348 Diseases of (he Genital Organs 



uterine mucosa. In such cases, however, the outlook for the 

 breeding life of the patient is hopeless and an accurate clini- 

 cal diagnosis is not imperative. In some cases of uterine 

 tuberculosis, the masses of tubercles are so voluminous that 

 they throw the uterine walls into great transverse folds 

 which may be palpated per rectum. When such folds are 

 present, they have a distinct diagnostic value. Usually in 

 chronic abscessation of the uterus due to ordinary pyogenic 

 bacteria or to actinomycosis, while the uterus is enlarged 

 and hard, it is very irregular in outline. At one point there 

 may be little or no enlargement. In actinomycosis and in 

 pyogenic abscessation of the genitalia, some one part usually 

 contains a great abscess or abscesses quite overshadowing 

 other lesions, but in tuberculosis there is a strong tendency 

 to symmetrical enlargement. The two horns are approxi- 

 mately alike in volume, form, and consistence. This is im- 

 portant to remember in making a diagnosis. In one cow of 

 great breeding value, a reactor to tuberculin, which had not 

 calved for two years and had long suffered from an abun- 

 dant, fetid, highly repulsive genital discharge, I found one 

 uterine horn much enlarged, three to four inches in its 

 transverse diameter, very hard, and irregular in contour. 

 The other horn was approximately normal. The findings 

 by palpation, in conjunction with her reaction to tuberculin, 

 led me to diagnose uterine tuberculosis. The autopsy re- 

 vealed, instead, a macerating fetus, the bones of which 

 caused the irregular bulging of the cornu. Had I recog- 

 nized the fact that in uterine tuberculosis the enlargement 

 of the horns is usually symmetrical and that the pus from 

 the tuberculous uterus is not usually fetid, the error would 

 probably have been avoided. In those cases of uterine tu- 

 berculosis where only the superficial mucous layer is in- 

 volved, as in Fig. 110, the diagnosis by ordinary clinical ex- 

 amination fails. The ovaries, oviducts, and uterus are nor- 

 mal to palpation, the uterine catarrh is scant, and no out- 

 standing clinical evidences of genital tuberculosis are 

 present. 



The outstanding elements in the differentiation of utero- 



