in ANNUAL REPORT OF THE Off. Doc. 



niesenti'i'y wa» thickened and contained many nodules of small size. 

 The appearance was that of a typical case of giape or pearl disease, 

 1'he mesenteric and mediastinal glands were enlarged and somewhat 

 caseous. 



For several years past we have eudeavoied to obtain material from 

 cases of tuberculosis in children in which there was evidence of in- 

 fection through the alimentary tract, reasoning that if children con- 

 tracted tuberculosis through the ingestion of milk from diseased cat- 

 tle we would be most apt to find bacilli of the bovine type in tlhese 

 intestinal or mesenteric lesions. So far only three such casetj have 

 come to us, all through the kindly interest of Dr. Alfred Hand, and 

 in only one of these was the evidence of primary intestinal infection 

 clear. We have isolated from the mesenteric gland of this child, the 

 immediate cause of who&e death was tubercular meningitis, a culture 

 which has for cattle tihe most intense pathogenic power. Two calves 

 inoculated into the jugular vein and peritoneal cavity died in nine- 

 teen and twenty-seven days respectively; and a grown cow was in- 

 oculated both in the jugular vein and peritoneal cavity died in eigh- 

 teen days. All of these animals exhibited marked symptoms from 

 the day of inoculation. Examination of the lesioni?, both macro- 

 people and microscopic, leaves no doubt that the animals succumbed 

 to a pure tuberculosis. The details of these cases are as follows: 



History of Culture. — Designated BB. Obtained from a child sev- 

 enteen months old. Death was due to tubercular meningitis. Au- 

 topsy: Lungs normal, except posterior part of the right upper lobe, 

 which was consolidated, red on section, and had excess of connec- 

 tive tissue. Bronchial and mediastinal glands not enlarged. 

 Spleen, liver and kidneys show pearly tubecles. Two feet from lower 

 end of ileum is an ulcer 1 cm. by 2 cm., the long diameter transverse 

 io axis or gut. Nodules are seen on peritoneal surface. Four small 

 ulcers, two above and two below, are found in ileum, Mesenteric 

 glands enlarged, cheesy, and some purulent. Meninges show yel- 

 low tubercles most marked along longitudinal fissure, in choride 

 plexus and over cerebellum. TQie mesenteric glands were used in 

 obtaining the culture. 



This case is considered by Dr. Hand the clearest one of primary 

 intevstinal tuberculosis ever seen by him. 



Guinea-pigs were inoculated intraperitoneally with an emulsion 

 made from the mesenteric glands on March 9, 1901. One was chloro- 

 formed on April 19th, and cultures made. Scant^^ growtlli on one 

 tube was found on June 8th, and subcultures made. 



Calf No. 26596, weight i;i2 pounds. Tested with tuberculin, but 



gave no reaction. On December 4, 1901, 5 c.c. of a suspension of the 



.fifth and sixth generation of culture BB were injected into the right 



