Tuberculosis in the Dog and Cat

Tuberculosis in the Dog and Cat

GENERAL ARTICLES. 10 3 TUBERCULOSIS IN THE DOG AND CAT. 1 By C. O. JENSEN, Lecturer at the Royal Veterinary and Agricultural College, Copenhagen. SI...

2MB Sizes 4 Downloads 136 Views

GENERAL ARTICLES.

10 3

TUBERCULOSIS IN THE DOG AND CAT. 1 By C. O. JENSEN, Lecturer at the Royal Veterinary and Agricultural College, Copenhagen. SINCE within recent years increased attention has been bestowed upon tuberculosis, it has been shown that this disease may attack a great many-probably most-warm-blooded animals; and, indeed, there is to hand a report regarding a case-certainly the only one yet recorded -of tuberculosis in a serpent (Sibley). Among our domestic animals, next to the ox and the pig, poultry are most frequently the subject of tuberculosis, and it is well-known that among these the disease pretty often prevails in an endemic fashion. Judging from the few observations published, the goat and the sheep are only seldom attacked by this disease, while the horse, on the other hand, appears to be in not a slight degree susceptible to tuberculosis. Cases of tuberculosis in the horse have been observed in almost all countries, and here in Denmark it appears, indeed, to be quite specially frequent; for Bang 2 in the course of a few years has had the opportunity to examine 29 cases. Estimated by the cases recorded in literature, tuberculosis in the dog and the cat appears to occur comparatively seldom-much more seldom than one might suppose when it is remembered that these animals, partly through their frequent close cohabitation with human beings, partly through their food (raw flesh, lung, milk), are quite specially exposed to infection. In the literature at my disposal I have found the following cases of tuberculosis in the dog reported : Brusasco 3 reports a case of supposed transmission of the disease from a human being to a dog. In the latter there were found numerous recent, grey, non-caseated tubercles in the lung and liver. The diagnosis was confirmed by positive inoculation experiments on rabbits. Dogs also were inoculated, and when one was killed three and a half months later numerous nodules were found in the liver and lungs. Filleau and Petit 4 observed tuberculosis in two dogs that had cohabited with phthisical persons. Marcus 5 reports that in the pathological institute of the Veterinary College in Hanover, tuberculosis was several times discovered at the autopsy of dogs. Most frequently the disease was found localised in a pronounced degree in the lungs. J ohne 6 made the post-mortem of a dog belonging to a consumptive, whose sputum the animal had been in the habit of licking. He found a wide-spread, lobular, fatty, caseous, purulent infiltration of both posterior and middle lobes of the lungs, complete caseation of the bronchial glands, and a marked enlargement and caseation of all the mesenteric glands. Csokor 7 found tuberculosis of the dog four times on post-mortem examination. In two cases he found tuberculous lesions in the intestines, peritoneum, and mesenteric glands, as well as in the liver and spleen; in the third case he found in addition to the bowel disease 1

2 3

5 1

Trnm,lateJ. from tbe Deutsche Zeitschrift fur ThierIlIedicin, Ma.y 18f1l. Deutsche Zeitschr. f. l'hiermed., vol. xvi., p. 424. II Medico Veterinario, 1882. • Deutsche Med. Woehensehr., 1888, p. 301. Deutsche Zeitschr. f. Thiermed., vol. xiv., ISSf'. 6 Ibidem, vol. XIV" 188U.
104

GENERAL ARTICLES.

a miliary tuberculosis of the lung; and in the fourth dog the disease was mainly localised in the mediastinal and bronchial lymphatic glands, in both lungs, and in the pleura. At the veterinary school in Utrecht Cramer 1 observed three cases of tuberculosis in the dog. In the first case there was found a widespread miliary tuberculosis of the pleura, lungs, heart, peritoneum, bowel, liver, spleen, kidneys, ovaries, and corresponding lymphatic glands. In the second case there were affected: intestines, peritoneum, mesenteric glands (with very large cavernous tumours), prostate, and lungs. In the third case there was advanced affection of the mesenteric glands, kidneys, and prostate, and also tuberculous ulcers in the large bowel. Thomassen 2 alludes very briefly to a fourth case observed at the same place. Nocard 3 mentions an example of supposed transmission of the disease from the human subject to a dog. In the latter he found a collection of fluid in the abdomen and thorax, tuberculous deposit on the peritoneum and pleura, tuberculosis of the llver, lungs, and some lymphatic glands. Austin Peters 4, found in a dog phthisis of both lungs and a grey abscess in the posterior lobe of the left lung. Numerous tubercle bacilli were recognised. Weyl5 found accidentally in the lung of a dog poisoned by metanilin yellow a small sharply defined nodule, which was composed of a caseous material and surrounded by a connective-tissue capsule. Bacilli were detected. Beugnot 6 found in a small three-year-old dog wide-spread tuberculosis in the lungs and bronchial glands, as well as a formation of small nodules in the liver. The other organs were healthy. ] udging by the literature on the subject, observations regarding spontaneous tuberculosis in the cat are still more scanty; I have found mentioned only the following cases : Brezzo 7 gives the clinical history and the post-JIlortem report of a cat which, as he supposes, had been infected through cohabitation with a tuberculous human being. In the cat there were found in the lungs small nodules, partly scattered, partly collected into small groups. A few similar nodules were found under the pleura costalis and the pericardium, and, lastly, one such was present in the right side of the heart. Zschokke 8 mentions a similar case. At the post-JlZortem of an old cat, which for a long time had lived with consumptives, the lungs were found completely filled with grey, miliary tubercles; a couple of smaller nodules were present in the mucous membrane of the trachea, and there were tubercles in the omentum. Filleau and Petit observed tuberculosis in a cat which in their laboratory had frequently consumed tuberculous sputum. It became lean, and acquired a cough, and in the nasal discharge tubercle bacilli could be recognised. When it was subsequently killed there were found in the right lung scattered indurated and calcified bronchoHollandische Zeitschr., vol. xv., 1888, Ref. in Jahresbericht der Veterimirmedicin fur 1888. Recueil de MOd. Veter., 1888, p. 784. ' Bulletin de la Societe de Medicine yeter., 1888, p. 98. Proceedings of the Massachusetts Veterinal'Y Association, 2ith February IS89. 6 Centralblatt fur Bacteriologie, vol. vi., 1889. 6 Recueil de Med. VeteT., lSflO. 7 II Medico Veterinario, 1883. B Schweizer Archil'. f. Thierheilkunde, 1884

1

2 4

GENERAL ARTICLES.

10

5

pneumonic foci, and a 'chronic bronchial catarrh, with bacilli in the mucus of the bronchi. M'Fadyean found in a cat with spontaneous tuberculosis miliary and larger nodules in the lungs and also in the bronchial glands. Nocard 2 has reported an interesting case of perforating peritonitis in a young cat, induced by tuberculous ulceration in the small intestine; there were also found large numbers of tuberculous nodules in the liver and spleen and single smaller nodules in the lungs. In another young cat:! he found the following: Mesenteric glands enlarged and caseous at the centre; spleen full of miliary greycoloured small nodules; wall .of the intestinal canal at its junction with the c.ecum thickened and ulcerated. It thus appears, judging from the foregoing literature, that tuberculosis is a disease that relatively seldom occurs among the carnivora. This is surprising, when it is recollected, on the one hand, that numerous infection experiments have proved that neither the dog nor the cat is specially resistant towards tuberculosis (indeed it appears, on the contrary, that the latter may be infected qy the most various methods of inoculation, and this applies especially to young cats, which are infected with striking facility through the digestive tract), and when, on the other side, one knows how directly these animals are exposed to infection. It is not only that they often live mainly on raw flesh and milk; they have frequently quite special opportunity to eat tuberculous organs, and numerous dogs and cats live with tuberculous human beings, lead a very intimate cohabitation with them, and are daily exposed to infection through both the digestive organs and the air passages. On the ground of these circumstances one must entertain justifiable doubt that the disease actually occurs in these animals as seldom as it is reported, or as is assumed. It is much rather to be supposed that the assumed rarity of tuberculosis is ascribable to the circumstance that dogs, and especially cats, which are affected with such a chronic and lingering disease very frequently never come under professional treatment, or at least are seldom brought to a clinique for a long period. As a rule the owner takes the cat away after a short time; if it is killed he often will not permit a post-mortem examination, but has the animal buried. Lastly, it was easy to imagine that tuberculosis in the dog and cat might present a different pathological and anatomical picture, and in consequence of that be frequently overlooked-a circumstance to which Marcus J had already drawn attention. These considerations, in conjunction with the fact that Dr Bang in the course of some years had observed not a few cases of tuberculosis in the dog, induced me to give closer attention to the more or less frequent occurrence of the disease among the carnivora. Extensive material for this purpose was afforded to me by dogs and cats which are brought to this college in not inconsiderable numbers to be killed. Since the 1st November 1889 almost all the animals that have in this way been at my disposal have been examined; some of them had been killed on account of disease, but the majority were not diseased. My servant opened the cadaver, and whenever he observed the slightest 1 2 .4,

The Journal of Comparative Pathology and Therapeutics, March 1888. Bulletin dela Societe de MOd. Voter., 1888, p. 537. • Ihidem, IS89, p. Cu • Deutsche Zeitschr f. Thiermed, vol. xiv 0, p. 113.

