Chapter 17

It follows from what has been just said that a succulent diet, including a large quantity of water (gruels, sloppy mashes, turnips, beets, potatoes, apples, pumpkins, ensilage, succulent grasses), is an important factor in the relief of the milder forms of stone and gravel.

_Prevention._--Prevention of calculus especially demands this supply of water and watery rations on all soils and in all conditions in which there is a predisposition to the disease. It must also be sought by attempts to obviate all those conditions mentioned above as causative of the malady. Sometimes good rain water can be furnished in limestone districts, but putrid or bad-smelling rain water is to be avoided as probably more injurious than that from the limestone. Unsuccessful attempts have been made to dissolve calculi by alkaline salts and mineral acids, respectively, but their failure as a remedy does not necessarily condemn them as preventives. One dram of caustic potash or of hydrochloric acid may be given daily in the drinking water. In diametrically opposite ways these attack and decompose the less soluble salts and form new ones which are more soluble and therefore little disposed to precipitate in the solid form. Both are beneficial as increasing the secretion of urine. In cases in which the diet has been too highly charged with phosphates (wheat bran, etc.), these aliments must be restricted and water allowed ad libitum. If the crystals passed with the urine are the sharp angular (octahedral) ones of oxalate of lime, then the breathing should be made more active by exercise, and any disease of the lungs subjected to appropriate treatment. If the crystals are triangular prisms of ammonia-magnesium phosphate or starlike forms with feathery rays, the indications are to withhold the feed or water that abounds in magnesia and check the fermentation in the urine by attempts to destroy its bacteria. In the latter direction plenty of pure-water diuretics, and a daily dose of oil of turpentine in milk, or a dose thrice a day of a solution containing one-tenth grain each of biniodid of mercury and iodid of potassium would be indicated.

In considering the subject of prevention, it must never be forgotten that any disease of a distant organ which determines the passage from the blood into the urine of albumin or any other colloid (uncrystallizable) body is strongly provocative of calculus, and should, if possible, be corrected. Apart from cases from geological formation, faulty feeding, and other causes, the grand preventive of calculus is a long, summer's pasturage of succulent grasses, or in winter a diet of ensilage or other succulent feed.

The calculi formed in part of silica demand special notice. This agent is secreted in the urine in the form of silicate of potash and is thrown down as insoluble silica when a stronger acid displaces it by combining with the potash to its exclusion. In cases of siliceous calculi, accordingly, the appropriate chemical prevention is caustic potash, which being present in the free state would attract to itself any free acid and leave the silica in its soluble condition as silicate of potash.

STONE IN THE BLADDER (VESICAL CALCULUS, OR URETHRAL CALCULUS).

Stone in the bladder may be of any size, but in the ox does not usually exceed half an inch in diameter. There may, however, be a number of small calculi; indeed, they are sometimes so small and numerous as to form a small, pulpy magma by which the bladder is considerably distended.

_Symptoms._--The symptoms of stone in the bladder may be absent until one of the masses escapes into the urethra, but when this occurs the escape of urine is prevented, or it is allowed to pass in drops or driblets only, and the effect of such obstruction becomes manifest. The point of obstruction is not always the same, but it is most frequently at the S-shaped curve of the penis, just above the testicles or scrotum. In cows and heifers the urethra is so short and becomes so widely dilated during the urination that the calculi easily escape in the flow of liquid and dangerous symptoms practically never appear.

Even in the male the signs of illness are at first very slight. A close observer may notice the cylinders of hard, earthy materials encircling the tufts of hair at the opening of the prepuce. It may further be observed that the stall remains dry and that the animal has not been seen to pass water when out of doors. The tail may at times be gently raised and contractions of the muscle (accelerator urinÊ) beneath the anus (Pl. IX, fig. 2) may take place in a rhythmical or pulsating manner. As a rule, however, no symptom is noticed for two days, only the animal is lacking in his usual spirits. By this time the constantly accumulating urine has distended the bladder beyond its power of resistance and a rupture occurs, allowing the urine to escape into the cavity of the abdomen. Then dullness increases; the animal lies down most of his time; he becomes stupid and sometimes drowsy, with reddish-brown congestion of the lining membrane of the eyelids; pressure on the abdomen causes pain, flinching, and perhaps groaning, and the lowest part of the belly fluctuates more and more as the escaping urine accumulates in greater and greater amount. If at this stage the oiled hand is introduced into the rectum (last gut), the animal flinches when pressure is made downward on the floor of the pelvis, and no round, distended bladder is felt. If the same examination is made prior to the rupture, the rounded, tense, elastic bladder is felt extending forward into the abdomen, containing one or two gallons of liquid. There may be uneasy shifting of the hind limbs and twisting of the tail, also frequent lying down and rising, but these symptoms are exceptional.

