Tuberculous _meningitis_, cerebral or spinal, is in surgical cases practically always of miliary type, accompanied by the inevitable increase of fluid, and, in the cerebrospinal canal, of consequent tension. Inasmuch as the latter constitutes the most formidable feature of these cases, its possible relief by puncture may be considered. And so lumbar puncture (_q. v._) may be practised, and even tapping the cerebral ventricles after making the small trephine opening has been done a few times, though not with encouraging success. (See Hydrocephalus.) Too often tuberculous meningitis is the terminal infection which ends many a case of local tuberculous disease in other parts of the body. In general the more acute and miliary the lesions presented in tuberculous disease of serous membranes the greater the tendency to profuse watery (serous) exudate, whose volume may demand operative measures for relief. _In the bones_ we often find indications of tuberculous disease. It is not much more than sixty years since Nélaton called attention to the frequency of these intra-osseous lesions, and demonstrated the essentially tuberculous character of much that had hitherto been overlooked or considered under that vague term scrofula. All those forms of bone disease comprehended under the names _Pott’s disease_, _spina ventosa_, _tumor albus_, etc., are now known to be distinctly tuberculous lesions. In many instances these follow the slight circulatory disturbances brought about by contusions sprains, etc. This is especially the case in those who are predisposed to this disease. [Illustration: FIG. 21 Tuberculous spondylitis (caries): _a_, osteogenesis and osteosclerosis; _c_, cavity formed by degeneration of tuberculous focus. (Krause.)]