400 CHRONIC INFECTIOUS DISEASES 



the skin feels leather-like and thick. In time emaciation 

 is in evidence, the patient very anemic and, toward the end 

 (usually after months), cachectic. 



(6) Larynx. — In tubercular laryngitis palpation of the 

 larynx readily causes coughing. In some cases tuberculous 

 growths develop in the lumen of the larynx, 'inducing great 

 dyspnea and even suffocation. As swallowing becomes 

 difficult the animals eat little, and hence fall off in flesh. 



(c) Lymph Glands. — The lymph glands may be primarily 

 diseased or in association with other organs (lungs, udder, 

 bowel, etc.), which are also tuberculous. The following 

 superficial lymph glands are most commonly eleqted: sub- 

 maxillary, subauricular, prescapular, precrural and supra- 

 mammary. The glands enlarge to form tumor-like growths, 

 plainly visible on the surface of the body. They may attain 

 the size of a large potato, are round or oviform, little sensitive, 

 firm, nodular, not readily movable and the overlying skin 

 not adherent. In calves they may show fluctuation and when 

 incised discharge a thick, white pus. 



Internally, tuberculous lymph glands may interfere with 

 the functions of organs with Which they are in contact. The 

 mediastinal glands, if much enlarged, may depress the dorsal 

 wall of the esophagus, constricting its lumen, and thus 

 indirectly lead to intermittent bloating. The enlargement 

 of the parapharyngeals causes dysphagia. 



(d) Udder. — Usually secondary. In the latter stages there 

 appear in the hindquarters firm, painless, not well-defined 

 nodular enlargements which may develop into hard tumor- 

 like growths as large as a human head. In some cases the 

 whole quarter or quarters may be swollen to enormous size 

 and be almost of the consistency of stone. Smaller enlarge- 

 ments (lumps) are best palpated after the udder is milked 

 out. The supramammary lymph glands are increased in 

 size to sometimes that of a clenched fist. In not a few cases 

 only these glands seem tuberculous, the udder appearing intact. 



The milk is usually normal in appearance for a long time 

 after the udder is involved. In the late stage, however, it 

 becomes mixed with tubercular exudate, is watery and of 

 greenish color, or contains white flocculse. 



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