Chapter V: Part 5

Among agents that act more exclusively as antiseptics may be named: muriatic acid 1 to 1½ drs. largely diluted in water; carbolic acid, creosote or creolin, 4 drs. largely diluted; sulphite, hyposulphite or bisulphite of soda 1 oz.; kerosene oil ½ pint; chloride of lime 4 drs.; chlorine water 1 pint; wood tar 2 oz. The latter agent is a common domestic remedy in some places being given wrapped in a cabbage leaf, and causing the flank to flatten down in a very few minutes as if by magic. The extraordinarily rapid action of various antiseptics is the most conclusive answer to the claim that the disorder is a pure paresis of the walls of the rumen. The affection is far more commonly and fundamentally an active fermentation, and is best checked by a powerful antiferment. Even chloride of sodium (½ lb.) and above all hypochlorite of soda or lime (½ oz.) may be given with advantage in many cases.

Among agents which condense the gasses may be named ammonia, calcined magnesia, and milk of lime for carbon dioxide, and chlorine water for hydrogen.

Among agents used to rouse the torpid rumen and alimentary canal are eserine (ox 3 grs., sheep ½ gr. subcutem), pilocarpin (ox 2 grs., sheep ⅕ gr.), barium chloride (ox 15 grs., sheep 3 to 4 grs.), tincture of colchicum (ox 3 to 4 drs.). Trasbot mentions lard or butter (ox 4 oz., sheep ½ oz.), as in common use in France.

In the most urgent cases, however, relief must be obtained by _puncture of the rumen_, as a moment’s delay may mean death. The seat for such puncture is on the left side, at a point equidistant from the outer angle of the ilium, the last rib and the transverse processes of the lumbar vertebræ. Any part of the left flank might be adopted to enter the rumen, but, if too low down, the instrument might plunge into solid ingesta, which would hinder the exit of gas, and would endanger the escape of irritant liquids into the peritoneal cavity. In an extra high puncture there is less danger, though a traumatism of the spleen is possible under certain conditions. The best instrument for the purpose is a trochar and cannula of six inches long and ⅓ to ½ inch in diameter. (For sheep ¼ inch is ample.) This instrument, held like a dagger, may be plunged at one blow through the walls of the abdomen and rumen until stopped by the shield on the cannula. The trochar is now withdrawn and the gas escapes with a prolonged hiss. If the urgency of the case will permit, the skin may be first incised with a lancet or pen knife, and the point of the instrument having been placed on the abdominal muscles, it is driven home by a blow of the opposite palm. In the absence of the trochar the puncture may be successfully made with a pocket knife or a pair of scissors, which should be kept in the wound to maintain the orifice in the rumen in apposition with that in the abdominal wall, until a metal tube or quill can be introduced and held in the orifices.

When the gas has escaped by this channel its further formation can be checked by pouring one of the antiferments through the cannula into the rumen.

When the formation of an excess of gas has ceased, and the resumption of easy eructation bespeaks the absence of further danger, the cannula may be withdrawn and the wound covered with tar or collodion.

When the persistent formation of gas indicates the need of expulsion of offensive fermentescible matters, a full dose of salts may be administered. If the presence of firmly impacted masses can be detected, they may sometimes be broken up by a stout steel rod passed through the cannula. If the solid masses prove to be hair or woolen balls, rumenotomy is the only feasible means of getting rid of them.

In _chronic tympany_ caused by structural diseases of the œsophagus, mediastinal glands, stomach or intestines, permanent relief can only be obtained by measures which will remove these respective causes.

CHRONIC TYMPANY OF THE RUMEN.

Causes: catarrh of rumen, impaction of manifolds, debility, paresis,
peritoneal adhesions, neoplasms, concretions, sudden change in diet,
gastric congestion, lesions of gullet, or of mediastinal glands.
Symptoms are usually after feeding only, inappetence, rumbling,
costiveness, rumen indentable. Treatment: obviate causes, give
salines, acids, bitters, and water, laxative food, carminatives,
antiseptics, electricity, emetic tartar, eserine, pilocarpin, barium
chloride, apomorphin.

_Causes._ The persistence of causes of acute tympany may lead to the appearance of the condition after each meal, or even in the intervals between meals. Among the more specific causes may be named catarrhal inflammation of the rumen, impaction of the third stomach, paresis of the rumen, general debility, peritoneal adhesions affecting the viscus, tuberculosis, actinomycosis or other morbid productions in its walls, hernia of the reticulum into the chest, hard stercoral, hair or wool balls, or masses or foreign bodies in the rumen, and the ingestion of a very fermentescible quality of food. When the rumen is affected by catarrh or paresis or debility, even ordinary food will lead to tympany, but much more so any food to which the animal has been unaccustomed (green for dry, or dry for green, grain for grass or hay, or beans or peas for grain). Also food in process of fermentation, or the seat of fungoid growth.

Again, so intimately related are the different stomachs that derangement of one instantly impairs the functions of the other, and thus a slowly progressive impaction of the third stomach leads to torpor of the first, and the aggregation of more or less of its contents into solid, fermenting masses. In the same way congestion of either the third or fourth stomach impairs the functions of the rumen and induces tympany.

Morbid conditions affecting the functions of the œsophagus and interfering with rumination and eructation of gas are familiar causes. For example, strictures and saccular dilations of the tube, and enlargements—tubercular, sarcomatous, actinomycotic,—of the mediastinal glands.

The _symptoms_ do not differ from those of acute tympany excepting that they are less severe; and are continuous or remittent, suffering a material aggravation after feeding. Rumination may be suppressed or tardy, the bowels also are torpid, the fæces glazed, and the ordinary intestinal rumbling little marked. When the tympany has temporarily subsided, the knuckles, pressed into the left side, can often be made to strike against the hard, solid impacted mass of ingesta. Symptoms of impacted manifolds may also be patent and the patient steadily loses condition.

