211 KEVIEW— TKOmCAL MEDICINE, ETC. 



Tuberculosis Niold Cook' called attention to the large amount of tuberculosis in Calcutta ; and as 



—coiUiiiual bovine tuberculosis in India is rare, the channels of infection from milk and meat can 

 practically be excluded. Schroeder, in an interesting paper, states that 40 per cent, of 

 dairy cows that retain the appearance of health and are not known to bo affected till they 

 are tested with tuberculin, actively expel tubercle bacilli from their bodies in a way 

 dangerous to the health of other animals and persons, and that tuberculous cows do not 

 expel tubercle bacilli till some time after they contract the affection. The practical 

 importance of this is that herds of tuberculous cattle can be cleaned by the periodic 

 application of the tuberculin test. 



Schroeder- draws attention to the fact that a considerable proportion of the dairy 

 products are infected with tubercle bacilli owing to the frequency with which cow fteces are 

 found in milk, for it has been proved that the commonest way for tubercle bacilli to pass from 

 the bodies of tuberculous cows is with their faeces, and once milk is contaminated with tubercle 

 bacilli, the latter enter the various articles of diet prepared from it, and are specially 

 numerous in butter, in which they may remain alive seven weeks or longer without 

 diminishing in virulence. He points out the usefulness of the tuberculin test, and the 

 desirability of separating all reacting animals. Some interesting experiments were conducted 

 by Oberwarth and Rabinowitsch-'* to disprove the assertion that the appearance of tubercle 

 bacilli in the lungs and bronchial lymphatic glands after introduction into the alimentary 

 canal was due to aspiration. 



Experiments were carried out in young guinea pigs, tubercle bacilli being introduced 

 by laparotomy into the stomach. Some hours later tubercle bacilli were found in the lungs ; 

 but the objection was raised that regurgitation and subsequent aspiration might have 

 taken place, so further experiments were carried out, gastrostomy being performed, 

 and four weeks after, the oesophagus was cut at the neck and connected with the skin so that 

 there were now two fistulous openings separated from each other by a bridge of skin. 



The animals then received a feed of dried tubercle bacilli, the CESophageal fistula being 

 closed by cotton wool and collodion to prevent regurgitation. In every animal tubercle 

 bacilli were found in the blood, lungs and other organs, and in one animal 22 hours after 

 the experiment. The result of these researches proves that virulent tubercle bacilli may 

 bo absorbed by the mucous membrane of the alimentary canal into the blood and may be 

 deposited and possibly become latent in the lungs and other organs. Whitla,'' in a 

 paper entitled " The Etiology of Pulmonary Tuberculosis," discusses all the recent work 

 on human and bovine tuberculosis, and has confirmed the results obtained by Calmette. 

 Amongst other points, in an interesting paper, he notes that it has been definitely proved 

 that the tubercle bacillus can pass through the intestinal mucosa like the fine particles of 

 China ink without causing any lesion or leaving any local evidence of its point of entrance. 

 McCaw, in an interesting paper, suggests that the following rules should be formulated in 

 order to protect the State from the ravages of tuberculosis. 



(1) Compulsory notification of births within 24 hours. 



(2) Complete control of the milk supply by the State, ensuring the removal of 



dairies from the centres of large towns and cities ; cleanliness in the collection 

 of milk and in the transmission of it from the dairy to the consumer ; the 

 application of the tuberculin test to dairy cattle and the removal of such as 

 react to this test. 



(3) Medical inspection of school cliildren and school premises to ensure sufficient 



hygienic measures and sanitary arrangements. 



(4) Housing reform ; thus raising the social and domestic conditions of the poor. 



(5) Segregation of advanced cases. 



(6) Compulsory notification of the disease. 



' Nield Cook, J. (November, 1907), " Tuberculosis iu Calcutta." Juarnnl of Public Health. 



- Schroeder, E. C. (March 31st, 1908), '■The Unsuspected but Dangerously Tuberculous Cow." Juuriwl nf 

 Comparative Pathology and Therapeuties. 



" Oberwarth, E., and Rabinowitsch, L. (1908), "Infection with Tubercle Bacilli which have been absorbed 

 from the .-Vlimcntary Canal." Fierlin Kliii. Ifoch., No. G, p. 298. 



•• Whitia, \V. (.liily 18th, 1908), "The Etiology of Pulmonary Tuberculosis." Linieri. Vol. II. 



* Article not consulted in the original. 



