276 GLANDERS 



into contact with horses ; even amongst them it is a comparatively 

 rare disease. 



In horses the lesions are of two types, to which the names "glanders " 

 proper and "farcy" have been given, though both may exist together. 

 In glanders proper the septum nasi and adjacent parts are chiefly affected, 

 there occurring in the mucous membrane nodules which are at first firm 

 and of somewhat translucent grey appearance. The growth of these is 

 attended usually by inflammatory swelling and profuse catarrhal dis- 

 charge. Afterwards the nodules soften in the centre, break down, and 

 give rise to irregular ulcerations. Similar lesions, though in less degree, 

 may be found in the respiratory passages. Associated with these lesions 

 there is usually implication of the lymphatic glands in the neck, media- 

 stinum, etc. ; and there may be in the lungs, spleen, liver, etc., nodules 

 of the size of a pea or larger, of greyish or yellow tint, firm or somewhat 

 softened in the centre, and often surrounded by a congested zone. The 

 term "farcy" is applied to the affection of the superficial lymphatic 

 vessels and glands, which is specially seen where infection takes place 

 through an abrasion of the skin, such as is often produced by the rubbing 

 of the harness. The lymphatic vessels become irregularly thickened, so 

 as to appear like knotted cords, and the associated lymphatic glands 

 become enlarged and firm, though suppurative softening usually follows, 

 and there may be ulceration. These thickenings are often spoken of as 

 " farcy buds " and " farcy pipes." In farcy, also, secondary nodules may 

 occur in internal organs and the nasal mucous membrane. The disease 

 is often present in a "latent form," and its presence can only be detected 

 by the mallein test (vide infra). In the ass the disease runs a more 

 acute course than in the horse. 



In man the disease is met with in two forms, an acute and a 

 chronic ; though intermediate forms also occur, and chronic cases 

 may take on the characters of the acute disease. The site of 

 inoculation is usually on the hand or arm, by means of some 

 scratch or abrasion, or possibly along a hair follicle, sometimes on 

 the face, and occasionally on the mucous membrane of the mouth, 

 nose, or eye. In the acute form there appears at the site of 

 inoculation inflammatory swelling, attended usually with spread- 

 ing redness, and the lymphatics in relation to the part also become 

 inflamed, the appearances being those of a " poisoned wound." 

 These local changes are soon followed by marked constitutional 

 disturbance, and by an eruption on the surface of the body, at 

 first papular and afterwards pustular, and later there may form in 

 the subcutaneous tissue and muscles larger masses which soften 

 and suppurate, the pus being often mixed with blood ; suppuration 

 may occur also in the joints. In some cases the nasal mucous 

 membrane may be secondarily infected, and thence inflammatory 

 swelling may spread to the tissues of the face ; in others it 

 remains free. The patient usually dies in two or three weeks, 

 sometimes sooner, with the symptoms of rapid pyaemia. In 



