As supplementary to the article on hæmoglobinæmia (vol. II., page 437)
the later bacteriological investigations of Lignieres must be noted. A
superb Percheron, after two days of idleness, went to work at 10 P. M.,
was attacked at 1 A. M. and died at 3 P. M. Inoculations from blood,
spleen, liver, kidney, bone marrow, myelon and subarachnoid fluid from
the loins to the bulb proved sterile, excepting that made from the
subarachnoid liquid on a level with the bulb, which yielded a rich
culture of a streptococcus that appeared to the eye as small granules.
It proved ærobic and anærobic, stained well with Gram’s (I) solution,
coagulated milk, acidified the culture, formed small, round, grayish
white colonies on peptonized gelatine, without liquefying, failed to
propagate on potatoes, but grew well in serum and bouillon.
Two or three drops proved fatal to mice, producing, when thrown into the
peritoneum a highly acute parenchymatous nephritis with bloody urine.
Very few microbes were found in the kidney. There was loss of control of
the hind limbs and extreme nervous irritability.
Intravenous injection of 300cc. of the culture in a powerful stallion
produced hyperthermia, 102° F. on the second day, 104° on the third,
105° on the fourth, on the sixth day he became paraplegic and died on
the seventh.
A second horse, which received 150cc., was sick for several days, but
without paraplegia, then appeared to recover, but three weeks after he
became paraplegic with albuminous urine and died next day.
In neither of the horses was the urine sanguineous.
Carnivora, swine, ruminants and birds proved insusceptible. The guinea
pig succumbed to intraperitoneal inoculation, and the rabbit to
intravenous.
It is to be noted that hæmoglobinuria was lacking in both experimental
equine cases, and though this may be so in mild casual cases, the same
is not true of violent and fatal ones. It is, therefore, evident that
further research is necessary in this direction.
Accepting the conclusions reached by Lignieres, we are still debarred
from entering the affection in the list of animal plagues proper, to be
met by official restrictions. The streptococcus may be an essential
condition in each case of the disease, or it may be one of several
microbes that may act in the causation, yet the microbe in ordinary
doses as accidentally introduced, does not prove pathogenic excepting in
the presence of concurrent conditions of high feeding and condition,
work, interrupted by one or more days of absolute idleness, and the
resumption of exercise. The presence of the microbe is not enough to
cause the disease in the horse in continuous work, nor in that which is
kept in the stable all the time, nor even in the horse that has worked
steadily and then stood idle for a day, until he again goes to work. One
animal or a few only out of a stable, are attacked, and there is no such
active extension from animal to animal in the vicinity that
characterizes the plagues proper.
The _prevention_ of the disease, therefore, must be sought along the
lines previously laid down and well understood, in the avoidance of
sudden plethora, of transient idleness during a period of high condition
and steady work, and of gradual restoration to work after such period of
rest. Similarly the _treatment_ by rest, depletion, diluents, evacuants,
and nerve sedatives is still in order. A new importance, however,
attaches to the use of nerve sedatives and antiseptics, as calculated to
prove a check on the disorder of the nervous structure and functions and
on the active proliferation of the microbe.
The presence of the streptococcus may also contribute, along with the
permanent changes in the nerve structure, in predisposing to relapses or
second attacks, which are so common unless the animal which has once
suffered is subjected to very special care.
As a fruit of the research by Lignieres, W. A. McClanahan, Redding, Ia.,
essayed internal antisepsis by ½ oz. doses of potassium iodide. In three
severe cases relief was obtained in 15 to 20 minutes and an early and
complete convalescence followed. In the hands of J. H. Kelly of New
Haven, Conn., and T. S. Childs of Saratoga, N. Y., it seemed to prove
equally successful, the first meeting with almost invariable success,
and the latter reporting a series of 10 successive cases, several of
them severe, which all recovered in from 1 to 5 days. The only untoward
result was an open knee joint in one subject, the result of bruises
sustained before Dr. Childs arrived. His treatment was ½ oz. of the
iodide at once, and 1 to 2 drs. every hour or second hour, according to
the size of the animal and the severity of the case.
In other hands this medication has been less successful, which may well
be explained by the violence of the attacks, and the lack of absorption
from the inactive stomach. Unless it passed on to the duodenum, it would
be utterly useless, and hence the exhibition by the rectum or subcutem
might be tried. The parallelism of the treatment of the two diseases of
the plethoric and possibly infected subject,—parturient paresis and
hæmoglobinæmia,—is striking, and it does not seem that the iodide
treatment should be abandoned because of a few unsuccessful cases.
Whether the iodide acts mainly as a microbicide, a chemical antidote to
toxins, an eliminant, or a nerve sedative, or in two or more of these
modes, is unknown, but it would be rational to expect good results along
one or more of these lines. Iodide treatment should supplement, not
supersede, the methods formerly in use.