GLANDERS or FARCY (equinia), a specific infective and contagious disease prevailing in most parts of the world. Caused by Bacillus mallei, it affects chiefly the horse, ass, and mule but is communicable to man. In Equidae it is one of the most serious of maladies, and specially affects the lungs, respiratory mucous membrane, and the lymphatic system. It occurs partic ularly among horses kept in foul, crowded, badly ventilated stables or such as are over-worked, badly fed, or debilitated. It may be contracted by inhalation of the bacilli, ingestion of the virus with food or water, or inoculation of a wound of the skin or a mucous membrane. Carnivorous animals—lions, tigers, dogs, and cats—have become infected through eating the flesh of glandered horses ; and men attending diseased horses are liable to be infected (see below).
Sometimes a distinction is made between glanders with nasal ulcers and other symptoms of respiratory disease, and glanders of the skin, or farcy, but there is no essential difference. Both are due to the same organism, and both may be acute or chronic. Acute glanders is always rapidly fatal, and chronic glanders may become acute or terminate by apparent recovery.
The symptoms of acute glanders are initial fever, thirst, loss of appetite, hurried pulse and respiration, emaciation, languor, and disinclination to move. Sometimes the legs or joints are swollen ; but the characteristic symptoms are a greyish-yellow viscid discharge from one or both nostrils, a peculiar enlarged and nodulated condition of one or both submaxillary lymphatic glands, which though they may be painful very rarely suppurate, and on the nasal membrane small yellow pimples or pustules, running into deep, ragged-edged ulcers, and sometimes on the septum large patches of deep ulceration. The discharge from the nose adheres to the nostrils and upper lip, and causes snuffling and frequent snorting. The lymphatic vessels of the face often appear as painful subcutaneous "cords" passing across the cheek. These vessels sometimes present nodules which break and discharge a glutinous pus. As the disease progresses, the ulcers on the nose increase in number, enlarge or become confluent, extend in depth, and may perforate the septum. The nasal discharge, now more abundant and tenacious, is streaked with blood and offensive, the respiration is noisy or roaring, and there may be coughing with bleeding from the nose. Painful oedematous swellings appear on the muzzle, throat, between the fore legs, at the flank or on the limbs, and "farcy buds" may form on some of the swollen parts. Pneumonia and pleurisy, with extreme prostration, and diarrhoea precede death, which is due to asphyxia or to exhaustion.
Chronic or latent glanders generally presents few definite symp toms. The suspected animal may have a discharge from the nose, or an enlarged submaxillary gland, or both, and small unbroken nodules may exist on the septum, but usually there is no visible ulceration of the nasal membrane. In some horses suspicion of glanders may be excited by lameness and sudden swelling of a joint, by profuse staling, sluggishness, general loss of condition or by refusal of food, rise of temperature, swollen fetlocks, with dry hacking cough, nasal catarrh, and other symptoms of a com mon cold. With rest in the stable the horse improves, but a one-sided nasal discharge continues, the submaxillary gland en larges, and, after an interval, ulcers appear in the nose or "farcy buds" form on a swollen leg. In occult glanders the horse may appear to be in good health and be able to perform ordinary work. In these cases the existence of glanders can only be discovered by resorting to the mallein test.
In cutaneous glanders, or farcy, symptoms occur on the skin of a limb, usually a hind one, or on the body, where the lym phatics become inflamed and ulcerated. The limb is much swollen, and the animal moves with pain and difficulty. The lymphatic vessels appear as prominent "cords," hard and painful on manip ulation, and along their course arise nodular swellings—the so-called "farcy buds." These small abscesses break and discharge a yellow, glutinous, blood-stained pus, leaving sores which heal very slowly.
Medical treatment of glanders or farcy should not be attempted. The disease is dealt with under the contagious diseases (animals) acts. Horses which present suspicious symptoms, or those which have been in contact with glandered horses, should be isolated and tested with mallein. Animals which are found affected should immediately be destroyed, and their harness, clothing, and the utensils employed with them thoroughly cleansed, while the stalls, horse-boxes, and places which the horses have frequented should be disinfected. Forage left by glandered horses should be burned.
Mallein, the toxin formed by B. rnallei, was discovered in 1888 by Helman, a Russian military veterinary surgeon, and the first complete demonstration of its diagnostic value was given in 1891 by Kalning, also of Russia. It is present in a sterilized and filtered broth culture of glanders bacilli. Subcutaneously injected in a glandered horse, mallein causes a marked rise of temperature and an extensive painful swelling at the seat of injection.
In man, glanders is relatively a rare disease. It occurs chiefly among those who are much in contact with horses, such as grooms, coachmen, cavalry soldiers, veterinary surgeons, etc., but has caused the death of several bacteriologists who were carrying on researches with B. mallei. Usually the bacillus is communicated from a glandered animal either through a wound or scratch or through application to the mucous membrane of the nose or mouth. After an incubation period of three or four days, or longer in some cases, there is a general feeling of illness, with pains in the limbs and joints like those of acute rheumatism. If the disease has been introduced through an abrasion, local pain and inflammation occur and extend up the lymphatics. An ulcer with offensive discharge is formed, and blebs appear in the in flamed skin, along with diffuse abscesses. The disease now may stop short, but more commonly rapidly grows worse. Anywhere in the body cutaneous and subcutaneous foci appear which ulti mately open and become extensive sloughing ulcers. The con dition is then a specialized variety of pyaemia or blood-poisoning.
The mucous membranes suffer like the skin, and this is particu larly the case with the interior of the nose, where in many in stances the disease first shows itself. Not infrequently the bronchi become affected, and abscesses form in the lungs. In the acute form the case generally terminates fatally in from two or three days to as many weeks.
A chronic form of glanders and farcy is occasionally met with, in which the symptoms advance much more slowly, and cause less urgent constitutional disturbance. Recovery from this form is recorded ; but in general the disease proves fatal by exhaustion of the patient, or by suddenly becoming acute. On the other hand, acute glanders is never observed to become chronic.
The sole treatment available is maintenance of the patient's strength. Cauterization should be resorted to if the point of infection is early known.