48 
CASE OF ACUTE GLANDERS. 
an enormous tumour. I have already mentioned some of his 
symptoms, but it may not be amiss to recapitulate the following. 
There was a profuse discharge of saliva running from his 
mouth; the tongue was tumid, and its surface covered with a 
white, moist fur; the gums were soft and swollen, and his teeth 
loose. On passing my finger under the tongue, a large elastic 
tumour was felt on each side of the fraenum linguae, apparently 
consisting of the enlarged sublingual and submaxillary glands, 
and the distended ducts of the latter. I made a free incision 
in each of these, and a great quantity of clear glairy mucus 
poured out, which gave the patient much relief. I was unable 
to examine the throat, on account of the general swelling of the 
parts; but, from the character of the breathing and the difficulty 
of swallowing, it was evidently swollen, and the isthmus faucium 
contracted : I could not, however, see any appearance of erosion, 
ulceration, or pustules. The nostrils were filled with a viscid, 
yellow, opaque secretion, which, as I have said, was with dif¬ 
ficulty dislodged, on account of its tenacity. The conjunctivae 
were injected, and the eyes watered profusely. The patient 
complained of severe headache, which was greatest over the 
eyes and frontal sinuses, but at times it was felt over the greater 
part of the head. He was very sick, could not retain food upon 
his stomach, and was very restless and uneasy. He stated that 
he had not slept for a week. He was alternately chilly and hot, 
and, at times, broke out into cold sweats. His pulse was quick 
and weak, and he complained of great lassitude. He had no 
rheumatic pains, or any perceptible eruption on the skin or 
mucous membrane; the blister which had been applied had 
risen, and had a greenish, sloughy, unhealthy appearance. His 
bowels had twice acted during the morning, and he made water 
freely. 
Treatment .—He was directed to take immediately an emetic, 
consisting of half a drachm of ipecacuanha, and, as soon as 
the vomiting had ceased, to take five grains of the sesquicar- 
bonate of ammonia in water, every hour, as concentrated as he 
could swallow it; to use frequently a gargle of chloride of lime, 
and to have wine and such nourishment as he could swallow 
given freely, and to take an opiate at night, consisting of twenty 
drops of the tincture, 
July 28 th .—Up to this date he had been daily gaining 
ground, under the continuance of the ammonia, and an occasional 
dose of blue pill, with animal food and porter for diet. The 
ammonia was discontinued on the 25th, and since then he has 
been taking merely a nourishing diet, with a pint of porter 
daily. He now wished to be discharged, declaring that he 
never felt better in his life. He left the next day. 
The “ report of the case ” we have just concluded the perusal 
