NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
"
MUSTH."
175
be much lower. A better method is to fit it with a ring which is
forcibly driven on to the tusk till it maintains a secure hold.
Tusks that have been shortened often show a tendency to split.
In the female and so-called tuskless males, the tusks are liable to
be broken off or to become diseased.
Should there be a cavity, it must be cleaned and washed out
with permanganate of potash 2 or 3 grains to the pint and then
dried after which it should be plugged with a single piece of tow or
cotton wool, medicated with a few drops of carbolic acid, creosote,
or oil of cloves.
If it should happen that too much of the tusk has been cut off
and the pulp exposed, the following treatment should be adopted :—
The bleeding is not as a rule very excessive ; the injured part
must be washed or syringed out with a warm solution of perman-
ganate of potash 2 grains to the ounce, or carbolic lotion 1 to
60, or thymol 10 grains to the pint of hot water, after which
the part may be dressed with carbolic oil, iodoform ointment, cam-
phorated oil, etc. (Part III, Formulae 121, 122, 128, 129), and
then carefully bandaged. Hawkes employed an ointment which
can be strongly recommended ; it is as follows :—
Dikamali
...
...
Bees-wax ... ...
Gingili oil
...
...
Gall-nuts (powdered) ... ...
5 tolas, i.e., 2 ozs. approximate.
5 tolas, i.e., 2 ozs. approximate.
6 tolas, i.e., 2½ ozs.
2 tolas, i.e., 7 drs.
Boil the gall-nuts in the oil and add the dikamali ; when this has
melted strain through a cloth ; lastly add the wax and stir till cold.
[Dikamali is the Madras term for the resin from the Gardenia
lucida, a most useful ingredient in ointments, as it is healing and at
the same time repels flies.] Hawkes recommends that the oint-
ment be rubbed over the end of the tusk and then covered over with
a cotton rag ; over this a second piece of rag saturated in coal tar,
or neem oil, i.e., margosa-oil {Azadirachta Indica, co»do1sgo:), may
be bound. Dress every second day.
Great care should be taken to see that flies are kept off, other-
wise the wretched animal owing to the presence of maggots may
have to endure fearful suffering.
CONGESTION OF THE TEMPORAL GLANDS OR "MUSTH."
Male elephants and very rarely females, on attaining maturity,
are subject to peculiar periodical paroxysms of excitement, which
seem to have some connection with the sexual functions to which
the name musth is applied by the natives of India and mon-kyathi
176
A TREATISE ON ELEPHANTS.
(
) by the Burmans. It is probably analogous to the rut
in deer.
Causes.—It occurs both in wild and tame animals, and in the
latter is more often met with in highly fed pampered beasts that
receive insufficient exercise. It occurs most frequently in the cold
season and may perhaps be due to ungratified sexual desire in some
cases, but not always so, since the society of a female by no means
always quells or even pacifies animals in musth.
At other times
an animal in nmsth undoubtedly seeks a mate of the opposite sex.
Symptoms.—Musth
occurs frequently in some beasts, seldom in
others, so that the intervals are variable in different animals and in
the same manner so are the svmptoms. More or less excitement is
usual, but on the other hand some elephants become dull and morose.
The behaviour changes, shown by disobedience to commands, trying
to break away, or showing violence to man or destructive tendencies
and being altogether out of sorts. The temples become puffy, due
to swelling of the temporal glands which lie beneath the skin and
at this stage is called by many mahouts kherr musth ; later an
oily discharge exudes from the hole or duct over the gland which is
then called musth by the natives. When musth is established
there is often a partial retention of urine, the water dribbling
away. As soon, however, as the urine is passed freely the natives
consider the dangerous stage over, irrespective of the amount of
discharge from the glands.
The attack may last a few days, weeks, or months. In some
cases cowardly mahouts are said at a certain stage of the attack to
administer some species of pumpkin which has the effect of abating
the excitement, etc. The effect of such treatment, however, is
said to be very prejudicial to the health of the animal. Mr. Petley
informs me that once musth is established it ought to come on
every year although in no particular month, and he has known
elephants in which owing to overwork or ill-health the usual
occurrence of musth has failed, to become useless for work. The
only remedy is to set them free for months until musth again
comes on, after which care should be taken to see such animals are
treated with extra care.
