Clinical diagnosis is therefore possible, but only in exceptional cases

can it be absolutely relied upon. Fortunately, methods of investigation

increase and become more exact every day, so that the points which

clinical examination is incapable of deciding are often cleared up in

the laboratory. Bacteriological examination of morbid products, such as

the nasal discharge, the products of suppuration, the milk or the

diseased tissues, is a valuable means in many cases of determining the

presence of the organism which causes the disturbance. In all cases, in

fact, the tubercle bacillus should be sought for in order to confirm the

diagnosis.

[Illustration: $1]

If this method cannot be employed, as for example in tuberculosis of the

liver, brain, etc., and the diagnosis is uncertain, the use of

tuberculin constitutes the surest and easiest method of coming to a

conclusion. Nocard’s researches have shown the precautions to be

observed. A minimum febrile reaction of 2° Fahr. (1·5° C.) is, however,

necessary before the existence of the disease can be affirmed.

Lastly, there remains a less rapid method, which aims at transmitting

the disease to specially susceptible animals by inoculating with

suspected materials, such as the nasal discharge, pus, milk or pulp of

internal organs. This method is most valuable when bacteriological

examination has failed and tuberculin has produced only doubtful

results. The guinea-pig is the subject usually chosen, but some weeks,

or even months, may elapse before definite results are obtained.

In those forms where ordinary methods of investigation prove sufficient

it is well to bear in mind the symptoms which differentiate this disease

from others closely resembling it.

Pulmonary tuberculosis, for example, should always be suspected whenever

there exists frequent coughing, nasal discharge and poor bodily

condition; if in addition to this respiration is found on auscultation

to be rough, inspiration interrupted or rasping, expiration prolonged or

blowing and the vesicular murmur non-existent, suspicion becomes almost

a certainty. The diagnosis is even more assured if the respiration is of

a blowing character at certain points, accompanied by snoring and

sibilant _râles_ and gurgling or cavernous souffles.

The distinction between pulmonary tuberculosis and chronic bronchitis or

simple pulmonary emphysema is based on the increased resonance revealed

by percussion in the latter case; the different character of expiration;

the existence of a double breathing movement; the external appearance of

the animal; the absence of bacilli from the nasal discharge, and the

failure to react to tuberculin.

The condition cannot be mistaken for verminous broncho-pneumonia if the

information furnished by auscultation and the results of microscopical

examination of the discharge are taken into account, the eggs or embryos

of strongyles being extremely easy to detect.

Tuberculosis of the pleura may be mistaken for peripneumonia if the

observer trusts to percussion alone, but the auscultation sounds are

then different, and an injection of tuberculin will remove any doubt.

Tuberculosis of the peritoneum is often suggested by the indications

afforded by careful palpation (thickening of the walls of the abdomen,

rigidity and sensitiveness), and is distinguished from ordinary acute

peritonitis by the difference in the appearance of the animals and the

absence of much fluid. Chronic exudative peritonitis and ascites also

exhibit sufficiently well-marked characteristics to enable them to be

differentiated from tuberculosis of the peritoneum, but this is

certainly not true of adhesive peritonitis, and in cases of the latter

kind tuberculin is the only means of confirming the diagnosis.

External tuberculosis of the retro-pharyngeal and cervical lymphatic

glands resembles, at a first glance, simple inflammation of lymphatic

glands, but in the last-mentioned disease the lesions are symmetrical

and the glands still retain a certain amount of elasticity, whilst in

tuberculosis they are bosselated, hard, and sometimes fluctuating.

Tuberculosis of the mediastinum is suggested by difficulty in

swallowing, especially if tympanites follows soon after eating,

eructation is absent, and rumination is arrested.

A careful study of the development of the ulcerations will also in most

instances make clear the difference between tuberculous stomatitis and

simple stomatitis or stomatitis due to actinomycosis. Intestinal

tuberculosis and tuberculous enteritis are sufficiently characterised by

persistent intractable diarrhœa accompanied by tympanites, by the fœtid

character of the fæces, and by moderate but continued fever. Chronic

diarrhœa, which alone presents some analogy with this condition, is

never accompanied by permanent tympanites.

Tuberculosis of the genital organs in male animals is always liable to

be mistaken for simple orchitis and the development of tumours in the

testicle; an injection of tuberculin will, however, indicate the nature

of the lesion.

When the symptoms of genital disease or chronic mammitis in female

animals suggest that the disease is of a specific character, the

diagnosis can frequently be confirmed by a microscopical examination of

the pus or milk.

Finally, should the practitioner hesitate as to the nature of the

lesions which are the cause of arthritis, deformity of bones, cerebral

symptoms, etc., tuberculin again will in most cases settle the question.

=The prognosis= in cases of tuberculosis is extremely unfavourable,

whatever the form of the disease or its manifestations. Clinically the

disease should be regarded as incurable in the strict sense of the word,

however limited may be the lesions. The affected animals are not all

doomed to immediate death: some may be kept alive, and may even serve an

economic purpose without necessarily endangering others; it is sometimes

possible to fatten them, though the risks probably far outweigh the

advantages, but one can never rely on recovery in any particular case.

The gravity of this disease is the greater inasmuch as it assumes so

many forms, any one of which may result in the infection of other

animals.

All those forms of the disease, such as tuberculosis of the respiratory,

digestive and genital tracts, in which virulent material containing

bacilli is discharged realise these conditions. The patient becomes a

source of infection to others of its kind, a fact which more than

anything else renders the disease so dangerous to the farmer and

breeder.

Only in cases where the lesions are closed (as in tuberculosis of the

lymphatic glands, serous membranes, joints, etc.) can the sufferers be

regarded as innocuous, and—as these lesions are exceptional or at least,

as animals suffering from them are very frequently afflicted with open

lesions from which bacilli are continually being discharged—every

tuberculous animal must be regarded from a clinical standpoint as a

constant danger to its neighbours.

This, however, must not be understood to mean that there are not

different degrees of danger. It is quite certain that a patient with

pulmonary caverns which are constantly throwing off enormous quantities

of material full of bacilli is much more dangerous than another

suffering only from slight bronchial or tracheal lesions, though the

danger in the latter case is none the less always present.

=Treatment.= There is no really curative treatment of tuberculosis.

It must not be thought, however, that we are completely helpless and

that the present condition of affairs must be allowed to continue

indefinitely. Nocard and Leclainche have minutely laid down the lines to

be followed as regards prophylaxis, though unfortunately the measures

recommended cannot always be carried out.

Tuberculin having been proved an exact means of detecting tuberculous

lesions in animals even where none were suspected, it is desirable,

firstly, to test all the animals in a given establishment with

tuberculin; and, secondly, to separate into classes (1) all animals

which have reacted, and (2) those which have resisted.

The stables, etc., should then be completely disinfected by sweeping,

washing first with hot water, then with strong antiseptic solutions,

brushing over the walls with quick-lime solution and fumigating with

sulphurous acid or formic aldehyde. The healthy animals should then be

placed in one shed and the diseased animals in another. In order to

render this system of isolation really efficacious the isolated animals

and the healthy animals should have nothing in common, and the persons

tending the two classes of animals, the buckets and other utensils, the

watering places, etc., should be kept rigorously apart.

The animals known to be tuberculous should as rapidly as possible be

prepared for slaughter, and if pregnant cows are included in the number

the calves should be removed to the healthy stable immediately after

birth and brought up either on boiled milk or by a healthy mother,

experience having shown that congenital tuberculosis is of rare

occurrence.

After the tuberculous animals have left the shed, this should again be

thoroughly disinfected, in order to make it fit for the reception of

healthy subjects.

Unfortunately such precautions can only be observed in model

establishments. They necessitate expenses and immediate sacrifices of a

very serious character, and breeders too often view only the sacrifice

without regard to the after benefits. For this reason the above system

has only been practised in certain of the best known and best managed

farms.

To ensure the full benefit of these precautions, and to prevent a fresh

introduction of tuberculosis into the herd, every new animal introduced

should be subjected to the tuberculin test. Unless this precaution is

taken, there is always a risk of introducing a tuberculous subject, thus

nullifying all the precautions previously taken.

The problem is therefore still very complex, and the system can only

give good results when rigorously observed and followed out.

As, however, in spite of all precautions, animals regarded as healthy

are always, under normal conditions of existence, more or less exposed

to accidental infection, it is desirable to subject the entire herd to

the tuberculin test annually. This would cause the immediate detection

of any animals with latent infection, so that they could be removed from

the herd.

These wise precautions might, if understood and observed, eliminate the

disease from the country, but they depend on individual initiative, and

have not as yet been grasped by the mass of small breeders, farmers,

etc. This class only see the difficulties in the way of realising the

idea, without appreciating the constant benefit which they would derive

from it.

SWINE FEVER—VERRUCOUS ENDOCARDITIS AND PNEUMONIA OF THE PIG.

Although it is not contemplated in this work to deal with those

disorders which, on account of their highly contagious or infectious

character, can only be dealt with by legislative action and by processes

of “stamping-out,” it may be permissible to make certain exceptions.

While we have made no reference to contagious pleuro-pneumonia of

cattle, foot-and-mouth disease, rinderpest, anthrax and black-quarter we

have devoted some space to Texas fever and tuberculosis, and give

herewith a summary of the present state of knowledge regarding swine

fever or hog cholera and a hæmorrhagic septicæmia of cattle known under

various names in different countries and of very wide distribution.

SWINE FEVER.[9]

Footnote 9:

Report of the Departmental Committee _re_ Swine Fever. (Annual Report

of Board of Agriculture, 1896.)

Swine fever may assume two distinct forms, viz., the acute and fatal and

the non-acute or slowly progressive.

=Symptoms.= In the acute form all those symptoms which are indicative of

a severe febrile affection are present. The animals are disinclined to

feed; they present evidence of great prostration and lie about their

dwellings in a listless manner sheltering themselves from cold; their

skins are hot, their eyes partially closed, and they are obviously

suffering from some severe constitutional disturbance. Within a very few

hours after these premonitory symptoms have set in the pigs become

rapidly worse; they may or may not have a deep-red blush on the skin,

which is more particularly noticeable on those parts of the body where

there is an absence of hair, such as the inside of the thighs, the point

of the axilla, and over the abdomen. Choleraic evacuations, having a

most offensive odour, succeeding upon constipation, follow later on, and

the animals die perhaps as early as the third or fourth day after the

symptoms have first been observed.

In some instances the disease proceeds with great rapidity through a

herd, the symptoms being of a most aggravated and pronounced character,

and the outbreak attended with great fatality.

Generally speaking, the above description depicts the symptoms of swine

fever in the acute form, more especially when it breaks out in a herd of

young pigs.

In the non-acute form the disease progresses slowly, the clinical

evidence is extremely obscure, the reddening of the skin, formerly

regarded as being invariably present in swine fever, is absent, and

beyond the fact that the animal is unthrifty, develops slowly, and

perhaps has a constantly relaxed condition of the bowels, it may be

asserted that there are no symptoms which could be regarded as

absolutely indicative of swine fever, and nothing short of a post-mortem

examination will enable even an expert to satisfy himself that the

animal was affected with the disease.

