NEURALGIA.
Intermittent or remittent pains, in line of nerve without inflammation, or other structural lesion. Diagnosis: lameness, stiffness of particular muscles having a common nerve. Unnatural position habitual. Pain of inflammation and of neuralgia. No functional change. Rheumatism. Tumors. Causes: lead, rheumatism, gout, auto-poisons, cold, anæmia, reflex. Facial neuralgia, occipito-cervical, dorsointercostal, lumbo-abdominal, sciatic. Treatment: elimination, of lead, etc.; intestinal antiseptics, tonics, hot water, anodynes, arsenic.
This is characterized by pain paroxysmal, intermittent or remittent situated in the course of given nerves. It must be a pure neurosis and unaccompanied by any specific structural lesion like inflammation, degeneration, atrophy, hypertrophy, tumor or the like. It is therefore manifested subjectively and cannot be easily identified in the lower animals. Nevertheless, Lafosse, Zundel, Genée, and others have recorded cases, their conclusion being deduced from symptoms which were held to indicate nervous suffering in the absence of any structural lesion whatever. A priori one can with difficulty escape the conviction that neuralgia must exist in the lower animals as in man, and the only drawback to its recognition is the difficulty of diagnosis.
The first step in such diagnosis must usually be the presence of lameness, stiffness or indisposition to free movement of some particular muscle or group of muscles deriving their innervation from a particular nerve. Or there may be a particular position habitually assumed such as semi-closed eyelids, drawn back ears, laterally inclined neck which strongly suggests nervous suffering. Next, there must be the exclusion of any appreciable structural cause and especially of inflammation. The three prominent features of the pain of inflammation is that it is aggravated by pressure, it is heightened by movement, and it is accompanied by some decided alteration of the function of the part. If there are at the same time
exudation and swelling, inflammation is all the more certainly indicated. In a neuralgic pain on the contrary pressure does not increase the pain: it may even alleviate it: movement of the part may be rather satisfactory to the patient than painful; and the disturbance of function, contractile, secretory, trophic, is not perceptible. There is no local exudation nor swelling to account for the nervous disorder.
The liability to confound the affection with a neuritis more centrally situated, but the pain of which is referred to the periphery of the nerve, is to be obviated by a tracing of the nerve along its course to the nerve centre so as to identify any centre of tenderness, and also by the implication of all the peripheral branches coming off ectal of that point.
Again, rheumatism may be easily confounded with neuralgia, but here the affected nerve and muscle and even the skin over it is liable to be very tender to the touch or pinch, and if at all acute some hyperthermia is present. Like rheumatism, neuralgia shows a tendency to shift from place to place.
Pains due to pressure on the nerves by tumors, aneurisms, and other swellings, are constant, whereas neuralgic pains are marked by remissions and aggravations and even by intervals of complete relief.
Causes. The toxic neuralgias are illustrated by chronic lead poisoning, in which, in man, there are wandering pains like those of rheumatism, and in the lower animals muscular stiffness and contractions which suggest a similar condition. In man, too, gout is a common factor, and in pigs and birds in which this condition exists, stiffness and evidence of suffering may well be at times attributed to a similar cause. How many other forms of chronic metallic poisoning and poisoning by morbid autochthonous products of indigestion are attended by disorders of innervation and nutrition, it is as yet impossible to say. The direct action of cold, an anæmic condition of the nerves, and reflex action from distant sources of irritation are among the other invoked causes. Inflammation in the nervi nervorum is also invoked as a factor, but in this case the symptoms would not accord with the rule given above, since the nerve trunks would be very tender to touch or pressure, and the suffering would be unshifting and shown permanently in the one seat.
Facial Neuralgia. Lafosse and Zundel describe as cases of this kind those in which periodically the horse’s eyes are fixed and
shining, the ears drawn back and depressed as in vice, the head at intervals bent on the neck, with plaintive neighing, rubbing the head on the stall and pawing. Those cases of twitching of the head or rapid jerking of the ears in horses, when they have been driven for some distance, and which are relieved by wearing a close net over the nostril or by section of the trifacial nerve at the infra-orbital foramen, manifestly partake of this character.
