NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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the outside. The fever rapidly becomes intense, — 40° to
42º C. or 104º to 107º F. There are sometimes observed
symptoms of cerebral hyperæmia, inquietude, excitation,
rabiform phenomena, weakness, tottering gait, and
lastly death from apoplexy. Sometimes the symptoms
of pulmonary congestion predominate; also we may
observe sanguinolent discharges from the normal orifices,
hæmaturia, petechiæ of the conjunctivæ, convulsions, and
in some cases death from asphyxia.
(3) The sub-acute form.—The clinical characters resemble
those of the acute form are, however, clearer, and run a
much slower course—24 hours to 5 or 7 days maximum.
There are symptoms due to pulmonary and cerebral
congestion. To these manifestations grave intestinal
symptoms are often added.
B. Charbon with visible localization.—This form is that in
which tumors and cutaneous charbonous oedemata are pre-
sent, and has been called carbuncular fever. It occurs
more particularly in the horse and the ox, but is also
seen in the dog. Tumefactions appear on various parts
of the body, at first hot and painful; charbonous
œdemata are diffuse, doughy, fluctuating, indolent tumefac-
tions. The duration of this form is from 3 to 7 days.
Cases in which recovery occurs are more numerous.
The fever may occur either before or after the tumefac-
tions. The throat is often affected in this form.
Symptoms of Anthrax in Cattle.—Apoplectic Anthrax Charbonous
fever.—Charbonus fever may sometimes occur in the large ruminants,
and is probably more common in them than it is in the horse. When it
does occur, it is, as has been before stated, generally met with at the
very commencement of an outbreak of the disease; the first cases seen
being those of apoplectic Anthrax, and it is most probably due to the in-
fection having been from the spores, as stated by Friedberger and Frohner.
This form appears suddenly without any previous symptom having been
manifested, the animals attacked suddenly staggering and falling, bleed-
ing from the nose and mouth, and becoming attacked with convulsions,
in the midst of which they die in a very short time. It is not by any
means uncommon to find a number of the best animals dead in the yard
in the morning, although they were left the previous evening in perfect
health apparently. It often, however, announces itself by dullness, loss
of appetite, grinding of the teeth, cessation of rumination, weakness, pros-
tration, etc., these being accompanied in some cases by stupor and at others
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by great excitability. Trembling, shivering fits and sweats, either general
or partial, appear, the loins are tender on pressure. Colic is sometimes
observed. The strength rapidly diminishes, the hind quarters swaying
about when the animal moves. About this time a fœtid and sanguinolent
diarrhœa is often observed. The blood undergoes the changes which
have already been indicated. The pulse is frequent, small, and feeble,
and the heart-beats at the commencement are often tumultuous, but later
on become feeble. The conjunctivæ and gums are injected, sometimes
of a yellowish red or rusty colour and dotted over with ecchymoses,
at others black or violet coloured. The eyes are sometimes prominent,
injected, and tears flow down the face.
The respiration is accelerated, tumultuous, or even panting. The
ears and horns are cold, the muffle dry, the mouth becomes cold, the
tongue violet or very dark coloured and frequently pendant. Œdemata
may or may not appear on the body. Blood or a frothy sanguinolent
spume may issue from the nostrils and mouth; it may also appear in the
urine and fæees, which are diarrhœic. In a few hours certain of the sick
succumb; others resist for a longer time, depending on circumstances,
as has already been pointed out. If the symptoms are not intense, they
may last for six or seven days, or recovery may take place: when the end
comes the animals fall, the abdomen becomes distended, convulsions come
on amidst which the animal succumbs. Recovery may occur in a number
of cases spontaneously, even in those where no treatment has been
adopted.
Glos Anthrax in Cattle.—This form of anthrax with external mani-
festations is not by any means an uncommon one, and I have had numer-
ous opportunites for observing the disease amongst cattle in India, where
it is usually in the northern parts at least called "Galghotu." Cases
are constantly occurring in the Punjab, and the fact that it is well known
to the zamindars, who describe it perfectly, points to its more or less
wide spread.