_Treatment_ must be directed toward the removal of the special cause of the trouble, and if this cannot be secured, as in tuberculosis, the case is hopeless. In cases of solid masses in the rumen the free use of common salt with a drachm of hydrochloric acid, and one grain strychnine with each meal, and a free access to water may succeed. The food had best be restricted to gruels and sloppy mashes. The daily use of electricity through the region of the paunch is an important accessory. The common salt may be increased as required, so as to keep up a very relaxed condition of the bowels.

In obstinate cases of this kind puncture may be resorted to and an attempt made to break down the impacted masses with a steel rod introduced through the cannula. Should this also fail the solid masses or foreign bodies may be extracted by rumenotomy.

In simple catarrh of the rumen the continued use of strychnine with gentian, and sulphate of iron, may prove successful under a carefully regulated diet. Oil of turpentine, balsam of copaiba, or balsam of tolu may also prove useful, or in other cases extract of hamamelis, or of wild cherry bark. While strychnine and electricity are to be preferred to rouse the muscular activity of the viscus, such agents as tartar emetic, emetine, apomorphin, eserine, pilocarpin and barium chloride are recommended and may be resorted to in case of necessity.

OVERLOADED (IMPACTED) RUMEN.

Definition. Causes, excess of rich unwonted food, gastric torpor,
paresis, starvation, debility, partially ripened, poisonous seeds,
paralyzing fungi or bacteria, lead, cyanides, congestion of rumen,
chlorophyll, acrids, dry, fibrous innutritious food, lack of water,
enforced rest on dry food, over-exertion, salivary fistula or
calculus, diseased teeth or jaws, senility. Symptoms, suspended
rumination, inappetence, anxious expression, arched back, bulging
pendent left flank, impressible, no friction sounds, excessive
crepitation, hurried breathing, colics, grunting when moved, diarrhœa,
stupor, cyanosis. Signs of improvement. Phrenic rupture. Diagnosis
from tympany, pneumonia, or gastro-intestinal catarrh. Treatment,
hygienic, antiseptic, stimulants, puncturing, purgation, rumenotomy.

_Definition._ The overdistension of the rumen with solid food is characterized by two things, the excess of ingesta which produces the torpor or paresis which is common to all over-filled hollow viscera, and the comparative absence of fermentation and evolution of gas. If the ingesta is of a more fermentescible nature the rapid evolution of gas occurs before this degree of repletion with solid matters can be reached, and the case becomes one of tympany, but if the contents are comparatively lacking in fermentability they may be devoured in such quantity as to cause solid impaction.

_Causes._ Overloading of the rumen is especially common as the result of a sudden access to rich or tempting food to which the animal has been unaccustomed. Accidental admittance to the cornbin, breaking into a field of rich grass, clover, alfalfa, corn, sorghum, vetches, tares, beans, peas, or grain, or into a barrel of potatoes or apples will illustrate the common run of causes. A pre-existing or accompanying torpor or paresis of the stomach is a most efficient concurrent cause, hence the affection is especially common in animals debilitated by disease or starvation, but which have become convalescent or have been suddenly exposed to the temptation of rich food. For the same reason it is most likely to occur with food which contains a paralyzing element, as in the case of the following when they have gone to seed but are not yet fully ripened: Rye grass, intoxicating rye grass, millet, Hungarian grass, vetches, tares and other leguminosæ, and to a less extent, wheat, barley, oats and Indian corn. The same may come from the paralyzing products of fungi or bacteria in musty fodder or of such chemical poisons as lead, and the cyanides.

A catarrhal affection of the rumen, and the congestion produced by irritant plants, green food with an excess of chlorophyll, and the whole list of irritants and narcotico-acrids, will weaken the first stomach and predispose to overdistension.

Anything which lessens the normal vermicular movements of the rumen and hinders regurgitation and rumination tends to impaction, and hence an aliment which is to a large extent fibrous, innutritious, and unfermentable, such as hay from grass that has run to seed and been threshed, the stems of grasses that have matured and withered in the pastures, fodder that has been thoroughly washed out by heavy rains, sedges, reedgrass, rushes, chaff, finely cut straw, and in the case of European sheep, the fibrous tops of heather contribute to this affection. Lack of water is one of the most potent factors, as an abundance of water to float the ingesta is an essential condition of rumination. Hence pasturage on dry hillsides, prairies or plains, apart from streams, wells or ponds is especially dangerous unless water is supplied artificially, and the winter season in our Northern states, when the sources of drinking water are frozen over, and when the chill of the liquid forbids its free consumption, is often hurtful.

Gerard attributes the affection to constant stabulation. This, however, has a beneficial as well as a deleterious side. It undermines the health and vigor, and through lack of tone favors gastric torpor and impaction, but it also secures ample leisure for rumination, which is so essential to the integrity of the rumen and favors the onward passage of its contents. With dry feeding and a restricted water supply it cannot be too much condemned, but with succulent food and abundance of water the alleged danger is reduced to the minimum.

Active work and over exertion of all kinds must be admitted as a factor. At slow work the ox can still ruminate, but in rapid work or under heavy draft this is impossible, and the contained liquids may pass over from rumen to manifolds conducing to impaction of the former, or fermentations may take place, swelling up the mass of ingesta and distending the walls of the first stomach. Similarly, cattle and sheep that are hurried off on a rapid march with full stomachs are greatly exposed to both tympany and impaction.