When the obstruction is low down between the thighs (at the S-shaped flexure), the line of the pulsating urethra from the anus downward may be felt distended with liquid, and though, by the hard swelling of the urethra, it is seldom easy to distinguish the exact seat of the stone, yet there is usually tenderness at the point of obstruction, and from this it may be accurately located.

_Treatment._--The treatment of stone in the bladder or urethra consists in the removal of the stone by incision and the use of forceps. (Pl. XI, fig. 4.) When the stone has been arrested at the S-shaped flexure just above the scrotum, the patient being lean, the thickened tender part of the penis may be seized between the fingers and thumb of the left hand, while the calculus is exposed by a free incision with the knife held in the right. If there is no other obstruction between this point and the bladder, and if the latter has not yet ruptured, a flow of urine should take place from the opening. If there is no escape of liquid, a catheter or sound, one-fourth of an inch in diameter, must be passed up through the canal (urethra) until it is arrested by the next stone, on which a similar incision should then be made to effect its extraction. In case the stone has been arrested in the portion of the urethra which is in front of the arch of the hip bone and inside the pelvis, it can be reached only by making an opening into the urethra beneath the anus and over the arch of the hip bone, and from this orifice exploring the urethra with fine forceps to the neck of the bladder or until the stone has been reached and extracted. Owing to the small size of the canal (urethra) to be opened and the great thickness of erectile tissue to be cut through, the operation requires a very accurate knowledge of the parts, while the free flow of blood is blinding to the operator. A staff should always be passed up through the urethra from the lower wound, if such has been made, or, in case of its absence, through the whole length of the penis, that organ having been drawn out of its sheath until the S-shaped curve has been effaced and the course of the canal rendered straight. Upon the end of this staff the incision can be made with far more confidence and certainty. The operation can be undertaken only by a skilled veterinary anatomist, but the hints given above may be valuable in showing the stock owner when he is being properly served in such a case.

In outlying districts, where no skilled operator can be had, a transverse incision may be made with a clean, sharp knife through the root of the penis, just over the arch of the hip bone, when the urine will flow out in a full stream. The attendant bleeding may be ignored, or if profuse it may be checked by packing the wound firmly with cotton wool for several hours. The urine will continue to escape by the wound, and the ox should be fattened for the butcher.

The immediate relief is not to be looked upon as a permanent cure, as the calculi in the affected ox are usually numerous, and later attacks are therefore to be looked for. Hence it is desirable to fatten and kill such cases after a successful operation. If a breeding animal is too valuable to be killed, he should be subjected to preventive measures, as laid down under "Stone in the kidney," page 139.

It should be added that when the bladder is filled with a soft magma a catheter may be introduced through the whole length of the urethra to be used in pumping water into the bladder. This water is extracted through the same channel when it has been charged with the suspended solids by manipulations of the bladder with the oiled hand introduced through the rectum.

CALCULI, OR GRAVEL, IN THE PREPUCE, OR SHEATH.

This is usually a collection of gravel, or a soft, puttylike material which causes distinct swelling of the sheath and gives it a soft, doughy feeling when handled. It may be removed in part by the oiled fingers introduced into the cavity, assisted by manipulation from without, or a tube may be inserted until the end extends behind the collection and water pumped in until the whole mass has been evacuated. Should even this fail of success, the sheath may be slit open from its orifice back in the median line below until the offending matter can be reached and removed. In all such cases the interior of the sheath should be finally lubricated with sweet oil or vaseline. It is unnecessary to stitch up the wound made in the sheath. (See "Inflammation of the sheath," p. 155.)

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DISEASES OF THE URINARY ORGANS. DESCRIPTION OF PLATES.

PLATE IX. Kidney and male generative and urinary organs.

Fig. 1. Kidney of the ox. (From Handbuch des Vergleichenden Anatomie des Haus S‰ugethiere, vol. 7, 1890.) A, renal artery carrying blood into the kidney; V, renal vein carrying blood from the kidney back to the heart; H, ureter, the tube carrying the urine from kidney to bladder. It is formed by the union of a number of branches which begin as cups (calices), each inclosing the tip of a conical mass of tissue from which the urine excludes.

