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 1t with the suscepti-
! pil1ty of man to bovine tuberculosis? This
| question was far more important to us
In IMAM n that OF the susceptibility Of cattle
| TO human tuberculosis, highly important
| as that was, too. 1t was impossible to
| give this question a direct answer, be-
cause, of course, the experimental inves-
I t1gatlon OF 1t with human beings was out
| OF the question. Indirectly, however, we
could try to approach it. It 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 a living condition, as the
numerous infection experiments with
s9ch dairy products on animals had prov
! ed. Most OF the inhabitants of such cities
! daily consumed such living and perfect
| ~ virulent bacilH of bovine tuberculosis
and Internationally carried out the ex-
| pertinent Which we were not at liberty to
make. If the bacilli of bovine tubercu-
losfs were able to infect human beings,
| many cases of tuberculosis caused by the
consumption of ailments containing tu-
| bercle bacilli could not but occur among
| the inhabitants of great cities, especially
| the children. And most medical men be-
i1eved that this was actually the case.
| In reality, however, it was not so. That
a case of tuberculosis had been caused by
/ ailments could be assumed with certainty
| only when the intestine suffered first /.
e., when a so-called primary tuberculosis
| OF the intestine was found. But such
! cases are extremely rare. Among the
| many cases of tuberculosis examined af-
| ter death he himself remembered having
| seen primary tuberculosis of the intestine
! only twice. Among the great post NOR
! tenn material of the Charlie hospital, in
| Berlin, ten cases of primary tuberculosis
of the intestine occurred in five years.
| Among !33 cases of tuberculosis in chill
! dren at the Emperor and Empress Fred
erick's hospital for children Baginsky
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
! Ject many more statistics of the same
! kind, all indubitably showing that pri-
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. 1t
was just as likely that they were caused
by the widely propagated bacilli of hu-
man tuberculosis, which might have got
into the digestive canal in some way or
! other-for instance, by swallowing <RliVa
| of the mouth. Hitherto nobody could de-
| eide with certainty in such a case wheth-
| er the tuberculosis of the intestine was
| of human of animal origin. Now We
! could diagnose them. All that was neces-
| sary was to cultivate in pure culture the
| tubercle bacilli found in the tubercular
| material and to ascerta to WI en-
| they belonged. For this purpose he
5mnen5ed subcutaneous injection,
! which yielded quite specially character
! istic and convincing results. For half
year past he had Cccupi d 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
1 did not speak for the assumption that
| bovine tuberculosis occurred in man.
! Though the important question whether
man was susceptible to bovine tube. Gu
I 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 at liberty to say that, If
such q susceptibility really existed, the
infection of human beings was but a
! very Iare 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 INFECTIONS
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 its diffusion. Well, 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 es~
adjustments. That, however was not
only absolutely impracticable but also
unnecessary for a consumptiVe VINO
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 were 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, ill-ventilated rooms.
The patient was left without the nursing
he needed, because the able-bOdied MEM
berS of the family must go to their work
How could the necessary cleanliness be
secured under such circumstances? How
was such a helpless patient to remove his
sputum so that it might do no harm:
But let them go a step further anu 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
DID matter SeCret6d 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 it was he
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
Biggs has shown, in the case of the
lar nests of foci 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 I'M
der which the poor everywhere. but es-
pecially 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 we'll
TODD population when the domestic con-
ditions, especially as regarded the bed
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; 1t was out of them that
the disease always cropped up anew, and
it was to the abolition of these conditions
that they must first and foremost dire ,.