Treatment.—On the first signs being evinced, the animal should
be speedily removed from the vicinity of habitations and very securely
fettered (extra chains being employed). Should he escape or
show violence before being fettered, if possible give a dose of opium
or ganja mixed up with plantains, jaggery, or sweetened rice. It
is as well to bring in the aid of a couple of heavy tuskers if very
troublesome to assist in effecting one's object. Once fettered, a
female should be tethered not far from him, but should this enrage
" MUSTH."
177
him she must be removed. Foresters generally have some females
loose with males when out grazing as a precaution, lest an animal
becoming musth should stray away in search of such companionship
and be lost as they occasionally are.
Grain must be entirely withheld and green food only given in
small quantities for several days. To calm the excitement, drugs
are generally necessary and the best of these in the early stage is
a strong purgative (Formulæ 29 to 38), also in the early stages
opium, or ganja 4 to 6 drachms, given mixed with boiled rice,
plantains, or jaggery.
The following may be tried :—
Extract of belladonna two drachms, bromide of potash half an ounce, mixed
with sugar and aniseed or cardamoms and given in tamarind pulp or jaggery
twice a day for two days.
OR
Camphor
...
...
Opium
...
...
3 drs.
3 drs.
Twice a day for two days.
OR
Wheat flour ... ...
Onions ... ...
Sugar ... ...
Ghee ... ...
8 lbs.
8 lbs.
8 lbs.
4 lbs.
Mix and make into pills the size of an orange, and give one night
and morning till the whole is taken.—Hawkes.
The use of bromide of potash in doses from ½ to ¾ of an ounce
once or twice daily. If this drug is given in the early stages so
much the better. I have records of most troublesome animals that
had always to be securely fettered during musth under this treatment
carry on their work as usual. With drugs of the nerve-depressing
class, however, exceptions must be looked for as some individuals
possess greater resistance.
INFLAMMATION OF THE TEMPORAL GLANDS.
Causes.—Sometimes
the unusual congestion of these glands
during the period of musth runs on to inflammation especially when
musth has been prolonged.
This may even go on to the formation of a fistula, in time extend-
ing to a depth of several inches, ten or more, and affecting the
adjacent bone. In these cases there is often much swelling owing
to pent-up matter, etc. If a probe be passed down the sinus very
foul-smelling pus as a rule wells out.
12
178
A TREATISE ON ELEPHANTS.
Symptoms.—The temples become hot, tender, painful and much
swollen and an abscess may form.
Treatment.-—At first a smart purge and hot fomentations ; later,
if matter forms, it should be evacuated by incision. The skin below
must be smeared with oil or vaseline to prevent the discharges
irritating the skin and making it sore.
Should there be a fistula with careful treatment and persever-
ance the cavity will heal up in due course. The best way to treat
these cases is to procure rubber tubing fairly stiff, of sufficient
size and length to pass down the wound and thus permit of free
irrigation with a disinfecting astringent lotion. These should be
freely applied at least three or four times a day and the outward
opening of the sinus not allowed to close up too soon. The injec-
tions should be made lukewarm. Elephants as a rule do not object
to this treatment as it seems to afford them great relief. Phenyle
lotion, carbolic lotion, corrosive sublimate lotion may be used and
later sulphate of zinc lotion.
CHAPTER IV.
WOUNDS. ABSCESS. SEROUS ABSCESS.
WOUNDS.
Definition.—A wound is a solution of continuity of soft struc-
tures, generally induced by violence from without, but at times from
within, as is the case when a broken bone pierces the tissues.
Causes.—In elephants, lighting is one of the chief causes of
serious wounds. Severe falls and other accidents may similarly
occasion them.
Varieties of wounds.—For convenience of description, they
have been divided into several classes. It is however only neces-
sary to describe those most likely to be met with, namely—
(i) Incised wounds, such as are inflicted with clean cutting
instruments, knife (da), bamboo, etc. These wounds
bleed freely from their whole surface and generally heal
rapidly.
