Glanders. 281 



and degeneration of numerous foci of cell proliferation gives the 

 ulcer a very uneven outline. The continuous growth of fresh 

 centres of proliferation may cause marked elevations between the 

 ulcers, constituting extended patches, or the entire nasal mucosa 

 may be thickened as the result of the morbid deposit. The cica- 

 trices resulting from the apparent healing of deep or extensive 

 ulcers or from a fibroid transformation of the neoplasm consist of 

 condensed connective tissue with small scattered nests of lymphoid 

 cells and bacilli. In chronic cases the bacilli are very scanty. 



The mucosa of the Eustachian pouches and tubes, the larynx, 

 trachea and bronchia often present lesions similar to those of the ' 

 pituitary membrane. 



The lungs are usually marked in chronic cases by circumscribed 

 lobular pneumonia, interlobular and peribronchial inflammations 

 and miliary or larger areas of degeneration resembling tubercles. 

 These may begin as a minute congestion and ecchymosis, which 

 later shows in the centre a translucent or gray mass of lymphoid 

 cells, with a surrounding area of congestion. Later still this 

 central mass becomes yellowish and caseated from granular and 

 fatty degeneration and this gradually extends so as to involve the 

 whole area of the nodule. The peripheral portion may condense 

 into a fibroid envelope, but usually this is less smooth and evenly 

 rounded than in the case of an inspissated abscess or bladder- 

 worm. The bacilli are found in the affected tissue but not always 

 abundantly. 



In cutaneous glanders the lesions may begin in the papillary 

 layer by active congestion and infiltration and proliferation of 

 lymphoid cells which cause an eruption of rounded papules like 

 small peas that degenerate and soften and form superficial ulcers. 

 When the derma is mainly involved the inflamed area becomes 

 the seat of larger hard nodules which are at first deeply congested, 

 with capillary thrombi, minute extravasations and rapid cell pro- 

 liferation ; later on section they show numerous caseated centres 

 with a dense fibroid framework and surrounded by an area of 

 active congestion and capillary haemorrhage ; later still the casea- 

 tion and softening has caused rupture of the investing epithelium 

 and the discharge from the ulcerous cavity of a yellowish, glairy, 

 grumous liquid (open farcy buds). Sometimes the nodule 

 undergoes fibroid induration and fails to ulcerate, becoming the 

 counterpart of the cicatrices in the nose. When the infective in- 

 flammation extends to the subcutaneous connective tissue, diffuse 



