xli
Stomach.—The organ is somewhat contracted. On Section it is found to be nearly-
empty. The cuticular portion is healthy in appearance, with the exception of a
narrow band two inches in width, the seat of a yellow coloured deposit, situated close to
the line of demarcation. The mucous membrane of the villous portion also is healthy in
structure, with this exception that there are four tumours, the size of walnuts, each
being surmounted by a hole one-sixth inch in diameter, leading into it, these being placed
on the cuticular border of the line of demarcation, whilst the fourth lies about three inches
from it at the fundus, along the greater curvature.
Small intestines.—About midway between the pyloric end of the stomach and the
ileo-cæcal valve, the mucous membrane for a distance of three feet is dotted over with
small superficial patches of congestion, varying in size from one-eighth to one-fourth of an
inch in diameter. There is however no loss of epithelium on the surface of these patches
and no sign of ulceration throughout the whole length of the small intestine. Peyer's patches
and the solitary glands present a normal appearance.
Large intestine.—There is a quantity of semi-fluid fæces in the cæcum and upper
part of the colon, which was found to contain a number of small nematodes—a few ex-
amples of the strogylus armatus six in number, were discovered attached to the mucous coat,
which latter does not present any particular changes, except a few patches of slight
congestion.
Bladder.—Contains several litres of a viscid fluid, of the consistency of white of egg,
Sp. Gr, 1,030, alkaline.
The inner surface of the organ is free from extravasations
of blood, except at the fundus and here a patch, two inches square, made up of small
hæmorrhages, dark in colour, is situated.
Brain.—The brain and cerebral membranes present a healthy appearance. There is
however about half an ounce of fluid in the lateral ventricles.
Remarks.—This animal, aged 5 years, was recognized to be suffering from ' Surra' on
the morning of the 7th October 1892, when the hæmatozoon was discovered on micros-
copical examination of its blood.
On admission to the Laboratory Hospital on the 9th October at 8 A.M. the animal
was found to be in apparently perfect health and in splendid condition. On this day the
hæmatozoon was absent from the blood, and it was observed that it would have been an
absolute impossibility for any one to diagnose the case as one of 'Surra' in the absence of
the organism, or even to recognize that the animal was ill, much less that it was the subject
of an incurable disease, which must in the course of a few months prove fatal. For the
next two days the hæmatozoa were swarming in the blood ; specific treatment was deferred
and a simple febrifuge draught was given to try and reduce the fever. On the 12th
however the "organisms were few in the blood. Recognizing therefore that this case offered
advantages which might not again be forth-eoming, it was decided to again attempt the
destruction of the hæmatozoon by the exhibition of Cinchona Alkaloids and Arsenic, com-
mencing in this instance with large doses, viz., Alkaloids three drachms and Arsenic four
grains. The reason why large doses of the former were exhibited, was that few hæmiatozoa
remained in the blood, and in order to decide whether their destruction could be compassed
by the drug, the dose was so regulated as to insure its having a fair trial. On the morning
of the 13th, after two doses of the medicine had been given, the animal presented a
bright appearance, the temperature was 38.1°C. and the symptoms were ameliorated some-
what. The urine was found to have a Specific Gravity of 1,006, alkaline, but was free from
albumen, phosphates were present in a small amount and crystals of Carbonate and Oxalate
of Lime. From this date until the evening of the 15th, the temperature varied between
38.l°C and 39.3°C, the hæmatozoa were few in the blood and the pulse did not exceed 52.
On the morning of the 16th the temperature rose and in the evening registered 40.3°C. The
hæmatozoa were numerous, respirations were increased in number and the œdematous
exudation had extended; the treatment was continued, the dose of Arsenic having been
gradually increased to six grains. On the 17th the orgauisms had again fallen to few,
but the temperature and pulse were still above normal, and a trace of albumen was found
in the urine. It was decided to try the effect of full doses of Quinine, as this drug
has been said to be of much value when exhibited with Arsenic, and Rankin states
that he has been able to cure the disease. From noon on this date until the evening of
the 22nd the animal received thirty-three drachms of Quinine and seventy-two grains of
Arsenic. The fever was characterized by mid-day exacerbations and remissions in the
evening, extending until the morning in most instances ; the pulse varied between 42 and 64,
beats per minute, but the respirations showed considerable differences in their range,
especially after the first dose of Quinine ; on the 17th morning observation being recorded
as 12, whilst that of the evening was 51 per minute.
On the second day the organism was absent, but on the four subseqent days these
were few in the blood. On the morning of the 23rd the animal presented a dull appear-
ance, but not markedly so, and as the Quinine and Arsenic in large doses had apparently
produced no amelioration of the animal's condition, nor the slightest effect upon the
vitality of the hæmatozoon which was as active as before, it was resolved to abandon the
Quinine and return to the use of Cinchona Alkaloids and Arsenic; consequently six
B 1086-11 op