

TUBERCULOSIS. 465 



"by inflammation of the surrounding tissue, etc. Then the circle 

 is rounded, and scrofulosis and tuberculosis are identical, 

 according to the ideas of Laennec and Rokitansky. 



Why, in certain organisms, are the tissues so easily inflamed? 

 Virchow says : "It is remarkable that the disposition for tuber- 

 culosis is always associated with a disposition for inflammation. 77 

 Here again a factor, the "disposition" is introduced, which ought 

 to explain so much, and in reality does explain nothing. 



Let us say: we do not know why inflammatory processes 

 occur, with much frequency, in certain organisms. Let us fur- 

 ther acknowledge that we do not know why inflammation ever 

 arises spontaneously ; in saying this, we speak the simple truth. 



Then we are at liberty to analyze critically all experiments 

 which have been committed, since Villemin 7 s time, for the pur- 

 pose of artificially producing tuberculosis in animals by inocula- 

 tion and infection but what would we gain ? It would be folly 

 to fight against observers not to use a harsher expression 

 who, even in our day, insist upon the infectiousness of cheese, 

 and assert that not every kind of cheese is equally infectious. Wal- 

 denburg, one of the soundest experimenters, came to the conclu- 

 sion that tuberculosis, by which he, in agreement with Virchow, 

 obviously refers only to miliary tuberculosis, is due to the taking 

 into the circulation finely distributed corpuscular elements. These, 

 according to his view, would be deposited in numerous scattered 

 foci in various organs, with the formation of nodules. Inspis- 

 sated, cheesy pus, and caseous tissue of the lymph-ganglia, he 

 says, are most generally the subjects of absorption. With him, 

 too, miliary tuberculosis is a disease of absorption, for he agrees 

 with the idea of Buhl, that miliary tuberculosis depends upon 

 preexisting cheesy foci in the face of the fact that Buhl himself 

 admitted that in ten per cent, of the cases of miliary tuberculosis, 

 he was unable to discover any cheesy foci whatever. 



What is the real gain from all this? Many experimenters 

 have succeeded in inducing an inflammation, every one in his own 

 way, perhaps through embolism, perhaps by a diiferent process. 

 All of them have produced "miliary tubercles, 77 that is, circum- 

 scribed inflammatory products in circumscribed inflammatory 

 foci, and it may be admitted that all this was brought about by 

 embolism. The inflammatory products, however, did not proceed 

 to vascularization, but shriveled up and became "cheesy, 77 there- 

 fore tuberculous. This was not due to the skill of the experi- 

 menters, for the reason that the cause of such a result lay in the 

 30 



