Diagnosis, Treatment. 415 



symptoms, the inflammation of the eyes (cornea), and the nasal 

 mucous membrane, the marked depression of the sensorium 

 are characteristic of the affection. From these signs the dis- 

 ease is easily recognized when it occurs sporadically and no 

 intensive affections of other organs are associated. If how- 

 ever several cases follow each other rapidly, or if the intestinal 

 canal and the genital organs are severely affected, and the 

 course is very rapid, a differentiation from other similar dis- 

 eases requires great care, and very accurate observation. 



The greatest similarity exists with rinderpest, especially 

 when at the same time there exists a severe inflammation of 

 the intestinal and vaginal mucous membranes. However in 

 malignant catarrh the symptoms of the affections of the eye 

 (diffuse keratitis, which may exceptionally be absent), and 

 sinuses of the head, as well as the severe nervous symptoms, 

 are in the foreground of the clinical picture, and besides the 

 disease is not contagious, which condition may in emergency 

 be established by subcutaneous inoculations of blood (in rinder- 

 pest in 4 to 5 days after such inoculation fever and a severe 

 catarrh of the mucous membranes develops). 



The fibrinous rhinitis (croup of cattle), which sometimes 

 also occurs in an infectious character and manifests quite 

 similar symptoms, usually attacks cows shortly after parturi- 

 tion, and at the same time nervous symptoms as well as indica- 

 tions of an eye affection are absent (Grunth). By the affection 

 of the nose and its sinuses, as well as by the great dullness, 

 the disease is distinguished from foot-and-mouth disease, and 

 from the various forms of intestinal inflammation (scours, 

 mycotic and toxic enteritis). The croupous character of the 

 mucous membrane distinguishes it from the non-infectious nasal 

 catarrh, while in infectious keratitis the process is confined 

 exclusively to the eyes. Finally tuberculous meningitis may 

 enter into consideration on account of the great apathy, in 

 which however inflammatory changes of the mucous membranes 

 are absent, and instead paralysis of certain nerves of the head 

 is observed. 



Treatment. At present the treatment is purely symp- 

 tomatic. To alleviate the acute inflammation of the mucous 

 membranes of the head energetic cold applications, or cold 

 irrigation of the head are indicated first of all. The accumula- 

 tion of discharges should be prevented by repeatedly washing 

 the conjunctiva, as well as the nasal and buccal mucous mem- 

 branes with mild astringents and disinfectants (boracic acid, 

 alum, copper sulphate, creolin, lysol, in 1-2% solutions), fur- 

 ther by inhalation of water vapors, and if possible by manual 

 removal of the necrotic tissue. In attacks of asphyxiation 

 tracheotomy must be performed, and it is advisable to retain 

 the tube in the opening of the trachea for a time, even after 

 the respiratory difficulties diminish. 



If a great quantity of exudate accumulates in the frontal 



