Definition: Structure of lesion. Nomenclature. History, smallpox, sheeppox, cowpox, horsepox. Animals susceptible: Man, sheep, cow, goat, horse, pig, dog, buffalo, camel, monkey. Microbiology: A pure contagium, particulate contagium, cocci, sporidium vaccinale. Horsepox: Early history, means of infection. Symptoms: Vesicles on lips, on heels, concretions, treatment. Cowpox: Relation to horsepox. Causes. Relation to smallpox. Observations of Ceely, Fletcher, Thiele, Klein, Martin, Reiter, Chauveau, influence of vaccination, of spring parturitions, of infected stables. Symptoms: Incubation, seat and nature of vesicle, inoculations for vaccine. Diagnosis from aphthous fever, rinderpest, eruption of mastfeeding, false cowpox, streptococcus eruption. Duration. Course. Prognosis. Treatment. Sheeppox: Synonyms. Definition. Pathogenesis: Sheep, goat, ox, dog, pig, horse. Forms: Discrete, confluent, hæmorrhagic. Distribution. Causes. Contagion; extends on air; experiments on blood; wool, hides, litter, buildings, yard, parks, railway cars, boats, clothes, manure, wine, milk, men, dogs, cats, birds, vermin, flies. Receptivity. Overcrowding, filth, starvation, neglect, wars, commerce. Recovered sheep. Disinfectants. Incubation 4 to 7 days; conditions affecting. Symptoms: Hyperthermia, general disorders, rigors, anorexia, skin blush on parts devoid of wool, red points, papules, vesicles, pustules, desiccation. Successive crops. On eye, nasal mucosa, mouth, pharynx, intestines, lungs. Confluent cases. Lesions. Prognosis. Mortality. Depreciation. Treatment. Prevention: By segregation, slaughter and disinfection; by ovination. Technique of ovination. Resulting immunity. Sheeppox in Goat: Danger of infection to sheep. Goatpox. Swinepox: From man, sheep, goat. Symptoms. Forms: Discrete, confluent. Susceptibility of young. Treatment. Prevention. Dogpox: From man; from sheep. Other eruptions in dog. Symptoms: Fever, flushed skin, red points, papules, vesicles, pustules. Discrete. Confluent. Treatment. Prevention of infection of man and sheep.
By the generic name Variola is understood a febrile malady attended by a characteristic eruption on the skin, at first papular, then becoming vesicular and finally pustular. The structure of the vesicle is so characteristic that it may be taken to indicate the variolous eruption as found in man and a variety of the domestic animals. The first indication of the lesion is the appearance on the skin of fine points of congestion like fleabites. This is followed by active diapedesis and proliferation of cells in the papillary layer and rete mucosum, constituting the nodule or pimple stage. In smallpox this is so firm and definitely outlined that it has been compared to the presence of a shot in the skin. As the proliferation of cells increases these form in separate clusters or groups, isolated from each other by septa or walls largely made up of the epidermic cells. In the next stage, therefore, when exudation takes place the lymph accumulates in the spaces occupied by the clusters of growing cells, and is found in a series of chambers more or less perfectly separated from each other, so that to evacuate the whole vesicle, each minute sac must be punctured independently. The vesicles thus differ from others caused by ordinary irritants in that each is chambered, instead of forming one common undivided sac, which may be emptied by a single puncture. In the next stage, when suppuration ensues, the septa usually undergo liquefaction, so that the liquid occupies one individed cavity in each pustule. For this reason the central depression seen in the larger vesicles (cowpox) in their early stage tends to disappear in the pustule. It may reappear later in the resulting scab. Desiccation, scabbing and desquamation complete the course of the affection, a distinct pit being left as a result of the destruction of the superficial layer of the dermis.
Nomenclature. The term variola is believed to come from the Latin varius (variegated, spotted) and pox from the Saxon pock (pouch). The specific names, drawn from these tongues sustain this view: As, variolæ vaccinæ, cowpox, kine-pox; variolæ equinæ, horsepox; variolæ ovinæ, sheeppox; variolæ caprinæ, goatpox; variolæ suillæ, swine pox; variolæ caninæ, dog pox. The term smallpox, (petite verole) is deduced from the small size of the vesicle as compared with that of cowpox, just as the same has originated the term smallpox in sheep.
History. Variola has undoubtedly existed from very ancient times. Moore found it referred to in Chinese records of 1122 years before Christ, but it was only clearly described early in the tenth century by Rhazes an Arabian physician. Gregory, however, found the name variola in Latin manuscripts in the British Museum of a much earlier date. The early epidemics of small pox have usually extended from the east, and the disposition has been to refer its origin to the crowded communities of central Asia, but nothing is certainly known as to such origin and the lack of definite recognition and description cannot be taken as implying that the disease did not exist. The extension of small pox to America in 1520 was distinctly traced to a sick negro slave landed in Mexico, and the way in which it swept the continent killing the Indians by tens of thousands, speaks strongly for its prior absence and the extraordinary susceptibility of the hitherto unaffected Indian races.
The variolæ of animals are not recorded until later, the mildness of the forms attacking cattle and horses, and the lack of close observation of the diseases of sheep furnishing a reasonable explanation. We must pass over as uncertain the lues ovium of Thomas Wallsingham, (Historia Anglicana), imported in a rotten Spanish ewe in 1274, and which prevailed for 25 years destroying nearly all the sheep of the kingdom, also the reference to the “pockes” of sheep in Chaucer’s “Pardoners’ tale” as highly uncertain. Laurent Joubert in his work on the “peste” mentions sheep pox as prevailing in 1567, and Rabelais speaks of it as prevailing in France in 1578. It prevailed in Padua in 1649, in Venice in 1664, 1672, and 1674 (Bottani), in Italy in 1690 (Ramazini), in Germany in 1687–8 (Stegman), in England in 1711, in Hungary in 1712, in France, Italy, etc., in 1714 (Kanold), in Venice and Bohemia in 1719 (Bottani), in Saxony in 1720, in Venice and France in 1723–24 (Bottani, Astruc), in Thuringia in 1725, in Siberia in 1771 (Pallas), and in Persia generally at the beginning of the 19th century (Bruce). Great Britian, long protected by her insular position, was infected by sheep from Germany in 1847 and again in 1862. Under ovination the first invasion prevailed for four years causing wide spread destruction; under strict separation based on thermometry, the second lasted but four months.
