Anthrax in Man. 223 



Meat just killed may be thoroughly disinfected by the secretions 

 of a healthy stomach, yet the bacillus may pass through in an 

 envelope of fat, in an undigested mass or during an attack of dys- 

 pepsia, and infect the intestines. The spores are proof against the 

 gastric juice, and as they are produced in a few hours after death 

 the meat of an anthrax animal must always be considered as ex- 

 ceedingly dangerous. 



Man is much less susceptible than some other animals and the 

 disease wherever inoculated tends to remain for a time localized, 

 in the skin, the lungs or the bowels. The forms of the disease 

 are malignant carbuncle (pustule), malignant cedema, intestinal 

 anthrax, and pulmonary anthrax. 



Lesions. The morbid hi.stology is in the main the same as 

 described in animals. In the protracted cases there is the same 

 dark nonaerated blood, forming a loose coagulum, the crenated 

 or distorted blood globules aggregated in irregular masses, the 

 escape and solution of the haemoglobin so as to stain the white 

 tissues, the enlargement of the spleen which is gorged with dark 

 blood, and the hyperaemia of the liver and lymph glands. There 

 is in the affected tissues and usually in the blood the character- 

 istic large bacillus anthracis. 



In the malignant vesicle there is first a minute, firm central, 

 dark nodule like an insect bite with a lighter colored areola, and 

 showing not only hyperaemia, but blocking of the capillaries, and 

 minute areas of extravasation. Somewhat later the dark centre 

 is surmounted by a small vesicle, beneath which the tissues are 

 becoming necrotic, and the area of congestion and extravasation 

 has extended and thus the local disease advances by a constant 

 invasion of new tissue which in its turn becomes the seat of coag- 

 ulation necrosis. On microscopic section the central necrotic part 

 shows the cells of the rete Malpighi separated by a finely granular 

 coagulum, and the papillae are greatly swollen by serous and 

 haemorrhagic exudate. The cell nuclei are necrotic and no 

 longer take a stain. The capillaries are gorged with red globules 

 and bacilli. In the surrounding tissues there is much congestion 

 and exudation, with numerous points of extravasation, but the 

 abundant multinuclear cells retain their staining power. 



In Anthrax CEdema, which appears in parts like the eyelids, 

 neck and forearm where there is an abundance of loose connective 



