TUBERCULOSIS. 705 



120 beats per minute, and the urine contains albumen in notable 

 quantities. This condition continues for weeks without apparent di- . 

 niinution, the patients refuse food, lose flesh with startling rapidity, 

 and finally die of exhaustion. 



It would be impossible from these peculiarities alone to identify 

 the nature of the disease which causes such progressive organic 

 wasting, as the continued presence of fever prevents the use of ' 

 tuberculin, but fortunately the preliminary changes in the lungs, 

 lymphatic glands, genital tract, etc., are sufficient in most cases for 

 the purj^oses of diagnosis. 



Sheep, Goats, and Pigs. — In the other domestic animals tubercu- 

 losis is only of secondary importance to the practitioner. 



It has been seen in the sheep and goat, but almost exclusively as 

 the result of experiment. It must be understood, however, that pro- 

 longed co-habitation with diseased oxen or lengthened sojourn in con- 

 taminated places may easily produce tuberculosis in the goat, though 

 the sheep continues to resist for a somewhat longer period. 



Clinically such tuberculosis presents little interest on account of 

 its rarity. 



The same remark applies to pigs ; nevertheless, an entire herd 

 may become infected, and it may be necessary, after making a pre- 

 liminary post-mortem, to examine the other patients. All forms of 

 the disease occur in pigs, the lung being most frequently aftected, but 

 tuberculosis also attacks the intestine, udder, lymphatic glands, joints, 

 etc. The pig, in fact, is extremel}^ susceptible to this disease, whilst 

 the sheep is only subject to it in a comparatively trifling degree. 



* Diagnosis. The clinical manifestations of tuberculosis are so 

 numerous and so various that it is often an extremely hard task to 

 form a diagnosis. Without doubt detection is relatively easy in well- 

 marked forms, such as tuberculosis of the lungs, lymphatic glands 

 and genital apparatus, but even in such cases the symptoms must 

 be reasonably well-marked. 



At first, unless the lesions produce externally visible signs, diag- 

 nosis is impossible, and in the case of hidden forms, such as tuber- 

 culosis of the serous membranes, mediastinum, intestine, testicle, etc., 

 all that can be done is to take into account the probabilities. 



Clinical diagnosis is therefore possible, but only in exceptional 

 cases can it be absolutely relied upon. Fortunately, methods of in- 

 vestigation increase and become more exact every day, so that the 

 points which clinical examination is incapable of deciding are often 

 cleared up in the laboratory. Bacteriological examination of morbid 

 products, such as the nasal discharge, the products of suppuration, 

 the milk or the diseased tissues, is a valuable means in many cases 

 D.c. 7. z 



