TUBERCULOSIS. 453 



Finally, I would draw attention to the fact that the ganglion 

 in grayish-yellow or cheesy infiltration may become softened 

 and suppurate. This process starts from certain centers, and 

 results in the formation of a " scrofulous n abscess. In an abscess 

 of this kind, the thin pus mixed with cheesy crumbs is so charac- 

 teristic that the experienced surgeon Schuh at once made the 

 diagnosis of " scrofulosis " in an apparently well-nourished indi- 

 vidual, when upon incision the abscess yielded pus of the above 

 description. 



On the other hand, the softened infiltration may become 

 fatty and encysted, or calcified, and in the latter case the 

 whole lymph-ganglion in time is transformed to a calcareous 

 mass the size of a hazel-nut, such as we sometimes find in the 

 mesentery. 



Tuberculosis of the Kidneys Concomitant Nephritis. Before 

 entering upon the description of my researches concerning tuber- 

 culosis of the kidneys, I would remark that the kidneys here con- 

 sidered were not primarily affected by tuberculosis, but the same 

 pathological condition existed in other organs, notably in the 

 lungs. 



Not infrequently we meet, both in the pyramids and in the 

 cortical portion, with single, white, almost cartilaginous infiltra- 

 tions, of sizes varying from that of a millet- up to that of a hemp- 

 seed, which are surrounded by unchanged kidney-tissue, and, in 

 accordance with analogous occurrences before described, might 

 be considered as healed tubercles. Whether or not the firm, yel- 

 lowish-white, callous nodes, the size of a lentil or a pea, are tuber- 

 culous formations is doubtful, for we also see such nodes in the 

 kidneys of non-tuberculous individuals. They might be, with 

 equal reason, considered healed infarctions, more particularly if 

 any evidences of healed endocarditis are found. 



Chronic and Subacute Tuberculosis of the Kidneys I have 

 encountered much less frequently than other forms of the 

 disease. I have occasionally seen small, yellow, friable infiltra- 

 tions in the swelled, cloudy, partly ecchymosed cortex, in the 

 neighborhood of which wreath-like or discrete infiltrations, the 

 size of a millet- or hemp-seed, were found. I concluded, from 

 similar occurrences in the lungs, that the larger infiltrations were 

 the oldest, the smaller ones of a later date, without maintaining, 

 however, that the former originated from the latter. In chronic 

 tuberculosis of the kidneys, tuberculous phthisis may arise from 

 confluence of a number of foci, which, though a simultaneous cal- 



