136 H. F. Formad, 



I think this quite plausible, but would rather suspect here a blocking 

 up of the lymph - spaces of the connective tissue by the fibrin mole- 

 cular débris suspended in the serum which is being reabsorbed. I 

 think that in this way the anatomical characteristics of a scrofulous 

 tissue become artificially established. If such is the case, then it is 

 evident that a subsequent inflammation must of necessity lead to tu- 

 bercular disease. I suggest this, however, on mere hypothetical grounds, 

 not having made any thorough observations in this direction. 



The before-mentioned pseudo-tubercles, originating in the earlier 

 stages of inflammation of serous membranes, vary in histological 

 character from mere collections of lymph-cells held together by some 

 fibrinous coagula, to firm, organized nodules, not distinguishable from 

 true tubercles. These usually do lead to true tubercles. To produce 

 them artificially in the peritoneum is a very simple experiment. Dr. 

 0. C. Robinson did it under my eyes, by introducing simple foreign 

 bodies into the cavity, and succeeding in three out of five or six ex- 

 periments. I tried the same experiment in four dogs last summer, 

 using chemically clean powdered glass, with one successful and ex- 

 ceedingly beautiful result. Koch has unquestionably produced tuber- 

 culosis in the peritoneum of his cats and dogs. Whether they were 

 false or true tubercles, however, we must leave undecided: of course 

 they all contained bacilli, as the latter were introduced into the peri- 

 toneal cavity, and, acting as foreign bodies, excited the inflammation 

 with its natural termination in serous membranes. From what I have 

 detailed above, one of these natural terminations is tubercular disease, 

 so that the specific action of the bacilli is not required, even in the 

 non-scrofulous dog. Koch could just a well have used some sand for 

 inoculation, and saved his valuable cultures of the Bacillus tuberculosis 

 for inoculation into some other parts of the bodies of the non -scro- 

 fulous dogs, cats, rats, etc. 



Why did Dr. Koch inoculate the latternamed animals only in the 

 peritoneum and anterior chamber of the eye, while scrofulous animals 

 (rabbits and guinea-pigs) he inoculated indiscriminately in any part 

 of the body? This is a mystery. Let us try to solve it. 



I wish to mention some of our experiments in connection with 

 tuberculosis. 



