"That nothing may be omitted which in any shape can contribute to the success of inoculation, due attention should be paid to the constitution and state of the beast, no less in this practice on the cattle than on the human species. Undoubtedly the young, healthy, and strong bid fairer for a good issue than the old, sickly, and feeble; each of these different constitutions demand a particular treatment, even in the method of preparation; and however trifling it may seem to many—the urging a necessity of preparation—I will venture to affirm that I have seen excellent effects arising from a rational preparation, and fatal events from want of preparation. I have likewise been witness of unfavourable turns, merely from an injudicious preparation.
"The beasts which are sanguine require moderate bleeding; those that have but a small share of blood must have none drawn. The strong must, besides moderate bleeding and purging, be kept on light diet and their body kept open. Thus, scalded bran, mixed with their hay and chaff; will cool them. The weakly, and such as are inclined to scour, must be kept on dry fodder, and have peas and beans given them to strengthen them. A mess of malt, or a quart of warm ale, with a few spices, will be very suitable for them.
"Whatever diseases the cattle be affected with, if time will permit, they are first to be removed.
"The cattle to be inoculated are first to be well washed, rubbed dry, and then curried, to remove all the filth from the hair and skin. Then they are to be placed in a spacious barn or stable, where the air is temperate and no cold can come to them. There they are to be prepared according to the direction already given, foddered with good sweet hay, and watered with clear spring water; and if the distemper be not near they may be turned out into the air, near the barn or stable, and may stay there a few hours in the middle of the day.
"When it appears that the cattle are in perfect health, free from any infection or other disease, brisk and lively, neither costive nor scouring, and chewing their cud, then the operation may be safely undertaken, and henceforth they must be confined to the barn.
"Since there is observed to follow the greatest flow of the contagious and putrid particles separated from the blood, wherever the infectious matter makes an impression at first, particular care must be taken not to inoculate near such vital parts as the heart and lungs, nor near the womb, if a cow with calf be inoculated; for, though rowels are properly applied in the dewlaps, to draw off the pestilential humour from the breast, and in other cases beasts are frequently rowelled in the flanks,—yet in this operation, as matter is inserted by these channels into the neighbouring vessels, those vital parts, or the womb, might become the chief seat of the disease, and the event prove fatal.
"To prevent such accidents, human beings have been inoculated on the arms and legs, and now-a-days the arms are found sufficient. I would recommend that the cattle should be inoculated about the middle of the shoulders or buttocks, on both sides, to have the benefit of two drains. The skin is to be cut lengthways two inches, deep enough for the blood to start, but not to bleed much. In this incision is to be put a dossil or pledget of tow, dipped in the matter of a boil full ripe, opened in the back of a young calf recovering from the distemper. It may not be amiss to stitch up the wound, to keep the tow in, and let it remain forty-eight hours. Then the stitches are to be cut, the tow taken out, and the wound dressed with yellow basilicon ointment, or one made with turpentine and yolk of egg, spread on pledgets of tow. These dressings are to be continued during the whole illness, and till after the recovery of the beast, to promote the discharge; and then the wound may be healed with the cerate of lapis calaminaris, or any other.
"On the third day after inoculation, the discolouring of the wound, whose lips appear grey and swollen, will be a sign that the inoculation has succeeded; but the beasts, as Professor Swenke informs us, did not fall ill till the sixth day, which answers exactly to the observations daily made in the inoculating of children. Yet the Professor adds that on the third day a costiveness came on, which was removed by giving each calf three ounces of Epsom salts.
"No sooner do the symptoms of heaviness and stupidity appear than the beasts must have a light covering thrown over them, and at night fastened loosely. They must be rubbed morning and evening, and curried, till the boils begin to rise; warm hay-water and vinegar-whey must be given plentifully. Should the beasts require more nourishment, dry meat, such as hay, with a little bran, may be offered. I should be very cautious in giving milk-pottage, even after the boils and pimples had all come out, for fear of bringing on a scouring. However, this caution is proper, that whenever milk-pottage be given the vinegar-whey is to be omitted for obvious reasons. In cases of accident, the same attention is to be observed in the disease by inoculation as in the natural way, and the medicines recommended are the same I would use; but by inoculation there seldom is a call for any, so favourably does the distemper proceed through its several stages.
"The crisis being over, it will be proper to purge the cattle, to air them by degrees, and to have the same regard in the management of them as is laid down in the chapter on the method of cure."
The typhic virus is so highly infectious and poisonous that the first animals inoculated would have all died; it would have been necessary to inoculate successively a number of animals with the virus derived from the first inoculation, and transmitted from an inoculated animal to a healthy one, by which means they would have acquired a virus of the first, second, third generation, and so on. These inoculations having always been made on four animals at a time; on two of them, the disease would have been left to take its own course, in order that the experimentalists might watch its progress and development, and the two others would have supplied the virus for inoculation.
At the third or fourth generation, the virus, modified and attenuated in its infectious principles, would no longer have been mortal in its effects, as experience has proved in Russia. Then the inoculated animals, placed under the control of hygienic cares and a few purgative and tonic medications, would have passed from convalescence to health. The virus thus attenuated would have supplied the means of a practical inoculation on a large scale to all healthy animals.
Proceeding thus, they would, moreover, but have followed the method adopted in those times of epidemic and epizootia when the small-pox is raging. On those occasions, we subject our sick patients to vaccination or revaccination; we inoculate the variola in our sheep threatened with the contagion; we pursue the same course in cases of epizootia, of peripneumonia. And truly, that which it is reasonable to do in one case may be generalized and applied to a greater number.
