NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
tions have been made at the abbatoir at Limoges on this subject, and go to
show that the disease is by no means so rare as is generally supposed :—
Date.
12th January 1890 . .
16th January 1890 . .
18th January 1890 . .
20th January 1890 . .
3rd May 1890 . . .
16th December 1891 . .
4th January 1892 . .
16th February 1892 . .
8th March 1892 . .
Seat of tumor.
Hind limb
.
.
.
Fore leg and dewlap . .
Right hind leg . . .
Left hind leg . . .
Right fore leg
.
. .
Both thighs
.
.
.
Shoulder .
.
.
.
Left thigh
.
.
.
Shoulder .
.
.
.
Age of subject.
2 months.
2½ „
2⅓ „
2
„
3 „
4½ „
2½ „
2
„
4 „
The existence of the disease in these animals was confirmed by ex
periment. M. Moulé states that out of 36 cases observed by him from
1886 to 1892 inclusive, 14 were in calves of about two months of age
(Rec. de Med., Oct. 1892).
Animals which have rapidly come into good condition are more liable
to it than are others. The attack is sudden, and occurs in two different
ways; sometimes its existence suddenly reveals itself by the appearance
of a tumor (charbon essential of Chabert), at other times more or less
grave general symptoms precede the tumor (charbon symptomatique).
These symptoms consist of fever, derangement of digestion and arrest
of rumination, partial tremblings of the quarters and shoulders, shivering
fits, dryness of the muffle, dulness, inappetance, coldness of the extremities
accompanied by lameness, the cause of which is at first hidden, but which
we are able later on to attribute to the development of a tumour on one
or other of the limbs. There is often apparently a remission in the
symptoms after the appearance of the tumor, the animals feed and even
ruminate a little, but the apparent amendment is not real, although it
may lead the inexperienced practitioner and the owner to hope for a
recovery, which will not take place.
The tumor may appear on any part of the body, be very marked, or
hidden and impossible to demonstrate during the life of the animal. Gener
ally it has its seat in those parts which are richest in masses of muscle.
Most frequently it appears at the superior parts of the limbs and in
the neighbouring muscles, around the shoulder or the arm (mal d'epaule,
A 2
4
avant cæur, anticæur), of the croup and thigh (mal de cuisse), of the thigh
(mal de jambe), of the genital organs (trousse-galant). In other cases
it appears on the head, neck and trunk, on the masseters, in the sub-
maxillary region (estranguillon), in the throat (esquinancie gangreneuse)
along the jugular channel in the pectoral region on the sides of the chest,
on the lumbar region or on the mammary gland. Hess has compiled a
very valuable table showing in what parts the tumor most commonly
appears, and from this we learn that the most frequent seats are :—right
hind limb 13.51%, right fore limb 10.86%, left hind limb 9.24%, right
shoulder 7.18%, left fore limb 6.33%, left shoulder 5.94%, chest
6.14%, head and neck 5.04%. Whatever its seat, this tumor is badly
circumscribed and progresses in all cases with astonishing rapidity ;
in eight or ten hours it has acquired a great size. At first homogeneous
and extremely painful at all points, it becomes by degrees insensible
at its centre, crepitant and sonorous as a bladder filled with air. All
the tissues which form it are black, friable and easily torn. On incision
at the beginning of the disease it gives exit to thin blood, and at a later
period to a liquid resembling venous blood, and at the end of the disease
to a spumous serosity. When the tumor has its seat in a region very
rich in connective tissue, however, it shows itself by a voluminous
œdema, the fluid of which is citron in colour or slightly red.
If in the great majority of cases the symptoms unfold themselves
as we have mentioned, such is by no means always the case. There are
cases where dullness, dryness of the muffle, loss of appetite, some shiver-
ing, slight colic and tympany are the only objective signs; the
diagnosis is very difficult in these cases, and we are likely to mistake
it for some digestive derangement. The tumor, but slightly developed,
may easily escape notice, even at the autopsy, runs its course in the
depth of the muscular masses without attaining the superficial layers.
We have occasionally found it in positions where we are not led to look
for its appearance, such as the diaphragm. In cases where there is no
sign of a tumor at the exterior of he body, we should search carefully
at the autopsy in the thickness of the thoracic and pelvic muscles,
remove the shoulder and examine the muscles which it hides. We are
nearly certain to find some black or claret colored infarcts; whilst the
tumor is being evolved, the general symptoms are exacerbated, the
fever increases, the pulse is hard, beating 90—100—110 times a minute;
the respiration is plaintive and accelerated; the temperature of the
skin is much elevated, the animal becomes feeble and indifferent to its
surroundings; the gait is painful and uncertain; the adynamic condi-
tion becomes more and more pronounced, the animal lies down and
remains extended on the ground: the skin becomes cold, and death
generally occurs in from 36 to 55 hours after the appearance of the
5
first symptoms. The oscillations of the temperature under the influence
of this disease are very remarkable. The following gives a good idea
of what occurs in the sheep :—
Wednesday evening 40.7°C. (3 hours after inoculation).
