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one of the larger arteries is severed the blood comes in intermitting jets or spurts corresponding to the beats of the heart. It is well to call attention to the fact that the dark-re
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y gentle pressure on the wound clear it of the accumulated blood. The jet of fresh blood reveals the end of the vessel, which is readily recognized by its whitish-yellow or buff color
small, pulpy magma by which the bladder is considerably distended.
_Symptoms._--The symptoms of stone in the bladder may be absent until one
of the masses escapes into the urethra, but when this occurs the escape of
urine is prevented, or it is allowed to pass in drops or driblets only, and
the effect of such obstruction becomes manifest. The point of obstruction
is not always the same, but it is most frequently at the S-shaped curve of
the penis, just above the testicles or scrotum. In cows and heifers the
urethra is so short and becomes so widely dilated during the urination that
the calculi easily escape in the flow of liquid and dangerous symptoms
practically never appear.
Even in the male the signs of illness are at first very slight. A close
observer may notice the cylinders of hard, earthy materials encircling the
tufts of hair at the opening of the prepuce. It may further be observed
that the stall remains dry and that the animal has not been seen to pass
water when out of doors. The tail may at times be gently raised and
contractions of the muscle (accelerator urinÊ) beneath the anus (Pl. IX,
fig. 2) may take place in a rhythmical or pulsating manner. As a rule,
however, no symptom is noticed for two days, only the animal is lacking in
his usual spirits. By this time the constantly accumulating urine has
distended the bladder beyond its power of resistance and a rupture occurs,
allowing the urine to escape into the cavity of the abdomen. Then dullness
increases; the animal lies down most of his time; he becomes stupid and
sometimes drowsy, with reddish-brown congestion of the lining membrane of
the eyelids; pressure on the abdomen causes pain, flinching, and perhaps
groaning, and the lowest part of the belly fluctuates more and more as the
escaping urine accumulates in greater and greater amount. If at this stage
the oiled hand is introduced into the rectum (last gut), the animal
flinches when pressure is made downward on the floor of the pelvis, and no
round, distended bladder is felt. If the same examination is made prior to
the rupture, the rounded, tense, elastic bladder is felt extending forward
into the abdomen, containing one or two gallons of liquid. There may be
uneasy shifting of the hind limbs and twisting of the tail, also frequent
lying down and rising, but these symptoms are exceptional.
When the obstruction is low down between the thighs (at the S-shaped
flexure), the line of the pulsating urethra from the anus downward may be
felt distended with liquid, and though, by the hard swelling of the
urethra, it is seldom easy to distinguish the exact seat of the stone, yet
there is usually tenderness at the point of obstruction, and from this it
may be accurately located.
_Treatment._--The treatment of stone in the bladder or urethra consists in
the removal of the stone by incision and the use of forceps. (Pl. XI, fig.
4.) When the stone has been arrested at the S-shaped flexure just above the
scrotum, the patient being lean, the thickened tender part of the penis may
be seized between the fingers and thumb of the left hand, while the
calculus is exposed by a free incision with the knife held in the right. If
there is no other obstruction between this point and the bladder, and if
the latter has not yet ruptured, a flow of urine should take place from the
opening. If there is no escape of liquid, a catheter or sound, one-fourth
of an inch in diameter, must be passed up through the canal (urethra) until
it is arrested by the next stone, on which a similar incision should then
be made to effect its extraction. In case the stone has been arrested in
the portion of the urethra which is in front of the arch of the hip bone
and inside the pelvis, it can be reached only by making an opening into the
urethra beneath the anus and over the arch of the hip bone, and from this
orifice exploring the urethra with fine forceps to the neck of the bladder
or until the stone has been reached and extracted. Owing to the small size
of the canal (urethra) to be opened and the great thickness of erectile
tissue to be cut through, the operation requires a very accurate knowledge
of the parts, while the free flow of blood is blinding to the operator. A
staff should always be passed up through the urethra from the lower wound,
if such has been made, or, in case of its absence, through the whole length
of the penis, that organ having been drawn out of its sheath until the
S-shaped curve has been effaced and the course of the canal rendered
straight. Upon the end of this staff the incision can be made with far more
confidence and certainty. The operation can be undertaken only by a skilled
veterinary anatomist, but the hints given above may be valuable in showing
the stock owner when he is being properly served in such a case.
