686 Tuberculosis 



chronic lesions were found. Those inoculated with the bovine 

 bacillus lose weight, suffer from constitutional symptoms, and show 

 extensive lesions at the necropsy. Two-thirds of the cattle inocu- 

 lated experimentally with the bovine bacillus die. 



Lesions. — 'In general the lesions produced by the bovine bacillus 

 are rapid, extensive, and necrotic. Many bacilli are present. 

 Those produced by the human bacillus are more apt to be productive, 

 chronic, and contain relatively few baciUi. The bacilli of human 

 tuberculosis produce lesions with many giant cells; those of bovine 

 tuberculosis, lesions with rapid coagulation necrosis. Thelesions 

 resulting from the intravenous injection of human bacilli into rabbits 

 resembled those observed by Prudden and Hodenpyl* after the 

 intravenous injection of boiled, washed tubercle bacilli. 



From these data it is evident that the bovine bacillus is by far 

 the more virulent and dangerous organism. 



At the International Congress on Tuberculosis, held in London, 

 1 901, Koch expressed the opinion that bovine tuberculosis was not 

 communicable to man. The matter is of the utmost importance to 

 the medical profession and of far-reaching influence upon many im- 

 portant sanitary measures that bear directly upon the public health. 



Koch's opinion, being opposed to all that had been believed before, 

 received almost universal disapproval. The papers by Arloing,t 

 Ravenel,f and Salmon § contain evidence showing that under certain 

 conditions bovine tuberculosis can be communicated to man. 



Ravenel|| has reported 3 cases of accidental cutaneous inoculation 

 of bovine tuberculosis in man. All were veterinary surgeons who 

 became infected through wounds accidentally inflicted during the 

 performance of necropsies upon tuberculous cattle. The tubercle 

 bacilli were demonstrated in some of the excised cutaneous nodules. 



Theobald Smith,** in studying 3 cases of supposed food infection, 

 found what corresponded biologically with the human rather than 

 the bovine bacillus. 



In a later paper Kochft analyzed the cases usually selected from 

 the literature to prove the cdmmunicability of bovine tuberculosis 

 to man, and showed that not one of the cases really proves what is 

 claimed for it, and that the subject requires further careful investiga- 

 tion and demonstration before it will be possible to express any posi- 

 tive opinion in regard to it. 



During the years that have elapsed since 1901 and the present 

 time sentiment has been almost uniformly against Koch, and an 

 enormous hterature has accumulated that in reality means very 



* "New York Med. Jour.," June 6-20, 1891. 

 t "Lyon M^d.," Dec.i, 1901. 

 «, ^ "Univ. of Pa. Bulletin," xrv, p. 238, 1901; "Lancet," Aug. 17 and 19, 1901; 

 "Medicine," July and Aug., 1902, vol. viii. 



§ "Bull. No. 33, Bureau of Animal Industry," U.S. Dept. of Agriculture, 1901. 

 II ;;Phila. Med. Jour.," July 21, 1900. 

 ** "Amer. Jour. Med. Sciences," Aug., 1904, vol. cxxvni, No. 389, p. 216. 

 tt Eleventh International Congress for Tuberculosis, Berlin, 1902. 



