we find the intensity of the symptoms modified by the species of animals
affected, by the races which subdivide the species, by the families
which form groups of the races, and by certain conditions in individuals
themselves. For example, a pricked foot in a Thoroughbred may cause
intense fever, while the same injury in the foot of a Clydesdale may
scarcely cause a visible general symptom. In the horse, fever produces
the following symptoms:
The normal body temperature, which varies from 99 deg. to 100 deg. F., is
elevated from 1 deg. to 9 deg.. A temperature of 102 deg. or 103 deg. F. is moderate
fever, 104 deg. to 105 deg. F. is high, and 106 deg. F. and over is excessive. The
temperature is accurately measured by means of a clinical thermometer
inserted in the rectum.
This elevation of temperature can readily be felt by the hand placed in
the mouth of the animal, or in the rectum, and in the cleft between the
hind legs. It is usually appreciable at any point over the surface of
the body and in the expired air emitted from the nostrils. The ears and
cannons are often as hot as the rest of the body, but are sometimes
cold, which denotes a debility in the circulation and irregular
distribution of the blood. The pulse, which in a healthy horse is felt
beating about 42 to 48 times in the minute, is increased to 60, 70, 90,
or even 100. The respirations are increased from 14 or 16 to 24, 30, 36,
or even more. With the commencement of a fever the horse usually has
diminished appetite, or it may have total loss of appetite if the fever
is excessive. There is, however, a vast difference among horses in this
regard. With the same degree of elevation of temperature one horse may
lose its appetite entirely, while another, usually of the more common
sort, will eat at hay throughout the course of the fever, and will even
continue to eat oats or other grains. Thirst is usually increased, but
the animal desires only a small quantity of water at a time, and in most
cases of fever a bucket of water should be kept standing before the
patient, which may be allowed to drink ad libitum. The skin becomes dry
and the hairs stand on end. Sweating is almost unknown in the early
stage of fevers, but frequently occurs later in their course, when an
outbreak of warm sweat is often a most favorable symptom. The mucous
membranes, which are most easily examined in the conjunctivae of the eyes
and inside of the mouth, change color if the fever is an acute one;
without alteration of blood the mucous membranes become of a rosy or
deep-red color at the outset; if the fever is attended with distinct
alteration of the blood, as in influenza, and at the end of two or three
days in severe cases of pneumonia or other extensive inflammatory
troubles the mucous membranes are tinged with yellow, which may even
become a deep ocher in color, the result of the decomposition of the
blood corpuscles and the freeing of their coloring matter, which acts as
a stain. At the outset of a fever the various glands are checked in
their secretions, the salivary glands fail to secrete the saliva, and we
find the surface of the tongue and inside of the cheeks dry and covered
with a brownish, bad-smelling deposit. The excretion from the liver and
intestinal glands is diminished and produces an inactivity of the
digestive organs which causes a constipation. If this is not remedied at
an early period, the undigested material acts as an irritant, and later
we may have it followed by an inflammatory process, producing a severe
diarrhea.
The excretion from the kidneys is sometimes at first entirely
suppressed. It is always considerably diminished, and what urine is
passed is dark in color, undergoes ammoniacal change rapidly, and
deposits quantities of salts. At a later period the diminished excretion
may be replaced by an excessive excretion, which aids in carrying off
waste products and usually indicates an amelioration of the fever.
While the ears, cannons, and hoofs of a horse suffering from fever are
usually found hot, they may frequently alternate from hot to cold, or be
much cooler than they normally are. This latter condition usually
indicates great weakness on the part of the circulatory system.
It is of the greatest importance, as an aid in diagnosing the gravity of
an attack of fever and as an indication in the selection of its mode of
treatment, to recognize the exact cause of a febrile condition in the
horse. In certain cases, in very nervous animals, in which fever is the
result of nerve influence, a simple anodyne, or even only quiet with
continued care and nursing, will sometimes be sufficient to diminish it.
When fever is the result of local injury, the cure of the cause produces
a cessation in the constitutional symptoms. When it is the result of a
pneumonia or other severe parenchymatous inflammation, it usually lasts
for a definite time, and subsides with the first improvement of the
local trouble, but in these cases we constantly have exacerbations of
fever due to secondary inflammatory processes, such as the formation of
small abscesses, the development of secondary bronchitis, or the death
of a limited quantity of tissue (gangrene).