In speaking of dry, fibrous food and lack of water as factors, we must avoid the error of supposing that succulent or aqueous food is a sure preventive. In a catarrhal condition of the rumen or in a state of debility, impaction may readily occur from the excessive ingestion of luscious grass, wheat bran, potatoes, apples, turnips, beets, or cabbage.

Finally defects in the anterior part of the alimentary tract may tend to impaction. Salivary fistula or calculus cutting off the normal supply of liquid necessary for rumination, tends to retention and engorgement. Diseased teeth and jaws interfering with both the primary and secondary mastication has the same vicious tendency. Old cows, oxen and sheep in which the molar teeth are largely worn out, suffer in the same way, especially when put up to fatten or otherwise heavily fed. In this case there is the gastric debility of old age as an additional inimical feature.

_Symptoms._ These vary with the quantity and kind of ingesta also to some extent with the previous condition of the rumen, sound or diseased. They usually set in more slowly than in tympany. On the whole the disease appears to be more common in the stable than at pasture. The animal neither feeds nor ruminates, stands back from the manger, becomes dull, with anxious expression of the face, arching of the back and occasional moaning especially if made to move. The abdomen is distended but especially on the left side, which however hangs more downward and outward and tends less to rise above the level of the hip bone than in tympany. If it does rise above the ilium this is due to gas and it is then elastic, resilient and resonant on percussion at that point. The great mass, and usually the whole of the paunch is nonresonant when percussed, retains the imprint of the fingers when pressed, and gives the sensation of a mass of dough. The hand applied on the region of the paunch fails to detect the indication of movements which characterize the healthy organ. The ear applied misses the normal friction sound, but detects a crepitant sound due to the evolution of bubbles of gas from the fermenting mass. This is especially loud if the impaction is one of green food or potatoes, even though the gas remains as bubbles throughout the entire fermenting mass, instead of separating to form a gaseous area beneath the lumbar transverse processes.

The respiration is hurried, labored and accompanied with a moan, the visible mucosæ are congested, the eyes are protruded and glassy from dilatation of the pupils, the feet are propped outward, and the head extended on the neck. There may be signs of dull colicy pains, movements of the tail and shifting of the hind feet, in some cases the patient may even lie down but never remains long recumbent. There may be occasional passages of semi-liquid manure, though usually the bowels are torpid and neither passages nor rumbling sounds on the right side can be detected. When moved the animal usually grunts or moans at each step, and especially when going down hill, owing to the concussion of the stomach on the diaphragm. In cases due to green food the irritation may extend to the fourth stomach and intestines and a crapulous diarrhœa may ensue. The temperature remains normal as a rule. The disease is more protracted than tympany, yet after several hours of suffering and continual aggravation the dullness may merge into stupor, the mucosæ become cyanotic and death ensues from shock, asphyxia, or apoplexy.

_Course. Termination._ Many cases recover in connection with a restoration of the contractions of the rumen, the eructation of gas, in some rare cases vomiting or spasmodic rejection of quantities of the ingesta, and the passage of gas by the bowels. This may be associated with a watery diarrhœa, and loud rumbling of the right side, which may continue for twenty-four hours or longer. With the subsidence of the diarrhœa there comes a return of health, or there may remain slight fever, inappetence, suspended or impaired rumination, dullness, listlessness, and a mucous film on the fæces. This indicates some remaining gastro-enteritis.

In some instances there is rupture of the diaphragm with marked increase in the abdominal pain and the difficulty of breathing. In others there is a laceration of the inner and middle coats of the rumen so that the gas diffuses under the peritoneum and may even be betrayed by an emphysematous extravasation under the skin.

_Diagnosis._ From tympany this is easily distinguished by the general dullness on percussion, the persistence of the indentation caused by pressure, the outward and downward rather than the upward extension of the swelling, and the slower development of the affection.

It is far more likely to be confounded with pneumonia, which it resembles in the hurried, labored breathing, the moans emitted in expiration, in the dullness on percussion over the posterior part of the chest, it may be even forward to the shoulders, and in the cyanotic state of the mucosæ. The distinction is easily made by the absence of hyperthermia, and of crepitation along the margins of the nonresonant areas in the lungs, by the fact that the area of chest dullness covers the whole posterior part of the thorax to a given oblique line, and by the history of the case and the manifest symptoms of overloaded stomach, not with gas but with solids. From gastro-intestinal catarrh it may be distinguished by the more rapid advance of the symptoms and by the absence of the slight fever which characterizes the latter.

_Treatment._ Slight cases may be treated by hygienic measures only. Walking the animal uphill, injections of cold water, friction on the left side of the abdomen to rouse the rumen to activity, antiseptics as in tympany to check further fermentation, and stimulants to overcome the nervous and muscular torpor, may be employed separately or conjointly. When it can be availed of, a rubber hose may be wound round the abdomen and a current of cold water forced through it.

When further measures are demanded we should evacuate any gas through the probang or a cannula, as in tympany, and thus relieve tension and then resort to stimulants and purgatives. Common salt 1 ℔. is of value in checking fermentation, and may be added to 1 ℔. Glauber salts in four or five quarts of warm water. A drachm of strong aqua ammonia or 2 oz. oil of turpentine and ½ drachm of nux vomica may be added. Bouley advocated tartar emetic (2 to 3 drachms), and Lafosse ipecacuan (1 oz. of the wine) to rouse the walls of the rumen, and more recently pilocarpin (ox 3 grs.), eserine (ox 2 grs.) and barium chloride (ox 15 grs.), have offered themselves for this purpose. The three last have the advantage of adaptability to hypodermic use, and prompt action. The repetition of stimulants and nux vomica may be continued while there appears any prospect of restoring the normal functions of the paunch, and when all other measures fail the only hope lies in rumenotomy.

