ABSTRACTS AND REPORTS.

that the disease was not leuk~mia, while the fact that the h~morrhages were mainly localised in the gums led to the diagnosis of scurvy. Nothing positive could be learned regarding the cause.-Monatshifte jiir praktische Tilier­Ileilkunde.

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MALLEIN IN THE DIAGNOSIS OF GLANDERS.

KOCH'S discovery of the diagnostic value of tuberculin in tuberculosis suggested the employment of an extract made from cultures of the glanders bacillus as an aid to diagnosis in glanders. This extract, or mallein, as it is termed, has been tried in an extensive series of experiments on horses by Professor Dieckerhoff and Dr R. Lothes, and the results obtained are summarised as follows: 1_

The specific action of mallein on the glanders lesions can no longer be doubted, since no febrile reaction was obtained with it in healthy horses, or those affected with any other disease than glanders. In animals that are the subject of glanders, on the other hand, it causes an elevation of temperature of at least 1° C. Besides this febrile reaction, there were noticed after the injection of mallein increased frequency of the pulse and respirations, and marked cerebral depression. Some horses showed also great weakness, and more or less suppression of appetite. The effect at the seat of injection was extraordinarily variable. In the majority of cases an inflammatory swelling, as large as a hen's egg on an average, developed here j this subsided on the following day. In one lot of horses those affected with glanders developed at the seat of injection a strong local reaction, which did not completely disappear for several days.

The febrile reaction in horses affected with glanders set in regularly. One or two apparent exceptions could be ascribed to loss of strength in the mallein used.

The period that elapsed between the injection of the mallein and the occurrence of the febrile reaction was very variable. In one horse affected with acute cutaneous glanders the reaction set in 4 hours after the injection, whereas in a case of chronic pulmonary glanders it did not occur until 20

hours had elapsed. On an average the febrile reaction set in 9i hours after the injection. These variations were probably ascribable to inconstancy in the strength of the mallein. The duration of the reaction was more con­stant. From 4 to 6 hours after the beginning of the reaction the temperature in most cases had reached its maximum, and it then gradually subsided.

Analogous to tuberculin, mallein appears to act on the specific lesions of glanders, or on the immediately surrounding tissues. In a series of cases with glanders nodules in the lungs and spleen, a dark red zone of reaction excited around these by the mallein was observed.

In one case the farcy buds had somewhat diminished 10 hours after the injection of mallein j on the other hand, in several horses that had shown no symptoms of glanders prior to the injection, these appeared a few days later. "

The dose of mallein required depends upon the strength of the preparation. In that supplied by Preusse the medium dose was 0·5 gramme. In view of the variable composition of the material it is advisable to test it first on a horse known to be glandered.

When possible a record of the temperature before injection ought to be made. That, however, is not indispensable, since great fluctuations of temperature are not observed either in healthy horses or in those affected with chronic glanders. When fever is present it is absolutely necessary to ascertain the temperature before injection.

1 Berliner Thier.uztUche Wochenschl'ift, May 1892. M

178 ABSTRACTS A:-ID REPORTS.

After the injection' the temperature ought to be taken every 2 hours, beginning at latest 6 hours after the operation, and continuing the observations for I4-20 hours. If this is impossible, the temperature ought to be taken several times between the Ioth and 16th hours after injection, but in that case the result is less certain. For the certain diagnosis of occult glanders two injections are necessary, in order to guard against the danger of drawing a wrong conclusion from an accidental elevation of temperature after one injection. If any unusual result of both injections makes a third necessary, the dose ought to be increased about one-half, as the system becomes accustomed to the mallein.

Dieckerhoff and Lothes hold that their experiments prove that mallein is of great value as an aid to diagnosis of occult cases in a stud in which glanders is suspected, and they consider that it is no longer doubtful that by its use practitioners will be able to combat outbreaks of glanders without, as formerly, having to ordain the slaughter of every animal suspected of being affected.

THE CURATIVE ACTION OF TUBERCULIN.

IN a recent lecture on tuberculosis Mr Watson Cheyne in speaking of the use of tuberculin said that it was attended with two great dangers: (I) its use where there are septic cavities or surfaces; and (2) leaving it off too soon. As regards the first danger, the chief trouble lay partly in the increase in the inflammation as the result of the action of the tuberculin and partly in the weakening of the tissue by this inflammation allowing the pyogenic organisms to penetrate further and more rapidly. As regards the second danger-that of leaving off the treatment too soon- it was a fact that recurrence took place quickly under those circumstances, and in his experience the disease seemed to progress with greater rapidity than before the treatment was employed. He did not think the same was the case when the treatment had been continued for some months and then left off. At any rate while under these c'ircum­stances lupus had come back in places pretty quickly at first, it had afterwards seemed in some cases to come more or less to a standstill, or even to improve somewhat. In several of the cases the condition of the patient some months after the treatment was stopped had not been so bad as before it was commenced, nor so bad as it seemed likely to become when recurrence first began to take place.

As to the remedial powers of tuberculin, there could be no doubt that in many cases where the conditions are favourable-as in lupus and tuberculosis on a free surface--a certain amount of improvement follows its use, which, however, but seldom ends in a cure of the whole area within a reasonable time. In only three of the cases where no operation was performed had the improvement been complete over the whole surface, and lasting after the treat­ment was discontinued. These were two children with synovial disease of the knee-joint and one patient with phthisis. In all three cases the treatment was continued for about five months, and these patients remain well. Four other cases where sinuses were present and healed at the time also remain healed. In all the others in which the treatment was stopped recurrence has taken place; but in the case of lupus, where one can see what occurs, this recurrence has not as a rule taken place over the whole of the previously affected area. In several bad cases of lupus considerable tracts which were previously diseased have remained well, showing, along with the cases just mentioned, that tuberculin has really the power of causing the permanent disappearance of tuberculous tissue under certain conditions. From the micro­scopical appearances he concludes that the main condition is that the tubercles shall be isolated and not aggregated into masses. Isolated tubercles seem to