NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
27
Switzerland.—"In the spring of 1887 twenty-four thousand six
hundred and fifty young cattle were inoculated. The inoculations were
divided amongst the cantons as follows:—
Feme
Graubunden
Waadt
...
..
...
14,890
3,292
2,396
Fribourg
Saint Gall
Glaris
...
...
...
1,725
963
707
Uri
Obmalden
Wallis
...
...
...
323
180
119
Of this number 132 died from the disease or 0.45 per cent. The results
of the inoculations varied in the different cantons. The total losses
amongst animals were as follows:—
Saint Gall
Fribourg
Glaris
Berne
Waadt
.
.
.
.
.
Granbunden
Obmalden
Uri .
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Per cent.
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0.20
0.23
0.25
0.37
0.54
1.
1.43
2.47
There was no death in Wallis. The deaths amongst inoculated animals
was 1.43 per cent. altogether.
Austria.—In the spring of 1877 inoculation was carried out in the
duchy of Salzbourg, in the Tyrol, the Boralberg, Caranthia and the
principality of Lichteinstein with the following results:—
Duchy of Salzbourg 2,472 inoculated, eight died, or a 0.32 per cent,
whilst out of 3,561 non-inoculated animals inhabiting the same pastures
the losses were 225 or 6.30 per cent.; out of the eight fatal cases two had
only received one inoculation.
In the Tyrol 2,183 were inoculated and thirteen succumbed to the
disease. Amongst 7,499 non-inoculated animals there were 99 deaths or
1.20 per cent. Borarlberg, 1,238 inoculated, four deaths or 0.32 per
cent.; amongst the non-inoculated the deaths were 9.60 per cent.
Lichteinstein inoculated 230, no death, Carinthia inoculated 221,
one death. The total result shows an average 0.54 per cent. of casualties
amongst the inoculated.
Prussia.—Gueldre inoculated 485, two deaths.
Cleve inoculated 180 two deaths.
Résumé. There were twenty-six deaths amongst the inoculated animals
or a total of 0.86 per cent., whilst 336 non-vaccinated animals died or a
proportion of 2 per cent. (Schweizer archiv., 1889, H. I.)
Diagnosis.—The diagnosis of this disease when it is characterized by
the crepitant and sonorous tumor is easy. Moreover, microscopical
examination and the inoculation of the products of the tumor into guinea
pigs allows of an absolutely certain diagnosis being made. When the
tumor is not present, an attentive study of the lesions, the examination
of diseased organs (spleen, ganglia, etc.) under the microscope, as well as
the inoculation of their pulp permits of our making it. Much assistance
28
can be gained from the history of the case. In practice charbon symp-
tomatique may be most commonly confounded with charbonous fever
(anthrax) or septicæmia, notably gaseous septicæmia, and sometimes with
gangrenous coryza. Despite its resemblance to these maladies, the above
procedure enables us to distinguish it easily. With regard to septicæmia,
if we inoculate a rabbit, an animal refractory to charbon symptomatique
but susceptible to septicæmia, the differentiation is soon made. With
regard to charbonous fever, we have a large choice of methods. The
symptoms and lesions are markedly different; in the one we have crepitant
tumors, in the other tumefactions which are non-crepitant. In charbon-
ous fever the blood is very virulent, whilst in charbon symptomatique the
tumor is more virulent. The first is inculable with very small doses,
whereas the other is not. The one is easily inoculated with slight punc-
tures with a lancet, the other is not. The subcutaneous inoculation with
anthrax produces a more or less insignificant local lesion, whilst that with
charbon symptomatique produces the large characteristic crepitant one
of that disease. Charbonous fever is easily inoculable by intravenous
injection, whilst C. Symptomatique is so induced with difficulty; the first
has a longer period of incubation; its microbe is "ærobic,'' it does not
form spores in the sick, and presents different characters to that of the
latter, which does form spores in the sick and is anærobic. Again, anthrax
is inoculable to the rabbit, whilst C. Symptomatique is not.
