J Clin Pathol: first published as 10.1136/jcp.4.4.508-a on 1 November 1951. Downloaded from

508 ABSTRACTS The Morbid Anatomy of Tuberculosis in rence of which in old people may possibly Old Age. ROULET, F. (1950). Ann. be due to reduced general resistance and Med., 51, 69. response. In 270 necropsies carried out at the University of Basle on subjects over 60 years Glomerulonephrosis. A Morphologic old, frank evidence of tuberculosis was Manifestation of Renal Cortical Ische- present, although it was the cause of death mia in Toxic Oliguria and Lower in only 90 cases. The active focus was found . FRENCH, A. J. in 245 cases around an old calcified or ossi- (1950). Arch. Path., 49, 43. ned nodule in the tracheo-bronchial lymph The histopathological findings in the nodes; The lungs in these cases revealed kidneys of 20 specially selected cases of no active primary focus, though an old, glomerulonephrosis are described, special calcified, inactive lesion was often discovered. stress being laid on the glomerular changes. It is argued that active tuberculosis in old This study was undertaken in the hope of age is frequently caused by reactivation of explaining the anuria or oliguria which an old lesion in the lymph nodes around the accompanies lower nephron nephrosis bifurcation of the trachea, possibly due to (" tubular " or " toxic" nephritis), in which the chronic of the lower condition, on physiological grounds, there trachea and main bronchi, which is extremely should be polyuria if a tubular lesion alone common in old people. Tuberculosis of the be present. For this purpose it was essential tracheo-bronchial nodes frequently leads to to eliminate cases of primary or secondary complications: of the 245 cases of tracheo- renal disease, eclampsia, and cardiovascular bronchial-node infection, there was also . copyright. frank tuberculous infection of the lungs in The changes found in the glomeruli, 35: in 12 cases there was a generalized tubules, and medulla in sections of the haematogenous spread either from a focus kidneys (mostly stained with haematoxylin in the tracheo-bronchial nodes or from an and eosin) are tabulated. Glomerular alternative site of active infection; in 13 ischaemia, together with thickening of the cases there were foci both in the tracheo- capillary walls, was found in every case. The bronchial nodes and elsewhere, but no presence of granular material staining grey- generalized spread; and in 25 cases haema- blue in the glomerular spaces and proximal http://jcp.bmj.com/ togenous spread had occurred with tracheo- tubules was noted, this being regarded as the bronchial nodes as the only possible primary precursor of the protein casts seen in the source. In the remaining 160 cases the distal convoluted tubules in all except one infection was confined to the tracheo- of these cases. R. B. T. Baldwin. bronchial nodes. Speaking generally, miliary tuberculosis develops more rapidly in the old than at Conrections.-Dr. Varadi writes: I shall be on September 25, 2021 by guest. Protected other ages. The appearances are classical, obliged if you will print the following corrections though the tubercles may be rather large- to my article "Combined Fragility Test for as big as a pea or a hazel nut. In the whole Congenital Haemolytic Jaundice " (J. clin. Path., 4, 221). On page 222 in paragraph 3 read 0.021 % series there were 16 cases of miliary spread instead of 0.21% NaCl, and, on page 224 para- amongst the 43 cases of frank pulmonary graph 2 of the Appendix, marrow puncture tuberculosis. Tuberculosis of the serous instead of culture. cavities is not uncommon in the elderly. Pulmonary tuberculosis may be of the We much regret that in the description of a with cell-suspension mixer by Dr. Matthews (J. clin. chronic apical fibro-caseous type Path., 4, 383) the pipettes were described as 20 ml. cavities, or of the ulcerative caseous type and 50 ml. These should be 20 c.mm. and of acute tuberculosis, the frequent occur- 50 c.mm.