Читать книгу On the cattle plague: or, Contagious typhus in horned cattle. Its history, origin, description, and treatment - Bourguignon Honoré - Страница 6

On Typhous Diseases in general, and the Typhus which affects the Ox in particular

By following the example of those authors who have described the contagious typhus of the ox, we might proceed at once to explain its symptoms, and go directly to our purpose; but, by taking this hasty course, we should expose ourselves to be imperfectly understood by the majority of our readers, and to leave certain doubts in the minds of physicians as to the nature of the disease and the propriety of its treatment.

All animals, including man himself, are born with a predisposition and liability to contract a certain number of contagious febrile diseases; they bear in a manner a certain number of physiological elements, which might be called latent germs, and which, under given conditions, become the leaven of these diseases. This must, indeed, be the case, since after these disorders have been once developed those who have been cured of them are not apt to contract them again, the morbid developments having destroyed that natural aptitude which had previously existed to undergo the morbid action of the contagious virus. These diseases are not numerous; they constitute a very distinct class, and the same laws, which regulate the phenomena in one of them are applicable to all the rest.

These diseases exhibit the following characteristics: 1st, a period of incubation, during which the whole economy, more particularly the blood and humours, experience very important changes and modifications; 2nd, a febrile state, which varies in its continuous or intermittent types, and in its intensity, according to the species of the animals, and which proceeds from the alteration of the blood; 3rd, a revulsion at once toxical and congestive towards the nervous centre, inducing stupor; 4th, a flux of mucus from the mouth and chest; 5th, a more intense, congestive, and inflammatory flux or discharge from the external or internal teguments – the skin or the mucous membrane of the digestive channels; 6th, a period of adynamia and dejection, with a tendency, in some cases, to a critical or salutary rejection of the morbid matter by the development of tumours or abscesses in the skin; 7th, they are at once infectious and contagious, epizootic or epidemic; that is to say, they are transmitted in different degrees by contact, by inoculation, and at a distance by the means of vitiated air; 8th, finally – and this is their leading characteristic —they are not subject to recurrence, each individual that has once been affected, losing in general all aptitude to contract the disease a second time.

This last characteristic, when well understood, ought in reason to induce us to have recourse to the preventive treatment, and such has been the case with respect to the most virulent amongst them – small-pox and the typhus of the ox.

Prompted by these principles, which are as logical and fixed as any mathematical deduction, I suggested in 1855 that inoculation should be applied in typhoid fever, which is nothing else but the equivalent of intestinal small-pox, in order to prevent the disease in men. But if the simplest truth sometimes requires a contest of ages before it is heard and understood, I could not hope to fix attention on a fact which might be taken as problematical. I felt that I was outrunning time, and that I should neither be heard nor understood; and so it has proved.

Be that as it may, these typhous diseases have, as is seen, their laws and foreseen development. They attack animals generally, but chiefly herbivorous animals, endowed, as we have shown in the first part, with a vital resistance which is, relatively speaking, very inconsiderable.

These febrile typhous diseases (whether their development is caused by a spontaneous morbid action in the patient or by an evident contagion), have a period of incubation during which the vital strength undergoes latent morbid modifications, though not sufficient to indicate, save in times of epizootics and epidemics, the particular form which is about to reveal its symptoms in the course of a few days. This period of incubation being over, the mouth and chest become affected, and fever declares itself; and then the materies morbi, which is to become the special and dominant characteristic of the distemper, is directed either to the skin, or to the digestive mucous membrane. In the first case, we see evidence of exanthematic diseases, which present only the lightest forms of detersive disorders, such as measles, scarlatina, or that more serious one, from its pustulous form, the small-pox. In the second case, the elimination takes place from the intestinal canal, and then we see produced in animals, as well as in men, the typhous diseases: that is to say, the typhoid fever – a pustulous and ulcerous malady of the intestines – or the common typhus of the hospitals, prisons, and campaigning armies; and again, in animals, there is also the typhus of the steppes, of the marshes, &c.

The Eastern pestilence, the plague of Rome in the age of Antoninus and the plague of Athens, which might have given to Hippocrates the right of treating with Artaxerxes as one potentate treats with another, ought perhaps to be classed among those typhuses not subject to recurrence.

As for the cholera, it seems to be a contagious and epidemic disorder, of a distinct and particular kind. We are ignorant of its essential cause, its nature, and its mode of treatment; and although it has prevailed in every age, and even frequently of late years, it will always, by reason of the strange formation of our medical institutions, find us as weak and defenceless to resist its attack as we have ever been.

If we have been properly understood, typhous diseases are, above all, general febrile affections. At one time the materies morbi, or discharge, affects the skin; at another, the digestive mucous membrane. When it acts upon the skin, as clinical observation shows, there is sometimes a sort of hesitation in the eruptive process; people wonder what disease is coming forth; the eruption wavers in the form it will assume, till at length its real character is determined. The same uncertainty prevails when the intestines are affected. Sometimes the exanthema is merely the equivalent of simple measles or scarlatina of the intestinal mucous membrane, and many typhoid fevers of short continuance are nothing else in their nature. The same occurs in common typhuses. Sometimes the local affection proceeds as far as pustulous eruption, sometimes only to exanthematic rubefaction; hence the various alterations which we have witnessed in the intestines of cattle killed in our presence at the slaughter-houses of the Metropolitan Market, and which we ourselves dissected. The experienced Professor Bouley, from the Ecole Vétérinaire of Alfort, near Paris, whose visit must have been beneficial to England, clearly recognised in an ox which was slaughtered and dissected at the Metropolitan Market, the genuine pustule of typhoid fever. But in most cases, as we shall show, it is the other forms which prevail.

