Course and Prognosis. 38]^ 



the French army, in the period between 1888-1897, 90,381 horses were aifeoted with 

 strangles, of which 992 (1.1%) succumbed. In the Italian ariliy colt 'depots the 

 number of cases in the years from 1903-1907 varied between 645 and 1329, among 

 '5000-6000 colts, the number of deaths varying between 16 and 30. 



After the subsidence of the acute affection, various sequels 

 occasionally develop; thus the inflammation of tlie mesenteric 

 glands may come to a stop in case no acute peritonitis or 

 pyemia result. But the nutrition of the animals usually re- 

 mains more or less affected through suppuration in the glands, 

 thrpugh new formation of connective tissue and the resulting 

 thickening of the mesentery and sometimes also through a con- 

 striction of the intestinal lumen. Consequently a severe cachexia 

 gradually develops (tabes mesaraica). The inflammation of 

 the guttural pouches, and of Highmore's cavities, which is at 

 first acute, may sometimes change in its further course and be- 

 come chronic, while contracted tendons, which may result from 

 the disease on the extremities, produce lasting lameness. In 

 some animals symptoms of hydrocephalus develop gradually as 

 a result of encapsulated abscesses in the brain (Kofler found in 

 12 out of 40 horses which were slaughtered on account of hydro- 

 cephalus, softened areas in the brain, with streptococci in the 

 contents of the abscesses). Further purpura hemorrhagica may 

 develop in horses recovered from strangles, while roaring is a 

 frequent sequel and is due to paralysis of the recurrent laryn- 

 geal nerves (according to Wiart out of 100 colts affected with 

 strangles 25 later became roarers, while according to Nocard, in 

 Argentine, where strangles does not occur, roaring is supposed 

 to be unknown). ■ - 



Diagnosis. In those cases in which the infection of stran- 

 gles is indicated only by acute nasal catarrh or pharyngitis, 

 without suppuration of the lymph glands, the specific nature 

 can only be established with more or less probability, by the 

 condition of other horses in the same stable in which attacks 

 with characteristic symptoms of strangles might be present. 

 A demonstration of streptococci in the nasal discharge would 

 have to be considered with caution as streptococci may be pres- 

 ent in the discharge without true strangles. 



In affections of the lymph glands in the pharyngeal region 

 strangles may be confounded with pharyngitis resulting from 

 other causes, or with inflammation of the parotid gland. If the 

 disease process is exclusively localized in the region of the 

 throat, only the further course of the disease will reveal the 

 true nature of the affection, while previous to that the diag- 

 nosis can be based only on the mode of infection, or upon the 

 fact that in strangles the symptoms of pharyngitis usually 

 reach a very high intensity. In cases of inflammation of the 

 parotid gland the inflammatory swelling is less- diffuse,^ at least 

 at the beginning, but is more or less sharply circumscribed fol- 

 lowing the borders of the glands or its lobules. 



In the cases in which the affection is exclusively confined 