Cervico-Occipital Neuralgia. Lafosse speaks of this as often mistaken for torticolis, the head being turned to the affected side during the paroxysms. In man this is often a result of cold draughts on the back of the head, and associated with tender points on the course of the nerve, between the mastoid and the median line.
Dorso-intercostal neuralgia causes pain in deep inspiration, and lumbo-abdominal neuralgia develops tenderness in the loins, in one testicle, or in one lip of the vulva according to Lafosse. Diagnosis between such cases and neuritis, spinal disease, and other obscure nervous affections must be very problematical.
Sciatic Neuralgia. This is described by Zundel as causing jerking and lameness in the affected limb, sometimes aggravated and sometimes improved by work and associated with muscular weakness or paresis. Sciatica in man is, however, rarely a simple neuralgia, but partakes rather of the nature of a neuritis, and there is no good reason for supposing that the disease of this nerve in the lower animals is other than an inflammatory condition.
Leclainche after consideration of the testimony adduced, is of the opinion that we still lack absolute evidence of uncomplicated neuralgia in the domestic animals.
Treatment. For toxic cases elimination of the poison is the first consideration. For lead carefully graduated doses of iodide of potassium to carry off the offending agent without increasing its poisonous action must be continued as long as the metal is passed by the urine. It may be followed by a course of strychnia, by electricity, massage and blisters. Gouty subjects may be treated with salicylate of soda, alkalies, or colchicum. The victims of Bright’s disease must be treated for the kidney affection.
Where there has been trouble of the digestive organs, intestinal antiseptics (salol, sodium salicylate, bismuth-salicylate,
beta-naphthol) and small doses of arsenious acid will sometimes benefit.
In anæmic conditions a course of tonics (cod liver oil, iron, quinine, nux vomica) are indicated, and, to improve the local blood supply, nitro-glycerine. A rich stimulating ration, currying, an open air life, and sunshine (in summer a run at grass) are called for.
In man with a suspicion of traumatic origin, W. H. Thomson strongly advocates a persevering use of the hot water douche to the parts first affected, the hypodermic use of morphia and atropia, and in case of local anæmia nitro-glycerine every three hours. Where there is a suspicion of inflammation he successfully employs absolute rest, with opium narcotism so as to abolish the pain, for twenty days if necessary. Aconite, antipyrin, acetanilid, phenacetin, exaglin, and gelsemium have their advocates, and may benefit in individual cases. A course of arsenic is often successful, and phosphorus and ergot have each proved of value.
ATROPHY OF NERVES.
From arrest of function, from lesions, pressure, distal, but at times central of lesion. Symptoms: Loss of function advancing to paralysis. Muscle atrophy. Prognosis: in absence of incurable cause, is hopeful. Union of divided ends, restoration of function. Treatment: time, ligature of divided ends.
This is usually the result of arrest of function. It may be due to transverse section of the nerve, as in surgical neurectomy when the separated peripheral end of the nerve gradually wastes. It may come from contused wounds implicating the nerve and causing destruction of its substance. It may be from tumors or other neoplasms pressing on the trunk of the nerve and preventing the passage of nerve currents. Or, inflammatory effusion may press on the nerve, as happens often to the crural in hæmoglobinuria. Or the pressure may come from enlarged mediastinal glands, or even from the distended posterior aorta under habitual violent exertion so as to permanently incapacitate and atrophy the left recurrent laryngeal nerve as in chronic laryngeal paralysis (roaring). Similar wasting occurs in other nerves under corresponding conditions. Atrophy may, however, extend centrally from the peripheral end of a nerve when it can no longer remain functionally active. We find an example of this in the atrophy of the optic nerve up to the commissure when the eyeball has been excised. A similar condition is often seen in horses in which the integrity of the eye has been completely destroyed in connection with recurring ophthalmia.
