Text book of veterinary medicine, Volume 4 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 4 (of 5)
Law, James
Veterinary medicine
bacillus, is however, so readily destroyed by thorough desiccation that
this mode of transmission is exceptional. Some men are immune to
glanders, and suffer only when predisposed through a course of ill
health, and yet a large proportion of the cases on record have been in
strong hearty men.
_Symptoms of Glanders in Man._ In man as in the horse, glanders occurs
in the _acute_ and _chronic forms_. In the _acute_ supervening on an
external inoculation, _incubation_ is from one to four days. When it
enters through other channels it may seem to extend to a week or more.
When a skin abrasion has been inoculated it will show in a few days a
soft inflammatory swelling or a firm nodule with a puffy reddish areola,
and it may be mistaken for a carbuncle. In not a few cases the small
nodule has been mistaken for small pox. In my experience a horsemen on a
ranch on which over a hundred horses showed glanders, died of an
ulcerous skin affection which was variously supposed to be a malignant
small pox and measles, though neither malady was known to exist in the
district. Other cases are confounded with gangrenous erysipelas. The
absence of these other affections from the locality, and the fact that
the patient was employed about glandered horses, should go far to
correct such mistakes. The early supervention of ulceration is further
diagnostic, and discovery of the bacillus mallei in the products will be
conclusive. From anthrax it is easily distinguished by the absence of
the dark centre of the sore in the early stages, and of the large sized
bacillus anthracis. The caseation or liquefaction of the necrotic centre
further distinguishes it from the characteristic anthrax slough, and the
thickening and induration of the lymphatic walls are not present in
anthrax. Sometimes the inoculated case proves mild and recovers in two
or three weeks with healing of the ulcer, but in other cases there is an
extension to adjacent tissue and a general infection with the
supervention of nasal glanders.
There is a spread of the erysipelatoid inflammation and swelling, and
the formation in such newly invaded tissue of nodules and ulcers in
successive crops. In acute cases too, the nasal mucosa becomes involved
with the formation of the nodules and ulcers that are so pathognomonic
in the horse. The discharge is then somewhat sticky and often tinged
with blood. In acute cases according to Senn, the nose may be completely
destroyed and deep facial ulcers may be formed in a week. The
submaxillary glands are enlarged and painful and the facial lymphatic
vessels leading from these to the nose may be red, thickened and tender.
Suppuration and ulceration of the glands may ensue. Headache,
prostration, nausea, inappetence and vomiting with diarrhœa usually
supervene. Then follow dyspnœa, wakefulness, troubled dreams, anxiety,
nocturnal delirium, stupor and coma. The pulse may rise to 120 and the
temperature to 104° F.
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