MORBID ANATOMY 



189 



the lymphatic system to the lymph glands draining the lungs 

 where the lesions first appear. If the specific bacteria are 

 first lodged in the intestinal mucosa, primary tuberculous ulcers 

 may develop or they may pass into the mesenteric lymphatics 

 or the portal vein. It may happen that the bacteria may be 

 carried by means of the lymph or blood stream and lodged in 

 any part of the body, such as the brain, kidneys, spleen, 

 testes, ovaries, bones, joints, and subcutaneous and intermus- 

 cular glands and serous membranes. The evidence at hand. 



Fig. 35. A drawing of a section o/very young tubercles in spleen {Thotna). 



however, seems to show that in a large majority of cases the 

 primary lesions are located in one of the five following organs : 

 (i) in the lungs or the lymphatic glands draining them, (2) 

 in the lymphatic glands about the head, (3) in the mesenteric 

 glands and intestines, (4) in the portal glands or liver sub- 

 stance itself, and (5) in the generative organs and udder. 



It not infrequently happens that the apparent primary 

 lesions occur on the pleura, peritoneum, meninges or synovial 

 membranes while the organs remain free from disease. In 

 such cases the lesions consist of many tubercles varying from 



Digitized by Microsoft® 



