TUBEECULOSIS. 707 



prolonged or blowing and the vesicular murmur non-existent, suspicion 

 becomes almost a certainty. The diagnosis is even more assured 

 if the respiration is of a blowing character at certain points, ac- 

 companied by snoring and- sibilant rales and gurgling or cavernous 

 souffles. 



The distinction between pulmonary tuberculosis and chronic bron- 

 chitis or simple pulmonary emphysema is based on the increased 

 resonance revealed by percussion in the latter case ; the different 

 character of expiration ; the existence of a double breathing move- 

 ment ; the external appearance of the animal ; the absence of bacilli 

 from the nasal discharge, and the failure to react to tuberculin. 



The condition cannot be mistaken for verminous broncho-pneu- 

 monia if the information furnished by auscultation and the results of 

 microscopical examination of the discharge are taken into account, 

 the eggs or embryos of strongyles being extremely easy to detect. 



Tuberculosis of the pleura may be mistaken for peri-pneumonia if 

 the observer trusts to percussion alone, but the auscultation sounds 

 are then different, and an injection of tuberculin will remove any 

 doubt. 



Tuberculosis of the peritoneum is often suggested by the indica- 

 tions afforded by careful palpation (thickening of the walls of the 

 abdomen, rigidity and sensitiveness), and is distinguished from ordi- 

 nary acute peritonitis by the difference in the appearance of the 

 animals and the absence of much fluid. Chronic exudative perito- 

 nitis and ascites also exhibit sufficiently well-marked characteristics 

 to enable them to be differentiated from tuberculosis of the peri- 

 toneum, but this is certainly not true of adhesive peritonitis, and in 

 cases of the latter kind tuberculin is the only means of confirming 

 the diagnosis. 



External tuberculosis of the retro-pharyngeal and cervical lym- 

 phatic glands resembles, at a first glance, simple inflammation of 

 lymphatic glands, but in the last-mentioned disease the lesions are 

 symmetrical and the glands' still retain a certain amount of elasti- 

 city, whilst in tuberculosis they are bosselated, hard, and sometimes 

 fluctuating. 



Tuberculosis of the mediastinum is suggested by difficulty in swal- 

 lowing, especially if tympanites follows soon after eating, eructation 

 is absent, and rumination is arrested. 



A careful study of the development of the ulcerations will also in 

 most instances make clear the difference between tuberculous stoma- 

 titis and simple stomatitis or stomatitis due to actinomycosis. Intes- 

 tinal tuberculosis and tuberculous enteritis are sufficiently charac- 

 terised by persistent intractable diarrhoea accompanied by tympanites, 



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