552 Tuberculusis. 



weaken the patients. The digestion is usually more or less 

 disturbed and the condition is aggravated by periodical attacks 

 of bloating, caused by compression of the esophagus by the 

 enlarged j^eribronchial and mediastinal lymph glands which 

 interrupt or prevent eructations ot gas and interfere with 

 rumination. In case of suspected animals this latter condition 

 always indicates the probable presence of tuberculosis! (Johne), 

 it is however, usually not oliserved until symptoms of pulmonary 

 affection have manifested themselves. Distention of the jugular 

 vein, which is occasionally observed, may l)e due to the same 

 cause. 



Cardiac symptoms are usually observed only when the 

 l)ericardium is involved. There may be pericardial friction 

 sounds and more or less pronounced disturbance of the heart 

 action. But since the pericardial sac rarely contains any con- 

 siderable amount of fluid these sounds are usually absent. The 

 heart sounds are clearly audible and in rare cases only nun- 

 cardiac dullness be noted. Swelling of the skin in the anterior 

 thoracic region is rare as is also a jugular pulse (contrast 

 with traumatic pericarditis). In advanced stages of the disease 

 the pulse is subject to considerable variation in character as 

 well as in rate. In advanced cases it is much accelerated aiid 

 empty. 



In one ease observed by Lienanx there was displacement of the 

 heart toward the right side, and great distention of the jugular vein 

 as a result of compression by the anterior lobe of the left lung which 

 was indurated and contained numerous cheesy and calcified foci. In 

 another case he succeeded in demonstrating the presence of tubercle 

 bacilli in the pericardial fluid which was obtained by aspirating the 

 pericardial sac. 



Toward the termination of the disease the respiratory diffi- 

 culties become increasingly great. The affected animals stand 

 without moving from the spot, with elbows projecting outward, 

 the neck held low and the head stretched forward, groaning 

 and gasping for breath while their forced respiratory move- 

 ments cause the whole l:)ody to tremble. The cough is weak, 

 painful and frequent and is easily provoked by slight pressure 

 exerted upon the back. Purulent or ichorous secretion which 

 is discharged from the nostrils is no longer "licked away" by 

 the animal. As the animals become weaker and more and 

 more emaciated they lie down continuously, being no longer 

 able to stand. In the meantime the abdominal organs may have 

 become involved ; there is a continuous diarrhea, and finally, 

 after long suffering the end approaches without spasms. 



Tuberculosis of the abdominal organs which in regard to 

 frequency of occurrence is second to pulmonary tuberculosis 

 develops in an equally insidious manner. Tuberculosis of the 

 peritoneum may reach an advanced stage of development ])efore 

 it manifests its presence by any outward indications. In cows. 



