Text book of veterinary medicine, Volume 3 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 3 (of 5)
Law, James
Veterinary medicine
_Treatment._ In all cases of phrenitis, quiet, darkness, and coolness
are especially demanded. For the horse a roomy, loose box or a well
fenced yard may be secured, and if he can be secured by a halter from a
point above the level of the head and in the centre of the box it will
obviate the increase of congestion by hanging of the head. The
application of cold to the cranium in the form of wet cloths, ice bags
or irrigation is always in order, and should be continued so long as
heat of the head and other indications of cranial hyperæmia last.
In the _horse_ suffering, as is so often the case, from narcotic
poisoning an active purgative is one of the first considerations to
clear away any remains of the poison from the _prima viæ_. An ounce of
aloes may be safely given, as there is in this case little danger of
superpurgation, and, to secure an even more prompt response, eserine (1½
grain) or barium chloride (½ drachm) may be given subcutem. Or an ounce
or two of glycerine by the rectum might be used as a substitute for
these last. The action of the purgative proves not only eliminant and
therefore antidotal, but it is a most effective derivative from the
brain. When the restlessness or excitement is very great we may use
acetanilid, trional, sulphonal or some one of the many brain sedatives
and antithermics. Sedatives, or anodynes like opium, which tend to
increase cerebral congestion are dangerous.
Bleeding from the jugular or temporal artery, has been objected to on
the ground that it tends to increase the exudate and therefore the
pressure and cerebral anæmia. On the other hand it often proves of great
value in vigorous, muscular and plethoric horses in temporarily
lessening the blood pressure in the brain, and affording the walls of
the overcharged capillaries an opportunity to resume a more normal tone
and to control that very exudation which is so much dreaded. It is most
effective in the early stages when little or no exudation has taken
place and may then be pushed to the extent of producing a perceptible
softening of the pulse (4, 6 or 8 quarts). Even in the advanced stages
when exudation has led to stupor or coma a moderate and carefully
guarded bleeding may favor reabsorption of the liquid exudate. In weak
and anæmic cases in which general bleeding appears to be
contra-indicated the shaving of the cranial surface followed by leeching
or wet cupping can be safely resorted to.
Counter-irritants like bleeding are denounced and advocated by different
practitioners. In cases of extreme hyperæsthesia where excitement and
fever would be dangerously increased by their use, they must be
discarded, or used only in the modified form of soothing hot
fomentations to the extremities. Where there is less sensitiveness
mustard poultices or pulp applied on the sides of the neck, or upon the
limbs, or even more energetic blisters will be of great service.
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