NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
PART V.
Infective Diseases.
CHAPTER I.
GENERAL REMARKS.
CONTAGIOUS DISEASES are not only communicable directly from
one animal to another, but may be indirectly so by the poison
(virus) being carried by attendants or their clothes, contaminated
fodder, or in water presented in utensils to which sick animals have
had access. Dogs, etc., should not be kept in elephant camps. It
is as well to remember these points.
2. It should be a rule to treat all newly purchased animals as
having been exposed to contagion. They with their attendants
should be kept quite separate for at least a fortnight. The animals
should be inspected certainly once, if not twice a day. Any case of
sickness should be forthwith isolated, the healthy animals divided
into small groups and kept well apart. A strict watch should be kept.
3. At all times it is advisable to segregate any case of fever
and keep it so until proof is afforded that the disease is non-infective.
4. In case of a disease being contagious the most important
step is without delay to separate the sick with their attendants, gear,
utensils, etc., from the healthy. Divide the healthy into small
batches, picket them well apart and to windward of the sick camp.
Take the temperature of the healthy animals twice a day, by this
means any fresh cases will be detected in the earliest stage of disease
and they can be removed to the sick camp at once, thus to a great
extent arresting the further spread of disease. If this very necessary
aid to detecting cases early be adopted, it will as a rule be found
that the disease is confined to one or two groups and can be
effectively dealt with.
5. With regard to the isolated area set apart for the sick
camp this should, when possible, be near a stream and situated well
below all other camps. The attendants and their sick animals should
not be permitted to leave it. Forage, if it has to be brought, should
be carried to the edge of the sick camp and then removed by
attendants in the isolated area. One of the first duties should be to
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A TREATISE ON ELEPHANTS.
have a number of pits dug for the reception of rejected fodder, moist
dung and discharges, which should not under any pretext be allowed
to lie about or be pushed a few yards away from the standings.
Apart from the unpleasantness of such insanitary conditions filth
tends to collect flies, and they not only irritate and worry sick
animals but can and do carry infection in certain diseases. The
pits should be covered in with two feet of earth. During the dry
season there is no reason, apart from laziness, why all such material
should not be destroyed by fire. The constant burning of such
material on the windward side generally suffices to keep away the
various kinds of insect torments frequenting elephant camps. When
camps are within easy reach of railways or steamers a plentiful
supply of cheap disinfectants should be obtained, perhaps the easiest
carried is powder, such as McDougal's, Sanitas, etc., which should be
freely used. Quicklime is very useful to throw over the refuse
before filling in the pits. Standings should be changed frequently if
only to a distance of 20 or 30 yards. When an animal is removed
the ground should be covered with straw, grass or leaves, etc., and
fired. Before moving from a camp care should be taken to see that
it is left thoroughly clean, not only on account of the possibility of
having to use it again, but to safeguard the animals of other owners
who may perchance camp there.
6. As to diet of sick animals, plenty of good, freshly-made
gruel should be allowed and freshly-cut green fodder offered. The
healthy animals should be kept on green fodder ; coarse, dry, indi-
gestible food is objectionable at any time, but especially so during
outbreaks of disease.
7. Ropes and other gear easily replaced that have been used
or in contact with sick animals should be burned. All iron work,
i.e., chains, etc., should be run through a fire. Should a case of
any dangerous infectious malady occur in a shed, if inexpensive, it
should be burned. If costly, the walls must be thoroughly washed
with boiling water mixed with very strong carbolic acid or phenyle.
As the floor becomes soiled with the discharges, it is necessary to
remove the earth to the extent of two feet at least, throw in new
earth and disinfect the whole standing. The shed should not be
occupied for some little time. All posts and other wood should be
washed with strong carbolic and, later on, dressed with tar.
8. The carcases of animals that die should be buried as near to
the place of death as possible. If they have to be dragged to any
distance the natural orifices should be plugged with tow or cloths
wrung out of some disinfecting fluid to prevent, as far as is possible,
soiling the ground. The grave, whenever possible, should be dug
alongside the carcase. Where cremation is possible it should be
GENERAL REMARKS.
