This is another infective disease, the presence of which depends upon the introduction of a certain germ (discovered in 1884) into the blood of a living animal. The germ lives freely outside the body in the soil, particularly those that are rich in animal manures, perhaps especially that of horses. Its geographical distribution is practically unlimited, although it is much more prevalent in hot than in cold climates.
Any of the animals may have it, but it is most frequently developed in them in the following order: horses and mules, sheep, cattle, and dogs.
Causes. The germ is most frequently carried into the body by wounds, penetrating through into the blood, made by objects having infected soils attached to them; or when, after a clean wound has been received, it becomes contaminated by a direct application of dirt to it, as from street dust, or a soiled handkerchief, piece of dusty bagging, old dusty cobwebs, dirty hands and finger nails, etc. It is not probable that it is conveyed through the stomach.
The germs having been received into the wound remain there and the body becomes affected through a poison developed by them at that spot; this is a remarkable variation from the usual course pursued in diseases of this class.
General Symptoms. After the wound has been made, and in a period lasting from six hours to six weeks, generally within a few days, muscular spasm begins to be shown, more particularly in the neck and head, spreading from them to the trunk and legs. The nose is at first protruded upon an outstretched stiffened neck, the eyes are drawn back into the sockets, which throws the haw up over them, the back and legs are more or less stiff, and the whole picture presented is one peculiar to the disorder, and when once seen will not be forgotten.
Because of the spasm of the head muscles the power to chew food is very much interfered with or lost entirely; if the muscles of the throat become involved, swallowing becomes more or less impossible. The back may be curved up or down, it is most generally down. and the belly becomes tucked up and the animal constipated; the legs, almost or quite incapable of bending or being bent, are stretched out both behind and forward and appear like four bracing stakes. If the muscles of the ribs become implicated, breathing is shallow and frequent. The pulse, although the artery feels hard under the finger, is not particularly disturbed in number, even though the breathing movements are as many as forty eighty to the minute. The temperature at first is but little, if any, elevated; if it does rise, the elevation does not remain above the normal for any length of time together, unless the animal is growing worse. Sweating is at times profuse.
The spasms of the muscles, though never entirely absent, occur with greater intensity, at irregular periods, and their frequency is increased by great light, any sudden or continued noise, as well as by the approach of strangers, or if he falls down, as he is not unlikely to do at any time, if his legs become very stiff. During the paroxysms all of the symptoms are considerably increased in severity, and if the repetition of them becomes frequent or they remain at long periods at a time the animal will die.
As the disease grows worse and a fatal termination is to be the result, all symptoms increase in intensity; the breathing is very rapid and may be from eighty to one hundred in the minute; the pulse hard, and from seventy to ninety in the minute, in horses; the temperature becomes elevated to one hundred and six or one hundred and seven; and much higher just before and, for a little while, just after death, so high, possibly, as one hundred and twelve. The bra*m generally remains clear almost to the end, and because of this and the great suffering, such an animal, ff not mercifully destroyed, is a pitiable object.
In Cattle the particular differences to be noticed are the frequent drawing back of the lips; the back is arched; the hurried breathing does not appear so early in the attack, gases form in the paunch so as to greatly distend the belly, in a few days, and the spasms are not so frequent or severe as in the horse.
In Sheep, the legs, beginning with the hind ones, are stiffly stretched out, the animal does not move, the tail is stiff and carried straight out. After a little time the animal falls down and lies with
the legs stiffly straightened out, with the neck drawn backward,
which increases the difficulty of breathing.
In Dogs general tetanus is rare, so much so that it was formerly supposed this animal was not affected at all by the disorder. Still, later experience has shown they do have it, at times. The affected dog will show a stiff, elevated head and neck, the ears stiff, anxious expression of the face, a puckering into folds of the skin of the forehead; the legs are stretched out and stilty, and the voice is lost because of the stiffness of the muscles of the jaw and throat.
The Mortality is very great: in horses from seventy-five to eighty-five per cent; in cattle from seventy to eighty; in sheep about one hundred, or nearly all of them; in dogs it is much smaller. The periods at which the fatal termination is reached are variable. A quickly developed case never recovers. Horses live about a week, although the period may be anywhere from one day to two or three weeks. Recovery in about three weeks.
In Cattle the course is not so rapid and the disease runs its course in about three weeks. A fatal end may come anywhere from two days onward, after full establishment of the symptoms. Recovery is. from two to three weeks.
In Sheep death usually takes place in about one week, although it may happen in two or three days.
In Dogs the rapidity of the course will be about as in sheep; the end is not so universally fatal. Recovery may take place in from twelve to fourteen days.
Treatment. The wound should at once and for all be cleansed as thoroughly as possible under the given circumstances, by removing all foreign substances that can be found; syringing out thoroughly and repeatedly with a solution of one part of corrosive sublimate to one thousand parts of water; and cutting away or burning out the tissues that may have become contaminated, as far as possible, with a sharp knife, a red hot iron, or, perhaps better than either, a few drops of pure carbolic acid, or, in dogs, pure nitrate of silver instead of the acid. This cannot be done always, either because of the stiffness of the animal or that the attempt to do so will cause strong and persistent spasms, in which cases this part of the treatment must not be undertaken. The animal should then be placed where the light is dim, the air good, as far removed from noise as possible, and seen only by his nurse, who should always be the same individual, an acquaintance if possible. For it is through careful, quiet nursing only, that recovery may be hoped for. Horses had better be put into slings at once so that they may be saved from falling if the legs become stiff.
The food should be very nourishing and made quite soft by the addition of boiling water, and allowed to get cold before being offered to the animal. Ground oats, cornmeal, the last bulked with a little wheat bran, if necessary; no hay or anything that must be chewed much before it can be swallowed, excepting a very little freshly cut grass, if it can be obtained. All food not eaten should be removed before it gets soured. For dogs, strong beef broth, milk, and raw eggs. The food should be given often, each two or three hours, and in small quantities at a time. Fresh water in large quantities should always be kept within easy reach of the animal. No attempt to relieve constipation should be undertaken unless considerable annoyance is caused by its presence. Manure may be removed from the larger animals with the hand and arm; injections of strong, warm, soapy water may be given the smaller ones, but either operation is apt to excite them considerably.
Medication, if used to any considerable extent, will do more harm than good, because its administration adds so much to the general excitement. The writer has had very good success with cases in which he has used the sulphate of atropia, a product of the belladonna plant. Three grains of this agent, for a good sized adult horse, is folded in a piece of very thin tissue paper one inch square and slowly and carefully pushed into the mouth through the space between the front and back teeth, and allowed to remain there. It may be given two or possibly three times a day, at equal intervals. The dose of this very poisonous drug must be varied for the different animals and for young ones. (See dose table at end.) Further medication is not recommended.
In a stall or box in which a case of this disorder has been kept, and after the animal has been removed from it, the floor and walls should be thoroughly cleaned from all dust and manure, by dry scraping and brushing,
There is a serum (antitoxin) the use of which will prevent the development of lockjaw in instances wherein the germs have gained access in the usual way. But in order that it may be surely effective it must be administered before any symptoms of the malady are shown; it probably possesses no curative powers when the disease has developed.
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