CO129-468 - Governor Sir Stubbs - 1921 [6-8] — Page 64

the broncho-pulmonary in particular,vere large and cassated; those on the left ware

net so large, and, though swollen and congested, showed no cassation. From the compara-

tively widespread distribution of the tuberoles they must have arisen by the haema-

togenaue route, and if we even go so far as to say that the source of the blood in-

feetion might have bem the adherent and caseous gland, we still leave unsolved the

question as to whence this hoomne infected, Ascording to the statment there shouldi

have bem a fosus in the right lung in close relation to the gland,but there cart-

Ainly me none.

63

No_35. A female child, 4 years of age. In this ease the glands at the hilus were swollen and the tracheo-bronchial gland on the right side was large and not only

casented but was breaking dow to oremy pus. There were niliary tubercles,not num

erous, but scattered evenly through the right lung. There was no indication of any

pulmonary focus.

No.48. A female child of one year. The lowest lobe of the right lung and the lover

of the left contained mail grey tubercles in considerable n abers; the other lobes

did not appear to be involved. Nothing which could be designated a focus was discov-

ared in either lung,nevertheless the hilus glands on each side vere enlarged and

enseous, rather more so on the right. A possible explanation of the limited area of the pulmonary affection might be that the glende constituted the focus whence the

lưng tissue became affected,butar no we are still in the dark sa to the dourse

whence they themselves beame tuberculous. If it be said that the grey tubersies in

the lungs together constituted the focus for the glandular involvment on each side,

only one can amply reply that mich appears to be somewhat straining terminology and that

the peculiar distribution in the lowest lobes only would land one to suspect some other soures whence the lungs became infected and through the the mediastinal glands. No 63. A boy aged 3 years. This is evm more definite. A gland at the hilus of the right lung was enlarged and cassous, and above it a paratracheal gland was in a sini- lar condition, as large as a cobnut. The lung,however, (in fact both lunge) showed merely scattered miliary tubercles,not vary mmerous but distributed evenly, leg No focus, unless the mediastinal glands are regarded as such,could be found at all, though milŝary tubercles were also seen in the left pleurs lining the ribs, a few on the surface of the splom, several at the base of the brain and along the Sylvian fismires,and a few on the conresity, The tonsils ware not affected,nor were the

certical glande enlarged,

A propos of some of these cases the remarks of Bushnell in the Military Surgeon (1918) may be recalled. He states that from a hilus infection the tuberele bacillus