The Pathogenesis of Tuberculous Meningitis. A Criticism of Rich's Focus-theory

Abstract

1) The pathogenesis of tuberculous meningitis was studied by the preparation of the spreading specimens of meninges. 2) The tuberculous meningitis in infant succeeded to primary tuberculosis will break out by the cerebrospinal fluid infection from multiple caseous foci in meninges, which were formed in the walls of meningeal arteriols in the early dissemination. 3) Sometimes caseous foci in brains and choroid plexuses were found, but these foci are not essential as the cause of meningitis. 4) There will be rarely some cases, in which bacilli will be discharged in the subarachnoid space from the caseous foci in brains. In such cases tuberculous meningitis apt to be chronic and to relapse in spite of the adequate therapy.