9 2 



thirty years it has been known that the disease called 

 anthrax or charbon is characterized by the presence of a 

 large bacillus ; yet in some cases the site of inoculation 

 was indicated not by a malignant pustule or carbuncle, 

 but by a local necrosis with subcutaneous formation of 

 gas. These cases were designated charbon symptoma- 

 tique. Five years ago Bollinger discovered that the ba- 

 cillus found in the so-called charbon symptomatique is 

 another variety than the bacillus anthracis which charac- 

 terizes the malignant pustule distinguished by both 

 morphological and physiological features. And now the 

 two diseases are recognized as etiologically distinct, 

 though anatomically and clinically almost identical. 

 To-day we can say with Schottelius, that one infectious 

 disease, one infectious tuberculosis, is characterized by 

 the presence of Koch's bacillus, though there may be 

 others, clinically and anatomically entitled to the same 

 name, which future research may distinguish etiologi- 

 cally from this tuberculosis, just as charbon sympto- 

 matique has been distinguished from charbon. Indeed, 

 some observers have already expressed the suspicion, 

 based on their own investigations, that there is more 

 than one bacillus tuberculosis. 



The association of Koch's bacillus with tuberculous 

 tissues, and its absence from other structures, is there- 

 fore demonstrated and acknowledged ; and this fact, 

 taken in connection with Koch's own demonstrations, 

 constitutes an array of evidence which has induced nu- 

 merous German, Austrian, and English pathologists to 

 accept as a fact the vital activity of the bacillus as the 

 starting-point of the disease. Among these is Billroth, 

 whose acquiescence is notable not merely because of his 

 eminence as pathologist and surgeon, but because his own 

 elaborate researches upon bacteria, published in 1874 an d 

 still widely quoted, led him to the conclusion that these 

 organisms appeared in human tissues as the result, and 

 not as the cause of morbid processes. Billroth, like the 

 German pathologists generally, is open to conviction. 



Yet while we may have, probably have, found in this 



