Pathology and treatment of diseases of women . ay be passed over on account of itsgreater capability of resistance, due to the squamous epithelium and itsacid secretion, and the uterus and tube may become immediately infected. According to the preceding statements we define our views concerningthe spread of infection in tuberculosis of the female genitals as follows: 1. Where another recent tuberculous focus can be demonstrated in thebody in addition to the genital infection, a secondary hematogenousinfection must be taken for granted. (This group comprises the greatmajority of eases.) 2. Wher
Pathology and treatment of diseases of women . ay be passed over on account of itsgreater capability of resistance, due to the squamous epithelium and itsacid secretion, and the uterus and tube may become immediately infected. According to the preceding statements we define our views concerningthe spread of infection in tuberculosis of the female genitals as follows: 1. Where another recent tuberculous focus can be demonstrated in thebody in addition to the genital infection, a secondary hematogenousinfection must be taken for granted. (This group comprises the greatmajority of eases.) 2. Where tuberculosis of another organ cannot be proved, an ascendingprimary infection is to be accepted as probable. (This group is lessnumerous.) It has been proven by animal experiment that the non-motile tuberclebacillus can spread upward against the force of the secretion. The form in which tuberculosis appears in the female genitalia. 192 DISEASES OF WOMEN varies. We distinguish two chief types in the closed hollow organs,the tubes and FM 3 3 1. The miliary form, with well-developed epithelioid tubercles andgiant cells. 2. The cheesy infiltrating form, without typical tubercles and withscanty giant cells. PATHOLOGY OF THE VAGINA AND UTERUS 193 The demonstration of the 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 attack
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