CHRONIC ECZEMA OF THE CARPUS AND TARSUS; MALANDERS: SALLENDERS.

Eruption in bends of carpus and tarsus and downward: Causes: lymphatic

temperament, constitutional predisposition, deranged internal organs,

excessive secretions, modified, congested skin, friction between

dermal folds. Symptoms: stiffness, heat, thickening and redness,

vesicles or oozing, crusts, erect hairs, shedding hair, squamæ,

cracks, abrasions, fissures, subcutaneous engorgement,

lymphangiectasis. Treatment: Cleanse, get pure air, regular exercise,

non-stimulating food, avoid cold water, mud, slush, caustic soap,

lime, sharp sand, foul organic matter. Massage. Light bandages. Bland

ointments. Dusting powders. Rest. Iodoform. Starch. Zinc oxide. Boric

acid. Magnesia. Bismuth. Lycopodion. Lead. Tannin. Pyoktannin.

Stimulating ointments. Green soap. Arsenic.

The bends of the carpus and tarsus in heavy, lymphatic, coarse skinned

horses are especially subject to eczema followed by a dense scabby

eruption, which in the old farrier’s nomenclature was known as malanders

in the fore limb and sallenders in the hind. It is not always confined

to the joints but may extend down the limb, especially on the back,

where the hair is coarser and the skin thicker, as far as the fetlock or

even to the hoof.

In the matter of _causation_ much depends on the general constitutional

state which tends to eczema, and on the torpor or derangement of some of

the internal organs the functions of which are interdependent with those

of the skin. Something too must be attributed to the freer secretions of

these parts in coarse bred horses, to the accumulation of such

secretions and of extraneous irritants under the long hair, to the

sluggishness of the circulation in the limbs which has to overcome the

force of gravitation, and to friction between the thick folds of skin in

flexion, and stretching in extension. Swelling of the lower limbs is at

once a cause and an effect of the disease.

_Symptoms._ At the outset the animal may be seen to move rather stiffly,

and the skin is found to be hot, thickened and if white reddened. Soon a

close observation may detect the eruption of vesicles, or simply an

oozing of a yellowish or bloody serum which concretes around the hairs

forming an encrusted covering for the part, holding the hairs erect and

bristly, and even lifting them out of their follicles. Cracks also

appear in the depth of the fold, leading to a more abundant exudate, and

the disease may extend around the whole surface of the limb.

In the more acute cases this may be followed by more or less depilation,

dessication and recovery, but too often the condition becomes chronic,

the thickened, encrusted or squamous skin continues to exude, crack and

cover itself with crusts, under which the decomposing liquids macerate

and irritate the exposed cuticle, and engorgment of the whole limb with

hyperplasia of the connective tissue and lymphatic plexus and vessels is

the result. This hyperplasia of the skin and connective tissue

(elephantiasis) is also a common result of lymphangitis.

_Treatment._ As in other skin affections attention must first be given

to removal of the causes. Ensure cleanliness, pure air, regular

exercise, non-stimulating food, the avoidance of cold water, melting

snow, soapy washes and all other sources of irritation. Deep mud,

especially if charged with lime, sharp sand, decomposing organic matter

or other irritant, is particularly offensive.

Hand-rubbing (massage) of the limbs and evenly applied light bandages

are often of the greatest value in dispersing or obviating swelling.

The slighter attacks may be met at the outset by bland ointments or

dusting powders and rest from all but necessary exercise. Dressing with

iodoform may bring about a recovery in a few days. Starch and oxide of

zinc, boric acid, magnesia carbonate, bismuth or lycopodion may give

good service. Lotions of lead acetate, tannin, iron sulphate, alum,

potassium permanganate or pyoktannin may be used as in other forms of

eczema. In obstinate cases green soap followed by stimulating ointments

or liniments, tar, oil of white birch, Canada balsam, turpentine and

glycerine, oil of cade, etc., will often serve an excellent purpose. In

these advanced cases an alterative such as arsenic may be employed.

ECZEMA OF ALIMENTARY ORIGIN IN CATTLE.

STARVATION MANGE. STALK DISEASE. MALT ECZEMA. POTATO ECZEMA.

