546 Tuberculosis. 



describes calcified concave scaly lesions in the endocardium as 

 large as a silver dollar, also lesions as large as a lentil on the 

 nasal mucous membrane. 



The tuberculous lesions usually contain tubercle bacilli in 

 large numbers. 



In pigs tuberculous lesions are most common in the diges- 

 tive organs and their haiipli glands. In some of the cases we 

 find, in addition to tubercles in the mucous membrane of the 

 pharynx and in the tonsils, enlargement of the retropharyngeal, 

 cervical and mediastinal lymph glands (scrophulosis). These 

 glands contain a thickish cheesy purulent mass. Tuberculous 

 processes in some of the superficial glands may even perforate 

 the skin. In other cases the mesenteric glands may be similarly 

 affected. The lumbar glands may constitute an irregular, con- 

 voluted tumor mass under the spinal column. In these cases 

 tuberculous nodules and ulcers occur also in the intestines, 

 especially in the ileum and cecum. The liver and spleen may 

 contain cheesy foci ranging in size up to that of a nut. In 

 exceptional cases wedgelike or irregular firm foci extend from 

 the surface of the liver or spleen toward the interior of the 

 atfected organ. On section these areas show a homogeneous 

 structure, are grayish-white or yellowish-white in color and 

 present no evidence of caseation or calcification (Junack, 

 Sommer). In rare cases the peritoneum is covered with numer- 

 ous small nodules. (The so called cheesy enteritis of pigs 

 [page 133] may perhaps, in exceptional cases also develop upon 

 a tuberculous basis.) 



In the lungs the disease may manifest itself by the presence 

 of a few or of exceedingly numerous small dry cheesy foci, 

 or a correspondingly smaller number of larger centers. Or 

 there may be a caseous or cheesy pneumonia with large areas 

 of the lung devoid of air, firm and inelastic, the sections ap- 

 pearing grayish-red or grayish-yellow. The adjacent portions 

 of the pleura are indurated, and sometimes covered with a layer 

 of red fibro-granular connective tissue i/o mm. thick and result- 

 ing in extensive adhesions (Schlegel). The same changes may 

 occur in the pericardium. Small tubercles and small ulcers 

 are occasionally found in the tracheal mucous membrane (Graf) ; 

 in such cases the peribronchial, substernal and subspinal hnnpli 

 glands are usually enlarged and caseated. 



Tuberculosis of the central nervous system results from 

 the spread of a tuberculous process of the inner or middle 

 ear or of the petrous bone (Schuetz) ; it may also be produced 

 metastatically in tuberculous disease of remote organs (Azary). 

 Tuberculosis of the spinal meninges is very rare. It manifests 

 itself in the appearance of numerous yellowish miliary nodules 

 on the peripheral surface. Occasionally they form large con- 

 glomerate tumors which produce compression atrophy of the 

 spinal cord (Vogt). 



Tuberculosis of the bones is comparativeh'' common, 



