22 Anthrax. 



cases of recovery are more frequent. The prognosis is most 

 unfavorable in the peracute cases, and most favorable in the 

 primary local skin affections as long as there are no intensive 

 general disturbances to indicate the entrance of the bacteria 

 into the blood circulation. The development of edematous 

 swellings in the course of the febrile affection is almost in- 

 variably of unfavorable significance, while the appearance of 

 bacilli in the blood is indicative of approaching death. 



Treatment. In primary local affection of the skin, sub- 

 cutaneous tissue or the visible mucous membranes, surgical 

 treatment is first indicated. This consists in deep incisions of 

 the swellings, and after thorough squeezing and scraping, the 

 wound is repeatedly washed and cauterized. Cross incisions 

 are advisable, while large swellings may be incised in several 

 places. As disinfectants the following are recommended: 

 Corrosive sublimate (1-1000), carbolic acid (3%), creolin (5%), 

 etc. Good results are also obtained from subcutaneous injec- 

 tions at various places in the periphery of the swelling with 

 2-3% carbolic acid or 5% creolin solution, and covering with a 

 carbolic dressing. 



In cases of generalized disease which are not yet far ad- 

 vanced the treatment with immune serum (see page 28) gives 

 remarkably good results. After the intravenous injection of 

 40-80 g. of sufficiently active serum the temperature falls 

 rapidly, frequently within as short a period as 6 hours, and this 

 is followed by a complete recovery after 12 hours (Jaeger, 

 Detre, Raebiger, Gal and others). In cases in which no im- 

 provement is observed after a few hours, or in which the tem- 

 perature rises, it is advisable to repeat the serum injection. 

 Serum of high potency proves effective even in small doses and 

 in subcutaneous applications. 



Sometimes favorable results may be obtained from symp- 

 tomatic treatment, viz., repeated bathing with cold water, rub- 

 bing with camphor, turpentine or pure alcohol. Internally 

 wine, alcohol or camphor may be given ; also subcutaneous in- 

 jections of ether or camphor, etc. In the presence of an in- 

 testinal infection the administration of disinfectants in large 

 doses is indicated, such as creolin or lysol (larger animals 

 20-50 gm., smaller animals 5-10 gm. or even larger doses) ; creo- 

 sote (5-10 and 1-2 gm., respectively), carbolic acid (according 

 to Hess 40-50 cc. of a i/2i% solution daily), calomel in small 

 and frequent doses (for horses, with %: gm. opium) and oil of 

 turpentine (for larger animals 200-300 gm. mixed with sweet 

 oil). Enemas with disinfecting fluids may also be tried, es- 

 pecially in cases in which the symptoms indicate a severe af- 

 fection of the rectum. Intravenous injections of coUargol (1 

 gm. dissolved in 50-100 gm. of water) are also recommended. 



The sick animals should be provided with well-ventilated, 

 shady and cool quarters. They should receive an abundant 