Glos Anthrax is that form of charbon in which the tongue and throat
are more particularly involved, and the supposed reason of this is that the
virus gains entry to the system by means of a wound in the mouth.
This explanation appears to be a very plausible one, and the more so on
account of its being very frequently seen contemporaneously with foot-
and-mouth disease, a malady in which the mucous membrane of the
mouth and tongue become vesicated and ulcerated, large masses being
removed and offering a favourable point of entry to the virus of
anthrax.
In this form the mouth and tongue are more particularly the seat
of the local manifestations of the disease, which are accompanied by
the general symptoms of charbon.
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The local symptoms consist in the appearance on the general surfaces
of the tongue and the frænum and also on the gums, palate, and lips
of an eruption of bullæ or phlyctenæ. These phlyctenæ are white at
first, often presenting a pearly aspect, but they soon change to yellow and
progressively become almost or entirely black; their situation may be
either on the summit of a thickened portion of submucous tissue, or
they may be directly under the mucous membrane. It is a very notable
fact that the eruption of these vesicles is in the vast majority of instances
unaccompanied by fever, and this might perhaps justly be taken as
evidence to show that the disease is at first local, and also that it arises
from infection through the mouth and does not become general until the
vesicles have advanced to maturity, and then the virus enters the general
circulation and gives rise to the symptoms of Anthrax fever. This
supposition is of very great importance clinically; for if these local
symptoms are comparable to what goes on in the point of inoculation
in some diseases, we can do much by discharging their contents and
subjecting them to stringent disinfection. To resume, the phlyctenæ
rapidly increase in size, in some cases assuming the proportions of a
fowl's egg. The tongue becomes much inflamed, œdematous, dark in
colour and protrudes from the mouth. The vesicles soon become
ruptured by the movements of the jaws and tongue, and are replaced by
ragged ulcers, red in the centre and black at the circumference. Now
appear symptoms of Anthrax fever. The ichorous liquid which flows
from these ulcers mixes with the saliva, communicating to it its corrosive
properties. This saliva, of a thick, stringy, and sanguinolent appearance,
flows from the mouth by both commissures; the tumefaction attacks
the lips and cheeks more severely and reaches the base of the tongue,
larynx, pharynx, soft palate and parotidean region, so that the animal
may die of asphyxia if it has so far resisted the malady. The
animal usually succumbs in from 24 to 48 hours after the appearance of
the vesicles. The symptoms of this disease shortly then are, the appear-
ance of characteristic phlyctenæ in the mouth without fever generally,
tumefaction and inflammation of the parts affected, with difficulty or
inability to masticate; maturation of the phlyctenæ, and their rupture,
with the appearance of fever and the formation of ulcers, rapid
congestion and swelling of the parts, and the invasion of neighbouring
parts, consequent difficult respiration, sterterous breathing, etc., hard,
rapid pulse at first, but soon becoming feeble; and, in fact, the general
disturbance of the circulatory apparatus which are met with in Anthrax.
Symptoms of Anthrax in the Sheep and Goat.—The sheep is very
susceptible to the action of the bacillus of Anthrax, and the form which
the disease usually takes in that animal is the apoplectic form. It
appears suddenly, no prodromic symptoms being witnessed as a rule; it
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rapidly terminates in death. The symptoms noticed are that the sheep
stops feeding and ruminating, bleats, trembles, the breathing is hurried,
the eyes prominent, and visible mucous membranes congested. The
animal stumbles about, or perhaps turns round in a circle and falls to
the ground; there is much distress, convulsions come on, a frothy san-
guinolent discharge issues from the nose, and the urine is mixed with
blood; death occurs in an incredibly short time, sometimes in a few
moments.
