SJTRANGLES—COBYZA CONTAGIOSA EQVORUM 399 



(c) The mesenteric lymph glands. These glands may be 

 primarily or secondarily involved. The symptoms are fever, 

 mild colic and a history of exposure to strangles. The con- 

 dition leads to death either gradually or suddenly through 

 rupture of the abscess and the resulting peritonitis. Similar 

 symptoms may arise from abscess formation in any other of 

 the lymph glands of the £\bdominal cavity whether they be 

 parietal or visceral. 



Diagnosis. — ^The recognition of the usual case of strangles" 

 is not difficult. The purulent nasal discharge and abscess 

 formation in the submaxillary region are characteristic. 

 Cases occur, however, which are so atypical that from the 

 clinical symptoms alone, a diagnosis is impossible. The 

 history of exposure to strangles, the age of the patient and 

 the existence of more typical cases on the same premises may 

 assist to establish a diagnosis. The microscopical examina- 

 tion of the pus (nasal discharge) for streptococci and the inoc- 

 ulation of expei"imental animals (white mice) are frequently of 

 service in this regard. Very puzzling are those cases in which 

 the abscesses form in internal organs (lymph glands of 

 abdomen), as the symptoms are often vague. The history of 

 the case, the tendency to attacks of mild colic, the irregular 

 temperature and the presence of albumoses in the urine are 

 suggestive of hidden pus of probable strangles origin. 



Course and Prognosis. — Most cases of strangles heal readily 

 in two to four weeks without complication. This is especially 

 true of the usual benign type ("regular form") of the disease 

 which is confined largely to the nasal cavities and lymph 

 glands of the submaxillary space. On the other hand, when 

 the disease assumes an atypical (" u-regular") form, affecting 

 the pharynx and its lymph glands or involving internal glands 

 or organs (lungs, mediastinal glands, mesenteric, lumbar 

 glands, brain, etc.) the course is greatly protracted, and the 

 prognosis doubtful to bad. When, after the submaxillary 

 abscess is evacuated, the temperature continues up or rises 

 again after a temporary fall, the development of further 

 abscesses is probable. In some cases, as the abscesses heal, 

 fresh ones appear, prolonging the course and complicating the 

 prognosis. The resistance of the patient and its surroundings 



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