The experiment we have suggested might, perhaps, have been long and difficult, nay, even costly, but we should have established, after a certain time, the rational method of this preventive treatment, and have distributed the same throughout the country. Veterinarians would have formed in particular districts their centre of operation, in which the preventive virus might have been produced, and they might have gone from farm-house to farm-house to inoculate all the cattle within them.
From these facts and observations made by the physicians, precious documents would have been derived; and if, contrary to all expectation, success had not justified every hope, we should have bequeathed to future generations facts and experiences which would have been of the most useful character to them and full of instruction. Thus it is that science advances and progress is accomplished.
If all that we have just indicated as a realizable matter had been done, in effect, England would have afforded in this, as she has so often done in other cases, a noble example to be followed, and would have acquired a new title to the admiration of other nations.
But, unfortunately it has not been so: silence has succeeded to eloquence at Guildhall, and the meetings at the Mansion-house have flickered away. That which was held on the 27th of September, seems likely to be the last of them.[U]
The subscriptions which, in spite of all the praiseworthy efforts and earnestness of the Lord Mayor, did not reach 2000l., were returned to the subscribers, so that all the attempts which have been made to centralize the direction to be given to the various measures have proved abortive. The plan of forming sanitariums, as well as that of compensating the owners of cattle, have both fallen to the ground.
What can we think of such a state of things when we see the ox-typhus extending its ravages to sheep, and have to fear that the disease will spread to other animal species? What serious reflections it creates in our minds, and what awful consequences we might deduce therefrom! But what would be the use of them?
Let us add, however, that France, save on the recognised principle of indemnification, and a more speedy extermination of her tainted cattle, has shown the same deficiency as to the means of treatment as England; whilst we have the consolation of attributing this impotence on the part of this country to the fact that the outbreak of the epizootia has occurred during the Parliamentary recess.
It is, therefore, to institutions rather than to individuals that we must ascribe the impossibility of conquering the difficulties which have been met, and which at any other time might not have obstructed the course of things. Far be it from us therefore to accuse of indifference a great people renowned for their zealous promotion of public interests, for their charity and inexhaustible philanthropy, whose innumerable asylums have been opened to every misfortune, who support so many hospitals and public charities by their voluntary contributions, and who, in so many calamities, have seen some devoted heroine issue from her retirement to assuage them. For if the Crimean war produced its lady beneficent in the person of Florence Nightingale, all of us must allow that if others had followed the example of Miss Burdett Coutts, who, in a manner, has stood alone against the storm, by the facilities she has afforded for treating and experimentalizing on the cattle smitten with typhus, the formidable scourge might have been arrested in its focus.
III.
Curative Medication.
We might acquire the means of resisting the general causes which develop the typhus; we might stop its diffusion, we might even prevent it, by inoculating the sound and healthy animals, and yet it would be necessary, none the less, to search for the means of curing it; for, as in the small-pox, the preventive treatment of which we know, certain circumstances would arise in the disease which would oblige us to treat it. And as we are far from being able to resist the generation and dissemination of this scourge, which reckons almost as many victims as sufferers, it is important to make known what treatment we can oppose to the functional derangements to which it gives rise.
As we have already said, this typhus, when the organism has absorbed its peccant and infectious miasma, produces a succession of disorders which become in a manner temporary functions; it pursues its phases, its periods; and as the functional derangements differ at these several epochs from the development of the morbid phenomena, the course of medicine which is employed to check them cannot always be the same. Starting, therefore, from practical data, we will attend the disease in its gradual advance—that is to say, in its distinct periods—and will afterwards explain certain predominant symptoms, which, owing to their importance, must likewise fix the attention of the careful therapeutist.
It will be remembered that we have recognised four periods in the regular course of typhus:—
1st, a period of incubation;
2nd, a period of initiation;
3rd, a period of duration;
4th, a period of decline.
But, in the first place, before beginning the treatment, every farmer or grazier, or cattle-owner, who keeps a certain number of cattle, should divide his herd into several classes, in order to regulate and methodize the cares to be given to the sick.
Thus, he will form a first class, comprising the animals in a sound and healthy state, having had no intercourse, either direct or indirect, with the tainted cattle, and which he will be careful immediately to isolate and keep apart.
A second class must be formed of those beasts, which, though as yet unaffected with the distemper, have, nevertheless, been exposed more or less directly to its contagion, by living and consorting with them, or by their contact with other animals, either at fairs or markets, or in the ships and cattle-trucks on the railway during their transit from one place to another. The horned cattle composing this latter class must be carefully watched, and be made the subject of the preventive treatment, the moment the first sign appears of the working of the incubation.
A third class must be formed, consisting of cattle actually smitten with the distemper.
These divisions of animals being thus settled and separated, will diminish the labour and the cost of treatment and the liability to diffuse the complaint, especially when the epizootia begins to lose its virulence.
We have said that infectious diseases, when once the frame had suffered the effects of the poisonous miasma, pursued their fatal course, and that, generally speaking, it was impossible after such infection to arrest its development. We say generally, for the typhus at the outbreak of its appearance on a virgin soil sometimes manifests itself in a benignant manner, then it becomes more destructive, by-and-bye its pernicious properties decline, and it in some sort goes out of itself. One would say that the epizootia, like those it smites, has likewise its peculiarities, its period of initiation, of duration, and of decline. There are in consequence fixed times or epochs during which the sufferers afford better scope for our means of action; at a given moment the attenuated virus, having lost much of its deadly effects, ceases to produce death, which decline is the real source of the marvellous successes obtained by certain remedies against the epizootia.