Treatment.—The treatment of this disease has so far been un-
attended with favorable results and various remedies have been tried with
little effect. Such agents as chlorate of potash, hyposulphite of soda, etc.,
have been used. The direction in which treatment should be adopted
appears to be to attack the tumor and make injections of antiseptics into
its depth, at the same time giving chlorate of potash internally.
Setoning, etc., as a preventive, is adopted in England, but the results
cannot be vouched for. Information regarding experimental treatment
is required.
CIVIL VETERINARY DEPARTMENT
LEDGER SERIES No. IV.
MAIN HEAD .
SUB-HEAD .
. STOCK DISEASE.
. SPECIFIC DISEASE.
SUBJECT:
HORSE SURRA.
1894.
CALCUTTA:
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1894.
PREFACE.
THESE notes on Surra, put together in a handy form for
convenience of reference, are abstracted from the report
of Dr. Lingard, the Imperial Bacteriologist, and contain a
résumé of the observations of Evans, Steel, Gunn, and
others, together with the results of the work which has been
done by the Imperial Bacteriologist during the last three
years. Dr. Lingard has very kindly corrected the proof and
added the supplemental note at page 29.
Information on all points connected with this disease
is required, and should be given whenever possible. There
is every reason to believe that Surra is a much more gener-
ally widespread disease that it at present appears; informa-
tion of new centres is constantly being received, and it is
feared that we do not at present know the extent of the
losses to which it gives rise.
HENRY T. PEASE, A.V.D., Vety. Lieut.,
Assistant to the Inspector-General, Civil Vety. Dept.
MEERUT, 1894.
HORSE SURRA.
Definition.—Surra is a specific and continuous febrile disease
occurring spontaneously in solipeds and camels, and capable of being
transmitted by inoculation to other animals. It is due to the presence
in the blood of an infusorian (Trypanosoma Evansi). It is chiefly
met with in an epidemic form, during certain months of the year,
viz., between July and January. It is characterized by an intermittent,
remittent, and sometimes by a relapsing type of fever, which continues
for varying periods, according to the species and constitutions of ani-
mals attacked, and presents definite symptoms following each other in
regular sequence. The chief symptoms, in addition to the peculiar febrile
ones, are the occurrence of petechiæ or blood extravasations on the
mucous membranes, chiefly those covering the membrana nictitans
and the appearance of œdemata on the limbs, sheath and lower parts
of the abdomen and chest, due to the exudation into the subcu-
taneous and other connective tissues of a yellow semi-gelatinous
material. The animal rapidly loses condition and strength, although
in the great majority of cases the appetite remains good through-
out the whole course of the disease; indeed, it is remarkable to note
that a patient will continue to feed during a paroxysm of fever,
when its temperature is as high as 105º F.—a peculiarity not noted, so
far as I am aware, in any other febrile disease of the horse. The visible
mucous membranes first become pallid, and at a later period yellow or
icteric. From first to last there is progressive anæmia; the blood at
the commencement presents a normal appearance, but after a time
undergoes, marked changes. The white corpuscles increase in number
and the red ones usually cease to form normal rouleaux, lose their
individuality, and run together, forming irregular masses, which are at
first dark, but, as the disease advances, almost entirely lose their colour-
ing matter and become pale.
The presence of the infusorian in the blood is not continuous
during the whole course of the disease. At first it is usually found
in few numbers, and increases with greater or less rapidity, until,
having attained a maximum, it disappears either gradually or sud-
denly to reappear after an interval. The periods during which it is
present in, and absent from, the blood, are marked by extreme irre-
gularity, varying from one to six days, but the latter period is very
unusual. The disease is invariably fatal; death is generally due to
2
exhaustion, the result of anæmia, but it may occasionally be due to
complications which arise in the course of the malady. After death no
specific lesions are found on post-mortem examination.
