Chapter 28

(8) The recumbent cow is kept resting on her breastbone, with the head elevated, even if it should be necessary to pack around her with straw bundles or to suspend the head by a halter. When lying on her side she is liable to develop fatal bloating and to have belching of gas and liquids, which, passing down the windpipe, cause fatal broncho-pneumonia.

(9) If in 2 hours the cow is not on her feet, if there is no brighter or more intelligent expression, if she has passed no manure or urine, and if the air has become absorbed, leaving the udder less tense, the injection of the bag may be repeated, under the same scrupulous and rigid precautions as at first. In all cases, but especially in severe ones, it is well to keep watch of the patient, and to repeat the distention on the first indication of relapse. Should there not be a free discharge of feces and urine after rising, indicating a natural resumption of the nervous functions, the case should be all the more carefully watched, so that the treatment may be repeated if necessary.

Accessory treatment may still be used, but is rarely necessary. A dose of purgative medicine (1-1/2 pounds of Epsom salt) in warm water may be given in the early stages, while as yet there is no danger of its passing into the lungs through paralysis of the throat. Eserin or pilocarpin (1-1/2 grains) may be given under the skin to stimulate the movements of the bowels. Sponging the skin, and especially the udder, with cool water, may be resorted to in hot weather.

Bloating may demand puncture of the paunch, in the left flank, with a cannula and trocar, the evacuation of the gas, and the introduction through the tube of a tablespoonful of strong liquid ammonia in a quart of cold water or other antiferment.

The economic value of the new treatment of milk fever is enormous. The United States has more than 22,000,000 milk cows. If we could raise their quality by preserving and breeding from the largest producers of both milk and butterfat, in place of losing the best by milk fever, as in the past, and if we could thus obtain an average increase of 2 quarts a day, the proceeds at 3 cents a quart would amount to $130,000,000 a year.

PALSY AFTER CALVING (DROPPING AFTER CALVING).

This consists in a more or less complete loss of control of the hind limbs occurring after calving, and caused by low condition, weakness, and exposure to cold or to injurious compression of the nerves of the hind limbs by a large calf passing through the pelvis. Its symptoms do not differ from those of palsy of the hind limbs, occurring at other times, and it may be treated in the same way, except so far as bruises of the vagina may demand special smoothing treatment.

CONGESTION OF THE UDDER (GARGET).

In heavy milkers, before and just after calving, it is the rule that the mammary gland is enlarged, hot, tense, and tender, and that a slight exudation or pasty swelling extends forward from the gland on the lower surface of the abdomen. This physiological congestion is looked upon as a matter of course, and disappears in two or three days when the secretion of milk has been fully established. This breaking up of the bag may be greatly hastened by the sucking of a hungry calf and the kneading it gives the udder with its nose, by stripping the glands clean thrice daily, and by active rubbing at each milking with the palm of the hand, with or without lard or, better, with camphorated ointment.

The congestion may be at times aggravated by standing in a draft of cold air or by neglect to milk for an entire day or more (overstocking, hefting) with the view of making a great show of udder for purposes of sale. In such cases the surface of the bag pits on pressure, and the milk has a reddish tinge or even streaks of blood, or it is partially or fully clotted and is drawn with difficulty, mixed, it may be, with a yellowish serum (whey) which has separated from the casein. This should be treated like the above, though it may sometimes demand fomentations with warm water to ward off inflammation, and it may be a week before the natural condition of the gland is restored.

INFLAMMATION OF THE UDDER (SIMPLE MAMMITIS).

Congestion may merge into active inflammation, or it may arise direct, in connection with exposure to cold or wet, with standing in a cold draft, with blows on the udder with clubs, stones, horns, or feet, with injury from a sharp or cold stone, or the projecting edge of a board or end of a nail in the floor, with sudden and extreme changes of weather, with overfeeding on rich albuminous feed like cotton seed, beans, or peas, with indigestions, with sores on the teats, or with insufficient stripping of the udder in milking. In the period of full milk the organ is so susceptible that any serious disturbance of the general health is liable to fall upon the udder.

_Symptoms._--The symptoms and mode of onset vary in different cases. When following exposure there is usually a violent shivering fit, with cold horns, ears, tail, and limbs, and general erection of the hair. This is succeeded by a flush of heat (reaction) in which the horns, ears, and limbs become unnaturally warm and the gland swells up and becomes firm and solid in one, two, three, or all four quarters. There is hot dry muzzle, elevated temperature, full, accelerated pulse, and excited breathing, impaired or suspended appetite and rumination, with more or less costiveness, suppression of urine, and a lessened yield of milk, which may be entirely suppressed in the affected quarter.

