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Page 1 2 matches 48 VII. Diagram of the circulation of the blood 86 VIII. Position of the lung Page 2 4 matches and irritation of the digestive tract. The rusts, such as _Puccinia graminis_, _P. straminis_, _P. Coronata_, and _P. arudinacea_, cause colic and diarrhea, and in some cases partial Page 3 1 match ean and the cavity injected once or twice daily with a solution of 1 dram of carbolic acid in 8 ounces of water. Under this treatment the pus may cease and the wound heal without comp Page 4 5 matches n to be used in such case is made up as follows: Sulphate of zinc, 1 dram; carbolic acid, 2 drams; glycerin, 2 ounces; water, 14 ounces; mix. It is clear that this operation requires Page 5 3 matches of 30 to 60 grains is good. Subnitrate of bismuth in doses of 1 to 2 drams may be given. Pulverized opium may be used, if the diarrhea is severe, in 1 to 2 dram doses. If the bowel mo Page 6 3 matches first 24 hours, divided into three doses, and afterwards he gives 6 drams three times daily. Opium in doses of 2 to 3 drams may be given. To bring on evacuations of the bowels it is Page 7 1 match chronic poisoning may result. The poisonous dose for an ox is from 3 drams to 1 ounce. _Symptoms._--The symptoms of acute poisoning first appear as those of colic; the animal is rest Page 8 2 matches symptoms have abated, iodid of potassium may be given, in doses of 2 drams each, three times a day for a week. No treatment is likely to be of avail until the cause is removed. COP Page 9 1 match y to be tedious. Tannin may be given internally in doses of one-half dram twice daily for a few days to neutralize the unabsorbed alkaloids of the ergot. At the same time give Page 10 3 matches e the branches of a tree), become smaller and smaller, and ultimately ramify into every part of the body. Between the ultimate ramifications of the arteries and the beginning of the v Page 11 1 match y, and rapid, labored breathing. It is caused by non-closure of the foramen ovale, connecting the right with the left side of the heart, and the consequent mixing of the venous with t Page 12 3 matches LOOD VESSELS, AND LYMPHATICS. DESCRIPTION OF PLATE. PLATE VII: Diagram illustrating the circulation of the blood. The arrows indicate the direction in which the blood flows. The va Page 13 10 matches orrhage is profuse and persistent, either a drench composed of 1-1/2 drams of acetate of lead dissolved in a pint of water or 1-1/2 drams of gallic acid dissolved in a pint of water s Page 14 4 matches tive tissue. Nerves divide and subdivide, sending off branches, which ramify in all parts of the body, and, as they near their terminations, they contain but one or two fibers. The b Page 15 7 matches e ascertained by pouring a little cold water into the mouth), give 3 drams of stronger liquor ammonia, diluted with a quart of cold water. Be very careful in drenching the animal when Page 16 5 matches ition to the wholesome dry food, and, by way of medicine, doses of 2 drams each of sulphate of iron and iodid of potassium may be given twice daily. In obstinate cases 2 drams ergot o Page 17 9 matches tincture of chlorid of iron, 2 drams, may be given in a pint of water thrice a day. In some cases 1 or 2 teaspoonfuls of oil of turpentine twice Page 18 4 matches After relief has been obtained the administration of belladonna in 2-dram doses daily for several days will tend to prevent a recurrence of the retention. When the body of the bladde Page 19 2 matches ge doses of laudanum (2 ounces) or of solid extract of belladonna (2 drams) will not only soothe the pain but relax the spasm and favor the onward passage of the calculus. The animal Page 21 4 matches Castile soap, or with a weak solution of sulphate of zinc (one-half dram to a quart of water). If these attentions are impossible, most cases, after cleansing, will do well if merely Page 22 4 matches after this the sore may be treated by a daily injection of one-half dram sulphate of zinc, 1 dram carbolic acid, and 1 quart milk-warm water. SIGNS OF PREGNANCY. If a cow remains Page 24 1 match is avoids danger of exposure and yet leaves the whole arm free and untrammeled. Before inserting the hand it and the arm should be smeared with oil, lard, or vaseline, care being take Page 25 2 matches ould be washed frequently with an antiseptic lotion (carbolic acid 1 dram in 1 quart of water). CONSTRICTION OF A MEMBER BY THE NAVEL STRING. In early fetal life the winding of the Page 27 2 matches the pelvis or in the openings in the bones of its floor (obturator foramina) will give sufficient purchase for extraction. Another method is to insert a knife between the bone of the Page 30 5 matches acid, or acetate of lead) may be thrown into the womb, and one-half-dram doses of acetate of lead may be given by the mouth, or 1 ounce powdered ergot of rye may be given in gruel. W Page 31 6 matches ree are not without danger. Ergot of rye, 1 ounce, or its extract, 1 dram, may be resorted to to induce contraction of the womb. The mechanical extraction of the membranes is, however Page 32 1 match