Tuberculosis. 435 



of the viscns. There is usually coincident tuberculosis of the 

 lymph glands of the porta. 



Tubercle of the Spleen. This is also a favorite seat of the 

 morbid process, exposed as it is to the reflux of infected blood in 

 the portal vein, and to access of the bacillus from the peritoneum 

 and omental lymphatics. 



The pancreas is less exposed to the channels of the circulation 

 and is less frequently affected. 



Ge?iito- Urinary Tubercles. The kidneys are always liable to 

 suffer in generalized tuberculosis, in accordance with their func- 

 tion of elimination and the great quantity of blood that passes 

 through them. The tubercles may be numerous, encroaching 

 upon and destroying the glandular tissue, and determining con- 

 gestion, nephritis and haemorrhage (Schiitz). The ovaries, 

 when tuberculous, lead to nymphomania and sterility ; they be- 

 come swollen, with rounded projections, indurated, and on sec- 

 tion show all stages of infiltration, caseation and calcification. 

 The}' may encrease to a great size. Tubercles are found on the 

 Fallopian tubes, the serous and mucous surfaces of the womb, and 

 in the broad ligaments, in all their characteristic forms. The 

 bladder and vagina are less frequently involved. In the male 

 the testicle, epididymus , tunica vaginales and prostate vesicles are 

 sometimes affected. The swelling and induration of the affected 

 organ, or the existence of hydrocele, may be noted. 



Tubercle of the Udder. From the mass of blood passed 

 through the udder it is specially exposed to infection whenever 

 the bacilli enter the circulation. It may also be directly infected 

 by the entrance through the teat, or a trauma, of the bacillus of 

 the stable dust. There may be for a time only a slight general 

 swelling which leads to no suspicion on the part of the milker, 

 and as the secretion is not arrested, a dangerous product may be 

 distributed. At this stage the lobules on section appear swollen, 

 gray, with paler or yellowish points and minute haemorrhages. 

 The milk ducts contain coagula and bacilli (Bang). In other 

 cases, usually more advanced, the gland is hard, nodular, en- 

 larged, and shows a marked thickening of the walls of the smaller 

 milk ducts and secreting follicles, with yellowish and even cas- 

 eous and calcified centres. The gland is often greatly enlarged, 

 the milk suppressed or completely altered, and tubercular neo- 

 plasms or ulcers exist in the larger ducts. 



