528 



NA TURE 



[August i, 1901 



small-pox into the calf had been so very rarely successful that 

 eminent pathologists had concluded that small-pox and cow-pox 

 were two entirely different diseases. We now knew that this was 

 an entire mistake; that cow-pox was small-pox modified by passing 

 through the cow. He referred to some very instructive experi- 

 ments by Dr. Monckton Copeman, who entirely failed to inoculate 

 human small-pox into the calf, but invariably succeeded in inocu- 

 lating it into the monkey, and was as invariably successful when 

 he introduced matter from the pustules in the monkey into the 

 calf, the result being ordinary cow-pox which could be used for 

 vaccinating children. It may be that some species of animal 

 may serve as an intermediary host for tubercle between man 

 and the bovine species. Or it may turn out that, if a sufficient 

 number of experiments are made, human tubercle may prove 

 occasionally transmissible to the bovine animal, as small-pox is 

 in rare instances to the calf, and that the bovine tubercle so 

 produced may be transmissible to man, as is the virus of vaccine. 

 The evidence, necessarily indirect, on which Koch relied as 

 showing that bovine tubercle could not be transmitted to man 

 did not seem at all conclusive. It consisted mainly in the 

 alleged rarity of primary tubercular intestinal lesion in children, 

 in spite of the multitudes of tubercle bacilli swallowed by them 

 in milk. Even if it be admitted that primary tubercular intes- 

 tinal lesions are as rare in children as Koch's statistics indicate, 

 it is certainly true that tabes mesenterica exists in a con- 

 siderable percentage of children that die of tubercular 

 disease without tubercle being found in any other part 

 of the body. When the mesenteric glands are thus 

 affected without any discoverable intestinal lesion, the 

 natural, and, indeed, inevitable, interpretation seemed to 

 him to be that the tubercle bacilli had passed through the intes- 

 tinal mucous membrane without causing obvious lesion in it, 

 and had been arrested in the glands of the mesentery. It was 

 known that even typhoid bacilli, whose essential place of de- 

 velopment is the intestinal mucous membrane, occasionally pass 

 through it without producing the characteristic lesion. And if 

 this might occur with the typhoid bacilli, how much more likely 

 was such an occurrence with tubercle bacilli ! If this be so, 

 Koch's main argument falls to the ground. As regards the ex- 

 periments Koch had referred to of inoculating bovine animals 

 with material from the glands of children affected with tabes 

 mesenterica, the result being negative, these experiments had 

 been but few ; and even were they more numerous, they would 

 not, to his mind, be quite conclusive. It might be that tubercle 

 from milk in the intestines might be so modified by passing 

 through the human subject that the bacilli in the mesenteric 

 glands, though derived from a bovine animal, might be no 

 longer those of true bovine tubercle, but bacilli having the 

 characters of human tubercle little disposed to develop in cattle. 

 The Congress would probably require a more searching inquiry 

 into the subject before accepting this doctrine of the immunity 

 of man to bovine tuhercle. 



In all other points Prof. Koch, Dr. Brouardel and Prof. 

 JNIcFadyean are thoroughly at one, and they carried with 

 them, by the simplicity and earnestness of their state- 

 ments, the whole of the members of the Congress, and 

 the efifects of their work and observations were plainly 

 manifest in the resolutions that were submitted at the 

 final meeting. These may be summed up in the state- 

 ment that for the prevention of tuberculosis it is necessary 

 to attend to the housing of the people, to the provision of 

 a sufficient supply of fresh air, as good nutrition as pos- 

 sible, and to the prevention of the dissemination of the 

 tubercle bacillus (for which purpose proper precautions 

 should be taken to have it collected and destroyed as 

 soon as it comes from the patient) ; for the cure of con- 

 sumption fresh air, good food and well-regulated exer- 

 cise ; whilst in regard to bovine tuberculosis there seems 

 to be no difference of opinion that, until the question 

 raised by Prof Ixoch is finally settled, no relaxation of 

 the methods at our disposal for the examination and con- 

 fiscation of tuberculous meat and milk should be allowed. 

 The work of the sections was, of course, somewhat 

 more specialised in character. The report of the com- 

 bined discussion on tuberculin will direct attention to the 

 advantages and disadvantages claimed for and against 

 the use of this therapeutic agent. Other methods of treat- 

 ment also received full attention in Section I (Medicine). 



