A chronic form is known, distinguished mainly by slowness or tardiness of lesions, though the local changes are not particularly different in character. There is perhaps more tendency to suppuration and less to lymphatic complications. The nodule which breaks down will leave a foul ulcer, the _discharge_ from these lesions being _extremely infectious_. =Diagnosis.=--This is not always easy, but may be based in suspicious cases to some extent upon the occupation of the patient. The presence of multiple lymphatic lesions and subcutaneous nodes, especially when breaking down as above described, and accompanied by ozenous discharge from the nose, should at least be suggestive, and will serve to distinguish between this disease and, for instance, typhoid fever. The chronic type of glanders might be mistaken for syphilis, and here is where the real difficulty of diagnosis will probably occur. In doubtful cases the crucial tests are the microscopic examination of discharges, after staining for bacilli, and the cultivation test. =Prognosis.=--A generalized attack of glanders is a matter of gravest import, especially when acute. Scarcely more than 10 or 15 per cent. of such cases recover. In the more chronic manifestations the prognosis is more favorable, half of the patients making a final recovery. =Treatment.=--All infected animals should be isolated and destroyed, their carcasses being _burned_. If possible, the infected wound or abrasion should be induced to bleed freely, and then cauterized with an active caustic. By prompt interference with the first manifestations it may be possible to cut short the disease. This would necessarily be done by _excision_, _cauterization_, _packing_, etc. Bayard Holmes has reported a case in which, during two and a half years of chronic manifestations of this disease, he anesthetized the patient twenty times for the purpose of opening new foci or scraping out old ones, finally obtaining a permanent cure. There is no specific treatment, but the septic symptoms should be combated as indicated in the chapter on Septicemia. By making a _glycerin extract_ from the filtered and evaporated culture of the glanders bacillus it is possible to prepare a toxalbumin analogous to tuberculin, which reacts in a similar way. By it animals may be fortified against inoculation, and by its use a peculiar reaction is produced in those affected by the disease. It is known as _mallein_, and by it are tested all horses used for the preparation of the diphtheria antitoxin, in order that all possibility of glanders may be eliminated. It is probable that it might be made of therapeutic value in treating the disease when actively present in man. ANTHRAX.