=Rumenotomy.= The warrant for this operation is found in the entire lack of movement in the rumen, the absence of eructation, the cessation of rumbling and motion of the bowels, and the deepening of the stupor in which the patient is plunged. The longer the delay and the deeper the stupor and prostration the less the likelihood of a successful issue from the operation. The animal is made to stand with its right side against a wall, and its nose held by the fingers or bulldog forceps. If judged necessary a rope may be passed from a ring in the wall in front of the shoulder around the animal to another ring behind the thigh and held tight. Or a strong bar with a fulcrum in front, may be pressed against the left side of the body, and well down so as to keep the right side fast against the wall. A line may be clipped from the point of election for puncture in tympany down for a distance of six inches. A sharp pointed knife is now plunged through the walls of the abdomen and rumen in the upper part of this line, and is slowly withdrawn, cutting downward and outward until the opening is large enough to admit the hand. The lips of the wound in the overdistended stomach will now bulge out through to the wound in the abdominal walls, and three stitches on each side may be taken through these structures to prevent displacement as the stomach is emptied and rendered more flaccid. A cloth wrung out of a mercuric chloride solution may be laid in the lower part of the wound to guard against any escape of liquid into the peritoneal cavity. The contents may now be removed with the hand, until the organ has been left but moderately full. Two or three stable bucketfuls are usually taken, but it is by no means necessary nor desirable that the rumen be left empty, as a moderate amount of food is requisite to ensure its functional activity. As a rule at least fifty pounds should be left. Before closing the wound and especially in cases due to dry feeding, it is well in a tolerably large animal to introduce the hand through the demicanal to ascertain if impactions exist in the third stomach and to break up these so far as they can be reached. This done, the edges of the wound in the stomach are to be carefully cleansed, washed with the mercuric chloride solution and sewed together with carbolated catgut, care being taken to turn the mucosa inward and to retain the muscular and peritoneal layers in close contact with each other. It will usually be convenient to cut first the two lower stitches through the abdominal walls, and suture from below upward. When finished the peritoneal surface of the gastric wound may be again sponged with the mercuric chloride solution, together with the edges of the wound in the abdominal walls. Finally the abdominal wound is sutured, the stitches including the skin only or the muscular tissues as well. The smooth surface of the paunch acts as an internal pad and support, and with due care as to cleanliness, antisepsis and accuracy of stitching, it is rare to find any drawback to continuous and perfect healing. It is well to restrict the animal for three days to well boiled gruels, and for ten days to soft mashes in very moderate amount lest the wound in the paunch should be fatally burst open before a solid union has been effected.

RUMINITIS. INFLAMMATION OF THE RUMEN.

Prevalence in different genera. Causes, as in tympany and impaction,
irritants, specific fevers. Symptoms: impaired rumination, tympanies,
impactions, depraved appetite, fever, nervous disorders. Lesions:
hyperæmia, petechiæ, exudates, ulcers, desquamation, swollen or
shrunken papillæ. Treatment: remove cause, mucilaginous food, or
gruels, sodium sulphate, or chloride, bismuth, bitters, mustard
cataplasm, electricity.

This is not a prevalent disease but affects animals at all periods of life and is a cause of tardy and difficult digestion and rumination. It usually shows itself as a catarrhal inflammation and by favoring fermentation in the food, and torpor of the muscular walls of the organ contributes to tympany and impaction. It is more common in the ox than in the sheep owing, perhaps, to the more habitual overloading of the stomach and to the hurried, careless manner of feeding. In the goat it is rare.

_Causes._ Among the causes may be named tympany and overloading, so that all the dietary faults that lead to these may be set down as causes of inflammation. Irritants taken with the food, whether in the form of acrid plants (ranunculaceæ, euphorbiaceæ, etc.), musty fodder, irritant products in spoiled fodder, aliments which are swallowed while very hot or in a frozen state, and foreign bodies of an irritating kind are especially liable to induce it. Congestions of the paunch are not uncommon in specific infectious diseases like Rinderpest, malignant catarrh, anthrax, and Texas fever, and specific eruptions sometimes appear in aphthous fever and sheeppox.

_Symptoms._ Rumination is slow and irregular, appetite capricious, tympanies appear after each feed, and there is a marked tendency to aggregation of the ingesta in solid masses, which resist the disintegration and floating which is necessary to rumination, and favor the occurrence of putrid fermentation. There is usually a tendency to lick earth, lime from the walls, and the manger, and a depraved appetite shown in a desire to chew and swallow foreign bodies of many kinds. Vomiting or convulsive rejection of the contents of the rumen is not unknown (Vives, Pattaes). There is slight fever with heat of the horns and ears, dry muzzle, and tenderness to pressure on the left flank. The bowels may be alternately relaxed and confined, and bad cases may end in a fatal diarrhœa. In other cases the disease may become acute and develop nervous symptoms, as in tympany and impaction. When the disease takes a favorable turn, under a careful ration, recovery may be complete in eight or ten days.

_Lesions._ These are violet or brownish patches of hyperæmia on the mucosa of the rumen, circumscribed ecchymoses, exudates in the sense of false membranes and even pin’s head ulcerations. On the affected portions the mucosa is swollen, puffy, dull and covered with mucus, and epithelium may desquamate. The papillæ are often red, and thickened or shrunken and shortened. In the specific affections like aphthous fever and sheeppox the lesions are rounded vesicles containing liquid. The ingesta is more or less packed in masses.