he teats and milk ducts with a solution of iodid of potassium (1-1/2 drams to 1 quart of water). This reduced the mortality to 17 per cent. Others followed this lead by the injection Page 33 4 matches cted part is often fatal. It demands antiseptics (chlorid of zinc, 1 dram to 1 quart water) applied frequently to the part, or, if the case can not be attended, smear the affected qua Page 34 5 matches acters. By fencing the spring in and giving the affected cows each 2 drams bisulphite of soda daily, the trouble was arrested promptly and permanently. CHAPPED TEATS. These may be Page 35 4 matches ily with tincture of iodin, or an ointment of biniodid of mercury (1 dram) and lard (2 ounces) may be rubbed on the affected joints daily until they are blistered. In case of swelling Page 36 9 matches elled in this way, carminatives and demulcent agents may be given--1 dram of anise water, 1 dram nitrate of bismuth, and 1 dram of gum arabic, three times a day. Under such course the Page 37 3 matches branches of blood vessels which pass into the bones through holes (foramina) on their surface and are distributed in the soft structure (medulla) of the inside. The structure of the Page 38 2 matches mined. If the animal is young, valuable, and of reasonably quiet temperament, and the fracture is not too great in extent, the chances of recovery are fair. On the other hand, if the Page 39 3 matches l soon be noticeable. FRACTURES OF THE PELVIS.--The pelvis, or bony framework which gives shape to the posterior part of the body, is liable to fracture in many ways. A common one is Page 41 1 match e operation will better fit him for his work by so modifying his temperament and physical condition that he may easily be controlled by his master. Again, if he is merely to be used f Page 42 1 match of the organism together; bony tumors add nothing to the supporting framework of the body; the tissue of fatty tumors never serves as a storehouse of feed and energy; the cells of an Page 43 2 matches o the swelling. Injections of iodin solution, 5 grains of iodin in 1 dram of 25 per cent alcohol, may also be made into the substance of the gland. When the swelling which follows thi Page 45 5 matches xposing the exuding dermis, an application of boric-acid solution, 2 drams of the acid to 8 ounces of water, often relieves the smarting or itching, and also serves to check the exuda Page 46 1 match ed much shock, the animal may require internal stimulants, such as 2 drams of carbonate of ammonia every hour until it rallies. When the pain is very great, hypodermic injections of 6 Page 47 2 matches elieve it from foreign bodies which may fall upon it. It has for its framework a fibro-cartilage, irregular in shape, thick, nearly prismatic at its base, and thin anteriorly where it Page 48 5 matches onics may be given in the feed, namely, powdered sulphate of iron, 1 dram; gentian, 2 drams; nux vomica, one-half dram; to be given twice a day. In cases of rheumatism, one-half ounce Page 51 1 match s._--Owing to the complexity of the structure of the lung tissue, its ramifications of bronchial tubes and blood vessels, and its abundant supply of lymphatics, the pathological chang Page 54 4 matches ourse of the disease headache, pain in the limbs, vertigo, abdominal cramps, vomiting, diarrhea, and weakness are occasionally observed. The disease is seldom fatal, usually appearing Page 56 1 match readily be differentiated from rabies by the persistence of muscular cramps, especially of the face and abdomen, which cause these muscles to become set and as hard as wood. In tetanu Page 57 1 match _a_) is ulcerated and covered with yellowish cheesy particles. The supramammary lymphatic gland (_b_) is greatly enlarged and contains many miliary tubercular foci. * * Page 62 6 matches e cure. The iodid of potassium is given in doses of 1-1/2 and 2-1/2 drams once a day, dissolved in water, and administered as a drench. The dose should vary somewhat with the size of Page 64 2 matches 5µ to 1µ. Hence it is described as polymorphic. It does not stain by Gram, but takes the ordinary anilin dyes, often presenting, especially the longer forms, a beaded appearance. A ch Page 65 3 matches mouth make an excellent treatment. The internal administration of 2 grams of salicylic acid and 3 grams of chlorate of potassium three times a day has also proved to be very benefici Page 69 1 match ng the intestines with intestinal antiseptics, such as tannopin in 1 dram doses twice daily, and strengthening the animal by the use of stimulants such as strychnin in half-grain dose Page 72 2 matches organisms apparently are in no way injurious. A species of fluke (_Paramphistomum cervi_ or a closely related species) is occasionally found in North American cattle, especially gras Page 73 6 matches f fluke disease. Moussu states that the average dose for cattle is 1 gram of the extract for each 10 kilograms of live weight; that is, 10 grams for a young animal weighing 100 kilogr Page 75 1 match milk, protection from flies, 503 Cramps of hind limbs during pregnancy, cause, 162 Cranium, fracture, description and trea Page 77 1 match arts of body, cause, 109 _Paramphistonum cervi_, parasite affecting cattle, 519 Paraplegia, symptoms and treatment, Page 78 3 matches , caused by twisted wireworm, treatment, 527 Pregnancy-- cramps of hind limbs during, cause, 162 duration,
