Under no circ.u.mstances have I seen the kidneys irritated to excess or other unfavorable effects produced.
The feet should be kept in a tub of water at a temperature of 45 to 50 F., unless the animal is lying down, when swabs are to be used and wet every half hour with the cold water. The water keeps the horn soft and moist and acts directly upon the inflamed tissues by reducing the temperature. Cold maintains the vitality and disease-resisting qualities of the soft tissues, tones up the coats of the blood vessels, diminishes the supply of blood, and limits the exudation. Furthermore, it has an anesthetic effect upon the diseased tissues and relieves the pain.
Aconite may be given in conjunction with the niter when the heart is greatly excited and beats strongly. Ten-drop doses, repeated every 2 hours for 24 hours, are sufficient. The use of cathartics is dangerous, for they may excite superpurgation. Usually the niter will relieve the constipation; yet if it should prove obstinate, laxatives may be carefully given. Bleeding, both general and local, should be guarded against. The shoes must be early removed and the soles left unpared.
Paring of the soles presents two objections: First, while it may temporarily relieve the pain by relieving pressure, it favors greater exudation, which may more than counterbalance the good effects.
Secondly, it makes the feet tender and subject to bruises when the animal again goes to work. The shoes should be replaced when convalescence sets in and the animal is ready to take exercise. Exercise should never be enforced until the inflammation has subsided; for although it temporarily relieves the pain and soreness it maintains the irritation, increases the exudation, and postpones recovery.
If at the end of the fifth or sixth day prominent symptoms of recovery are not apparent, apply a stiff blister of cantharides around the coronet and omit the niter for about 48 hours. When the blister is well set, the feet may again receive wet swabs. If one blister does not remove the soreness it may be repeated, or the actual cautery applied.
The same treatment should be adopted where sidebones form or inflammation of the coronet bone follows. When the sole breaks through, exposing the soft tissues, the feet must be carefully shod with thin heels and thick toes if there is a tendency to walk on the heels, and the sole must be well protected with appropriate dressings and pressure over the exposed parts. When there is turning up of the toe, blistering of the coronet, _in front only_, sometimes stimulates the growth of horn, but as a rule judicious shoeing is the only treatment that will enable the animal to do light, slow work.
When suppuration of the laminae is profuse, it is better to destroy your patient at once and relieve his suffering: but if the suppuration is limited to a small extent of tissue, especially of the sole, treatment, as in acute cases, may induce recovery and should always be tried. If from bed sores or other causes septicemia or pyemia is feared, the bisulphite of soda, in half-ounce doses, may be given in conjunction with tonics and such other treatment as is indicated in these diseases.
As to enforced rec.u.mbency I doubt the propriety of insisting on it in the majority of cases, for I think the patient usually a.s.sumes whatever position gives most comfort. No doubt rec.u.mbency diminishes the amount of blood sent to the feet, and may greatly relieve the pain, so that forcing the patient to lie down may be tried, yet should not be renewed if he thereafter persists in standing.
When the animal persistently stands, or constant lying indicates it (to prevent extensive sores), the patient should be placed in slings. When all four feet are affected it may be impossible to use slings, for the reason that the patient refuses to support any of his weight and simply hangs in them. Lastly, convalescent cases must not be returned to work too early, else permanent recovery may never be effected.
DISEASES OF THE SKIN.
By JAMES LAW, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., Cornell University._
As we find them described in systematic works, the diseases of the skin are very numerous and complex, which may be largely accounted for by the fact that the cutaneous covering is exposed to view at all points, so that shades of difference in inflammatory and other diseased processes are easily seen and distinguished from one another. In the horse the hairy covering serves to some extent to mask the symptoms, and hence the nonprofessional man is tempted to apply the term "mange" to all alike, and it is only a step further to apply the same treatment to all these widely different disorders. Yet even in the hairy quadruped the distinction can be made in a way which can not be done in disorders of that counterpart and prolongation of the skin--the mucous membrane, which lines the air pa.s.sages, the digestive organs, the urinary and generative apparatus. Diseased processes, therefore, which in these organs it might be difficult or impossible to distinguish from one another, can usually be separated and recognized when appearing in the skin.
