ACUTE GLANDERS IN THE HUMAN SUBJECT. 347 
wine at intervals, or brandy and water. With this advice, 
however (having been a teetotaller for twelve years), he 
declined to comply. 
July 18th. — At my morning visit I found him much worse. 
None of the local symptoms were ameliorated, and the con- 
stitutional disturbance had greatly increased. His difficulty 
of speech was such as to render his articulation almost unin- 
telligible. He had been slightly delirious during the night, 
and said he should die. The case, I confess, now puzzled 
me not a little ; I could not account for such severe and 
protracted disturbance of the circulation and nervous sys- 
tem, and such remarkable resistance to local remedies. On 
the afternoon of the same day, at the patient’s own request, 
he was seen by Dr. Frederick W. Mackenzie. On hearing 
my account of the case, and from the similarity it seemed to 
present to others which he had previously seen, he imme- 
diately suspected it to be acute glanders ; and he was con- 
firmed in this opinion upon visiting the patient w 7 ith me. 
Upon questioning him, the following history was elicited ; 
the patient, however, not suspecting, and scarcely crediting, 
that it had anything to do with his illness. 
About ten days previously, after breakfasting at six o’clock, 
he walked w T ith a heavy load of clogs, &c., to Paddington (a 
distance of more than two miles), walked about there a good 
deal, and had nothing to eat or drink until between ten and 
eleven ; when, on his way home, he called at some livery 
stables to see a friend who was employed therein. While 
there, he noticed a glandered horse, and felt faint and 
sickened by the effluvia proceeding from the animal. He 
remained a short time, (perhaps twenty minutes) and then 
returned home, and had thought no more of the occurrence. 
The next day he felt soreness of the mouth and throat, with 
slight salivation, which increased daily, up to the day on 
which he applied to me for advice 
i)r. Mackenzie immediately advised the following: — ten 
grains of sesquicarbonate of ammonia, with five drops of 
tincture of opium, and one drop of creosote, to be taken 
every two hours. 
1 saw him again the same evening. He had taken two 
doses of the mixture, but declined continuing it, on account 
of the creosote. I therefore advised wine to be given freely 
during the night. 
July 19th. — We found him slightly improved. There had 
been during the night a slight viscid tenacious discharge 
from one nostril ; and on examination, a scab was discernible, 
evincing tendency to ulceration of the Schneiderian mem- 
