310 THE PATHOLOGICAL HISTORY OF GLANDERS. 
spot, at whose borders smaller vesicles arise of the same type and 
form. 
“ Suppuration occurs beneath the skin and betwixt the muscles, 
and both beneath and within the periosteum. Here, likewise, differ- 
ent grades of morbid deposition are perceptible. In a few instances, 
more or less extensive ecchymoses are present; in others, effusion 
of limpid or turbid serosity ; in others, again, a jelly-like mass. For 
the most part, however, there are differently sized abscesses, either 
terminating abruptly in healthy structure, or else surrounded by 
sero-purulent infiltration within softened texture. The pus itself 
often appears laudable, on other occasions ichorous, and as if 
mingled with decomposed blood and with dissolved tissues. 
“ Thorough contamination of the blood and other fluids is, in- 
variably, evidenced by fcetor during life, and by rapid putrescence 
of the body after death. In the heart and vessels the blood is 
fluid, there being but little fibrinous coagulum deposited, whilst 
there is tumefaction and softening of the spleen, together with 
general imbibition of the tissues. The ecchymoses already alluded 
to, conjointly with similar ones in the mucous membranes of the 
digestive organs, seem, in a like manner, to denote the decompo- 
sition of the blood. 
“ The order of sequence of the several organic changes is toler- 
ably uniform in different cases, appearing to deviate only accord- 
ing to the way in which the distemper has been contracted. 
Glanders seem to be conveyed from the horse to man in a two- 
fold manner, namely, by infection and by inoculation. We are 
altogether in the dark as to the conditions that govern the for- 
mer mode of propagation. Does abiding in the atmosphere of the 
diseased animals suffice ! Is it that their exhalations operate upon 
injured portions of the skin, or upon the injured surface of the 
respiratory mucous membrane 1 In some cases there is no evi- 
dence of the morbid animal matter having come in contact with 
wounds of the skin in persons attacked. At present, therefore, 
we are compelled to assume general infection, apart from contact, 
inasmuch as the local affection on those occasions was invariably 
preceded by constitutional ailment, referable to no other obvious 
cause, and nowise differing from any other violent eruptive fever. 
In the majority of cases, however, the disease is traceable to inocu- 
lation with the virus. The patients have either allowed abrasions 
of the skin to come in contact with the nasal secretions of the horses 
they are tending, or had wounded themselves whilst occupied in 
skinning or cutting up the dead animals. Here the disease dates 
from the moment of inoculation, and the progress of the superven- 
ing organic changes could be pursued anatomically. Thus, when 
