TUBERCULOSIS. 463 



though infiltrated with pus, is still a tissue. The comparison with 

 pysemic infarctions of the lung, as alluded to before, proves this 

 statement to be correct. The differences, however, are sharply 

 defined. The firm, brittle, half -dry tuberculous infiltration grows 

 gradually, i. e., in peripheral recurrences, therefore in a chronic 

 manner, and may remain for months in the tissue stage before it 

 becomes softened and disintegrated. In suppuration, on the con- 

 trary, the whole process runs an acute course, being limited to a 

 few days. Eight days after an injury which was immediately 

 followed by purulent phlebitis, numerous suppurating pyaemic 

 infarctions or abscesses may be found in the lungs, and the more 

 recent infarctions appear as soft, moist, yellow infiltrations. In 

 the production of pus within the inflammatory district, the new 

 formation of blood and blood-vessels is likewise absent, and the 

 living matter of older blood-vessels breaks down into the inflam- 

 matory new formation. Nevertheless, the result is strikingly 

 different from tuberculosis. 



I recall the purple inflammatory area at the boundary and 

 the dark red hepatization in the vicinity of an infarction of the 

 lung, before alluded to. Such an inflammatory area is constantly 

 present around every acute abscess. The tissue in purulent infil- 

 tration is evidently richly supplied with liquid i. e., an exuda- 

 tion from without. When the separation of the elements follows, 

 they are suspended in a comparatively large amount of liquid, 

 the serum of pus. Then the result is the same as in the soft- 

 ening and suppuration in the formation of tubercle, namely, an 

 abscess, though in the latter instance this result only is reached 

 by slow process. The abscess in the former instance is u acute? 

 containing thick, genuine pus the " good, laudable, and healthy 

 pus" of the surgeons ; in the latter instance it is "chronic" " scrof- 

 ulous" inclosing serous pus mingled with tuberculous matter. In 

 the former case the process is accomplished within a few days ; in 

 the latter it is extended over months and years. 



By inspissation of genuine pus and the shrinkage of the pus- 

 corpuscles the same condition will result as after incapsulation 

 of a softened tuberculous focus viz. : a fatty, viscid paste, a 

 cement-like mass, a calcareous concretion. Such a termination 

 of suppuration is well known, especially in peripsoitic abscesses. 

 If, on the contrary, an inundation of the inspissated pus takes 

 place by exudation from without, in consequence of new inflam- 

 mation, we find pus with " cheesy " crumbs, which is not materi- 



