Part 99

The lymphatic ganglia are increased four, five, six, or ten times their natural size, enlarged by the engorgement of blood. The spleen shows nodulated black spots containing a muddy blood, which is found teeming with the virus. This organ is much enlarged and is quite friable. The mucous membranes of the intestines are congested and reddish brown; the surface of the intestines is in many places denuded of its lining membrane, showing fissures and hemorrhagic spots. The liver has a cooked appearance; the kidneys are congested and friable; the urine is red; the pleura, lungs, and the meninges are congested, and the bronchi of the lungs contain a bloody foam.

Treatment.--Treatment of anthrax in animals by medicinal means has not proved satisfactory. In cases of local anthrax an incision of the swelling followed by the application of disinfectants sometimes causes good results. In such cases, however, the danger of disseminating the infection from the wounds tends to make this procedure inadvisable unless great care is taken.

Good results are obtained from the use of serum in the treatment of the disease. For this purpose 30 to 100 cubic centimeters should be administered subcutaneously or intravenously. If no improvement is noticed within 24 hours the injection should be repeated. In a number of instances afforded to test the curative value of the serum in cases of anthrax in man and animals splendid results were obtained.

The prophylactic treatment formerly consisted in the avoidance of certain fields and marshes which were recognized as contaminated during the months of August and September and had been occupied the years in which the outbreaks usually occurred. It underwent, however, a revolution after the discovery by Pasteur of the possibility of a prophylactic inoculation or vaccination which granted immunity from future attacks of the disease similar to that granted by the recovery of an animal from an ordinary attack of the disease.

This treatment consists in the use of a vaccine which is made by the artificial cultivation of the virus of anthrax in broth and in the treatment of it by means of continued exposure to a high temperature for a certain time, which weakens the virus to such extent that it is capable of producing only a very mild and not dangerous attack of anthrax in the animal in which it is inoculated, and thus protects it from inoculation of a stronger virus. The production of this virus, which is carried on in some countries at the expense of the governments and is furnished at a small cost to the farmers in regions where the disease prevails, in this country is made in private laboratories only.

At the present time very good results are being obtained with vaccination consisting of an injection of highly potent anthrax serum on one side of the animal and a vaccine on the other side. This method of treatment requires only a single handling of the animals and further possesses advantages over the Pasteur treatment in that it immediately makes animals immune. In the numerous applications of this form of treatment very good results have been obtained and the immunity produced thereby visually lasts at least one year. The vaccinated animals should be kept for a period of ten days to two weeks from exposure, since during that period they are at times even more susceptible to the disease, and therefore care should be taken not to reduce their vitality.

Prevention.--In attempts to control the disease it is essential, aside from protective vaccination, to prevent the reinfection of localities. For this purpose it is essential, if possible, to drain thoroughly and keep under cultivation the infected areas before animals are permitted to pasture on them. The complete destruction of all anthrax carcasses is also very important. This is best accomplished by burning, but as this method of disposal is impracticable in many localities, deep burial may be found to be better. Covering the carcasses within their graves with quicklime adds another valuable precaution against further dissemination of the infection. No animal dying from anthrax should ever be skinned or cut open, as the blood from these sources is one of the most dangerous means of spreading the infection, being charged, while in the animal, with great numbers of bacilli, which quickly turn into spores as soon as spread about upon the face of the ground. All discharges from the body openings should also be burned or buried deeply, as they are frequently of a virulent character.

GLANDERS AND FARCY.

(Pls. XL-XLII.)

Definition.--Let it be understood at the outset that glanders and farcy are one and the same disease, differing only in that the first term is applied to the disease when the local lesions predominate in the internal organs, especially in the nostrils, lungs, and air tubes, and that the second term is applied to it when the principal manifestation is an outbreak of the lesions on the exterior or skin of the animal. The term glanders applies to the disease in both forms, while the term farcy is limited to the visible appearance of external trouble only; but in the latter case internal lesions always exist, although they may not be evident.