In outlying districts, where no skilled operator can be had, a transverse
incision may be made with a clean, sharp knife through the root of the
penis, just over the arch of the hip bone, when the urine will flow out in
a full stream. The attendant bleeding may be ignored, or if profuse it may
be checked by packing the wound firmly with cotton wool for several hours.
The urine will continue to escape by the wound, and the ox should be
fattened for the butcher.
The immediate relief is not to be looked upon as a permanent cure, as the
calculi in the affected ox are usually numerous, and later attacks are
therefore to be looked for. Hence it is desirable to fatten and kill such
cases after a successful operation. If a breeding animal is too valuable to
be killed, he should be subjected to preventive measures, as laid down
under "Stone in the kidney," page 139.
It should be added that when the bladder is filled with a soft magma a
catheter may be introduced through the whole length of the urethra to be
used in pumping water into the bladder. This water is extracted through the
same channel when it has been charged with the suspended solids by
manipulations of the bladder with the oiled hand introduced through the
rectum.
CALCULI, OR GRAVEL, IN THE PREPUCE, OR SHEATH.
This is usually a collection of gravel, or a soft, puttylike material which
causes distinct swelling of the sheath and gives it a soft, doughy feeling
when handled. It may be removed in part by the oiled fingers introduced
into the cavity, assisted by manipulation from without, or a tube may be
inserted until the end extends behind the collection and water pumped in
until the whole mass has been evacuated. Should even this fail of success,
the sheath may be slit open from its orifice back in the median line below
until the offending matter can be reached and removed. In all such cases
the interior of the sheath should be finally lubricated with sweet oil or
vaseline. It is unnecessary to stitch up the wound made in the sheath. (See
"Inflammation of the sheath," p. 155.)
[Illustration: PLATE IX.
KIDNEY AND MALE GENERATIVE AND URINARY ORGANS.]
[Illustration: PLATE X.
MICROSCOPIC ANATOMY OF THE KIDNEY.]
* * * * *
DISEASES OF THE URINARY ORGANS.
DESCRIPTION OF PLATES.
PLATE IX. Kidney and male generative and urinary organs.
Fig. 1. Kidney of the ox. (From Handbuch des Vergleichenden Anatomie des
Haus S‰ugethiere, vol. 7, 1890.) A, renal artery carrying blood into the
kidney; V, renal vein carrying blood from the kidney back to the heart; H,
ureter, the tube carrying the urine from kidney to bladder. It is formed by
the union of a number of branches which begin as cups (calices), each
inclosing the tip of a conical mass of tissue from which the urine
excludes.
Fig. 2. Genital and urinary organs of the bull. (From Leisering, Mueller,
and Ellenberger, Handbuch des Verg. Anat. des Haus S‰ugethiere.) the serous
membrane enveloping the testicles; 3, the right testicle, outer view; 3',
left testicle, inner view; 4, epididymis, or the beginning of the excretory
canal of the testicle; 4', globus major, or the head of the epididymis;
4'', globus minor, or the tail of the epididymis; 5, vas deferens, the duct
through which the seminal fluid reaches the ejaculatory ducts; 5', pelvic
dilation of the vas deferens; 6, vesicula seminalis. The vesiculÊ seminalis
are two oval pouches, which, in addition to their own secretions, receive
the semen conveyed by the seminal ducts and hold it in reserve until
copulation; 7, membranous or intrapelvic portion of the urethral canal
covered by Wilson's muscle; 8, part of the prostate gland, covered by
Wilson's muscle; 9, Cowper's gland. This gland, like the prostate gland,
secretes a fluid which is thrown into the urethal canal in abundance
immediately before ejaculation; by this means the expulsion of the semen is
facilitated; 10, ejaculator seminis, or accelerator urinÊ muscle; 11,
penis; 11', cut portion of same; 12, cut suspensory ligaments of penis; 13,
sheath, or prepuce laid open; 14, retractor muscles of sheath; 15,
cremaster muscle cut at superior extremity; 16, duplicature of peritoneum;
17, ureters carrying urine from the kidneys to the bladder.
PLATE X. Microscopic anatomy of the kidney.
Fig. 1. In this figure the minute apparatus for the secretion, collection,
and discharge of the urine into the pelvis of the kidney (see preceding
plate) is shown. The course is as follows: The urine is secreted from the
blood vessels in the little round bodies called glomeruli (12), and by the
minute cells in the curved tubes (11, 9, 10, 8), and passes through the
convoluted and straight tubes (7, 6) into the larger tube (1), and then out
into the pelvis, thence through the ureters into the bladder. The fluid and
salts dissolved in the urine are taken from the blood, and the minute blood
vessels are therefore very abundant in the kidneys, as is shown by the
branches and network on the left of the figure. The blood passes into the
kidney in the artery (13), which then divides into branches which pass into
the glomeruli (12) and also forms network around the secreting tubules (11,
9). The urine and salts pass from these vessels through the cells lining
the tubules into the latter, and are discharged as described above. The
blood is again collected in veins drawn black in the figure.
