No. 6. DEPARTMENT OP AGRlCtJLTTrRE. 133 



tuberculous inliltriition of the greatly enlarged glands of the neck 

 and of the mesenteric glands, and also extensive tuberculosis of the 

 lungs and spleen." 



Clinical Ohse7'vation . — The number of cases in which infection 

 can be traced to tiu' consumption of tuberculous milk is not large, 

 and almost all of them are open to some criticism from the fact that 

 all other sources of infection cannot be positively excluded. Fiom 

 the nature of the case this will always be true, and we can never 

 shut children up and feed them with tuberculous milk in the way 

 of an experiment. However, evidence in some of the cases is so 

 clear that Nocard has well said: "Jt has almost the value of an ex- 

 periment," and it is (luite sure that we would unquestionably ac- 

 cept evidence of much less value if any other disease than tuber- 

 culosis were concerned. 



The cases reported by Stang, Demme, Gosse, Ollivier and Law, 

 involving nineteen persons, are too well known to need repetition 

 here. 



Ebers rei)orts six cases, collected by several observers, of tuber- 

 culosis in children, attributed to the milk of tuberculous cows. 



Bang, through iniiuiries in Denmark, has collected reports of nine 

 persons in wliom infection could be traced with reasonable certainty 

 to milk from tuberculous cows. 



Von Ruck re])orts the case of a father and child which are verv 

 oonviocing, and says that he has observed several others in which 

 there was very good reason to believe that milk was the agent of 

 transmission for the tubercle bacillus. 



Klebs and Rievel have recently reported two cases which came 

 under the observation of the former. A healthy young man em- 

 ployed by Klebs to assist in making some investigations o« milk in- 

 fection had the habit of drinking the milk of the tuberculous cows 

 used in the experiment. In a few months he died of miliary tuber- 

 culosis. The second case was one of six male children, who died at 

 the age of two years of tuberculosis of the cord and meninges. This 

 child was the only one of the six fed on cow's milk atid the only one 

 that developed tuberculosis. 



Postmortem Evidence. — The reports of pathologists based on au- 

 topsies prove conclusively that in a certain proportion of persons 

 dying of tuberculosis, and especially in children, the infection takes 

 place through the intestine. As to the frequency of infectiou by this 

 route there is a wide divergence of opinion, due partly, no doubt, to 

 the fact that this method of infection is much more common in some 

 localities than others, owing to local conditions, and partly to the 

 interpretation given to the postmortem findings. Our method of de- 

 termining the portal of entry is not entirely satisfactory, as is shown 

 by the large number of cases reported by many pathologists in which 

 it is impossible to locate the primary lesion. 



