Part 16

════════════╤═══════════════╤════════════════╤════════ Animal │ Causative │ Pneumonia, │Abscess │condition upper│septic or other │ or │ respiratory │ │Gangrene │ tract │ │ ────────────┼───────────────┼────────────────┼──────── Sooty │Negative │Catarrhal │Gangrene Mangabey │ │pneumonia │ Cercocebus │ │ │ fuliginosus │ │ │ │ │ │ Rhesus │Negative │Septic from │Abscess Macaque │ │suppurating │ Macacus │ │gland │ rhesus │ │ │ Am. Wild Cat│Aspiration │ │Gangrene Felis ruffus│vomitus from │ │ │violent │ │ │gastroenteritis│ │ │ │ │ │ │ │ │ │ │ Puma Felis │Acute purulent │No │Abscess concolor │nasopharyngitis│ │and │ │ │gangrene │ │ │ │ │ │ Ichneumon │Negative │Sepsis, scalp │Abscess Herpestes │ │wound │ mungo │ │ │ │ │ │ │ │ │ Raccoon │Negative │Pneumonia │Abscess Procyon │ │followed by │ lotor │ │sepsis │ │ │ │ │ │ │ Skunk │Cellulitis face│Sepsis, very │Abscess Mephitis │and neck │mild │ mephitica │ │ │ Puma Felis │Perforating │Secondary │Abscess concolor │abscess around │terminal │ │jaw │pneumonia, │ │ │sepsis │ │ │ │ │ │ │ Porcupine │Negative │Enteritis, no │Abscess Erethizon │ │special sepsis │ dorsatus │ │ │ │ │ │ │ │ │ │ │ │ Kangaroo Rat│Negative │Right sided │Abscess Perodipus │ │bronchopneumonia│ richardsoni │ │ │ │ │ │ Squirrel │Abscess under │No │Abscess Sciurus p. │eye and in │ │ carolinensis│masseter muscle│ │ │ │ │ │ │ │ │ │ │ Mule Deer. │Actinomycosis? │Arthritis. │Abscess Mazama │nasopharynx │Myositis │and hemionus │ │Tenosynovitis │gangrene │ │ │ │ │ │ Axis Deer. │Negative │Negative │Abscess Cervus axis │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ Tapir. │Abscess of │Died from │Abscess Tapirus │parotid │enteritis │ indicus │ │ │ │ │ │ │ │ │ │ │ │ Gazelle. │Negative │Sepsis from │Abscess Gazella │ │infected wound │ isabella │ │ │ │ │ │ │ │ │ Kangaroo. │Negative │Catarrhal │Abscess Macropus │ │pneumonia │and rufus │ │ │gangrene │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ │ Kangaroo. │Kangaroo │Sepsis │Abscess Macropus │mycosis of jaw │ │ rufus │ │ │ │ │ │ Kangaroo. │Kangaroo │ │Abscess Macropus │mycosis of jaw │ │ giganteus │ │ │ │ │ │ Kangaroo. │Negative │Sepsis from │Abscess Macropus │ │infected wound │ robustus │ │ │ Devil. │Negative │Negative sepsis │Abscess Sarcophilus │ │ │ ursinus │ │ │ │ │ │ │ │ │ Crow. │Negative │Filaria in │Abscess Gymnorhina │ │blood? │ leuconota │ │ │ Heron. Ardea│Negative │Negative │Abscess tricolor │ │ │ ruficollis │ │ │ │ │ │ │ │ │ Goose. Anser│Syngamus in │Negative │Abscess fabalis │trachea │ │ │ │ │ │ │ │ │ │ │ │ │ │ ────────────┴───────────────┴────────────────┴────────