The symptoms attendant on atrophy of a nerve are those of impaired function gradually advancing to complete paralysis of motion or sensation. In cases of a complete breach of continuity as in section or severe traumatism the entire loss of function necessarily precedes the atrophy. Again, when it comes from destructive changes
DISEASES OF THE URINARY ORGANS.
Relative prevalence in man and animals. Causes of difference. Kidneys as eliminating organs for nitrogenous material, toxins, bacteria, mineral, vegetable and animal poisons, diuretic drinking water, condition powders, cantharides, urea, etc. Suppression of urine, precipitation of urine. Filtration through kidney. Secretion. Urinary solids. Nervous control of secretion. Excess.
Diseases of the urinary organs are less prevalent in the lower animals than in man, owing largely no doubt to the greater simplicity of their habits of life and to the comparative shortness of the lives of those that are kept for meat producing. It is a mistake, however, to suppose that they are so infrequent as would appear, since the absence of subjective symptoms in the animal allows a number of the milder forms of renal disease to be passed over without recognition.
In man the excessive consumption of animal food, the lack of exercise, the abuse of alcohol, the prevalence of venereal diseases, conduce largely to renal troubles, while animals in general escape. Yet animals suffer much more extensively than is generally supposed. The kidneys are, as in man, the eliminating organs for superfluous and waste nitrogenous matter, and in overfed animals may be overcharged with this work. They are the general emunctories for the soluble poisonous products of bacteria and plants, which may stimulate the urinary secretion, and from these irritation may result. It is through the kidneys that the bacteria themselves largely leave the animal body, and trouble is liable to come during their passage. Further, exposure to cold tends to increase the urinary secretion, over-stimulating the kidneys, and the same may come from diuretic drinking waters and condition powders, also from cantharides and other diuretic agents applied to the skin. Urea and many toxins are diuretic, hence the occurrence of polyuria at and after the crisis of fevers.
On the other hand suppression of the urinary secretion may occur in connection with profuse perspirations in hot weather, with prolonged diarrhœa, or with privation of water, and in such cases the liquid becomes concentrated and irritating and there is a disposition to precipitate its solids under slight disturbing causes. As conducive to such precipitation may be named foreign solid bodies, bacterial ferments and probably the goitre poison since gravel and calculus are common in goitrous regions.
There are two forms of elimination through the kidneys. 1, filtration; 2, secretion.
1. Filtration is referred to the glomeruli, and is determined by the relative blood pressure. Increase of pressure causes increase of watery transudation. Digitalis increases heart action and arterial pressure, and accidently urination. Excessive consumption of water and watery liquids increases intravascular tension, and the amount of urine.
2. Secretion is referred to the columnar epithelium of the convoluted tubes. It is by the elective affinity or selective power of this epithelium that the solids of the urine are abstracted from the blood and passed into the urine. Crystals of uric acid have been found in these cells and it is supposed that the abundance of water furnished by the glomeruli, irrigating these convoluted tubes, dissolves and washes on the various solids and other products with which the epithelial cells are charged. The protoplasm of the cells becomes saturated with the urea, uric acid, hippuric acid coloring matter (indican, urochrome, etc.), and this is washed out, passing by exosmosis to the liquid of lesser density with which the tubes are filled.
Nervous Control of Urinary Secretion.
An electric current through the renal plexus of the sympathetic (vaso-motor) lessens, or suppresses urinary secretion (inhibition).
