GLANDERS— MALLEUS 465 



rise again later in the day. Such a reaction is spoken of as 

 positive. On the second and sometimes on the third day 

 a second temperature curve, though usually less pronounced, 

 may occur. 



When the post-injection temperature exceeds the highest 

 pre-injection temperature, 2.7° F. and reaches 103.1° F., 

 or over, and a marked swelling occurs at the point of inocu- 

 lation, the swelling being hot, sensitive and at least 5 to 

 10 cm. in diameter, the reaction is positive. The swelling 

 should persist for at least twenty-four to thirty hours. 



The reaction is doubtful even if the temperature exceeds 

 3.6° F. and no local reaction appears. 



The reaction is negative when, notwithstanding the height 

 that the temperature may reach, the febrile condition does 

 not last at least four to six hours. 



The reaction is negative when the temperature elevation 

 is not more than 1.8° F. and does not exceed 102.5° F. « 



A positive reaction denotes that the patient is affected 

 with glanders. An atypical reaction indicates that the case 

 should be considered suspicious. A negative reaction denotes 

 the absence of glanders. Cases of doubtful reaction should 

 be retested but not sooner than fifteen days to six weeks 

 following the next previous test. 



4. The endermic method of applying mallein is very rarely 

 used. It does not compare in accuracy with the intradermic. 



B . Serum Diagnosis by Means of Agglutination. — The 

 so-called agglutination test for glanders is a fairly reliable 

 laboratory method in which the serum of the blood of a 

 suspected horse is prepared in various dilutions by means of 

 the addition of physiological salt solution. In order to 

 determine the agglutinating power equal quantities of emul- 

 sions of glanders bacilli which have been attenuated by heat- 

 ing at -60° C. (test fluid) are added to the serum solutions. 

 Blood serum which will agglutinate glanders bacilli in dilu- 

 tions 1 to 1000 or in greater dilutions must be considered 

 as coming from a glanderous horse. Agglutinations occurring 

 only in dilutions ranging from 1 to 500 to 1000 are doubtful. 

 Agglutinations in dilutions of less than 500 indicate the 

 absence of glanders. The test often fails in chronic glanders, 

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