NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
186
A TREATISE ON ELEPHANTS.
Apart from damaging granulations, the more pain occasioned the
more timidity will be aroused in the patient and greater will be the
difficulty in future applications.
Owing to the neglect and improper treatment of wounds,
elephants are constantly incapacitated for work for months, which is
absurd. Experience proves that with care and attention wounds in
elephants, though perhaps not disposed to heal as rapidly as in most
other creatures, will heal in about one-fourth the time it takes a
mahout to cure them.
Owners of elephants and especially firms who have European
assistants should insist that elephants placed in their charge shall
not be treated (except under their personal direction) by mahouts.
The assistants should be careful to note that the strength of all
antiseptics, disinfectants, etc., laid down should be adhered to. In
many cases much unnecessary pain and injury to the tissues is
caused by using these solutions much too strong. The method of
pouring an unknown quantity of drugs such as phenyle and carbolic
acid, etc., into a bucket of water is to be strongly condemned.
ABSCESS.
The term applied to a circumscribed collection of matter (pus)
usually occurring in the deeper layers of the skin or tissues beneath
it.
Causes.—Entrance of micro-organisms, irritation and uncleanli-
ness, pricks from thorns, stakes, nails, bruises, uneven pressure from
loads, ill-fitting gear; hence it follows that they are most often met
with on parts subject to pressure such as the back and sides ; they
are not infrequently seen in the feet.
Symptoms.—Swelling
accompanied by heat (not always pro-
nounced), pain and tenderness. The formation of matter in these
animals is a somewhat slower process than in man and many animals
and. owing to the thickness of the skin, the abscess does not readily
come to a head and so permit of exit of the contents but instead it
burrows beneath it. Constitutional disturbance is manifested by a
more or less severe degree of fever.
Treatment.—As
soon as a swelling about the back after work
is noticed, it should be treated as laid down later for this condi-
tion under the heading of abrasion. When matter has formed, the
only treatment consists in evacuating it : this in itself is a simple
process, but the diagnosis of the presence of fluid is frequently a
difficult matter as, owing to the thickness of the skin, fluctuation is
not readily obtained. To observe fluctuation, place the fingers
[Facing page 187.
CASE OF LOSS OF SOME OF THE SPINAL PROCESSES FROM SOREBACK
(AFTER
SANDERSON).
ABSCESS.
187
firmly on one side of the swelling and with the fingers of the other
hand gently press the tumour ; if the swelling be felt to rise and fall
under the first hand, it is due to the presence of fluid, and the sensa-
tion imparted is what is understood as fluctuation ; it is as well to
try and obtain it in two directions at least. To recognize fluctuation
only requires a little practice, but much skill is necessary to detect
matter in small quantity or where it is deeply seated. As already
observed if matter be not liberated it will burrow and increase the
extent of the mischief; hence it is essential to evacuate it as soon
as possible after it has formed. A swelling that has shown no sign
of reducing and is attended by pain, local heat and tenderness, and
especially if there be any fever present, even if fluctuation be not
obtained, a knife should be plunged deeply into it, for it is better to
do this when no matter exists than to postpone doing it for some
time after it may have accumulated; no harm beyond laying the
animal up for a few days can arise from the first contingency, but
considerable harm in the latter.
A better method, whenever there are any reasonable grounds
for suspecting the presence of matter, such as continued high tempe-
rature after an injury, is to use a fine trocar and canula (Campbell's)
and plunge this into the suspected swelling and on the removal of
the trocar fluid if present will flow through the canula and the
swelling may then be freely opened with a knife. Two or three
punctures may be made in different parts. No harm is likely to
result from this procedure provided the instrument is well boiled
before use ; on the contrary some swellings where pus has not been
detected have dispersed after puncture.
Mahouts are proverbially dilatory in opening an abscess and
prefer to leave it, saying that it is not ripe or too hard and are there-
fore responsible for the loss of an animal's service for a much longer
period than need be.
