SYMPTOMS OF GLANDERS. 171 



possess but little feeling ; indeed, often in the course of time, the 

 disease having become sub-acute or chronic, they acquire a scir- 

 rhous hardness, and almost total insensibility. When first found, 

 as I said before, the tumour frequently is loose and moveable ; as 

 it acquires firmness, however, it acquires fixity, getting by degrees 

 adherent to the side of the jaw, the tumefaction being confined to 

 whichever side of the head the disease occupies. A swollen gland 

 or mass of glands forming a tumour of this description is, perhaps, 

 the most usual kind of submaxillary tumefaction in glanders : it is 

 known by its isolated character, by its distinctly being the only 

 tumour present, the skin being drawn tensely over it. and the 

 surrounding space being perfectly clear from any tumefaction; 

 lastly, by its close and immoveable adherence to the side of the 

 jaw against which it lies. Should there be disease in both cham- 

 bers of the nose, we shall have tumefied glands on both sides, 

 though it will rarely happen that both sets of glands will swell at 

 one and the same time. While recent or susceptible of pain from 

 compression, these tumours are apt to fluctuate in magnitude, being 

 at one time large, at another comparatively small. In general, 

 blisters and sometimes common stimulants will reduce them, thoug^h 

 I have known the opposite effect produced. I do not remember 

 seeing suppurative action produced in them ; commonly, as T have 

 before observed, they become hard, void of sensibility, and scir- 

 rhous in their nature, and so continue to the end. In reference to 

 their variable character, 



DUPUY makes the following observations on these glands : — 

 " when the mucous membrane of the chambers of the nose is 

 affected, the sublingual (submaxillary) glands become tumefied, 

 and undergo some very variable changes. In succession, they 

 grow, in the same subject, swollen, firm, painful, and moveable. 

 In a short time after this they become insensible, diminished in 

 volume, and appear to resume their natural condition ; then again, 

 all on a sudden, they recommence swelling, and in the course of a 

 few days grow larger than ever they have been." 



TUMEFACTION OF THE ALA NASI is a frequent, not 

 a constant symptom of glanders: when present, it is always highly 

 characteristic of the acute disease. It is seen in virulent and ma- 



