545 
He further says that he has — 
proven the cheesy tubercle in the lung to be associated not with the finer 
branches of the air tubes, but with the terminal capillaries of the pulmonary 
arteries. 
While he is not a special advocate of the intestinal way as the sole 
mode of infection, he ends his article here referred to with these 
words : “ The inhalation theory for lung tuberculosis is no longer 
tenable.” Kohler,® who reviews Aufrecht’s work, justly remarks that 
it deserves wide recognition, as it supplies important arguments for 
a thorough revision of the older views about the development of 
pulmonary tuberculosis. 
Fibiger and Jensen ^ conclude from their own investigations and 
a critical analysis of the reports from numerous widely separated 
hospitals that the former doctrine, which taught that primary intes- 
tinal tuberculosis is a rare disease, can no longer be held as valid. 
Among 289 children from 1 to 15 years old who had succumbed to 
various diseases, 44, or over 15 per cent, were found on autopsy to be 
affected with primary intestinal tuberculosis. These investigators 
say that we must, without doubt, return to our former view and re- 
gard the ingestion of raw milk as an important cause of primary 
intestinal tuberculosis during childhood. This view is in perfect 
harmony with Calmette’s experiments, which proved that primary 
intestinal tuberculosis is of commoner occurrence, with infection that 
enters the body through the alimentary canal, in youth than in adult 
life, because tubercle bacilli can pass through the mesenteric glands 
of adults more readily than through those of children. 
Orth ® makes the statement that even with localized tuberculosis 
in the lymph glands and the lung we can not exclude the intestine as 
the portal of entry for the tubercle bacillus. At the international 
conference on tuberculosis, held in Vienna during September, 1907, he 
said that tubercle bacilli can enter the body from the intestinal canal, 
which might itself, however, remain completely unaffected, but that 
from the prophylactic point of view the channel of infection was of 
only secondary importance, as the object to be aimed at was the de- 
struction of all sources from which infection might take place. As 
sources of infection be named milk and butter from tuberculous cows 
and sputum from tuberculous individuals, and bovine tuberculosis 
he characterized as undoubtedly infectious for human beings.'^ 
Klebs ® has convinced himself that tuberculosis is a disease of the 
lymphatic system and may remain such until the end of life, and that 
® Intren. Centralb. fur die gesam. Tuber. Forsch., Vol. II, No 1, 1907. 
* Berliner Kliniscbe Wochens., Nos. 4 and 5, 1907. 
c Berliner Kliniscbe Wochens., No. 8, 1907. 
^ Editorial in the New York Medical Record, vol. 72, No. 22, p. 905, 1907. 
®Deutsch. Medic. Wochens., No. 15, 1907. 
45276°— Bull. 56—12 35 
