DISTRIBUTION OF BACILLI 311 



attacked ; young adults suffer from disease of the lung 

 (consumption, phthisis), and older people from chronic 

 disease of the lung and tuberculous disease of the urinary 

 organs and testes, and of the suprarenal capsules (Addi- 

 son's disease). Scrofula and struma were terms formerly 

 much employed ; both denote a swollen neck, and were 

 applied to cases suffering from chronic tuberculous inflam- 

 mation with enlargement of lymphatic, especially of the 

 cervical, glands, with which other conditions, such as 

 inflammations of the ear, throat and eye, and implication 

 of bones and joints, are frequently associated. 



The distribution of the bacillus in the tissues varies 

 considerably. In young and active tubercles the bacilli 

 are more plentiful and more easily demonstrated than in 

 older and more chronic ones. They tend to be more 

 numerous in some animals than in others in the ox and 

 horse than in man, for example. In man the bacillus is 

 difficult to demonstrate (by staining) in enlarged and 

 caseating glands, in pus, in synovial membranes, and in 

 lupus. In some animals, especially the ox and horse, 

 bacilli can usually be readily demonstrated, and may be 

 present in large numbers, and frequently have the typical 

 distribution, viz. within and at the periphery of the giant- 

 cells, though they are by no means confined to this locality 

 (Plate IX. b). 



It was asserted, particularly by Rosenberger and For- 

 syth, that tubercle bacilli can be detected in the blood in 

 the majority of cases of pulmonary tuberculosis. Hewat 

 and Sutherland, 1 however, made twenty-two blood exami- 

 nations on twenty patients in all stages of the disease and 

 in only one detected two acid-fast bacilli. Schroeder and 

 Cotton tested the blood of forty-two cattle in all stages of 

 tuberculosis by inoculation into guinea-pigs with negative 

 results. 



1 Brit. Med. Journ., 1909, vol. ii, p. 1119 (References). 