════════════╤═════════╤══════════════╤══════════════ Animal │Single or│ Position │ Bacteria │Multiple │ │ │ │ │ │ │ │ ────────────┼─────────┼──────────────┼────────────── Sooty │Massive │Upper part │Streptothrix, Mangabey │single │lower lobe and│necrosis Cercocebus │ │adherent part │bacillus. fuliginosus │ │upper lobes │ │ │left side │ Rhesus │Single │Occupied │ Macaque │ │nearly all │ Macacus │ │right middle │ rhesus │ │lobe │ Am. Wild Cat│Bilateral│Right middle │ Felis ruffus│ │lobe, left │ │ │lower lobe, │ │ │left bronchus │ │ │ruptured, │ │ │right middle │ │ │lobe ruptured │ Puma Felis │Bilateral│Right upper │Streptococcus concolor │ │and left lower│pyogenes. │ │lobe abscesses│ │ │biggest, right│ │ │middle also │ Ichneumon │Bilateral│Scattered │ Herpestes │ │small │ mungo │ │abscesses, │ │ │under pleura │ │ │especially │ Raccoon │Bilateral│Probably all │ Procyon │ │lobes, right │ lotor │ │middle │ │ │contains │ │ │largest │ Skunk │Single │Left lower │ Mephitis │ │lobe, single │ mephitica │ │small │ Puma Felis │Bilateral│Numerous small│ concolor │ │abscesses, │ │ │irregularly │ │ │scattered │ │ │through both │ │ │lungs │ Porcupine │Bilateral│Multiple small│ Erethizon │ │scattered. │ dorsatus │ │Parasitic? No │ │ │notes │ │ │parasites or │ │ │bacteria │ Kangaroo Rat│Single │Left lower │ Perodipus │ │lobe, small │ richardsoni │ │abscess, │ │ │record scanty │ Squirrel │Multiple │Left lung │ Sciurus p. │ │scattered, │ carolinensis│ │small │ │ │abscesses, │ │ │parasites not │ │ │seen │ Mule Deer. │Bilateral│Scattered both│ Mazama │ │lobes under │ hemionus │ │pleura, upper │ │ │right inferior│ │ │tip gangrenous│ Axis Deer. │Single │Apparently │Streptothrix. Cervus axis │ │primary │ │ │streptothrix, │ │ │abscess in │ │ │cardiac tip of│ │ │upper lobe │ │ │with extension│ │ │toward hilum │ Tapir. │Bilateral│Multiple │Staphylococci. Tapirus │ │subpleural pus│ indicus │ │pockets, │ │ │surrounded by │ │ │catarrhal │ │ │pneumonia │ Gazelle. │Bilateral│Multiple │ Gazella │ │subpleural and│ isabella │ │internal, both│ │ │lungs about │ │ │the same │ Kangaroo. │Double │Lower middle │Pneumococci Macropus │left │left lobes, │streptothrix. rufus │ │seat of a │ │ │ruptured │ │ │gangrene │ │ │surrounded by │ │ │pneumonia, │ │ │right lung │ │ │pneumonic │ Kangaroo. │Bilateral│More on right │Streptothrix, Macropus │ │side, sharply │cocci. rufus │ │outlined │ │ │abscesses │ Kangaroo. │Single │Abscess and │Streptothrix Macropus │ │atelectasis, │ giganteus │ │right middle │ │ │lobe │ Kangaroo. │Single │Lower right │ Macropus │ │lobe │ robustus │ │ │ Devil. │Multiple │Largest middle│Probably Sarcophilus │ │of right lung,│streptothrix. ursinus │ │many small │ │ │scattered │ │ │abscesses. │ Crow. │Multiple │Scattered tiny│ Gymnorhina │ │abscesses, no │ leuconota │ │worms seen │ Heron. Ardea│Single │Upper pole, │ tricolor │ │right lung, no│ ruficollis │ │apparent │ │ │antecedent │ │ │cause │ Goose. Anser│Single │Lower half │ fabalis │ │right lung │ │ │occupied by │ │ │abscess, which│ │ │has penetrated│ │ │air sac │ ────────────┴─────────┴──────────────┴──────────────

The distribution of abscess and gangrene in the lungs in terms of the antecedent disease, therefore its causation, may however be of interest. The lower animals move more in the horizontal position, they seldom cough, they are subject to several different diseases with principal lesions in the anterior head (diphtheria, actinomycosis, etc.) but not to chronic lymphatic infection, they push their snouts into all kinds of filth thereby probably taking into the nose and throat many objects which can find their way to the bronchi, and finally they are not subjected to various instrumental operative procedures when they chance to have a focus of pathology in the nasopharynx. For these reasons the position of abscess and its sequels may be instructive. It has recently been stated that abscesses of the lung in human beings following anesthesia for infections of the upper respiratory tract, occur most often in the upper parts of the lung whereas those following pneumonia develop more in the lower lobes. For the animals of this series, these facts are not borne out. In the accompanying list will be found our acceptable cases of abscess and gangrene. Little can be said about incidence save the fact that the highest percentage and number occur in the Carnivora. It will be found that the right lung is affected nine times predominatingly while the left lung is affected seven times. The lobe most often singled out for an isolated lesion is the lower left, the right middle being the next most often affected. These figures concern the mammals alone, the three birds being considered too few to discuss. It cannot be said from these figures that there is in animals any definite distribution of pulmonary abscess and gangrene.

