DR. J. W. POUCHER. 255 



but an attack of measles three years later so aggravated 

 it that she died of acute tuberculosis in a few days. 



The two most common avenues for the introduction of 

 tubercle bacilli into the human system are by inhala- 

 tion into the air passages, and by its introduction into 

 the stomach with articles of food and drink, but there 

 are many authentic cases where it has been accidentally 

 inoculated into the skin and caused tuberculosis. A 

 veterinary surg^^on named Moses, while doing a post- 

 mortem upon a tuberculous cow, accidently cut his hand. 

 He first suffered from local tuberculous abscesses, and 

 afterward developed general tuberculosis, which proved 

 fatal. Only a few months ago Prof. Gutzman, of Berlin, 

 while holding an autopsy on a patient who had died 

 from acute tuberculosis, slightly injured one of his 

 fingers under the nail. He felt a slight pricking sensa- 

 tion at the time at the tip of his finger, but could see no 

 wound. He washed the finger carefully in corrosive sub- 

 limate and alcohol and forgot all about it. A month 

 later it became painful and a small abscess was found 

 under the nail. This was opened and the pus examined 

 and found to contain tubercle bacilli. This cavity was, 

 of course, carefully cleaned and every precaution possi- 

 ble taken against general infection, but the professor is 

 awaiting results, as may be imagined, with no little 

 anxiety. However, by far the most common mode of 

 infection is by inhalation into the air passages, and since 

 the lungs are by far the most exposed of all the organs, 

 pulmonary consumption is the most common form of the 

 disease. 



Just what conditions are necessary in the bronchial or 

 alveolar mucus membrane for the favorable reception of 

 the bacilli is not exactly known, but it is pretty well 

 agreed that there must be either a predisposition or a 

 deteriorated condition of the air passages which favor 

 the lodgment of the bacilli, which are inhaled in the 



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