In other cases the shivering escapes notice, the general disorder of the system is little marked or comes on late, and the first observed sign of illness is the firm swelling, heat, and tenderness of the bag. As the inflammation increases and extends, the hot, tender udder causes the animal to straddle with its hind limbs, and, when walking, to halt on the limb on that side. If the cow lies down it is on the unaffected side. With the increase in intensity and the extension of the inflammation the general fever manifests itself more prominently. In some instances the connective tissue beneath the skin and between the lobules of the gland is affected, then the swelling is uniformly rounded and of nearly the same consistency, pitting everywhere on pressure. In other cases it primarily attacks the secreting tissue of the gland, then the swelling is more localized and appears as hard, nodular masses in the interior of the gland. This last is the usual form of inflammation occurring from infection entering by the teats.

In all cases, but especially in the last-named form, the milk is suppressed and replaced by a watery fluid colored with blood (sometimes deeply) and mingled with masses of clotted casein. Later it becomes white and purulent, and in many cases of an offensive odor.

The course of the disease is sometimes so rapid and at others so slow that no definite rule can be laid down. In two or three days, or from that to the end of the week, the bag may soften, lose its heat and tenderness, and subside into the healthy condition, even resuming the secretion of milk. The longer the inflammatory hardness continues the greater the probability that its complete restoration will not be effected. When a portion of the gland fails to be restored in this way, and has its secretion arrested, it usually shrinks to a smaller size. More commonly a greater quantity of the inflammatory product remains in the gland and develops into a solid, fibrous mass, causing permanent hardening (induration). In other cases, in place of the product of inflammation developing into a fibrous mass, it softens and breaks down into white, creamy, liquid pus (abscess). This abscess may make its way to the surface and escape externally, or it may burst into a milk duct and discharge through the teat. It may break into both and establish a channel for the escape of milk (fistula). In the worst types of the disease gangrene may ensue, a quarter or half or even the whole udder, losing its vitality, and sloughing off if the cow can bear up against the depressing influence. These gangrenous cases are probably always the result of infection and sometimes run a very rapidly fatal course. I remember one to which I was called as soon as the owner noticed it, yet I found one-quarter dark blue, cold, and showing a tendency to the formation of blebs containing a bloody secretion. The cow, which had waded through a depth of semiliquid manure to reach her stall, died within 24 hours.

_Treatment._--Treatment varies with the type and the stage of the disease. If the case is seen in the shivering fit, every effort should be made to cut it short, as the inflammation may be thereby greatly moderated, if not checked. Copious drinks of warm water thrown in from horn or bottle; equally copious warm injections; the application of heat in some form to the surface of the body (by a rug wrung out of hot water; by hanging over the back and loins bags loosely filled with bran, sand, salt, chaff, or other agent previously heated in a stove; by the use of a flatiron or the warming of the surface by a hot-air bath), or by active friction with straw wisps by two or more persons; the administration of 1 ounce of ground ginger may serve to shorten the attack. After half an hour's sweat the animal should be rubbed and covered with a dry blanket.

If, on the other hand, there is little or no fever, and only a slight inflammation, rub well with camphorated ointment or a weak iodin ointment, and milk three, four, or six times a day, rubbing the bag thoroughly each time. Milking must be done with great gentleness, squeezing the teat in place of pulling and stripping it, and if this causes too much pain, the teat tube (Pl. XXIV, fig. 4) or the spring teat dilator (Pl. XXIV, fig. 3) may be employed. Antiseptic injections of the teats and udder are often useful, and iodoform in water has been especially recommended. It may be replaced by one of the injections advised for parturition fever, used with the same careful precautions.

In cases in which the fever has set in and the inflammation is more advanced, a dose of laxative medicine is desirable (Epsom salt, 1 to 2 pounds; ginger, 1 ounce), which may be followed, after the purging has ceased, by daily doses of saltpeter, 1 ounce. Many rely on cooling and astringent applications to the inflamed quarter (vinegar, sugar-of-lead lotion, cold water, ice, etc.), but a safer and better resort is continued fomentation with warm water. A bucket of warm water, replenished as it cools, may be set beneath the udder, and two persons can raise a rug cut of this and hold it against the udder, dipping it anew whenever the temperature is somewhat lowered. A sheet may be passed around the body, with holes cut for the teats, soft rags packed between it and the udder, and kept warm by pouring water on every 10 or 15 minutes, as warm as the hand can bear. When this has been kept up for an hour or two, the bag may be dried, well rubbed with soap, and left thus with a soapy coating. If the pain is great, extract of belladonna may be applied along with the soap, and a dry suspensory bandage with holes for the teats may be applied. Strong, mercurial ointment is very useful in relieving pain and softening the bag. This is especially valuable when the disease is protracted and induration threatens. It may be mixed with an equal quantity of soap and half as much extract of belladonna. In cases of threatened induration excellent results are sometimes obtained from a weak-induction current of electricity sent through the gland daily for 10 minutes.

