Excision of the Caecum for Epithelioma: Death on the Thirteenth Day
Authors: W. Whitehead
Journal: BMJ (1885)

method of cultivating on solid( media, though, in nmy paper on abscesses, I still nmaintain-that fluids have advantages in certaini cases.Thus, when I came to work at tubercle, one of the first things I did was to work witlh fluids, thinking that perhaps Dr. Koch had limited himself to cultivating on solids.Indeed, before Koch published on tubercle at all, I had already planned out a series of experiments on tubercle, in repetition of Schiiller's, which would have been beguin in earnest in the spring or summer of 1882.But, during the winter of 1881, I had made several preliminary experiments by cultivation in fluids; I had introduced portions of tubercles from tubercular guineapigs into various infusions, and kept them at the body-temperature, without in any case gettinig any development, thus at once disproving Schtiller's results.Indeed, anyonie who has worked practically at these matters will see at once where Schuiller's errors lie.Since the publication of Koch's paper, I have often inoculated tubercles directly into cultivating fluids, but always with the same niegative results; although in some instances, where portions of broken-down cheesy glands were introduced, there was slight development at the bottom of the flask ; and I have also got slight developinent where broken-un crusts of growth on blood-seruin have been introduced into infusions.In no case, however, was there any turbidity of the fluid, nor any growth of which use could be made.It is a great pity that Dr. Creighton's criticism comes at a tiImle when oine is nio longer working at this subject, au-d wlhen, for my own part, I had come to regard the causal relation between the bacilli and tuberculosis as settled; had it come earlier, I could have shown flasks in support of my statements.But with the fact that these bacilli do not grow in fluids, Dr. Creighton's whole argument falls to the ground.It was not possible to separate the bacilli from the tubercular material in any other way than was done, and the question is, was that method sufficiently satisfactory ?I maintain that it was.You have seen, in these little vessels, how the bacilli spread away from the tubercular material, which cannot follow them.Whenl, then, the marginal growths are picked up, it is clear at once that we have got the bacilli free from the tubercular material; and if this process be continued through a num- ber of successive generations, there can be no possible doubt that the tubercular material has been got rid of; and much more certainly got rid of than could be the case by the method of fractional cultivation as described by Dr. Creighton.Thus, let a flask of meat-infusion be inoculated with a crushed tubercle, and let us suppose for one moment that the tubercle-bacilli could develop freely in the fluid.You re- move a drop of this fluid for inoculation, but in the fluid are floating bacilli, and also the d6bris of the tubercular material.Who is to say that you do not take a considerable quantity of tubercular debris?And who is to say that, in every successive inoculation, you do not take debris?In the fluid, the bacteria and the tubercular matter would be floating about together.On the solid, the tubercular matter is fixed, while the bacilli spread away from it, and may be removed without touching the tubercular matter at all.And further, the stained specimens of the growth, to which I have previously alluded, and to which I would earnestly beg your attention, show absolutely that all the tubercular material has been got rid of, and that the growth consists only of tubercle-bacilli ; for if any remains of tubercular material were present, I know from practical experience that they would, with this method of staining, have come out blue.,'And the experiments on animals with these bacilli show definitely that they are the real virus.Introduce a piece of tubercle and a mass of bacilli of equal size into two animals, and the latter will be far ad- vanced in tuberculosis before the earliest symptoms are evident in the former.I think, 3Mr.Presideit, I lhave said enough to show that the state- m-ients which I took as texts are each anid all erronieous ; that Dr. Koch, in cultivating the tubercle-bacillus, has not departed from the original principle of cultivation on solid media; that the method em-