DESCRIPTION OF THE BACILLUS TUBERCULOSIS. 157 



tion soon showed that these were instances of pseudo-tuberculosis ; 

 that while the gross appearances of the lesions resembled true 

 tuberculosis, inoculations with this material never reproduced the 

 disease, while inoculations with tubercular material could be done 

 through a series of animals without impairing the potency of the 

 virus, or varying the constancy of the results. Koch's discovery 

 did not lead to such energetic search for the bacillus of tuberculosis 

 among surgeons as physicians, because, as Konig asserts, the symp- 

 toms and signs of the tubercular affections coming under the obser- 

 vation of surgeons are so characteristic, that for practical purposes 

 a correct diagnosis could be made in the majority of cases without a 

 knowledge of their microbic nature and the improved methods for 

 making a positive diagnosis derived therefrom. Koch, himself, in 

 the publication above referred to, demonstrated the presence of the 

 bacillus in lupus, scrofulous glands, tubercular joints, etc. He 

 called attention to the fact that in these affections the bacillus can 

 be constantly found in giant cells and between the epithelioid cells, 

 while it is more difficult to find it in cheesy products, unless casea- 

 tion has taken place quite rapidly. 



Weichselbaum ("Tuberkelbacillen im Blut.," etc., Wiener meet. 

 Wochenschrifi, 1884, Nos. 12, 13), Meisels, and Lustig found 

 tubercle bacilli in the blood in cases of acute miliary tuberculosis, 

 both during life and after death. Schuchardt and Krause (" Ueber 

 das Yorkommen der Tuberkelbacillen bei fuugosen uud scrofu- 

 losen Entziindungen," Fortschritte der Medicin, B. i. S. 277) 

 examined forty cases of tuberculosis of bones, joints, tendon- 

 sheaths, and the skin in Volkmanu's klinik, and never failed in 

 finding bacilli, although in some specimens careful and prolonged 

 search had to be made. They found the bacilli in various lesions 

 which had formerly been regarded as scrofulous affections. 



Schlegtendal (" Ueber das Vorkommen der Tuberkelbacillen im 

 Eiter," Fortschritte d. Medicin, B. i. S. 537) examined 520 speci- 

 mens of pus from tuberculous suppurations and found bacilli pre- 

 sent in about 75 per cent, of the cases. Mogliug (Die Chirur- 

 gischen Tuberkulosen, Tubingen, 1884) found the bacilli never absent 

 in tubercular pus from 53 patients. 



During the last few years, surgeons have made valuable contri- 

 butions to surgical literature on the subject of tuberculosis corrobo- 

 rative of the statements of Koch, which have placed many hereto- 

 fore obscure lesions within the range of rational and successful 

 surgical treatment. 



DESCRIPTION OF THE BACILLUS TUBERCULOSIS. The bacillus 

 described by Koch as the essential cause of all forms of tubercular 

 inflammation appears in the shape of very thin rods from two to 

 eight micromillimetres in length, and rounded at the ends. They 



