152 
Editorial  Notes  and  Comments . 
f  Am.  Jour  Pharm. 
1      Xarch,  1902. 
"  (i)  The  accidental  infection  of  man  by  inoculation  with  bovine 
bacilli. 
"  (2)  The  infection  of  man  by  consuming  the  milk  of  tuberculous 
cows. 
"To  corroborate  this  evidence  statistics  are  presented  proving  the 
occurrence  with  mankind  of  a  large  number  of  cases  of  intestinal 
and  other  abdominal  forms  of  tuberculosis,  particularly  in  England 
and  Scotland.  It  is  shown  that  there  is  no  relation  between  the 
total  number  of  cases  of  tuberculosis  and  the  cases  of  abdominal 
tuberculosis  in  various  countries,  and  the  conclusion  is  drawn  that 
the  primary  abdominal  tuberculosis  probably  is  not  caused  entirely 
by  infection  from  other  causes  of  human  tuberculosis.  It  is  also 
shown  from  statistics  of  postmortem  examinations  carefully  made 
by  competent  persons  that  in  some  parts  of  the  world  at  least  there 
is  a  considerable  proportion  of  cases  of  tuberculosis  in  man  in  which 
the  infection  occurred  through  the  intestine. 
"  These  lines  of  evidence  are  clearly  opposed  to  the  principal 
assertion  made  in  the  paper  read  by  Koch  at  the  British  Congress 
on  Tuberculosis  this  year.  But  this  is  not  the  worst  aspect  of 
the  case,  since  the  evidence  of  Delepine  and  Still  indicates  that 
there  are  many  more  cases  of  intestinal  tuberculosis  in  children  than 
are  actually  discovered  or  recognized.  More  than  this,  it  is  shown 
on  the  evidence  of  such  competent  witnesses  as  Woodhead,  St.  Clair 
Thompson,  and  Lord  Lister  that  infection  through  the  medium  ot 
the  food  may  not  necessarily  be  accompanied  by  disease  of  the 
intestines.  The  organs  first  attacked  after  feeding  on  tubercular 
material  may  be  the  mesenteric  glands  and  liver,  or  even  the  bron- 
chial and  mediastinal  glands  and  the  lungs.  While,  therefore,  the 
facts  show  that  the  intestines  are  sometimes  the  first  organs  attacked 
after  tubercular  infection  is  taken  into  the  digestive  organs  through 
the  mouth,  they  also  show  that  the  number  of  cases  of  primary 
intestinal  infection  is  no  indication  of  the  number  of  cases  in  which 
the  infection  has  been  carried  by  the  food." 
In  commenting  upon  the  above,  the  editors  of  the  Bulletin  issued 
by  the  Delaware  State  Board  of  Health  say  :  "In  our  praiseworthy 
agitation  of  a  pure  milk  law  we  must  not  forget  that  milk  may 
contain  substances  far  more  destructive  to  life  than  the  usual 
adulterations.  Even  formaldehyd  sinks  into  insignificance  when 
compared  with  tubercle  bacilli  and  pus-forming  organisms." 
