GLANDERS. 791 



than this, its effects remaining confined to the lesions about the wound 

 just described, and to a fever of an intensity corresponding to the 

 severity of the case. Signs of a general implication of the system 

 often accompany the above symptoms, however; and indeed they 

 usher in the disease whenever it has not been preceded by a wound. 



The term prodromal stage, or stage of invasion, is usually applied 

 to the period during which, although none of the lesions characteristic 

 of glanders or farcy have as yet appeared, still the fever, constitutional 

 disturbance, and certain subjective symptoms, announce a general in- 

 fection of the system. 



Sometimes a single rigor occurs at the beginning of the attack, in 

 others the rigor is repeated several times. The skin grows hot, the 

 thirst augments, the pulse is accelerated, the patient feels depressed 

 and languid, complains of pain in the head, sleeps badly, has no appe- 

 tite ; in brief, exhibits a series of symptoms such as accompany other 

 infectious diseases or local disorders which are accompanied by fever. 

 These manifestations, however, are accompanied by another constant, 

 and somewhat characteristic phenomenon, namely, a violent pain in 

 the joints and muscles. The seat of this pain is usually in the vicinity 

 of the greater articulations. It is generally augmented by motion or 

 pressure, and is sometimes, although not always, attended by moderate 

 swelling of the painful part. Although these articular and muscular 

 pains often cause the disease to be mistaken for rheumatism, yet, when 

 they occur in an individual whose history is suspicious, they may aid 

 us in an early and correct interpretation of the symptoms. 



The first stage of the disease lasts for a longer or shorter period 

 (and it may continue for three or four weeks, or more) ; the symptoms 

 either increase steadily all the time, or else gradually grow milder, so 

 as to subside almost completely when the second or eruptive stage, 

 the stage of localization of the malady, sets in. The aspect of the dis- 

 ease at this period presents many varieties, according as the malady 

 selects one or other tissue as its seat. If it attack the nasal mucous 

 membrane as glanders in the stricter sense of the term, an erysipela- 

 tous inflammation makes its appearance upon the exterior of the nose 

 and its vicinity. The nose, the eyelids, and the forehead swell, as- 

 suming a dusky redness, and are covered by blebs, the precursors of 

 gangrene. The patient cannot breathe through his nostrils, from 

 which there flows a liquid, at first scanty, thia, and mingled with 

 streaks of blood ; afterward foul, bloody, and sanious. If the patienl 

 lie upon his back, the discharge flows through the posterior nares into 

 the pharynx, and provokes him to hawk and cough.* The discharge 

 sauses erosion of the lining of the mouth, soft palate, and tonsils, 

 winch are of a deep-red hue, and are covered with ulcers and sloughs 

 100 