As a general rule swine fever assumes this non-acute and slowly

progressive form in pigs which have arrived at an age when their powers

of resistance to disease are materially increased, _i.e._, in animals of

eight or more months old; on post-mortem examination they are found to

have been extensively diseased, more particularly in the large

intestine, a portion of the digestive apparatus which does not appear to

perform any very important function in connection with the nutrition of

the animal, and so long as the stomach and small intestines remain

healthy, pigs with a considerable amount of disease in the large

intestine may still keep up their condition for a considerable time.

=Etiology.= As regards the etiology of the form of swine fever prevalent

in England no question now exists. It has been proved to demonstration

by the bacteriological inquiry conducted by Professor McFadyean that it

is due to a special pathogenic organism, a bacillus, which, after

cultivation in artificial media, will produce in the healthy pig fed

with the pure cultures the typical ulcerations which are found in the

intestines of pigs affected with swine fever contracted in the ordinary

way.

The observations made by the veterinary officers of the Board of

Agriculture caused them to doubt whether there was any disease of the

lungs of pigs which, in the absence of lesions in the intestinal tract,

could be accepted as evidence of swine fever.

The bacillus which produced swine fever when introduced in the healthy

pig did not induce any special disease of the lungs.

=Pathology and morbid anatomy.= Swine fever, like typhoid fever in man,

is essentially a disease of the digestive system, its chief

characteristic being certain morbid changes of a well-marked nature

which are found upon the surface of the mucous membrane in some part of

the alimentary canal.

The changes referred to consist of what have been commonly described as

the formation of a series of ulcers, single or confluent, distributed

upon some part of the intestinal tract, varying in size and shape, of a

yellowish-grey to black colour, and assuming as a rule a circular form.

In some instances the lesions consist of diphtheritic exudations with

necrosis of the lining membrane of the bowels.

These ulcers or necrotic patches may be found upon the tongue, tonsils,

epiglottis, stomach, and small intestines, but they are more constant in

the large intestines, especially the cæcum and colon. The lesions may

involve the whole thickness of the mucous membrane, but seldom penetrate

the other coats of the intestine; in fact, perforation of the peritoneal

covering of the bowel is very rare in even prolonged cases of swine

fever.

In cases where swine fever assumes the more acute form and death

supervenes rapidly, it is usual to find that the small intestines are

largely involved.

In the non-acute or slowly progressing form the lesions are more

abundant in the large intestines, and in some instances the walls of the

intestines become so thick as a result of infiltration into their

structure and the excessively thick deposits upon the lining membrane,

that it becomes a matter of surprise that the passage of the ingesta has

been possible and that the animal has lived so long.

Next to the intestinal lesions the congested condition of the lymphatic

glands, especially those of the mesentery, may be considered as most

prominent among the pathological changes which occur in swine fever.

Occasionally centres of necrosis are observed in the liver, and some

writers refer to changes in or upon the spleen and kidneys.

The only lesions which can be characterised as absolutely typical of

swine fever are those present in the bowels, the absence of which will

justify any observer in declining to accept the case as one of swine

fever without some further evidence or inquiry. It must, however, be

distinctly understood that in the case of very young pigs which have

died shortly after infection, there is often an entire absence of the

lesions described, the only changes present being inflammation of the

stomach or some part of the intestines.

Further, there are instances where older pigs have been slaughtered in

the early stage of the disease in which no definite lesions have been

found, and in such cases inquiry into the condition of the rest of the

herd becomes necessary.

One most important feature in connection with the morbid anatomy of

swine fever is the disposition which many animals have to recover from

the disease; evidence of the reparatory process having often been

detected in the intestines after they had been carefully washed.

Dr. Klein also maintained that many pigs took the disease in the mild

form, and recovered without presenting any of the marked symptoms of

swine fever.

It was found that, whether infected in the ordinary way or by direct

inoculation, in some pigs killed only a few days after being infected

the ulcers were occasionally seen gradually detaching from the surface

of the intestines, and cicatrisation had already commenced.

VERRUCOUS ENDOCARDITIS OF THE PIG.

In the report of the Board of Agriculture for 1894 reference was made to

the numerous instances in which the heart of the pig had been found

affected with verrucous endocarditis.

This form of disease of the heart was known to veterinarians in Great

Britain as far back as the year 1847. For reasons given in that report

it became obvious that this diseased condition of the valves of the

heart was not produced by swine fever. The question arose whether in

addition to swine fever another disease existed, known on the Continent

under the name of swine erysipelas. The importance of this question will

be appreciated when it is explained that on the Continent swine

erysipelas is classed among the contagious diseases of the pig.

The clinical evidence of the disease called swine erysipelas on the

Continent appears to be more or less discoloration of the skin, similar

to that which is frequently observed in swine fever, together with the

occasional presence within the warty growths upon the valves of the

heart of a bacillus which is regarded by Continental authorities as the

cause of the disease.

Early in the inquiry it was ascertained that a bacillus identical with

that found in swine erysipelas was also present in the diseased portion

of the valves of the heart of the pigs in this country.

But the inquiries made did not corroborate or favour the suggestion that

the disease which produced these morbid growths was in any way

infectious or contagious. Such inquiries as could be made led to the

opposite conclusion, since in every instance where the cases could be

followed up it was ascertained that the deaths had been quite sudden,

were limited to a single animal, and that those in contact remained in

perfect health.

At this stage the all-important point to determine was whether the

disease which existed in this country, “verrucous endocarditis,” was

communicable from pig to pig, and with this object numerous experiments

have been conducted to discover whether the bacilli found within the

hearts of diseased pigs were pathogenic to healthy swine.

A large number of healthy pigs have been fed or inoculated with the

blood, the diseased portions taken from the valves of the heart, and

with artificial cultures of the bacilli obtained from the heart, but in

no instance has the attempt to produce this disease been successful.

PNEUMONIA OF THE PIG.

The occasional association of pneumonia with or without pleurisy in

cases of swine fever has led many veterinarians in England to regard

lung complications as one of the lesions produced by that disease.

In the Board of Agriculture’s report for the year 1894 a description was

given of the various diseases in the lungs of swine which had come under

notice, and it was therein stated that the Board had been unable to

discover any special lesion of the lung which would warrant them in

stating that it was indicative of swine fever or due to contagion.

It is an indisputable fact that pigs are extremely liable to pneumonia

and pleurisy. But as the clinical appearances present in the lungs

examined in no wise differed from those which take place in the lungs of

other animals which have been exposed to cold or septicæmia and other

causes, the Board’s officers have never accepted these lesions as being

specific.

It is well known that both in Germany and the United States outbreaks of

pneumonia of a contagious nature attributed to the presence of a

bacillus pathogenic to the pigs of those countries are reported to

occur. Indeed, contagious pneumonia of swine under the names of

schweineseuche in Germany and swine plague in America are regarded as

one and the same disease.

In view of the fact that in a large number of cases pneumonia, more or

less extensive, sometimes associated with pleurisy, was found among the

specimens forwarded to London, it was considered desirable that the

departmental committee should institute a series of experiments to

decide whether we had in this country a form of pneumonia in the pig

which was communicable from one pig to another.

Accordingly a series of bacteriological experiments were conducted by

Professor McFadyean with a view to isolate, if possible, a microorganism

which would be capable of inducing pneumonia in healthy pigs. A number

of diseased lungs, some of which were taken from pigs affected with

swine fever, were examined microscopically by him, and, as was to be

expected, several organisms were isolated, but they proved to be

morphologically and culturally different from the bacillus of swine

fever. Inoculations were carried out with these organisms not only

subcutaneously but directly into the lung through the walls of the

chest, and feeding experiments were also conducted. The results of these

experiments were entirely negative; a certain amount of local injury was

caused to the lungs at the seat where they had been punctured, but in no

case was either pneumonia or swine fever induced.

The experiments have therefore demonstrated that the pneumonia found in

the lungs of pigs affected with swine fever is not due to the swine

fever bacillus.

The departmental committee arrived at the conclusion that the pneumonia

which is occasionally encountered as an independent disease of the pig

or in association with swine fever is not ascribable to contagion, but

to the presence of organisms which are generally saprophytic in their

mode of life, and which only in particular circumstances (such as

lowered vitality and diminished resistance on the part of the pig) are

able to multiply in the air passages and lung tissue and thus induce

pneumonia; and it appeared to the departmental committee that in this

country pneumonia of the pig is sporadic and not contagious or

epizootic.

CONCLUSIONS.

There is now no reason whatever to believe that there exists at the

present time in Great Britain any disease of a contagious nature

affecting pigs other than swine fever. The disease of the heart,

“verrucous endocarditis,” and the pneumonia which are so frequently met

with in pigs cannot be regarded as lesions indicative of an attack of

swine fever.

As regards verrucous endocarditis and pneumonia, it may safely be said

that they do not exist in England in a contagious form.

Considering all the evidence, it may reasonably be concluded that the

departmental committee were correct in their views when they stated that

“the evidence obtained during the whole inquiry justifies the conclusion

at which they have arrived, viz., that there is no epizootic of swine

except swine fever in any part of the United Kingdom which requires to

be dealt with under the provisions of the Act of 1894.”

Finally, it may be said that the great factors in perpetuating swine

fever will always be pigs which are affected with that disease in the

less fatal and unrecognisable form. These animals are constantly

distributing the germs of swine fever through their highly infective

evacuations wherever they may be taken during the whole period of their

illness, and the final extinction of the malady must depend upon the

possibility of enforcing measures which will have the effect of

preventing the movement of pigs affected with swine fever in this

particular form.

HÆMORRHAGIC SEPTICÆMIA IN CATTLE.

In 1902 Drs. Wilson and Brimhall, of the State Board of Health of

Minnesota, U.S.A., described under the title of “hæmorrhagic septicæmia

of cattle” a widespread infectious disease of bovines which has the

following general characteristics:—The disease is distributed the world

over, but is apparently most common in low-lying regions, and most

general in wet seasons. The animals attacked are of all ages. The onset

of the disease is sudden, its course rapid, and its termination usually

(90 to 98 per cent.) fatal. Thirty to 90 per cent. of all animals in an

infected herd die. The clinical symptoms are refusal of food, cessation

of rumination and lactation, initially increased temperature (107° to

109° F.: 42° to 43° C.), rapid, laboured breathing, sometimes bloody

discharge from nostrils, bladder, and bowels, and non-crepitant

swellings in the throat region, back of shoulders, or about the

fetlocks. The most striking pathological lesions are hæmorrhages from 1

millimètre to 20 centimètres in diameter, throughout the subcutaneous,

submucous, subserous and intermuscular connective tissue, infiltrating

the lymphatic glands, and involving several or all of the internal

organs. The spleen is neither enlarged nor darkened. The causative

bacteria, which may be isolated from the larger hæmorrhagic areas, lymph

glands, heart’s blood, lung, spleen, etc., have the following

distinguishing characteristics:

Ovoidal bacilli, with rounded ends of 0·5 to 0·8 microns in transverse

diameter, and 1·0 to 1·5 microns in length; sometimes paired and

sometimes in chains of three to six individuals. The bacilli in the

tissues exhibit polar staining with an unstained “belt” or “middle

piece.” They are non-capsulated, non-spore-forming, non-Gramstaining,

and non-motile. They grow best aërobically at 98·5° F. (37° C.), though

capable of developing anaërobically and at room temperature; prefer the

depths rather than the surfaces of media; grow feebly, if at all, on

potato; fail to liquefy gelatine; produce acid, but no gas in glucose

media, neither acid nor gas in lactose media; and develop varying

amounts of indol and phenol in peptone solution. The organisms have been

named _Bacillus bovisepticus_. The lesions of the disease are reproduced

in cattle and other animals by inoculation of pure cultures of the

organism.

