TUBERCLE BACILLUS 439 



(284 children, 335 adults, 9 age unstated), all of whom had drunk 

 the milk of cows having tuberculosis of the udder, or had consumed 

 uncooked products made from the milk. Only two patients, both 

 very young children, were definitely shown to be infected with bovine 

 tubercle bacilli. Both had enlarged caseous cervical glands from which 

 the organism was isolated and identified. Six children and one adult 

 had glandular swelling in the neck, but the evidence was not conclusive 

 that bovine infection had taken place. The general conclusion was 

 that there was relatively little danger from drinking milk containing 

 viable bovine tubercle bacilli. 



Much more convincing are the studies of Park and Krumwiede. 1 

 The accompanying table (see preceding page), which is their sum- 

 mary of their own extensive investigation and a recapitulation of 

 authentic observations of others, shows very definitely that infection 

 with bovine bacilli is relatively common in children and young adults 

 up to sixteen years of age, but relatively uncommon in adults. 



Bovine bacilli are found not only in unpasteurized market milk, 2 

 but also in the glandular organs of a considerable proportion of cattle 

 and swine. The muscles are usually not invaded. No meat from 

 tuberculous animals can be offered for sale in the public markets, 

 however. 



Lipschutz 3 has reported a case of cutaneous infection by the avian 

 tubercle bacillus in man which resembled leprosy anatomically. The 

 diagnosis was arrived at only after an exhaustive study of the organism. 

 Infection of man with the avian tubercle bacillus is uncommon. 



The mechanism of infection with the tubercle bacillus has been the 

 subject of much controversy. It is apparent that the acid-fastness 

 of the organism per se does not confer pathogenic properties upon the 

 organism because other non-pathogenic acid-fast bacteria are unable 

 to induce progressive disease from man to man or from animal to 

 animal. Acid-fastness, however, may be an initial factor in patho- 

 genism, an opening wedge as it were, for it appears to be well estab- 

 lished that acid-fast bacteria are relatively insoluble in body fluids 

 and remain unchanged for considerable periods of time when they 

 are introduced into the animal body. Theobald Smith 4 has advanced 

 a tentative hypothesis which explains satisfactorily many of the 



1 Trans. 6th Ann. Meet. Nat'l. Assn. Study and Preven. Tuberculosis* 



2 See Kober, Trans. Am. Phys. for literature to 1903. Hess, Jour. Am. Med. Assn., 

 1909, Hi, No. 13, 1011. Moore, Jour. Med. Research, 1911, xxiv, 517. 



3 Arch. f. Dermat. u. Syph., June, 1914, cxx. 



4 Jour. Am. Med. Assn., April 28, 1906. 



