STRANGLES. 469 



and the abscess of the submaxillary glands came to a head, later 

 on, in the usual manner. This complication did not appear to 

 increase in any way the severity of the attack. 



A manifestation of strangles which is sometimes present, is a 

 skin eruption that takes the form of nettle-rash (p. 160), or 

 eczema (p. 150), the serum of the vesicles of which, accord- 

 ing to Trasbot, is capable of communicating the disease by 

 inoculation. 



Uncomplicated strangles is a mild disease which runs its course 

 generally in less than three weeks' time. 



COMPLICATED STRANGLES.— The usual complication of 

 strangles is extension of the inflammation from the mucous mem- 

 brane of the nose to other air-passages, with the result of laryn- 

 gitis, nasal gleet, pus in the guttural pouches, inflammation of 

 the lungs ; and the formation of abscesses (by pyaemia, p. 532) in 

 the lungs, liver, kidneys, and other parts of the body. Fiedler 

 considers that roaring is sometimes caused by such an abscess 

 forming in the glands on the left side of the neck, about the 

 middle of the jugular groove. These abscesses do not come to 

 a head, after running a regular course, as does the abscess of simple 

 strangles. As a rule, these swellings appear between the branches 

 of the lower jaw (their typical position), at the base of the neck, 

 at the point of the shoulder, under the shoulder-blade, in the 

 chest, or in the abdomen. When they are under the jaw, they 

 remain hard and indolent, and may, even, diminish in size. " At 

 other times, particularly when affecting the hnnph-glands at the 

 point of the shoulder, the abscess is of great extent, and the pus 

 well formed " (Robertson). Here we have a case of abscess due to 

 pyaemia, similar to that described on p. 78. The internal glands 

 which are usually affected, are those of the mediastinum and of 

 the mesentery; the former being the partition that divides the 

 cavity of the chest into two parts ; and the latter is the mem- 

 brane that suspends the intestines from the roof of the abdomen. 

 In both cases a fatal termination may be expected. When the 

 mediastinum is involved, there is cough, difficulty of breathing, 

 and dropsical swellings of the chest. When the abscesses occur in 

 the mesentery, "the most prominent and characteristic sign is a 

 total loss of appetite, or an apparent loathing of food associated 

 with occasional colicky pains " (Williains). The existence of these 

 pains points to interference with the action of the intestines. 



In these complicated cases, the febrile symptoms are, generally, 

 better marked than in the simple form; especially, when the in- 

 ternal organs are involved. If the temperature rises to 104° or 

 ]I05° F., we shall have good reason for concluding that an internal 



