896 Paralytic Hemoglobinemia. 



gradual aggravation of the general condition. Finally in rare 

 cases there exists only a stiffness and weakness of the hind 

 parts, as well as hemoglohinnria, for 3 to 5 days, and complete 

 paralysis does not develop until later, as a result of which 

 the animals collapse, and soon die (according to Utz there is 

 a subacute form of the disease in contra-distinction to the above 

 acute form). 



In severe cases death may ensue on the third or fourth, 

 exceptionally even on the first day, mostly however the animals 

 do not die until towards the end of the first week or at the 

 beginning of the second. The immediate cause of the fatal 

 termination is probably most frequently a general septic infec- 

 tion with its consequences, more rarely hypostatic pneumonia 

 or uremia. 



In the favorable cases the improvement makes either rapid 

 progress, so that the gait of the animal becomes normal within 

 a few days, or on the contrary a weakness of the hind parts 

 persists for several weeks, although it gradually subsides. 

 Sometimes the weakness or the paralysis of one extremity may 

 remain for months, even for 1 to 2 years, exceptionally even 

 permanently, and meanwhile lead to a rapidly progressing 

 atrophy of some of the muscles (the extensor quadriceps of the 

 leg, the abductor of the thigh or the rump). 



Repeated attacks also occur, either at shorter or at longer 

 intervals, sometimes even after several weeks (Kronburger 

 observed a horse become affected three times within one week). 



Diagnosis. The disease can be diagnosed with certainty 

 only by the presence of its two cardinal symptoms, namely, the 

 peculiar muscular affection and the hemoglobinuria. None of 

 these symptoms however suffice in themselves as a firmer con- 

 sistency of the muscles and their functional disturbances may 

 be observed also in muscular rheumatism, but in this affection 

 the tendon reflexes are normal. Hemoglobin may be present 

 in the urine also in acute infectious diseases or intoxications, 

 but in these pronounced symptoms of paralysis and reduction 

 of the reflex irritability are absent. 



A traumatic injury of the spinal cord or spinal meningitis 

 can easily be excluded by the history of the case, in some cases 

 by the evident sensitiveness of the vertebral column, by the 

 complete insensibility of the paralyzed part of the body, by 

 the disturbances of the functions of bladder and rectum, and 

 by the action of the patellar reflex, which in contusions' of the 

 sacral cord is normal, in the presence of a lesion anteriorly 

 to the lumbar cord appears to be normal or increased, while 

 after injuries of the middle lumbar cord on the other hand 

 it is not present. Moreover, in hemoglobinemia there also 

 exists in most instances a hemoglobinuria which is absent in 

 contusions of the spinal cord. — From the enzootic spinal 

 meningitis (infectious spinal meningitis, Schlegel) the paralytic 



