MORBID ANATOMY II7 



^ 102. Morbid anatomy. In chronic glanders, the most 

 frequent locations of the lesions are on the respirator}- mucous 

 membrane, in the lungs, lymph glands and skin. Other or- 

 gans are more rarely invaded. The upper respiratory mucous 

 membrane is the usual seat of the lesions. Glanders occurs in y 



two forms, viz., (a) as circumscribed nodules with the forma- cA ^y-*''^^ 

 tion of ulcers and cicatrices; and (d) as diffuse or infiltrated ^'\ 

 lesions. 



(a) In nodular glanders, which is the common form, the 

 lesions ar.e most frequently situated on the upper portion of 

 the nasal septum, and in the cavities of the turbinated bones. 

 The affection begins with the appearance of nodules varying 

 in size from a grain of sand to a millet seed. They are more 

 or less translucent, of a roundish or oval shape, and of a dirty 

 gray or grayish red color. The nodules, w^hich may attahi to 

 the maximum size of a pea, project somewhat above the sur- 

 face of the mucous membrane. They are surrounded by a red- 

 dish ring. Some of them are i.solated and others are arranged in 

 groups. Microscopically they consist of a large number of lym- 

 phoid cells, which disintegrate in the centre of the nodule. In 

 consequence of the central fatty and purulent disintegration, the 

 nodules become yellowish in color, discharge and form ulcers. 

 These ulcers are sometimes superficial, sometimes deep, lentic- 

 ular or crateriform, surrounded by a hard, indurated edge, and 

 frequently becoming confluent with irregularly serrated and 

 eroded edges. They are sometimes covered with a brownish 

 crust. The ulcers may increase in area or in depth and may 

 even involve the underlying cartilage or bone, causing perfora- 

 tion of the septum nasi, and distensions of the maxillary or exos- 

 toses on the turbinated bones. The shallow lenticular ulcers 

 may heal without leaving any visible changes ; but the deeper 

 ones, after granulating, leave a radiating, star-shaped cicatrix 

 which is either smooth or horny, and which, according to the 

 shape of the ulcer, may be of an irregular, oblong form. The 

 nasal septum is frequently covered with these scars. The 

 ulcers and cicatrices are sometimes found in the maxillary and 

 frontal sinuses, in the guttural pouches and in the eustachian 

 tubes. They may also occur in the larynx, especially in the re- 



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