460 ANNUAL REPORT OF THE Off. Doc. 



Considering all these facts, I feel justified in maintainiog that 

 human tuberculosis differs from bovine, and cannot be transmitted 

 to cattle. It seems to me very desirable, however, that these experi- 

 ments should bo repeated elsewhere, m order that all doubt as to 

 the correctness of my assertion may be removed. 



I wish only to add that, owing to the great importance of this mat- 

 ter, the German (Government has appointed a commission to make 

 further inquiries on the subject. 



But, now, how is it with the susceptibility of man to bovine tuber- 

 culosis? This question is far more important to us than that of the 

 susceptibility of cattle to a human tuberculosis, highly important as 

 that is too. It is impossible to give this question a direct answer, 

 because, of course, the experimental investigation of it with human 

 beings is out of the question. Indirectly, however, we can try to 

 approach it. It is well known that the milk and butter consumed 

 in great cities very often contain large quantities of the bacilli of 

 bovine tuberculosis in a living condition, as the numerous infection- 

 experiments with such dairy products on animals have proved. 

 Most of the inhabitants of such cities daily consume such living and 

 perfectly virulent bacilli of bovine tuberculosis, and unintentionally 

 carry out the experiment which we are not at liberty to make. If 

 the bacilli of bovine tuberculosis were able to infect human beings, 

 many cases of tuberculosis caused by the consumption of alimenta 

 containing tubercle-bacilli could not but occur among the inhabi- 

 tants of great cities, especially the children. And most medical 

 men believe that this is actually the case. 



In reality, however, it is not so. That a case of tuberculosis has 

 been caused by alimenra can be assumed with certainty only when 

 the intestine suffers first — i.e., when a so-called primary tuberculosis 

 of the intestine is found. But such cases are extremely rare. Among 

 many cases of tuberculosis examined after death, I myself remem- 

 ber having seen primary tuberculosis of the intestine only twice. 

 Among the great ^ost-mortem material of the Charity Hospital in 

 Berlin ten cases of primary tuberculosis of the intestine occurred in 

 five years. Among 9:^:3 cases of tuberculosis in children at the Em- 

 peror and Empress Frederick's Hospital for Children, Baginsky 

 never found tuberculosis of the intestine without simultaneous dis- 

 ease of the lungs and the bronchial glands. Among 3,104 post-mort 

 ems of tubercular children, Biedert observed only sixteen cases of 

 priuiary tuberculosis of the intestine. I could cite from the litera- 

 ture of the subject many more statistics of the same kind, all in- 

 dubitably showing that primary tuberculosis of the intestine, es- 

 pecially among children, is a comparatively rare disease, and of these 

 few cases that have been enumerated, it is by no means certain that 

 they were due to infection by bovine tuberculosis. It is just as 