Method of procedure in opening an abscess.—First of all wash the
part thoroughly with some disinfecting solution (see Formulæ 114 to
120), then plunge a knife deeply into the most prominent part of the
swelling, i.e., stab it, or better still, first plunge a fine trocar and
canula into it, withdrawing the former; if matter now escapes, make
a free incision into the swelling in such a situation as to allow the
readiest means of drainage, that is if on the back incise the lowest
portion of the swelling. Naturally, if the upper portion were opened
a pocket would be left in which the discharges would collect. A
free incision right through the length of the swelling is the shortest
procedure in the long run. Mahouts if allowed to carry out their
own methods will tinker about the business, fail to give free vent to
the discharges and will lay an animal up indefinitely. If in the
188
A TREATISE ON ELEPHANTS.
region of the spine or bony points, the hands or fingers should after
disinfection be thrust in and the wound explored for dead pieces of
bone, which may occasionally be found and should be removed, after
which the cavity should be cleansed by syringing it out with dis-
infecting lotions and the wound dressed, and a large piece of lint
steeped in some camphorated oil, dikamali ointment or some other
preparation which will keep flies away {see Part III, Formulae 128,
130 and 137) should be placed between the lips of the wound to
prevent its closing too rapidly. Dressings can be kept in place by
using strips of good resin plaster. The cavity will require dressing
at least once daily till healed. In neglected cases when the skin has
become undermined, and this may be extensive in every direction,
to promote the healing process it is necessary to have recourse to
caustic solutions. The cavities should be syringed out with tincture
of iodine, 1 to 2 drs. to the pint, carbolic acid (1 to 20), or sulphate
of zinc or copper lotion, 5 grs. to the ounce (also see Part III,
Formulae 98 to 102), after which as a rule healing commences:
if not, the injection must be repeated every second or third day till
the wound assumes a healthy aspect. Where pockets exist, one or
more openings should be made so that the discharges can completely
drain away. Pieces of tape previously disinfected may be passed
from the original wound through the new openings and then knotted,
or a piece of wood tied at each of the ends to keep them from
slipping through ; the tapes should be moved up and clown once or
twice a day and removed as soon as a healthy discharge issues
(see Setons, page 113). In old standing cases a blister or strong
liniment applied over the undermined portion but not on the wound
itself often promotes healing. All incisions through the skin should
as much as possible be made in the direction of the natural folds or
wrinkles, not across them., otherwise they will gape and when
healed leave ugly scars {see Fig. 36).
SEROUS ABSCESS.
What are known as serous abscesses are occasionally met with,
they may contain blood or serum.
Causes.—Falls or severe blows.
Symptoms.—After
a heavy fall or a severe blow, a swelling
suddenly appears, fluctuation may be detected, there may be no heat
or pain as in an acute abscess containing matter, the effused material
may be blood or serum the result of direct injury to the underlying
tissues, or rupture of some of the vessels.
SEROUS ABSCESS.
189
Treatment.—Rest,
a purgative and frequent fomentation, which
usually brings about absorption of the effused material. Should the
swelling increase and be accompanied by doughiness, increased pain,
heat, tenderness and fever, it may be inferred that matter has formed
(purulent abscess), and must accordingly be evacuated without delay
and treated as laid down.
NOTE.—In operations such as opening abscesses and cysts, slitting
up sinuses, removing small tumours, etc., gratifying results are
obtained by the injection of " Eudrenine"
into the
surrounding
tissues. This preparation is a combination of Eucaine and Adrenalin
whereby the properties of the two drugs are combined, the former
renders the part painless while the latter prevents bleeding.
It
is employed by injecting deeply 15 to 20 minims with a hypodermic
syringe at various points around and into the part to be operated
on and waiting 10 to 15 minutes to allow it to take effect.
Three-
quarters of an ounce may be injected.
Messrs. Parke Davis &
Co., who have Agents in Bombay and Simla, supply Tabloids, etc.,
with full directions for use.
The preparation might be made up of the strength
recommended
by Wallis Hoare* viz. :—
Eucaine Hydrochloride
Adrenalin Chloride
... 1/6 fc gr.
... 1/2000 gr.
in each cubic centimetre (about 17 minims).
* " Veterinary Therapeutics and Pharmacology," by Wallis Hoare, F.R.C.V.S.
CHAPTER V.
ULCERATION. SINUSES AND FISTULÆ. BURNS AND SCALDS.
An ulcer is an open sore of some superficial structure, whether
skin or mucous membrane.
Causes.—Ordinary
pus forming organisms of specific disease,
neglect of abrasions or wounds, malnutrition.
An ulcer is brought about in the same manner as an abscess,
with this difference, that in an abscess the dead material is retained
in the tissues, whereas in an ulcer dead cells are 'thrown off almost
immediately.
