FORAGE POISONING ERGOTISM 23 



may be congestion of the brain and cord with extensive effusion into the 

 ventricles and subarachnoid spaces. Few small hemorrhages and parenchyma- 

 tous degenerations within the various organs have been mentioned. MacCallum 

 and Buckley have found in the brains of horses dying of this disease, areas of 

 softening "in the frontal region on each side, anterior to the motor region of 

 the cortex." This lesion was practically confined to the white matter immediately 

 under the cortex. In the affected areas there was "complete destruction of the 

 brain substance, in which the anatomical structures are disintegrated and largely 

 replaced by a colloid-like material. The neighboring blood vessels were acutely 

 inflamed, with cellular infiltration of leucocytes and red corpuscles into the 

 perivascular spaces and tissues. In a later outbreak these writers failed to find 

 the brain lesion, but did observe the vascular changes above described. 



McCarthy and Ravenel, in a study of fifteen animals found certain lesions 

 in the upper gastro intestinal tract and in the central nervous system. These 

 were: 



(1) In the intervertebral and Gasserian ganglia, where a pericapsular, 

 small round cell accumulation was present. The cells were all of the same type, 

 the nucleus and protoplasm being about the size of a red corpuscle. There was 

 no evidence that these cells were the result of proliferation of the original 

 layer of capsular cells. 



(2) Cortical lesions. These consisted of congestion of the cerebellar and 

 cerebral cortex. There were also capillary hemorrhages. The meninges were 

 normal. 



(3) Changes in the choroid plexus. In three cases the choroid plexus 

 was changed into a triangular tumor-like mass, of a yellowish red color and of 

 a firm consistency. The increase in size was found to be due to a proliferation 

 of the elastic tissue surrounding the vessels. 



(4) Changes in the nerves. There was a distinct degeneration of the 

 nerves supplying the larynx and neck. This was present in the nerve up to the 

 ganglion, but was not found in the posterior roots. Other slight changes were 

 detected. 



Moore failed to find any gross lesions in the nervous system and other 

 organs in the cases examined by him. In one case the brain, spinal cord, and 

 organs were studied histologically with negative results. 



Differential diagnosis. A very important point in the recognition of forage- 

 poisoning is the history which has been referred to previously. It must be 

 distinguished from inflammations of the brain and meninges, and from rabies. 



Treatment. In the acute cases this is seldom successful, although quick- 

 acting stimulants to arouse the patient may be tried. In the subacute cases a 

 purge should always be given to rid the intestines of the poison. Strychnin in 

 large doses, to overcome the extreme depression of the nerve centres, and 

 atropin to support a failing circulation may be administered hypodermically 

 at frequent intervals with benefit. 



In the very mild cases, all that is necessary is to empty the bowels with a 

 purge. 



It is of the utmost importance, in all cases, with the return of the appetite, 

 to supply only such food and water concerning the wholesomeness of which 

 there can be no question. 



Prevention. Since it seems to be quite generally accepted that this 

 disease is brought about by the ingestion of mould-contaminated food 