283
carried out though it takes time and is usually an expensive process.
Anthrax carcases should not be opened. Anthrax graves should be
marked in some way, such as by fencing with rough logs, to prevent
animals grazing over them or grass-cutters cutting grass over them.
9. A guard should be placed over a grave for 24 hours to
prevent Burmans who are, as is well known, particularly partial to
elephant's flesh from removing the earth and taking any flesh.
10. As later on it will be observed that certain diseases are
common to other animals, it would be as well, before selecting camps
near villages or grazing grounds, to ascertain from the villagers or
herdsmen if such diseases as anthrax, hæmorrhagic septicaemia or
foot-and-mouth disease are or have been lately prevalent amongst
the cattle, etc., and if so such localities should be avoided. If this
is not feasible the animals should be tethered on the highest ground
available and no strange animals allowed near the camp. Animals
should not be allowed to graze in the locality. Fodder and water
should be brought to them ; the former, if grass is given, should be
cut well above the ground and rushes, reeds and swamp grasses on
no account used. It is even better to restrict the fodder to boughs
of trees, bamboos, etc. On the march, caravan and other tracks
used by cattle-drivers and their camps should be avoided.
11. In such cases, where it is deemed advisable to help to a
correct diagnosis of disease, blood smears should be taken and it
is well to be acquainted with the method.
Method of making a blood smear.—Blood smears are made either
on little slips of glass called slides, or on squares or circles of very
thin glass called cover-slips ; these can be obtained from any chemist
and all Europeans in charge of elephants should be supplied with
them. Before making a smear one should see that the slips or slides,
whichever are used, are clean and free from grease. To free a slide
from grease it is only necessary to dip it in spirit and burn the
spirit off. Before puncturing the skin wash it with some spirit,
then pass the needle or point of lancet to be used through a
flame and puncture. If blood is to be taken from more than one
animal the lancet or needle should be cleansed by passing it through
a flame before each operation. Wipe off the first drop or two of
blood and then take up on the slide a minute quantity of blood ; next
apply the edge of another slide to the edge of the drop, wait
till the blood runs along the edge, then gently pull the wet edge of
the slide along the surface of the first slide, leaving a thin film of
blood on it. It must be borne in mind that a thin film is what is
required, and to make this very little blood is necessary. When
the blood is thoroughly dry on the slides each slide should be
wrapped separately in tissue or other soft paper and then packed in
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A TREATISE ON ELEPHANTS.
cotton wool. Thick slides and those that are packed film to film are
no use for blood examination (see Diagram).
To prepare cover-glass specimens, a minute quantity of blood,
or pulp from the spleen or other organs, or jelly-like diseased
material is taken on the point of a needle which has just previously
been heated in a flame. The material is placed between two
cover-glasses, which are to be pressed gently together in order
to expel any excess of material, and to leave a very thin layer
between them ; they are then to be separated by sliding them gently
one over the other and allowed to dry under a watch or wine-glass
to exclude dust, or the layer may be fixed by taking the cover-glass,
coated surface uppermost, between the finger and thumb (see Diagram),
and passing it rapidly two or three times over the flame of a spirit
lamp. When dry, they should be carefully packed separately in
cotton wool with slips of paper intervening and placed in a small
wooden box, and for extra protection this box should be again packed
inside a tin one. About half a dozen specimens should be sent. All
cover-slips, also slides, should be boiled and cleaned and kept in
spirit.
(Facing page 234.
DIAGRAM
SHOWING
METHOD
OF
MAKING
BLOOD
SMEARS.
The drop may either be taken up on the end edge or the middle, towards one end of one slide as in I. Another
slide should be approached so as to contain the drop in the angle between the two slides, II. The drop will spread itself
out along the line where the two slides meet. The drop should then be spread evenly over the bottom slide, by gently either
pushing or pulling the end of the upper slide along its surface, III. Only a very small drop should be taken,
CHAPTER
II.
GENERAL SEPTIC INFECTION AND INTOXICATION.
BLOOD
POISONING.
1. Septicaemia is met with in two forms :—
(a) Septic poisoning.