In low condition: erythema, hæmorrhagic extravasations, or vesicles on

tail, lips, fore legs, udder. Trombidium holosericeum. Malt or potato

eczema: marc eczema on legs and body. Causes: feeding on marc only,

skins, green potatoes, fermenting. Attack in ratio with marc eaten.

Worst on new stock, and feeding cattle. Calves have diarrhœa, children

eruption. Bean trefoil and milk sickness act similarly. Solanin.

Unaffected by boiling. Season. Field. Chlorophyl. Narcosis absent. Is

brain adaptable? Other ingredients inoperative. Eczema ceases with

change of food: is not inoculable. Symptoms: fever, costiveness,

inappetence, red mucosæ, weeping, stringy salivation, debility,

emaciation, black diarrhœa. May lie with extended head, grinding

teeth, tympany, lethargy, coma. Pig and dog vomit. Abortion. Redness,

swelling, stiffness on pasterns: may extend to whole body: exudations:

thick crusts: erect or shed hairs: rigid thickened, folded, cracked

skin, buccal mucosa may suffer: abscess, sloughs. Mortality slight and

up to 20 per cent. Lesions: congestions of small intestine, brain and

muscle. Treatment: stop or lessen the marc adding grain: turn to

pasture: locally bathe, cold or tepid: lead lotions: dusting powders:

tannin: blue stone: creolin: cresol: tar or birch oil: carbolic acid.

The skin of cattle seems to suffer more than that of other animals in

connection with the ingestion of poisons. In starved or very low

conditioned animals, eruptions are met with which may be in the form of

a simple erythema, a hæmorrhagic extravasation in spots, or an eruption

on the end of the tail in the form of epidermic concretions or pustules

(impetigo). Among the vineyards it is common to find an eruption with

papules and vesicles on the lips, fore legs and udder of cows which were

fed on the succulent young shoots and leaves of the grape vine. In cases

of this disease, Railliet and Moreau have found a great number of the

silky trombidium larvæ (harvest bug), and accordingly attribute the

affection exclusively to their attacks. The growth of the vine on the

warmest and sunniest exposures, the most favorable to the propagation of

this acarus, gives much support to this conclusion.

=Malt or Potato Eczema.= On the continent of Europe where potatoes are

largely used for distillation and the production of starch, herds of

cattle are fed often almost exclusively on the refuse or marc, and in

such herds an eczematous eruption of the legs and exceptionally of the

body is a familiar occurrence.

_Causes._ The disease has been definitely traced to an exclusive dietary

on potato marc, and still more so to the skins, to tubers rendered green

by exposure to the sun, and to the distillery potato refuse which has

undergone fermentation. Thus 80 litres of the pulp daily without dry

food will determine a violent attack in the animal consuming it, while

the animal consuming 40 litres has it much milder (Friedberger and

Fröhner). It attacks animals living in the best conditions of

cleanliness and pure air, and the essentially toxic quality of the cause

may be deduced from the fact that newly bought animals, which are not

yet habituated to it suffer the most, that fattening cattle are the

common victims, while work oxen which perspire more freely and milch

cows escape, yet calves fed upon their milk may suffer from diarrhœa and

infants from a cutaneous eruption (Johné). The poison it is to be

inferred is eliminated in the milk. Similar examples of the protecting

of the milch animal by elimination of the poison through the milk are

found in bean trefoil (cytisus) which poisons the milk while proving

harmless to the goat which yields it, and the poison of milk sickness

which is deadly to cattle which are not giving milk, and harmless to the

milch cow, yet deadly to those that consume her milk.

The exact nature of the poison is as yet uncertain, and as solanin is

the only toxic principle so far discovered in potato, this has been held

tentatively to be the essential cause. The amount of solanin in young

and germinated potatoes has been given by Cornevin as follows:

Germinated tubers Young tubers.