Cowpox has existed in England for centuries, but it has only attracted general attention since the introduction of vaccination by Jenner in 1796. Horsepox has existed concurrently with cowpox, the infection being habitually transferred by the hands of the milkers from horse to cow and vice versa. Jenner found it so common in the Valley of Gloucester, that he considered it as the habitual source of cowpox. Sacco recognized it at the beginning of the 19th century, Hertwig in Berlin in 1830, Röll in Vienna in 1855, and Bouley and others later in different parts of Europe.
Animals Susceptible. Variola in some form affects man, sheep, cattle, horses, goats, pigs, dogs, buffaloes, camels and monkeys.
Microbiology and Infection. It has long been well established that variola is due to contagion alone. The habitual dread of contact with a smallpox patient, shows the general appreciation of the danger of contagion, and the many epidemics, started by the introduction of a smallpox patient and thereafter spreading from that as a centre, together with the long continued immunity of certain insular or trans-oceanic countries illustrate this. One of the most striking examples is the immemorial immunity of the New World until the landing of the variolous slave in Mexico in 1520, and the immediate, rapid and destructive spread of the disease among the native tribes. Sheeppox offers a no less striking example. Prevailing for centuries in Asia and Europe, its extension to a new district was always the manifest result of the movement of infected sheep; England remained immune until her first invasion in 1847, and the second in 1862, in both cases the source was easily traced, and the disease completely extinguished by the destruction of the infection in its circumscribed area; the more distant sheep raising countries, America, North and South, Australia, Tasmania, New Zealand, South Africa, in the absence of importation of infected sheep remain free to the present time. For horsepox and cowpox the demonstration is more difficult as limited outbreaks, have occurred at intervals in different localities, traceable more or less clearly to infection from vaccinated persons, yet often mistakenly attributed to spontaneous developments of the disease. Before the days of Jenner however it prevailed habitually in certain dairying districts (Gloucestershire), and I can point to localities in New York, in which the infection is manifestly laid up in the stables, and the disease develops yearly in the heifers coming into milk for the first time and in newly purchased cows, that have not been previously exposed.
The contagion varies greatly in force in the different forms of variola, the milder horsepox or cowpox, requiring actual contact (inoculation) while in smallpox and sheeppox, infection may take place at some distance from the patient (in sheep over 200 yards).
A particulate infecting material was demonstrated by Chauveau, who filtered the virus and inoculated the filtered liquid without effect, while the solids retained on the filter invariably produced the disease.
The identity of the microbe of variola has been much discussed. Guttmann and Grigorjew found in the lymph a coccus (Staphylococcus albus variolæ), Ruete a very motile diplococcus, and others streptococcus, but in cutaneous lesions it is very difficult to exclude such elements. Pfeiffer, Guarnieri, Van der Loeff, Wasielewski and others have drawn attention to small protoplasmic bodies (manifestly protozoa) found in the vaccine lymph, and which appear to be the infecting agents. Wasielewski cultivated these on a rabbit’s cornea to the 48th generation, and from the last successfully inoculated a calf and several children.
Funck finds this sporidium vaccinale constantly in the vaccine lymph and surrounding tissue, as a refractile, amœboid, spherical organism (spore) 1 to 3μ in diameter, and, less abundantly, a round or ovoid spore cyst 25μ. These cysts are either smooth or uneven like a raspberry, and have a single or double contoured membrane. They are easily stained with Sudan III. Examined in hanging drops they are seen just under the cover glass, not on the surface of the drops. Larger flattened bodies found in the lymph, with many included spores are manifestly epithelial cells. Copiman cultivated the organism in glycerinated collodion capsules in the peritoneal cavity of rabbits and dogs, producing zoöglœea masses staining peripherically with methylene blue, and which caused typical vaccinia in calves. He found the same elements in variola of man.
This was recognized toward the end of the 18th century, in the valley of the Severn, England, by Jenner, who believed it to be the origin of cowpox, but failed apparently to distinguish it from ordinary “grease”. To-day, when we must trace each case to a preëxistent one in some animal, and ignore the question of primary origin, we must still recognize that it passes readily from horse to cow, and from cow to horse, through the hands of milkers and stable-men, but that it also has the source of vaccinated persons in the families of those handling the horses. Whether it was also often derived from the very prevalent small pox in past times is doubtful, yet it appears to have been much more common about the year 1800 than it is to-day. When once started in a stable it passes readily from horse to horse, through the hands of shoeing-smiths and grooms, including of course their aprons, brushes, sponges and rubbers, and also through blankets, bandages, litter and other things on which the virus has been received. The susceptibility of the skin in the hollow of the pastern depends mainly on the frequency of chaps and abrasions, and to a certain extent on contact with the road-mud infected by other passing animals. At times the suffering animal licks the affected part, and determines the eruption on the mouth, lips and nose (see contagious pustular stomatitis). Megnin saw cases affecting the external generative organs and transmitted between the sexes by coition. (See vesicular eruption on the genitals). All such cases should be identified by inoculation.
Hertwig, as early as 1830 recorded the existence of horsepox in Berlin, where it has been seen frequently since, and noted its transmission to man. Bouley gave evidence of its special prevalence at Paris, and of the production of typical vaccine vesicles in man by its inoculation. More recently it has been frequently observed and studied by inoculation and otherwise.
Symptoms. These, whether seen in horse, cow or man, do not differ from those of cow pox, with which it may be held to be identical. The observations of Chauveau, Warlomont, and Pfeiffer that experimental infection, intravenous, subcutaneous, intratracheal (inhalation), or by feeding almost always failed to give the general eruption which characterizes small pox and sheep pox. It remains strictly local except when inoculated on other parts of the skin or mucosa. It must be added, however, that small pox or sheep pox, when inoculated successfully on the horse, as a rule remains confined to the seat of inoculation. The constitution of the horse, like that of the cow, tends to resist its virulence.
The affected horse may show preliminary febrile symptoms, but these are usually too slight to be noticed. They are followed by heat, tenderness and swelling of some part of the skin, usually in the hollow of the pastern and perhaps the back part of the metatarsal region, with more or less (sometimes extreme) lameness. On the swollen skin may be detected nodules, which may pass early into vesicles and pustules. The eruption varies, however, as developed on the comparatively hairless lips or nose, or on the densely pilous pastern.
On the lips, or other part lightly covered with hair, one can easily follow the successive formation of the round nodule, the distinct (sometimes umbilicated) vesicle, with its clear translucent straw-colored contents, and the pustule, which bursts, forming a sore, or dries up forming a dense scab, like that of cowpox.
On the heels, or on any part thickly covered with hair, the vesicle or pustule is rarely recognized, the exudate on the contrary takes place mainly on the surface, which becomes encrusted with an abundant yellowish concretion, matting the hairs together, and sometimes literally covering them. This may be very misleading to the practitioner who expects to see the succession of fully developed vesicle and pustule, and overlooking the true nature of the malady he may allow it to spread widely in a stable.
