TUBERCULOSIS OF THE SKIN. 



708 



\Yhen localised in the meninges, the disease produces the symp- 

 toms of ordinary meningitis, general weakness, vacillating, stagger- 

 ing or irregular gait, disturbed vision, variation in the size of the 

 pupils, difficulty in swallowing, muscular twitching, cramp of the 

 muscles along the upper margin of the neck, etc. 



Tuberculosis of the brain proper seems more commonly to affect 

 .the anterior convolutions and the depths of the frontal and temporal 

 lobes. It produces some of the symptoms of meningitis or symptoms 

 suggestive of the existence of coenurosis, as, for instance, walking 

 in circles, lameness of central origin, without appreciable lesions of 

 the limbs, prolonged kneeling, disturbed vision, generalised attacks 

 of epilepsy or of Jackson's epilepsy, spasm of the pharynx, general 









Fig. 281.— Tuberculosis of the brain. 1, 2 and 3, Tuberculous centres. 



signs of compression of the brain or cerebral dropsy, dulness, 



coma, etc. 



In the absence of pulmonary lesions it is extremely difficult to 

 arrive at an exact diagnosis except after injection of tuberculin, for 

 the above symptoms very closely resemble those of ccBnurosis, bram 

 tumours, and even tumours in the frontal sinuses. 



TUBERCULOSIS OF THE SKIN. 



Cutaneous tuberculosis is one of the rarest forms of the disease. 

 It is distinguished by the formation beneath the skm of httle har- 

 dened swellings varying in size between a hazel-nut and a walnut, 

 and containing caseous or calcareous material. These swelhngs have 

 no connection with the superficial lymphatic glands. They may be 

 found grouped together within certain areas, or distributed irregularly 

 over the whole body, particularly towards the base of the tail. 



The condition may be mistaken for generahsed sarcomatosis, from 



