222 
SOCIETY MEETINGS. 
the giving off of tubercular matter which enters the lymphatic 
channel and is carried supported by the lymph fluid and envel¬ 
oped in the lymph corpuscles to the adjacent members of the 
lymphatic system. The chain of the glands en route of the 
lymph stream become each in turn subjected to the infection. 
Many of course under favorable circumstances become affected, 
giving rise to the formation of new foci. The blood stream 
spreads the disease from the primary focus and receives the in¬ 
fection, which it carries in two ways, first, the lymph fluid 
charged with the germ of tuberculosis is poured into the general 
circulation through the thoracic duct; secondly, the walls of the 
capillaries adjacent to the primary focus become infiltrated with 
tubercular products and the bacillus enters the blood stream 
direct. The generalization, the extent, and the acuteness of the 
disease depend largely upon the supply of tubercular matter 
from the focus. Tuberculosis spreads also by the contiguity of 
tissue ; this is exemplified in the manner by which the nodules 
appear upon the serous membranes and by the infiltration of 
glands such as we see in tuberculosis of the liver. The germs 
carried by the lymph or blood stream find lodgment in some 
tissue or organ favorable to their development, its presence ex¬ 
cites inflammation, the germ multiplies and becomes the centre of 
infection, the leucocytes enter for the purpose of eliminating 
the system of the irritant. They take up the poison and enter 
the lymph channels only to die, leaving their load of germs or 
spores to become the centre of another tubercle. The bacillus 
having no power of movement within itself can spread only by 
the aid of one or all of the above methods, and in these ad¬ 
vanced cases we can usually find the presence of nodules on 
various parts of the body, in fact it may appear upon any tissue 
or organ. The lymphatics most commonly affected in the cases 
I have examined were the maxillary, guttural, pharyngeal, pre¬ 
pectoral, sublumbar, and those of the visceral organs. By 
means of contiguity of tissue, I have found the tonsils and 
pharynx to be extensively studded with tubercular products in 
cases which were not generalized. 
While in a number of cases we find the lungs the seat of 
extensive tuberculosis and often find the parieties of the chest 
cavity to be well covered with miliary tuberculosis, I am in¬ 
clined to believe that the disease rarely enters the system by 
means of respiration. When we consider that swine produce 
no sputa and that they are usually slaughtered before the dis¬ 
ease reaches au advanced stage and knowing that in the early 
O J 