It should be insisted upon that the identification of the disease in a

locality in which it has not been previously described, or by

veterinarians not having had previous experience therewith, shall take

into consideration—(_a_) _the essential clinical symptoms_; (_b_) _the

pathological lesions as observed before the onset of decomposition; and_

(_c_) _the morphological and biological identification of the specific

bacilli_.

The following is a tabulated list of the principal epidemics so studied

and reported to January 1st, 1901:

_Table showing the Principal Epidemics of Hæmorrhagic Septicæmia in

Bovines due to_ Bacillus bovisepticus.

┌─────────────────┬─────┬──────────────┬──────────────────────────────┐

│Name of observer.│Year.│ Locality. │ Local or reporter’s name of │

│ │ │ │ disease. │

├─────────────────┼─────┼──────────────┼──────────────────────────────┤

│Bollinger │1878 │ Germany │Wild und Rinderseuche. │

│Kitt │1885 │ „ │Rinderseuche. │

│Kitt │1887 │ „ │Septikæmia hæmorrhagica. │

│Poels │1886 │ Holland │Septic pleuro-pneumonia of │

│ │ │ │ calves. │

│Oreste et Armanni│1886 │ Italy │Barbone. │

│Jensen │1889 │ Jutland │Rinderseuche. │

│Piot │1889 │ Egypt │Kounnaq. │

│Van Eecke │1890 │ Java │Septichæmia hæmorrhagica. │

│ │1895 │ │ │

│Hubenet │1895 │ „ │ „ „ │

│ │ │ France, │ │

│Galtier │1891 │imported from │Infectious pneumo-enteritis. │

│ │ │ Algiers │ │

│Reischig │1891 │ Hungary │Maladie des buffles ou Angine │

│ │ │ │ Charbonneuse. │

│Bongartz │1892 │ Germany │Wild und Rinderseuche. │

│Jakobi │1892 │ „ │Wildseuche. │

│Buch │1892 │ „ │Hæmorrhagische septikæmia. │

│Güllebeau and │1894 │ „ │Septikæmia hæmorrhagica. │

│ Hess │ │ │ Charbon Blanc. │

│Fischer │1894 │ Dutch Indies │Septichæmia hæmorrhagica. │

│Leclainche │1895 │ France │Pneumo-enteritis. │

│Von Ratz │1896 │ Hungary │Barbonekrankheit. │

│Sanfelice, Loi, │1897 │ Sardinia │ „ │

│ and Malato │ │ │ │

│Bosso │1898 │ Italy │Septicæmia hæmorrhagica. │

│Pease │1898 │British India │Ghotwa or Ghotu. │

│Lignières │1898 │ Argentina │Pasteurellosis bovina. │

│ │ │ │ “Diarrhœa” and “Enteque.” │

│Fenimore │1898 │ Tennessee │Wild and cattle disease. │

└─────────────────┴─────┴──────────────┴──────────────────────────────┘

It may not be out of place to give at this point a short list of the

principal infective diseases of definitely known ætiology, with which

hæmorrhagic septicæmia in cattle has been, and may readily be, confused:

_Name of disease._ _Diagnostic points._

Anthrax Altered condition of blood, enlarged spleen,

presence of _B. anthracis_, etc.

Black-quarter Usually localised lesion, crepitant tumour,

presence of _B. anthracis symptomatici_.

Septicpneumo-enteritis Due to a spore-bearing

of calves (Galtier) bacillus—“_Pneumobacillus septicus_”—which

grows rapidly on potato.

Septicæmia of calves Due to typhoid-like bacilli.

CONCLUSIONS.

(1.) Eight outbreaks of hæmorrhagic septicæmia in cattle due to _B.

bovisepticus_ occurred in Minnesota from August to December, 1900.

(2.) So far as can be determined, the only other outbreak of this

disease hitherto published as occurring in America was one near

Knoxville, Tenn., in 1898. The foci of the disease have also apparently

been present in Texas and the district of Colombia. No relation can be

traced between the disease elsewhere and the present outbreaks, nor

between any two of the present ones.

(3.) Of 160 animals in the eight herds, sixty-four showed symptoms of

the disease, and all such died—a mortality of 40 per cent. of all the

animals in the herds, and of 100 per cent. of those showing symptoms.

(4.) The chief symptoms were loss of appetite, fever, stiffness,

swelling of the legs and throat, and a black, tarry, or bloody discharge

from the bowels. Bloody urine and bloody nasal discharge were present in

some cases. Death occurred usually in from six to twenty-four hours

after the first appearance of symptoms.

(5.) The chief lesions discovered at autopsy were ecchymoses, and small

and large hæmorrhagic areas in the subcutaneous connective tissues,

muscles, lymph glands, and throughout the internal organs. The cervical

lymph glands, heart muscle, and alimentary canal were most affected. The

spleen was not enlarged nor darkened (except after onset of

decomposition).

(6.) From the twenty-two animals on which autopsies were made the same

bacillus was obtained from all the tissues examined. Where the

examination was made immediately after death—nine cases—it was unmixed

with any other organism.

(7.) The bacillus was identified as belonging to the hæmorrhagic

septicæmia group of Hüppe, best specifically designated as _B.

bovisepticus_; and besides causing hæmorrhagic septicæmia in cattle

(synonyms—rinderseuche, buffleseuche, barbone, khounnaq, charbon blanc,

ghotwa, pasteurellosis bovina, etc.), closely resembles, if, indeed, it

is not identical with, the bacilli causing wildseuche, swine plague,

schweineseuche, rabbit septicæmia, chicken cholera, grouse disease, duck

cholera, etc. The organism was studied in direct coverglass

preparations, parallel cultures in and on various media, and by

inoculation of animals in which the characteristic lesions were

reproduced, and from the tissues of which the inoculated bacilli were

recovered in pure culture.

(8.) An attempt was made to immunise cattle by the injection of

filtered, and later of the killed, cultures of the bacillus. The chief

difficulties met with were in maintaining the virulence of the bacillus

on artificial media, and in determining the proper dosage. The

experiments were too few, and the results not sufficiently tested to

warrant conclusive statements as to the protective value of the

inoculations, but it would appear that a fairly high degree of immunity

was produced.

(9.) The prompt removal of the dead animals and isolation of sick ones,

accompanied by thorough disinfection by fire, carbolic acid, corrosive

sublimate, and freshly-slaked lime, apparently served to check each

outbreak within a short time after the measures were instituted.

SECTION XI.

OPERATIONS.

CHAPTER I:

CONTROL OF ANIMALS.

CONTROL OF OXEN.

The safe and efficient performance of surgical operations renders it

necessary that the animal should first of all be placed under complete

control. This precaution, therefore, is the first to merit attention.

Animals are either secured completely or to a more or less limited

extent, according to circumstances. The ox, for example, may be secured

by the head, one or more limbs may be fastened, or, by being placed in a

trevis, the whole of the animal may be secured.

PARTIAL CONTROL.

(1.) The simplest method of securing the ox is to grasp the nostrils or

lower extremity of the septum nasi between the thumb and index finger of

the right or left hand (Fig. 57).

(2.) This method may be rendered more complete by the assistant passing

his arm from behind forward over the animal’s head between its horns,

and then grasping the nostrils as above described, whilst one of the

horns is firmly held with the other hand (Fig. 58).

(3.) A third method consists in fixing the head to a post, tree, fence,

or other solid body, by passing a rope round the base of the horns and

tying it to the object selected.

CONTROL OF THE LIMBS.

To prevent the animal kicking or moving about during an operation it is

sometimes necessary to fix the limbs. A front leg may be lifted as for

shoeing, or may be kept lifted by means of a rope passed around the

fetlock, over the withers, downward between the front legs, outside the

forearm, in front of the chest and inside the pastern, after which one

or more turns may be made around the pastern to prevent the rope

slipping.

A hind limb may be secured in a simple way by passing the end of the

tail round it in front of the hock (Fig. 284); any violent and extensive

movement of the limb is then necessarily painful to the animal owing to

the tension of the tail.

[Illustration: $1]

Greater security, however, is given by passing a rope backward and

forward around the hind legs, above the hocks, in the form of a figure

of eight (Fig. 285). This does not prevent all movements of the hind

limbs, but it limits them and secures both animal and operator from

danger.

[Illustration: $1]

Should it become necessary to examine the hind foot or interdigital

space, it is useful at times to pass a loop of cord round the leg in the

region of the tendo-Achillis, and to twist and tighten this loop by a

short, stout stick passed through it; this is the leg twitch described

in Dollar’s “Operative Technique,” p. 7.

For such examinations, however, the animal is usually placed in the

trevis, or is secured to the side of a long waggon (Fig. 286).

To secure the limbs beneath the abdomen a strip of webbing or a rope is

fastened round the pastern, passed between the fore limbs, then in front

of the shoulder of the opposite side, over the withers and beneath the

elbow of the same side, being secured with a slip-knot.

For castration in the standing position a hind and a fore limb may be

fastened together, as shown in Fig. 287.

In examining the sole of the hind claws, the animal’s head may be

secured to a tree, and the hind limb lifted by a strip of webbing or

rope fixed to the body of a waggon (Fig. 288).

GENERAL CONTROL.

General control in the standing position can only be made really

effective by using the trevis, in which both the head and the fore and

hind limbs are secured.

[Illustration: $1]

[Illustration: $1]

The practitioner, however, is often content with much less perfect

methods, using either the so-called “bulldogs” or the nose ring, which

may usually be so manipulated as to control all but the most dangerous

animals. The nose ring is seldom employed except for bulls, which are

usually ringed at an early age; the “bulldogs” can be employed and

removed at will.

In inserting a nose ring the head is securely fixed, the centre line of

the muzzle is grasped with the left hand, and the septum nasi is pierced

with a straight bistoury, the cutting edge being turned in a backward

direction; the aperture being thus prepared, the ring is introduced and

fixed. Some operators prefer to use a trocar, slightly exceeding in

diameter the ring to be worn; in that case the manual technique is the

same. The puncture is made, the trocar alone is withdrawn, and the

canula remains _in situ_; one extremity of the ring is then inserted

into the canula, and both are drawn through the septum together. There

is no difficulty in thus inserting the ring, though puncture with the

trocar is perhaps rather less convenient than with the bistoury.

[Illustration: $1]

Relative control without casting may also be effected by attaching the

end of the tail to the base of the horns or the head to the cannon bone

of a front or hind limb. These methods, however, are of little value

except to prevent animals at grass from escaping entirely during

operation.

CONTROL BY CASTING.

Oxen should always be cast on a thick straw bed to avoid fracturing the

horns.

The simplest method consists in using hobbles and ropes, as for the

horse.