Thursday morning 40.4°C.
Friday morning
41.9°C.
Saturday morning 41.3°C.
„
at 2 p. m. 40.6°C.
„
„
6
„
38.6°C. (an hour before death).
We have observed a maximum temperature of 42' 8° which has
been maintained for twenty-hours, after which it rapidly fell to 37° at
death.
It has been said that a remission occasionally occurs after the
appearance of the tumour, a respite during which the animal sought
to feed and ruminate. The subjoined tracing, taken from M. Gotti,
shows this very clearly. The temperature of the bullock, which fur-
nished it, was 38.2°C at the time of inoculation, the next day it rose to
39.7°C and fell to 39.4°C, where it remained until the morning of the
following day, when it rose to 40.5° and then fell to 38.8° just before
death.
If we open the jugular during the course of the disease, we observe
that the bleeding is not dribbelling; the blood which flows freely, rapidly
coagulates and separates its serum more quickly than blood from a
healthy animal.
Terminations.—The most common is death, many veterinarians
never having observed a cure. Sometimes recovery does occur, and in
these cases it is always preceded by considerable œdema about the seat
of the tumor. At times death may result after a month or two has
elapsed, from a metastatic pleurisy.
It appears that recoveries are not uncommon in Algeria, and pro-
bably they often take place in India.
Mortality.—The mortality caused by this disease is very great.
Animals affected under two years of age almost invariably die, but older
ones frequently recover; so much so is this the case that many affirm
that all animals of over three years of age are free from danger of con-
tracting the disease.
Post mortem Appearances —The cadaver becomes rapidly distended
with gas, and spumous blood flows from the mouth, nose and anus, due to
the tympanitis.
Besides the gas which develops in the abdominal viscera, some is
set free in the subcutaneous and intramuscular tissues of the part in-
6
vaded by the tumor. Thus, on raising the skin, we observe that the
subcutaneous connective tissue is the seat of emphysema, more particular-
ly about the shoulder and back, but also at times extending to the croup,
quarters and thighs. We occasionally meet with a serogelatinous infiltra-
tion into the cellular tissue of various parts of the trunk. The muscles
may be cribbled with hæmorrhagic effusion, and easy to tear ; but what is
most striking is the presence of one or several characteristic tumors on
them.
These tumors vary as to their seat, as has been already stated; they
may be confined to the deeper parts of large muscular masses, on the
diaphragm, in the depth of the pelvic muscles or those of the thorax,
under the scapula, etc., but more frequently they attack the superficial
layers of the muscles of the regions where they exist. Besides these, we
may meet with infarcts of black or claret color, of more or less consi-
derable extent in certain of the muscles. We may observe one or
several sanguinolent tumors more or less voluminous. The muscles
invaded by the tumor are very dark colored, especially at their centres;
but this coloration becomes modified as we leave the centre and approach
the periphery passing successively from a very dark red to rose and
yellow with black streaks. The dark color of the central portions be-
comes modified by exposure to the air, turns brighter and brighter in
color after a few moments exposure. When the tumor exists in a
part very rich in loose connective tissue, it is surrounded by a more or less
voluminous œdema, of red color and strewn over with grains or yellow
fibrinous filaments in the neighbourhood of the diseased muscles. In
addition to the œdema, we observe a more or less marked gaseous infil-
tration more especially abundant when the œdema is small in quantity.
The gas may be present in only small quantity in cases where death has
been very rapid, as has been observed in guinea pigs dead from the
inoculated disease; but it is generally present in tumors of the ox tribe,
and is extensive in the inter and intra muscular tissue around the
vessels and nerves. The parts infiltrated with gas are crepitant, elastic,
less dense, and the muscular fibres are dissociated and friable. The gas
gathered a short time after death is odourless, and is composed almost
exclusively of carbonic acid with a trace of marsh gas.
Microscopical examination of a fragment of the œdematous tissue,
which surrounds the tumor, reveals a fibrinous reticulum between the
fascia of connective tissue, containing cellular elements and special micro-
organisms. The muscular fibres easily dissociated are surrounded by
masses of blood globules and leucocytes: certain of them, compressed
by the escaped blood, by lymphatic cells, and fibrin, deprived of oxygen,
have undergone fatty or colloid degeneration; some have here and there
lost their structure, and present granulations which are stained black
7
with osmic acid; others present fractures and appear as hyaline, vitreous
and refringent blocks.