In other cases, however, the disease is announced by certain prodro-
mic symptoms. The animal appears excited, there is unusual expression
of countenance, redness of the skin in those parts where it is fine about
the eyes, nose, and ears; the conjunctivæ are red and their vessels inject-
ed. The temperature is elevated, etc. The blood soon becomes black;
the appetite disappears, rumination ceases, the sick animal remains
behind the flock, the abdomen becomes distended; the fæces coated,
soft, and sanguinolent. The respiration becomes painful, dyspnœic,
rattling or whistling; it is accompanied by snorting and a flow of
frothy sanguinolent spume from the nose. The urine becomes red and
sanguinolent. We may make it flow for inspection by stopping the
nostrils for a short time, as recommended by Reynal, or by exercising
careful and moderate pressure over the bladder. Tremblings come on;
the gait is uncertain and stumbling, and eventually the tottering sufferer
falls to the ground, passes blood by the natural orifices, grinds the
teeth, is seized with convulsions and cramps; the muscles of the neck
and limbs are violently contracted, the head thrown back, the eyes
revolve in their sockets, respiration is difficult and accompanied by
various sounds; the pulse is small, thready and almost imperceptible;
after a few hours of suffering, death occurs in the midst of a tetanic
convulsion.
A certain number of sheep which have been either spontaneously
or experimentally contaminated escape death after having been more
or less gravely sick, but generally the animals attacked succumb unless
they belong to certain races, such as Algerian, the receptivity of which
is, as we shall see later on, less marked. It has been suggested that
the Indian sheep may be endowed with a certain amount of immunity,
but this is not by any means the case, as I have been able to destroy
them by inoculating them with virulent virus almost invariably.
Symptoms of Anthrax in Soliped Animals.—In the horse, char-
bonous fever, on the Continent, is often accompanied by colic, severe
pains, intestinal apoplexy, enterrhagia, and sometimes by an access of
fury, when the disease becomes localized in the nerve centres.
The ordinary symptoms by which the disease announces itself are
the following: loss of appetite, elevation of temperature, dulness,
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prostration, intermittent colic alternating with somnolence and coma,
muscular weakness, swaying of the hind quarters, dryness and heat
of the skin; shivering and trembling of the muscles at the arms,
limbs, quarters, etc., sometimes vertigo, etc. The blood soon under-
goes the changes already noted; the circulation is at first accelerated,
the heart-beats are strong and tumultuous, the pulse becomes small,
quick, thready, and imperceptible. The mucous membranes are con.
gested, dark coloured, violet, or reddish yellow. The tongue is con-
gested and dark coloured; the colicky pains become more persistent;
the animals make frequent expulsive efforts; the rectal mucous
membrane is sometimes everted as a violet tumour; the fæces become
sanguinolent and diarrhœic. The respiration is precipitous, the ex-
pression of the face is pinched; sweats appear; the sick become rapidly
weak, and there is some difficulty in maintaining the erect posture;
the muscles are agitated by spasmodic movements; the temperature
falls lower than normal; the animal falls and dies amidst convulsions.
The course of the disease is sometimes very sudden; and in some cases
we see hard non-emphysematous and non-crepitant tumours on the
surface of the body. On the Continent charbon is an exceedingly
grave affection of the horse, chiefly of the young and those which are
of sanguine or nervous temperament. The animals succumb rapidly,
in a few hours often, generally in less than a day. They nearly always
die of this malady. Asses seem to resist it better than horses.
The form of Anthrax occurring in the horse in England is thus
described by Gresswell:—This disease, i.e., Anthrax without localiza-
tion, is rare in Great Britain. The symptoms appear suddenly. The
horse has violent mascular tremors, perspires freely, and breathes with
difficulty and irregularly. There is complete loss of control of the mus-
cular movements, especially of the lumbar muscles and those of the
posterior limbs in particular. The animal staggers and dies convulsed.
These acute symptoms, especially those of nervous complications, may,
however, abate in two or three days, and finally end in death or re-
covery. However, the symptoms are not always so rapidly developed.
