Treatment.—­When the symptoms have once developed they can only be palliated.  The patient must be kept absolutely quiet and free from all sources of irritation.  The spasms may be diminished by means of chloral and bromides, or by chloroform inhalation.

ANTHRAX

Anthrax is a comparatively rare disease, communicable to man from certain of the lower animals, such as sheep, oxen, horses, deer, and other herbivora.  In animals it is characterised by symptoms of acute general poisoning, and, from the fact that it produces a marked enlargement of the spleen, is known in veterinary surgery as “splenic fever.”

The bacillus anthracis (Fig. 27), the largest of the known pathogenic bacteria, occurs in groups or in chains made up of numerous bacilli, each bacillus measuring from 6 to 8 [micron] in length.  The organisms are found in enormous numbers throughout the bodies of animals that have died of anthrax, and are readily recognised and cultivated.  Sporulation only takes place outside the body, probably because free oxygen is necessary to the process.  In the spore-free condition, the organisms are readily destroyed by ordinary germicides, and by the gastric juice.  The spores, on the other hand, have a high degree of resistance.  Not only do they remain viable in the dry state for long periods, even up to a year, but they survive boiling for five minutes, and must be subjected to dry heat at 140 C. for several hours before they are destroyed.

[Illustration:  FIG. 27.—­Bacillus of Anthrax in section of skin, from a case of malignant pustule; shows vesicle containing bacilli. x 400 diam.  Gram’s stain.]

Clinical Varieties of Anthrax.—­In man, anthrax may manifest itself in one of three clinical forms.

It may be transmitted by means of spores or bacilli directly from a diseased animal to those who, by their occupation or otherwise, are brought into contact with it—­for example, shepherds, butchers, veterinary surgeons, or hide-porters.  Infection may occur on the face by the use of a shaving-brush contaminated by spores.  The path of infection is usually through an abrasion of the skin, and the primary manifestations are local, constituting what is known as the malignant pustule.

In other cases the disease is contracted through the inhalation of the dried spores into the respiratory passages.  This occurs oftenest in those who work amongst wool, fur, and rags, and a form of acute pneumonia of great virulence ensues.  This affection is known as wool-sorter’s disease, and is almost universally fatal.

There is reason to believe that infection may also take place by means of spores ingested into the alimentary canal in meat or milk derived from diseased animals, or in infected water.

#Clinical Features of Malignant Pustule.#—­We shall here confine ourselves to the consideration of the local lesion as it occurs in the skin—­the malignant pustule.