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is described as travelling by the paribronchial lymph spaces in a direction eppo ai ta
to that of the normal lymph flow to a region in the upper lobes where the lymph
motion is most sluggish. This might be alded by a reversal of the lymph surrent, and
such a reversal night in turn occur as the result of a block at the hilus. The tub-
by erole bacilli travelling in these spaces to the parenchyma are resisted by the tissue cells and a type of peribronchial tuberculosis resulta. Önseation through
the bronchus may take place although peribronchial tuberculosis is more ofim of the "closed" type, as is evidenced clinically by the frequency with which the broilli, are
64 found in the sputum and the rarity of hamorrhages in such cases.
No 70. A girl of 7 years.The mediastinal glands were adherent in masses and onBOOUN, forming almost a collar around the trachea, and there were two cassous masses at the base of the heart. The lunga revealed absolutely no indications of tuberculosisjin fact, the only places where tuberoles vare found were in the kidneys,both of which showed several arranged focally at the base of a pyramid towards the lower pole. No 25. In this case, a female of 8 years, there were two enlarged and caveated tracheo-bronchial glands on the right, the size of filberts. There was no sign of any lung infection at all, even on section and microscopical examination. No focus was detected anywhere. In the meninges there wore fairly closely aggregated tuberoles at the base in the interpeduncular space, several also in each Sylvien fissure, and a few scattered about the convexity and inner surfaces of the cerebral hazispheres./ Mo 162. A boy, aged 3 years, showed osseous glands at the left hilus, while the trache bronchial on the same side wore enlarged but not casented. No focus was found in the lungs. There were miliary tubercles distributed generally through both, rather more in the left, but not very mmerous in either. Milia were also present in the
spleen and in the basal meninges,
No 173. A gårl of 10 years of age. The findings hers were closely similar to those in the last. There were miliary tubercles in both lunge and also in the basal maa- inges, but no focus was detesta; anywhere. The nadiastinal glands,hilus and para- tracheal,on the right side were mlarged and cassous; those on the left appeared
to be unaffected.
19 181. A girl of 4 years. There were miliary and gray tubercles scattered through both lunga, sparse in the left,more in the right and mostly in the upper lobe, dɛ in the last two the spleen showed milia, while the mmingen were more affected than in them, there being many tuberéles at the base,along the Sylvian fissures and below the cerebellum. No focus was discovered,neverthelons the mediastinal glands were
swollen and caserted on both sides,
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