

HUMAN TUBERCULOSIS 



293 



tion of bovine and human tubercle bacilli found respectively in alimentary 

 and in pulmonary lesions in man. Thus of nine cases of cervical gland 

 tuberculosis in children three were found to be caused by the bovine tubercle 

 bacillus and six by the human tubercle bacillus ; and of twenty-seven cases 

 of primary abdominal tuberculosis in children, fourteen were caused by the 

 bovine tubercle bacillus and thirteen by the human tubercle bacillus (Cobbett 

 and A. S. Griffith). " In these cases," the Commission remarks, " the tubercle 

 bacillus had unquestionably been swallowed." The examination of tissues 

 from fourteen fatal cases of primary pulmonary tuberculosis (A. S. Griffith 

 and Cobbett) showed that in all of the cases the human tubercle bacillus 

 alone was responsible for the disease. A. S. Griffith subsequently examined 

 the sputum from twenty-eight cases of pulmonary tuberculosis : in twenty- 

 six the human tubercle bacillus was the 

 infective agent and in the remaining two 

 the bovine tubercle bacillus (confirmed by 

 repeated examination of the sputum). 



[Baumgarten holds that tuberculous 

 phthisis is due to infection during intra- 

 uterine life, but this view receives very 

 little support at the present day.] 



Attempts have been made to draw a dis- 

 tinction between the disease as it affects the 

 internal organs, pleurae and peritoneum on the 

 one hand and that form of it which affects 

 the skin, glands, joints, etc. According to 

 Arloing, the latter, the so-called surgical tuber- 

 culoses, are due to an attenuated bacillus which 

 must be regarded as a separate variety. But 

 seeing that in these localized lesions the bacillus 

 is fully virulent, it is more likely that the slight 

 tendency to dissemination which it exhibits is 

 to be explained on other grounds, such as the 

 personal resistance of the infected individual, 

 the influence of the particular tissues in which 

 it is growing, and the small number of the 

 invading organisms which grow but feebly in 

 a soil relatively unfavourable to their multipli- 

 cation (Krompecher and Zimmermann). 



[ Arloing' s theory, in so far as it relates to 

 tubercle bacilli which infect the skin, is in part 

 supported, and greatly amplified, by A. S. 

 Griffith (working for the English Commission). 

 Twenty cases of lupus were examined. The 

 tubercle bacilli isolated from nine of them showed 

 the cultural characteristics of the bovine 

 tubercle bacillus, but only one had the patho- 

 genicity ordinarily associated with that type, 

 while the rest showed varying degrees of lesser 



virulence: the least virulent being no more dysgonic or bovine type : (ft) the eugonicor 

 virulent for calves and rabbits than a human human type. (This and the succeeding 

 tubercle bacillus but differing from the latter $"7$$ ^mSion 6 o^TubSosis 

 in that they were also of relatively slight (Human and Bovine) Part II. Appendix, 

 virulence for guinea-pigs and monkeys. Ssio^oUheCon'tro&fH'KTa&n^ 



L-brom the remaining eleven cases tubercle office.) 

 bacilli were isolated which had the cultural 



characteristics of the human tubercle bacillus ; two had the full virulence of the 

 human tubercle bacillus, the others being of lower virulence. 



[It was found possible in two of the cases in which a degraded bovine bacillus 

 was the infective agent to " increase the virulence of the culture from the original 



10th Generation 

 3 months o!d. 



(b) 



5th Generation 

 56 days old. 