HISTORICAL ACCOUNTS OF SURRA.
Our first knowledge of this disease was communicated by Evans, in
a report dated November 1880, to the Government of India. The
malady he designated "Surra," and defined it as a specific, parasitical,
non-inflammatory, enzoötic blood disease, characterized by fever, jaundice,
petechiæ of the mucous membrane, especially of the eye and vagina,
dropsy, sometimes albumen in the urine, great prostration of strength
and rapid wasting, and with a specific parasite in the blood during life;
but no characteristic structural organic lesions are found after death.
It may be transmitted by the subcutaneous injection of blood, and by
drinking fresh blood containing the live parasites, but is not contagious
or infectious in the ordinary way. The average duration of the disease
is probably less than two months, but reliable statistics are wanting
upon that point. Evans describes the invasion of the disease acquired in
the ordinary way as that common to all low fevers. In a small major-
ity of cases, the legs are swollen and œdematous; later a similar
swelling is found between the fore legs of mares, or at the sheath of
horses, and the animal is dropsical, there is great thirst, and the urine is
high-coloured.
The conjunctival membranes become decidedly yellow in colour, with
claret-coloured spots on the membranæ nictitantes. In the case of a mare
the mucous membranes of the vagina are decidedly yellow, with pe-
techiæ even more marked than in the eye. The duration of the disease
is a difficult matter to settle, and depends on the constitution of the
animal; weak animals succumb sooner. The progress of the disease is
variable; the symptoms may sometimes subside, and again return worse
than before; the most constant and invariable symptom in the progress
of the disease is the wasting away of the flesh, and this is the more re-
markable, seeing how much, and with what good appetite the patient eats.
The wasting goes on more rapidly in some cases than in others. The
record of the 4th Punjab Cavalry shows an average duration of forty-
three days after the admission on the sick list; whether the animals die
early or late, they are generally reduced in condition to mere living
skeletons. There is often much anæmic palpitation of the heart in the
last stage, and the membranes become blanched; some animals drop
down and die suddenly, perhaps when eating, others become delirious
and struggle on the ground, while other animals linger for days after
they are helped up, but go on eating grass and corn until they die.
3
Evans noted a certain amount of clear serum in the peritoneal cavi-
ty, but no sign of any inflammatory action. In one case the pericardial
sac was distended with fluid.
He says "that when he first saw the parasite, he thought for a mo-
ment it was some form of spirillum, but rapidly changed his mind on
that point. It has an apparently round body when it is fresh and active,
which tapers in front, forming a neck, ending in a blunt head, and be-
hind it has a tapering tail, from which there extends a long slender lash,
so fine that it can seldom be seen. It had two fin-like papillæ on each
side, one pair placed near the neck, and one near the tail. He only
occasionally saw the four at once, and they always appeared to occupy the
same relative positions."
He describes the parasite as being wonderfully active, and presenting
undulatory eel-like movements; it has the power of altering its shape,
progressing almost always in the direction of the blunt end, though it
is able to go in the reverse manner when pulling a corpuscle. He exa-
mined the kidneys, liver, spleen, heart, lungs, and the mucous lining
of the stomach and intestines throughout, with great care, and stated
positively that this disease is not characterized by any structural organic
change; it is purely a disease of the blood. Petechiæ were noticed
on the mucous lining of the intestines in some cases, but in no case
was the structure of the liver diseased. The disease is absolutely fatal
to horses, mules, and camels.
There is no evidence to show that the disease is either contagious or
infectious in the ordinary sense; the weight of evidence is to the
contrary.
Seventy-seven horses of the 3rd Punjab Cavalry became
affected at Jutta, and were taken to Edwardesabad, where all died, but
did not communicate the disease to others. He considers that when
horses are closely packed together, a large fly called "burra-dhang" may
inoculate healthy animals with the blood of the diseased.
