GLANDERS, OR FARCY.
Definition.—This disease develops pri marily in the nasal passages and bron chial tubes of horses and cattle, produc ing a mucous flow. It has been found to be due to the bacillus mallei. Large nodules form in the respiratory passages, and metastatic nodules in the liver, spleen, etc.
Symptoms.—In man the disease does not often present itself. However, vet erinary surgeons, butchers, and those surrounded with horses are likely to con tract the disease. It occurs in the con junctiva and on the skin after some in significant injury. Nodules result and the disease sometimes takes an acute form, beginning generally with malaise, pain in the limbs and back, and termi nates in the breaking out of several ab scesses over the body.
Case of a coachman observed into whose system the glanders bacilli gained entrance by means of a wound of the finger. Multiple abscesses appeared in all parts of the body. Not till a few days before death was there a moderate discharge from the nose and increased salivary secretion. The patient died from exhaustion in six months. Proust (Revue et de Police Sanitaire, Jan. 20, 'SS).
Case of chronic glanders in which the patient's body was covered with hard swellings. After a period of illness char acterized by fever, prostration, (liar rhma, and bloody passages, he died from exhaustion, none of the surface lesions having ulcerated. Editorial (Brit. Med. Jour., July 28, '88).
Bacilli of glanders can gain access to the body through the unbroken skin, penetrating the hair-follicles, traversing the epithelial cells, and producing the induration which characterizes the pap ules of the incipient disorder. Babes (Lancet, Aug. 25, '88).
Glanders is allied to the chronic and infectious diseases, and its normal host is probably one of the domestic animals; the bacillus is a parasite of its host; and it resembles morphologically the other bacterial parasites that produce chronic diseases in man, especially tuberculosis and leprosy. Holmes (Jour. of the Amer. Med. Assoc., Aug. 12. '93).
Case of glanders which was remark able for the fact that the large joints —i.e., the elbow, the knees, and the
ankles—showed suppurative inflamma tion, while the multiple abscesses in the muscles were absent. Errich (Zeit. z. klin. Chir., vol. xvii, sec. 1).
Case of acute glanders characterized by the development in all the extremi ties of fluctuating tumors that con tained hannorrhagic pus. There were numerous broncho-pneumonic foci in the lungs. Toward the end of the disease a general pustular eruption appeared, and periostitis developed over the frontal bones. The diagnosis was confirmed by bacteriological investigation. Forestier (Lyon mcia.. No. n. '97).
A number of bacteria cultivated that present the following characteristics: They decompose albumin; ferment the carbohydrates, with production of bu tyric acid and lactic acid in alcohol: they are of obligate anaerobes, and the group contains au organism that is non motile, and causes glanders of cattle. Schattenfroh and Grassberger (Miln chener med. W'och., Jan. 8, 1901).
Diagnosis.—When the disease occurs in the mouth or nose bacilli can be found in the mucous flow. When the disease starts internally the bacillus may be found in the sputum, or when the sec ondary abscesses form. It is of the greatest importance that these should be early recognized.
Case of perforating ulcer of the hard palate, with foul discharge from the nose and ear and gumma-like indura tions appearing in various parts of the body, treated for some time as syphilis, till, after several months, the character istic farcy-buds containing the glanders bacilli made their appearance. Death occurred from exhaustion. Editorial (Brit. Med. Jour., June 16, '88).
Case in which the rapid diagnosis of glanders was made, after the method of Straus, by the inoculation of the sus pected material into male guinea-pigs, which presented, after the second or third day, a marked glandular affection of the testicles, which is a special form of localization for this material. Sil veira (La Semaine M6d., June 17, '91).