METHODS OF EXAMINATION 317 



never rises as much as 1 -5°, the reaction is considered doubtful. In the 

 negative reaction given by an animal free from glanders, the rise of 

 temperature does not usually exceed 1°, the local swelling reaches the 

 diameter of three inches at most, and has much diminished at the end 

 of twenty-four hours. In the case of dry mallein, local reaction is less 

 marked. Veterinary authorities are practically unanimous as to the 

 great value of the mallein test as a means of diagnosis. It has recently 

 been shown that mallein instilled into the conjunctival s:ic, or inoculated 

 by scarification into the skin of glandered animals, gives corresponding 

 reactions to the ophthalmic and cutaneous tuberculin reactions in cases 

 of tuberculosis (p. 291) ; in the case of glanders the conjunctival reaction 

 would appear to be the more convenient and reliable. 



Methods of Examination. — Microscopic examination in a 

 case of suspected glanders will at most reveal the presence of 

 bacilli corresponding in their characters to the glanders bacillus. 

 An absolute diagnosis cannot be made by this method. Cultures 

 may be obtained by making successive strokes on blood serum or 

 on potato, and incubating at 37" C. The colonies of the glanders 

 bacillus do not appear till two or three days afterwards. This 

 method may fail unless a considerable number of the glanders 

 bacilli are present. The most certain method, however, is by 

 inoculation of a guinea-pig, either by subcutaneous or intra- 

 peritoneal injection. By the latter method, as above described, 

 lesions are much more rapidly produced, and are more character- 

 istic. If, however, there have been other organisms present, 

 the animal may die of a septic peritonitis, though even in such a 

 case the glanders bacilli will be found to be more numerous in 

 the tunica vaginalis, and may be cultivated from this situation. 

 It is extremely doubtful whether the application of mallein to 

 diagnosis of the disease in the human subject is justifiable. 

 There is a certain risk that it may lead to the lesions assuming 

 a more acute character ; moreover, culture and inoculation tests 

 are generally available. In the case of horses) etc., a diagnosis 

 will, however, be much more easily and rapidly effected by means 

 of mallein, or by one of the serum reactions described above. 

 In some cases of acute glanders in the human subject the bacillus 

 has been obtained in cultures from the blood during life. 



Rhinoscleroma. 



This disease is considered here as, from the anatomical 

 changes, it also belongs to the group of infective granulomata. 

 It is characterised by the occurrence of chronic nodular 

 thickenings in the skin or mucous membrane of the nose, or 

 in the mucous membrane of the pharynx, larynx, or upper part 

 of the trachea. The nodules are of considerable size, sometimes 



