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January 11, 1902


JAMA. 1902;XXXVIII(2):111. doi:10.1001/jama.1902.02480020041008

It is a well-known fact that tuberculosis of the lungs involves by preference the apices, but no explanation that has been offered is entirely satisfactory. Deficient functional activity of the portions of lung in question would seem to be in general an adequate predisposing factor. This does not necessarily imply, however, that infection takes place invariably by way of the air passages. As opposed to the view that the air is exclusively the medium through which tubercle bacilli gain access to the apices of the lung, is the report by Baumgarten1 of experimental observations in which injections, in not too large amount, of virulent tubercle bacilli into the uninjured urethra and bladder were followed by tuberculosis of the apices of the lungs. The same result followed subcutaneous and intraocular inoculation. When large amounts of bacilli, however, are employed, or when intravenous inoculation is practiced, miliary tuberculosis is likely to