_Treatment._ If irritant foreign bodies have been taken rumenotomy is demanded. If caustic alkalies, acetic or other mild acid. If acids, lime water or magnesia. Feed well boiled flax seed, or farina gruels, and wheat bran or middlings in limited quantity. Solids may be at first withheld, coarse or indigestible food must be. It may be necessary to rouse the organ by 10 or 12 ozs. of sulphate of soda with a little common salt and abundance of thin gruels as drink. As a tonic the animal may take nitrate of bismuth ½ oz., powdered gentian ½ oz., and nux vomica 20 grains, twice a day. The application of a mustard pulp or of oil of turpentine on the left side of the abdomen may also be resorted to. A weak current of electricity through the region of the paunch for twenty minutes daily is often of great service.

HAIR BALLS IN THE RUMEN AND RETICULUM. EGAGROPILES.

Balls of hair, wool, clover hairs, bristles, paper, oat-hair,
feathers, chitin, mucus, and phosphates. Causes: Sucking and licking
pilous parts, eating hairy or fibrous products. Composition. Symptoms:
Slight, absent, or, gulping eructation, vomiting, tympany, in young
putrid diarrhœa, fœtid exhalations, emaciation. Diagnosis. Treatment.

_Definition._ The term egagropile, literally goat-hair, has been given to the felted balls of wool or hair found in the digestive organs of animals. The term has been applied very widely, however, to designate all sorts of concretions of extraneous matters which are found in the intestinal canal. In cattle the hair licked from their skin and that of their fellows rolled into a ball by the action of the stomach and matted firmly together with mucus and at times traces of phosphates, are the forms commonly met with. In sheep two forms are seen, one consisting of wool matted as above and one made up of the fine hairs from the clover leaf similarly matted and rolled into a ball.

In pigs the felted mass is usually composed of bristles, (exceptionally of paper or other vegetable fibre), and in horses felted balls of the fine hairs from the surface of the oat, mingled with more or less mucus and phosphate of lime make up the concretion. These are found in the stomach, and intestines. In predatory birds the feathers and in insectivorous birds chitinous masses are formed in the gizzard and rejected by vomiting.

_Causes._ Suckling animals obtain the hair from the surface of the mammary glands hence an abundance of hair or wool on these parts favors their production. The vicious habit of calves of sucking the scrotum and navel of others is another cause. In the young and adult alike the habit of licking themselves and others especially at the period of moulting is a common factor.

_Composition._ Hair, wool, and the fine hairs of clover are the common predominant constituents, but these are matted together more or less firmly by mucus and phosphates, the ammonia-magnesian phosphate uniting with the mucus and other matters in forming a smooth external crust in the old standing balls of adult animals. The centre of such balls is made up of the most densely felted hair. In balls of more recent formation the external crust is lacking and the mass is manifestly hairy on the surface, and the density uniform throughout. These have a somewhat aromatic odor, contain very little moisture, and have a specific gravity approximating .716 (sheep) to .725 (ox). Ellagic, and lithofellic acids, derivatives of tannin, are usually present, and are abundant in the egagropiles of antilopes.

In the balls of recent formation, as seen especially in sucking calves, the hair is only loosely matted together, and often intermixed with straw and hay, and is saturated with liquid and heavier than the old masses. These are usually the seat of active putrefactive fermentation, and being occasionally lodged in the third or even the fourth stomach, the septic products act as local irritants, and general poisons. They are therefore far more injurious than the consolidated hairballs of the adult animal, and often lay the foundation of septic diarrhœas and gastro-enteritis.

The balls may be spherical, elliptical, ovoid, or, when flattened by mutual compression, discoid.

_Symptoms._ Generally these balls cause no appreciable disturbance of the functions of the stomach. This is especially true of the large, old and smoothly encrusted masses. The museum of the N. Y. S. V. College contains specimens of 5½ inches in diameter, found after death in a fat heifer, which had always had good health and which was killed for beef. This is the usual history of such formations, they are not suspected during life, and are only found accidentally when the rumen is opened in the abattoir.

The smaller specimens, the size of a hen’s or goose’s egg, or a billiard ball, have produced severe suffering, with gulping, eructation, vomiting and tympany from obstruction of the demicanal or gullet, and such symptoms continued until the offending agents were rejected by the mouth. (Caillau, Leblanc, Prevost, Giron). Again they may block the passage from the first to the third stomach (Schauber, Feldamann, Adamovicz, Tyvaert, Mathieu).

In calves on milk they are especially injurious as beside the dangers of blocking the passages already referred to, the unencrusted hairs and straws irritate the mucous membranes and still worse, the putrid fermentations going on in their interstices, produce irritant and poisonous products, and disseminate the germs of similar fermentations in the fourth stomach and intestine. Here the symptoms are bloating, colics, impaired or irregular appetite, fœtid diarrhœa, fœtor of the breath and cutaneous exhalations, and rapidly progressive emaciation.

_Diagnosis_ is too often impossible. Tympanies, diarrhœa, colics, etc., may lead to suspicion, but unless specimens of the smaller hair balls are rejected by the mouth or anus there can be no certainty of their presence. If arrested in the cervical portion of the gullet they may be pressed upward into the mouth by manipulations applied from without. The looped wire extractor may be used on any portion of the œsophagus. If lodged in the demicanal the passage of a probang will give prompt relief. If retained in the rumen and manifestly hurtful, rumenotomy is called for as soon as a diagnosis can be made.

FOREIGN BODIES IN THE RUMEN AND RETICULUM.

Common. Harmless or injurious. Perforating objects. Traumatisms of
contiguous organs. Causes; hurried primary mastication, morbid
appetite. Bodies found. Lesions; catarrh, perforations, congestions,
ulcerations of mucosa, abscess, trauma of liver, spleen, diaphragm,
abdominal and thoracic walls, lung, pleura, pericardium, heart.
Symptoms; absent, or, indigestion, tympany, eructations, hepatic,
respiratory or circulatory disorder, colics, local tenderness,
crepitation, substernal exudate, costiveness, difficult urination or
defecation, bloody fæces, nervous disorder. Treatment; Prevention;
avoidance of causes, gravitation methods, incision.

