Avenues of Infection 77 



isms find themselves in the tissues, surrounded by the tissue lymph, 

 under conditions appropriate for growth and multiplication, provided 

 no inhibiting or destructive mechanism be called into action. 



The digestive apparatus is the portal through wlhich many infec- 

 tions take place. The BaciUus diphtheriae, finding its way to the 

 pharynx, speedily estabUshes itself upon the surface, producing 

 pseudomembranous inflammation there. Typhoid bacilli, dysentery 

 amoeba, and bacilli, cholera spirilla and related organisms, finding 

 their way to 'the intestine, where the vital conditions are appropriate, 

 take up temporary residence there, to the injury of the host, who 

 may suffer from the respective infections. 



Various organisms pass from the pharynx to the tonsils and so 

 to the lymph-nodes and deeper tissues of the neck, where their first 

 operations may be observed. 



It is supposed by some pathologists that the digestive tract is a 

 constant menace to health in that it regularly admits bacteria, 

 through the lacteals, and perhaps through its capillaries, to the 

 blood, where under slightly abnormal conditions they might do 

 harm. According to Adami,* the intestine is responsible for a 

 condition of sub-infection depending upon the constant entrance 

 of colon bacilli into the blood. He finds the colon bacillus in 

 the blood, and traces it to the hver, where its final dissolution 

 takes place in the fine dumbbell-like granules enclosed in the cells. 

 Nichollsf confirms Adami by finding similar dumbbell or diplococcoid 

 bodies in the epithelial denuded tissues of the mesentery of normal 

 animals. 



Nicholas and DescosJ and Ravenel§ fed fasting dogs upon a soup 

 containing quantities of tubercle bacilli, killed them three hours 

 later, and examined the contents of the thoracic duct, where 

 tubercle baciUi, some alive and some dead, were found in large 

 numbers, van Steenberghe and Grysez|l found that carbon particles 

 readily passed through the intestinal mucosa, entered the lymphatics, 

 were thrown into venous circulation, and so carried to the lung, 

 where anthracosis was produced. 



In a subsequent paper** they beHeve that they have demonstrated 

 that the tubercle bacUlus like the carbon particles may also pass 

 through the normal intestinal wall, and follow the same course to 

 the lungs. They believe that pulmonary tuberculosis thus depends 

 upon ingested and not inhaled micro-organisms. Montgomeryft re- 

 peated the work of van Steenberghe and Grysez at the Henry Phipps 

 Institute, Philadelphia, but though many attempts were made by 



* "Jour, of the American Medical Association," Dec. i6 and 23, 1899, vol. 

 xxxiii, Nov. 25 and 26. 



t "Jour. Med. Research," vol. xi, No. 2. 

 t "Jour, de Phys. et Path. g6n.," 1902, iv, 910-912. 

 § "Jour. Med. Research," 1904, x, p. 460. 

 . II "Ann. de I'lnst. Pasteur," Dec. 25, 1905, Tome xix, No. 12, p. 787. 

 ** Ibid., 1910, XXIV, 316. 

 tt "Jour, of Med. Research," Aug., 1910, vol. xxiii, No. i. 



