390 "^he Philippine Journal of Science ms 



an eruption appeared on the face and later on the chest and abdomen. On 

 the third day of the eruption the patient died. The patient was the owner 

 of a stable where horses and vehicles were kept for hire; he had recently 

 lost several horses from glanders. 



Autopsy. — The body appears emaciated. A papulo-vesicular eruption is 

 scattered over the skin surface. These lesions are most numerous on the 

 face, back of the trunk and upper arms, buttocks and back of the upper 

 part of the thighs, and more scattered over the chest and the abdomen. 

 They are not distributed regularly, but are grouped with intervening areas 

 of comparatively free skin, and vary in size from 2 to 3 and 6 to 8 milli- 

 meters in diameter. The smaller ones appear as shotty papules, while the 

 larger ones are distinctly vesicular. Several of these vesicles show de- 

 pressed areas, which give the appearance of being umbilicated, although 

 more commonly their surfaces appear wrinkled. On section they are seen to 

 be situated on a fairly well-defined, yellowish, firm nodular base, which 

 extends into the subcutaneous tissue. The eruption on the face seems 

 to be more advanced. On the forehead and cheeks the lesions appear as 

 irregularly circular, raised, dark red and purple-colored plaques, about 1 to 

 1.5 centimeters in diameter. Some of these are rounded and nodular, others 

 flat with depressed center and raised edges. A few present a reddish 

 yellow, ulcerated center surrounded by raised edges. Two of these nodular 

 plaques occur beneath the skin of the scalp, just above the upper margin 

 of the forehead. 



The tissues just to the right of the nose are so swollen as to close the 

 right eye, which itself does not seem to be affected. A section through 

 these swollen tissues reveals many discrete and confluent, yellowish and 

 grayish, caseous foci, which are surrounded by congested and necrotic tissue 

 and extend to the depth of about 2.5 centimeters from the skin surface. 

 The alae nasi are thickened by similar nodules, and one can be seen on the 

 mucous membrane of the upper lip, just to the left of the nasal fossa. A 

 dirty, purulent discharge escapes from the nostrils. Upon opening the 

 nares, the mucous membrane, especially of the right one, is seen to be 

 ulcerated. The ulceration covers most of the mucous surface of the floor 

 and walls of this nostril, and extends upon the inferior turbinated bone. 

 Small, grayish or yellowish nodules may be seen projecting from the ulcer- 

 ated surfaces. The right nostril is not affected to such a marked degree. 

 The ethmoidal cells are filled with purulent matter. The right clavicle is 

 much thicker than the left, but nothing of note is seen on section. 



The thoracic cavity contains no fluid. Both lungs are bound to the 

 thoracic walls by firm, fibrous strings of adhesions. The lungs are emphys- 

 ematous anteriorly, and posteriorly show considerable hypostatic congestion. 

 On palpation small nodules can be felt beneath the visceral pleura, which 

 on section appear as pea-sized or smaller, circumscribed, grayish yellow 

 areas of a confluent tubercular structure. None of them are capsulated or 

 caseated, but some are surrounded by an irregular, reddish area of 

 pneumonic consolidation. They seem to be limited to the pleural surface. 



The bronchial glands appear normal on section. The trachea and bronchi 

 are slightly congested, and are covered by a mucopurulent secretion. The 

 heart muscle is rather pale on section, but otherwise the organ appears 

 normal. The m.ucous membrane of the oesophagus shows hyperplasia of 

 the solitary follicles. 



The liver is of about normal size, soft, and on section its markings are 



