516 Epizootic Cerebro-spiual Meningitis. 



not go forAvards, or they flex the joints of their limbs that the body 

 abnost comes into contact with the ground. 



In some cases there is a vesicular eczema (Fambach, Knabe). 



Course. The symptoms described do not always follow in 

 the order given, nor are they all present in every case. They 

 vary considerably in severity. As a rule the inflammation starts 

 at the base of the brain and extends to the medulla and spinal 

 cord, but sometimes the order is reversed. In six cases seen 

 by Noack the disease commenced with paralysis of the quarters. 

 The inflammatory processes may remain more or less localized 

 up to the time of death, spinal symptoms being consequently 

 absent. In other cases these may be the more prominent. 



The duration and termination of the disease are also varia- 

 ble. In the mildest cases there is simply dullness for five to 

 eight days, followed by complete disappearance of the symp- 

 toms, (in the other hand, there may be severe spasms or even 

 paralysis on the first or second day, death following after a 

 short interval. On an average the disease lasts from one to two 

 weeks, symptoms gradually coming to a crisis, or they may 

 abate for a time and finally disappear. In many cases slight 

 symptoms persist for some length of time. In certain cases 

 there is a temporary improvement, followed by a relapse, espe- 

 cially when the animal is put back to work. 



In well-marked cases the disease tends to be fatal, although 

 the mortality varies in different outbreaks within wide limits. 

 Kocourek observed recovery in 50 per cent of cases, while in the 

 case of Borna disease and even in milder outbreaks at the most 

 20 to 25 per cent of the animals remain alive, and sometimes the 

 majority or even the whole of the diseased animals may die. 

 Recovery is, as a rule, incomplete, various sequels being ob- 

 served, dulness, amblyopia, amaurosis, lumbar weakness, epilep- 

 tiform seizures. These may disappear in the course of months. 



Diagnosis. Diagnosis is based upon the epizootic nature 

 of the disease and the simultaneous appearance of symptoms 

 due to disease of the membranes of the brain and cord. In this 

 connection the spasms of the neck, and the presence of symp- 

 toms of disease of the bulb and spinal cord, are of the utmost 

 importance. In infected districts the diagnosis may with great 

 certainty be based upon a far less complete series of symptoms. 

 The symptoms described differentiate the disease from cerebral 

 meningitis, including hydrocephalus internus, tubercular men- 

 ingitis, staggers (ccenurosis), rabies, vertigo, epilepsy, poison- 

 ing, etc. In cases of tetanus there is stiffness of the neck and 

 other portions of the body, but there are no clonic spasms and 

 consciousness persists to the end. 



Treatment. Treatment is in general principle like that for 

 cerebral meningitis (see page 604). Cold applications, such as 

 icebags, are the best local treatment. The spasms may be mod- 



