Fever in all animals is characterized by the same general phenomena, but we find the intensity of the symptoms modified by the species of animals affected, by the races which subdivide the species, by the families which form groups of the races, and by certain conditions in individuals themselves. For example, a p.r.i.c.ked foot in a Thoroughbred may cause intense fever, while the same injury in the foot of a Clydesdale may scarcely cause a visible general symptom. In the horse, fever produces the following symptoms:
The normal body temperature, which varies from 99 to 100 F., is elevated from 1 to 9. A temperature of 102 or 103 F. is moderate fever, 104 to 105 F. is high, and 106 F. and over is excessive. The temperature is accurately measured by means of a clinical thermometer inserted in the r.e.c.t.u.m.
This elevation of temperature can readily be felt by the hand placed in the mouth of the animal, or in the r.e.c.t.u.m, and in the cleft between the hind legs. It is usually appreciable at any point over the surface of the body and in the expired air emitted from the nostrils. The ears and cannons are often as hot as the rest of the body, but are sometimes cold, which denotes a debility in the circulation and irregular distribution of the blood. The pulse, which in a healthy horse is felt beating about 42 to 48 times in the minute, is increased to 60, 70, 90, or even 100. The respirations are increased from 14 or 16 to 24, 30, 36, or even more. With the commencement of a fever the horse usually has diminished appet.i.te, or it may have total loss of appet.i.te if the fever is excessive. There is, however, a vast difference among horses in this regard. With the same degree of elevation of temperature one horse may lose its appet.i.te entirely, while another, usually of the more common sort, will eat at hay throughout the course of the fever, and will even continue to eat oats or other grains. Thirst is usually increased, but the animal desires only a small quant.i.ty of water at a time, and in most cases of fever a bucket of water should be kept standing before the patient, which may be allowed to drink ad libitum. The skin becomes dry and the hairs stand on end. Sweating is almost unknown in the early stage of fevers, but frequently occurs later in their course, when an outbreak of warm sweat is often a most favorable symptom. The mucous membranes, which are most easily examined in the conjunctivae of the eyes and inside of the mouth, change color if the fever is an acute one; without alteration of blood the mucous membranes become of a rosy or deep-red color at the outset; if the fever is attended with distinct alteration of the blood, as in influenza, and at the end of two or three days in severe cases of pneumonia or other extensive inflammatory troubles the mucous membranes are tinged with yellow, which may even become a deep ocher in color, the result of the decomposition of the blood corpuscles and the freeing of their coloring matter, which acts as a stain. At the outset of a fever the various glands are checked in their secretions, the salivary glands fail to secrete the saliva, and we find the surface of the tongue and inside of the cheeks dry and covered with a brownish, bad-smelling deposit. The excretion from the liver and intestinal glands is diminished and produces an inactivity of the digestive organs which causes a constipation. If this is not remedied at an early period, the undigested material acts as an irritant, and later we may have it followed by an inflammatory process, producing a severe diarrhea.
The excretion from the kidneys is sometimes at first entirely suppressed. It is always considerably diminished, and what urine is pa.s.sed is dark in color, undergoes ammoniacal change rapidly, and deposits quant.i.ties of salts. At a later period the diminished excretion may be replaced by an excessive excretion, which aids in carrying off waste products and usually indicates an amelioration of the fever.
While the ears, cannons, and hoofs of a horse suffering from fever are usually found hot, they may frequently alternate from hot to cold, or be much cooler than they normally are. This latter condition usually indicates great weakness on the part of the circulatory system.
It is of the greatest importance, as an aid in diagnosing the gravity of an attack of fever and as an indication in the selection of its mode of treatment, to recognize the exact cause of a febrile condition in the horse. In certain cases, in very nervous animals, in which fever is the result of nerve influence, a simple anodyne, or even only quiet with continued care and nursing, will sometimes be sufficient to diminish it.
When fever is the result of local injury, the cure of the cause produces a cessation in the const.i.tutional symptoms. When it is the result of a pneumonia or other severe parenchymatous inflammation, it usually lasts for a definite time, and subsides with the first improvement of the local trouble, but in these cases we constantly have exacerbations of fever due to secondary inflammatory processes, such as the formation of small abscesses, the development of secondary bronchitis, or the death of a limited quant.i.ty of tissue (gangrene).
