300 Specific Inflammations. 



or lymphocytes collect about the periphery of the focus occupied 

 by the bacilli. In this manner a rounded cellular nodule is 

 formed, at first microscopic in size, but later increasing in bulk to 

 that of the head of a pin or millet seed, and known when visible 

 to the naked eye as a suhmiliary and miliary tubercle (niilium, a 

 millet seed). It is of a gray, opal-glass-like color, with a dead-white 

 to yellowish point in the centre which indicates the early stage of 

 coagulation necrosis (caseation). [The central cells of the unde- 





••;- 'fa^sSv-iix , . y^^,-' r^iji ;::<'•' 



Fig. UJ. 



Miliary tubercle (higher magnification): a, giant cell: b. caseated centre; c, zone 

 of epithelioid cells ; d, zone of lymphoid cells. 



generated miliary tubercle, in and among which the tubercle bacilli 

 are found, are of uncertain origin. They are commonly spoken of 

 as endothelioid or epithelioid from the comparatively large amount 

 of protoplasm and the rather pale and vesicular nucleus, and are 

 distinguishable by these features from the ordinary fibroblasts. They 

 vary in shape but are more commonly of a rather flattened spindle 

 form than otherwise. The author's view that these are essentially 

 the same as young connective tissue corpuscles and tlie product of 

 proliferation of the fixed connective tissue cells is accepted by some; 