106

GENERAL ARTICLES.

abnormality I made a more minute examination. Unfortunately I am not in a position to say even approximately how many dogs and cats have been killed and examined. Since November 1889 I have in this way discovered tuberculosis in 6 of the dogs here killed, and also in one dog that was brought here dead. In the case of only one of the dogs was it reported that it had been treated by a veterinary surgeon. In the cats, on the other hand, the disease has been observed much more frequently, viz., in 21 animals, and yet it is pretty certain that considerably more dogs than cats were killed. Tuberculosis was further found in 7 dogs which either died or were killed after they had been treated in the stationary clinique of the college (Dr Bang). In 6 cases the diagnosis was made while the animal was still alive, in one case by puncture of the pleural cavity and recognition of tubercle bacilli in the exudate; in 7 cases the disease was found to be accompanied by fatal~y ending sarcomatosis. In cats only I case was observed in the clinique (primary renal tuberculosis, extirpation, death). In the ambulatory clinique (Professor Sand) during the same time 1 dog and 1 cat were treated as tuberculous; both animals were subjected to post-mortem examination, which confirmed the diagnosis. Altogether, since November I 889-that is in the course of 15 monthsI have made a post-morte11l of 15 dogs and 22 cats affected with tuberculosis (the above cats from the stationary clinique not being therein included). As already mentioned Dr Bang had previously observed not a few spontaneous cases of tuberculosis in dogs and cats, viz., 13 cases in dogs and 2 in cats. Since he has been so kind as to place his notes at my disposal (for which I here return him my best thanks), I find myself in the possession of material from 28 cases in dogs and 25 in cats. In the following I shall report very briefly the record of the postmortem, for, as a rule, for sake of brevity I mention only such changes as stand in connection with tuberculosis. With the exception of a couple of cases, a miscroscopic examination was always carried out; special mention of it is made only where a special reason for it exists. CASES OF TUBERCULOSIS IN THE DOG.

I. Medium-sized dog, treated in the ambulatory clinique of the college on account of ulcerating tumours of the chin. Died on the 19th December 1889. Tuberculosis in the thoracic organs, liver, and peritoneum. Under the chin a roundish tumour of 5 cm. diameter, its surface ulcerated and covered with a scab. The tumour extended as far as the inferior maxillary bones, and consisted of soft granulation tissue (tuberculosis?) The mesentery, and more especially the omentum, is beset with a great number of small nodules, which vary in size between a millet-seed and a lentil. Liver pale, yellowish, full of lentil-sized to nut-sized white nodules, which on section are seen to be composed of numerous smaller confluent nodules. The large tumours have degenerated at the centre to a soft pultaceous milk-white material. The abdominal side of the diaphragm is partly covered with small whitish tuberculous nodules. In the most posterior lobe of the right lung, near the point of exit of the chief bronchus, there is a nodule as large as a nut, and close beneath that one walnut-sized and some smaller nodules, all of a similar character to the liver nodules, the larger being transformed into a

GENERAL ARTICLES.

10

7

emi-fluid milk-white material. The bronchial and mediastinal glands are much enlarged, forming a prominent tumour-like mass, which is made up of closely applied tumours with semi-fluid milky contents and varying in size from a nut to a goose's egg. The submaxillary lymphatic glands are swollen, the right one to the size of a hen's egg. On microscopic examination numerous tubercle bacilli were recognised in the swollen lymphatic glands. II. pog," old Danish" breed, 3 years old; admitted to the stationary clinique on 17th January 1890, after it had been ill for two months. It was ascertained that the dog had frequently consumed offal from a slaughter-house. It is very lean and dull. On clinical examination a tumour in the abdomen and heart disease are diagnosed. The dog was killed on the 19th January 1890. Tuberculosis in the digestive organs. Secondary tuberculosis in lungs and kidneys. On the abdominal side of the diaphragm partly small, partly larger, white nodules, up to the size of a nut, and with their centres caseous or soft and milk-white. The omentum and in part also the mesentery are beset with nodules which vary in size from such as are scarcely visible up to the volume of a hazel nut. The mesenteric glands are enormously enlarged, and partially grown together so as to form a tumour of the size of 3 or 4 clenched fists. The tumour is composed of a whitish firm tissue with large central cavities. filled with a semi-fluid white material. At several places of the mesentery and omentum, and at two places of the small intestine, the tumour is adherent ;. at one of these places the intestinal wall is notably thickened, and an opening of the size of a sixpence here leads through the wall into the beforementioned cavity. The mucous membrane of the intestine is in other respects. normal. In both kidneys there are found some small tubercles; scattered everywhere through the liver numerous whitish-yellow nodules from the size of a nut to that of an egg, and with caseous centres. The liver tissue is also beset with numerous quite small tubercles. In the lungs here and there nodules up to the size of a pea, with fatty degenerated or caseous centres. The bronchial glands and the lymphatic glands along the trachea are much swollen; the majority show on the cut surface milk-white small soft parts. III. Old .middle-sized dog, killed without any previous treatment on the' 7th February 1890, on account of hcemorrhagic enteritis. Tuberculosis in the digestive and respiratory organs. No intestinal lesion. In the omentum and mesentery a quantity of nutsized nodules; mesenteric glands much enlarged, as large as two clenched fists and for the most part composed of soft (partly, indeed, almost fluid) white, fatty-degenerated tissue. In the liver numerous small tubercles, and not a few large nodules, up to the size of a bean; in the spleen one, and in the kidneys several small nodules. The right bronchial gland with the contiguous lung tissue is converted into a thick-walled cyst filled with milk-white fluid in which half-dissolved pieces of tissue are suspended. These nodules. lie close to the main bronchus of the right anterior lobe, which is enlarged, firm, and completely solidified (tuberculous pneumonia). In the other parts. of the lung ther~ are found scattered small tubercles. IV. Large old dog, killed here on the 11th February 1890. Tuberculosis in the lymphatic glands of the thorax. Four tumour-like new formations in the mediastinum. The most posterior has the size of two clenched fists, the others of a hen's egg. These have a large cavity filled with .a mucoid fluid, in which float numerous fine milk-

r08

GENERAL ARTICLES.

white tissue fibres. Their walls are composed of a soft greyish-white tissue with numerous small milk-white spots; inwardly the walls pass gradually into the before-mentioned milk-white fibres. The tumours appear to take their origin from the bronchial glands of the right side and from the lymphatic glands of the mediastinum, and to closely surround the posterior vena cava. In the lung tissue some very small whitish nodules. Abundant ascites (about 8 litres of fluid), congestive hyperremia and commencing induration of the liver, in which there are found some scattered tubercles. In the kidneys, close under the capsule, some small nodules. V. Old Gordon setter, killed after long illness on the 22nd February 1890, owing to Veterinary Surgeon Collat having diagnosed tuberculosis. Tuberculosis in the liver and in the thoracic organs. The digestive organs healthy, with the exception of the liver, on the surface of which there are found a number of small white granules and two large nodules, one of the size of a goose's egg, the other of a walnut; both have a cicatricial depression in the centre. On section it is seen these nodules are composed outwardly of a firm yellowish-white tissue, but inwardly of a soft tissue enclosing several large cavities filled with a purulent fluid. Small tubercles are everywhere scattered through the texture of the liver. In the anterior lobe of the left lung a large rather well-defined pneumonic condensed part, with a uniform grey-coloured somewhat moist cut surface (tuberculous pneumonia); here and there in the lungs roundish small nodules. The postero-superior part of the thoracic cavity is occupied by a tumour as large as the fist, and having its origin in the lymphatic glands of the mediastinum. The same is similar in structure to the tumours in the liver, only the softening in the centre is further advanced. Tubercle bacilli are present, but not in specially great number. VI. Old hound, the property of a slaughterman. Treated in the stationary clinique of the Veterinary College from the 20th January to the 21st February, and killed with chloral. Primary pleural tuberculosis, secondary acute miliary tuberculosis. The mediastinal pleura, especially the part covering the pericardium, is the seat of a considerable conglomeration of larger and smaller firm yellowish-grey tumours, with an uneven surface, and varying in size between a pigeon's and a goose's egg. The cut surface is for the most part firm and whitish-yellow; but here and there there are also found softened milk-white parts containing mostly a slimy turbid fluid. The part of the pleura covering the aorta and diaphragm is thickly beset with similar larger or smaller, but for the most part discrete, nodules. Costal pleura also partly beset with numerous small nodules, partly covered with a thick layer of reddish, soft, granulation tissue. Everywhere in the lungs and liver there are very small, often only just visible, nodules. Tubercle bacilli were recognised. VII. Medium-sized old dog, killed on the 17th March 1890 and brought for post-mortem. Tuberculous pneumonia. The right lung large, inelastic; the anterior and posterior lobes show on section a great number of larger or smaller irregularly-shaped cavities, some of which are quite filled with a pus-like fluid, but the majority of which are empty; the tissue between these caverns, some of which stand in connection with the bronchi, is in a condition of pneumonia; the entire middle lobe is very firm, contains no air, and has a slaty cut surface, from which one can squeeze out a semi-fluid pus-like material. The middle lobe of the left lung

