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JBERCULOSIS AMONG CATTLE.

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THe BaciLtiti TUBERCULOSIS.

(Enlarged about 4,000 times.)

PoRTION oF LUNG. WITH TUBERCLES.

A HAND-BOOK

ON

PUBERCULOSIS
AMONG CATTLE,

WITH

CONSIDERATIONS OF THE RELATION OF THE DISEASE
TO THE HEALTH AND LIFE OF THE HUMAN
FAMILY, AND OF THE FACTS CONCERN-

ING THE USE OF TUBERCULIN AS A
DIAGNOSTIC TEST.

COMPILED BY

4

HENRY L. SHUMWAY.

‘}

“‘The fact is, those who can, kill the bacilli however acquired ;
those who cannot, are killed by them.”’

Sor é Sb A { i
BOSTON:

ROBERTS BROTHERS.
1895.

Copyright, 1895,
By HENRY L. SHUMWAY.

All rights reserved.

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Ny

COMMONWEALTH OF MASSACHUSETTS.

BoarpD oF CATTLE COMMISSIONERS.

52 Village St., Boston, March 4, 1898.

WE have been familiar with the work of the com-
piler of this volume in all its details, and can testify
to the patience and care with which he has per-
formed it. We have examined the work in manu-
script, and consider it a complete, comprehensive,
and candid presentation in all its phases of a
subject upon which we believe the great body of
the public is in need of the information he has

presented.

CHARLES P. LYMAN. F. H. OSGOOD.

ul

PREFACE.

Tas book is an evolution, its germ being an assign-
ment to me as a member of the Boston “ Herald”
staff, to cover the work of the Massachusetts Cattle
Commission in its attempt to control bovine tuber-
culosis. As I became familiar with the work, I was
impressed with its importance, and with the fact that
the general public had but meagre and imperfect
information on the subject.

Accordingly, I attempted to gather and arrange
the observations and experiences of those engaged
in similar work, with the purpose of using it as a
newspaper article for the better information of the
public. I did not aim to instruct professional men ;
nor did I especially design to influence the relatively
small proportion of the public who are producers of
meat and dairy products. My conviction was that
the great mass of consumers — the general public —
had the largest interest in the matter, and to arouse
their interest, and to supply them with reliable infor-
mation, was my purpose.

Viii PREFACE.

The article was prepared and published; and it
was so well received and so warmly commended by
the medical and veterinary profession, that I was
encouraged to enlarge and complete it for publica-
tion in a permanent form.

In doing this work I have been most cordially
assisted by Drs. Frederick H. Osgood and Charles
P. Lyman, of the Massachusetts Cattle Commission
and the Harvard University Veterinary School ; and
they have been kind enough to revise and approve
the matter herewith presented.

Iam also under obligation to the United States
Bureau of Animal Industry, and to Professor
J. L. Hills of the Vermont Experiment Station,
for permission to reproduce the illustrations in this
volume.

THE COMPILER.

Boston, March 1, 1895.

CHAPTER

CONT ANTS:

PAGE
Fae, ‘OF PRINCIPAL AUTHORITIES «0. « eos 2 3%
mIPE TACIT COTTON 50 a eral ah treat ah | gee eee a SNe
GENERAL PREVALENCE OF THE DISEASE. .. 5
THE DISEASE IN THE LOWER ANIMALS... 15
Its VARIED SYMPTOMS AND APPEARANCES . . 25
Post-MORTEM REVELATIONS (4) (2) «6 6 ee yet) (ED
THe GERM AND THE DISEASE. .... . . 48
OnE DISEASE IN MAN AND CATTLE .... . 50
PREDISPOSING CAUSES, —NOT HEREDITARY . 57
NATURE AND CERTAINTY OF TUBERCULIN .. 62
OPERATION AND DELICACY OF THE TEST AY ee
OBJECTIONS TO THE TEST ANSWERED... . 104
THE TRANSMISSION OF THE DISEASE... . .111
Tue DANGER FROM INFECTED Mink .. . . 125
CoNncLUSIVE TESTIMONY AS TO Mixx INFECTION 127

ANOTHER PERIL FROM THE DISEASE .. . . 148
NECESSARY MEASURES FOR PROTECTION. . . 154

i"

LIST OF PRINCIPAL AUTHORITIES.

THE principal authorities quoted in this volume, and their
professional positions, are as follows : —

Dr. F. H. Oscoon, President of the Massachusetts Cattle
Commission, Professor of Surgery and Superintendent of the
Hospital of the Harvard University Veterinary School.

Dr. C. P. Lyman, Secretary of the Massachusetts Cattle
Commission, Dean of the Harvard University Veterinary
School.

Dr. D. E. Satmon, Chief of the Bureau of Animal Industry,
United States Department of Agriculture.

Dr. Haroip C. Ernst, Assistant Professor of Bacteriology,
Harvard University Medical School.

Dr. Austin PETERS, a prominent Boston veterinarian, for-
merly Veterinary Inspector of the New York State Board
of Health.

Dr. Bane, Chief of the Veterinary Department of the Royal
Agricultural College, Copenhagen.

M. Senn, M.D., Ph. D., author of the standard text-book
“Principles of Surgery,” and member of many notable
Medical and Surgical Societies.

Proressor THomas WALLEY, M. R.C.V.S., one of the most
eminent British veterinarians, Principal and Professor of
Veterinary Medicine and Surgery in the Edinburgh Royal

xii LIST OF PRINCIPAL AUTHORITIES.

Veterinary College, ete.; author of “The Four Bovine
Scourges.”

Dr. GEORGE FLEMING, Principal Veterinary Surgeon of the
British Army, and author of a series of standard veteri-
nary text-books.

Irvine A. Watson, M. D., President of the New Hampshire
State Board of Health.

Proressor P. H. Bryce, M.A., M.D., Secretary of the
Provincial Board of Health, Ottawa.

Dr. JAmMes LAw, Professor of Veterinary Science at the Cor-
nell University Agricultural Experiment Station.

Proressor J. L. Hixus, Director and Chemist, Vermont
Agricultural Experiment Station.

Dr. F. A. Ricu, Veterinarian, Vermont Agricultural Ex-
periment Station.

Proressor J. J. MAcCKENzIE, Analyst of the Provincial
Board of Health, Ottawa.

J. H. Kettoee, M.D., Battle Creek (Mich.) Sanitarium.

PROFESSOR LEONARD PEARSON, of the Veterinary Depart-
ment of the University of Pennsylvania.

ae Oe

TUBERCULOSIS AMONG CATTLE.

INTRODUCTORY.

TUBERCULOSIS is not a new disease. Its existence
has been recognized for ages, and its ravages have
for almost an equal period been a subject of com-
ment by statisticians, and of anxiety, observation,
and experiment by the medical profession. Much,
in a general way, concerning its character was long
ago established ; its contagiousness was recognized,
and, while until a comparatively recent period it
was not differentiated from some other diseases,
nor were all its varied manifestations referred to
its single cause, yet its identity in man and in
animals was more than suspected.

At the present time this disease is occupying a
conspicuous position, not only among professional
men, — physicians, veterinarians, and _bacteriolo-
gists, — but among all intelligent people. Profes-
sional journals and the public press have frequent
allusions to it, and there is general anxiety for
information in regard to a wide variety of questions

in which it is involved.
1

2 TUBERCULOSIS AMONG CATTLE.

This general and increasing interest in the dis-
ease has resulted, first, from the identification by
Professor Koch of the germ of the disease ; second,
from the confirmation of the theory that the disease
is communicable between man and animals; third,
from the clearer appreciation of the peril to the
human family through the careless and ignorant
use of meat and dairy products in which the germs
of the disease are present; and, fourth, from the
discovery of an agent by which its presence
among animals can be declared with practical in-
fallibility.

This last discovery, as yet hardly more than two
and a half years old, has resulted in the most gen-
eral increase of interest concerning the disease;
for it brought with it a promise of a possible
method of controlling its ravages, and relieving the
human family from much of the affliction resulting
from it.

Before the last mentioned discovery, while all
else was practically certain, there was no means by
which tuberculosis could be assuredly recognized
until it had so far advanced as to place its spread
beyond control, and its dissemination and steady
increase were accepted as inevitable. As soon,
however, as a means of practical relief was demon-
strated, steps were taken at various points to
apply it. The nature of the new agent was recog-
nized as such that it was not available in the direct
treatment of the disease in the human subject;

ae

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ie

INTRODUCTION. 3

but as the disease in animals was believed to be a
considerable source of human infection, its control
in the animal kingdom was recognized as a most
desirable end to be accomplished.

This resulted in intense activity among scien-
tists, students, and practical men, — the end sought
being full information as to the nature and effect
of the disease, and a thorough test of the new agent
to determine whether its claims were valid. Its
value has been so far demonstrated that it has been
generally accepted by the veterinary profession as
a diagnostic of the disease; and the boards of
agriculture and cattle commissions of several of the
States have undertaken, with its aid, the control
and the suppression of bovine tuberculosis.

As might be expected, the advent of a claimant
for so large a measure of public confidence has
been the signal for no little opposition, discussion,
criticism, and misunderstanding. Conservative
scientists at first contradicted and doubted its
claims; but they are now, with few exceptions, its
advocates and defenders, although they do not
agree on some of the details of its practical appli-
cation. The cattle owners, who saw in its advent
a possible source of loss in the exposure of the con-
dition and the condemnation of a portion of their
herds, were at first, through what they thought
was self-interest, disposed to reject its claims and
resist its use. Many of these, however, recognizing
that not only public duty, but their real personal

4 TUBERCULOSIS AMONG CATTLE.

interest was involved in the prompt and certain
purification of their herds, have, after examination
and observation, accepted the new agent. There
yet remain a few veterinarians who do not agree
with the majority of their professional brethren in
regard to its value, and a considerable section of
the cattle owners whose fears of the consequences
of its adoption control their judgment of its value ;
while the great masses of the public, those who as
consumers of cattle and dairy products are really
most interested in the purity and healthfulness of
their food supply, are as yet hardly aware of the
real character and importance of the discussion to
which their attention is occasionally attracted.

It has been thought best to bring together for
the information of this public a comprehensive and
consecutive presentation of the leading features of
the whole subject, which is herewith published. It
has been compiled with considerable patience and
care by one who has endeavored to bring together,
not an argument in support of any theory, but the
carefully prepared and expressed opinions of a
large body of scientific men on this important sub-
ject. That these authorities agree in their main
conclusions is not the fault of the compiler. They

are governed by the facts that have come to them —

in their professional work; and that they do so
fully agree is strong presumptive evidence that the
professionals, rather than their lay critics, are cor-
rect in their conclusions.

iirc

CHAPTER I.
GENERAL PREVALENCE OF THE DISEASE.

NotWwITHSTANDING the prominence which this dis-
ease has attained in the public mind during the
last two years, there is yet a very indefinite and
meagre idea of its true proportions. In very many
minds tuberculosis and ‘‘ consumption” are con-
sidered the same, while in fact “ consumption ” is
only one of several forms of tuberculosis. The old
and indefinite term “ scrofula” is more nearly a
synonym; but even this fails to convey the whole
truth. Cholera infantum, cerebro-spinal menin-
gitis, convulsions in children, and nearly a score of
other ailments, are all attributed to this one cause.

Dr. N. Senn says: “ The frequency of tubercular
affections is something appalling. At least one
person out of every seven dies of some form of.
tuberculosis. Most of the large hospitals contain
from 25 to 50 per cent of patients afflicted with
this disease. ‘The ravages of the disease are to be
seen everywhere, in the shape of disfiguring scars
of the neck, deformed limbs, and bent spines.
Health resorts, frequented for years by tubercular
patients, have become infected to such an extent

6 TUBERCULOSIS AMONG CATTLE.

that there is great danger of the whole popula-
tion becoming exterminated by this disease. The
sources of infection in such places have become so
numerous that it is unsafe to breathe the air, to
drink the water, or to eat the food prepared in
houses which for years have been hot-beds for the
bacillus of tuberculosis, and by persons carrying
the microbe upon every square inch of their sur-
face. That whole communities and nations, where
this disease has been prevalent for centuries, have
not been completely depopulated long ago is owing
to the fact that many persons possess, from the
time of their birth, a degree of resistance to infec-
tion that even the direct infection by inoculation
would prove harmless.”

Dr. Senn also says: “That large class of ill-
defined lesions which were grouped under that
indefinite and vague term ‘scrofula, in the text-
books of but a few years ago, have been shown by
recent research to be identical with the recognized
forms of tuberculosis, etiologically, clinically, and
anatomically.”

In another chapter he says: “It is but a few
years since it was thought impossible that any
other organ than the lungs should be the seat of
tuberculosis. The different forms of surgical tuber-
culosis . . . were not correctly understood until
quite recently, and consequently a rational surgical
treatment was out of the question. Almost all
the localized tubercular processes were included

:
2
8
:
4

GENERAL PREVALENCE OF THE DISEASE, 7%

under the general term ‘scrofula” and were re-
earded as local manifestations of a general dyscra-
sia, and treated in accordance with this view of
their pathology. The discovery of the bacillus of
tuberculosis has rendered the word ‘ scrofula’ obso-
lete, and has assigned to the tubercular processes
in the various organs and tissues of the body their
correct etiological and pathological significance,
and prepared the way for their successful surgical
treatment. There is hardly a tissue in the body
which may not become the primary seat of tuber-
cular infection, or which escapes when diffuse dis-
semination occurs through the medium of the
general circulation.”

Professor Boyce includes in his discussion of
tuberculosis the following diseases as belonging in
the class: cholera infantum, cholera morbus, diar-
rhoea, dysentery, hydrocephalus, tabes, and phthisis.

Dr. Clark, of the Medford (Mass.) Board of
Health, at a legislative hearing in 1892, said that
in ten years there had been between 190 and 200
deaths from “ consumption, or tuberculosis,” in the
town ; the next greatest cause of death was “ heart
disease,’ with between 90 and 100 deaths. These
designations of disease are very indefinite, but the
figures show an: alarming preponderance of the
disease we are considering.

In a hearing before a committee of the Massa-
chusetts Legislature, in February, 1891, Dr. Ernst
said of the disease: “It is not confined, as is

8 TUBERCULOSIS AMONG CATTLE.

popularly supposed, to the lungs. Tuberculosis of
the lungs is commonly known as ‘ consumption’ ;
but it occurs in all parts of the body, —as surgical
tuberculosis of the joints, as tuberculosis of the
membranes of the abdominal organs, as the local-
ized skin disease called ‘lupus,’ which is precisely
the same thing as tuberculosis occurring elsewhere,
except that it is located in the skin, and as the
dreaded disease called ‘leprosy’; . . . for leprosy,
I have little doubt, will within a short time be in-
cluded under the head of tuberculosis.”

Those who have most carefully considered the
subject are now practically agreed that tuberculosis
is by far the most fatal disease in the human family.
Their opinion is thus summarized by Dr. Law: —

“Tuberculosis is equivocal and underhand in its
method, slow and uncertain in its progress, and on
this account escapes recognition, and proves by far
the most deadly of any single disease attacking the
human family. The average ratio of deaths from
tuberculosis to the total mortality is 14 per cent, or
one death in every eight, while under special condi-
tions it rises to one in three. . . . But the deaths
from tuberculosis being constant and uniform, peo-
ple accept them as inevitable, and fold their idle
hands in true Mohammedan fatalism, instead of
boldly exposing the hidden death-trap, and cutting
short its destructive work.

“If the 5,490 deaths from tuberculosis which
occur every year in the city of New York could be

3
1,
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5
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4
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j
;

GENERAL PREVALENCE OF THE DISEASE. 9

brought together in an epidemic lasting but one
week, no small-pox, cholera, nor yellow-fever scare
would approach the panic which would thus be
created, for when did all those diseases create such
mortality in this city? Nay, if we take the whole
civilized world, and compare with the tuberculosis
mortality all the accumulated deaths from war,
plague, cholera, yellow-fever, and small-pox, we find
that the latter are comparatively very insignificant.
Yet tuberculosis, like every germ-disease, is abso-
lutely preventable, and is allowed to continue its
career of death only because of reprehensible, igno-
rant, and criminal indifference.”

Professor Hills and Dr. Rich say: “ When con-
ditions have favored its spread, the death-rate from
tuberculosis has been as high as 50 per cent of all
mortalities. Many of the fatal bowel troubles of
infants have their origin in tubercular infection.
An article in the ‘ Archives de Médecine’ says that
‘of the population of the globe three millions die
annually of consumption.’ ”’

Dr. Abbott, at a hearing before a Massachusetts
legislative committee, stated the annual number of
deaths per 10,000 inhabitants in that State from
tuberculosis to be, from 1870 to 1879, 33.4; from
1880 to 1889 it was 29.7. Of the apparent decrease
he said: “I do not, and I think that the physicians
generally do not, take that as an indication that the
causes of consumption or tuberculosis are less preva-
lent than formerly. Ido think that the intelligence
of the people as to the promotion of consumption,

10 TUBERCULOSIS AMONG CATTLE.

and that it is an infectious disease, is one of the
explanations of this variation.”

Dr, Lagneau, a noted French authority, compiled
the statistics of 662 localities in France, to show
that the more dense the population the more preva-
lent is tuberculosis. The per cent who die annu-
ally from tubercular phthisis to every one thousand
inhabitants appears as follows : —

Ninety-five cities, with less than 5,000 inhabitants,
1.81. Three hundred and thirty-two cities, with be-
tween 5,000 and 10,000 inhabitants, 2.16. One hun-
dred and twenty-seven cities, with between 10,000
and 20,000 inhabitants, 2.71. Fifty cities, with be-
tween 20,000 and 50,000 inhabitants, 2.88. Forty-six
cities, with between 80,000 and 100,000 inhabit-
ants, 3.05. Eleven cities, with between 100,000 and
430,000 inhabitants, 3.63. Paris, with 2,424,703
inhabitants, 4.90.

Lehmann, of Copenhagen, gives as the results of
the total deaths in that city for a period of twenty
years, from revised death certificates, the following
as the per cent of deaths from tuberculosis at dif-
ferent ages, with sex division : —

Age. Male. Female.

DO MI VORES 806 Fe ae Ato ey LF

PEAS acai Ck a) Sha) hee gat 9 ea 11,07

REE Foo og ie ae oe Dia ae | 32.03

EM) oo wk was Be we ee 42.68
eB RL as ae De oe 33.1
RO Si ce I aR I EINE TAS 33.6
I rT oa eg ict! ey hake ede eae 29.9
a Bay oP Ren aa eRe eR MER est LS 23.8

GENERAL PREVALENCE OF THE DISEASE, 11

He remarks, in commenting on his tables, that in
the female sex from fifteen to forty-five years of age,
every third: person died of tuberculosis. —

Wahl of Essen furnishes similar tables from that
city, showing the per cent of total deaths resulting
from tuberculosis as follows: to 5 years of age, 3.7
per cent; 6 to 20 years, 23.1; 21 to 40 years, 35.1;
40 to 60 years, 34.7; over 60 years, 12.8. The
average for all ages is 15 per cent. |

Dr. Salmon writes of the history of the disease
that it has been known for many centuries, and
legislative enactments having reference to the de-
struction of affected animals, and forbidding the use
of the flesh, date far back into the Middle Ages. He
says: “The opinions entertained regarding the na-
ture and cause of the malady varied much in differ-
ent periods, and very markedly influenced the laws
and regulations in vogue. Thus, in the sixteenth
century, the disease was considered identical with
syphilis in man. In consequence of this belief very
stringent laws were enacted, which made the de-
struction of tuberculous cattle compulsory. In the
eighteenth century this erroneous conception of
the nature of the disease was abandoned, and all
restrictions against the use of meat were removed.
Since that time, however, the tide of opinion has
again turned against the disease.”

The Vermont Experiment Station Bulletin de-
fines tuberculosis as a general name for a class of
diseases which attack various organs, and which

12 TUBERCULOSIS AMONG CATTLE.

both man and animals readily contract. It states
that the human death-rate from the disease in its
numerous forms is one in four of the total, and that
its extent among cattle cannot be accurately stated,
owing to a lack of systematic inspection.

Professor Walley writes: ‘‘ Tubercle is a visible
local manifestation of a constitutional diathesis,
‘scrofulosis.. While this proposition is in the main
correct, it must not be assumed that tubercle does
not originate independently of the constitutional
condition known as ‘scrofulosis.’” From a variety
of causes, or rather from a concatenation of circum-
stances (not yet distinctly understood), tubercular
inflammation may be established, and the usual
local manifestation (tubercle) be produced; and
in different ways tuberculosis can be originated in
the systems of animals in which not a trace of
scrofula is to be discovered.”

Of the gravity of the disease, Professor Walley
says: ‘ Looking at an individual tubercle, we might
be led to despise its comparative insignificance, and
to ignore its deadly meaning; but when we see
thousands upon thousands of these knots existing
in the organism of a single animal, a truth is forced
upon our minds which we cannot refuse to recog-
nize, — namely, that we have to deal with an insid-
ious, implacable, and deadly foe. And, indepen-
dently of its ultimate fatality, I think I may with
safety reiterate what I have before asserted, that no
morbid substance known to the pathologist is so

i

GENERAL PREVALENCE OF THE DISEASE. 13

protean as tubercle in the number of functional de-
rangements to which it gives rise. . . . He does not
take into account the vast deterioration, the slow
but certain decimation of many of our best herds, the
destruction of human food, the danger — not, as it
is now proved, chimerical or hypothetical —to hu-
man life and human comfort, and the insidious
progress of that fell destroyer, tubercle. The other
three bovine scourges sweep their victims off in a
manner which is seen by all; but the ravages of
tubercle are only realized by those whose duties
are connected with the public abattoirs, or who
are called upon to act as arbiters on the nature
of disease.” It is a sad commentary on the above
that within a few weeks, and after it was copied
from his work, Professor Walley himself has died
from the disease, acquired three years ago by inocu-
lation in connection with his profession.

The frequent failure of proper diagnosis, and the
carelessness with which death-returns are often
made up, seriously complicate any attempt to defi-
nitely show the real prevalence of this disease.
It appears in numerous and varied forms in the
human subject; and while a physician might be
aware that they were all referable to tuberculosis,
the general public has no knowledge that even
suggests this fact. The list of locations of the dis-
ease in the animal body, elsewhere given, suggests
something of the carelessness that is possible in
defining the disease.

14 TUBERCULOSIS AMONG CATTLE.

In a recent discussion by the Massachusetts Asso-
ciation of Boards of Health, the matter of death-
certificates was discussed, and there was general
agreement of opinion that there is much need of a
greater degree of accuracy. Dr. William Y. Fox,
of Taunton, presented statistics showing that in
his city, from 1889 to 1895 (four years), there were
defective certificates in about 22 per cent of the
entire record. That Taunton is not alone in this
direction he showed by citing other returns, from
which it appeared that in 1895 Haverhill had 14
per cent of worthless certificates, Worcester had
12 per cent, Woburn 15 per cent, Lawrence 18 per
cent, Newton 11 per cent, Marlborough 14 per cent,
and New Bedford 19 per cent. It is quite clear
that the public will remain ignorant of the real ex-
tent of the effect of tuberculosis until its numerous
and varied forms of manifestation are better known
through increased attention to correct diagnosis, and
through general education on the subject.

<i Ee

CHAPTER II.
THE DISEASE IN THE LOWER ANIMALS.

EXPERIMENTS carefully made and widely observed
show that tuberculosis affects a far wider range of
animals than any other disease. Horses and sheep
are popularly supposed to be free from infection,
under ordinary conditions, but they can readily
receive it by inoculation.

On the other hand, fowls, cats, guinea-pigs, rab-
bits, swine, and neat cattle are very susceptible to
the disease, either by natural or artificial infection.
While nearly all domestic animals may take on
and impart the disease, fowls, swine, and cattle are
recognized as most dangerous, from their favorable
conditions for its dissemination.

Until the discovery, in 1891, of the efficacy of
tuberculin as a detective of the disease, there was
no possibility of ascertaining to what degree it
prevailed in live animals. The statistics from the
slaughtering establishments are of little value, be-
cause of the varying regulations in different coun-
tries. Reports from European countries represent
a wide range, — Baden showing only 2 per cent of
disease found at the abattoirs, while France reports

16 TUBERCULOSIS AMONG CATTLE.

5 per cent. On the other hand, Paris reports 6 per
cent, Holland 20 per cent, Pomerania 50 per cent,
and Hanover 60 to 70 per cent. Such variations
cannot be due to differing conditions so much as to
local regulations and inspection requirements.

Professor Hills and Dr. Rich, after alluding to
the conditions which make it impossible to secure
positive data on this subject, say : —

“Probably many of the estimates given by vari-
ous authors are based on faulty or insufficient data.
The following examples may serve to some extent
to indicate its prevalence. The extremes are wide,
being from 2 per cent (among 2,273,547 cattle,
mostly steers killed in the meat inspection districts
of the United States from May 15, 1891, to March
1, 1892) to 60 or 70 per cent (at Hilderstein, Han-
_over, according to Haarstick). In a large number
of German abattoirs it is stated that 6.9 per cent
of the cows, 3.6 per cent of the steers, 2.6 per cent
of the bulls, and 1 per cent of the young stock were
tuberculous. Of 1,270,604 animals slaughtered in
German abattoirs from October, 1888, to October,
1889, 26,352, or 2 per cent, were tuberculous. Care-
ful post-mortems by skilled veterinarians showed
12 per cent of tuberculous animals out of 12,000
slaughtered in England as affected or exposed to
contagious pleuro-pneumonia (a disease entirely dis-
tinct from tuberculosis). In seventeen counties in
New York State the inspectors of the State Board of
Health found 3.4 per cent of tuberculous cattle out of

THE DISEASE IN THE LOWER ANIMALS. 17

20,000 inspected. Cattle slaughtered at Baltimore
were found tuberculous to the extent of from 2.5
per cent to 3.5 per cent, while of 1,158 cattle from
the Eastern States (mainly New England), slaugh-
tered at Brighton, Mass., 52, or 4.5 per cent, were
tuberculous. Doctors Salmon and Smith state that
‘it is not far from the truth to assume... that
one of every fifty head of cattle in the more densely
populated areas of Kurope and America is tubercu-
lous.’ Dr. Salmon states yet later, however, that
‘the ideas in regard to the prevalence of tubercu-
losis have been radically changed by the facts
brought out in using tuberculin.’ ”

As long ago as 1890 it was determined that 4.5
per cent of cattle slaughtered at Berlin were tuber-
culous, while one abattoir in Upper Silesia reported
9.5 per cent.

Professor J. J. Mackenzie, in discussing tubercu-
losis in a paper printed in 1892, said: “That the
disease is common in cattle needs no specific proof
from me. We may accept it as more than prob-
able that in ordinary milch cows in the provinces
[Dominion of Canada] the percentage of animals
affected may reach six per cent: that, at any rate,
has been shown to be the case in countries where
exact data have been obtained. In the expensive
in-bred stock, such as the Jerseys, the percentage
is higher, — so high in fact that it is very startling
to think of.”

The chief of the Bureau of Animal Industry for

9

_

18 TUBERCULOSIS AMONG CATTLE.

Maryland reports that of cows killed for beef in the
Baltimore slaughter-houses about 3.1 per cent proved
tuberculous. In six months, so long ago as 1889,
he inspected 122 stables supplying milk to Balti-
more, with 1,611 cows, and found 11.3 per cent to
be badly tuberculous. This was by physical exami-
nation only; later experience with tuberculin sug-
gests that its use then and there would have re-
vealed a far more serious condition of affairs.