In specific cases, such as influenza, strangles, and septicemia, there is a definite poison in the blood-vessel system and carried to the heart and to the nervous system, which produces a peculiar irritation, usually lasting for a specific period, during which the temperature can be but slightly diminished by any remedy.
In cases attended with complications, the diagnosis at times becomes still more difficult, as at the end of a case of influenza which becomes complicated with pneumonia. The high temperature of the simple inflammatory disease may be grafted on that of the specific trouble, and the determination of the cause of the fever, as between the two, is therefore frequently a difficult matter but an important one, as upon it depends the mode of treatment.
Any animal suffering from fever, whatever the cause, is much more susceptible to attacks of local inflammation, which become complications of the original disease, than are animals in sound health. In fever we have the tissues and the walls of the blood vessels weakened, we have an increased current of more or less altered blood flowing through the vessels and stagnating in the capillaries, which need but an exciting cause to transform the pa.s.sive congestion of fever into an active congestion and acute inflammation. These conditions become still more distinct when the fever is accompanied with a decided deterioration in the blood itself, as is seen in influenza, septicemia, and at the termination of severe pneumonias.
Fever, with its symptoms of increased temperature, acceleration of the pulse, acceleration of respiration, dry skin, diminished secretions, etc., must be considered as an indication of organic disturbance. This organic disturbance may be the result of local inflammation or other irritants acting through the nerves on nerve centers, alterations of the blood, in which a poison is carried to the nerve centers, or direct irritants to the nerve centers themselves, as in cases of heat stroke, injury to the brain, etc.
The treatment of fever depends upon its cause. One of the important factors in treatment is absolute quiet. This may be obtained by placing a sick horse in a box stall, away from other animals and extraneous noises and sheltered from excessive light and drafts of air. Anodynes, belladonna, hyoscyamus, and opium act as antipyretics simply by quieting the nervous system. As an irritant exists in the blood in most cases of fever, any remedy which will favor the excretion of foreign elements from it will diminish this cause. We therefore use diaph.o.r.etics to stimulate the sweat and excretions from the skin; diuretics to favor the elimination of matter by the kidneys; cholagogues and laxatives to increase the action of the liver and intestines, and to drain from these important organs all the waste material which is aiding to choke up and congest their rich plexuses of blood vessels. The heart becomes stimulated to increased action at the outset of a fever, but this does not indicate increased strength; on the contrary, it indicates the action of an irritant to the heart that will soon weaken it. It is, therefore, irrational further to depress the heart by the use of such drugs as aconite. It is better to strengthen it and to favor the elimination of the substance that is irritating it. The increased blood pressure throughout the body may be diminished by lessening the quant.i.ty of blood. This is obtained in some cases with advantage when the disease is but starting and the animal is plethoric by direct abstraction of blood, as in bleeding from the jugular or other veins; or by derivatives, such as mustard, turpentine, or blisters applied to the skin; or by setons, which draw to the surface the fluid of the blood, thereby lessening its volume without having the disadvantage of impoverishing the elements of the blood found in bleeding. In many cases antipyretics given by the mouth and cold applied to the skin are most useful.
When the irritation which is the cause of fever is a specific one, either in the form of bacteria (living organisms), as in glanders, tuberculosis, influenza, septicemia, etc., or in the form of a foreign element, as in rheumatism, gout, hemaglobinuria, and other so-called diseases of nutrition, we employ remedies which have been found to have a direct specific action on them. Among the specific remedies for various diseases are counted quinin, carbolic acid, salicylic acid, antipyrene, mercury, iodin, the empyreumatic oils, tars, resins, aromatics, sulphur, and a host of other drugs, some of which are of known effect and others of which are theoretical in action. Certain remedies, like simple aromatic teas, vegetable acids, such as vinegar, lemon juice, etc., alkalines in the form of salts, sweet spirits of niter, etc., which are household remedies, are always useful, because they act on the excreting organs and ameliorate the effects of fever.
Other remedies, which are to be used to influence the cause of fever, must be selected with judgment and from a thorough knowledge of the nature of the disease.
METHODS OF ADMINISTERING MEDICINES.
By CH. B. MICHENER, V. S.
