BACILLI OF TUBERCULOSIS. 41 



sels. Other experimenters affirm that if the bacilli of anthrax are 

 injected in moderate quantities into the circulation of animals, they 

 disappear soon from the blood without having produced any 

 pathogenic eifects ; but, if in animals thus injected a contusion is 

 produced in some part of the body, the bacilli pass out of the 

 vessels into the connective tissue along with the blood, grow there, 

 and soon cause the formation of the characteristic inflammatory 

 product, the diffusion of the disease, and its fatal termination. 



2. BACILLI OF TUBERCULOSIS. Yolkmann (" Chirurgische 

 Erfahrungen liber die Tuberculose," Verh. der Deutschen G-esell- 

 scha/t /. Chirurgie, 1885), from an extensive clinical experience, 

 came to the conclusion a long time ago that a severe trauma seldom, 

 if ever, gives rise to tuberculosis at the seat of injury, but that 

 where local tuberculosis is caused by an injury the trauma was 

 always slight, sometimes almost insignificant. He maintains that 

 the active tissue-changes which follow a severe injury during the 

 reparative process counteract the growth and propagation of the 

 bacillus. Luecke attributes to exposure to cold an important role 

 in the causation of tubercular and other infective forms of inflam- 

 mation, as he asserts that the sudden diminution of blood-supply 

 to the cutaneous surface causes internal congestions which favor the 

 localization of pathogenic germs in some one of the congested parts, 

 otherwise predisposed to the specific inflammation. 



Schueller (Experimentette und histologische Untersuchungen uber 

 Entstehung der skrophulosen u. tuberJculosen Grelenkleiden, Stuttgart, 

 1880) studied the localization of the tubercular virus experiment- 

 ally in the same manner as others have studied the localization of 

 pus-microbes. He inoculated animals with the products of tuber- 

 cular inflammation, subsequently produced contusions and sprains 

 of joints, and observed that localization usually occurred at the 

 seat of injury. If the tubercular virus was introduced by inhala- 

 tion, the same typical lesions occurred in the injured joints as when 

 infection was made more directly. In all cases the products of the 

 local lesion corresponded with the character of the material intro- 

 duced through some remote point. Surgeons are well aware of the 

 danger of general infection following an injury to a part or an 

 organ the seat of a local tuberculosis, more particularly in cases of 

 tubercular disease of joints. Cases like the following are not of 

 rare occurrence. 



Szuman (" Brisement force eines skrefulos entzundeten Knie- 

 gelenkes und konsecutiver acuter allgemeiner Miliar-tuberculose," 

 Centralblatt f. Chirurgie, 1885, No. 29) relates the case of a small, 

 well-nourished child, the subject of tuberculosis of one of the knee- 

 joints. The joint was punctured with a fine trocar, and although 

 no pus escaped, it was washed out through the cauula with a solu- 



