for
the eruption of small-pox.

After breaking down, these pustules give rise to irregular ulcers, which
by their confluence lead to extensive destruction of skin. Sometimes the
nasal mucous membrane becomes affected, and produces a discharge--at
first watery, but later sanious and purulent. Necrosis of the bones of
the nose may take place, in which case the discharge becomes peculiarly
offensive. In nearly every case metastatic abscesses form in different
parts of the body, such as the lungs, joints, or muscles.

During the development of the disease the patient feels ill, complains
of headache and pains in the limbs, the temperature rises to 104 or
even to 106 F., and assumes a pyaemic type. The pulse becomes rapid and
weak. The tongue is dry and brown. There is profuse sweating,
albuminuria, and often insomnia with delirium. Death may take place
within a week, but more frequently occurs during the second or third
week.

_Differential Diagnosis._--There is nothing characteristic in the site
of the primary lesion in man, and the condition may, during the early
stages, be mistaken for a boil or carbuncle, or for any acute
inflammatory condition. Later, the disease may simulate acute articular
rheumatism, or may manifest all the symptoms of acute septicaemia or
pyaemia. The diagnosis is established by the recognition of the bacillus.
Veterinary surgeons attach great importance to the mallein test as a
means of diagnosis in animals, but in the human subject its use is
attended with considerable risk and is not to be recommended.

_Treatment._--Excision of the primary nodule, followed by the
application of the thermo-cautery and sponging with pure carbolic acid,
should be carried out, provided the condition is sufficiently limited to
render complete removal practicable.

When secondary abscesses form in accessible situations, they must be
incised, disinfected, and drained. The general treatment is carried out
on the same lines as in other acute infective diseases.

#Chronic Glanders.#--_In the horse_ the chronic form of glanders is
known as _farcy_, and follows infection through an abrasion of the skin,
involving chiefly the superficial lymph vessels and glands. The
lymphatics become indurated and nodular, constituting what veterinarians
call _farcy pipes_ and _farcy buds_.

_In man_ also the clinical features of the chronic variety of the
disease are somewhat different from those of the acute form. Here, too,
in