be infected while the rest of the herd remain well, or it may appear as 19967 characters on this page
be infected while the rest of the herd remain well, or it may appear as an epizootic attacking a large number at about the same time. _Symptoms._--The symptoms in cattle vary considerably, according as the disease begins in the skin, in the lungs, or in the intestines. They depend also on the severity of the attack. Thus we may have what is called anthrax peracutus or apoplectiform, when the animal dies very suddenly as if from apoplexy. Such cases usually occur in the beginning of an outbreak. The animal, without having shown any signs of disease, suddenly drops in the pasture and dies in convulsions, or one apparently well at night is found dead in the morning. The second type (anthrax acutis), without any external swellings, is the one most commonly observed in cattle. The disease begins with a high fever. The temperature may reach 106∞ to 107∞ F. The pulse beats from 80 to 100 a minute. Feeding and rumination are suspended. Chills and muscular tremors may appear and the skin show uneven temperature. The ears and base of the horns are cold, the coat staring. The animals are dull and stupid and manifest great weakness. To these symptoms others are added in the course of the disease. The dullness may give way to great uneasiness, champing of the jaws, spasms of the limbs, kicking and pawing the ground. The breathing may become labored. The nostrils then dilate, the mouth is open, the head raised, and all muscles of the chest are strained during breathing, while the visible mucous membranes (nose, mouth, rectum, and vagina) become bluish. If the disease has started in the bowels, there is much pain, as shown by the moaning of the animal; the discharges, at first firm, become softer and covered with serum, mucus, and blood. As the disease approaches the fatal termination the weakness of the animal increases. It leans against supports or lies down. Blood vessels may rupture and give rise to spots of blood on the various mucous membranes and bloody discharges from nose, mouth, rectum, and vagina. The urine not infrequently contains blood (red water), and death ensues within one or two days. A third type of the disease (anthrax subacutus), which is rarely observed, includes those cases in which the disease is more prolonged. It may last from three to seven days and terminate fatally or end in recovery. In this type, the symptoms are practically as described in the acute form, only less marked. In connection with these types of intestinal anthrax, swellings may appear in different parts of the body under the skin, or the disease may start from such a swelling, caused by the inoculation of anthrax spores in one of the several different ways already described. If the disease begins in the skin, it agrees in general with the subacute form in prolonged duration, and it may occasionally terminate in recovery if the swellings are thoroughly incised and treated. _Lesions._--These swellings appear as edemas and carbuncles. The former are doughy tumors of a more or less flattish form passing gradually into the surrounding healthy tissue. As a rule, they are situated beneath the skin in the fatty layer, and the skin itself is at first of healthy appearance, so that they are often overlooked, especially when covered with a good coat of hair. When they are cut open they are found to consist of a peculiar, jellylike mass of a yellowish color and more or less stained with blood. The carbuncles are firm, hot, tender swellings, which later become cool and painless and undergo mortification. The edemas and carbuncles may also appear in the mouth, pharynx, larynx, in the tongue, and in the rectum. The bodies of cattle which have died of anthrax soon lose their rigidity and become bloated, because decomposition sets in very rapidly. From the mouth, nose, and anus bloodstained fluid flows in small quantities. When such carcasses are opened and examined it is found that nearly all organs are sprinkled with spots of blood or extravasations of various sizes. The spleen is enlarged from two to five times, the pulp blackish and soft and occasionally disintegrated. The blood is of tarry consistency, not firmly coagulated, and blackish in color. In the abdomen, the thoracic cavity, and in the pericardium, or bag surrounding the heart, more or less blood-stained fluid is present. In addition to these characteristic signs, the carbuncles and swellings under the skin, already described, will aid in determining the true nature of the disease. The most reliable method of diagnosis is the examination of the blood and tissues for anthrax bacilli, which requires a trained bacteriologist. The cases of fatal anthrax number from 70 to 90 per cent, and are usually more numerous at the first outbreak of the disease. _Differential