NO. 1657, VOL. 64] 



In Section II. (Preventive Medicine) preventive 

 measures were fully discussed, and the number of papers 

 brought forward and dealt with give ample evidence of 

 the interest taken in the work of this section. 



In Section III. (Pathology and Bacteriology) some of 

 the most useful work that came before the Congress was 

 discussed. We would specially refer to Prof. Benda's 

 paper on the channels of spread of tuberculosis and 

 Dr. Ravenel's paper on the relation of bovine to human 

 tuberculosis. This latter paper was exceedingly well- 

 timed from the fact, already mentioned, that the author 

 had to record three cases of infection of the human subject 

 by bovine tuberculosis. 



In Section IV. ( \'eterinary Section) an exceedingly 

 interesting series of papers was discussed, especially one 

 dealing with the application of tuberculin to cattle 

 supplying milk. In connection with this. Prof. Bang 

 pointed out that tuberculous animals might have non- 

 tuberculous lesions of the udder ; but, if there was any 

 suspicion of tuberculosis of the udder and the animal . 

 was otherwise tuberculous, the benefit of the doubt 

 should always be given in favour of the consumer, and the 

 lesion should be looked upon, temporarily at any rate, 

 as of a tubercular nature, and the necessary precautions 

 should certainly be taken. Where, however, it could be 

 proved that the lesion was non-tuberculous he thought 

 that the milk might sometimes be used, if proper pre- 

 cautions were taken ; though we should imagine that 

 most people would consider the proper precautions in 

 such a case would be absolute sterilisation of the milk. 



.A.s proof of the great interest taken by the King in the 

 work of the Congress, His Majesty received a number of 

 the foreign delegates in the Throne Room at Marlborough 

 House. The delegates were accompanied by the Earl of 

 Derby, Sir William Broadbent (chairman of the Organis- 

 ing Committee), Prof. Clifford .^VUbutt (regius professor 

 at Cambridge and chairman of the General Purposes 

 Committee), Mr. Malcolm Morris (honorary secretary- 

 general of the Congress), and Dr. St. Clair Thompson 

 (honorary financial secretary of the Congress). The fol- 

 lowing delegates were presented by the Earl of Derby, 

 but Dr. Koch, who had promised to open a discussion at 

 Eastbourne, and a i&w other foreign delegates were 

 unable to be present : — Prof Osier and Prof Janeway, 

 United States ; Hofrath Prof von Schrotter and Prof 

 Dvorak, Austria ; M. le Scnateur Montefiore Levi and 

 Dr. van Ryn, Belgium ; Dr. Mickailovsky, Bulgaria ; 

 Prof Bang and Dr. Charles Gram, Denmark ; Dr. 

 Brouardel (Doyen de la Faculte de Medicine de Paris), 

 Prof Bouchard and Prof Nocard, France ; Geheimrat 

 Prof Gerhardt, Prof Fliigge, Geheimrat Prof von 

 Leyden, Prof Fraiikel, Dr. Werner and Dr. Dettweiler, 

 Germany ; Prof Thomassen, Holland ; Prof Koranyi, 

 Hungary ; M. Malm, Norway ; Prof da Silva Amado, 

 Portugal ; Seiior Don Antonio Espina y Capo, Spain ; 

 Hof-Marshal Printzjold, Sweden ; and Dr. Neuman, 

 Switzerland. His INIajesty shook hands with each dele- 

 gate as he was presented, and then said : — 



"Gentlemen, — Let me express to you the great 

 pleasure and satisfaction it has given me to ask you to 

 come here to-day ; I only regret that you should have 

 arrived during such a severe thunderstorm. It has been 

 a source of great concern to me that, owing to circum- 

 stances over which I had no control, I was prevented 

 from presiding at the opening of your important 

 Congress and attending its meetings ; but I can assure 

 you that, though not present, I take the deepest interest 

 in its proceedings, and that I follow with much interest, 

 through the medium of the daily Press, the papers which 

 are read and the discussions on the subject. There is no 

 more terrible disease than that known as consumption, 

 and I only hope and trust that you may be the means of 

 minimising its evil efifects, and thereby receive the grati- 

 tude of the whole world. There is still one other terrible 