Nor do these figures correspond to those appearing in literature of human pathology. In man inspiration of foreign bodies, including bacteria-laden mucus, usually carries them into the right lung because of the larger and more directly vertical bronchus to that side. Emboli go as a rule also to the right lung more than to the left because of the greater size of the pulmonary artery and more direct blood current to that side. In these animals right side lesions are more numerous but the left lower lobe is the principal segment of the lung to be affected. The cases are too few and the anatomy too variable to permit any deductions. There is in the affected animals no uniform anatomical peculiarity which would explain the predominance of the right lung as a whole or the left lower lobe as a unit.

PNEUMONOKONIOSIS.

Pneumonokoniosis, because of its importance in industrial diseases, has been subjected during recent years to considerable intensive study in human medicine, from which activity some interesting and useful information has been obtained as to its genesis and effect upon the function of the lung. This condition is of course a purely environmental one, the degree and particular kind of “dusting” being dependent upon the duration and nature of exposure of the particular individual. This Garden is situated beside an active railroad trunk line so that the opportunity for coal dust inhalation is continuous. The degree of anthracotic pigmentation of the lungs and related serous membranes is really negligible and with one questionable exception, we have not seen fibrosis due to this cause in any animal. The one exception, an amazon presented and living in the Garden but three months, at necropsy showed an interstitial chronic bronchitis and pneumonitis stretching out from the hilum, all of the affected area being deeply pigmented. The picture was comparable to what might be expected from a second degree anthracotic fibrosis of Landis and Pancoast. Many specimens come to autopsy with some grade of pigmentation, but none, except the one above, with resultant fibrosis. The degree of anthracosis is usually so slight that it has been considered important enough to include in the diagnosis but eighteen times and curiously enough seventeen of these were observed in birds. Were there more cases it might be profitable to plot their exhibition period but the use of this small number might lead to error; the average length of exhibition of the birds was about a year. It is common to observe some black specklings of the air sacs, as if pepper were dusted on them as has been said before, but even this is rarely marked. It is most often seen in the Anseres, Psittaci and Struthiones but a goodly number of cases occur in the long-lived Passeres.

The distribution of the pigment is essentially the same throughout Mammalia—peribronchial, submucous and in the lymph nodes at the root of the lung. In the birds it is first seen in the subepithelial spaces of the septa of the small alveoli where they project into the secondaries, later accumulating in the connective tissue of the main septa. Collections under the pleura and at the root of the lung are rare, the dust usually spreading out along the air passages into the air sacs.

Other forms of pneumonokoniosis are unknown. Although animals must inspire much dust from dry feed and from floors it must be caught early and removed by snorting or by the lymphatic drainage. It seems fairly well accepted that dusts are dangerous to the degree that they contain inorganic substance and as these animals are not exposed to concentrated mineral or metallic dusts, no effects are seen.

INFARCTION OF LUNG.

Infarctions of the lung, while not at all common, are interesting because of their incidence in the Carnivora and in the distribution. The figures concern the mammals only since the decision for or against infarct in the birds is very difficult because of the frequency in this class of hemorrhage with pulmonary congestion. There were eleven single or double non-septic infarcts, of which seven occurred in Carnivora, one in an ungulate, two in Primates and one in a rodent. The existence of parasites was excluded in most of the cases but could not be entirely in all. Eight of these infarcts were on the left side, five of these being in the lower lobe.

EMPHYSEMA.