[Revised by Leonard Pearson, B. S., V. M. D.]
Medicine may enter the body through any of the following designated channels: First, by the mouth; second, by the air pa.s.sages; third, by the skin; fourth, by the tissue beneath the skin (hypodermic methods); fifth, by the r.e.c.t.u.m; sixth, by the genito-urinary pa.s.sages; and, seventh, by the blood (intravenous injections).
BY THE MOUTH.--Medicines can be given by the mouth in the form of solids, as powders or pills; liquids, and pastes, or electuaries.
_Powders._--Solids administered as powders should be as finely pulverized as possible, in order to obtain rapid solution and absorption. Their action is in this way facilitated and intensified.
Powders must be free from any irritant or caustic action upon the mouth.
Those that are without any disagreeable taste or smell are readily eaten with the feed or taken in the drinking water. When placed with the feed they should first be dissolved or suspended in water and thus sprinkled on the feed. If mixed dry the horse will often leave the medicine in the bottom of his manger. Nonirritant powders may be given in capsules, as b.a.l.l.s are given.
_Pills, or "b.a.l.l.s"_ when properly made, are cylindrical in shape, 2 inches in length and about three-fourths of an inch in diameter. They should be fresh, but if necessary to keep them some time they should be made up with glycerin, or some such agent, to prevent their becoming too hard. Very old, hard b.a.l.l.s are sometimes pa.s.sed whole with the manure without being acted upon at all. Paper is sometimes wrapped around b.a.l.l.s when given, if they are so sticky as to adhere to the fingers or the balling gun. Paper used for this purpose should be thin but firm, as the tougher tissue papers. b.a.l.l.s are preferred to drenches when the medicine is extremely disagreeable or nauseating; when the dose is not too large; when the horse is difficult to drench; or when the medicine is intended to act slowly. Certain medicines can not or should not be made into b.a.l.l.s, as medicines requiring to be given in large doses, oils, caustic substances, unless in small dose and diluted and thoroughly mixed with the vehicle, deliquescent, or efflorescent salts. Substances suitable for b.a.l.l.s can be made up by the addition of honey, sirup, soap, etc., when required for immediate use. Gelatin capsules of different sizes are now obtainable and are a convenient means of giving medicines in ball form.
When b.a.l.l.s are to be given we should observe the following directions: In shape they should be cylindrical, of the size above mentioned, and soft enough to be easily compressed by the fingers. If made round or egg-shaped, if too long or too hard, they are liable to become fixed in the gullet and cause choking. b.a.l.l.s may be given with the "balling gun"
(obtainable at any veterinary instrument maker"s) or by the hand. If given by the hand a mouth speculum or gag may be used to prevent the animal from biting the hand or crushing the ball. Always loosen the horse before attempting to give a ball; if tied he may break his halter and injure himself or the one giving the ball. With a little practice it is much easier to give a ball without the mouth gag, as the horse always fights more or less against having his mouth forced open. The tongue must be firmly grasped with the left hand and gently pulled forward; the ball, slightly moistened, is then to be placed with the tips of the fingers of the right hand as far back into the mouth as possible; as the tongue is loosened it is drawn back into the mouth and carries the ball backward with it. The mouth should be kept closed for a minute or two.
We should always have a pail of water at hand to offer the horse after balling. This precaution will often prevent him from coughing out the ball or its becoming lodged in the gullet.
_Pastes or electuaries_ are medicines mixed with licorice-root powder, ground flaxseed, mola.s.ses, or sirup to the consistency of honey, or a "soft solid." They are intended, chiefly, to act locally upon the mouth and throat. They are given by being spread upon the tongue, gums, or teeth with a wooden paddle or strong, long-handled spoon.
_Liquids._--It is, very often, impossible to get b.a.l.l.s properly made, or to induce owners or attendants to attempt to give them, and for these reasons medicines by the mouth are mostly given in the form of liquids.
Liquids may be given as drenches when the dose is large, or they may, when but a small quant.i.ty is administered, be injected into the mouth with a hard-rubber syringe or be poured upon the tongue from a small vial.
