TUBERCULOSIS

chronic disease, caused by a micro-organism, the Bacillus tuberculosis, the lesions which are nodules (tubercles) or infiltrations which undergo a istic caseation. In addition to man, domesticated animals may be it is particularly widespread bovines, an important fact, their milk and flesh are so largely as food. In general c. 10 per cent. the deaths per annum are due to culosis, but there is a progre ive in mortality. The discovery of bacillus was announced by Koch 1882, since when there has been added to the facts regarding it: found in all tuberculosis lesions. The bacillus may gain an to the body in several different (1). by way of the respiratory moist particles of sputum from fected person or dust containing being inhaled and thus carried blood to the lungs; (2) being in the air or itself food, by the tonsils or other lymph at which a ti ue in the neighborhood of the pha: into ynx, and carried by the lymphatics t fly-disease. the lymphatic glands in the neighborhoox damp or even to those of the lungs; (3) by tk appearance alimentary canal, particularly the lowe long part of the ileum, being contained i milk or other articles of diet, infectio of the intestine being particularly com mon in children. The bacillus onc E.), having entered the body, infection ma Korea. spread along the air pa ages or alimer T. the tary canal, along the lymphatic ve el: the or by way of the blood-ve els, chief i by the veins. Tuberculosis of the lungs may tak town, the form of military tuberculosis, i bp. which infection is spread from a primar focus by way of the blood-ve els or th Berlymphatics; or broncho-pneumonic tube: at culosis, in which infection is sprea ancient along the air pa ages. Tuberculosi monogis rarely primary in the pleura, or linin invasion. membrane of the lungs, extensio part usually taking place from _ disease areas of the lungs, the pleura be com in thickened, with tuberculosis points in + SaThe lymphatic glands may be affecte by in various regions; in the neck infectio area is conveyed by the lymphatics from th Tidikelt. tonsils and other pharyngeal lymph at i 134 structures; the bronchial lymph at i 20,000 glands and those at the root of the lung may become infected in the same wa} with or by extension from the lungs; th mesenteric glands, in the structure tenor supporting the intestines, become ir fected by bacilli which have entere with the food and have been carrie military to them by the lymphatics. In th alimentary canal the most commo: tuberculosis lesion is ulceration c infective Peyer’s patches, which are ma es c lymphatic ti ue found chiefly in th in lower part of the ileum, infection havin diffuse come through the food; tuberculosi character of the pharynx, oesophagus, stomact all and upper part of the small in test in attacked; is rare, and occurs usually only sec oné among arily in advanced cases. Tuberculosis c because the liver and of the spleen is usuall used secondary to lesions elsewhere, partic of larly in connection with the alimentar tuber canal and. mesenteric glands. Tuber decrease culosis of the kidney is also usual] the secondary, infection being believed t in be carried by the blood stream, whil little from the kidney infection may sprea: it is to other parts of the genito-urinar system; the disease may also origin at entrance in other parts of the genito-urinar ways: system. tract, Tuberculosis is a common diseas an in of bone, injury predispos ing to th bacilli disease, and infection being usuall directly conveyed by the blood stream; tuber culosis of joints (eg., of hip-joint) is usually secondary to lesions in bones. In the brain and spinal cord tuberculosis may occur, infection usually spreading from another tuberculosis lesion in the body (e.g.), a lymph gland or bone, or by extension from the bones of the skull; the disease usually occurs as an inflammation of the meninges or memarias coverings of the brain and spinal cord. The diagnosis of tuberculosis depends largely on the naked-eye and microscopical appearance of the lesion, and on the discovery of the specific bacilli (e.g.), in the sputum, in tuberculosis of the lung; in addition, however, inoculation with Koch’s tuberculin (made from filtered cultures of bacilli) produces a characteristic reaction, showing that tuberculosis is present somewhere in the body. Treatment consists in enabling the patient to have as much sunlight and fresh air as po ible, and _ therefore residence in localities where the climate permits continuous outdoor life is desirable. The patient should be taught to rely on his own heat production rather than artificial means of warmth, and a liberal dietary is imperative. A course of training in a sanatorium is therefore advisable, although efficient treatment may be carried out at home. Carefully regulated injections of tuberculin are often beneficial. Fever, sweating, cough, and other troublesome symptoms should be treated as they arise, plant often grown for its highly scented flowers. town, on Neckar, Wiirttemberg, Germany; with Stiftskirche, town hall (XV. cent.), Castle of Hohen-Tiibingen, museum, famous univ. (1477); chemicals scientific instruments, gloves, dyeing, etc. Pop. 20,000.