diagnosis._--The diagnosis from blackleg may be made by noting the subcutaneous swellings which appear upon the patient. Those of blackleg are found to crackle under pressure with the finger, owing to the presence of gas within the tissues, while the tumors of anthrax, being caused by the pressure of serum, are entirely free from this quality and have a somewhat doughy consistence. The tumors of blackleg are usually on the shoulder or thigh and are not found so frequently about the neck and side of the body as are the swellings of anthrax. The blood of animals dead of blackleg is normal, and the spleen does not appear swollen or darkened, as in those affected with anthrax. The chief differences between anthrax and Texas fever are that the course of the former is more acute and the blood of the animal is dark and of a tarlike consistence, while in the latter it is thinner than normal. The presence of Texas-fever ticks on the cattle would also lead one to suspect that disease in regions where cattle are not immune from it. _Treatment._--In cases which originate from external wounds, the swellings should be opened freely by long incisions with a sharp knife and washed several times daily with carbolic-acid solution (1 ounce to a quart of water). Care should be taken to disinfect thoroughly any fluid discharge that may follow the incision. When suppuration has set in the treatment recommended in the chapter on wounds should be carried out. In the treatment of animals showing symptoms of anthrax, the serum recommended under the next heading of "Prevention" should be administered in large doses. Animals showing only a high temperature with no other symptoms of the disease should be given from 30 to 50 cubic centimeters of the serum, but if the gravity of the disease is pronounced 100 cubic centimeters should be administered. In most instances a drop in temperature may be observed and a diminishing of the severity of the symptoms. At times, however, a relapse occurs about the second or third day following the serum injection, when it becomes necessary to administer another dose of serum. It has been proved that animals affected with anthrax may recover after injections of potent serum. _Prevention._--In this disease prevention is the most important subject demanding consideration. The various means to be suggested may be brought under two heads: (1) The surroundings of the animal, and (2) preventive inoculation. (1) Surroundings.--What has already been stated of those conditions of the pastures which are favorable to anthrax, after a little thought, will suggest to most minds some of the preventive measures which may be of service in reducing losses in anthrax localities. All that conduces to a better state of the soil should be attempted. The State or Nation, by appropriate engineering, should do its share in preventing frequent inundations. If pools of stagnant water exist in the pastures, or if any particular portions are known by experience to give rise to anthrax, they should be fenced off. Efforts should likewise be made toward the proper draining of swamp lands frequented by cattle. Sometimes it has been found desirable to abandon for a season any infected or dangerous pastures. This remedy can not be carried out by most farmers, and it is liable to extend the infected territory. In some instances withdrawal of cattle from pastures entirely and feeding them in stables is said to have reduced the losses. It is of the utmost importance that carcasses of animals which have died of anthrax be properly disposed of, as every portion of such animal contains the bacilli, ready to form spores when exposed to the air. Perhaps the simplest means is to bury the carcasses deep, where they can not be exposed by dogs or wild animals. It may be necessary to bury them on the pasture, but it is better to remove them to places not frequented by susceptible animals and to a point where drainage from the graves can not infect any water supply. If they are moved some distance it must be borne in mind that the ground and all objects which have come in contact with the carcass should be disinfected. This is best accomplished with chlorid of lime. For washing utensils, etc., a 5 per cent solution may be prepared by adding 3 ounces to 2 quarts of water. This should be prepared fresh from the powder, and it is but little trouble to have a small tin measure of known capacity to dip out the powder, to be added to the water whenever necessary. The carcass and the ground should be sprinkled with powdered chlorid, or, if this is not at hand, an abundance of ordinary, unslaked lime should be used in its place. The removal of carcasses to rendering establishments is always fraught with danger, unless those who handle them are thoroughly aware of the danger of scattering the virus by careless handling in wagons that are not tight. As a rule, the persons in charge of such transfer have no training for this important work, so that deep burial is to be preferred. Burning large carcasses is not always feasible; it is, however, the most certain means of destroying infectious material of any kind, and should be resorted to whenever practicable and economical. All carcasses, whether buried, rendered, or burned, should be disposed of unopened. When stables have become infected they should be thoroughly cleaned out, and the solution of chlorid of lime freely applied on floors and woodwork. The feed should be carefully protected from contamination with the manure or other discharges from the sick. (2) Preventive inoculation.