Evans submitted a puppy, inoculated with surra parasites transferred
from the horse, to Dr. Lewis for his opinion. Lewis reported that "the
parasites appeared to be very closely allied to the flaggellated variety,
which were detected by himself in a considerable number of apparently
healthy rats, but he could not then venture to express an opinion as to
whether they were specifically identical."
Major Money, 4th Punjab Cavalry, stated that the disease was com-
mon amongst the horses of the 3rd Punjab Cavalry, when they obtained
the grass from inundated ground near the River Indus, but it ceased
when they got grass from higher ground. The outbreak takes place
usually in August, but more in September, and continues until January,
when it suddenly ceases.
A 2
4
Treatment.—The only form of treatment Evans tried was carbolic
acid in glycerine (1 to 4), of which 219 drachms were administered
during a period of 15 days, and still the organisms persisted in few
numbers in the blood. The dose was then increased to 3 ozs. daily for a
week, with no better result. He tried the same treatment with three
other animals, but they all succumbed.
Steel, five years later, reported upon an outbreak in British Burma.
The animals which he had to deal with, and which he made post-
mortem examination on, were transport mules. He was much struck
with the lesions found in the stomach, so provisionally termed the disease
Gastric-typhoid fever of malarial origin; at a later date, when he had
made careful thermometric observations, he came to the conclusion that
the disease must be regarded as a true relapsing fever, closely resembling
relapsing fever in man, and was essentially the same as the disease de-
scribed in 1880 by Evans as "Surra," and only differed from it sufficiently
to warrant his considering the cases as local varieties of the same disease.
Steel carefully watched and recorded the symptoms of the disease,
confirming and adding to those previously described by Evans. He
communicated the disease to the mule, pony, dog, and monkey, but was
unsuccessful in his trials to inoculate bullocks and goats.
He found that the size of the parasite varies in different cases;
usually one-sixth the diameter, and three to six times the length of a red
blood corpuscle. In the fresh state it is an eel-like body; dried and
stained, it looks like an oxyuris on a small scale, with a thick portion in
its body, and a spiral tail. The body portion tapers in either direction,
anteriorly it terminates rather abruptly, and is somewhat rigid, and there
is apparently a holdfast organ at the blunt extremity. He describes
the movements as being eel-like, lashing and vermiform, less frequently
spiral, and believes the parasite to be a form of spirilloid, closely related
to the spirillum found in relapsing fever in man.
He concludes by defining the disease thus: Relapsing fever of
mules is an invariably fatal disorder, characterized by the periodical
occurrence of attacks of high fever, during which a special organism
closely resembling that of spirillum fever of man is found in the blood.
The organism causes disorganization of the blood, which is to an extent
repaired during the inter-paroxysmal phases, and thus the patient is
usually able to hold up against the disorder for some time. But
anæmic symptoms and lesions gradually accumulate, and culminate in
death from exhaustion, plugging of vessels, or gastric perforation as a
result of local atrophy of the stomach. In some cases the symptoms are
acute, and the animal succumbs to the height of the fever.
Gunn, in 1886, reported on an outbreak at Kohat, on the North-
Western Frontier, among the grass-cutters' ponies belonging to No. 1
Kohat Mountain Battery.
5
He noted the usual symptoms of surra in the four affected animals.
On microscopical examination of the blood, he observed numerous
minute parasites, somewhat like eels, which appeared to vigorously
attack the red corpuscles; the parasite is not to his mind a spirilloid,
nor does it resemble a nematode or round worm: the pseudopodia de-
scribed by Evans are really the margin of the sides "waved." He estimates
the total length at about .0003, and the greatest breadth at .00023, of
an inch. He examined the urine of the four patients microscopically,
and states that in three he found parasites, non-motile and probably dead.
As to the mode of contagion, he thinks stagnant water was the source,
for the following reasons: —
A.—Only grass-cutters' ponies were attacked by the disease.
B.—No mule belonging to the Mountain Battery, nor horse from the
Punjab Cavalry, became ill of the disease.
