When conditions are favorable and an absolutely secluded pasture can be secured, with shelter from storms, and where civic or state authorities do not take effective measures to stamp out glanders, nor compensate owners for animals killed, mild, chronic and cutaneous cases and occult ones that have reacted to mallein without showing any other symptom, may be subjected to treatment. They should have an open air life, a generous diet, including grain, perfect cleanliness and pure air in the shelter-shed, an antiseptic and tonic medication (sulphites, tonics) may be given, and every three months a new mallein test may be applied. If the individual horse passes two successive tests without reaction, and shows no other indication of glanders, if his general health appears perfect and his condition good, he may be returned to work as a sound animal. With effective measures of extinction in force on the other hand, and indemnity for the slaughtered animal, any such measure would be entirely unwarrantable.
Treatment by injecting the serum of immune animal subcutem has given encouraging results. Helman, Semmer and Itzkovitch, Pilavios, Bonome and Vivaldi, Johne, Schindelka, Prieur and others record recoveries in recent cases and there need be no doubt of its value in subjects that are naturally somewhat refractory to the germ. Babes introduced the blood serum of the ox, which is naturally immune, and Prieur speaks with confidence of the treatment of cutaneous glanders in man and certain cases of pulmonary glanders in the horse.
TREATMENT IN MAN.
The surgical treatment of glanders in man does not differ materially from that given for animals. It is more frequently possible to deal with the local lesion in its early stages and then a thorough cauterization of the infected sore, and a little later the complete excision of the primary nodule, or the limited regional infiltration, the curetting of the adjacent parts and the maintenance of thorough disinfection by irrigation, sponging and compress will often be followed by success. Where such radical measures are inadmissible the infected parts should be excised and curetted as far as safe and the adjacent parts subjected to carbolic injections (1:200). Abscesses should be evacuated, fistulæ slit open, and thorough disinfection applied. For the affected air-passages, iodoform insufflations and antiseptic gases, sprays, and solutions should be freely used.
Internally, antiseptics such as sulphocarbolates and tincture of muriate of iron, iodides, and carbolic acid have been largely employed. Whitla recommends 5 grains of quinia in 15 grains of tincture of muriate of iron every four hours. Tonics (arsenate of strychnia), and stimulants, ammoniacal or alcoholic, may be called for. Special symptoms such as pain, rigors, nausea, vomiting, diarrhœa and profuse perspirations must be met by suitable remedies. Finally blood serum from healthy cattle or from immunized animals may be employed subcutem. Pure air and nourishing, easily digestible food are very essential. Every effort should be made to check the disease at its outset, as generalized acute glanders is speedily fatal, and recoveries in chronic cases usually leave a broken down constitution.
LYMPHANGITIS SACCHAROMYCOTICA (FARCINOIDES: EPIZOÖTICA:ULCEROSA.) FARCY IN CATTLE.
Geographical distribution and nature: Japan, Northern Europe, France, Guadaloupe; caseating nodules in skin, subcutem, in mucosæ and internal organs. In horse skin nodules, and glandular abscesses, with thick ovoid refrangent bacterium; saccharomyces (Hitt); swellings first local, then multiple, and general, extending along lymph vessels to glands (Hitt); along air-passages to lungs, from prepuce or scrotum to peritoneum (Hitt), or from conjunctiva to other parts in the orbit (Caparini and Ferner). In cattle, multiple, subcutaneous, nodules—hazlenut to walnut, isolated, hard, painless. Suppurate slowly. Same saccharomyces (Tokishige, Nocard). May invade lungs with fatal result in a year. Mallein test gives no reaction. Treatment: actively antiseptic; open, curette, pack with antiseptic gauze, sublimate bandages; internally, tonics, antiseptics.
Horses and cattle in certain countries (Japan, Sweden, Finland, France, Guadaloupe) are subject to a chronic lymphangitis resembling cutaneous glanders, but associated with the development of bacilli or fungi in the nodular, caseating swellings in the skin, subcutem, in mucosæ and in internal organs.
Nocard describes the affection in the horse as characterized by skin nodules (buttons, boils), which burst and discharge a thick, grumous, or thin, oily, yellowish or bloody pus. The surrounding lymph plexus swells up into corded lines, with at intervals nodules or abscesses. The infection extends to and implicates the lymph glands and general pyemia may follow. The thick ovoid refrangent, pathogenic, bacterium stains in Gram’s solution.
In Northern Europe and Asia, Southern Europe and Guadaloupe an analogous affection is described by Rivolta, Claudio-Fermi, Aruch, Tokishige and Nocard and Leclainche. Hitt attributes this to saccharomyces. The infection attacks horses and cattle, entering by sores and abrasions of the skin of the limbs, or under the harness (back, breast, rump, head). Confined at first to the point of infection it becomes multiple, being conveyed from place to place, through the soil, floor, stall, harness, blankets, brushes, combs, straw, etc., and may extend on the mucosæ. The wounds fester, forming pus and crusts over a more or less considerable swelling. In a variable time, (one to twenty weeks) the surrounding lymphatics become swollen and tender (corded), and nodular swellings appear on their course which fluctuate, burst and discharge a whitish or yellowish pus, sometimes oily or slimy. The disease extends along the lymphatics, invading the lymph glands and even the internal organs.