If it be true that the distemper at its period of duration, and at its most critical moment, cannot be fettered, we should not be justified in asserting positively the same, as respects the period of incubation. Indeed, we are convinced ourselves, that if ever this disease shall be clogged in the wheel, if ever its specific remedy shall be discovered, it will be within the period of incubation, when the economy begins to struggle with the first phenomena of the poisoning. Be that as it may, we cannot, in epizootic times, too earnestly enjoin the owners of cattle to submit their animals to a strict and close inspection, in order that, when the first signs of incubation appear, they may modify the animal's usual diet, and attack the disease at its birth, so as to render it abortive, if the thing can be done.
At this period we must endeavour to come to Nature's assistance, we must shake and stir up the economy, we must unseat the morbid functions which seek to master us, and then the vital force, thus solicited and stimulated, may sometimes struggle with advantage. To do this effectually, if the animal is atonic and predisposed to adynamia, if his internal organs are relaxed, we will strengthen him by administering every day a stimulating beverage. If he is confined to the stall we will give him the open air, and let him graze the fields; which is a treatment by itself for the invalid animal, so vivifying is the pure air of the common, and so thoroughly different from the atmosphere which is pent up within his stall. If the animal is strong, lusty, exuberant with health, let him be purged once or twice, the purgative to be given at intervals of twenty-four hours. (We shall give the medical formula in the chapter addressed to farmers, graziers, &c.)
This purgation, moreover, will correspond with the theory of those authors who consider the evacuations as the proper means of delivering the economy from the infectious miasms which have been absorbed.
If the beast is plethoric, recourse should sometimes be had to bleeding, especially in hot and dry seasons, like the one we have recently passed through.
These stimulative and depletive medications cannot but be favourable to the animal, since it will anticipate the treatment to which he must be submitted a few days later, when the disease shall have declared itself.
To this treatment, in some sort preventive, must be annexed an antimiasmatic beverage, either a permanganate of potash, or a solution of chlorate of potash, or of arsenic acid in powder, mixed with some aromatized beverage, or solution of arseniate of soda. These anti-typhic drinks must be discontinued on those days when the sick cattle are purged.
It need hardly be said, that during this period of incubation the feeding of the cattle must be strictly attended to, and that the animal must receive unusual hygienic care.
Second Period, or that of Initiation.
At this period the constitution and temperament of the sick cattle must first of all be deliberately studied, so as to ascertain fully which are lymphatic, which are nervous, and which are sanguine. We must notice the age, the sex, the state of gestation, and make allowance for any prior complaints to which any of the sick cattle may have been subject. For if, like certain system-mongers, we reduced the treatment of all tainted cattle to the same mathematical formula of medication, that is, either to bleeding or to purging exclusively, we should certainly increase the number of victims.
In this stage of the disease we have to contend with the derangements of the circulation and secretions. The fever is generally intense, the blood is inflamed or vitiated, the mucous membranes are dried up; shiverings, alternations of cold and heat, &c., occur. We must then mitigate these morbid phenomena either by bleeding or purging. The bleeding must be more or less copious, according to the strength of the animal. For, it must not be forgotten that we have several critical phases to pass through, and if we exhaust the animal by too largely draining him of blood, we may forfeit the success of the treatment. If bleeding is considered unnecessary, let the sufferer be purged at once, by administering either sulphate of magnesia (Epsom salts), or sulphate of soda (Glauber's salt). These purges to be taken daily, for two or three days, according to the way they operate. Linseed oil, mixed in some warm beverage, may be given instead of these, or else a mixture of rhubarb and calomel, or even a decoction of senna. Preference should be given to saline or laxative purges, as, drastic purgatives, such as aloes or jalap, sometimes concentrate the inflammation on the narrow parts of the digestive channels.
In this second stage—the period of initiation—the appetite is generally gone, the thirst excessive; so that nutritive or solid feeding must of course be suppressed.
As for the drinks, they must be cold, consisting of water with sufficient flour mixed in it to whiten it, and a little vinegar or sulphuric acid, to acidulate it. A decoction of good hay with some marine salt, or nitrate of potash; a decoction of pellitory or wall-wort, of ground-ivy, or whey, or buttermilk, likewise acidulated, and which the cattle are very partial to, will in every way be suitable for their use. If the heat of the skin diminishes, and if congestion appears to settle on the lungs, the drinks must be given warm, consisting of a decoction of borage leaves, mallows, marsh-mallow, and pellitory. In these cases, the body must be protected from chills by overlaying it with blankets, so as to keep the mass of the blood as much as possible on the surface, and check the tendency it has to load the internal organs.
By following these prescriptions, we shall answer all the conditions of the treatment during the second period. In truth, by the process of bleeding, we shall have reduced the heat of the fever, and prevented too great a flow towards the nervous, pulmonary, or digestive centres. The purgings will have acted with similar effects; and, what is more, they will have cleared the primæ viæ, and rendered the circulation of the abdominal apparatus more easy. In fine, the drinks will have contributed to assuage the violence of the fever. The washing, which must be effected with a wet sponge passed over the nose, mouth, and eyes, and then over the skin, which must afterwards be rubbed dry, will be both useful and pleasant to the sick animal. This cleansing will maintain the important functions of the skin in due order.
Some persons have advocated as most efficacious at this period hydro-therapia, or the Water-cure, in the form of warm and cold ablutions, vapour baths, &c. This treatment, so bracing by its revulsive action, and the powerful influence of which we witnessed for several years in the establishment which we superintended at Belle Vue, near Paris, might prove of some service in ox-typhus, especially in the form of the vapour bath; but it requires so much practice, and so incessant and watchful a care, that it is needful to have the process attended by an experienced practitioner.
We must remark, in addition, that the general state of the animal, and his desire for food, will show the degree of strictness and restraint which must be observed in regulating his diet. His instinct must be taken by us as a guide; and if the drinks rendered nutritive by the addition of bran, oatmeal, barley flour, or even seed of grass pounded, are relished by him, we must indulge his desires to some extent, in order to keep up his strength.
