BOVINE DIPHTHERIA. 
461 
situations, to the development of grave symptoms and to impor¬ 
tant sequelae. The symptoms vary with the anatomical system 
involved, namely, circulatory, cutaneous, respiratory, digestive, 
nervous and urinary. 
The pulse may be frequent at first, then suddenly falling 
below the normal. Epistaxis is sometimes profuse, and there 
may be haemorrhage from throat and mouth, which denotes 
great danger. The skin rarely presents much increase of heat, 
and not infrequently in the course of the disease the surface 
becomes cool or cold. Pyrexia, as a rule, is less than in most 
other acute diseases; however, it may be high. 
Petecchial spots or ecchymoses, are sometimes observed, 
generally in connection with haemorrhage from mucous sur¬ 
faces. In some cases the skin presents an anaemic aspect, even 
when haemorrhage has not occurred. Diarrhoea is not uncom¬ 
mon, and is a bad omen. In the majority of cases the mind is 
unaffected, but delirium does occur; convulsions and coma 
occasionally occur and are a forerunner of a fatal termination. 
The probability in these cases is that it is due to uraemia. 
Albuminuria is a frequent symptom, but it varies consider¬ 
ably at different times. In cases in which albumen is abundant 
the diphtheritic exudation is generally large and the glands of 
the neck unusually great. 
Haematuria has been observed in cases presenting symptoms 
of purpura. The duration of the disease is between one and 
two weeks. In fatal cases death may occur as soon as forty- 
eight hours ; on the other hand the illness may continue for an 
indefinite period, owing to the sequelae. The sequelae of this 
disease form an important part of the clinical history ; anaemia 
and general debility are likely to persist for a considerable 
period. Death may occur from syncope due to heart failure. 
Paralysis, involving both voluntary and involuntary muscles, is 
a characteristic sequel. 
The lesions of the paralysis have been found in the central 
nervous system, in the spinal nerve roots and in the peripheral 
nerves. The anatomical basis of the paralysis does not seem to 