They may begin with a small, weak and dierotous pulse, uneven sur-
face temperature and violent tumultuous action of the heart. The in-
ternal temperature is high, but generally falls before death; the con-
junctival membrane is yellowish red and swollen. There is disincli-
nation to move, inco-ordination and loss of power in the muscles of
locomotion and twitching of the muscles in various parts. Drowsi-
ness and stupidity with much prostration are marked symptoms. There
is a yellowish discharge from the nose, often tinged with blood, and the
nasal membrane is covered with blood extravasations. The breath is
fœtid and the superficial lymphatic glands swollen; abdominal pain
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hown by uneasiness, pawing, and looking to the sides is sometimes
manifested. The fæces are fluid or blood stained, the skin is harsh
and dry. The respiration becomes tumultuous and hurried, the nostrils
dilate, and the animal foams at the mouth. The temperature finally
declines, the animal staggers at every step; convulsions, and delirium or
coma ensue, and death closes the scene.—(Gresswell, Manual of Equine
Medicine.)
Symptoms of Charbon in other Animals.—Charbon in the Pig.—
Although the pig shows a very slight receptivity to charbon, the
affection has sometimes been observed in animals belonging to the
porcine species, in France, Germany, Belgium, and England, following
the ingestion of charbonous debris: it has also occasionally been trans-
mitted to them by causing them to ingest charbonous material, or by
inoculation.
An œdematou sinfiltration is generally produced around the point
where the virus has been absorbed. When the disease follows the inges-
tion of charbonous material, a swelling appears about the throat, due to
the infiltration of the tissues about that region, and there are observed,
together with the tumefaction of the throat, the characteristic symptoms
of charbonous angina, ulceration of the amygdylæ, and extension of
the tumefaction towards the face. Charbonous pigs may present the
majority of the symptoms observed in herbivora, fever, notable elevation
of the temperature, inappetance, general malaise, weakness of the hind
quarters, diarrhœa, red spots on the skin, etc. Death may ensue in from
one to six days.
Charbon in the Rabbit and Guinea-Pig.—The rabbit and guinea-
pig, more especially the latter, have a great receptivity for charbon,
which is very easily transmitted to them by the various methods of
inoculation, and which generally destroys them very rapidly. Gener-
ally the point of inoculation becomes the seat of a very marked
infiltration, more especially in the guinea-pig. The rabbit attacked
with charbon presents, one or two hours before death, restlessness, and
frequently changes his position; the respiration and circulation are
accelerated, the animal soon becomes apathetic, insensible, somnolent;
there is difficulty in co-ordinating movements, and death soon closes
the scene.
Charbon in Man.—Man, although less exposed and less apt to
contract charbon than animals, the small ruminants, for instance, may
sometimes contract it. He may receive the virus in three ways: by
accidental inoculation at the surface of the skin, by ingestion, and
by inhalation of the germs. The most common method is by accidental
cutaneous inoculation, which gives rise to a local lesion, the "malig-
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want pustule." Sometimes cases of internal charbon, bronchopulmo-
nary or intestinal, show themselves, following the introduction of
germs into the digestive or respiratory passages. External charbon,
which follows the accidental inoculation of the virus at any point of
the surface of the body, is observed in those persons who manipulato
fresh charbonous material, or materials containing the spores; it is
observed in veterinary surgeons, butchers, horse-slaughterers, herdsmen,
etc., and persons who make post-mortem examinations of animals
which have died from the malady, or who have manipulated the debris:
it has also been met with in persons working in wool, hides,
horns, etc. Wounds, punctures, excoriations, and scratches which may
exist previously or occur at the time of manipulating charbonous
materials, may serve as the point of entry of the bacillus or its spores.
It may sometimes happen that the contact or the bites of flies which
have frequented charbonous carcasses or material may give rise to local
charbon.