Third Period, or that of Duration.
At this stage of the distemper we must watch and follow step by step the symptoms which attend it, and come to their relief.
All the secretions have now resumed their course; from the mucous membranes there occurs a copious discharge, first of all serous, then thick and muco-purulent; the breathing may be obstructed, the diarrhœa frequent; the air infiltrates beneath the integument. The fever is sometimes continuous, sometimes intermittent. We must satisfy the cravings of the vital powers by administering the same beverages as in the preceding period. Far from checking the diarrhœa, as some advise, we must regulate the evacuations by means of laxatives, such as tartrate of potash, sulphate of magnesia, or sulphate of soda. It is very essential, indeed, that the mucous membranes of the digestive channels should be free, and not irritated by the contact of solid alimentary substances or bilious secretions.
If the diarrhœa be too frequent or irritating, we must give the sufferer night and morning a clyster, consisting of bran water.
At this period we will follow the advice given over and over again by all the physicians of the last century, and apply cauteries with red-hot iron, or fix one or two setons either on the dewlap, the neck, or the thighs, and these issues must be kept open by means of basilicon ointment. It is unquestionably of the highest importance to promote all the depurative secretions in animals whose cellular tissue is choked up with grease and lymph. Those only have got well in which the running has been regular and copious, and the wasting of the flesh progressive.
If the fever is not regular, two pills of sulphate of quinine must be given, each pill containing one gramme, one pill in the morning, the other during the day, in order to prevent the fit, which usually takes place in the evening. If the state of atony, of adynamia, comes on at this period, acetate of ammonia must be given, from one to six ounces, in a pint of water, the same to be administered in two doses; only the acidulous or alkaline drinks must be discontinued, otherwise the acetate of ammonia would be decomposed in its passage into the digestive channels. Finally, the eyes, the nostrils, and the mouth must be frequently washed with an infusion of camomile, or some other aromatic plant.
The setons must be kept up very carefully. If the sick animal relishes the nutritive beverages, let him have a decoction of bread, rice, barley, or oats.
Fourth Period, or that of Decline.
At this stage of the disease, in which adynamia predominates, everything must tend to support the organism. The drinks must be bitter and stimulating; beer, with plenty of hops in it, with an addition of powdered Peruvian bark or sulphate of iron, may be given; or a decoction of this bark, with gentian roots, centaury leaves, and hops; or again, a beverage may be administered night and morning, made of veterinary theriacum, of extract of juniper and alcohol; or finally, an infusion of aromatic plants.
If the diarrhœa be bloody and fetid, give the animal night and morning a clyster, consisting of a decoction of Jesuit's bark, adding thereto a spoonful of powdered wood charcoal, pounded to the finest powder, and passed carefully through a sieve. If the running ceases, its return must be excited by injecting in the nostrils a spoonful of sternutatory vinegar or smelling salts. Finally, the purulent boils must be opened, and dressed with stimulating ointment.
At this closing period, which determines the fate of the disease, as we say, there is a tendency to despair of the cure. Seeing the fatal course of most attacks, we lose heart, death seems inevitable, and we yield its prey to its fangs. But let us not despair; let us remember that, in these febrile infectious diseases, above all, the phenomena must almost always proceed to the last stage of exhaustion of the vital powers to render the cure attainable. Some patients, smitten with typhoid fever or cholera, have owed their lives to the indefatigable tenacity of the contest in extremis between life and death.
I still see before me a choleraic patient, whom, during the epidemic of 1849, I had left in the morning at ten o'clock, passing into the cold period. At five o'clock I returned to see him; the whole family was in tears, and the sheet had been thrown over the patient's head, as if he had already breathed his last. Time was precious to me at that fell season, and I was about to retire, when I applied my finger to the wrist of the sufferer, and felt a faint pulsation at long intervals. I threw my coat off directly, called for flannel and essential oil of mustard, which I had prescribed that morning. I set the example, and instantly the whole family helped me to rub the patient in every direction. In a quarter of an hour the heart quickened and revived, and in less than half an hour more the circulation resumed its course; at the end of an hour of this obstinate struggle the vital heat began to show itself—in a word, the patient was saved.
We must not, therefore, give up the contest until the death of the sufferer is fully ascertained; and the same persistency should be practised in the case of animals smitten with the typhus. If the circulation slackens, if the skin turns cold, take a piece of wool, coat it with rubefacient liniment, and rub the animal therewith, more particularly along the spine. Then give him a cordial drink, and pass raies de feu over the loins. All these appliances will help to stimulate the nervous system, and resuscitate the exhausted powers of life.
If, at last, we are so fortunate as to overcome the profound adynamia which has utterly prostrated the frame, we next shall have to sustain the sick animal by giving him decoctions of meat with sea-salt, or sulphate of iron added to it, or a light broth, made with meat and bread.
Herbivorous animals, put upon a carnivorous diet, would not generally endure it, of course; but some of them rather incline to unctuous beverages, and even to cooked or raw meat. All men know that certain horse trainers give race-horses a small portion of meat, especially when the races are coming on, in order to increase their mettle and strength.
We remember a sheep, which we saw at the Ecole d'Alfort, during our studies of comparative pathology and the cutaneous diseases of domestic animals, which manifested a great liking for meat, and even ate it ravenously like a glutton.
In convalescence, the animal must be sent into the open air, in some fold enclosed with bars; he must be taken every day to pasture, each day increasing the time he is allowed to feed, and gradually he will be left to return to his usual regimen. But still it must be observed, that in this distemper convalescence is long and slow, and very deceitful. A too substantial course of feeding often revives the inflammation of the intestines by irritating ulcerations not yet healed, and more than one animal which had been looked upon as cured has perished in its convalescence through a lack of watchful attention.
