224 BACTERIOLOGY FOR NURSES 



In man one of three forms of infection may occur : entrance of 

 the bacilli may be through a cut or an abrasion of the skin, result- 

 ing in a malignant 'pustule; through the lungs by inhalation of the 

 spores, wool sorter's disease; or through the alimentary tract, in- 

 testinal anthrax. 



When infection takes place through the skin a small red papule 

 appears on the exposed surface in about one to three days. Very 

 soon it becomes vesicular and contains clear or blood-stained 

 fluid. The area surrounding it becomes greatly inflamed and 

 within thirty-six hours the center begins to show signs of necrosis. 

 If the pustule is not excised the disease spreads. Invasion of the 

 blood stream by the bacilli is most likely to happen, and death 

 from septicemia result in from three to five days. Occasionally 

 instead of the typical pustule an extensive edematous area appears 

 which may be so intense as to result in gangrene. Such cases are 

 usually fatal. Skin infections develop chiefly among shepherds 

 and butchers or those who work among hides. 



The pulmonic form of anthrax, " wool sorter's disease," is 

 contracted by the inhalation of spores during the sorting and 

 cleansing of wool from infected animals. The symptoms are 

 those of pneumonia, often with edema in the cutaneous tissue 

 over the neck and chest. Recovery may occur or the disease 

 may be fatal in from two to seven days. 



Intestinal anthrax, although the usual form in cattle, rarely 

 occurs in man. The few instances on record have been caused by 

 the ingestion of spore-infected food or accidentally amongst 

 laboratory workers. The symptoms produced are those of in- 

 tense poisoning, chills, vomiting and diarrhea, and a moderate 

 degree of fever. 



Immunity. With the hope of producing protective immunity 

 Pasteur, in 1880-1882, devised a method whereby a mild attack 

 of the disease could be produced by means of inoculation with 

 attenuated cultures. Other methods have since been suggested, 

 but that employed by Pasteur, Chamberland, and Roux is the 

 one still most generally used. 



Two vaccines are prepared : No. 1 is a broth culture so attenu- 