Nor is this differentiation unimportant. The cutaneous covering presents such an extensive surface for the secretion of cuticular scales, hairs, horn, sebaceous matter, sweat, and other excretory matters, that any extensive disorder in its functions may lead to serious internal disease and death. Again, the intimate nervous sympathy of different points of the skin with particular internal organs renders certain skin disorders causative of internal disease and certain internal diseases causative of affections of the skin. The mere painting of the skin with an impermeable coating of glue is speedily fatal; a cold draft striking on the chest causes inflammation of the lungs or pleura; a skin eruption speedily follows certain disorders of the stomach, the liver, the kidneys, or even the lungs; simple burns of the skin cause inflammations of internal organs, and inflammation of such organs cause in their turn eruptions on the skin. The relations--nervous, secretory, and absorptive--between the skin and internal organs are most extensive and varied, and therefore a visible disorder in the skin may point at once and specifically to a particular fault in diet, to an injudicious use of cold water when the system is heated, to a fault in drainage, ventilation, or lighting of the stables, to indigestion, to liver disease, to urinary disorder, etc.
[Ill.u.s.tration: PLATE x.x.xVIII.
THE SKIN AND ITS DISEASES.]
STRUCTURE OF THE SKIN.
The skin consists primarily of two parts: (1) The superficial nonvascular (without blood vessels) layer, the cuticle, or epidermis; and (2) the deep vascular (with blood vessels) layer, the corium, dermis, or true skin. (See Pl. x.x.xVIII, fig. 1.)
The cuticle is made up of cells placed side by side and more or less modified in shape by their mutual compression and by surface evaporation and drying. The superficial stratum consists of the cells dried in the form of scales, which fall off continually and form dandruff. The deep stratum (the mucous layer) is formed of somewhat rounded cells with large central nuclei, and in colored skin containing numerous pigment granules. These cells have prolongations, or branches, by which they communicate with one another and with the superficial layer of cells in the true skin beneath. Through these prolongations they receive nutrient liquids for their growth and increase, and pa.s.s on liquids absorbed by the skin into the vessels of the true skin beneath. The living matter in the cells exercises an equally selective power on what they shall take up for their own nourishment and on what they shall admit into the circulation from without. Thus, certain agents, like iodin and belladonna, are readily admitted, whereas others, like a.r.s.enic, are excluded by the sound, unbroken epidermis. Between the deep and superficial layers of the epidermis there is a thin, translucent layer (septum lucidum) consisting of a double stratum of cells, and forming a medium of transition from the deep spheroidal to the superficial scaly cuticle.
The true skin, or dermis, has a framework of interlacing bundles of white and yellow fibers, large and coa.r.s.e in the deeper layers, and fine in the superficial, where they approach the cuticle. Between the fibrous bundles are left inters.p.a.ces which, like the bundles, become finer as they approach the surface, and inclose cells, vessels, nerves, glands, gland ducts, hairs, and in the deeper layers fat.
The superficial layer of the dermis is formed into a series of minute, conical elevations, or papillae, projecting into the deep portion of the cuticle, from which they are separated by a very fine transparent membrane. This papillary layer is very richly supplied with capillary blood vessels and nerves, and is at once the seat of acute sensation and the point from which the nutrient liquid is supplied to the cells of the cuticle above. It is also at this point that the active changes of inflammation are especially concentrated; it is the immediately superposed cell layers (mucous) that become morbidly increased in the earlier stages of inflammation; it is on the surface of the papillary layer that the liquid is thrown out which raises the cuticle in the form of a blister, and it is at this point mainly that pus forms in the ordinary pustule.