[Illustration: $1]

Another, though less practical, method consists in using two long ropes,

each fixed to the base of the horns and passed first between the front,

then the hind limbs, round the hind pasterns from within outwards and

then brought forward (Fig. 292). When the ropes are drawn tight by

assistants standing in front of the animal, the latter usually falls on

its hocks and rolls over to the right or left, according to the

direction given to it.

A third method is particularly useful in young or feeble animals. It

consists in fixing around the horns a rope about eight to ten yards in

length, the free end of which is carried along the upper margin of the

neck and back. A loop is formed embracing the base of the neck, a second

behind the shoulders in the region occupied by the girth, and a third

around the flanks (Fig. 293). By pulling in a backward direction the

rope is drawn tight, and the animal first backs and afterwards falls on

its hocks, subsiding either to the right or left, as in the case

previously mentioned.

[Illustration: $1]

[Illustration: $1]

In using either of these two methods it is very important, as soon as

the animal falls, to secure the limbs in a certain way, according to the

nature of the operation to be performed. This can be effected with

hobbles and ropes passed round the hocks, above the knee, etc.

CONTROL OF SHEEP AND GOATS.

The above animals may be secured, whilst standing, by grasping the head

and neck or, when cast by crossing the front and hind limbs in the form

of an =X= and tying a soft rope or piece of webbing round the crossing

of the limbs.

[Illustration: $1]

[Illustration: $1]

CONTROL OF PIGS.

No difficulty is usually experienced in controlling young pigs, either

when standing or cast, only one or two assistants being required, but

aged animals are more difficult and more dangerous to deal with, and by

their tusks sometimes inflict severe wounds.

In the standing position they can be partially fixed by passing a

running loop behind the canine teeth of the upper jaw, but should the

examination to be carried out prove to be of a difficult character it is

best to cast the animal.

A strong assistant grasps one of the hind limbs by means of a running

loop, fixed, for example, above the right hock. He rapidly slides his

left knee towards the front of the left side of the chest, passes his

left hand over the withers, and by the combined use of his knees and

arms throws the animal on its left side, controlling as far as possible

the struggles of the right front and hind limbs, which he grasps with

his hands.

The animal is then further secured by rapidly passing a thin rope in

figures of eight around the front and hind limbs. If necessary all four

legs may be brought together and fastened by a rope passed round the

region of the pastern; a muzzle can afterwards be applied to prevent

biting.

ANÆSTHESIA.

Oxen rarely receive general anæsthetics, though in certain obstetrical

cases they may be necessary. Ether and chloroform are given by

inhalation, and chloral of 10 to 20 per cent. strength by intravenous

injection. In utilising the latter method the injection should be made

slowly, the pulse and heart being closely scanned to prevent cardiac

syncope. The dose of chloroform varies with the size of the animal, 2

ounces often sufficing for a full-grown ox. The same methods may be used

for sheep, goats, and pigs, the doses being suitably altered. (For

fuller particulars see Dollar’s “Operative Technique,” pp. 44 to 70.)

Most frequently, however, the surgeon contents himself with producing

local anæsthesia by the injection of a 4 to 10 per cent. solution of

cocaine.

CHAPTER II.

CIRCULATORY APPARATUS.

BLEEDING.

Bovine animals are usually bled from the superficial jugular, or the

mammary vein.

=Bleeding from the Jugular.=—The animal having been suitably fixed, the

jugular is raised by means of a cord drawn tightly round the base of the

neck, and the vessel is opened with a fleam about the middle of the

neck.

The skin of the ox being thick, a long-bladed instrument is necessary.

When the bleeding ceases, the cord is removed: some practitioners take

no precautions as regards the wound; it is better to insert a pin

suture.

Bleeding from the jugular may also be performed with the trocar,

particularly in animals with fine, thin skin.

=Bleeding from the Mammary Vein.=—The mammary vein may be opened with

the fleam, the straight bistoury, or the lancet. The head is firmly

fixed and the hind limbs controlled by a rope passed in a figure of

eight above the hocks.

In bleeding on the left the operator places himself at an angle to the

animal’s side, opposite the hypochondriac region, with his back towards

the animal’s head, and holds the fleam in his right hand. To operate on

the right-hand side the fleam is held in the left hand.

This method of bleeding always causes thrombus formation, on account of

the low position of the opening in the vein. The animal’s bed should be

kept very clean, in order to prevent any local infection which might

cause hæmorrhagic or suppurative phlebitis. The lancet or bistoury can

only be used in animals with very fine skin.

In bovine animals small quantities of blood are sometimes taken from the

facial vein or the veins of the ear or tail.

BLEEDING IN SHEEP.

On account of the quantity of fatty tissue and wool covering the jugular

furrow in the sheep, bleeding is scarcely practicable at that point. The

operation is usually performed on the angular vein of the eye, the

external saphenous vein, or the subcutaneous vein of the forearm.

In operating on the facial vein the animal’s head is firmly held, the

operator compresses with the fingers of his left hand the facial vein at

the point where it passes into the maxillary fissure, and with a lancet

opens the angular vein of the eye or one of the other branches of origin

which project prominently beneath the skin. Bleeding ceases as soon as

the pressure is relaxed.

In the case of the external saphenous vein, the vein is raised by

compressing the middle region of the limb and the vessel is opened with

a lancet, a little above and towards the outside of the hock.

[Illustration: $1]

The subcutaneous vein of the forearm can be raised by compressing the

fore limb below the elbow. The vein is visible throughout the length of

the inner surface of the radius, and can easily be opened with a lancet.

It is also possible to withdraw small quantities of blood by opening the

marginal veins of the ear.

BLEEDING IN THE PIG.

Breeders sometimes bleed by slitting one of the animal’s ears or cutting

the tail. It is preferable to bleed with a lancet from the marginal

veins of the ear, the external saphenous vein a little above the hock,

or the subcutaneous vein of the forearm.

SETONS, ROWELS, PLUGS, OR ISSUES.

Although the application of setons is still practised in horses, that of

“issues” has largely been given up in bovine animals, although some

practitioners still regard issues as of considerable value and as

producing effects similar to, or better than, those of sinapisms.

They are usually inserted in the region of the dewlap; the materials

employed comprise black and white hellebore, veratrine and stems of

clematis.

Two methods are practised.

In the first, a transverse fold is raised in the skin of the dewlap,

which is divided with a stroke of the bistoury, leaving a little

aperture in the skin. By introducing the rounded ends of a pair of

curved scissors the subcutaneous connective tissue is broken down,

leaving a little space beneath the skin, into which the plug is

introduced. Swelling takes places very rapidly—in twenty-four to

forty-eight hours it is very considerable—and if the substance employed

is violent in its action, like hellebore, it must be withdrawn, as

otherwise considerable sloughing takes place. To facilitate this object

a thread or piece of string is usually attached to the plug before it is

inserted.

In the second method, the irritant material is attached to, or smeared

on, a strip of broad linen tape which is passed in precisely the same

manner as in the horse (see Dollar’s “Operative Technique,” pp.

107–111).

CHAPTER III.

APPARATUS OF LOCOMOTION.

[Illustration: $1]

The customary operations on the apparatus of locomotion are almost

entirely confined to the feet. They consist in operations for sand

crack, picked-up nail, stabs by nails and bruising of the sole,

elsewhere mentioned. As they call for no special precautions they need

not be further mentioned here.

SURGICAL DRESSING FOR A CLAW.

The surgical dressing necessitated by the operation for sand crack,

picked-up nail, or injury to the heels is often very difficult to fix in

the ox, and necessitates a support round the pastern. It can, however,

be secured in the following way:

The seat of operation is covered with small antiseptic pads, which are

also applied round the pastern and in the interdigital space. A bandage

is then passed twice round the pastern and over the posterior two-thirds

of the claw, as in fixing the dressing used after removal of the lateral

cartilage in the horse. The bandage is then passed repeatedly round the

pastern in an upward direction and tied above the interdigital space.

AMPUTATION OF THE CLAW OR OF THE TWO LAST PHALANGES.

It sometimes happens that certain grave diseases in the foot or pastern

(stabs or picked-up nails, panaritium of the interdigital space,

necrosis of the ends of the flexor tendons, etc.) are accompanied by

necrosis of the bones, suppurative synovitis, and even suppurative

arthritis of the second and first inter-phalangeal joints.

If carefully treated these forms of arthritis may disappear, leaving the

joints anchylosed, but unfortunately the application of the necessary

antiseptic injections (free injection with warm boiled water, injection

of 10 per cent. iodised glycerine, 3 per cent. carbolic glycerine or ·1

per cent. sublimate) is difficult and costly.

[Illustration: $1]

[Illustration: $1]

It is better, in such cases, to remove the claw or the two last

phalanges. With antiseptic precautions the stump heals, and recovery

takes place without the interminable suppuration and pain which

otherwise cause such grave loss of condition.

(1.) =Disarticulation of the Claw and Third Phalanx.=—The patient is

cast and suitably fixed. The horn-secreting coronary band of the claw

must be preserved.

=First stage.= The horny wall immediately beneath the coronary band is

thoroughly thinned and the tissues are divided as far as the bone.

=Second stage.= Disarticulation: The tendon of the extensor pedis is

divided and the joint opened. The claw is pressed backwards, and first

the external and internal ligaments, then the flexor tendons of the

phalanges, are divided.

[Illustration: $1]

[Illustration: $1]

This operation is of no great use, because, on account of the position

of the joint and the arrangement of the articular surfaces, the end of

the second phalanx extends beyond the line of section. To avoid

complications, therefore, it is better to remove the lower extremity of

the second phalanx, which, moreover, is always injured to a greater or

less extent in cases of pedal arthritis. To effect this it is only

necessary to draw back the flap of skin a little and rapidly divide the

second phalange at its upper third with a fine saw. The points of

section of the tendons and ligaments must be carefully examined, and if

they exhibit necrosis should be further shortened.

The stump is enveloped in a surgical dressing fixed to the pastern.

=Amputation of the two First Phalanges.=—When necrosis is very serious

and has extended a long way upwards, it is often better immediately to

resort to amputation of the two last phalanges.

The region is first shaved and thoroughly cleansed. The coronary band of

the claw is also preserved in this case.

=First stage.= The horn below the coronary band is thoroughly thinned

and the tissues are divided as far as the bone.

=Second stage.= The skin covering the front of the limb is vertically

incised from the lower third of the first phalanx (Fig. 298) to the

coronary band; the skin is separated and external and internal flaps are

formed.

=Third stage.= The extensor pedis tendon is divided, the first

inter-phalangeal joint opened, the internal and external lateral

ligaments are divided, the claw is pressed backwards, and the flexor

tendons are also divided.

To facilitate disarticulation, and particularly to facilitate section of

the lateral ligaments, the claw is rotated successively outwards and

inwards.

According to circumstances, the lower extremity of the first phalange is

either scraped or divided and the stumps of the tendons are carefully

trimmed to a regular shape.

A surgical antiseptic dressing is applied over the whole of the seat of

operation.

Several other methods of performing this operation will be found in

Möller and Dollar’s “Regional Surgery,” pp. 831–835.

CHAPTER IV.

DIGESTIVE APPARATUS.

RINGING PIGS.

[Illustration: $1]

This operation is customary in countries where pigs are allowed to roam

more or less at liberty, and it is necessary to adopt some precaution to

prevent them from uprooting the soil and thus causing damage, but the

practice tends nowadays to disappear. It simply consists in passing

through the nose some object which on being rubbed against anything

causes pain and thus checks the animal’s natural proclivity.