Describing his inoculation cases, Chauveau gives the following successive phenomena:—
“From the fifth to the eighth day the points of inoculation become distinctly papular. As far as about the tenth day, the papules encrease, and become more prominent, taking the form of an extremely wide cone, with a base of ⅓ to ½ inch. During this period these large conical papules are resistant and painful on pressure, but show no elevation nor change in the epidermis, save a slightly reddish reflection in animals with white skins. Afterward supervenes a new stage which may be called the period of secretion. This commences from the ninth to the twelfth day. The epidermis, slightly raised upon all the papule, sweats out numerous drops of a limpid, very slightly yellow serosity. These drops soon concrete into yellowish, transparent crusts covering the whole surface of the pustule:—a species of characteristic crystallization, very different from the crusts that succeed the vaccine pustules in mare and cow. The secretion, which continues several days, is terminated from the thirteenth to the seventeenth day after inoculation. If then the crust is raised there is exposed a humid, pink, granular surface not projecting beyond the surrounding skin. This surface is hollowed out by a very deep central cavity, a sort of umbilicus, in which is inserted, like a nail, a projection from the deep surface of the crust.”
I would add that after recovery the hair in the seats of the nodules has a lighter color and, on the shanks and higher, remains dappled for the season.
No treatment is demanded. The application of a solution of sodium bisulphite once or twice a day, or continuously on a bandage, will greatly modify the intensity of the inflammation, and ward off complex infections. If the skin is left tender or with a disposition to crack, treat it as advised under chapped heels.
This is manifestly the same disease, and due to the same microbe as horse pox. The disease of the one genus is easily transmitted to the other and the lesions and symptoms are the same, as if the virus were derived from an animal of the same species. Differences in the local manifestations appear to be due rather to the varying conditions of the skin and hair follicles, than to any material distinction in the virus.
Causes. Aside from the germ (Sporidium vaccinale) the conditions which favor infection are: the milking of susceptible cows with imperfectly washed hands, after dressing legs, the seat of horse pox eruption; the milking of healthy cows after those affected with cowpox; and the milking with hands contaminated with the exudate in cases of vaccination of man. That susceptible cows may also be inoculated successfully from smallpox patients, under given conditions appears to be true, but in Western Europe and America this is very uncommon, and would be much more so if vaccination were universally carried out. Among those who claim the identity of small pox and cow pox may be named Ceely, Reiter, Babcock, Thiele, Voigt and Klein.
Ceely alleges the infection of five cows and one heifer, in 1839, in England, from chewing the flock of a bed on which a small pox patient had died. In 12 or 14 days they had tender congested udders, with hard pimples imbedded in the skin, followed by blisters, and brownish scabs. The milk diminished, saliva drivelled from the mouth, the cheeks were inflated and retracted, the coat stared, their feet were drawn together, and the back was arched. The disease was communicated to the owner. This was clearly an outbreak of aphthous fever, which invaded England in that year, and was still an unknown disease to medical men. The implication of the heifer which would not have been inoculated with variola through the hands of the milker, and the salivation which is unknown in cow pox, but points directly to the buccal vesicles of foot and mouth disease, are conclusive on this point.
Ceely later, after many fruitless attempts to convey smallpox to the cow, at last met with results which indicated cowpox, and which he thereafter passed from cow to cow with the characteristic cowpox eruption.
Fletcher further reports the transmission of smallpox through the horse to the cow, and thence to the child in the form of cowpox.
In 1836, Thiele, Kasan, S. Russia inoculated some cows on the udder with smallpox lymph, and conveyed the lymph of the resulting vesicles back to man, and from man to man for seventy-five generations of the virus without finding any variation from the type of the true vaccine disease. He repeated the experiment with equal success in 1838.
Such experiments, made before the days of careful antiseptic, or aseptic, laboratory methods, by men who were daily engaged in making vaccinations, cannot be very implicitly relied on, yet the success of Thiele in Central Asia, the early home of variola, may indicate the possibility of a transition, under given eastern conditions, which, to say the least, is exceedingly rare in Western Europe or America.
The experiments of Klein, conducted under modern methods, are more conclusive, and seem to imply the possibility of smallpox passing into cowpox, in the bovine system, under some not yet clearly defined conditions. Until such conditions are sufficiently well known, so that they can be controlled at will, no one can be justified in attempting to produce lymph for vaccination by simply passing smallpox virus through the system of the cow.
It seems important to note one or two instances of the evident transmission of smallpox from man to man through the bovine system.
In 1860, Martin inoculated variolous matter, from a man who had just died of smallpox, on a cow’s udder, and subsequently inoculated about fifty persons from the eruption caused in the cow. Most of those so inoculated had unmistakable smallpox and three died.
Reiter had a very similar experience.
Chauveau (French Commission) inoculated twelve susceptible cattle with smallpox virus and produced, in all but one, small conical (smallpox) papules and vesicles, and in ten of these, on subsequent inoculation with cowpox, six proved immune, three had rudimentary pustules, and one had a distinct cowpox eruption.
A milch cow and two heifers were inoculated with smallpox and cowpox on two sides of the vulva, with the result that each disease appeared in the seat of its inoculation, with its characteristic vesicles, and the two developed side by side. The smallpox vesicles were by inoculation conveyed from ox to ox with steadily decreasing activity. Inoculated from the cow on a child, it caused great hyperthermia, vomiting, one large vesicle like vaccinia and a general eruption like varioloid. Inoculation from this child upon another produced a mixed eruption of cowpox and varioloid. Inoculation from the second child on a bull and heifer produced papular eruption only.
Smallpox virus, inoculated on a horse produced a papular eruption, but failed to affect another horse that had been previously vaccinated. Cowpox virus inoculated on the first horse which had had the papular eruption, caused a second papular eruption (not cowpox). The virus from a vesicle in the first horse caused a similar eruption in another horse, on which it was inoculated. The lymph from the papular eruption led to a similar eruption in cattle, on which it was inoculated, but did not protect against cowpox, subsequently inoculated.
The lymph from the papular eruption in the horse, inoculated on two children, produced fever, vomiting, a general papular (smallpox) eruption, in which a few of the pustules only showed a tendency to umbilication. A child and its mother in the same ward contracted varioloid. A child inoculated from one of the first named children, had six large umbilicated vesicles like cowpox and a general papular (smallpox) eruption. Another child inoculated from the last had six large umbilicated vesicles, and a general papular (smallpox) eruption. From the papular eruption of one of these children a horse and seven cattle were inoculated and in all a varioloid eruption resulted.