In the case of a wound which degenerates into an
ulcer, it should be remembered that the natural tendency of all
tissues is to heal, but neglect or severe injury to the tissues so
lessens their vitality as to allow pus-forming organisms to gain the
upper hand, with the result that the wound instead of healing
becomes an ulcer and tends to enlarge.
Characters of an ulcer.—Ulcers may be classified into three
main groups—
1. Ulcers which are granulating.
2. Ulcers which are spreading.
3. Ulcers which are stationary.
1. Ulcers which are granulating may be quite healthy, in which
case we find the base of the ulcer covered with an even layer of
small red uniform granulations with sharp points which do not bleed
readily if lightly touched, the edges neither everted nor inverted and
with a glistening mother-of-pearl-like appearance, showing that it is
commencing to heal over.
The discharge is small in amount,
yellowish in colour, contains little pus and is inodorous.
Treatment.—Consists
chiefly in cleansing the sore by irrigation
with some such lotion as carbolic acid, phenyle (1—80), perchlo-
ride of mercury (1—2000, i.e., grs. v to the pint), potassium per-
manganate (grs. iv—xx to one pint), thymol (grs. x to one pint).
It may then be dusted with boracic acid powder, equal parts of
iodoform, zinc oxide and starch, or equal parts of iodoform and
starch (see Part III, Formulae 64 to 69).
A granulating ulcer is said to be weak when its base is covered
with an uneven layer of granulations which are irregular in shape,
flabby and with more or less rounded points and discharging a thin
unhealthy-looking pus.
[Facing Page 101.
PLATE IX.
Cow
ELEPHANT
"
MA
PU."
Showing loss of cartilage of ear, the result of extensive ulceration ; also showing original ulcer nearly healed.
ULCERATION.
191
Treatment: —The ulcer should be washed as before and lead
lotion (see Formulæ 105 and 106) should be applied, or a lotion con-
sisting of zinc sulphate and lead acetate, two drachms of each to one
pint of water. Sulphate of copper or sulphate of zinc lotion (grs. ii
to the ounce) may also be used (see also Formulæ 61 and 62). As
dry dressings, equal parts of alum and starch or acetate of lead and
starch may be used. Sometimes a gentle scraping of the base and
edges of the ulcer with a blunt knife will excite healthy granulation;
Again, the base of a granulating ulcer may be covered with large
prominent dark red uneven granulations which easily bleed, the
edge may be concealed by the sprouting base, the surrounding tissues
are healthy looking, and there is abundant discharge of matter ; such
an ulcer is known as an exuberant ulcer.
Treatment.—The
ulcer should be thoroughly washed as before,
and should then be touched once daily or every other day as neces-
sary with Sir W. Burnett's fluid * (zinc chloride lotion) of a strength
of half a drachm to eight ounces of water. Sulphate of copper or
sulphate of zinc (grs. x to the ounce) may however be used
instead until it assumes a healthy appearance, after which it may be
dressed with ordinary dressings.
If the discharge is excessive
the dry dressings should be changed frequently.
With these ulcers
pressure, i.e., the application of a pad of medicated tow or cotton
wool with a bandage if it can be applied, often yields good results;
care must, however, be taken that the bandage is not put on too-tight.
2. Ulcers of the spreading variety are characterised by the base
being depressed, or uneven in appearance and reddish yellow in
colour. The edge may be uneven but sharply defined and the
surrounding skin is red, inflamed hot and painful, the discharge is
thick and greyish yellow in colour and the ulcer shows no tendency
to heal.
These ulcers, though not common, are occasionally met with ; I
quote as an illustration a case sent me by Mr. Nisbet of Messrs.
Steel Brothers & Company (see Plate IX).
A female elephant "Ma Pu":-
" The left side of the head is all diseased, the ear being three-
quarters eaten away. During the last day or two it has reached the
right side of the face, having travelled round the chin which is also
diseased. To outward appearance the skin of the part affected is
dry and cracked, and here and there the skin is off altogether, the
part is also all swollen. The disease is of long standing."
* Sir W. Burnett's disinfecting and antiseptic fluid contains 25 grs. of zinc
chloride in every fluid drachm. It is a strong caustic and should be employed with
great care.
192
A TREATISE ON ELEPHANTS.
A Burman who informs me he has seen two or three cases of
this with elephants before says the disease slowly eats into the
brain through the ear hole or the throat, when the animal dies, and
there is no cure for it.