The characteristic pathogenic micro-organisms are abundant in
the tumor; we find them around the fascia, in the lymph spaces of the
intra muscular connective tissue. We find them just inside the sarcolemna
of the muscular fibres, and more particularly at those spots where
fracture of the fibres has occurred transversely. They are accompanied
by migrated cellules and a certain quantity of fibrillated fibrin. The
morbific agent of charbon symptomatique tends to provoke mortification
of the muscular tissues in which it determines the evolution of a tumor.
We may, in fact, cause localized mortification of the connective and
muscular tissue by inoculating the virus of the disease into subjects
which have been protected by inoculation or those which are refractory
to the disease, which resist and allow the organisms to perform their
work. In this way, by inoculating the virus into the muscle of a
guinea pig, an ox, or a sheep, previously protected by inoculation, or
into a soliped animal which has natural immunity, we give rise to a
limited engorgement, which persists for a certain time, and which is
nothing more nor less than a sequestrum composed of brown or yellow
mortified fibres. This sequestrum becomes surrounded by a connective
tissue capsule, the cellules of which progressively absorb its débris.
When the tumor invades the vicinity of a bone, the periosteum
becomes thickened, red, presents blood extravasations between its fibres;
the marrow is vascularized, becomes redder, and presents micro-organisms.
In the abdominal cavity of animals which have presented symptoms
of colic, we find a more or less abundant deep colored serosity containing
few blood globules, and some round micro-organisms as well as batonnets.
When a tumor has extended to the abdominal walls, when a portion
of the intestine is inflamed, we find clare t colored spots on the peritoneum
on a level with the diseased points. In certain cases the peritoneum is
marbled with sanguineous effusions. Sometimes the abdominal muscles
are black and studded with extravasations or infarcts; at others
they are pale, degenerated and friable, resembling cooked flesh.
Sometimes the epiploon and the mesentery are studded with ecchy-
motic patches (Delamotte).
When glos anthrax is present in charbon symptomatique, that is to
say when we have tumefaction of the throat and tongue in this disease
the walls of the pharynx and œsophagus are black and friable, and these
lesions may extend to the muscles at the base of the tongue and the
soft palate. The intestine is found to be red, congested and studded
with blood spots, and it is frequently thickened at parts. The walls of
the stomach rarely undergo any change. The liver and spleen appear
normal, undergoing no changes as to volume or consistence, and thus
8
markedly differing from what they show in charbon bacteridien; this
enables us to distinguish readily between these diseases as a rule, but
there are cases when a microscopical examination of the spleen pulp is
absolutely necessary to enable a certain diagnosis to be made. Both
these organs contain a considerable number of the pathogenic micro-orga-
nisms, which are also present in the bile. My own opinion is that we
should seldom neglect to make a microscopical examination when it is
practicable, as by doing so we demonstrate the " bacterium " if the
disease be charbon symptomatique, and the " bacillus anthracis " if we
are dealing with charbonous fever.
The kidneys are often normal in appearance, sometimes infiltrated
with blood, owing to the presence of a tumor in the neighbourhood;
they may occasionally be found to be congested and surrounded by sero-
sanguinolent infiltration, which may or may not be mixed with gas.
The pathogenic microbes exist in the kidneys and urine.
The scrotum is distended, and the testicles wine colored when the
tumor is situated on the posterior extremities. The placenta is tumefied
and gorged with microbes in the pregnant female.
In the thorax we meet with changes similar to those seen in the
abdominal cavity, red plaques and hæmorrhagic patches in the lungs, sero-
sanguinolent effusion when the tumor has invaded the pectoral walls.
The lung is often hyperæmic. The respiratory mucous membrane,
principally that of the anterior passages, sometimes shows deep congestion,
and may be even black. The pleura often contains a sanguinolent serosity;
the thoracic muscles are dark when the tumor has made its appearance on
the shoulder.
The pericardium contains serosity, "the myocardium presents here and
there hæmorrhagic patches; the endocardium is generally stained in both
cavities, more particularly towards the summits. The blood which fills
the cardiac cavities and the large vessels coagulates as in the healthy
animal" (Arloing, Cornevin and Thomas).
The blood appears to have undergone little if any change either in
its physical or anatomical characters; it is ccagulable, and its globules
are not deformed. It sometimes contains gas and organisms imme-
diately before death.
The majority of the lymphatic ganglia are altered, more especially
those near the tumor, which are hyperæmic, red and infiltrated. They are
generally rich in microbes.
Etiology—Charbon symptomatique is determined by a special
micro-organism, which may be isolated, cultivated, and which, inoculated
in the form of a pure cultivation, reproduces the disease. The affection
is transmissable by inoculation to those animals which are susceptible to
it, provided that we inoculate the virus in sufficient quantity and accord-
9
ing to a certain method. In practice the disease is almost exclusively
observed affecting bovines, which become infected by introducing into
their system with the food, drink or inhaling with the dust the patho-
genic agents, which they get from external media.