Numerous methods have been suggested. One of the simplest is as follows:

The animal having been cast, suitably secured and muzzled, two thick

iron wires sharpened at the ends are passed through the snout, and the

two ends are then twisted together in the form of two rings. These can,

if necessary, be united.

Another method, perhaps even more efficacious, consists in bending a

thick wire into the shape of the letter =U=, and preparing a small metal

plate with two holes corresponding in position to the distance between

the two nostrils. The ends of the wire, being sharpened, are passed

through the nostrils and securely united to the metal plate by being

bent into a spiral or simply at right angles.

ŒSOPHAGUS.

The operations practised on the œsophagus comprise passage of the

œsophageal sound or probang, taxis, crushing of foreign bodies within

the œsophagus, and œsophagotomy.

PASSING THE PROBANG.

Passage of the probang is called for in cases of marked tympanites,

suspected dilatation or contraction of the œsophagus, and accidental

obstruction. Special or improvised instruments may be used, according to

circumstances.

The animal is secured in a standing position with the head extended on

the neck and in a straight line with the body. A gag is placed in the

mouth and the tongue is grasped and withdrawn by an assistant, whilst

the operator, having carefully oiled the probang, passes it through the

gag towards the back of the pharynx. Violence should be avoided, the

probang being gently slid along the centre of the vault of the palate.

When the animal makes swallowing movements, the apparatus is slowly

pushed onwards.

This manipulation, though simple, requires some dexterity, because at

the moment when the instrument enters the pharynx the animal often

thrusts it to one side or the other with the base of its tongue,

bringing it between the molar teeth, and so crushing, or at least

injuring it.

The passage of hollow probangs gives comparatively little relief in

cases of tympanites, because the probang is almost always obstructed by

semi-digested material from the rumen, or plunges into the semi-solid

masses of food contained therein.

When the œsophagus is dilated at a point within the thorax, the progress

of the probang is checked by the accumulated food material, and it

becomes possible to determine approximately the place where the

dilatation occurs. In the same way, should a slender probang be arrested

at a given point in the œsophagus, this indicates that there is

contraction of the tube at that point.

In cases of obstruction the cupped probang is always arrested by the

foreign body. Efforts to thrust the latter onwards should always be made

with great caution, otherwise the œsophagus may be greatly distended or

its walls even ruptured.

CRUSHING THE FOREIGN BODY.

No attempt should be made to crush a foreign body within the cervical

portion of the œsophagus unless it is quite certain that that body is of

comparatively soft character. Crushing may be performed by lateral

pressure with the fingers within the region between the two jugular

furrows, or mechanical means may be adopted.

In the latter case a small piece of board is applied to one side of the

neck behind the foreign body, whilst gentle blows are given from the

opposite side with a little wooden mallet. Whatever precautions may be

taken, however, this method cannot be recommended.

The same remark applies to the use of forceps, the jaws of which are so

fashioned as to escape pressing on the trachea whilst they grasp

directly the foreign body through the walls of the œsophagus.

ŒSOPHAGOTOMY.

Œsophagotomy, or incision of the œsophagus, is an operation which,

though sometimes necessary, should only be regarded as a last resort

after all other methods have failed. Unfortunately it can be performed

only in the region of the neck, and even then the most favourable point

(viz., the lower third of the jugular furrow) cannot always be selected,

the operation having to be performed directly over the foreign body.

The animal may be either standing or lying down. The seat of operation

should be thoroughly cleansed and disinfected.

=First stage.= Incision through the skin and subcutaneous connective

tissue above the level of the jugular vein and opposite the foreign

body.

=Second stage.= Isolation of the œsophagus by dissection and tearing

through of the connective and fibro-aponeurotic tissue at the base of

the jugular furrow.

=Third stage.= Incision through the œsophagus for a distance just

sufficient to enable the foreign body to be extracted.

=Fourth stage.= Suturing of the mucous membrane, suturing of the

muscular walls of the œsophagus, suturing of the skin, precautions being

taken to allow of drainage at the lower part of the operative wound.

SUB-MUCOUS DISSECTION OF THE FOREIGN BODY.

As œsophagotomy, despite every precaution, often leads to fistula

formation, Nocard has recommended submucous dissection of the

obstructive body, such body being usually semi-solid. This method has

considerable advantages.

The first and second stages of the operation are exactly the same as

those above mentioned.

The third stage consists in puncturing the walls of the œsophagus with a

straight tenotome immediately behind the foreign body, as in tenotomy. A

curved, button-pointed tenotome having next been introduced and passed

with the blade flat between the foreign body and the mucous membrane of

the œsophagus, it is turned on its axis, and attempts are made to divide

the obstruction. A few moments are often sufficient to effect this,

after which the substance may be further broken up by the fingers.

These various methods may lead to delayed complications, such as

dilatation or contraction of the mucous membrane of the œsophagus,

muscular atrophy of the œsophageal walls, œsophageal fistula, and,

sometimes, abscess formation.

RUMEN.

Two operations are currently performed on the rumen, puncture and

gastrotomy.

[Illustration: $1]

PUNCTURE OF THE RUMEN.

Puncture of the rumen is essentially an urgent operation for the relief

of acute and rapidly progressive tympanites. It is performed in the left

flank, at an equal distance between the last rib and the angle of the

haunch, and an inch or two beyond the transverse processes of the lumbar

region.

=First stage.= Incision of the skin to the extent of about one inch (not

absolutely necessary).

=Second stage.= Puncture with a sharp trocar directed forwards,

downwards, and inwards. In making this puncture the point of the trocar

is passed through the incision, and a sharp push is given. The sensation

of resistance overcome indicates that the trocar has penetrated the

cavity of the rumen. Gas then escapes. When the operation is completed,

and the canula is being withdrawn, care should be taken to press down

the skin on either side with the fingers of the left hand, to prevent

accidental lifting and laceration of the connective tissue. Even so

slight an accident as this might cause serious complications at a later

stage.

In the absence of a trocar, and in cases of extreme urgency, the rumen

may be directly punctured with a straight bistoury, and after the

punctured wound is slightly enlarged, but before the blade of the

bistoury is withdrawn, an improvised canula, consisting of a hollow

elder twig, may be introduced. Were the blade of the bistoury withdrawn

before the introduction of the canula, the rumen would be displaced, and

the points punctured would no longer correspond.

=Complications=, such as respiratory or circulatory syncope, attacks of

vertigo, etc., have been noted, but these in reality are very rare.

=Subcutaneous Emphysema.=—When the canula is carelessly removed, and the

subcutaneous connective tissue is torn, local emphysema may occur if the

pressure of gas in the rumen is very great. This gas enters the

puncture, proceeds along the connective tissue, particularly the

subcutaneous connective tissue, and causes crepitant subcutaneous

emphysema, very easy to recognise. This emphysema may remain localised

in the neighbourhood of the puncture and gradually become absorbed. It

may, however, extend to the whole of the flank or even beyond, and in

exceptional cases bring about generalised subcutaneous emphysema. Such

very extensive emphysema as this rarely becomes reabsorbed without

complications.

=The suppuration= which follows puncture of the rumen may assume one of

two forms:—

(_a_) That of a little local abscess at the point of puncture, when

foreign matter or the microbes of suppuration have been left in the path

made by the withdrawal of the canula. Such abscesses are of little

importance. They rapidly heal if opened and treated with antiseptic

injections.

(_b_) That of diffuse subcutaneous or interstitial suppuration following

accidental emphysema.

The pressure of gas forces fragments of food material between the layers

of tissue, and suppuration is set up, the pus escaping by a fistula at

the point of puncture. Such suppuration is decidedly dangerous, because

it may result in necrosis of the aponeurotic layers of the small oblique

muscle, in which case recovery is tedious and uncertain.

=Treatment= consists in laying open the orifice and fistula, and making

a counter-opening at the lowest point of the swelling. Free drainage and

abundant irrigation with boiled water at the body temperature, followed

by antiseptic injections, complete the treatment.

=Peritonitis= is not altogether exceptional as a sequel to puncture of

the rumen, if ordinary precautions are neglected or if infective

material or fragments of food pass into the peritoneal cavity.

At first the condition is usually local, but it may extend and assume

the form of general peritonitis two or three weeks later. The symptoms

are those of acute peritonitis.

Speaking generally, however, puncture of the rumen in cattle and sheep

is seldom followed by any complication.

GASTROTOMY.

Gastrotomy is performed for the relief of impaction of the rumen and to

remove foreign bodies, such as linen, nails, bits of leather, etc.,

which have been swallowed.

[Illustration: $1]

A vertical or slightly oblique incision is made in the left flank,

extending from the fourth transverse process of the lumbar vertebræ

towards the last rib. The operation comprises the following stages:—

[Illustration: $1]

=First stage.= Incision through the skin for a distance of from 6 to 10

inches, according to the size of the animal.

=Second stage.= Incision through the muscles and peritoneum and torsion

of any small muscular arterioles, which may be divided.

=Third stage.= Fixation and immobilisation of the rumen with from four

to six sutures (Fig. 303).

=Fourth stage.= Vertical incision into the rumen; manual examination of

the cavity and its contents.

Formerly the operation was confined to these stages. In such cases

localised adhesive peritonitis follows, causing the rumen to adhere to

the internal surface of the abdominal wall, and the fistula continues in

existence for months before complete cicatrisation. It is better,

therefore, to insert sutures in the rumen, in order to secure more rapid

and complete closure.

=Fifth stage.= Suture of the rumen with carbolised silk. The lips of the

wound should be brought together face to face, or they can be slightly

inverted, but the sutures should only pass through the peritoneum and

muscular coats, avoiding the mucous coat. If the silk threads pass

through the mucous membrane and come in contact with the gas in the

upper zone of the rumen they are rapidly macerated, and the sutures tear

out before the wounds can heal. The rumen should always be kept fixed to

the abdominal wall towards the upper and lower extremities of the

operative wound, in order to avoid displacement and occurrence of

peritonitis. For a similar reason the passing of the silk sutures should

be preceded by careful disinfection of the operative wound, and free

washing of the parts with boiled water.

[Illustration: $1]

The operation is concluded by bringing the skin together with a few silk

sutures and inserting a strip of iodoform gauze into the lower portion

of the wound, to serve as a drain.

LAPAROTOMY.

Laparotomy is comparatively seldom performed on animals of the bovine

species, though it may become necessary in dealing with cases of hernia,

uterine torsion (where direct taxis is called for), Cæsarean section,

invagination or strangulation of the intestine, and under a few other

exceptional circumstances.

If simple exploration is aimed at, the operation is most conveniently

performed from the right flank with the animal in a standing position,

but should a prolonged operation be contemplated the animal should be

cast. The incision varies in length, according to circumstances, from 8

to 16 inches, and, like that in gastrotomy, should correspond in

direction with the fibres of the small oblique abdominal muscle; the

seat of operation should previously be washed, shaved, and disinfected.

The operation comprises the following stages:—

=First stage.= Incision of the skin.

=Second stage.= Incision through the muscles and peritoneum.

=Third stage.= Exploration, inspection, palpation, extraction or

ablation, etc.

