blunt instrument or by falls. The seriousness depends largely on the depth
of the injury, and treatment should be directed to allaying the
inflammation and preventing the consequent tendency to sloughing. To this
end soothing applications, such as antiseptic fomentations and poultices,
are plainly indicated.
METHODS OF HEALING.--Technically these may be divided into a number of
distinct processes, but practically we may speak of them as two only,
namely, by primary union, or adhesion, and by granulation. As suppuration
is not so liable to occur in cattle as in horses, healing by the former and
more speedy process is much more common in the first-named species, more
particularly in clean-cut or incised wounds, provided they have been
stitched within 12 hours from the time the injury which caused them was
inflicted, that they have been kept antiseptically clean, and that the
patient by some means has been kept fairly still. This latter stipulation
is probably hardest to comply with. Quiet is an important factor in the
process of repair among the lower animals.
The second method of healing, namely, by granulation, which is, however,
the manner in which most wounds in animals heal, takes much longer. In
punctured wounds of any depth healing necessarily takes place in this way
only, and the treatment should be directed largely to alleviating pain and
moderating inflammation.
AFTER-TREATMENT AND DRESSING OF WOUNDS.--The dressing of wounds is one of
the most important branches of veterinary surgery, and one of the most
constant difficulties that the practicing veterinarian has to contend with
lies in the lack of cooperation on the part of owners in the care and
attention in the after-treatment of wounds.
In summarizing the treatment of wounds, the following recommendations
should be observed: wounds must be cleansed and kept clean, using
antiseptic solutions which do not produce irritation, and applying the
solutions with a syringe or with clean pieces of absorbent cotton. Bleeding
should be stopped before the closing of the wound by sutures or bandages.
An opening at the bottom of all wounds except small superficial wounds
should be provided as a drainage outlet for the escape of wound secretions
or pus if it should form. The edges of wounds and the muscles involved in
the wound should be kept as quiet as possible during the process of
healing. Every wound should be protected by a sterile or antiseptic
dressing whenever it is possible to retain a dressing in place. Dressings
should be changed when it is apparent that they have become drenched with
wound secretions or pus, or have become disarranged or too loose,
permitting dirt to enter between them and the skin. If swelling appears
beyond the edges of a bandage, it is an indication that it is too tight and
it should then be removed and again applied.
The hands of the operator and all instruments and dressings coming in
contact with a wound at any time should be made as clean as possible by the
use of antiseptics.
BARBED-WIRE CUTS.--We have specified these simply because in some sections
of the country there is a fixed idea that there is a specific poison in
barbed wire, causing injuries which require treatment differing from that
which is applicable to ordinary wounds. Barbed-wire cuts differ from
ordinary wounds only in the parts being often lacerated and torn, and the
treatment already indicated for wounds of that description is applicable to
them.
CASTRATION.
Castration consists in the removal of the essential organs of generation,
and is performed upon both the male and the female. In the male the organs
removed are the testicles and in the female the ovaries.
CASTRATION OF THE MALE.
Castration in the male is performed for several different purposes. It may
be necessary, as is the case in certain diseased conditions of the
testicles and in strangulated hernia, but the usual object of the operation
is to enhance the general value of the animal. For example, if the animal
is intended for burden, the operation will better fit him for his work by
so modifying his temperament and physical condition that he may easily be
controlled by his master. Again, if he is merely to be used for beef
purposes, the operation will improve the quality of the flesh and cause an
added development of the most valuable portions of the dressed carcass.
The operation upon the female may be performed on account of diseased
conditions, but we may say that the chief object of the operation is to
make the animal one of more profit to its owner by lessening the lacteal
secretion and also improving the physical condition from the point of view
of beef production. When the cow is spayed, it does away with all trouble
attending estrum, or heat, gestation, and parturition with its accidents
and ailments. The flesh of the spayed cow is more tender and juicy than
that of the natural animal.
