136 



TUBERCLE. 



'Note. — From a strictly histological point of view the leukhasmic 

 tumour is very nearly allied to the typhous product ; the former however 

 cannot be classed among the products of morbid growth without farther 

 evidence. {See Chapter I. of Special Part.) 



§ 113. Tubercle. A tliircl type of specific inflammation is 

 exemplified by tubercle. I have already pointed out, when 

 speaking of fatty metamorphosis, that the morbid anatomy of 

 the present day does not recognise as tubercle and tuberculi- 

 sation, what these terms were generally understood to denote 

 little more than ten years ago ; viz. every yellowish-white, 

 friable or greasy, in a word, caseous mass, wherever met with. 

 We restrict the term tubercle Kar 'iioxrjv to a definite nodule, 

 very hard, grey and translucent when first formed, seldom ex- 

 ceedino; a millet-seed in size, but ao:£:reo:ated too^ether in ^reat, 

 nay countless numbers. The confusion, both of names and 

 ideas, excited by the rigid distinction first pointed out by Rein- 

 hardy but carried through by VirclioWj is not diminished by the 

 circumstance that cheesy inflammation and miliary tuberculosis 

 are very often actually associated with one another. Discoveries 

 of extreme interest have very lately been made on this subject. 

 A series of investigations, started by Villemain, carried on by 

 Klehs and others, and in some sense concluded by CoJinheim, 

 have shown that the introduction of " cheesy debris " into the 

 imtrient juices is followed by " miliary tuberculosis." It matters 

 not whether the cheesy matter be introduced by inoculation, or 

 originate in the organism itself. On this view, the minutest 

 particles of cheesy debris must be regarded as endowed with 

 the properties of a virus, capable of causing the growth of 

 tubercle by irritating certain (we shall presently see what) 

 elements of tissue. So much is certain, that tuberculosis is 

 the expression of a dyscrasia, of a morbid state of the liquids 

 of the organism, which often spreads through the body from 

 a single point, but which may perhaps in some cases be con- 

 genital. 



There is hardly an organ in the body in vrliich tubercle is 



•.ot occasionally met with ; but its seats of election are the lungs 



and intestines. The extensive lesions of an ulcerative character, 



caused by the growth and especially by the degeneration of the 



tubercles, will be fully described in the Special Part of this 



