DISTEMPER 151 



symptoms of cerebral congestion, accompanied by 

 convulsions and sometimes by attacks of mania 

 closely resembling those of rabies, make their ap- 

 pearance. Again the patient may become partially 

 or even completely paralyzed, or it may develop 

 the persistent clonic convulsion of some group or 

 groups of muscles, known as chorea. 



In distemper the skin, especially that inside the 

 thighs, on the chest, and on the belly, is often the 

 seat of a pustular eruption (the exanthema of dis- 

 temper). These pustules discharge their contents, 

 dry up, and form scabs. The scabs later on fall 

 oflf, leaving small depigmented areas. 



The significance of the appearance of this exan- 

 thema is still a debated question among practition- 

 ers, some contending that it foreshadows a fatal 

 termination, others that its appearance is a favor- 

 able symptom. The author's experience is that it 

 is merely a manifestation of the disease and has no 

 significance either one way or the other. 



Another prominent symptom in distemper is the 

 characteristic and exceedingly offensive odor ema- 

 nating from the patient's exhalations and from the 

 skin,' the latter also having a peculiar greasy feel 

 to the touch which can hardly be mistaken when 

 once experienced. 



Treatment. — The therapeutic indications for dis- 

 temper vary with the particular complications the 

 case presents. In other words, symptoms must be 

 treated as they arise, but the whole rationale of 

 treatment may be summed up by saying that the 

 patient's powers of resistance must be raised to 

 resist the invading organisms, and free elimination 

 must be established to carry off both the microbic 

 toxins and those toxins produced by the normal 

 flora of the intestinal canal, which irj disease are 



