DIAGNOSIS OF GLANDERS 349 



Whit more 1 describes a glanders -like disease occurring in man in 

 Rangoon. A non-Gram-staining bacillus is present, morphologically 

 like the glanders bacillus, but killing guinea-pigs with septicaemic 

 symptoms and not affecting the testes, growing well and luxuriantly 

 on culture media, liquefying gelatin slowly, growing well on potato 

 with at first a cream-coloured, and subsequently a yellowish growth, 

 curdling milk and not fermenting any sugar. 



Clinical Examination 



(1) Prepare and stain film preparations of the pus or discharge 

 in Loffler's blue, with subsequent partial decolorisation in 4 per 

 cent, acetic. The ordinary pyogenic cocci will not be found unless 

 a secondary infection has occurred, and the material may appear 

 sterile, for the glanders bacilli may be very scanty. 



(2) Several tubes of glycerin-agar and potato should be inoculated 

 and incubated at 37 C. for seventy-two hours. On the agar, 

 colonies of the glanders bacillus will develop in twenty-four to 

 thirty-six hours, but the potato will not show the characteristic 

 amber-yellow growth under forty-eight to seventy-two hours. 



(3) It will usually be necessary (in man, at least) to confirm the 

 diagnosis by an inoculation experiment. A fully developed male 

 guinea-pig is chosen, and a little of the discharge, or an emulsion 

 of the material (O5 to 1 c.c.) is injected intraperitoneally, if the 

 material be fairly sterile, but if not, subcutaneously. In three to 

 five days the animal should show the characteristic swelling of the 

 testicles if the material be glandered. 



(4) An ophthalmo-reaction is stated to be reliable both in man 

 and in animals. 



(5) In animals the mallein test may be applied. The dose is 

 injected subcutaneously in the neck over the vertebrae, and midway 

 between the jaw and the shoulder. 



(a) The temperature of the animal should be taken if possible 

 morning and evening for two or three days previous to inoculation ; 

 in any case at the twentieth hour after inoculation, or, better, at 

 frequent intervals from the twelfth to the twentieth hour. 



(6) A complete reaction comprises (i) a rise of temperature of 

 more than 2-5 F., (ii) an extensive hot and painful swelling at the 

 seat of inoculation. Systemic disturbance, such as prostration, loss 

 of appetite, shivering, etc., majr occur. 



(c) The temperature reaction is unreliable in all cases in which 



1 Journ. of Hyg., xiii, 1913, p. 1. 



