If the crystals are triangular prisms of ammonia-magnesium phosphate or starlike forms with feathery rays, the indications are to withhold the feed or water that abounds in magnesia and check the fermentation in the urine by attempts to destroy its bacteria. In the latter direction plenty of pure-water diuretics, and a daily dose of oil of turpentine in milk, or a dose thrice a day of a solution containing one-tenth grain each of biniodid of mercury and iodid of pota.s.sium would be indicated.
In considering the subject of prevention, it must never be forgotten that any disease of a distant organ which determines the pa.s.sage from the blood into the urine of alb.u.min or any other colloid (uncrystallizable) body is strongly provocative of calculus, and should, if possible, be corrected.
Apart from cases from geological formation, faulty feeding, and other causes, the grand preventive of calculus is a long, summer"s pasturage of succulent gra.s.ses, or in winter a diet of ensilage or other succulent feed.
The calculi formed in part of silica demand special notice. This agent is secreted in the urine in the form of silicate of potash and is thrown down as insoluble silica when a stronger acid displaces it by combining with the potash to its exclusion. In cases of siliceous calculi, accordingly, the appropriate chemical prevention is caustic potash, which being present in the free state would attract to itself any free acid and leave the silica in its soluble condition as silicate of potash.
STONE IN THE BLADDER (VESICAL CALCULUS, OR URETHRAL CALCULUS).
Stone in the bladder may be of any size, but in the ox does not usually exceed half an inch in diameter. There may, however, be a number of small calculi; indeed, they are sometimes so small and numerous as to form a small, pulpy magma by which the bladder is considerably distended.
_Symptoms._--The symptoms of stone in the bladder may be absent until one of the ma.s.ses escapes into the urethra, but when this occurs the escape of urine is prevented, or it is allowed to pa.s.s in drops or driblets only, and the effect of such obstruction becomes manifest. The point of obstruction is not always the same, but it is most frequently at the S-shaped curve of the p.e.n.i.s, just above the t.e.s.t.i.c.l.es or s.c.r.o.t.u.m. In cows and heifers the urethra is so short and becomes so widely dilated during the urination that the calculi easily escape in the flow of liquid and dangerous symptoms practically never appear.
Even in the male the signs of illness are at first very slight. A close observer may notice the cylinders of hard, earthy materials encircling the tufts of hair at the opening of the prepuce. It may further be observed that the stall remains dry and that the animal has not been seen to pa.s.s water when out of doors. The tail may at times be gently raised and contractions of the muscle (accelerator urinae) beneath the a.n.u.s (Pl. IX, fig. 2) may take place in a rhythmical or pulsating manner. As a rule, however, no symptom is noticed for two days, only the animal is lacking in his usual spirits. By this time the constantly acc.u.mulating urine has distended the bladder beyond its power of resistance and a rupture occurs, allowing the urine to escape into the cavity of the abdomen. Then dullness increases; the animal lies down most of his time; he becomes stupid and sometimes drowsy, with reddish-brown congestion of the lining membrane of the eyelids; pressure on the abdomen causes pain, flinching, and perhaps groaning, and the lowest part of the belly fluctuates more and more as the escaping urine acc.u.mulates in greater and greater amount. If at this stage the oiled hand is introduced into the r.e.c.t.u.m (last gut), the animal flinches when pressure is made downward on the floor of the pelvis, and no round, distended bladder is felt. If the same examination is made prior to the rupture, the rounded, tense, elastic bladder is felt extending forward into the abdomen, containing one or two gallons of liquid. There may be uneasy shifting of the hind limbs and twisting of the tail, also frequent lying down and rising, but these symptoms are exceptional.
When the obstruction is low down between the thighs (at the S-shaped flexure), the line of the pulsating urethra from the a.n.u.s downward may be felt distended with liquid, and though, by the hard swelling of the urethra, it is seldom easy to distinguish the exact seat of the stone, yet there is usually tenderness at the point of obstruction, and from this it may be accurately located.
_Treatment._--The treatment of stone in the bladder or urethra consists in the removal of the stone by incision and the use of forceps. (Pl. XI, fig.
