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Related post: focus of tuberculous adenitis. On this point I also
quote Steffen-" : "The lymph glands offer in a great
number, perhaps in the majority, of cases of tuber-
culosis of individual organs, the primary seat of tu-
bercle formation."
While these statistics do not admit of any con-
clusion in the nature of a mathematical certainty,
nevertheless, when we consider them as a whole,
we have some very important data from which we
can draw inferences, if not positive conclusions.
We are at least justified in saying that:
1. Tuberculosis is common in childhood, caus-
ing about 25 per cent, of the deaths occurring dur-
ing the last quarter of the first year, and quite a
large proportion of those during the second and
third years.
2. Nearly all cases of tuberculosis show involve-
ment Lexapro 2.5 Mg of the lymph glands ; and if the fact that the
process is furthest advanced is an indication, they
are in a large percentage of cases to be considered
the primary foci.
3. Nearly all children show enlarged glands dut-
ing the period of infancy and early childhood, of
which investigation seems to show from 60 to yo
per cent, to be tuberculous ; and, of those chroni-
cally enlarged, even a larger per cent, are so af-
fected.
4 A large per cent, of those who have enlarged
glands during childhood develop tuberculosis in
later life ; and it is probable that the gland was
" Osier. Practice of Medicine, 189s, p. 22s.
^ Bios. Mittheil. atts d. Grensgebieten der Medisin und Chirurgie,
1890, No. iv.
"Osier. Practice of Medicine, 1892, p. 206.
^ Steffen. Zur pothologisclien Anatomic des Kindesaltcrs, p. 159.
frequently the primary focus whence came the
spread of infection.
It now remains to show Lexapro Online Pharmacy what becomes of the Lexapro 10 Mg Price
bacilli and tubercles which are found in these 2.5 Mg Lexapro lymph
glands in childhood.
Why the bacilli, in these children with lowered
vitality, do not produce a general tuberculosis at
once has not been satisfactorily explained. We
must remember that the lymphatic elements have a
defensive function ; and, may it not be probable
that the bacilli meet such opposition in these struc-
tures that they are unable to make further head-
way at the time; but, after a time, the bacilli be-
come accustomed to and adapt themselves to their
new environment. Experiments show that the ba-
cilli that come from these glands are less virulent
than those that come from other foci, as the lungs.
Whether this Buy Lexapro From Canada is due to Buy Cheap Lexapro Online the absorption of germs of
less virulence, and the absence of a general infec-
tion is due to this ; or whether the lessened virulence
is due to the action of the various lymphatic ele-
ments upon them ; or, whether it is to be accounted
for by saying that the rapidity of the process de-
pends upon the number of the bacilli which cause
the infection, we are not able to say. Perhaps all
of these are to be considered. It must be remem,-
bered, as shown above, that the Cheap Lexapro Online bacilli, when thrown
out of the system, are almost always cast into an
environment unfavorable to them. The tempera- Lexapro 10mg Price
ture is either too low or too high ; or the atmo.s-
phere is too dry; or they are exposed to the light
or the direct rays of the sun. Consequently, the
only bacilli that are taken into the system in Cost Of Lexapro 10 Mg a highly
virulent state are those that are taken directly from
the infected person or from bacillus-bearing mate-
rial which has been freshly cast oft', or from a case
in which the bacilli are specially virulent. Such an
infection can come through kisses, by the use of
the same table ware, or by any very intimate asso-
ciation.
If this theory of infection by germs of lowered
resistance together with the defensive action of the
lymph elements, Cost Of Lexapro Without Insurance is to account, either in part or
wholly, for the localization of the tuberculous pro-
cess that is noted so often in childhood, then we
should expect to find that those children who live
in intimate association with tuberculous patients,
if they develop the disease, are most apt to take on
extension to other parts of the organism at once.
On Buy Lexapro Canada this point it would be well to gather statistics,
to see if they do undergo a more Lexapro 10 Mg Cost virulent Online Pharmacy Lexapro course than
those who receive their infection from a less inti-
mate connection. The statistics which I have at
hand indicate this ; but they do not cover enough
cases to warrant a Lexapro Cost Without Insurance positive conclusion.
When the bacilli find their way into a lymph
500
POTTENGER: TUBERCULOUS INFECTION.
[N. y. Med. Jour.,
gland, if they are not destroyed three courses are
open to tlieni. They may cause a local degenerative
process in the lymph gland, or they may be carried
on into the Buy Lexapro Online Cheap distant parts of the organism, as the
lungs, through the lymph or blood channels ; or,
they may become encased in the glands Lexapro Best Price to remain
quiescent forever unless they are carried out into
the lymph or blood stream at some future time,
when the gland involved is irritated and swollen
from some cause, as is the case in the acute infec-
tious diseases.

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