These are so frequent that they can hardly be looked on as abnormal, but they must be accepted as pathological when they cause serious irritation or digestive disorder. This result is seen especially in the case of cutting or sharp pointed bodies, which beside wounding the walls of the rumen, show a marked tendency to advance to the heart and penetrate it, or to perforate the liver, diaphragm or abdominal walls and even to cause a fistula through which the ingesta escapes.

_Causes._ The common cause in cattle is the habit of swallowing, after one or two strokes of the teeth, any small object that is mixed with the provender. Next to this comes the habit of stabled cows, and of such as suffer from a lack of phosphates or other important element in the food, of licking, chewing, and swallowing articles that can in no sense be considered as alimentary.

Among the rounded or smooth bodies found in the rumen and reticulum may be named coins, rivets, fragments of wood, cords, pieces of rope, leather, gloves, cloth, small garments like vests or caps, ribbons, bones, pieces of lead, dried paints, cotton waste used as packing for machinery, shot, and even small animals such as frogs, toads, and snakes; also sand and pebbles.

Among sharp or pointed bodies the most common are nails, pins, needles, baling wire, pieces of iron or other metals, knives, scissors, forks, fragments of glass, thorns, etc.

_Lesions._ These are as varied as the nature of the traumatic agent, the seat and nature of the trauma. The rounded bodies, if non-poisonous, act merely by attrition of the walls and tend to induce a local catarrhal inflammation. Yet even sharp pointed bodies may prove comparatively harmless. The museum of the N. Y. S. V. College contains a pocket knife which had remained open in the rumen for a length of time without producing any visible injury.

Sharp and pointed bodies are especially liable to be entangled in the cells of the reticulum; so that this viscus is the most common seat of the resulting trauma. Around this there occur hyperæmia, exudation, thickening and centrally ulceration, which may lead into a fistula or abscess, confined it may be to the wall of the viscus, or continued into the surrounding organs. In this way may be implicated, the liver, the spleen, the diaphragm, the abdominal or thoracic walls, the lung, the pericardium or the heart. The pus is always fœtid and usually mixed with alimentary matter. If it approaches the surface it may burst and allow exit to the offending body. If it encroaches on the liver, symptoms of hepatic disorder supervene. Its progress through the lung or pleura is marked by objective symptoms of pulmonary or pleural inflammation (crepitation, flatness or percussion, creaking or friction sounds), but without the customary amount of hyperthermia, and with some evidence of gastric disorder. When the pericardium is reached there are the usual signs of pericarditis, attended by comparatively little fever, and a doughy swelling beneath the sternum is added to the objective signs of exudation in the pericardium.

Among the peculiar routes followed by such bodies may be named the following: to the side of the ensiform cartilage; through an intercostal space; into a chondro-costal articulation; through the muscles of the flank; and even in the region of the croup. If the attendant abscess or fistula bursts into a serous cavity it determines septic peritonitis or pleurisy, while in the lung it may cause septic pneumonia. As a rule, however, this is prevented by the excessive quantity of exudation.

_Symptoms._ These are extremely variable according to the seat and nature of the lesion. So long as the foreign body is confined in the rumen there is usually no symptom. Even when it has penetrated surrounding organs the symptoms are usually for a time very obscure. A few years ago a cow entered the prize ring, at the New York State Fair, was awarded first prize, and died a few minutes later from a piece of baling wire penetrating the pericardium. When symptoms are patent there are usually early indications of indigestion in the rumen, capricious appetite, sluggish and imperfect rumination, dullness, tardy movements, frequency and fœtor of eructations, colicy pains, grunting when moved, and wincing under pressure in the left hypochondrium. Pressure below, to the left of the ensiform cartilage is sometimes particularly painful.

If the object is advancing toward the heart a broad area or line of dullness may often be detected by percussion on the left side of the chest and under the acts of respiration or walking, gurgling sounds may be heard along this line. The movements of the ribs on the same side are limited as compared with the other side, and straining in defecation or urination may be manifestly painful and accompanied by groaning. For the same reason costiveness is liable to set in.

When the body approaches the skin there is formed a large, hot, phlegmonous swelling similar to that which marks the advance of an intercostal abscess.

In special cases there are symptoms of disease of the particular organ penetrated. Hepatitis, splenitis, and peritonitis are occasionally seen. Eggeling notes a fatal hemorrhage from the wounding of the œsophagus by a nail, and Brauer bloody fæces from penetration of the pylorus by a piece of glass. In other cases fatal results have followed on trauma, thickening and obliteration of the pylorus. (Olivier).

In cases of the ingestion of shot, the spray of bullets, white or red paint or other form of lead, the special symptoms of lead poisoning supervene. (See lead poisoning).

_Treatment._ As a rule this is unsatisfactory and especially in cases implicating the pericardium, as the symptoms may be entirely overlooked until sudden death occurs. Hence the great value of preventive measures, and above all the careful removal of all nails from the vicinity of fodders. Bailed hay is always dangerous, and when used, each bale should be carefully freed from its wires and any short pieces removed. Pointed metallic bodies of all kinds should be removed from the pastures and stables.

In case the migrating foreign body leads to the formation of a superficial phlegmon at any point, this should be freely opened and the offensive agent extracted.

