176 Veterinary Medicine. 



in lime or phosphorus, overwork, exhausting milking, or chronic 

 disease of important organs (heart, liver, lung, kidney). 



Symptoms. These are indefinite and not easily distinguished 

 from those of disorders of the third stomach. There is impaired 

 or capricious appetite, a disposition to eat lime, earth, and all 

 sorts of non-alimentary objects, rumination is rare or altogether 

 suspended, efforts to regurgitate are ineffectual, or result in 

 gaseous eructations only, there are tympanies and abdominal 

 pains especially after feeding, and constipation with a firm glazed 

 appearance of any faeces passed, may alternate for a short time 

 with diarrhoea. The mouth is hot and clammy, the eyes sunken 

 and semi-closed, the pulse small and weak, though the heart may 

 palpitate, and there is a constantly progressive emaciation and 

 prostration. Among the more characteristic symptoms are 

 tenderness of the right hypochondrium to manipulation and per- 

 cussion, and the presence of slight hyperthermia. 



Lesions. The changes consist mainly in hypertrophy of the 

 gastric mucosa, with changes in the epithelium and submucosa 

 such as are already described in the horse. The pyloric region 

 suffers most, and here ulcers are not at all uncommon. 



Treatment. The main aim must be to remove the causes, and 

 to build up the general health, so that the patient may rise above 

 the debilitating conditions. More is to be expected from the 

 change of diet to green food, roots, mashes, etc., and an outdoor 

 life than from the action of medicines, which are liable to dis- 

 appear by absorption in the first three stomachs, so that they can 

 only act on the fourth through the system at large. Yet benefit 

 may be expected from the use of nitrate of bismuth, and salol, as 

 calmatives and antiferments, nux vomica as a tonic and even 

 from pepsin and muriatic acid as digestive agents. The two last 

 are not dependent on the fourth stomach for their activity but 

 will digest the contents more or less in the first three, and the 

 finely disintegrated and partly peptonized ingesta coming to the 

 fourth stomach in a less irritating, and less fermentescible condi- 

 tion, lessens the work demanded of that organ and gives a better 

 opportunity for recuperation. Small doses of common salt and 

 one or other of the carminative seeds may be added. The appli- 

 cation of mustard or oil of turpentine to the right hypochondrium 

 will sometimes assist in giving a better tone to the organ. 