(b) Septic infection.
(a) Septic poisoning.—The effects produced by the absorption
of a poisonous dose of the chemical products of germs without the
germs being alive that elaborate these poisons. In this the symptoms
must be directly in proportion to the dose absorbed, which dose
cannot increase in the body.
(b) Septic infection.—The
effects produced by the absorption
of poisons of living infective germs. The symptoms here are not
proportionate to the initial dose which may be infinitesimal and not
lethal, but which, owing to multiplication of the germs in the blood
and a corresponding increase of poison elaborated by their vital
processes, leads to death sooner or later.
This naturally is of a graver character than the preceding.
2. Pyaemia—Occurs in the same way as septic infection, but
differs in its symptoms.
Prognosis.—In septic poisoning, if the dose is small, recovery
is probable. In septic infection and pyœmia recovery is rare.
Causes—Always
due to absorption through some abraded
surface, i.e., sores, scratches, heel cracks, abscesses. The poison
may have been introduced by the weapon causing the injury or may
have been absorbed subsequently from neglecting the wounds (a
frequent cause).
Symptoms.—In all forms the following are the most frequent :
repeated shivering often unnoticed, and sudden accessions of high
fever, often followed by a fall of temperature sometimes to normal
before the next rise, grave prostration and muscular tremors being
marked symptoms, and towards the end foetid diarrhoea , occasionally
there may be paralysis of the hind-quarters. The disease takes
a rapid course, ending usually in death after a short period.
In septic poisoning no further symptoms are observed, but in
septic infection there may be swelling of joints and collections of
fluid in the body cavities (chest, belly), and in pyœmia abscesses
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A TREATISE ON ELEPHANTS.
scattered over the body and in the organs. The cause of the
formation of these abscesses is as follows. In the case of many
wounds veins are injured and this leads to the formation of blood
clots blocking the lumen of the injured vessels. The clot may
extend until it reaches a considerable collateral branch. The
clot is adherent to the wall of the vessel except at its free end
which protrudes into the blood current. Clots may soften and
break down. Small portions are thus detached and carried by
the circulation to distant parts. As a rule they are arrested at the
bifurcation of vessels. At such points infective centres or foci for
suppuration are formed. Thus, according to the seat of injury
different organs—the lungs, liver, kidneys, spleen—may become
the seat of numerous abscesses, which are usually small and wedge-
shaped. Unlike septicaemia, pyœmia does not supervene till some
days after the receipt of injury. In septic infection death occurs
more rapidly than in the other two forms.
Treatment : Preventive.—Is
the most important and consists
in strict attention to all kinds of wounds, however trivial, which if
properly treated to a great extent precludes chances of infection.
Curative.—First
thing necessary is local treatment, which
consists in thoroughly cleansing with disinfectants the wound or
wounds, and when abscesses occur freely opening them, and
syringing the cavities out with some disinfecting solution (carbolic
acid lotion 1—40), and see Formulae 114 to 120, and afterwards
dressing. Soiled dressings should be treated as already noted.
With regard to general treatment no certain remedy is known,
but the following may prove useful. The diet must be nourishing,
such as fresh green grass, fruits, wheaten cakes, gruels, and, though
fever is present, rice or other grains should in these cases be
offered, also stimulants such as rum, brandy, etc., and plenty of
good drinking water.
Hyposulphite of soda, or sulphite of soda in 2-oz. doses every
three hours, or small doses of calomel, say ½ drachm, repeated every
three or four hours. Euquinine may also be tried.
PUERPERAL
SEPTICÆMIA.
This is an acute form of blood-poisoning following parturition,
and is occasionally met with. The infection is due to minute
organisms which gain entry through a wound or simple abrasion
of the passage.
Symptoms.—These
generally set in suddenly on the second
or third day after calving. In two cases on the second day
PUERPERAL SEPTICÆMIA.
287
the animals were said to have had no milk and would not have
anything to do with their offspring. There was thirst, complete
loss of appetite, considerable fever, hurried breathing, dulness, eyes
lustreless, occasional moaning. In another case the symptoms
started on the third day, there was suppression of milk but the
mother was induced to take charge of the calf which was hand-fed.