The rational conclusion is, that while there is every indication of a primal identity of the two diseases, and indeed of all forms of variola, as shown by a disposition of the virus from one genus, when inoculated upon a totally different genus, to show some indication of the characteristic eruption of the latter, yet the generic type, which comes from the long continued growth in the one class of animal, becomes so fixed, that it cannot be overcome at once, and sometimes apparently not at all, by transferring it to an animal of another class.
If the unfortunate results obtained by Martin, Reiter, and Chauveau, are insufficient to deter from the use of smallpox lymph which has been passed through the cow, the long experience with humanized vaccine, which in its inoculation from man to man for a century has shown no tendency to revert to smallpox virus should be a sufficient warning against such dangerous optimism.
No deduction can be safely drawn from the comparative mildness of most of the cases caused by reinoculation from cow or horse to man, inasmuch as that all forms of variola can be rendered less severe by resorting to inoculation, which was extensively practised to limit the ravages of smallpox before the days of vaccination, and is still largely resorted to in the case of sheeppox in Europe. In each of these diseases the mortality can easily be reduced to 2 per cent. instead of the 20 to 50 per cent. which are lost when the disease is contracted casually.
As occurring casually, cowpox like horsepox is rare. Yet in Denmark, a dairying country, 1,037 cases were reported in 1877–8, and 878 cases in 1888–9. I have found some outbreaks explainable, through the existence of vaccinations in the families of the milkers, and Bollinger says that in Germany, most outbreaks take place in spring, the time when children are vaccinated. He should have added that this is the usual time of parturition in the cow, the time when primipara are first subjected to the danger from the hands of the milker, and when the cow from the noninfected district is brought into an infected stable for the season’s milking. In a dairying district in Tompkins Co., N.Y., the affection appeared every spring, in the same barns, in heifers with their first calf and in newly bought cows. All older cows, bulls, steers and unimpregnated heifers escaped.
Symptoms. The period of incubation is two days, after inoculation, and though it may appear to extend to a week when the disease is contracted accidently, it is impossible in such cases to state the exact date of infection. The preliminary fever is not always present, or recognized, yet there may be slight encrease of temperature, partial impairment of appetite and rumination, extra firmness of the fæces, a higher color of the urine, and above all a slight diminution of milk, which is a little more watery and coagulates more readily, than the normal.
This is followed by heat and tenderness of the udder and the appearance on the teats of small, pale red nodules the size of a pea or larger. In one or two days more the nodule, largely encreased in size, presents in the centre a depressed or umbilicated bluish white portion, with a firm yellowish, reddish or reddish blue margin, and outside this a soft pink areola, shading off into the white skin. The epidermis is raised at points by a viscid, yellowish lymph, enclosed in a series of saccules (multilocular vesicle). The vesicle encreases to 8 or 10 lines in diameter by the eighth or tenth day, and exceptionally, the umbilication is effaced by the excessive production of lymph. If left unbroken a brownish shade appears in the centre and gradually extends toward the periphery, the contents becoming purulent, and the pustule gradually drying up to form a crust. The drying and thickening of the crust goes on until the fourteenth day and the crust is usually detached by the twentieth, leaving a pale rose colored, smooth, shallow depression, which forms the permanent pit left after the skin has healed. The primary scabs usually show the central umbilication, and always the conical projection in the center of the deep aspect, and corresponding to the pit.
Vesicles on the mammæ may pass through the above stages, but those on the teats are usually ruptured by the hands of the milker as soon as the liquid is thrown out, and this gives rise to troublesome sores, with complex infections, at times implicating the gland tissue so as to cause destructive mammitis with loss of one or more quarters, and in any case abraded and irritated at each milking, so that the animal resists handling, the milk is drawn off imperfectly, and dries up or the cow becomes an inveterate kicker. If the milker has not been vaccinated he is liable to contract the disease.
A succession of vesicles often appear on the same animal, so that they may be found in all different stages of vesicle, pustule and crust on the same bag at one time. The later eruptions may be the result of inoculation from the earlier ones, and tend to prolong the attack materially.
In inoculation of the bovine animal for the production of lymph for vaccination, the skin of the abdomen from the symphysis pubis to the umbilicus is shaved, or in other cases the skin between the thighs, or in still others the skin on each side over the loins, and the virus applied in 50 to 200 points, by preference scraped until liquid oozes, but without any escape of blood. In a warm room the eruption matures in four or five days, its form taking on an appearance approximating that seen on the hairy skin of the horse. The individual lesions are somewhat extended corresponding in form and size to the abrasion on which the lymph was applied, and usually present the appearance of a raised patch, covered by a grayish film of epidermis, on the removal of which there is seen a raw alveolated surface filled with the amber-colored lymph.
Differential Diagnosis. From aphthous fever, cowpox is clearly distinguished by (a) the multilocular structure of the vesicle, while that of aphthous fever is a single undivided cavity which can be drained completely by a single needle prick; (b) by the pitting or umbilication, the aphthous vesicle being uniformly rounded and convex; (c) by the absence of vesicles or sores on the mouth and feet, which are rarely wanting in the aphthous eruption; (d) by the comparative absence of hyperthermia and constitutional disturbance, which is better marked though still slight in aphthous fever, and (e) by the absence of the intense and subtle infection of aphthous fever, which quickly attacks a whole herd and extends with equal rapidity over sheep, goats and pigs, attacking all cloven-footed animals virtually without exception. The cowpox patient, on the contrary, does not necessarily attack the cow in the next stall unless milked by the same hands, and spares heifers, bulls, steers, sheep, goats and pigs.
From the rinderpest cutaneous eruption it is easily distinguished by the presence of lymph in the lesion, that of rinderpest being a mere epidermic concretion; by the absence of the intense fever, anorexia and general constitutional disturbance, and of the early and high mortality which characterize that disease; by the absence of rapid and uniform infection of other cattle irrespective of a common milker; by the immunity of heifers, steers and bulls, which are speedily prostrated by rinderpest, and by the absence of the congestions and epithelial concretions of the mucosæ which characterize rinderpest.
From the leg irruption found in animals feeding on distiller’s swill and grains, or on the mast of beet sugar factories, by the history of the outbreak, of the dietary, of the seat and nature of the disease, and by the escape of animals living on a different aliment.
From the false cowpox (varicella) it is distinguished by the unilocular lesion of the latter, its absence of areola, and its rapid pustulation and drying, in five or six days into a thin papery crust instead of a thick, firm, umbilicated scab, as in cowpox. Varicella is further liable to appear in successive crops and thus last for several weeks.
