TRANSMISSION OF TUBERCULOSIS THROUGH MEAT AND MILK. 709 
This series of experiments and observations has been selected 
from literature with the greatest care. Any reports which ap¬ 
peared not to be well authenticated or of a doubtful nature have 
been excluded. Besides this mass of positive evidence there is 
much more, that, while not so positive, is not less convincing. 
It appears that the evidence collected by Thorne from physi¬ 
cians in Ohio is especially valuable, not only in itself, but because 
it indicates what might be learned by addressing the same 
series of questions to physicians throughout the world. 
Still further corroborative evidence is offered in the fact that 
such great numbers of bottle-fed children die of abdominal tu¬ 
berculosis, and in the fact that tuberculosis of adults is decreasing 
in many places, while tuberculosis of infants and small children 
does not show this marked decrease, and is, in fact, increasing. 
Death from tuberculosis in all its forms in England and Wales 
has decreased 39.1 per cent, in the past 35 years. The greater 
part of this diminution was in the lung forms of this disease ; 
for the same period the intestinal form has decreased only 8.5 
per cent. It is noteworthy that in the same period, the increase 
in abdominal tuberculosis in children under one year has been 
27.7 per cent. Northrup 59 and Still 60 have presented statistics 
of autopsy in children which show that the pulmonary form of 
the disease is most common ; that is, that the pulmonary lesions 
are primary, thus refuting the conclusion of most other patho¬ 
logists also based on autopsy. Koch 61 in his very recent (July 
23, 1901) address before the British Congress on Tuberculosis, 
has made reference to the findings of several physicians, includ¬ 
ing himself, in support of a similar allegation. This differ¬ 
ence of conclusion can hardly be accounted for, except upon 
the supposition that it is due to a difference in judgment among 
pathologists, as to what is a primary and what a secondary 
lesion. This is a point on which the pathologist must exercise 
great care. He must not in this connection overlook the fact 
that, even though the most marked lesions appear in the tho¬ 
racic cavity, this does not exclude primary infection by way of 
the digestive tract, because, as is well known, the infective 