GENERAL ARTICLES.

10

9

similarly condensed, while the other lobes are in great part permeable, only the middle portions appearing to be pneumonically altered and contain several caverns. The bronchial and mediastinal glands somewhat swollen. Numerous small tubercles in the liver. Numerous tubercle bacilli in the altered portions of the lungs. IS

VIII. Old large dog, died in the stationary clinique on the 9th April 1890, after a subcutaneous injection of 0'02 grm. of pilocarpin. Tuberculous pericarditis. In the pericardium about 300 grm. of a very clear yellowish fluid containing some whitish flakes. The heart is atrophic to an extraordinary degree; the epicardium covered with a 2 mm. thick layer of soft newly formed tissue; the external lamina of the pericardium is also, but not so uniformly, covered with similar tissue. In the mediastinum, and adherent to the pericardium, a lymphatic gland as large as a good-sized walnut; on' section it is seen to be composed of a soft yellowish tissue, with scattered milk-white degenerated (fatty) parts. Tubercle bacilli in the exudate of the pericardium and in the enlarged lymphatic glands. Abundant ascites; congestive hyperremia of the liver. IX. White medium-sized dog, treated in the stationary clinique, and killed on the 12th April 1890. Primary tuberculosis in the mesenteric glands. Tuberculous pleuritis. Disseminated tuberculous pneumonia. Large caseous and partly calcified nodules in the mesenteric glands. A considerable collection of turbid fluid in the pleural cavity; pulmonary and costal pleura thickened and covered with a thick layer of soft, newly-formed, granulation-like tissue. Diaphragmatic and mediastinal pleura also thickened, spotted with a similar new-formed tissue, and beset with numerous whitish, soft, partly stalked, and confluent tuberculous nodules. In the lungs scattered small pneumonic foci, with the tissue partly in a state of purulent degeneration. Bronchial glands somewhat swollen. Numerous bacilli in the pleural exudate and in the affected organs. X. Old dog, died in the stationary clinique on the 19th May 1890, after a long illness. Tuberculosis in some of the lymphatic glands (sarcomatosis). In the peritoneal cavity about 2 litres of yellowish fluid. In the liver some small, ill-defined, whitish nodules. In the small intestine, about 40 cm. from the pylorus, a prominent thickening of the wall over an extent of about 10 cm.; and about IS cm. farther backwards there is found a large opening leading into a cavity as large as a hen's egg, and filled with intestinal contents. The walls of the same are firm, about 1 cm. thick, and ulcerated on their inner surface. A large tumour between stomach, liver, and pancreas. A tumour (round-celled sarcoma) as large as a hen's egg at the entrance to the chest (sarcomatosis). At the middle of the neck a walnut-sized lymphatic gland cystically degenerated, containing a slimy fluid, which is full of white tissue fibres. In the mediastinum, exactly in front of the heart, a tuberculous lymphatic gland as large as a pigeon's egg; its tissue is in great part converted into a yellowish, caseous material, enclosing some soft, milk-white parts. Scattered tubercle bacilli in both glands. XI. Medium-sized,4-5 years old dog, killed here on the 27th May 189°· Tuberculosis of the lung-miliary tube,rculosis. In the middle lobe of the right lung there is found a tumour as large as a

110

GENERAL ARTICLES.

hen's egg and provided with a navel-like depression externally, where it projects from the surface of the lung. On the cut surface it is seen that the tumour has a rather firm consistence and a slaty colour (slaty pigmentation). Only at the edges of the tumour can one recognise that it has been partly formed by the confluence of numerous small nodules. Such small nodules are found scattered throughout the affected pulmonary lobe, and also in the other parts of the lungs. Bronchial glands healthy. In the liver scattered small, whitish nodules, not so large as a pea. In the cortical substance of the kidneys, especially near the surface, similar small nodules, some of which extend as whitish streaks through the cortex. XII. Old bull-dog, killed on the 30th June 1890, on account of disease. Phthisis cavernosa. Renal tuberculosis.

Lungs: On the two anterior lobes of the right lung the pleura is thickened in spots; in the lung tissue some slaty nodules of the size of a pea; in the upper and anterior part of the posterior lobe a nodule as large as an egg, composed of a soft whitish tissue which has degenerated to a gruel-like matter in the centre; the nodule contains a large hremorrhage, and is surrounded by a connective-tissue capsule. The degenerated tissue stands in connection with the main bronchus by means of a small opening. The entire remaining tissue of the lobe is in a condition of slaty induration, full of numerous caverns from the size of a lentil to that of a bean, and filled with mucus and pus. Throughout the left lung there are scattered slaty nodules from the size of a millet-seed to that of a bean, and partly in a state of caseous degeneration at the centre. Bronchial glands swollen. Pulmonary and diaphragmatic pleura and also the mediastinum beset everywhere with fine reddish connective-tissue new formations. The kidneys show the picture of a chronic nephritis with marked shrinking of the cortical substance and with numerous small cysts and occasional streak-like, somewhat caseous, infiltrations in the medullary substance. In the caseous parts of the kidneys and in the diseased parts of the lung there are numerous tubercle bacilli. XIII. Large old black long-haired dog, killed on the 10th August 189 0 . Tuberculosis of the lungs and pleura (Perlsucllt). Over the whole costal, pulmonary, and diaphragmatic pleura there are numerous new formations, partly in the shape of reddish fine fibres of connective tissue, partly as diffuse thickenings of the pleura, or as sharply defined perl nodules of various sizes, the most small, up to the size of a hazel nut, but a single one on the left side of the chest-wall and another on the mediastinum as large as a pigeon's egg. The nodules are rounded and rather smooth, not stalked. The cut surface is markedly granular, but shows no trace of caseation or degeneration. In the upper part of both lungs, close under the pleura, there are found collections of whitish nodules up to the size of a bean; like the perl nodules these have a granular cut surface, but, on the other hand, show no degenerative changes. No miliary tubercles in the lungs. Bronchial glands swollen and strongly pigmented, but without any tuberculous deposit. The other organs healthy. Tubercle bacilli were recognised in the lungs and on the pleura. XIV. Large "Old Danish" dog, 2 years old, the property of a slaughterman, who reported that the animal had constantly consumed tuberculous organs. After about five weeks' illness it died on the 6th October 1890.

GENERAL ARTICLES.