4.) When the stone has been arrested at the S-shaped flexure just above the s.c.r.o.t.u.m, the patient being lean, the thickened tender part of the p.e.n.i.s may be seized between the fingers and thumb of the left hand, while the calculus is exposed by a free incision with the knife held in the right. If there is no other obstruction between this point and the bladder, and if the latter has not yet ruptured, a flow of urine should take place from the opening. If there is no escape of liquid, a catheter or sound, one-fourth of an inch in diameter, must be pa.s.sed up through the ca.n.a.l (urethra) until it is arrested by the next stone, on which a similar incision should then be made to effect its extraction. In case the stone has been arrested in the portion of the urethra which is in front of the arch of the hip bone and inside the pelvis, it can be reached only by making an opening into the urethra beneath the a.n.u.s and over the arch of the hip bone, and from this orifice exploring the urethra with fine forceps to the neck of the bladder or until the stone has been reached and extracted. Owing to the small size of the ca.n.a.l (urethra) to be opened and the great thickness of erectile tissue to be cut through, the operation requires a very accurate knowledge of the parts, while the free flow of blood is blinding to the operator. A staff should always be pa.s.sed up through the urethra from the lower wound, if such has been made, or, in case of its absence, through the whole length of the p.e.n.i.s, that organ having been drawn out of its sheath until the S-shaped curve has been effaced and the course of the ca.n.a.l rendered straight. Upon the end of this staff the incision can be made with far more confidence and certainty. The operation can be undertaken only by a skilled veterinary anatomist, but the hints given above may be valuable in showing the stock owner when he is being properly served in such a case.
In outlying districts, where no skilled operator can be had, a transverse incision may be made with a clean, sharp knife through the root of the p.e.n.i.s, just over the arch of the hip bone, when the urine will flow out in a full stream. The attendant bleeding may be ignored, or if profuse it may be checked by packing the wound firmly with cotton wool for several hours.
The urine will continue to escape by the wound, and the ox should be fattened for the butcher.
The immediate relief is not to be looked upon as a permanent cure, as the calculi in the affected ox are usually numerous, and later attacks are therefore to be looked for. Hence it is desirable to fatten and kill such cases after a successful operation. If a breeding animal is too valuable to be killed, he should be subjected to preventive measures, as laid down under "Stone in the kidney," page 139.
It should be added that when the bladder is filled with a soft magma a catheter may be introduced through the whole length of the urethra to be used in pumping water into the bladder. This water is extracted through the same channel when it has been charged with the suspended solids by manipulations of the bladder with the oiled hand introduced through the r.e.c.t.u.m.
CALCULI, OR GRAVEL, IN THE PREPUCE, OR SHEATH.
This is usually a collection of gravel, or a soft, puttylike material which causes distinct swelling of the sheath and gives it a soft, doughy feeling when handled. It may be removed in part by the oiled fingers introduced into the cavity, a.s.sisted by manipulation from without, or a tube may be inserted until the end extends behind the collection and water pumped in until the whole ma.s.s has been evacuated. Should even this fail of success, the sheath may be slit open from its orifice back in the median line below until the offending matter can be reached and removed. In all such cases the interior of the sheath should be finally lubricated with sweet oil or vaseline. It is unnecessary to st.i.tch up the wound made in the sheath. (See "Inflammation of the sheath," p. 155.)
[Ill.u.s.tration: PLATE IX.
KIDNEY AND MALE GENERATIVE AND URINARY ORGANS.]
[Ill.u.s.tration: PLATE X.
MICROSCOPIC ANATOMY OF THE KIDNEY.]
DISEASES OF THE URINARY ORGANS.
DESCRIPTION OF PLATES.
PLATE IX. Kidney and male generative and urinary organs.
Fig. 1. Kidney of the ox. (From Handbuch des Vergleichenden Anatomie des Haus Saugethiere, vol. 7, 1890.) A, renal artery carrying blood into the kidney; V, renal vein carrying blood from the kidney back to the heart; H, ureter, the tube carrying the urine from kidney to bladder. It is formed by the union of a number of branches which begin as cups (calices), each inclosing the tip of a conical ma.s.s of tissue from which the urine excludes.
Fig. 2. Genital and urinary organs of the bull. (From Leisering, Mueller, and Ellenberger, Handbuch des Verg. Anat. des Haus Saugethiere.) the serous membrane enveloping the t.e.s.t.i.c.l.es; 3, the right t.e.s.t.i.c.l.e, outer view; 3", left t.e.s.t.i.c.l.e, inner view; 4, epididymis, or the beginning of the excretory ca.n.a.l of the t.e.s.t.i.c.l.e; 4", globus major, or the head of the epididymis; 4", globus minor, or the tail of the epididymis; 5, vas deferens, the duct through which the seminal fluid reaches the ejaculatory ducts; 5", pelvic dilation of the vas deferens; 6, vesicula seminalis. The vesiculae seminalis are two oval pouches, which, in addition to their own secretions, receive the s.e.m.e.n conveyed by the seminal ducts and hold it in reserve until copulation; 7, membranous or intrapelvic portion of the urethral ca.n.a.l covered by Wilson"s muscle; 8, part of the prostate gland, covered by Wilson"s muscle; 9, Cowper"s gland. This gland, like the prostate gland, secretes a fluid which is thrown into the urethal ca.n.a.l in abundance immediately before e.j.a.c.u.l.a.t.i.o.n; by this means the expulsion of the s.e.m.e.n is facilitated; 10, ejaculator seminis, or accelerator urinae muscle; 11, p.e.n.i.s; 11", cut portion of same; 12, cut suspensory ligaments of p.e.n.i.s; 13, sheath, or prepuce laid open; 14, retractor muscles of sheath; 15, cremaster muscle cut at superior extremity; 16, duplicature of peritoneum; 17, ureters carrying urine from the kidneys to the bladder.
