Human and Bovine Tuberculosis. 41 



the whole. The acre at which these tubercular glands in the 

 mesentery were found is significant. During the first year of life 

 there were 4 cases; from one to two and a half years, 33; from 

 three to five and a half years, 29 ; from six to seven and a half 

 years, 12 ; from eight to ten years, 13 ; and from eleven to fifteen 

 years, 9. In fourteen of these cases the mesenteric glands only 

 were affected, that is no tubercle was found in any other part of 

 the body. Here again more than half the cases appeared between 

 two and five and a half years. Since these figures were published. 

 Still, Shennan and the Royal Commissions on Tuberculosis in 

 this country and in Germany have published corresponding 

 statistics which in the main agree with those I have given and 

 I only use my own figures because they were the factor that 

 influenced, perhaps even biassed, my own conclusions. I should 

 now like to point out that whilst the child is suckled by its mother, 

 i.e. during the first year after birth, it is not nearly so liable to 

 contract mesenteric trouble as at a later period; whilst during 

 the next two periods during which children are living on mixed 

 diet and, usually, are taking some milk from the cow, the number 

 of cases of tuberculosis rises very rapidly. Dr B. Hubermaas 

 studying tuberculosis of the breast pointed out that although 

 tuberculosis is so common in young married women, tuberculosis 

 of the breast is exceedingly rare. This observation has been 

 fully confirmed by later observers. It may, of course, be sug- 

 gested that tuberculosis is a disease of such slow development 

 that even if it were conveyed from other sources than by food and 

 by other channels than by the intestinal canal it would take some 

 time for the disease to manifest itself, and therefore would not 

 kill the child until it had reached an age beyond the first year. 

 It must be remembered, however, that in my investigation a very 

 careful search was made with the special object of finding tubercle 

 and that therefore tuberculous disease even though it had not 

 given rise to any symptoms during life would scarcely be over- 

 looked. I do not wish to minimise the importance of infection by 

 the tuberculous mother kissing and fondling her child, but this 

 factor (except that the process is not extended over such a long 

 period) is just as likely to be brought into play in the early years 

 of life, as later. We should not expect to have the very sudden 

 rise that we meet with if this were the only factor at work. It is 

 evident, however, that after the first year a second factor comes 

 in — food, in this instance milk, and so far as the reports of the 

 Royal Commission on Tuberculosis have been published and from 

 the reports from various laboratories there seems to be little 

 doubt that tubercle bacilli in enormous numbers are often present 

 in the milk that is supplied for human consumption. Quite apart 

 from anything else then, I am satisfied that these statistics as to 



