164 TUBEKCULOSIS. 



inoculation with collodium. All of his experiments failed in pro- 

 ducing tuberculosis, while in the control animals in which the infec- 

 tious material was introduced into the subcutaneous tissue, or into 

 the peritoneal cavity, tuberculosis developed without a single excep- 

 tion. He believes that the results of these experiments are only 

 corroborative of the assertion previously made by Bollinger and 

 Koch that the susceptibility of the cutis for tubercular infection is 

 slight. A sufficient number of well-authenticated cases, however, 

 have been reported during the last few years to prove that in man 

 tuberculosis is not infrequently contracted by the absorption of 

 tubercular material through small wounds and superficial abrasions 

 of the skin. Volkmann a number of years ago made the statement 

 that tubercular infection never takes place through large operation 

 wounds, or at the site of severe injuries, but that localization of 

 the bacillus is likely to take place in parts the seat of very slight 

 contusions, or what may appear at the time as an insignificant 

 injury. He explained this by assuming that the active tissue- 

 changes which take place during the process of regeneration after 

 a severe trauma prevented the infection. In studying the cases of 

 inoculation-tuberculosis, which will be referred to below, it will be 

 seen that the infection-atrium was always caused by a trivial injury. 

 Martin du Magny (Contribution a ftude de V inoculation tuber- 

 culeuse chez Vhomme, These, Paris, 1886) has collected the clinical 

 material of cases of inoculation -tuberculosis and in his comments 

 upon them asserts that the sputum of phthisical patients and animal 

 excretions were the usual carriers of contagion, consequently, the 

 affection is most frequently met with among physicians, nurses, 

 butchers, and teamsters. The external appearances manifested at 

 the point of inoculation consist of the formation of a red nodule 

 in the skin which increases slowly in size and forms a miliary 

 abscess in which papillomatous proliferation takes place, and around 

 which a new zone of infiltration forms, which in turn again sup- 

 purates and becomes papillomatous. The centre heals with the 

 formation of a flat cicatrix, while the destructive process progresses 

 slowly in a peripheral direction. Raymond ( u Contribution a 

 1'etude de la tuberculose cutane par inoculation directe," France 

 Med., 1886, p. 99) reports two cases. In the first case the patient, 

 suffering from advanced tuberculosis, inoculated himself through 

 an abrasion of the skin of the hand by sucking a wound to arrest 

 hemorrhage. The little wound refused to heal, and became covered 

 with a crust under which suppuration was going on. Later, a 

 papillomatous elevation formed, which continued to ulcerate on the 

 surface. The margins of the ulcer were surrounded by an infil- 

 trated zone, the skin covering it presenting a brownish color. The 

 second case, a healthy man, injured himself by the prick of a thorn. 



