626 INFECTION AND IMMUNITY. 



intestines and adjacent tissues frequently results, 

 the organisms may become generalized, causing the 

 disease in the nose, skin or other organs, without 

 the establishment of foci in the intestines. 



In man infection occurs chiefly through abra- 

 sions in the skin, and perhaps also through the 

 nose, to which the bacilli have been carried by 

 soiled fingers or other means. In experimental 

 work with glanders extreme care is necessary as 

 infection occurs very easily. Glanders has been 

 transmitted to animals by rubbing bacilli on the 

 intact skin. Several cases of acute glanders, end- 

 ing fatally, have occurred in laboratory workers as 

 the result of accidental inoculation. There appears 

 to be little danger to man in eating the meat of 

 horses in which the disease was localized, pro- 

 vided the meat has been well cooked. Such meat 

 was fed to soldiers in one instance with no ill 

 results. 



Variations in the course of the disease and in the 

 intensity of the pathologic changes in different 

 cases probably depend on variations in the resist- 

 ance of the host and in the virulence of the para- 

 site. In acute general infections in man, follow- 

 ing an incubation period of from two to five days, 

 during which the point of inoculation becomes vio- 

 lently inflamed, a severe febrile condition develops, 

 which is accompanied by general pains, swollen 

 joints, a macular eruption, and often muscular and 

 subcutaneous abscesses. In a short time nodules 

 and indurated cords, made up of a leucocytic exu- 

 date, edematous fluid and proliferating connective 

 tissue cells, form in the subcutaneous lymphatic 

 channels, and mark the progress of the infection 



