Pathologie et traitement des maladies des femmes . tubercle bacillus selon de nombreuses autoritaires (par exemple, Sellheim) est très difficile et souvent altogetherimpossible. Cela ne coïncide pas avec ma très grande expérience. Isuccéder presque toujours à démontrer des bacilles de tubercules dans le tissu eux-mêmes avec une bonne fixation de la préparation (formaline-alcool) et des sections minces et une coloration adéquate (j'utilise la méthode de Ziehl-Neelsen). Les résultats négatifs sont probablement dans de nombreux cas d'être l'arbitre des défauts techniques. La démonstration de bacilles dans la sécrétion est veryincertains et dif

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Pathology and treatment of diseases of women . tubercle bacillus according to many authori-ties (for instance, Sellheim) is very difficult and oftentimes altogetherimpossible. This does not coincide with my very large experience. Isucceed almost always in demonstrating tubercle bacilli in the tissuesthemselves with good fixation of the preparation (formalin-alcohol) andthin sections and adequate staining (I employ the method of Ziehl-Neelsen). The negative findings are probably in many cases to be referredto defects in technic. Demonstration of bacilli in the secretion is veryuncertain and difficult without a culture process. (See chapter on Bac-teriology. ) Of the different parts of the genital apparatus the tubes are by farmost frequently attacked by tuberculosis, next the corpus uteri, morerarely the cervix and ovaries, and quite seldom the vagina and vulva. The Individual Organs 1. The Tubes The tube is jointly diseased in most cases of genital tuberculosis.The view that this organ with its secluded position could become dis-. FlG. 103.—Salpingitis Tuberculosa Miliaris. (Authors preparation.Zeiss, Obj. AA, Oc. 4.) eased only secondarily cannot be sustained in view of the fact that anumber of indisputable observations from the post-mortem table existin which not a trace of tuberculosis could be found on very exact and 194 DISEASES OF WOMEN close examination of the body, except in the tube. We suppose that inthis primary tuberculosis the bacilli pass through the vagina and uteruswithout leaving a trace and settle first in the tube. In some cases auterine tuberculosis may have been overlooked which experience showsmay not rarely happen. We also differentiate in the tube the two formsmentioned above. 1. The Miliary form. The mucosa is attacked first; it offers ingeneral the picture of a catarrhal inflammation. Typical epithelioidtubercles with giant cells and positive but scanty proof of bacilli arefound isolated or in small groups in the folds of the mucosa. (See

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