The operation upon the male may be either the uncovered or the covered. In
the former the incision is made down to the testicle proper, and in the
latter the cut is made through the scrotum or the outside covering and
through the dartos, or the next coat, care being taken to cut no deeper
tissues or coats. The age at which the operation is performed varies, but
usually it is performed between the second and third month. If done in
early life, there is less danger of complications, the organs being in a
latent condition and not fully developed. There are many different methods
of operating, the principal ones of which we shall mention. In the
uncovered operation a good free incision should be made, exposing the
testicle completely. Now it may be removed by simply cutting it off. The
only danger of doing this is that hemorrhage is liable to follow. To
obviate this, before the division of the spermatic cord it should be
twisted several times in the following manner: Take hold of the cord with
the left hand, having it between the thumb and the index finger. Now twist
the free portion several times with the right hand, all the time being
careful to push with the left hand toward the body of the animal. In this
way the danger of injury to the cord during the animal's struggles will be
overcome. There will be no hemorrhage, or very little, if it has been done
properly. This is the most simple manner of torsion. There are forceps and
other instruments made to perform the operation in this manner. The actual
cautery is an old method, but we shall not describe it, as we consider that
we have better methods now. The next method with the clamps, although
extensively used upon the horse, is not practiced to so great an extent
upon the bovine at the present time. It is a very old method, and is
considered very safe. Clamps are used in the covered and uncovered
operations.
More modern methods are by the use of special instruments known as the
emasculator and the Ècraseur.
The operation of "mulling" or crushing the spermatic cord is an
unscientific and barbarous procedure, causing unnecessary pain and
suffering.
The methods described above apply only to the animal in a normal condition.
Before operating everything should be examined to see that it is as it
should be. If otherwise, a special operative procedure will be necessary.
Whichever mode of operation is adopted from a practical standpoint, the
principal precautions to be taken in order to attain success are as
follows: First, thorough cleanliness under strict aseptic and antiseptic
precautions; second, a free and boldly made incision; third, the avoidance
of undue pulling or tension upon the spermatic cord; fourth, free drainage,
which can be maintained, provided the original incision has been properly
made.
The operation of castration of the male is by no means a serious one, and
when properly performed there is little danger from complications. Although
the danger is trifling, the complications which may arise are sometimes of
a serious nature. Hemorrhage, either primary or secondary, tetanus (or
lockjaw), abscesses, hernia (or rupture), gangrene, and peritonitis are the
most serious complications that follow castration. Whichever complication
arises will require its own special treatment, which we will not go into
here, as it will be fully dealt with under another heading. We would add,
however, that, generally speaking, the animal, after being castrated,
should either be regularly exercised or be allowed freedom so that it can
exercise itself. Sudden changes of the temperature are dangerous. The
animal should be fed moderately, but of a diet easily digestible.
CASTRATION OF THE FEMALE.
The operation of ovariotomy (spaying) should be performed when the heifer
is in her prime and in moderate condition not too plethoric and not in heat
or pregnant. This operation may be performed in one of two ways--namely, by
the flank or by the vagina--each operation having its special advantages.
In the flank operation the animal may be operated upon either while
standing or while in the recumbent position. If standing, she should be
placed against a wall or a partition and her head held by a strong
assistant. The legs also must be secured to prevent the animal from
kicking. A vertical incision should be made in the left flank, about the
middle of the upper portion, care being taken not to make the opening too
far down, in order to avoid the division of the circumflex artery which
traverses that region. The operator should now make an opening through the
peritoneum, which is best done with the fingers. Next the hand and arm
should be introduced into the abdominal cavity and the hand directed
backward toward the pelvis, searching for the horns of the uterus; if
followed up the ovaries will easily be found. They should then be drawn
outward and may be removed either by the Ècraseur or by torsion. Closing
and suturing the wound will complete the operation. An adhesive plaster
bandage can be beneficially applied.
