Tubercular meningitis as it occurs in children : with an appendix of illustrative cases and two chromo-lithographs / by Martin Oxley.

  • Oxley, Martin.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Tubercular meningitis as it occurs in children : with an appendix of illustrative cases and two chromo-lithographs / by Martin Oxley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    reason, as in every instance where the membranes of the brain are the seat of the miliary deposit, diffused and widespread in- flammatory disturbance of the circulation in the brain rapidly supervenes, and the signs of the deposit in the lungs, liver, &c., are veiled, as also are the ordinary indications which usually guide us in our diagnosis of this disorder. In this paper I shall confine my remarks to tubercular meningitis as it occurs in children, while at the same time en- deavouring to take a broad view of the disorder, and keeping in mind that the meningitis is not a disease of itself, but one of the manifestations of a general complaint. The manner in which this deposit of miliary tubercle is placed in and upon the vessels of the brain, is so well shown in a microscopic specimen, prepared from one of my cases by Mr F. Paul, that I have had a drawing made by my friend Dr Hyla Greves of the branch of the artery magnified five times, as also one of part of the vessel magnified 50 diameters, and another giving an excellent representation of one of the tubercles magni- fied 300 diameters. The following description will explain the drawings:— Fig. 1. Branch of meningeal artery, five times the natural size, showing miliary tubercles scattered along the walls of the vessel. At (a) the tubercular nodule entirely surrounds a small branch, at (b) they are situated at the side of the vessel. Fig. 2. Part of the same vessel magnified 50 diameters. The relationship of the tubercle is well shown, The wall of the artery in the immediate neighbourhood of the tubercles (if) is seen to be infiltrated with small round cells similar to those of which the tubercles themselves are chiefly composed; this, how- ever, is better shown in fig. 3. Fig. 3. One of the tubercles magnified 300 diameters. The tubercle is seen to be composed of an aggregation of embryonic or lymph corpuscles in the vessel wall. The deposit of miliary tubercle, as well as the amount of lymph exudation, varies very much in different cases, and as a consequence we have great diversity in the lesions of the brain and membranes. At one time only a few nodules will be