Herbivorous beasts, therefore, incline to and digest animal food; consequently, we must give sick oxen meat broths, pure milk, or milk and water. With these must be mixed wheat straw chopped small, for hay or even oat straw would swell and distend the stomachs.
The typhus in this epizootia is not regular in its progress and development. Frequently the nervous or pulmonary phenomena predominate, when the treatment, such as we have just explained, must be modified. We must also bear in mind that nature does not divide a disease into periods, like those we have adopted to render our exposition of the symptoms more intelligible and the treatment itself more methodical.
If the nervous form of the disease prevails—if the animal shows alternations of dulness and restlessness—if, pressure on the spine is very painful—above all, if, in bulls, for instance, there is plethora, let the bleedings and purgings be increased in order to abate the nervous erethismus. In this form, the violence of the attack usually carries off the beast. Should there, however, be any chance of saving him it will be by employing this medication, which is at once revulsive and depletive, notwithstanding the well-known fact that bleedings, far from relieving the nervous system, sometimes aggravate its irritability.
A general ablution with cold water may be tried in desperate cases. The animal must then be immediately well rubbed, and covered with wool, in order to excite a thorough reaction.
In the pulmonary form of the typhus, but only during the acute stage, the drinks must be warm and emollient, composed of a decoction of soothing substances, with mallows, &c.; or one of linseed, to which must be added some oxymel of squills and opium. The purgatives must be non-stimulating; and emetics, freely diluted, for instance, will be very serviceable.
At the third and fourth period in this pulmonary form of the disease, adopt the treatment prescribed for intestinal typhus.
We might have greatly enlarged the list of the pharmaceutic agents, but the richer a treatment is in remedies the poorer it is in cures. We have made choice of the simplest and safest among all the remedies advised by experienced men, making allowance for the difficulties inherent to the number of animals, the mode of application, the cost, &c., always keeping in view the life of the animal to be saved and the interest of the cattle owners.
We think that the treatment by inoculation might have prevented the typhus in a very large proportion, and that the curative medication might have saved many of the infected cattle at the worst period of the epizootia.
Such, then, are the results which will one day be obtained, when we shall be able to supersede the barbarous process of general extermination, by the adoption of a rational treatment, founded at once on science and practical experience.
Hygienic Measures to be taken against the Extension of the Contagion—Acts and Orders concerning Sanitary Police Regulations.
I have purposely neglected, in discussing the various plans of treatment, certain measures to be adopted with the object of opposing the spread of the contagion. The memorandum published on this subject by the Privy Council, and drawn up by Dr. Thudichum, is so complete and so clear, that we can find nothing better to say. I recommend its perusal to all who possess horned cattle, and who have occasion to send them to any distance. It is of the highest importance to follow this judicious advice, as the general interest will constitute here the safeguard of the pecuniary interests of each in particular. I add to this memorandum upon hygienic measures, the consolidated and amended acts and orders published under the head of "Sanitary Police." In this way those interested will have beneath their eyes all which it is important for them to know, both in a medical and legal point of view.
Memorandum on the Principles and Practice of Disinfection, as applicable to the present Epidemic of Cattle Disease. By J. L. W. Thudichum, M.D.
I.—Principles of Disinfection.
1. The term disinfection signifies the removal and destruction, or destruction and subsequent removal of the products of destruction, of all matters actually being or containing products of disease capable of reproducing disease in other animals.
2. If the same processes and means, as used for this purpose, are applied to the purification and deodorization of places and things not actually infected, but capable or suspected of being infected, then these preventive measures are practically and properly included under the definition of disinfection.
3. The reproducers of the infectious matter or contagion are all kinds of cattle of the ox tribe, which also are at present in this country the only animals liable to its specific effects. It is probable that the contagion adheres with particular pertinacity to all secretions and discharges from sick animals. For this reason, fæces or droppings, urine, ruminated food, all secretions from the mouth, nose, and eyes, and any sore parts of the surface of the diseased animals must be considered as the principal and primary carriers of the infectious matter or plague poison. It is also probable that many parts of animals which have died from the cattle plague, or have been killed during advanced stages of the disease, are infectious, some because they are primarily imbued with the contagion, others because they have been in contact with it after the death of the animal. Skins, hides, hair, horns, and hoofs, must therefore always be treated with precaution. The chances of infection by flesh, fat, cleaned guts, and blood, are perhaps more remote, but cannot be lost sight of.
4. The cattle plague, although affecting every part of the animal, shows its visible effects most extensively in the intestinal canal. It is believed, and apparently upon good grounds, that the intestinal discharges are the principal agents, upon the distribution of which mainly depends the spread of the disorder.
