446 
GLANDERS IN THE HUMAN BEING. 
the largest being above the right knee (which had been very pain¬ 
ful, and was still tender on pressure), and on each instep. No 
portion of these patches was hardened or circumscribed; their 
surface was rather glossy, and the redness readily disappeared 
under the touch, re-appearing as quickly. No other form of cu¬ 
taneous eruption was visible. He was capable of answering 
questions collectedly, but speedily relapsed into the soporose state, 
with muttering delirium. In this state he generally lay; and his 
sensibility to pain was, no doubt, greatly blunted, and the parti¬ 
culars of his suffering not very clearly to be ascertained at this 
stage of his disease. Paroxysms of excitement now and then 
occurred, during which he endeavoured to leave his bed. He did 
not complain of pain in the head. The breathing was oppressed 
and hurried, with mucous rhoncus at times. The abdomen was 
very tympanitic; the bowels rather confined. 
Turpentine was administered by the mouth and in clysters, 
and copious dark offensive dejections, with free discharge of urine, 
took place. The tympanitis subsided in great measure, and he 
subsequently took several doses of a mixture containing creasote. 
His state, however, became gradually worse. The delirium was 
in the course of the night more violent, so that he was kept in bed 
with difficulty; and, on the following morning (April 4th) the 
swelling had extended to the left eyelids, and on the right side it 
had assumed a dark livid hue, in parts nearly black; the dis¬ 
charge from the left nostril was slightly tinged with blood. The 
delirium was much the same in character and degree as yesterday. 
I observed that, in his mutterings, he had frequent reference to 
horses. In the course of the day the coma became more com¬ 
plete, and he died in the evening, without any further change in 
his symptoms. 
It appeared that he had been affected for about a fortnight with 
pain in the loins, lassitude, chills, and other feverish symptoms, 
which were referred to a mild form of ‘‘ influenza,” then prevalent. 
The subsequent sore throat and erysipelatous inflammation of the 
eyelid were not sufficiently peculiar to have excited much attention. 
The ensemble” of his appearance and symptoms led me im¬ 
mediately on my first seeing him, though knowing at the time no¬ 
thing of his history or occupation, to suspect the influence of some 
animal poison on the system; and as the contagion of “ glanders” 
was that to which he might most probably have been exposed, I 
directed my inquiries, in the first place, to this point. I then found 
that he had been employed as driver of a van, and that one of his 
horses had been for many months diseased, and affected with a 
discharge from the nostril, and that he had attended the horse 
closely, and had been in the habit of wiping away the discharge. 