III

Tuberculosis in the lymphatic glands of the a:sophagus, in the mesenteric glands and in the liver; tuberculous pleuritis. Retropharyngeallymphatic glands swollen; in those of the left side a milkwhite caseous nodule as large as a pea. In the duodenum, close to the pylorus, two tuberculous ulcers of ordinary appearance, about I - I ! cm. in diameter. Mesenteric glands somewhat swollen and moist, with three or four whitish non-caseous, small nodules, and one nodule as large as a pea and composed of a milk-white pulpy matter. In the liver a single walnut-sized nodule, degenerated centrally to a whitish, flaky, semi-fluid material, and composed at its periphery of numerous small confluent nodules; in the liver scattered scarcely visible tubercles. Both pleural cavities contain a large quantity (about 6 litres) of turbid yellowish fluid. Mediastinum much thickened, partly by infiltration, partly by a layer of soft, reddish, close-set, stalked nodules, so as to form a 2-3 cm. thick folded lamina. Above and behind on the mediastinum in the right pleurjll cavity there is found a whitish tumour as large as the two fists; on section it is seen to be composed of a fibrous membrane enclosing a milk-white thready material and a turbid fluid; a somewhat fatty firm tissue is found only in the anterior part of the tumour. The right lung is compressed. The entire pleura is thickened, and covered with a thick (up to I cm.) membrane of reddish newly formed tissue, which in the main is composed of confluent small nodules. The layer is especially prominent on the costal and diaphragmatic pleura, less so on the pleura pulmonalis. The lungs contain no tubercles, the bronchial glands and the pericardium are also normal. Anteriorly, at the entrance to the chest, there are a couple of firm tumours, as large as pigeon's eggs. Tubercle bacilli were found, but only in slight numbers, in the various new formations and in the lymphatic glands. XV. Large long-haired dog. Taken into the statio~ary clinique on the 4th December r 890, and killed on the 22nd December. Tuberculosis in the intestine and mesenteric glands; general tuberculosis. Everywhere in the emphysematous lungs there are found small nodules up to the size of a pea, of a grey colour, partly degenerated into caverns at the centre, and containing some purulent detritus. Bronchial glandS swollen and pigmented. On the abdominal surface of the diaphragm there are some whitish nodules, many very small, others large-up to I cm. in diameter. In the liver numerous greyish-white nodules up to the size of a pea; the lymphatic glands at the hilus swollen and fatty. Behind the stomach and adherent to that and the liver and duodenum, there is found a tumour as large as the two shut fists. This is composed of a firm whitish fatty tissue, which contains only a few small softened foci. In the duodenum, where that is adherent to the tumour, there are found two round deep ulcerations. The hinder part of the small intestine, the c::ecum, and the anterior part of the colon have also become adherent to the tumour. The omentum is beset with nodules, some of which are very small, others up to the size of the fist. In the kidneys there are occasional tubercles. Tubercle bacilli are present in small numbers. To these r 5 well authenticated cases of tuberculosis in the dog I can, through the kindness of Dr Bang, add r 3 others, which have been observed by him in our Veterinary College between r882 and November r889. XVI. Large yellow dog, "Old Danish" breed, brought to the clinique in March r882 because it was lame behind and showed H

Il2

GENERAL ARTICLES.

symptoms of consolidation at the lower part of the left lung. As the patient was in a very low condition it was killed. Tuberculosis of the respiratory organs, heart, liver, and spleen. In the lowest part of the lung there is an extensive consolidation, in great part it is of a caseous character; scattered tubercles and smaller caseous nodules in the other parts of the lungs. Pleural tuberculosis. Bronchial gland swollen and caseous. Heart large and soft; in its muscular substance there are several small caseous and fibrous nodules. Caseous nodules in the spleen, but only in small numbers. In the liver a large swollen part with caseous nodules. Chronic nephritis. XVII. Slaughterhouse dog, treated in the stationary clinique, and killed on the 27th October 1885. Tuberculosis of the thoracic organs. There is no complete post-mortem record of this case, but some of the organs of the cadaver in question are preserved in the museum of our institution, and show the following condition: Diaphragm partly covered on its thoracic side with a thick adherent layer of tuberculous tissue, partly beset with perl nodules. Mediastinum beset with numerous small nodules; in the superoIn the lungs, posterior part a collection of enlarged lymphatic glands. especially close under the pleura, there are groups of small nodules. The .bronchial glands on the right side are transformed into a whitish soft tumour, nearly as large as an egg. XVIII. Large old dog,' brought dead for post-JIlortem on the 18th June 1886; said to have been ill for a couple of days. Phthisis cavernosa. Secondary tuberculosis in the liver and kidneys. Diffuse septic phlegmon in the neck. The posterior lobe of the left lung almost entirely solidified and adherent to the surrounding parts; on the cut surface the tissue is seen to be full of caverns, mostly varying in size from a pea to a bean, some as large as a walnut; the walls of the same are smooth and slaty; contents a small quantity of purulent fluid; surrounding tissue In the other pulmonary lobes a few small nodules. slaty and fibrous. Bronchial glands swollen; contain no visible tubercles. In the liver scattered granules. Left kidney somewhat contracted over a limited part, shows numerous tubercles on its surface, whitish streaks in its cortex, and caseous ulceration at the corresponding part of the pyramids. XIX. Large dog, of "Old Danish)) breed, placed in the stationary clinique on account of a h~morrhagic inflammation of the stomach and intestines. Died on the 18th August 1886. The post-mortem showed among other changes: Primary (?) tuberculosis in the urinary organs; tuberculosis of the epididymis, lungs, and liver. In the lungs a great number of miliary, grey, small nodules, partly calcified. In the liver, both on the surface and on section, numerous grey-coloured tubercles. Kidney small, surface shrunken and granular. Cut surface of the left kidney somewhat indistinct in its markings; medullary substance yellowish, markedly infiltrated, in part caseous; this applies especially to the apex of the pyramid. At the boundary between medulla and cortex a light-coloured zone with grey-coloured small nodules. Posterior part of the right kidney altered in a similar way, while in its anterior part only occasional granules are scattered through the medullary substance. Pelvis of both kidneys somewhat dilated. In the upper part of the left ureter a number of sub-miliary tubercles

GENERAL ARTICLES.

113

in the mucous membrane. The bladder contains clear very albuminous urine; mucous membrane, especially towards the point of the bladder, beset with a large number of small granules. The testicle firmly adherent to the tunica vaginalis; in one epididymis some groups of calcified small nodules. XX. Bull-terrier bitch, I I years old, treated for a long time by a veterinary surgeon on account of thoracic disease. Died in the clinique on the 14th September 1886. Pulmonary and pleural tuberculosis. l Some transudate in the peritoneal cavity; about ~ a litre of clear yellowish fluid in the thorax. Endocarditis valvo chronica, and dilatatio cardis. Pleura pulmonalis beset with numerous small nodules; on the cut surface of the lung, small roundish, grey-coloured tubercles, occurring, separately and III groups. Bronchial glands swollen. XXI. Large dog, " old Danish" breed, killed after long illness on the 19th October 1886 (clinical diagnosis: albuminuria). Tuberculosis in pleura, pericardium, peritoneum, liver and kidneys. Diaphragmatic and mediastinal pleura beset with a great number of whitish and reddish miliary nodules; these are partly grouped together in conglomerate masses up to the size of a pigeon's egg; here and there between the nodules there are reddish connective-tissue fibres. On the surface of the lung at some places there are small flat whitish nodules. Bronchial glands much enlarged, in great part transformed into caseous abscesses. In the pericardium some bloody fluid; serous lining of the same beset with a large number of connective-tissue new formations, in which are found numerous small tubercles; epicardium similarly altered. At the edge of the tricuspid and bicuspid valves occasional calcified small nodules. Omentum closely beset with small irregular nodules. In the liver several tumour masses up to the size of an egg; on section these show at the periphery a calcified granular texture, and in the centre a diffluent milk-white flaky character. Kidneys somewhat shrunken, capsule difficult to tear off; on section in the cortex whitish connective-tissue strands correspond to the skrunken parts. In the cortex and marrow a great number of small nodules, mostly of longish form and partly transformed into caseous abscesses. In the connective tissue around the renal· pelvis several whitish nodules. The urine was clear and contained 5 per cent. of albumen. XXII. In a gland tumo,ur of the mesentery of a dog, which was examined post-mortem in December 1886, a large number of tubercle bacilli were found. There is no further record of the case. XXIII. Medium-sized, three years old dog, which in the course of half a year had become extremely emaciated. Kilfed on the 27th September 1887. Tuberculosis of the digestive organs, kidneys, and lungs. Liver much enlarged, very irregular in shape, with deep furrows. It was full of nodules from the size of a bean to that of a walnut, some, indeed, much larger. These resembled carcinomatous nodules, were white, and often provided with a central umbilication. On section they showed a broad white ring, surrounding a mass of cicatricial tissue, in which there were found near the centre of the nodules caseous and calcified parts. Some of the larger nodules contained in the middle a soft reddish, gelatinous tissue, and the two largest a turbid semi-purulent gelatinous material; they lay in the 1 Inasmuch as tubercle bacilli were not detected in this case, the diagnosis is perhaps somewhat uncertain.

II4

OENERAL ARTICLES.