In specific cases, such as influenza, strangles, and septicemia, there
is a definite poison in the blood-vessel system and carried to the heart
and to the nervous system, which produces a peculiar irritation, usually
lasting for a specific period, during which the temperature can be but
slightly diminished by any remedy.
In cases attended with complications, the diagnosis at times becomes
still more difficult, as at the end of a case of influenza which becomes
complicated with pneumonia. The high temperature of the simple
inflammatory disease may be grafted on that of the specific trouble, and
the determination of the cause of the fever, as between the two, is
therefore frequently a difficult matter but an important one, as upon it
depends the mode of treatment.
Any animal suffering from fever, whatever the cause, is much more
susceptible to attacks of local inflammation, which become complications
of the original disease, than are animals in sound health. In fever we
have the tissues and the walls of the blood vessels weakened, we have an
increased current of more or less altered blood flowing through the
vessels and stagnating in the capillaries, which need but an exciting
cause to transform the passive congestion of fever into an active
congestion and acute inflammation. These conditions become still more
distinct when the fever is accompanied with a decided deterioration in
the blood itself, as is seen in influenza, septicemia, and at the
termination of severe pneumonias.
Fever, with its symptoms of increased temperature, acceleration of the
pulse, acceleration of respiration, dry skin, diminished secretions,
etc., must be considered as an indication of organic disturbance. This
organic disturbance may be the result of local inflammation or other
irritants acting through the nerves on nerve centers, alterations of the
blood, in which a poison is carried to the nerve centers, or direct
irritants to the nerve centers themselves, as in cases of heat stroke,
injury to the brain, etc.
The treatment of fever depends upon its cause. One of the important
factors in treatment is absolute quiet. This may be obtained by placing
a sick horse in a box stall, away from other animals and extraneous
noises and sheltered from excessive light and drafts of air. Anodynes,
belladonna, hyoscyamus, and opium act as antipyretics simply by quieting
the nervous system. As an irritant exists in the blood in most cases of
fever, any remedy which will favor the excretion of foreign elements
from it will diminish this cause. We therefore use diaphoretics to
stimulate the sweat and excretions from the skin; diuretics to favor the
elimination of matter by the kidneys; cholagogues and laxatives to
increase the action of the liver and intestines, and to drain from these
important organs all the waste material which is aiding to choke up and
congest their rich plexuses of blood vessels. The heart becomes
stimulated to increased action at the outset of a fever, but this does
not indicate increased strength; on the contrary, it indicates the
action of an irritant to the heart that will soon weaken it. It is,
therefore, irrational further to depress the heart by the use of such
drugs as aconite. It is better to strengthen it and to favor the
elimination of the substance that is irritating it. The increased blood
pressure throughout the body may be diminished by lessening the quantity
of blood. This is obtained in some cases with advantage when the disease
is but starting and the animal is plethoric by direct abstraction of
blood, as in bleeding from the jugular or other veins; or by
derivatives, such as mustard, turpentine, or blisters applied to the
skin; or by setons, which draw to the surface the fluid of the blood,
thereby lessening its volume without having the disadvantage of
impoverishing the elements of the blood found in bleeding. In many cases
antipyretics given by the mouth and cold applied to the skin are most
useful.
When the irritation which is the cause of fever is a specific one,
either in the form of bacteria (living organisms), as in glanders,
tuberculosis, influenza, septicemia, etc., or in the form of a foreign
element, as in rheumatism, gout, hemaglobinuria, and other so-called
diseases of nutrition, we employ remedies which have been found to have
a direct specific action on them. Among the specific remedies for
various diseases are counted quinin, carbolic acid, salicylic acid,
antipyrene, mercury, iodin, the empyreumatic oils, tars, resins,
aromatics, sulphur, and a host of other drugs, some of which are of
known effect and others of which are theoretical in action. Certain
remedies, like simple aromatic teas, vegetable acids, such as vinegar,
lemon juice, etc., alkalines in the form of salts, sweet spirits of
niter, etc., which are household remedies, are always useful, because
they act on the excreting organs and ameliorate the effects of fever.
