TUBERCULOSIS A BACTEREMIA

That tubercle bacilli occur in circulating blood under certain conditions has long been known. In 1884 Weichselbaum found them postmortem, especially in the coagulated blood in the heart. Several observers have cultivated the organism directly from the blood in pure growth in acute cases, and the well-known lesions of miliary tuberculosis, diffusely scattered everywhere in the system, is explained as an infection of hematogenous origin due generally to vascular lesions. Generalized distribution of miliary lesions, however, is less common than local lesions in lungs, bones, lymph glands, etc., with little involvement or change in other parts of the body, and the prevailing idea in such instances has been that the bacilli are limited to such foci where they remain or slowly invade the neighboring tissues by direct extension or through the lymphatic vessels. We know such foci occasionally break into blood vessels and especially into the thoracic duct and a