This animal suffered from severe abdominal pain, strained greatly
and moaned frequently. No swelling, etc., was observed about the
genital organs. The course of this disease is very rapid—two or
three days—and recovery is exceptional.
Treatment.—Medicinal
treatment is of little use, camphor and
turpentine have been recommended, both troublesome drugs to mask
the smell of. Alcoholic stimulants are beneficial. If the animal
can be induced to permit it, irrigation of the womb twice a day
with weak antiseptic lotions warmed to body temperature are
recommended, such as carbolic acid or phenyle one per cent. For
this purpose the elephant should be made to lie on her side and a
piece of rubber tubing with a funnel attached may be used, or better
still a garden syringe with tubing attached ; the fluid should
be injected slowly and gently ; from 2 to 2½ quarts is ample. If
the elephant resents the operation the only thing then is to
keep the parts clean externally by means of spraying lotion on
them. When any symptoms of disease appear in an animal after
calving, any pregnant animal or animals should be removed to a
distance. Cleanliness is of vital importance ; anyone handling a sick
animal should be most careful to thoroughly wash and disinfect his
hands. The standing should be kept scrupulously clean by firing
the ground and sprinkling disinfectants on it.
Post-mortem examination.—The
peritoneum shows blood spots
here and there, the liver and kidneys are soft, the spleen soft and
enlarged. The blood is fluid and not coagulated. The flesh has a
half-boiled appearance. There are usually some blood spots on the
surface of the womb and some exudation between its layers. In the
womb itself there is generally some dark-coloured fluid.
CHAPTER III
ANTHRAX.
Before considering the disease as it occurs in elephants, it will
be advisable to discuss it as it affects some other animals. From
numerous records of the disease and the heavy mortality reported
therefrom, as well as its infectious character, we have learnt
to consider it one of the most formidable diseases we have to
encounter.
Definition.—A virulent infective fever caused by the entrance
into the blood and tissues and multiplication therein of a micro-
organism known as the " bacillus anthracis."
The organism—Is a large rod-shaped bacillus, smooth in outline,
with square cut ends and easily stained by the basic aniline dyes.
It forms spores only when exposed to the atmospheric air, i.e., after
the death of the animal. The spores are extremely resistant bodies,
much more so than the bacillus, and are capable of producing the
disease when they are taken into the system of an animal, hence the
importance of not cutting open animals dead from this disease.
Incubation (that is, period which elapses between the time of
entry of the organism into the system and the appearance of its first
symptom).—In naturally acquired anthrax in elephants the incuba-
tion period is indefinite, as it is impossible to tell when the animal
was exposed to the contagion. After the exhibition of symptoms
of illness some die within an hour and others may live a week or
more.
Prevalence.—Certain
localities are peculiarly adapted to the
development of the disease which recurs in them repeatedly, notably
low-lying swampy districts subject to inundation, especially in hot
and damp climates, with clay and loamy soils ; some areas in these
localities, particular pastures, are specially notorious for frequent
outbreaks. From these localities the disease may be carried in
various ways and infect extensive areas constituting epidemics.
Season.—Outbreaks in Burma generally occur during April, May,
and early part of June, i.e., the advent of the rains, and September
and October, the close of the rains. At these times there are heavy
thunderstorms, often followed by intense heat.
Altitude.—It
is rarely met with on any elevated well-drained
land.
[Facing page 288.
PLATE XIII.
ANTHRAX.
TETANUS.
HÆMORRHAGIC SEPTICÆMIA.
SURRA TRYPANOSOMES.
ANTHRAX.
289
Sources of infection.—Food, water and articles soiled by excreta,
etc., of affected animals. Flies may carry the bacillus on their feet,
mandibles, or may infect by means of their biting apparatus.
(a) Food.— In the case of carnivora, the flesh of animals that
have died of the disease.
(3) In herbivora, fodder or water which has been infected by
discharges from affected animals or carcases.
