TUBERCULOSIS. 755 



strainino- of the brain and of" the liody, especially dnrino" 

 childhood, greatly condnce, by iinderniinini>; the general state 

 of health, to impair the resisting- power of the whole system, 

 and particularly of the lungs. Besides the deterioration of 

 the Avhole system, nearly all affections of the respiratory 

 organs offer a very favourable condition for the invasion of 

 the bacillus. Bronchitis, catarrhal inffanimation of the lungs, 

 pleurisy, and other diseases, more particularly in children 

 when recovering from measles and wlioojiing-cough, are the 

 preliminary complaints which but too often change into real 

 consumption. But it must be always borne in mind that 

 all those injuries inflicted upon the body are notable to ])ro- 

 duce consum]>tion of the lungs by themselves ; they only 

 create a predisposition, an increased liability. A direct infec- 

 tion by the bacillus-tubercle must always take place before 

 the fatal disease can set in. 



2. The seconil way of tubercular infection is l)y direct 

 inoculation. It is quite appai'ent that this mode of occur- 

 rence is more frecpieait in intentional experiments than in 

 everyday life. I mention it here more for the sake of com- 

 pleteness than on account of its imj)ortance for public health. 

 However, a few instances quoted might be of general 

 interest, affording at the same time striking evidence of the 

 danger of this minute form of vegetable life. Thei'uig 

 reports a very interesting case of a servant who, quite 

 healthy, cut her finger at a broken spittoon of her consump- 

 tive master. Some time afterwards she developed tuber- 

 culosis in the sheats of the sinew, and the axillary glands 

 had to be extirpated on account of tubercular swelling. Dr. 

 Gutzmann, at Berlin, contracted early last year, on a post 

 mortem examination of a consumptive, a small w^ound on the 

 finger, which did not heal for some weeks. On subsequent 

 examination by Professor Ehrlich it was found that tubercular 

 bacilH were present in the jnis underneath the fingernail. 

 Professor Koenig, of Goettingen, mentions a case where the 

 use of a Praraz syringe for the injection of morphia pro- 

 duced localised tuberculosis in a patient because it had been 

 used in a tubercular patient pi-eviously, and not ])ropei"ly 

 cleansed. Lehman has observed 10 cases of inoculation 

 tuberculosis in Jewish boys, caused " by sucking the wound 

 after ritual circumcision by a phthisical person. Ten days 

 after circumcision the w^ound became the seat of ulceration ; 

 four of the children died of tubercular meningitis, and three 



