Post-mortem tuberculous lesions : their prevalence and distribution in 404 consecutive examinations conducted at the Royal Infirmary, Edinburgh

1. Tuberculous lesions were found in 69 per cent. of persons (386) who died in the Royal Infirmary, Edinburgh, from disease other than tuberculosis. 2. In 50 per cent. of cases calcareous, that is healed lesions were found. 3. In 9 per cent. the lesions were quiescent and in another 9 per cent. they were active. 4. Lungs and tracheo-bronchial glands are the organs most frequently involved in adults. 5 . Lungs, tracheo-bronchial glands and mesenterie glands in that order, are the most common sites of tubercle. 6. Other organs, except cervical glands, are always infected secondarily to those mentioned above. 7. Tuberculosis of the kidney is always secondary and does not heal. 8. There is evidence of a marked tuberculisation occurring during infancy of abdominal type and of a late and more constant tuberculisation affecting lungs and bronchial glands in later life. 9. Evidence is afforded by the figures relating to abdominal glandular lesions of a marked tendency for these lesions to disappear within` the individual. The degree of tuberculisation of the population must therefore very considerably exceed the percentage of the tuberculous lesions which have been proved in this series of examinations. It must be greater than 69 per cent. 10. The facts which have been obtained from the study of this particular population indicate that in order that correct conclusions may be obtainable from post-mortem material, the factors of age incidence with respect to the various manifestations of the disease must be taken into account. 11. From the facts demonstrated that tuberculosis in later life is mainly pulmonary in type and subacute or chronic in nature and that in a large proportion of cases the pulmonary must have been preceded in the individual by definite abdominal tuberculosis, it would appear that a resistance to this disease is active during later life, . and that the disease in a large number of instances must.h &ve been due to alighting up of an early infection and not to an reinfection.