INOCULATION-TUBERCULOSIS. 165 



The wound became infected with the sputum of his phthisical wife. 

 The puncture became the centre of a papillomatous swelling sur- 

 rounded by a dark red zone. Suppuration took place at several 

 points at the same time. The whole of the diseased portion of the 

 skin was removed and the sections taken from it, on staining, 

 showed the presence of numerous bacilli. In both cases the period 

 of incubation was three weeks. 



Hanot (Archives de Physiologic, July, 1886) has collected six 

 observations which would tend to show that tubercular inoculation 

 in man does take place, one case having fallen under his own 

 observation. In the case observed by Hauot, the patient was in 

 the third stage of phthisis, and died soon after with a tubercular 

 ulcer on the arm of at least two years' standing ; while the history 

 of cough only dated from the last two months, which would show 

 that the cutaneous lesion preceded the pulmonary, and was the 

 cause of the phthisis. In the cases which he collected the sources 

 of inoculation were necropsies on tubercular subjects, nursing 

 phthisical patients, handling old bones, pricking the hand with a 

 fragment of porcelain from the broken spittoon of a phthisical 

 patient, and in four of the cases the tubercular character of the 

 cutaneous lesion was verified by finding the bacilli. 



Axel Hoist mentions the case of an attendant on phthisical 

 patients at a hospital, who had suffered for a long time from atonic 

 ulceration of the fingers, which had been treated unsuccessfully by 

 various external applications; no tubercle bacilli could be found 

 with certainty in the sores. Later, the man was affected with 

 tuberculous glandular swelling in the axilla, which contained a 

 considerable number of bacilli, and Hoist considers that it is highly 

 probable that the patient had been infected through the ulcers. 



Merklen (" Inoculation tuberculeuse localisee aux doigts," Gazette 

 hebd., 1885, No. 27) presented a case of inoculation tuberculosis to 

 the Society des hopitaux in which the infection of the wife of a 

 phthisical husband could be clearly traced, and had occurred 

 through the fissures of the fingers. At the point of inoculation 

 hard nodules formed in which bacilli were found ; this was followed 

 by tubercular lymphangitis, which finally led to pulmonary tuber- 

 culosis. The patient had previously been in perfect health and 

 without any hereditary taint. 



Eiselsberg (" Beitrage zur Impf-tuberculose beim Menschen," 

 Wiener med. Wochenschrift, 1887, No. 53), during the last few 

 years, has observed four cases of inoculation-tuberculosis. The first 

 case was a girl sixteen years old, in whom the disease developed in 

 the track of a perforation of the lobe of the ear made preparatory 

 to the wearing of an earring, and which was kept from closing by 

 the insertion of a thread. The tubercular product appeared in the 