The experience of the Massachusetts Commis-
sion in the work brought to them through the local
inspectors in cities and towns indicates a much
wider prevalence of the disease than appears at
Nantucket. The local inspectors are required to
examine all the cattle in their districts twice each
year, and to report all cases suspected of tubercu-
losis to the Commission. All cases thus reported
are tested with tuberculin by the expert agents of
the board. Under this system some large herds
have been almost entirely destroyed. In each of
two herds, one near Boston and the other in the
Connecticut River valley, of 65 animals each, 60
were killed from each herd, and all showed the
disease on autopsy. In several other large herds
fully one half were taken. In this department of
their work the Massachusetts Commission has found
nearly all the animals condemned to show the dis-
ease In very pronounced and advanced forms.

In connection with the report of Professor Ernst
and Dr. Peters to the Massachusetts Society for

7

THE DISEASE IN THE LOWER ANIMALS. 19

. Promoting Agriculture, of their work in investigat-

ing the transmission of tuberculosis by means of
milk, the latter gentleman especially discusses the
prevalence of bovine tuberculosis. He quotes
Fleming’s Manual of Veterinary Sanitary Science
or Police: “Tubercular phthisis, or tuberculosis,
probably prevails among the domesticated animals
over the entire globe, though its frequency will
depend upon various external influences, as well as
the constitutional tendencies of different species
and breeds. ... In Europe, particularly in the
cow-sheds of the larger towns and cities, it is
extensively prevalent, and in this country [ Eng-
land] it has long been recognized as a common
disorder among animals, but more especially as
affecting the bovine species.”

Professor Walley counts contagious pleuro-pneu-
monia, rinderpest, foot-and-mouth disease, and tu-
berculosis as the “four great bovine scourges,”
and Dr. Peters says the last named is the only
one “staring us in the face, and challenging us to
combat, if we are not afraid to grapple with it.”

In connection with his work, Dr. Peters sent out
about 350 circulars to veterinarians in various parts
of the United States, asking as to the frequency or
infrequency of tuberculosis in their practice. Only
19 replies were received. Of these, 21 had no
cattle practice, 19 reported “no cases,” and only 39
reported any contact with the disease. From the
last class, in seventeen different States, most of

20 TUBERCULOSIS AMONG CATTLE.

them reporting for one year only, 549 cases were ~
reported, with 242 suspicious cases,— a total of 79% 4)
in 165 herds containing about 3,000 animals; that
is, where the disease existed, about 18 per cent
were diseased, with 8 per cent suspicious, — a total
of 26 per cent. It should be borne in mind that
all these reports were based only upon physical
examination. What would be the result if tuber-
culin were applied to these herds, is a matter for
grave consideration.

The New York State Commission on Tuberculo-
sis in Cattle, in their report to the Legislature,
January, 1895, say: “ During the short time since
its creation this Commission has carefully studied,
by a system of special inspection, the prevalence,
distribution, mode of infection, and general behavior
of tuberculosis in cattle, confining part of its work
to a given area which was thought to be com-
paratively free from general infection from other
sources. In this district 947 animals were exam-
ined, and out of this number 66 were condemned
and slaughtered. A dissection of each animal
showed it to be tuberculous, showing 6.96 per cent
diseased; and it is believed that this is a fair
average if the State were taken as a whole.) A
Jarge proportion of these animals were common
stock, which fact controverts the opinion, which
obtained very generally hitherto, that common
bovine animals have immunity from tuberculosis.
Tuberculosis is not a respecter of breeds. The

THE DISEASE IN THE LOWER ANIMALS. 21

disease once introduced into a herd spreads with
certainty throughout, and with a rapidity propor-
tionate to the unsanitary surroundings. Cattle
kept in well-ventilated stables, with free admission
of sunlight, are less prone to the disease, while
those kept in dark, ill-ventilated stables, amid filth
and unsanitary environments, develop the disease
rapidly, once it is introduced.” —

Dr. J. F. Winchester, of Lawrence, Mass., a
veterinarian, and in 1888 a member of the State
Cattle Commission, collected all attainable informa-
tion on the prevalence of the disease in this State.
In the report of the Board of that year, his results
are given, showing that reports from thirty-four
farms, with 886 animals, showed 243 animals, or
28 per cent, killed as diseased, and 189 animals, or
21.30 per cent, “suspicious.” On fifteen other
farms, with 244 animals, he found over 11 per cent
by physical examination showing symptoms of the
disease, beside 10 per cent “ suspicious.”

The Tuberculosis Committee at the Veterinary
Congress of America, in connection with the Chi-
cago Exposition, 1893, in discussing the indefinite-
ness of statistics of the disease, said: ‘* We have
no regular inspection of herds nor a complete
inspection of meat. It is only possible to glean
facts relating to the extent and distribution of the
disease incidentally, when cattle are examined with
other ends in view. Even if we had an organized
inspection of herds, the result of such an inspection

22 TUBERCULOSIS AMONG CATTLE.

would not teach us how much tuberculosis is pres-
ent among our cattle, because the disease is notori-
ously hard to discover in the living animal, except
when advanced; and breeders and farmers who
have had some experience with it are clever enough
to remove animals that show the first suspicious
symptoms. It is only by an extensive examination
with tuberculin, or a thorough and well-organized
system of meat inspection, that reliable statistics
can be obtained.”

This committee, in discussing the dangers from
the disease, place its transmission through the meat
and milk to man as first, and its transmission
among cattle as second in importance.

Occasionally the statement appears that there is —
less of tuberculosis, human or bovine, now than
there was a score or two of years ago. That this
is a superficial and unfounded idea appears from
the fact that Professor Walley, in 1874, quoted the
Veterinary Record of 1847, in its allusion to a case
of tumors of bovine tuberculosis as “ similar to some
we have occasionally seen,” and saying, “ On this
subject our English veterinary authors are silent,
and we believe the above to be the only case of the
kind recorded.” That the post-mortem appearances
of the disease were unknown to English veterinaries
of half a century ago argues that the disease itself
was practically unrecognized. It is also true that
at no very remote time medical men made no
distinction between syphilis and tuberculosis; and

THE DISEASE IN THE LOWER ANIMALS. 23

it is less than a quarter of a century since glanders

and tuberculosis were considered the same disease.

Professor Walley committed himself to this state-
ment in 1872. These facts justify the conclusion
that there are no statistics covering any considera-
ble period that are of any value as a basis of com-
parison as to the prevalence of the disease. -

- Bulletin No. 27 of the Hatch Experiment Station
of the Massachusetts Agricultural College, issued
in December, 1894, gives a history of tuberculosis
in the College herd, from which it appears that even
at this presumably well-informed institution, in the
year 1871, a well-defined case of the disease failed
of recognition. On post-mortem examination, “ it
was found that the pleural surface of the thorax
was thickly studded with large and small nodular
erowths, some of which were filled with pus and
others with caseous or calcareous material. The
true nature of these excrescences was not recog-
nized. No one even suspected that they were the
result of disease, but rezarded them as an abnormal
erowth and a curiosity.”

Two years later another animal died, of which
the Annual Report says: “ The disease was a most
obscure one; but her trachea, lungs, liver, pleura,
and whole thoracic cavity, were affected with a
morbid growth, apparently of a scirrhous nature.
..- In this connection I may mention that by
many cow-doctors the symptoms were referred to
horn-ail ; and it was only with the greatest difficulty

24 TUBERCULOSIS AMONG CATTLE. -

that I prevented the most zealous from boring the
suffering creature’s horns and stuffing them with
cayenne pepper, spirits of turpentine, and other
soothing preparations.” In the Report of 1874
this case is identified as tuberculosis.

That such clear illustrations of the disease
could fail of identification in such an institution
is suggestive of the denser ignorance which must
have pervaded the public at that time, and which
unfortunately is not yet entirely dissipated.

The limitation of tuberculosis to pulmonary con-
sumption is still a popular error, and not a few
medical men still fail, in their returns of death
causes, to recognize the full list of diseases that are
tuberculous. On the other hand, modern classifi-
cation is tending to closer differentiation, as several
classes of- cases once entered as “consumption”
now appear under newer names. It is therefore
extremely difficult to make a fair comparison of
statistics so as to determine with any certainty
whether tuberculosis is or is not on the decrease in
the human race.

Those writers who admit that the disease has
thus decreased, find an explanation of this in the
increased attention paid to sanitation under the
influence of modern boards of health, and especially

in the present general recognition of the infectious-

ness of the disease, and the consequent practica-
bility of controlling it by preventive measures.

CHAPTER III.
ITS VARIED SYMPTOMS AND APPEARANCES.

Tue slower progress of tuberculosis as compared
with other infectious diseases has aided in the gen-
eral indifference with which it has been regarded.
In its acute form it often runs its course in a few
weeks, but its usual manifestation is of a chronic
and dilatory character, often lasting for years.
The disease attacks many of the organs of the
body, and it often makes considerable progress in
one organ before others are involved. ‘This results
in great difficulty in recognizing its presence in
its earlier stages, or in identifying it where some
difficulty or disease is indicated. Often the disease
is well established before any noticeable indication
is seen, and as often the symptoms are so varied,
as one or another organ is affected, that there can
be no certainty of recognizing it.

Cases are frequent where the animal appears
to be in excellent condition in every way, and on
autopsy extensive and long-seated disease of some
one or more organs is exposed. In one case a
Boston merchant with a thoroughbred herd of one
hundred animals suspected the presence of tuber-

°6 TUBERCULOSIS AMONG CATTLE.

culosis, and employed a veterinarian to apply the
tuberculin test. He had exercised his own best
judgment, after twenty years of close study of
his herd, in the selection of two young cows
which he felt sure were free from the disease,
and these he had set aside to supply his own
family with milk and butter. He was confounded
when the tuberculin test pronounced these two
animals diseased, and could hardly accept the
verdict; but when they were killed, with thirteen
others, and the autopsy showed them the worst
diseased animals in the herd, his astonishment was
equalled only by his distress over the peril to
which he had unwittingly exposed his family. This
is but one of several similar cases that have oc-
curred in the work of the Massachusetts Cattle
Commission.

On the other hand, cases are of frequent occur-
rence where careful and experienced owners and
the best veterinarians have examined animals that
were badly out of condition and might well have
been killed on general principles, and have felt sure
that they were affected by tuberculosis, even when
tuberculin said they were not, but found their opin-
ion contradicted by the facts at the autopsy, no
traces of the disease being discernible.

Such experiences confirm the general opinion of
all experts, that physical examination alone really
counts for but little in the discovery of the disease.
If physical examination was alone available, the

% 7
le s
“th

ITS SYMPTOMS AND APPEARANCES. 27

task of eradicating or even of controlling the disease
would be a hopeless one.
Especially where the disease attacks the lymphatic
glands, its recognition by physical examination is
__very uncertain, and is certainly much delayed. The
affection of the bronchial and mediastinal glands
lying between the lungs, and of the mesenteric
glands amid the involutions of the intestines, is sim-
ilarly concealed and of doubtful detection. And,
besides, these glands are subject to other diseases
of less dangerous character; so that, if disease
is recognized there, its true character cannot be
declared.

In acute cases, and in chronic cases where the
disease involves a large portion of the internal
organs, there is usually a feverish condition, loss of
flesh, sinking and dulness of the eye, roughness of
the coat, rigidity of the skin, and other attendant
symptoms of illness; but all these may be present
without. tuberculosis. They are sure symptoms of
illness, but they make no certain declaration of
its character.

It is a popular, but an unfounded notion, that
this disease is only of the lungs, and that a cough
is its only certain indication. ‘That the disease is
far more varied in its location has already been
stated. That a cough is the certain indication of
the disease in cattle, even when the lungs are af-

fected, is also a delusion. All cattle cough more
or less when in health, and an observer needs far

28 TUBERCULOSIS AMONG CATTLE.

more than ordinary training to determine with any
certainty the difference between a normal cough
and the cough of tuberculosis.

The tuberculous cough is described as small, dry,
and wheezing, or rattling, and may be expected to
follow the drinking of cold water, or unusually vio-
lent exercise. A trained observer may sometimes
detect the disease, if it is located in the lungs, by
tapping on or listening on the walls of the chest ;
but the anatomy of the animal, the frequent and
varying sounds in the stomach and bowels, and the
pressure of these when distended against the lungs
by their contents, so complicate the sounds that no

certain conclusion can be reached by these means.

The fact that in tuberculosis the disease often scat-
ters itself in small masses throughout the whole lung
tissue, while most other lung diseases involve large
masses and finally the whole structure, renders the
sounding of the lungs but an uncertain test. Often
the nodules are found scattered through the lungs
like plums ina pudding, when no information could
be secured by tapping or listening.

In advanced cases, where the lungs or the glands
of the throat are involved, the breathing is some-
times labored, and there is an offensive discharge
from the nostrils. When the disease is general
throughout the body the animal may curl and writhe,
and perhaps cough or groan, if the back is strongly
pinched over the shoulders or loins, or above the
breast-bone, or if the ribs are struck sharply by
the fist.

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ITS SYMPTOMS AND APPEARANCES. 29

Dr. Law says: “In the advanced stages of lung
tuberculosis any one can recognize the consumptive

animal. It is miserably poor, and wastes visibly |

day by day ; the dry coat of hair stands erect; the
harsh, scurfy skin clings tightly to the bones; the
pale eyes are sunken in the sockets, tears run down
the cheeks; yellowish, granular, fetid, and often
gritty discharges flow from the nose; the breathing
is hurried and catching, the breath fetid; the cough
is weak, painful, and easily roused by pinching the
back or breast, or striking the ribs. Temperature
may vary from below normal, 101, to 107 degrees
Fahrenheit.”

In sucking calves, tuberculosis, if received in the
milk, shows itself in bowel troubles, with enlarge-
ment of the intestinal glands and their filling up

_ with the tuberculous deposits. In mature animals,

when the disease attacks the digestive apparatus its

especial symptoms are capricious appetite, bloating,

scouring, costiveness, colic, and even more emacia-
tion than when the lungs alone are involved. The
temperature usually increases as the disease pro-
gresses in activity.

When the disease is well established in the sexual
organs there is abnormal excitement. The cow is
frequently in heat, but fails to conceive. There is
often a whitish discharge from the vulva, and ele-
vated temperature is frequently observed. ‘The liver
is often one of the early seats of infection, and the
attendant symptoms are quite like those where the

.

30 TUBERCULOSIS AMONG CATTLE.

bowels are affected. When the kidneys and bladder
are involved there is tenderness of the loins, which
may be detected by pinching. There is also, in some
cases, frequent urination, and the fluid sometimes
shows traces of blood,.or of purulent matter.

The glands of the throat are often the first seat
of the disease, the infection coming from inhaling or
swallowing the dry bacilli floating in the atmosphere.
There is a wheezy sound in breathing, and the glands
at the base of the tongue and along the throat are
enlarged, those on one side usually more than on
the other. They may be reduced in size, and much
harder than normal, or soft and yielding if handled.
A loose cough sometimes attends the throat trouble,
with difficult swallowing and a discharge of slime
from the mouth. When the tubercles are located in
small masses along the lining of the throat and air
passages, there is a harsh and spasmodic cough.
When the lungs are first infected it often occurs that
the bacilli pass to the mouth with the sputum, and
from there are swallowed to infect the intestines.

The udder is usually attacked one quarter ata
time, with swelling which may involve the whole

gland. The lymphatic glands in the front and rear —

of the udder are much enlarged and hardened,
so as to be readily felt on examination. In some
cases the milk shrinks in amount, and is thin and
watery; but often the disease advances until the
whole udder is infiltrated with the products of the
disease before any reduction in the amount of milk
is observed.

4 tn a + Bae cia

ITS SYMPTOMS AND APPEARANCES. 31

There is a small gland in front of each shoulder-
blade in a cow, which is often sought for in judging
of her milking quality. This is frequently affected,
and its enlargement and undue hardness may be
easily felt, especially in thin cattle. A similar gland
ig in front of the stifle, which is likewise sought for
by the buyer, may also disclose the presence of the
disease by its enlargement. Glands on the sides of
the udder, and those at the lower part of the chan-
nel containing the jugular vein, have similar mani-
= festations. There is occasional manifestation of
2 the disease about the stifle and hock joints, with
| a hard enlargements, causing lameness. In extreme
4 eases the bone is so diseased as to crumble, and
expose itself through the skin.
| Although the foregoing presents a formidable
array of symptoms, supposably easily recognized,
, j it must be remembered that all are rarely present
ina single case; and usually each is so masked,
or so characteristic of some other ailment, as to
confuse and confound even the expert veterina-
rian. Beside, it must be remembered that the affec-
tion of one organ with the disease sooner or later
leads to the affection of others. Thus the expecto-
rations from diseased lungs, rising to the mouth,
may pass into the stomach and bowels, and these,
_ being affected, send the disease to every other organ
by means of the circulation.
Professor Walley recognized the difficulty of de-
| termining the presence of tuberculosis by physical

J
| oe

32 TUBERCULOSIS AMONG CATTLE. : '

examination. In 1879 he wrote: “ Acute tubercu-
lar disease of an organ may give rise to no symp-
toms of a positive character. Particularly would
this be so in the case of an organ having no external
outlet; and even where one exists, it would be of
far less aid to us in acute than it would in chronic
disease. In acute hepar tuberculosis, for instance,
there might be no symptom which would not be
equally present in acute hepatitis from any cause;
so in acute pulmonary, renal, or intestinal tubercle,
nor either in acute or chronic, should we have any
symptoms to guide us, where the disease is confined
to the internal lymphatic glands. In chronic tuber-
culosis of organs having an external outlet there is
always just the possibility of our being able to de-
tect, by patient ocular and microscopical exam-
ination, tubercular elements in the secretions or
excretions.”

Of the difficulty of diagnosing the disease in its
pulmonary form, Professor Walley says: “ Perhaps
there is no form of tuberculosis which is more
likely to be confounded with other affections than
this ; and the reason is not far to seek. Itis simply
that so many pathological conditions, totally differ-
ent in themselves, give rise to the same physical
lung symptoms and general constitutional indica-
tions.” It will be generally conceded that, if the
difficulty of diagnosis is so great when the disease 1s
located in the lungs, where its appearance is most
apparent to the general observer, there is but little

4

~ «¢ aad

Ai

‘ITS SYMPTOMS AND APPEARANCES. 33

hope of a correct diagnosis by physical examina-
tion when it is located in other and less accessible
organs. |
5 Professor Hills and Dr. Rich, after full consider-
ation in preparing their bulletin on the disease,
decided that the symptoms are so obscure and
_yariable, except in advanced stages, that it was
inadvisable and would be misleading to attempt
_to give a further description of the symptoms than
the following, which is from the special report of
the Bureau of Animal Industry of the United States
Department of Agriculture on “Diseases of Cat-
tle Feeding”: “A dry, short, interrupted, hoarse
cough, which the sick animals manifest in the
morning at feeding-time, and still more after some-
_ what violent exertion. At first these animals may
_ be full-blooded, and lay on a considerable amount of
_ fat when well fed. As the disease progresses, they
grow thin, and show more and more those appear-
ances which indicate diseased nutrition, such as
_ staring, lustreless eyes, dishevelled coat, dirty, tense
skin, which appears very pale in those regions free
from hair. The temperature of the skin is below
normal. The loss of fat causes sinking of the eyes
in their sockets; they appear swimming in water,
and their expression is weak. The cough is more
frequent, but never or very rarely accompanied
with a discharge. The body continues to emaciate
even with plenty of food and a good appetite, so
_ that the quantity of milk is small. At times in the
): 3)

es 7 ie a, .
— > <a Be! ae Reo

34 TUBERCULOSIS AMONG CAT "%

early stages of the disease, still more in the le
stages, the diseased animals manifest consit rable
tenderness when pressure is applied to the fron’ nt
or sides of the chest, by coughing, moaning, ete.
Often all symptoms are wanting, in spite of the
existence of the disease.”

TUBERCULOSIS OF THE LUNGS.

(The two cuts show different stages in the growth of the
tubercles.)

a ee

— ae

CHAPTER IV.

-POST—MORTEM REVELATIONS.

_ Hat the impossibility of the diagnosis of this
disease by physical examination is not an invention
of those who are advocating the use of tuberculin
may be seen from the declarations of Monsieur
Van Hertsen, chief inspector of the Brussels abat-
toir; Dr. George Fleming, principal veterinary
inspector of the British army; and Herr Lydtin,
principal veterinary surgeon of the Grand Duchy

_-of Baden, who, in a report prepared for discus-
sion at the International Veterinary Congress at
Brussels, in September, 1883, wrote as follows : —

“Taking all. the circumstances into considera-
tion, we need not. be astonished at the numerous
voids that still.remain in the symptomatology of
tuberculosis; and it can easily be understood that
the diagnosis of the disease is looked upon as very
difficult, and often even impossible. Certainly the.
difficulties in the way of diagnosis are real; they
are the consequence, in many cases, of the slow
and insidious course of the disease, which some-
times lasts for years, and tne phenomena of which
often pass unperceived. And, besides, as the mor-

36 TUBERCULOSIS AMONG CATTLE. :

bid products of the malady may in certain cases be
deposited in organs which under ordinary condi-
tions would remain free from them, (as in the
brain, spinal cord, kidneys, and genital organs,)
and produce special manifestations, it is scarcely
possible to trace in a precise and definite manner
all the symptons which mark the presence of the
disease in every case.”

The same gentlemen also report the various loca-
tions of the disease as follows. In the lymphatic
glands of the head, neck, and chest; the cervical
maxillary, sub-maxillary, prescapular, parietal and
thoracic glands; mediastinal and bronchial glands ;
the lungs; the pleura; the peritoneum; the mu-
cous membrane of the larynx, pharynx, trachea,
and cesophagus; the brain and spinal cord ; the skin
of the forehead ; the mesenteric glands; the omen-
tum ; the intestinal mucous membranes ; the liver,
spleen, and kidneys; the coats of the bladder, the
vaginal sheath, the testicle, the spermatic cord,
the prostate gland, the uterus, the fallopian tubes,
and the ovaries; the udder; the cardiac muscle;
the muscles of the body, and the bones and the
articulations. ‘So formidable a list needs no com-
ment to suggest the unscientific character of the
idea that tuberculosis is only a lung disease. They
mention, as exceptional phenomena of the disease,
a bovine uterus weighing three and a half hundred-
weight, and a tumor on the heart of an ox weigh-
ing twenty-seven pounds.

POST-MORTEM REVELATIONS. 37

From the writer’s observation of several hundred
autopsies in the autumn of 1894 and the winter of
1894-95, the following indications are gathered
as substantially all that may ordinarily be expected
to appear.

The establishment of the disease in any organ of
the body is usually in the form of a lesion, or colo-
nization and multiplication of the bacilh, resulting
in arounded nodule, which is called a tubercle; but
this formation is sometimes absent, and a diffused
permeation of the tissues by the bacilli results in
only a thickening of the infected part.

The tubercle or nodule is at first only of micro-
scopic size; but its earliest readily visible appear-
ance is in size like a millet seed, from which this
stage of the disease is called “milliary.” These
tubercles soon accumulate in masses, and gradually
change from a red or congested condition to yellow-
ish gray cheesy masses, in which gritty particles of
lime salts are present ; and as the disease progresses
these sometimes are resolved into semi-fluid masses
of yellowish pus or matter. All these stages may
be found in a single animal, or only one may be
found in a single organ. Frequently the cheesy
mass, instead of developing into the pus stage,
forms firm and fibrous nodules, which hang in
clusters from the lungs, or adhere on the walls of
the chest and abdomen. This form is known
among butchers as “ pearl disease” or “ grapes.”

The thoracic, bronchial, and mediastinal glands

388 TUBERCULOSIS AMONG CATTLE.

of the lower throat between the lungs, the mesen-
teric glands within the involutions of the intestines,
and the glands connected with the udder, are often
creatly enlarged, — from the size of a bean to the
size of a man’s fist, or larger, and filled with a
cheesy mass of dead tubercle, or with semi-fluid
pus.

In discussing the disclosures at sixty autopsies,
Bulletin No. 7 of the Bureau of Animal Industry
comments on the high percentage of infection in
the herd in which not more than five or six showed
physical indications of disease, and says: “The
concealed character of the disease was not always
limited to the very mild infections, but in some
cases considerable lung disease remained unob-
served during life. Of the sixty animals killed
only seven, or about 12 per cent, were free from all
traces of tuberculosis.”

A summary of the disease in this herd, as dis-
closed by a thorough examination of the head,
thorax, abdomen, and the glands of the lungs only,
is given as follows : —

Total number'in the herd... ... 1” ee

a5 BR, hy PEO CLOG + Axes eh - 2! 9 yn
Retropharyngeal glands git) . . i
oF ‘i ‘* only affected . .” . (ue
Thoracic organs affected ... .:. .. # 2 See
Lungs affected . . . «ieee

Thoracic glands, but pe inne affected . «.
Bronchial glands only affected . . . . . .. 5
Mediastinal glands only affected ....... 9

a Seto 2 ese

i
i
:
t
t

POST-MORTEM REVELATIONS. 39

Lungs diseased and glands healthy . . . . .. 1
Exclusively thoracic lesions (air infection) . . . 26
Digestive tract and head-glands affected . . . . 26

Intestinal walls affected od Sr be SNC eae ae eas BRT Ey
Mesenteric glands affected. . . . . . «1... 16
Portal glands affected . . pit dhe ae Eh | ae Pe aA
Mesenteric but not portal affected Mass heel eae aa Cok
Portal and not mesenteric affected . . . ... 4
Parenchyma of liver involved 2
merous Membranes aifected . ... « « 2 « « QB
Udder glands affected 1

Dr. Bryce reports four groups of post-mortems,
in which the per cent of the various organs found
diseased was as follows: —

Number in each group . . 58 48 138 7,829

Lungs . ae 70 82 75
Glands, Ehroat, ve hangs at! 56 61 29
fieuta . : ¢ 20 ore t a)
Mesenteric Baia) Sela tes, Ne 22 48
PRSEUCR ek ee OD A 1 2
BM rene! aye 3) of we) 42 rar 14 28
0 GN a ee iia 1 10
eee 2 2 19

En a ey 25 22

There are reported 7,329 post-mortems in which
the disease was recognized as follows, in cases
and per cent. It will be understood that in
nearly all the cases several separate organs were
affected.

40 TUBERCULOSIS AMONG CATTLE.

Cases. Per cent.
General tuberculosis . . . . . . 469 6.26
Lungs... ee 75.81
Pleura Ninicnets fe le ie 59.49
Peritoneum and mesentery. . . . 3,316 48.27
Pleura of chest wall... ....... ). 3 46.71
Bronchial and mediastinal glands . 2,022 29.43
Liver 5 ge) Bae as. Chats yee 28.24
MIPIOCR i) dk Oe be oe, SU 18.53
Uterus... sph) ke tel, eee 10.17
Inguinal Baha em eo 5.30
Pharyngeal clands =.) 0. s\n) ee 4.35
avaches yoy.) Gs. Cur cae Os) ae 3.39
ebae ies parece ave tence 1.62
Drees i e Tn! eee tree Ae re ee 89 1.30
Ovaries . . fire et oe ee 1.25
Lymph glands of vet Ge Matas) PY 80 1.16

The lymphatic glands of the thorax and abdo-
men, the heart, kidneys, stomach, brain, bones,
etc., were found diseased in less than one per cent
of the cases.

