108 TUBERCULOSIS. 



phthisical patients." And he adds — " In children this mode of 

 infection is comparatively common, and tubercular ulceration of 

 the intestines, or tubercle of the glands connected with the 

 intestinal tract is of frequent occurrence." In connection with 

 the mortality amongst infants Dr. Woodhead quotes his own 

 experience as follows : — " In 127 cases of tuberculosis in children 

 that I examined this tubercular ulceration was found in 43 ; 

 whilst in 100 cases, or nearly 79 per cent, of the whole, the 

 glands were in some stage or other of degeneration. It would 

 thus appear that tuberculosis connected with the intestine is of 

 frequent occurrence in children, and we should therefore argue 

 that the infection, in these cases at any rate, frequently takes 

 place by the alimentary canal. The age at which these tuber- 

 cular glands were found is very significant ; during the first year 

 of life there were 4 cases ; from 1 to 2}j years, 33 ; from 3 to 5^ 

 years, 29 ; from 6 to 7^ years, 12 : from 8 to 10 years, 13 ; and 

 from 11 to 15 years, 9 cases. In 14 cases these glands only 

 were afiected." The result of a much more extensive investi- 

 gation, during which the bodies of 2,576 children were submitted 

 to a post mortem, examination, is given in detail, and of these 424 

 cases, or 16-4 per cent, were tubercular. The tables show that 

 children still-born and up to four weeks old were free from 

 tubercle ; from 5 to 10 weeks, those affected were 0-9 per cent. ; 

 from 3 to 5 months, 8-6 per cent.; 6 to 12 months, 18-3 per cent.; 

 1 to 2 years, 26*8 per cent. ; 2 to 3 years, 33 per cent. ; 3 to 4 

 years, 29-6 jDer cent. ; 4 to 5 years, 31-8 per cent. ; 5 to 10 years, 

 34-3 per cent. ; 10 to 15 years, 30-1 per cent. These figures 

 agree so far as the large percentage at from 2 to 3 years or 

 thereabouts is concerned. Dr. Woodhead's greatest number 

 being from 1 to 2^ years, while Bolitz's tables show 33 per cent, 

 from 2 to 3 years. Woodhead's percentage decidedly decreases 

 after this age, whereas with Bolitz the percentage never goes so 

 low as during the second year of life. I have been particular 

 in quoting these figures because they form the basis of the 

 arguments as -to the great danger of feeding children with 

 unboiled cows'^ milk. Let me quote Woodhead once more : — 

 more : — " As regards the possibility of bacillus tuberculosis being 

 in the intestinal canal, it should be remembered that the 

 class of patients amongst whom abdominal tuberculosis is most 