--One of the most important discoveries in connection with the disease was made by Louis Pasteur in 1881, and consisted in the new principle of producing immunity by the inoculation of weakened cultures of the bacillus causing the disease. This method has been quite extensively adopted in France, and to some extent in other European countries, and in the United States. The fluid used for inoculation consists of bouillon in which modified anthrax bacilli have multiplied and are present in large numbers. The bacilli have been modified by heat so that to a certain degree they have lost their original virulence. Two vaccines are prepared. The first or weaker, for the first inoculation, is obtained by subjecting the bacilli to the attenuating effects of heat for a longer period of time than in the case of the second, or stronger vaccine, for a second inoculation some 12 days later. There are several difficulties inherent in the practical application of Pasteur's vaccine. Among them may be mentioned the variable degree of attenuation of different tubes of the vaccine and the varying susceptibility of the animals to be inoculated. The use of this vaccine is increasing, nevertheless, and has reduced the mortality in the affected districts from an average of 10 per cent in the case of sheep, to less than 1 per cent, and from 5 per cent with cattle, to less than one-half of 1 per cent. It is very important to call attention to the possibility of distributing anthrax by this method of protective inoculation, as the bacilli themselves are present in the culture liquid. It is true that they have been modified and weakened by the process adopted by Pasteur, but it is not impossible for such modified virus to regain its original virulence after it has been scattered broadcast by the inoculation of large herds. It is obviously unsafe to have such vaccine injected by a layman; instead, it should be handled only by a competent veterinarian. There are other disadvantages in this method of vaccination, and they all must be given due consideration. The unstable keeping quality of the Pasteur vaccine is a very important factor to be considered. Experience in this line has proved that Pasteur vaccine may deteriorate within a very short time after its preparation, and in repeated instances it has proved inert within three months of its preparation. When exposed to warm temperature and light, it deteriorates very rapidly; and when it is considered that the products of manufacturers may be stored under unfavorable conditions in branch houses and on the shelves of rural drug stores, the loss of potency can be readily explained. These deficiencies have been recognized by many investigators, and because of the superior keeping qualities particular attention has been directed toward the preparation of a spore vaccine by Zenkowsky of Russia, Detre of Hungary, and Nitta of Japan. For the purpose of producing a spore vaccine it is desirable to use a peptone-free agar medium, and after inoculation with an attenuated culture of the anthrax bacillus, it is allowed to grow at a temperature of 37∞ C. for 4 to 7 days. By this time an abundance of spores will have formed. The growth is then collected in sterile flasks and heated to a temperature of 60∞ C. for one-half hour to destroy the vegetative forms of the organism. If it is desired to use for vaccination one million spores, it is advisable to dilute the vaccine to a quantity of which 1 cubic centimeter would contain this number. Of such a vaccine 1 cubic centimeter would constitute the dose for cattle and horses. In all forms of vaccination against anthrax in sheep the greatest care must be exercised, as these animals are very susceptible to the disease, and at times vaccines which have no ill effects on cattle will prove fatal to sheep. Therefore the dose of the spore vaccine for sheep should not be more than one-fourth of that given to cattle. Sclavo, Sobernheim, and others have established that injections of increasing quantities of virulent cultures into immune animals produced a serum which has great protective value against anthrax. Such protective serum may be produced in the various susceptible animals. For immunization purposes it is advisable to use the simultaneous method; that is, both the spore vaccine and the anthrax serum should be injected. It is desirable to divide the herd to be treated into groups of ten or twelve and inject, first, each animal of the group with the serum, following this with the injection of the spore vaccine. The serum should be injected on one side, either on the neck or back of the shoulder, and the spore vaccine