Glanders

Glanders, or Farcy (Equinia), a specific infective and contagious disease, caused by a tissue parasite (Bacillus mallei), to which certain animals, chiefly the horse, ass and mule, are liable, and which is communicable from them to man. Glanders in the domesticated animals is dealt with under Veterinary Science; it is happily a rare form of disease in man, there being evidently less affinity for its development in the human subject than in the equine species. For the pathology see the article Parasitic Diseases. It occurs chiefly among those who from their occupation are frequently in contact with horses, such as grooms, coachmen, cavalry soldiers, veterinary surgeons, &c.; 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. A period of incubation, lasting from three to five days, generally follows the introduction of the virus into the human system. This period, however, appears sometimes to be of much longer duration, especially where there has been no direct inoculation of the poison. The first symptoms are a general feeling of illness, accompanied with pains in the limbs and joints resembling those of acute rheumatism. If the disease has been introduced by means of an abraded surface, pain is felt at that point, and inflammatory swelling takes place there, and extends along the neighbouring lymphatics. An ulcer is formed at the point of inoculation which discharges an offensive ichor, and blebs appear in the inflamed skin, along with diffuse abscesses, as in phlegmonous erysipelas. Sometimes the disease stops short with these local manifestations, but more commonly goes on rapidly accompanied with symptoms of grave constitutional disturbance. Over the whole surface of the body there appear numerous red spots or pustules, which break and discharge a thick mucous or sanguineous fluid. Besides these there are larger swellings lying deeper in the subcutaneous tissue, which at first are extremely hard and painful, and to which the term farcy “buds” or “buttons” is applied. These ultimately open and become extensive sloughing ulcers.

The mucous membranes participate in the same lesions as are present in the skin, and this is particularly the case with the interior of the nose, where indeed, in many instances, the disease first of all shows itself. This organ becomes greatly swollen and inflamed, while from one or both nostrils there exudes a copious discharge of highly offensive purulent or sanguineous matter. The lining membrane of the nostrils is covered with papules similar in character to those on the skin, which form ulcers, and may lead to the destruction of the cartilaginous and bony textures of the nose. The diseased action extends into the throat, mouth and eyes, while the whole face becomes swollen and erysipelatous, and the lymphatic glands under the jaws inflame and suppurate. Not unfrequently the bronchial tubes become affected, and cough attended with expectoration of matter similar to that discharged from the nose is the consequence. The general constitutional symptoms are exceedingly severe, and advance with great rapidity, the patient passing into a state of extreme prostration. In the acute form of the disease recovery rarely if ever occurs, and the case generally terminates fatally in a period varying from two or three days to as many weeks.

A chronic form of glanders and farcy is occasionally met with, in which the symptoms, although essentially the same as those above described, advance much more slowly, and are attended with relatively less urgent constitutional disturbance. Cases of recovery from this form are on record; but in general the disease ultimately proves fatal by exhaustion of the patient, or by a sudden supervention, which is apt to occur, of the acute form. On the other hand, acute glanders is never observed to become chronic.

In the treatment of this malady in human beings reliance is mainly placed on the maintenance of the patient’s strength by strong nourishment and tonic remedies. Cauterization should be resorted to if the point of infection is early known. Abscesses may be opened and antiseptic lotions used. In all cases of the outbreak of glanders it is of the utmost consequence to prevent the spread of the disease by the destruction of affected animals and the cleansing and disinfection of infected localities.