GLANDERS— MALLEUS 461 



speaks for a superficially located glanders tumefaction at 

 least the size of a double clenched fist. Auscultation is 

 usually negative, although after a smart gallop moist rales 

 are heard in some cases, especially if the ear is placed over 

 the lower end of the trachea. The trachea is sensitive on 

 palpation in individual instances (tracheitis). If the larynx 

 is involved, spasmodic cough and inspiratory dyspnea with 

 stenotic noise are noted. As a rule, in time the general 

 condition of the patient becomes bad. It loses weight, the 

 hair coat appears dull, and the mane and tail hairs become 

 loose. In some cases there is a tendency for passive edemas 

 to develop on the limbs and pendent portions of the body 

 (sheath, udder, ventral part of the abdomen). Following 

 a remission in the course of the disease these dropsical 

 symptoms may temporarily disappear. 



Diagnosis. — Provided the clinical symptoms are well 

 developed the diagnosis of glanders is not difficult. ' The 

 occurrence of the nodules, characteristic ulcers, and stellate 

 cicatrices on the mucous membrane of the nasal cavity, 

 the enlargement of the submaxillary lymph glands, and the 

 symptoms of fever are almost pathognomonic. However, 

 in many cases the lesions are too high up in the nasal cavity 

 (or they may be in the adjacent sinuses) to be seen or felt. 

 In these cases, imless there is a history of glanders infection, 

 or other horses or mules on the premises showing typical 

 lesions, the diagnosis from ordinary physical examination 

 may be impossible. 



The skin glanders is characterized by the indolent ulcers 

 which often are not surrounded by a zone of acute inflam- 

 mation. However, any persistent edematous swelling, 

 nodular thickening or ulcer formation on any part of the 

 body especially under the abdomen, sheath or udder should 

 be looked upon with suspicion. 



Differential Diagnosis. — ^There are a number of diseases 

 producing nasal discharge, lesions on the nasal mucous 

 membranes, swellings of the submaxillary lymph glands, 

 and nodules and ulcers in the skin. At times some of these 

 appear strikingly like glanders. Formerly when a differen- 

 tiation was only possible by carefully weighing the clinical 



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