80 ILLINOIS ACADEMY OF SCIENCE 



It is, in viewing sncli an autopsy that one feels that had 

 the potential immnnity been reinforced by the coopera- 

 tion of the patient and community, the fight against the 

 tubercle bacillus would have been won instead of lost. 



THE EFFECT OF THE TOXINS ON THE SYSTEM 



Beside the local reactions above described, the toxins 

 of the tubercle bacillus developing in an active lesion, 

 have certain general effects upon the system. The toxins 

 tend to bring about a depression of cell activity. This is 

 manifested by the low white count frequently observed 

 and recorded in our work, also by the general muscular 

 weakness and low blood pressure. There is, too, a dis- 

 tinct singling out of the nervous system by these poisons 

 which manifests itself in the reaction to stimuli of dif- 

 ferent kinds. ^^ Advanced cases of tuberculosis show fre- 

 quently mental weakness. These patients have erratic 

 appetites. This may be due to the action of the toxin on 

 the central nervous system or of tuberculous inflamma- 

 tion of the abdominal viscera. These tuberculous in- 

 flammations were present in a very large precentage of 

 cases either as a tubercular involvement of the peri- 

 toneum, small intestines, the appendix, or cecum, or as 

 a toxic cirrhosis of the liver. 



ATRIA OF EXIT 



As to the atria of exit of the tubercle bacillus from 

 tuberculous patients, the bacilli in the case of open lesions 

 are undoubtedly constantly leaving the body in the feces. 

 Occasionally we have found them in the urine. We al- 

 ways found them in the sputum in open lesions of the 

 lungs, and in the discharges from pleural fistulae. 



MEANS OF DIAGNOSIS 



From the standpoint of diagnosis the problem of tuber- 

 culosis was approached in at least five different ways. 

 First, the application of the usual staining reactions to 

 the sputum, by which means in open lesions one is usually 

 able to determine the presence of tuberculosis positively. 



" THe Nervous System in the Tuberculous, A. Ferrannini in Riforma 

 Medica, Naples. 