The operation by the vagina is more complicated and requires special and
expensive instruments. The mode of procedure in brief is as follows: A
speculum is introduced into the vagina, and an incision is made into the
superior wall of that passage about 2 inches from the neck of the uterus,
cutting from below upward and from before backward. An incision which
should not exceed 3-1/2 inches in length should be made. The next step is
to get possession of the ovaries. They are situated in a fold of the broad
ligament and should be drawn carefully through the incision into the
vagina. Now take the long-handled scissors, specially made for this
purpose, with which the thick border of the broad ligament is divided. The
torsion forceps are introduced and applied to the broad ligament above the
ovary. The left hand is then introduced, and the thumb and the index finger
grasp hold of the broad ligament above the forceps. With the right hand
torsion is applied and the ovary removed. The other ovary may be removed in
the same manner.
What has been said with regard to complications and aftertreatment in the
case of the male also applies to the female.
OTHER SURGICAL OPERATIONS.
Descriptions of other surgical operations not given in this chapter may be
found in other parts of this work by reference to the index.
* * * * *
SURGICAL OPERATIONS.
DESCRIPTION OF PLATES.
Plate XXVI. Devices for casting cattle. (From Fleming.)
Fig. 1. Reuff's method of throwing or casting the ox.
Fig. 2. Miles's method of throwing or casting the ox.
Plate XXVII. Surgical instruments and sutures. (After Reynders and
Fleming.)
Figs. 1 and 2. Seton needles. These may be either long or short, straight
or curved, according to the locality in which a seton is to be inserted.
Fig. 3. Various forms of surgical needles.
Fig. 4. Suture forceps or needle holder, for passing needles through thick
and dense tissues.
Fig. 5. Knot properly tied.
Figs. 6, 7, 8, 9, 10. Various forms of sutures. Fig. 6, interrupted suture;
7, quilled suture; 8, uninterrupted suture; 9, twisted suture, made by
passing suture pins through the parts to be held together and winding the
thread about them so as to represent the figure 8; 10, single-pin suture.
Fig. 11. Appliance for ringing the bull, one-fourth natural size.
Fig. 12. Nose clamp, with spring and keeper.
[Illustration: PLATE XXVI. DEVICES FOR CASTING CATTLE.]
[Illustration: PLATE XXVII. SURGICAL INSTRUMENTS AND SUTURES.]
* * * * *
TUMORS AFFECTING CATTLE.
By JOHN R. MOHLER, V. M. D.,
_Chief, Bureau of Animal Industry._
[_Synonyms:_ New growth, neoplasm, neoformation, pseudoplasm, swelling, and
hyperplasia.]
_Definition._--Tumors[3] are abnormal masses of tissue, noninflammatory and
independent in character, arising, without obvious cause, from cells of
preexistent tissue, possessing no physiologic function, and
characteristically unrestrained in growth and structure.
Tumors are abnormal masses of tissue. The application of the term "tumor"
is directly connected with the fact that they produce local enlargement.
They are noninflammatory; that is, the process of inflammation is not
directly the cause or accompaniment of them. An inflammatory new growth
tends to disappear upon the subsidence of the inflammatory process, while
spontaneous disappearance of a tumor is comparatively rare.
Tumors are independent. For instance, their nutrition bears no relation to
the nutrition of the body. A lipoma, or fatty tumor, in the subcutaneous
tissue, may go on increasing to huge bulk while the body is steadily
emaciating. Again, the tissues of the aged gradually undergo atrophy, yet
cancers arise at this time and grow rapidly.
Tumors are unrestrained in growth and structure. In the development of an
animal we know at what period of its existence the mass of tissue called
liver will develop--what its site, structure, and size will be. We know
that it will remain only in that locality, and not, as it were, colonize
throughout the system. With tumors it is different; there are no laws by
which we can forecast the time, place, nature, or size of development of
them. There is no cartilage in the kidney or parotid gland, yet a
chondroma, or cartilage tumor, may develop in either. Even when a new
growth of tissue is started by an injury and consequent inflammation--as,
for instance, proud flesh--there is a limitation of its size, but the
controlling influences which govern the size of an organ or normal mass of
tissue and limit the extent of an inflammatory overgrowth are all absent in
the case of tumors. They are unrestrained, lawless.