The fibrous bundles of the true skin contain plain, muscular fibers, which are not controlled by the will, but contract under the influence of cold and under certain nervous influences, as in some skin diseases and in the chill of a fever, and lead to contraction, tightening, or corrugation of the skin, contributing to produce the "hidebound" of the horseman. Other minute, muscular filaments are extended from the surface of the dermis to the hair follicle on the side to which the hair is inclined, and under the same stimulating influences produce that erection of the hair which is familiarly known as "staring coat."
Besides these, the horse"s skin is furnished with an expansion of red, voluntary muscle, firmly attached to the fibrous bundles, and by which the animal can not only dislodge insects and other irritants, but even shake off the harness. This fleshy envelope covers the sides of the trunk and the lower portions of the neck and head, the parts unprotected by the mane and tail, and serves to throw the skin of these parts into puckers, or ridges, in certain irritating skin diseases.
The hairs are cuticular products growing from an enlarged papilla lodged in the depth of a follicle or sac, hollowed out in the skin and extending to its deepest layers. The hair follicle is lined by cells of epidermis, which at the bottom are reflected on the papilla and become the root of the hair. The hair itself is formed of the same kind of cells firmly adherent to one another by a tough, intercellular substance, and overlapping each other, like slates on a roof, in a direction toward the free end.
The sebaceous glands are branching tubes ending in follicles or sacs and opening into the hair follicles, lined by a very vascular fibrous network representing the dermis, and an internal layer of cells representing the mucous layer of the cuticle. The oily secretion gives gloss to the hair and prevents its becoming dry and brittle, and keeps the skin soft and supple, protecting it at once against undue exhalation of water and undue absorption when immersed in that medium. Besides those connected with the hair follicles there are numerous, isolated, sebaceous glands, opening directly on the surface of the skin, producing a somewhat thicker and more odorous secretion. They are found in large numbers in the folds of the skin, where chafing would be liable if the surface were dry, as on the sheath, s.c.r.o.t.u.m, mammary glands, and inner side of the thigh, around the a.n.u.s and v.u.l.v.a, in the hollow of the heel, beneath the fine horn of the frog, on the inner side of the elbow, on the lips, nostrils, and eyelids. When closed by dried secretion or otherwise these glands may become distended so as to form various-sized swellings on the skin, and when inflamed they may throw out offensive, liquid discharges, as in "grease," or produce red, tender fungous growths ("grapes.")
The sweat glands of the horse, like those of man, are composed of simple tubes, which extend down through the cuticle and dermis in a spiral manner, and are coiled into b.a.l.l.s in the deeper layer of the true skin.
In addition to their importance in throwing offensive waste products out of the system, these glands tend to cool the skin and the entire economy of the animal through the evaporation of their watery secretion. Their activity is therefore a matter of no small moment, as besides regulating the animal heat and excreting impurities, they influence largely the internal organs through the intimate sympathy maintained between them and the skin.
Diseases of the skin may be conveniently divided, according to their most marked features, into--
(1) Those in which congestion and inflammation are the most marked features, varying according to the grade or form into (a) congestion with simple redness, dryness, and heat, but no eruption (erythema); (b) inflammation with red-pointed elevations, but no blisters (papules); (c) inflammation with fine, conical elevations, each surmounted by a minute blister (vesicle); (d) inflammation with a similar eruption but with larger blisters, like half a pea and upwards (bullae); (e) inflammation with a similar eruption, but with a small sac of white, creamy pus on the summit of each elevation (pustules); (f) the formation of pustules implicating the superficial layer of the true skin, a small portion of which dies and is thrown off as a slough, or "core" (boils); (g) the formation of round, nodular, transient swellings in the true skin (tubercles); and (h) the excessive production of scales, or dandruff (scaly or squamous affections).
(2) Diseases in which there are only deranged sensations of itching, heat, tenderness, etc. (neurosis).
(3) Diseased growths, such as warts, callosities, h.o.r.n.y growths, cancer, etc.
(4) Diseases from parasites, animal and vegetable.