Cutting the nerves of this plexus causes excessive vaso-dilation, renal pulsations synchronous with heart beats and arterial pulse, and great increase of urine. A similar increase comes from the application of cold to the surface, from fatigue, from heat exhaustion, from irritation of the floor of the fourth ventricle just in front of the origin of the vagus and from section of the splanchnic nerve. This last is, however, much less marked and more transient than from section of the renal nerve noted above; the latter causing dilation of the renal vessels only, and increased pressure, whereas the former causes dilation of the abdominal organs generally, diverting the blood largely to other parts than the kidney and preventing the same increase of pressure in the vessels of the latter. For the same reason transverse section of the medulla oblongata, or of the spinal cord as far back as the seventh cervical vertebra, lessens or interrupts the urinary secretion, the pressure in the kidney being reduced by the diversion of much of the blood elsewhere. This influence of the nervous system on the urinary secretion seems to be mainly or entirely one of increase or decrease of blood pressure in the kidney. For this reason a weak heart tends to lessen urinary secretion.
Excessive increase of urine is only important when continuous and in the absence of visible cause, such as diuretics.
pea or bean straw). Color may be due to indican and sometimes to indicanin or indigo blue, which explains the blue urine sometimes described.
Dog: Normal urine is yellow, straw colored, aniline yellow, honey yellow, to brownish yellow in hot season or on dry nitrogenous food. Is always relatively deeper than in ruminants.
Cat: Straw yellow to honey yellow, with variation as in the dog.
Pig: Very pale yellow, more highly colored on dry feeding, nuts, peas, etc.
Birds: White or yellow, sedimentary. Mixed with fæces in cloaca.
Color of Pathological Urine: Pale yellow with excessive secretion glycosuria, polyuria, cryptogamic polyuria, chronic interstitial nephritis, under diuretics, or after excessive drinking. The free secretion of a crisis in a fever is pale yellow.
Deep yellow, deep red, deep brown color, indicates excess of urinary pigment (urobiline) and is deepened by nitric acid. This is seen in all hyperthermias with suppressed or diminished secretion, in privation of water, or food. This urine is acid even in herbivora.
Yellow, saffron yellow, brownish yellow, greenish, olive, or brownish red indicate the presence of bile pigments (biliverdin, bilirubin) as in jaundice or cholyuria. Bile salts should be tested for. A similar coloration may come from free consumption of carrots, or other yellow pigmentary matters.
Red, brownish red, blood red, or deep brown color implies the presence of blood or blood coloring matter in the urine (hæmaturia, hæmoglobinuria). Exposed to the air this becomes brown or chocolate in ratio with the amount of blood or blood pigment present. Some such cases are complicated by blood clots.
Color due to Foreign Constituents.
Bronze or black color may come from injection of phenic acid.
Deep green or olive green may come from tar, carbolic acid, salol, creosote, or derivatives of benzine taken in.
Brownish green comes from thallin and reddens with iron chloride.
Brown or blood red from rhubarb or senna.
Purple red from santonin, if alkaline (if acid, is reddish yellow).
Red from madder (it is alleged from indigo).
Yellow from carrots.
Blue (indigo blue) may occur in urine of horse or ox when exposed to the air.
Bluish green will come from feeding indigo.
White or yellow color will result from the presence of pus.
White, chylous urine occurs with a hæmatozöon (Bilharzia Crassa) in the blood of cattle.
Translucency. Urine may be passed clear and become turbid by standing. The presence of colloids hinders precipitation and prevents clearing.
Horse: Urine is generally turbid, especially what has been long in the bladder, and that which is last passed. The turbidity is largely due to precipitation of calcium carbonate and bicarbonate, and increases on green food, or if the liquid stands exposed to the air and is cooled. Not unfrequently the salts are thrown down as fine spherical granules, or there may be a white pultaceous mass. They are sometimes entangled in extremely mobile cylindroid masses coming from the uriniferous tubes during convalescence from fevers or during fasting. A fine pellicle on the surface is normal in horse’s urine left in the air.
Ox, Sheep and Goat: Urine is passed clear. May become turbid through the change of lime carbonate into bicarbonate in cattle but always more slowly than in the horse.
Carnivora: Urine is passed clear but becomes turbid on decomposition, or if concentrated. With excess of fat in the food it may become opaque from floating oil globules, apart from the classic chyluria.
