148 SPECIAL EQUINE THEEAPY 



Cases of such virulency are not so common as those in 

 which the disease begins with a moderate rise in tem- 

 perature. Some difficulty in swallowing is present ; the 

 facial expression is dull, vacant, stupid; the head hangs 

 heavily or it is pressed firmly against a wall or other 

 object. If the animal is made to move, the movements 

 are made sub-consciously and without recognition. There 

 are moments when the animal appears brighter, but these 

 become less frequent and of shorter duration. At the end 

 of two or three days the animal goes down, remaining in 

 the reeiunbent position for variable lengths of time until 

 recovery or death terminates the case. During the entire 

 period of recumbency (which may last from three to fif- 

 teen days) there are spells of delirium alternating with 

 lucid periods. Before death occurs there is in most cases 

 marked coma with subnormal temperature. 



Favorable cases begin to improve after a few days of 

 semi-comatose periods; the horse recognizes voices, calls 

 for feed, later rises to chest position and with assistance 

 will rise. Dysphagia, lack of coordination, facial paraly- 

 sis, paraphimosis and other troubles may remain indefi- 

 nitely, as complications or sequelae. 



Cases with violent symptoms must be differentiated 

 from rabies. Anthrax must be considered in diagnosis 

 of hyper-acute cases. Mild cases must be differentiated 

 from simple meningism. The differential point here has 

 been pointed out in the chapter on meningism. 



Treatment. I begin the treatment in every case with 

 fifteen grains barium chlorid intravenously. This pro- 

 vokes rapid elimination of the intestinal contents and, if 

 administered early enough in the attack, changes the 

 entire aspect of even a serious case. In my hands the 

 results from this handling have been very gratifying. 

 The remainder of the treatment consists of alternate 

 doses of Fowler 's solution of arsenic and potassium iodid 



