GI.ANDERS IN MAN 121 



cord. Ulcers often develop from these secondar}- nodes. The 

 neighboring lymph glands are at first swollen and soft, but 

 later they become indurated by the growth of connective tissue 

 and studded with dirty white nodules about as large as a pin's 

 head, or with yellow foci of caseation. The capsule around 

 the lymph glands becomes infiltrated with small cells and sub- 

 sequently thickened. In rare cases secondar}- chronic farcy 

 occurs. It is marked by a large diffuse new-growth of con- 

 nective tissue with nodular thickening of the skin. This con- 

 dition is termed glanderous elephantiasis or pachyderma. It 

 chiefly affects the limbs and head. 



Of the abdominal organs, the spleen is most frequently at- 

 tacked. It then contains embolic nodules, varying in size 

 and which either suppurate, or become calcareous. Similar 

 nodules occur, though not so often, in the liver, kidneys, testi- 

 cles, brain, muscles, heart, and bones. In the bones, a cellu- 

 lar infiltration of the medulla and purulent breaking down of 

 the osseous tissue. Ulcers are ver}' rare on the mucous mem- 

 branes of the eyes, stomach and vagina. The blood shows 

 signs of slight leucocytosis. The specific bacteria are found 

 in the blood only in cases of acute general infection. 



The anatomical changes in acute glanders consist chiefl}' 

 in a disintegration of the respirator}- mucous membrane, in a 

 serous infiltration of the submucous, subcutis, and inter- 

 muscular tissue, with inflammation and suppuration of the 

 Ij-mph vessels and lymph glands. There are also metastatic 

 formations in the skin and lungs. The nasal mucous mem- 

 branes are covered with rapidly spreading ulcers with consider- 

 able infiltration into the submucosa. The mucous membrane 

 of the larynx and pharynx is swollen and covered with ulcers. 

 The lungs are studded with purulent metastatic foci or fresh 

 nodules. The skin is excessively swollen and covered with 

 glanderous nodes. Sometimes diffuse gangrene of the skin 

 occurs. 



§ 103. Glanders in man. The symptoms of glanders 

 in man are of much importance to the veterinary surgeon. 

 Although the susceptibility to the disease is usuallj' not very 

 great, cases of human glanders unfortunately occur, especially 