If _abscess_ threatens, it may be favored by fomentation and opened as soon as fluctuation from finger to finger shows the formation of matter at a point formerly hard. The wound may bleed freely, and there is a risk of opening a milk duct, yet relief will be obtained; also a dressing twice daily with a lotion of carbolic acid 1 part, water 20 parts, and glycerin 1 part will suffice to keep the wound clean and healthy.

_Gangrene_ of the affected part is often fatal. It demands antiseptics (chlorid of zinc, 1 dram to 1 quart water) applied frequently to the part, or, if the case can not be attended, smear the affected quarter with Venice turpentine, melted, or even wood tar. Antiseptic tonics (tincture of chlorid of iron, 4 drams) may also be given four times daily in a quart of water.

CONTAGIOUS MAMMITIS (CONTAGIOUS INFLAMMATION OF THE UDDER).

As stated in the last article, that form of inflammation of the udder which attacks the gland ducts and follicles, causing deep-seated, hard, nodular swellings, is often contagious. Franck has demonstrated this by injecting into the milk ducts in different cows (milking and dry) the pus from the bags of cows affected with mammitis, or the liquids of putrid flesh, or putrid blood, and in every case he produced acute inflammation of the gland tissue within twenty-four hours. He thinks that in ordinary conditions the septic germ gains access by propagating itself through the milk, filling the milk canal and oozing from the external orifice. He points to this as a reason why dry cows escape the malady, though mingling freely with the sufferers, and why such dry cows do not suffer from inflammation of the gland tissue when attacked with foot-and-mouth disease. In this last case it is evident that it is not simply the inoculation with the milker's hand that is lacking, for the skin of the bag is attacked, but not its secreting, glandular parts. Now that in any case of abscess we look for the cause in the chain forms of globular bacteria (_Streptococcus pyogenes_), in the cluster form of white, globular bacteria (_Staphylococcus pyogenes albus_), and in the golden and citron-yellow forms of clustered globular bacteria (_Staphylococcus pyogenes aureus_ and _Staphylococcus pyogenes citreus_), the formation of pus gives presumptive evidence of the action of one or more of these germs. So in cases of mortification of the bag; in the very occurrence there is fair circumstantial evidence of the presence of erysipelas micrococcus or other germ which kills the local tissues. Again, in tuberculosis affecting the bag (a not uncommon condition), the active local cause is without doubt the tubercle bacillus.

It has been found that false membranes have formed in certain cases of mammitis in the cow, and Klein, after inoculating the diphtheria of man on the cow, found an ulcerous sore in the seat of inoculation and blisters on the teats and udder, in which he found what he believed to be the bacillus of diphtheria. The results are doubtful, even in the absence of false membranes. Lˆffler, too, in the diphtheria of calves, found that the germ was longer and more delicate than that of man, and that its pathogenesis for rodents was less, guinea pigs having only a nonfatal abscess. The presence of false membranes in one form of mammitis in cows does not necessarily imply its communicability to man.

It has been asserted that scarlet fever has been transmitted from the cow to man, and it can not be denied that in many cases the infection has been spread by means of the milk. The facts, however, when brought out fully have shown that in almost every case the milk had first come into contact with a person suffering or recovering from scarlet fever, so that the milk was infected after it left the cow. The alleged exceptional cases at Hendon and Dover, England, are not conclusive. In the Hendon outbreak inoculations were made on calves from the slight eruption on the cow's teats, and they had a slight eruption on the lips and a form of inflammation of the kidneys, which Dr. Klein thought resembled that of scarlatina. The cows that had brought the disease to the Hendon dairies were traced back to Wiltshire, where cows were found suffering from a similar malady, but no sign of scarlet fever resulted. In the Dover outbreak the dairyman first denied any disease in his cows, and brought a certificate of a veterinarian to prove that they were sound at the time of the investigation; then later he confessed that the cows had had foot-and-mouth disease some time before, and consequent eruption on the teats. So the question remains whether the man who denied sickness in the cows to begin with, and adduced professional evidence of it, did not later acknowledge the foot-and-mouth disease as a blind to hide the real source of the trouble in scarlatina in his own family or in the family of an employee.

