CO129-468 - Governor Sir Stubbs - 1921 [6-8] — Page 73

i

side were enlarged and showed mall pin-head foci, the related lung containing a def-

inite foeus the sise of a pen in the middle lobe.

72

Ho 66 affords an even better example. This was a female child of 20 months with

extensive tuberculous infection of the intestine. There were several ulsors in the

ileum and the nesmteric glands were in large caseous masses. The left lung showed

no involveɔent at all,while just below the apex of the lower lobe of the right was

■ focus the size of a pen and the corresponding gland was tuberculous.

No 106. A boy of 4 years. The anatomical findings in this were very si diar to

those in the last, The mall intestine showed several tubersulous uisers, the mas-

enterie glands were enlarged, caseous and aggregated; the peritoneum was thickened

and studded with tuberslas varying in size from milin to hapssed. In the left lung,

upper just below the apex of the huur lobe,was a definite focus, the size of a pen, and

the glands at the hilus on that side were enlarged and tuberculous.

12

No 80 may also be included, This was a male child of žả months. Although no ulcers

were seen in the intestine the portal of entry was probably alimentary, sines the

mesenteric glands were mlarged, caseous and adherent. The lower lobe of the right

lung contained a tuberculous focus,as large as a mall marblo, and the corresponding

gland at the hilus was oasented.

It is a difficult matter to disouse this question apart from the next,namely

5. The almost constant absence of evidence that the portal of entry might be

elsewhere when a ling focus was present,

In the previous points ny findings have been to a great extent in agrement,but in

this,if I understand it correctly,my experience is distinctly at variance, Several

of the cases reported in this series would find an explanation in a dual routs of

infection, whereas the statement above would appear to rule out such an occurrence,

nɔt merely as a more or less simultaneous infection, but even after an interval. Bo

it would seem to put forward the claim that,givm a primary lung focus due to re-

spiratary route infection, there is little if my likelihood of the intestine becom- ing affected unless secondarily to the pulmonary focus. This cannot be ascribed to

an increased resistance or imunity owing to the presence of the lung tuberculosis,

because it is a well established fact that intestinal tuberculosis can arise from

the swallowing of infected sputța.

to say

One explanation which,however, in my opinion savours rather of evading the difficulty than explaining it,would be my that whenever a lung focus is present together with definite alimentary tuberculosis, the former was the primary site and