The Birmingham age-herald., 1914-06-07

blood vessels or one organ from another like the intestines from sputum swal- lowed.
 All the internal organs, the serous mucous mebranes, the glands, bones and skin are susceptible to the infection but In different degree. The symptoms and signs and course of the disease will large ly depend upon the organ effected Thus In the bone or joints 1t will lead to more or less destruction of the bone or joint running along its chronic course, while in the membranes of the brain and spinal cord there will be the active and acute symptoms and course of a meningitis with a more or less rapid end in death In the lungs if may run the long and pro- tracted course of pulmonary consumption But in all these the essential nature of the tubercular process is the same.
 Let us briefly review the various things that may happen when there is an in- lection with tubercle bacilli:
 l. They may be thrown out of the body before they find Judgement in the tissues
 ?. Having found Judgement they may be destroyed by the resisting power of the body cells.
 3. Having trfumphed over the cells they produce gray tubercles, which may be arrested at that stage.
 4. Having produced gray tubercles ana continuing to act. they cause these to decay making yellow tuberces, and the process may, though rarely stop here.
 5. The yellow tubercles group together forming tubercular mass of various sizes.
 G. This large mass of dead cheesy ma terial may soften and liuuefy and dis charge into bronchial tube, cavity or joint or through the skin according to where it is, leaving a cavity.
 T. The mass may absorb lime salts and form a stone.
 s. At any stage of the game nature may build around this tubercular mass fibrous, hard wall, which will arrest the further progress of the disease.
 g. The acuteness and chroncity, symp- toms and signs and effects will depend upon the virulence of the infection, the amount of the infection, the distribution of the bacilli and the nature of the tissues and organs involved.
 10. The object of treatment is to in- crease the resisting power of the body cells and to promote the growth of a limiting tissue. thus destroying the bacilli and preventing their spread.
 The following is a very good cassfica- ton of the types of tuberculosis:
 l. Local chronic tuberculosis.
 ?. Local acute tuberculosis.
 8. General chronic tuberculosis
 1. General acute tuberculosis.
 In all these the primary infection is introduced from without, and Us at first local and more or less chronic. This local infection becomes the depot of supply for tubercle bacilli and results in self infection, producing an active local acute tuberculosis or. through the blood. pro. ducing general tuberculosis-lungs, liver, spleen, kidneys serous membranes, etc., which will be acute or chronic, according to the virulence and extent of the dis. tribution of the bacilli Acute local or both acute and chronic general tubercu- losis is almost always fatal. and as a rule is the terminal conditions that de- stroy life. Hence, the transcendant i'm. portance of maintaining, if possible. the localization of the primary infection.
 Tn the next bulletin the contributing and predisposing causes and the principle of treatment will be considered. R. M CUNNINGHAM, M. D.. City Health Officer