The streptococcus eruption on teats and udder, is marked by the formation of abscesses of various sizes from a simple pustule upward, by the unilocular condition of the pus sac, by its tendency to invade the deeper tissues, and by its rupture and granulation without the formation of the thick umbilicated scab of cowpox.
The hard warty growths on the teats which last for weeks or months should never be mistaken for cowpox.
Cowpox usually lasts for some weeks in a herd, the duration depending on the number of susceptible animals and, whether these are habitually milked by the same person.
Course. Prognosis. It is a mild affection, which does not endanger life, yet it causes considerable loss through diminution of the milk secretion and, it may be, altered character of the milk, through the persistent sores and ulcers of the teats, through inflammation of the mammæ, and through an acquired habit of kicking.
Treatment is rarely needed. Any costiveness should be corrected by a cooling saline laxative (½ to 1 lb. Epsom salts) or by soft food, and milking should be done with great care to prevent rupture of the vesicles and the formation of sores. A teat tube may be used if necessary. Sores may be dressed with bland ointment. An ounce each of spermacetti and sweet almond oil with half a dram of gum myrrh. Or the vesicles or sores may be washed after each milking with a solution of 2 drams hyposulphite of soda in 1 quart water.
Synonyms. Pocks; Peltrot; Clavelee, Picotte, (Fr.).
Definition. An acute febrile affection, eminently contagious, prevailing epizoötically in sheep and goats, characterized by early and marked hyperthermia, and general constitutional disorder, followed by the appearance on the bare or merely hairy portions of the skin, of diffuse redness becoming intensified in points, a rounded papular eruption, passing into vesicles, pustules and scabs, which latter dry up and drop off in 15 to 20 days.
Pathogenesis. Beside sheep and goats which contract the disease by exposure, the following genera have been successfully inoculated: ox, dog, pig, horse.
Forms. Two typical forms are recognized: (a) the discrete, regular or benign, in which the vesicles remain relatively few, and well isolated from each other, and (b) the confluent, irregular or malignant in which the vesicles are generally diffused over the body, even on the parts covered by wool, and set so close together that they merge into each other forming extensive continuous lesions. Other forms are the hæmorrhagic, purple or black sheeppox, the volante or intermittent kind, etc.
Geographical Distribution. Formerly common in Central and Western Europe, it still prevails continuously in the Balkans, the Danubian Principalities, Italy, Spain, the South of France and Algiers. Like other forms of variola, its permanent home is in Asia.
Causes. Long before the advent of modern bacteriology, sheeppox was held to be always and everywhere the result of contagion alone. Whenever it entered a new locality it was as the result of the importation of an affected sheep or one of its products; insular places like England maintained a permanent immunity, though the disease prevailed on the other side of the narrow straits or channel; yet when imported (1847 and 1862) it demonstrated a general susceptibility of the flocks on exposure or inoculation; more distant lands (America, Australia, Tasmania, South Africa, etc.) in the absence of imported infection remain clear to the present day.
The infection is more intense and diffusible than that of cowpox and horsepox following in this the smallpox of man. Absolute contact is not necessary, in either case the infection is carried in the air either on dust or otherwise, and above all in a confined building, a crowded sheep fold or a dusty highway.
In all forms of variola the virulence is concentrated in the lymph of the vesicle, and in horsepox and cowpox it is largely confined to this, whilst in sheeppox in severe cases it must also at times infect the blood, as lambs are occasionally born with sheeppox. On this basis the infection of the secretions generally has been advocated, but it is to be supposed that in moderate cases these are contaminated after secretion. Nocard and Roux produced immunity by the transfusion of blood from the sick to the healthy, but in no case a variolous eruption. Even the serosity from the swollen lymph glands failed to convey the disease.
In view of the diffusible nature of the germ, however, we must recognize that all secretions may be quickly contaminated as soon as they are exposed, and therefore no product of a sick or suspected sheep can be held to be safe, and all should be treated as presumably infected. The most dangerous products and those most liable to convey the disease are wool, hides, litter, buildings, yards, covers, parks, railway cars, boats, manure, urine and milk.
Living creatures like men, dogs, cats, birds, vermin, flies and other predacious insects are occasional bearers of infection.
Receptivity must be considered in every case. In countries and districts habitually immune from sheeppox, all breeds appear to be equally susceptible, the only refractory specimens being sheep that have survived a first attack, and lambs born of ewes that had the disease (naturally or inoculated) during the later stages of gestation. New born lambs, on an exclusively milk diet, are alleged to be somewhat refractory. In a country where sheeppox has prevailed long and extensively, as in Algiers and Brittany, certain breeds of sheep seem to have attained to a large measure of immunity (Nocard). This is doubtless largely due to the survival of the more insusceptible strains of blood, as Algerian sheep carried into France lead to most virulent outbreaks among the native animals (Galtier).
This relative immunity is still more decided when we come to animals of other genera. Though the latest results of research seem to identify the sporidia found in the different forms of variola, yet the long habit of living in an environment found in the ovine race unfits the germ for pathogenic life in various other genera that have their own variolæ. Sacco and Villain reported inoculations from sheep to man, but as the first was experimenting with variola at the same time, and the second did not test his pustules by reinoculation the results are not convincing. Küchenmeister had a general eruption in sheep after intravenous injection of variola of man, but failed to test it by reinoculation. Voisin and Nocard on the other hand were uniformly unsuccessful in attempts to convey sheeppox to man, and the handling of variolous flocks from time immemorial must have led to many cases in man, had he been appreciably receptive. It is virtually the same with cowpox. Huzard vaccinated 2,000 sheep without producing immunity from sheeppox. Voisin had precisely similar results. He further inoculated infants with sheeppox, and later, successfully, with vaccine lymph.
It does not follow that these genera would be insusceptible under all conditions. Yet the failure to immunize against each other would argue a wider divergence of sheeppox and cowpox, than of smallpox and cowpox, or than of bovine and avian tuberculosis.
Galtier failed to inoculate sheeppox on rabbits or Guinea pigs, yet Jourdan, records a destructive outbreak in the Alps, in hares, kept in the same places with variolous sheep.
Accessory External Causes. All unwholesome conditions of life, and especially overcrowding, filth, starvation, and neglect contribute to the extension of the infection. Still more so, the importation of sheep, whether in the parks of armies, or in the channels of trade, by rail, or steamboat, through stockyards or markets.