(2) Punctured,
in which the depth is much greater than
its superficial extent. Example:
stabs, wounds from
spikes, bamboos and injuries by sharp tusks. These
wounds are generally dangerous owing to the possibility
of important organs being injured and the difficulty in
thoroughly cleansing them. Any poison which may
have gained entry lurks in the wound and may set up
various serious diseases.
(3) Lacerated wounds, in which the tissues are torn; they
do not bleed so freely as incised and punctured wounds,
for the simple reason that the coats of torn vessels
contract more readily than is the case when they are cut
clean across.
(4) Contused-lacerated,
in which, in addition to a wound,
there is much bruising of the surrounding parts. Such
injuries do not heal very rapidly owing to the mechani-
cal, injury the tissues may have suffered which may be so
severe as to lead to their death.—(Slough.) There is a
tendency to formation of matter.
Example:
After a
fight, as the defeated animal retires he is often followed
up by his opponent who freely butts his hinder part;
180
A TREATISE ON ELEPHANTS.
should he happen to be in possession of blunt, short
tusks, a contused-lacerated wound is likely to be the
result.
(5) Poisoned wounds, bites of venomous snakes, stings of
insects.
Treatment of wounds in general:—
(a) Arrest the bleeding.
(b) Search for and remove foreign bodies such as pieces of
glass, thorns, splinters, and cleanse wound.
(c) If possible secure edges of wound in apposition.
(d) Apply dressings with a view to exclusion of micro-
organisms, flies, dust, also to ensure cleanliness and
promote healing.
(a) Arrest of bleeding.—Bleeding may arise from an artery, a
vein, or capillaries. The methods employed are—
Torsion : seize the end of the vessel when seen with forceps,
twist three or four times and let go ; only applied to
small vessels about the calibre of a packing needle or
less.
Pressure, as with pad and firm bandage ; only employed for
slowly oozing blood.
Application of cold, such as ice ; only applied for trifling
oozing.
Application of heat, such as hot iron, or water at a tempera-
ture which the hand will barely bear, about 110° F.
Drugs : perchloride of iron, gallic and tannic acids.
Ligature, tying the vessel. The end of the vessel is seized
with forceps and a piece of silk, catgut, or fishing gut
(previously disinfected) tied round it and secured.
The thread is then cut off leaving ends from ½ to ¾ of
an inch in length. If the vessel be a vein both ends
must be secured. This is the method most certain and
can be applied to vessels of any size.
Blood from an artery may be recognized by its red colour, rapid
flow and the blood spurting out in jets ; while that from a vein is
darker and the flow continuous. In capillary bleeding there is a
general oozing over the wounded surface. Capillary bleeding is the
least serious.
The danger of bleeding depends on the size of the vessels injured;
if large and not secured the animal will bleed to death. Bleeding
from large arteries and veins is serious. Haemorrhage from small
arteries, small and even medium sized veins, frequently stops without
intefierenGe of any kind. Hæmorrhage, is more severe when a
WOUNDS.
181
vessel is divided transversely than when the wound is in a longitu-
dinal direction and the more rapid the loss the greater the danger.
Symptoms of severe bleeding are a blanched state of the mem-
branes, coldness of the body and extremities, a swaying staggering
gait, marked weakness and prostration. If the pulse can be taken
it will be found to be irregular. The animal falls, usually becomes
unconscious, the excretions may be passed involuntarily, a few
slight convulsions and the animal is dead.
(b) Removal of foreign bodies.—Splinters
of wood, pieces of
glass or bone and other bodies often remain in a wound; search
should always be made for these and if found removal may be
effected by means of the fingers, or with the aid of forceps. Much
handling and probing of a wound is not necessary. Dirt, gravel,
can best be removed by the free use of warm water. As a rule no
raw surface should be wiped or rubbed. To cleanse the wound, small
pieces of clean old linen should be employed. This may be carried
out by merely dipping clean cloths in boiled water (which should be
lukewarm when used) or in a weak solution of carbolic acid (1 to
60), phenyle (1 to 60), or 2 to 4 grains of permanganate of potash
to the pint (Formulæ 114 to 120). Each cloth should be gently
squeezed above the wound so as to allow the water to trickle
over it, or better still, rubber tubing may be attached to a funnel,
or a large tin-pot with a spout. The solution can then be directed
all over the wounded surface so as to thoroughly cleanse it. A
large syringe also answers the purpose. Great force is unnecessary.
