538 Di' Cobbett, The Absence of Living Tubercle Bacilli 



healing, an almost painless slowly growing lymphatic gland ap- 

 peared in the axilla, and about two months later it ulcerated 

 through the skin and discharged a thin fluid. Some of this 

 discharge was used for the injection of guinea-pigs but without 

 effect. The quantity of it was small, but its tuberculous nature 

 was demonstrated by finding a few tubercle bacilli in it. 



The fifth case occurred in Sheffield. It was clinically a typical 

 case of Addison's disease, in a young woman. No trace of the 

 supra-renals could be found though carefully sought for, and no 

 lesion of any kind was found, except a single mesenteric gland of 

 stony hardness and entirely calcareous. No tubercle bacilli could 

 be found in it by microscopic examination. The gland was 

 emulsified and injected into guinea-pigs but no tuberculosis re- 

 sulted. They were killed two months later and traces of the 

 material injected were found bound to the omentum, but no 

 tubercle bacilli could be found in this material and there was 

 no cellular action around them. 



In the next two cases living tubercle bacilli were found in the 

 old lesions. 



The sixth case occurred in Cambridge, it concerned a child of 

 four who had tuberculous disease of the upper dorsal vertebrae. 

 An abscess formed in the thorax which interfered with respiration, 

 and the child died. At the post-mortem examination an old 

 caseous mesenteric gland was found. It was about | of an inch 

 in diameter and consisted of thick gritty caseo-pus contained 

 within pink-coloured fibrous walls. 



Two guinea-pigs were injected with the caseous material, one 

 developed tuberculosis, the other did not. 



The seventh case, a youth of eighteen, died of heart disease. 

 A caseous bronchial gland, as large as a bean, and filled with 

 creamy caseous contents containing calcareous grains. No tubercle 

 bacilli were found in it by microscopic examination, but it caused 

 tuberculosis when injected into guinea-pigs. 



Among these seven cases were five in which material which 

 I think may be regarded as undoubtedly tuberculous was injected 

 into guinea-pigs without producing tuberculosis. 



Similar observations have been made by those working for the 

 Committee of the Kaiserliches Gresundheitsamt, appointed to in- 

 vestigate the relation of bovine to human tuberculosis. It cannot 

 be doubted then, I think, that tuberculous material taken from 

 man is sometimes incapable of causing tuberculosis in susceptible 

 animals. And it seems a fair inference that it contains no living 

 bacilli. 



It may perhaps be argued that these lesions were not really 

 tuberculous, but this can hardly apply to case No. 2. And if 

 these caseous and calcareous glands were not tuberculous what 