Metastasis expresses the lawlessness of tumors as regards being limited to
the original site of development. Small particles of tumors enter the blood
vessels or lymph streams and are carried to distant parts of the body,
where they lodge and start new tumor formations. Expansion by colonization
in this manner is a rule with many tumors, and, since they exercise no
function of use to the organism, this dissemination of actively growing
particles becomes a menace to the system by numerically increasing the
body's burden, opening new channels of drain upon the system and adding new
centers for the absorption of putrefactive materials when the secondary
tumors shall have degenerated. It is this which makes metastasis such an
important element in the malignancy of tumors.
Tumors possess no physiological function. They are absolutely useless.
Fibrous tumors bind no parts of the organism together; bony tumors add
nothing to the supporting framework of the body; the tissue of fatty tumors
never serves as a storehouse of feed and energy; the cells of an adenoma,
or gland tumor, furnish no secretion; a tumor composed of muscle tissue
produces no increase to the strength of the individual--its muscle cells
are not contractile.
Tumors arise from cells of preexistent tissue. Tumor tissue is not a new
variety. Whatever the structure of a tumor, its counterpart is found among
the tissues of the body, the lawlessness of the tumor, however, showing
itself in more or less departure from the normal type. This departure is
usually a reversion to a more elementary or embryonic stage, so that the
tumor tissues may be said to be structurally immature.
Tumors arise without obvious cause. Concerning the ultimate cause of tumor
formation we are absolutely ignorant. Various theories have been advanced
from time to time, but none of them have been applicable to more than a
limited number of cases. The most important theories may be briefly
mentioned.
(1) _The theory of tumor diathesis._--Bilroth taught that tumors are caused
by a peculiar predisposition consisting of a diseased state of the fluids
of the body. This constitutional taint might be acquired, but, having been
acquired, is also hereditary. This theory is known also as the heredity
hypothesis, but, while it is true that heredity appears to play some role
in the causation of certain neoplasms, its application is too limited to
make it of value.
(2) _The mechanical or irritant theory._--Virchow assumed that tumors arise
as the result of previous irritation of the part. This has been noticed
particularly in the case of certain cancers. They frequently develop on the
edges of old ulcers, thus being dependent apparently on chronic irritation.
Cancer of the lip in pipe smokers is a case in point. Cancerous tumors of
the skin often develop on the arms of workers in paraffin, tar, or soot,
the chemical irritation of these substances being the cause. On the
contrary, the proportion of those thus affected among the exposed is very
small and forces the conclusion that if the real cause were in the
irritation vastly more cases would occur.
(3) _The theory of nervous influence._--That is based upon (_a_) the
observed fact that tumors occur more frequently in man and the higher
animals than in those lower in the scale, among which the nervous system is
less highly developed; (_b_) that certain formations seem to be directly
connected with nerve distribution, while others have been associated with
alternations in neighboring nerve trunks.
(4) _The embryonal theory._--This is known also as Cohnheim's hypothesis.
In early fetal life there occurs a production of cells in excess of those
required for the construction of the various parts of the body, so that a
certain number of them are left over in the fully developed tissue or
become misplaced during the sorting of cells for future development of
tissues and organs. These cells lie dormant until favorable conditions
arise or until some sufficient stimulus is applied, when, released from
their inactivity, they begin to reproduce and grow. Not being normally
related to their site, they lack the controlling and limiting influences of
the part, and, their embryonic character enduing them with a most potent
proliferating power, they develop in a lawless and unrestrained manner.
There are tumors whose existence can be explained only on these grounds.
Still, this theory falls far short of answering the question as to the
origin of tumors.
(5) _The parasitic theory._--This is not only one of the latest, but,
merely as a hypothesis, it is the most attractive and plausible of all. The
serious objections to it, however, are the almost uniform failure that has
met the attempts to transplant these tumors from one animal to another and
the absence of any constant variety of organism in them. Several forms of
parasites have been found in certain tumors, but nothing definite has been
shown with reference to the relation they bear to the causation of the
neoplasm.
CLASSIFICATION OF TUMORS.