Emphysema of the atrophic and chronic vesicular types with the soft, fluffy, pigmented or pale pink organ has not occurred in the animals under observation. Acute vesicular emphysema, such as is seen in chronic bronchial and cardiac diseases, has been encountered several times. Cardiac lesions were found four times, nephritis eleven times, acute enteric conditions seven times, hepatic diseases seven times. Two cases of wide spread amyloid disease showed a deposit of this substance in the alveolar walls. It is quite common to find some grade of emphysema in monkeys dying from osteomalacia and rickets. The process is then most prominent in the upper lobes and along the free anterior margins. The incidence in the orders is Primates 5, Lemures 2, Carnivora 2, Pinnipedia (drowning) 1, Rodentia 1, Ungulata 4, Marsupialia 4. The best example was found in a Skunk (_Mephitis mesomelas_) having a general infection, emanating from the cranial sinuses, and cardiac dilatation. Emphysema does not seem to occur in birds for only one was seen which seemed to present this condition. This was a Bald Eagle (_Haliæetus leucocephalus_) with chronic renal and enteric disease and cardiac hypertrophy. The lungs were tensely distended under their serous covering and showed a few small bullæ anteriorly. Unfortunately a histological preparation is not at hand.

TUMORS.

Tumors of the lung are moderately common, both of primary and secondary origin. Thus we have seen three primary and six metastatic growths in mammals and one of each kind in birds. The primaries were: carcinomata in a civet (_Viverra tangalunga_), a bandicoot (_Thylacomys lagotis_), a kangaroo (_Macropus rufus_), and a lorikeet (_Glossopsittacus concinnus_). The secondaries were: carcinomata in a black bear (_Ursus americanus_), a polar bear (_Ursus maritimus_), a lion (_Felis leo_), and a dasyure (_Dasyurus maculatus_); sarcomata in a prairie wolf (_Canis latrans_), and a raccoon-like dog (_Canis procyonoides_); adenocarcinoma in a chestnut-eared finch (_Amadina castanotis_).

The histological character of the primary cancers would place them in group of the nodular and infiltrative types of Kauffman. They all seem to have taken their origin from the smaller bronchi, the usual starting point. The growths were small in the civet and bandicoot and strongly suggest that the tumors arose in bronchi occupied by parasites; such bodies could not be demonstrated. It is the usual thing to find in cases of parasitism of the bronchi that if there be no ulcerative destruction of tissue the epithelium undergoes some form of hyperplasia, and even structural metaplasia in the air tubes supplied with cuboidal or cylindrical cells. Epithelia many layers deep have been encountered, usually arranged in orderly fashion but frequently “papillomatoid,” suggesting the epidermal layers yet not so far as to show protoplasmic bridges. Distention of various degrees, affected by the contents of the tube and the surrounding inflammation, are common. Such a picture naturally resembles epithelioma and indeed growths of this nature are reported as due to verminous pneumonitis.

There are, especially in cats and dogs, small scattered adenomatoid growths[21] under the pleura and in the pulmonary substance, thought to originate in the alveolar epithelium and occasionally growing to large size; the case in the kangaroo may have had this origin. _It was the only primary tumor to give metastasis_ (to the spleen and gastric wall), the secondaries being decidedly adenomatous in character.

Metastatic growths come from the following originals: two from the thyroid, well known to give pulmonary embolism in dogs; one each from the breast, uterus, adrenal, intestine and kidney. The form assumed is a gray and red mass lying under the pleura or an isolated nodule in the substance. Sarcomatosis, the form apparently spreading out from the hilum and growing in isolated grayish tubercular masses, has not been seen.

THE PLEURA.

The pleura is a tissue apparently quite susceptible to infection in mammals and so closely associated with the air sacs in birds as to be a part of the same membrane, therefore the two being affected together. Throughout the higher class all orders give copious examples of the involvement of the pleura, principally of course as an accompaniment or a sequel to pneumonitic or bronchitic processes but also as a part of acute infectious diseases, such as hemorrhagic septicemia, pleuropneumonia and the like. However two orders present such a number of instances of pleuritis that they deserve notice. The seals, Pinnipedia, of which we have twenty autopsy records, showed inflammation of this membrane four times, three of which were dependent upon pulmonary infection and one apparently due to general septicemia with trifling damage to the lung proper. One of the first cases had gone on to empyema of the classical type, a shrivelled dry almost carnified lung with a thick fibrinopurulent covering. The lung of the seal is well divided into lobules, the external surface being generously supplied with lymphatic channels under the pleura, an arrangement which should carry away infection one would think. Perhaps this high percentage of pleurisy in our Pinnipedia is but accidental. The marsupials, while having a notable percentage of pleurisy both among all the cases and in relation to the number of postmortems, are not so striking from the etiological standpoint since practically all of these have suffered with Kangaroo mycosis or pneumonia. In over half the cases of this infectious disease some grade of pleuritic exudate has been observed, only one, however, going to the stage of empyema.