890 Paralytic Hemoglobiiiemia. 



lime, been observed without a doubt only in horses, and usually after 

 the animals had been kept from work for a time, at the same time 

 were well fed and subsequently were used for some hard muscular 

 work, which, of course, may occur also in the sta})le. as for instance 

 after suddenly rising to the feet. Although sometimes the disease 

 develops also Avithout cooperation of these factors; in such cases an 

 excessive exertion may be found to be originally connected Avith the 

 development of the disease. At the same time it has frequently been 

 ol)served that in horse stables in which the disease has occurred 

 regularly it may be prevented by systematic exercising of the animals 

 or by a considerable reduction in the quantity of nitrogenous food 

 (Benjamin, Lavalard. Brun). The fact has further been supported liy 

 numerous observations that without exception the muscles usually be- 

 come affected and the changes occur chiefly on that side of the body, 

 Avhich has to perform the greatest muscular exertion in the execution 

 of the work. These are especially the muscles of the hind parts, more 

 rarely those of the anterior extremities. In animals which are lying 

 down the muscles of the back may be involved. 



Against the importance of the influence of cold the already men- 

 tioned observations may be quoted, according to Avhich the diseas*^ 

 occurs in continuous Avarm AA^ather more frequently than in cold seasons 

 (Pr. ]\Iil. Yb., Hofling, Marek). Lassar & Nassaroff succeeded by an 

 excessiA^e cooling of the body (the inner temperature of the animals 

 falling to 18° C.) only in producing a not especially severe degeneration 

 in the muscles, and more markedly in the parenchymatous organs, 

 AA'hich, exclusive of actual freezing to death, could not occur under 

 natural conditions. On the other hand Dexler failed to produce the 

 disease by strongly cooling the hind parts of a horse. 



The signs of a nephritis AA'hich according to Lucet dcA^elops from 

 cold and Avhich is said then to produce the hemoglobinemia, are fre- 

 quently absent. 



Against the infectious origin of the disease it may be mentioned 

 that the respective authors have failed up to the present time in 

 producing the disease in its typical form artificially in horses, and 

 that further the sudden appearance of the disease and its characteristic 

 clinical picture is difficult to reconcile Avith a theory of infection, as 

 is also the not infrequent sequel of an atrophy confined to certain 

 muscles, AA'hich after a time again disappears. In spite of the position 

 taken by Schlegel on this question, Hutyra & ]\Iarek consider their 

 non-committed standpoint in regard to the infectious origin of the 

 disease the more justified since paralytic hemoglobinemia AA-as originally 

 separated by Schlegel himself from infectious spinal meningitis, and 

 also because ZAA'ick, AA'ho accurately described a disease AA'hich appears 

 to be identical Avith Schlegel's streptococcus septicemia, observed no 

 similarity between infectious spinal meningitis and paralytic hemo- 

 globinemia. It therefore remains for further investigations to elucidate 

 the relationship of Schlegel's disease to paralytic hemoglobinemia and 

 the nature of the last mentioned disease. 



Against the myogenic origin of hemoglobinemia it may be said 

 that in all cases inA^estigated by Hutyra & Marek the hemoglobin con- 

 tent of the blood AA'as found to be someAA'hat diminished (on Fleischl's 

 apparatus beloAv 70° against the normal of 70-80°). At the same time 

 they ncA^er succeeded in finding an increase in the specific graA'ity 

 of the blood, although it Avas tested A^ery accurately Avith the pyknometer. 

 On the other hand they established in all cases a diminution of red 



