408 PRINCIPLES OF VETERINARY SURGERY 



DIAGNOSIS. — The determination of the exact nature 

 of the disease is usually easy. The existence of a sheltered 

 anfractuous wound in a horse, that is followed by the ap- 

 pearance of an oedematous, crepitant engorgement, with 

 local mortification of the tissues, leaves but little doubt as 

 to what the symptoms reveal. In the ox it may be con- 

 founded with symptomatic anthrax, but the history gener- 

 ally makes it possible to exclude the latter disease. The 

 non-existence of symptomatic anthrax in certain localities, 

 and the development of an advancing oedema from the pe- 

 riphery of a wound or sanguineous sac, or following parturi- 

 tion, would constitute symptoms of real importance. In the 

 other species, the hog for example, the diagnosis is of little 

 importance. The disease is only verified when it is too late 

 for intervention. 



ANNOTATION, 

 Malignant oedema is a much more frequent disease in America than 

 was once supposed. Heretofore the real nature of the affliction has not 

 always been recognized. Its galloping course often terminates the patient's 

 life before expert advice is procurable. The disease has been so little studied 

 in the American schools that the cases encountered seldom arouse suspicion 

 as to their true nature. Inquiry among veterinarians proves that some have 

 never thought of the disease, others have recognized a few cases, while still 

 others claim to meet it quite frequently. 



Malignant cedema is, in fact, quite a common disease of citv horses. 

 It supervenes nail punctures of the feet, surgical operations, setons, and 

 various accidental punctured wounds. Among the latter, the wounds about 

 the shoulders seem particularly prone to favor its evolution. Operations 

 upon fistulas of the withers, poll-evils and shoulder tumors are especially 

 dangerous. The malignant cedema cases following nail punctures are prob- 

 ably of very common occurrence. The cases from this cause are, however, 

 subjects for future study, because the clinical aspect is not always typical 

 enough to make an absolutely positive diagnosis. Acute blood-poisonings, 

 terminating fatally a few days after the nail wound is sustained, are at 

 least sometimes, typical cases of the disease. About twenty-four hours after 

 t^he'nail is "picked up'' the patient begins to manifest unusual symptoms of 

 distress which seein entirely out of proportion to the apparent character of 

 the. wound. The temperature is elevated, the appetite nil, the respirations 

 greatly accelerated. The foot is found hot, the lameness intense, and the 

 wound absolutely free from suppuration. At the end of forty-eight hours 

 the symptoms are accentuated and the wound, when reopened, will bubble as 

 if gas is escaping. , Within a few days the patient dies rather suddenly. Irv 

 some cases the hoof falls off shortly before death. The post-mortem exam- 