on the other side, injections being made subcutaneously. In herds in which the disease has already made its appearance it is necessary to take the temperatures of all the animals and to subject to the simultaneous vaccination only those that show no rise in temperature. All others should be given the serum-alone treatment in doses varying in accordance with the severity of the symptoms manifested by the individual animals. If the examination reveals a considerable number of infections, it is advisable to use the serum alone for all the animals, and in three or four weeks to revaccinate by the simultaneous method. The dosage should depend on the potency of the serum, serum of a high potency naturally being most desirable. Thus serum in 10 cubic centimeter doses for large animals, and 3 to 5 cubic centimeter doses for smaller ones, has been found to be effective in producing a temporary immunity. As anthrax is entirely different from blackleg, vaccine for the latter does not act as a preventive against the former. ANTHRAX IN MAN (MALIGNANT PUSTULE, OR CARBUNCLE). Anthrax may be transmitted to man in handling the carcasses and hides of animals which have succumbed to the disease. The infection usually takes place through some abrasion or slight wound of the skin into which the anthrax spores, or bacilli, find their way. The point of inoculation appears at first as a dark point or patch, compared by some writers to the sting of a flea. After a few hours this is changed into a reddened pimple, which bears on its summit, usually around a hair, a yellowish blister, or vesicle, which later on becomes red or bluish in color. The burning sensation in this stage is very great. Later this pimple enlarges, its center becomes dry, gangrenous, and is surrounded by an elevated, discolored swelling. The center becomes drier and more leatherlike, and sinks in as the whole increases in size. The skin around this swelling or carbuncle is stained yellow or bluish, and is not infrequently swollen and doughy to the touch. The carbuncle itself rarely grows larger than a pea or a small nut, and is but slightly painful. Anthrax swellings or edemas, already described as occurring in cattle, may also be found in man, and they are at times so extensive as to produce distortion in the appearance of the part of the body on which they are found. The color of the skin over these swellings varies according to the situation and thickness of the skin and the stage of the disease, and may be white, red, bluish, or blackish. As sooner or later these carbuncles and swellings may lead to an infection of the entire body, and thus be fatal, surgical assistance should at once be called if there is well-grounded suspicion that any swellings resembling those described above have been caused by inoculation with anthrax virus. Inasmuch as physicians differ as to medicinal treatment of such accidents in man, it would be out of place to make any suggestions in this connection. Extensive data are available, however, on the effectiveness of anthrax serum for the treatment of the disease in man. It is recommended that from 30 to 40 cubic centimeters of serum be injected in three or four different places. Should no improvement follow in 24 hours additional injections of 20 to 30 cubic centimeters should be administered. In most instances the results are favorable, and this treatment is acknowledged to be superior to any other mode of treatment known for the disease. To show that the transmission of anthrax to man is not so very uncommon, we take the following figures from the 1890 report of the German Government: The attention of the authorities was brought to 111 cases, of which 11 terminated fatally. The largest number of inoculations were caused by the slaughtering, opening, and skinning of animals affected with anthrax; hence, the butchers suffered most extensively. Of the 111 thus affected, 36 belonged to this craft. Infected shaving brushes also are very dangerous. In addition to anthrax of the skin (known as malignant pustule), human beings are subject, though very rarely, to the disease of the lungs and the digestive organs. In the former case the spores are inhaled by workmen in establishments in which wool, hides, and rags are worked over, and it is therefore known as woolsorter's disease. In the latter case the disease is contracted by eating the flesh of diseased animals which has not been thoroughly cooked. These forms of the disease are more fatal than those in which the disease starts from the skin. BLACKLEG. [Pl. XLII.] Blackleg, black quarter, quarter ill, symptomatic anthrax, charbon symptomatique of the French, Rauschbrand of the Germans, is a rapidly fatal, infectious disease of young cattle, associated with external swellings which emit a crackling sound when handled. This disease was formerly regarded identical with anthrax, but investigations by various
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PUBLIC-DOMAIN BOOK Special Report on Diseases of Cattle United States Bureau of Animal Industryprimary
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