SEVENTH ANNUAL REPORT. 103 
facts in relation to it. In the majority of cases the disease has 
been contracted before the animals reach the Park. Several an- 
imals have died from advanced tuberculosis almost immediately 
after their arrival. I am fully convinced that the average case 
of monkey tuberculosis is contracted under the unfavorable con- 
ditions usual in the quarters of the dealers, or under the still 
more unhygienic surroundings prevailing in transit. The pri- 
mary infection takes place generally in the cervical and bronchial 
lymph nodes, and extension of the disease usually follows as 
metastases from these foci. This also is, no doubt, the most 
frequent story in the pulmonary tuberculosis of children, which, 
I think, simulates closely in nearly every particular the history 
of the disease as we find it among the monkeys. Pulmonary 
tuberculosis is by far the most frequent form of the disease as 
in man, but other types of the disease are also observed, for in- 
stance, two cases of typical primary intestinal tuberculosis have 
been discovered, both of which probably received their infection 
in our cages. Pure cases of lymphatic tuberculosis are even more 
frequent. In these instances the lymph nodes and the spleen are 
the most frequent sites of the disease, the liver becoming involved 
later. Generally cases of lymphatic tuberculosis terminate with 
pulmonary involvement, though sometimes otherwise, as by 
tubercular meningitis. 
The general character of the lesions produced in simian tuber- 
culosis correspond very closely to those of the human, and the 
bacilli found also simulate morphologically those of the human 
infection. No comparative biological tests have, however, yet 
been made by us. Chronic tubercular lesions are much more in- 
frequent in the monkey, and the pronounced fibroid changes of 
pulmonary phthisis as seen in the man have never been observed 
by me in the monkey. Neither does one frequently find healed 
tubercular lesions in the tissues, particularly in the lungs of these 
animals, as in man. In man, dying of other than tubercular 
disease, healed tubercles are present in from 50 per cent. to 80 
per cent. of cases. I infer from these facts that the disease is 
of a much more virulent form in the monkey, and that the rule 
is death in infected animals, while in man the average case re- 
covers. This observation may be likened to the characteristics 
of the disease when it affects a primitive people, particularly one 
in which tubercular infections are infrequent in their natural 
habitat; we may thus compare the primate tuberculosis to that 
of the Indians, of the Esquimaux, or even to that of the negro, 
in his native land. From this line of reasoning it appears that 