The bacilli, inoculated into any part of the body whatsoever,
multiply, causing at their point of entry a local lesion; then around
this lesion a swelling appears, and œdema which is hot and painful
and gradually extends. Then the malady becomes general. The germs
penetrating the walls of the vessels, or gaining access to the circulation
by means of the lymphatic system, are carried to the various organs
of the body. The general symptoms which have already appeared,
following the development of the local lesion, now become doubled in
intensity. The fever becomes very severe, the temperature is elevated,
the thirst intense; there is general malaise, headache, and nausea;
vomition and diarrhœa occur; then follow prostration, coma, asphyxia
black colour of the skin, convulsions, trismus, tetanus, etc., etc.
We may recognize three successive periods in the evolution of
malignant pustule. From the moment of inoculation to the time of
the appearence of the first symptom of the disease one, two, three,
or sometimes more days pass. The first period is characterized by prick-
ing and itching at the seat of inoculation, soon after which a small
phlyctenoid tumour, red at its periphery, and brownish black at the
centre, filled with a brown serosity, and soon surrounded or studded
around with small fine vesicles, appears. During the second period,
the tumor becomes indurated at its base, livid, black, and forms a scab.
At the same time the tissues surrounding the eschar become tumified,
swollen and œdematous, red or livid in colour, and sometimes covered with
small pblyetenæ with reddish-coloured contents. In the third phase, the
eschar extends, as does also the peripheric œdema, which invades the
arms, neck, trunk, face, etc., and is accompanied by swelling of the
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ganglia of the neighbouring parts. The bacilli in greater or less numbers
may be seen in the Malphigian layer, the superficial part of the pustule,
in the eschar, in the subjacent and peripheral tissues, in the derm and
the œdematous subcutaneous tissue, etc.
Man may present gastro-intestinal charbon without any cutaneous
lesion. He may contract the malady by ingesting the spores with his
food or drink, by ingesting charbonous material in which the spores have
been produced and not destroyed again, by ingesting even fresh charbon-
ous material, containing a considerable number of filaments of the virus,
etc., etc. The symptoms observed in such cases are as follows:—more or
less intense fever, lassitude, abdominal pain, vomition, tympany, sanguin-
olent diarrhœa, cerebral symptoms, dyspnœa, etc., etc. The bacilli can
be demonstrated in the blood.
Lastly, we have observed cases of broncho-pulmonary charbon in
persons whose work exposed them to the inhalation of infective dust,
notably in wool-workers. The disease manifests itself by the following
symptoms:—malaise, general fatigue and somnolence, vertigo; by coryza,
flow of tears from the eyes, cough, difficulty in inspiration, palpitation,
by a constricting pain at the base of the thorax, by dyspnœa, expector-
ation of saliva, signs of pleurisy and broncho-pneumonia; by digestive
troubles, nausea, vomition, colic, the appearence of a sanguinolent
diarrhœa, etc., etc.
"In fatal cases death may take place in a few hours, or not for
five or six days. The duration varies in the different forms. Although
if left to itself the disease is almost invariably fatal, many cases of the
external form have recovered under suitable treatment."—(Robert's
Medicine.)
Post-mortem Charges.—The lesions of charbon vary slightly accord-
ing to the modes of infection, but those which predominate in the majority
of cases are alterations of the blood caused by the microbe.
The bodies of animals dead of charbon cool very slowly; they rapidly
decompose and become distended with gas. Rigor mortis seldom comes
on, blood may be noticed flowing from the mouth and nose, and also from
the anus, which may be everted.
The subcutaneous connective tissue presents general congestion more or
less marked, and we also find ecehymoses and punctiform hæmorrhages
into it; we sometimes meet with greyish serosity, which is, however,
generally yellow and gelatiniform; sometimes even redor sanious and more
or less rich in bacilli, according as it is more or less dark coloured and
contains hæmorrhagic spots or patches. These infiltrations show them-
selves more frequently in certain regions, about the ganglia around
glands, in the interstices of muscles, and on certain parts such as the
throat, neck, etc.