Symptoms. Course. 785 



form of lactose; less often grape sugar iiia}^ be foniid as well as 

 milk sugar. 



According to the records of many observers the udder is 

 flaccid, and always secretes little or sometimes no milk at all. 

 Vaginal discharge is always absent, but the external os remains 

 more or less open, and the already mentioned incomplete in- 

 volution of the uterus can be demonstrated (Hess). 



At first a moderate rise of temperature occurs at times, 

 later, however, with the onset of the paralytic condition, the 

 temperature always falls and may decline to 35.4° C. (Him- 

 melstoss). Nelke attributes the low temperature to failure of 

 action of the sphincter ani muscle ; when he put the thermome- 

 ter sufficiently far enough into the rectum he always found a 

 temperature of between 38.8 and 39.0° (J. The ears, horns and 

 feet always feel very cold. 



Zehl reeognizes three forms of milk fever. In the subacute form digestive dis- 

 turbances and dullness are prominent, whilst paralytic symptoms are absent or at 

 most trivial (see also chronic intestinal catarrh of cows after calving, page 265). The 

 mild form manifests itself by the exclusive presence of paralytic symptoms and cor- 

 responds clinically with sacral paralysis after birth (see page 748). In the third form 

 both previous forms unite to bring about the true milk fever. How far the first two 

 forms can be ascribed to milk fever later observations must determine. 



Course. The form of illness described above usually de- 

 velops within a very short time, even as early as 1 or 2 hours, 

 and remains unchanged for a certain period, generally about 

 a day. In favoraljle cases improvement usually occurs just as 

 rapidly as the symptoms of illness have set in. The patient 

 opens her eyes, looks about with uplifted head, moves her 

 tongue, and makes swallowing movements, she passes dung and 

 urine, her temperature returns to normal, finally she gets up 

 and takes food. Recovery can occur without any treatment 

 within a quarter to half an hour, often even in very severe 

 cases where death was to be feared every moment (thus Hess 

 saw some cows that appeared to be lost, recover in a few 

 minutes after being turned over). In other cases the ailing 

 animal exhibits some weakness for 1 or 2 days, or it may even 

 be for 3 days. 



In unfavorable cases death may occur almost unnoticed, the 

 quiet breathing becoming gradually slower and finally being 

 arrested along with the heart action. In other cases death is 

 immediately preceded by symptoms of restlessness, perhaps by 

 convulsions, or by a sudden copious diarrhea. Occasionally it 

 happens that the animal after a short period of unrest suddenly 

 collapses, lies as if Hfeless and passes away under convulsions. 

 In such cases a fracture of the l)ones of the skull or the verte- 

 brae may be thought of (in a case of Wilhelmi's the animal struck 

 its head on a piece of wood which had been placed under it and 

 broke the second cervical vertebra). 



In a number of cases the animal recovers after the disap- 

 pearance of the paralytic s^miptoms, but one or two days later 