The virus is possessed of unusual vitality, and in the dried condition, secluded from air and light will remain virulent for an indefinite period. Hence the danger of wool, and dried sheepskins. Even in the moisture of an ordinary shed it has retained its infectiveness for five or six months. The sheep that has recovered from the affection may transmit the disease to others for a period of six weeks. The virulence is rapidly destroyed by exposure to free air and sunshine, by a high temperature (140° F.), by dilute HCl (2:100), by carbolic acid (2:100), by zinc chloride (5:100), by potassæ permanganas (10:100), by lime chloride (4:100), or indeed by any of the strong antiseptics.
Incubation. This extends from four to seven days on an average, with a minimum of two and a maximum of twenty days. The conditions favoring an early eruption are youth, high condition, and a hot season, or close warm building, with overcrowding. Those favoring a tardy eruption are old age, debility, and above all a cold or wet season with exposure in the open air. Simonds, who inoculated in England in the cold months (October and November) never saw it exceed 13 days. In certain cases, however when the eruption had already commenced in mild weather, the sudden occurrence of a week of cold and wet, would stop it short to start anew on the return of warm weather a week later. In inoculated cases the incubation is shortened, while it is prolonged when the virus is introduced by the digestive or respiratory passages.
Symptoms. During the last two or three days of a prolonged incubation and especially in old sheep, there may be some impairment of appetite and rumination, dulness, a stiffness of movement of the hind limbs, and a disposition to lag behind the flock. The temperature may even have risen (104.5° F.), yet Simonds has never seen the febrile symptoms precede the eruption.
There follow, trembling, or rigors, accelerated pulse (80 to 90) and breathing, arched back, anorexia, suspension of rumination, costiveness, redness of the eyes, epiphora, a watery discharge from the nose, gradually becoming more viscid, and a marked hyperthermia (105°, 106° or 107° F.) If the skin is white, a blush, with some heat, is shown in the seat of the future eruption, usually on the parts uncovered by wool, the axillæ, sternum, abdomen, udder, inner sides of the thighs, lower surface of the tail, and the face—especially the eyelids, nostrils and lips.
In two days more, deep red points, like flea bites, appear more or less numerously, in the congested parts of the skin, and in twenty-four hours these have increased to firm rounded papules which are felt to extend into the true skin. These vary in size from 3 to 12 mm. or more. In two or three days the papule has become firmer and less tender, and shows in the centre a paler area where the exudation has resolved it into a vesicle. The characteristic sheeppox vesicle is rounded or flattened on its summit, being rarely pointed as in smallpox, or umbilicated as in cowpox. It is usually surrounded by a pink zone, which is at times infiltrated, firm and resistant. After about the sixth day, the vesicle becomes yellowish from the formation of pus. The pustules, with the surrounding tumefaction, encrease for about three days, when if they have not become confluent nor infected, they begin to dry up, acquiring a grayish crust on the surface which gradually encreases to a thick scab, which in five or six days more is detached leaving a pink, pitted spot covered by forming epidermis. Sometimes no distinct scab forms, but the crust dries, cracks up, and falls off in scales.
All the vesicles do not appear at once, but some earlier and some later, so that the successive stages of the eruption may be often seen together on the same subject, and the case is thereby materially prolonged.
As in other forms of variola the hyperthermia usually subsides with the appearance of the eruption, but as often reappears in some measure with pustulation (secondary fever of reaction), and becomes more severe in proportion to the extent and confluence of the eruption and the occurrence of complex infection.
The eruption may invade the conjunctiva, the cornea (inducing blindness), the nasal mucosa (causing difficult breathing), the mouth (salivation, difficult mastication), the pharynx (difficult deglutition), the stomach and intestines (diarrhœa), the bronchia (cough), or the vulva.
With the occurrence of desiccation, in discrete cases, the fever subsides, the swelling of the skin and head disappears, the discharges from the nose and eyes cease, and the animal is restored to health.
A secondary eruption will sometimes take place, but only papules form, which disappear without reaching maturity.
The duration of discrete sheep pox is usually about three weeks, but it may reach four in cool weather. It is more rapid and more prone to dangerous complications in hot weather. As the members of a flock are usually attacked in succession, it may take three months to pass through a flock.
In confluent or complicated cases the fever of invasion is very high, the sheep dull, prostrate, tender to touch along the back and loins particularly, with hurried, labored, panting, breathing, and mawkish, fevered breath, the weakness increases rapidly, standing even may become difficult, the wool is loosened and falls off in patches, the exposed skin is red, shading, it may be, into a violet hue. The head droops, the lips and nostrils swell, saliva drivels abundantly, anorexia is complete, though thirst may be ardent, a yellowish and even reddish, fœtid discharge may flow from the nose, respiration is difficult, the eyes are watery and deeply sunken, and the head, limbs, breast and abdomen are extensively infiltrated and œdematous.
Fever does not subside with the occurrence of eruption, which may appear thickly over the whole body, the woolly parts as well as the bare or hairy. The vesicles, which have often a dark, unhealthy look, tend to become confluent, and instead of proceeding regularly to maturity, they may remain hard or indolent papules or nodules or blacken and dry up. The secretion, when it takes place, is liable to be a thick, yellowish, fœtid pus. The eruption has much more tendency than with the discrete form to invade mucosæ, and not infrequently the serosæ are involved, especially those covering the lungs, liver and spleen. In the worst cases death may result from the fever before any eruption has taken place, in other cases the extent of the internal lesions tends to hasten a fatal result. With the amount of care that can be given to a flock, confluent cases are usually fatal.
In connection with the itching and scratching of the nose, abrasions and complex infections ensue, resulting in extensive ulceration and gangrene implicating the nasal cartilages and bones. The eruption around the pasterns may lead to shedding of the hoofs, and sloughing of the whole digital structures. Suppurating and gangrenous swellings form subcutaneously and in the lymph glands with fatal results. Blindness is especially liable to happen from the formation of the eruption on the conjunctiva and cornea. Ulcerations and sloughs are common on the internal mucosæ, and even on the serosæ. In implication of the abdominal organs, a fœtid diarrhœa is usually present, and in pregnant ewes abortion is the usual result.
