Cases of pharnygitis with false membranes have been seen in horses by Delafond, Targue, Rey, Bouley, Riss, Sonin, Robertson, Dieckerhoff and Schneidemühl.
They have been attributed to various causes, as caustic alkalies and acids, the smoke of a burning building (Bouley, Rey, Riss), to an infection which operated on dogs and horses (Robertson), to bacteria and other irritants.
Lesions. The mucous membrane of the mouth, pharynx and even the nares presents active inflammation with branching redness, petechiæ, circumscribed foci of necroses, and false membranes of a grayish, yellowish, reddish, greenish or blackish color. These are formed of a pellicle consisting mainly of fibrine and epithelium, pus globules and numerous cocci, and ovoid bacteria. The false membranes have been found on other parts of the intestinal canal (colon, cæcum); and broncho-pneumonia and pulmonary dropsy have been concomitants. The effect of the toxic products is seen in hæmorrhagic inflammation and infarctions of the kidneys, and in a black color of the somewhat diffluent blood.
Symptoms. Besides the usual phenomena of pharyngitis, there is intense hyperthermia (105°–106°), hurried breathing threatening suffocation, painful cough roused by the slightest pressure on the swollen throat and often causing the discharge from the nose of shreds of false membrane. Auscultation of the pharynx gives a loud gurgling sound. Deglutition is very difficult and painful, liquids and even solids being rejected through the nose. The face is pinched and anxious and the mouth is often held open and the tongue pendant. Weakness and prostration are marked symptoms from the first, and the walk may be unsteady and swaying. The visible mucous membranes are congested and usually have a more or less deep tinge of yellow. The disease makes rapid progress and may prove fatal under six days. When it takes a favorable turn, recovery and convalescence may be equally prompt.
Unless the expectoration of false membrane is detected, such cases are difficult of diagnosis, though a fair inference may be deduced from the extreme severity of the symptoms, and the unusual degree of prostration which is present. When a pharyngeal speculum, passing through the nose, can be availed of, it may become possible to reach a more definite conclusion.
Treatment. Beside the measures advised for catarrhal pharyngitis (poultice, counter-irritants, laxatives, antithermics, alkalies, etc.), the main reliance must be placed on antiseptics. Persistent inhalations of warm water vapor with carbolic acid, creolin, tar, lysol, camphor or sulphurous acid are in order: also a mixture of one or other of these agents or of boric acid, bisulphite of soda, or salicylic acid in honey or molasses to be frequently smeared on the teeth. One of the best agents is the saturated solution of chlorate of potash in tincture of muriate of iron, of which a drachm may be added to three ounces of water and given every hour or two. Calomel may be injected through the nose during inspiration, by means of an insufflator, care being taken not to exceed the physiological dose.
Most common in calves. Inoculations successful on rabbits, mice and sheep. Bacillus: its cultural characteristics. Predisposing causes. Symptoms: nasal mucosa congested; false membranes; snuffling, wheezing breathing; painful, rattling cough; agonized expression; salivation; bowel disorder. Course. Duration. Lesions; intense congestion and false membranes. Treatment: as for horse; special antiseptics; solvents; anodynes; tracheotomy.
This has appeared especially in calves, and though apparently readily transmissible among the young, it rarely attacks aged cattle. Cadeac and others inoculated it on guinea pigs and rabbits without success. Dammann, on the other hand, had his inoculated rabbits die in twenty-four hours with hemorrhages in the seat of inoculation. Löffler inoculated it hypodermically on mice and produced extensive infiltration of the entire walls of the abdomen, and often of the peritoneum including the surface of the liver, kidneys and intestines, on which was formed a thick, yellowish exudate containing the microbe. Damman claimed to have successfully inoculated the sheep as well.
Causes: Microbe. Löffler found in the deeper layers of the exudate a long delicate bacillus, five or six times as long as broad, and about half the thickness of the bacillus of malignant œdema. Several bacilli were usually joined so as to form long filaments. These failed to grow in nutrient gelatine, or sheep blood serum, but grew readily in the blood serum of the calf.
Beside the specific microbe Cadeac enumerates as predisposing causes: sudden chills, rapid changes of temperature, suppression of perspiration, inhalation of irritant gases, swallowing of irritant liquids, and traumatic injuries.
Symptoms. The nasal mucosa is violently congested, reddened, thickened, and covered at intervals by false membranes which block the normally narrow passages and produce snuffling, wheezing, and difficult breathing. The throat is swollen, and tender, the slightest touch producing a painful gurgling cough which leads to the discharge of mucopurulent matter, shreds of false membrane and even blood. These membranes may be seen on the nose or mouth. There is high fever, rapid, small pulse, cyanosed mucous membranes, pinched countenance, and usually open mouth, pendant tongue and drivelling saliva. There may be either constipation or diarrhœa.
The course of the malady is rapid, death sometimes supervening in 24 to 48 hours. Recovery and convalescence may be prompt, or the disease may last for weeks.
Lesions. The congestion is intense and may invade the mouth, nose, pharynx, larynx and bronchia, with at intervals the patches of yellowish white false membranes. These may be soft and diffluent when recent, and tough and resistant when of longer standing. The deeper layers are often bloodstained. Preitsch has seen them extend to the gullet, paunch and manifolds, and attended with considerable ulceration of the subjacent mucous membrane.