In America Dr. Stickler said that he had produced scarlatina in children by inoculation with imported virus of foot-and-mouth disease, but his contention is negatived by the facts that with foot-and-mouth disease constantly present in Europe scarlatina does not accompany it, and that in America, with scarlatina constantly prevailing at some point, foot-and-mouth disease is unknown locally except at long intervals and as the result of the importation of infected animals or their products. Man is susceptible to foot-and-mouth disease, but it never appears during the frequent epidemics of scarlatina.

Among other contagious forms of mammitis I may name one which I have encountered in large dairies, starting as a sore and slight swelling at the opening of the teat and extending up along the milk duct to the gland structure in the bag, all of which become indurated, nodular, and painful. The milk is entirely suppressed in that quarter of the bag, and from that it may extend to the others as it does from cow to cow through the milker's hands.

Another form almost universally prevalent in this district of central New York in 1889 broke out on the teats and udders as blisters strongly resembling cowpox, but which were not propagated when inoculated on calves. It was only exceptionally that this extended through the teat to the gland tissue, yet in some instances the bag was lost from this cause. Scarlatina in man was very prevalent at the time (many schools were closed in consequence), but no definite connection seemed to exist between this and the cow disease, and on different dairy farms there were families of young children that had never had scarlet fever and who did not at that time contract it.

The most common cause of contagious mammitis in cattle is a spherical bacterium in chain form (_Streptococcus_) (Moore, Ward). Yet it is clear that contagious mammitis is not a single affection, but a group of diseases which have this in common, that they attack the udder.

_Prevention._--Prevention is to be especially sought in all such cases. In purchasing new cows see that they come from a herd where the teats and udder are sound. If a new cow with unknown antecedents comes from a public market, let her be milked for a week by a person who does not milk any other cows. Keep her in a separate stall from others, so that there may be no infection from litter or flooring. Wash the udder with soap and water, and wet with a solution of two teaspoonfuls of carbolic acid in a pint of water before letting the regular milker of the other cows take her. If any cow in the herd shows the indurated end of the teat or the inflammation and nodular tender character of the gland, sequestrate her at once and give her a separate milker. If another cow is to be put into the stall she occupied, first clean and scrape it, and wet it with a strong solution of bluestone, 5 ounces in a gallon of water. The milk may be drawn off with a teat tube, or spring teat dilator (Pl. XXIV, figs. 3 and 4), and the milk ducts injected frequently with a solution of peroxid of hydrogen or iodoform. I have had little success in checking the upward progress of the disease through the teat with carbolic acid or boric-acid solutions. Used on the outside of the other teats, however, they may serve to prevent them from becoming infected. In the absence of peroxid of hydrogen the affected teat may be injected with a solution of 1 grain corrosive sublimate in a pint of water, and the same may be used on the other teats, provided it is washed off every time before milking.

As additional precautions, no cow with a retained afterbirth or unhealthy discharge from the womb should be left with the other cows. Such cows doubtless infect their own udders and those of the cows next them by lashing with the soiled tail. If milkers handle retained afterbirth or vaginal discharge, or unhealthy wounds, or assist in a difficult and protracted parturition, they should wash the hands and arms thoroughly with soap and warm water and then rub them with the corrosive-sublimate solution, or if not, at least with one of carbolic acid. Clothes stained with such offensive products should be thoroughly washed.

The general treatment of contagious mammitis does not differ from that of the simple form, except that antiseptics should be given by the mouth as well as applied locally (hyposulphite of soda, one-half ounce daily).

COWPOX.

This is another form of contagious inflammation of the udder which does not spread readily from animal to animal except by the hands of the milker. It is held to occur spontaneously in the cow, but this is altogether improbable, and so-called spontaneous cases are rather to be looked on as instances in which the germs have been preserved dry in the buildings or introduced in some unknown manner. It is not uncommon in the horse, attacking the heels, the lips, or some other inoculated part of the body, and is then easily transferred to the cow, if the same man grooms and dresses the horse and milks the cow. It may also appear in the cow by infection, more or less direct, from a person who has been successfully vaccinated. Many believe that it is only a form of the smallpox of man modified by passing through the system of cow or horse. It is, however, unreasonable to suppose that this alleged modified smallpox could have been transmitted from child to child (the most susceptible of the human race) for 90 years, under all possible conditions, without once reverting to its original type of smallpox. Chauveau's experiments on both cattle and horses with the virus of smallpox and its inoculation back on the human subject go far to show that in the climate of western Europe, at least, no such transformation takes place. Smallpox remains smallpox and cowpox, cowpox. Again, smallpox is communicable to a person who visits the patient in his room but avoids touching him, while cowpox is never thus transferred through the air unless deliberately diffused in the form of spray.