Cough, its artificial production, precautions, character in different animals. Cough in disease, strong, full, ringing, weak, short, broken, abortive, dry, rasping, croupy, small, husky, soft, humid, rattling, mucous, paroxysmal, sympathetic, wheezing, roaring, whistling, grunt, moan. Expectoration, nasal in horse, also buccal in other animals. Morbid expectoration, watery, viscid, cloudy, flocculent, purulent, rusty, cretaceous, parasitic, fœtid, varicolored, microbic. Expired air, warm, cool, vegetable odor, acid, fœtid, heavy. Respiration, number in health, alteration in disease, rapid, slow, tardy, short, catching, quick, deep, labored. Position, standing, lying. Pleuritic breathing, broken winded.
Before describing specific diseases, it is needful to consider the methods of physical diagnosis which enable the practitioner to differentiate the diseases of the chest. Some of the following remarks will bear equally on diseases of the nose and throat as well.
The cough so varied in health and in disease deserves careful practical study. It can usually be excited in solipedes, sheep and dogs by pinching the first ring of the windpipe between the thumb and first two fingers. In oxen it is best produced by compressing the anterior part of the larynx. In old cattle it is difficult to produce coughing. In no animal should the attempt be made rudely nor unnecessarily repeated, as it may tend to excite or to aggravate already existing sore throat.
The cough of the healthy horse is sharp, loud and ringing, often repeated two or three times and followed by a snort (clearing of himself). It is weaker in young horses and shorter and drier in the aged.
The usual cough of the ox is weak, dry, slightly husky and prolonged.
That of the sheep, small, weak and dry.
That of the dog, also weak and dry.
A strong, full, deep, ringing cough is rarely heard in disease except in slight irritation of the larynx. In such cases the larynx is tender and slight handling or pinching develops the cough.
A weak cough wanting in resonance and heard only at a short distance from the horse, is usually associated with chronic chest diseases and the last stages of acute thoracic inflammations.
A short, broken or abortive cough is one which appears to be suddenly cut short and suppressed, from the pain it causes. It is seen in the early stages of inflammations of the serous membranes of the chest or abdomen, when the quick rubbing of the dry and inflamed surfaces of these membranes on each other produces exquisite pain. It characterizes especially the debut of pleurisy, pleuro-pneumonia and peritonitis. This cough is infrequent for the same reason that it is short.
A dry, loud, rasping, or croupous cough is peculiar to the early stages of laryngitis, tracheitis and bronchitis, when the membrane is swollen, tense and dry. It is equally met with in diphtheritic and croupous affections implicating the larynx.
A small, weak, dry, husky cough without any rasping is characteristic of broken wind (heaves) emphysema of the lungs, asthma, or chronic bronchitis.
A soft, humid or rattling cough exists in the advanced stages of laryngitis, bronchitis and pneumonia when the activity of the inflammation has given way and a free exudation has taken place from the mucous membrane. It is usually accompanied by a discharge, in solipedes from the nose, and in other animals from nose and mouth.
A soft cough with a peculiar gurgling in the larynx is sometimes met with in croup.
A paroxysmal cough is one repeated five, ten, or twenty times in rapid succession. It is common in chronic bronchitis, early heaves, emphysema, verminous bronchitis and influenza. In such cases it is observed chiefly when the subject is brought out to the cold air, when he takes a drink of cold water, or when he has just had some active exertion, or some dusty or fibrous food.
A symptomatic cough is one due to disease in some other organs than the respiratory, and which irritates the air passages through nervous sympathy (reflex action). It is commonly small, short and dry. Inflammation or other disease of the liver, indigestions and intestinal worms are occasional causes of symptomatic cough. In the case of worms it may be loud, clear and ringing.
Besides cough may be noticed the wheezing breathing characteristic of broken wind, chronic bronchitis and asthma, roaring, whistling, etc., as already described, and the sound between a moan and grunt, produced in pneumonia especially in the ox.
This escapes almost exclusively by the nose in horses, because of the length of the soft palate. It may come from the mouth of other animals, especially when they cough. In the ox the discharge from the nose is rarely seen because of his licking it out with his tongue. Rattles (râles) in the larynx, trachea or bronchia, enable us to ascertain the source of such discharges.
The nasal discharge in acute catarrh, laryngitis or bronchitis, is thin, clear, and slightly viscid, becoming thick, whitish and flocculent as the disease advances. It is yellowish, thick, flocculent and intermixed with shreds of false membranes in diphtheria or in the croup of young foals and calves. It is clear, slightly viscid and watery at the onset of bronchitis. At the debut of pneumonia it is often reddish (rusty). It is bright, red, frothy and bloody in hæmoptysis. It is scanty, clear, watery, and containing minute white flocculi in pulmonary emphysema (broken wind). It is white, thick, curdy, and devoid of viscidity in chronic bronchitis or when a pulmonary abscess is being emptied. It is grayish, thick and flocculent in advanced pneumonia in the horse.
