Glanders iti Man. 289 



Pathological Anatomy and Diagnosis. This is fundamentally 

 the same as in the horse. The bacillus and its toxic products act 

 on the infected tissues to produce clusters of lymphoid cells in a 

 fibrous stroma after the manner of tuberculosis. l,ike that disease 

 it also tends to affect primarily the lymph channels* and glands, 

 showing a particular tendency to the respiratory mucosa and has 

 a great disposition to early coagulation necrosis, ulceration, sup- 

 puration and abscess. The giant cell of tuberculosis is not a 

 prominent feature in glanders, and the disposition to suppuration 

 is greater especially in the human being so that the disease often 

 resembles pyaemia. As in solipeds, however, the glander abscess 

 has somewhat more sanious or glairy contents and the investing 

 wall is not smooth and regular, but uneven and ulcerous from the 

 successive softening and discharge of the clusters of degenerating 

 lymphoid cells in the adjacent tissue. The pallor of the adjacent 

 tissues from exudation and from the presence of numerous nests 

 of lymphoid cells, the thickening of the efferent lymphatics, and 

 the presence of numerous lymphoid neoplasms in the adjacent 

 glands and tissues, and often in the internal organs such as the 

 liver and spleen and in the nasal mucosa or lungs, together with 

 the history of the patient's exposure to glanders, serve to diagnose 

 from pyaemia. From smallpox and rotheln the skin lesions are 

 distinguished by the presence of a central coagulation necrosis 

 bathed in a glairy seropurulent fluid, and by the infiltration and 

 thickening of the efferent lymphatic trunks. It differs from ery- 

 sipelas in the same way by the presence in the affected tissues of 

 the small hard lymphoid masses of embryonal tissue, and in a 

 more advanced stage by the granular fatty debris resulting from 

 their fatty degeneration. The presence in the affected tissue of 

 these miliary or pea-like neoplasms in all stages of development 

 from the primary congestion, through the embryonal tissue to the 

 coagulation necrosis and caseation or softening is characteristic of 

 the lesions of glanders. The sanious, sticky or glairy pus is espe- 

 cially noticed in the newly opened abscess, as after exposure to 

 the air it is speedily infected with pus microbes, and the discharge 

 becomes less serous and more creamy. Another characteristic of 

 glanders in man is the frequent implication of the bone marrow, 

 and the formation of the lymphoid deposits in the cancellated tis- 

 sue until the bone may be reduced to a mere friable shell. Even 

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