When medicine is to be given as a drench we must be careful to use water or oil enough to dissolve or dilute it thoroughly; more than this Wakes the drench bulky and is unnecessary. Insoluble medicines, if not irritant or corrosive, may be given simply suspended in water, the bottle to be well shaken immediately before giving the drench. The bottle used for drenching purposes should be clean, strong, and smooth about its neck; it should be without shoulders, tapering, and of a size to suit the amount to be given. A horn or tin bottle may be better, because it is not so easily broken by the teeth. If the dose is a small one the horse"s head may be held up by the left hand, while the medicine is poured into the mouth by the right. The left thumb is to be placed in the angle of the lower jaw, and the fingers spread out in such manner as to support the lower lip. Should the dose be large, the horse ugly, or the attendant unable to support the head as directed above, the head is then to be held up by running the tines of a long-handled wooden fork under the noseband of the halter or the halter strap or a rope may be fastened to the noseband and thrown over a limb, beam, or through a pulley suspended from the ceiling. Another way of supporting the head is to place a loop in the end of a rope, and introduce this loop into the mouth just behind the upper front teeth or tusks of the upper jaw, the free end to be run through a pulley, as before described, and held by an a.s.sistant. It is never to be fastened, as the horse might in that case do himself serious injury. The head is to be elevated just enough to prevent the horse from throwing the liquid out of his mouth. The line of the face should be horizontal, or only the least bit higher. If the head is drawn too high the animal can not swallow with ease or even with safety. (If this is doubted, just fill your mouth with water, throw-back the head as far as possible, and then try to swallow.) The person giving the drench should stand on some object in order to reach the horse"s mouth--on a level, or a little above it. The bottle or horn is then to be introduced at the side of the mouth, in front of the molar teeth, in an upward direction. This will cause the horse to open his mouth, when the base of the bottle is to be elevated, and about 4 ounces of the liquid allowed to escape on the tongue as far back as possible, care being taken not to get the neck of the bottle between the back teeth.
The bottle is to be immediately removed, and if the horse does not swallow this can be encouraged by rubbing the fingers or neck of the bottle against the roof of the mouth, occasionally removing them. As soon as this is swallowed repeat the operation until he has taken all the drench. If coughing occurs, or if, by any mishap, the bottle should be crushed in the mouth, lower the head immediately.
Do not rub, pinch, or pound the throat nor draw out the tongue when giving a drench. These processes in no way aid the horse to swallow and oftener do harm than good. In drenching, swallowing may be hastened by pouring into the nose of the horse, while the head is high, a few teaspoonfuls of clean water, but _drenches must never be given through the nose_. Large quant.i.ties of medicine given by pouring into the nose are liable to strangle the animal, or, if the medicine is irritating, it sets up an inflammation of the nose, fauces, windpipe, and sometimes the lungs.
BY THE AIR Pa.s.sAGES.--Medicines are administered to the lungs and upper air pa.s.sages by insufflation, inhalation, injection, and nasal douche.
_Insufflation_ consists in blowing an impalpable powder directly into the nose. It is but rarely resorted to.
_Inhalation._--Gaseous and volatile medicines are given by inhalation, as is also medicated steam or vapor. Of the gases used there may be mentioned, as the chief ones, sulphurous acid gas and, occasionally, chlorin. The animal or animals are to be placed in a tight room, where these gases are generated until the atmosphere is sufficiently impregnated with them. Volatile medicines--as the anesthetics (ether, chloroform, etc.)--are to be given by the attending surgeon only.
Medicated vapors are to be inhaled by placing a bucket containing hot water, vinegar and water, scalded hay or bran, to which carbolic acid, iodin, compound tincture of benzoin, or other medicines have been added, in the bottom of a long grain bag. The horse"s nose is to be inserted into the top of the bag, and he thus inhales the "medicated steam." Care must be taken not to have it hot enough to scald the animal. The vapor from scalding bran or hay is often thus inhaled to favor discharges in sore throat or "distemper."
_Injections_ are made into the trachea by means of a hypodermic syringe.
This method of medication is used for the purpose of treating local diseases of the trachea and upper bronchial tubes. It has also been used as a mode of administering remedies for their const.i.tutional effect, but is now rarely used for this purpose.
_The nasal douche_ is employed by the veterinarian in treating some local diseases of the nasal chambers. Special appliances and professional knowledge are necessary when using liquid medicines by this method. It is not often resorted to, even by veterinary surgeons, since, as a rule, the horse objects very strongly to this mode of medication.