!1eighbourh?od of the large bile ducts, with which they appeared to stand m connectIOn. Liver adherent to the diaphragm. On the abdominal side of the latter a rather extensive deposit, partly of white small miliary nodules, partly of more flat tumour-like new formations. In the omentum numerous pea-sized to bean-sized nodules with caseous centre and fibrous periphery. All the mesenteric glands swollen, contain large caseous and mortar-like spots, which at some places have the milk-white colour peculiar to tuberculosis of the carnivora. In the most posterior part of the small intestine there are two pea-sized transverse thickenings with central ulceration; on section it is seen that the thickening affects especially the muscular coat, which shows traces of whitish spe<;:ks. Kidneys swollen, about -} of the surface occupied by groups of grey-coloured miliary small nodules; from here whitish streaks run through the cortex and marrow, and in the latter there are found some small oval empty cavities. Lungs beset with groups of miliary tubercles; no caseous changes. Bronchial glands somewhat swollen; in one of them there are small caseous parts. Tubercle bacilli in abundance were recognised.

XXIV. Large dog" Old Danish" breed, died in April 1889, after having been in the stationary c1inique for four weeks. Tuber,culous pleuritis. Tuberculosis of the lungs . ., Very advanced bilateral pleurisy; the diaphragm strongly pressed backwards. Pleura everywhere-on lungs, diaphragm, and chest wall-beset with fine small nodules. Mediastinum thickened, forms strongly folded rather stiff laminre, which at some places reaches a thickness of ·s cm. ; the tissue homogeneous and whitish. In the upper and outer part of one lung a firm portion with somewhat depressed surface; pleura itself shows fibrous thickening. On section it is seen that the nodule possesses centrally a small cavity with degenerated walls, and for the rest is composed of a rather firm uniformly grey-coloured material without caseation or calcification; peripheral part of the nodule formed of confluent small nodules. Little or no enlargement of the bronchial glands. Many tubercle bacilli.

XXV. Pointer, about 8 years old; treated by a veterinary surgeon for several months on account of bronchitis. Killed on the 21st May 1889. Tuberculosis of the bronchial glands. General tuberculosis. Diaphragm pushed far backwards. Bronchial glands converted into tumours as large as the fist; these on section consist mainly of a whitish, soft, cheesy material. Small granules on the posterior part of the pleura covering the right lung. Several larger firm whitish nodules in the diaphragmatic pleura (bronchitis chronica). Pericardium notably thickened, outwardly beset with reddish new formations as large as a pea. Along the anterior edge of the heart the parietal and visceral layers of the pericardium have grown together; at the apex of the right ventricle there are present in the musculature two whitish, rather firm, and somewhat granular tumours of the size of a nut; they project above the surface of the heart, and adhere to the outer layer of the pericardium. Scattered small nodules in the omentum; abdominal side of the diaphragm beset with occasional, flat, larger, firm tumours. The surface of the liver closely covered with small tuberculous new formations; in one of the lobes at the same time a tumour as large as a hen's egg, and degenerated at its centre. Kidneys much reduced in size; on their surface there are seen scattered small nodules, which on section show a caseous centre. On the limit between the renal tissue and the pelvis there is found in one kidney a nodule as large as a pea. Comparatively few tubercle bacilli.

GENERAL ARTICLES.

XXVI. Old pug-dog, killed in the Veterinary College here in October 1889. Tuberculosis of one bronchial gland. One bronchial gland as large as a walnut, externally of a whitish-grey colour, dark pigmented at one end; on section it shows centrally a small cavity, and around that a granular tissue with soft, milk-white portions. Relatively few tubercle bacilli, which are almost all enclosed in epithelioid cells. XXVII. Large dog, killed in October 1889, after it had been treated for lung disease by a veterinary surgeon. Tuberculosis of the thoracic organs and of the liver. On opening the thorax the lower part of the mediastinum is seen to be thickened, folded, and full of small and large whitish firm nodules. The right lung is not visible, owing to its being pressed upwards towards the spine, and attached posteriorly to a tumour springing from the mediastinum and as large as the two clenched fists. The tumour is whitish and firm, but in its centre there are soft milk-white parts. To the right, at the entrance to the chest, there is a similar tumour as large as an egg (lymphatic gland ?). Over the entire costal and diaphragmatic pleura there are flat nodules of the size of a pea. In both lungs scattered nodules from the size of a lentil to that of a pea; numerous similar nodules in the liver. Relatively few tubercle bacilli. XXVIII. Large, three-year-old dog, treated for three months by a veterinary surgeon on account of a lung affection, then brought to the clinique, and killed there on 6th October 1889. Tuberculosis in the thoracic organs, liver, and kidneys. In the thoracic cavity about I litre of clear, reddish fluid. Pleura beset with numerous whitish-yellow, firm, flattened tumours, from the size of a millet-seed to that of a bean, but mostly of the volume of a pea. In the posterior part of the mediastinum a tumour of the size of the two shut fists; a smaller one in the anterior part. Both tumours are of irregular shape, and formed by the confluence of several smaller ones. At the entrance to the chest, under the trachea, a tumour as large as an egg. All the tumours show a homogeneous cut surface, but contain pea-sized pigmented nodules. In the liver, both on the surface and in the texture, numerous small whitish nodules; occasional similar nodules in both kidneys. In the pathological museum of our Veterinary College there are three old preparations from dogs, dated 1837, 1839, and 1842, which are certainly to be regarded as cases of tuberculosis of the lymphatic glands of the thoracic cavity, and of the bronchial and mediastinal glands. In all three cases there are large tumours, of the size of the fist, which have occupied a large part of the thoracic cavity. The cut surface of these tumours shows in one preparation a soft yellowish, cheesy character; in both the other preparations the tumours are soft, and show on section cavities which are partly filled with white soft tissue fibres, and are surrounded outwardly by a soft slaty-coloured tissue (similar, for example, to the tumours in Dog IV.). In two of these preparations there are also found scattered small nodules in the lungs. These changes thus resemble completely several of the observed cases of tuberculosis in the dog, and there can therefore be hardly any doubt as to the tuberculous nature of the same. It is true that I have not been fortunate enough to recognise with certainty tubercle bacilli in these old preparations, but, as is well known, that is very difficult even in much more recent museum preparations.

II6

GENERAL ARTICLES.

The preparations have a special interest, inasmuch as they belong to a time when tuberculosis was not very widespread in this country. CASES OF TUBERCULOSIS IN THE CAT.

1. Female cat, without history. Killed on the 27th November 1889. Tuberculosis in different lymphatic glands and in the lungs. Much emaciated. In the anterior and middle lobes of the right lung not a few whitish nodules, which are composed of numerous milk-white granules, separated from one another by pigmented and infiltrated lung tissue; the posterior lobe of the lung is the seat of a slaty hepatisation. In the left lung perfectly similar alterations. Bronchial glands swollen and pigmented; beset with small white nodules. Lymphatic glands along the trachea much swollen, up to the size of a bean or a nut; they and the retro-pharyngeal lymphatic glands, which are also markedly swollen, show scattered milkwhite granules on the cut surface; submaxillary glands on the left side similarly altered, up to the size of a nut. Mesenteric glands also swollen and tuberculous. Numerous bacilli in the different lymphatic glands and in the nodules in the lung.

II. Young male cat, killed on the IOth April r890. Tuberculosis in the abdomen. Testicular tuberculosis. Mesenteric glands much swollen, show on section a milk-white soft part in the centre. Intestinal canal normal. Lumbar lymphatic glands from the size of a pea to that of a bean, altered in the same manner as the glands of the mesentery. Omentum closely beset with whitish nodules. One testicle normal, about the size of a bean; the other forms along with the epididymis and the membranes a roundish body of the size of a pigeon's egg; on the cut surface one can scarcely recognise the normal markings. Tissue of the same grey-coloured, soft, infiltrated with pus. In the lungs occasional scattered grey-coloured miliary tubercles; purulent bronchitis and atelectasis of one lobe of the lung. Extraordinarily numerous tubercle bacilli in the diseased lymphatic glands and in the testicle. III. Female cat, killed on the IOth April r890. Pulmonary and pleural tuberculosis. , Lungs full of nodules up to the size of a bean. These are confluent; greycoloured, whitish in the centre, soft and more or less caseous. Emphysema of the lung. Bronchial glands somewhat swollen. On the mediastinum and partly also on the costal pleura numerous granules and nodules from the size of a millet-seed to that of a lentil. Many bacilli. IV. Female cat, treated in the ambulatory clinique of the college on account of a chest affection, and killed on the 16th April 1890. Tuberculosis of the mediastinum, lungs, kidneys, and mesenteric glands. Submaxillary glands swollen, succulent, and as large as a big bean. Diaphragm pushed well towards the abdomen. In the thoracic cavity about 60 grm. of rather flocculent fluid; almost the entire cavity of the chest filled up by a very large tumour mass occupying the position of the mediastinum; the same is whitish-yellow to red, and entirely fused with the pericardium, which it completely surrounds anteriorly. Its cut surface is moist, rather uniform, but still beset with scattered small milk-white spots. Lungs very small, pressed towards the spine and the diaphragm; they contain scattered nodules. In the pericardium a large quantity of fluid and flakes of fibrin;

GENERAL ARTICLES.

