MAD AND SLEEPY STAGGERS. 275 



draughts will also be useful in exciting the secretions of these latter 

 organs. 



When Coma arises from the other causes detailed in the latter part of 

 par. 554, medicinal treatment will not be of much avail. 



In Mad staggers, the same course of treatment as has been recom- 

 mended for the comatose phase is desirable, and should be applied, as far 

 as circumstances may admit, in any particular case. But except in the 

 very early stage or in mild attacks, it is generally almost impossible to 

 apply those remedies on account of the violence of the animal. 



As topical relief, both in the comatose and also in the mad stages (if 

 possible) cold wet cloths should be constantly applied to the head, and a 

 stream of cold water should be poured on them from above, or ice may 

 be employed. 



Blisters to the head and neck are not advisable during the acute sym- 

 ptoms, whether comatose or phrenitic, as they tend to increase the 

 derangement. But when the acute symptoms have subsided, they may bo 

 beneficially applied, or a seton may be inserted. The latter generally 

 answers best. In all cases the patient should be placed in a cool, airy, 

 darkened box. 



The duration of the Comatose state is very uncertain. When arising 

 from indigestion, it will probably be over in favorable cases in twenty- 

 four hours ; or it will run on into mad staggers with occasional intervals 

 of coma. A decided change for better or worse will probably take place 

 in from one to three days. When the Coma arises from a tumour or 

 abscess on the brain, the case may last for weeks or months if the 

 animal be allowed to live so long. In concussion of the brain the coma- 

 tose symptoms may 'last a considerable time, but the patient will not 

 long survive repeated attacks of a violent phase. 



In Mad staggers, Encephalitis, Phrenitis, or Brain fever, from whatever 

 cause proceeding, the exhaustion produced by the violence of the disease 

 will probably cause the animal to sink in a few days, unless relief is 

 given. 



It will be observed that we have recommended nearly the same treat- 

 ment both for Sleepy and Mad Staggers. We have done so because we 

 regard the disease, namely functional derangement of the brain, from 

 whatever cause proceeding, as the same in both cases. According to 

 circumstances the effect produced may be either coma or inflammation, 

 or both at alternate intervals. But after all the main point is to get the 

 bowels open. 



557. After-treatment. 



When the disease has taken a favourable turn and the patient is re- 

 covering, the after-treatment consists in most careful attention to the 

 diet, iii good nursing, fresh air, and the administration of tonics, espe- 

 cially of iodide of iron. The feeding should be liberal. The strength 

 of the patient is always greatly reduced by the attack if severe, and 

 especially if prolonged. 



