Prevention. Avoid known causes, untimely clipping, exposed buildings,
over-fatigue, chills, cold rains, dews and frosts, disorders of liver
and bowels, sweets, spiced food, overfeeding, constipation, torpid
liver, injuries to joints or tendons. Treatment: warm stall and
clothing, laxative food in moderation, purgatives, aloes, castor oil,
jalap, saline enemas, colchicum, alkalies, trimethylamine, acetate of
ammonia, salicylic acid, salicylates, salicine, oil of gaultheria,
salicine for debilitated. Large doses hourly or every two hours. Less
effective in chronic cases. Heart failure. Salol. Salophen. Phenocoll.
Antipyrin. Acetanilid. Pilocarpin. Tartar emetic. Dover’s powder.
Ammonium acetate. Chamomile. Boneset. Hot baths and packs, with cold
on head. Hand-rubbing. Hot drinks. Nauseants. Hot iron. Anodyne
liniments. Rubefacients. Blisters. Salicylate of methyl and other
salicylates. Quinine and potassium iodide. Tincture of muriate of
iron. In chronic cases, tonics, cod liver oil, arsenic, guaiacum,
potassium iodide. Essential oils. Electricity.
_Prevention._ This consists in the avoidance of all known causes of the
disease and must vary to some extent for different genera of animals.
The avoidance of cold and exposure, of clipping at unsuitable seasons,
of exposed sites for buildings (north and northwest exposures, narrow
valleys and ravines), of over-fatigue, of perspiration and subsequent
chilling, of cold rains, dews and frosts, of inactivity, or habitual
overloading of the liver and bowels, and of local injuries of joints or
tendons. House dogs especially should be protected from sweets, spiced
food, frequent feeding, constipation and torpid liver.
_Treatment._ One of the most important considerations is a warm stall or
building, or warm clothing including loose woolen bandages on the legs,
in the horse. Laxative food is called for.
In acute cases and especially in fat pampered dogs, and in all cases
associated with torpid or disordered liver, a preliminary laxative will
be of great service, and others should be given later as demanded. The
horse may have aloes or salines, and saline enemata may be given to all
animals when called for throughout the progress of the disease. Pigs may
take 1 or 2 drops croton oil, or like dogs they may be given castor oil
or jalap. Torpid liver and constipation must always be carefully guarded
against.
To cut short the attack much reliance was formerly placed on colchicum
which increases the elimination of solids in the urine, and on alkalies,
which beside the theoretic antagonism to acidity are at once chologogne
and diuretic. The action was somewhat slow but on the whole
satisfactory, usually abating the suffering very materially in the
course of a few days. To the horse or ox ½ dram doses of colchicum were
given daily in combination with 4 to 6 drams of bicarbonate of soda;
pigs of 100 lbs. may take 1 grain of the former to 10 grains of the
latter; a shepherd’s dog may take half the amount just named.
Trimethylamine proved even more effective than colchicum, and acetate or
citrate of ammonia, soda, or potassium was often substituted for the
carbonate.
But the modern treatment of rheumatism dates from 1876, when the
introduction of salicylic acid and later sodium salicylate, salicine and
ol. gaultheriæ gave to such treatment an efficacy previously unknown.
Salicylic acid acts very harshly on the gastric mucosa, and with
sensitive stomachs is advantageously replaced by sodium salicylate, into
which it is transformed in any case in the blood. Salicine which is held
to be transformed into salicylic acid in the system, is specially
recommended for its bitter and tonic action exercised in the stomach and
prior to such transformation. In debilitated subjects, therefore, and in
those that suffer from the characteristic rheumatic reduction of the red
blood globules it would be somewhat preferable. As a prompt and
effective anti-rheumatic agent however it appears to be somewhat less
reliable than sodium salicylate or ammonium salicylate. Ol. gaultheriæ
may be better borne by the stomach of the dog and pig than the
salicylates, the dose being 10 to 15 drops thrice a day.
The secret of success with all of these salicylate compounds, lies in
the speedy saturation of the system with the drug, rather than in its
moderate and continuous administration. The horse or ox may take ½ oz.
repeated every two hours for ten hours if relief is not obtained
earlier. The pig may take 20 grains, and the dog 5 to 10 grains at
similar intervals. It is not desirable, however, to continue this
indefinitely, and therefore when immediate relief has been secured it is
well to give the agent but twice or thrice a day, and resort in part to
the alkaline treatment. If the salicylates fail to relieve when pushed
energetically for ten hours, there is reason to fear that the case is
not one of genuine rheumatism.
The salicylates are less applicable to chronic cases and may be even
dangerous when the heart is affected, as they tend to render the heart’s
action slower and weaker, and thus add to the dangers of
hypo-hæmoglobin, and heart failure. A similar caution applies to an
excessive use of alkalies and especially of compounds of potassium which
depress the heart action.
As substitutes for the salicylates, salol, salophen, phenocoll,
antipyrin and acetanilid have been largely resorted to. The first is
safe and trustworthy and does not irritate the stomach nor interfere
with digestion. It may be given to horse or ox in a dose of 3 drams,
thrice a day, to the pig in 10 grain, and to the dog in 5 grain doses.