117

heart atrophic to a high degree. Mesenferic glands much enlarged, beset with large granules and whitish soft spots. In one kidney a whitish nodule almost as large as a lentil. Many tubercle bacilli in the lung nodules; only a few, on the contrary, in the large tumour and in the swollen glands.

V. Old male cat, killed on the 28th April 1890.

Renal and pulmonary tuberculosis. Tuberculous arthritis (tuberculosis of the mesenteric glands ?). In the lungs some large caseous nodules and very numerous miliary and submiliary tuhercles. Bronchial glands somewhat swollen. Mesenteric glands markedly swollen, but the cut surface homogeneous and not beset with the already repeatedly described soft spots and points of degeneration. Kidneys large, capsule everywhere adherent, surface very uneven, with large cicatricial depressions. Parenchyma markings on the cut surface very indistinct; in the cortical substance a diffuse formation of connective tissue; on the limit of cortex and medulla and in the latter some caseous nodules and many longish cavities up to the size of a pea; these are partly filled with a yellowish pus which swarms with tubercle bacilli. All the joints of the extremities more or less swollen; in their capsules an increased quantity of fluid; joint capsules thickened, quite surrounded and partly filled by reddish granulation-like tissue. Some small spots in the ends of joints filled with a similar tissue. Tubercle bacilli dete~ted. VI. Old, well-nourished female cat, which a short time previously had given birth to young; killed on the 27th May 1890. Uterine tuberculosis. Tuberculosis in the subcutaneous tissue and in the muscles of one hind leg. Vagina healthy. Uterus enlarged, its body as large as the little finger; left horn small, contracted, only the most posterior part somewhat thicker than normal; right uterine horn 18-19 cm. long, and thicker than the finger. Uterine cavity full of whitish-grey, pus-like fluid, which contains numerous tubercle bacilli; walls of the uterus notably thickened (8-10 mm.) and fatty; this applies especially to the mucous membrane, on which, however, no ulcerations or caseous parts are recognisable. Under the microscope it is found that the epithelium is partly shed, the mucous membrane and partly also the other coats are thickly infiltrated with large and small round cells; here and there single bacilli. Tubes and ovaries healthy, in the latter corpora lutea. On the outer face of the right leg a small wound, about I cm. in diameter. At this place, under the skin, there is a flattened sharply limited nodule, half as large as a walnut. On section of this one sees that the tumour is composed of firm connective-tissue, enclosing a soft reddish granulation tissue with scattered whitish-yellow purulent points of degeneration. The tumour has its seat in the subcutis and the underlying muscles. Not a few tubercle bacilli. VI I. Cat without any history, killed on the 27th May. Tuberculosis in the mesentery, liver, and lungs. A single pea-sized nodule in the mesentery of the small intestine. Liver beset with grey-coloured, transparent nodules of the size of a millet-seed. Lungs full of similar tubercles. Bronchial glands healthy. Bacilli were detected. VIII. Cat killed on the 17th June 1890. Tuberculosis of the lung. Right Lung: Hinder half of the posterior lobe firm and somewhat hard, density increased from pneumonia; cut surface slaty, with whitish spots

lIS

GENERAL ARTICLES.

distributed through it. Throughout the denser part single firm nodules of the size of a lentil. Middle lobe emphysematous with scattered whitishyellow nodules from the size of a millet-seed to that of a lentil. Single miliary tubercles in the anterior lobe, which is also emphysematous. Left Lung: In the posterior lobe a pneumonic nodule as large as a walnut and three or four as large as a bean; these are firm and around them there are numerous small tubercles. Anterior lobe emphysematous, with scattered miliary to lentil-sized nodules. Bronchitis. Bronchial glands somewha swollen, pigmented, without any distinct deposit of tubercles. A good many bacilli. IX. Old cat, killed on the 18th June 1890. Tuberculosis of the mesenteric glands, kidneys, and lungs. Mesenteric glands swollen; one of them almost as large as a nut and caseous at the centre. Left kidney atrophic to a high degree, not larger than a walnut; surface uneven, capsule adherent. On the cut surface the cortical layer is seen to be diminished in size, of very firm consistence, normal marking vanished; in its place there is seen a grey-coloured tissue ~ith irregular whitish connective-tissue streaks. Medullary substance also smaller, partIy transformed into fibrous-tissue, enclosing numerous caseous centres up to the size of a lentil; renal pelvis dilated and full of a caseo-purulent material. Walls ulcerated. Right kidney very large, anterior part greatly hypertrophied, the posterior shrunken; cicatricial depressed parts alternate with whitish nodules that project above the surface; capsule partly adherent; cortical substance has distributed through it streaks of connective-tissue and fatty spots; in the medullary layer single small cavities filled with purulent matter. Many tubercle bacilli in the pus· like degenerated material of the kidneys. At the upper part of the posterior lobe of the right lung a bean-sized bronchiectatic cavity and scattered nodules of the size of a pea, as well as numerous quite small tubercles, which are partly arranged in rows (along the lymph paths); in the posterior lobe of the left lung scattered pea-sized nodules and miliary tubercles. X. Old pregnant cat, killed on account of supposed disease on the 20th June 1890. It was ascertained that the animal had been fed only with fish and boiled milk, and also that there was no tuberculosis in the family of the owner. Tuberculous (?) ulcer on the abdominal wall; pulmonary tuberculosis; About the centre of the abdominal wall an ulcer Ii cm. long, i cm. broad, with fatty base; in the surrounding tissue numerous nodules; however, I did not succeed in finding tubercle bacilli in some cover-glass preparations made from the same. Throughout the entire lungs grey-coloured, firm, non-caseous nodules, varying in size from a millet-seed to a lentil; tubercle bacilli recognised in them. Bronchial glands somewhat swoilen, otherwise normal. XI. Cat, killed on the 30th June 1890. Pulmonary and renal tuberculosis. Both lungs filled with grey and yellow-coloured, partly confluent, caseous nodules, so that sound lung was left only here and there. Left kidney rather large, capsule easily stripped off; the greater part of the surface uneven owing to grey prominent nodules. On section the anterior half of the cortical substance appears to be reduced in size, markings on the same indistinct, here and there grey-coloured nodules deposited in it; at the limit between cortex and medulla some small cysts. Medullary substance transformed into fibrous tissue, traversed by streak-like, yellowish, caseous infiltrations, most of which

GENERAL ARTICLES.

have a radial disposition; here and there small cavities-one almost as large as a bean-filled with pus-like matter. Renal pelvis normal. XII. Cat, killed on the 1st July 1890. Tuberculosis of the lung. 'In both lungs, especially under the pleura, scattered pea-sized nodules, partly caseous at the centre. Bronchial glands somewhat swollen. XIII. Young cat, killed on the 2nd July 1890. Tuberculosis of various lymphatic glands and of the spleen. Submaxillary glands markedly swollen, caseous and partly calcified. Lymphatic glands along the neck swollen. - Mesenteric glands beset with caseous and partly calcified nodules. In the spleen numerous small nodules with caseous centres. XIV. Female cat, killed on the 20th July 1890. Tuberculosis of the lung. Mesenteric glands enlarged, beset with many small caseous and partly calcified nodules, from the size of a millet-seed to that of a lentil and some larger (up to a nut). Numerous somewhat granular tubercle bacilli detected. Xv. Female cat, killed on the 20th July 1890. Pulmonary tuberculosis. In the posterior lobe of the right lung a walnut-sized nodule with a greycoloured, homogeneous, fatty cut surface, and having at its centre a cavity as large as a pea and filled with pus-like degenerated material. Distributed throughout both lungs pea-sized whitish nodules, some showing purulent degeneration at the centre. Bronchial glands slightly swollen. XVI. Old cat, killed on the 30th July 1890. Tuberculosis of the mesenteric glands. In the mesenteric glands a couple of lentil-sized, caseous and calcified nodules, which contained not a few granular tubercle bacilli. XVII. Oldish cat, killed on the 5th August 1890. Tuberculosis of the mesenteric glands. In one of the mesenteric glands a lentil-sized calcified nodule, in which one could recognise pretty numerous markedly granular tubercle bacilli. XVIII. Youngish cat, which a short time previously had aborted; killed on the 19th August 1890. Tuberculosis of the kidneys, and axillary and mesenteric glands. Kidneys .large (55 x 46 mm., and 53 x 39 mm.); capsule in part firmly adherent; surface beset with numerous whitish-yellow caseous nodules, up to the size of a pea, and which in great part are seated close together along the outer edge of the organ. The cut surface shows, especially in the medullary substance, numerous small and larger yellowish, caseous, partly round, partly streak-like conical areas. Parenchyma marking of the kidneys otherwise indistinct, the tissue somewhat firm and whitish. The axillary glands form large tumours (4-5 cm. long and 2 cm. broad), composed of whitish, fatty tissue with large yellowish caseous parts. Mesenteric glands swollen, and beset with small caseous and calcified nodules. XIX. Old cat, killed on the 19th August. Tuberculosis of the mesenteric glands. In the mesenteric glands a couple of whitish caseous nodules, as large as

