350 
ACUTE GLANDERS IN THE HUMAN SUBJECT. 
the glanderous nasal discharge is recognised as the chief 
vehicle of infection, yet it can hardly be doubted that the 
contagion may exist in the other excretions ; nay, that occa- 
sionally, as in damp stalls, infection may take place without 
any observable contact ; probably, through the medium of inspired 
air” This opinion appears to have been shared by Rayer, 
who says : “ There are cases where no local results of inocu- 
lation are observed, the first symptoms being those of a 
general infection of the system.” Still, this view is not 
generally adopted, as is evident from the following observa- 
tion of Dr. Copland : “ Whether or not it (the glanderous 
matter) is capable of producing the disease by being applied 
to the unabraded mucous surface, or by merely contami- 
nating the air breathed by the unaffected, is certainly not 
proved as respects the human subject.” 
The case of my patient lends a strong confirmation to Dr. 
Mackenzie’s views of the possibility of infection. In his 
case there still existed a doubt, as the matter might have 
come in contact with and been absorbed by an entire mucous 
surface : but in my case this certainly did not occur. The 
facts bearing on this point, which I afterwards gleaned from 
the patient, are these : — On entering the stable to see his 
friend, he did not approach any of the horses, but passed on 
to an upper department (which formed a slope or inclined 
plane), separated at its extremity, at the head of the building, 
by a depth of six feet from the animals themselves, in the 
lower or ground department — the edge being protected by a 
rail, over which he leaned whilst conversing with the stable- 
man. He was thus at a distance of six feet from the 
glandered horse, the foetid breath of which he doubtless in- 
haled as he leaned his head over the rail ; inasmuch as he 
states he felt sickened thereat. Moreover, he was positive 
the animal did not sneeze during the time of his visit. It 
appears then from this evidence pretty clear that— 
a. The atmosphere was the medium of communication ; 
and 
b. The distance of safety exceeds six feet. 
The circumstance of this mode of communication of the 
morbid agent entirely explains the apparent anomaly of the 
absence of glandular swellings, aoscesses, &c., usually ob- 
served in cases of equinia. When the poison is introduced 
through an abrasion or wound in any part, it naturally 
follows the course of the absorbents ; and thus the local 
symptoms precede the constitutional. The reverse, of course, 
must occur where the disease (as in the present instance) is 
caught by infection. 