As a precaution, when an elephant will permit the operation, in
cases where punctured wounds are found on the limbs, after the
offending agent is withdrawn, the wound should be enlarged with
the knife, carefully inspected again for foreign bodies and then
treated with carbolic acid (1 in 3), which must be carefully rubbed
into the deepest portions, but this method must not be applied wher-
ever there is any likelihood of any internal organ being touched ;
here it is best to cleanse the wound with carbolic lotion (1 in 40)
and dress and await developments.
Generally speaking the less wounds are handled and interfered
with the quicker they heal. Mahouts are fond of treasuring up every
piece of filthy rag for future use and they are for ever rubbing or
wiping raw surfaces with them, and not infrequently use them for
plugging wounds of the back. There is only one way of preventing
this, namely to make a point of burning all pieces of cloth and
dressings after use ; and this is not much trouble.
(c) Whenever a wound is found gaping, it is where possible
desirable to bring the edges into contact in order to promote
union, and the handiest method and one least calculated to be
182
A TREATISE ON ELEPHANTS.
resented by the patient is to apply strips of the best resin plaster
each strip must be passed sharply backwards and forwards over hot
embers to ensure perfect adhesion. Hair should be removed.
To apply it cut two strips of plaster about 2 feet in length and
of width according to length of wound, say from 1 inch to 3 inches
shaped as Nos. 1 and 2 ; pass No. 1 through the window C of No. 2
and adjust before sticking down, so that the length of one piece
overlies the length of the other [see Fig. 36). Having done this;
stick A end of No. 1 on one side of the wound and the B end of
No. 2 on the other, leaving the B end of No. 1 and the A end of
No. 2 free. Exert traction on both these free ends, which will
approximate the edges of the wound. Having performed this stick
the ends down. In case the above is not clearly expressed, cut
strips out of paper and practise the method. This plan answers
well in some wounds.
Another method may be tried as follows : Suturing or sewing.
This is a less easy matter in the case of elephants owing to the
thickness of the hide and the strength of the muscle beneath the
skin. It is certainly worth trying in recent incised wounds. Ordi-
nary stitches do not as a rule hold well. The use of some new
suture buttons suggested by Mr. Pugh, and manufactured by
Messrs. Arnold & Sons, West Smithfield, London, is therefore
recommended. The button is to be had in various sizes and in
two shapes, oval and round. It is made of aluminium and is there-
fore light ; there is a hole in the centre for passage of the wire and
on each side of the hole is a clip, around which the wire can be
twisted in a figure of eight. The advantages claimed are : its
simplicity and lightness, it prevents cutting or tearing of the edges
of the wound, and lastly it is easily rendered aseptic for future use
by boiling.
In stitching elephant wounds separate stitches are the best. It
is better to make the first stitch at the centre of the wound. To
make a stitch, the needle is passed through the skin on one side of
the wound from without inwards ; then through the other edge from
within outwards ; the ends of the wire are to be taken and drawn
in gentlv so as to bring the edges of the wound together ; when
this has been effected, the ends of the wire are to be twisted
securely. The employment of buttons will be preferable. Stitches
should not be too close : a space of at least 1¼ inches to 1½ inches
should be allowed. The most dependent part of the wound must be
left open in order to permit free escape of all discharges. The lips
of large gaping wounds must not be forcibly dragged together, as
the stitches will cause much pain and are almost certain to give way
Again, stitches should not be made too near the edges; they should
WOUNDS.
183
Method of applying to wound.
A and B in position over the wound.
FIG. 36.
184
A TREATISE ON ELEPHANTS.
be placed far enough from them and of sufficient depth to ensure a
good hold.
(d) Dress the wound.—Dressings
should be applied where an
animal can be kept quiet and prevented from removing them. The
object of dressing is to keep the wound clean, to prevent exposure
to the air, entrance of dust, micro-organisms, flies and to provide a
means of applying certain medicaments (see Formulæ 121, 125 to
129 and 64 to 69).