=Fourth stage.= Suture of the peritoneal opening, the lips being brought

together face to face.

=Fifth stage.= Suture of the muscles and the skin. It is sometimes

advisable to insert a drain of iodoform gauze under the skin.

In small animals, such as the sheep, goat, and pig, laparotomy is more

easily practicable, and can be performed either in the right flank or

towards the white line. The stages of operation are exactly the same,

but after operating near the white line it is extremely important to use

numerous and strong sutures, and afterwards to apply a suspensory

bandage around the abdomen, securing it above the loins.

HERNIÆ.

The situation and nature of the hernia determine whether or not a

radical cure should be attempted.

[Illustration: $1]

When a decision has been arrived at the seat of operation must first of

all be thoroughly cleansed and disinfected. The animal is cast in a

convenient position, and a general anæsthetic is given or a subcutaneous

injection of 1 per cent. cocaine solution administered.

The operation comprises:—

=First stage.= Incision through the skin covering the hernial sac,

opposite the orifice of the hernia.

=Second stage.= Isolation of the hernial sac.

=Third stage.= Reduction of the hernia and breaking down of any

adhesions that may exist.

=Fourth stage.= Resection of the sac and obliteration of the peritoneal

orifice by suture and ligature.

=Fifth stage.= Suturing of the muscles and skin, and application of a

surgical dressing.

In practice, the deep sutures should be of bichromatised catgut or silk,

and the skin sutures of catgut ligature or aseptic silk.

INGUINAL HERNIA IN YOUNG PIGS.

One of the most frequent forms of hernia which the practitioner is

called on to treat is inguinal hernia in young pigs. Although this

allows little tendency towards strangulation it is always desirable to

operate, as otherwise the patients develop badly. There is no difficulty

in this, though the animals must be cast and placed on their backs, the

hind quarters being raised (Fig. 305).

=First stage.= A longer or shorter cutaneous incision over the neck of

the hernia and along its greater curvature.

=Second stage.= Isolation of the hernial sac, consisting of the dilated

internal sheath.

=Third stage.= Direct reduction of the hernia without opening the sac,

provided no adhesions occur, or, in the event of adhesions, after

incision of the sac.

=Fourth stage.= Torsion of the hernial sac and of the testicular cord up

to the inguinal ring. Application of a catgut or silk ligature around

the sac and cord at the level of the inguinal ring.

=Fifth stage.= Fixation of the ligature to the lips of the ring. Suture

of the skin wound, and drainage of the wound with a strip of iodoform

gauze.

IMPERFORATE ANUS.

This anomaly of development, which is not uncommon, presents two

different degrees of development.

In the first degree the rectum is well formed, and extends as far as the

skin below the base of the tail.

In the second the rectum is incomplete or non-existent, the floating

colon terminating in a blind end at the entrance to the pelvis.

In calves, lambs, and young pigs very often imperforate anus is not

diagnosed until the second or third day after birth. Defæcation cannot

occur, and death is inevitable unless an artificial anus be established.

FIRST DEGREE.—The patient loses appetite, the abdomen remains distended,

and on examination of the anal region a doughy swelling is felt, which

projects backwards when the animal strains. The operation is quite

elementary, and always proves successful.

=First stage.= The skin beneath the tail is incised vertically; the

rectal cul-de-sac projects towards the incision.

=Second stage.= The rectal cul-de-sac is punctured, the contents are

removed, and the rectum and skin united by a few sutures. An anus is

thus established, though there is no sphincter.

SECOND DEGREE.—The general symptoms are similar, though very often the

little patient shows symptoms of atrophy or arrest in development. The

operation is somewhat complicated.

=First stage.= Vertical incision through the skin at the base of the

tail.

[Illustration: $1]

=Second stage.= Digital exploration of the cavity of the pelvis after

breaking down of the layers of connective tissue, and search for the

blind end of the floating colon. When discovered, the colon is grasped

between the jaws of a clamp or large forceps with smooth jaws, and

gently drawn towards the opening.

=Third stage.= Puncture of the blind end of the colon, and suture of the

latter to the cutaneous wound, as in the former case.

A third condition may exist, where the extremity of the colon remains

within the abdomen. Operation by way of the pelvis then proves

unsuccessful. If considered advisable, an opening may be made through

the right flank, so that the floating colon may be brought to the

surface and an artificial anus produced in this region.

An incision 1 or 2 inches in length is made below the haunch, to allow

of the introduction of the index finger, with which the loop is sought.

The colon is withdrawn, and the operation thenceforth is as above

described.

PROLAPSUS AND INVERSION OF THE RECTUM.

This condition occurs in young pigs in various degrees. The necessity

for reduction depends on the extent to which tearing or gangrene of the

mucous membrane has progressed. The inverted portion is carefully

washed, freely dressed with some non-irritant fatty substance such as

vaseline, and progressively pushed back with the thumbs and index

fingers of both hands applied flat on either side of the anus. To

facilitate reduction it is best to check the animal’s expulsive efforts

by placing a gag in the mouth.

In more aggravated cases, when prolapsus of the rectum has returned

several times and the mucous membrane is gangrenous in places so that

such a complication as peritonitis of the pelvic cavity is to be feared,

it is better to amputate the prolapsed portion.

The animal is secured either standing or lying down, and a large enema

is administered to remove the contents of the rectum. The herniated

portion of bowel is carefully examined, for it sometimes happens that

loops of intestine have become lodged in the dilated peritoneal sac,

produced by displacement of the rectum. In such cases reduction should

be effected before anything more is done, and for this purpose the

patient’s hind quarters should be lifted or even suspended.

The operation for removal comprises two stages:

(1.) Fixation of the two layers of bowel by the passage of either two or

four sutures about ½ an inch behind the anus.

(2.) Circular amputation of the sutured tissues; insertion of

interrupted silk sutures through the lips of the wound; reduction. The

patient is restricted to milk diet for a week. Laxative gruels, etc.,

may then be given.

The complication to be feared is peritonitis of the pelvic cavity owing

to the sutures tearing out and allowing infective material to pass from

the bowel into the cavity.

Slight cases of prolapsus might possibly be treated by the injection in

lines of melted paraffin wax beneath the mucous membrane of the last

part of the bowel. The injection is made by means of a large syringe

provided with a long needle, the needle being gradually withdrawn as the

melted wax is expressed. Four “pillars” of wax are usually injected at

equidistant points. As they solidify they support the bowel and prevent

the recurrence of the prolapse. The operation, however, is delicate, and

scarcely to be recommended in pigs. Moreover, in man, in whom it has

chiefly been practised, the deferred results have not always proved

satisfactory.

CHAPTER V.

RESPIRATORY APPARATUS.

TREPHINING THE FACIAL SINUSES.

This operation is necessary when pus, tumours, or parasites exist within

the sinuses, and in some cases where tumours form within the nasal

cavities, etc.

TREPHINING THE HORN CORE.

This cavity is opened in front, at the base of the horn, about ¾ of an

inch above the keratogenous band.

FRONTAL SINUS.

The frontal sinus may be trephined at one of two points, that is, either

towards its highest or lowest extremity.

In the former case the point selected is in the direction of the axis of

the horn core, about ¾ of an inch nearer the middle line than the base

of the horn itself.

The animal should be cast.

=First stage.= A =V=-shaped incision ¾ of an inch long on each side is

made through the skin and subjacent tissues, exposing the bone.

=Second stage.= The skin and periosteum are dissected away and reflected

upwards.

=Third stage.= Trepanation.

The lower portion of the cavity is trephined within the angle formed by

a transverse line uniting the upper margin of the orbits and the inner

margin of the super-orbital foramen.

The stages are precisely the same as those above described.

MAXILLARY SINUS.

In adult animals the maxillary sinus is opened immediately above the

maxillary tuberosity. In the young the point selected is ¾ of an inch

higher.

TRACHEOTOMY.

In bovine animals tracheotomy is only performed in urgent cases, in

order to ward off asphyxia or to facilitate some other operation on the

upper air passages. It is performed exactly as in the horse, the animal

either standing or lying down. In the former case, the animal may be

placed in the trevis, but two strong assistants holding the animal’s

head and nose by means of “bulldogs” are often sufficient.

To prevent the animal from striking out with the front legs, a rope is

passed above and around the knees in the form of the figure =8=; the

animal is backed into a corner, and operation is then quite safe.

Large animals must be cast or placed in the trevis.

The seat of operation should be washed, shaved, and disinfected.

The operation may be divided into four stages.

=First stage.= Vertical median incision about 2 inches long through the

skin at the height of the upper third of the trachea.

=Second stage.= Separation with a blunt director of the muscles covering

the trachea. Incision through the pretracheal connective tissue.

=Third stage.= Circular or elliptical opening through the trachea of a

size corresponding to that of the tracheotomy tube.

=Fourth stage.= Insertion of the tracheotomy tube.

CHAPTER VI.

GENITO-URINARY ORGANS.

In the domestic ruminants the penis exhibits a peculiar =S=-shaped

curve, situated in the subpubic region (Fig. 226), so that when

operation on the urethra, or even on the extremity of the penis, becomes

necessary the organ must first of all be withdrawn.

The manipulation is as follows:—

The animal having been fixed by the head and front legs in a standing

position, and if possible thrust against a wall, the operator stands on

its left side. With his right hand he seizes the penis and the skin

immediately in front of the scrotum and pushes them forward in the

direction of the opening of the sheath.

The extremity is nipped between the first fingers of the left hand, and

to prevent the glans slipping or escaping when the right hand is removed

(for the purpose of taking a fresh hold of the body of the penis further

back) the operator may reverse the free extremity of the penis so that

it forms a loop, and thus secure a firmer hold. With the right hand the

skin is thrust backward, a new portion of the sheath fixed, and the

organ again pushed forward. In this way the penis is gradually extended.

When the animal is cast, this manipulation is much easier.

URETHROTOMY IN THE OX.

Urethrotomy consists in incising the urethra, usually for the purpose of

extracting a foreign body or calculus which impedes micturition. In the

ox, calculi may become fixed either in the intra-pelvic portion of the

urethra, though this is very rare; in the ischial curvature, or more

commonly at some point in the =S=-shaped curve of the penis; or

sometimes even within the sheath itself.

Urethrotomy is performed in the ischial or scrotal region, according to

the point where the obstruction exists.

ISCHIAL URETHROTOMY.

Urethrotomy is performed in the ischial region either to displace or

indirectly to abstract a foreign body fixed in the membranous portion of

the urethra, or directly to remove one from the spongy portion opposite

the ischial curve.

Calculi fixed in the intra-pelvic region are detected by rectal

exploration.

The exact position of the foreign body is determined by inspection and

palpation, whilst distension of the urethra by urine may be noted even

before more striking symptoms appear.

The urethra can be incised by one of three methods.

The animal should be secured, if possible, in the standing position.

The =first method=, which dates back to very early times, consists in

puncturing the urethra at one stroke with the fleam or lancet, and

opening it more freely, after introducing a grooved director. This

method is very useful where rupture of the bladder is imminent.

The extraction of a calculus fixed in the ischial region, or the

manipulation of an obstruction at any other point, can afterwards be

undertaken.

