422 CHRONIC INFECTIOUS DISEASES 



■i 

 disease. In the meantime a number of horses may become 

 infected by the unsuspected "occult case." The patient 

 may show occasional cough, which is usually dull, weak, 

 and dry. Less often periodical slight nasal hemorrhages 

 (epistaxis) are noted. The horse may tire easily at work and 

 show dyspneic symptoms resembling "heaves." From time 

 to time the temperature may be elevated 1° or 2°. Percussion 

 of the thorax usually gives negative results. In rare cases > 

 dulness from an; area of the lung may be determined, which 

 speaks for a superficially located glanders tumefaction at 

 least the size of a double clenched fisk 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 \he 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, unless there is a history of glanders 

 infection, , or other horses or mules on the premises showing 

 typical lesions, the diagnosis from ordinary physical examina 7 

 tion 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, 



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