya, Carrere, Levriere,

Bernadin, Lhomme, Hartmann, Dieckerhoff).

The affection is a bacteridian disease, in which there is a great

destruction of red globules, and liberation of hæmatin, with hæmaturia

and yellow coloration of the tissues.

_Causes._ Carrere attributes much to a supposed congenital weakness

induced by the unnatural generation of ass with mare. Cadeac noticed

that the offspring of certain mares and horses remained sound, while the

progeny of the same animals, and asses suffered largely from icterus.

Levrier found it especially in the mules born of mares having a

lymphatic temperament or suffering from canker, grease or chronic

lymphangiectasis. Bernadin and Lhomme attribute much to bad hygiene, and

especially to poor or spoiled fodders. Lhomme, Lafosse and Trasbot find

accessory causes in cold and wet weather. Retention of the meconium is

another cause. Dieckerhoff, Hartmann, Cadeac and Bournay trace the

disease to bacterial infection as the essential cause. Many cases

originate in septic infection and inflammation of the navel and

umbilical veins. Others commence with mucous gastro-enteritis, attended

by diarrhœa or dysentery. In other cases the germs appear to have

reached the liver through the circulation as the animal is already

affected at birth.

_Symptoms._ When not congenital, symptoms are usually seen in the first

few days of life, usually before the fifth day.

In congenital cases the new born animal is unable to stand at all or for

longer than a very short time, it lies listlessly and makes no attempt

to suck even when held up to the teat. There is acceleration of pulse

and respiration, the heart beats are tumultuous, the mouth is dry, the

mucosæ of a straw yellow, the bowels are costive, and the urine, whether

discharged in life, or found in the bladder after death, is bloody.

When attacked later, the animal becomes dull, weak, and stupid, refuses

the teat, and has the bowels relaxed. The mucosæ become pale yellow, the

breathing accelerated, the heart beats violent, and the pulse rapid,

small and weak. The urine is passed slowly and with effort and has a red

hue more or less deep according to the severity of the attack. Colics

are not uncommon, causing uneasy shifting of the limbs and tail, cries,

frequent lying down and rising, and partial or general perspiration.

Complications on the part of the navel and umbilical veins are to be

looked for, in open sores, swellings, abscess, phlebitis, and in

arthritis and secondary abscesses in different organs. Death may occur

quietly, as from exhaustion, while in other cases it is preceded by

convulsions.

In case of recovery, there is an improvement of the general symptoms,

the heart and respirations become moderate, appetite is restored, the

little animal sucking the teat, there are abundant, yellow, semi-solid

defecations, the strength increases day by day, and convalescence may be

fully established by the twelfth to the fifteenth day.

_Diagnosis._ This is mainly based on the extreme weakness and

prostration, the violent heart action, the jaundiced hue of the mucous

membranes, and the bloody urine. Confirmation may be sought in the

presence of streptococci in the fresh urine, kidneys, liver and blood,

and in the artificial cultures made from them. The presence of

omphalitis is further significant.

_Prognosis._ Bernardin says that if hæmaturia is present nine out of ten

cases are fatal, while in the absence of this feature nine-tenths

recover.

_Lesions._ The jaundiced appearance of the conjunctiva and other tissues

is constant. The heart is pale, soft and flaccid, with petechial patches

of a deep red extending into the muscular substance; the lungs are

congested with similar patches of blood-staining; the blood in the heart

and larger vessels is dark, and fluid or only loosely clotted. The liver

is congested to twice or thrice its normal size (10 lbs. in place of 3

or 4 lbs.); the spleen is enlarged, softened, and shows spots of

brownish yellow. The small intestine contains a yellowish or dark red

meconium, and it may contain effusions of dark blood, while its mucosa

is inflamed, thickened, easily lacerated, and pigmented, or marked by

petechiæ. The large intestines and especially the rectum are packed with

hard dry balls.

The kidneys are enlarged, often to double their volume, and deeply

congested, with infarcts, and patches of necrosis, of a pale brownish

yellow hue. The urine in the bladder is deeply stained with blood

coloring matter.

_Treatment._ For congenital cases it is manifest that treatment must be

preventive and applied to the dam, before parturition. An open air life,

moderate exercise, sound, easily digestible and nourishing food;

grooming; in the stable, cleanliness, dryness and good ventilation; good

water, are essential.

For the offspring, antiseptics (tannin, mercuric chloride lotion,

copperas, calomel, iodoform), applied to the navel, and protection

against cold winds and rains, and damp lairs. For mules and other young

animals born in severe, winter weather a dry, warm, foaling box is

desirable, and the little animal should be rubbed dry and covered with a

warm woolen blanket. When the temperature approaches zero or the barn is

cold, the smaller animals, as soon as they are dropped, should be placed

under a box with a jar of hot water wrapped in woolen coverings, or with

hot bricks similarly wrapped, and should only be let out for food when

they are completely dried, or when the weather has moderated.

_Therapeutic treatment_ may be commenced by a dose of aloes given to the

dam, or of olive or castor oil or manna given to the offspring. As a

substitute sulphate of soda may be used. Antiseptics like salicylate of

soda, salol, or the sulphites may be added. To act as a demulcent on the

alimentary and urinary tracts, well boiled flaxseed tea is usually

recommended. Weakness may be met by warm strong coffee, salicin, quinia,

or other bitters, and more stimulating agents like camphor, angelica,

assafœtida, or even oil of turpentine may be added. Diarrhœa may be

checked by linseed tea, mustard plasters, or in obstinate cases, by

opium. Elimination should be sought by administering abundance of pure

water or watery demulcents, and even by the use of alkalies like

bicarbonates of soda or potash. A moderately free action of the bowels

must be constantly maintained.

Antiseptic treatment of the navel and umbilical veins must not be

overlooked.

Text book of veterinary medicine, Volume 2 (of 5) · 第 245 / 308 题