DIAGNOSIS. 159 



confounded with it. Now, altliougli it may be true that 

 mistakes have been made in the diagnosis of these diseases, I 

 am rather inchned to beheve that this equine variola when 

 encountered has more frequently been mistaken for glanders 

 or farcy, not been recognised or regarded as of a varioloid 

 character, but accepted as simply stomatitis or aphtha when 

 the eruption has been prominently developed on the mem- 

 brane of the mouth and of the cutaneous surfaces contiguous, 

 and as the recurrent skm disease known by the name of 

 ' grease ' when the pustules were largely present on the skin 

 of the extremities. That it should in its early stages and when 

 examined cursorily be mistaken for glanders is easy enough 

 understood. It has so long been regarded as settled that 

 erosions on the membrane of the nasal cavities and in the 

 vicinity of the nose and mouth, accompanied with swelling of 

 the adjacent gland-structures, are to be regarded as diagnostic 

 of glanders without further considering the nature of these 

 erosions and swellings, that the existence in horse-pox of the 

 pustules, either singly or in groups, might readily enough be 

 regarded as symptomatic of the more malignant disease. And 

 this is even more likely to be the case when similar sores exist 

 on the external cutaneous surface of the limbs, which tlirough 

 abrasion, to which they are very liable from their situation, 

 may induce a corded state of the lymphatic vessels ; while to 

 any observer who has not previously encountered this affection 

 the alarm will be greater, and the suspicion of glanders more 

 likely to be confirmed, when the disease is found to spread, and 

 apparently by contagion. 



It is only, however, in the earlier stages, and when examined 

 hurriedly, and when there may, from other circumstances, be 

 an apprehension of glanders, that the danger of this mistake is 

 at all great. The resemblance disappears when the eruption 

 is more closely looked at, or when the disease in its different 

 features is watched in its general development ; the longer 

 equine variola exists, the older the eruption, the more unhke 

 is it to that of glanders. 



The differentiation of the eruption in the various modifica- 

 tions of glanders and of horse-pox having already, in describing 

 the former, been sufficiently entered into, it will be unnecessary 

 to recapitulate the distinguishing features here. 