Other remedies, which are to be used to influence the cause of fever,
must be selected with judgment and from a thorough knowledge of the
nature of the disease.
METHODS OF ADMINISTERING MEDICINES.
By CH. B. MICHENER, V. S.
[Revised by Leonard Pearson, B. S., V. M. D.]
Medicine may enter the body through any of the following designated
channels: First, by the mouth; second, by the air passages; third, by
the skin; fourth, by the tissue beneath the skin (hypodermic methods);
fifth, by the rectum; sixth, by the genito-urinary passages; and,
seventh, by the blood (intravenous injections).
BY THE MOUTH.--Medicines can be given by the mouth in the form of
solids, as powders or pills; liquids, and pastes, or electuaries.
_Powders._--Solids administered as powders should be as finely
pulverized as possible, in order to obtain rapid solution and
absorption. Their action is in this way facilitated and intensified.
Powders must be free from any irritant or caustic action upon the mouth.
Those that are without any disagreeable taste or smell are readily eaten
with the feed or taken in the drinking water. When placed with the feed
they should first be dissolved or suspended in water and thus sprinkled
on the feed. If mixed dry the horse will often leave the medicine in the
bottom of his manger. Nonirritant powders may be given in capsules, as
balls are given.
_Pills, or "balls"_ when properly made, are cylindrical in shape, 2
inches in length and about three-fourths of an inch in diameter. They
should be fresh, but if necessary to keep them some time they should be
made up with glycerin, or some such agent, to prevent their becoming too
hard. Very old, hard balls are sometimes passed whole with the manure
without being acted upon at all. Paper is sometimes wrapped around balls
when given, if they are so sticky as to adhere to the fingers or the
balling gun. Paper used for this purpose should be thin but firm, as the
tougher tissue papers. Balls are preferred to drenches when the medicine
is extremely disagreeable or nauseating; when the dose is not too large;
when the horse is difficult to drench; or when the medicine is intended
to act slowly. Certain medicines can not or should not be made into
balls, as medicines requiring to be given in large doses, oils, caustic
substances, unless in small dose and diluted and thoroughly mixed with
the vehicle, deliquescent, or efflorescent salts. Substances suitable
for balls can be made up by the addition of honey, sirup, soap, etc.,
when required for immediate use. Gelatin capsules of different sizes are
now obtainable and are a convenient means of giving medicines in ball
form.
When balls are to be given we should observe the following directions:
In shape they should be cylindrical, of the size above mentioned, and
soft enough to be easily compressed by the fingers. If made round or
egg-shaped, if too long or too hard, they are liable to become fixed in
the gullet and cause choking. Balls may be given with the "balling gun"
(obtainable at any veterinary instrument maker's) or by the hand. If
given by the hand a mouth speculum or gag may be used to prevent the
animal from biting the hand or crushing the ball. Always loosen the
horse before attempting to give a ball; if tied he may break his halter
and injure himself or the one giving the ball. With a little practice it
is much easier to give a ball without the mouth gag, as the horse always
fights more or less against having his mouth forced open. The tongue
must be firmly grasped with the left hand and gently pulled forward; the
ball, slightly moistened, is then to be placed with the tips of the
fingers of the right hand as far back into the mouth as possible; as the
tongue is loosened it is drawn back into the mouth and carries the ball
backward with it. The mouth should be kept closed for a minute or two.
We should always have a pail of water at hand to offer the horse after
balling. This precaution will often prevent him from coughing out the
ball or its becoming lodged in the gullet.
_Pastes or electuaries_ are medicines mixed with licorice-root powder,
ground flaxseed, molasses, or sirup to the consistency of honey, or a
"soft solid." They are intended, chiefly, to act locally upon the mouth
and throat. They are given by being spread upon the tongue, gums, or
teeth with a wooden paddle or strong, long-handled spoon.
_Liquids._--It is, very often, impossible to get balls properly made, or
to induce owners or attendants to attempt to give them, and for these
reasons medicines by the mouth are mostly given in the form of liquids.