We make these observations in order to anticipate the objections of those reasoners who, being more influenced and guided by the local facts and by the symptoms, than by the general phenomena of comparative pathology, might argue that such or such fact is opposed to our doctrine.

In a word, then, typhous diseases have their types; but the living being is subjected to so many different influences, hereditary, idiosyncratic, climataic, hygienic, &c., that by the side of one subject going through the course of morbid phenomena with fatal regularity, another may be seen in which such or such functional derangement is readily distinguished. Thus in some animals, predisposed thereto by prior disorders, the morbid action originally propelled towards the channels of respiration will continue to be most salient; and after dissection the lungs will be congested and emphysematous, and the intestines relatively but scarcely altered. The animal, indeed, though bordering on typhus, will sink under the effect of functional derangement in the breathing passages. In others, by the influence of some particular predisposing cause, disorders of the nervous centres will be signalized; a cerebral and spinal pains will be intolerable, delirium will quickly ensue, and the asphyxiated patient, if a man, will succumb in the course of a few days; or if an ox, he will be wild and ungovernable, and then fall as if thunderstruck, fastened to his stall. Finally, in other cases, these first two phases of the distemper will not prove fatal, the intestinal injuries will pursue their course, and the affected animals will not die until the third period.

As we have seen, the morbid phenomena may be different, although the affection continues the same; the typhoid fever or the typhus being nevertheless the essential disease which prevails.

These generalities, to some readers, may appear irrelevant, but let them not be mistaken; they have a claim to our notice, and are really important. They show, indeed, that independent of the preventive treatment, which is an absolute rule in the case of virulent, contagious, and non-recurring diseases, the treatment of the disease itself, when it has declared itself, and when it pursues its course, cannot be the same for every patient; and that, moreover, this treatment must vary in the different phases of the disease, as physicians and veterinarians are well aware.

These generalities, likewise, explain the various diseases – viz., those in which the animals blend together the typhous and exanthematic diseases. The measles and the scarlet fever, affecting the external or internal membranes, are like the first steps of these maladies; they are generally slight, and we have but to watch over the progress of the symptoms, and to assist nature, which, with few exceptions, brings all things to a favourable issue.

These disorders, which are relatively slight and do not provoke in the economy any of those changes which in some sort transform the constitution, are not absolutely proof against relapse. They lead us rationally and by degrees to the more infectious and contagious diseases, to the common typhus; therefore it is unnecessary to apply the preventive treatment to them, that being exclusively reserved for the latter.

Let it then be well understood, that the typhus of the ox, the study of which we are about to enter upon, may vary in its symptoms and post-mortem appearances, without losing thereby the characteristic mark which renders it a thoroughly distinct, and, in the present day, a thoroughly well known distemper.

Now that the reader possesses these general notions of the Contagious Typhus, we shall be able to speak to him in a language which he will understand, and give a definition which he will be able to judge and appreciate.

The typhus of the ox, then, is a virulent, contagious, febrile, and non-recurring disease, with stupor and derangement of the nervous, respiratory, and digestive functions; leaving various changes in the respective organs of these functions, and chiefly in the intestines.

This new definition seems to us to be more faithful and just than those hitherto given; and this, if needed, we could demonstrate.

I do not disguise from myself that some of the opinions expressed in these generalities may, at first sight, appear strange and liable to objection. Thus, it may be argued that inoculation as a preventive treatment of typhous maladies is far from being a general law, applicable to every case; since in Russia, for instance, where this inoculation is practised every day, it completely fails in certain foreign herds, and they die of the consequences of the operation; and that this, therefore, might happen in England.

To these objections we would reply, first, as regards the novelty of opinions expressed, that we have taken up the pen, because we had to write something different from what has already been published in known works, otherwise it would have been our duty to remain silent; and secondly, as regards the inefficacy of inoculation, that organic and vital phenomena have their principles and their laws, which are fixed and invincible, from which it is reasonable to deduce consequences and positive rules of conduct, which cannot yield to superannuated opinions or imperfectly executed experiments. To institute experiments indeed under the rigorous conditions of a logical and irrefutable demonstration, is not so easy a matter as may generally be thought.

For our part, the principles deduced from strict observation are the basis on which we build, and if it so chance that we are baffled in our experiments we vary them indefinitely; and if still we are deceived in our hopes, we ascribe the miscarriage to our impotence, to inadequate means, and to the defective instruments which the physical and chemical sciences, still in their cradle as regards organic matter, supply for our use. Above all, we wish it to be remembered – "Scribo nec ficta, nec picta, sed quæ ratio, sensus, et experientia docent."