(c) Respiration.—The
spores of the organism may be carried
by the wind and thus taken in with air to the lungs.
(d) Local wounds and sores may be infected by being brought
into contact with the anthrax poison either through
the discharges of infected animals directly, or through
the agency of flies, or suctorial insects, that have
either settled on infected material, or have bitten
infected animals.
General symptoms.—The
most characteristic features of the
disease consist of the suddenness of the onset, accompanied with
violent shivering or trembling, early pronounced prostration ; the
very aspect of the animal, which it is impossible to describe, but
which once seen will not be forgotten, denotes the gravity of the
seizure ; fever, which rapidly becomes high, bleeding from the mucous
membranes, evidenced by purplish spots and blotches on the mouth
and palate, or by blood-stained discharges from the mouth, anus, or
bladder. These symptoms run a severe and rapid course and are
usually succeeded by a fatal issue in from one hour or less, to several
clays, according to the virulence of the poison, or more rarely may
end in recovery. Over and above these ordinary symptoms may
be seen those arising from local conditions :—
(a) The lungs, shown by distressed breathing which may
culminate in suffocation.
(b) Intestinal colic, with often severe diarrhoea, attended with
voiding of dark liquid or blood-stained evacuations.
(c) Nervous system, in which spasms, wild excitement, extreme
listlessness or insensibility, paralysis with tottering gait,
and convulsions ending in death.
(d) The skin. Rapidly formed swellings or tumours localized
or diffuse beneath the skin which may either precede
or succeed the advent of fever, and which are at first
hot, painful and doughy, but later become cold and
painless, and which on incision are found to contain a
jelly-like material but never pus. The swellings are
more frequently seen behind the jaws (parotid glands),
between the limbs, groin, on the front of shoulders,
belly, or hind-quarters ; sometimes sores on the skin.
19
290
A TREATISE ON ELEPHANTS.
As regards the disease in elephants it will be sufficient to observe
that all degrees of severity and diversity of symptoms may be met
with.
It frequently happens that the most virulent forms are
encountered during the early period of an outbreak. Death some-
times ensues so rapidly without any symptoms having been noticed,
that it has been attributed to apoplexy, heat-stroke, lightning-stroke
and snake-bite. During the rains, when anthrax is prevalent, occa-
sionally more or less sudden deaths are recorded in which the mouth,
tongue and throat have been observed to be in a diseased state, and
these symptoms have been attributed by Burmans to a black hairy
caterpillar which is common at this season of the year in certain
localities where it often does immense damage to teak and other
trees. Burmans state that if an elephant takes up one of these
creatures with its food death will result. In the same way similar
cases in horned cattle have been ascribed to this caterpillar, but
these are often cases of anthrax. I have handled the caterpillar
and have not suffered except some slight irritation.
Prognosis.—Most
unfavourable : Friedberger and Fröhner
give the average mortality amongst domestic animals from 70 to
90 and even 100 per cent. in the worst types (i.e., apoplectic).
After an epidemic has continued some time the disease may
assume a milder type and recoveries without any treatment are not
unusual.
Diagnosis.—Though
it is highly important readily to recognize
anthrax, it is in reality often a most difficult matter owing to the
variation in symptoms, or owing to a fatal issue arising without any
definite symptoms at all having been manifested. Again, it is often
difficult in dealing with isolated cases. When some of the more
important symptoms enumerated above have been detected, there is
less difficulty in pronouncing the character of the disease. Positive
diagnosis can only be made by finding the anthrax bacillus in the
blood by means of the microscope. If anthrax has been prevalent
in a locality previously, and sudden deaths occurred among cattle at
the same time as among elephants, or if elephants have grazed in
places where carcases are known to have been buried, the disease
may reasonably be suspected to be anthrax.
When anthrax is suspected as a cause of death, slides or cover-
glass preparations should be made and sent in at once for examina-
tion.
In connection with this it should be remembered that anthrax
bacilli only invade the blood stream shortly before death, and
that after death putrefactive organisms which closely resemble
anthrax bacilli enter the blood stream from the bowels.
Therefore
in all cases, if blood cannot be taken either half an hour