TUBERCULOSIS. 225 



I also found tubercle bacilli in the milk from six cows out of 

 six hundred examined. So certainly are the bacilli found in 

 cases of tubercular disease of the udder that certain authori- 

 ties maintain that it is possible to differentiate between the 

 simple and the tubercular inflammation of the udder in the 

 cow merely by means of a microscopic examination of the 

 milk. (See Appendix). 



This question of tubercle in milk has now assumed such importance that 

 much attention has been given to it abroad, and in Denmark a most 

 complete system of inspection has been instituted in connection with one 

 of the largest milk supply associations in the world ; and private enterprise, 

 guided by Prof. Panum and Mr. Busck of Copenh^en, has indicated 

 a way in which the State might tread with very great advantage. In 

 connection with this association, six special veterinary surgeons, in addition 

 to local practitioners, are constantly employed in keeping watch over the 

 cattle that supply the milk to it. One of these veterinary surgeons alone, 

 specially retained, examines eight hundred cattle fortnightly,- and makes 

 most careful notes (notes that I had an opportunity of examining) of the con- 

 dition of every animal. Bang, to whose energy and observations the opening 

 up of the tuberculosis question is very greatly due, contends that a diagnosis 

 of tubercular disease of the udder can generally be made without difficulty 

 during life and in the very early stages of the disease. With this conclusion 

 it is somewhat difficult to agree, but much more may be done in the way of 

 careful and systematic examination than is done at present, and in Denmark 

 they have certainly systematized the examination of cattle to a far greater 

 extent than we have succeeded in doing. As it may be of interest to 

 mention the points on which the veterinary surgeon should depend in 

 making his diagnosis, they may, so far as I was able to follow (he routine 

 of a number of inspectors, all of vihom however differed slightly in their 

 methods, be briefly summed up in the following : — 



{a) First of all the sub-maxillary glands are examined ; these are easily felt, 

 and any change is readily made out. 



(6) The glands at the root of the neck and those in front of the haunch 

 bones are always carefully examined. The glands in the flank should be 

 equal in size, about the size of the middle finger, and not hard. Mere 

 enlargement, even when considerable, is, however, not looked upon as of 

 great importance if it is perfectly equal on the two sides. 



(c) The animal is made to cough by means of pressure on the trachea, 

 and the lungs are carefully examined during and after the coughing. 



The condition of the skin over the flanks is carefully observed ; it should, 

 in a healthy animal, be " loose," like that of a dog, soft and pliable ; any 

 adhesion, hardness, or harshness, should be carefully noted. 



{d) The udder is carefully examined for inequality of size and for any 

 induration. It is a somewhat curious fact that tuberculous disease usually 

 affects the hind quarters of the udder, which become hard and knotty, but 

 not painful ; whilst in acute inflammation of the udder, the anterior quarters 

 are quite as much affected as the posterior ; the pain is usually very acute, 

 and the process is accompanied by much more marked febrile symptoms. 



(«) Then the glands above the udder, high up between the quarters, are 



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