TUBERCULOSIS. 461 



One fact only remains to be considered namely, that on the 

 one hand the phenomena in the vascular system, under certain 

 circumstances, may be slightly marked, and on the other hand 

 the new formation of living matter may be comparatively so 

 scanty that in the inflamed district a new formation of blood- 

 vessels is completely absent. With this knowledge we may 

 undertake to analyze tubercle it is immaterial whether in the 

 form of a nodule or an infiltration. 



Tubercle arises in vascularized tissues only. The inflammatory 

 phenomena in the vascular system in the initial stage of 

 forming nodules are not marked to the naked eye, but are rather 

 more distinct in the formation of an infiltration. 



Tubercle, for the cellular pathologist, is a tissue composed of pro- 

 liferated and divided "cells" ; with us, it is bioplasson freed from 

 basis-substance, with a scanty new formation of living matter. This 

 explains the gray color and the softness of a fresh tubercle 

 nodule. 



Tubercle, furthermore, is a tissue which is connected with the 

 mother-tissue, and in which all elements are in a living union, 

 established by the connecting filaments. 



Tubercle is composed mostly of small elements, as there are 

 only small centers of living matter viz. : small nuclei and 

 nucleoli. 



Finally, tubercle is avascular ; in other words, in the produc- 

 tion of the tissue of the tubercle the new formation of blood-ves- 

 sels is wanting. 



Tubercle may therefore be defined as an inflammatory new 

 formation, a tissue arising from an inflammation, ivith a scanty 

 new formation of living matter and without any neiv formation of 

 blood-vessels. 



Further Changes of Tubercle. In our conception, all later meta- 

 morphoses of the tubercle become easily understood. So long as 

 tubercle is a tissue, in spite of the lack of blood-vessels, it may 

 give rise to new basis-substance ; and if it has not exceeded a 

 certain size, it then becomes fibrous or cartilaginous. This proc- 

 ess leads to a healing of tubercle and to its obsolescence, while, 

 as the residuum remains an indurated nodule, a granulation (in 

 the sense of Bayle), a papillary vegetation. My views regarding 

 the curability of miliary tubercle fully coincide with those of 

 Empis and Waldenburg. 



Far more frequently a shrinkage of the bioplasson, an absorp- 

 tion of the liquid, a so-called cheesy degeneration occurs, which is 