=Second method.= A second method consists in incising the subcutaneous

tissues, layer by layer, until the urethra is reached at the ischial

arch.

The operation is terminated by puncturing the urethra and enlarging the

incision in an upward direction after passing a grooved director. This

method minimises hæmorrhage and urinary infiltration. By previously

injecting cocaine, the operation may be made practically painless.

=Third method.= Puncture of the urethra by a single stroke with a

straight bistoury at the ischial arch.

The opening is enlarged in an upward direction with the same instrument.

SCROTAL URETHROTOMY.

Scrotal urethrotomy is necessary when the calculus is situated in one of

the =S=-shaped curves of the penis or nearer the glans.

The operation is facilitated by casting the animal and withdrawing the

penis from the sheath, but as there is considerable danger of rupturing

the bladder when casting an animal with marked distension of that organ,

the more serious operation should be preceded by puncturing the urethra

with a fleam at the ischial arch.

By repeated moderate traction on the extremity of the glans, the

=S=-shaped curve can be obliterated and the anterior portion of the

penis withdrawn beyond the sheath.

One of two conditions may exist.

=First case.= Where the calculus is in the anterior, extra-prepubic

portion, it is removed through an incision made directly over it. After

extraction and disinfection, one or two sutures are inserted.

=Second case.= Should the calculus be situated in that portion of the

penis which remains within the sheath after the fullest withdrawal of

the organ, it is necessary to proceed as follows:—

(1.) The skin covering the sheath, the subcutaneous tissue, and the

mucous membrane are first incised for a length of from 1¼ to 1¾ inches.

(2.) The penis is drawn through this opening; an incision is made

directly over the calculus, dividing the fibrous layer, erectile tissue

and mucous membrane of the urethra; the parts are disinfected and the

wounds closed with sutures.

With ordinary antiseptic precautions little danger is to be feared.

Even should infiltration of urine occur, the operator need not be unduly

anxious, for, provided the parts are punctured or scarified early,

recovery usually follows.

PASSAGE OF THE CATHETER AND URETHROTOMY IN THE RAM.

Obstruction of the urethra in rams is more commonly caused by deposits

of gravel than by single large calculi. It is generally found in

highly-fed animals, in which gravel accumulates and becomes massed

together at some point in the canal, often near the free extremity,

where it forms a plug, causing complete retention of urine. In other

cases this retention is due to a mass of sediment formed by vesical

mucus and fine gravel which collects about the neck of the bladder.

Three operations have been advised for the removal of this condition:—

(1.) =Section of the Appendix of the Penis.=—When the disease is just

appearing the sedimentary material may be collected at the anterior

extremity of the penis behind the appendix. The shepherds in such cases

remove the extremity of the penis. The resistance disappears, the plug

formed of gravel yields to the pressure of urine, and micturition occurs

as usual. Excision of the appendix, however, incapacitates the ram for

service.

(2.) =Passage of the Catheter.=—Passage of the catheter has been

recommended for the removal of deposits of gravel in the urethra, but it

seems a very questionable method.

Should it be determined on, the animal must be placed on its back. The

penis is then withdrawn and the double =S=-shaped curve is obliterated.

An incision is made over the canal behind the appendix and a soft

gutta-percha sound is passed. The sabulous accumulation is thus

dispersed.

(3.) =Urethrotomy.=—Scrotal urethrotomy may be performed as in the ox.

[Illustration: $1]

Ischial urethrotomy is impracticable in very fat animals, but when the

obstruction is about the neck of the bladder, and the animal’s condition

admits of it, this operation may be performed.

The patient is fixed on its back, and a metallic or gutta-percha sound

is passed into the urethra. The tissues are incised layer by layer in

the direction of the sound. Once the urethra has been opened the soft

magma may be washed out of the bladder by a free injection of boiled

water or similar aseptic liquid.

[Illustration: $1]

PASSAGE OF THE CATHETER IN THE COW.

It sometimes becomes necessary to examine the bladder of the cow.

There is an obstacle, however, to the introduction of the sound into the

urethral canal. The meatus urinarius is covered by a little valve which

springs from the lower wall and forms behind the real opening of the

urethra a cul-de-sac, into which the point of the catheter is apt to

pass. The instrument usually employed is of gutta-percha, glass, or,

better still, of metal, as more easily sterilised (Fig. 308). It is held

like a pen, and is directed along the floor of the vagina as far as the

opening of the meatus, being guided by the index finger of the left

hand, which has previously been introduced. The point being very

slightly depressed, it enters the cul-de-sac. It is then only necessary

to reverse the movement, that is to say, raise the point, whilst gently

pressing forward; a slight resistance is felt and the sound enters the

bladder. If necessary the little valve may be held down by gently

pressing on it with the point of the left index finger.

It is sometimes an advantage to expose the seat of operation. In such

cases the lips of the vulva and the walls of the vagina may be separated

by retractors or by the use of a speculum.

CASTRATION.

Castration is performed for the purpose of removing the reproductive

power, either by obliterating the testicle or ovary or by suppressing

their functions.

In ruminants, the testicles are elongated and placed in a vertical

position, the upper portion of the scrotum presenting a constriction and

the whole scrotal mass resembling in shape a cone with its base

downwards.

CASTRATION OF THE BULL AND RAM.

These two animals, when destined for slaughter, are usually castrated

either at birth or at latest two or three months afterwards. In

Normandy, in Franche-Comté, and in England breeders castrate young bulls

by torsion of the cord.

Two incisions about 1¼ to 1¾ inches in length are made on the lower

extremity of the scrotum. The testicles are enucleated and the

testicular cords seized with two pressure clamps, with which torsion is

effected. In the South of France, in Auvergne, and in the Limousin,

bulls intended for working are not castrated until after the lapse of

some months, on account of the influence which the testicles have on the

development of the bones and muscles. Such animals are only operated on

at the age of from six months to a year, and as a rule the method

employed is that of bistournage.

BISTOURNAGE.

This method of castration has been practised from time immemorial. It

consists essentially of torsion of the testicular cord, and aims at

obliterating the vessels which it contains, and thus bringing about

atrophy of the organs served by them.

=The Bull.=—The animal is operated on in the standing position. The head

is fixed to a post or ring somewhat high up, in order to check movement

of the hind legs. The hind legs are also partially secured by means of

ropes or two pieces of webbing passed in a running noose about the hocks

and fixed above the knee. No preliminary disinfection is practised,

because no wound is made.

[Illustration: $1]

=Manual Technique.= The operation comprises four stages:

[Illustration: $1]

=First stage.= The operator, standing behind the animal’s hocks, grasps

the testicular cords with the hands, immediately above the testicles,

and by exercising strong pressure, thrusts the latter to the extreme

base of the scrotum. The movement is next reversed; seizing the base of

the scrotum with the right hand, he draws it smartly downwards, whilst

he places the left hand above the right, and thrusts the testicles

towards the abdomen. If the testicles do not rise sufficiently high, the

right hand is slipped between these and the left hand, and the testicles

are thus thrust upwards towards the lower inguinal rings, slightly

dilating the latter.

After this manipulation has been repeated two or three times, the

scrotum, etc., become more pliable and the testicles more easily

displaced. The second stage of the operation is thus facilitated.

=Second stage.= The second stage of operation may be effected by one of

two methods.

[Illustration: $1]

_Old method_: The oldest method consists in allowing one of the

testicles to rise towards the inguinal ring and to turn the other in a

vertical plane. If, for instance, it is desired to turn the right

testicle, the cord is grasped between the thumb and index finger of the

left hand (Fig. 311), the lower part of the scrotum is seized with the

right hand, and the object then is to slide the point of the testicle

along the dorsal surface of the fingers (Fig. 311). Simultaneously the

operator presses on the base of the testicle with the thumb of the left

hand, thus causing a rotary movement in a vertical plane; the tail of

the epididymis becomes uppermost. A certain empty space separates the

testicle from the base of the scrotum.

=Third stage.= Torsion of the cord. The testicle having been rotated,

the cord must be twisted so that the vessels may be obliterated. The

left hand continues grasping the cord, which is then brought in front of

the testicle, whilst with the right hand the testicle is pushed

backwards and is made to describe a semi-circle. The cord was previously

on the left side; it is now on the right, and simultaneously the

testicle passes from right to left.

[Illustration: $1]

In completing the turn the hands must not be changed, and, above all,

must not let go their hold; and the cord is pushed forwards and towards

the right with the right hand, whilst the testicle is pushed backwards

and to the left with the left hand. The cord and the testicle resume

their original position; one complete turn has been effected. These

manipulations are repeated several times, and the cord soon assumes the

appearance of a large, hard, tense string. To ensure obliteration seven

or eight turns should be made in the case of the bull and four or five

in that of the ram.

Torsion of the right testicle being complete, the gland is thrust

towards the upper part of the scrotum and the left testicle is submitted

to the same manipulation, the position of the hands, however, being

reversed.

=Fourth stage.= Fixation of the testicles in the inguinal region. Both

testicles having been thrust upwards as far as possible into the

inguinal region, the scrotum is ligatured below them. Tape or thick cord

should be used, to guard against gangrene of the lower portions of the

scrotum. A considerable œdematous swelling soon occurs, and when at the

end of twenty-four or forty-eight hours infiltration is well developed,

the ligature should be removed.

Dubourdieu has described a different method, in which the testicle is

rotated in a horizontal plane. The position of the hands is then

different. The left testicle, for instance, being at the base of the

scrotum, the cord is grasped with the right hand opposite the base of

the testicle, and the tail of the epididymis and the testicle are held

with the whole hand whilst being rotated. If care is taken to fix the

cord with the right hand, rotation is more rapid and easier than in the

preceding method.

[Illustration: $1]

[Illustration: $1]

=Difficulties in Operation.=—Bistournage is highly commended in France

on account of its avoiding all the complications resulting from

sanguinary operations. Nevertheless it presents great difficulties,

particularly in bulls of from two to three years of age, in which the

testicles are hard to manipulate on account of their size, the thickness

of the connective tissue, and sometimes because of abnormal adhesions.

In such cases the preliminary manipulation alone sometimes extends over

half an hour.

Bistournage is of doubtful efficacy when the testicles are small and

round, because after the ligature has been applied the testicular cord

tends to untwist, and the shape of the testicles readily lends itself to

such movements. If untwisting occurs, the operation fails.

=Consequences of the Operation.=—The operation is often followed by more

or less violent attacks of colic; the animal may suffer for five or six

hours, after which it recovers.

If torsion has been clumsily performed, or if the ligature becomes

displaced, the testicle may descend and the cords untwist; the latter

then appear to have lost the firm, tense consistence which they

presented after operation. To prevent slipping of the ligature and

untwisting of the cord, Guittard suggests the use of an iron needle,

with which the scrotum is pierced through the median line, just beneath

the testicles when at their highest position; above this is placed the

ligature, which then cannot possibly slip.

The Basque operators, in order to avoid untwisting, exercise vigorous

traction from above downwards after rotating the testicle. In this way

ruptures occur which diminish the elasticity of the cord and the

epididymis, and tend to check the untwisting of the former.

When the operation has succeeded the testicles gradually atrophy. They

do not disappear completely, and may sometimes be found several years

later of the size of a hazel-nut or a chestnut and of fibrous

consistence. It need scarcely be said that in the event of bistournage

failing, cutting operations can always be resorted to.