As a matter of fact these cases after proper treatment usually do
quite well.
Treatment.—This
variety of ulcer is extremely troublesome
besides being extremely painful. The treatment consists in the
relief of pain by the application of powdered opium ½ to 1 dr. in hot
water, 8 ozs. macerated for two hours and then decanted, or acetate
of lead 8 grs., acetate of morphia 8 grs., water 4 ozs. Sir W. Burnett's
fluid of a strength of 1 dr. to 16 ozs. of water, or nitric acid lotion
may also be used, consisting of 2½ drs. of dilute nitric acid to 8 ozs.
of water. Sulphate of copper 16 grs. to. water 8 ozs. may also be
used mixed with equal parts of the abovementioned opium lotion.
Sometimes the base of the edge of the ulcer is covered with a
tough tenacious material, the surrounding tissues are swollen and
painful, and the discharge is extremely offensive. Such a variety is
known as sloughing ulcer.
Treatment.—The
application of warm opium lotions made as
already mentioned will be found of benefit. Creosote ointment (oil
of creosote 20 drops to lard 1 oz.), carbolic acid ointment (grs. x—xx
to boracic ointment 1 oz.) may also be used.
3. Ulcers which are stationary are recognised by the fact that
their bases are depressed and sunken, they are devoid of granula-
tions, and they may appear as smooth and glistening or covered with
a thin tough rind ; their edges are smooth, rounded, glistening and
inverted, and they discharge a thin watery fluid often very foul
smelling.
Treatment.—Thoroughly
wash with antiseptics and apply resin
ointment (see Formula 131), or nitrate of mercury ointment or
Friar's balsam. Any of the lotions mentioned in Formulae 109 to
113 may be used.
In all cases of chronic ulcerations, where the base is depressed
and the edges are callous and hard, scraping with a blunt knife until
they bleed freely generally yields good results. Whatever may be
the nature of the local treatment decided on, it is always desirable to
supplement it by internal medication in the way of tonics, the best
being arsenical preparations or iron combined with cinchona, nux
vomica, etc., the bowels should be kept regular, and good clean
nourishing food is also necessary if good results are to be expected.
A special form of sore which is occasionally met with, as far as
my experience goes, during the rainy season, is probably due to a
specific organism. It is usually situated about the feet, but Messrs.
ULCERATION.
193
Royle and Baker of Messrs. Steel Brothers in the Katha District came
across similar sores about the body, especially in the region of the
saddle. Animals in good condition are attacked as well as others ;
the first thing observed is a swelling which may be about the size of
a pigeon's egg, i.e., half to an inch in diameter, more or less circular
in shape, hard to the touch and not painful, in fact it resembles a
chafe. If disregarded, the centre softens and breaks down and a
white fibrous-looking core sloughs out, leaving a raw healthy-looking
ulcer with clean cut edges.
Treatment.—If
the swelling be observed early two or three
paintings with double strength iodine liniment may disperse it. A
hypodermic injection of a few drops of pure carbolic acid into the
centre of the swelling is also of service. After the slough has come
awav, the surface of the wound should be well washed with
disinfectants and cauterised if necessary with lunar caustic, copper
sulphate, or swabbed out with Burnett's fluid ½ dr. to 8 ozs. of water,
after which it may be treated in the ordinary way.
Internally
calcium sulphide may be tried in 3-dr. doses.
Again in cases of advanced debility, ulcers about the genitals are
often observed only visible during micturition. Their treatment is
obvious, i.e., tonics, rest, cleanliness, good nourishing food, and
dressing with some mild ointment.
INJURIES AND ULCERS ON THE ELBOWS.
Causes.—Animals being frequently made to assume the recum-
bent posture on hard ground for loading, swelling may result at the
points of contact with the ground ; if neglected they may ulcerate
causing troublesome sores. They are not frequently met with in
Burma, as generally speaking most people use the kah or basket,
and the animal is not as a rule required to assume the recumbent
posture, the packages being handed up. Sanderson's pattern gear
is supplied to Government officers. In an article in the " Veterinary
Journal" of November 1882, Nunn treats of these sores.
Symptoms.—Local swellings in the position of capped elbow in
the horse ; the swellings are often very painful and tender.
Treatment.—Avoid
the cause abovementioned and do not keep
an animal in the recumbent position longer than is absolutely neces-
sary. The elephant should be loaded as quickly as possible, and
this can be done if those around are made to work instead of talk
and argue with the mahout.