5. It follows from the above, that all articles which have been in contact with a diseased animal, or any of its discharges, particularly its fæces, are capable of carrying the infection for an indefinite time, and must be looked upon as being actually infectious to other healthy animals. Such are racks of wood or iron; cribs or mangers of wood, iron, or stone; articles used for fastening animals; leather collars and straps, ropes and chains; all harness of any animals used for drawing, and all carts, waggons, and carriages which they have actually been drawing; the stalls or sheds in which animals have been standing; the whole lengths of the gutters and drains through which their urine has been flowing; the entire surface over which their manure has been drawn, and all implements with which the removal has been effected; the entire dung-heap upon which infected manure has been put, and the fluid contents of the manure pit, or of the special receptacle for the urine; yards or sheds in which cattle have been kept to tread down long straw, and the whole of such straw and manure, as also the ground beneath them; paths and roads upon which diseased cattle have walked or been carried; fields and meadows upon which they have been grazing; all carts, carriages, trucks and railway trucks in which diseased cattle have been conveyed, and all the platforms, railings, bridges, and boards upon which they have been moved thereto; as also all apparatus which has been used to pen, tie, lift, haul, lower, and fix them; the clothes, and particularly shoes and boots, and iron-pointed sticks of drivers and their dogs; the apparel of all cattle-herds or attendants, particularly their shoes and boots; the shoes and boots of all persons visiting places where diseased cattle are or have been standing; and, in general, the clothes of all persons visiting infected places, ships, and all parts of the platforms, stages, stairs and bridges, hoists and cranes used for embarking and landing the animals; markets, and all sheds, and pens, and implements used in contact with cattle; slaughter-houses, and all persons and implements in them which have been employed upon sick cattle, as also sundry parts or organs which come from sick animals killed in slaughter-houses; knackers' yards, trucks or carts, horses, men, and implements which have been employed in the disposal of sick or dead animals; wells and ponds from which diseased cattle have been drinking, or into which any portion of their excreta has had any opportunity of flowing, directly or indirectly; all fodder, grass, hay, straw, clover, &c., and particularly remnants of fodder upon which diseased cattle have been feeding; and, in general, all persons, animals, places, buildings, and movable things which have been in contact with matters proceeding from diseased cattle, or with such diseased cattle themselves. To the above-mentioned places and things any of the processes and agents enumerated and described in the following may have to be applied.
II.—Practice of Disinfection.
A. Disinfection by Earth. 1. Burying.—All matters that can be buried, so as to remain covered with a thick layer of ground or earth are innocuous. The ground chosen for such interment should be dry. The quickest, and cheapest, and most certain way of disinfecting an animal dead from the plague is to bury it entire.
2. The droppings, and all straw and other matters contaminated therewith, may also be buried into ground where they are not likely to be disturbed for a long time. The places from which such droppings have been removed to be cleaned and disinfected as will be described below.
3. Manure heaps and the down-trodden manure of cattle yards, if they have become infected by even a small quantity of the droppings of a diseased animal, should be carefully shifted to a suitable piece of ground, and there be transformed into compost heaps. A layer of manure one or two feet in thickness should be covered all over with six inches of dry earth, ashes, and mineral rubbish; upon this another layer of manure may be placed, and then again a layer of earth, and so forth, until the whole of the manure is stacked; it should be covered all over with a continuous layer of earth of from six inches to one foot in thickness. If the manure heap or yard manure cannot be shifted, it may be covered on the spot with a layer of dry earth, after which all animals are to be kept away from it.
4. If the floor of any shed or stable in which diseased cattle has been standing is not constructed with special water-tight and impenetrable material, it must be assumed to be infected to the depth of at least six inches. This ground should therefore be removed, together with any stones, pavements, or wood work which may have been in contact with it, carted to a piece of dry land and buried. Half-rotten wood is a particularly favourable carrier of infection. Mortar, bricks, loam, or any other lining of the sides of a pen in which a diseased animal has been standing, should be broken out and buried.
B. Disinfection by Fire. 1. Burning.—All infected articles of a minor value, or made of incombustible materials, can be disinfected by exposing them to a heat which will char organic matter. To this class of articles may be reckoned racks of wood or iron; cribs or mangers of wood, iron or stone; leather collars and straps, ropes and chains; dry manure, residues of fodder from which diseased cattle have eaten; and all such small articles of little value which can easily be replaced by new ones. Chains may be exposed to a dull red heat; all other articles may be heated over a fire of coal, brushwood, or straw until well scorched. All new articles of ironware should be bought in a galvanised state, to prevent the formation of rust, the accumulations of which form convenient seats for infectious matter, and for the same purpose it is desirable that iron articles which have been disinfected by heat as above should afterwards be either galvanised, or, at least, while hot be treated with resin, to cover them with a durable varnish, or should be varnished or painted.
C. Disinfection by Chloride of Lime.—Chloride of lime, or bleaching powder, is the most powerful, the cheapest and most easily managed of all artificial disinfectants. It can be had everywhere, and at any time, and in quantities sufficient for every purpose. It should as much as possible he applied in solution, of a strength varying somewhat with the particular purpose for which it is to be employed; and after it has been allowed to act upon the surface or matter to be disinfected a reasonable time, should be washed off, together with all products of decomposition. As chloride of lime does not destroy only the infectious matter in a mixture, but destroys all organic matter without distinction, it is not applicable to large quantities of matter, such as the manure of cattle, dung-heaps, &c., inasmuch as twice or three times the weight of these matters of chloride of lime would be required for their effectual destruction and disinfection. It is further inapplicable to all matters rich in ammonia, particularly putrid urine, as it destroys the ammonia and evolves a large amount of gases, some of which have a repugnant odour, and are perhaps not quite innocuous. But for the disinfection of surfaces of things and places no better or more suitable agent than chloride of lime is at present known to science.
D. Special Directions for the Disinfection of Stables, Sheds, Vans, Railway Trucks, and Cattle Ships,[V] and of Persons and Things connected with them.—1. After such a place has been cleaned by mechanical means, scraping, &c., as much as possible, and all manure and
dirt has been carefully buried, the entire surface which has been contaminated, or is likely to have been contaminated, should be covered with a layer of chloride of lime in powder. The powder should be worked about with a broom until equally distributed. It is intended to disinfect the water to be used in the washing process which is now to commence. Clean water, from a hose in which it flows under pressure, or from a force-pump, garden-engine, or from large watering-pots or water-cans, or poured freely from buckets, should now be applied to the entire surface by one person, while another at the same time scrubs the entire surface; and particularly all crevices, joints, and irregularities. The washing water and chloride of lime are then to be worked down the gutters, into the sinks, cesses, or natural watercourses. No washing water from any infected place or thing should ever be allowed to flow into any cesspool, urine-hold, dung-heap, pond, sewer, or natural watercourse, without having previously been mixed and stirred with a liberal amount of chloride of lime. When the place has thus been scrubbed until the water flows off clean, it is ready for effectual disinfection.