These figures probably do not represent the
absolutely accurate proportions of the locations of
the disease, for so close autopsies as would be
necessary to find the disease in the obscure loca-
tions were hardly made in so large a number of
cases. From personal observations of over 400
autopsies under the direction of the Massachusetts
Cattle Commission, the writer feels confident that
the per cent of udder affections above given is far
under the average. The table is of value, however,
as illustrating the wide bodily area through which

POST-MORTEM REVELATIONS. 41

the disease may be distributed, and to counteract
the current idea that tuberculosis is only pulmonary

consumption. ,

Among the comparatively infrequent locations of
the disease are the brain and spinal cord. Dr.
Salmon quotes Semmer as reporting four lesions on
the brain in forty observed cases, and remarks:
“Jt is not improbable that, owing to the infre-
quency of exposing the brain and spinal cord,
tuberculosis there may have escaped the attention
of pathologists, and it may be that it is not so
uncommon as is generally supposed.”

This remark is of great importance in consider-
ing the statistics now accumulating from the work
in progress in Massachusets and other States. Not
infrequently post-mortems on fifty animals are held
in a day, by a single observer. His object is not to
demonstrate all the manifestations of the disease in
his subject, but simply to find it present as a basis
of compensation.- When this is accomplished, he
hastens to another subject ; and each goes on record
as a manifestation of the disease in the organs
where he happened to find it first. If the case
were obscure, he might examine several organs;
but if quite clear, he would only make a record
which as a basis of accurate observation would be
quite worthless.

Upon this point Bulletin No. 7 of the Bureau
of Animal Industry remarks: ‘ Autopsies upon
tuberculous cattle are mainly made when the tuber-

42 TUBERCULOSIS AMONG CATTLE.

cular virus has become pretty generally dissemi-
nated through the lymphatic glands, and even over
the serous membranes and through the various
vital organs. A determination of the point in the
body whence the virus has spread is, in many of
these cases, out of the question. On the other
hand, when the disease is in the incipient or quies-
cent stage, it is hidden away in the lymphatic
lands; and unless a thorough search is made
through every gland in certain regions of the lym-

phatic system, the disease may be overlooked.

This search is not likely to be made on general
principles, for it is exceedingly tedious, and not
usually of any definite value in diseases other than
tuberculosis.

bad)
Path
a
rs
t

CHAPTER V. —
THE GERM AND THE DISEASE.

Tue germ of the disease is a vegetable parasite
that inhabits animal tissues, and is known as the
Bacillus tuberculosis. It is rod-shaped, and is va-

os ; i ee aye ;
riously described as from 5745 to zp} inch in

length. It can be artificially propagated and culti-
vated in blood, meat juices, or in gelatine. Its
favorite temperature is from 100 degrees to 102
degrees Fahrenheit, and its vitality is destroyed
by a continued temperature of 167 degrees. Its
vitality is not affected by drying with moderate
heat, by frost, or by the gastric fluids. It dies in
a few hours in direct sunlight, and in a few days
in ordinary daylight. It has been known to remain

vigorous in an ordinary room seventy-five days or

more.

As dryness does not affect the bacillus, there is
ereat danger of infection from the mucous or other
discharges of those who are diseased. Discharges
from the throat and nose, dried and pulverized,
may float in the air as dust, and find lodgment,
through the breath, in other individuals.

While absolute heat of 167 degrees kills the
germ under ordinary exposure, it has been known

44 TUBERCULOSIS AMONG CATTLE.

to survive a supposed higher temperature. The
uncertainty of temperature under ordinary condi-
tions of cooking is such as to render unsafe the
use of anything in which the germ has found lodg-
ment, especially by those of delicate health.

Dr. Ernst quotes a series of experiments in his
own laboratory by Dr. A. K. Stone, ‘‘in which this
organism, after an extreme degree of drying, has
been shown to retain its vitality and infectious
properties for a period of three years and a half at
least.”

Dr. Law quotes a case where in one store, with
a tuberculous clerk, the dust raised in sweeping
affected one clerk after another; and a similar
scattering of spittle in houses, stores, barns, cars,
and streets supplies infected dust to spread the dis-
ease indefinitely. With animals, a manger smeared
with head discharges from a diseased animal infects
the next susceptible animal using it. Drinking
troughs and all stable appliances are also channels
of infection. The germ survives in water and moist
earth, and neither salting nor putrefaction will
render meats innocuous.

The disease (tuberculosis) of which the germ
above chronicled is the single prime cause, is as old
as humanity. It has been long known to prevail,
both in human and animal forms. As early as four
centuries before the Christian era Hippocrates de-
scribed it; and so long ago as the Middle Ages the
animal type of the disease was considered conta-
gious, and the affected flesh was discarded.

THE GERM AND THE DISEASE. 45

Infection occurs by breathing the germs, by
- swallowing, or by their entrance through a cut or
- wound. The main sources of infection are the dust
4 of dried spittle of consumptives, or other tubercu-
lous matter breathed or swallowed, contact with
tuberculous matter or people, or the use of the meat
or milk of tuberculous animals.

The fact of contagion from tuberculosis by inha-
lation, inoculation, feeding, and other forms of
contact, was demonstrated as early as 1865; but
the true cause of the contagion was not determined
until the discovery of the bacillus by Dr. Robert
Koch, in 1882. He demonstrated the presence of
the germ in saliva and other secretions, as well as
in the various forms of the disease in the organs of
the body; and he also demonstrated its infectious
character by inoculations upon various animals
through the germs obtained from known seats of
the disease. In closing the paper before the Phys-
iological Society of Berlin, in which he announced
the result of his investigations, Dr. Koch declared
a fact, which later observations by scientists of all
countries have confirmed: “ We can, with good
reason, say that the tubercle bacillus is not simply
one cause of tuberculosis, but its sole cause; and
that without tubercle bacilli you would have no
tuberculosis.”

Dr. N. Senn says: “If the bacilli are injected
directly into the circulation, or gain entrance into
the blood current from some tubercular focus, they

- ; = ; comet -- _ —) ? = + a ss . a
a - i. J 4 ‘ a Gn 2 ‘ - 3 Sl : oe = . es Coe | —_ =: rs
; . ae = a Pre a nit as ‘ ay ne ee ke ah a = 7 he , a> = 2.
7 er oe Se rr oo * 5 aS 2 a 0 age Bey es aa st Wis ‘~
. a ” ® ¥ ae Se, oy o> oe ire acer a — ’ es oe “d arp ’
- x ., Ga ee i. ’ i mia Pats tite ee PE a
a os f a ¥ Peet See ee
‘ = al ne eens |

a ~t,
. es
. =

46 TUBERCULOSIS AMONG CATTLE.

become implanted upon the wall of distant capillary
vessels, and the nodule which forms at the seat of
implantation consists of cellular elments formed by
the tissues of the vessel wall. As soon, however,

as the bacilli reach the extra-vascular tissues, they

in turn furnish their part of the material for the
further growth of the nodule. If the tubercle bacil-
lus becomes implanted upon a mucous surface, —
as the bladder, intestines, nose, larynx, uterus, etc.,
—if such surface is susceptible to tubercular infec-
tion, the epithelial cells take an early and active part
in the inflammatory process. . . . All tissues, when
infected, take part in the process.”

In summing up a discussion of the germ theory
of disease, Professor Hills and Dr. Rich say the
theory is “that those minute plants grow in the
body; that the products of their growth are poison-
ous, and that a definite disease is due to the effects
of the poisons produced by a definite species of
germ.” |

They also quote the artificial propagation and
proof of a bacillus, usually called the “ four postu-
lates of Koch,” as follows : —

1. The germs must be found in the blood, lymph,
or diseased tissues of man or animal, suffering or
dead from the disease.

2. The germs must be isolated from the blood,
lymph, or tissue, and cultivated in suitable media
outside the animal body. These pure cultures must
be carried on through successive generations of the
organism.

ee ee

ee

ad

iin al

ee ee ee ee ae eee ee oe

THE GERM AND THE DISEASE. 47

8. A pure cultivation thus obtained must, when
introduced into the body of a healthy animal, pro-
duce the disease in question.

4. In the inoculated animal the same germs must
be found again.

Since Professor Koch’s announcement, the con-
nection between the germ and the visible mani-
festations of the disease has been so thoroughly
demonstrated that in ordinary practice the detec-
tion of the germ by the microscope as proof of the
disease is rarely necessary. In several hundred
autopsies on diseased cattle witnessed by the com-
piler of this volume, there were scarcely half a
dozen cases in which the visible record of the
disease was not clearly apparent.

In a discussion of the infection of tuberculosis,
W. H. Chapin, M. D., of Springfield, said the ques-
tion is settled in the affirmative forever. But he
considered the details of infection an important
subject of study, and had tabulated and analyzed
the deaths reported from the disease in Sprinefield
from 1868 to 1894. He included in the list not
only cases classed as tuberculosis, but also those
which seemed to him to belong there, including
children’s brain diseases, etc. He also said that
many cases of typhoid fever and pneumonia would
be included if autopsies had been made; but all
these he had excluded.

Dr. Chapin’s list included about 4,800 cases, in-
cluding those confessedly tuberculous, and all cases

48 TUBERCULOSIS AMONG CATTLE.

of convulsions, spinal meningitis, cerebral conges-
tion, hydrocephalus, cerebro-spinal meningitis, tu-
bercular meningitis, brain fever, and brain disease
in infants. He considered that the diagnosis of
tubercular meningitis is altogether too infrequently
made. He analyzed the 4,800 cases, and found that
in 3,372 cases, or 72.5 per cent, no relative had died
in Springfield of tuberculosis in twenty-five years.
The proportion of tubercular meningitis to other
cases of brain disease was about the same in the
family groups as in the other groups.

Dr. Chapin found peculiar relations of brain dis-
eases to other diseases. Thus, of 346 cases of brain
disease 43 deaths occurred within a year from con-
sumption in the same family, 24 were within two
years, 18 within three years, and so on; 12, 11, 12,
9, 5, and 5, respectively, within nine years. The
further away we get from deaths from consumption,
the fewer deaths appear from the allied disease.
He called attention to the fact that a case of ordi-
nary consumption occupies about three years, and
said that 50 per cent of all deaths from brain dis-
ease in children in tuberculous families occur within
three years of a death from consumption. He said
that in districts where houses are new and the
people are well-do-do, there is less consumption;
while among old houses and poor people the dis-
ease is rampant. Where other infectious diseases
flourish, tuberculosis flourishes. In these old houses
the floors and walls are reeking with it.

THE GERM AND THE DISEASE. 49

_ Harold C. Ernst, M. D., says he does not believe
in the hereditary nature of tuberculosis, but thinks
that the widespread scattering of the infectious
material and its characteristics account for its
occurrence in families and in neighborhoods. The
bacillus is very retentive of life. He considers that
the expectoration from persons affected with pul-
monary tuberculosis is the most general source of
infection ; and he says that the bacillus may be
found in the spittle before the physical signs of the
disease appear in a destructive process of the lungs ;
therefore the earlier stages are most critical, as well
as most infectious.

Dr. George H. Bailey, State Veterinarian of Maine,
says in his Report for 1892: “ The days of discussion
regarding the heredity and contagion of tuberculosis
have passed away, and it is no longer possible to
doubt the dangers to which tuberculous animals ex-
pose their neighbors and their progeny. Solongas
such animals discharge virus by the respiratory and
digestive passages, and by the mammary secretion
can infect healthy subjects by its introduction into
their digestive apparatus with food or drink, or into
their respiratory apparatus with the atmospheric air,
they will continue to remain a menace to the public
health. Rigorously, the theory can be maintained
that a tuberculous animal is a subject dangerous to
the property of others, and it is not permitted to any
person wittingly to injure any one ; therefore, if the
animal that is the source of the injury does not dis-

4

_

ee
50 TUBERCULOSIS AMONG CATTLE. *e8

appear by the good will of the shah is. society taal
the right to exact its destruction.” nies -

Dr. Salmon says: “Tuberculosis would not by —
many be considered contagious in the sense that
foot-and-mouth disease is, because of the insidious _
beginning and slow course of the disease. Yet the
bacillus must come from pre-existing disease in
either case.”

Te
‘, Noe rere

CHAPTER VI.
ONE DISEASE IN MAN AND CATTLE.

BEsIDE the proof that mankind are infected with
the disease by the use of meats and dairy products
from diseased animals, and that the disease has
been transmitted from men to animals by inocula-
tion, the identity of the disease in the two is shown
by numerous well authenticated instances in which
it has been taken on by veterinarians and others
through cuts or scratches received while making
post-mortem examinations of diseased animals.

It is beyond question that the germs, the post-
mortem appearances, and in many respects the
symptoms of the disease, are the same in man and
in animals. Professor Hills and Dr. Rich declare:
‘ Human tuberculosis infects the lower animals,
and, what is vastly more important, and the central
fact, bovine tuberculosis infects man.” They ex-
press the belief that ‘“‘ countless thousands of deaths
have occurred due to this source of infection, which
have not been thus described, and of which no record
has been made.”

Dr. E. O. Shakespeare, formerly United States

Cholera Commissioner, says: “ With all its terrors,

52 TUBERCULOSIS AMONG CATTLE.

cholera is not nearly so deadly as tuberculosis ;”
and “it has been found that in infants and young
children in some large cities the mortality from some
form of tuberculosis is far greater than is generally
believed, amounting in some localities to one fifth —
of the deaths in the young. The significant fact in
this connection is, that it is most frequently some
part of the digestive passages that become first
affected.”

When it is once recognized that the various dis-
eases are the offspring of the one bacillus, — that
of tuberculosis,— the questions of infection and
poisoning by the life product of the bacillus become
of great importance.

Whatever may be the relative responsibility of
cattle and man in the dissemination and the perpet-
uation of the disease, it is quite certain that there is
an intimate relation between the two in this regard.
It is plain that wherever cattle are few or absent
there is little or no consumption among the people,
and that wherever civilization has introduced cattle
consumption has soon followed.

In the temperate regions of Europe and the United
States, statistics show that 12 per cent of all deaths
are from consumption. In New York city the rate
is reported at 20 per cent. Among the American
Indians, who use diseased meat without cooking, ~
the rate is 50 or 60 per cent.

Recent statistics show that in Fall River the
death-rate among children from cholera infantum

ONE DISEASE IN MAN AND CATTLE. 53

is 50 per cent more than it is in Boston; and there
is reason for the inference that this excess is due
to the fact that the Fall River mothers wean their

children very early, and feed them on cows’ milk,

to allow the mothers to resume their mill work.
If the cows are tuberculous, the excess of cholera
infantum through the infection of the mesenteric
glands of the infants would be the natural expla-

nation of the excessive mortality.

Dr. Abbott, of the Massachusetts State Board of
Health, supports this idea. He said in a legislative
hearing, in 1892: “The milk supply is one of the
most important food supplies that we have. It
begins with the life of the children, and a large
number of children are dependent upon the milk of
cows; and we know very well that the health of
such children, as compared with the health of those
who are fed from their own mothers, is very much
poorer, and their death-rate is greater. Whether
this simple question depends on tuberculosis, of
course I could not say; but it is certain that tuber-
culosis may be—I think that it is conceded now
that it may be—conveyed in this way.... As
this is one of the methods that can be controlled
to a certain extent, it certainly is an important
matter, and one which measures should be taken
to control.”

Dr. E. F. Brush, of Mount Vernon, N. Y., who
has given years of attention to the matter, has fre-
quently published the statement that tuberculosis

54 TUBERCULOSIS AMONG CATTLE.

does not exist among people who do not employ
milch cattle. Drs. Hills and Rich quote this
and say: ‘The inference to be drawn is not that
human tuberculosis comes mainly from cattle, —
for man gets his infection mostly from his fellow
man,— but that possibly the primary source of in-
fection and more or less of its maintenance and
extension are due to cattle. Whatever the infer-
ence, there is little question that human consump-
tion is relatively less prevalent in countries where
there are few or no cattle. .. . In some of the
western South American countries cattle are used
only for beef; so many cases of consumption have
been traced to the use of milk that the entire popu-
lation with scarcely an exception leave it alone.”

Dr. Donohue, in an address elsewhere referred to,
says that the broad fact is established that a tuber-
culous cow may give tuberculous milk, and will do
so if her udder be affected ; and if in a given case
the tuberculous cow does not give infected milk,
it is only a question of time when she will do so.

Irving A. Watson, M.D., says: “It has been
proven that pulmonary consumption in the human
family and tuberculosis in animals are precisly the
same disease; and that this disease is a commu-
nicable one, as it is largely, if not wholly, a pre-
ventable one.”

In a paper read in June, 1894, before the National
Live Stock Sanitary Convention, Dr. Kellogg, of —
Michigan, spoke of the identity of tuberculosis in

ONE DISEASE IN MAN AND CATTLE. 55

man and animals as “ demonstrated,” and said:
‘“ Numerous investigations have shown that the
products of the dairy are in some sections to a
most astonishing extent infected with the microbe,
which is responsible for the loss of more human
lives than any other, not excluding the organisms
which give rise to those dreaded maladies, small-
pox and yellow-fever.” He also says that “ infec-
tion of the human race in civilized communities with
the bacillus tuberculosis has come to be at the
present time exceedingly common. Indeed, it may
be said that such infection threatens to become
universal.”

M. Van Hertsen, Dr. Fleming, and Herr Lydtin,
whose report to the Brussels Congress of 1883 has
been before alluded to, in summing up the data
submitted, say : —

‘‘ We arrive at the conclusion that all the evidence
points to the fact that tuberculosis of mankind and
that of animals is one and the same disease, which,
more than any other, chooses its victims from among
warm-blooded animals, irrespective of species, pro-
vided they live in agglomerations.

“1. Tuberculosis has been observed in all
warm-blooded animals submitted to domesticity
or deprived of their liberty.

“2. Tuberculosis in animals and mankind pre-
sents analogous manifestations, in the living as in
the dead creature.

“3. The course and termination of the disease
in mankind and animals is the same.

56 TUBERCULOSIS AMONG CATTLE.

“‘4. The masses of tubercle, and especially the
sputa of the phthisical, produces tuberculosis in
animals when these matters are introduced through
the respiratory or digestive apparatus, or through a
deep wound. Tuberculosis, inoculated from man to
animals, may in its turn be transmitted from one
animal to another, and always produces tuberculosis.

“5. Tuberculosis of man and of animals is
transmitted by heredity.

“6, The disease is contagious in man and ani-
mals.

‘‘7. There are clinical observations which prove
the transmission of tuberculosis from animals to
man, by the consumption of the milk of phthisical
animals.

“8. Tuberculosis of animals and man is rare in
cold climates, where it does not even appear to be
developed. Itis most frequent in Southern coun-
tries. The tracings of the geographical propaga-
tion of the disease in man and animals are nearly
parallel.

“9, It is evidently proved that a pathogenic
microbe, having the same morphological and bio-
logical characters, exists in the tubercle of man
and in that of animals. This organism, whether
it be developed in man or animals, may induce
tuberculosis when, cultivated in a pure state, it is
conveyed to the animal possessing the necessary
receptivity.”

CHAPTER VII.
PREDISPOSING CAUSES, — NOT HEREDITARY.

WHILE it is scientifically established that the dis-
ease is propagated only by its germ, and the old
idea of the inheritance of the disease is disproved,
it should be understood that there are certain con-
ditions of the animal system which may be termed
predisposing causes. While none of these causes
can generate tuberculosis in the absence of the
bacillus, if the bacillus is present the causes con-
tribute to its development. As in the case of all
disease, a delicate or debilitated or depleted con-
dition of the system invites it; and it will find
lodgment when a stronger or more healthful con-
stitution might repel or overcome it.

Among the predisposing causes usually recog-
nized, heredity has its place. The germ is not
inherited, but conditions favorable to its reception
and development may be. Observations in Saxony
show that with 165 tuberculous cattle in 1,000,
there were only two tuberculous calves in 1,000.
At Lyons only five diseased calves were found in
400,000, and at Munich there were but two in the
same number.

58 TUBERCULOSIS AMONG CATTLE.

Close or ill ventilated buildings, dark stables,
insufficient or unwholesome food, breeding too
young or too frequently, inbreeding, over-feeding
to secure abnormal] milk production, and, in short,
any treatment of cattle that tends to debilitate or
over-stimulate, may be considered as a predisposing
cause.

Observation has demonstrated that the idea of
the heredity of the disease must be replaced by the
theory that family predisposition invites the disease.
Thus Dr. Law quotes a case in which in 1877 he
recognized the disease in a herd of thoroughbreds.
The worst were slaughtered, and the milder cases
(young animals) were pastured by themselves dur-
ing the summer. ‘They indicated robust health
until after they were housed in the fall, when they
began to fall away, and after another examination
eleven more were destroyed. It was ascertained
later that these two killings had removed every
representative of a certain family, —not even a
grade being left.

“Dr. Senn says: “It is more probable that the
hereditary or acquired predisposition to tubercu-
losis, which must now be recognized as an impor-
tant element in the causation of the disease, must
be regarded rather as a diminution of the power of
resistance inherent in the tissues to the action of
the specific microbic cause than any characteristic
anatomical cell defects. From a clinical standpoint,
it is important that in the causation of tuberculosis

et yee

PREDISPOSING CAUSES. 59

we must recognize a combination of etiological
factors; namely, (1) local or general conditions
resulting from hereditary or acquired causes, which

diminish the resisting capacity of the tissues to the

action of the bacillus of tuberculosis, which must
be regarded as the predisposing cause; and, (2) the
presence in the tissues of the essential cause of the
disease, — the bacillus of tuberculosis. The pre-
disposing cause can under no circumstances result
in tuberculosis without action of the essential cause ;
and the bacillus of tuberculosis is most certain to
produce its specific pathogenic effect in tissues

- debilitated by hereditary or acquired causes.”

In discussing this branch of the subject Dr. Senn
also quotes Whittier, who compares the causes
of syphilis and tuberculosis: “One man is not
more predisposed to either disease than another.
Syphilis affects one person more than another,
because its virus finds a better lodgment upon the
mucous membrane. Tuberculosis finds also, for-
tuitously, a better nidus in one case than another.
The virus of tuberculosis is lodged,in one case, and
not coughed up; just as in syphilis the virus is
secreted, and not washed off.” And again: “ From
any deposit of syphilis reabsorption may take place
at any time, and reinfection with syphilis; or, bet-
ter, the reappearance of external signs. So from
any caseous nodule, wherein the tuberculous virus
is locked up in temporary innocence, absorption
may take place under favoring circumstances, and a

60 TUBERCULOSIS AMONG CATTLE.

new outbreak of tuberculous symptoms appear... .
While the virus is thus locked up, the disease is
latent; when set free, it is manifest.”

On the effect of unhealthy surroundings, Dr. Law
says imperfect ventilation spreads infection by ani-
mals breathing the same air, and by concentrating
the germs in a confined space; that diseased cattle
improve when turned to pasture, and fall away
when returned to the stable; that the disease is
absent or very infrequent on Western ranges, and
most abundant where cattle are most closely con-
fined; that a moist, changeable climate favors germ
development, while dry and rare air and uniform
temperature tend to suppress it; that faulty feed-
ing lowers the vitality and the animal’s power of
resistance ; that in-and-in breeding, and early, late,
or too frequent breeding have a similar effect; and
that anything resulting in ill health must be viewed
as a predisposing cause.

Dr. F. R. Brush of Philadelphia calls the cow
“the wet-nurse of consumption,’ and explains the
connection between animal and man in the fol-
lowing : — |

‘ Scrofulous females in the human race usually
secrete an abundance of milk, because in scrofula
there is an unusual tendency to glandular enlarge-
ment and activity. As the mammary is the highest
type of glandular structure, it is stimulated to
increased action. A scrofulous cow is usually the
largest milker; and the closest kind of consan-

PREDISPOSING CAUSES. 61

guinity has been practised by cattle breeders, with
the object of producing a scrofulous animal, — not
because she is scrofulous, but because the particular
form she represents are the largest yielders of milk.
We find, too, that consanguineous breeding has
been alleged as one of the causes of tuberculosis in
the human race, where it can never be conducted
with so close and intimate blood relations as in the
dairy animals.”

CHAPTER VIII.
NATURE AND CERTAINTY OF TUBERCULIN.

THERE are but three tests known to veterinary
science that can be relied upon to declare with any
degree of certainty the presence of the bacillus of
tuberculosis in the animal system. These are the
examination of the animal secretions by the micro-
scope; the inoculation of other less valuable ani-
mals with these secretions; and the injection of
tuberculin. Aside from the last named, these tests
are manifestly impracticable for general use. They
have long been at the command of scientists,
and the disease has steadily increased. It would
be impossible even to control it through these
agencies.

The injection of tuberculin is, however, a uni-
versally available and a practically certain test.
It declares the presence of the disease with cer-
tainty in its earliest as well as its later stages.
Its only failures have been from ignorant or care-
less use; and these have thus far been so infre-
quent as to weigh nothing against its real value.
As its character and application are better under-
stood as the result of intelligent experience, even
these few failures will cease to be reproduced.

NATURE AND CERTAINTY OF TUBERCULIN. 63

The present prominence of tuberculin as a diag-
nostic agent is a curious illustration of the facts
that a failure in one direction is often a success in
another, and that no scientific research or discovery
is without its value as a contribution to general
knowledge, even if its especial aim is not reached.
If the latest claim for tuberculin, as recorded at the
close of this chapter, proves correct, it will also
illustrate the possible success that often lies beyond
failure and discouragement.

A few years ago the medical and scientific world
was intensely interested in the anouncement of the
discovery by Dr. Robert Koch, of Berlin, of a lymph
which was to,be a cure for consumption in the
human family. The results of the tests to which it
was put by Dr. Koch and others were watched with
great interest; and when it was finally determined
that the discovery was a failure, there was a gen-
eral sense of disappointment in the scientific world.
It failed because it was found that, while its early
promise was encouraging, its final result was usu-
ally the rapid acceleration of the disease it was
intended to cure.

The operation of tuberculin in the human patient
was carefully watched by Professor Gutman, of
Dorpat, Russia; and after its use as a curative
agent was abandoned, he was induced to test its
application as a detector of the disease among
animals. His observation led to the fact that,
wherever administered to a tuberculous patient,

64 TUBERCULOSIS AMONG CATTLE.

tuberculin produced a characteristic rise in tem-
perature and the acceleration of the progress of
the disease. It was apparent that such a result
could not be invited in the human patient; but it
was entirely proper to invite it if the presence of
so obscure and so dangerous a disease among dairy
animals could thereby be demonstrated. He insti-
tuted a series of experiments in the administration
of tuberculin, followed by a series of post-mortem
examinations, through which he learned that his
theory was correct; and he was also able to point
out the features of fluctuation in temperature fol-
lowing its administration, by which the presence of.
the disease could be demonstrated, and by which it
could be distinguished from other diseases which
are attended with arise in temperature. His dis-
covery of this valuable property in tuberculin was
announced in 1892, and its acceptance by the
veterinary profession is already general throughout
the civilized world.

Tuberculin as used in the detection of disease is
a thick fluid, the agent itself being diluted with
glycerine, so that there are but three drops in a
dose of thirty drops, which is the usual application.

Every infectious disease is transmitted by a germ,
which, once introduced into the system under favor-
able conditions, grows and multiplies. This germ
may or may not be harmful of itself; but each
throws off as a product of its life a substance
which also may or may not be harmful. Just as

NATURE AND CERTAINTY OF TUBERCULIN. 65

carbonic acid gas is thrown off as a product of |
human life, tuberculin is thrown off or evolved as
the life product of the tubercle bacillus. It isa
physiological poison; and it, rather than its parent,
the bacillus, is the agent. which produces the effects
of the disease. It cannot enlarge itself, and it
cannot produce the disease in a healthy system.
It is quickly and steadily eliminated from the system
by natural processes; but while it is present the
bacilli propagate rapidly, and these in turn throw
off new supplies of the destructive agent. Thus
tuberculin in tubercular animals has a continuous
destructive action, reacting with the germ of which
it is the product within the body; while it and its
associated bacilli are thrown off from the system
through the various secretions ; the latter are scat-
tered far and wide to infect other animals and the
human race. 7

The process of artificially producing tuberculin
is aSfollows. A quantity of the bacilli of tubercu-
losis is selected and separated from all other bac-
teria. They are then placed in a tube containing
the serum or clear part of ox blood, meat juice, or
any other favorable material, and the mixture is
kept at blood heat for several weeks. During this
time there is a rapid increase of the bacilli, and a
resultant accumulation of tuberculin in the develop-
ing fluid, or culture, as it is called, until the whole
mass is saturated.