The entire tuber contains 0.21 0.16

The central fleshy part 0.16 0.12

The parings and pickings 0.24 0.18

The toxic strength of the marc is not impaired by boiling, cooking or

other culinary treatment, and the same is true of solanin. The toxicity

is greatest after the potato has been subjected to germination, or when

it has become green by exposure to the sun, and in these conditions the

solanin is increased. The toxicity of the marc is higher in certain

years, and in the product of certain fields, than in others, and this is

in keeping with the effect of environment in modifying the products of a

plant. The increased production of chlorophyl under the action of

sunlight is associated with a material increase of the amount of

solanin. Until therefore another toxic product can be shown to be the

essential cause of this affection the solanin must be charged with this

result. This conclusion would be more inviolable if the animals attacked

showed other symptoms of solanin poisoning such as narcotism, vertigo,

stupor and paralysis, and the absence of these may perhaps be due to the

gradual advance of the toxic action, and the progressive immunizing of

the animal system. The brain may be able to accommodate itself more

readily than the skin.

The other constituents of the potato or of the marc fail to produce the

eruption under other conditions: the alcohol in brewers and distillers’

grains, the acetic, lactic and butyric acids in the refuse of starch,

beet sugar and canning factories, the potash in turnips and other roots,

the yeast ferment in brewers’ grains. The acarus of foot mange

(symbiotis bovis) is rarely present in the affected animal though the

eruption in the same situation would strongly suggest its presence and

lead to a search for it. Moreover the eczema appears at once in a large

number of animals, affecting a large area without evidence of slow and

steady progression and disappears with equal rapidity in many cases when

the diet is changed. Finally the eczema has not been successfully

propagated by inoculation which conveys mange infallibly from animal to

animal.

_Symptoms._ The disease is associated with slight fever, costiveness,

impaired appetite, hyperæmia of the mucosæ, epiphora, viscous

salivation, muscular weakness, and finally emaciation and black

diarrhœa. The gravity of these symptoms varies, being greater when the

animals have eaten the leaves and stems, the raw potatoes in their

skins, the young shoots and parings, or green potatoes which have been

sunned. The animals may lie most of their time stretching themselves out

with head extended on the ground, they may grind the teeth, may have

pulse small and rapid, tympany, lethargy, coma and even paraplegia but

these severe symptoms are exceptional and almost altogether confined to

the cattle of distilleries which receive an exclusive diet of potato

marc. In the pig and dog vomiting has been noticed (Cornevin). Pregnant

animals may abort.

The local symptoms begin with redness and swelling of the skin around

the pasterns, especially of the hind limbs, stiffness and a disposition

to lie most of the time; then small flattened vesicles appear, isolated

or confluent, which bursting, form extended, raw patches the abundant

exudations of which concrete into thick crusts. The hairs stand erect

and are abnormally thick at their roots. The eruption may extend to the

whole limb, the scrotum, mamma, tail and body at large, so that in

severe cases it is practically universal. The skin becomes thick, rigid,

hide bound, wrinkled and folded with intervening cracks. As a rule,

however, the eruption is confined to the limbs, scrotum, mammæ and tail.

In some extensive and persistent cases the buccal mucosa suffers,

particularly on the pad on the upper jaw, which shows extensive and

irregular ulcers with purulent centre and swollen, congested margin.

Abscesses may develop in the skin and subcutem and sloughing of the

integument is not unknown.

_Mortality_ is slight as a change of food is usually made and a recovery

ensues in a few weeks. Yet Baranski noted 20 per cent. of deaths in

Galicia, mostly in old, worn out animals which had been stabled for a

length of time.

_Lesions._ On examination, _post mortem_, there are found hyperæmia and

inflammation of the small intestine, some congestion of the cerebral

meninges, and a red, bloody condition of the muscular system.

_Treatment._ The toxic provender must be stopped, or reduced to 20 or 30

litres of pulp daily, supplemented by sound wholesome dry fodder. Marker

claims that 70 quarts daily of the potato marc may be given if combined

with a fair ration of Indian corn. Turning out doors to pastures usually

effects a speedy cure.

Local treatment is rarely demanded but when the irritation is great it

may be soothed by bathing with cold or tepid water, lead lotion,

glycerine and lead lotion, or by the application of ointments of lead,

tar, oil of cade or birch, or carbolic acid. Dusting powders of zinc

oxide, starch, lycopodium, boric and tannic acids may also be employed.

Decoction of oak bark or solution of blue stone is often used, also

creolin or cresol one part, to alcohol five parts.

It is rarely necessary to use other than the cooling and astringent

lotions, yet the persistence of irritable sores, ulcers and crusts must

be treated as in other chronic skin affections.

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