Fig. 278.—Well-developed tuberculosis of the mediastinal lymphatic glands. PG, Left lung; PD, right lung; Œ, œsophagus; A, posterior aorta; T, tuberculous lymphatic glands.
If, as often happens, the glands of the posterior mediastinum are affected and greatly enlarged, they may involve the œsophagus and the œsophageal nerves, interfere with deglutition and rumination, and thus produce marked disturbance. The animals only swallow with difficulty, and later rumination becomes impossible, the antiperistaltic movement not being powerful enough to overcome the resistance. Soon after eating, the patients exhibit tympanites, certainly only to a moderate extent, but the swelling is long in disappearing. This tympanites is due to the difficulty in eructation and to the impossibility of rumination. The contents of the rumen pass slowly towards the intestine until the onset of a fresh attack.
On account of digestive difficulties, the animals rapidly lose flesh, just as though they were suffering from extensive visceral lesions.
TUBERCULOSIS OF THE DIGESTIVE TRACT.
Tuberculosis of the digestive tract is rarer than tuberculosis of the lungs or lymphatic glands, and occurs in two well-differentiated clinical forms, that is to say, tuberculosis of the buccal and pharyngeal membrane and tuberculosis of the intestines. Tuberculosis of the liver, which is less easily recognised, is indicated by signs of dyspepsia.
Bucco-Pharyngeal Tuberculosis.—This may be primary or secondary, and occurs in the form of local or general glossitis or superficial ulcerative stomatitis.
In the former case the glossitis may be regarded as due to actinomycosis; in the latter it can only be mistaken for simple ulcerative stomatitis.
It is accompanied by difficulty in mastication, and still more, where the pharynx is invaded, in deglutition; abundant frothy salivation in feeding; sometimes by true spasm of the pharynx and rejection of masticated balls of food.
Locally the buccal mucous membrane (cheeks, tongue, pillars of the fauces, etc.) exhibit ulcerations, with festooned borders, in size something between a florin and a five-shilling piece, covered with a greyish-yellow, earthy-coloured exudation adhering firmly to the subjacent parts. The margin of the ulceration is but slightly indurated, and the tongue preserves its mobility, except in cases of general deep-seated glossitis.
The condition may continue for weeks and months without improvement.