Glanders is a contagious constitutional disease of the genus Equus (the horse, ass, and mule), readily communicable to man, the dog, the cat, the rabbit, and the guinea pig. It is transmitted with difficulty to sheep and goats, and cattle seem to be entirely immune. It runs a variable course and usually produces the death of the animal affected with it. It is characterized by the formation of neoplasms, or nodules, of connective tissue, which degenerate into ulcers, from which exude a peculiar discharge. It is accompanied with a variable degree of fever, according to the rapidity of its course. It is subject to various complications of the lymphatic glands, of the lungs, of the testicles, of the internal organs, and of the subcutaneous connective tissue.

GLANDERS.

Nasal septum of horse, right side, showing acute lesions.]

GLANDERS.

Middle region of nasal septum, left side, showing ulcers.]

GLANDERS.

Posterior half of nasal septum, right side, showing cicatrices.]

History.--Glanders is one of the oldest diseases of which we have definite knowledge in the history of medicine. Absyrtus, the Greek veterinarian in the army of Constantine the Great, described it with considerable accuracy and recognized the contagiousness of its character. Another Greek veterinarian, Vegetius Renatus, who lived in the time of Theodosius (381 A. D.), described, under the name of "malleus humidus," a disease of the horse characterized by a nasal discharge and accompanied by superficial ulcers. He recognized the contagious properties of the discharge of the external ulcers, and recommended that all animals sick with the disease be separated at once with the greatest care from the others and should be pastured in separate fields, for fear the other animals should become affected.

In 1682 Sollysel, the stable master of Louis XIV, published an account of glanders and farcy, which he considered closely related to each other, although he did not recognize them as identical. He admitted the existence of a virus which communicated the disease from an infected animal to a sound one. He called special attention to the feed troughs and water buckets as being the media of contagion. He divided glanders into two forms--one malignant and contagious and the other benign--and he stated that there was always danger of infection.

Garsault in 1746 said that "as this disease is communicated very easily and can infect in a very short time a prodigious number of horses by means of the discharges which may be licked up, animals infected with glanders should be destroyed."

Bourgelat, the founder of veterinary schools, in his "Elements of Hippiatry," published in 1755, establishes glanders as a virulent disease.

Extensive outbreaks of glanders are described as prevailing in the great armies of continental Europe and England from time to time during the periods of all the wars of the last few centuries.

Glanders was imported into America at the close of the eighteenth century, and before the end of the first half of the last century had spread to a considerable degree among the horses of the Middle and immediately adjoining Southern States. This disease was unknown in Mexico until carried there during the Mexican War by the badly diseased horses of the United States Army. During the first half of the last century a large body of veterinarians and medical men protested against the contagious character of the disease, and by their opinion prevailed to such an extent against the common opinion that several of the Governments of Europe undertook a series of experiments to determine the right between the contesting parties.

At the veterinary school at Alfort and at the farm of Lamirault in France several hundred horses which had passed examination as sound had placed among them glandered horses under various conditions. The results of these experiments proved conclusively the contagious character of the disease.

In 1881 Bouchard, of the faculty of medicine in Paris, assisted by Capitan and Charrin, undertook a series of experiments with matter taken from the farcy ulcer of a human being. They afterwards continued their experiments with matter taken from horses, and in 1883 succeeded in showing that glanders is caused by a bacterium which is capable of propagation and reproduction of others of its own kind if placed in the proper media. In 1882 the specific germ of glanders was first discovered and described by Loeffler and Schuetz in Germany.

When we come to study the etiology of glanders, the difference of susceptibility on the part of different species of animals, or even on the part of individuals of the same species, and when we come to find proof of the slow incubation and latent character of the disease as it exists in certain individuals, we understand how in a section of country containing a number of glandered animals others can seem to contract and develop the disease without having apparently been exposed to contagion.

Causes.--The contagious nature of glanders, in no matter what form it appears, being to-day definitely demonstrated, we can recognize but one cause for all cases, and that is contagion by means of the specific virus of the disease. The causative organism is known as the Bacillus mallei.

In studying the writings of the older authors on glanders, and the works of those authors who contested the contagious nature of the disease, we find a large number of predisposing causes assigned as factors in the development of the malady.