OASTBIC DERANGEMENT FROM FOREIGN BODIES. 



127 



tract with the sound we may penetrate as far as the stomach. 

 Ordinarily the fistula heals only after some weeks^ perhaps months ; 

 occasionally the cure is complete within a relatively short time; in 

 some cases the patients are attacked by marasmus and succumb ; 

 finally, there are animals showing, so to speak, nothing abnormal 

 either before or after abscess formation. 



Ditferential diagnosis. The diagnosis is quite difficult ; a care- 

 ful examination of the patient, however, often permits us to detect 

 important and significant symptoms. 



If there is any possibility of confounding this affection with 

 common catarrh of the stomach, the following indications may 

 guide us and assist in eliminating the former condition : The 

 absence of reactions when making compression of the insertion of 

 the diaphragm, the region of the reticulum, etc., also the uniformity 

 of the gastric troubles ; etiological data that may be elicited by 

 inquiry, and the effect of curative treatment prolonged for a certain 

 time ; further, we see a less marked emaciation in common catarrh 

 of the stomach than in cases of traumatism of this organ. 



We may be embarrassed in trying to establish a difference be- 

 tween the disease in question and a peritonitis or gastro-enteritis ; 

 but these latter affections are ordinarily distinguished by a more 

 rapid march, a more intense fever, and more serious disturbance of 

 nutrition. When the foreign body has penetrated into the lungs, 

 it may produce symptoms of a chronic pulmonary affection which 

 is often difficult to distinguish from pulmonary tuberculosis, except 

 when former indigestions, an affection of the diaphragm, or absence 

 of any bronchial catarrh, lead us to suspect the presence of a foreign 

 body. 



Contagious pleuro-pneumonia is recognized by its epizootic char- 

 acter, its typical course, and by the pneumonic symptoms which 

 predominate ; lastly, also to absence of serious disturbance in the 

 direction of stomach and intestine. 



Treatment. Measures of prophylaxis are indicated by the 

 etiological considerations. Harms proposes to make small holes upon 

 the opposite extremities of the crib, which are intended to gather 

 the foreign bodies which are accidentally mixed in the forage. The 

 efficiency of the treatment depends upon the time when the diag- 

 nosis has been made. Cases are not rare where treatment for 

 stomachal catarrh has been first used ; but as soon as we are con- 

 vinced of the presence of a foreign body, we have simply the 



