EQUI'NIA, or GLANDERS. In another part of this work, glanders has been considered simply as a disease peculiar to animals, and especially the horse. We shall here con sider it as a disease affecting man, to whom it is transmissible from animals. It is remarkable that although the disease in the horse and ass has been recognized from the time of Aristotle (who describes it as common in the ass), it was not till the year 1810 that Waldinger of Vienna drew attention to the fact, that special precautions should be taken in the dissection of horses affected with glanders and farey, inasmuch as the most serious and often fatal consequences might arise from the inoculation of the morbid matter. Strangely enough, however, he does not seem to have noticed that the disease thus induced in man is identical with that' of the horse; and it was not till 1821 that Seidl hng recognized this important point. It was not till a living physician, Dr. Elliotson, published his memoir, On the Glanders in Me Human Subject, in 1830, that the attention of the medical profession in this country was directed to the subject. In 1837, Rayer, in his memoir De la MOrre et du Farcin chez l'Homme, collected all the cases that had been observed up to that date, and gave a complete description of the various forms of glanders both in the horse and in man; and in 1843, Tardieu published his investigations, De la 3forve et cbtt Fareita ChkOniques, It is to these writers and to'tha brothers Gamgee (" Glanders—Equinia," by Arthur Gamgee, M.D., and John Gaingee, in Reynolds's System of Medicine, vol. i. 1866) that we owe almost all our knowledge of this terrible disease.
In the great majority of cases, the disease is transmitted from the horse, the ass, or the mule to man; but. several instances have been recorded in which it has been trans mitted from one human being to another. The disease is no doubt generally due to inoculation, but the virus is also probably capable of being absorbed by unbroken mucous membrane. Most of the recorded cases have occurred in•inen of good constitution and in the prime of life. The four varieties of this disease which occur in the horse have also been observed in man—viz., (1) acute glanders, (2) chronic glanders, (3) acute farcy, and (4) chronic farcy.
Acute glanders is the commonest form. The period of inoculation ranges, in the majority of cases, from three days to a week. If there is a distinct wound or abrasion through which the poison has been absorbed, the parts around the broken surface become red, tense, and painful, often before the appearance of any of the constitutional symptoms, such as a general feeling of illness, great depression of the spirits, headache, rigors, increased rapidity of the pulse, and pain in the joints. A characteristic pustu
lar eruption, often accompanied by blebs, appears on the face and limbs; and abscesses frequently occur on the face and about the principal joints. A yellow, puru lent, fetid discharge, often mixed with blood, exudes from the nasal mucous membrane, which is invariably the seat of a pustular eruption, or of ulcerations. The prostration which is observable from the beginning increases during the course of the disease. The pulse becomes weak and frequent, the breathing difficult, the voice feeble, and the bowels very relaxed, the stools being extremely fetid. Delirium now sets in, which is followed by coma and death. Death usually occurs about the end of the second week, but the duration of the disease has been known to vary from three to fifty-nine days.— Chronic glanders is so rare an affection in man that it hardly requires notice. The course of the disease usually extends over several months; and only one case of recovery is reported.—Acute fang seems only to differ essentially from acute glanders in the fact of there being no affection in the mucous membrane of the nostrils. The cutaneous eruption may or may not be present; in most cases, it is present, and the disease then follows exactly the same course as glanders. When there is no eruption, there is merely an inflammation of the lymphatic vessels and glands, or. adenitis and angeiolett citis (q.v.), accompanied with the formation of soft subcutaneous tumors at various parts. This form of the disease often terminates favorably, or may merge into chronic fang, which is characterized by the formation of an abscess on the forehead or else where, which is followed by indolent and fluctuating tumors, which follow one another in various parts of the body, open spontaneously, and form very intractable ulcers. The disease usually runs its course in about a year. Of twenty-two cases recorded by Tardieu, six recovered.
Little need be said regarding treatment, since no remedies have been found to exer cise any influence in the course of acute glanders. Arsenic, combined with strychnia, has been found useful in chronic glanders in the horse, and is recommanded by the brothers Gamgee as worthy of trial in man; and some relief might probably be afforded by the application of weak injections of carbolic acid into the nostrils.