The Saint Paul globe. (St. Paul, Minn.) 1896-1905, 1901-08-11
mission to make further inquiries on the

mission to make further inquiries on the
| subject.
BOVINE TUBERCULOSIS NOT DAN
| GEROUS TO MAN.
But now, how was it with the suscepti-
ohity or man to bovine tuberculosis? This
| question was far more important to US
| than that of the susceptibiIity Of cattle
| to human tuberculosis highly important
as that was, too. It was impossible to
give this question q direct answer be-
cause, of course; the experimental inyes-
tlsat1on of It with human beings was out
| OF the question. Indirectly, however, we
could try to approach it. 1t was well
known that the milk and butter consum-
ed IN great cities very often contained
| large quantities Of the bacilli Of bovine
tuberculosis in living condition, as the
numerous Infection experiments with
such dairy products on animals had prov
| ed. Most of the inhabitants of such cities
| daily consumed such living and perfect
/ and Intentionally carried out the eX-
pertinent which we were not at liberty to
make If the bacilA of bovine tubercu-
| IoS1S We're able to infect human beings,
many cases OF tuberculosis caused by the
consumption of ailments containing tu-
berele bacilh could not but occur among
| the inhabitants of great cities, especially
| the children. And most medical men be-
| lieved that this was actually the case.
In reality, however, it was not so. That
case or tuberculosis had been caused by
ailments could be assumed with certainty
| only when the intestine suffered first, i.
e., when a so-calied primary tuberculosis
| OF the intestine was found. But such
cases are extremely rare. Among the
many cases Of tuber culosis examined af-
| ter death he himself remembered having
| seen primary tuberculosis of the intestine
| only twice. Among the great post-mor-
tenn material of the Charlie hospital in
Berlin, ten cases of primary tuberculosis
I of the intestine occurred in five years.
/ Among s33 cases of tuberculosis in chill
! dren at the Emperor and Empress Fred
| erick's hospital for children Baglnsky
| never found tuberculosis of the intestine
without simultaneous disease of the lungs
and the bronchial glands. Among 3,104
| post-mortem examinations of tubercular
! children Biedert observed only 16 cases of
! primary tube. culosis of the Intestine He
| could cite from the literature of the sub
! 1ect many more statistics OF the same
kind, all indHbitably showing that prt-
mcry tuberculosis of the intestine, espe-
c.ally among children was a compare
lively rare disease, and Of these few
cases that had been enumerated it was
! by no means certain that they were due
| to infection by bovine tuberculosis. It
was just as likely that they were caused
! by the widely propagated baeillf Of hu-
man tuberculosis, which might have got
| into the digestive canal in some way or
| other-for instance by swallowing OLIVIA
| of the mouth. Hitherto nobody could de-
| eide with certainty in such a case wheth-
er the tuberculosis of the intestine was
of human or of animal origin. Now We
could diagnose them. All that was neces-
sary was to cultivate in pure culture the
| tubeTcle bacilli found in the tubercular
| material, and to aScertan to WIN ch
| they belonged. For this pUrp09s he
rec 5mmenGed simultaneous injection,
which yielded quite specially character
iStic and convincing results For half a
year past he had cccupi himself with
such Investigations. but, owing to the
! rareness Of the disease in question, the
number of the cases he had been able to
| investigate was but small. What had
! hitherto resulted from this investigation
did not speak for the assumption that
bovine tuberculosis occurred in man.
Though the important question whether
man was susceptible to bovine tube GU
losis at all was not yet absolutely decid-
ed, and would not admit of absolute de-
/ CiSion today or tomorrow, one was never
! theless already ait liberty to say that if
such a susceptibility really existed, the
infection OF human beings was but a
very rare occurrence He should esti-
mate the extent of infection by the milk
and flesh of tubercular cattle, and the
butter made of their milk as hardly
greater than that of hereditary trans
mission, and he therefore did not deem
it advisable to take any measures against
THE MAIN SOURCE OF INFECTION.
So the only main source of infection of
tuberculosis was the Sputum of conSump--
| tive patients, and the measures for the
combating of tuberculosis must aim at
the prevention of the dangers arising
from It's diffusion. We'll, what was to be
done in this direction? Several ways
were open. Ones first thought might
! be to consign all persons suffering from
tuberculosis of the lungs, whose sputum
contained tubercle bacilli, to suitable eso
| adjustments That, however, was not
| only absolutely impracticabIe but also
unnecessary, for a consumptive who
| coughed out tubercle bacilli was not nee,
| essarily a source of infection on that ac-
count so long as he took care that his
| sputum was properly removed and rem
dered innocuous. This was Certainly true
OF very many patients especially in the
| first stages. and also those who belonged
! to the Well-to-do classes and We're able
to procure the necessary nursing. But,
how was it with people of very small
means? Every medical man who had
often entered the dwellings of the poor
and he could speak on this point from
| his own eXperience-knew how sad was
| the lot of consumptives and their families
| there. The whole family had to live.
/ in one or two small, ll-ventilated rooms.
| The patient was left without the nursing
he needed. because the able-boded mem
bers of the family must go to their work.
/ How could the necessary cleanliness be
secured under such circumstances? How
was such helpless patient to remove his
sputum so that it might do no harm.
But let them go a step further ana pic
| ture the condition of the poor consump.
tive patients dwelling at night. The
whole family slept crowded together in
| one small room. However cautious he
might be, the sufferer scattered the NOR
bid matter secreted by his diseased lungs
every time he coughed, and his relatives
close beside him must inhale this poison.
| Thus whole families were infected They
/ died out, and awakened in the minds Of
those not knowing the righteousness of
! tuberlucosis the opinion that 1t was he
I reditary, whereas it's transmission in the
cases in question was due solely to the
simplest process of infection, which did
not strike people so much because the
consequences did not appear at once but
generally only after the lapse of years
/ Often under such circumstances the in
lection was not restricted to a single
family, but spread in densely Inhabited
tenement houses to the neighbors, and
then, as the admirable investigation of
Bisgs has shown, in the case Of the
densely peopled parts of New York, regu-
lar nests of focf disease were formed
But If one investigated these matters
more thoroughly one found that it was
not poverty per Sc that favored tubercu-
losiS, but the bad domestic conditions un-
der which the poor everywhere, but es-
peclaIly in great cities, had to live. For,
as the German statistics showed, tuber-
culosis was less frequent, even among
the poor, when the population was not
densely packed together and might at
tain very great dimensions among a WELL
to-do population when the domestic con-
ditions, especially as regarded the bed
rooms, were bad, as was the case for in
stance among the Inhabitants of the
North Sea coast. So it was the over
crowded dwellings of the poor that we
had to regard as the real breeding places
of tuberculosis; it was out of them that
the disease always cropped up anew. and
1t was to the abolition of these conditions