Fig. 2. Genital and urinary organs of the bull. (From Leisering, Mueller, and Ellenberger, Handbuch des Verg. Anat. des Haus S‰ugethiere.) the serous membrane enveloping the testicles; 3, the right testicle, outer view; 3', left testicle, inner view; 4, epididymis, or the beginning of the excretory canal of the testicle; 4', globus major, or the head of the epididymis; 4'', globus minor, or the tail of the epididymis; 5, vas deferens, the duct through which the seminal fluid reaches the ejaculatory ducts; 5', pelvic dilation of the vas deferens; 6, vesicula seminalis. The vesiculÊ seminalis are two oval pouches, which, in addition to their own secretions, receive the semen conveyed by the seminal ducts and hold it in reserve until copulation; 7, membranous or intrapelvic portion of the urethral canal covered by Wilson's muscle; 8, part of the prostate gland, covered by Wilson's muscle; 9, Cowper's gland. This gland, like the prostate gland, secretes a fluid which is thrown into the urethal canal in abundance immediately before ejaculation; by this means the expulsion of the semen is facilitated; 10, ejaculator seminis, or accelerator urinÊ muscle; 11, penis; 11', cut portion of same; 12, cut suspensory ligaments of penis; 13, sheath, or prepuce laid open; 14, retractor muscles of sheath; 15, cremaster muscle cut at superior extremity; 16, duplicature of peritoneum; 17, ureters carrying urine from the kidneys to the bladder.

PLATE X. Microscopic anatomy of the kidney.

Fig. 1. In this figure the minute apparatus for the secretion, collection, and discharge of the urine into the pelvis of the kidney (see preceding plate) is shown. The course is as follows: The urine is secreted from the blood vessels in the little round bodies called glomeruli (12), and by the minute cells in the curved tubes (11, 9, 10, 8), and passes through the convoluted and straight tubes (7, 6) into the larger tube (1), and then out into the pelvis, thence through the ureters into the bladder. The fluid and salts dissolved in the urine are taken from the blood, and the minute blood vessels are therefore very abundant in the kidneys, as is shown by the branches and network on the left of the figure. The blood passes into the kidney in the artery (13), which then divides into branches which pass into the glomeruli (12) and also forms network around the secreting tubules (11, 9). The urine and salts pass from these vessels through the cells lining the tubules into the latter, and are discharged as described above. The blood is again collected in veins drawn black in the figure.

Fig. 2 illustrates the manner in which the blood is distributed in the glomerulus (_f_), and also to the secreting tubules (_e_).

Fig. 3 shows the relation between the blood vessel in the glomerulus (_e_) the tubule which conducts the urine therein secreted from the blood vessel; (_c_) represents a glomerulus from which the urinary tubule has been removed.

PLATE XI. Calculi of kidney and bladder.

Fig. 1. Calculus, or stone, from the kidney. These are in the pelvis or portion of the ureter receiving the urine. The prolongations are casts of the branches of the pelvis. See the plates of the kidney for further description.

Fig. 2. Calculus made up of oxalate of lime magnified 215 times.

Fig. 3. Phosphatic calculus containing a nucleus of uric acid, sawed through to show concentric layers.

Fig. 4. Straight forceps used in removing stones from the bladder.

Fig. 5. Casts of the minute tubules of the kidney found in the urine in various kinds of kidney disease. Highly magnified.

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FOOTNOTES:

[1] Encyklop. der Thierheilk., Vol. IV, p. 208.

DISEASES OF THE GENERATIVE ORGANS.

By JAMES LAW, F. R. C. V. S.,

_Formerly Professor of Veterinary Science, etc., in Cornell University._

[Revised by Adolph Eichhorn, D. V. S.]

GENERAL DISCUSSION.

Diseases of the generative organs are practically confined to animals which are kept for reproduction and the dairy. The castration of the bull condemns these organs to inactivity and protects them from the many causes of injury attendant on the engorged blood vessels in the frequent periods of sexual excitement, on the exposure to mechanical violence, and on the exposure to infective inoculation. In three respects the castrated male is especially subject to disease: (1) To inflammation and tumefaction of the cut end of the cord that supported the testicle and of the loose connective tissue of the scrotum; (2) to inflammation of the sheath and penis from the accumulation of gravel in the former, from which the penis is not usually protruded in passing water; and (3) to bruising, abrasion, and inflammation of the sheath and penis during suspension in the stocks for the purpose of shoeing. Apart from these the ox is practically almost exempt from the inflammations and injuries of the genital organs. The same applies to the castrated heifer. Inflammation may occur in the broad ligament of the womb whence the ovary has been removed or infective inflammation in the abdominal cavity (peritonitis) in case the operation has been performed through the flank, as it usually is in the young heifer. Apart from these, the castrated heifer is practically immune from any trouble of the generative apparatus. Even the virgin heifer is little subject to such troubles, though she is not exempt from inflammations, and above all, from morbid growths in the ovaries which are well developed and functionally very active after the first year, or in precocious animals after the first few months of life. The breeding cow, on the other hand, is subjected to all the disturbances attendant on the gradual enlargement of the womb, the diversion of a large mass of blood to its walls, the constant drain of nutrient materials of all kinds for the nourishment of the fetus, the risks attendant and consequent on abortion and parturition, the dangers of infection from the bull, the risks of sympathetic disturbance in case of serious diseases of other organs, but preeminently of the urinary organs and the udder, and finally the sudden extreme derangements of the circulation and of the nervous functions which attend on the sudden revulsion of a great mass of blood from the walls of the contracting womb into the body at large immediately after calving.

