REVIEW—GLANDERS IN THE HUMAN BEING. 109 
vinced me that this could not be a case of typhus, I acknowledge 
that the suspicion sometimes occurred, whether it might not be 
some rare form of this disease. The diarrhoea, the character of 
the stools, the involuntary discharge of urine, and the sibilant 
rale favoured this supposition. 1 was assured that the case 
must terminate fatally ; but, in order to afford the patient every 
chance, a blister was applied over the region of the stomach, 
and a decoction of bark was administered, united with ether. 
Wth .—My mind being pre-occupied by the peculiar appear¬ 
ance of the pustular eruption which I had observed on so many 
parts of his body, and the resemblance of some of them to those 
of chicken-pox {varicella), and of others to common papulous 
scall {ecthyma), and of others, still with the enlargements of blain, 
become purulent {rupia), and of the coincidence of this eruption 
with the gangrenous spot on the glans, I determined to examine, 
more carefully than I had done before, the whole surface of his 
body. I then recognized on the skin and under it various other 
morbid alterations. One large black gangrenous phlyctaena 
{vesicle) was situated beneath the left ear, near the insertion of 
the sterno-mastoidean muscle, almost as large as a twenty-sous 
piece. At the centre, the epidermis was irregularly elevated by 
a somewhat blue-coloured liquid, variously shaded. The base of 
this black enlargement was encircled by a ring of coherent 
vesicles, which had a light rose, or, in some places, a violet tint. 
The cellular tissue situated below the portion of skin surmounted 
by this phlyctajna, and that which surrounded its base, was 
scarcely swelled, and was without hardness, oedema, or emphy¬ 
sema. The skin of this phlyctsena, slightly red, soon regained 
its natural colour. This group of characteis immediately and 
plainly distinguished the enlargement from the ordinary form of 
malignant pustule. Its contents also were more bloody than 
purulent, and of the consistence of syrup. 
On the jaw on the same side of the face was a large pustule, 
with a tuberculous rounded base, but depressed in the centre, 
seemingly on account of the escape of a portion of its contents, 
and which a yellow scab replaced. This pustule was surrounded 
by a yellow circle, but with very slight thickening of the skin. 
On the fore-arm was a large pustule full of pus, having the 
appearance of one of rubia become purulent. 
On the right shoulder were three considerable abscesses, dis¬ 
posed as a chaplet, one below another. Thirteen others of the 
same kind were found on various parts of the body. In the 
greater part of these purulent depots, there was no change of the 
colour of the surrounding skin. 
All these purulent collections were soft, uniformly fluctuating, 
VOL. XI. g 