Fig. 2 illustrates the manner in which the blood is distributed in the
glomerulus (_f_), and also to the secreting tubules (_e_).
Fig. 3 shows the relation between the blood vessel in the glomerulus (_e_)
the tubule which conducts the urine therein secreted from the blood vessel;
(_c_) represents a glomerulus from which the urinary tubule has been
removed.
PLATE XI. Calculi of kidney and bladder.
Fig. 1. Calculus, or stone, from the kidney. These are in the pelvis or
portion of the ureter receiving the urine. The prolongations are casts of
the branches of the pelvis. See the plates of the kidney for further
description.
Fig. 2. Calculus made up of oxalate of lime magnified 215 times.
Fig. 3. Phosphatic calculus containing a nucleus of uric acid, sawed
through to show concentric layers.
Fig. 4. Straight forceps used in removing stones from the bladder.
Fig. 5. Casts of the minute tubules of the kidney found in the urine in
various kinds of kidney disease. Highly magnified.
* * * * *
[Illustration: Plate XI.
CALCULI OF KIDNEY AND BLADDER.]
FOOTNOTES:
[1] Encyklop. der Thierheilk., Vol. IV, p. 208.
DISEASES OF THE GENERATIVE ORGANS.
By JAMES LAW, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., in Cornell University._
[Revised by Adolph Eichhorn, D. V. S.]
GENERAL DISCUSSION.
Diseases of the generative organs are practically confined to animals which
are kept for reproduction and the dairy. The castration of the bull
condemns these organs to inactivity and protects them from the many causes
of injury attendant on the engorged blood vessels in the frequent periods
of sexual excitement, on the exposure to mechanical violence, and on the
exposure to infective inoculation. In three respects the castrated male is
especially subject to disease: (1) To inflammation and tumefaction of the
cut end of the cord that supported the testicle and of the loose connective
tissue of the scrotum; (2) to inflammation of the sheath and penis from the
accumulation of gravel in the former, from which the penis is not usually
protruded in passing water; and (3) to bruising, abrasion, and inflammation
of the sheath and penis during suspension in the stocks for the purpose of
shoeing. Apart from these the ox is practically almost exempt from the
inflammations and injuries of the genital organs. The same applies to the
castrated heifer. Inflammation may occur in the broad ligament of the womb
whence the ovary has been removed or infective inflammation in the
abdominal cavity (peritonitis) in case the operation has been performed
through the flank, as it usually is in the young heifer. Apart from these,
the castrated heifer is practically immune from any trouble of the
generative apparatus. Even the virgin heifer is little subject to such
troubles, though she is not exempt from inflammations, and above all, from
morbid growths in the ovaries which are well developed and functionally
very active after the first year, or in precocious animals after the first
few months of life. The breeding cow, on the other hand, is subjected to
all the disturbances attendant on the gradual enlargement of the womb, the
diversion of a large mass of blood to its walls, the constant drain of
nutrient materials of all kinds for the nourishment of the fetus, the risks
attendant and consequent on abortion and parturition, the dangers of
infection from the bull, the risks of sympathetic disturbance in case of
serious diseases of other organs, but preeminently of the urinary organs
and the udder, and finally the sudden extreme derangements of the
circulation and of the nervous functions which attend on the sudden
revulsion of a great mass of blood from the walls of the contracting womb
into the body at large immediately after calving.
In reviewing this class of diseases, therefore, we have to note, first,
that they are almost exclusively restricted to breeding animals, and
secondly that in keeping with the absolute difference of the organs in the
male and female we find two essentially distinct lists of diseases
affecting the two sexes.
EXCESS OF VENEREAL DESIRE (SATYRIASIS IN MALE, OR NYMPHOMANIA IN FEMALE).
This may occur in the male from too frequent sexual intercourse, or from
injury and congestion of the base of the brain (vasodilator center in the
medulla), or of the posterior end of the spinal cord, or it may be kept up
by congestion or inflammation of the testicles or of the mucous membrane
covering the penis. It may be manifested by a constant or frequent
erection, by attempts at sexual connection, and sometimes by the discharge
of semen without connection. In bad cases the feverishness and restlessness
lead to loss of flesh, emaciation, and physical weakness.