Seat of the virus.—The virus is most abundant in the tumors; it is
also found in other diseased organs, in the ganglia, liver, spleen, kidneys,
etc., and in certain products of secretion and excretion. The pulp
obtained by trituration or scraping of the black portion of the tumors
is very rich in microbes: by agitating it with sterilized water we obtain
an emulsion which, after filtration through linen, may be employed for
inoculation purposes. The serosity or the blood-stained material which
escapes from the incised tumor may also serve for inoculation; as may
also the serosity of the œdemata, that from the serous membranes, peri-
toneum and pleura, etc., but the virulent agents are incomparably less
abundant in them than in the tumor and the serosity surrounding it.
The pathogenic microbes are always more or less abundant in the diseased
organs, in the thymus, ganglia, spleen, liver, kidneys, lungs, mucous mem-
branes, etc. It may pass, when hæmorrhage occurs, into the secretions
and excretions bile, milk (Galtier), amniotic fluid, aqueous humor, semen
(Galtier), excrement, urine (Galtier). The blood does not contain many
microbes excepting towards the end of the disease, and after death
they multiply and become abundant.
Nature of the virus.—The microbe which we find in the tumor,
diseased organs and tissues, and in the blood at death, is the agent of
virulence; it causes the disease. The following proofs clearly establish
the rôle which it plays.
The liquid obtained by filtration of an emulsion rich in microbes is
deprived of all pathogenic properties, whilst the part remaining on the
filter produces the disease. When we dilute a virulent emulsion and
leave it at rest for two or three days the superior strata contain few or
no microbes and are not virulent; whilst the inferior strata, which are
very rich in microbes, are also very virulent. When we provoke a
tumor by inoculating a large dose of the virus into the connective tissue,
the microbes only appear in the blood a few hours before death, and it
is only then that this fluid becomes virulent. In like manner the urine
does not become virulent until it contains microbes. The micro-organisms
which are found in the lesions of the disease assume two different forms,
as we shall see later on; we observe the bâtonnet and the spore form.
By cultivating under the microscope bâtonnets provided with one or
two brilliant bodies, we see them undergo degeneration and set free their
spores; and these spores reproduce the bacillary form and determine the
disease. In this manner blood taken from an animal at a time when
it contains spores gives the same results as that taken from the tumor,
10
which contains the microbe in its various forms, and more particularly as
bâtonnets. Lastly, the microbe taken from a sick animal and sown in
artificial culture media, purified, isolated by successive cultures, repro-
duces the disease on inoculation.
The virus presents itself in several forms. As a bacillus, bâtonnet
straight and mobile, formed of one or two articulated segments varying
in length between 5u to 10u ; it multiplies by scissiparity or segment-
ation, and also forms spores in the sick animal. In preparations made
with the pulp of the tumor, for instance, we see many bâtonnets which
contain spores in their interior. Those about to produce spores are irre-
gularly swollen, sometimes in the whole of their length, assuming
somewhat of a spindle shape, but more generally the spore appears at one of
their extremities, causing a swelling, and giving to the microbe the
appearance of a pendulum. The thickness varies from 1.1 to 1.3u, when
they are spore-bearing. The same bâtonnet may sometimes produce two
spores, one at each extremity, but this is not a common occurrence.
We find very much longer bâtonnets in certain organs; it is not rare
to meet with them in masses.
In the tissue of the muscular tumor, the micro-organism assumes its
most characteristic forms. We find it under the form of straight and
regular bâtonnets ; in the form of clubs, pendulum-shaped, or racquet-
shaped with one extremity bearing a spore and enlarged; spindle-shaped,
swollen in their middle with or without apparent spore; lastly of a rounded
or ovoid form. We find them as bâtonnets, pendulum-shaped, and more
especially as entire regular rods more or less elongated, in the bile, spleen,
liver, kidneys, urine, ganglia, lung, etc.
In the blood we find them either as entire straight rods or rounded
masses. To recapitulate, then, we may meet with the pathogenic micro-
organism of this disease in three principal forms, viz., in the form of
entire and homogenous rods; under the form of spore-bearing rods
swollen in their middle or at one extremity; and as rounded or ovoid
bodies. The virus may be cultivated in an artificial nutritive medium;
it is anœrobic. MM. Arloing, Cornevin and Thomas remark: " This or-
ganism is not easily cultivated." They have, however, succeeded in mak-
ing cultures in broth. The details of cultivation need not be entered into
here; it will be sufficient to say that a culture in veal broth or serum,
made in an atmosphere of carbonic acid, preserved its virulence for
three generations, after which it became attenuated, and it remained
capable of giving immunity during the fourth and fifth generations, after
which its activity appeared to become extinct. It may be cultivated in
chicken broth, to which has been added a small quantity of glycerine and
sulphate of iron, and in this medium the best cultures are obtained
in vacuo.