Treatment. 121 



those wliicli are weak or emaciated must be nourished artificially 

 (see page 123). The same procedure must be instituted with 

 patients who entirely refuse to eat. Where water by moutli 

 has to be withheld completely, water injections per rectum must 

 be resorted to. 



Drugs can be dispensed with in all cases with a typical 

 course. If the pulse varies only slightly from the normal, 

 alcohol is indicated in small, often repeated doses (ordinary 

 spirits), larger animals 25-50 gm., sheep, goats, swine 10-20 gn\., 

 carnivora 1-2 gm. ; wine 1/.-1 quart or teaspoon doses, cognac, 

 carnivora Yi teaspoon. Sulphuric ether (10 gm., 5 gm., or 

 0.25-1.0 pro dosi) may likewise be administered. If the number 

 of pulse beats is increased to more than twice the rate, and 

 also if they are weak, cardio- and vasotonic drugs are indicated. 

 The most serviceable of these drugs is camphor, as ol. camph. 

 according to Frohner in tolerably large doses (for large animals 

 20-50 gm., for smaller animals 4-10 gm., for carnivora, 1-2 sub- 

 cutaneously in one dose). The same results may be had with 

 the much cheaper ol. camph. syntheticum (Frohner) used in 

 similar doses. Caffeine (for large animals 6-8 gm., for small 

 animals 0.5 to 1 gm., subcutaneously every six hours) is likewise 

 beneficial. (Gmeiner claims to have shortened the course of 

 cases of pneumonia by the use of sulicutaneous injections of 

 caffeine.) Strophantinum purissimum Merck (horses 0.003 gm.) 

 recommended by Regenbogen by subcutaneous injections in 

 cardiac affections has not proved beneficial in the authors' 

 cases. It acts much better by intravenous injection (for horses 

 up to 0.015 gm. — Dorn, authors' own observation). For the 

 purpose of sul)cutaneous injection strophantine must be dis- 

 solved in enough water (6-10 gm.) in order to avoid necrosis 

 of the skin (Frohner) ; however, even if applied in this dilution, 

 a painful infiltration at the place of injection, which lasts 

 several days, cannot be avoided. Such swellings are likewise 

 frequently seen after injections of caffeine. Digitalis prepara- 

 tions to be used are: pulverized leaves of digitalis (for large 

 animals 2-5 gm., for smaller animals 0.5-1.0 gin., for carnivora 

 0.05-0.3 for three to four days) ; also folia digitalis diah^sata 

 (for larger animals 5-15 cc. per os) ; further, digitalysatum 

 Burger (small animals 20-30 drops, sul)cutaneously). Accord- 

 ing to the investigations of Salvisberg, digitalis preparations 

 are destroyed in the stomach of ruminants ; hence the proper 

 preparations must be given subcutaneously or intravenously. 

 It must not be forgotten that digitalis has a tendency to produce 

 abortion in pregnant cows. The general use of the excellent 

 preparation digalen (horses 5-15 cc, cattle 20-30 cc, subcu- 

 taneously or intravenously) is frequently prohibited by its high 

 price (Dorn) ; tincture of strophantus has been found unreliable 

 (Regenbogen, Gmeiner). 



In the face of threatening cardiac weakness the proper 

 preparations of digitalis must be given intravenously because 



