694 INFECTIOUS DISEASES. 



accompanied by lesions of the pleura, of the mediastinal lymphatic 

 glands, of the liver, etc. 



Digestive disturbances often occur ; the appetite is capricious or 

 in abeyance, there is atony of the rumen and chronic dyspeptic 

 tympanites. These disturbances are easily understood where there 

 are lesions of the liver, intestine, and mesenteric lymphatic glands, 

 but not when the lung alone appears the seat of the disease. In 

 this condition the patients probably suflfer from permanent complex 

 intoxication, due to toxins elaborated by the tubercle bacillus and 

 other microbes which multiply on or in the lesions, and this chronic 

 intoxication reacts on the vital functions (innervation, secretion, 

 digestion and nutrition). Nor are the effects limited to these appear- 

 ances ; the heart's action is also accelerated, and the temperature 

 rises. During the first and part of the second phase there is com- 

 paratively little fever, but afterwards this is continuous or of a 

 peculiar intermittent character. In the morning the patient's 

 temperature may be normal; in the evening it has risen from 

 1'5 to as much as 9*^ Fahr. (1'1° to 5*2° C.) above normal, and 

 this recurs day by day. These attacks coincide with softening of the 

 lesions, and when suppurating caverns exist they are more marked 

 and more nearly continuous, assuming the characters of the hectic 

 fever shown in consumption. 



Often during the febrile periods the urine is albuminous. 



In chronic tuberculosis of bovine animals bleeding from the lung 

 is rare even when caverns exist, and Moussu, in spite of extensive 

 experience, has seen only two cases. This is in striking contrast with 

 the condition in human sufferers from pulmonary tuberculosis, two- 

 thirds of whom bleed at the lungs. 



TUBERCULOSIS OF SEROUS MEMBRANES. 



After pulmonary tuberculosis, tuberculosis of the pleural and peri- 

 toneal serous membranes is the most frequent clinical form of this 

 disease. Sometimes both forms exist, and although the pleural and 

 peritoneal lesions predominate or alone attract attention, there are 

 also lesions in the lung or mediastinal lymphatic glands. 



It is difficult to explain how the pleural and peritoneal serous 

 membranes can l)e seriously invaded without the lung becoming 

 affected, though in point of fact such a state of things frequently 

 exists. 



Tuberculosis of the pleura without pulmonar}' lesions is suggested 

 by very obscure symptoms. The general signs consist in diminution 

 of appetite, loss of condition, tachycardia, elevation of temperature, 



