LIVE TUBERCLE BACILLI IN MILK 483 



a cervical adenitis. 1 From the fact that almost all of the children 

 who had been regularly drinking infected milk were found in good 

 health, the author concluded that milk containing bovine tubercle 

 bacilli does not necessarily or even usually excite tuberculosis in children. 

 On account of the extent and importance of the discussion of the 

 transmissibility of bovine tuberculosis to man, the German Imperial 

 Health Office instituted a collective investigation of a number of 

 cases in which milk from cows suffering with tuberculosis of the 

 udder was regularly and for a long period of time consumed raw. 

 Kossel has recently published a summary of the results of the inves- 

 tigation. It was found that 360 persons had consumed such milk; 

 of these 200 were adults, 151 children, age not given for 9. Two 

 children aged one year and ten months, and one year and three 

 months, respectively, showed undoubted evidences of infection with 

 bovine tuberculosis. 



In both the cervical glands were affected, and in the younger child 

 tubercle bacilli of the bovine type could be demonstrated. In examin- 

 ations, however, respectively one and one-half and two and one-half 

 years subsequent to the first examination both children showed a 

 healthy development and a good appearance, notwithstanding the 

 fact that they had been fed on raw milk from cows with advanced 

 udder tuberculosis. Four adults and 8 other children which had 

 habitually consumed the same raw milk remained well. In 12 cases 

 of the 360, tuberculous infection was suspected, but examination made 

 months and years after the first did not reveal any evidence of gland- 

 ular tuberculosis; in fact, the gland swellings had disappeared and 

 some of the physicians who had made the earlier examinations doubted 

 the correctness of their former diagnosis. In reviewing the results of 

 this investigation, Weber concludes that the danger to man from raw 

 milk from tubercular cows is very small in comparison with the danger 

 from persons with open pulmonary tuberculosis, and he agrees with 

 Fliigge and Osterman's claim that great numbers of tubercle bacilli 

 must be present before much danger of infection exists. 



Methods for the Determination of the Presence of Live Tubercle Bacilli 

 in Milk. As milk and milk products, such as cream and butter, fre- 

 quently contain acid-fast saprophytes which cannot morphologically 

 be distinguished from the tubercle bacillus, the usual staining method 

 used for exhibiting this organism can only be considered a preliminary 

 procedure, and the finding of acid-fast bacilli must be followed by a 

 proper inoculation of the suspected material. The steps in the 

 complete examination are the following : 



I. Centrifuge the milk in an electric centrifuge for five to ten 

 minutes. A layer of cream is then formed on top and a sediment at 

 the bottom of the tube. 



1 It was ascertained in a subsequent examination that the tubercle bacilli responsible for 

 the cervical adenitis in this child were of the typus humanus. (Personal communication from 

 Doctor W. H. Park, Director of the New York Health Research Laboratory.) 