In reviewing this class of diseases, therefore, we have to note, first, that they are almost exclusively restricted to breeding animals, and secondly that in keeping with the absolute difference of the organs in the male and female we find two essentially distinct lists of diseases affecting the two sexes.

EXCESS OF VENEREAL DESIRE (SATYRIASIS IN MALE, OR NYMPHOMANIA IN FEMALE).

This may occur in the male from too frequent sexual intercourse, or from injury and congestion of the base of the brain (vasodilator center in the medulla), or of the posterior end of the spinal cord, or it may be kept up by congestion or inflammation of the testicles or of the mucous membrane covering the penis. It may be manifested by a constant or frequent erection, by attempts at sexual connection, and sometimes by the discharge of semen without connection. In bad cases the feverishness and restlessness lead to loss of flesh, emaciation, and physical weakness.

It is, however, in the female especially that this morbid desire is most noticeable and injurious. It may be excited by the stimulating quality of the blood in cows fed to excess on highly nitrogenous feed, as the seeds of the bean, pea, vetch, and tare, and as wheat bran, middlings, cotton seed, gluten meal, etc., especially in the case of such as have no free exercise in the fields, and are subject to constant association with a vigorous young bull. A more frequent cause is the excitation or congestion of some part of the genital organs. Disease of the ovaries is preeminently the cause, and this may be by the formation of cysts (sacs containing liquid) or of solid tumors or degenerations, or, more commonly than all, the formation of tubercle. Indeed, in case of tuberculosis attacking the abdominal organs of cows, the ovaries or the serous membranes that support and cover them (the broad ligaments of the womb) are peculiarly subject to attack, and the animal has constant sexual excitement, incessantly riding or being ridden by other cattle, having no leisure to eat or chew the cud, but moving restlessly, wearing the flesh off its bones, and gradually wasting. In some localities these cows are known as "bullers," because they are nearly always disposed to take the bull, but they do not conceive, or, if they do, they are subject to early abortions. They are, therefore, useless alike for the dairy and for the feeder, unless the removal of the ovaries subdues the sexual excitement, when, in the absence of tuberculous disease elsewhere, they may be fattened for the butcher.

Among the other sources of irritation charged with causing nymphomania are tumors and cancers of the womb, rigid closure of the neck of the womb so that conception can not occur and the frequent services by the male which stimulate the unsatisfied appetite, inflammation, and a purulent discharge from the womb or vagina.

_Treatment._--The treatment in each case will vary with the cause and is most satisfactory when that cause is a removable one. Overfeeding on richly nitrogenous feed can be stopped, exercise in the open field given, diseased ovaries may be removed (see "Castration," p. 299), catarrhs of the womb and passages overcome by antiseptic, astringent injections (see "Leucorrhea," p. 224), and tumors of the womb may often be detached and extracted, the mouth of that organ having been first dilated by sponge tents or otherwise. The rubber dilator (impregnator), sometimes helpful in the mare, is rarely available for the cow, owing to the different condition of the mouth of the womb.

DIMINUTION OR LOSS OF VENEREAL DESIRE (ANAPHRODISIA).

This occurs in either sex from low condition and ill health. Longstanding, chronic diseases of important internal organs, leading to emaciation and weakness, or a prolonged semistarvation in winter may be sufficient cause. It is, however, much more common as the result of degeneration or extensive and destructive disease of the secreting organs (testicles, ovaries) which elaborate the male and female sexual products, respectively. Such diseases are, therefore, a common cause of sterility in both sexes. The old bull, fat and lazy, becomes sluggish and unreliable in serving, and finally gets to be useless for breeding purposes. This is not attributable to his weight and clumsiness alone, but largely to the fatty degeneration of his testicles and their excretory ducts, which prevents the due formation and maturation of the semen. If he has been kept in extra high condition for exhibition in the show ring, this disqualification comes upon him sooner and becomes more irremediable.

Similarly the overfed, inactive cow, and above all the show cow, fails to come in heat at the usual times, shows little disposition to take the bull, and fails to conceive when served. Her trouble is the same in kind, namely, fatty degeneration of the ovaries and of their excretory ducts (Fallopian tubes), which prevents the formation or maturation of the ovum or, when it has formed, hinders its passage into the womb. Another common defect in such old, fat cows is a rigid closure of the mouth of the womb, which prevents conception, even if the ovum reaches the interior of that organ and even if the semen is discharged into the vagina.