MARTELAGE.

The process of martelage consists in mutilating with a mallet the

testicular cord whilst still covered by all its envelopes. This

mutilation injures the walls of the arteries, causing the formation of a

clot, which cuts off the supply of blood to the testicle and causes the

gland to atrophy.

The practice is very ancient.

The animal is fixed by the horns as if for bistournage, and the limbs

are secured by two strips of webbing or two ropes, as in the former

case, though some practitioners neglect the latter precaution.

Two cylindrical rods the size of broomsticks and a wooden mallet or

farrier’s hammer are the instruments employed.

The method, however, is barbarous, cruel, and of doubtful value. It

would never be countenanced in England.

CASTRATION BY CLAMS.

Castration of bulls by means of clams has been practised in many

different forms.

[Illustration: $1]

=Castration by the Exposed Method.=—The operation is the same as in the

horse, the scrotum being incised on either side, and the dartos,

connective tissue, tunica vaginalis scroti, and tunica vaginalis testis

being divided. Short clams are applied to the cord, and the lumen of the

arteries is completely obliterated in five to six days, when the clams

can be removed.

Instead of an incision being made for the removal of each testicle, the

scrotum and dartos may be divided in the middle line, after which

incisions may be made to the right and left respectively, exposing the

fibrous tissue and enabling the testicles to be enucleated. A clam may

then be applied to each cord, or the two cords may be included in one

pair of clams.

This method has the advantage of inflicting less injury on the scrotum,

a point which is of some importance in animals destined for slaughter.

=Castration by the Covered Method.=—This operation is identical with the

preceding, except that the incision of the scrotum does not involve the

cremaster and fibrous tunic, or the tunica vaginalis scroti.

CASTRATION BY TORSION.

The cord may be twisted throughout its entire length or torsion may be

limited to a part of the cord, hence the two methods hereafter

described.

(_a_) =Limited Torsion.=—The testicles are exposed as in castration by

the open method. The cord is then drawn forward and fixed by means of

forceps applied just outside the scrotum; ¾ to 1 inch below this point

the torsion forceps are applied. The cord is slowly twisted, and usually

ruptures about the centre of the fragment included between the two pairs

of forceps.

[Illustration: $1]

(_b_) =Direct or Unlimited Torsion.=—=First stage.= The testicle is

exposed, as in castration by the covered method.

=Second stage.= The cord and vaginal tunic are twisted by grasping the

testicle, which is protected with a piece of clean linen.

CASTRATION WITH THE ACTUAL CAUTERY.

The testicles are exposed, the cords are seized with clams and divided

separately or together with a sharp-bladed cautery at a white heat. The

eschar so produced is sufficiently dense to obliterate the vessels.

CASTRATION BY THE ELASTIC LIGATURE.

This method has been largely employed during the last ten or fifteen

years. It consists in applying to the upper part of the scrotum several

turns of a tensely stretched round or square rubber thread. The two ends

of the rubber thread are crossed and tied with string. About the seventh

or eighth day the testicles may be removed with a knife close to the

ligature, provided the process of delimitation is well advanced.

The chief objection to this method lies in the fact that the scrotum is

destroyed, which lowers the value of the animal from a commercial point

of view.

CASTRATION OF THE RAM.

Most of the preceding methods may be used in castrating rams, but

certain special methods are more generally employed. These we shall

shortly mention.

=Castration by Bistournage.=—The method is exactly similar to that in

the bull. The animals are placed in the position shown in the figure,

except that the hind limbs are extended and held in that position by the

operator’s knees or feet. The process is only applicable to animals of

four or five months old.

=Castration by Tearing.=—This method is only practised by shepherds, and

on animals a few days or at most a month old. The base of the scrotum is

snipped off with scissors, the testicles are enucleated, and each in

turn is seized and torn away with a sudden snatch. Even though a

considerable length of cord is removed with the testicle, bad results

seldom follow, provided the subject is not of greater age than that

mentioned.

[Illustration: $1]

=Castration by Ligature.=—This method consists in passing a stout

ligature in the form of a running knot over the neck of the scrotum and,

by means of two short pieces of wood, drawing it tight. The method,

however, is not to be recommended, as it not infrequently leads to

tetanus.

CASTRATION OF BOARS AND YOUNG PIGS.

For castration boars should be cast on the left side, and three legs at

least firmly secured together (Fig. 317). The best method is that of

limited torsion. Care should be taken to avoid dragging the cord

downwards during the operation, for the testicular artery ruptures

readily, and fatal abdominal hæmorrhage may follow.

As the subjects are apt to wallow in the litter after the operation a

strip of iodoform gauze should be applied and secured by one or two

sutures. This is removed on the third or fourth day.

On young pigs the operation is simpler. The animal is cast on the left

side and firmly held, the left hind limb being extended and the right

drawn towards the right shoulder.

The testicles are grasped each in turn with the left hand, whilst with

the right they are exposed by a single sweep of the bistoury. The

testicles are removed by torsion with artery forceps. Many laymen simply

use the hands, the cord being grasped between the left thumb and index

finger, whilst torsion is effected by the right index finger thrust

between the vas deferens and the body of the testicle.

CASTRATION OF CRYPTORCHIDS.

Cryptorchids are very rare amongst cattle and sheep, as the testicles

enter the scrotum during intra-uterine life. The internal inguinal ring

in the pig being of very small size, the condition is more common in

that animal.

The same process is employed in castrating cryptorchid bulls, rams, or

boars. The animal is thrown on one side and securely fixed. A vertical

incision is made in the region of the flank, varying in length from 4 to

5 inches in the bull, 2 to 2½ inches in the ram, and 4 to 5 inches in

the pig. The abdominal cavity is examined, the testicle found, and a

ligature applied to the cord, after which the testicle is removed.

Another method consists in employing the _écraseur_ for division of the

cord.

To avoid subsequent complications antiseptic precautions should be

taken.

=Complications after Castration.=—Whatever the method employed, swelling

of a more or less abundant character always develops during the few days

immediately succeeding the operation. It is, however, of little

importance.

Should antiseptic precautions be neglected, suppuration, septicæmia,

tetanus, and sometimes scirrhous cord may follow.

FEMALE GENITAL ORGANS.

=Examination with the Speculum.=—In the cow certain diseases of the

vagina, bladder, neck of the uterus, and even of the uterus itself, may

necessitate visual examination in addition to the manual examination

commonly employed. Under such circumstances a special speculum is

introduced in a closed condition, being afterwards opened and dilated to

the required extent.

Before inserting the speculum, however, the genital passages should be

cleaned, and the speculum itself smeared with vaseline. It penetrates

readily with moderate pressure.

Heifers and similar animals require a special (small) instrument (Fig.

318).

[Illustration: $1]

In certain circumstances, moreover, it is preferable to use retractors,

with which local examination is easier. These can be applied at either

side of the vagina and drawn apart, thus exposing the depths of the

genital tract.

CASTRATION OF THE COW.

The operation of castrating the cow is very old, and was mentioned by

both Aristotle and Pliny. Many other descriptions of it have since been

given. But more recently the manual technique has been considerably

simplified and very fully described.

=Utility.=—The operation is practised for the cure of nympho-mania; also

to prolong the period of milk-yielding and to facilitate fattening.

As regards nympho-mania, it is only of value where the excessive

excitement is due to disease of the ovaries.

Under ordinary conditions the secretion of milk diminishes more or less,

and becomes very slight after eight or nine months from calving. If,

however, the cow is castrated under favourable circumstances, lactation

continues for several months, sometimes for several years, beyond this

period. It is said that castrated cows yield milk of a more constant

composition and richer in butter fat, casein, and mineral salts than

those which are not castrated, although the point cannot be said to have

been fully established.

To obtain the best results the subjects should have attained their

maximum yield of milk and be from five to seven years old. The best

period is six weeks to two and a half months after calving. Neglect of

these considerations is liable to be followed by inappreciable,

doubtful, or bad results.

The influence of castration on fattening is explained by the suppression

of œstrum.

=Manual Technique.=—An ovariotome with a hidden blade and an _écraseur_

with an extra long stem are the only instruments required. The animals

should be prepared for some days by diminishing their food supply and

administering gentle laxatives.

Acute or chronic lesions of the genital tract should be held to

contra-indicate operation, and it should be noted that tuberculous

animals are particularly liable to awkward complications.

On the day of operation an abundant enema is given, to empty the rectum,

after which the vagina is washed out freely with a lukewarm solution of

some non-irritant antiseptic. The hind quarters, and particularly the

neighbourhood of the anus, vulva, base of the tail, etc., should be

carefully washed and disinfected with a solution of lysol, cresyl or

carbolic acid.

[Illustration: $1]

The patients are secured in a standing position, a rope being passed in

the form of the figure =8= around the hind limbs above the hocks, and

the animal is then firmly thrust against a wall by several strong

assistants.

The operator’s hands and instruments must be rigorously disinfected.

The operation comprises three stages:

=First stage.= Puncture of the vagina.

=Second stage.= Finding and securing the ovaries.

=Third stage.= Ablation.

The hand is smeared with sterilised oil, and, grasping the ovariotome,

is passed into the vagina, which contracts on it and on the forearm.

Within a short time, however, which may vary between two or three

minutes and a quarter of an hour, the vagina becomes distended and its

walls rigid, so that the operator is able to continue his manipulations

more easily. This is the moment for effecting puncture, after an

examination of the pelvic organs through the vaginal walls.

The blade of the ovariotome is advanced until fully exposed, and the

point is brought directly above the neck of the uterus, about ¾ to 1¼

inches from it. By a sharp movement the instrument is then thrust

directly forward, dividing the wall of the vagina in the median line.

The blade is next retracted into its sheath and the instrument dropped

on to the floor of the vagina. The right index finger is at once passed

through the orifice so made into the peritoneal cavity, in order to make

certain that all the membranes have been divided. By pressing on and

slightly tearing the tissues the middle finger is then introduced

alongside the index. Only these two fingers should be passed into the

peritoneal cavity.

In order to secure the ovaries it then suffices (Fig. 321) to thrust

forward the base of the vagina, allowing the two fingers to glide over

the body of the uterus and thence downward over its side to the point

where the horns of the uterus originate. Here the fingers meet the

ovary, which is readily recognisable on account of its size and shape

(those of a walnut). The gland is nipped between the index and middle

fingers, and is drawn into the vagina through the operative opening.

[Illustration: $1]

In order to remove the ovary the operator seizes the _écraseur_ with the

left hand, a loop of chain about an inch long projecting, and slides the

instrument along his right forearm. The arm must be retained in the

vagina, the fingers grasping the ovary. The organ is slipped into the

loop of the _écraseur_, which is then manipulated with the left hand

until the pedicle is divided. To prevent hæmorrhage the screw of the

_écraseur_ should only be turned at the rate of about twice a minute.

The ovary when separated is left on the floor of the vagina, the fingers

being again introduced into the abdominal cavity to secure the second

one. This is removed in precisely the same way.

The pedicles of the ovaries are released, and at once return to the

peritoneal cavity, while the operator, in withdrawing his hand, brings

with it the knife and the ovaries themselves. The lips of the operative

incision come together again spontaneously as the vagina contracts.