GLANDERS. 
529 
though it will rarely happen that both sets of glands will swell at 
one and the same time. While recent or susceptible of pain from 
compression, these tumours are apt to fluctuate in magnitude, being 
at one time large, at another comparatively small. In general, 
blisters and sometimes common stimulants will reduce them, though 
I have known the opposite effect produced. I do not remember 
seeing suppurative action produced in them ; commonly, as I have 
before observed, they become hard, void of sensibility, and scir- 
rhous in their nature, and so continue to the end. In reference to 
their variable character, 
DUPUY makes the following observations on these glands : — 
“ when the mucous membrane of the chambers of the nose is 
affected, the sublingual (submaxillary) glands become tumefied, 
and undergo some very variable changes. In succession, they 
grow in the same subject, swollen, firm, painful, and moveable. 
In a short time after this they become insensible, diminished in 
volume, and appear to resume their natural condition ; then again, 
all on a sudden, they recommence swelling, and in the course of a 
few days grow larger than ever they have been.” 
TUMEFACTION OF THE ALA NASI is a frequent, not 
a constant symptom of glanders: when present, it is always highly 
characteristic of the acute disease. It is seen in virulent and ma- 
lignant attacks, and especially when the disease has set in suddenly : 
it is seldom an accompaniment of the sub-acute forms of glanders, 
so long as they remain sub-acute, and is never seen in the 
chronic varieties. Should the tumefaction not accompany the 
onset of acute glanders, it is almost certain to come on during the 
latter stages, prior to dissolution. The swelling of the nostrils may 
arise from the intensity and spread of the inflammation in the 
interior of the nose : very often, however, it is obviously the result 
of an attack of farcy of the integuments clothing the nostrils, in- 
cluding frequently the upper lip as well ; and in that case there 
will be tumefied or corded lymphatics perceptible upon the swollen 
parts, and very frequently traceable from them along the cheek to 
the border of the jaw, proceeding into the submaxillary glands. 
Pustules or farcy-buds will also appear, and break and become 
ulcers, seated occasionally within the fold of the ala nasi , the 
same as in other parts of the body. The tumefaction of the 
nostrils when combined — w r hich it commonly is — with a profusion 
of gummy discharge, adds greatly to the embarrassment in the 
breathing. The partial closure of one nostril produces a good 
deal of inconvenience and annoyance : when this happens with 
both, the suffering and distress it occasions will be likely, as I 
before observed, to end in suffocation, unless relief in some way or 
other be afforded. 
VOL. XVII. 4 A 
