1908] on The Present Phase of the Tuberculosis ProUem. 293 



up to the present moment agree that, although there are certain 

 differences between the bacilhis of bovine and that of human tuber- 

 culosis, the former can and does set up tuberculosis in the human 

 being. 



Our own Commission found that of the cases of tuberculosis which 

 they examined, and which were in their opinion undoubtedly of intes- 

 tinal origin, a large percentage had been infected from the bovine 

 source, and they say later : " A very considerable amount of disease and 

 loss of life, especially among the young, must be attributed to the 

 consumption of cow's-milk containing tubercle bacilli," adding that 

 •' The fact that the bacilli of bovine tuberculosis can readily by 

 feeding, as well as by subcutaneous injection, give rise to generahsed 

 tuberculosis in the antliropoid ape so nearly related to man .... 

 has an importance so obvious that it need not be dwelt upon." 



The question to which this country is now awaiting an answer by 

 help of the Royal Commission on Tuberculosis, which is still sitting, 

 is — what amount of our total tuberculosis is due to the milk of cows ? 

 It seems clear that amongst infants the amount may be very con- 

 siderable, since the bacilli of actual bovine origin are found dissemi- 

 nated in the lesions. With regard to tuberculosis developing in after 

 life the answer must seemingly depend largely upon whether the 

 bacillus of bovine origin can by long residence in the human economy 

 become indistinguishable from the bovine bacillus. As to this the 

 necessary data are still wanting. 



It is, however, clear that, as Lord Lister predicted, bovine bacilli 

 can traverse the walls of the intestines without then- showing evi- 

 dences of their passage ; and the question is as to how far von 

 Behring's view of prolonged latency will receive support from the 

 further researches of the Commission. 



The need for far more rigorous control of the tuberculous cows 

 is obvious when we are told that the percentage of the milk reaching 

 certain of our large towns from beyond the borough limits is as 

 follows: Liverpool, 14 '5, Birmingham, 14*0, Sheffield, 13" 0, and 

 Manchester 7 ' 8. 



It has, too, to be remembered that, contrary to what was formerly 

 believed, apparently healthy cattle may yield tuberculous excretions 

 and secretions, a fact which renders the danger from the consumption 

 of unboiled cows' milk greater than was hitherto thought to be the 

 case. 



Ceetain Considerations as Regaeds the Sanatorium 

 Treatment of Phthisis. 



As to this, time will only allow a few words to be said, but I am 

 desirous to draw attention to the need for keeping the statistics 

 relative to the " after-results " of sanatorium treatment in a fashion 

 which will bring out the results in a clearer manner than is at 

 present the case. It is well that we should boldly face the results in 



