356 ACUTE GENEBAX INFECTIOUS DISEASES 



dependent on the hygienic surroundings and care of the 

 patient. 



Treatment. — ^As yet no successful specific treatment has 

 been devised to combat the disease. The principal factor in 

 bringing cases to a favorable termination is good hygiene. 

 The patient should be placed in a light, clean, well-ventilated, 

 bedded box stall and the head halter removed (prevents 

 necrosis of skin of face). In proper weather it may be let run 

 out of doors during the day. A light blanket may be used for 

 covering. Allow plenty of clean water. The food should 

 consist of oats, grass, and bran with plenty of salt. If there 

 is difficulty in swallowing, gruels or milk may be used or tube- 

 feeding employed. The treatment is surgical, serotherapeutic 

 and medicinal. The surgical treatment consists in a thor- 

 ough disinfection of the tumefactions, wounds, ulcers, and 

 abscesses (creolin, lysol 3 per cent.). The application of 

 Burrows' solution with camphor (camphor giss, lead acetate 

 5vj, alum giij, a tablespoonful to a winebottleful of water) 

 is good to ward off gangrene. Spirits of turpentine applied 

 two or three times is said to have like effect. Scarification 

 of the swellings as usually practised does no good and opens 

 an avenue for further infection. 



When suffocation threatens, tracheotomy should be per- 

 formed. While it no doubt prolongs life, in most cases where 

 called for, death follows. 



Good results are reported from the use of antistreptococcic 

 serimi in doses from 25 to 50 c.c. It may be given subcu- 

 taneously and intratracheally. Naturally, its effect will 

 depend upon the presence of a streptococcus infection which 

 is by no means proved in purpura. Further, the serum is 

 expensive. Perhaps some of the good results reported are due 

 less to the potency of the serum than to the fact, that when 

 used, the resistance of the patient is not being reduced by 

 overdrugging, a common practice before the introduction of 

 modern serum therapy. 



The medicinal treatment is very varied and purely empiri- 

 cal. The following suggests some of the possibilities in this 

 regard : 



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