The contents of the tube are then subjected to a

5

66 TUBERCULOSIS AMONG CATTLE.

heat of 250 degrees Fahrenheit for forty-eight
hours to kill the bacilli. They die ina temperature
of 167 degrees, but the higher temperature is in-
sisted on to make absolutely certain the extermina-
tion of every germ. Then the contents of the tube
are filtered through porcelain under air pressure,
until all the dead remains of the bacilli are strained
from the liquid. It is again heated to 250 degrees
to make assurance doubly sure that no germs re-
main, and then the mass is evaporated to dryness.
The result is tuberculin, absolutely free from
any germs. It is then dissolved in glycerine with
a small proportion of carbolic acid, the dilution
making a 10 per cent preparation. It is carefully
put up in vials and securely sealed, to prevent the
infection by germs that may possibly be in the air;
and it is not opened except for the filling of the
hypodermic syringe with which it is administered.
Its administration is a simple process in compe-
tent hands, and consists only of the injection of the
required amount in the cellular tissues just under
the skin, usually behind the shoulder of the animal.
The operation is no more painful than the prick of
a pin, and if the animal operated on is free from
tuberculosis there is no apparent result. If the
above description of the production of tuberculin
is understood, it will be plain to every reader that it
cannot possibly introduce the disease in any case.
Professor Hills and Dr. Rich declare that “the
detection of tuberculosis in its earlier stages by

NATURE AND CERTAINTY OF TUBERCULIN. 67

external signs is usually impossible. Unless the
lesions are in the lungs, even advanced cases are
hard to detect. An animal in this condition may
be sleek, fat, and frisky, may give large amounts of
apparently normal milk, and yet may be infecting
other stock as well as those using her milk.”

Professor’ Mackenzie, after describing the physi-
cal symptoms of the disease, says: “It will be
seen from this brief outline of the clinical features
of the disease, that a diagnosis is hardly possible
until the disease is far advanced, and that even
then diagnosis may not be considered absolutely
safe.”

He then discusses the methods of detecting the
bacilli in milk by the use of the microscope; but
he quotes approvingly the conclusion of Professor
Ernst, that “the virus may be present in the milk
while yet the closest examination fails to reveal
the tuberculosis of the udder.”

In this connection he cites the interesting con-
clusion of Scheurlen, “ that bacteria which are in-
capable of independent motion (as is the bacillus
of tuberculosis) settle quite rapidly when submitted
to centrifugal action ; at least, they separate from
the milk, but a great percentage are carried up
with the cream.” This opposes a somewhat prev-
alent idea that the bacilli may be removed from
milk by the use of centrifugal cream separators.
If they are to be concentrated in the cream, and
later in the butter, it is a separation hardly to be

68 TUBERCULOSIS AMONG CATTLE.

desired. The experiment may be of interest in the
laboratory, but it is useless in the interest of public
health.

Dr. Irving A. Watson says: “ The great value of
tuberculin as a means of determining the existence
of tuberculosis in a herd of animals is far beyond
that of any other means or methods known. In
fact, it comes so near being an infallible test that
the errors of diagnosis based upon its use are prac-
tically nil. By this means the disease can be de-
tected when in its incipient stages, long before it
would be possible for the most skilled veterinary
surgeon to discover it by the ordinary physical
examination. In fact, it places in the hands of
state and national authorities the means through
which bovine tuberculosis may be eradicated, and
without which it would not have been possible to
do more than to‘hold the disease in check, even if
that could be accomplished.”

Dr. F. O. Donohue, Secretary of the New York
Tuberculosis Commission, in a recent paper read
before the American Public Health Association,
stated that his board had made the tuberculin test
an especial study; and that they were convinced
that it was perfectly harmless to healthy animals,
and that their board condemned no animal that did
not respond to this test.

Bulletin No. 7 from the United States Bu-
reau of Animal Industry, in concluding the reci-
tal of recent experience with tuberculin, says: ‘It

NATURE AND CERTAINTY OF TUBERCULIN. 69

is not necessary to repeat the many favorable opin-
ions expressed by different observers in support
of the value which is claimed for tuberculin as an
aid in diagnosing doubtful cases of tuberculosis
in cattle. The number of instances in which the
conditions indicated by the results of the injections
do not conform to the conditions found on post-
mortem examination is so many times less the
number of errors from all other methods used to
diagnose tuberculosis, and there are so many cases
of tuberculosis which could not possibly be detected
by any other method, that even they who are least
inclined to favor the use of tuberculin cannot fail
to recognize its importance.”

The Connecticut Commissioners on Diseases of
Domestic Animals, in their report for 1894, describe
their use of tuberculin as satisfactory. They say:
“The trial of tuberculin has been ample for you to
determine its approximate value as a diagnostic
agent, both for the detection of tuberculosis in all
stages and the differentiation between it and other
conditions. In all those cases tested by your board
not an instance of failure has yet appeared. Care-
fully used, with conscientious attention to every
detail, it appears to be beyond doubt the only
safe method by which bovine tuberculosis can be
detected in its earlier stages. Such errors as have
been reported in the use of this lymph have been only
such as would naturally be expected as incidental to
a comparatively new experiment, especially when in

70 TUBERCULOSIS AMONG CATTLE.

the hands of those not familiar with its use. It has
now passed the experimental stage; and after being
tested on many thousand animals, we are, I think,
warranted in agreeing with its most enthusiastic
advocates that it is indeed one of the greatest of
modern discoveries in the medical world.”

The impossibility of determining the presence of
tuberculosis by physical examination is thus stated
as the resuit of their experience by the Massachusetts
Cattle Commissioners, in their report for 1894:
‘“¢ Prior to October 4, the existence of the contagious
diseases in these animals was determined by the
Commission upon a physical examination; and, as
before stated, in the cases of tuberculosis the results
were found to be exceedingly unsatisfactory both to
the Commission and to the owners of the animals.
The symptoms were so unevenly shown that animals
which were apparently sound were released, and in
some cases afterward found to be affected with the
disease ; in others, animals which appeared to have
the symptoms of the disease were, after slaughter
and upon post-mortem examination, found to be
free from tuberculosis, but affected with bronchitis,
pneumonia, or other non-contagious disorders ; and
in this way throughout the State a large number of
mistakes occurred, notwithstanding the fact that
the greatest care was taken to prevent them. In
fact, we were simply repeating the experiences of all
other countries that had tried to do anything toward
the removal of tuberculous animals from among

NATURE AND CERTAINTY OF TUBERCULIN. 71 -

their herds, and we felt that the ultimate result was
sure to be extremely unsatisfactory to all parties
concerned.”

The latest European conclusions on the subject
of the use of tuberculin as a diagnostic appear in a
report of the proceedings in the veterinary section of
the International Congress of Hygiene and Demog-
raphy, at Budapest, in September, 1894. Professor
Bang reported on 340 post-mortems after tuberculin.
fixcluding questionable cases, there were 207 cases
in which there was well marked reaction; and of
these 96 per cent proved tuberculous. He concluded
that tuberculin was an exceptionally reliable agent
in the diagnosis of tuberculosis. He said his ex-
periments showed him that in certain localities 80
per cent of the cattle are tuberculous. Under such
circumstances he did not favor killing off all that
react, but advised that animals showing no clinical
indications of disease — that is, the milder cases
—should be preserved. He said these may even
be used for breeding, by taking the precaution to
remove the calves when born, and bringing them
up by hand. As most calves which react to tuber-
culin show intestinal or retro-pharyngeal affection,
Professor Bang thought their disease due to raw
milk, and advised boiling it from the second day
onward. ‘This advice suggests his opinion as to the
infectiousness of milk from tuberculous cows.

Professor Bang reported tests in Seeland, where
two years ago he tested 208 cattle on one estate,

72 TUBERCULOSIS AMONG CATTLE.

and found 80 per cent of the cows, 40 per cent of
the steers, and 40 per cent of the calves infected.
The sound animals were separated from those in-
fected, and special attendants were provided. The
calves and diseased mothers were separated at birth,
and the calves fed on boiled milk. A few weeks
after birth the calves were tested with tuberculin,
but not one reacted. Each year the whole herd
was injected twice. The first year, when isolation
was incomplete, 10 per cent of the presumably
healthy animals reacted ; the second year only one
out of 107 was affected, and in the spring of 1894
only two out of 122,

It is unfortunate that Dr. J. A. W. Dollar, from
whose report of the Congress to the Central Veter-
inarian Medical Society of London these statistics
are taken, does not tell what became of the group
of cattle originally isolated, nor of those exposed by
the later semiannual tests. He remarks, “ Bang’s
method seems the easiest and cheapest for stamping
out tuberculosis ;” but just how much “stamping
out”? was done does not appear. The facts given
indicate only that, as actually diseased animals
were removed from the herd, there was a great
decrease in the spread of the disease.

We cannot question Dr. Bang’s skill as a veterina-
rian nor his care as an observer, but there seems to
be good reason to question his conclusions. He
advocates in this report the preservation of dis-
eased animals, but insists that they shall be isolated

mY as ee,

NATURE AND CERTAINTY OF TUBERCULIN. 73

from other animals, and not allowed to suckle their
own calves. He thus admits the extreme danger of
infection from diseased animals, either by contact
with other stock or through milk to their calves.
It will hardly appear, to an American farmer or
breeder, that it is a practical matter to keep a cow
who must be isolated, and whose milk is not fit
even to feed a calf. Certainly the milk could
not be fit for human consumption, and to keep such
a cow for a calf once a year would be extravagant
on ordinary farms. It would be much more sensi-
ble to kill the diseased animal at once.

The report says that in 1893 Denmark provided
a large sum for experiments with tuberculin, and
Professor Bang was intrusted with the work. Up
to the assembling of the Congress he had inocu-
lated 8,401 animals on 327 farms. Of these, 3,362
(or 40 per cent) reacted. The greatest number of
diseased animals was always found where the traffic
was most active, isolated farms being often entirely
free.

Dr. Hess, of Berne, said that after using tuber-
culin the animals often showed loss of appetite,
great depression, and diminished yield of milk.
Here, again, the report is incomplete, as we are
not told whether it was the healthy or the diseased
animals that exhibited the unfavorable symptoms.
If the latter, the known effect of tuberculin in
accelerating the disease, if present, might account
for the symptoms. ‘That Dr. Hess was referring to

74 TUBERCULOSIS AMONG CATTLE.

animals that reacted seems probable from his later
remark, that the worst effects of tuberculin are the
“production” of acute tuberculosis; and therefore,
while he considers tuberculin an excellent diagnos-
tic in most cases, he warned the Congress “ against
relying on it in either old or widespread tubercu-
losis, and laid stress on the frequent occurrence of
acute miliary tuberculosis.”

Professor Nocard referred to experiences in
France, Saxony, Berlin, and Copenhagen, which
point to the contraction of the disease in adult life.
He considered that heredity plays a very insignifi-
cant part in its spread. He said long and intimate
contact 1s necessary for infection ; and that in Paris,
since the custom has obtained of keeping milch
cows only one year and then sending them to the
butcher, the disease has greatly decreased, while
when they were kept five or six years the disease
was very widespread. He considered tuberculin the ©
best test for the disease, and, in opposition to Dr.
Hess, said he had seldom seen even a falling off in
milk after its use. He recommended testing all
suspected animals with it, but considered the im-
mediate slaughter of those that react unnecessary,
if they do not show symptoms by physical examina-
tion. By merely isolating them, their usefulness
for work or milking is preserved, or they may be
prepared for the shambles. He had seen only two
eases of generalized tuberculosis in two thousand
cases tested with tuberculin.

NATURE AND CERTAINTY OF TUBERCULIN. 75

Professor Ostertag pointed out the great dan-
ger of allowing animals to feed from a common
manger,—a method, he said, which especially
favored the spread of the disease. _

At the conclusion of the discussion, President
Dammarin summed up the results as follows:
“ The essayists are agreed that tuberculin is a most
valuable diagnostic agent. The number of failures
with it are practically unimportant. The greater
number of those present do not share Dr. Hess’s
views as to the frequent occurrence of acute tuber-
culosis after inoculation, and therefore consider
his warning unnecessary.”

Dr. James B. Paige, V. 8., who has had charge
of the herd at the Hatch Experiment Station of
the Massachusetts Agricultural College since 1890,
writes of the early attempts to suppress tubercu-
losis there: “At the time of the examination of
the animals by Dr. Law (1890), and for some time
after, nothing was known in this country of the use
of tuberculin as a diagnostic agent of this disease ;
and we had confidently expected up to the date of
its introduction to be able, by the weeding-out

‘process, by the immediate slaughter of suspicious

animals, by careful selection, breeding, and good
sanitary surroundings, to eradicate the disease from
the herd. That in all probability we should never
have been able to accomplish this is shown by a
study of the records of the tuberculin tests. These
tests at the Station extended from October, 1892,

76 TUBERCULOSIS AMONG CATTLE.

to June, 1894, and in all 55 animals were killed,
of which 14 did not present the characteristic
reaction of tuberculosis, but were killed as a pre-
cautionary measure and for observation.”

Dr. Paige summarizes his conclusions from ob-
servations of this herd as follows : —

“1. That it is unsafe to purchase animals, to add
to a healthy herd, from a herd in which tubercu-
losis has existed.

«¢2. That poor sanitary surroundings — especially
imperfect ventilation and insufficient light — are fa-
vorable to the rapid spread of tuberculosis among
cattle.

“3. That itis much better to dispose of excre-
ment outside of stables than in cellars underneath
them.

“4, That mangers and other stable fixtures
which increase the amount of surface, cracks, and
corners that cannot be easily cleaned are objection-
able, from the fact that when the germs of tubercu-
losis become scattered under such conditions, they
are not easily destroyed by the use of disinfecting
fluids.

“5. That infected stables bear close relation to
the propagation of the disease.

“6. That even by the use of strong disinfecting
fluids it is very difficult, if not impossible, to rid an
old stable of the germs of tuberculosis.

“7. That the diagnosis in most cases of this dis-
ease by physical examination is impossible.

BARE

NATURE AND CERTAINTY OF TUBERCULIN. [7

“8. That in tuberculin we have an exceedingly
delicate and reliable test for tuberculosis.

“9, That tuberculin indicates the existence of
tuberculosis in the lungs and other parts of the body
when objective symptoms are absent, and when no
germs can be discovered by miscroscopical exam-
ination of mucus from the nostrils.

“10. That its use is not followed by any ill effects
of a serious or permanent nature.

“11. That in some instances the injection of
tuberculin produces a marked rise of the internal
temperature where no tuberculosis exists.

“12. That in some cases, where tubercles are
present in the body, its injection is not followed
by a well defined reaction.

“13. That the reaction following the use of
tuberculin bears no relation to the extent or devel-
opment of the disease.

“14. That itis impossible to forties arule by
which we can say that certain variations of tem-
perature may or may not indicate the presence of
tubercles.

‘15. That in tuberculin we have the only means
by which we can eradicate tuberculosis from among
our cattle.

“16. That our old-style and unsanitary stables,
thoroughly infected with the germs of tuberculosis,
make the complete eradication and suppression of
this disease wellnigh impossible.”

In support of his conclusion 11, Dr. Paige cites
three cases in his record of tests. In view of a more

78 TUBERCULOSIS AMONG CATTLE.

extended observation of the test, it may be said, in
explanation of these apparent failures, that in case
one the first rise in temperature was fifteen hours
alter injection, and it did not remain up hardly
as long as would be desirable to be conclusive. In
case two, the first rise was fifteen hours after injec-
tion, and it remained up only at one observation,
dropping at the next from 106.2 degrees to below
normal, ‘This, in the light of late experience, would
entitle the animal to a retest. In case three there
was a perfect typical reaction. The disease was not
found on autopsy, but the thoroughness of that may
fairly be questioned.

In support of conclusion 12, Dr. Paige quotes one
case where the reaction which he says was not well
defined was certainly well defined; but it was not —
so strong as is usual. Its maximum was 1.2 de-
grees, which is quite close to the accepted indica-
tions at the Virginia Experiment Station, elsewhere
quoted.

It would not be fair to the public nor to the
subject to omit, in this connection, a reference to
the latest experimental phase of tuberculin. In
the foregoing there is presented substantially the
known facts in regard to it. What follows is not yet
demonstrated, but it comes with so much of weight
and possibility as to give it great interest to all
who are engaged in the problem of public health
as affected by tuberculosis.

As appears elsewhere, Professor Koch abandoned
tuberculin as a curative agent, when he found that

NATURE AND CERTAINTY OF TUBERCULIN. 79

in very many cases it proved to be an accelerator
of the disease it was intended to control. To him
it was a failure, but others seized upon the feature
which condemned it as a curative, and utilized it
with great success as a diagnostic. It is generally
understood among scientific students that Professor
Koch’s discovery was prematurely given to the world,
and its alleged virtue as a curative of consumption
was proclaimed before he was prepared to declare
his work as complete.

Tuberculin was to him a single substance, whose
ordinary effect, in cases of tubercular disease, was
to incite fever and hasten the end, but in his ex-
periments, as well as in those of others who have
given attention to it, there were individual cases
where decidedly curative results were seen, or where
it produced immunity from subsequent infection,
but they were hardly more than enough to serve as
the “exceptions that prove the rule.”

Among those who have been at work with tuber-
culin is Professor Edwin Klebs, who has earned
the confidence and gratitude of the whole world
by his discovery and application of “ anti-toxine,”
which is so rapidly coming into general and suc-
cessful use as a specific against diphtheria. Obsery-
ing the varying and contrary effects of tuberculin
in different cases, he was led to consider whether it
was really a homogeneous single substance, or a
compound whose separate elements might cause
the varying effects.

80 TUBERCULOSIS AMONG CATTLE.

He pursued the subject in his laboratory, and
quite recently has given the public the result of his
work. He claims to have resolved tuberculin into
three separate elements, — toxines, toxalbumens,
and a germicide,— and to have so isolated the
germicide, a sozalbumen to which he has given the
name “ anti-phthisin,’ that he can produce it as a
commercial article.

This new substance, Professor Klebs claims, is
the agent which has produced the curative effects
occasionally observed from tuberculin, and that
these effects are due to the fact that in some way
the “ anti-phthisin”’ was enabled in these cases to
exert its normal curative influence without the usual
complication and control of the other and toxie or
poisonous elements in tuberculin. Having isolated
the “anti-phthisin,’ he was prepared to test his
theory by the usual methods of inoculation of the
lower animals, and later by its prescription to the
human subject.

The results, as reported by the discoverer, and by
Dr. Karl Von Ruck, of Asheville, N. C., who has
been intrusted with the secret, have been remarka-
bly successful. The latter reports over 20,000 in-
jections without observing a single instance where it
acted detrimentally, or produced undesirable symp-
toms or discomfort to the human patient.

The observation of these two gentlemen leads
them to the conclusion that the failure of Professor
Koch’s lymph was due to the effects of the poison-

NATURE AND CERTAINTY OF TUBERCULIN. 81

ous elements in tuberculin, while its occasional suc-
cesses were due to the agent which they now have
in complete isolation and control, and which in
their hands uniformly gives encouraging results as
a curative agent.

It is administered by subcutaneous injection, and
none of the unfavorable effects of tuberculin appear,
but in all cases where the lesions of tuberculosis
have not so far advanced as to cause a breaking
down of the tissues and the consequent interrup-
tion of the circulation, decidedly curative effects
have resulted, and a restoration to normal health
has been secured.

The record of these experiments, so far as pub-
lished, is most interesting and encouraging, and
the success of Professor Klebs’s earlier discovery
— “anti-toxine ” — is, in a way, a factor tending to
justify a degree of confidence in his later announce-
ment. ‘he reader needs no reminder, however,
that the history of medical science is strewn with
failures of alleged panaceas as promising as this.
Whatever may be its result, its. success or failure
cannot affect the acceptance of tuberculin as a
diagnostic of bovine tuberculosis. That is-estab-
lished, and if the new “ anti-phthisin”’ should come
into general use as a curative agent of the disease
among cattle, tuberculin would still hold its place
as a diagnostic preliminary to the administration
of “ anti-phthisin.”’

CHAPTER IX.
OPERATION AND DELICACY OF THE TEST.

In cases where tuberculosis is entirely localized on
the surface of the body, —as in the case of wounds
upon the hands during autopsy, or in the infrequent
cases where the disease appears on the surface, —
treatment with tuberculin may result in cure; its
application leading to a more active process of cell
growth followed by degeneration and death, the
dead mass sloughing off, and leaving sound tissues
to heal. Usually, however, there are more deeply
located colonies of bacilli in connection with the
surface manifestations; and to these tuberculin
can only prove an accelerator of the disease, this
acceleration being the fact relied upon for its detec-
tion under the test.

It should be clearly understood that the system
of a tuberculous animal is more or less saturated
with tuberculin. The animal becomes accustomed
to the presence of poison, just as a man may accus-
tom himself to alcohol, nicotine, or morphia, so
that a certain amount is tolerated by the system
without immediate manifest effects. But if there
is an addition to the amount to which the animal

(‘sonssTy [VULION oT} JO MoTONAYSOp oY
JO JU94X9 O1[7 MOYS 07 YSnoryy yn ‘soporoqny Jo ssvut oSavp v st uoMsod azoddu oy)

“UMA YT AHL FO SsIsOTOONdEN TF

OPERATION AND DELICACY OF THE TEST. 83

has been accustomed, the bacilli are excited to
unusual activity throughout the system, and the
characteristic changes in temperature result.

It is an interesting fact, that in most cases
where the disease is but recently established, and
has made so little progress that its presence can-
not possibly be even suspected by the appearance
of the animal, this characteristic change in tem-
perature is most’ marked. This is accounted for
by the fact that the newly established colony of
bacilli is most active in its youthful stage; and it
is also true that this activity in the early stages
renders the animal affected a more prolific source
of contagion than when the disease is in a later
stage. It is a strong point in favor of the tuber-
culin test that. it thus searches out, excites, and
exposes the disease, even in such early stages that
only the microscope most carefully used can be
relied on to verify the truth of the detective.

The usual practice in the use of tuberculin as a
diagnostic of tuberculosis in cattle is first to deter-
mine the normal temperature of the animal, which
is done by the use of a clinical thermometer, usu-
ally inserted in the rectum. Then the tuberculin
is injected, the dose being varied from the standard
in proportion to the age and size of the animal.
This injection is usually at night, as eight or ten
hours must clapse before the effect of the injection
can be noted.

The next morning the temperature of the animal

84 TUBERCULOSIS AMONG CATTLE.

is taken again, before food and water are given;
and the work is repeated every two hours until the
test is completed. After the first morning observa-
tion of temperature, food and water are given in only
moderate quantities, and the animal is kept in the
stall during the test. |

There is some variation among animals in their
response to the test; but the first indication of rise
in temperature is expected in about ten hours after
injection; and it is expected to continue eight or
ten hours, or until the injected tuberculin begins to
be eliminated from the body through the excre-
tions, when it is expected to fall to or below its
normal stage.

There are numerous influences constantly or oc-
casionally present in the animal, which may affect
the temperature during the test; and these and
their complication of the test can be understood
and allowed for only by a skilled observer. It is
for this reason, coupled with the delicacy of the
test in itself, that tuberculin is not a safe agent in
general hands. Mistakes have happened, even in
the wisest hands, and they would be multiplied
indefinitely if the use of tuberculin was made
general.

The mere elevation of temperature after injec-
tion is but one element in the process of detecting
the disease. Other causes may come in to induce
a temporary fever, and these must be eliminated.
If the animal shows a normal temperature of 101

OPERATION AND DELICACY OF THE TEST. 85

degrees Falir., and ten hours afterward it has risen
to 104 or above, keeping there for several hours,
and then perhaps eighteen hours after injection it
falls to or a little below the normal point, the
inference of disease is very strong. If, however,
the temperature should continue high after the
period when the tuberculin should be eliminated
from the body, —or if, instead of a single curve of
rise and fall, there should occur a rise and fall fol-
lowed by a second rise and fall during the time the
tuberculin remains in the body,—then the infer-
ence would be but a doubtful one, and skilful ob-
servation of the other conditions would be required.
As a rule, however, the best practice in this class
of cases is to give the animal a second test after a
few days’ interval.

The difference between the normal reaction in
an animal after injection where the disease is pres-
ent, and the abnormal phenomena resulting from
other causes, may be better understood from the
following temperature charts, which were taken in
actual practice.

In Chart No. 1, the temperature line shows a
typical reaction of tuberculin in a diseased animal,
and is such in character, varying only in the de-
gree and continuance of elevation, as is uniformly
secured in the tests where all the conditions are
normal, and the work is properly performed. Fre-
quently the rise is as high as seven degrees; but
this is generally seen only when the disease is in

86 TUBERCULOSIS AMONG CATTLE.

its early and most active stage. The chart was
from an animal far advanced with disease.
Chart No. 2 differs from No. 1 in that, while
the rise in temperature — which happened to be
coincident with the injection of tuberculin — was

TIME =
OF
DAY

=
-<«
-
.
-«
.
-«
-
-~«<

CHarT No. 1.

TEMPERATURE

much more marked, and which a hasty observer
might readily declare was decisive of disease, it
did not recede toward or to the normal point when
the tuberculin had been excreted from the body.
The animal from which the chart was taken was
killed, but the post-mortem disclosed no indications
of disease.

Chart No. 8 is somewhat unusual, but it has

ee
wv

OPERATION AND DELICACY. OF THE TEST. 87

occurred, and is noted in several reports. It is
known as “the double curve,’ and in the present
state of positive knowledge of chart reading it is
considered a puzzle. Some animals furnishing such
a chart have been found diseased on post-mortem ;

TIM E &
OF
DAY

TEMPERATURE

CuHart No. 2.

while others, with a chart apparently identical in
character, have not disclosed the disease.

At present, in Massachusetts practice, animals
exhibiting Charts 2 and 3 are held for retest, their
peculiar character indicating some unknown cause
of febrile condition other than the sought for dis-
ease. ‘They are under careful observation, and it is
hoped that increasing experience will soon enable
observers fully to comprehend their import.

88 TUBERCULOSIS AMONG CATTLE.

Dr. E. P. Niles, veterinarian of the Virginia
Experiment Station, reports four cases where the
reaction was but one or two degrees, and all were
proved diseased. He says: ‘From our own ex-
perience we are led to believe that any elevation

TIME © ‘
OF
DAY

a

of temperature that continues over two or more
readings above the highest normal variation dur-
ing a period of twelve hours before injection 1s
diagnostic of tuberculosis; and if we expect com-
pletely to eradicate the disease from our herds, we
must take this as a standard. It would be much

TEMPERATURE...

CHarT No. 3.

more profitable occasionally to destroy a healthy

animal than to let one that is diseased escape, even

OPERATION AND DELICACY OF THE TEST. 89

though we expect to repeat the test in six months’
time.” |

Dr. Niles is also of opinion that the animal sys-
tem acquires a certain tolerance to the action of
tuberculin after the first injection, thereby making
a second test unreliable without the intervention of
several months.

