270 GLANDERS. 



nodules may occur in internal organs and the nasal mucous 

 membrane. In the ass the disease runs a more acute 

 course than in the horse. 



In man the disease is met with in two forms, an acute 

 and a chronic ; though intermediate forms also occur, and 

 chronic cases may take on the characters of the acute 

 disease. The site of inoculation is usually on the hand or 

 arm, by means of some scratch or abrasion, or possibly 

 along a hair follicle, sometimes on the face, and occasionally 

 on the mucous membrane of the mouth, nose, or eye. In 

 the acute form there appears at the site of inoculation 

 inflammatory swelling, attended often with spreading 

 redness, and the lymphatics in relation to the part also 

 become inflamed, the appearances being those of a 

 " poisoned wound." These local changes are soon followed 

 by marked constitutional disturbance, and by an eruption 

 on the surface of the body, at first papular and afterwards 

 pustular, and later there may form in the subcutaneous tissue 

 and muscles larger masses which soften and suppurate, the 

 pus being often mixed with blood ; suppuration may occur 

 also in the joints. .In some cases the nasal mucous 

 membrane may be secondarily infected, and thence inflam- 

 matory swelling may spread to the tissues of the face ; in 

 others it remains free. The patient usually dies in two or 

 three weeks, sometimes sooner, with the symptoms of rapid 

 pyaemia. In addition to the lesions mentioned there may 

 be foci, usually suppurative, in the lungs (attended often 

 with pneumonic consolidation), in the spleen, liver, bone- 

 marrow, salivary glands, etc. In the chronic form the local 

 lesion results in the formation of an irregular ulcer with 

 thickened margins and sanious, often foul, discharge. The 

 ulceration spreads deeply as well as superficially, and the 

 thickened lymphatics have a great tendency to ulcerate 

 also, though the lymphatic system is not so prominently 

 affected as in the horse. Deposits form also in the sub- 

 cutaneous tissue and muscles, and the mucous membrane 

 may become affected. The disease may run a very chronic 

 course, lasting for months, and recovery may occur, though, 