BY THE SKIN.--Medicines are often administered to our hair-covered animals by the skin, yet care must be taken in applying some medicines--as tobacco water, carbolic-acid solutions, strong creolin solutions, mercurial ointment, etc.--over the entire body, as poisoning and death follow in some instances from absorption through the skin. For the same reasons care must also be exercised and poisonous medicines not applied over very large raw or abraded surfaces. With domestic animals medicines are only to be applied by the skin to allay local pain or cure local disease.
BY THE TISSUE BENEATH THE SKIN (HYPODERMATIC METHOD).--Medicines are frequently given by the hypodermic syringe under the skin. It is not safe for any but medical or veterinary pract.i.tioners to use this form of medication, since the medicines thus given are powerful poisons. There are many precautions to be observed, and a knowledge of anatomy is indispensable. One of the chief precautions has to do with the sterilization of the syringe. If it is not sterile an abscess may be produced.
BY THE r.e.c.t.u.m.--Medicines may be given by the r.e.c.t.u.m when they can not be given by the mouth, or when they are not retained in the stomach; when we want a local action on the last gut; when it is desired to destroy the small worms infesting the large bowels or to stimulate the peristaltic motion of the intestines and cause evacuation. Medicines are in such cases given in the form of suppositories or as liquid injections (enemas.) Foods may also be given in this way.
_Suppositories_ are conical bodies made up of oil of theobroma and opium (or whatever medicine is indicated in special cases), and are introduced into the r.e.c.t.u.m or v.a.g.i.n.a to allay irritation and pain of these parts.
They are not much used in treating horses.
_Enemas_, when given for absorption, should be small in quant.i.ty, neutral or slightly acid in reaction, and of a temperature of from 90 to 100 F. These, like feeds given by the r.e.c.t.u.m, should be introduced only after the last bowel has been emptied by the hand or by copious injections of tepid water. Enemas, or clysters, if to aid the action of physics, should be in quant.i.ties sufficient to distend the bowel and cause the animal to eject them. Simple water, salt and water, or soap and water, in quant.i.ties of a gallon or more, may be given every half hour. It is best that the horse retain them for some little time, as the liquid serves to moisten the dung and favors a pa.s.sage. Stimulating enemas, as glycerin, should be administered after those already mentioned have emptied the last bowel, with the purpose of still further increasing the natural motion of the intestines and aiding the purging medicine.
Liquids may be thrown into the r.e.c.t.u.m by the means of a large syringe or a pump. A very good "irrigator" can be bought of any tinsmith at a trifling cost, and should be constantly at hand on every stock farm. It consists of a funnel about 6 inches deep and 7 inches in diameter, which is to be furnished with a prolongation to which a piece of rubber hose, such as small garden hose, 4 feet long may be attached. The hose, well oiled, is to be inserted gently into the r.e.c.t.u.m about 2 feet. The liquid to be injected may then be poured in the funnel and the pressure of the atmosphere will force it into the bowels. This appliance is better than the more complicated and expensive ones.
Ordinary cold water or even ice-cold water is highly recommended by many as a rectal injection for horses overcome by the excessive heat of summer, and may be given by this simple pipe.
BY THE GENITO-URINARY Pa.s.sAGES.--This method of medication is especially useful in treating local diseases of the genito-urinary organs. It finds its chief application in the injection and cleansing of the uterus and v.a.g.i.n.a. For this purpose a large syringe or the irrigator described above may be used.
BY THE BLOOD.--Injections directly into veins are to be practiced by medical or veterinary pract.i.tioners only, as are probably some other means of giving medicines--intratracheal injections, etc.
[Ill.u.s.tration: PLATE III.
DIGESTIVE APPARATUS.
1. Mouth. 2. Pharynx. 3. Esophagus. 4. Diaphragm. 5. Spleen. 6. Stomach.
7. Duodenum. 8. Liver, upper extremity. 9. Large colon. 10. Cec.u.m. 11.
Small intestine. 12. Floating colon. 13. r.e.c.t.u.m. 14. a.n.u.s. 15. Left kidney and its ureter. 16. Bladder. 17. Urethra.]