Lesions. The cutaneous lesions are in their multilocular structure, the same as in cowpox, but differ materially in size and form. The typical vesicle is small (5 to 12 mm.), and neither broad and umbilicated like cowpox, nor conical and pointed as in smallpox, but round with a slight flattening on the summit. On the same animal may often be found all the successive stages at once, red points or hæmorrhagic spots, vesiculation, pustulation and even desiccation. The early changes are seen in the papillary layer and rete mucosum, in the form of swelling and congestion of the papillæ, exudation, active proliferation of the epidermic and tissue cells, and migration of leucocytes, (embryonic cells polynuclear) vacuolation of the papule, the spaces being filled with a straw colored exudate, and finally, the replacing of this by pus. If the local inflammation is very acute, the pustule may be resolved into a small abscess. On section of the skin the affected parts are found to be the seat of congestion and gelatinoid exudation, extending into the subcutaneous and intermuscular connective tissue, and even the muscles themselves are blackish and their capillaries engorged. The exudation is especially abundant in the dependent parts (head, neck, sternal and abdominal regions, legs). In proportion to the severity of the attack there are congestion, exudation, swelling, and blood extravasation in the lymph glands.
The nasal mucosa is congested, thickened or even ulcerated with abundant, tenacious, muco-purulent secretion and the nasal chambers narrowed or obstructed, and similar changes may be present in the larynx, trachea and bronchia. Spots of ecchymosis and even distinct variolous vesicles are to be expected. The pleuræ are often the seat of congestion, petechiæ, exudation, and discoloration (red or pale). The lung may show congestion and hepatisation in circumscribed areas, or there may be on the surface of such hepatised portions red or grayish foci, like a lentil, pea or bean, the seat of degeneration or forming minute abscesses. The pericardium and myocardium may be involved to a limited extent.
The buccal and pharyngeal mucosæ may be the seats of vesicles, or erosions or ulcers the result of their destruction, and the gastro-intestinal mucosa presents ecchymoses, vesicles, abrasions, and open sores in the midst of inflamed catarrhal patches. The mesenteric and other lymph glands are congested, swollen, softened and friable. Congestions and petechiæ are found on the peritoneum, liver, spleen and kidneys, with, at times, nodular foci. In certain cases congestions and effusions have been found on the pia mater and arachnoid, in the cerebral ventricles and the brain substance.
Prognosis. Mortality. Mortality varies much with the severity of the special outbreak and the conditions of life, favorable or otherwise, in which the flock is placed. In the milder forms the mortality may not exceed seven per cent, while in the more violent the whole flock almost may perish. A fatality of 20 to 30 per cent is the general average. Yet the inoculated form kills but 2 per cent.
If at the outset there is great weakness and prostration, complete anorexia and high fever, the prospect is discouraging. If the fever is moderate and strength and appetite retained, the case is very hopeful. On its first advent into a new country it causes a far greater mortality than after it has been long domiciled there, and frequent outbreaks have killed off the more susceptible strains of blood. Again very hot weather, or, still more, the prevalence of cold, drenching rains aggravates an outbreak and greatly encreases the fatality.
The loss is not to be measured by the deaths alone. The failure of the crop of lambs, through abortion, the shedding of wool, the loss of sight, hearing, hoofs, digits, flesh, stamina, etc, render recovery far from desirable, in the worst cases, as the animal fails to thrive or pay for its keep. On the contrary it is immune from any future attack, and if left in a thrifty condition it becomes especially valuable in a district where sheeppox prevails.
Treatment. Once established in the system the disease will follow its regular course, through all its stages. Yet we can, by dieting, pure air, cleanliness, shelter and even by medicinal measures, do much to render that course a safe one. Cool sheds, pure air, clean floor, dry clean litter and shelter from rain are above all important. The sheep may be separated in different enclosures in small lots of 5 or 6 to prevent crowding, heating, and excitement, and in any case the infected should be removed from the noninfected, and even from each other to avoid infection and reinfection. This is especially requisite in hot weather.
For the strong and vigorous, a diet of sliced roots and meal (oat, bran, linseed, barley, wheat middlings) is good, while for the weak, gruels of oat meal, barley meal, linseed meal, or the same agents dry, may be given. Powdered saltpeter may be given in this (1 oz. to 8 or 10 sheep) and common salt allowed to be licked at will. Drinking water may be given pure, or slightly acidulated with sulphuric or hydrochloric acid, or hyposulphite or bisulphite of soda may be used as a substitute for the latter. The bowels are usually costive, and may be relieved at first by 3 ozs. of sodic sulphate, and later, if need be, by soapy injections. Often during the course of the disease a sudden access of fever may be cut short by a mild laxative, if that is not contra-indicated by existing diarrhœa.
Avoid giving heating agents to bring out the eruption. The severity of any case and the danger of complex infection are usually in ratio with the extent of the eruption.
Lotions of hyposulphite of soda may be applied to the affected parts from the first, and even weak lotions of chloride of zinc after the maturation of the pustules. For the eyes, nose and mouth antiseptic lotions may be called for.
In the advanced stages, in weak subjects, tonics and stimulants may prove useful. To the mineral acid, quinine (10 grain doses) or gentian (drachm doses) or other bitter may be added for valuable stock.
Treatment is only permissible in the case of very valuable animals and when they are surrounded with the most perfect antiseptic precautions, to prevent the escape of the infection.
Prevention. As in all dangerous infections this must be the preëminent object, and when a new country has been invaded by the disease, no sentiment nor alleged value of affected or exposed animals should be made the warrant for treatment, nor stand in the way of the extinction of the plague by the most rigorous measures. The recovery of an individual flock is never to be put in the balance with the danger to which other flocks are thereby exposed. To avoid smuggling away of exposed animals, and consequent spread of the disease, the loss should be met by the commonwealth and no foolish idea of administrative economy, should tempt a stock owner to endanger the flocks of a whole nation.
Sheep and goats from countries where sheeppox exists should be absolutely excluded. If, in exceptional cases they are allowed to land on our shores, they should be guaranteed by a veterinary certificate as coming from a noninfected district, by a route free of infection, they should be critically examined by an expert on arrival, and if passed, should still with all clothing and utensils, be subjected to thorough disinfection. The clothing of attendants should be similarly dealt with. If importation is merely across a frontier, a quarantine of 21 days followed by a disinfectant bath should be enforced.
If sheeppox has gained a footing in a flock in a new country, the flock should be at once appraised and destroyed, and the place thoroughly disinfected and shut up for three months. All cars, ships, wharfs, landings, chutes, yards, buildings, parks, roads, etc., used by them should be closed and thoroughly disinfected. All flocks exposed to any such place or thing should be placed in strict quarantine for three weeks, under official veterinary supervision and disposed of, should they become affected.