Liquids may be given as drenches when the dose is large, or they may,
when but a small quantity is administered, be injected into the mouth
with a hard-rubber syringe or be poured upon the tongue from a small
vial.
When medicine is to be given as a drench we must be careful to use water
or oil enough to dissolve or dilute it thoroughly; more than this Wakes
the drench bulky and is unnecessary. Insoluble medicines, if not
irritant or corrosive, may be given simply suspended in water, the
bottle to be well shaken immediately before giving the drench. The
bottle used for drenching purposes should be clean, strong, and smooth
about its neck; it should be without shoulders, tapering, and of a size
to suit the amount to be given. A horn or tin bottle may be better,
because it is not so easily broken by the teeth. If the dose is a small
one the horse's head may be held up by the left hand, while the medicine
is poured into the mouth by the right. The left thumb is to be placed in
the angle of the lower jaw, and the fingers spread out in such manner
as to support the lower lip. Should the dose be large, the horse ugly,
or the attendant unable to support the head as directed above, the head
is then to be held up by running the tines of a long-handled wooden fork
under the noseband of the halter or the halter strap or a rope may be
fastened to the noseband and thrown over a limb, beam, or through a
pulley suspended from the ceiling. Another way of supporting the head is
to place a loop in the end of a rope, and introduce this loop into the
mouth just behind the upper front teeth or tusks of the upper jaw, the
free end to be run through a pulley, as before described, and held by an
assistant. It is never to be fastened, as the horse might in that case
do himself serious injury. The head is to be elevated just enough to
prevent the horse from throwing the liquid out of his mouth. The line of
the face should be horizontal, or only the least bit higher. If the head
is drawn too high the animal can not swallow with ease or even with
safety. (If this is doubted, just fill your mouth with water, throw-back
the head as far as possible, and then try to swallow.) The person giving
the drench should stand on some object in order to reach the horse's
mouth--on a level, or a little above it. The bottle or horn is then to
be introduced at the side of the mouth, in front of the molar teeth, in
an upward direction. This will cause the horse to open his mouth, when
the base of the bottle is to be elevated, and about 4 ounces of the
liquid allowed to escape on the tongue as far back as possible, care
being taken not to get the neck of the bottle between the back teeth.
The bottle is to be immediately removed, and if the horse does not
swallow this can be encouraged by rubbing the fingers or neck of the
bottle against the roof of the mouth, occasionally removing them. As
soon as this is swallowed repeat the operation until he has taken all
the drench. If coughing occurs, or if, by any mishap, the bottle should
be crushed in the mouth, lower the head immediately.
Do not rub, pinch, or pound the throat nor draw out the tongue when
giving a drench. These processes in no way aid the horse to swallow and
oftener do harm than good. In drenching, swallowing may be hastened by
pouring into the nose of the horse, while the head is high, a few
teaspoonfuls of clean water, but _drenches must never be given through
the nose_. Large quantities of medicine given by pouring into the nose
are liable to strangle the animal, or, if the medicine is irritating, it
sets up an inflammation of the nose, fauces, windpipe, and sometimes the
lungs.
BY THE AIR PASSAGES.--Medicines are administered to the lungs and upper
air passages by insufflation, inhalation, injection, and nasal douche.
_Insufflation_ consists in blowing an impalpable powder directly into
the nose. It is but rarely resorted to.
_Inhalation._--Gaseous and volatile medicines are given by inhalation,
as is also medicated steam or vapor. Of the gases used there may be
mentioned, as the chief ones, sulphurous acid gas and, occasionally,
chlorin. The animal or animals are to be placed in a tight room, where
these gases are generated until the atmosphere is sufficiently
impregnated with them. Volatile medicines--as the anesthetics (ether,
chloroform, etc.)--are to be given by the attending surgeon only.
Medicated vapors are to be inhaled by placing a bucket containing hot
water, vinegar and water, scalded hay or bran, to which carbolic acid,
iodin, compound tincture of benzoin, or other medicines have been added,
in the bottom of a long grain bag. The horse's nose is to be inserted
into the top of the bag, and he thus inhales the "medicated steam." Care
must be taken not to have it hot enough to scald the animal. The vapor
from scalding bran or hay is often thus inhaled to favor discharges in
sore throat or "distemper."