120

GENERAL ARTICLES.

a bean, beset with calcareous particles, and containing numerous granular tubercle bacilli. All other organs sound. XX. Oldish cat, killed on the 24th August 1890. Tuberculosis of the lungs and kidneys. Lungs much ,distended, emphysematous. In the anterior and posterior lohes of the right lung some pea- to bean-sized whitish-yellow nodules, of which a single one is in a state of caseous degeneration; in the middle lobe pretty numerous whitish nodules. In the anterior lobe of the left lung similar nodules; posterior lobe for the most part transformed into a very firm, yellowish to slaty-grey, hepatised tissue, which encloses several cavities with muco-purulent contents and up to the size of a nut. Bronchi filled with purulent mucus. Bronchial glands swollen and pigmented. Kidneys somewhat enlarged; capsule easily stripped off; surface uneven, in part cicatricially contracted, full of yellowish nodules and cysts from the size of a millet-seed to that of a nut, and filled partly with clear or blood-coloured fluid, partly with pus; cortical substance firm, yellowish, without distinct marking on the cut surface; scattered small caseous abscesses both in the cortex and medulla. XXI. Young female cat, killed on the 16th January 1891. Tuberculous ulceration; tuberculosis of the lungs and mesenteric glands. In the neck, in the region of the parotid gland, an ulcer about the size of a sixpence, and close beside that in the subcutaneous tissue, a bean-sized nodule, in a state of caseous degeneration, and some enlarged lymphatic glands. In the lungs scattered nodules; bronchial glands partly in a state of caseous degeneration. The mesenteric glands as large as a nut, and containing several caseous abscesses. XXII. Old cat, killed on the 16th January 1891. In the mesenteric glands a caseous and partly calcified nodule as large as a millet-seed. Tubercle bacilli detected; they are small and granular.

,

To these twenty-two cases of tuberculosis in the cat, which were observed in the course of ten months, I am able to add still a few others, which have been observed by Professor Bang. XXIII. Cat, killed on the 31st May 1885, after about four months illness (loss of appetite and difficulty of breathing). Tuberculosis of the lungs and kidneys. Both lungs full of tubercles of recent grey-coloured appearance, partly isolated, partly grouped closely together in large masses, between which there are small air-containing and, as a rule, markedly emphysematous parts. Only a little mucus in the bronchi. Bronchial glands very much swollen and full of nodules. In one kidney six or seven grey-coloured nodules, some of which have a whitish central part. Tubercle bacilli detected. XXIV. Medium-sized kitten, "from the very first had not thriven," killed on the I Ith March 1886. Tuberculosis of the digestive organs, miliary tuberculosis in the lungs. . Around the cesophagus large caseous and partly purulent lymphatic glands. The most posterior Peyer's patches in the small intestine swollen,' without distinct ulceration; the lymphatic vessels on the serosa of that part of the bowel had the form of beaded strings; the adjacent mesenteric glands swollen

GENERAL ARTICLES.

121

up to the size of an almond, firm, and caseated; one more remote mesenteric gland was also swollen, and contained at the same time caseous parts. The lungs filled with miliary tubercles. Masses,of bacilli in the mesenteric glands. XXV. Five-year-old female cat, brought to the stationary clinique for treatment on.the 21st November 1891. For some days it had suffered from want of appetite, vomiting, and constipation. A tumour larger than a hen's egg could be felt in the abdomen. Laparatomy and removal of the tumour (which proved to be the morbidly altered right kidney) on the 21st November. Peritonitis. Death on the 23rd November. Primary (?) tuberculosis of the right kidney. The extirpated kidney greatly enlarged, 5'5 cm. long, 4'3 cm. broad, and 4'8 cm. thick. Capsule is easily stripped off at only one part of the kidney; at the other end it is firmly adherent and much thickened; the surface of the kidney in general comparatively smooth and even, only about the third part of it granular. On section the greater part of the tissue is seen to be of a whitish, fatty, somewhat swollen appearance, in consequence of a disseminated not sharply defined infiltration; between these parts, which reached the size of a nut, only a little perfectly sound renal tissue is left. Microscopically it is recognisable that the whitish swollen parts are composed of a granulationlike tissue, which partly replaces the renal tissue and partly is intermixed with the latter. Only a few tubercle bacilli could be detected in this remarkable kidney. As the owner would not permit a further post-mortem examination, only the abdominal organs were examined, but in these no tuberculosis was found. If we now consider the behaviour of the tuberculosis towards the different organs of the dog, as shown by the above-reported 28 postmortem records, we find circumstances that strongly remind us of what we know in the case of the ox; the disease attacks with especial preference the lung, the liver, and the serous membranes, with striking frequency also the kidneys. In 19 cases the lungs were affected. In two cases there was a deposit of miliary tubercles, more frequently there were found scattered often caseous nodules, varying from the size of a millet-seed to that of a bean; in two cases the nodules were as large as an egg and more or less degenerated in the centre. Frequently the tuberculosis had the character of a more or less wide-spread, sometimes indeed, lobular pneumonia. C.aseation processes were not observed in the latter, the hepatised lung tissue was often in a state of puriform degeneration, and the greater part of the lung in many cases was transformed into a system of irregular, larger and smaller cavities in part filled with pus-like material; in a single case these stood in direct connection with the large bronchi. The bronchi appeared to be only seldom affected. The lymphatic glands of the thoracic cavity, especially the bronchial glands, and the glands lying anteriorly and posteriorly on the mediastinum, were very often tuberculous, not seldom to such an extraordinary degree that they were transformed into very large tumours, which were composed of a fatty tissue, more or less degenerated at its centre. Proper caseation processes were, as a rule, not observed; there was, on the other hand, frequently a peculiar softening of the tissue which owing to advanced fatty degeneration often assumed a milk-white colour. Sometimes the process of degeneration had attained

122

GENERAL ARTICLES.

such a degree that the tumour was transformed into a cyst, which generally contained a whitish fluid with interspersed tissue fibres. In about the half of the cases of tuberculosis observed in the dog the lymphatic glands were altered in the way described. , In the half of the cases also the serosa of the large body cavities were affected, the pleura being most frequently the seat of disease. In most of the cases of pleural tuberculosis the disease was analogous with perlsue/lt / deposit of soft connective-tissue new formations, of numerous confluent nodules or of large roundish tumours; in a few cases there was, in addition to this formation of new tissue, an exudative inflammation (sero-fibrinous pleurisy, purulent pleurisy); in two cases there was a similar tuberculous inflammation of the pericardium. A peculiar change was repeatedly found in the mediastinum, this being converted into a very thick folded lamina, which was composed of tuberculous tissue and closely covered on its surface with nodular tuberculous new formations. In the heart, which is certainly seldom affected with tuberculosis, tuberculous processes were found in only two cases. If we turn next to the digestive organs, we see that the lymphatic glands of the head and neck were only seldom affected, and the submaxillary and retropharyngeal only once. On the other hand the mesenteric glands were frequently found diseased, and in several ca~es they were converted into tumours with central degeneration precisely similar to the lymphatic glands of the thorax. Intestinal tuberculosis was relatively seldom-more seldom than one would expect, and it was confined to occasional unimportant ulcers. On the other hand the liver was found to be very often affected, frequently filled throughout with small nodules, often, however, also with a smaller number of larger nodules (up to the size of an egg), which, in consequence of fatty degeneration, showed regularly in the centre the customary milk-white colour, either diffusely or in spots. Only in two cases was the spleen found to be tuberculous, and in these only to a slight degree, while the kidneys, on the other hand, were with striking frequency (in 12 cases) the seat of more or less prominent changes. Most frequently there were scattered nodules in the medullary and cortical substance, but there were often found also caseous abscesses and spots, especially in the marrow, accompanied by a chronic indurative nephritis. In a single case an ulcerative process was observed in the renal pelvis. In only one dog were the ureter and bladder found to be tuberculous to a slight degree. The sexual organs were always found to be healthy, with the exception of a few small nodules in one epididymis. An interesting question is the manner in which in'the different cases the infection must have taken place. There can be no doubt that in some of these the port of entrance must be sought in the respiratory organs, but it is just as certain that one must regard other cases as examples of tuberculous infection proceeding from the alimentary tract (FUtterungs-tuberculose), and probably a larger number than one might at the first glance suppose. Dog XIV. is a striking example of what slight changes are sometimes found in tuberculosis proceeding from the alimentary canal. The animal died from an enormous pleural tuberculosis, for which the digestive canal must be regarded as

GENERAL ARTICLES.