In Senn's work on tumors occurs the following: "A uniform system of
classification of tumors is one of the great wants of modern pathology, and
all attempts in this direction have proved failures." It would be folly,
therefore, to burden the pages of a work of this kind with one or several
of the proposed systems which have, admittedly, at some important point,
failed of their purpose. Since the value of this chapter depends chiefly
upon its practical character, which in turn is measured by its aid in
diagnosis, prognosis, and treatment, the old but important clinical
division is here adopted.
Tumors are either malignant or benign. The essential difference between the
two classes is that while _benign tumors depend for their ill effects
entirely upon their situation, malignant neoplasms wherever located
inevitably destroy life._ The clinical features of each group are in many
cases sufficiently marked to distinguish them.
MALIGNANT TUMORS.
(1) These are invariably pernicious, and from the beginning tend to destroy
life.
(2) The cellular element predominates; therefore they grow rapidly.
(3) Possessing no capsule, they infiltrate surrounding tissues.
(4) They infect adjacent lymph glands.
(5) They recur even after complete removal.
(6) They give metastasis; that is, they become disseminated in different
organs.
(7) Their presence develops a progressive emaciation.
BENIGN TUMORS.
(1) These in and of themselves do not tend to produce death.
(2) As the cellular element is not liable to predominate, they grow slowly.
(3) They are encapsulated, and when diffuse do not infiltrate surrounding
tissues.
(4) They do not infect adjacent lymph glands.
(5) They do not recur after complete removal.
(6) They do not manifest metastasis.
Benign tumors, though harmless, may, by the accident of their location,
indirectly produce death. Mere pressure on the brain substance of an
otherwise innocent tumor, compression of the blood supply for vital organs,
growth in such manner as to cause obstruction in the alimentary tract or
pressure upon nerves, may cause death, or, prior to death, so combine the
effects of anemia (deficiency of blood), starvation, and pain, with its
consequent restlessness, as to produce a veritable cachexia (condition of
general ill health).
On the other hand, a malignant tumor in its primary growth may so implicate
a vital organ as to destroy life before metastasis can occur or even before
cachexia can develop. Thus, to the untrained observer, environment may so
operate as to cause these two classes of new growths to simulate each
other. The boundary lines may seem to overlap. It is here that the
microscope, as the court of last appeal, adjudicates positively in the
diagnosis between these two clearly marked divisions.
It may almost be asserted that a true classification of tumors can not be
made until we know more about the cause of them. The arrangement here
presented is offered to meet the practical needs of the veterinarian,
student, and farmer rather than of the pathologist.
We may roughly divide the tissues of the body into structural and lining
tissues. The structural tissues are composed of the tissues of special
function and simple connective tissues. The lining or covering tissues,
both internal and external, are known as epithelium.
Section A of the table below contains the true tumors or proper neoplasms.
Section B includes the cysts, some of which are true tumors, while others
are false ones, but the latter are added because of their gross resemblance
to the true and the consequent necessity of considering them at the same
time.
TUMORS AND CYSTS.
A.--Tumors.
BENIGN.
I.--_Tumors composed of tissues resembling those of special function._
1. Type of muscle tissue Myoma.
2. Type of nerve tissue Neuroma.
3. Type of vascular tissue Angioma.
4. Type of gland tissue Adenoma.
II.--_Tumors composed of fully developed connective tissue._
1. Type of fibrous tissue Fibroma.
2. Type of adipose, or fat, tissue Lipoma.
3. Type of cartilage tissue Chondroma.
4. Type of osseous, or bone, tissue Osteoma.
5. Type of neuroglia, or nerve, sheath Glioma.
6. Type of mucoid, or mucous, tissue Myxoma.
MALIGNANT.
III.--_Tumors composed of embryonic or immature connective tissues._
1. Type of immature connective tissue Sarcoma.
2. Type of endothelial tissue Endothelioma.
IV.--_Tumors in which epithelial elements predominate._
1. Type of various epithelial cells and associated tissues Carcinoma.
B.--CYSTS.