C.—The grass which the grass-cutters' ponies bring in is alike eaten
by mules, horses, and ponies.
D.—The mules and horses were watered at a stream, which runs
from a mountain spring through the cantonment of Kohat, and at no
other place.
E.—That the grass-cutters' ponies are watered at any place, pool, or
otherwise, which happens to be at hand.
F.—The ponies stand in the same lines and partake of the same grain
as the other animals, and the same system of sanitation appertains to all
mules in the battery and regiment.
Experiments.—He inoculated a dog from a pony on the 20th Sep-
tember, and on the morning of September 24th many parasites were
found in the blood.
The following is an abstract of a report by Veterinary Surgeon C. E.
Nuttall, A. V. D., on two outbreaks of "Surra" at Meerut during the
years 1886 and 1887, amongst the horses and baggage animals of the
19th Bengal Lancers. These observations were made under the personal
supervision of Inspecting Veterinary Surgeon W. T. Russell, 2nd Circle,
at the present time the Principal Veterinary Officer in India:—
The outbreak in 1886 commenced on the 3rd July, and terminated
on the 22nd December of the same year. During this period, 48 animals
succumbed to the disease, viz., 25 horses and 23 grass-cutters' ponies,
thirteen and six of each, respectively, having died, the remainder being
destroyed. For those animals which died, the average number of days
of the disease was for horses 36, and for ponies 6.
The outbreak of 1887 extended over 151 days, from September 6th
1887, to February 4th, 1888, and attacked horses, ponies, and mules.
Forty-seven in all died or were destroyed.
6
Veterinary Surgeon Steel happened to be in Meerut at the time of the
epidemic, and at once recognised the disease as surra, organisms having
been discovered at a later date in the blood of 15 out of 20 animals
examined. It is of interest to notice that seven other animals were
discovered suffering from fever, with yellow and petechial condition of the
conjunctivæ, and a more or less degree of constitutional disturbance
(symptoms frequently recognised by us in Poona, and by G. H. Evans
in Burma), but these animals were not affected with surra, and recovered
after a few days.
The outbreaks in Meerut, as in other localities, have occurred only at
a special time of the year, i.e., from the rainy season well into the cold
weather, and up to the present time there are no sporadic cases on record
as having occurred at this station at other times of the year.
The deaths during this period were in September, 10; October, 26;
November, 7; December, 2; January, 2. The average number of days of
disease in cases that died, being for horses 52, ponies 30, and mules 19.
In this series of cases, the surra parasite was found in the blood at
different periods of the disease in 43 out of the 47 attacked. Veterin-
ary Surgeon Nuttall apparently experienced the same difficulty in deter-
mining the exact commencement of the attacks in animals as has been
found by other investigators. All attempts at curative treatment were
negative.
As regards the post-mortem appearances of the stomach, Mr. Nuttall
states, that "it may be found in some instances replete with food, in others
a little partly digested blood-stained material, fibrinous clots, etc., and
the organ usually the seat of special lesions; which may be ulceration
or erosion, either of the cuticular or villous portions, usually confined
to the former, extending in some cases to perforation, the villous por-
tion in places denuded of the epithelial lining, resulting from degenera-
tive changes, and yellow pigmentation of varying intensity is constantly
seen."
In the appendix to the report, it is stated that gastric lesions were
found in the case of 25 horses, 15 ponies, and 2 mules.
Ranking published, in June 1891, a preliminary report, in which
he states his opinion that surra is a disease of malarial origin com-
parable to ague, and that this view of its pathology is borne out both
by the period of prevalence of the disease, which corresponds with
that of ague, and also by the results of treatment. Quinine in full
doses appears to control the disease, supplemented by general measures
to combat the anæmia and weakness, consequent on prolonged illness,
chiefly by milk, iron, and arsenic. He believes that the facts put now
on record will, if allowed as guides to diagnosis, enable the disease to