1893 Journal of the American Medical Association (JAMA)  
what irregular bodies from the size of sago grains to small peas. So far as the eye could detect there were none of the millet seed sized, whitish-gray hard nod¬ ules sometimes seen in acute miliary tuberculosis. These were larger, softer, and more caseous in appear¬ ance. The abdominal glands were all greatly en¬ larged, many of them from walnut to hen's eggs in size. The omentum was a thick, hard, nodular mass. The liver was somewhat enlarged, everywhere adher¬ ent to surrounding parts, but
more » ... esented no visible tubercles in its interior. The capsule of the spleen was very thick and dense, and so intimately adher¬ ent to adjacent parts that it was extracted only after long and powerful tearing. The organ was consider¬ ably enlarged, but no tubercles were seen in its par-• enchyma. The kidneys were like the other organs firmly imbedded by the thickened peritoneum, but appeared normal on section. All the internal organs of chest and abdomen excepting the heart were ad¬ herent into one mass by the adhesions. The cause of death was general tuberculosis aris¬ ing from tuberculous glands. Among the occasional sources of pruritus, I believe Kaposi and others mention lymphadenoma or Hodgkin's disease, and it is perhaps not to be marveled at that so protean a disease as tuberculosis should give rise to a great variety of symptoms. Probably no other specific infection save the syphilitic gives rise to such varied symptom complexes as the tubercu¬ lous. Outside of the pulmonary and other more ordinary manifestations, its ravages are often most curious. The autopsy is not rarely a surprise party.
doi:10.1001/jama.1893.02420450013002 fatcat:n6mevieaejgofhsfgfx6njeubu