350 
GLANDERS IN A FEMALE. 
abundant all over the body ; none seemed to have burst, 
except on the forehead, where bruised. The pulse was 
weaker ; the tongue moist, but coated ; the arm better. The 
wool had not been removed from the ankles. The attendant 
said that the matter from the nostrils was peculiar and 
sickening. The patient was almost in a state of low 7 deli- 
rium. The colchicum w 7 as omitted, and she w 7 as directed to 
take bark, with diluted hydrochloric acid and stimulants, 
also an expectorant. Vespere: She was more sensible. The 
phlegm was very copious, but more easily expectorated. The 
nostrils were much dilated, and discharged a dark sanious 
fluid. The pustules generally appeared more suppurative ; 
some over the chest were as large as a sixpence, full of pus, 
but without inflamed edges round them ; those on the legs 
were in all stages; and the patches of erythema were very 
bright. The eyelids were closed, but she could open the 
right one. She had taken some porter. Bark and expec- 
torants were continued, and the eyes w T ere ordered to be well 
w r ashed with w arm water. 7th : She died at half-past tw 7 o 
o’clock in the morning. 
Remarks , — On my first visiting the patient, the state of 
fever, the severe pain of the joints, and the redness and 
swelling of the ankles, led me to think that she was suffering 
from acute rheumatism. I concluded that the pustules over 
the body were of the epidemic character that has so long 
prevailed, and that the occurrence of the acute rheumatism 
at the same time w r as merely accidental. The urine being 
scanty and high-coloured, I prescribed (what I have never 
found to fail in acute rheumatism) the acetate of potass 
every two hours, with a pill of soap and opium at bed-time. 
But this opinion did not satisfy me. There was an in- 
definable expression about the patient and a varied pecu- 
liarity about the appearance of the eruption, for which I 
could not account ; and I left her w ith the unsatisfactory 
conclusion that she w as very seriously ill, and that I did not 
know 7 what was the matter with her. As I passed through 
the stable (she lived on the loft) on my w 7 ay out, I asked her 
husband if his horses, three in number, w r ere healthy, and he 
said that they w 7 ere so. On the next day her general appear- 
ance was in no w ay improved. She had a low typhoid look, 
and yet she was sensible and collected. The urine had 
improved ; but as the general symptoms had not, I altered 
her medicine, and gave her colchicum with an anodyne. On 
the third day, the sudden and profuse discharge of sanious 
matter from the nose; its peculiarly offensive sickening 
odour ; the dilated nostrils ; the sudden affection of the 
