ON TUBERCULOSIS 197 



less complete stasis of the lacteal circulation, and ultimate 

 inanition of the dependent body structures, with con- 

 sequent withering and death of the entire organism. 



Other causes there are whose initiation is dependent on 

 primary cutaneous invasion, facilities for which are afforded 

 in the exfoliating epidermis, where the bacillary organisms 

 find a soil and pabulum ready prepared for their specific 

 mode of growth, progress, and distribution, and where 

 the morbid phenomena displayed resemble in many respects 

 those of leprosy. In this, we may take it, we have not a 

 resemblance only, but a close relationship, in specific 

 origin, character of infective organism, and morbid changes 

 wrought in the dermal and epidermal structures. 



Tuberculosis, therefore, in whatever phase or form 

 observed, conforms in manner of origin and evolution 

 to the laws of zymosis, to use a concrete phrase, i.e. being 

 due to the growth and spread of a living organism within 

 a living organism, it parasite-like incubates or takes root 

 in totally or partially inactive or adynamic materials or 

 structures within its host, lives for a time passively or more 

 actively, and, according to the resisting power and physio- 

 logical impermeability of the living materials and struc- 

 tures, doggedly and steadily waits the advent of favourable 

 conditions for its further morbid progress and pathological 

 domination, locally and generally ; when it usually sooner 

 or later effects its fell purpose with a gradually declining 

 opposition, and ultimate capitulation and annihilation, 

 material and dynamic, of invaded structures and host 

 alike. 



The indications for treatment in such morbid or diseased 

 conditions must be deduced from a study mainly of the 

 natural history of the tubercle bacillus, together with a 

 close observation and study of the circumstances and 

 conditions of health of the subjects of its attack, and will, 

 we are persuaded, be found, shortly speaking, to resolve 

 themselves into a destruction of the organisms tuber- 

 cular root and branch hygienically, and by the withdrawal 

 of the susceptible from its sphere of influence, or the 

 fortification of the susceptible against its attack, the 

 neutralisation of its destructive influence, and the adop- 

 tion of therapeutic measures to meet its various manners 



