164 GLANDERS 



charge, ulcers on the nasal mucous membrane, pustules and 

 abscesses in the skin, ulcers in the oral cavity, larynx, and 

 conjunctiva, articular swellings, and grave general distur- 

 bances. Sometimes there is intense gastrointestinal trouble. 

 Nodules occur in the lungs in some cases. As a rule, death 

 takes place in from two to four weeks, and occasionally in a 

 few days. In other instances, the disease becomes chronic, 

 lasting for months or years. Bad. mallei has been found in 

 the blood in cases of acute glanders. The positive diagnosis 

 depends on the possibility of infection having taken place, on 

 inoculation in guinea pigs, or the proof of the presence oi Bad. 

 mallei. Treatment is usually of no avail. The only hopeful 

 cases are those that are purely local in their manifestation. 

 A few of these are reported to have been cured by applying 

 deep cauterization. 



§ 135. Differential diagnosis. Glanders is to be differ- 

 entiated from a variety of nasal and lymphatic disorders more 

 or less common in the horse kind. Before the discovery of 

 the specific bacterium of glanders or of mallein, it was neces- 

 sary to determine as closely as possible the differential anato- 

 mical characters between glanders and those of other affec- 

 tions, such as chronic nasal catarrh, strangles, lymphangitis, 

 follicular ulceration of the nasal mucosa, cancer, sarcoma, 

 actinomycosis, melanosis and the like. Strong has described 

 a disease in the Philippine Islands, which first appears in 

 nodules, that resemble those of glanders very closely. It is 

 caused by a blastomyces. It occasionally attacks cattle as 

 well as horses. The disease most liable to be mistaken for 

 farcy or skin glanders is epizootic lymphangitis caused by a 

 yeast-like fungus (^Sacdiaromyces farcimiyiosiis') . This disease 

 has recently been discovered by Pearson in Pennsylvania. 



Since the discovery of practically positive means of diag- 

 nosis, it does not seem wise to speculate upon the chances of 

 a correct differential determination by obscure clinical evi- 

 dences. If the diagnosis of glanders can not be made from the 

 symptoms and lesions in evidence three reliable diagnostic 