It is, however, in the female especially that this morbid desire is most
noticeable and injurious. It may be excited by the stimulating quality of
the blood in cows fed to excess on highly nitrogenous feed, as the seeds of
the bean, pea, vetch, and tare, and as wheat bran, middlings, cotton seed,
gluten meal, etc., especially in the case of such as have no free exercise
in the fields, and are subject to constant association with a vigorous
young bull. A more frequent cause is the excitation or congestion of some
part of the genital organs. Disease of the ovaries is preeminently the
cause, and this may be by the formation of cysts (sacs containing liquid)
or of solid tumors or degenerations, or, more commonly than all, the
formation of tubercle. Indeed, in case of tuberculosis attacking the
abdominal organs of cows, the ovaries or the serous membranes that support
and cover them (the broad ligaments of the womb) are peculiarly subject to
attack, and the animal has constant sexual excitement, incessantly riding
or being ridden by other cattle, having no leisure to eat or chew the cud,
but moving restlessly, wearing the flesh off its bones, and gradually
wasting. In some localities these cows are known as "bullers," because they
are nearly always disposed to take the bull, but they do not conceive, or,
if they do, they are subject to early abortions. They are, therefore,
useless alike for the dairy and for the feeder, unless the removal of the
ovaries subdues the sexual excitement, when, in the absence of tuberculous
disease elsewhere, they may be fattened for the butcher.
Among the other sources of irritation charged with causing nymphomania are
tumors and cancers of the womb, rigid closure of the neck of the womb so
that conception can not occur and the frequent services by the male which
stimulate the unsatisfied appetite, inflammation, and a purulent discharge
from the womb or vagina.
_Treatment._--The treatment in each case will vary with the cause and is
most satisfactory when that cause is a removable one. Overfeeding on richly
nitrogenous feed can be stopped, exercise in the open field given, diseased
ovaries may be removed (see "Castration," p. 299), catarrhs of the womb and
passages overcome by antiseptic, astringent injections (see "Leucorrhea,"
p. 224), and tumors of the womb may often be detached and extracted, the
mouth of that organ having been first dilated by sponge tents or otherwise.
The rubber dilator (impregnator), sometimes helpful in the mare, is rarely
available for the cow, owing to the different condition of the mouth of the
womb.
DIMINUTION OR LOSS OF VENEREAL DESIRE (ANAPHRODISIA).
This occurs in either sex from low condition and ill health. Longstanding,
chronic diseases of important internal organs, leading to emaciation and
weakness, or a prolonged semistarvation in winter may be sufficient cause.
It is, however, much more common as the result of degeneration or extensive
and destructive disease of the secreting organs (testicles, ovaries) which
elaborate the male and female sexual products, respectively. Such diseases
are, therefore, a common cause of sterility in both sexes. The old bull,
fat and lazy, becomes sluggish and unreliable in serving, and finally gets
to be useless for breeding purposes. This is not attributable to his weight
and clumsiness alone, but largely to the fatty degeneration of his
testicles and their excretory ducts, which prevents the due formation and
maturation of the semen. If he has been kept in extra high condition for
exhibition in the show ring, this disqualification comes upon him sooner
and becomes more irremediable.
Similarly the overfed, inactive cow, and above all the show cow, fails to
come in heat at the usual times, shows little disposition to take the bull,
and fails to conceive when served. Her trouble is the same in kind, namely,
fatty degeneration of the ovaries and of their excretory ducts (Fallopian
tubes), which prevents the formation or maturation of the ovum or, when it
has formed, hinders its passage into the womb. Another common defect in
such old, fat cows is a rigid closure of the mouth of the womb, which
prevents conception, even if the ovum reaches the interior of that organ
and even if the semen is discharged into the vagina.
_Preventive._--The true preventive of such conditions is to be found in a
sound hygiene. The breeding animal should be of adult age, neither overfed
nor underfed, but well fed and moderately exercised; in other words, the
most vigorous health should be sought, not only that a strong race may be
propagated, but that the whole herd, or nearly so, may breed with
certainty. Fleming gives 79 per cent as the general average of cows that
are found to breed in one year. Here more than a fifth of the progeny is
sacrificed and a fifth of the product of the dairy. With careful management
the proportion of breeders should approach 100 per cent. The various local
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