The animal should be tethered on soft ground so that he may lie
down ; fomentations and afterwards painting with liniment of iodine
13
194
A
TREATISE ON ELEPHANTS.
(Formula 138), or applying a blister, may reduce the swellings. If
ulcerated, treat as laid down under that heading.
ULCERATION OF THE FOREHEAD.
The skin of the forehead is liable to become tender and sore from
constant exposure to a hot sun. Ill-tempered careless drivers are
given to a too free use of the goad, inflicting punctured wounds.
Injury may also occur to the forehead when not protected, while
the animal is engaged in pushing or overthrowing obstacles.
Care must be taken with these cases, as the inflammation is liable
to spread to the sinuses of the skull.
Treatment.—If
due to exposure, the animal should be given
complete rest, kept under shelter, the bowels opened by a smart
purge, and cold applications by wet cloths applied (Formulas 103 to
106). In some cases hot fomentations afford more relief. When
the inflammation subsides, alum lotion, or weak zinc or copper
lotion, 3 to 5 grs. to the ounce of water, may be applied, or
carbolic, iodoform, or oxide of zinc ointment (see Formulas 109,
no, 125, 127,
129).
When lotions are used, care should be taken to see that the
cloths are well wrung out to prevent any dripping into the eyes,
and as an extra precaution vaseline, lard, or oil should be freely
smeared round the eyes.
In severe cases there may be some ulceration and formation at
matter. Such parts must be kept thoroughly clean, the matter given
free exit and the injuries carefully protected. Some of these cases
are difficult to cure. If the ulcers are indolent, they may be touched
with a little lunar caustic or blue-stone, or dressed with ointment
subacetate of copper 2 drs., oil of turpentine 2 drs., lard 3 ozs. The
turpentine and lard should be melted together and the copper later
thoroughly stirred in. If the bone be exposed, the surface should be
dressed with dilute nitric acid lotion (dilute nitric acid 2 drs. to 8 ozs.
of water).
Elephants that are much exposed to the sun should be provided
with a quilted pad, especially if employed for much pushing work.
If a pad is not available, a coating of pipe-clay, chalk, etc., assists
in protecting the head from the effects of the sun. Oil is very
useful to the attendant so is indented for, but is of no material
advantage to the elephant.
The skin of the forehead of elephants under Indian mahouts is
often tender and sore, owing to the brutal manner in which many of
these men employ the goad.
The best treatment for maltreatment
ULCERATION.
195
and carelessness is to place the attendants on half pay during
the period their charge is incapacitated from work.
ULCERATION OF THE EAR.
This may be seen on the edges of the ear, on the flaps, or in the
canal which leads internally.
Causes.—Dirt, advanced debility and old age, or bathing the
animal when heated, neglected tears and wounds. The condition
is also met with sometimes in well-conditioned elephants, the tail
being affected at the same time, and this may be due to eating certain
grasses, or even grain food affected by a fungus such as "ergot."
Ergot is a fungus which grows on rye and other grasses and pro-
duces gangrene, or a destructive ulceration of the fingers, toes and
other extremities in human beings. It seems possible that this
identical fungus or something similar may account for this condition
which we see in these animals.
Symptoms.—That
form, seen on the edges of the ear, has a
tendency to spread and the parts to become destroyed and thrown
off, considerably reducing the size of the flap.
That which is met with on the flap and sometimes extending into
the canal, discharges profusely. When the canal itself is attacked
there is a danger of the disease extending to the brain.
Treatment—Is difficult in this situation owing to the perpetual
motion of these appendages. The sore surfaces must be kept
thoroughly clean and dressed on the lines already mentioned for
ulcers.
When the canal is affected, a syringe will be required to keep the
parts clean ; no force should be employed and the canal must not be
plugged. To insure powders reaching the ulcerated surfaces, they
should be placed in a small bamboo, which when inserted into the
orifice may have its contents gently blown in.
ULCERATION OF THE TAIL.
Ulceration sometimes attacks the extremity of the tail.
Causes.—General debility or extreme age, though young and
well-conditioned animals may suffer. A similar condition may be
met with in monkeys, and I believe in the camel.
Symptoms.—The hair is shed and the skin ulcerates for a vari-
able distance up the tail. This destructive process is prone to extend
to the deeper tissues, all of which may die and considerable portions