If the lesion in the reticulum has been diagnosed, the combined methods of Kolb and Schobert should be tried. Turn the animal on its back with the head and shoulders up hill, and employ strong pressure, with the foot, in jerks, over the ensiform cartilage. The object is to slide the foreign body back into the viscus, and success is claimed in seven cases out of nine.

Failing in such methods there remains only the operation of rumenotomy and the removal of the offending bodies so far as they can be reached.

TUMORS OF THE RUMEN AND RETICULUM.

Tumors of different kinds have been found in the walls of these organs, though by no means frequently. Epithelial hypertrophy and papilloma have been found in the ox the former undergoing necrotic changes. Chondroma is reported by Kitt, Sarcoma by Cadeac and Beylot. There seems to have been a special tendency to invade the demicanal, and to interfere with deglutition, rumination, and the passage of food into the third stomach. The impairment and loss of appetite and of rumination, the presence of tympany, and the general loss of condition are suggestive. If the disease of the demicanal leads to antiperistaltic movements of the œsophagus which can be felt by the hands pressed on the jugular furrows the diagnosis may possibly be made.

_Treatment_ is manifestly hopeless. To be effective it must be surgical and would too often entail excision of the affected part of the viscus and careful suture of its walls. This would be even more hopeless when the demicanal was the seat of disease.

Temporary palliation might be secured by a sloppy diet, the withholding of all rough food which would demand rumination, and the use of common salt, saline laxatives and abundance of water.

ANIMAL PARASITES OF THE RUMEN AND RETICULUM.

Infusoria. Amphistomum Conicum. Actinomycosis. Tumors: Papilloma,
Chondroma, Sarcoma. Treatment—palliation or surgical.

Colin describes and figures as many as eight varieties of infusoria found habitually in the first two stomachs. All appear to be introduced with the food, in the infusions of which they also appear, and they find in the fermenting mass of ingesta in the first two stomachs a favorable medium in which to grow and multiply. It cannot be shown that they are in any way detrimental and they have even been supposed to be beneficial to digestion as glycogen has been demonstrated in their protoplasm. Like the bacterial ferments they doubtless assist in the disintegration of the mass of food.

_Amphistomum Conicum._ This is a trematode worm about the size of an apple-seed (10 millimetres long by 2 millimetres thick), rounded at both ends, slightly curved on itself, and, as usually found, of a bright red color. It attaches itself by its sucker (on thick end), usually in the vicinity of the demicanal. Its life history is closely allied to that of the distomata, but as it is not known to prove at all injurious to its host, it possesses no pathological importance.

=Actinomycosis of the Rumen and Reticulum.= Tumors of this fungus are sometimes found in the walls of the two first stomachs projecting in the form of polypi, or imbedded in the thickness of the coats. Where they are completely covered by the mucous or serous membrane their true nature is not readily recognized. When incised they show the characteristic yellow granules made up of club-shaped cells, though the usual stellate arrangement may be somewhat imperfect. From the serous surface the growth may invade the different adjacent organs. It is impossible to diagnose a primary actinomycosis of the rumen, if unaccompanied by more superficial lesions, but, if the disease is recognized elsewhere, the same general treatment with iodide of potassium will dispose of these formations as well.

IMPACTION OF THE OMASUM (THIRD STOMACH).

Definition. Synonyms. Causes, torpid action, defective insalivation,
inactive rumen, fever, inflammation, spinal paresis, dry, fibrous,
innutritious food, fungi, ergot, smut, privation of water, or of
succulent food, microbian ferments and their products, chronic heart
disease, dry farinas, extreme changes of diet, brain disease.
Symptoms: slight or violent; ill health, impaired appetite and
rumination, grunting, tympany, diarrhœa, constipation, baked coated
fæces, percussion signs, separation from herd, red eyes, stiffness,
agalactia, fœtid eructations, paralysis, drowsiness, stupor, delirium,
nervous symptoms mostly in acute cases. Course in chronic and acute
cases. Diagnosis; from pneumonia, and overloaded rumen. Lesions; solid
impacted omasum, baked contents, shedding of epithelium, congestion,
petechiæ, ulceration, empty, and congested abomasum and small
intestine. Treatment: laxative food, purgatives, stimulants,
antiseptics, enemata, stimulants of peristalsis, counter-irritants,
mucilages, laxative diet, tonics.

_Definition._ This may be defined as a form of indigestion of which the prominent feature is the drying and impaction of the ingesta between the folds of the third stomach. It may seem to be a primary disease, but in very many cases it occurs as a result of some acute febrile or inflammatory affection.

_Synonyms._ As the disease has been long popularly known it has received a variety of popular names which are more or less characteristic. Dry murrain, Clewbound, Fardelbound, Stomach staggers, Grass staggers, Vertigo, Chronic dyspepsia, and Chronic indigestion may serve to illustrate these.

_Causes._ Torpor of the manifolds and the suppression of secretion of saliva, together with the absence of a continuous access of waves of liquid floating the finely divided food from the mouth or rumen to the third stomach are prime conditions of dessication of the contents. The third stomach, like the two first, has no provision for liquid secretion, but is dependent for its supply on constant flushing from in front. If therefore feeding and rumination are interrupted as the result of a febrile disease, if the secretion of saliva is in great part suppressed, if the vermicular movements of the rumen and resulting overflow into the third stomach are checked, and if in addition the omasum itself is rendered torpid, the ingesta compressed between its folds becomes drained of its liquid, and in no great length of time, to such an extent that it may be rubbed up into a dry powder. All this is a necessary result of an acute febrile condition, and therefore all febrile and inflammatory affections tend to drying and impaction of the contents of the omasum. If therefore the observer were to go no further than this he would have a very simple pathology, for all or nearly all fevers and inflammations would be to him simply impacted omasum. In the great majority of cases this condition is to be looked on as a secondary and subsidiary affection, while the real primary disease has still to be sought for.

