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Updated: May 18, 2025
The predisposing causes of consumption are the tuberculous habit of body, hereditary predisposition, narrow or contracted chest, deformed spine, delicacy of constitution, bad and scanty diet, or food containing but little nourishment, impure air, close in-door confinement in schools, in shops, and in factories, ill-ventilated apartments, dissipation, late hours, over-taxing with book-learning the growing brain, thus producing debility, want of proper out-door exercises and amusements, tight lacing; indeed, anything and everything, that either will debilitate the constitution, or will interfere with, or will impede, the proper action of the lungs, will be the predisposing causes of this fearful and lamentable disease.
Only slight cases are treated at the infirmary; serious cases are removed to Hospital No. 21 at Alexandria, situated within 10 minutes of the camp, a large modern hospital overlooking the sea. On the day of our inspection there were in the infirmary 1 prisoner ill with bronchitis; at the hospital 1 tuberculous case and 1 with a wounded elbow.
Sooner or later pyogenic organisms gain access to the sinus, and through it to the wall of the abscess. They tend further to depress the resisting power of the tissues, and thereby aggravate and perpetuate the tuberculous disease.
Thus tuberculosis, alcoholism, gonorrhea, and syphilis may be acquired during the life of an individual, but do not become fixed in the germ plasm. If the infants show effects of any of these diseases, it is not because of true heredity but because they were infected or influenced before birth. Rarely does this happen to children of a tuberculous mother, but often to those of a syphilitic mother.
In the immediate vicinity of the area of infection young connective tissue, and later, fibrous tissue, is formed. This may replace the tuberculous tissue and bring about repair a fibrous cicatrix remaining to mark the scene of the previous contest. Scars of this nature are frequently discovered at the apex of the lung after death in persons who have at one time suffered from pulmonary phthisis.
#Diagnosis.# A cold abscess is to be diagnosed from a syphilitic gumma, a cyst, and from lipoma and other soft tumours. The differential diagnosis of these affections will be considered later; it is often made easier by recognising the presence of a lesion that is likely to cause a cold abscess, such as tuberculous disease of the spine or of the sacro-iliac joint.
In the case of caseated glands in the neck, for example, it is obvious that the removal of this inert material is necessary before the tissues can be irrigated with fluids of high bactericidal value. Again, in tuberculous ascites the abdominal cavity is filled with a fluid practically devoid of anti-bacterial substances, so that the bacilli are able to thrive and work their will on the tissues.
Anyway, it gives 'em more time to make trouble for their neighbours. We call 'em Serviles locally. And they are apt to be tuberculous. 'Just so! said the man called Mulligan. Transportation is Civilisation. Democracy is Disease. I've proved it by the blood-test, every time. 'Mulligan's our Health Officer, and a one-idea man, said the Mayor, laughing.
It results in an increase in the reactive changes around the tuberculous focus, an increase in the immigration of leucocytes, and infiltration with the lymphocytes.
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