In any wound where much pain is evinced the following may be
employed to allay this :—
Acetate of lead
Acetate of morphia
Water
... 4 grs.
... 2 grs.
...
2 OZS.
In a neglected sore there may be maggots which may be actually
seen, or suspected by applying the nose close to the wound, when
there is usually a foetid odour and a dirty offensive thin discharge.
When seen they must be removed with forceps ; if only a small
opening exists, it should be opened up and the maggots cleared out.
and subsequently the wound dressed with carbolic acid lotion (1 in
40). Some elephants will not permit much handling, others insist
on removing dressings, blowing in dirt, etc. ; and when wounds exist
in such animals, to avoid the entrance of flies, dikamali ointment
(the resin from the Gardenia lucida), a common bazaar drug
(Formula 130), or powdered camphor dissolved in spirit and mixed
with sweet-oil, or equal parts of turpentine and sweet-oil, should
be very frequently applied. The above-named drugs will also remove
maggots from wounds.
Poisoned wounds.—These include snake-bite, stings of insects,
and wounds inflicted by tigers.
In the case of hornet stings, apply dilute ammonia.
Snake-bite.—I have heard of three cases of elephants said to
have been bitten by cobras ; no case proved fatal, though one was
reported to have been in a precarious condition for twenty-four hours.
When elephants die suddenly Burman mahouts invariably report
the cause of death as due to snake-bite. I think I am correct in
stating that quite a large number of deaths amongst elephants in this
Province are attributed to snake-bite. I have never seen a case
proved nor have I met anyone who has. Owners should not accept
such reports unless there is ample proof. The poisonous snakes
likely to be met with in heavy jungle are—
(1) Hamadryad (
), rare.
(2) Cobra (
), rare.
(3) Green pit viper (
), a common tree viper the bite of
which however is very rarely fatal even to human beings.
WOUNDS.
185
In open country—
(4) Russell's viper (
), common.
(5) Cobra (
), common.
(6) Banded krait (
), common.
(7) Indian krait, rare.
In cases of suspected snake-bite the Burmans apply what they
consider an infallible method of diagnosis which is that in every
case of snake-bite the hair from any part of the body can be pulled
out without any effort.
Tiger-wounds.—Elephants
are occasionally attacked and severely
mauled and the wounds inflicted are peculiarly poisonous, but such
wounds must be treated on principles already laid down, that is
thorough cleansing and application of some caustic such as carbolic
acid 1 in 3.
Healing of wounds.—Wounds are said to heal by primary union
or first intention, or by second intention, and thirdly under a scab.
Healing by the first method is rare and can only be brought
about in clean-cut wounds whose edges can be brought together by
stitches and protected by careful dressing, e.g., surgical wounds.
The edges of the wound adhere very quickly and become covered
with a thin scab of clotted blood. This scab soon falls off, leaving a
slight scar which soon loses its colour.
Healing by second intention or granulation with or without
suppuration is the commonest method.
When not disturbed the
wound is soon covered with blood and lymph which quickly dries,
and later on a thin secretion is poured out which gradually
becomes thicker and of a yellow colour. In a few days granulations
(small red points) form, which rapidly increase filling up the wound.
The secretion gradually lessens and it will be noticed that the skin
around the edges begins to contract, the granulations also shrink,
gradually drawing together the edges of the wound and this results
in the formation of a white depressed linear scar. Healing under a
scab occurs in small wounds which are not exposed to infection
such as abrasions or excoriations. It may also occur in small incised
or superficial wounds which have been almost immediately covered
with antiseptic powders such as boric acid, etc. The dried blood, etc.,
soon forms a scab under which-the injury heals by granulation. The
scab after a time drops off and leaves exposed a soft red cicatrix or
scar which afterwards becomes pale and hard like the surrounding
tissues.
When dressing wounds the soiled dressings when adherent
should be thoroughly soaked with solution of carbolic acid or
phenyle (1 in 60), and gently withdrawn instead of being pulled off.