548 
A. O. ZWICK. 
tion play at least an equally important role with air-infection, 
digestion and ingestion methods of infection with inhalation, gas¬ 
tric and intestinal with respiratory, pulmonary ways of infection? 
Before I am through I believe I shall have, from the close 
study of this subject which I shall present to you here to-day, 
convinced you that in all probability the gastro-intestinal tract is 
by far the more important route of tuberculo-infection, far more 
important than the respiratory, in fact by far the most important 
route of all! In other words, gentlemen, and that is exactly what 
I propose to do, I shall have laid the burden of the protection of 
the public, of the human race, against a further spread of the 
great white plague, this scourge of humanity, where I believe it 
belongs, that is to say : At your door! 
It is true that when comparing the tonsillary entrance with 
the intestinal we must admit that we frequently, I purposely say 
and emphasize frequently , find the tonsil diseased, not always; 
while in a large proportion of the cases of pulmonary tuberculosis 
which I shall contend are due to the consumption of tubercular 
food, I have to admit that we frequently find the intestines ap¬ 
parently free of foci of the disease. This seeming discrepancy is 
easily disposed of, however, by the now well-established fact that 
tubercle bacilli may pass through an uninjured, perfectly sound 
and whole mucous membrane without causing any localized lesion 
or even leaving any traces behind them at their point of entrance! 
This is a fundamental fact that militates with irresistible force 
against Koch’s strongest argument: The overwhelming prepon¬ 
derance of pulmonary tuberculosis as compared with all other 
forms of tuberculosis, being as eleven-twelfths to one-twelfth. 
Dr. Karl H von Klien, now of Chicago, formerly surgeon in 
the Russian army, who was present at the International Congress 
in London when Koch declared that tuberculosis cannot be trans¬ 
mitted from animal to man, tells me that all his friends tried to 
persuade him not to read his paper, but with stubbornness he in¬ 
sisted on presenting it just the same, and, as Dr von Klien says. 
“ that started the ball rolling, and it has been rolling against him 
ever since! ” 
