72 THE AMERICAN MONTHLY [Mar 
peripheral end of divided nerves, but a limited amount of 
exudation is seen in the central end of a divided nerve. 
I believe the exudations in peripheral neuritis are due 
‘to the local action of the toxin either in lymphatics or 
blood-vessels or both, and the varying amount of exuda- 
tion at different levels in an affected nerve may depend 
on the fact that the blood supply to the funiculi enters by 
“small branches of arteries, which run for a long course 
down the funiculi; and probably, where the branch en- 
‘ters the funiculus there the exudation is most marked. 
My serial sections so far bear out this theory, although it 
is difficult to prove that it is absolutely correct. 
Of more practical importance is the role played by tie 
exudation in causing the pain, interference with function 
of nerve fibres, and when not removed, the permanent dis- 
-ablement of the nerve. 
‘The affection of the fine fibers, the nuclear proliferation 
in the small arteries and in the capillaries, and the exu- 
dations are apparently all closely related together, and I 
have endeavored to demonstrate how far the connecting 
links in my chain of evidence cover existing facts, although 
I admit much has yet to be discovered before the theories 
“can be considered indisputable.—Hnglish Mechanic. 
‘Is the Bacillus Always Present in Pulmonary Tuberculosis? 
HUBBARD WINSLOW MITCHELL, M.D. 
- The presence of the tubercle bacillus is generally re- 
garded as an infallible sign that the disease is true tuber- 
“culosis, and I have myself hitherto regarded this sign as 
infallible, but in many cases which have come under my 
care where the symptoms wereof unusual severity, such 
-as coarse bubbling rales, more or less extensive in one or 
‘both lungs, extreme emaciation, night-sweats, diarrhea, 
loss of appetite, thirst and fever, with copious expectora- 
tions of offensive sputum, no bacilli existed, Some of these 
cases recovered, while others died. hats 
