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ACUTE MILIARY TUBERCULOSIS FOLLOWING RENAL TUBERCULOSIS, SECONDARY TO OLD HEALED BILATERAL APICAL TUBERCULOSIS

PAUL H. RINGER, A.B., M.D.
JAMA. 1909;LIII(14):1100-1101. doi:10.1001/jama.1909.92550140030003d.
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ABSTRACT

The following case may be of interest to many as being to a great degree illustrative of the relations of cause and effect in the mobilization of tubercle bacilli after an apparent cure has been effected. In the case reported here no knowledge of the primary disease was obtained until the autopsy, the patient having died from general dissemination. A point of special interest is the intermediate route chosen by the tubercle bacilli, and their temporary halting place in the right kidney before spreading to the body at large.

Patient.  —I was called on July 19, 1909, to see Mr. J. C., aged 28, a farmer from Kentucky, who had been in Asheville three weeks. Data were obtained from his wife.

History.  —Mother and several brothers died of pulmonary tuberculosis. Patient well as a child; no past illnesses; was an athlete at college. About a

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