2. For this purpose a solution of chloride of lime in water, in the proportion of one pound of the powder to one gallon of water, is made. For the lair of one animal from six to ten gallons of such fluid should be prepared. This fluid is now distributed over the whole surface to be disinfected, gradually, by squirting from a syringe, or by pumping through a force-pump, garden-engine, or by watering from a watering-pot or can with a finely pierced rose. All woodwork, stones, bricks, cement, mortar, all fixtures of whatever material, should be well wetted with the solution, and immediately be scrubbed with a hard brush. Floor and ceiling are also scrubbed, and the whole is left in this wet state covered with the chloride of lime solution for at least one hour, during which time care is taken that no parts become dry.
3. As the chloride of lime and the products of its decomposing action upon infectious matters may be hurtful to cattle, these matters have to be carefully washed off by a second and final flushing. For this too much water and too much scrubbing cannot be employed. Care should be taken to apply the clean water always to the highest parts, so as to cause it to flow thence to the lower parts, and to wash away the waste from the lower parts before applying any fresh water to the upper parts.
4. Care should also be taken to rinse and flush every broom which has worked away sediment and waste from the lower parts into and through the gutters and drains before applying it again to the clean upper parts. Care should also be taken that the working persons should not step from the dirty or partially cleansed places on to the clean ones, as this may suffice to bring infection back to the disinfected place.
5. Lastly, all persons employed in this work, having swept and flushed the gutters with the same care as the lairs, are collected, together with all engines and tools which they have used, as near as possible to the sink or place of final egress of water from the premises, and there disinfected as will be described.
The tools, such as hooks, forks, spades, hoes, barrows, &c., are scrubbed with the above solution of chloride of lime, and subsequently water until clean; they are then repeatedly wetted with the solution, and after it has had time to disinfect the entire surfaces of them, they are washed clean and laid up, or hung up to dry.
The workmen, then, having finished the disinfection and flushing of all objects and surfaces, effect their own disinfection in the following manner:—They wash their boots most carefully with chloride of lime and water, scraping the soles and scrubbing the seams where the soles join the upper leather. They wash their hands and arms, and by means of clean rags or sponges they remove any splashes from their clothes. After this they go indoors, remove all clothes from head to foot, wash their bodies, and particularly their hands, faces, hair and feet, with plenty of soap and water, and put on fresh clothes and linen. The clothes and linen which they have taken off should be treated as infected, set to soak immediately in boiling water and afterwards disinfected, or in water containing two ounces of chloride of lime to the gallon in solution, or containing four ounces of Condy's red permanganate of potash fluid in solution; or the clothes and linen should be put in a copper and boiled and subsequently washed. All articles of little value which are much soiled should be burned on a bright fire.
E. Disinfection of Live Stock.—1. Live cattle may carry infection in two ways: first, by being themselves infected with the plague and reproducing the poison; and secondly, by accidentally carrying the poison from other animals in a dormant state upon some part of their surface, their hair, and particularly their feet. These latter animals may therefore infect others without being or becoming themselves subjects of the plague. All persons therefore buying new animals, should disinfect them before allowing them to enter their premises. In a similar manner, if in a stable there has been a case of plague, the healthy or apparently healthy animals should all be disinfected.
2. The mode in which live animals may be disinfected, consists in washing them with disinfectant solutions of such strength as will destroy the contagion without injuring the surface of the animal. A solution of two ounces of chloride of lime in a gallon of water, is a proper solution for washing the coat of animals. A mixture of four ounces of Condy's red permanganate of potash fluid, with one gallon of water, is also a proper disinfectant solution. For full-sized cows and bullocks, &c., several gallons of either of these solutions should be used. Great care should be taken to keep the solution away from the eyes, nostrils, mouth, and tender parts. When the entire surface is washed and disinfected, all disinfectant is removed by the application of great quantities of clean tepid water to all parts. The animal is given a warming and refreshing drink, and is conducted by a clean attendant to the clean quarantine shed. There it should receive fodder both dry and green, and sop, and plenty of pure cold water, and be rubbed dry with whisks of straw and hay.
F. The Quarantine Shed.—1. The quarantine shed is intended to keep the new and suspected cattle separate for a period of at least ten days, in order to afford the security, to be obtained by observation alone, that it is not actually infected with plague. While, therefore, disinfection of the surface of cattle removes one kind of danger, another, which cannot be removed, can only be kept circumscribed or penned in, and this is done by the quarantine shed. But the keeping of cattle in the quarantine shed would not disinfect its surface with certainty even during a much longer period than ten days; disinfection of the surface therefore cannot supply the precaution of the quarantine shed, and a rigorous quarantine cannot supply the effect of surface disinfection. Both precautions are necessary for perfect security, although either of them, without the other, obviates a particular kind and a certain amount of danger.
2. The quarantine shed should be situated in an isolated part of the premises. All manure and urine from it should flow and be carried to a particular place separate and distinct from the common dung-heap, and be buried daily.
The utmost cleanliness should be observed in the shed. All tools, pails, currycombs, etc., used in this shed should be used in it exclusively and nowhere else. The person attending the quarantine shed should not be allowed to go into the shed where healthy stock is kept, or permitted to approach healthy stock. No person attending healthy stock should be permitted to approach quarantine cattle, or to go near or into the quarantine shed. But should unfortunately only one person be available for both duties, that person should be allowed to approach quarantine cattle only when clothed in the safety dress to be immediately described.