Hübner had good success with pilocarpine hydrochlorate hypodermically (4
grains for a 7 months colt,) but this was not equally successful in the
hands of Siedamgrotzky. Other sudorifics like tartar emetic, Dover’s
powder, ammonium acetate, hot or spiced drinks (chamomile, boneset,) hot
baths, hot air baths, and wet packs have been used successfully and may
still be employed in suitable cases. The opium is often very helpful in
relieving intense suffering, and beside or in place of the Dover’s
powder internally, morphia may be injected subcutem over the affected
region. The main objection to its use is its tendency to lock up the
liver and bowels. Liquor of the acetate of ammonia fills at once the
rôle of a potent diaphoretic, an antacid, and an eliminant.
In the use of baths and packs it is well to consider the condition of
the patient. If the surface is cold with little reaction, and if the
attack has supervened on exposure, or chill, persistent hot applications
are indicated. Dogs and other small animals should have full hot baths
lasting for 15 or 20 minutes, and while in full glow may be quickly
sponged with cold water and rubbed dry in blankets, great care being
taken to avoid exposure or chill when damp. Or for these and the larger
animals as well, a hot air or steam bath may be applied under similar
precautions. A cold wet wrapping on the cranium will tend to relieve
cerebral congestion during the administration of the hot bath. In horses
and cattle surface heat and sudation may be secured by active rubbing
with wisps of straw, of both body and limbs, or by covering the neck and
trunk with large bags containing a small amount of chaff, sand or grain
hot from an oven. Hot carminative or alcoholic drinks are excellent
adjuvants, and even sedatives or nauseants (opium, veratrum, aconite,
tobacco). Another resort is to pass a hot smoothing iron an indefinite
number of times over the affected region. The part may be finally
wrapped in cotton.
In cases where the temperature runs high, on the other hand, and when
the surface glows, this dread of chill and reaction may be dismissed.
For the small animal a bath starting at 70° F. may be gradually lowered
to 60° or 50° F. Or a full pack may be employed, a sheet wrung out of
cold water being closely wrapped around the body, and covered at all
points with two or more dry woolen blankets, care being taken to avoid
the entrance of air and the occurrence of evaporation from the inner,
damp layer. This cools the surface and the blood returning inwards, and
in fifteen or twenty minutes it should induce free perspiration. It may
be kept up twenty to thirty minutes and may be repeated as often as
there is a serious rise of temperature. A less energetic method is the
mere sponging of the surface with cold water. In all such cases friction
is a valuable accessory.
Anodynes and revulsives are often applied to the affected parts with
good results. In very acute cases (especially articular), lotions and
liniments of salicylic acid or salicylate of soda with laudanum,
aconite, or chloral hydrate may be used. In the less violent cases
camphorated spirit, soap liniment, or a combination of essential oils
(gaultherium, turpentine, cajeput, origanum, peppermint) with aqua
ammonia and sweet oil may secure great relief. Mustard or essential oil
of mustard in vaseline is an excellent alternate. Finally active
cantharidine blisters are usually most effective. These are applied over
the affected joints or muscles and if the inflammation shifts to other
parts it is followed up until it finally disappears. A concurrent
alkaline treatment, and more important still, absolute rest, will serve
to protect the heart to some extent, against a metastasis from the
exterior. It has been supposed that the beneficial action of the blister
is in ratio with the amount of exudate, and hence cantharides has been
highly esteemed in this connection. Friedberger and Fröhner have used
tincture of iodine and biniodide of mercury.
The local application of anti-rheumatic agents would embrace all the
salicylates, oil of wintergreen and guaiacol, the latter mixed with an
equal amount of glycerine. Methyl salicylate has been strongly
recommended for external use.
Stengel covers the surface with lint smeared with salicylate of methyl
ointment, and then applies a plaster bandage over all. This removes
muscular spasm, pain and swelling and is rarely required for longer than
a few days.
In cases in which salicylates fail, other agents have been resorted to
in man and to a lesser extent in the lower animals. Greenhow strongly
advocates a combination of quinine and potassium iodide internally,
while Russell Reynolds has successfully employed tincture of muriate of
iron in large doses repeated every three hours.
In _chronic_ cases these would especially commend themselves as
calculated to repair the general health and overcome the loss of
hæmoglobin. In _chronic rheumatism_ a course of tonics is often the best
resort, and in dogs especially cod liver oil has benefited when all else
had failed. Arsenic too (3 to 8 drops Fowler’s solution thrice daily)
has been beneficial in both dogs and pigs. In other cases iodide of iron
has been helpful. So also with gum guaiacum given in combination with
potassium iodide. In such cases too, treatment by alkalies and
salicylates may be called for, and close attention should always be
given to secure a free action of the liver, bowels and kidneys. The
local treatment recommended for acute rheumatism, (hot baths, frictions
with essential oils and above all blisters of mustard or cantharides) is
even more applicable to the chronic. A firm bandage over a covering of
cotton wool, and a systematic application of electricity will often
help. Warmth, a run at grass in a sheltered sunny paddock, moderate
exercise and a nutritious and easily digestible diet are important
conditions.