(5) Diseases connected with a specific poison, such as horsepox, erysipelas, anthrax, farcy, or cutaneous glanders, etc.
(6) Physical injuries, like wounds, burns, scalds, etc.
CONGESTION (RED EFFLORESCENCE, OR ERYTHEMA).
This is a congested or slightly inflamed condition of the skin, unattended with any eruption. The part is slightly swollen, hot, tender, or itchy, and dry, and if the skin is white there is redness. The redness is effaced by pressure, but reappears instantly when it is removed. Except in transient cases the hairs are liable to be shed. It may be looked on as the first stage of inflammation, and therefore when it becomes aggravated it may merge in part or in whole into a papular, vesicular, or pustular eruption.
Erythema may arise from a variety of causes, and is often named in accordance with its most prominent cause. Thus the chilling, or partial freezing, of a part will give rise to a severe reaction and congestion.
When snowy or icy streets have been salted this may extend to severe inflammation, with vesicles, pustules, or even sloughs of circ.u.mscribed portions of the skin of the pastern (chilblain, frost-bite). Heat and burning have a similar effect, and this often comes from exposure to the direct rays of the sun. The skin that does not perspire is the most subject, and hence the white face or white limb of a horse becoming dried by the intensity of the sun"s rays often suffers to the exclusion of the rest of the body (white face and foot disease). The febrile state of the general system is also a potent cause; hence the white-skinned horse is rendered the more liable if kept on a heating ration of buckwheat, or even of wheat or maize. Contact of the skin with oil of turpentine or other essential oils, with irritant liquids, vegetable or mineral, with rancid fats, with the acrid secretions of certain animals, like the irritating toad, with pus, sweat, tears, urine, or liquid feces, will produce congestion or even inflammation. Chafing is a common cause, and is especially liable to affect the fat horse between the thighs, by the side of the sheath or s.c.r.o.t.u.m, on the inner side of the elbow, or where the harness chafes on the poll, shoulder, back, breastbone, and under the tail. The acc.u.mulation of sweat and dust between the folds of the skin and on the surface of the harness, and the specially acrid character of the sweat in certain horses, contribute to chafing or "intertrigo." The heels often become congested owing to the irritation caused by the short, bristly hairs in clipped heels. Again, congestion may occur from friction by halter, harness, or other foreign body under the pastern, or inside the thigh or arm, or by reason of blows from another foot (cutting, interfering, overreach). Finally, erythema is especially liable to occur in spring, when the coat is being shed, and the hair follicles and general surface are exposed and irritable in connection with the dropping of the hairs.
If due only to a local irritant, congestion will usually disappear when the cause has been removed, but when the feeding or system is at fault these conditions must be first corrected. While the coat is being shed the susceptibility will continue, and the aim should be to prevent the disease from developing and advancing so as to weaken the skin, render the susceptibility permanent, and lay the foundation of persistent or frequently recurring skin disease. Therefore at such times the diet should be nonstimulating, any excess of grain, and above all of buckwheat, Indian corn, or wheat, being avoided. A large grain ration should not be given at once on return from hard work, when the general system and stomach are unable to cope with it; the animal should not be given more than a swallow or two of cold water when perspiring and fatigued, nor should he be allowed a full supply of water just after his grain ration; he should not be overheated or exhausted by work, nor should dried sweat and dust be allowed to acc.u.mulate on the skin or on the harness pressing on it. The exposure of the affected heels to damp, mud, and snow, and, above all, to melting snow, should be guarded against; light, smooth, well-fitting harness must be obtained, and where the saddle or collar irritates an incision should be made in them above and below the part that chafes, and, the padding between having been removed, the lining should be beaten so as to make a hollow. A zinc shield in the upper angle of the collar will often prevent chafing in front of the withers.
