^ETIOLOGY OF TUBERCULOSIS. 
73 
It has now been shown to be certain that the gigantic cells occur in other 
disease processes and are not specific products of tuberculosis. Nevertheless the 
conviction that the infectious material must be contained in the gigantic cells has 
proved itself correct. For as soon as gigantic cells appear in the tubercles, tuber¬ 
culous bacilli are almost regularly found in them, and the relation of bacilli to 
gigantic cells is a manifold on ( e. 
In all slowly developing tuberculous processes, for example scrofula, spongy 
inflammation of the joints, etc., in which the bacilli are present only in scanty 
numbers, we find the bacilli almost exclusively in gigantic cells, and then always 
only one or at most a few specimens in each cell. But when, corresponding with 
the more or less intensive course of the process, the bacilli appear in considerable 
numbers, then the gigantic cells which may be present are more generously sup¬ 
plied with them, and the number of bacilli enclosed by a gigantic cell may reach 
fifty or more. 
A single bacillus in the interior of a gigantic cell is sometimes not easily rec¬ 
ognized, for it often happens that the little staff may not be in the horizontal 
plane of the prepared section, but is placed diagonally or perpendicularly, and 
then appears in the microscopic image not as a blue line but only as a point, 
which can only be traced to a certain distance and its staff form recognized by 
raising and lowering the tube. Since the contents of the giant cell take a 
more or less brown-color tone, the little staff does not always show itself in the 
characteristic blue, but in a darker, almost black color, the reason being that ani¬ 
line brown absorbs the blue part of the spectrum, and therefore a blue object 
observed through a brown solution, must appear black. Attention should, by 
this opportunity, be given to the fact that bacilli never look blue but always black 
when the ground on which they are seen is brown, when, for example brown- 
colored nuclei lie under them. 
Although, as already said, it may sometimes be difficult to find a single bacil¬ 
lus in a gigantic cell, bacilli which in considerable masses fill a giant cell give a 
so much the more striking picture, which cannot be overlooked, even by a weak 
magnifying power. In this case the giant cells appear like little blue circles 
which are surrounded by a brown wall, the nuclei of the giant cell. 
The arrangement of the bacilli in the giant cells often takes a very peculiar 
form. When the nuclei of the giant cell form a closed ring, and, for example, 
only one bacillus is found within it, the same generally lies in the centre or at 
least only a little excentric. 
The nuclei of the giant cell are often forced toward one end, that is in a uni- 
polaric arrangement, especially if the cell possesses an oval figure, or one even 
longer in proportion to its width. In this case the bacillus is usually found in the 
part of the cell free from nuclei; it often takes a position exactly opposite to 
them, and lies in the extreme point of the nucleus free pole. In the observation 
of the giant cells the supposition involuntarily forces itself upon one that a sort 
of antagonism exists between the nuclei of the giant cell and the parasite enclosed 
by it, which effects the greatest possible distance between the nuclei and the 
bacilli. This remarkable opposition between nuclei and bacilli is most noticeable 
in those giant cells whose nuclei are grouped equatorially and which then a 
bacillus in each of the nucleus, free poles, or by a bipolar arrangement of the 