Pig: Fed on raw fresh vegetables the urine is clear, but if on cooked or dried vegetables, and especially if nitrogenous, it may show opacity.
Pathological: The horse’s urine is limpid and acid in polyuria; limpid and alkaline or neutral with modified phosphates. It may be morbidly turbid from excess of lime phosphate or sulphate, urea or other acid salts, exudates, leucocytes or pus. These usually indicate nephritis. Mucus and muco-purulent exudate suggest pyelitis or pelvic nephritis. Blood elements indicate nephritis, cystitis or urethritis. Debris of kidney tissue may indicate tuberculosis; tumors, etc.
Turbidity in other animals than solipeds is abnormal: examine the urine.
Consistency of Urine. Morbid urine may be gluey, sizy, syrupy, mucous, oily. If a horse’s urine is scanty a slight siziness may be normal and due to tenacious mucus from the pelvis of the kidney, and from the solution of mucin and epithelium in the alkaline fluid. Viscous, sizy, stringy, and tarry (pitchy) urine is found in pyelitis, pyelo-nephritis, or cystic catarrh, but not in polyuria owing to the presence of the solvent acid.
Odor of Urine. This is somewhat aromatic in horse and ox, disagreeable in the dog, and repulsively heavy in the cat. With polyuria the odor is less. If the urine has been retained and fermented it is ammoniacal, if there are ulcers or tumors it is fœtid, in diabetes it smells of acetone, after taking turpentine it has a violet odor, and after phenic acid, camphor, ether and other drugs it is variously modified.
Specific Gravity of Urine in ratio to water 1000:
Phosphates of lime, soda, potash and, scantily, of magnesia are normally present (horse 0.08 to 0.60 gramme phosphoric acid daily) and are present in excess in digestive disorders and in malnutrition of bones (rachitis, osteoporosis and rheumatoid arthritis). The alkaline phosphates are very soluble and never precipitated. Earthy phosphates dissolve in acid urine, but are precipitated from alkaline. To a little of the urine add a few drops of acetic acid, followed by a few drops of uranium acetate. A yellow precipitate of uranium and ammonium double phosphate is thrown down.
Indican (C8H7NSO4) is formed from indol which passes successively through the forms of indoxyle and indoxylid potassiosulphate. This is normally present in the urine, the horse excreting 1 to 2 grammes daily, the dog 0.15 gramme. It is present in excess in intestinal indigestions, constituting indicanuria. It is tested by adding a drop of muriatic acid and one of a solution of chloride of lime to the urine, when it will show a blue ring, the depth of which indicates the relative amount.
Urea (CON2H4) the principal waste product of nitrogenous matter, is always present in considerable amount. The sound horse may eliminate 100 to 200 grammes daily, the dog 5 to 180 grammes. It is present in excess in all fevers and inflammations unless urination is suspended or impaired, in cryptogamic diuresis, in mellituria, uræmia, nephritis and cystitis. Test: The addition to a filtered solution of urine, freed from phosphates, of solution of acid nitrate of mercury, precipitates it as nitrate of urea. A simpler test is to add to a drop or two of urine on a glass slide a drop of nitric acid and heat gently. The nitrate of urea is precipitated in the characteristic rhombic or hexagonal crystals as seen under the microscope. Heat urea crystals in a test tube: biuret is formed and ammonia escapes. Add a trace of a copper sulphate solution and a few drops of a 20 per cent. solution of caustic potash: a rose-red color is produced—the biuret reaction.
Uric Acid (C5H4N4O3). Traces only of this are found in the normal herbivorous urine, yet it is more abundant when on a full dry grain diet, on milk (suckling) or on animal food. The dog kept on animal food has a large amount.