Drs. Osgood and Lyman, of the Massachusetts
Cattle Commission, do not usually accept so slight
reactions as are indicated by Dr. Niles, unless quite
suspicious physical indications are present. They
are also of opinion that tuberculin does not create
a tolerance of itself when injected, so that a second
injection without the long delay is uncertain. They
advise, however, in cows where the period of heat
may have complicated the test, that twenty-one days
elapse before re-injection, as this avoids contact with
the next period of heat. The experience of these
two gentlemen, much greater than that of any oth-
ers in this country, justifies great confidence in their
suggestions concerning the details of the test.

It should be stated in this connection, that, where
the characteristic reaction of tuberculin has pro-
nounced the disease present, the failure to detect it
in an ordinary post-mortem does not settle the
question against the accuracy of the tuberculin test.
It is the common experience of those of the widest
opportunity for observation, that the disease is often
found on post-mortem only in a trivial lesion, in some
out-of-the-way corner of the body, where it might

90 TUBERCULOSIS AMONG CATTLE.

readily escape such scrutiny as is possible under the
usual conditions in practical work. And even when
these slight lesions are not discovered, aud reference
is had to the microscope without success, still tuber-
culin is not convicted of error. It has been so often
seen to reveal the disease where but the slightest
visual traces of it could be discovered, that where
no traces are discovered science can only say it was
not found. No skilful and wise operator would say
more until the most exhaustive examination, visual
and microscopic, had furnished a scientific basis for
such a declaration; and such an examination is a
practical impossibility.

A bulletin from the Connecticut Commissioners
on Diseases of Domestic Animals, 1894, reports
twenty-nine tests, in which the normal temperatures
were determined by two observations, two hours
before and two hours after feeding. The result
shows that in twenty-three animals there was a rise
of 0.95 of a degree after feeding, the maximum rise
being 1.7 degrees, while six of the animals showed a
decrease in temperature averaging 0.51 of a degree.
The maximum was one degree.

The animals were injected over night, and at six
o'clock the next morning twenty showed an average
fall in temperature of 0.86 of a degree, the maxi-
mum being 2.5 degrees. Seven showed arise of an
average of 1.04 degrees, the maximum being 3.6
degrees. 'Twoshowed the same temperature in the
morning as the average of the night before. The

OPERATION AND DELICACY OF THE TEST. 91

eccentricity of these figures, taken by careful ob-
servers, confirms what has been said before in
regard to the danger of intrusting tuberculin to
unskilled hands. Wide general knowledge of ve-
terinary science is needed to balance the vary-
ing physical indications, and to read correctly the
confusing temperature records.

At arecent examination of a herd in Meriden,
Conn., where two animals had been found suspicious
by physical examination, nine were exposed by
‘tuberculin; and all, an observer declared, were
“as apparently healthy animals as man ever wit-
nessed led out to slaughter.” All were found
markedly diseased. Their reactions were as fol-
lows :—

Normal. Highest Reaction.
° °
No. 1 101.5 aks Fee. cite nn se ee
No. 2 TO sya AN a
No. 3 BEE ee gh adr) ea ct ac
No. 4 Wea a ay thes eo ne eee
No. 5 a eae fee an ee
No. 6 102:1 Mite Se ta a
No. 7 102.1 RR MO iat Ggemnes Kote
No. 8 RO) re Wa hoe wees ls
No. 9 EO Ie NY ae ak) ae

This test has been in use in this country since
1891, the first experiments being by Professor
Zuill, of the veterinary department of the Univer-
sity of Pennsylvania. The experiment stations or
other agencies of Canada, Maine, Vermont, New
York, Massachusetts, New Hampshire, New Jersey,

92 TUBERCULOSIS AMONG CATTLE.

Pennsylvania, Virginia, Wisconsin, and Minnesota
have used it with satisfactory and conclusive results.

The result of the use of tuberculin has been so
monotonously successful that as long ago as June,
1892, a scientific journal in Berlin announced: “ We
shall now stop publishing reports on tuberculin in
the Berlin Veterinary Weekly unless they contain
some new facts and figures. Since the publication
of the reports of the extensive experiments of the
Royal Health Office, we may regard the question of
the value of tuberculin in the diagnosis of tubercu-
losis in cattle as settled. The proof which has
been presented to our readers is more than suff-
cient. The results are absolute and gratifying,
and show that tuberculin is a reliable agent for
determining the presence of tuberculosis in cattle.”

Professor Hills and Dr. Rich say of the tuber-
culin test: “There have been mistakes made by its
use by incompetent persons, and it has occasionally
failed in careful hands. Experience, however, has
brought a greater measure of success ; unfavorable
reports are now rare, and many who considered
tuberculin unreliable are acknowledging that the
fault was theirown. But notwithstanding its occa-
sional and admitted failures, it has proved infinitely
more reliable than any other means of diagnosis
now in use.”

In most of the literature emanating from various
agricultural bureaus and other places where the
tuberculin test has been studied, it is insisted that

4
I
=
3

OPERATION AND DELICACY OF THE TEST. 93

the normal temperature of an animal cannot be de-
termined by a single taking with sufficient accuracy
to serve as a safe basis from which to compute the
reaction after injection. This theory is based upon
the fact that there are very considerable variations in
individual temperature, under normal conditions, at

various times during the day; and that these vari-

ations, unless determined in each individual case
by numerous observations, may complicate and ren-
der valueless the record of temperature under the
test.

Drs. Osgood and Lyman, of the Massachusetts
Cattle Commission, recognizing in their extended
experience the increased trouble and expense of
these prolonged observations, have worked out a
system by which they are able to avoid them. They
made a record of some ten thousand temperatures
taken on about five hundred animals, recording also
their careful observation of attendant physical con-
ditions. These observations have enabled them to
secure a basis by which to determine the probable
variations in normal temperature which can be

- applied in individual cases, so that a single tem-

perature taken before injection is generally suffi-
cient. Wherever a notably abnormal temperature
is indicated, the test is withheld until the conditions
are favorable. This single normal temperature,
coupled with the observation and record of tempo-
rary physical conditions in each case, has proved
so efficient in the thousands of cases that have

94 TUBERCULOSIS AMONG CATTLE.

passed through their hands without any material
error justly chargeable to tuberculin, that they now
consider the repeated observations unnecessary to
determine the normal temperature.

Professor Mackenzie, in 1892, said of tuberculin:
“Tt may now be considered as past the experimental
stage; and if tuberculin never becomes a success as
a remedy, it certainly will be used to a very large
extent as a diagnostic re-agent in animals.” And,
after stating the early results of its use, — results
which have been almost infinitely reinforced by later
observations, —he said: “I think I have made it
clear that we have in tuberculin a re-agent which
is of immense value in the diagnosis of the disease,
especially as it is just in those cases in which other
clinical evidence is wanting that it is most certain ;
for the results have all shown that in animals with
only few tubercular lesions, so few that the ordinary
health is in no way affected, the reaction is most
marked.”

He also remarks: “It is quite useless to use the
re-agent if we are not going to destroy the animals
that give the reaction.”

Dr. Bryce, in a recent report on tuberculosis,
says of tuberculin, that itis ‘so delicate and yet so
accurate that the most unbelieving among veterina-
rians are to-day confessing to its marvellous diag-
nostic value and significance.”

Professor Leonard Pearson writes: ‘In my ex-
perience of more than five hundred cases, of which

OPERATION AND DELICACY OF THE TEST. 95

about one hundred have been slaughtered, I can
count but one error in diagnosis,—an old cow,
badly diseased, which did not react after a small
dose. All of the other results have been most
satisfactory. Every cow that gave a reaction and
was killed was shown to have tuberculosis.”

Nearly all the experience with tuberculin reported
thus far has been of its use upon cattle in their nor-
mal conditions, in their home stables, and with but
a minimum of irritation and excitement. It is well
known that milch cattle are nervous, highly organ-
ized animals; and it is one of the strongest proofs
of the harmlessness of tuberculin that in all these
stable tests reported there is no authentic report of
injury, or of failure of tuberculin to detect the dis-
ease if present, when it was used by intelligent and
discreet veterinarians.

The Massachusetts Commission has, however,
at the cattle markets at Brighton and Watertown,
been brought into contact with far different and
more difficult conditions. Most of the cows offered
in the market are in full milk; they come in cars,
and fora day or two have been milked, fed, and
watered irregularly; they have been made nervous
by being roughly driven among unaccustomed sur-
roundings, and after they reach the market are
encompassed by a crowd of buyers. There is no
time for the animals to rest, and to acquire their
normal condition of quiet, before they are injected ;
because the test occupies from twenty to twenty-four

“-

96 TUBERCULOSIS AMONG CATTLE. ea:

hours, during which time impatient drovers, owners,
and buyers are clamoring for the completion of the
work, so that their business may be accomplished.

It is under these conditions that this market
inspection has been carried on; and while some
mistakes have been made because of inexperience,
haste, mischievous interference, and the generally
unfavorable conditions attending the experiment,
the post-mortems have shown but comparatively few
failures. The writer has been personally conversant _
with every step of this work, and is quite aware of
the sweeping charges that have been brought against
it by interested and prejudiced parties; but he is
confident that, while errors and mistakes are admit-
ted, they are chargeable not to the failures of tuber-
culin, but to the conditions under which the tests
were made. As these conditions have become better
understood. and some of them have been made sub-
ject to control, the proportion of errors has greatly
decreased. The only wonder, to one familiar with
the delicacy of the test and with the surrounding
conditions at these markets, is that errors are not
more numerous. The record of the work at these
markets, up to the latest date to which the figures
could be inserted here, is as follows. 9

The work began on November 21, 1894, and the ~
record for 14 weeks, to March 1, 1895, shows 4,226 —
animals tested, and 250 condemned. Of these,148 _
per cent failed to show evidences of the disease at —
the post-mortems. Counting all these as failures, —

_—
ee

OPERATION AND DELICACY OF THE TEST. 97

the record shows success in 85.2 per cent of the
condemned cases. But it should be remembered
that the failure to find the disease with the hasty
and imperfect methods of autopsy compelled by the
conditions, and the element of mischief, whose pro-
portions are not yet determined, are so important
factors in the result that a considerable discount
from the above estimate of failures must be allowed.

Another branch of the work of the Massachusetts
Cattle Commission, but just begun, is the systematic
inspection with tuberculin of all the cattle upon the
farms. The counties of Nantucket and Dukes have
been completed. A total of 1,837 animals have been
tested in these two counties, with but seven con-
demned, all of which proved diseased on post-mortem.
In addition to the seven condemned on the two
islands, seven other animals were bought and killed
because of physical indications which induced the
agents of the board to withhold the brand of sound-
ness. None of these last, however, proved to be
tuberculous.

The extremely small percentage of disease in
these counties is credited to the fact that the stock
is almost entirely home-raised, is kept largely outi
of doors under favorable sanitary conditions, and is
not forced to undue milk production, — conditions
which are everywhere recognized as unfavorable to
the development of this or any other germ disease.

The third branch of the Massachusetts Commis-

sion’s work is in responding to the calls of local
7

98 TUBERCULOSIS AMONG CATTLE.

inspectors. These officials make semiannual ex-
aminations of all cattle in their respective districts,
and report all suspicious cases to the Commission.
Agents who are trained veterinarians are then sent
to test these suspected cases with tuberculin, and
the temperature charts are sent to the Commission
for decision. The basis of all this work being ani-
mals that are suspected on physical examination,
it would be unjust to use it as a basis for any esti-
mate of the prevalence of the disease. As showing
the accuracy of tuberculin under normal conditions,
however, it is of interest.

Up to March 1, 1895, the number of animals thus
tested has been 4.457. Of these 1,567 were indicated
as diseased, and on post-mortem nearly all disclosed
lesions of tuberculosis. When these figures were
compiled the returns of the agents were not all in,
so that the actual number of failures to find the dis-
ease on autopsy could not be given, but such cases
have been very infrequent, — doubtless not over a
a quarter of one percent. It is worthy of note, as
indicating the uncertainty of physical examination,
that in these cases only a little over 30 per cent of
_those reported suspicious proved to be diseased.

Bulletin No. 7 of the Bureau of Animal Industry
calls attention to the delicacy of observation re-
quired correctly to read the temperature charts,
saying: “ Before we can determine in what meas-
ure the result of tuberculin injections correctly in-
dicated the presence or absence of a tuberculous

==" 7

|

OPERATION AND DELICACY OF THE TEST. 99-

affection, we must form a more or less definite idea
of what is in truth to be called a reaction. On this
point little agreement apparently exists between dif-
ferent observers, which is not an extraordinary fact
when we consider the marked normal variations in
the temperature of milk cattle, the readiness with
which the temperature of many animals is influenced
by slight and frequently unrecognizable causes, the
dissimilar conditions under which different herds
live, the lack of constancy in the quantity of tuber-
culin injected, and the possible variations in the
strength, purity, and state of preservation of the tu-
berculin used. The elevation in temperature neces-
sary to constitute a reaction has variously been given
from 0.9 to 1.8 degrees Fahr. But it is not suffi-
cient to consider merely the number of degrees the
temperature after the injection rises above the tem-
perature before the injection. The height reached
by the temperature and the duration of the eleva-
tion certainly cannot be disregarded. In estimating
the reliability of the results from tuberculin injec-
tions where the temperature after the injection is
low, Eber maintains that a rise of not less than 0.9
degree Fahr. must occur, and be continuous during
many hours, before the presence of fever can be
conclusively affirmed. A low temperature after the
injection is specified as 103.1 degrees Fahr. This
is a rule which we believe it is necessary to observe.”

The experience in Massachusetts, which is far
more extended than elsewhere up to the present

100 TUBERCULOSIS AMONG CATTLE.

time, justifies a demand for a more marked rise in
temperature than is above indicated ; and while the
moderate rise is looked upon as suspicious, it would
hardly be accepted as a conclusive indication, un-
less physical symptoms appeared in corroboration.
A rise of 1.5 or of 2 degrees Fahr. with physical
indications might be accepted ; but it would also be
expected that the post-mortem would reveal a very
advanced and generalized case of disease. A con-
siderably higher rise should be looked for in a case
where the disease was incipient, or but recently
established.

The report of the Bureau of Animal Industry
gives a table of results of the injection of sixty-
three animals, of which seventeen gave reactions of
2.5 degrees Fahr. or less. On post-mortem it ap-
peared that six of the seventeen were not diseased.
The details of these cases were as follows : —

Highest Length of
Reaction. Reaction. Result.
idesree . . .. . Lhour. . ... eee
A ela a ee eee ord - « « ». Jiseaeee
72 ili SNe lkey | al ernie flee 5s. ORSORE gi
2. 2 as . . ° - 1 7 “é S . 7 > ee
16) ** ee te ee . »« « « Nebiaea
: ek PR 5 Ra ry Yeo Seok “ <
Ss git) Nok a a ae --e'«. » Jipeaneee
1 ies SP ee me Po ee =
vy Dl be <n gl we LY ae ee Woy fice os
O45. ** try Ve) har Bas “ote er a a
16, ait beat tale} Le Ree ee ri:

2.4 CE eet | rs . « « « Not diseaaeue

OPERATION AND DELICACY OF THE TEST. 101

1.2 degrees Ba eet Ate nt. Lh” Not disedsed:
5 | OIE eee §; SK, Le grat ae! | ea Rog
Sad Og Lh ne URN AG a LK eee aa, he sie
Si eam eats a obra in DOs diseased
ME ys ye eee ST ee Epes sek.

When, in addition to the above general consider-
ations, it is taken into account that only a moderate
supply of food, water, or exercise may result in a
rise in temperature in a cow of from 1 to 1.5 de-
grees Fahr.; that her condition -as to fatness has
its influence on temperature variations; and that
temporary physical conditions (heat, calving pe-
riod, etc.) may furnish other complications, — it
will be readily seen that the work of correctly in-
terpreting the temperature chart is not an indiffer-
ent affair. To include and properly balance all
these elements, and to draw therefrom an accurate
deduction, demands far more knowledge and astute-
ness than is possessed by the ordinary farmer. Such
work should always be confided to a veterinary
expert. |

In a recent discussion upon this subject Dr. Leon-
ard Pearson said: “I have examined about five
hundred cases, and have killed a few over one hun-
dred animals that reacted ; and all those animals that
have reacted showed tuberculosis on post-mortem
examination. I should say, however, that some of
them showed it but very slightly; and in some of
them it required a very careful examination to dis-
cover the tuberculosis. In one of them in particular

102 TUBERCULOSIS AMONG CATTLE.

(I do not know that there was more than one) I
could find no tuberculosis at all, nothing but an
inflammation of the mesenteric glands of certain
small portions of the intestines, and a little pleurisy.
The mesenteric glands were examined (by micro-
scope), and the tests showed that even in this case
the animal was tuberculous. In fact, in the sections
of the mesenteric gland tuberculosis bacilli were ex-
ceedingly numerous. There were great numbers of
them, and for that reason some of them were kept
for class demonstration as showing a large number
of tubercles ina small area. I have heard of a few
cases that reacted, and under post-mortem examina-
tion tubercles were not found. . .. I have read of
a number of other cases that did not react when
tested with tuberculin; and I have heard of a few
cases in the western part of New York State in
which the animals did not react, but were killed,
and afterward found to have tuberculosis. But in
all these animals the disease was quite advanced,
and I think that is the reason. You know tuber-
culin is the product of the growth of tuberculosis
bacilli; and it is fair to suppose that in general
tuberculosis the system is so thoroughly saturated
with it that the small amount of tuberculin injected
makes no difference. But a few of these cases were
so well marked that they could have been recognized
even before injecting tuberculin; so the tuber-
culin test in these cases was unnecessary. My
own experience has been most gratifying, and I am

OPERATION AND DELICACY OF THE TEST. 103

using a good deal of it now, and expect to con-
tinue it.”

Dr. Anderson Crowforth, V. S., related the fol-
lowing experience before the Ontario Veterinary
Medical Association at Toronto, December, 1894:
‘¢ While examining a herd of domestic cows by the
ordinary means, — that is, without the aid of the
tuberculin test, — I discovered one cow that I sus-
pected, and ordered her to be treated with tuber-
culin. Through a mistake of the herdsman that
was not discovered till after the examination by the
tuberculin test, he submitted the wrong animal.
She was a cow six years old, apparently in good
health, and did not show the slightest trace of
tuberculosis by ordinary means; and when tested
by Koch’s lymph she proved to be diseased, her
temperature rising to 108 degrees Fahr. fifteen
hours after the injection. The post-mortem showed
tubercles in most of the lymphatic glands, lungs,
kidneys, adipose tissue, and, lastly, the liver, —
this last containing a tubercle, which I have pre-
served in my office, weighing several pounds. This
led to a test of the rest of the herd with tuberculin,
and I discovered that 50 per cent were affected.
In another herd of 87, reaction after tuberculin
occurred in 31, while 6 gave no reaction. When
killed, the 6 proved sound, and the 31, without
exception, tuberculous.”

CHAPTER X.
OBJECTIONS TO THE TEST ANSWERED.

ASIDE from the eccentricities of temperature here-
tofore alluded to,— which may result from other
diseases, from the animal being in heat or near to

calving, from lack of discretion in the allowance of —

food or water during the test, or from active exertion
or unusual excitement, all of which are within the
observation of the expert, and should be considered
in his conclusions,—there are in the public mind
certain other features which are urged against
tuberculin as a reliable test of the presence of dis-
ease. Most of these are fallacious, but they deserve
explanation in this connection.

It is correctly alleged that the expected variation

in temperature fails to appear in some cases where the
presence of the disease is demonstrated by autopsy.
These cases are rare, and are usually of the extreme
type where the system is so thoroughly permeated
by tuberculin that the small amount added by the
injection has no appreciable effect. In such cases
the disease is usually apparent on a physical exam-
ination. They do not, however, appear with suffi-
cient frequency to justify their quotation against

OBJECTIONS TO THE TEST ANSWERED. 105

the general efficacy of the test. So rare are they,
indeed, that some veterinarians of extended experi-
ence express doubt of their genuineness.

It is alleged that the test causes reactions or rise
in temperature ‘in slight cases where the animals
might live and be profitable for years. This is also
true, and it would be a valid objection if the prime
object were to perpetuate the disease and the oftfer-
ing for sale of the diseased products. But if the
desire is to detect and eradicate the disease, the
fact that this agent exposes it in its otherwise secret
and most dangerous stages is one of its most cred-
itable features.

That this reaction is thus caused by tuberculin is
shown by an early German experiment when thirty-
one animals reacted out of a herd of thirty-seven.
All were killed, and the six that did not react were
found healthy, while the entire thirty-one were found
diseased. Only one of these showed general disease,
and was sold as cheap meat, while all the others
were accepted as fit for food. This illustration
suggests that the German standard of fitness for
food is not so high asin this country ; and it should
be said also that the incident was early in the his-
tory of tuberculin, and that the peril of using any
part of an infected carcass is much better under-
stood now than heretofore.

Dr. Law, in discussing this phase of the subject,
says: ‘“* While a cow with one or two tubercles only
in the lymphatic glands may not be liable to transmit

106 TUBERCULOSIS AMONG CATTLE.

the disease to others, yet whenever an extension
takes place, the germs being carried by the blood,
and therefore throughout the whole system, there
must always be danger of their escape from the
natural surfaces to infect other animals. And, let it
be borne in mind, this diffusion through the blood
takes place before its occurrence is revealed by the
formation of tubercles in new situations. So long,
therefore, as a single victim of even slight tubercu-
losis is left in a herd, it can only be looked upon
as an invitation to a renewed extension of the
disease. It also may become at any moment a
source of infection for man through the use of
meat or milk. Itis only in degree that the con-
tagion of tuberculosis differs as to its sanitary
aspect from that of any one of the more contagious
diseases, and in all alike. So soon as we attach
more importance to the preservation of an infected
animal that may possibly recover than we do to the
radical extinction of the disease, we undermine and
destroy the effectiveness of our sanitary work... .
Is the remorseless scourge of tuberculosis to be
perpetuated, not only in herds, but in our homes
as well, to save for a few months or years some
tuberculous cows? No country has ever dealt
succcessfully with any of these animal plagues on
the basis of preserving the mild cases for recovery.
Always and everywhere it has been by the radical
and thorough extinction of the disease germ wher-
ever found that success has been achieved. While

OBJECTIONS TO THE TEST ANSWERED. 107

this cannot be done for man, it must be done for our
flocks and herds if we would ever cut off this prolific
animal source of tuberculosis from the human race.
Even as regards the herds themselves, the stock
owner who would consult his own future interests
would at any cost exclude from his farms and fields
every possible source of future tuberculosis.”

It is admitted by nearly all authorities that the use
of the tuberculin test tends to aggravate tuberculosis
wherever it is present; but this is no objection to
its use, if the purpose is to destroy the disease
wherever found. If the early German system, which
preserved the animals that were but slightly affected,
is adopted, then, of course tuberculin should not be
used. It is useful only where radical measures are
determined on. Dr. Law’s summary of the situa-
tion is: “The tuberculin test aggravates existing
tuberculosis, and is therefore unwarrantable for use
on man, or on cattle that are to be kept alive. Itis,
however, the only known means of detecting many
occult cases of tuberculosis, and is therefore indis-
pensable in any systematic effort to stamp out the
disease by the purchase and slaughter of every
tuberculous animal.”

It is sometimes urged that the use of tuberculin
may produce the disease in healthy animals; but, as
has been shown in the description of the process of
manufacture, this result is practically impossible.

Dr. George H. Bailey, Maine State Veterinary
Surgeon, writes, under date of November 15, 1894:

108 TUBERCULOSIS AMONG CATTLE.

‘“‘ Experiments thus far conducted seem to establish
the fact that tuberculin injected into well cattle
causes no reaction, and no injurious effects; while
if diseased in the slightest degree, the exposure is
certain, and the autopsies almost invariably confirm
the diagnosis. ‘There may be some rare exceptions
to as broad a statement as the above; but such varia-
tions can all be explained by the physical condition
of the animal at the time the test is made, especially
if submitted to incompetent persons. Or the animal
may be so thoroughly diseased that its system is al-
ready saturated with the natural tuberculin, so that
the slight addition has no effect. Usually such cases
may be detected without recourse to tuberculin, or
in spite of its lack of reaction.”

Dr. M. Stalker writes: “The theory that tuber-
culin prepared as it is can produce tuberculosis, is
too absurd for discussion. Such a claim does not
possess the dignity of respectable nonsense.”

Elaborate experiments by the United States Bu-
reau of Animal Industry, to discover whether the
injection of tuberculin produces results other than
a rise in temperature, of so characteristic a nature
as to furnish a basis for conclusions indicative of
the condition of the animal, have failed to disclose
any such results.

Professor Pearson, after describing experiments
showing a rapid advance in the disease subsequent
to injection with a large dose of tuberculin, quite
parallel with the experience of Professor Koch

te We
ry, Ut
Ae
oe
ORF
wid
Y

4
OBJECTIONS TO THE TEST ANSWERED. 109

with the human subject, declares: “The normal
dose, instead of doing harm, may produce good
effects; and I have several cows under observation
that gave decided reactions when first tested, clearly
indicating the presence of tubercles; but after re-
ceiving three or four injections of tuberculin, the
reactions ceased, the general condition of the ani-
mals improved, and at present it is impossible to
elicit evidence of tuberculosis, either by physical
examination or the tuberculin test.”

This is the first and only testimony found, after an
exhaustive examination of the literature of the sub-
ject, indicating a substantial curative result. The
observations indicate this; but they may perhaps
be quoted in support of a claim that repeated injec-
tions of tuberculin produce an immunity to its fur-
ther effects, —a claim, however, which quite careful
and extended experiments by Drs. Osgood and
Lyman tend to disprove.

An interesting detail in the successful use of
tuberculin is suggested in a paper by F. L. Russell,
V.S., Professor of Veterinary Science in the Maine
State Agricultural College, in a paper published in
the “ Journal of Comparative Medicine and Veter-
inary Archives,” Philadelphia, December, 1894. He
presents a somewhat extensive comparison of the
effects of large and small doses of tuberculin, from

_ which he concludes that small doses are entirely

effective. He reports complete success, confirmed
by autopsies, with doses of from 0.05 to 0.015 cubic

110 TUBERCULOSIS AMONG CATTLE.

centimeters. The usually accepted average dose
has been 3 cubic centimeters.

It would not be just to the public, nor to those
who are working or who propose to work with
tuberculin, if allusion were not here made to the
widely quoted unfavorable results of its use by the
Rhode Island State Board of Agriculture. It is
freely stated that tuberculin has failed in that State
in 25 per cent of the cases where it has been tried.

It appears, however, from the reports of the So-
ciety’s officials, that this statement rests upon a
single experiment, where thirty-two animals were
pronounced diseased by a tuberculin test, and eight
of them failed to disclose the disease at the autopsy.
The only comment necessary in this connection is,
that, in view of the mass of testimony in support of
tuberculin as an accurate test under normal and
controllable conditions, it is quite as safe to refer
the failure toa lack of thoroughness in the autopsy,
or to lack of experience in the operators, as to ac-
cept the reported facts as conclusive against the
value of tuberculin. It has been carelessly stated
that Professor Law was responsible for the work
and for the report; but he emphatically denies the
story, and, as elsewhere appears, expresses the
strongest confidence in tuberculin as a diagnostic
of bovine tuberculosis, and advises its general use
by properly educated agents.

CHAPTER XI.
THE TRANSMISSION OF THE DISEASE.

THE present degree of knowledge of the infectious
character of the Bacillus tuberculoses has been
reached through a long series of carefully con-
ducted experiments by leading scientists in all
parts of the world. Two processes have been
used,—the feeding to animals of food known to
be infected, and the injection into their systems of
tuberculous matter obtained from other living ani-
mals or from human beings.

