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10
From the point of view of the bacillus it is a natural life process. The bacillus
has a plan of life laid down for it, providing as usual for the maintenance of
the individual, and the propagation of its kind. Clearly, it is necessary that
we should understand this plan before we can hope to disconcert it."
THE LIFE OF THE BACILLUS.
There is now a concensus of opinion that the bacillus is not inherited,
although it may pass from a tubercular patient into the foetus, and be born
with it, but this is so rare that it is really a matter of the smallest moment, and
" for all practical purposes, the hygienic administrator is bound to regard
every case of tuberculosis as caused by infection which has taken place so to
speak in the open—within the sphere of his control."
We are therefore driven to inquire how it gets into the body. The experiments
of Villemin, Chauveau, and Tappeiner have demonstrated that the bacillus
may enter it through an injury to the skin, through the alimentary canal, or
through the respiratory passages and organs, whence it may be conveyed to
the internal tissues of the body by the blood vessels or the lymphatic vessels.
When the bacillus enters the blood it multiplies with great rapidity, and a
generalized form of the disease quickly results, but when it propagates in the
lymphatic system, which is its most frequent habit, its progress is much slower,
and consequently the tissues are not so quickly affected. The bacilli multiply
at first without causing noticeable lesions, but after a time they penetrate the
fixed cells of the tissues, and give rise in them to a nutrative and formative
irritation, whether they be cells of the connective tissue, of the blood vessels, or
of the lungs, which cause their (the cells) multiplication. This multiplication
of cells in turn leads to the formation of small nodules, really tubercular follicles,
which are full of baccilli, and these follicles by their agglomeration form granulations
and miliary tubercles, which may in turn by their coalescence become
large tubercles, the size of a nut or an egg, such as may be found at times in
the lungs, in the brain, and in other organs. Tubercular products such as
these undergo a caseous (cheesey) degeneration, caused by the necrosing toxins
secreted by the microbe, which begins at the centre, while at the same time
the lesions are spreading at the circumference. And thus tubercular matter,
which is at first grey and hard, then yellow and pliable, becomes a puriform
thick yellowish paste which seeks discharge outside. Sometimes instead of
forming clusters the tubercular follicles spread out in a sheet, and infiltrate the
tissues, which, thickening, "assume an appearance similar to that of bacon.
These infiltrations pay a considerable part in pulmonary consumption and in
tubercular disease of the bones and joints, and follow a course similar to that