As an alternative each infected and suspected flock should be secluded in a well fenced place or shed from which all men except the necessary attendants, all dogs and other mammals, including vermin, all birds and as far as possible all flies are excluded. They should be divided into small lots of 5 or 6 placed in separate pens, their temperatures should be taken 3 or 4 times a day, and any one showing a temperature of 104° or 105° F. should be instantly removed to a separate pen, and destroyed as soon as the disease can be identified. In this way a diseased sheep can usually be removed before it has infected its fellows, and at the worst the infection will rarely spread beyond the 5 or 6 animals enclosed in the pen where the first case appeared. It is well to sprinkle the wool of all the flock with a 5 per cent solution of carbolic acid, and the floor or ground with chloride of lime. The diseased carcasses should be thoroughly sterilized by burning, boiling, or immersion in strong acids, or they should be deeply buried, the infected pen disinfected on each occasion, and the hands and clothes of the attendants purified.
Careful treatment in this way will usually cut short the disease with the loss of those only that were already infected when the outbreak was taken in hand, but it must be in the hands of men who are at once experts and vigilant and trustworthy. The English invasion of 1862, under the direction of the late Professor Gamgee, was completely stamped out in four weeks on this plan, whereas the invasion of 1847, met by the expedients of inoculation and quarantine, lasted for four years, with great losses in a number of flocks, and a very heavy bill for continued expert supervision. This should be a wholesome lesson to the American legislators who consider the prompt extinction of infection, by abolishing this source of its increase in the living body, as a wasteful outlay.
Preventive Inoculation, Ovination. If it were possible to give immunity against sheeppox by inoculation with the exudate of cowpox, and without danger to the sheep from fatal cowpox, or from its transformation into the more destructive sheeppox, it would be a most desirable resource. But experiment goes to show that vaccination is useless, in the temperate climates at least. Sacco, Hussan, Buniva and others in Italy vaccinated sheep extensively and claimed to have obtained good results, but this has not been endorsed by subsequent observers. D’Arboval vaccinated 1,523 sheep, of which 1,341 contracted cowpox, and out of 429 of these exposed to sheeppox later, 308 contracted the latter disease. Ceely vaccinated two sheep, both of which afterward had mild sheeppox through inoculation. Simonds and Marson vaccinated 306 sheep, 112 of them successfully, and of these last two-thirds contracted cowpox a second time on re-vaccination. Twenty-nine of the successfully vaccinated sheep were inoculated with sheeppox lymph, and in every case successfully. It is obvious that vaccination, as a protective measure, is absolutely untrustworthy in France or in England. Under the warm skies of Italy, as in Persia, there may be a close relationship between the two diseases, yet in Italy sheeppox was constantly prevalent, and it is to be feared that the immunity in a number of cases was due to a previous attack of that disease rather than to the vaccination. It should be noted that in Persia sheeppox is said to be communicable to man, while in England, Ceely failed to transmit it.
Ceely suggested variolisation with human smallpox as a preventive of sheeppox, but Simonds and Marson failed to convey smallpox to the sheep, though the same animal readily contracted sheeppox. One can hardly contemplate Ceely’s proposal with equanimity. Immunity for sheep would be dearly bought at the cost of a general diffusion of smallpox virus.
Ovination or inoculation with the lymph of sheeppox is the only available method of immunization. It entails, however, an extraordinary multiplication of the virus in each inoculated animal, and considering the numerous loopholes for its possible diffusion it can only be looked on as a very dangerous and usually, in the long run, a very expensive resort. The experience of England, above referred to, is eloquent in witnessing against ovination, and “in Prussia and Austria the dissemination of sheeppox went hand in hand with inoculation.”—Friedberger and Fröhner.
On the other hand ovination is not fatal to the flock operated on. The mortality is often below 1 percent., and virtually never exceeds 4, with a general average of about 2 per cent. It is this comparative impunity of the inoculated flock which closes the eyes of most persons to the great danger to a whole country and the wasteful prodigality of the operation.
Ovination further shortens the duration of the outbreak in a large flock, passing all through the disease in 21 days, whereas as contracted by simple exposure, the duration of the outbreak may last 90 days or more. It further enables the owner to give such protection, shelter and care as will guard the flock against exposure and dangerous complications. But while preferable to the abandoning of the disease to its natural course, it is always to be strongly condemned, where it is possible to adopt the method which detects the sick animal in the incipient stage by thermometry, and does away with the infection by its removal, followed by disinfection. The only excuse for ovination is the general prevalence of sheeppox on an island or other secluded district where there is no great added danger from the further diffusion of the virus, and when its simultaneous practice over the whole region can be made the basis for universal disinfection and the definite extinction of the contagium.
Technique of Ovination. The lymph (“ovine”) should be taken from a mild case of the disease, and from a vesicle at full maturity (about the 6th day), but containing as yet a clear, translucent exudate, without turbidity or other indication of formation of pus, or other infection. Inoculation is made by preference on the bare lower surface of the tail near its tip or 3 to 4 inches behind the anus. If this is unsuitable, the inner side of the ear, an inch from the tip is usually selected, though there is here an added element of danger, owing to its proximity to the eye. The insertion is made with an ordinary suture needle, which is introduced obliquely under the epidermis about one line, and pressed upon with the thumb as it is withdrawn. A still better instrument is the inoculation needle or lancet with a groove or spoonlike hollow on one side. Or the skin may be scratched or abraded with the lancet, as in vaccination, until serum oozes, when the virus is rubbed on and the part is covered with a piece of sticking plaster. On the third or fifth day the flock is again examined and those that have failed to take are ovinated anew.
The virus is most conveniently taken direct from the affected sheep, but it may be preserved in capillary tubes, or on glass or ivory points, or mixed with glycerine between glass plates, or finally, the first scab well dried may be preserved and utilized, a minute portion being inserted with the lancet in a pocket made under the epidermis.
Attempts have been made to secure a mitigated and safer virus, by diluting the lymph with water or normal salt solution (1:50–150) (Peuch), by amputating the seat of inoculation (the tip of the ear) on the 4th or 7th day, when the vesicle is formed (Galtier), by taking a susceptible sheep and inoculating it with sheeppox virus for ten consecutive days, and then selecting for use the lymph from the papule of the sixth inoculation. The inoculations of the seventh day and later give rise to no papule even (Pourquier). By this means it is claimed that the inoculated disease remains strictly local, passes through its successive stages in a shorter time (15 days or less), and is perfectly harmless to the sheep inoculated. Nocard and Mollereau sought the same end by mixing the virus with oxygenated water, and Semmer and Raupach by heating it to 130° F. In view of the facts that it is only under extraordinary conditions that ovination is permissible at all, and that the mortality, resulting from it can be kept down to about 1 per cent., it seems hardly worth while to attempt to obviate this loss, by any method which may come short of the full measure of immunity.
Ovination confers immunity for a year or longer.
The care of the flock during eruption is the same as in sheeppox contracted in the usual way.