There is one feature incident to the experiment
of the feeding of tuberculous matter to animals
which tends to prevent uniform results. In 322
Kuropean experiments of this character, 13 per
cent resulted in the transmission of the disease.
Dr. Law accounts for the small per cent of favor-
able results in these tests by citing the varying
susceptibility to infection in the several animals
subjected to the test, and the varying degree of
infection in the material used for feeding.

The condition of the digestive organs of an
animal at the time such an experiment is tried
is also an important factor. The bacillus thrives

112 TUBERCULOSIS AMONG CATTLE.

in an alkaline or neutral medium, and is weakened
or destroyed by acids. If, therefore, infected mate-
rial enters a stomach where the gastric juices are
abundant and sharp, and where the digestive
processes are active, the bacilli are less likely to
survive and set up fresh infection than in a stom-
ach where the juices are weak and the digestive
processes are partially suspended. In the latter
case their chances of passing on to the mesenteric
glands are much more favorable. So, also, if there
happens to be any abrasion of the mucous mem-
brane in the mouth or throat, the germ may find
lodgment and enter into the system by absorp-
tion; or if it happens to pass from the mouth to
the lungs, it will find there a favorable spot for
colonization.

It is also proved by experiments that the bacillus
varies in energy as it is derived from one animal
or another. Thus the germ from an ox is almost
certain to infect a guinea-pig by inoculation, while
its vigor is so reduced by passing its progeny
through several generations of birds that the pig
cannot afterward be infected by it. But if the
germ from the last bird is inoculated in the guinea-
pig it soon regains its normal vigor. The same
variation in potency appears in germs taken from
different cattle, all apparently equally diseased.

There is also a difference in potency in the mate-
rial fed, the diseased glands and the contents of
tubercles being much more certain to infect than

THE TRANSMISSION OF THE DISEASE. 113

the blood or the muscular tissue of an infected
animal; and the peril from milk is found to vary
greatly, but not always in proportion to the localiza-
tion of the disease in the udder.

Dr. KE. P. Niles, veterinarian of the Virginia
Agricultural Experiment Station, in a recent bul-
letin, says: “ Although the lesions may be local,
the germ may be in all parts of the body, since it is
circulated by the blood and lymph. It may be
stated, in this connection, that the germ is neces-
sarily circulated in the system for some time before
general tuberculosis takes place. The mere fact,
then, that the visible lesions are local is no indica-
tion that the flesh and milk of such animals are
free from the germ. That the milk of tuberculous
animals is exceedingly dangerous is demonstrated
by the fact that a large majority of all the deaths
of bottle-fed infants in the large cities are due to
some form of tuberculosis.”

Included in Dr. Ernst’s report of his experiments
under direction of the Massachusetts Society for
Promoting Agriculture, which there has been so
frequent occasion to quote in this volume, is an
article by Dr. Henry Jackson, of Boston, on tuber-
culosis among the Hebrews. From statistics gath-
ered under his observation in boston for three
years, he finds one case of tuberculosis in 30.3
individuals among Gentiles, and only one case in
83 among Jews. He also shows by statistics from

Kuropean sources that Jews show a much greater
8

114 TUBERCULOSIS AMONG CATTLE. |

longevity than other races. At first sight a rea-
son for these differences might be inferred, and
perhaps justly so far as the European figures are
concerned, in the exclusion from the Jewish dietary
of tuberculous meats by the Mosaic code; but Dr.
Jackson seems satisfied that there is not a sufficient
observance of the code in Boston to account for his
statistics.

Dr. Jackson discusses in this connection the
evidence that tuberculous meat is infectious, and
quotes Nocard, an eminent French authority, that
meat of tuberculous animais can under certain cir-
cumstances be dangerous; but it is very excep-
tional, and where it occurs it is only toa slight
extent. He also quotes another French authority,
M. Butel, who says: “Tuberculous meat and milk
are the prominent, and perhaps the chief, cause of
consumption in man. ... The danger is formida-
ble, both on account of the large number of tubercu-
lous animals which enter into consumption, and the
frightful number of persons that a single animal can
infect, and because each person in turn becomes an
agent in the spread of the disease.”

At the first Congress for the study of tubercu-
losis at Paris in 1888, where the above opinions
were expressed, after a prolonged discussion the
following proposition was adopted with but three
dissenting votes: “It is proposed to follow out
by all means, including indemnity to owners, the
general application of the principle of seizing

;
P
}
#

THE TRANSMISSION OF THE DISEASE. 115

and destroying all meat of tuberculous animals,
no matter what the severity of the lesions in the
animals affected.’

It seems a fair conclusion, from the expressions
of the latest and best authorities, that there is, as
compared with milk, but little danger of infec-
tion with the disease by the use of the muscular
tissues of beef. The reason is that discoveries of
the Bacillus tuberculosis in muscular tissue of beef
are comparatively rare. Its favorite haunt, in the
bovine race, is the glandular system; and the only
practical danger of infection from lean beef is the
possible presence of the bacilli in the numerous
small glands that are located among the muscles,
some of which are not removed before cooking.
It should be remembered, however, that the condi-
tions are different in regard to pork. Here the
bacilli are found to generally pervade the flesh,
so that the danger of infection is much greater
from tuberculous pork than from tuberculous
beef.

The blood is understood not to be a favorable
home for the germ; but it seems certain, from
experiments, that it may survive the unfavorable
location long enough to allow lodgment in glands
or tissues where its development is certain. All
the facts show that the general diffusion of the
disease so frequently found to exist must be due to
its transmission throughout the system by the cir-
culation of the blood.

116 TUBERCULOSIS AMONG CATTLE.

That the blood can and does infect is shown by
a recent Massachusetts experiment, where a litter
of pigs, whose mother was proved to be free from
the disease, were kept under a slaughter-house
where they had no food but corn meal and the
blood-drippings from tuberculous cattle; and all
were found to be badly diseased in a few weeks.

Professor Hills and Dr. Rich state that hundreds
of experiments have proved that tuberculosis can
be passed from a diseased to a healthy animal. A
German author reports 650 successful experiments
in the transmission of the disease to the lower
animals.

At a hearing before the committee on public
health of the Massachusetts Legislature, Dr. H. C.
Ernst stated that he “ had here something like two
thousand references to articles written in all lan-
cuages, and in different parts of the world, bearing
upon and proving the infectious nature of tubercu-
losis, including only the literature extending over
about the past seven years.”

At the same hearing Dr. Ernst cited a case of
localized tuberculosis of the tongue: “ A gentleman
perfectly well on Thanksgiving day, so far as he
knew, by eating something infected with tubercu-
losis, became infected with tuberculosis of the
tongue. . . . He had a nodule half as large again
as an English walnut, which was pure tuberculosis,
as was shown under the microscope in a piece taken
off with the use of cocaine.”

q
:

THE TRANSMISSION OF THE DISEASE. 117

In a report of the State Live Stock Sanitary Board
of Maryland it is stated: “In the opinion of this
board the suppression of tuberculosis is more im-
portant than that of contagious pleuro-pneumo-
nia; for while the latter disease affects animals
only, the former destroys human life.”

It is a curious suggestion that comes from
Desmartis, of Bourdeaux, who asserts that. he has
succeeded in the inoculation of plants with tuber-
cular matter. 3

Professor Hills and Dr. Rich suggest three gen-
eral sources of infection. They are: (1) The dust
of the dried sputa of consumptives, or other tubercu-
lous matter, either inhaled or swallowed. (2) Con-
tact with the tuberculous material of those suffering
from the disease, thus becoming infected either by
inhalation, ingestion, or inoculation. For exam-
ple, in kissing a tuberculous person there might
be danger of either ingestion or of inoculation with
tuberculous sputa. (8) The meat and milk of
tuberculous animals.

In discussing the first two of these sources they
say: “The sputa of consumptives containing tu-
bercle bacilli is freely strewn around our streets
and buildings. Since the virulence of the germ is
not lessened by drying, dust is necessarily a com-
mon and omnipresent source of infection. The
dust from our streets, stores, dwellings, and places
of assembly, particularly where tuberculous people
live and congregate, is infectious. The dried sputa

118 TUBERCULOSIS AMONG CATTLE.

from handkerchiefs, the beds and bedrooms of con-
sumptives, and the mangers of tuberculous cattle,
are particularly rich with these germs. This is
the main source of infection to human beings, one
to which every one is exposed.”

In answer to the question, Why, if this infectious
principle is all about us, does not every one die of
tuberculosis ? the same writers say that many do
so die, — the death-rate from consumption, which is
but one form of the disease, being one in seven,
while from all its forms it is one in four.

It needs to be remembered, in considering this
phase of the subject, that while all Nature is pro-
lic with disease germs, so too all animal life has
in its normal state a wonderful capacity to resist
disease. In the human race, air and sunshine,
proper food, abstinence from all excesses, regular
employment, an easy mind and a clear conscience
—Jin fact, all the elements of life that are usually
counted as essentials to normal health—are so
partly because they are all naturally antagonistic
to disease. The statement is generally true, that
in the normal constitution and under normal cir-
cumstances these beneficent influences may be re-
lied on to counteract and vitiate the aggressions of
disease.

Aside from this general and generally apparent
protection, scientists declare that there are natural
forces in the body which are antagonistic to germ
life, and which are the real causes of immunity,

THE TRANSMISSION. OF THE DISEASE. 119

One theory is that the white blood corpuscles at-
tack and destroy the germs; and another is that
the blood serum and tissue juices have a similar

function. Other scientists dispute these two ideas,

and claim that a certain standard of vitality, based
of course on the natural conditions above referred
to, is sufficient to ward off the attacks of germ dis-
ease. That anormal gastric juice is fatal to many
disease germs has been abundantly proved. The
general principle will undoubtedly stand that a
good condition of health is a barrier against the
introduction of germ diseases.

The British Medical Journal reports the follow-
ing, which shows the tenacity of life of the bacillus
under ordinary conditions: “A family of nine
occupied a house occupied ten years previously by
two tuberculous patients. A short time after, al-
though the whole family had been in splendid
health, three among them showed symptoms of
tuberculosis. They used the same bedroom as the
former tenants. Dr. Ducor had pieces of wall-
paper examined, and dust from the ceiling and
walls was also examined. In both cases the tuber-
cle bacillus was found. The former occupants had
been uncleanly in their habits; the sputa had dried
on the walls, and the bacillus retained its vitality.”

Dr. Flick, at a recent meeting held to discuss
this subject, showed by a map of the city of Phila-
delphia, which located every house in the fifth
ward in which tuberculosis had occurred in twenty-

120 TUBERCULOSIS AMONG CATTLE.

five years, that the disease chiefly prevailed in a
series of infected houses which constituted less
than one third of all the houses in the ward, but
furnished more than one half the deaths. It was
also observed that a large percentage of all the
cases of mesenteric tuberculosis in children oc-
curred in these houses.

Dr. Kellogg declares that the sputum of tubercu-
lous cattle and the apartments occupied by such
cattle are as dangerous a source of infection as
those occupied by human beings, and even more so.
He also says: “It is evident that safety from this
source of danger to human life can be found only
in a thorough inspection, not only of all cows and
cattle furnishing food for human consumption, but
of all domestic animals which are subject to this
disease. The astonishing thing is that there should
be so little interest in relation to this question.
Tuberculosis is a disease much more rapidly fatal
in its effects, much more actively contagious, than
the much dreaded leprosy of India and the South
Sea Islands, and is almost equally fatal when it
has obtained a foothold in the human system.”

In considering the ways in which tubercle bacilli —

cause infection, Dr. Salmon places them in the
order of their frequency as follows: (1) by in-
halation into the lungs; (2) ingestion into the
digestive tract in the milk of tuberculous cows;
(5) during coition, when the sexual organs are tu-
berculous; and (4) from the tuberculous mother to

—_—
fe
a)
aN

THE TRANSMISSION OF THE DISEASE. 121

the foetus of the infant. He quotes German statis-
tics showing infection of the lungs 144 times as
frequently as of the digestive organs; but these can
be hardly accepted in view of the writer’s observa-
tion of several hundred post-mortems in Massachu-
setts, in which the disease was manifest in a far
greater proportion in the digestive tract. It is
noticeable, however, that Dr. Salmon places infec-
tion by milk as second in the scale of importance.
He also says in this connection: “The source of
infection is always some previous case of the dis-
ease, for the latter can never arise spontaneously.
Hence, in those stables in which there is frequent
change of cattle, the introduction of tuberculosis
by cattle coming from other infected stables is the
most frequent source of infection. Since the bacilli
when dried can be carried by the air, it is not neces-
sary that healthy animals should come in direct
contact with cases of disease to become infected.”
On a later page he says: “The disease of the
stomach, intestines, and mesenteric glands is very
probably the result of food infection. Tubercle
bacilli may have been scattered upon the feed by
diseased animals. But the most common source of
infection is the milk of tuberculous cows. Calves
may become infected in this way. The disease
may remain latent until the animal becomes older.”

In a general discussion of infectious diseases, Dr.
Salmon, in 1892, wrote: “ The growing facilities
for intercourse between one section of the country

122 TUBERCULOSIS AMONG CATTLE.

and another, and between different countries, cause
a wide distribution of the infectious diseases once
restricted to a definite locality. Not only the ani-
mals themselves, but the cars, vessels, or other con-
veyances in which they are carried, may become
agents for the dissemination of disease. The grow-
ing tendency to specialization in agriculture, which
leads to the maintenance of large herds of cattle,
sheep, and swine, makes infectious diseases both
more common and more dangerous. Fresh ani-
mals are being continually introduced, which may
be the carriers of disease from other herds; and
when this is once introduced into a large herd the
losses become very high, because it is difficult, if
not impossible, to check a disease after it has once
obtained a foothold.” |
Henry Mitchell, M. D., Secretary of the New Jer-
sey State Board of Health, in a recent circular on
the communicability and prevention of this disease,
emphasizes the former point as admitted by all who
are informed on the subject. Of the conditions
which aid in causing the spread of the disease he
says: “ Dwellings, factories, and shops which are
located upon damp or undrained sites, or which are
so constructed or surrounded or managed that pure
air and sunlight do not enter in abundance, or
which are supplied with impure water or with
imperfect drainage, or which are overcrowded or
filthy, will diminish the strength and vigor of the
inmates, and assist in rendering them unable to

THE TRANSMISSION OF THE DISEASE. 123

repel this disease. Persons whose energy is im-
paired by indulgence in indigestible or unwhole-
some foods, and those who are insufficiently fed, or
who choose foods which do not contain all of the
necessary elements of nutrition, and those who
yield to habits of intemperance in alcoholic drinks,
or to any dissipation, become liable to contract
tuberculosis.”

The New York State Commission on tuberculosis
in cattle declare: “The investigations of this Com-
mission have shown that tuberculosis is under cer-
tain conditions congenital; but its general diffusion
is due to contagion. But a very small proportion
of tuberculosis is disseminated by hereditary trans-
mission. All the facts in the possession of this
Commission, as a result of investigation, show that
tuberculosis spreads with certainty when diseased
and healthy animals are housed together. The
contagiousness of the disease is established beyond
a doubt, for in most cases it can be traced from
herd to herd in localities where dairymen deal with
each other in the purchase of cattle from infected
herds. The lesions found on post-mortem exami-
nation are variable, from small deposits of caseated
tubercles to generally disseminated lesions in differ-
ent viscera. In many cases the udders have been
found to be the seat of extensive disease. Some
cases of advanced disease were found in the udder
from which pus was seen to exude from the teats.”

In summing up a discussion of the disease as it

wy fF 4
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. 1

affects the lungs, Dr. Theobald Smith, in Bulletin
No. 7 of the Bureau of Animal Industry, after re-
ferring to the liability of repeated infections of the
Same animal says: “The more frequent the infec-
tions, the more rapid the disease, and the speedier
the danger of the one case transmitting infection to
other animals. The fewer the tubercle bacilli in the
air, the more reduced the danger. It is highly prob-
able that cattle may, under certain conditions, in-
hale a few tubercle bacilli without permanent injury.
They may become absorbed into the lymph glands,
and the disease focus remain small and finally heal.
The writer has seen the large caudal gland of the
posterior mediastinum extensively cicatrized by old
- completely healed tuberculous foci. Such changes
will of course not be found excepting where the
tubercle bacilli were originally deposited. When
the disease has once extended beyond the confines
of the primary focus, it has acquired sufficient
momentum to continue its destructive action un-
interruptedly. The importance of reducing the
amount of infection in a herd by all possible means,
and keeping it permanently reduced, is one neces-
sary condition requisite for the successful eradica-
tion of tuberculosis. Even if tuberculin does not
reach every mild case, the peculiar nature of the
affection, in virtue of which a slight amount of
infection may be overcome, bridges over the gap
which may have been left by tuberculin.”

124 TUBERCULOSIS AMONG CATTLE.

CHAPTER XII.
THE DANGER FROM INFECTED MILK.

A cuiEF danger to the human race from this disease
in cattle arises from the fact that the disease is
frequently found in the udder; that milk is gener-
ally used without cooking; and that it is, besides,
the chief food of young children and invalids, who
from their delicate constitutions are especially liable
to take on the disease.

It is true that experiments have often failed in
attempting to inoculate the disease from the milk
of animals whose udders were not affected; but, on
the other hand, the successful experiments under
similar conditions have been so frequent as to
justify the warning that the milk of all suspected
cows should be discarded. One German expert

produced the disease in rabbits fourteen times in

twenty-nine experiments with milk from diseased
cows whose udders appeared to be free from the
disease.

Another German operator inoculated from sixty-
three diseased cows whose udders were sound, and
secured results in nine cases. A microscopic exam-
ination of the udders in the nine cases showed that

126 TUBERCULOSIS AMONG CATTLE.

only three had traces of the disease, leaving six that
were plainly infectious, although the best scientific
resources failed to discover the germs in the udder.
An American experiment reported by the Bureau
of Animal Industry found three cases of infectious
milk in six cows whose udders were apparently
sound,— one in five being infected from one cow,
eight in ten from another, and six from six in the
third.

Dr. Law has secured the following authentic
cases of infection of human beings by the use of
tuberculous milk. A lad five years old, with a clean
ancestry, died from acute tuberculosis of the mesen-
teric glands and the lungs. The family cow was
found to be badly diseased. Four infants in a
children’s hospital in Berne, Switzerland, with
clean ancestry, died of the disease as the result
of infected milk. The physicians were certain in
these cases. A North Hadley case is reported,
where a boy a year and a half old spent a week at
an uncle’s, and used the milk of a cow afterward
found diseased. In three months he died of tuber-
culosis of the abdomen.

In the Medical News of March 26, 1892, Dr. E. O.
Shakespeare attributes one fifth of all deaths of
infants and young children feeding on milk to :
tuberculosis, which usually begins in the digestive —
organs. : a

Professor Hills and Dr. Rich cite numerous cases
which strongly support the theory that milk is

THE DANGER FROM INFECTED MILK. 127

responsible for very many cases of tuberculosis,
especially in its intestinal forms, among children.
A Vermont herd of cows revealed seventy-eight
out of ninety-one animals diseased by the tuberculin
test; and many of the swine fed on the skim milk
from this dairy were found as tuberculous as were
the cows. On another Vermont farm where the
disease was located, over sixty cows, over one bun-
dred hogs, all the chickens, the dogs, and even the
family cat, were exterminated on account of the
disease, and were proved diseased by autopsy.

Dr. Abbott, of the Massachusetts State Board of
Health, expresses this opinion: “ The question of
disease as propagated through milk is a far greater
and a far more important one than the question
of adulteration; and it is one which, I think, the
State has the same right to control, and to super-
vise and inspect, as it has in the simple case of
the standard of milk.”

As early as 1879 Professor Walley expressed
the view that “as to the use of milk from animals
in which tubercle is suspected to exist, no two
Opinions can be held; its deleterious effect, even
when exposed to a tolerable degree of heat, has
been abundantly proved. . . . It would be far bet-
ter to give compensation, and have even a sus-
pected animal destroyed, than allow her to remain
in a herd with the probability of spreading the
disease to her neighbors and poisoning the con-
sumers of the milk.” It should be noted that at

128 TUBERCULOSIS AMONG CATTLE.

this comparatively early date in the modern con-
sideration of the question Dr. Walley was so rad-
ical as to advise and declare against the safety of
milk from even a “ suspected” animal.

Professor Mackenzie wrote in 1892: “It has |
been unfortunately maintained by some writers
that there is comparatively little danger of tuber-
culosis in man resulting from the use of milk from
tuberculous cows; but it seems to me that this is
an idea which should be combated at every point
by sanitarians. One must, of course, grant that
appearances show that the great majority of cases
of phthisis are due to infection through the respi-
ratory organs; and as long as phthisical patients
ignorantly spread the disease in all directions by
allowing their sputum to fall in any locality where
it may be converted into dust, such must be the case.
But this very carelessness masks the real danger
from tubercular cattle, and renders it less apparent.
The primary tubercular lesions in the adult are
undoubtedly commonest in the respiratory organs;
but in infants we find the disease often as a milliary
tuberculosis, or tuberculosis of the meninges, or of
the joints, — all conditions which may be taken to
point to an infection through the intestinal tract;
and it is just this class, namely, infants, which are
most exposed to the danger of infection from milk.”

Bollinger showed that a pure culture of tuber-
cle bacilli gives positive results in inoculation
experiments in a dilution of 1 to 400,000; thus

THE DANGER FROM INFECTED MILK. 129

showing that milk may be infectious when the
bacilli are so scanty as to be undiscoverable with
the microscope without an extremely exhaustive
examination.

Professor W. H. Welch, of Johns Hopkins Uni-
versity, in an address before the American Medical
Association in 1889, quotes Bollinger’s statistics,
that with cows affected with extensive tuberculosis
the milk was infectious in 80 per cent; in cows
moderately infected milk was infectious in 66
per cent; and with only slight infection the milk
was infectious in 83 per cent. Dr. Welch added:
“There is reason to believe that many of the so-
called scrofulous affections of children are due to
infections from milk from tuberculous cows.”

At the Paris Congress in 1888, Professor Bang,
of Copenhagen, reported on twenty-seven cows
whose udders were diseased, in which the milk of
every animal proved tuberculous.

Professor Mackenzie reports, as a result of his
Own experiments, that where no udder disease
appeared on. post-mortem, 40 per cent of the milk
was infected.

After an exhaustive summary of his reading
and observation Professor Bryce concludes: “ That
while the great number of deaths from tubercu-
losis in children, as from consumption of the
bowels, points to the probability of frequent cases
of infection through milk and other food by way
of the alimentary tract, yet the still larger number

9

130 TUBERCULOSIS AMONG CATTLE. : 4 :

Ei wet

of cases of lung tuberculosis in children, the rela-
tively small number of calves and young cattle in-
fected with tuberculosis, and the comparatively few
instances of tuberculous cattle in which the intes-
tines, mesentery, or other abdominal organs are
found on examination to be exclusively tubercular,
point very strongly to the conclusion that infec-
tion by way of the intestines is relatively seldom
in cattle: and that when it does take place in
children, it most probably is dependent on the pre-
viously unhealthy and congested state of the mucous
membrane of the walls of the stomach and of the
intestines.”

As a typical and not an extravagant type of the
possible sequence of diseases, all referable to infec-
tion from tuberculous milk in infancy, the follow-
ing may be considered. A female infant is infected
and has an attack of cholera infantum; she is saved
by medical skill and good nursing. A little later
in life she is subject to convulsions. I cerebro-
spinal meningitis supervenes, death will probably
end the sequence. But if not, she will be “ail-
ing and delicate” on attaining the age of puberty ;
after her first child-birth she will show tendency to 2
pulmonary consumption, and, if she survives this, :
will drop away at the “change of life.” Such a
sequence has attended the life of many a woman ;
and only the recent investigation of tuberculosis
has made possible an intelligent diagnosis of the
various ailments, and their reference to a single
infantile cause. |

THE DANGER FROM INFECTED MILK. 131

Dr. Theobald Smith, in Bulletin No. 7 of the
Bureau of Animal Industry, discusses the dissemi-
nation of the disease within the body from the
primary seat of infection. He says: “ After the
lodgment of tubercle bacilli in the primary focus,
where their multiplication stimulates the formation
of neoplasms or tubercles peculiar to this malady,
the disease may after a time become stationary, and
the tuberculous products finally undergo calcifica-
tion. In most cases, however, the disease, after
being purely local for a time, and not disturbing
the normal functions of the animal to any recog-
nizable degree, spreads from the original focus
more or less rapidly, and invades a greater number
of organs and structures the longer the life of the
infected animal continues. The courses which the
virus takes in moving from the primary focus, or
foci, to establish new centres are subject to much
puzzling variation, and have been the subject of
much investigation and speculation. . . . In gen-
eral, the tubercle bacilli may be disseminated either
by the lymph or the blood channels, or by both com-
bined. To these may be added the dissemination
by contiguity, which is probably responsible for
most forms of tuberculosis of the serous mem-
branes (pearly disease).”

While the world is waiting for governmental
action that shall greatly reduce the sources of
infection of tuberculosis, the question of whether
meat and milk that are or may be infected can be

132 TUBERCULOSIS AMONG CATTLE.

so treated as to make their use safe to the public
is of interest. In a later chapter of this volume
Dr. Law’s observations on the peril from tuber-
culin are fully stated. Against this peril there
seems to be no shield. But against the infection
there is a shield within the reach of every one, but
quite liable to be so neglected or so carelessly used
as to demand especial emphasis on its importance
wherever this subject is discussed.

It has been before stated that a temperature of
167 degrees Fahrenheit is sufficient to destroy the
vitalized germs of the disease. It is, therefore,
only necessary to cook meats and to scald milk to
this temperature to render them comparatively
safe.

While beef muscle is not usually affected, numer-
ous small glands embedded in it are frequently so.
Therefore, thorough cooking is essential. The flesh
of swine is more generally affected, and is therefore
more dangerous. Rare roasts, steaks, and cutlets
should be avoided, as experiment has shown that,
although they may have been subjected to a tem-

perature considerably higher than that above in- |

dicated, there is no certainty that their interior
portions may not contain living germs. LExperi-
ments have resulted in succcessful inoculations,
even after meat has been generously roasted.
With milk, the use of a sterilizer or a double kettle
is entirely practicable and safe, the only precau-
tion necessary being to continue the heat for from

THE DANGER FROM INFECTED MILK. 133

fifteen to thirty minutes. Care is necessary, in
preparing the milk for infants, not to raise the
temperature much above 167 degrees, as this would
so nearly boil it as to cook its albuminous particles,
rendering’ them indigestible, and harmful as infant
food.

But Dr. Ernst is very emphatic on the method of
sterilization. He says: “If I sterilized the milk
myself, I should be satisfied ; but it is not a method
that can be applied generally with success. It is
not a safe method at all, particularly for the supply
of milk to the poor, unless something is done here
similar to what is done in one or two of the cities
abroad, where the milk is sterilized for the poor at
the rate of eight, ten, or twenty thousand flasks a
day. But that, of course, is something that we
cannot attempt.”

Of the result of cooking meats, Dr. Ernst also
says: “It destroys the germs, certainly, on the
outside; but it does not destroy them on the inside.
Kvery experiment that has been made goes to show
that a piece of meat is precisely the same as a roll
of cloth. The outside, receiving a high tempera-
ture, is necessarily affected by it; but the desired
result is not produced on the inside for hours and
hours. No roast of meat would be disinfected on
the inside by two or three hours’ cooking.”

