816 
PROCEEDINGS OF SECTION I. 
Again, I have recently been furnished with the details of a case 
which occurred in the Taranaki district, in New Zealand. On an 
arable farm on which only a few cows were kept, the milk of one 
particular cow was used for a number of years for family use. This 
cow ultimately developed tuberculosis and was destroyed, well-marked 
tuberculosis of the udder being manifested. One of the sons was in 
the habit of drinking milk largely as a beverage. He was not 
particularly robust, but there was no previous history of tubercle in 
the family. After being ill, debilitated, and subject to attacks of 
persistent diarrhoea for some time, symptoms of nephritis supervened. 
The patient was removed to Wellington, and there operated upon. 
The affected kidney was removed, the lesiou being tuberculous 
nephritis. Tor a time considerable improvement in the general health 
resulted. Ultimately pulmonary tuberculosis developed, and at the 
end of about three years from the onset of the disease the patient 
died. Having regard to the history of this case, the sequence of 
intestinal, renal, and pulmonary tuberculosis, the medical men in 
attendance were firmly convinced that the source of infection was the 
diseased cow’s milk, which the patient had drunk in large quantities. 
It will be noticed that in the three cases I have detailed, the 
cows from which the infective milk was derived were affected with 
mammary tuberculosis. And this might lead to the conclusion that 
milk is infective only when there is disease of the udder. Such, 
however, is by no means certain. Iu fact, the expeiiments of 
Bollinger* point to a directly opposite conclusion. He produced 
tuberculosis in animals by the ingestion and inoculation of the milk 
of tuberculous cows in which the udder was healthy. This milk 
proved virulent in 55 per cent, of cases. He also proved the specific 
virulence of the milk in a lesser degree when there was only localised 
tuberculosis in some organ remote from the udder. He concluded 
that leucocytes most probably conveyed the virus either in the form 
of bacilli or spores to the udder. That leucocytes do absorb and carry 
micro-organisms, including the tubercle bacillus, is now generally 
accepted, the fact being commented on and put to practical use by 
Ur. JSimsAV oodhead in his recent elaborate explanation of the channels 
of infection in tuberculosis, especially in regard to invasion of the 
mesenteric lymphatic glands, when infection results from ingestion in 
children and pigs. On the other hand it must be pointed out that 
the experiments of Dr. Bang, Chief Veterinary Surgeon to the Danish 
Government, an authority equally eminent and reliable, are not so 
conclusive ou this point as those of Bollinger would appear to be. 
He found that the milk of only two out of twenty-eight tuberculous 
cows with healthy udders proved infectious — i.e., 7 per cent, against 
Bollinger’s 55 per cent. 
Unfortunately the microscope furnishes no material aid towards 
determining whether milk is infective or not. The Bacillus tuberculosis 
is very difficult to discover in milk from an udder extensively diseased, 
and even when it is known to be highly infective. 
To sum up, then, it may be definitely stated that experiments, 
investigations, and practical observations all render palpable the 
danger to a susceptible subject of the use of milk from a cow with 
Lancet, September, 1890. 