12 3

the port of infection, and yet there were found only one small caseous nodule in a lymphatic gland on the cesophagus, a similar one in one mesenteric gland, and 2 small ulcers in the duodenum. If we turn next to the cat, we see here also that the lungs were very frequently affected with tuberculosis (16 times out of the 25 cases observed). In most cases the disease consisted in the presence of more or less numerous nodules, scattered or arranged in groups; frequently there were also found scattered nodules, from the size of a pea to that of a bean and often degenerated; pneumonic changes were less frequently observed than in the dog, and cavernous degeneration of the lung tissue was found in only one cat. Tuberculosis of the serous membranes was surprisingly seldom in comparison with what was the case in the dog; only once could we observe a deposit of nodules on the pleura, and also only once in the omentum, whereas important tuberculous new-formations were found twice in the mesentery. In a female cat there was found in the thorax a very large tumour which had its origin in the glands of the mediastinum (at the same time a turbid fluid in the thoracic cavity); with this exception large glandular tumours were not found in the thorax, whereas such, as already mentioned, were frequent in the dog. The digestive organs appear to be affected with special frequency. The lymphatic glands of the head and neck were found to be affected in several cases (submaxillary glands 3 times, retropharyngeal glands twice, glands along the trachea twice). The mesenteric glands were diseased in no fewer than 14 animals, and, indeed, in 5 of these the affection was found to be confined to these glands. Sometimes the glands were found to be much enlarged, and beset with large caseous and partially calcified.nodules; sometimes not specially enlarged, but of the size of a lentil or a pea, and containing more or fewer calcified nodules. In the small intestine tuberculous changes were only once detected, and they consisted in a tumour-like enlargement of the patches of Peyer without the formation of ulcers; two nodular cords in the mesentery led from the affected part of the intestine to a caseous lymphatic gland. The liver was strikingly seldom affected, only in a single cat were scattered miliary tubercles found in it. The spleen also was only once affected. On the other hand renal tuberculosis was frequent, and, exactly as in the dog, there were seen in the kidneys partly scattered small nodules, partly larger caseous processes, accompanied by typical chronic indurative nephritis with its various changes. In Cat XXIII.which is perhaps to be regarded as a case of primary renal tuberculosis-only one kidney was affected. This was much enlarged, showed no caseous changes, but a fatty cut surface; microscopically a diffuse tuberculous infiltration of the renal tissue and a slight number of tubercle bacilli were recognised. In another case the process had extended to the renal pelvis, the walls of which were ulcerated. The sexual organs were affected in two cats. One of these was undoubtedly a case of primary infection of the uterus and this observation is doubly interesting owing to the fact that in the other case there was a very advanced tuberculosis in one testicle of a male animal; the possibility of an infection through coitus is also hereby proved beyond doubt.

124

GENERAL ARTICLES.

The two or three cases in which tuberculosis was observed in the subcutaneous tissue are interesting; this must have been brought about by an infection determined by scratches or accidental small wounds; the secondary tuberculosis of the axillary glands merits through this special attention. This applies no less to the joint disease found in Cat V., and all the more owing to the fact that Nocard has also observed a quite similar case. On the 19th December 1886 he fed a cat and her four kittens with tuberculous material. All the kittens died (as is commonly the case) after the lapse of seme time (6 weeks to 4 months) from tuberculosis of the abdominal organs; the cat, on the contrary, remained \vell for 3 years and on different occasions had young. On the 10th of October 1889 it became lame, and was found to be suffering from tuberculous arthritis. The animal was killed, and tuberculosis was discovered in the liver, and in slighter degree in the kidneys and lungs. If we turn now to consider in what way in the cats examined the infection must have taken place, infection by means of the digestive canal stands decidedly at the top of the list. That is shown quite specially by the frequency of tuberculous changes in the mesenteric glands. In not a few cases, indeed, the tuberculosis was strictly confined to the digestive organs. Nevertheless an infection by way of the lungs may not be very rare. In cases VIII., XII., and XV., it is at any rate not easy to think of any other way in which the bacilli could have penetrated into the body, and this applies also to several other cases. It has already been mentioned that tubercle bacilli in the cat-as in other animals-penetrate by means of wounds, and also that entrance into the organism may be effected through the female sexual organs. If we compare tuberculosis in the cat with that in the dog, we find certain striking differences. In the dog the serous membranes (especially the pleura), the lymphatic glands of the thoracic cavity, and the liver are the organs most frequently and to the highest degree affected, whereas this is far from being the case in the cat. On the other hand, we often find in both tuberculosis in the lungs and kidneys, and then a peculiar milk-white colour of the cut surface of the larger nodules, with, in the dog, frequently at the same time a softening and disintegration of the central part of the latter. All these are the consequence of a very pronounced fatty degeneration of the tissue, which deserves mention as a specially striking change. Judging by these observations one cannot say that tuberculosis in the dog and cat is a rare disease; on the contrary it must be designated a frequent disease. In opposition to this it will possibly be objected that what my investigations have shown applies only to Denmark and specially to Copenhagen, but I have no doubt that one can obtain the same results elsewhere whenever a sufficient and appropriate material for post-mortem examination is forthcoming. In support of this view also 1 may cite the fact that I have also frequently observed tuberculosis in other carnivora, and indeed in proportions that compel me to assume these are certainly not, as is frequently supposed, insusceptible to tuberculosis. On the 7th June 1890 I made the post-mortem of a polar fox (canis lagopus) which died in the Zoological Garden. The cause of death

GENERAL ARTICLES.

12 5

was found to be a bowel affection, but there was at the same time tuberculosis of the lungs and kidneys. In the left lung a bean-sized caseous abscess; scattered through the lungs, near their surface, whitish-yellow nodules varying in size from a millet-seed to a lentil, and showing purulent softening towards their centres. Numerous just visible tubercles in both kidneys. Tubercle bacilli present in masses.

On the 17th October 1890 I obtained for examination the organs removed from a jackal (canis aureus), which had died from a hcemorrhagic enteritis, and I found also present tuberculosis of the pleura, lungs, and mesenteric glands. Diaphgramatic pleura beset with numerous small nodules, which partly by confluence form diffuse plate-like growths. In the middle lobe of the right lung some hepatised parts; the entire posterior lobe is condensed, traversed by developing caverns; above and close to the main bronchus of the same lung a caseous nodule quite as large as a bean. Scattered through the lungs single scarcely visible tubercles. In the diseased parts of the lungs masses of tubercle bacilli. In the mesenteric glands a bean-sized, calcified, white nodule, in which not a few granular tubercle bacilli are recognised.

Further, tuberculosis has been observed here some time ago in various other carnivorous animals-in bears (six or seven of these died fr<;>m phthisis cavernosa), two lions, a royal tiger, a black panther, and a Jaguar. During recent years a number of observations have been made showing that poultry are with difficulty affected with human tuberculosis, and, on the other hand, that avian tuberculosis is not . easily communicated to rabbits. Something similar appears to be the case with tuberculosis of the carnivora. Rabbits appear very resistant towards subcutaneous inoculation with the same. However, I have as yet so few observations in this direction to reason upon that I refrain from drawing any further conclusion from them.

CALCAREOUS DEGENERATIONS IN THE HORSE.

By FRED SMITH, M.R.C.V.S., F.I.c., Professor in the Army Veterinary School, Aldershot. IN 1885 I described in the Quarterly Journal of Veterinary Science in India a series of remarkable degenerative changes occurring in the viscera and limbs of horses in India, which I designated calcareous degeneration. The limited circulation of the periodical in question, and the importance of the subject as an addition to our patholog,ical knowledge, warrant me in bringing it before the notice of the profession in this country. / By calcareous degeneration I understand the conversion of certain tissues into lime. Such changes are not unknown in tumours, but the wholesale conversion of tissue into lime, such as I will have to record, is, I believe, quite an undescribed feature in pathology. Had such extensive changes only occurred in one or two cases, one would be inclined to regard the condition as a pathological rara avis; but the