CO129-468 - Governor Sir Stubbs - 1921 [6-8] — Page 79

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and meninges,if haematogenous metastasis occurs the first part to suffer is the

206 meninges,e,g.Mo» 95,160,181,286,211 and 275. On the other hand the two insta:des, Mos 48 and 173, are exceptions,in that the lungs are affected with mall tuberales (no focus) and the glands are caseous,but the plea is not involved; in the second blood infection is apparent since the meninges reveal tubercles at this bass.

On nine occasions were focal tuberoles found in the brain er serebellumi Mos 38, 42,66,119,145,139,837,939 and 283. In eight of these the focus was situated in the carebellum, in Nos 38.42 and 119 in the right lobe, in Nos 66,145,257 and 239 in the left, and in No 150 in both. In No 145 there were several foals three distinst ones in the left lobe of the cerebellum, two in the left cerebral hemisphere and one in the left hippocampus; in No 10 there were fur distinot foci, two in each lateral

Lemisphe lobs of the cerebellum in No 42 there was a second focus in the right cerebral, and

in No 237 one also in the left crus,

A striking feature of the tuberculous conditions as met with here is the rarity of bone, joint or skin affections. In this series there were five with tubereulous ulcers of the skin, four of these on the face and neck and ono o the forearm (Bea 100,118,164,173 and 263). Not a single instance of tuberculous joint disease was encountered and only four with bone lesions,vis.,Nos 39 (in which the mastoid vas involved and there we not absolute proof that this was tuberculous),59,104 with earies of the lower dorsal and upper lumbar vertebrae,und 141 who had caries of the 6th servical vertebra and tubercular disease of the left tibia and both fasara.

npm

Tuberculous servical adenitis, so frequently not with at home,is a comparative rari- ty in the post-mortes, here. Of the whole series there were only 20 instances, and in three of these the mlargment ma vary slight, so slight that there was no macro- adopádal evidence; on section,however, giant cells and tubercle bacilli were sein. In one oase, No P40, there was almost uniyərəni involvement of the gåinds--cervical, submaxi11ɛry, supraclavicular, axillary,mediastinal,nesenteric and fawral-together with widespread pulmonary intestinal and some ramal tuberculosis. This was a child of only three years, Sections did not show any of the usual conditions characterisḥ Be of Hodgkin's disease. In contrast to this may be inoidentally mentione No 54,a little girl of 7 months, showing but one oorvloal gland enlarged with very extensive

r,intestines,liver, tuberculous disease—lungs, pleura,mediastinal glærıds,nesentory,-

epleen, kidneys,meninges,