Anatomical Changes. Symptoms. 345 



stain never shows any fibrin in the eases examinetl, and the proper stains demon- 

 strated the presence of mucin (Johne). Chemical tests made by Lassaigne showed 

 that the pseudomembranes consist almost exclusively of condensed mucus; the same 

 results were obtained by Clement who investigated membranous enteritis in horses. 



All investigations made have failed to furnish any proof that mem- 

 branous enteritis is a genuine diphtheritic inflammation of the intestinal 

 mucosa, but they have rather shown that we are dealing with a peculiar 

 purely catarrhal process with an overproduction of mucus, analogous to 

 the membranous catarrh of the stomach of man (Nothnagel). One 

 could not reconcile the usually mild course of the infection with a grave 

 croupous inflammation. The preferably catarrhal character of the pro- 

 cess does, of course, not exclude an occasional deeply penetrating 

 inflammation. 



For these reasons it appears proper to consider here this form of 

 enteritis and to separate it from true croupous inflammation. This will 

 be considered among the gastro-intestinal inflammations (q. v.). 



Symptoms. The disease usually begins with disturbances 

 of digestion and mild attacks of colic. The animals do not eat 

 much, they are depressed and ruminate irregularly. One also 

 observes muscular tremor, reddening of the conjunctivas and an 

 acceleration of pulse and respiration. The secretion of milk is 

 suppressed. The mild attacks of colic last only 12 to 15 hours and 

 then cease for several days. The feces are at first dry ; they are 

 dropped less frequently and with increased abdominal pressure. 

 After five or six days, rarely somewhat later, colicky pains re- 

 cur, the animals Aval'k around restlessly, turn their heads to look 

 towards the abdomen, kick with their feet and drop feces with 

 signs of tenesmus. These are thin fluid and fetid, mixed with 

 gray or yellowish-white membranous, tubular or cylindrical 

 masses of variable, sometimes of considerable length. The solid 

 cylinders or the tubular pieces are either empty or filled with 

 feces and may at first sight be mistaken for pieces of intestines. 

 However, their homogeneous structure and the absence of 

 mesentery and blood vessels prevent such a mistake. After one 

 to two days the symptoms suddenly disappear; however, the 

 feces remain fetid for several days and are mixed with mucus ; 

 then the animals recover completely. 



Deviations from this clinical picture occur in two direc- 

 tions. In very mild cases animals previously apparently quite 

 healthy, very unexpectedly drop such membranes as described, 

 perhaps with symptoms of a little restlessness, then thin fluid 

 feces, mixed with mucus, then they soon get well again (Lafore, 

 Reynal, Combe). There are, however, on the other hand, cases 

 which run from the start a course with the symptoms of a grave 

 enteritis or these symptoms may develop later on and profuse 

 hemorrhages may occur in the further course of the disease. In 

 cases of this kind there is great prostration, complete lack of 

 appetite, high fever, the pulse cannot be felt, the peripheral 

 parts of the body feel cold as ice and the fluid and fetid feces are 

 more or less hemorrhagic. 