Bulletin No. 7 of the Bureau of Animal Industry
records a series of carefully conducted experiments
to discover the relation existing between the condi-

134 TUBERCULOSIS AMONG CATTLE.

tion of a tuberculous animal and the degree of milk
infection. Some information was also sought con-
cerning the probable extent to which tubercle bacilli
occur in a general city milk supply. In the latter
class of experiments, the microscope failed to dis-
close the presence of the bacilli. In experiments
by the injection of guinea-pigs, forty trials were
made with nineteen different samples of milk. Only
one trial disclosed infection on autopsy of the pigs.
In injection experiments with milk from twelve
cows, known to be tuberculous, upon thirty-two pigs,
only one transmission of the disease was accom-
plished. In another similar test, where repeated
injections were made in the same pig, a similar
negative result appeared. The conclusion of the
observer, Dr. E. C. Schroeder, is that “a careful in-
spection of all dairy herds which has for its object
the detection and removal of all advanced cases of
tuberculosis, and especially of cows with diseased
udders, would probably exclude the sale of most in-
fected milk.” Healso says: “ These experimental
observations further show that now and then the pre-
sumably mixed milk of dairies may contain enough
tubercle bacilli to prove fatal to guinea-pigs.”
While the foregoing is quoted as a substantial —
support to the position of those who deny the gen-
eral peril from the use of tuberculous milk, it does
not contribute anything in support of the opponents
of the theory of the infectiousness and general
danger of the disease. In any candid view of the

THE DANGER FROM INFECTED MILK. 135

question, the results of the as carefully conducted
and more extended experiments of Drs. Ernst and
Peters, elsewhere given, should be duly weighed.

Dr. A. W. Clement, of Baltimore, Md., says: ‘It
is the general opinion and belief that the major-
ity of cases of human tuberculosis are acquired from
the dried particles of sputa in the air; that a very
small percentage probably arises from the ingestion
of infected meat. Of course it is quite possible that
such infection may take place even in adults, as the
contact of the tubercle [bacilli?] with any part of
the body may produce infection. In children, how-
ever, itis quite different. I think the majority of
cases in children are in the intestinal canal; and
in those cases, of course, it is quite probable that
most of the infection is due to the ingestion of
food, of milk especially.”

Dr. W. EK. B. Miller, of Camden, N. J., gives a
case which he considers conclusive. He says: “It
was the case of a mother having raised a family
of four or five children; and there were three or
four older ones who were perfectly healthy, as were
the father and mother, and no trace of consumption
existed among their ancestors as far back as they
could go, and no tuberculosis whatever in the fam-
ily. The mother had ceased to furnish a sufficient
milk supply from which to support the child, and
they purchased a Jersey cow, .. . especially be-
cause they wanted to secure the milk from a single
cow for the support of the child. The child lived

136 TUBERCULOSIS AMONG CATTLE.

and grew to be about two years old, when it devel- —
oped tuberculosis and died; and in the mean time
a second child was born; it also developed tuber-
culosis; and last summer a third child was born,
which now has tuberculosis ;—and they have all
three been raised from this cow. In this connection
I might say I was called to see that cow, and found
one of the worst cases of tuberculosis that I have
ever met and made a physical examination of in my
life. . . . There is no doubt in my mind that all
three of these children received the infection from
the milk of that animal.”

CHAPTER XIII.
CONCLUSIVE TESTIMONY AS TO MILK INFECTION.

Doctors Ernst and Peters conducted, in 1890,
and later, under the auspices of the Massachusetts
Society for Promoting Agriculture, an exhaustive
series of experiments by inoculation and by feeding,
and made exhaustive inquiries of physicians and
veterinarians, to determine the danger of infection
through milk from tuberculous cows. Their pre-
liminary report shows the following results, which
have but just been made public in detail: “ From
114 samples of milk from cows showing clinically
no udder infection, 31.5 per cent tuberculous by
the microscope; 74 guinea-pigs inoculated with the
same milk, 13 per cent tuberculous on post-mor-
tem; 12 pigs fed with the same, 50 per cent tuber-
culosis; 23 calves fed with the same, 23 per cent
tuberculous.”

At the close of a report to the Massachusetts
Legislature of 1894, they conclude emphatically :
“(1) That the milk from cows affected with tuber-
culosis in any part of the body may contain the
infection of tuberculosis. (2) That the virus is
present whether there is disease of the udder or

4
1388 § TUBERCULOSIS AMONG CATTLE. * an

not. (8) That there is no ground for the assertion —
that there must be a lesion of udder before the
milk can contain the infection of tuberculosis.
(4) That, on the contrary, the bacilli of tuberculosis
are present and active in a very large proportion of
cases in the milk of cows affected with tuberculosis,
but with no discoverable lesion of the udder.”

In response to their inquiries of physicians and
veterinarians in all parts of this country, they re-
ceived numerous answers. The following are from
those who had observed or suspected the infection
of the human family from tuberculous milk.

From Dr. J. A. Gordon, of Quincy, Mass.: “A
child about ten months old, bottle-fed, developed
tuberculosis and died. ‘The cow from which the
milk was obtained died of tuberculosis a few weeks
afterward.”

From George H. Bailey, D. V.S., State Veteri-
nary of Maine: “I feel perfectly warranted in
saying ‘ Yes.’ I have a case now under observa-
tion, where, about a year ago, I condemned a tuber-
culous cow that proved upon post-mortem to be an
advanced case of pulmonary tuberculosis. The
milk from this cow was the sole supply of the
family, a man and wife; and although there isno ~
history in the family of the woman that can possi-
bly be traced to phthisis, she is in an advanced
stage of consumption, as I have every reason to
believe from the direct use of the milk of the cow
that I condemned. I have another case that closely —

aa 4
ir tig ere « es

TESTIMONY AS TO MILK INFECTION. 139

approximates the above, but where the history in-
volves the grandparents of the subject.” |

From Dr. Cornelius Kollock, of Cheraw, S. C.:
He wrote of a case where a strong, vigorous child,
without a trace of disease in its ancestry, lost its
mother at birth, and was suckled by a woman well
advanced in pulmonary consumption, in opposition
to his remonstrance. The child began to pine at
twenty months, was ailing ever after, had hemor-
rhage at ten years, and died of tuberculosis at four-
teen years of age. He says: “I pronounce this an
undoubted case of tuberculosis being transmitted
through the milk of the woman who nursed the
child.”

From Dr. M. Stalker, veterinary surgeon of the
Iowa State Board of Health: “A few days since I
made a post-mortem examination on a cow, the
milk of which had been used to nourish an infant.
The child died. A searching physical examination
of the cow failed to detect the slightest trace of
disease ; but the post-mortem examination revealed
in the clearest possible manner extensive tubercu-
lous deposits.”

From Dr. EH. T. Williams, of Roxbury, Mass. :
“T think I have seen many such, — for example,
tubercular disease from milk, mostly in hand-fed
babies of perfectly healthy parentage, developing
tabes mesenterica, phthisis, and tubercular menin-
gitis; yet I cannot prove it scientifically in a single
case. . . . I know that diseased milk breeds tuber-

140 TUBERCULOSIS AMONG CATTLE.

culosis; but when you ask for details of cases, I
am at a loss to give them.”

From Dr. R. C. Ward, of Northfield, Mass.: “I
have no doubt but tuberculosis in man may come
from the consumption of milk from diseased cows.”

From Dr, J. T. Whittaker, of Cincinnati, Ohio:
“T have had cases — one or two children — of basi-
lar meningitis secondary to intestinal affections and
independent of bronchial catarrh, in new houses,
parents and attendants unaffected, brought up on
the bottle, which I could interpret in no other
way, especially as the milk used was from one cow
only.”’

From Dr. P. Paquin, of Columbia, Mo., State
Veterinarian: “ I have seen three cases of tubercu-
losis in human beings that seemed to have origi-
nated in cow’s milk. I have positively induced
tuberculosis in animals in five or six cases, by feed-
ing or inoculating milk from cows having tubercu-
losis in the udder.”

From Dr. J. A. Kite, of Nantucket, Mass., who,
in answer to Dr. Ernst’s question, says: “ Yes, but
not with scientific accuracy. There were three
cases which came under my care from another.
All died. No other cause tenable.”

From Dr. Arthur H. Nichols, Boston, Mass.:
“While believing for many years that our milk
supply might be a prominent factor in the dissemi-
nation of tuberculosis, I have never found an oppor-
tunity for demonstrating such a relationship.”

aah *

ee

TESTIMONY AS TO MILK INFECTION. 141

From Dr. O. H. O’Brien, of Rockport, Mass. :
‘‘Have seen several, two in particular, in which I

strongly believed the ae might be found in the

milk of tuberculous cows.’ :

From Dr. Henry F. Leonard, of Boston, Mass.:
He writes of a case where a ete teubane cow tur-
nished milk that was used by two adult men, and
both died of consumption. “Others saw the cow,
and would not take her milk; of these none were
wi?’

From Dr. Beverly Robinson, of New York City:
“‘] have remarked that children have lost flesh and
strength at times, without assignable cause, and
with a very clear hereditary history. In such in-
stances, when the parents were closely questioned,
I have found occasionally that the children were
fed almost exclusively on milk. Now, when the
source of the milk supply was inquired into, it was
discovered that it was from a locality where I had
reason to suspect that there was little or no intelli-
gent supervision of the cattle, and where from the
poverty of the people and their bad hygienic sur-
roundings I premised that there might be tuber cu-
lous cattle in the herds.”

From Dr. Andrew F. Shea, of Lawrence, Mass. :
“ T could not trace any case of tuberculosis to milk
supply ; but I have seen cases of tuberculosis in
cows in the surrounding country which I feel sure
would give rise to tuberculosis in a fit subject
drinking such milk.”

142 TUBERCULOSIS AMONG CATTLE. . |

From Dr. Herbert F. Williams, of Brooklyn,
N. Y.: “ My difficulty has been with the general
statements of patients. In fact, after discovering
that none of them have been large milk-drinkers, I
conclude it would prove nothing if they were; for
one drop of tubercularized milk would do the in-
fection, if the subjective conditions are right. .. .
I believe that milk is a convenient vehicle, and the
most probable one, for human infection. Investi-
gations into the sudden sicknesses of healthy in-
fants, pointing to gastro-enteric irritation, with
subjective cerebral symptoms, would seem to me to
be the field most likely to lead to positive results.”

From Dr. Francis P. Kinnicutt, of New York
City: “ While firmly convinced that many cases
of tuberculosis in children which I see have their
origin in infected milk, such a genesis is exceed-
ingly dificult to demonstrate in a great city, with
its milk supply drawn from so many sources.”

From Dr. Charles E. Inches, of Boston, Mass.:
“From several cases | had become suspicious that
tuberculosis originated in the child from nursing, ;
and therefore have for a long time insisted that,
where the mother was suffering from tuberculous ‘
disease, the infant should be ‘ reared by hand.’ ” a

The last case refers to human milk, but a wise
discretion would view the milk of a tuberculous
cow with equal suspicion.

From Dr. N. Bridge, of Chicago, who in answer
to Dr. Ernst’s inquiry as to observation of infection

———o

TESTIMONY AS TO MILK INFECTION. 143

from milk replied negatively, but added the follow-
ing significant sentence: “ The fact is, those who
can, kill the bacilli, however acquired ; those who
cannot, are killed by them.”

From Dr. Israel T. Dana, of Portland, Me., who,
while replying negatively to Dr. Ernst’s inquiry for
known cases of infection from milk, wrote: ‘I have
had cases of infants brought up on cow’s milk,
where neither heredity nor environment would lead
to the expectation of tuberculosis, in which tuber-
culous symptoms have rapidly developed, with fatal
terminations. The symptoms have oftener been
abdominal than pulmonary. ... In some of the
cases the most natural explanation of the phe-
nomena present has seemed to me to be in the line
of infectious tubercle-producing cow’s milk.”

From W. J. Coates, M.D., V.S., who, in reply
to Dr. Ernst’s inquiries, indicated a very important
point in connection with tracing a source of infec-
tion: He wrote: “In regard to the human subject,
it is difficult to trace, as there is too great a differ-
ence between cause and effect; by the time the
physician could recognize the disease, the milk
source would be lost sight of. A man-might be
ailing for. many years, and his disease not appre-
ciated by his physician, until some day he takes
what is commonly termed a ‘cold, and develops
acute symptoms of phthisis, which will be given
credit to atmospheric influences, and not to a source
of meat or milk supply which may have been years
before.”

144 TUBERCULOSIS AMONG CATTLE.

From Dr. F. Forchheimer, of Cincinnati, Ohio,
who, while saying he could not establish “ positive
connection’ of the disease with the milk supply,
added the following most suggestive observations :
“ According to my notion, tuberculosis is by far the
most common of children’s affections; again, most
common ina localized form. The place where it is
most frequently found in them is somewhere in the
alimentary tract, or organs connected with it. Milk
is the most common article of diet in children;
milk contains tuberculous material to an extent
which, according to my idea, is not properly esti-
mated; so that I have the conviction that tubercu-
losis is frequently caused by milk. As toa record
of cases of this connection, or scientific proof of
the same, I should hesitate a very long time before
I would put down any individual case as in eyi-
dence. Cases are not uncommon, in practice, in
which a tuberculous mother nurses an infant, which
dies, let us say, of a meningitis tuberculosa. Yet
in such a case, in which I am convinced that the
mother has transmitted tuberculosis to her child,
how can I present evidence sufficiently conclusive
to prove that infection has not come from another
and extraneous source? J have seen children who,
according to the statement made to me, have had
no other food but milk, with the following set of
lesions: tuberculosis of the glands about the neck,
of intestine, mesenteric glands, lungs, and menin-
ges. lam justified, I think, in the conclusion that

a
“Ty :

TESTIMONY AS TO MILK INFECTION. 145

the tuberculosis was produced by a something in-
troduced into the alimentary canal. I am con-
vinced that it was by means of milk; yet I am not
justified in this individual case in stating that this
was the cause of my knowledge. In other words,
I cannot put down such a case as one capable of
exact demonstration.”

Dr. Ernst, in his final summary, just issued, based
upon all his investigations, says: “(1) While the
transmission of tuberculosis by milk is probably not
the most important means by which the disease is
propagated, it is something to be guarded against
most carefully. (2) The possibility of milk from
tuberculous udders containing the infectious ele-
ment is undeniable. (8) With the evidence here
presented, it is equally undeniable that milk from
diseased cows, with no appreciable lesion of the
udder, may and not infrequently does, contain the
bacillus of the disease. (4) Therefore all such
milk should be condemned for food.”

Dr. Ernst summarizes all the replies from med-
ical men to his letter as follows : —

Pere natneT ey CDN! Se co ae a wie
Pete ears miulkito e¢hild fo. 4 eer) etre pee
UE Se a ae a ee i ialar il! |
meeaveyidiebeliat . 6, ce ew) ee ke eG
? get) a gk my ar “gh ae gl
0 OC Sa ae ae er ce ner mean |
EG ed ke of at wil es ee ane tee
ROT TODMOR hii ao! wows, pay han po” ce ee. Oe

146 TUBERCULOSIS AMONG CATTLE. : ,

As showing the percentage of medical men whose
attention has been attracted to cases such as the
circular made inquiry of, he excludes the replies of
those out of practice, or who have paid no attention
to the matter. This would leave 937 observers; |
and counting the positive and the suspicious cases
together, he finds that 3.7 per cent of observers
have had their suspicions aroused, —“ a result that
is as unexpected as it is surprising in its size, if one :
takes into consideration the difficulties surround-
ing the question, and the newness of the subject.”
Besides this, and aside from those reckoned in the
above per cent, there were thirty who expressed
their entire belief in the actual occurrence of such
a method of transmission of the disease.

The replies from veterinarians were still more
conclusive. Dr. Ernst classifies all the answers
received from these as follows : —

Postave . oe Oe ls Oe
Suspicious: |<.) 5, 5 \<) = & 5) <0
Neéeative: . 2) 2.4) evel
Total replies ©. 0.) |.) >.) “3 earn :

Thus it appears that of fifty-four veterinarians
fourteen, or nearly 26 per cent. have seen positive
cases; and twenty-three, or over 42.59 per cent,
have seen cases where they felt justified in suspect-
ing such an origin of the disease as the investigation
was seeking.

Dr. Ernst remarks of the last quoted percentage:

TESTIMONY AS TO MILK INFECTION. 147

“It is startling in its size, until one remembers the
greater facilities that veterinarians have for observ-
ing such cases and their origin.” He also remarks:
“ Combining the statistics obtained from the two
sources, it appears that there were 991 answers
received to the circular letter that should be
counted; and that among these there were fifty-
eight gentlemen who have seen, or suspected, the
existence of such cases as were inquired about, —
giving a percentage of over 5.84, which seems to
be somewhat remarkable, for the reasons already
given.”
It should be considered, in estimating the weight
to be given the foregoing testimony, that the present
knowledge of the details of the action of tuberculo-
sis is of but recent origin; that many experienced
and useful medical men do much of their work by
routine methods, and their attention is not usually
attracted to the relations suggested by Dr. Ernst’s
inquiries; and that, as Dr. Forchheimer suggests,
scientific demonstration of the facts is of peculiar
difficulty. In view of these considerations, the posi-
tive assertions of only a small number of observers
are most important. Such observations are, though
comparatively few, far more impressive and con-
vincing than any number of confessions of indiffer-
ence or of failure to observe.

CHAPTER XIV.
ANOTHER PERIL FROM THE DISEASE.

THE infection of mankind by the tubercle bacillus
has been carefully studied and demonstrated, but
Dr. Law is the first to point out another danger
from the disease.
_ In explaining the production and the use of tu-
berculin it was stated that it is a physiological
poison, the life product of the bacillus. Dr. Law
discusses at length the effect of this poison upon
the system, and shows that it pervades the entire
muscular tissue of a tuberculous animal, and may
be taken into the human system whenever the meat
of such an animal is used for food.

While there may be degrees of peril, or in mild
cases degrees of safety, in the use of the cooked
meat of a tuberculous animal, the cooking temper-
ature possibly being enough to destroy the germ,
Dr. Law points out the fact that the poisonous
character of tuberculin is unchanged by heat, and
that “the professional mind in concentrating its
attention on tubercular infection has _ practically
entirely overlooked the no less real, and in many
cases no less dangerous, fact of tuberculin poi-
soning.”

:
:

(‘asvosip ayy Jo osvyd odvas 10 Azer oyy,)

‘SHTOUNEAT, HLIM GHUHAOOD ‘WOLNANG

ANOTHER PERIL FROM THE DISEASE. 149

Tuberculin, when taken into the human system
with the meat which is charged with it through
disease, produces fever and the impairment of the
functions of assimilation and secretion. The same
results follow as in the case of the production of
tuberculin through the progress of the disease in
human subjects,— death in these cases resulting
not from the ravages of the bacillus so much as
from the poisoning by tuberculin, which is thrown
off as a result of its life.

While the system of a tuberculous patient may
for a long time resist and withstand the poisonous
effects of the amount of tuberculin thrown off by its
own bacilli, more prompt and alarming results fol-
low the absorption of an added quantity of tuberculin
in the meat of infected animals: the bacilli are
abnormally excited, their multiplication and their
activity are increased, and the crisis of the disease
is hastened. And it should be remembered that,
as it is in the early stages of the disease that the
bacilli are most active, so it is in this stage that
the meat of diseased animals is most fully charged
with tuberculin, while it is at the same stage that
the same poison is most effective in the human
subject.

Dr. Law expresses this idea in the following vig-
orous language : —

“Ttis this extension of the tuberculosis under
the influence of the toxic (poisonous) products of
the bacillus which raises the most important ques-

150 TUBERCULOSIS AMONG CATTLE.

tion in connection with the consumption by man of
the flesh and dairy products of tuberculous animals ;
and yet this question has been overlooked by sani-
tarians in the most unaccountable way. It has
seemed enough for them that the living tubercle
bacillus did not exist in the juices of the muscles
nor in the meat. It seems never to have occurred
to them that all the soluble poisonous products of
this bacillus were constantly circulating in the
blood which passes through the muscles, and that
they equally traverse the blood-vessels of the mam-
mary glands, and escape into the milk. No pathol-
ogist can fora moment doubt this general diffusion
of these products in the tuberculous subject. Accept-
ing then as undeniable the presence of the soluble
chemical poisons in blood, flesh, and milk, it follows
that those who eat this flesh or milk are continually
taking in small doses of tuberculin; and in that
case, if they are already the victims of tubercu-
losis, in however slight or indolent a form, this con-
tinuous accession of the poison will rouse the morbid
process into greater activity and secure a dangerous
extension.

“Tf we now consider the frightful prevalence of
tuberculosis in the human race, — that here in New
York every eighth person dies of tuberculosis, that
in cities like Vienna 85 per cent of the people suffer
from it,and that in our own cities 30 to 50 per cent
contract it at some period of life,— we see what a
fearful risk is being run by the utilization of the meat

ANOTHER PERIL FROM THE DISEASE. 151

and milk of animals so affected, even if it could be
shown that such meat and milk were in themselves
free from the living bacillus. Such reckless con-
sumption of the products of tuberculous animals
can only be looked on as a direct means of sealing
the fate of that large proportion of the community
which are already slightly atfected with tubercu-
losis.”

Against this peril sterilization of milk and the
thorough cooking of meats are no defence, for the
poisonous character of tuberculin is unchanged by
these processes.

Experiments have shown that, after the inocula-
tion of guinea-pigs with the baciHus, the adminis-
tration of tuberculin greatly hastened the onset of
- general tuberculosis. Dr. Law points out that, if this
is the result with these animals, — which, although
very susceptible to tuberculosis, are not easily poi-
soned by tuberculin, — the peril is far greater to
man; and he presents a computation showing this
peril to be twenty thousand times greater, weight
for weight. He concludes: ‘“ We may freely allow
that the transmission of the bacillus from man to
man is far more common than from beast to man :
but though the implanted seed may have been in
many cases derived from a fellow man, its subsequent
destructive progress may be due far more to the con-
stant accessions of the soluble poisonous products
conveyed in the meat and milk of tuberculous
animals. Without these constant doses of soluble

152 TUBERCULOSIS AMONG CATTLE.

poisons of tubercle, the implanted germ would in
many cases have proved comparatively harmless.
Although it could be proved in regard to many
cases that the cow had not contributed the seed of
the disease, she is left little less responsible for the
destructive progress and fatal result. The germ,
which might have remained comparatively dormant
and harmless in the absence of the poisoned meat
and milk, is by these stimulated to a more deadly
energy.”

Dr. Kellogg adopts Dr. Law’s view, and says:
‘In the blood and lymph of every animal suffering
from tuberculosis there must be circulating a varia-
ble amount of extremely toxic substance called
tuberculin. The milk as well as the juices of the
flesh of such an animal must always contain a cer-
tain proportion of this poison. It is thus apparent
that whoever makes use of the flesh or milk of such
an animal is thereby introducing into his system
more or less of this extremely active and dangerous
poison.”

He also says: “Since the fluid portion of the
milk is made up from the plasma of the animal’s
blood, it is evident that it must contain at least
as large a proportion of this extremely soluble
and poisonous product as is found in the animal’s
blood, — perhaps even a larger quantity, the readi-
ness with which toxic substances of various sorts
are excreted by the mammary gland being too com-
mon an observation to require more than mention.

ANOTHER PERIL FROM THE DISEASE. 153

',.. If present in the animal when alive, it will
certainly be present in its flesh and milk; and
- those who make use of these infectious substances
as food must run an enormous risk of injury.”

While suggesting that this view of Dr. Law may
not be fully borne out by later investigations, Dr.
Salmon says the effect of the milk and flesh of
tuberculous animals on the consumers is a very
grave one. “There is danger, of course. We do
not know how much depends on cooking. Meat
and milk of tuberculous animals does contain tu-
berculin. At present we do not know the exact
danger. Live-stock boards must take cognizance
of such diseases.”

CHAPTER XV.
NECESSARY MEASURES FOR PROTECTION.

It seems the unanimous verdict of the experts
who have given the subject thorough study, that
the disease in -question can only be met by its
eradication from every herd kept for the supply of
food products. No inspection of these products
can meet the case. Every animal must be tested,
and tuberculin is the only known test upon which
any reliance can be placed. Without it there is no
possible guaranty for the products of the dairy.

Dr. Law says: “The sanitary officers who will
affect to deal with this disease in herds without the
aid of tuberculin are at best but pruning the tips
of the branches of the evil tree. Public money
ought not to be thrown away on such fruitless and
ineffective work.”

It is essential, after a stable has had all its in-
fected animals removed and destroyed, that all
cobwebs, dust, etc. should be removed from every
part; the mangers, feed-boxes, drinking troughs,
pails, etc. thoroughly cleansed ; and the whole prem-
ises and belongings thoroughly fumigated with burn-
ing sulphur, and all wood and iron work and glass

~ ee

NECESSARY MEASURES FOR PROTECTION. 155

sprayed with diluted corrosive sublimate. As has
been heretofore stated, the germ of the disease is
retentive of life, and only by thorough work and
strong disinfectants can the purity of a stable be
assured after it has once been infected.

Care should be taken also to prevent the access
of untested animals to a tested herd, and no animal
should be added to the herd without test. All farm
animals should also be tested, and human beings
suffering with tuberculosis should not be allowed
to come in contact with the herd.

Every carcass designed for human consumption
should be inspected, and not only the meat but all
the internal organs should be proved clean. All
meat supplies should be slaughtered at public abat-
toirs, under the inspection of a government official.

Professor Hills and Dr. Rich say: “It is ques-
tioned by some veterinarians whether for practical
purposes animals very slightly affected should be
considered tuberculous. Possibly they might live
for years without marked advance of the disease.
But who shall say in such cases when the danger
line is passed? Is it worth while to prolong for a
year or two the life of a few confessedly tuberculous
animals and run the risk of infecting a herd as well
as human beings? While many animals but slightly
affected might live for years in apparent health and

usefulness, a tuberculous animal, whatever its con-

dition, is a constant menace to the other members
of the herd, as well as to those who care for it or

156 TUBERCULOSIS AMONG CATTLE.

consume its products. If to-day the germs are in-
active, to-morrow they may pass into the blood, to
the udder, and infect the milk. It is stated on
good authority that the tubercle germs may exist in
- the milk even when the udder is not affected. The
preservation of a single tuberculous animal invites
renewed disease. There are as yet few, if any,
authenticated published accounts of cured bovine
tuberculosis, although possibly favorable climatic
conditions may arrest the progress of the disease.
Viewed solely from a monetary standpoint, the
truer economy lies in the exclusion of every possi-
sible source of future infection.”

Professor Walley presents the practical view in
the following remarks: “ In a discussion on this sub-
ject, which arose out of a paper read by me,.. . I
was taken to task for not giving the members of
the Association any information as to the cure of
tubercle. My answer was, that I did not perceive
how I was to be blamed for not devising measures
for the combating of a disease which had taxed the
energies and defied the efforts of many successive
generations of physicians and pathologists; and,
moreover, that as no practical purpose could be
served by curing a tuberculous animal, — seeing
that it was useless for breeding, dangerous for
dairy purposes, valueless and dangerous as a com-
panion, and its flesh nocuous for human food, — I
failed to perceive why time should be wasted in
such an inquiry, but believed rather that all our

a ted sel pthtligg Amey ie a

NECESSARY MEASURES FOR PROTECTION. 157

energies should be directed toward the prevention
and eradication of the disease.”

The above was written in 1879, but nothing has
been developed since then to detract from the force
or wisdom of Professor Walley’s opinion. Much,
indeed, has been learned, but it has all been in the
direction of emphasizing his opinion, or of reveal-
ing the impracticability of remedial measures. — It
is worthy of note, also, that, even at this early date
the writer recognized the fact that, even if the dis-
ease was checked for a time, its germs might later
be wakened to renewed and mischievous activity.

