326 ACUTE GENERAL INFECTIOUS DISEASES 



death. Defects in the skin due to gangrene may take months 

 to heal. 



Prognosis. — The prognosis is generally doubtful. When 

 the swellings on the head are extensive life is always threat- 

 ened. A high pulse (80), diarrhea, no appetite, constant 

 recumbency, with attending decubitus and severe colic, are 

 bad symptoms. The disappearance of the swellings is not a 

 good sign unless the other symptoms also improve. Blood 

 extravasations may form at any time in any organ (bowels, 

 brain, and spinal cord), precipitating sudden death. The 

 mortality varies from 30 to 50 per cent, and is largely de- 

 pendent on the hygienic surroundings and care of the patient. 



Treatment. — As yet no successful specific treatment has 

 been devised to combat the disease. The principal factor in 

 bringing cases to a favorable termination is good hygiene. 

 The patient should be placed in a light, clean, well- ventilated, 

 bedded box stall and the head halter removed (prevents ne- 

 crosis of skin of face). In proper weather it may be let run 

 out of doors during the day. A light blanket may be used for 

 covering. Allow plenty of clean water. The food should 

 consist of oats, grass, and bran with plenty of salt. If there 

 is difficulty in swallowing, gruels or milk may be used or tube- 

 feeding employed. The treatment is surgical, serotherapeutic 

 and medicinal. The surgical treatment consists in a thorough 

 disinfection of the tumefactions, wounds, ulcers, and abscesses 

 (creolin, lysol 3 per cent.). The application of Burrows' 

 solution with camphor (camphor g iss, lead acetat § vj, alum 

 giij, a tablespoonful to a wine bottleful of water) is good to 

 ward off gangrene. Spirits of turpentine applied two or 

 three times is said to have like effect. Scarification of the 

 swellings as usually practised does no good and opens an 

 avenue for further infection. 



When suffocation threatens, tracheotomy should be per- 

 formed. While it no doubt prolongs life, in most cases where 

 called for death follows. 



Good results are reported from the use of antistreptococcic 

 serum in doses from 25 to 50 c.c. It may be given subcu- 

 taneously and intratracheally. Naturally, its effect will de- 

 pend upon the presence of a streptococcus infection which 1 is 



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