292 Dr, E. T. BuUtrode [May 15, 



The Relation between Bovine and Human Tuberculosis. 



It may be said that the problem which calls immediately for 

 solution is as to the proportion of this vast prevalence of tuber- 

 culosis revealed by post-mortem records that is due to bovine in- 

 fection. Seven years ago, when much good work was being done, 

 or about to be done, towards the control of bovine tuberculosis, 

 Professor Koch referred the whole question back for reconsideration 

 by declaring with all the weight of his great influence, that 



Though the important question whether man is susceptible to 

 bovine tuberculosis at all is not yet definitely decided, and will not 

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

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

 infection of human beinsfs is but a very rare occurrence. I should 

 estimate the extent of infection by the milk and flesh of tuberculous 

 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 any measures against it. 



The effect of this statement was profound. It was made upon 

 the basis of a somewhat limited series of experiments as regards the 

 infection of cattle by means of bovine and human tuberculosis 

 respectively. Generally speaking, the cattle inoculated with bovine 

 tuberculosis developed the disease, while those inoculated with human 

 tuberculosis remained unaffected. There were, however, indications 

 amongst the cattle or swine inoculated with human tuberculosis which 

 suggested to many persons who heard the address that the inference 

 drawn from the experiments was not altogether justified, even 

 althousrh the alleged rarity of primary intestinal tuberculosis in the 

 adult human subject had obviously influenced the lecturer in arriving 

 at that conclusion. 



Professor Koch's inferences were criticised by men such as Lord 

 Lister, Nocard, Bang, Sims Woodhead, and Ravenel. Lord Lister 

 urged need for caution. It was a serious matter, he pointed out, if 

 the conclusion was wrong, and he raised the question as to the sound- 

 ness of Professor Koch's views with reference to the rarity of primary 

 intestinal tuberculosis. As Lord Lister pointed out, even if actual 

 tubercular lesions of the intestines were as rare as Professor Koch 

 thought, it must surely be admitted that tubercular disease of the 

 mesenteric glands is quite a common malady in children, and he 

 added, in words which subsequent experience has proved to have 

 been almost prophetic, " If this be a fact, the natural interpretation 

 is that the tubercle bacillus passes through the intestinal wall without 

 producing a distinct lesion of the intestine." 



A few days after this pronouncement. Royal Commissions were 

 appointed in this country and in Germany, and the findings of each 



