No. 6. DEPARTMENT OF AGRICULTURE. 461 



likely that thej were caused by the widely propagated bacilli of 

 human tuberculosis, vvliich may have got into the digestive canal in 

 some wu}' or otiier — for iustance, by swallowing saliva of the mouth. 

 Hitherto nobody could decide with certainty in such a case whether 

 the tuberculosis of the intestine was of human or of animal origin. 

 Now we can diagnose them. All that is necessary is to cultivate in 

 pure culture the tubercle-bacilli found in the tubercular material, 

 and to ascertain whether they belong to bovine tuberculosis by in- 

 oculating cattle with them. For this purpose I recommend sub- 

 cutaneous injection, which yields quite specially characteristic and 

 convincing I'esults. For half a year past T have occupied myself 

 with such investigations, but, owing to the rareness of the disease 

 m question, (he number of the cases I have been able to investigate 

 is but small. Uhat has hitherto resulted from this investigation 

 does not speak for the assumption that bovine tuberculosis occurs 

 in man. 



Though the important question whether man is susceptible to 

 bovine tuberculosis at all is not vet absolutelv decided, and will not 

 admit of absolute decision to-day or to-morrow, one is nevertheless 

 already at liberty to say that, if such a susceptibility really exists, 

 the infection of human beings is but a very rare occurrence. I 

 should estimate the extent of infection by the milk and flesh of tuber- 

 cular cattle, and the butter made of their milk, as hardly greater 

 than that of hereditary transmission, and I therefore do not deem 

 it advisable to take au}- measures against it. 



So the ouh" main source of the infection of tuberculosis is the 

 sputum of consumptive i3atie'ots, and the measures for the combat- 

 ing of tuberculosis must aim at the prevention of the dangers aris- 

 ing from its diffusion. Well, what is to done in this direction? Sev- 

 eral ways are open. Oncf's first thought might be to consign all per- 

 sons suffering from tuberculosis of the lungs, whose sputum con- 

 tains tubercle-bacilli to suitable establishments. This, however, is 

 not only absolutely impracticable, but also unnecessary. For a 

 consumptive who coughs out tubercle-bacilli is not necessarily a 

 source of infection on that account, so long as he takes care that 

 his sputum is properly removed and rendered inocuous. This is 

 certainly true of very many patients, especially in the first stages, 

 and also of those who belong lo the well-to do classes, and are able 

 to procure necessary nursing. But how is it with people of very 

 small means? Every medical man who has often entered the dwel- 

 lings of the poor, and I can speak on this point from my own ex- 

 perience, knows how sad is the lot of consumptives and their families 

 there. The whole family have to live in one or two small, ill-ven- 

 iilated rooms. The pati(>nt is left without the nursing he needs, 

 because the able-bodied members of the family must go to their 

 29 