Pathologically it is produced in the dog and even in the horse in fever, overwork and starvation, the animal living on his own tissues. Interference with oxidation in the lungs seems to produce it as an arrest in the transformation of albuminoids to urea. The neutral urate of soda remains in solution: the acid urate of soda is precipitated. Test: To the urine add one-fourth its volume of muriatic acid and set aside for 24 hours in a cool place. On the bottom and sides of the glass and on the surface of the liquid will be found the yellowish red acicular crystals of uric acid.
Hippuric Acid (C9H9NO3) is normally present in all urine, but is especially abundant in that of herbivora. The horse eliminates 60 to 160 grammes daily. It has been found to be increased by feeding on dandelion, carrots, clover, asparagus, apples, plums, benzoic acid, oil of bitter almonds, toluol, cinnamic or kinic acid. It is absent in sucking calves, and horses fed on grain devoid of husk. Pathologically it is increased in hyperthermia, icterus, some liver diseases and diseased kidneys. Test: Precipitate any albumen by nitric acid and boiling, then add hydrochloric acid which precipitates the hippuric acid in long needle-like crystals. Heated in a small glass tube it forms an oily liquid, and heated to redness gives off an odor of hydrocyanic acid (nitro-benzol) and carbon is left. This distinguishes alike from uric acid and benzoic.
Phenol is produced by intestinal fermentation. The horse normally excretes about 3 grammes daily. Pathologically it appears in excess in indigestions, abscesses, softened discharging tubercle, pyæmia, and septicæmia. Test: Dilute solutions of ferric salts give a blue coloration.
Creatinin, a product of metabolism of albuminoids, is found especially in the urine of carnivora and omnivora in health. It is pathologically increased when oxidation is interfered with, as in diseases of the lungs. Test: Add to the urine a very dilute solution of sodium nitro-prusside and then drop by drop some solution of caustic soda, when a ruby red color is shown and disappears again on boiling. Acetic acid changes to blue.
Acetone (C3 H6 O) is found in the urine of healthy omnivora and carnivora and increased by excess of nitrogenous food. Pathologically it has been found in fevers with much blood change, in inanition, in cancer, in indigestions, and auto-intoxications. Test: To several c c.
of urine add a few drops of iodo-potassic iodide solution and caustic potash when iodoform will be abundantly precipitated with its characteristic color and odor.
Oxalic Acid (C2 H2 O4) appears to be secreted in small amount by healthy kidneys and it may also come from the splitting up of uric acid after secretion. It is augmented by feeding agents rich in oxalic acid (beets, fresh beans, asparagus, tomatoes). Pathologically it abounds in certain indigestions, and is associated with lameness and emaciation. Test: Add lime water to the urine, and the white oxalate of lime is precipitated.
Allantoin (C4H6N4O3) is found in the urine of sucklings (calves) during the first few weeks of life, in pregnancy and when on a meat diet. It diminishes with the increase of vegetable food.
Xanthin (C5H4N4O2) is found in urine as a result of imperfect oxidation of nitrogenous matters especially, which would otherwise pass into uric or hippuric acid. Its immediate antecedents in such transformation are guanin and hypoxanthin or sarkin. It is a rare constituent of urinary calculus.
Hypoxanthin (C5H4N4O) is produced from fibrine in gastric and pancreatic digestion and in putrefaction, and is especially abundant in leucæmic subjects.
Cyanuric Acid (C20H14N2O6) occurs in dog’s urine.
Leucin (C6H13NO2) and Tyrosin (C9H11NO3) are products of pancreatic digestion of proteids, and the former occurs normally in the spleen, thymus, thyroid, liver, salivary glands, and urine. Both are present in large amount, in the urine, in acute atrophy of the liver. Test for leucin: Evaporate carefully to dryness with nitric acid: the residue, if leucin, will be almost transparent and turn yellow or brown on the addition of caustic soda. If now heated with the soda it forms an oily drop. Test for tyrosin: treated with strong sulphuric acid, gently warmed and chloride of iron added, it gives a violet color.
