Milk Sickness. " The Trembles.'' 375 



spiritless, drag their limbs slowly and stiffly and quickly stop 

 from pure weariness and debility. 



The prostration is even more marked in sheep, which often 

 seem unable to rise, or lack the nervous energy to do so. 



Calves tremble while sucking, and will sometimes leave the 

 teat, vomit the contents of the stomach, fall down and perish. 



In Vomiting Animals {fiig, dog), emesis usually occurs, and 

 torpor of the bowels or obstinate constipation is present. Pigs 

 burrow under the litter and are driven out with difficulty, and 

 dogs when called on to follow, do so reluctantly, slowly and 

 stiffly and fail to keep pace with their master ("the Slows"). 



In all animals alike, active or continued exertion rouses or in- 

 tensifies the symptoms. 



In man there is at first extreme langour, weariness and weak- 

 ness, the patient cannot be troubled to move, he loses appetite, 

 loathes food, and soon has nausea and retching — often from the 

 first. There is no chill, rigor nor violent headache as in other 

 fevers ; but insatiable thirst ; large, flabby, tremulous, moist 

 tongue, coated a dirty white ; cold nose, ears and general sur- 

 face ; dry skin ; sweet, mawkish or offensive breath ; flat, flabby 

 empty belly ; without peristalsis or defecation. Respiration be- 

 comes very slow, pulse weak and compressible, heart action 

 tumultuous and labored, temperature often below normal, and 

 though sometimes 99" or 100° F., never higher. The patient 

 takes to bed in four or five days, or, after exertion or fatigUe, in 

 a few hours becomes profoundly apathetic, expresses no concern 

 for his business, his own future or that of his family, is intolerant 

 of bed clothes or other covering and utterly oblivious of the de- 

 mands of decency. Nausea continues, but retching becomes 

 weaker, and comparatively ineffective, or brings up a little liquid 

 which has been compared to blueing water of the laundry. The 

 apathy merges into a state of hebetude and this into coma, with 

 fixed, glazed eyes, absence of all winking, and insensibility to 

 irritants and death takes place quietly without a moan or 

 struggle. 



Recovery is slow, and improvement for a time is almost imper- 

 ceptible. In some cases there remains a nervous atony, and in 

 man, a lack of mental and bodily vigor, and a disposition to re- 

 lapse under exposure to intense heat or fatigue has been noted. 