G. The Safety Dress.—1. This consists of strong water-boots reaching up to the knees, well greased all over; of a waterproof coat, buttoned close all the way up in front, and closing tightly round the neck and wrists. The head is to be covered with a cap which takes the hair well in.
2. Every person having occasion to visit sheds in which there is diseased cattle, or suspected cattle, or quarantine cattle, should be provided with the above dress, put it on when entering the place, take it off when leaving the place, and have it disinfected immediately. This precaution should be strictly observed by all inspectors, all veterinarians, or others called in to attend sick cattle, by all dealers and butchers entering sheds, yards, or meadows, for the purpose of sale or purchase, and by all other persons coming on the premises on business in connexion with cattle.
3. The owners of stock should not allow any strangers to enter their sheds, yards, or meadows, except in disinfected safety-dresses; and in case this should give rise to difficulties, they will do well to have themselves one or two such safety-dresses at hand, and to cause all persons whose business compels them to enter their sheds, to leave their own boots behind, and to put on the long boots, waterproof-coat, and special cap. Only thus can they hope to exclude all ordinary and obvious chances of infection from their previously healthy sheds, yards, and meadows.
H. Measures to be taken on Premises where Plague has actually appeared.—1. When the plague has actually appeared in any shed, yard, or place, the sick animal should at once be removed with all due precautions. It is certainly the safest and best to pole-axe the animal at once, and to bury it entire, and then to disinfect the particular lair as above described, clear out the stable or shed, disinfect the whole of it and all apparatus, also all the animals, and only to let the animals enter the shed, &c. again, after it is completely sweet and dry.
2. If, however, a proprietor is desirous of keeping a sick animal because its illness does not appear severe or fatal, he should place it in a separate shed, which must not be the same as or near to the quarantine shed, and be distant from all healthy animals, and so situated that the prevailing wind does not blow from this hospital shed towards the healthy or quarantine shed. The water should also not flow from this hospital shed towards the others, or the yard, or any meadow, but should be carefully drained away and sent off the premises by a special sink.
3. To prevent the scattering of fæces by infected animals (and also by suspected animals and all animals suffering from diarrhœa), their tails should be so tied to one or other of their horns as to protect them against being soiled by the intestinal discharges, and to prevent them from distributing such discharges by the ceaseless motions peculiar to these organs. The spattering of fæces should be prevented by a copious supply of rough straw, with some sand, sawdust, or ashes placed behind and underneath the animal. The straw and fæces should be dealt with as has been described. Animals affected with plague or diarrhœa should not be led along streets, highroads, and paths, as they would be certain to drop infectious fæces, which would then be distributed over the entire length of these roads by the feet of men and animals, and the wheels of vehicles.
4. The sick animals should be disinfected repeatedly; their pens should be cleaned and disinfected repeatedly, during the course of the illness. This should be done by persons either guarded by the safety dress, or—and this is safest—by such as may not come into contact with healthy cattle, or have to enter healthy sheds. All tools, pails, fodder, &c., to be used in the hospital shed to be kept for that purpose only, and never to be used with healthy, or quarantine, or only suspected cattle.
5. If the proprietor of any dead piece of cattle, whether it has died naturally or been killed, should decide upon dismembering it instead of burying it entire, and upon utilising the hide, horns, hoofs, tallow, and bones, he should disinfect the skin, horns, and hoofs, by steeping them for one hour in a strong solution of chloride of lime, containing one pound of the powder in each gallon of water, and afterwards washing them. The tallow should be thickly powdered with chloride of lime all over, and be sent directly to the boilers. It should not be boiled in any vessel employed on the farm. Under all circumstances, it is advisable to let this dismemberment of dead and fallen cattle he performed at the knacker's yard.
6. Flesh, blood, guts, lungs, and the bones of the head of infected animals should not be trafficked with, as they cannot easily be disinfected. They should always be buried.
I. Disinfection of Meadows, Fields, Roads, &c.—1. Meadows infected by diseased cattle should be carefully cleaned of all dung, by burying each dropping on the spot where it lies, cutting out the round piece of turf with the dropping on it, and turning it upside down. The grass on the entire meadow should then be cut and burned. It should then be left without any cattle for at least a month, including at least two wet days.
2. All roads, paths, streets of towns, or villages should be carefully and frequently scavenged. All carts, vans, or waggons used for carrying manure, should be water-tight, caulked and painted, and should not be permitted to ooze and drop their fluid or semi-fluid contents on the road over which they are drawn. They should be kept clean and disinfected, as a precautionary measure, by the proceedings above described.
III. General Recommendations.
In conclusion it must be pointed out to farmers, dairymen, and all persons having charge of cattle,
That the same great measures which are known to maintain and restore the health of human beings, will also maintain and restore the health of cattle.
Pure air; dry, spacious, well-ventilated and well-drained clean sheds; clean and dry meadows; plenty of pure water; frequent currying and washing; the prevention of the development, by the destruction of the germs, of internal and external parasites, particularly entozoa; proper food in suitable quantities, and at proper times; protection from inclement weather; the utmost cleanliness in the removal of manure; the storing of the manure at a great distance from the cattle-shed, and, in addition, the most conscientious observance of the precautionary and disinfecting measures above described—all these measures and agents together will secure the utmost possible health of stock and the prosperity of the agriculturist and dairyman. But the neglect of any one of them will make the stock liable to become infected, and the more so the more several or all collateral conditions of the healthy existence of animals are neglected. The negligent man is therefore certain to lose, to injure his neighbour by defeating his precautions, and to damage society; but the watchful and painstaking man will be rewarded not only by the preservation of his property, but particularly by the consciousness that it has been preserved by his own care and attention, and that thereby he has also benefited the state.
This consolidates and amends the former Orders.