Albumen is an important morbid constituent of urine, which appears in a great variety of diseases (nephritis, pneumonia, epilepsy, anæmia, leucæmia, diabetes, hæmaturia, hæmoglobinuria, hydræmia, infectious lung diseases, cardiac obstruction, venous
deep, (but one of them very broad) on the limit of the green and blue. Urine which contains the elements of blood is usually turbid and thick or glairy, by reason of the presence of salts, albumen and fibrine. There may also be crystals of urinary salts (calculi), fragments of broken down tissue (tumors) or the ova of worms.
Epithelium in Urine. The slight cloud seen in healthy urine contains epithelial cells. The source of these may be often determined under the microscope. The bladder epithelium are the most numerous, the largest, and are squamous. Those from the ureters and renal pelvis are also squamous, but neither so large nor so numerous. The epithelium from the uriniferous tubules are polyhedral with large nucleus or columnar. The cells from the male urethra are also largely columnar. In cases, however, in which these cells are passed in large amount because of catarrh of the mucosa all alike tend to assume the globular form with large nucleus so that their true source cannot be certainly stated. It is only from such cells as have become detached without change of form that the seat of desquamation can be determined. If an excess of cells approximating to the kidney type are associated with albuminuria and cylindroid casts they become diagnostically significant. Polygonal cells darkly granular with large oval nucleus and nucleolus suggest kidney inflammation. If the granules are freely soluble in ether there is probably fatty degeneration. If hard, tough and glossy they suggest (but don’t prove) amyloid degeneration.
Pus Cells in Urine. Pus cells, with multiple nuclei revealed by adding dilute acetic acid, may be found in small numbers in apparently healthy urine. When present in large numbers, they usually indicate a catarrhal affection of the mucosa, and especially pyelitis, cystitis, or urethritis. There is always cloudiness, excess of mucin, and, in the alkaline herbivorous urine, the liquid may be glairy or stringy.
Casts of the Uriniferous Tubes. These usually indicate the existence of nephritis, yet they may be present in small numbers in the urine of healthy individuals under a slight toxic action such as alcohol.
Unorganized casts of urinary salts or hæmatoidin found in sucklings appear to have no pathological significance. Organized casts, on the other hand, usually imply renal troubles, and especially
inflammation. As these will be fully described under Bright’s disease, it need only be noted here that they may be composed in great part of red globules, leucocytes, epithelium, bacteria, granules, a homogeneous wax-like matter, fat globules, hyaline matter, or urinary salts. The predominance of one or other of these determines the nature of the cast.
The observations of Mayer, Knoll, Bovida, Von Jaksch and others seem to show that the basis substance of urinary casts differs from all our familiar proteids and must be considered as a distinct nitrogenous compound, a derivative of one of the common proteids.
GENERAL SYMPTOMS OF URINARY DISEASE.
External symptoms, arched back, stiff gait, straining, tender loins, backing, turning, dropping under weight, urine checked, dribbled; in dogs and cats, palpation of kidney; bladder, urethra, pains in different animals. Internal symptoms, rectal exploration, vaginal, urethral, straining, ureters, bladder, calculi, neoplasms, prostate, urethritis.
External Symptoms. With inflammatory or painful affections of the urinary organs the animal tends to roach the back or loins, tuck up the abdomen, move the hind limbs stiffly and with a straddling gait, protract and withdraw the penis which may be semi-erect, retract and drop the testicles alternately, and stretch himself and strain to pass urine without success. Lying down and rising may be accomplished with marked effort and groaning. The loins along the spines or beneath the outer ends of the transverse processes may prove tender to tapping or pinching, the animal drooping to excess. Backing or turning in a narrow circle may be accomplished awkwardly and stiffly though usually more easily than with lumbar sprain. The animal drops when mounted but less than with sprained back. Urine may be passed in excess or in diminished amount, or it may be entirely suppressed. It may be abruptly interrupted when in full stream, suggesting calculus or polypus, or it may be passed often in mere dribblets, or finally it may ooze away constantly partly lodging in the sheath and partly trickling down the thighs.
