It is not proposed, in the following pages, to write
a critical digest, or even epitome, of the
pathology and etiology of tuberculosis. Such a test
would be impossible within the limits of a reasonable thesis owing to its complexity and magnitude.
It is rather my aim to sketch rapidly the features
of the pathological process, and the various factors
usually designated etiological and diagnostic and
in the light of the indications derived from them
to ascertain the lines along which to work, in order
to induce a natural arrest and eventually a complete'
The various steps of the argument I originally
worked out in the opposite direction, that is,
following an empirical line of treatment I set myself to work out, on physiological lines, the rationale concealed behind the complex pathological
processes, successfully combated by it. To follow
out the argument step by step, is however easier
in the former direction and perhaps equally striking
A vast amount of work has been done by many to unravel the numerous pathological factors, which are
the primary causes of the various signs and symptoms
by which we recognise the disease. Much of our
knowledge is still vague, by reason of the experimental difficulties by which work on the subject
is surrounded. The extent to which secondary factors
enter into and influence the signs and symptoms of
the disease does not yet receive the recognition which
it deserves. So far with one or two exceptions to
be noticed later) the treatment of tuberculosis has
been practically empirical, founded on various
fallacious interpretations of Pathological and
clinical facts, which themselves were but.little
understood. Until quite recently the progress of the
disease towards a fatal issue was a sufficiently
familiar prospect, while these cases which were treated satisfactorily were either relieved of their
disease mechanically or treated by change of climate.
In the former the process was rendered incapable of
study, inasmuch as the change was sudden and the cure
was independent of the effects of nature; in the
latter continued observation was usually impossible.
Thus.the results of treatment were frequently seen,
but the gradual development of the process was comparatively rarely studied except in those cases in
which progress was in the only too familiar direction.
As a case progresses towards arrest of the morbid
process the various secondary disturbing factors are
gradually eliminated,by appropriate treatment,or by
elimination of the various casual influences,and the
disease stands out stripped of many familiar features;
the inclusion of which in the essential clinical
picture has been so fruitfully productive of misconceptions.