panied by intense pains in the joints and muscles. Abscesses form, 

 most commonly in the biceps, the flexors of the forearm, the rectus 

 and the pectoral muscles. Sometimes very early in the course of 

 the disease, or again, just before death, an eruption of papules, 

 which soon become pustular, appears on the skin, especially on the 

 face and about the joints. This has been mistaken for variola and 

 the patients isolated and treated as smallpox cases. The eruption 

 differs from that of smallpox, however, in the great variation in 

 size and the irregular distribution of the pustules, which, further, 

 are not umbilicated. 1 The ulceration of the nasal mucosa may end 

 in necrosis of the deeper structures, accompanied by great swelling 

 of the nose and face. It is invariably fatal in eight or ten days. 

 Subacute cases have survived as long as thirty days. 



Chronic glanders. In chronic glanders the onset is often insi- 

 dious and the course of such an indefinite type that it may be 

 impossible to diagnose the disease without the use of special tests, 

 which will be described under the subject of diagnosis. 



The first symptom noted in the horse may be a sticky muco- 

 purulent secretion from one or both nostrils, with the formation 

 of small, grayish nodules on the upper portion of the nasal septum. 

 These vary in size from that of a pin head to that of a pea, and are 

 often surrounded by a zone of congestion. They soon break down 

 and give rise to discharging ulcerated areas (see Pis, I and II), 

 which may remain superficial or may deepen and even end in 

 perforation of the underlying cartilage and bone. When these 

 deeper ulcers heal they leave irregular, star-shaped cicatrices, which 

 are considered of diagnostic import from a clinical point of view. 

 (See PI. VII.) 



Such ulceration may be found in the frontal sinuses, eustachian 

 tubes, larynx, etc. The submaxillary glands are often involved 

 "and in some cases may be the only apparent seat of infection. 

 Along with the nasal and glandular involvement, the lungs are 

 often affected. Here nodular or diffusely infiltrated lesions may 

 form, accompanied, clinically, by coughing. 



If a lung from such a case of glanders be examined post 

 mortem and the hand passed over the pleural surface, few or many 



1 In one of our cases, Case II (see PI. IV), several of the pustules 

 showed depressed centers, but the umbilication was not so distinct as that 

 seen in smallpox. 



