The epithelioid cells are by some regarded as modified leukocytes; by others as the product of division of the fixed cells. The giant cell is probably the result of irritation in one of these cells, the stimulus being sufficient to provoke division of the nucleus, but not of the entire cell. As the principal cellular activity occurs in the interior of this nodule the result is a condensation about the periphery which furnishes eventually a sort of capsule, the tissues being hardened and condensed as if for this special purpose. The effect of this is to interfere with vascular supply and finally to shut it off completely. As long as no pyogenic infection occurs, the original tubercle may gradually shrivel down and disappear or caseous degeneration may occur, and it may persist as a cheesy nodule for an indefinite time. As such a tubercle grows old the cells lose their identity, refuse to take stains, and a slow or quiet coagulation necrosis results. In this nest sometimes calcium salts are precipitated, the result being a _calcareous nodule_. On the other hand, during the active stage of this tubercle formation cell resistance may be lowered, either from general or constitutional causes; the original focus disintegrates; tubercle bacilli are liberated, and are now carried hither and thither, _metastatic tubercles_ being the result of their dissemination. Spontaneous healing of tubercle is possible, and may be due to three different causes: (_a_) Necrosis and exfoliation of diseased tissue (_e. g._, in lupus); (_b_) Cicatricial formation; (_c_) Retrograde metamorphosis. Looked at from another point of view, the possible fates awaiting the miliary tubercle are the following: (_a_) _Absorption_; (_b_) _Encapsulation_; (_c_) _Cheesy degeneration_; (_d_) _Calcareous degeneration_; (_e_) _Suppuration_. =Absorption.=--Absorption of tubercle undoubtedly is possible under favorable circumstances, but just what constitute these favoring circumstances no one knows, since they occur in cases which do not terminate fatally. To be able to describe them would be to detail minutely the changes which permit of recovery after non-traumatic tuberculous infection, which clinical fact is amply demonstrated by the experience of the profession. Absorption is probably largely a matter of phagocytosis. =Encapsulation.=--Encapsulation has already been spoken of, the capsule being formed by the condensation of the original cells of the tuberculous agglomeration, the infectious organisms being thereby imprisoned as long that they are practically starved and finally die. The tubercle bacilli, however, may long lie latent in such a cellular prison, and should anything occur to break the prison wall they may escape and still prove actively infectious. In this way are to be accounted for the fresh eruptions from old miliary or other deposits.