<6 MICHIGAN ACADEMY OF SCIENCE. 



from eleven to fifteen years. 2. These figures correspond fairly closely 

 with those given by Rilliet and Barthez, and might serve as a basis for 

 comparison. 



* * * "Intestinal tubercle, again, is said to be most common in 

 the years following childhood, from twelve upwards, for six or seven 

 3'ears. From an analysis of 127 cases of tuberculosis in children it was 

 found that in 4.'] instances there W'as tubercular ulceration of the intes- 

 tine. During the first vear after birth there was onlv 1; between one 

 and two years and a half, 14; from three to five years and a half, 10; 

 from six to seven years and a half, 7; from eight to ten years, 5; and 

 from eleven to fifteen years there were G. In this series of cases, then, 

 the intestines are frequently affected during very early life, as w^ell 

 as in somewhat later years, but although the intestines are directly 

 affected by tubercle in such a small proportion of cases, the mesenteric 

 glands are found to be in some stage or other of tubercular degenera- 

 tion in no less than 100 instances, or in nearly 79 per cent of the 

 whole. This I consider to be a point to which special attention should 

 be paid, as it seems, to me, to shed a flood of light on the subject of 

 tuberculosis in children. The age at which these tubercular glands in 

 the mesentery were found is also significant. During the first year of 

 life there were 4 cases; from one to two years and a half, 33; from 

 three to five years and a half, 29; from six to seven years and a half, 12; 

 from eight to ten years, 13; and from eleven to fifteen years, 9 cases. 

 •Here, again, it will be noted the figures are higher during the earlier 

 periods than during later years, but the maximum is reached (as with 

 ulceration of the intestine) at a distinctly earlier period than in the 

 case of tubercular meningitis. In 14 cases the mesenteric glands only 

 were affected — /. e., there was no tubercle found in miy other part of 

 the body.'"* 



My own observation of the vital statistics of Michigan is that, as 

 a rule, in all years except wiien meningitis is epidemic, in which in- 

 stances the disease is most prevalent in the spring, that is, following 

 several weeks after the time of the exposures to greatest cold, and the 

 increase is undoubtedly due to the entrance of the specific germs by 

 way of the air passages, in other years meningitis is most prevalent in 

 August, following the time of warmest weather. My belief is that 

 the increase in meningitis at that time and which occurs among children 

 at and immediately following the milk-drinking ages, is in some way 

 connected with changes which occur in the milk because of the heat. 

 And one of the purposes of this paper is to present this view in order 

 that evidence on this important practical point may hereafter be 

 accumulated by bacteriologists and others. One distinct question is: 

 Do tubercle bacilli multiply in milk at temperatures of the atmosphere 

 common in July and August? At least, I suppose we may safely 

 assume that milk will maintain the animal heat longer in hot weather 

 than in cold weather. And ''Koch states that between 86° and 105° F. 

 tubercle bacilli grow, but that outside these limits it is exceedingly 

 difficult to obtain a growth. "f Our hottest weather in summer is well 

 within these limits, being from 90° to 100° F. 



* Laboratory Reports, Royal College of Physicians, Kdin.. Vol. I, pp. 181-2. 

 t Laboratory Reports, Royal College of I'hysicians, Kdin., Vol. I, p. 193. 