PLATE X. Microscopic anatomy of the kidney.
Fig. 1. In this figure the minute apparatus for the secretion, collection, and discharge of the urine into the pelvis of the kidney (see preceding plate) is shown. The course is as follows: The urine is secreted from the blood vessels in the little round bodies called glomeruli (12), and by the minute cells in the curved tubes (11, 9, 10, 8), and pa.s.ses through the convoluted and straight tubes (7, 6) into the larger tube (1), and then out into the pelvis, thence through the ureters into the bladder. The fluid and salts dissolved in the urine are taken from the blood, and the minute blood vessels are therefore very abundant in the kidneys, as is shown by the branches and network on the left of the figure. The blood pa.s.ses into the kidney in the artery (13), which then divides into branches which pa.s.s into the glomeruli (12) and also forms network around the secreting tubules (11, 9). The urine and salts pa.s.s from these vessels through the cells lining the tubules into the latter, and are discharged as described above. The blood is again collected in veins drawn black in the figure.
Fig. 2 ill.u.s.trates the manner in which the blood is distributed in the glomerulus (_f_), and also to the secreting tubules (_e_).
Fig. 3 shows the relation between the blood vessel in the glomerulus (_e_) the tubule which conducts the urine therein secreted from the blood vessel; (_c_) represents a glomerulus from which the urinary tubule has been removed.
PLATE XI. Calculi of kidney and bladder.
Fig. 1. Calculus, or stone, from the kidney. These are in the pelvis or portion of the ureter receiving the urine. The prolongations are casts of the branches of the pelvis. See the plates of the kidney for further description.
Fig. 2. Calculus made up of oxalate of lime magnified 215 times.
Fig. 3. Phosphatic calculus containing a nucleus of uric acid, sawed through to show concentric layers.
Fig. 4. Straight forceps used in removing stones from the bladder.
Fig. 5. Casts of the minute tubules of the kidney found in the urine in various kinds of kidney disease. Highly magnified.
[Ill.u.s.tration: Plate XI.
CALCULI OF KIDNEY AND BLADDER.]
FOOTNOTES:
[1] Encyklop. der Thierheilk., Vol. IV, p. 208.
DISEASES OF THE GENERATIVE ORGANS.
By JAMES LAW, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., in Cornell University._
[Revised by Adolph Eichhorn, D. V. S.]
GENERAL DISCUSSION.
Diseases of the generative organs are practically confined to animals which are kept for reproduction and the dairy. The castration of the bull condemns these organs to inactivity and protects them from the many causes of injury attendant on the engorged blood vessels in the frequent periods of s.e.xual excitement, on the exposure to mechanical violence, and on the exposure to infective inoculation. In three respects the castrated male is especially subject to disease: (1) To inflammation and tumefaction of the cut end of the cord that supported the t.e.s.t.i.c.l.e and of the loose connective tissue of the s.c.r.o.t.u.m; (2) to inflammation of the sheath and p.e.n.i.s from the acc.u.mulation of gravel in the former, from which the p.e.n.i.s is not usually protruded in pa.s.sing water; and (3) to bruising, abrasion, and inflammation of the sheath and p.e.n.i.s during suspension in the stocks for the purpose of shoeing. Apart from these the ox is practically almost exempt from the inflammations and injuries of the genital organs. The same applies to the castrated heifer. Inflammation may occur in the broad ligament of the womb whence the ovary has been removed or infective inflammation in the abdominal cavity (peritonitis) in case the operation has been performed through the flank, as it usually is in the young heifer. Apart from these, the castrated heifer is practically immune from any trouble of the generative apparatus. Even the virgin heifer is little subject to such troubles, though she is not exempt from inflammations, and above all, from morbid growths in the ovaries which are well developed and functionally very active after the first year, or in precocious animals after the first few months of life. The breeding cow, on the other hand, is subjected to all the disturbances attendant on the gradual enlargement of the womb, the diversion of a large ma.s.s of blood to its walls, the constant drain of nutrient materials of all kinds for the nourishment of the fetus, the risks attendant and consequent on abortion and parturition, the dangers of infection from the bull, the risks of sympathetic disturbance in case of serious diseases of other organs, but preeminently of the urinary organs and the udder, and finally the sudden extreme derangements of the circulation and of the nervous functions which attend on the sudden revulsion of a great ma.s.s of blood from the walls of the contracting womb into the body at large immediately after calving.
In reviewing this cla.s.s of diseases, therefore, we have to note, first, that they are almost exclusively restricted to breeding animals, and secondly that in keeping with the absolute difference of the organs in the male and female we find two essentially distinct lists of diseases affecting the two s.e.xes.