Treatment. This does not differ materially from that recommended for the horse. Among the additional antiseptics employed have been, iodoform, oil of turpentine, sulphide of calcium, silver nitrate and coal tar. To loosen and detach the false membranes ipecacuan and sulphates of soda and magnesia have been largely resorted to. Papayin and pepsin might be tried. Also as anodynes digitalis, morphia, aconite and belladonna. Finally tracheotomy has been employed when asphyxia seemed imminent.
Cause; infected dust on susceptible subject; inoculation. Symptoms; movement of jaws; frothy lips; salivation; viscid nasal discharge; difficult swallowing and breathing; swollen tender throat; extended head; anorexia; cyanosis; open mouth; cough expels shreds of false membrane; asphyxia. Lesions. Treatment; Glauber salts or muriatic acid in water; antiseptic fumigation and drinking water; antisepsis of the pharynx.
Roche-Lubin speaks of this disease as common in flocks, as the result of moving them around for twenty-four hours in a narrow enclosure covered with dust which is raised in a cloud and settles in the fleece so as to increase its weight. The fever and excitement caused by the constant driving and the local action of the infected dust on the respiratory mucous membrane is said to bring about the intense exudative inflammation. It has been seen especially in the spring in young lambs shortly after weaning. Damman claims that he transmitted the disease to sheep by inoculating the diphtheritic exudate of the calf.
Symptoms. There were constant movements of the jaws, with the accumulation of frothy saliva round the lips or the drivelling of this secretion from the mouth, the discharge of a viscid white material from the nose, difficulty of deglutition, hurried, panting, snuffling breathing, swelling and tenderness of the throat, and the occurrence of cough and the discharge of mucopurulent matter whenever it was pressed. The head and neck are held rigidly extended, the eyes are dull or glazed, the appetite is completely lost, the mucosæ red and cyanotic and the animal weak and unsteady upon its limbs. By the third or fourth day respiration has become so difficult that the mouth is held constantly open, the tongue protruded and the painful convulsive cough leads to the expulsion by the nose and mouth of shreds of false membrane. Careful examination of the nose or of the fauces may detect the grayish or yellowish patches of false membrane at an earlier stage. Death by asphyxia is common.
Lesions do not differ materially from those seen in the calf. The inflammation and pseudomembranous exudate may extend as far as the trachea and bronchia in which case the indications of death by asphyxia are clearly marked.
Treatment is the same as for the calf. Tepid drinks slightly acidified with muriatic acid, or the addition to the drinking water of one pound of sulphate of soda to every fifty sheep has been especially recommended. Fumigation with sulphurous acid or chlorine is easy of application in flocks. As alternatives for addition to the water may be named hyposulphite or bisulphite of soda, borax, carbolic acid, or spirits of turpentine. For treatment individually swabbing the throat with antiseptics and dilute caustics, electuaries, and hot poultices to the throat may be tried.
Prevalence in herds, in close pens, and in young. Relation to swine plague and hog cholera. Symptoms: sore throat, prostration, hoarse cough, yellowish discharge with shreds of false membrane, pellicles on mouth, fauces, tonsils. Diagnosis from swine plague. Treatment: Isolation, disinfection, antisepsis to throat, febrifuges.
This has long been recognized as a contagious affection, occurring especially where the animals were kept in herds and too often in close and filthy pens. These are more liable in youth than in maturity, partly no doubt because the older animals have already suffered and attained to an immunity. Modern observation has shown that pharyngitis with formation of false membranes is especially common in swine plague, and the present tendency is to refer all such cases to that category. It is however altogether probable that the occurrence of local irritation with the addition of an irritant or septic microbe altogether distinct from those of swine plague or hog cholera, gives rise at times to this exudative angina. Certain it is that septic poisoning with the food is not at all uncommon in the hog, in the absence of these infectious diseases.
The symptoms are those of severe sore throat with profound prostration, a hoarse, painful cough, a yellowish discharge from nose and mouth, and great muscular weakness. The base of the tongue, tonsils and soft palate are red and tumid with here and there grayish or yellowish patches of false membranes. The identification of swine plague may be made by the history of the outbreak, the number of animals affected, the tendency to pulmonary inflammation, the enlarged lymph glands, the presence of the non-motile bacillus which does not generate gas in saccharine media, and which readily kills rabbits and Guinea-pigs with pure cultures of the germ.
Treatment will depend largely on the nature of the attack—swine plague or simple pseudomembranous infection. Isolation, cleansing and disinfection will be demanded in both cases. In swine plague all additional precautions to prevent its spread must be resorted to. In the simpler exudative inflammations the antiseptic local treatment and general febrifuge measures will be demanded.
Relation to diphtheria in man and horse. Symptoms; fever, prostration; swollen throat; cough; vomiting; false membranes on fauces and tonsils; cyanosis. Treatment: local antisepsis; febrifuges.
Rossi and Nicholski claim that dogs contract diphtheria by swallowing the excrements of diphtheritic infants, but these observations lack confirmation, and the infrequency of such an occurrence argues against it. Robertson records cases of canine angina with false membranes occurring at the same time as a similar affection in the horse. The victims were puppies and the mortality was high. Exact observations are, however, lacking.
The symptoms were dullness, prostration, anorexia, a hard cough, swollen throat, vomiting, diarrhœa, and the presence of grayish or yellowish false membranes on the fauces and tonsils. The breathing was difficult and painful and the mucosæ cyanotic.
Treatment has been essentially local, consisting of swabbing with solution of boric acid (1:200), chlorate of potassa, perchloride of iron, or nitrate of silver.