Some explanation of the special susceptibility of the third stomach in such constitutional troubles, is found in the source of innervation of the viscus. Colin and Ellenberger could rouse the movements of the first two stomachs but not of the third by electric stimulation of the vagus, while the third stomach was excited to action by excitation of the spinal cord and of the sympathetic twigs proceeding from this to the manifolds. Ellenberger indeed avers that the walls of this viscus are abundantly furnished with ganglionic cells which are called into action by this sympathetic stimulus. The innervation being derived from an independent source, derangement of the third stomach may be quite independent of any primary disorder of the first, and the omasum deriving its motor supply from sources so closely related to the vaso-motor ones, may give an additional explanation of the intimate connection of its disorders with febrile and inflammatory diseases.

But while acknowledging the controlling influence of torpor or paresis of the omasum, it would be an error to follow Cadeac in denying the influence of food as a cause of impaction. It has long been notorious that impaction of the omasum is preëminently a disease of winter, or of the period of dry feeding. It occurs in cattle fed on dry, fibrous, innutritious fodder, and especially when there is a scarcity of water, or when in connection with severe frost the usual water supply has been frozen up. It prevails in stock turned in spring or autumn on pastures in which the fresh green grass grows up among the dead, dried and withered stems of a previous growth and tempts them to eat them. It appears when the stock consumes corn or cornstalks affected with smut or certain other fungi, or the cereals or grasses suffering from ergot or smut, but this is especially the case when there is also a privation of water, whereas, with an abundant water supply or a partial ration of roots, potatoes or ensilage the danger is greatly reduced. Sometimes a change from soft to very hard water appears to act as a cause but whether from a special astringent action or a disinclination to consume the usual amount has not been made clear.

It must be allowed that the sheep and goat which habitually drink little, suffer far less from this affection than the ox which drinks freely, yet allowance must be made for the constitution and long settled habits of the genus, and we must not forget that it is usually under privation of water or a restricted supply that the ox suffers.

Among other causes must be named fermented food, the microbian ferments and their products, serving to render the organ torpid, but also to produce fever, lessened secretion and an arrest or retardation of liquid supplies from the mouth or rumen.

Chronic heart disease, causing blood stasis in the omasum, appears to induce torpor and favor impaction.

The ingestion of lead has a very direct action in producing paralysis and consequent impaction.

Finally, finely divided dry food like meal or bran, swallowed hastily, tends to pass in large amount directly into the omasum, and, before the animal has become accustomed to the ration, is liable to clog the viscus and induce impaction.

In nearly all cases, the commencing impaction entails a certain rise of temperature and suppression of secretions, so that the malady tends to move in a vicious circle, each new step tending to aggravate the already existing condition. In chronic cases, which are very common, a careful record of bodily temperature shows oscillations, above and to the normal, at irregular intervals, each rise tending to add to the impaction.

The most acute and fatal forms of the affection occur in connection with a sudden change from dry to rich, luscious, green food in spring, the unwonted stimulus giving rise to general irritation of the whole gastric mucosa, with disordered and impaired function of all four stomachs, but especially of the third. Such cases are usually congestive and inflammatory and the suspension of the gastric movements is a grand cause of impaction. In such cases too the brain or spinal cord, or both, are seriously involved, and the early death is preceded by torpor, paralysis, violent delirium or convulsions, following largely the type of acute lead poisoning.

_Symptoms._ These vary according to the degree of impaction or gastric torpor, from simple, irregular, or suspended rumination (loss of cud) to the most severe gastric and nervous disorder.

The slighter or less acute cases are marked by a failure to re-establish regular rumination on partial convalescence from a fever or inflammation. The hyperthermia subsides, but the appetite remains poor and capricious, the muzzle dry, the eyes dull, the spirits low, breathing quickened and occasionally accompanied by a moan, especially when moving down hill, slight tympanies of the rumen may appear and the contents of that organ seem consolidated and may be felt as solid masses when pressure is made by the hand. The mouth is hot, clammy and fœtid, and the bowels costive, the fæces being passed in small amount and in the form of hard, black pellets, covered by a film of mucus, or streaks of blood, and containing particles of undigested food. This not unfrequently merges into a transient diarrhœa to be followed in turn by renewed constipation, and such alternations may repeat themselves again and again. The omasum is so deeply seated under the ribs on the right side that exploration is unsatisfactory, especially in the milder cases, yet pressure of the closed fist upward and forward below the middle of the chest will give the impression of a specially solid resistance and the patient may indicate suffering by a moan. Percussion with the closed fist has the same effect. There may be slight tremors of the body, the horns, ears and limbs are cold, and the hair erect in patches, dry and lustreless.

In cases occurring independently of previous disease, diarrhœa may be the first symptom noted, the malady being preceded by local irritation and congestion, but this soon gives place to constipation with alternating diarrhœa and the general train of symptoms above mentioned. The animal leaves the herd and is found lying apart on its left side with the nose in the right flank, the pulse and breathing quickened, the eyes congested, and a moan emitted occasionally in expiration. This is increased if the patient is raised and driven, especially down hill. He walks with stiff, arched back, unsteady gait and dragging limbs. Appetite may not be entirely lost at first, but only impaired and irregular, and as rumination ceases, grinding of the teeth becomes common. The secretion of milk is diminished or altogether arrested, and emaciation advances day by day. Fœtor of the eructations, the result of prolonged and septic fermentation in the rumen, is often a marked symptom.

This form may last from ten to fourteen days and merge finally into paralysis of the hind limbs, drowsiness and stupor, or delirium and convulsions.