_Injections_ are made into the trachea by means of a hypodermic syringe.
This method of medication is used for the purpose of treating local
diseases of the trachea and upper bronchial tubes. It has also been used
as a mode of administering remedies for their constitutional effect, but
is now rarely used for this purpose.
_The nasal douche_ is employed by the veterinarian in treating some
local diseases of the nasal chambers. Special appliances and
professional knowledge are necessary when using liquid medicines by this
method. It is not often resorted to, even by veterinary surgeons, since,
as a rule, the horse objects very strongly to this mode of medication.
BY THE SKIN.--Medicines are often administered to our hair-covered
animals by the skin, yet care must be taken in applying some
medicines--as tobacco water, carbolic-acid solutions, strong creolin
solutions, mercurial ointment, etc.--over the entire body, as poisoning
and death follow in some instances from absorption through the skin. For
the same reasons care must also be exercised and poisonous medicines not
applied over very large raw or abraded surfaces. With domestic animals
medicines are only to be applied by the skin to allay local pain or cure
local disease.
BY THE TISSUE BENEATH THE SKIN (HYPODERMATIC METHOD).--Medicines are
frequently given by the hypodermic syringe under the skin. It is not
safe for any but medical or veterinary practitioners to use this form of
medication, since the medicines thus given are powerful poisons. There
are many precautions to be observed, and a knowledge of anatomy is
indispensable. One of the chief precautions has to do with the
sterilization of the syringe. If it is not sterile an abscess may be
produced.
BY THE RECTUM.--Medicines may be given by the rectum when they can not
be given by the mouth, or when they are not retained in the stomach;
when we want a local action on the last gut; when it is desired to
destroy the small worms infesting the large bowels or to stimulate the
peristaltic motion of the intestines and cause evacuation. Medicines are
in such cases given in the form of suppositories or as liquid injections
(enemas.) Foods may also be given in this way.
_Suppositories_ are conical bodies made up of oil of theobroma and opium
(or whatever medicine is indicated in special cases), and are introduced
into the rectum or vagina to allay irritation and pain of these parts.
They are not much used in treating horses.
_Enemas_, when given for absorption, should be small in quantity,
neutral or slightly acid in reaction, and of a temperature of from 90 deg.
to 100 deg. F. These, like feeds given by the rectum, should be introduced
only after the last bowel has been emptied by the hand or by copious
injections of tepid water. Enemas, or clysters, if to aid the action of
physics, should be in quantities sufficient to distend the bowel and
cause the animal to eject them. Simple water, salt and water, or soap
and water, in quantities of a gallon or more, may be given every half
hour. It is best that the horse retain them for some little time, as the
liquid serves to moisten the dung and favors a passage. Stimulating
enemas, as glycerin, should be administered after those already
mentioned have emptied the last bowel, with the purpose of still further
increasing the natural motion of the intestines and aiding the purging
medicine.
Liquids may be thrown into the rectum by the means of a large syringe or
a pump. A very good "irrigator" can be bought of any tinsmith at a
trifling cost, and should be constantly at hand on every stock farm. It
consists of a funnel about 6 inches deep and 7 inches in diameter, which
is to be furnished with a prolongation to which a piece of rubber hose,
such as small garden hose, 4 feet long may be attached. The hose, well
oiled, is to be inserted gently into the rectum about 2 feet. The liquid
to be injected may then be poured in the funnel and the pressure of the
atmosphere will force it into the bowels. This appliance is better than
the more complicated and expensive ones.
Ordinary cold water or even ice-cold water is highly recommended by many
as a rectal injection for horses overcome by the excessive heat of
summer, and may be given by this simple pipe.
BY THE GENITO-URINARY PASSAGES.--This method of medication is especially
useful in treating local diseases of the genito-urinary organs. It finds
its chief application in the injection and cleansing of the uterus and
vagina. For this purpose a large syringe or the irrigator described
above may be used.
BY THE BLOOD.--Injections directly into veins are to be practiced by
medical or veterinary practitioners only, as are probably some other
means of giving medicines--intratracheal injections, etc.
[Illustration: PLATE III.
DIGESTIVE APPARATUS.