In dogs or cats with flaccid walls of the abdomen external manipulation may detect in the kidneys, differences in size, position, and tenderness as well as the presence of tumors. The distended bladder also may be distinctly felt, and the pyriform area of flatness on percussion will serve to map out its size and outline.
the careful search for the small central lower orifice. In the smaller animals the finger only can be introduced into vagina or rectum and the urethra, cervix and bladder only can be felt. The result of such exploration is straining even in healthy conditions but which becomes excessive in nephritis, pyelitis, renal, urethral, vesical or urethral calculus, cystitis, rectitis or enteritis.
The ureters are tender when inflamed, and they are swollen in calculus obstruction with an elastic feeling in front of the stone.
The bladder is very sensitive when overdistended, inflamed or pendent on the abdominal floor, or when the seat of calculus. In the absence of any liquid contents a calculus is felt as a hard solid mass firmly clasped by the contracted vesical walls. If liquid is present the solid hard calculus is felt movable in the fluid. An empty contracted bladder is firm and pyriform. An empty flaccid bladder, resulting from rupture or exhaustion, is flabby, with indefinite form and, if the seat of a lesion, tender. It varies in consistency with neoplasms (papilloma, sarcoma, carcinoma, or epithelioma). These have not the free mobility of the calculus floating in urine, and their point of connection with the wall may often be made out. When a solid body is felt, or suspected to be in the contracted bladder, an injection of sterilized water will usually facilitate diagnosis, and a differentiation of calculus and neoplasm.
Hypertrophy of the prostate is felt as a swelling of uneven outline over the cervix vesicæ. It is to be looked for especially in old dogs.
Urethritis is indicated by swelling and tenderness along the median line of the pelvic floor, back of the cervix. With a calculus in the urethra the swelling is more strictly localized and the canal in front of it may be full and elastic.
HEMATURIA.
Symptoms of different lesions of kidneys and constitutional states, of poisoning by irritant plants, common on moors and in woods. In puerperal cow fed on turnips raised on mucky, unreclaimed, sour lands. Bacteria. Toxins. Anæmia. Poor wintering. Limed new soils. Symptoms: in plethoric, congested mucosæ, vascular tension, hurried breathing, colics, straining, red urine; in vegetable irritants, depression, weakness, coldness, trembling, stiffness behind, scanty red or black urine, diarrhœa, constipation; in anæmia, poverty, debility, red urine, pink tinge in milk, emaciation, hidebound, anorexia, colics. Chronic or intermittent. Lesions: in plethoric, congested enlarged kidney, without softening; in irritant poisons, congestion also of throat, stomachs, intestines, liver with hæmorrhagic extravasations; in anæmia, kidneys pale, flaccid, hydroæmia, liver enlarged, softened, reddish liquids in serous cavities. Treatment: avoid the injurious soils, drain, cultivate, feed products of such soils with other food, oleaginous or saline laxatives, antiferments, tonics, astringents, flax seed, farinas.
The passage of blood or blood elements in the urine.
Causes. A symptom of a variety of diseases, producing lesions of the secreting structures of the kidneys; acute congestion, tumors, calculi, parasitism. Also as a manifestation of diseases of distant organs—hæmoglobinuria, southern cattle fever, anthrax, poisoning by irritant diuretics, wounds of the bladder, pelvic fracture with injury to bladder or urethra, cystitis with varicose cystic veins, etc.
Among the irritant plants charged with producing the affection are the young shoots of oak, ash, privet, hornbeam, alder, hazel, dogberry, pine, fir, and coniferæ, generally. Also ranunculus, hellebore, colchicum, mercuriales annuus, asclepias vincetoxicum, broom, etc. The disease is common in spring in cattle turned out too early to get good pasturage and which, it is alleged, take to eating the swelling buds and young shoots of irritant plants.
