ANTHRAX IN MAN (MALIGNANT PUSTULE, OR CARBUNCLE).
Anthrax may be transmitted to man in handling the carcasses and hides of animals which have succumbed to the disease. The infection usually takes place through some abrasion or slight wound of the skin into which the anthrax spores, or bacilli, find their way. The point of inoculation appears at first as a dark point or patch, compared by some writers to the sting of a flea. After a few hours this is changed into a reddened pimple, which bears on its summit, usually around a hair, a yellowish blister, or vesicle, which later on becomes red or bluish in color. The burning sensation in this stage is very great. Later this pimple enlarges, its center becomes dry, gangrenous, and is surrounded by an elevated, discolored swelling. The center becomes drier and more leatherlike, and sinks in as the whole increases in size. The skin around this swelling or carbuncle is stained yellow or bluish, and is not infrequently swollen and doughy to the touch. The carbuncle itself rarely grows larger than a pea or a small nut, and is but slightly painful.
Anthrax swellings or edemas, already described as occurring in cattle, may also be found in man, and they are at times so extensive as to produce distortion in the appearance of the part of the body on which they are found. The color of the skin over these swellings varies according to the situation and thickness of the skin and the stage of the disease, and may be white, red, bluish, or blackish.
As sooner or later these carbuncles and swellings may lead to an infection of the entire body, and thus be fatal, surgical assistance should at once be called if there is well-grounded suspicion that any swellings resembling those described above have been caused by inoculation with anthrax virus. Inasmuch as physicians differ as to medicinal treatment of such accidents in man, it would be out of place to make any suggestions in this connection.
Extensive data are available, however, on the effectiveness of anthrax serum for the treatment of the disease in man. It is recommended that from 30 to 40 cubic centimeters of serum be injected in three or four different places. Should no improvement follow in 24 hours additional injections of 20 to 30 cubic centimeters should be administered.
In most instances the results are favorable, and this treatment is acknowledged to be superior to any other mode of treatment known for the disease.
To show that the transmission of anthrax to man is not so very uncommon, we take the following figures from the 1890 report of the German Government: The attention of the authorities was brought to 111 cases, of which 11 terminated fatally. The largest number of inoculations were caused by the slaughtering, opening, and skinning of animals affected with anthrax; hence, the butchers suffered most extensively. Of the 111 thus affected, 36 belonged to this craft. Infected shaving brushes also are very dangerous.
In addition to anthrax of the skin (known as malignant pustule), human beings are subject, though very rarely, to the disease of the lungs and the digestive organs. In the former case the spores are inhaled by workmen in establishments in which wool, hides, and rags are worked over, and it is therefore known as woolsorter's disease. In the latter case the disease is contracted by eating the flesh of diseased animals which has not been thoroughly cooked. These forms of the disease are more fatal than those in which the disease starts from the skin.