MODE OF INFECTION AND PATHOLOGIC CHANGES 307 



seen in the inflammatory zone next to the necrotic area. In the slow 

 chronic cases the histologic examination shows the presence of much 

 fibrous connective tissue. 



Susceptibility. That man is not as susceptible to the natural 

 glanders infection as the solidipeds, can be seen in the fact that many 

 men handle affected horses, and yet, on the whole, the number of 

 persons contracting the disease is comparatively small. On the 

 other hand, the number of scientific investigators working with the 

 Bacillus mallei in the laboratory and contracting a fatal infection has 

 been alarmingly large. Hence, students working with live glanders 



FIG. 147 



The pustular eruption of acute glanders in man as exhibited on the day of the patient's 

 death, twenty-eight days after the initial chill. (Zeit.) 



cultures should be exceedingly careful. The first infection of glanders 

 in man was recognized by Lorin in 1812. By far the greatest number 

 of cases of natural glanders infection in human beings occurs among 

 hostlers, drivers, farmers, horse butchers, and other habitual handlers 

 of horses. In these trades the disease is generally contracted through 

 abrasions or wounds of the skin, commonly leading to the formation of 

 a pustular eruption which has very frequently been mistaken for small- 

 pox and also for a gangrenous erysipelas. In laboratory workers the 

 disease generally begins as a respiratory (nasal and pulmonary) infec- 

 tion. Even this mode of infection, however, is likely to lead to a pustu- 