Cows in the advanced stages of pulmonary tuberculosis expectorate a yellowish, sticky matter containing minute hard masses often cretaceous. Calves and lambs suffering from strongyli in the lungs expel these in little pellets in the midst of a thick white material.
The expectoration is fetid, dark red and grumous in gangrene of the lungs.
In pulmonary tuberculosis and glanders the expectoration usually contains the respective bacilli.
The breath is sensibly warmer in excited breathing, high fever, and acute bronchitis and pneumonia. It is cool in most chronic diseases, in advanced consumption and hydrothorax. Its odor is vegetable and acid in the acute indigestions of cattle, and fetid in many chronic diseases of the air passages attended with destruction of tissue, or the escape of imprisoned pus, but especially fetid in gangrenous sore throat or gangrene of the lung.
The number of respirations in a given time may afford valuable indications in the horse but in the other domestic animals variation in number imports little. In the ox for instance, the respirations in health may vary from twelve to eighty per minute, according to the heat of the cowhouse, the plentitude of the abdominal organs and other circumstances. So in the sheep and dog slight causes, quite compatible with health, may cause the breathing to become short, panting and hurried.
The young horse breathes ten to twelve times per minute, the adult animal nine to ten. Any excitement accelerates. A horse walked a few hundred yards had the respirations increased from ten to twenty-eight per minute; after trotting five minutes they numbered fifty-two; after galloping five minutes sixty-five.
Hurried breathing occurring independently of exercise, heat of the atmosphere, or distension of the abdomen, is indicative of fever, especially if associated with rapid pulse and increased heat of the body.
Infrequent respiration appears in certain brain diseases in the intervals between the more violent paroxysms, also in poisoning by opium and other narcotics. Tardy or slow respirations differ from those last noticed in the act occupying a longer time. In infrequent breathing the act may be short, though there are few respirations in the minute. This is likewise seen in brain diseases and sometimes in broken wind. In the last case there is double action of the flank, each act of expiration being effected by two successive and distinct elevations of the flank.
Quick breathing in which the act occupies only a short time is usually abruptly cut off, the inspiration terminating by a catch or jerk. It is significant of the early stage of pleurisy, and arises from the desire to avoid the pain attendant on the rubbing together of the inflamed surfaces during deep inspirations. It is further seen in tetanus, peritonitis, pericarditis and pleurodynia.
Deep breathing with great lifting of the flanks and loins is characteristic of water in the chest, and consequent inability to inflate the lungs.
Labored breathing, which is at once hurried, deep, and without intermission, is seen in severe laryngitis, croup, capillary bronchitis, and pneumonia, in all cases alike from the difficulty experienced in introducing into the lungs the requisite amount of air. It is especially marked in double pneumonia, pleuro-pneumonia, complicated with effusion in the chest, and in old standing broken wind with dilatation of the right heart.
In all such cases where there is much interference with the æration of blood, whether from obstruction to the circulation of blood or a hindrance to the introduction of air, the horse invariably stands. The fact that he has lain down may be taken as an indication that improvement has taken place. The peculiarity is due to the sharp outline of the horse’s sternum inferiorly so that in lying down he is compelled to rest on his side and the whole weight of the body tends to compress the chest. In the ox, sheep, pig and dog, which can rest on the sternum, breathing can be carried on with comparative ease in the recumbent position, and these animals accordingly do not necessarily stand except in very extensive and violent affections of the chest.
The occurrence of a short inspiration suddenly checked and a prolonged expiration characterizes pleurisy, the check to the inspiratory act being because of the pain caused by dilating the thorax.
The double lifting of the flank in expiration:—the act appearing to be performed by two distinct and successive acts is one of the most prominent symptoms of broken wind, but is not peculiar to this disorder. In the horse it exists in chronic bronchitis, dilatation of the right heart, old standing hydrothorax, and diaphragmatic hernia. It is further frequent in the acute diseases of the chest. In oxen it accompanies pulmonary emphysema, pulmonary consumption, dilatation of the heart, foreign bodies in the heart, and dropsy of the pericardium.
If accompanied by clear resonance over the chest, a permanent wheezing noise heard over the ribs, and the small, weak wheezy cough, it indicates emphysema (broken wind). If with strong impulse of the heart against the ribs behind the elbows, venous pulse in the jugulars, and modification of the second sound of the heart, it bespeaks cardiac dilatation or other heart disease. If with paroxysmal cough, white curdy nasal discharge and harsh rasping sounds heard at the lower part of the trachea or along the upper part of the lungs it betrays chronic bronchitis.