172 CLINICAL BACTERIOLOGY AND 



under the false rib will sometimes assist the clinician in 

 detecting nodules. Examination per rectum should be 

 made for visceral or parietal peritoneal proliferations. 



Enlargement of the abdominal glands should also be 

 sought for per rectum. The subsacral, lumbar, and mesen- 

 teric glands can all be felt if diseased and enlarged. To 

 the feel they are hard nodules, which do not fluctuate on 

 pressure. 



The liver is often involved, and frequently attains to a 

 great size. It can be felt when greatly enlarged over the 

 hepatic region, with dulness on percussion. The intestines 

 may be extensively diseased, and yet the only pronounced 

 symptoms may be persistent diarrhoea, alternated with 

 constipation. The faeces are usually thin and watery, con- 

 taining gas bubbles suggestive of fermentation. Sometimes 

 pus and even blood or mucus may be present in the fasces. 



Tuberculosis of the Generative System. 



This is not uncommon in cows, especially in those cases 

 of generalized tuberculosis, and is characterized by a 

 catarrhal discharge from the vulva, which usually emits a 

 disagreeable odour. The patient either does not conceive, 

 or, if she does, abortion takes place before full term is 

 reached. Examination per rectum will reveal a distended 

 womb, which may be hard and fibrous. The adjacent 

 lymph glands are enlarged, sometimes enormously, and are 

 hard and lumpy to the touch, somewhat like bunches of 

 grapes. 



Tuberculosis of the Nervous System. 



The diagnosis of tuberculosis of the brain or its meninges 

 is by no means easy, but when one is treating or examining 

 a patient whose symptoms are suggestive of tuberculosis — 

 especially generalized tuberculosis — and cerebral dis- 

 turbances manifest themselves, one may safely suspect 

 tubercular infection of that organ. The symptoms most 

 commonly noticed are as many as they are varied. The 



