GLANDERS IN MAN 



163 



Of the abdominal organs, the spleen is most frequently 

 attacked. It then contains embolic nodules, which vary in 

 size and either suppurate or become calcareous. Similar 

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

 testicles, brain, muscles, heart and bones. In the bones, the 

 lesions consist of a cellular infiltration of the medulla and 

 purulent breaking down of the osseous tissue. Ulcers are 

 very rare on the mucous membranes 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 chiefly 

 in a disintegration of the respiratory mucous membrane, in a 

 serous infiltration of the submucosa, subcutis, and inter- 

 muscular tissue, with inflammation and suppuration of the 

 lymph 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 consid- 

 erable infiltration into the submucosa. The mucous membrane 

 of the larynx and pharynx may be 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. 



§ 134. Glanders in man. The symptoms of glanders 

 in man are of much importance to the veterinarian. Although 

 the susceptibility to the disease is usually not very great, cases 

 of human glanders unfortunately occur, especially among 

 veterinary surgeons and those having the care of horses. 

 Human glanders is reported to be quite common in Russia. 

 The parts usually first affected are the hands, nasal mucous 

 membrane, lips and conjunctiva. After a period of incubation 

 of from three to five days the infected part becomes swollen 

 and painful, with subsequent inflammation of the lymph ves- 

 sels and swelling of the glands. Fever is often the first 

 symptom, and it is nearly always followed by a nasal dis- 



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