_Treatment._--Wash the chafed skin and apply salt water (one-half ounce to the quart), extract of witch-hazel, a weak solution of oak bark, or camphorated spirit. If the surface is raw use bland powders, such as oxid of zinc, lycopodium, starch, or smear the surface with vaseline, or with 1 ounce of vaseline intimately mixed with one-half dram each of opium and sugar of lead. In cases of chafing rest must be strictly enjoined. If there is const.i.tutional disorder or acrid sweat, 1 ounce cream of tartar or a teaspoon of bicarbonate of soda may be given twice daily.
CONGESTION, WITH SMALL PIMPLES, OR PAPULES.
In this affection there is the general blush, heat, etc., of erythema, together with a crop of elevations from the size of a poppy seed to a coffee bean, visible when the hair is reversed or to be felt with the finger where the hair is scanty. In white skins they vary from the palest to the darkest red. All do not retain the papular type, but some go on to form blisters (eczema, bullae) or pustules, or dry up into scales, or break out into open sores, or extend into larger swellings (tubercles). The majority, however, remaining as pimples, characterize the disease. When very itchy the rubbing breaks them open, and the resulting sores and scales hide the true nature of the eruption.
The general and local causes may be the same as for erythema, and in the same subject one portion of the skin may have simple congestion and another adjacent papules. As the inflammatory action is more p.r.o.nounced, so the irritation and itching are usually greater, the animal rubbing and biting himself severely. This itching is especially severe in the forms which attack the roots of the mane and tail, and there the disease is often so persistent and troublesome that the horse is rendered virtually useless.
The bites of insects often produce a papular eruption, but in many such cases the swelling extends wider into a b.u.t.tonlike elevation, one-half to an inch in diameter. The same remarks apply to the effects of the poison ivy and poison sumac.
_Treatment._--In papular eruption first remove the cause, then apply the same general remedies as for simple congestion. In the more inveterate cases use a lotion of one-half ounce sulphid of pota.s.sium in 2 quarts of water, to which a little Castile soap has been added, or use a wash with one-half ounce oil of tar, 2 ounces Castile soap, and 20 ounces water.
INFLAMMATION WITH BLISTERS, OR ECZEMA.
In this the skin is congested, thickened, warm (white skins are reddened), and shows a thick crop of little blisters formed by effusions of a straw-colored fluid between the true skin and the cuticle. The blisters may be of any size from a millet seed to a pea, and often crack open and allow the escape of the fluid, which concretes as a slightly yellowish scab or crust around the roots of the hairs. This exudation and the incrustation are especially common where the hairs are long, thick, and numerous, as in the region of the pastern of heavy draft horses. The term eczema is now applied very generally to eruptions of all kinds that depend on internal disorders or const.i.tutional conditions and that tend to recurrences and inveteracy. Eczema may appear on any part of the body, but in horses it is especially common on the heels and the lower parts of the limbs, and less frequently on the neck, shoulder, and abdomen. The limbs appear to be especially liable because of their dependent position, all blood having to return from them against the action of gravity and congestions and swellings being common, because of the abundance of blood vessels in this part of the skin and because of the frequent contact with the irritant dung and urine and their ammoniacal emanations. The legs further suffer from contact with wet and mud when at work, from snow and ice, from drafts of cold air on the wet limbs, from washing with caustic soaps, or from the relaxing effects of a too deep and abundant litter. Among other causes may be named indigestion and the presence of irritant matters in the blood and sweat, the result of patent medicated feeds and condition powders (aromatics, stimulants), green food, new hay, new oats, buckwheat, wheat, maize, diseased potatoes, s.m.u.t, or ergot in grains, decomposing green feed, brewers" grains, or kitchen garbage. The excitement in the skin, caused by shedding the coat, lack of grooming, hot weather, hot, boiled, or steamed feed conduces to the eruption. Lastly, any sudden change of feed may induce it.
The blisters may in part go on to suppuration so that vesicles and pustules often appear on the same patch, and, when raw from rubbing, the true nature of the eruption may be completely masked. In well-fed horses, kept in close stables with little work, eczema of the limbs may last for months and years. It is a very troublesome affection in draft stallions.