Professor P. H. Bryce says, in a paper published
in 1892: “ There are in the United States forty-two
thousand physicians (graduated in ten years), whose
duty I assume to be to maintain the people in good
health, or to heal those who are sick. What num-
ber of veterinary physicians is there, I ask, who are
devoting their attention to the problem of maintain-
ing these milk-producing animals in health, or in
preventing evil results from attending the use of
milk, unwholesome at the time of taking from the
cow, or in its often strange and eventful history up
to the time it reaches the consumer ?”

After enumerating the long list of infectious dis-
eases to which cattle are subject, he remarks: “ As
a rule, it is not those maladies fulminantes, slaying
whole herds in a few weeks, that cause us alarm in
the matter of milk supply, but rather those of less
acute diseases, which, owing partly to ignorance,

158 TUBERCULOSIS AMONG CATTLE.

partly to carelessness, and not infrequently to cul-
pable cupidity, while not depriving a cow wholly of
her milk-producing ability, are disseminated in milk
supphes to anextent proportionate to the numerous
opportunities offered and to the vulnerability of the
person taking the milk.”

This suggestion describes tuberculosis and illus-
trates its perils with great accuracy ; and Professor
Bryce continues, a little later: “ But as compared
with other diseases, the one which must be recog-
nized on every hand as being par excellence that to
which sanitarians, medical health officers, and phy-
sicians must devote their attention is tuberculosis.
That tuberculosis causes one seventh of all the
deaths of the human race is stated by reliable sta-
tisticians ; that it prevails in almost every land is”
well known; that it is disseminated everywhere on
the American continent is equally well established ;
and that it has greatly increased in prevalence is,
unfortunately, too true. That until recent years it
prevailed but little in American cattle is probable ;
but that it has increased, as animals improved by in-
and-in breeding have been imported for stock pur-
poses, is well known; and that it has been rapidly
developed by the growth of dairying for the supply —
of milk to the enormously increased populations of
our American cities has now become a well authen-
ticated fact.’*

That the above was published in 1892 suggests
that the present interest in the subject is not a late-

NECESSARY MEASURES FOR PROTECTION. 159

born “fad,” as has been ignorantly asserted in
some respectable quarters.

Professor Bryce computes that three per cent of
cattle die annually from tuberculosis. This rate,
in Massachusetts alone, means a loss of a little
more than seven thousand animals per year. These
at $30 per head represent a net loss of $210,000
each year. In view of such a loss now going on,
the expenditure of an equal sum each year, for a
few years, to practically eradicate the disease, loses
_ something of its formidable aspect. In fact, taken
in connection with the peril involved in delay or in
half-way measures, liberal and prompt expendi-
ture seems the only economical and conservative
policy.

In 1889, M. Arloing, a French veterinarian, bas-
ing his computation upon statistics from public
abattoirs, computed that five adult cattle in one
thousand were tuberculous. The French Minister
of Agriculture, in 1887, reported 8,623,441 adult
cattle. M. Arloing’s estimate would show, there-
fore, about 45,000 diseased cattle in France. Their
value is estimated at $60 each; their immediate
destruction would therefore cost $1,850,000. It
should be remembered, however, that the system
of inspection in the French abattoirs in 1888 and
1889 was not nearly so searching as is tuberculin,
and that its use would doubtless largely increase
M. Arloing’s per cent, and consequently the cost to
France of cleansing itself from the disease.

Yt. ae
ca |
bel

160 TUBERCULOSIS AMONG CATTLE.

Dr. Kellogg records it as his firm belief, “ that
the wonderful development in bacteriology and
physiological chemistry which the last decade has
witnessed has brought to us a solution of this ques-
tion; and that it only remains for sanitarians to
grapple with it resolutely, and to urge upon national,
state, and municipal authorities everywhere the
duty of undertaking a thoroughgoing and unrelent-
ing crusade against a disease which is annually
responsible for more deaths than war, pestilence,
and famine combined,—a disease which has been
aptly denominated ‘The Great White Plague, and
which is, in the light of modern-researches, as
proper a subject for public health measures, restric- i
tion, quarantine, and isolation, as small-pox, yellow-
fever, or cholera.”

Dr. Salmon says of the disease: ‘“ Physical ex-
amination cannot be depended upon; but a true |
test can be made by the use of tuberculin. We
must cut loose from old methods and take tuber-
culin. What is needed is a tuberculin test of all
animals within a certain district, followed by post-
mortem examinations.” |

Dr. Briggs of the Health Department of New York _
City, in a report to the municipal authorities, says: —
“The high mortality from this disease in this city
—over 6,000 in 1892 —2jis indubitable evidence of
the necessity of bringing it under the sanitary sur- —
veillance of the department. The same number of
cholera patients in one year would cause alarm. —

NECESSARY MEASURES FOR PROTECTION. 161

The affinity of bovine tuberculosis to the same dis-
ease in the human family must not be lost sight of,
because the dairy products— milk and cream as
well as flesh — hold the germs giving rise to the
disease; therefore not only should a system of
dairy cows’ milk inspection be advanced, but a
more than careful examination of the dairy cows,
individually, as factors of the milk, be advanced
also.”

Dr. Irving A. Watson, in concluding a long ad-
dress on this subject, recently said: “If I were to
turn for a moment from the public health side of
this discussion, I would ask, What are the stock-
raisers going to do with this disease? It seems to
me that there is but one thing to do, and that is to
turn their united efforts toward the eradication of
tuberculosis in cattle, else the disease will ulti-
mately ruin their herds, dairies, and markets for
milk. The suppression of this disease is demanded
from the standpoints of both the sanitarian and the
farmer and stock-raiser.”’

Dr. Salmon says: “ I know from experience that
many herds of cows are entirely free from the disease.
This may be proved by the history of the herds and
by the tuberculin test. Now, taking such herds as
a starting point, with proper precautions to prevent
their infection, I believe it is quite possible to breed
a race of cattle practically free from the disease ;
and while this is being done, the known infected

herds should be destroyed. <A great work like this
11

162 TUBERCULOSIS AMONG CATTLE.

cannot be accomplished by an individual, nor by a
single board of health. There must be co-opera-
tion, unity of effort, and the combined influence
and power of the nation, the state, the local author-
ities, the dairymen, and all organizations that are
interested.”

Dr. Law, in closing his bulletin, discusses the
question of who should pay the bill as follows:
“ The economist will object to drastic measures for
the suppression of tuberculosis on the ground of
expense. Who is to pay for the municipal abat-
toirs, the inspectorships, the disinfections, and the
indemnities for slaughtered animals? In return,
let me ask, Who now pays for the constant losses
of live stock which the proposed system would put
a stop to? for the frequent infection of sound herds
by unfortunate purchases of animals that prove to
be tuberculous ? for the losses to the nation, to the
community, and the family of the tuberculous
one eighth of all deaths? for the loss of work —
literary, scientific, manufacturing, commercial, do-
mestic, and manual — of the great host of consump-
tives waiting all over the land to fill the places of
this fatal eighth in coming mortality statistics ? for
the losses represented by the bills of the physician,
nurse, and druggist for these invalids, and for the
losses represented by the many migrations and
exiles in search of health, and of the costly con-
sumption hospitals and sanitaria ? And who is to
pay in the future for the needless harvest of similar

NECESSARY MEASURES FOR PROTECTION. 163

fruits which the seeds now sown through our su-
pineness must inevitably produce in the coming
generations? Is it not a truer economy to destroy
the seed before it has germinated, or even before
it has been sown, than to wait for the multitudi-
nous evils that must attend on its growth and
fructification ?”’

Dr. Theobald Smith, in Bulletin No. 7 of the
Bureau of Animal Industry, writes: “‘ As we are
now entering upon an era of suppression of this dis-
ease, it should be borne in mind that radical meas-
ures are the best to begin with, and that after the
disease has been weeded out of each large herd by
tuberculin one or more times, such herd becomes,
in a sense, an experiment in the prevention of this
disease, with the element of contagion presumably
completely eliminated. The future will then decide
how much is to be feared from the lapses of tuber-
culin, from sources of the virus outside of the bovine
species, and from heredity, breed, and environment
as predisposing agents.”

Massachusetts, which has perhaps taken a more
advanced ground than any other State in attempt-
ing to control tuberculosis, is now enforcing a
thorough systematic inspection and tuberculin test
of all the neat cattle in the State. The Cattle
Commission, in their report for 1894, explain their
adoption of this course as follows: —

“¢ At the time of the adoption of the tuberculin
test as the proper method of examining all animals

164 TUBERCULOSIS AMONG CATTLE.

suspected of being tuberculous, the Board were of
the opinion that, while its efforts in this direction
as based upon the mere examination of animals
reported by the inspectors to be tuberculous at
isolated points throughout the State would result
in the destruction of actually diseased animals to a
considerable extent, it would be of but little service
in really cleansing the herds of the State from
the disease, because the animals so examined and
selected for the test were only such as appeared to
show external symptoms of the disease; and also
because the Board felt, from its experience with
the test, that other animals, apparently healthy,
were being allowed to go free and spread the con-
tagion. Thus in the end the percentage of diseased
animals would be but slightly decreased.

‘‘ They were further impressed with the fact that
not only were the public interested in the destruc-
tion of diseased animals, but the farmers and dairy-
men were equally interested in having, if possible,
some means of assisting them in their purchase of
cattle, so that they might be able to replace the ani-
mals destroyed with others which had successfully
passed the test. The Board therefore felt that the
best method of protecting all parties and eradicating
the disease was only to be obtained by a thorough
scientific examination of all neat stock throughout —
the State. They therefore decided to begin a sys-
tematic examination of all animals in the State,
county by county; taking proper precaution, as

NECESSARY MEASURES FOR PROTECTION. 165

fast as all the animals in each county had been
examined, destroyed, or marked, to prevent, by
quarantine regulations, the importation within its

limits of animals which had not already been so

examined.”’

Dr. Niles, veterinarian of the Virginia Experi-
ment Station, recommends the following as neces-
sary to control the disease in the lower animals and
lessen the mortality in man: “ The establishment

of a State Board of Health with one member a ve-

j...-

_terinarian; a liberal State appropriation ; the estab-

lishment of public abattoirs, where all food animals
must be slaughtered ; veterinary inspection of all
meats, and of all public dairies; compensation for
condemned animals; power to the veterinarian to
destroy diseased animals; country hospitals for
indigent tuberculous people ; compulsory disinfec-
tion of all premises occupied by tuberculous people
or animals; cremation of all diseased carcasses,
and prohibition of tuberculous people from attend-
ing public gatherings in closed buildings.”

The New York Commission, in their report of
1895, say : —

“ Tuberculous cattle are valuable to the State only
when dead; and inspection and confiscation could
never be detrimental to the interests of the honest
dairymen, especially if liberal compensation were
granted, under well defined conditions. It is there-
fore necessary that there should be some regular
inspection of cattle in order that any affected should

166 TUBERCULOSIS AMONG CATTLE.

be eliminated from the milk supply. These should
at once be destroyed, as both their flesh and milk
are unfit for food. There should be devised some
central authority, conformably to the genius of our
oovernment, with authority to exercise continuous
inspection in this line; for, as will be seen from
the investigations of this Commission, this is not a
work to be taken up in a season and afterward
laid aside. There should be some supervision of
our meat and milk supply.

“The object lessons given by this Commission
have been of incalculable benefit to the people in
the work of disseminating knowledge concerning
the behavior of the disease, and many dairymen are
now engaged in examining their own cattle. The
stamping out policy can now be put into action by
rigorous inspection, first directed in the distrib-
uting centres and milk supplies of municipalities,
and dairies supplying milk to cheese factories,
creameries, and condensories, after which exam-
ination should extend to more remote districts.
Such action would be speedily followed by the
complete extinction of the disease. The question
is one of political economy in the improvement of
the dairy interests and the betterment of public
health. While it is admitted that this work will
involve a large expenditure, ultimate gain to the
agriculturists and to the saving of human life will
be beyond estimation.”

Dr. Salmon says: “If we start out practically to

NECESSARY MEASURES FOR PROTECTION. 167

get rid of tuberculosis, the first proceeding would
be to educate the public in regard to it. We want
the public and the dairymen to understand the
importance of the subject, and to co-operate with us.
If they did this, and were willing to annihilate a
herd when they found tuberculosis, and disinfect
the stables a little while before putting new cows
on the premises, and then bought new animals from
a healthy herd, we might accomplish much. I am
rather of the opinion that in a great many cases
it would be best to establish herds separate from
the disease ; and by care these herds might be kept
free from it indefinitely. Of course, there would
be some objections to undertaking such a step; but
I have great hopes, because I feel sure there are a
large number of herds in which the disease has
never been introduced. Therefore I think that
in connection with the sanitary work by officials
there should be educational work going on, and
endeavors by the dairymen themselves to estab-
lish herds which are free from the disease. Then,
in addition to the work as it is carried on, there
must be a co-operation of everybody interested.
As I look at the matter, there is very little use for
any one individual or any one State to start out on
a crusade of this sort, and expect it to result in
success. There must be co-operation between the
different State Boards of Health and the national
government; and we must try to co-operate with
the dairymen themselves, and the dairy associa-

168 TUBERCULOSIS AMONG CATTLE.

tions must take action in the matter. We must

do everything we can to sustain the hands of the

inspectors.”

Professor Pearson writes in a recent paper : —

‘“‘ By the use of tuberculin it is possible to isolate
the diseased animals, and make sure that those

remaining are free from tuberculosis. If the stable

is now disinfected, and the herd retested after an
interval of six months to find cases that might by
some almost impossible chance have escaped the

first examination, we should have freed the herd

from tuberculosis; and it would then only remain
to exclude diseased additions to keep clear of the
scourge.

‘An important question that presents itself is,
What shall be done with the cows that react?
Our previous experience and present: knowledge
allow but one answer to this question; and it is,
Destroy them! All animals that react, ignoring the

very few possible exceptions, are tuberculous ; but.

it should be remembered that some of them suffer to
but a very slight degree. In some of the animals
we may,upon making the autopsy, find nothing but
a few tuberculous areas of the size of a pea, and
perhaps these are situated in the lymph glands.
In such a condition an animal cannot scatter the
tubercle bacilli, and it might be objected that
slaughter is unnecessary waste. But how are we

to know that the tubercles, which we are sure exist

in the body, are not in the lungs, the kidneys, the

’ .
——
ap qa ~ *

NECESSARY MEASURES FOR PROTECTION. 169

sexual organs, or even the udder? The most
careful and exact physical examination could easily
fail to elicit their presence at some stages of their
’ growth. |

“We know that nearly all cases of tuberculosis in
cattle tend to advance, and that a slight depression
or illness may lead to the rapid development of a
more general tuberculous condition, starting from
the lesion which we know is present. The sale of
an animal known to have tuberculosis, though ever
so slightly, cannot be justified either morally or
legally ; and to keep such an animal in a herd is to
harbor a foe of unknown strength.”

In a recent bulletin of the United States Bureau
of Animal Industry, the necessity of absolute dis-
infection of premises where tuberculosis has been
discovered is insisted on. Corrosive sublimate
(mercurial chloride) is recommended,—an ounce
to eight gallons of water, to be dissolved for twenty-
four hours in wooden vessels, and to be applied
freely as a wash in all parts of the stable. As this
is @ very poisonous preparation, it should be care-
fully guarded. All dirt should be removed before
the wash is used, and afterward the stable should
be kept vacant as long as possible. Before ani-
mals are put in, all the parts they would be likely
to touch with their tongues should be washed
with clean water. Chloride of lime, five ounces to
a gallon of water, may be similarly used.

A serviceable disinfectant, that is quite corro-

170 TUBERCULOSIS AMONG CATTLE.

sive but not poisonous, is crude carbolic acid, two
quarts, and crude sulphuric acid, two quarts. Mix
these in wood or glass vessels, slowly adding the
sulphuric to the carbolic acid. As considerable
heat is evolved in mixing, the power of the mix-
ture is retained by keeping it in cold water while
mixing. It should be diluted one part to twenty
of water, and generously applied, care being taken
to avoid splashing the hands of the operator.

Whitewash is not strong enough to destroy the ~ )
bacilli; but if applied after the stalls are thor-
oughly washed, it will imprison them soastoren-
der at least temporary protection. |

The stanchions, feed-boxes, and halters,and the —__
walls, ceilings, and windows of stables should be |
frequently cleansed and disinfected, even where
the presence of the disease is not suspected. The
frequent removal of the manure, flushing of the
runs behind the cattle, and good ventilation, are all
aids to health.

Cattle should have plenty of room, with ‘i least
six hundred cubic feet of air space to each animal.
Each animal should always occupy the same place,
otherwise one diseased animal may soon infect a
whole stable. Stables should also be protectediag
from the expectorations of human beings affected —
with pulmonary tuberculosis. 4

The Massachusetts Veterinary Association has
also recently given this subject careful considera-—
tion, and through a committee it has issued rec

NECESSARY MEASURES FOR PROTECTION. 171

ommendations including the following. Farmers
should, as far as possible, raise their own stock,
breeding only from animals of strong constitution
and known freedom from tuberculous taint; each
farmer should own a bull, and restrict its use to
his own herd, except where he is sure of the purity
of his neighbors’ herds; allow no strange animal
to approach the herd ; never buy from a suspected
herd; never buy an animal with a cough, bad
breathing, lumpy or diseased udder, swollen joints,
or with a tendency to scour or bloat; give each
animal at least one thousand cubic feet of air space ;
provide constant ventilation without exposing the
animals to cold drafts; give abundant outdoor
exercise, except in extreme weather; keep the
barns clean, and sprinkle always before sweeping ;
exclude consumptive people from the barns; keep
no manure in the cellar or near the cattle; have
the cellar well drained, lighted, and ventilated ;
allow no accumulation of water or filth in the barn-
yard ; avoid early, late, and too frequent breeding,
and excessive feeding and milking.

To eradicate the disease where present, they
advise the test of all animals by tuberculin, fol-
lowed by immediate slaughter of all detected
animals, frequent retests, and the most thorough
disinfection of the stables and their surroundings.

The International Veterinary Congress at Brus-
sels, in September, 1883, now twelve years ago,
after a discussion of the subject, adopted resolutions
which are thus summarized by Dr. Fleming : —

172 TUBERCULOSIS AMONG CATTLE.

“1. In order that the flesh and viscera ‘of the
animal be allowed for consumption, the disease
should only be in its earliest stage, the lesions con-
fined to a small portion of the body, the lymphatic
glands yet free from alteration of a tuberculous
character, the tuberculous centres not softened, the
meat healthy and of the first quality, and the gen-
eral nutrition of the animal at the time of slaughter
leaving nothing to be desired.

“2. The flesh of tuberculous animals intended
for food should not be conveyed beyond the locality
in which slaughter has been effected, nor offered
for sale at the stall of an ordinary butcher.

“3. Every quarter of meat, and any viscera show-
ing tuberculous lesions or transformations, as well
as the flesh of every animal in which signs of more
advanced tubercular infection are found than those

above mentioned, should be rendered unsalable by

sprinkling them with petroleum, and finally buried,
under the surveillance of the police. The extraction
of the tallow by boiling, as well as the sale of the
skin, may be permitted.

“4, The inspection of every animal affected .with
tuberculosis should be made by a veterinary sur-
geon, who alone can judge whether the flesh may
be consumed.

“5. The milk of animals affected with or sus-
pected of tuberculosis should not be used for the
food of man, nor yet of certain animals, and its sale
should be rigorously prohibited.”

NECESSARY MEASURES FOR PROTECTION. 173

The International Veterinary Congress at Paris,
in 1888, after a prolonged discussion in which the
safety of mildly tuberculous meat was fully advo-
cated, resolved that ‘there is need to carry out by
every possible means, including compensation to
those concerned, the general principle of seizure
and total destruction of all the flesh derived from
tuberculous animals, no matter what number of
specific lesions may be found in them.”

The International Veterinary Congress of 1889
devoted considerable of its time to this subject, and
Professor Arloing formulated its expression as fol-
lows: “That it is necessary to eliminate from
human and animal consumption the flesh from tu-
berculous animals, mammals, and birds, whatever
may be the degree of tuberculosis or the apparent
qualities of the meat. That the skin and horns
may be utilized after disinfection, and also the fat
if need be. That the milk of tuberculous cows
should not be allowed for human alimentation.
That dairies in large towns or their vicinity should
be properly inspected. That everything should be
- done to insure the boiling of milk from unknown
sources before it is consumed.”

Professor Arloing concluded his address, present-
ing the above conclusions, with this expression :
‘“¢ We shall always gain in combating, no matter at
what cost in money, an enemy so redoubtable as
the virus of tuberculosis.”

The United States Veterinary Medical Associa-
tion in 1889 took action as follows : —

174 TUBERCULOSIS AMONG CATTLE.

“‘ Whereas, we, the members of the United States
Veterinary Medical Association, being sensible of
the prevalence of bovine tuberculosis in the United
States, particularly in the dairy stock of the Hast-
ern States, it being computed that at least from ten
to fifteen per cent are so affected in one form or
another, being satisfied of its infectious and conta-
gious character, and of its identity with tuberculosis
or consumption in the human family, that it can
be conveyed to others by inoculation and ingestion,
and believing that a large percentage of this dis-
ease in mankind can be traced to this source, —

“« Resolved, That we strongly condemn the use of
the milk or flesh of animals so affected, in any form,
as an article of diet. }

“* Resolved, That this Association urgently pro-
tests against the employment of empirics as meat
or dairy inspectors ; that such duties should be con-
fined to duly qualified veterinarians having a com-
prehensive knowledge of comparative pathology.

“¢ Resolved, That the inspection of meat can only
be properly conducted at the abattoirs.

“© Resolved, That all dairies should be periodically
visited, the cows carefully examined, and their con-
dition reported upon to the local authorities.

“ Resolved, That a committee of three be ap-
pointed by the chair to place these resolutions
before the Secretary of Agriculture, so that national

measures may be adopted by which this disease can

be placed under the same category as contagious
pleuro-pneumonia, and be similarly dealt with.”

pais

NECESSARY MEASURES FOR PROTECTION. 175

Of infectious diseases in general Dr. Salmon says:
“These diseases are not, as a rule, amenable to

treatment. When the symptoms have once ap-

peared, the disease is apt to run its course in spite
of treatment; and if it is one from which animals
usually recover, all that can be done is to put them
into the most favorable surroundings. Many infec-
tious diseases lead sooner or later to death, and
treatment is useless so far as the sick are con-
cerned. But it may be worse than useless for
those not yet infected. All animals suffering with
infectious diseases are a menace to all others, more
or less directly. They represent for the time being
manufactories of disease germs, and are giving
them off more or less abundantly during all the
period of disease. They may infect others directly,
or they may scatter the virus about, and the sur-
roundings may become a future source of infection
for healthy animals. . . . When an infectious dis-
ease has gained foothold in a herd, the course to be
pursued in getting rid of it will depend upon the
nature of the malady. A good rule is to kill dis-

eased animals, especially when the disease is likely

to run a chronic course, as in tuberculosis.”

H. F. Vickery, M. D., of Boston, says the present
awakening about tuberculosis fills him with enthu-
siasm. “It is a welcome thought that we are on
the threshold of a great diminution in the scourge;
and I cherish the hope that the work which is being
begun will in the course of the next two or three

176 TUBERCULOSIS AMONG CATTEE.

generations very greatly diminish the prevalence of
tuberculosis. If what we now believe is true, and
the efforts which we are to encourage are carried
out persistently for a few generations, this omni-
present germ will no longer be ready to enter every
weak human system; and the results of what we
do now will be increasing in a geometrical ratio,
not only for ten years or for twenty, but for fifty.”

In relation to the question of the discussion
causing alarm, he says: “ Needless alarm should
be deprecated ; but if we can throttle a disease
which is killing from a seventh to a fifth of all who
die, is it not well to excite the apprehensions of the
public? I should be glad to do it everywhere I
could.” )

Of the prevention of human infection Dr. Henry
Mitchell, of Trenton, N. J., writes : —

‘¢ All tuberculous discharges should be destroyed
before they become dry. Sputa should be received
upon pieces of cloth and burned ; or they should be
discharged into cups containing a little of a satu-
rated (five per cent) solution of carbolic acid. In
the street, and when travelling in public convey-
ances, a pocket cup should be carried to receive
the expectorated material. No such receptacle
should be emptied until boiling water has first
been poured upon its contents. The water should
be allowed to cool in the cup.

“The consumptive patient may reinfect himself
by swallowing some of the tuberculous matter from

NECESSARY MEASURES FOR PROTECTION. 177

his lungs, and thus cause the disease to attack one
of the abdominal organs; or by failing to destroy
the sputa he may permit the infection of the dust
of his apartment, and by inhaling the germs plant
the disease anew in some previously healthy por-
tion of his lungs. Meat and milk known to be
from diseased animals should be rejected. Milk
from a doubtful source may be sterilized by
boiling.

“ Carpets cannot be kept clean, and they are al-
most certain to become lodging places for tubercle
bacilli in houses occupied by consumptive patients.
Rugs, which are not permanently fastened, are
preferable to carpets. They should be frequently
carried out of doors and exposed all day to air and
light. Carpets, rugs, and floors which are believed
to be infected should not be swept when dry. Dust
should be removed from the furniture by wiping
with a damp cloth, and the cloth should be burned
at once.

‘No healthy person should sleep in a room occu-
pied by a consumptive. Rooms vacated by persons
having consumption should be disinfected by the
application of corrosive sublimate (1 to 1,000) to
the side-walls, doors, and all wood-work, including
floors and furniture. This solution is poisonous.
All wood-work should therefore be washed with
soap and water. Dishes, knives, forks, and spoons
used by a consumptive should be scalded after use.

All other infected articles should be subjected to a
12

178 TUBERCULOSIS AMONG CATTLE.

temperature of not less than 212 degrees Fahr., for
thirty minutes, or they should be destroyed.”

The matter here presented does not by any means
exhaust the material at hand ; but it is sufficient to
impress the patient reader with the gravity of the
situation, both as it affects cattle owners and the
general consumers of cattle products. The ques-
tion of the control or the extirpation of the disease
is a vital one. Massachusetts is among the first of
the States to take radical legislative action on it, and
her course will be watched with great interest by
the whole country. The other New England States
are moving substantially on Massachusetts lines,
and everywhere, where cattle are kept for dairy
use, the questions considered in this volume are
among the most interesting and important now
before the public.

The testimony herewith presented proyes that

the matter is not merely one of interest to the -

small circle of professional men, nor to those en-
gaged in the production of meat and dairy pro-

ducts ; but it involves the health, the happiness,

and the life of the great public, — the consumers.
These are hardly yet aware of their own deep con-
cern in the matter; but its discussion, and thie
consideration of relief measures, now so widely
begun, will continue until the whole civilized world
gives it attention.

a —_ ;

NOTE.

Just as the forms are closing on these pages
another feature of interest is appearing, not di-
rectly related to the subject treated here, but so
connected as to justify its mention. This is the
announced discovery that the inhalation of the odor
of peppermint is a cure for pulmonary tuberculosis
in the human family. The matter has been under
careful and extended experiment by Dr. G. W.
Carosso, at the military hospital at Genoa, Italy, and
he reports success with about three quarters of the
cases treated. It has also had limited trial in this
country. The treatment requires almost constant
inhalation, and is probably applicable only to cases
of pulmonary affection. For these and other prac-
tical reasons it does not seem probable that the
treatment will be of value with cattle.

THE END.

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